[Differentiation of temporal lobe epilepsy and temporal plus epilepsy using radiomics nomogram based on MPRAGE images].

A total of 82 patients with temporal lobe epilepsy (TLE) and temporal plus epilepsy (TPE)admitted in Xuanwu Hospital from January 1, 2019, to January 1, 2021 were restrospectively analyzed, including 41 males and 41 females, aged 2 to 52 (24±10) years. The patients were randomly divided into the training set (58 cases) and test set (24 cases) by Python. FreeSurfer software was used to segment the cortex of the affected hemisphere, defining 33 regions of interest (ROIs), and radiomics features were extracted by Python. After selecting features using the filter-based feature selection method, a radiomics model was constructed with a logistic regression classifier, and radiomics scores were calculated. Combining clinical characteristics with radiomics scores, a nomogram model was constructed using R software, the predictive accuracy of the model was assessed with the concordance index (C-index), and the model's goodness-of-fit was tested with the Hosmer-Lemeshow method. The results showed statistically significant differences between TLE and TPE patients in disease duration, intracranial electrode implantation, and hippocampal sclerosis (both P<0.05). The accuracy of the radiomics model in the training set and the test set was 91.4% and 87.5%, respectively. The nomogram model uses C-index to predict accuracy. Hosmer-Lemeshow method was used to test the goodness of fit, with AUCs of 0.95 (95%CI: 0.853-0.991) in the training set and 0.84 (95%CI: 0.676-0.999) in the test set. The study indicates that the radiomics nomogram model based on MPRAGE sequences can effectively differentiate TLE from TPE, providing reference for the development of personalized treatment plans in clinical practice.

[Comparison of extracorporeal membrane oxygenation applicated in critical patients with COVID-19 and novel influenza A (H1N1) virus pneumonia].

Objective: To compare the clinical characteristics and prognosis of critical patients with COVID-19 and novel influenza A (H1N1) virus pneumonia (influenza pneumonia) applied with extracorporeal membrane oxygenation (ECMO). Methods: A total of 24 patients with influenza pneumonia treated with ECMO in respiratory intensive-care unit (ICU) of Beijing Chaoyang Hospital from March 2016 to December 2019 and 12 patients with COVID-19 hospitalized from February 1, 2020 to March 31, 2020 in 5 government designated infectious hospitals of Beijing and Hebei Province that applied with ECMO were enrolled. The demographic data, clinical manifestations, and ECMO related information were described and analyzed and all numerical variables are described as M (P25, P75). Results: The age of COVID-19 patients was 77 (66, 79) years old, which was older than influenza pneumonia patients [46 (32, 62) years old], P<0.05; acute lung injury score and respiratory ECMO survival prediction (RESP) score before ECMO application were 3.3 (3.0, 3.5) and 1 (0, 2), respectively, which were lower than influenza pneumonia patients [3.8 (3.5, 4.0) and 4 (2, 6), respectively], all P values<0.05. Thrombotic complications, bleeding complications, and ventilator-associated pneumonia occurred in ECMO applied COVID-19 patients were 4, 10 and 5 cases, respectively, which were more than that among influenza pneumonia patients (1, 9, and 2 cases, respectively), all P values<0.05. The length of ICU stay of COVID-19 patients was 31 (28, 75) d, which was longer than that of influenza pneumonia patients [27 (18, 39) d], P<0.05. The cases with successful decannulation of ECMO among COVID-19 and influenza pneumonia patients were 6 and 14 cases, respectively and mortality during ICU stay were 8 cases and 11 cases, respectively, and the difference were not statistically significant (all P values>0.05). Conclusion: COVID-19 patients applied with ECMO have more ECMO-related complications and a longer stay in the ICU than patients with influenza pneumonia.

Quality Assessment of Psoralea fructus by HPLC Fingerprint Coupled with Multi-components Analysis.

Psoralea Fructus, the dried and ripe fruit of Psoralea corylifolia L., have been used as traditional medicine. There is substantial evidence that multiple constituents are responsible for the beneficial effects of this medicine. To effectively control the quality of this herbal medicine, HPLC fingerprint analysis was performed on a SinoChrom ODS-BP column with mobile phase of a gradient prepared from H2O and CH3CN, which the conditions used for gradient elution were: 0-10 min, 5-45% CH3CN; 10-45 min, 45-70% CH3CN; 45-50 min, 70-100% CH3CN; 50-60 min, 100-100% CH3CN, and the flow rate was 1.0 ml/min. It was obtained on the basis of the chromatographic data from 28 batches of samples, which contained 26 common peaks and 13 peaks were identified by the electrospray ionization-mass spectrometry as psoralen, isopsoralen, isobavachin, neobavaisoflavone, bavachin, corylin, broussochalcone B, psoralidin, isobavachalcone, bavachinin, corylifol A, bavachalcone and backuchiol. The contents of these 13 compounds were also simultaneously examined. By using principal component analysis, 28 batches of samples collected from 6 producing locations with different collecting time were evaluated and differentiated. In summary, the data as described in this study offer valuable information for quality control and proper use of Psoralea Fructus.

Blood pressure-to-height ratio simplifies the diagnosis of hypertension in Nigerian children.

The diagnostic accuracy of blood-pressure-to-height-ratios (BPHRs) in 716 Nigerian children was studied, using standard protocols. Systolic BPHR (SBPHR) and diastolic BPHR (DBPHR) had diagnostic accuracies ranging from 0.934 to 1.000, irrespective of sex and age. Optimal thresholds of SBPHR/DBPHR are provided, and their sensitivities and specificities all exceeded 80%. BPHR is a simple, sensitive and specific tool for the diagnosis of hypertension in this population.

How to simplify the diagnostic criteria of hypertension in adolescents.

Diagnosis of hypertension in adolescents is complicated because blood pressure values vary with age, gender and height. How can we simplify the diagnostic criteria for hypertension in adolescents? In 2006, anthropometric measurements were assessed in a cross-sectional population-based study of 3136 Han adolescents aged 13-17 years. Hypertension was defined according to the 2004 National High Blood Pressure Education Program Working Group definition. The following equations for blood pressure-to-height ratio (BPHR) were used: systolic BPHR (SBPHR)=SBP (mm Hg)/height (cm) and diastolic BPHR (DBPHR)=DBP (mm Hg)/height (cm). Receiver-operating characteristic curve analyses were performed to assess the accuracy of SBPHR and DBPHR as diagnostic tests for elevated systolic blood pressure (SBP) and diastolic blood pressure (DBP), respectively. After the cutoff points were determined, hypertension was defined by SBPHR/DBPHR, and the sensitivity and specificity were calculated. The accuracy of SBPHR and DBPHR (assessed by area under the curve) for identifying elevated SBP and DBP was >0.85 (0.989-1.000). The optimal thresholds of SBPHR/DBPHR for defining hypertension (stages 1 and 2) were 0.75/0.48 for boys and 0.78/0.51 for girls, and for defining hypertension (stage 2) were 0.81/0.57 for boys and 0.84/0.63 for girls. In identifying hypertension, the sensitivity and specificity were both >90% (91.0-99.1%). In identifying stage 2 hypertension, when the sensitivity was 100%, the specificity was 98.6% for boys and 99.1% for girls. BPHR is a simple, accurate and non-age-dependent index for screening hypertension in Han adolescents, especially for stage 2 hypertension.

[A comparative study of therapeutic effects of total versus proximal subtotal gastrectomy in adenocarcinoma of the gastric cardia].

485 patients with adenocarcinoma of the gastric cardia operated in our hospital. 283 cases were treated with total gastrectomy, and 202 cases were treated with proximal subtotal gastrectomy. The age, sex, clinical stage, size of tumour, radicality of surgical resection, lymph node involvement, tumour depth penetration and histological type had no significant difference in the two groups. Analysis of survival rates failed to demonstrate any significant difference between the two types of surgical operation for TNM stage I and II. Total gastrectomy resulted in significantly higher survival rate than proximal subtotal gastrectomy for stage III. The 3- and 5-year survival rate of TNM stage III patients increased by 14.6% and 15.1%, respectively (P < 0.05). Extended total gastrectomy was usually applied for stage IV patients without distant metastasis. If the neoplasm had spread beyond the confines of extended total gastrectomy, in order to eliminate obstruction or bleeding, palliative proximal subtotal gastrectomy or total gastrectomy should be considered.

Preliminary observation on human saliva alpha-fetoprotein in patients with hepatocellular carcinoma.

The saliva samples from 13 patients with hepatocellular carcinoma and a control group of 21 random healthy adults were measured for alpha-fetoprotein (AFP), using a highly sensitive sandwich enzyme immunoassay specific for human AFP. In patients with hepatocellular carcinoma, significantly higher levels of saliva AFP were observed (mean +/- Sx: 3 552.6 +/- 2 829.9 ng/L) when compared with the value of the normal controls (mean +/- Sx18.1 +/- 3.8 ng/L, P < 0.001). There was significant correlation between saliva and serum AFP in both normal controls (rs = 0.526, n = 21, P < 0.005) and patients with hepatocellular carcinoma (rs = 0.931, n = 13, P < 0.001). In patients with hepatocellular carcinoma, those with positive serum AFP had positive saliva AFP, while those whose serum AFP was negative showed saliva AFP negative as well. It is likely that saliva AFP is derived from plasma by passive seepage. It is promising that the saliva AFP surveillance may be helpful in detection of AFP positive hepatocellular carcinoma, because of its noninvasiveness, acceptableness by almost every person, simplicity in technique, and the strong correlation between saliva and serum AFP.

Highly sensitive sandwich enzyme immunoassay for alpha-fetoprotein in human saliva.

To determine alpha-fetoprotein (AFP) in human saliva, a highly sensitive sandwich enzyme immunoassay for saliva AFP was developed. AFP standards and saliva samples were added into the wells of a polystyrene plate coated with goat IgG antibody against human AFP. After incubation, the wells were washed and horseradish peroxidase-labelled antibody was added. The enzyme activity specifically bound to the well was assayed using 3,3',5,5'-tetramethylbenzidine and hydrogen peroxide as substrate. The reaction was stopped by addition of 2 M sulphuric acid and the AFP concentration was determined from the absorbance at 450 nm. The minimum detectable concentration was 8 ng/L. The recovery of AFP mixed with human saliva was 91.1-102.4%. The within-assay and between-assay coefficients of variation were 6.5-8.9% and 7.6-10.8%, respectively. The assay correlated well with a radioimmunoassay for human AFP (r = 0.985, n = 13, P less than 0.001). The mean concentration of AFP in normal human saliva was 14.3 ng/L (SEM = 4.9 ng/L, n = 10) and significantly higher levels of saliva AFP were observed in hepatocellular carcinoma patients with positive serum AFP (mean 1367.8 ng/L, SEM 595.4 ng/L, n = 6; P less than 0.001). Strong correlation was observed between saliva AFP and serum AFP (r = 0.978, P less than 0.01, n = 13).

Bile secretory immunoglobulin A in biliary infection and cholelithiasis.

Bile samples from 71 patients with cholelithiasis and a control group of 10 subjects without hepatobiliary diseases were cultured for bacteria and measured for secretory immunoglobulin A (SIgA) using enzyme immunoassay specific for SIgA. The results of bile bacterial culture were all positive in patients with primary bile duct pigment stones, and significantly lower bile SIgA levels were observed than in normal controls (P less than 0.005). It was also shown that the constitutent ratios of SIgA to total bile immunoglobulin and the bile-serum ratio of SIgA were markedly lower in these patients than in normal controls (P less than 0.001, P less than 0.001). In patients with cholecystolithiasis, bile SIgA concentrations of patients with biliary infections were remarkably lower than those of patients without biliary infection (P less than 0.01) and those of normal controls (P less than 0.01). These results suggest a close relationship between biliary tract infection and low concentrations of bile SIgA.

Detection of group B rotavirus in fecal specimens by dot hybridization with a cloned cDNA probe.

Cloned cDNA copies were synthesized from the genomic RNA of the IDIR strain of group B rotavirus (GBR) isolated in Baltimore, Md. These clones were screened for hybridization with heterologous GBR to identify cDNA for use in dot hybridization experiments. In multiple screening experiments, cDNA clones derived from gene segment 3 provided the most intense hybridization signals. 32P-labeled probes were produced from one of the gene 3 clones, and these were employed in dot hybridization assays. Purified preparations of bovine GBR were detected in concentrations of greater than or equal to 0.5 ng, and GBR was detected in fecal specimens obtained from five of six infected calves. Four of six human fecal specimens containing the Baltimore strain of GBR were also positive in the hybridization assay, while GBR was identified in only one of the six specimens by means of immunoelectron microscopy. A fecal specimen obtained from a patient infected with the adult diarrhea rotavirus strain of GBR was also positive in the dot hybridization assay. Fecal specimens from uninfected humans, calves, and rats, as well as specimens containing group A rotaviruses, did not hybridize with the cloned cDNA probe.