Spontaneous conus infarction with"snake-eye appearance"on magnetic resonance imaging:A case report and literature review

BACKGROUND Infarction of the conus medullaris is a rare form of spinal cord infarction.The first symptom is usually acute non-characteristic lumbar pain,followed by lower limb pain,saddle numbness,fecal incontinence,and sexual dysfunction.Spontaneous conus infarction with"snake-eye appearance"on magnetic resonance imaging has rarely been reported.CASE SUMMARY We report a 79-year-old male patient with spontaneous conus infarction who had acute lower extremity pain and dysuria as the first symptoms.He did not have any recent history of aortic surgery and trauma.Magnetic resonance imaging revealed a rare"snake-eye appearance."In addition,we reviewed the literature on 23 similar cases and summarized the clinical features and magnetic resonance manifestations of common diseases related to the"snake-eye sign"to explore the etiology,imaging findings,and prognosis of spontaneous conus infarction.CONCLUSION We conclude that acute onset of conus medullaris syndrome combined with"snake-eye appearance"should be strongly suspected as conus medullaris infarction caused by anterior spinal artery ischemia.This special imaging manifestation is helpful in the early diagnosis and treatment of conus infarction.

Expert Consensus on Nutritional Support for Children with Congenital Heart Disease(2023 Edition)

The second edition of the expert consensus on pediatric nutrition was formed based on a global update of pedia-tric nutrition guidelines or consensus worldwide,the management of congenital heart disease,and the results of multi-center clinical nutrition research for congenital heart disease following thefirst Chinese consensus edition of 2016.The consensus was also shaped by the results of three discussion sessions and two questionnaires con-ducted by the 13-member collaboration group.This process was informed by both clinical guidelines and expert consensus.The quality of literature,both in English and Chinese,and the level of recommendations were evaluated using the Grading of Recommendations Assessment,Development,and Evaluations(GRADE)system.

Clinical characteristics and prognosis of triple-negative breast cancer

客观我们调查了临床的特征，和三元组否定的乳癌的预示的因素。130 个三元组否定的乳癌病人在临床的特征和预后上被考察的方法。所有情况是免疫组织化学决定的雌激素受体，孕酮受体，和 HER2/neu 的表示的缺乏。结果 17.1% 所有乳癌病人(774 个案例) 是三元组否定的乳癌，并且 68.9% 三元组否定的乳癌病人(91 个案例) 是绝经前的。53.8% 病人(71 个案例) 与 T2 尺寸有肿瘤，并且(52 个病人) 他们中的 39.4% 个有淋巴节点转移。没有淋巴节点转移，在有淋巴节点转移的病人的恶化的率在病人显然比那高(P = 0.001 ) 。后续的中部的时间是 63 个月。33 案例 relapsed 和 20 个病人死了。23 个病人有至少二机关转移。5 年的没有疾病、全面的幸存率是 73.8% 和 85.7% 。结论三元组否定的乳癌病人通常在治疗以后在 2 3 年里有多重远转移的高率。淋巴节点的地位是最重要的预示的因素。有淋巴节点转移的三元组否定的胸 caner 病人有差的预后。

Successful totally transthoracic echocardiography guided transcatheter device closure of atrial septal defect in pregnant women

BACKGROUND Transcatheter device closure of atrial septal defect(ASD) guided by fluoroscopy and/or transesophageal echocardiography is a mature technology. Little study has focused on whether the technology can be guided totally by transthoracic echocardiography(TTE),even in pregnant women with ASD.AIM To evaluate the safety and efficacy of totally TTE guided transcatheter device closure of ASD in pregnant women.METHODS Six pregnant women(gestational age 20-26 wk) with ASD underwent transcatheter device closure totally guided by TTE at our cardiac center from January 2015 to August 2017. A routine transcatheter procedure without fluoroscopy or intubation and a domestic occluder were used in this study.RESULTS All patients had successful closure with good clinical results,and the overall immediate complete closure rate was 100%. The size of the occluder deployed ranged from 20 to 32 mm(26.7 ± 4.3 mm),the procedure time ranged from 30 to50 min(41.7 ± 7.5 min),and the length of hospital stay was 2-3 d(mean 2.2 ± 0.4 d). There were no serious cardiovascular related complications,and transient arrhythmias occurred in one patient during the procedure. During the follow-up period(3 mo to 2 years),no occluder dislodgement,residual fistulas,or thromboses occurred. All of the patients underwent vaginal delivery between 36 and 38 wk of gestation.CONCLUSION Totally TTE guided transcatheter device closure of ASD in pregnant women may be safe and effective.

Automatic Assessment of Expanded Disability Status Scale (EDSS) in Multiple Sclerosis Using a Decision Tree

The expanded disability status scale (EDSS) is frequently used to classify the patients with multiple sclerosis (MS). We presented in this paper a novel method to automatically assess the EDSS score from posturologic data (center of pres-sure signals) using a decision tree. Two groups of participants (one for learning and the other for test) with EDSS rang-ing from 0 to 4.5 performed our balance experiment with eyes closed. Two linear measures (the length and the surface) and twelve non-linear measures (the recurrence rate, the Shannon entropy, the averaged diagonal line length and the trapping time for the position, the instantaneous velocity and the instantaneous acceleration of the center of pressure respectively) were calculated for all the participants. Several decision trees were constructed with learning data and tested with test data. By comparing clinical and estimated EDSS scores in the test group, we selected one decision tree with five measures which revealed a 75% of agreement. The results have signified that our tree model is able to auto-matically assess the EDSS scores and that it is possible to distinguish the EDSS scores by using linear and non-linear postural sway measures.

Mechanism of action of the bile acid receptor TGR5 in obesity

G protein-coupled receptors(GPCRs)are a large family of membrane protein receptors,and Takeda G protein-coupled receptor 5(TGR5)is a member of this family.As a membrane receptor,TGR5 is widely distributed in different parts of the human body and plays a vital role in regulating metabolism,including the processes of energy consumption,weight loss and blood glucose homeostasis.Recent studies have shown that TGR5 plays an important role in glucose and lipid metabolism disorders such as fatty liver,obesity and diabetes.With the global obesity situation becoming more and more serious,a comprehensive explanation of the mechanism of TGR5 and filling the gaps in knowledge concerning clinical ligand drugs are urgently needed.In this review,we mainly explain the anti-obesity mechanism of TGR5 to promote the further study of this target,and show the electron microscope structure of TGR5 and review recent studies on TGR5 ligands to illustrate the specific binding between TGR5 receptor binding sites and ligands,which can effectively provide new ideas for ligand research and promote drug research.

Synthetic host-guest pairs as novel bioorthogonal tools for pre-targeting

Due to its simplicity, high efficiency, and chemo-selectivity, bioorthogonal chemistry has shown a great application potential in pre-targeting.Currently, four bioorthogonal pairs as targeting tools, including (strept)avidin/biotin, antibody/antigen, oligonucleotide hybridization and IEDDA tools, have been developed and applied in targeted delivery.Nevertheless, all of these tools still suffer from some limitations, such as difficult modification, biochemical fragility and larger molecular weight for biological association tools, as well as chemical instability for IEDDA tools.Synthetic host-guest pairs with relatively small molecular sizes not only possess strong chemical stability, but also have the features of fast conjugation rate, tunable binding affinity , easy modification, and high chemo-selectivity.Consequently, they can be used as a novel non-covalent bioorthogonal tool for pre-targeting.In order to further promote the development of host-guest pairs as novel bioorthogonal tools for pre-targeted delivery, we firstly calculate their conversion rate to make researcher aware of their unique advantages;next, we summarize the recent research progress in this area.The future perspectives and limitations of these unique tools will be discussed.This review will provide a systemic overview of the development of synthetic host-guest pairs as novel bioorthogonal tools for pre-targeting, and may serve as a “go for” resort for researchers who are interested in searching for new synthetic tools to improve pre-targeting.

Synthesis and Optical Properties of Polyaryl 2-(Pyridin-2-yl)phenol-Based Four-Coordinate Organoboron Complexes

Comprehensive Summary A family of polyaryl 2-(pyridin-2-yl)phenol-based four-coordinate organoboron complexes were prepared in good yields via deconstructive cycloaromatization of indolizines,cyclopropenones,and boric acids.The photoluminescence measurements have revealed that these N,Oπ-conjugated tetracoordinate boron complexes display bright fluorescence,large Stokes shifts,and good quantum yields(Φlum=0.15-0.45).In addition,the DFT calculations were carried out to deepen the understanding of the electronic structures and optoelectronic properties of these structurally unprecedented tetracoordinate boron complexes.

Visible Light-Induced C-5 Selective C-H Radical Borylation of Imidazo[1,2-a]pyridines with NHC-Boranes

A visible-light-induced C-5 selective C-H borylation of imidazo[1,2-a]pyridines with NHC-BH3 via Minisci-type radical borylation re-action has been developed for the first time.The present sustainable protocol provides a new family of regioselectively C5-borylated imidazopyridines that would otherwise be difficult to prepare.It is a supplement to site-selective borylation of azines(nitrogen-con-taining aromatic heterocycles)and the assembly of sp2 carbon-boron bond.

类器官的研究进展及应用

随着人类生物学研究的不断深入,需建立新的模型系统为研究提供了有力的工具。虽然传统的研究模型已被广泛应用,但难以准确反映组织、器官在机体中的生理现象。类器官(Organoid)是来源于干细胞或器官祖细胞的三维细胞聚集体,可分化和自组织形成具有人体相应器官的部分特定功能和结构。由于类器官具有人源性,可模拟器官发育和形成,在体外长期扩增中具有基因组稳定性,并能够形成活体生物库进行高通量筛选等优势,成为近年来备受关注的体外模型。目前,利用类器官模型结合新兴的基因编辑、器官芯片、单细胞RNA测序技术等,能够突破传统模型的瓶颈,在器官水平上为疾病模型的建立、药物研发、精准医疗以及再生医学等提供有价值的信息。文中就类器官分类及特性、研究应用、与其他技术结合应用及展望这4个方面进行综述。

Mechanistic insight into the synergistic Cu/Pd-catalyzed carbonylation of aryl iodides using alcohols and dioxygen as the carbonyl source

Pd-catalyzed carbonylation,as an efficient synthetic approach to the installation of carbonyl groups in organic compounds,has been one of the most important research fields in the past decade.Although elegant reactions that allow highly selective carbonylations have been developed,straightforward routes with improved reaction activity and broader substrate scope remain long-term challenges for new practical applications.Here,we show a new type of synergistic Cu/Pd-catalyzed carbonylation reaction using alcohols and dioxgen as the carbonyl sources.A broad range of aryl iodides and alcohols are compatible with this protocol.The reaction is concise and practical due to the ready availability of the starting materials and the scalability of the reaction.In addition,the reaction affords lactones and lactams in an intermolecular fashion.Moreover,DFT calculations have been performed to study the detailed mechanisms.

Electrochemical oxidative cyclization of alkenes,boronic acids,and dichalcogenides to access chalcogenated boronic esters and 1,3-diols

A sustainable,environmentally benign electrochemical oxidative three-component cyclization of allylic alcohols,boronic acids,and dichalcogenides under metal-free and oxidant-free conditions has been developed,which provides an efficient approach for the formation of C–Se/S and C–O bonds together.A series of chalcogenated boronic esters were afforded with a broad substrate scope through a clean electrochemical system.The resulting chalcogenated cyclic boronic esters were easily converted to chalcogenated 1,3-diols in good yields under mild conditions.

Guidelines for Diagnosis and Treatment of Atopic Dermatitis in China(2020)#

Atopic dermatitis(AD)is a common disease clinically characterized by chronic recurrent eczematous lesions,dry skin,and pruritus.AD can negatively impact patients’quality of life.The prevalence of AD in China has been increasing during the past few decades.Based on the most recent advances in the treatment of AD,we updated the 2014 version of the Guidelines for Diagnosis and Treatment of Atopic Dermatitis in China regarding the definition,epidemiology,pathogenesis,clinical classification,diagnosis,prevention,and treatment of AD.