Large isolated fibrous tumors in the upper esophagus: A case report.

BACKGROUND: Solitary fibrous tumors (SFT) are rare spindle cell tumors that are usually benign. A total of 10 cases of SFTs in the upper esophagus have ever been reported. Here, we report the anesthetic management of a patient with a large isolated fibrous tumor of the upper esophagus compressing the tracheal membrane. We also provide a literature review of the current research. CASE SUMMARY: We report the case of a 49 year old male with "cough aggravation and wheezing after exercise", who underwent esophagectomy for a large isolated fibrous tumor compressing the tracheal membrane in the upper esophagus. We advise the use of a single-lumen tube with a blocker in patients with difficult airways to reduce the incidence of airway injury and fibrinoscopy at all stages of the perioperative period to guide airway management. This case study is the first report of the anesthetic management of a large, isolated fibrous tumor compressing the tracheal membrane in the upper esophagus. CONCLUSION: This rare case emphasizes the importance of perioperative management of anesthesia in patients with large isolated fibrous tumors of the upper esophagus that compress the tracheal membrane. The use of blocker reduce the incidence of airway injury and fibrinoscopy at the perioperative period to guide airway management.

Successful remimazolam sedation-epidural block in an older patient with severe chronic obstructive pulmonary disease: A case report.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is associated with high morbidity and mortality rates worldwide. Older patients have a degenerative cardiopulmonary function, weak compensatory capacity, and poor surgical tolerance. Therefore, the mode of anesthesia must be optimized. Remimazolam is a new ultrashort-acting benzodiazepine with a rapid onset of action, rapid metabolism, and mild effects on pulmonary circulation. Remimazolam sedation combined with an epidural block has not been reported in hypertensive older adults with severe COPD and inguinal mass resection. CASE SUMMARY: We report the case of a 73-year-old man with hypertension and severe COPD, who underwent resection of an enlarged inguinal mass that he had noticed more than 7 mo before presentation. The patient presented with a "right inguinal mass" and was recommended to undergo an enlarged inguinal mass resection. Surgery was relatively challenging, due to the large mass (13 cm × 8 cm × 7 cm), hard texture, and poor mobility. Considering the advanced age of the patient, grade III hypertension, and severe COPD, we administered remimazolam combined with an epidural block for anesthesia to ensure perioperative safety and careful consideration. The anesthetic effect was precise; the procedure was performed smoothly without any complications, and the patient was successfully anesthetized. However, anesthetic management in such cases has not yet been reported by previous studies. CONCLUSION: Remimazolam sedation combined with an epidural block is safe and effective in older patients with hypertension and severe COPD.

Hyperlactemia associated with secondary hepatocellular carcinoma resection in relation to circulation stability and quality of recovery: A case report.

BACKGROUND: Intraoperative hyperlactatemia often affects circulatory stability, vital organ function, and postoperative recovery, poses a serious prognostic risk, and requires considerable attention from anesthesiologists. Here, we describe a case of hyperlactatemia during the postoperative resection of liver metastases after chemotherapy for sigmoid colon cancer. This did not affect the patient's circulatory stability or quality of awakening, which is rarely reported in clinical practice. We present our management experience with the aim of providing a reference for future studies and clinical practice. CASE SUMMARY: A 70-year-old female patient was diagnosed with postoperative liver metastasis following chemotherapy for sigmoid colon cancer. Laparoscopic right hemicolectomy and cholecystectomy under general anesthesia were required. Metabolic disorders, primarily hyperlactatemia, often occur intraoperatively. After treatment, other indices quickly returned to normal, lactate levels decreased slowly, and hyperlactatemia persisted during the awakening period. However, this did not affect the patient's circulatory stability or awakening quality. This condition has rarely been clinically reported. Therefore, we report our management experience in order to guide clinical practice in this regard. Hyperlactatemia did not affect circulatory stability or the quality of awakening. We considered that active intraoperative rehydration avoided serious harm to the organism caused by hyperlactatemia due to insufficient tissue perfusion, while hyperlactatemia caused by decreased lactate clearance due to impaired liver function associated with surgical resection had a mild effect on the function of important organs. CONCLUSION: Active intraoperative rehydration avoided serious harm to the organism caused by hyperlactatemia. Strengthening body temperature protection could improve lactate circulation.

The interaction of MC3R and MC4R with MRAP2a in rainbow trout (Oncorhynchus mykiss).

Melanocortin 3 and 4 receptors are two important neural G protein-coupled receptors that regulate energy homeostasis in vertebrates. Melanocortin receptor accessory protein 2 (MRAP2) is also involved in the regulation of food intake and body weight as a variable regulator of melanocortin receptors. Rainbow trout (Oncorhynchus mykiss) is a valuable cold-water fish cultured worldwide. In the rainbow trout model, we cloned and identified mrap2a, a paralog of mrap2. Rainbow trout mrap2a consisted of a 690 bp ORF and was expected to encode a putative protein of 229 amino acids. The qPCR results showed that rainbow trout mrap2a was expressed at high levels in brain tissue similar to mc3r and mc4r. In addition, co-immunoprecipitation verified that MRAP2a interacts with MC3R and MC4R in vitro and that MRAP2a is involved in and regulates the constitutive activity and signaling of MC3R and MC4R. MRAP2a reduced constitutive and agonist-stimulated cAMP levels of MC3R; furthermore, MRAP2a increased constitutive ERK1/2 activation but reduced ligand-induced stimulation at high levels of expression. For MC4R, MRAP2a showed decreased cAMP basal activity but increased agonist-stimulated cAMP signaling and increased ACTH ligand sensitivity. However, MRAP2a failed to affect MC4R constitutive activity and agonist-induced ERK1/2 signaling. Undoubtedly, our study will have great significance for revealing the conserved role of MC4R and MC3R signaling in teleost fish, especially in cold-water fish growth and energy homeostasis.

Molecular cloning, tissue distribution, and pharmacologic function of melanocortin-3 receptor in common carp (Cyprinus carpio).

Melanocortin-3 receptor (MC3R) not only regulates energy homeostasis in animals, but also is an important regulator of inflammation. As one of the most widely farmed freshwater fish, common carp has attracted great interest for its feeding and inflammation regulation. In this study, we cloned the coding sequence (CDS) of common carp Mc3r (ccMc3r), examined its tissue expression profile, and investigated the function of this receptor in mediating downstream signaling pathways. The results showed that the CDS of ccMc3r was 975 bp, encoding a putative protein of 324 amino acids. Homology, phylogeny, and chromosomal synteny analyses revealed that ccMc3r is evolutionarily close to the orthologs of cyprinids. Quantitative real-time PCR (qPCR) indicated that ccMc3r was highly expressed in the brain and intestine. The luciferase reporter systems showed that four ligands, ACTH (1-24), α-MSH, ß-MSH, and NDP-MSH, were able to activate the cAMP and MAPK/ERK signaling pathways downstream of ccMc3r with different potencies. For the cAMP signaling pathway, ACTH (1-24) had the highest activation potency; while for the MAPK/ERK signaling pathway, ß-MSH had the greatest activation effect. In addition, we found that the four agonists were able to inhibit TNF-α-induced NF-κB signaling in approximately the same order of potency as cAMP signaling activation. This study may facilitate future studies on the role of Mc3r in common carp feed efficiency and immune regulation.

Numerical Investigation of the Thermal Behavior of Cracked RP-3 in Rectangular Cooling Channels under Different Inclinations.

The pyrolysis effect of aviation kerosene is common in the regenerative cooling process of hypersonic aircraft scramjets. To find out the effect of inclination variation on the characteristics of aviation kerosene RP-3 considering thermal cracking in a regenerative cooling rectangular channel, a detailed chemical mechanism of RP-3 pyrolysis is introduced to construct a numerical model. The results indicate that the pyrolytic reaction begins at the junction of the heating wall and the side walls, and the main products of pyrolysis are light olefins and alkanes. The thermal cracking reaction slows down the velocity of the main flow on account of the increased density and increased viscosity resulting from the decrease in RP-3 temperature. With the decrease in inclination, thermal cracking is enhanced and the average heat transfer coefficient is decreased, which leads to an increase in wall temperature.

Development of a Chemical-Kinetic Mechanism of a Four-Component Surrogate Fuel for RP-3 Kerosene.

RP-3 kerosene is the most widely used aviation kerosene in China, and research on its chemical-kinetic mechanism is significant for understanding the combustion characteristics. Based on a novel four-component surrogate fuel consisting of n-dodecane, 2,5-dimethylhexane, 1,3,5-trimethylbenzene, and decalin (54, 22, 14, and 10% by mole), the detailed chemical-kinetic mechanism of the corresponding RP-3 surrogate fuel with 1333 species and 6803 reactions has been developed and then reduced to 145 species and 818 reactions for high-temperature conditions. After that, the merged surrogate mechanism of surrogate fuel was validated by various experimental data sets for each individual surrogate component. Then, the surrogate mechanism was validated by comparing the simulation and experimental data of the ignition delay times, species concentrations in a jet-stirred reactor, and laminar flame speeds. Good agreements between simulations and experiments were observed. In addition, using the sensitivity analysis method, the key reactions of RP-3 surrogate fuels were compared and analyzed. In summary, the mechanism developed in this study can accurately predict the ignition, oxidation, and flame propagation characteristics of RP-3 aviation kerosene. The novel surrogate model can help deeply understand the combustion characteristics of RP-3 aviation kerosene, and it is used for high-precision numerical simulation of combustion reaction flow.

Streptococcus thermophiles DMST-H2 Promotes Recovery in Mice with Antibiotic-Associated Diarrhea.

Antibiotic-associated diarrhea (AAD) is the most common side effect of antibiotics and is routinely treated with probiotics in clinical. Streptococcus thermophiles, extensively utilized for producing dairy foods, has recently been regarded as a new promising probiotic candidate. In this study, the efficacy of Streptococcus thermophiles DMST-H2 (DMST-H2) for AAD treatment in mice was investigated. DMST-H2 was isolated from Chinese traditional yogurt, proved to be non-toxic, and presented tolerance against simulated gastrointestinal conditions in vitro. Additionally, genomic analysis revealed that it possessed genes related to acid tolerance, bile salt tolerance, adhesion, oxidative stress and bacteriocin production. The animal experiment results showed that both DMST-H2 treatment and natural recovery could reduce fecal water content. Compared with spontaneous recovery, DMST-H2 accelerated the recovery of the enlarged caecum and intestinal barrier injury from AAD, and further decreased endotoxin (ET), D-lactate (D-LA) and diamine oxidase (DAO) content in serum. Moreover, pro-inflammatory cytokines (TNF-α) were reduced, while interferon-γ (IFN-γ) and anti-inflammatory cytokines (IL-10) increased after treating with DMST-H2. Furthermore, DMST-H2 better restored the structure of intestinal flora. At the phylum level, Firmicutes increased and Proteobacteria decreased. These findings indicate that DMST-H2 could promote recovery in mice with antibiotic-associated diarrhea.

Irregular Bone Defect Repair Using Tissue-Engineered Periosteum in a Rabbit Model.

BACKGROUND: In previous studies, we succeeded in repairing a long bone defect with tissue-engineered periosteum (TEP), fabricated by incorporating rabbit mesenchymal stem cells with small intestinal submucosa. In this study, we investigated the feasibility of allogeneic irregular bone defect repair using TEP. METHODS: We performed a subtotal resection of the scapula in 36 rabbits to establish a large irregular bone defect model. The rabbits were then randomly divided into three groups (n = 12 per group) and the defects were treated with TEP (Group 1), allogeneic deproteinized bone (DPB) (Group 2) or a hybrid of TEP and DPB (Group 3). At 4, 8, and 12 weeks after surgery, the rabbits were sacrificed, and the implants were harvested. X-ray radiographic and histological examinations were performed to detect bone healing. Ink-formaldehyde perfusion was introduced to qualitatively analyze vascularization in TEP engineered new bone. RESULTS: The repair of scapular defects was diverse in all groups, shown by radiographic and histological tests. The radiographic scores in Group 1 and Group 3 were significantly higher than Group 2 at 8 and 12 weeks (p < 0.05). Histological scores further proved that Group 1 had significantly greater new bone formation compared to Group 3 (p < 0.05), while Group 2 had the lowest osteogenesis at all time-points (p < 0.001). Ink-formaldehyde perfusion revealed aboundant microvessels in TEP engineered new bone. CONCLUSION: We conclude that TEP is promising for the repair of large irregular bone defects. As a 3D scaffold, DPB could provide mechanical support and a shaping guide when combined with TEP. TEP engineered new bone has aboundant microvessels.

Tuberculosis relapse is more common than reinfection in Beijing, China.

BACKGROUND: Recurrent tuberculosis (TB) is a major health problem in countries with a high TB burden. It is very necessary to elucidate the situation of recurrent TB in Beijing, capital of China. OBJECTIVE: To determine the proportion of recurrent tuberculosis (TB) cases and to identify relapsed or reinfected cases, as well as risk factors associated with recurrence in Beijing. METHODS: We conducted a retrospective study that included all TB cases in Beijing that were successfully treated from 2013 to 2015. Recurrence due to relapse or reinfection was determined using the variable number of tandem repeats (VNTR) method. Risk factors associated with recurrence were analysed. RESULTS: Tuberculosis recurred in 275 of the 4043 successfully treated TB patients, giving a recurrence rate of 6.8% (275/4043). 190 of the 275 cases were culture positive in both instances, and genotyping results for both episodes were available for 58 of these patients. The cultured isolates from 40 of the 58 recurrent cases (69%) had identical genotypic patterns in both episodes, indicating a relapse. 31% (18/58) had different genotypes, indicating reinfection by a new strain and suggested recent transmission. Those people in the 30-59 age group (p < .001), and those retreated for pulmonary TB (p < .001) were more likely to have TB recurrence. CONCLUSION: Our results indicate that relapse was more common than reinfection in recurrent TB cases in Beijing from 2013 to 2015. Age and retreatment were found to be risk factors for TB recurrence.

Structural characterization of a novel Lactarius volemus Fr. polysaccharide and its immunity activity in BALB/c mice.

Lactarius volemus Fr. has been regarded as a great edible medicinal fungal resource in China. In this study, L. volemus Fr. polysaccharide (LVP) with an average molecular weight of 16.842 kDa was obtained by water extraction. The structure of LVP was characterized to be mannan, and the linkages in the mannan were found to comprise the Manp, (1→4)-α-Man and (1→4,6)-α-Man. Furthermore, intraperitoneal administration of LVP increased the thymus, spleen and liver indices, dose-dependently. Additionally, LVP enhanced the immune response and the phagocytic activities. Pathological evaluations showed that LVP in mice increased the proliferation of red medullary lymphocytes (60-70%). Collectively, these results indicated that LVP might be a potential resource of raw material for further investigations of functional foods.

Embedded system for road damage detection by deep convolutional neural network.

Road pavement could be damaged due to various reasons, causing damages such as cracks and pits. These damages cause potential dangers in traffic safety. It is necessary for road maintenance departments to find damages in time before maintenance. At present, maintenance departments of some high-level roads are equipped with specialized detection vehicles such as laser scanning vehicles to detect road damages. These kinds of devices can get good detection performance, but the economic cost is very high. In this paper, we use a road damage image dataset to train an object detection model based on deep convolutional neural network and deploy it on a low-cost embedded platform to form an embedded system. The system uses a common camera mounted on windshield of a common vehicle as sensor to detect road damages. The embedded system consumes about 352 ms to process one frame of image and can achieve a recall rate of about 76% which is higher than some previous related works. The recall rate of this scheme using common cameras is less than that of high-level specialized detectors, but the economic cost is much lower than them. After subsequent development, the road maintenance department with limited funds can consider about schemes like this.

Molecular Dynamics Simulation of Heat Transport through Solid-Liquid Interface during Argon Droplet Evaporation on Heated Substrates.

This paper presents a series of molecular dynamics simulations of the evaporating process of an argon droplet on heated substrates and the energy transport mechanism through the solid-liquid interface. Results indicate that the mass density through the liquid-vapor interface decreases sharply when the evaporation is in the steady state. Meanwhile, there is an adsorption layer in the form of clusters at the solid-liquid interface, which has a higher mass density than the droplet inside. Furthermore, the wetting property of the solid substrate is related to the system's initial temperature and the solid-liquid potential energy parameter. The contact angle decreases with the increase of initial temperature and solid-liquid potential energy parameter. During the accelerated evaporation process, small part of energy transports into the liquid in the perpendicular direction to the solid-liquid interface and most of the energy transports along the parallel direction to the solid-liquid interface in the adsorption layer to the three-phase contact line. The heat-transfer process from the solid substrate to the droplet inside is hindered by the Kapitza resistance at the solid-liquid interface, no matter the solid substrate is hydrophilic or hydrophobic. Meanwhile, the Kapitza resistance gradually increases with the increase of the initial temperature and decreases with the increase of the solid-liquid energy parameter.

Apgar score and reduced vision in children aged 3 to 6 years.

PURPOSE: We aimed to examine the association between the 5-min Apgar score and reduced vision in children 3 to 6 years of age. METHODS: A total of 5834 preschool children aged 3 to 6 years participated in this school-based eye survey. Reduced vision was defined as unaided distance vision of 6/12 or worse in the better-seeing eye. The 5-min Apgar scores of the participants were retrieved from medical records. RESULTS: The overall prevalence of reduced vision in this population was 6.63 % (95 % confidence interval [CI] 5.99-7.27). In multivariate analysis, the presence of reduced vision was associated with a low 5-min Apgar score at birth (<7 vs. 7-10; odds ratio [OR] = 1.66, 95 % CI 1.48-3.05) after adjusting for age, gender, parental history of myopia, maternal age, gestational age, and birth weight. In addition, both myopia and amblyopia were associated with Apgar scores of less than 7 in multivariate analyses. CONCLUSIONS: Children with 5-min Apgar scores of less than 7 were more likely to have reduced vision at the age of 3 to 6 years.

Epidemiology of Intermittent Exotropia in Preschool Children in China.

PURPOSE: To determine the prevalence, subtypes, and associated risk factors for intermittent exotropia (IXT) in preschool children aged 3 to 6 years in eastern China. METHODS: A population-based study including 5831 preschool children aged 3 to 6 years was conducted from 2011 to 2012 in Yuhua District, Nanjing, China, using an age-stratified random sampling procedure. Clinical examinations including ocular alignment, ocular motility, visual acuity, prism cover test, cycloplegia refraction, stereopsis screening, slitlamp examination, and fundus examination were performed by trained ophthalmologists and optometrists. Intermittent exotropia was defined as an acquired intermittent exodeviation of at least 10 prism diopters in an otherwise healthy child following the classification recommended by the National Eye Institute. RESULTS: The overall prevalence of IXT in this population was 3.24% (95% confidence interval, 2.79 to 3.69%), with no age (p = 0.19) and sex (p = 0.89) differences. Among 166 children with IXT, the "basic type" was the most common type of IXT (74.7%), the "divergence excess" was the second (19.9%), whereas the "convergence weakness" was the rarest (5.4%). In multivariate analysis adjusting for age, sex, and other confounders, the presence of IXT was only associated with a history of hypoxia at birth (odds ratio, 4.41; 95% confidence interval, 2.47 to 7.86). CONCLUSIONS: Intermittent exotropia affected approximately 1 in 30 Chinese preschool-aged children in eastern China, indicating a relatively higher burden of this pediatric eye condition in the world's most populous country. The presence of IXT was strongly associated with a history of hypoxia at birth.

Association between childhood strabismus and refractive error in Chinese preschool children.

PURPOSE: To investigate the association between concomitant esotropia or concomitant exotropia and refractive error in preschool children. METHODS: A population-based sample of 5831 children aged 3 to 6 years was selected from all kindergartens in a representative county (Yuhuatai District, Nanjing, Jiangsu Province) of Nanjing, China. Clinical examinations including ocular alignment, ocular motility, visual acuity, optometry, stereopsis screening, slit lamp examination and fundus examination were performed by trained ophthalmologists and optometrists. Odd ratios (OR) and 95% confidence intervals (95% CI) were calculated to evaluate the association of refractive error with concomitant esotropia and concomitant exotropia. RESULTS: In multivariate logistic regression analysis, concomitant esotropia was associated independently with spherical equivalent anisometropia (OR, 3.15 for 0.50 to <1.00 diopter (D) of anisometropia, and 7.41 for > = 1.00 D of anisometropia) and hyperopia. There was a severity-dependent association of hyperopia with the development of concomitant esotropia, with ORs increasing from 9.3 for 2.00 to <3.00 D of hyperopia, to 180.82 for > = 5.00 D of hyperopia. Concomitant exotropia was associated with astigmatism (OR, 3.56 for 0.50 to 1.00 D of astigmatism, and 1.9 for <0.00 D of astigmatism), myopia (OR, 40.54 for -1.00 to <0.00 D of myopia, and 18.93 for <-1.00 D of myopia), and hyperopia (OR, 67.78 for 1.00 to <2.00 D of hyperopia, 23.13 for 2.00 to <3.00 D of hyperopia, 25.57 for 3.00 to <4.00 D of hyperopia, and 8.36 for 4.00 to <5.00 D of hyperopia). CONCLUSIONS: This study highlights the close associations between refractive error and the prevalence of concomitant esotropia and concomitant exotropia, which should be considered when managing childhood refractive error.

[Study on alkaloids of Corydalis ochotensis and their antitumor bioactivity].

OBJECTIVE: To investigate the chemical constituents of Corydalis ochotensis and their antitumor bioactivity. METHODS: The compounds were isolated by silica gel column chromatography and recrystallization. Their structures were identified by spectroscopic analysis (NMR) and physicochemical properties. Their cytotoxic activity was studied by MTT. RESULTS: Six compounds were elucidated as protopine (1), ochotensimine (2), fumariline (3), sanguinarine (4), tetrahydroberberine (5) and berberine (6). Compound 1 had excellent inhibitory activity on HepG2, SW480 and A549 cells, and compound 4 had excellent inhibitory activity on Hep2, HepG2, SW480 and A549 cells. CONCLUSION: Compounds 3, 4 and 5 are isolated from this plant for the first time; In the MTT antitumor experiments,compounds 1 and 4 show an antitumor activity.

[Study on early detection of gray mold on tomato leaves using hyperspectral imaging technique].

The present paper put forward the technology route for feature images extraction of grey mold sick on tomato leaves based on SIMCA--combination image extraction based on MLR-grey mold sick information extraction based on minimum distance method. Firstly, through the 680-740 nm band's variance image and the discrimination power parameter, the feature band images was found, then the feature bands information was used as the input of MLR analysis, and under the 0.5 accuracy threshold value, 99% accuracy was obtained, which showed the discrimination power of the features bands for grey mold sick tomato leaf detection, and using the MLR regression coefficient to extract a band combination image, and through the minimum distance method, tomato grey mold sick information was found. The result shows that the proposed method has a very good prediction ability and greatly reduces the hyperspectral data processing time.

[Early diagnosis of gray mold on tomato stalks based on hyperspectral data].

Early diagnosis of gray mold on tomato stalks based on hyperspectral data was studied in the present paper. A total of 112 samples' hyperspectral data were collected by hyperspectral imaging system. The study spectral region was from 400 to 1,030 nm. Combined with image processing and chemometric methods, the tomato stalk gray mold diagnosis models were built. Seven effective wavelengths were selected by analysis of variable load distribution in PLS model. The experimental results showed that the excellent results were achieved by EW-LS-SVM model with standard normal variate (SNV) spectral and multiplicative scatter correction (MSC) spectral, and the accuracy of diagnosing gray mold on tomato stalks was satisfied and better than PLS model with whole band. Hence, it is feasible to early diagnose gray mold on tomato stalks using hyperspectral imaging technology, which provides a new early diagnosis and warning method for tomato disease.