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Acute ischemic Stroke combined with Stanford type A aortic dissection:A case report and literature review

World Journal of Clinical Cases 2022年第22期10卷 8009-8017页

作者： Zhi-Yang He Lin-Peng Yao xiao-ke wang Nai-Yun Chen Jun-Jie Zhao Qian Zhou xiao-Feng Yang Department of Emergency and Trauma Center The International Medical CenterThe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina Department of Radiology The First Affiliated HospitalZhejiang University school of MedicineHangzhou 310003Zhejiang ProvinceChina

BACKGROUND Acute aortic dissection(AAD)is a high mortality disease that can lead to acute ischemic strokes(AIS).Some of the patients with AAD combined with AIS initially present with neurological symptoms,which can easily lead to missed or delayed AAD diagnosis.This is attributed to the lack of physician awareness or the urgency of patient thrombolysis.Intravenous administration of thrombolytic therapy(IVT)for AAD is associated with poor prognostic outcomes.We report a patient with AIS combined with AAD who developed a massive cerebral infarction after receiving IVT for a missed AAD diagnosis.CASE SUMMARY A 49-year-old man was admitted to a local hospital with an acute onset of leftsided limb weakness accompanied by slurred speech.The patient had a history of hypertension that was not regularly treated with medication.Physical examination revealed incomplete mixed aphasia and left limb hemiparesis.Cranial computed tomography(CT)scan showed bilateral basal ganglia and lateral ventricular paraventricular infarct lesions.The patient was diagnosed with AIS and was administered with IVT.After IVT,patient’s muscle strength and consciousness deteriorated.From the local hospital,he was referred to our hospital for further treatment.Emergency head and neck CT angiography(CTA)scans were performed.Results showed multiple cerebral infarctions,and aortic dissection in the ascending aorta,innominate artery,as well as in the right common carotid artery.Then,the CTA of thoracoabdominal aorta was performed,which revealed a Stanford type A aortic dissection and aortic dissection extending from the aortic root to the left external iliac artery.Laceration was located in the lesser curvature of the aortic arch.AAD complicated with AIS was considered,and the patient was immediately subjected to cardiovascular surgery for treatment.The next day,the patient underwent aortic arch and ascending aortic replacement and aortic valvuloplasty.CONCLUSION Clinical manifestations for AAD combined with AIS are diverse.Some patients may not exhibit

关键词： Acute aortic dissection Acute ischemic stroke Intravenous thrombolysis Ultrasound evaluation Case report

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New clinical trial design in precision medicine:discovery,development and direction

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Signal Transduction and Targeted Therapy 2024年第4期9卷 1293-1321页

作者： xiao-Peng Duan Bao-Dong Qin xiao-Dong Jiao ke Liu Zhan wang Yuan-Sheng Zang Department of Medical Oncology Changzheng HospitalNaval Medical UniversityShanghaiChina

In the era of precision medicine,it has been increasingly recognized that individuals with a certain disease are complex and different from each other.Due to the underestimation of the significant heterogeneity across participants in traditional"one-sizefits-all"trials,patient-centered trials that could provide optimal therapy customization to individuals with specific biomarkers were developed including the basket,umbrella,and platform trial designs under the master protocol framework.In recent years,the successive FDA approval of indications based on biomarker-guided master protocol designs has demonstrated that these new clinical trials are ushering in tremendous opportunities.Despite the rapid increase in the number of basket,umbrella,and platform trials,the current clinical and research understanding of these new trial designs,as compared with traditional trial designs,remains limited.The majority of the research focuses on methodologies,and there is a lack of in-depth insight concerning the underlying biological logic of these new clinical trial designs.Therefore,we provide this comprehensive review of the discovery and development of basket,umbrella,and platform trials and their underlying logic from the perspective of precision medicine.Meanwhile,we discuss future directions on the potential development of these new clinical design in view of the"Precision Pro","Dynamic Precision",and"Intelligent Precision".This review would assist trial-related researchers to enhance the innovation and feasibility of clinical trial designs by expounding the underlying logic,which be essential to accelerate the progression of precision medicine.

关键词： clinical approval successive

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Pituitary metastasis from lung adenocarcinoma:A case report

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World Journal of Clinical Cases 2024年第15期12卷 2597-2605页

作者： Qing wang xiao-Wei Liu ke-Yu Chen Department of Critical Care Medicine Chengdu First People’s HospitalChengdu 610000Sichuan ProvinceChina Department of Neurosurgery Chengdu Second People's HospitalChengdu 610017Sichuan ProvinceChina Department of the First Clinical Medical College Lanzhou UniversityLanzhou 730000Gansu ProvinceChina Evidence Based Medicine Center School of Basic Medical SciencesLanzhou UniversityLanzhou 730000Gansu ProvinceChina

BACKGROUND Pituitary gland metastasis is an unusual event,and pituitary metastasis from lung adenocarcinoma is extremely rare and associated with poor prognosis.To date,approximately 15 cases have been reported.CASE SUMMARY Here,we present the case of a 64-year-old woman with pituitary metastasis derived from lung adenocarcinoma,which was difficult to distinguish from other sellar tumors.The patient presented to the neurosurgery clinic with blurred vision and intermittent headache.During hospitalization,brain computed tomography(CT)and magnetic resonance imaging revealed a pituitary macroadenoma.Chest CT revealed irregular nodules in the basal segment of the lower lobe of the left lung,which were likely lung cancer.Positron emission tomography-CT revealed a carbohydrate metabolism tumor in the lungs and sellar region,which was considered malignant.Postoperative pathological examination of the sellar tumor revealed lung adenocarcinoma.CONCLUSION Excision of pituitary metastases combined with radiotherapy and chemotherapy should be a priority treatment for patients with pituitary metastasis.

关键词： Pituitary metastasis Lung adenocarcinoma Prolactin Sellar region tumors Case report

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Epidemiological Surveillance: Genetic Diversity of Rotavirus Group A in the Pearl River Delta, Guangdong, China in 2019

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Biomedical and Environmental Sciences 2024年第3期37卷 278-293页

作者： JIANG Jie Ying LIANG Dan wang Li xiao Yun LIANG Yu Feng ke Bi Xia SU Juan xiao Hong wang Tao ZOU Min LI Hong Jian ke Chang Wen School of Public Health Shantou UniversityShantou 515063GuangdongChina Guangdong Provincial Center for Disease Control and Prevention Guangdong Workstation for Emerging Infectious Disease Control and PreventionGuangzhou 511430GuangdongChina Guangdong Provincial key Laboratory of Virology Institute of Medical MicrobiologyJinan UniversityGuangzhou 510632GuangdongChina School of Public Health Sun Yat-sen UniversityGuangzhou 510275GuangdongChina School of Public Health Southern Medical UniversityGuangzhou 510515GuangdongChina Shantou University Medical College Shantou 515041GuangdongChina

Objective This study aimed to understand the epidemic status and phylogenetic relationships of rotavirus group A(RVA)in the Pearl River Delta region of Guangdong Province,China.Methods This study included individuals aged 28 days–85 years.A total of 706 stool samples from patients with acute gastroenteritis collected between January 2019 and January 2020 were analyzed for 17 causative pathogens,including RVA,using a Gastrointestinal Pathogen Panel,followed by genotyping,virus isolation,and complete sequencing to assess the genetic diversity of RVA.Results The overall RVA infection rate was 14.59%(103/706),with an irregular epidemiological pattern.The proportion of co-infection with RVA and other pathogens was 39.81%(41/103).Acute gastroenteritis is highly prevalent in young children aged 0–1 year,and RVA is the key pathogen circulating in patients 6–10 months of age with diarrhea.G9P[8](58.25%,60/103)was found to be the predominant genotype in the RVA strains,and the 41 RVA-positive strains that were successfully sequenced belonged to three different RVA genotypes in the phylogenetic analysis.Recombination analysis showed that gene reassortment events,selection pressure,codon usage bias,gene polymorphism,and post-translational modifications(PTMs)occurred in the G9P[8]and G3P[8]strains.Conclusion This study provides molecular evidence of RVA prevalence in the Pearl River Delta region of China,further enriching the existing information on its genetics and evolutionary characteristics and suggesting the emergence of genetic diversity.Strengthening the surveillance of genotypic changes and gene reassortment in RVA strains is essential for further research and a better understanding of strain variations for further vaccine development.

关键词： Infectious diarrheal disease Rotavirus Phylogenetic analysis Gene rearrangement Codon usage bias Genetic diversity

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Study on sex differences and potential clinical value of threedimensional computerized tomography pelvimetry in rectal cancer patients

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 773-786页

作者： xiao-Cong Zhou Fei-Yue ke Gaurav Dhamija Hao Chen Qiang wang Department of Colorectal Surgery The Dingli Clinical Institute of Wenzhou Medical University(Wenzhou Central Hospital)Wenzhou 325000Zhejiang ProvinceChina Postgraduate Training Base Alliance of Wenzhou Medical University Wenzhou Central HospitalWenzhou 325000Zhejiang ProvinceChina School of International Studies Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina Department of Radiology The Dingli Clinical Institute of Wenzhou Medical University(Wenzhou Central Hospital)Wenzhou 325000Zhejiang ProvinceChina

BACKGROUND Laparoscopic rectal cancer radical surgery is a complex procedure affected by various factors.However,the existing literature lacks standardized parameters for the pelvic region and soft tissues,which hampers the establishment of consistent conclusions.AIM To comprehensively assess 16 pelvic and 7 soft tissue parameters through computerized tomography(CT)-based three-dimensional(3D)reconstruction,providing a strong theoretical basis to address challenges in laparoscopic rectal cancer radical surgery.METHODS We analyzed data from 218 patients who underwent radical laparoscopic surgery for rectal cancer,and utilized CT data for 3D pelvic reconstruction.Specific anatomical points were carefully marked and measured using advanced 3D modeling software.To analyze the pelvic and soft tissue parameters,we emp-loyed statistical methods including paired sample t-tests,Wilcoxon rank-sum tests,and correlation analysis.RESULTS The investigation highlighted significant sex disparities in 14 pelvic bone parameters and 3 soft tissue parameters.Males demonstrated larger measurements in pelvic depth and overall curvature,smaller measurements in pelvic width,a larger mesorectal fat area,and a larger anterior-posterior abdominal diameter.By contrast,females exhibited wider pelvises,shallower depth,smaller overall curvature,and an increased amount of subcutaneous fat tissue.However,there were no significant sex differences observed in certain parameters such as sacral curvature height,superior pubococcygeal diameter,rectal area,visceral fat area,waist circumference,and transverse abdominal diameter.CONCLUSION The reconstruction of 3D CT data enabled accurate pelvic measurements,revealing significant sex differences in both pelvic and soft tissue parameters.This study design offer potential in predicting surgical difficulties and creating personalized surgical plans for male rectal cancer patients with a potentially“difficult pelvis”,ultimately improving surgical outcomes.Further research and utilization of these parameters

关键词： Computerized tomography Rectal cancer Three-dimensional reconstruction Pelvimetry Sex differences

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A Dietary Supplement Jinghuosu Ameliorates Reproductive Damage Induced by Tripterygium Glycosides

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Chinese Journal of Integrative Medicine 2024年第4期30卷 330-338页

作者： MA Jing SUN Bo TE Li-ger HUANG Xin ZUO Xin HAN xiao-ke wang Shu-song Hebei key Laboratory of Reproductive Medicine Hebei Institute of Reproductive HealthHebei Reproductive Health HospitalShijiazhuang(050071)China Graduate School of Hebei Medical University Shijiazhuang(050017)China School of Chemistry and Materials Science Hebei Normal UniversityShijiazhuang(050024)China Xingtai Infertility Specialist Hospital XingtaiHebei Province(054000)China

Objective To determine the possible protective effects of Jinghuosu,a dietary supplement(DS),on tripterygium glycosides(TG)-induced reproductive system injury in rats and its underlying mechanisms.Methods A reproductive damage model was established in rats by feeding of TGs.Twenty-eight male Sprague Dawley rats were randomly divided into 4 groups using a random number table(n=7 in each):control(C)group,model(M)group,DS group and L-carnitine(LC)group.Rats in M,DS and LC groups received 40 mg/kg TGs orally.Starting from the 5th week,after administration of TGs for 4 h every day,rats in DS and LC groups were administered with 2.7 g/kg DS and 0.21 g/kg LC,respectively,for protective treatment over the next 4 weeks.Rats in Group C continued to receive the control treatment.Hematoxylin-eosin staining was used for histopathological analysis of rat testicular tissues.Enzyme-linked immunosorbent assay was performed to measure alkaline phosphatase(ALP),lactate dehydrogenase,alcohol dehydrogenase,total antioxidant capacity(T-AOC),superoxide dismutase,glutathione peroxidase(GSH-Px),and malondialdehyde(MDA)concentrations.Chemiluminescence assay was used to determine the serum testosterone content.Quantitative real-time PCR and Western blotting were conducted to analyze the expression of genes and proteins related to the testosterone synthesis pathway and the nuclear factor erythroid 2-related factor 2/heme oxygenase 1 antioxidant pathway.Results Oral administration of TGs induced significant increases in the testicular levels of zinc transporter 1 and MDA(Pke protein 1,ALP,luteinizing hormone(LH)receptor,steroidogenic acute regulatory protein,Cytochrome P450 family 11 subfamily A member 1,3β-hydroxysteroid dehydrogenase 1 T-AOC,GSH-Px,nuclear factor erythroid 2-related factor 2,heme oxygenase-1 and NAD(P)H:quinone oxidoreductase 1 levels decreased following TGs exposure(P<0.05).All of these phenotypes were

关键词： dietary supplement Jinghuosu tripterygium glycosides reproductive damage infertility

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S1-supported Pd@CeO_(2) quasi-core@shell materials as advanced catalysts for selective hydrogenation of furfural

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Chinese Chemical Letters 2024年第3期35卷 493-496页

作者： Xiang Chu Lingling Zhang ke wang Rui Zhang xiao wang Shuyan Song Hongjie Zhang State key Laboratory of Rare Earth Resource Utilization Changchun Institute of Applied ChemistryChinese Academy of SciencesChangchun 130022China School of Applied Chemistry and Engineering University of Science and Technology of ChinaHefei 230026China

Bare Pd metal nanoparticles invariably suffer from poor selectivity in furfural hydrogenation by forming flat configurations,with the aromatic ring of the substrate molecules parallel to the metal surface.Herein,we put forward a promising solution by using CeO_(2)as promoters to modify Pd nanoparticles for modulating the adsorption behaviors of furfural molecules.To achieve the highly-desired ultra-small Pd@CeO_(2)core@shell nanostructure,a“constrained auto-redox”synthesis is developed,in which silicalite-1 supports play the key role of providing their surface as the landing place of PdO_(x)precursors for inhibiting the overgrowth and the deformation.To the best of our knowledge,this is one of the smallest core@shell materials obtained from aqueous synthesis.When evaluated as catalysts,Pd@CeO_(2)/S-1 gives 98.9%conversion of furfural with 94.3%selectivity for furfural alcohol in 15 h,which is much better than that of Pd/S-1(88.6%conversion with 44.3%selectively).The DFT simulation reveals a strong interaction between the defects of CeO_(2)and the oxygen atom of the–CHO group in furfural molecules,which benefits the selective hydrogenation occurred in the–CHO group rather than the furan ring.

关键词： Core@shell Palladium Ceria Auto-redox synthesis Hydrogenation

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Transcriptome analysis suggests broad jejunal alterations in Linghu’s obesity-diarrhea syndrome:A pilot study

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World Journal of Gastroenterology 2024年第21期30卷 2777-2792页

作者： xiao-Tong Niu Xiang-Yao wang Yan wang ke Han Nan Ru Jing-Yuan Xiang En-Qiang Linghu Medical School of Chinese PLA Chinese PLA General HospitalBeijing 100853China Department of Gastroenterology The First Medical Center of Chinese PLA General HospitalBeijing 100853China School of Medicine Nankai UniversityTianjin 300071China

BACKGROUND Obesity is associated with a significantly increased risk for chronic diarrhea,which has been proposed as Linghu’s obesity-diarrhea syndrome(ODS);however,its molecular mechanisms are largely unknown.AIM To reveal the transcriptomic changes in the jejunum involved in ODS.METHODS In a cohort of 6 ODS patients(JOD group),6 obese people without diarrhea(JO group),and 6 healthy controls(JC group),high-throughput sequencing and bioinformatics analyses were performed to identify jejunal mucosal mRNA expression alterations and dysfunctional biological processes.In another cohort of 16 ODS patients(SOD group),16 obese people without diarrhea(SO group),and 16 healthy controls(SC group),serum diamine oxidase(DAO)and D-lactate(DLA)concentrations were detected to assess changes in intestinal barrier function.RESULTS The gene expression profiles of jejunal mucosa in the JO and JC groups were similar,with only 1 differentially expressed gene(DEG).The gene expression profile of the JOD group was significantly changed,with 411 DEGs compared with the JO group and 211 DEGs compared with the JC group,129 of which overlapped.The enrichment analysis of these DEGs showed that the biological processes such as digestion,absorption,and transport of nutrients(especially lipids)tended to be up-regulated in the JOD group,while the biological processes such as rRNA processing,mitochondrial translation,antimicrobial humoral response,DNA replication,and DNA repair tended to be down-regulated in the JOD group.Eight DEGs(CDT1,NHP2,EXOSC5,EPN3,NME1,REG3A,PLA2G2A,and PRSS2)may play a key regulatory role in the pathological process of ODS,and their expression levels were significantly decreased in ODS patients(Pkers(DAO and D-LA)were significantly increased in all obese individuals(P<0.01),but were higher in the SOD group than in the SO group(P<0.001).CONCLUSION Compared with healthy controls and obese individuals without diarrhe

关键词： Obesity Chronic diarrhea Jejunum Transcriptome Intestinal barrier

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Industry-Oriented Detection Method of PCBA Defects Using Semantic Segmentation Models

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IEEE/CAA Journal of Automatica Sinica 2024年第6期11卷 1438-1446页

作者： Yang Li xiao wang Zhifan He Ze wang ke Cheng Sanchuan Ding Yijing Fan xiaotao Li Yawen Niu Shanpeng xiao Zhenqi Hao Bin Gao Huaqiang Wu Department of Internet of Things Technology and Application China Mobile Research InstituteBeijing 100053China Beijing Advanced Innovation Center for Integrated Circuits the School of Integrated CircuitTsinghua UniversityBeijing 100084China SigmaStar Technology Limited Xiamen 361199China IEEE

Automated optical inspection(AOI)is a significant process in printed circuit board assembly(PCBA)production lines which aims to detect tiny defects in PCBAs.Existing AOI equipment has several deficiencies including low throughput,large computation cost,high latency,and poor flexibility,which limits the efficiency of online PCBA inspection.In this paper,a novel PCBA defect detection method based on a lightweight deep convolution neural network is proposed.In this method,the semantic segmentation model is combined with a rule-based defect recognition algorithm to build up a defect detection frame-work.To improve the performance of the model,extensive real PCBA images are collected from production lines as datasets.Some optimization methods have been applied in the model according to production demand and enable integration in lightweight computing devices.Experiment results show that the production line using our method realizes a throughput more than three times higher than traditional methods.Our method can be integrated into a lightweight inference system and pro-mote the flexibility of AOI.The proposed method builds up a general paradigm and excellent example for model design and optimization oriented towards industrial requirements.

关键词： Automated optical inspection(AOI) deep learning defect detection printed circuit board assembly(PCBA) semantic segmentation.

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Construction of a nomogram model to predict technical difficulty in performing laparoscopic sphincter-preserving radical resection for rectal cancer

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World Journal of Gastroenterology 2024年第18期30卷 2418-2439页

作者： xiao-Cong Zhou Shi-Wei Guan Fei-Yue ke Gaurav Dhamija Qiang wang Bang-Fei Chen Medical University(Wenzhou Central Hospital) Wenzhou 325000Zhejiang ProvinceChina Department of Hepatobiliary Surgery The Dingli Clinical Institute of Wenzhou Medical University(Wenzhou Central Hospital)Wenzhou 325000Zhejiang ProvinceChina Postgraduate Training Base Alliance of Wenzhou Medical University Wenzhou Central HospitalWenzhou 325000Zhejiang ProvinceChina School of International Studies Wenzhou Medical UniversityWenzhou Central HospitalWenzhou 325000Zhejiang ProvinceChina Department of Radiology The Dingli Clinical Institute of Wenzhou Medical University(Wenzhou Central Hospital)Wenzhou 325000Zhejiang ProvinceChina Department of Colorectal Surgery The Affiliated Zhejiang HospitalZhejiang University School of Medicine(Zhejiang Hospital)Hangzhou 310000Zhejiang ProvinceChina

BACKGROUND Colorectal surgeons are well aware that performing surgery for rectal cancer becomes more challenging in obese patients with narrow and deep pelvic cavities.Therefore,it is essential for colorectal surgeons to have a comprehensive understanding of pelvic structure prior to surgery and anticipate potential surgical difficulties.AIM To evaluate predictive parameters for technical challenges encountered during laparoscopic radical sphincter-preserving surgery for rectal cancer.METHODS We retrospectively gathered data from 162 consecutive patients who underwent laparoscopic radical sphincterpreserving surgery for rectal cancer.Three-dimensional reconstruction of pelvic bone and soft tissue parameters was conducted using computed tomography(CT)scans.Operative difficulty was categorized as either high or low,and multivariate logistic regression analysis was employed to identify predictors of operative difficulty,ultimately creating a nomogram.RESULTS Out of 162 patients,21(13.0%)were classified in the high surgical difficulty group,while 141(87.0%)were in the low surgical difficulty group.Multivariate logistic regression analysis showed that the surgical approach using laparoscopic intersphincteric dissection,intraoperative preventive ostomy,and the sacrococcygeal distance were independent risk factors for highly difficult laparoscopic radical sphincter-sparing surgery for rectal cancer(P<0.05).Conversely,the anterior-posterior diameter of pelvic inlet/sacrococcygeal distance was identified as a protective factor(P<0.05).A nomogram was subsequently constructed,demonstrating good predictive accuracy(C-index=0.834).CONCLUSION The surgical approach,intraoperative preventive ostomy,the sacrococcygeal distance,and the anterior-posterior diameter of pelvic inlet/sacrococcygeal distance could help to predict the difficulty of laparoscopic radical sphincter-preserving surgery.

关键词： Nomogram Rectal cancer Laparoscopic operation Sphincter-preserving surgery Technical difficulty

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