[Comparison of the predictive value of Padua and the IMPEDE assessment scores for venous thromboembolism in patients with newly diagnosed multiple myeloma: A single institution experience]

Objective: To compare the predictive efficacy of the two thrombosis risk assessment scores (Padua and IMPEDE scores) in venous thromboembolism (VTE) within 6 months in patients with newly diagnosed multiple myeloma (NDMM) in China. Methods: This study reviewed the clinical data of 421 patients with NDMM hospitalized in Beijing Jishuitan Hospital from April 2014 to February 2022. The sensitivity, specificity, accuracy, and Youden index of the two scores were calculated to quantify the thrombus risk assessment of VTE by the Padua and IMPEDE scores. The receiver operating characteristics curves of the two evaluation scores were drawn. Results: The incidence of VTE was 14.73%. The sensitivity, specificity, accuracy, and Youden index of the Padua score were 100%, 0%, 14.7%, and 0% and that of the IMPEDE score was 79%, 44%, 49.2%, and 23%, respectively. The areas under the curve of Padua and IMPEDE risk assessment scores were 0.591 and 0.722, respectively. Conclusion: IMPEDE score is suitable for predicting VTE within 6 months in patients with NDMM.

[Septic shock induced by latent odontogenic orbital infection: a case report]

A 65-year-old patient was admitted to the hospital due to proptosis of the left eye accompanied with ophthalmodynia and toothache for two months. Ophthalmic examination revealed a palpable mass around the lateral orbit and temporal fossa, and maxillofacial CT suggested a malignant tumor invading the left orbital floor wall. One week later, the patient was diagnosed with left orbital cellulitis and septic shock due to peri-orbit redness, eyelid edema, chest tightness, nausea, vomiting, hypotension, and a marked increase in peripheral blood neutrophil count. The infection was well controlled after remission of shock, anti-infective therapy and surgical drainage. At 2 months after surgery, the surgical incision of the upper eyelid skin recovered well and the best corrected visual acuity of the left eye was 1.0.

Relation between therapy options for Graves' disease and the course of Graves' ophthalmopathy: a systematic review and meta-analysis

BACKGROUND

The relation between therapy options for Graves' disease (GD) and the course of Graves' ophthalmopathy (GO) are still controversial. Our aim was to compare the occurrence of development or worsening of GO in patients who were treated with antithyroid drugs (ATDs) or radioactive iodine (RAI) or thyroidectomy (TX).

METHODS

We conducted a comprehensive search of the Embase and PubMed database. Odds ratio (OR) was used as a measure of the effect of therapy options for GD on the risk of development or worsening of GO. The analysis was further stratified by factors that could affect the treatment effects.

RESULTS

Nine trials involving 1773 patients were included. RAI therapy showed a significant effect on the risk of development or worsening GO compared with ATD (OR 2.25; 95 % CI 1.61-3.14; P < 0.00001). Glucocorticoid prophylaxis was effective in preventing GO development or worsening (0.40; 0.23-0.68; P = 0.002); especially for patients with preexisting GO (0.41; 0.23-0.73; P = 0.002). At 3 months, showed GO to be improved in 17 TX and 21 total thyroid ablation (TTA) patients, with no significant difference between the two groups; between 6 and 12 months, TTA did show significant beneficial effect on the improvement of GO (6.02; 2.80-12.96; P < 0.00001); GO was found to be inactive in a significantly higher percentage of patients in the TTA (2.17; 1.04-4.52; P = 0.04).

CONCLUSION

Radioiodine therapy is a significant risk factor for development or worsening of GO in GD. But GO progression can be prevented by prophylactic glucocorticoids in patients with preexisting GO. Compared with TX alone, TTA induces an earlier and steadier GO improvement in patients with mild to moderate-severe and active GO. Whether this is sufficient to offer TTA to patients needs further investigation.

[A comparative study of lacrimal magnetic resonance hydrography and lacrimal endoscopy examination in the diagnosis and treatment of lacrimal duct obstructive diseases]

OBJECTIVE

To evaluate the diagnostic value and treatment guidance of lacrimal magnetic resonance hydrography (LMRH) and lacrimal endoscopy examination in lacrimal duct obstruction.

METHODS

A retrospective analysis of clinical and imaging data of 59 patients with epiphora who had LMRH examination in Tongji Hospital during June 2013 and January 2014. Multiplanar reconstruction (MPR) and maximum intensity projection (MIP) were used to process the three dimensions T2-weighted images (T2WI). The size of lacrimal sac, lacrimal mucosal lesions and the obstructed plane of nasolacrimal duct were observed. The lacrimal irrigation results were used as gold standard. The sensitivity, specificity, accuracy of LMRH in diagnosis of lacrimal duct obstructive diseases and the consistency between the two methods were analyzed. In addition, 22 cases had lacrimal endoscopy examination in less than half month after MRD. The results of lacrimal endoscopy were compared with LMRH images. The treatment method was made according to the results of LMRH and lacrimal endoscopy.

RESULTS

According to the results of lacrimal irrigation, among 78 eyes of 59 patients, 2 eyes were diagnosed as lacrimal canalicular obstruction (2.6%, 2/78), 8 eyes were diagnosed as nasolacrimal duct stenosis (10.3%, 8/78), 24 eyes were diagnosed as nasolacrimal duct obstruction (30.8%, 24/78), 44 eyes were diagnosed as nasolacrimal duct obstruction accompanied with chronic dacryocystitis (56.4%, 44/78). The other 40 eyes were negative controls. LMRH had a high degree of consistency with lacrimal irrigation in diagnosis of lacrimal duct obstructive diseases. The value of Kappa was 0.963 (P= 0.026). The sensitivity of MRD in diagnosis of lacrimal duct obstructive diseases was 97.4%, the specificity was 100%, the accuracy was 98.3%, the positive predictive value was 100% and the negative predictive value was 95.2% . According to 40 eyes of the control group, the mean value of the maximum cross-sectional area of the lacrimal sac was: (10.9 ± 0.4) mm(2). Twenty-two eyes underwent lacrimal endoscopy examination and the endoscopic findings were consistent with LMRH diagnosis. The lesions in the lacrimal duct displayed more clearly and intuitively than the LMRH, while LMRH had its unique advantages in showing the size of lacrimal sac, the mucosal thickness of lacrimal duct, large foreign bodies and lesions around the lacrimal duct. According to the results of LMRH and lacrimal endoscopy, 2 eyes of canalicular obstruction, 8 eyes of nasolacrimal duct stenosis, 20 eyes of nasolacrimal duct obstruction underwent lacrimal probing and stent implantation. Four eyes of nasolacrimal duct obstruction had drug treatment under lacrimal endoscopy. Thirty-eight eyes of chronic dacryocystitis underwent endonasal dacryocystorhinostomy. The other 6 eyes of chronic dacryocystitis underwent stent removal combined with endonasal dacryocystorhinostomy.

CONCLUSIONS

LMRH is a noninvasive and reliable method to examine the lacrimal duct obstruction. It can better display the size of lacrimal sac, lacrimal mucosal thickness and surrounding soft tissues of lacrimal duct. It is also a good complementary method of lacrimal endoscopy and has guiding significance for individualized treatment in patients with lacrimal duct obstruction.

A phase I trial of intratumoral administration of recombinant oncolytic adenovirus overexpressing HSP70 in advanced solid tumor patients

Our pre-clinical studies demonstrated that intratumoral vaccination with a recombinant oncolytic type 2 adenovirus overexpressing the heat shock protein (HSP)70 protein, designated as H103, can inhibit primary and metastatic tumors through enhanced oncolytic activity and HSP-mediated immune responses against shared and mutated tumor antigens. In the pre-clinical studies of local H103 administration, no significant toxicity was observed in the animal trials with mice, cavy or rhesus monkeys. A phase I clinical trial of intratumoral injection of H103 was conducted in the patients with advanced solid tumors. A total of 27 patients were injected intratumorally with H103 in a dose-escalation study from a dose of 2.5 x 10(7) to 3.0 x 10(12) viral particles (VPs). The maximum tolerated dose of H103 was not defined. Two patients developed dose-limiting toxicities of grade III fever at the dose of 1.5 x 10(12) VP and transient grade IV thrombocytopenia at the dose of 3.0 x 10(12) VP. The common adverse events were mainly mild to moderate (grade I/II) in nature, including fever, mild injection-site reaction, leucopenia, lymphopenia, thrombocytopenia and hypochromia. The objective response (complete response+partial response) to H103-injected tumors was 11.1% (3/27), and the clinical benefit rate (complete response+partial response+minor response+stable disease) was 48.1%. Interestingly, transient and partial regression of distant, uninjected tumors was observed in three patients. The numbers of immune cells (CD4(+) and CD8(+) T cells, and natural killer cells) were elevated after H103 administration, but without statistical significance. This phase I trial demonstrates that intratumoral administration of H103 can be safely applied to cancer patients and shows promising clinical antitumor activity, warranting a further clinical investigation.

Synthesis of CoOOH nanorods and application as coating materials of nickel hydroxide for high temperature Ni-MH cells

Studies on nanoscale materials have received great interest in both fundamental and applied aspects in recent years. In this letter, we report the synthesis of CoOOH nanorods and their possible applications as coating materials on nickel hydroxide for high-temperature nickel-metal hydride (Ni-MH) cells. The morphology and structure of CoOOH nanorods and coated nickel hydroxide particles are investigated by transmission electron microscopy, X-ray diffraction, and scanning electron microscopy, respectively. The electrochemical properties in the cylindrical AA size Ni-MH cells are evaluated. Our results show that the Ni-MH cells, where the positive electrodes are composed of such nanometer sized CoOOH coatings, have a higher capacity available and good performance at elevated temperatures of >50 degrees C.

Preparation and Electrochemical Hydrogen Storage of Boron Nitride Nanotubes

Boron nitride (BN) nanotubes were synthesized through chemical vapor deposition over a wafer made by a LaNi5/B mixture and nickel powder at 1473 K. Scanning electron microscopy, transmission electron microscopy, energy-dispersive spectroscopy, X-ray diffraction, and X-ray photoelectron spectroscopy were performed to characterize the microstructure and composition of BN nanotubes. It was found that the obtained BN nanotubes were straight with a diameter of 30-50 nm and a length of up to several microns. We first verify that the BN nanotubes can storage hydrogen by means of an electrochemical method, though its capacity is low at present. The hydrogen desorption of nonelectrochemical recombination in cyclic voltammograms, which is considered as the slow reaction at BN nanotubes, suggests the possible existence of strong chemisorption of hydrogen, and it may lead to the lower discharge capacity of BN nanotubes. It is tentatively concluded that the improvement of the electrocatalytic activity by surface modification with metal or alloy would enhance the electrochemical hydrogen storage capacity of BN nanotubes.