Near Real-Time Implementation of An Adaptive Seismocardiography – ECG Multimodal Framework for Cardiac Gating

Objective: Accurate gating for data acquisition of computed tomography (CT) is crucial to obtaining high quality images for diagnosing cardiovascular diseases. To illustrate the feasibility of an optimized cardiac gating strategy, we present a near real-time implementation based on fusing seismocardiography (SCG) and ECG. Methods: The implementation was achieved via integrating commercial hardware and software platforms. Testing was performed on five healthy subjects (age: 24–27; m/f: 4/1) and three cardiac patients (age: 41–71; m/f: 2/1), and compared with baseline quiescence derived from echocardiography. Results: The average latency introduced by computerized processing was 5.1 ms, well within a 100 ms tolerance bounded by data accumulation time for quiescence prediction. The average prediction error associated with conventional ECG-only versus SCG-ECG-based method over all subjects were 59.58 ms and 27.24 ms, respectively. Discussion: The results demonstrate that the multimodal framework can achieve improved quiescence prediction accuracy over the ECG-only-based method in near real-time.

Significant Efficacy of Apatinib in a Patient With Hepatocellular Carcinoma Lung Metastases After Liver Transplantation: A Case Report

Antiangiogenesis therapy plays an important role in the treatment of advanced hepatocellular carcinoma (HCC). However, treatment options for HCC recurrence after liver transplantation are currently limited. Apatinib is a small tyrosine kinase inhibitor molecule targeting vascular endothelial growth factor receptor-2. Here, we report for the first time one case of a patient with advanced HCC who received apatinib after occurring lung metastasis 7 months after liver transplantation. He took 500 mg of apatinib daily for one month, which was decreased to 250 mg daily because of side effects. The patient was confirmed to have a partial response, according to the Response Evaluation Criteria in Solid Tumors, for 10 months, and the progression-free survival time was greater than 21 months. Our data and experience have indicated that apatinib may be a good choice for HCC recurrence after liver transplantation.

Monolithic Axial and Radial Metal-Semiconductor Nanowire Heterostructures

The electrical and optical properties of low-dimensional nanostructures depend critically on size and geometry and may differ distinctly from those of their bulk counterparts. In particular, ultrathin semiconducting layers as well as nanowires have already proven the feasibility to realize and study quantum size effects enabling novel ultrascaled devices. Further, plasmonic metal nanostructures attracted recently a lot of attention because of appealing near-field-mediated enhancement effects. Thus, combining metal and semiconducting constituents in quasi one-dimensional heterostructures will pave the way for ultrascaled systems and high-performance devices with exceptional electrical, optical, and plasmonic functionality. This Letter reports on the sophisticated fabrication and structural properties of axial and radial Al-Ge and Al-Si nanowire heterostructures, synthesized by a thermally induced exchange reaction of single-crystalline Ge-Si core-shell nanowires and Al pads. This enables a self-aligned metallic contact formation to Ge segments beyond lithographic limitations as well as ultrathin semiconducting layers wrapped around monocrystalline Al core nanowires. High-resolution transmission electron microscopy, energy dispersive X-ray spectroscopy, and μ-Raman measurements proved the composition and perfect crystallinity of these metal-semiconductor nanowire heterostructures. This exemplary selective replacement of Ge by Al represents a general approach for the elaboration of radial and axial metal-semiconductor heterostructures in various Ge-semiconductor heterostructures.

[Screening of microRNAs targeting Notch signaling pathway implicated in inner ear development and the role of microRNA-384-5p]

Objective: To screen the key microRNAs targeting Notch signaling pathway in inner ear and investigate its potential regulating function. Methods: The interaction network and the Core-Notch network, involved with key genes in Notch signal pathway and differential-expressed microRNAs in inner ear, were constructed by bioinformatics methods. The important microRNAs in regulating Notch signaling pathway were screened via topological and GO analysis, followed by in vivo and in vitro investigation. Results: MiRNA-384-5p was identified as a key regulator specifically expressed in mouse brain and inner ear, which could down-regulate Notch1. The Notch1 expression was found significantly down-regulated in miRNA-384-5p-mimic-transfected HeLa cells. The dual-luciferase reporter gene assay further confirmed the effect of miRNA-384-5p on the down-regulation of Notch1 and Dll4 in Notch signaling pathway. Conclusions: The Core-Notch network is constructed to screen microRNAs implicated in inner ear development, and miRNA-384-5p is screened and verified to be target-regulating the Notch signaling pathway, which could be the potential target in the regeneration of impaired hair cells.

Enabling liquid vapor analysis using synchrotron VUV single photon ionization mass spectrometry with a microfluidic interface

Vacuum ultraviolet (VUV) single photon ionization mass spectrometry (SPI-MS) is a vacuum-based technique typically used for the analysis of gas phase and solid samples, but not for liquids due to the challenge in introducing volatile liquids in a vacuum. Here we present the first demonstration of in situ liquid analysis by integrating the System for Analysis at the Liquid Vacuum Interface (SALVI) microfluidic reactor into VUV SPI-MS. Four representative volatile organic compound (VOC) solutions were used to illustrate the feasibility of liquid analysis. Our results show the accurate mass identification of the VOC molecules and the reliable determination of appearance energy that is consistent with ionization energy for gaseous species in the literature as reported. This work validates that the vacuum-compatible SALVI microfluidic interface can be utilized at the synchrotron beamline and enable the in situ study of gas-phase molecules evaporating off the surface of a liquid, which holds importance in the study of condensed matter chemistry.

An Adaptive Seismocardiography (SCG)-ECG Multimodal Framework for Cardiac Gating Using Artificial Neural Networks

To more accurately trigger data acquisition and reduce radiation exposure of coronary computed tomography angiography (CCTA), a multimodal framework utilizing both electrocardiography (ECG) and seismocardiography (SCG) for CCTA prospective gating is presented. Relying upon a three-layer artificial neural network that adaptively fuses individual ECG- and SCG-based quiescence predictions on a beat-by-beat basis, this framework yields a personalized quiescence prediction for each cardiac cycle. This framework was tested on seven healthy subjects (age: 22-48; m/f: 4/3) and eleven cardiac patients (age: 31-78; m/f: 6/5). Seventeen out of 18 benefited from the fusion-based prediction as compared to the ECG-only-based prediction, the traditional prospective gating method. Only one patient whose SCG was compromised by noise was more suitable for ECG-only-based prediction. On average, our fused ECG-SCG-based method improves cardiac quiescence prediction by 47% over ECG-only-based method; with both compared against the gold standard, B-mode echocardiography. Fusion-based prediction is also more resistant to heart rate variability than ECG-only- or SCG-only-based prediction. To assess the clinical value, the diagnostic quality of the CCTA reconstructed volumes from the quiescence derived from ECG-, SCG- and fusion-based predictions were graded by a board-certified radiologist using a Likert response format. Grading results indicated the fusion-based prediction improved diagnostic quality. ECG may be a sub-optimal modality for quiescence prediction and can be enhanced by the multimodal framework. The combination of ECG and SCG signals for quiescence prediction bears promise for a more personalized and reliable approach than ECG-only-based method to predict cardiac quiescence for prospective CCTA gating.

Phase transitions in a programmable quantum spin glass simulator

Understanding magnetic phases in quantum mechanical systems is one of the essential goals in condensed matter physics, and the advent of prototype quantum simulation hardware has provided new tools for experimentally probing such systems. We report on the experimental realization of a quantum simulation of interacting Ising spins on three-dimensional cubic lattices up to dimensions 8 × 8 × 8 on a D-Wave processor (D-Wave Systems, Burnaby, Canada). The ability to control and read out the state of individual spins provides direct access to several order parameters, which we used to determine the lattice's magnetic phases as well as critical disorder and one of its universal exponents. By tuning the degree of disorder and effective transverse magnetic field, we observed phase transitions between a paramagnetic, an antiferromagnetic, and a spin-glass phase.

[Repairing the bone and skin defect of foot after improved toe-to-finger reconstruction utilizing periosteal perforator bone-skin flap of proximal anterior tibial artery]

Objective: To evaluate the clinical outcome of repairing donor site of foot after improved toe-to-finger reconstruction utilizing periosteal perforator bone-skin flap of proximal anterior tibial artery. Methods: Twelve patients of toe defect after reconstruction were repaired from March, 2015 to June, 2017 utilizing periosteal perforator bone-skin flap of proximal anterior tibial artery in the Department of Hand and Foot Microsurgery of Xin'an Hospital, Dongguan City.Of which, there were 7 cases of great toe defect with fibular side of phalanx ungual and skin, 5 cases of second toe defect with proximal interphalangeal joints and the partial bone accompanied the great toe defect.Double bone flaps of one pedicles were used to repair first and second phalanx defect in 5 cases.The skin injured area: 5.5 cm×2.5 cm to 6.5 cm×10.0 cm. Bone defect size of great and second toe were 1.5 cm×1.0 cm×0.8 cm to 1.7 cm×1.0 cm×1.0 cm and 2.5 cm×1.0 cm×1.0 cm to 4.0 cm×1.0 cm×1.0 cm, respectively.The flap size ranged from 6.0 cm×3.0 cm to 6.5 cm×12.0 cm, and the bone flap size ranged from 1.5 cm×1.0 cm×0.8cm to 1.7 cm×1.0 cm×1.0 cm(great toe) and 2.0 cm×1.0 cm×1.0 cm to 3.5 cm×1.0 cm×1.0 cm(second toe). The wound of donor site of the leg was directly combined or local skin transfer sutured with 8 cases, skin-grafting in 4 cases. Results: All the bone-skin flaps survived.After 6-27 months of follow-up, the great toe flaps were found with normal color, good texture and moderate thickness, the two-point discrimination was 7-10 mm. The donor site of the leg showed little influence with normal function.No pain and discomfort in the foot were recorded, and the patients walked well.The healing time of bone flap was from 1.5 to 4 months, with an average of 2.5 months.Using the Maryland Foot Score, 5 cases of 7 feet got excellent and 2 cases of 2 feet got good result in the great toe group (7 cases of 9 feet), the good rate was 100%.Three cases got excellent and two cases got good result in the combined reconstruction group (5 cases), the good rate was 100%. Conclusion: Repairing donor site of foot after improved toe-to-finger reconstruction utilizing periosteal perforator bone-skin flap of proximal anterior tibial artery can also repair bone and skin defect of the great and the second toe, keep the great and the second toe, and restore the appearance and function of the first and the second toe at utmost.

[Clinicopathologic features of myxoid adrenocortical adenomas]

Objective: To study the clinicopathologic characteristics, immunophenotype, pathologic diagnosis and differential diagnosis of myxoid adrenocortical adenomas. Methods: The clinical data, histological features and immunohistochemical results of 4 cases of myxoid adrenocortical adenomas were analyzed, which were collected from January 2014 to December 2016 at Guangdong General Hospital, with review of literature. Results: Four cases of myxoid adrenocortical adenomas were presented. The patients ages ranged from 26 to 45 years (mean =35 years). Microscopically, it showed a typical morphology, characterized by small-sized tumor cell cords or pseudo-glands embedded in an abundant extracellular myxoid matrix. Immunohistochemical staining showed tumor cells were strongly positive for Melan A, vimentin and focally for α-inhibin, one case showed strong and diffuse positivity for CAM5.2, and two cases showed diffuse positivity for synaptophysin, while negative for CgA, S-100 protein, epithelial antigen, CK7, CK20 and CKpan. Conclusions: Myxoid adrenocortical adenomas are extremely rare, which may cause confusion with metastatic well-differentiated neuroendocrine tumours, sex cord-stromal tumoursor metanephric adenoma. Recognition of this entity would be beneficial for pathologists to avoid misdiagnosis, and unnecessary treatment.

Randomised clinical trial: Tong-Xie-Yao-Fang granules versus placebo for patients with diarrhoea-predominant irritable bowel syndrome

BACKGROUND

Tong-Xie-Yao-Fang (TXYF) is a Chinese herbal formula for treating chronic diarrhoea accompanied by abdominal pain. The results were inconsistent in previous trials examining its effect.

AIM

To study the efficacy of TXYF granules for treating diarrhoea-predominant irritable bowel syndrome (IBS-D).

METHODS

We performed a double-blind, placebo-controlled randomised trial and enrolled 160 participants with IBS-D. The participants had VAS scores ≥3 cm in IBS-D global symptoms and ≥2 days in a week with abdominal pain and loose stools (Bristol score 5, 6 or 7). They were randomly assigned to received TXYF or placebo during a treatment period of 4 weeks, and they were followed up for 8 weeks after treatment. The primary outcome was adequate relief of IBS-D global symptoms for at least 2 of 4 weeks during weeks 1-4. Secondary outcomes included mean weekly VAS scores of IBS-D major symptoms, mean weekly stool frequency, mean weekly Bristol score, and adverse events.

RESULTS

155 of 160 patients completed the trial. We found a significantly higher rate of adequate relief of global symptoms in TXFY group during weeks 1 to 4 (57.5% vs 37.5%, χ² = 5.6391, P = 0.017); logistic regression analysis showed a similar result (OR 2.2, 95% CI 1.2-4.4, P = 0.016). Most of the secondary outcomes showed superiority of TXYF over placebo in weekly assessment from week 3 to week 7. The adverse event rate was low in both groups (3.8% vs 3.8%, P = 1.000).

CONCLUSION

During a 4 week trial, TXFY granules were superior to placebo in controlling symptoms of IBS-D.

[Experience of wound treatment on extremely severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident]

Objective: To explore experience of wound treatment of extremely severe mass burn patients involved in August 2nd Kunshan factory aluminum dust explosion accident. Methods: On August 2nd, 2014, 98 extremely severe burn mass patients involved in August 2nd Kunshan factory aluminum dust explosion accident were admitted to 20 hospitals in China. The patients with complete medical record were enrolled in the study and divided into microskin graft group with 56 patients and Meek skin graft group with 42 patients. Split-thickness skin in area of residual skin were resected to repair wounds of patients in microskin graft group and Meek skin graft group by microskin grafting and Meek miniature skin grafting, respectively. The residual wound size on 28 days post injury and wound infection after skin grafting of patients in the two groups, and position of donor site of all patients were retrospectively analyzed. Data were processed with t test and chi-square test. Results: The size of residual wound of patients in Meek skin graft group on 28 days post injury was (59±13)% total body surface area (TBSA), which was obviously smaller than that in microskin graft group [(70±14)%TBSA, t=4.379, P<0.05]. Twenty-nine patients in microskin graft group and 11 patients in Meek skin graft group suffered from obvious wound infection after skin grafting. Wounds of patients in two groups were repaired with residual skin around wound in head, trunk, groin, armpit, and uncommon donor sites of scrotum (4 patients), vola (10 patients), and toe or finger web (8 patients). Conclusions: Meek skin graft is the first choice for wound repair of extremely severe burn mass patients, with faster wound healing, less wound infection. Uncommon donor sites of scrotum, vola, and toe or finger web can also be used for wound repair in case of lack of skin.

Neurons derived from patients with bipolar disorder divide into intrinsically different sub-populations of neurons, predicting the patients' responsiveness to lithium

Bipolar disorder (BD) is a progressive psychiatric disorder with more than 3% prevalence worldwide. Affected individuals experience recurrent episodes of depression and mania, disrupting normal life and increasing the risk of suicide greatly. The complexity and genetic heterogeneity of psychiatric disorders have challenged the development of animal and cellular models. We recently reported that hippocampal dentate gyrus (DG) neurons differentiated from induced pluripotent stem cell (iPSC)-derived fibroblasts of BD patients are electrophysiologically hyperexcitable. Here we used iPSCs derived from Epstein-Barr virus-immortalized B-lymphocytes to verify that the hyperexcitability of DG-like neurons is reproduced in this different cohort of patients and cells. Lymphocytes are readily available for research with a large number of banked lines with associated patient clinical description. We used whole-cell patch-clamp recordings of over 460 neurons to characterize neurons derived from control individuals and BD patients. Extensive functional analysis showed that intrinsic cell parameters are very different between the two groups of BD neurons, those derived from lithium (Li)-responsive (LR) patients and those derived from Li-non-responsive (NR) patients, which led us to partition our BD neurons into two sub-populations of cells and suggested two different subdisorders. Training a Naïve Bayes classifier with the electrophysiological features of patients whose responses to Li are known allows for accurate classification with more than 92% success rate for a new patient whose response to Li is unknown. Despite their very different functional profiles, both populations of neurons share a large, fast after-hyperpolarization (AHP). We therefore suggest that the large, fast AHP is a key feature of BD and a main contributor to the fast, sustained spiking abilities of BD neurons. Confirming our previous report with fibroblast-derived DG neurons, chronic Li treatment reduced the hyperexcitability in the lymphoblast-derived LR group but not in the NR group, strengthening the validity and utility of this new human cellular model of BD.

The molecular mechanism of serum microRNA124b induced coronary heart disease by inducing myocardial cell senescence

The article "The molecular mechanism of serum microRNA124b induced coronary heart disease by inducing myocardial cell senescence" by Department of Cardiology, Qilu Hospital of Shandong University, Jinan, Shandong, China, published in Eur Rev Med Pharmacol Sci 2018; 22 (7): 2070-2076 has been withdrawn.

[Multi-variated analysis of differential diagnosis in ultrasonography of idiopathic granulomatous mastitis and invasive ductal carcinoma]

Objective: To evaluate the differential diagnosis of idiopathic granulomatous mastitis (IGM) and invasive ductal carcinoma. Methods: The ultrasonographic data of 37 IGM patients and 50 cases of IDC were analyzed retrospectively. The shape, growth direction, margin, internal echo, posterior echo, calcification, Adler blood flow classification, PSV(peak sestolic velocity), RI (resistance index)and elasticity scores were analyzed by χ(2) test and independent sample t test. The optimal cutoff values of age, PSV and RI were calculated by receiver operating characteristic (ROC) curve. Logistic regression analysis was used to calculate the odds ratio (OR) of ultrasonic variates in the diagnosis of both diseases. Results: There were no significant differences in the shape, margin, internal echo and blood flow grading between the two groups. The age, lesion growth direction, posterior echo, calcification, PSV, RI and elasticity were statistically different. The cut-of value of Age, PSV and RI were 38.5 years old, 13.20 cm/s, and 0.655. Logistic regression multi-variated analysis revealed that elastic score (OR=9.806) had the best value of the differential diagnosis, as well as calcification (OR=6.937), posterior echo decay (OR=4.613), RI (OR=3.257), lesion growth orientation (OR=3.198), and PSV (OR=1.202). Lesion shape, margin, internal echo, and Adler blood flow classification did not help in differential diagnosis. Conclusion: Ultrasound multi-parameter analysis has high value in IGM and IDC differential diagnosis.

Lateral orbital propeller flap technique for reconstruction of the lower eyelid defect

The lower eyelid, which has a unique anatomy and esthetic importance, is a common site of basal cell carcinoma. The reconstruction of the defect after the wide excision of the tumour is a special concern of many plastic surgeons. How to achieve the most satisfying effect through minimal invasive is important for patients. We successfully applied the lateral orbital propeller flap for one-stage reconstruction of a large lower eyelid defect after tumour resection. We consider that this flap can achieve better tissue mobilisation as it provides effective coverage of soft tissue defects and thus is especially useful for repairing facial defects.