Unilateral contrast-induced encephalopathy with contrast medium exudation:A case report

BACKGROUND Contrast-induced encephalopathy(CIE)is a rare transient,reversible abnormality in the structure or function of the nervous system caused by the intravascular use of contrast agents.CIE can present with a range of neurological manifestations,including focal neurological deficits(hemiplegia,hemianopia,cortical blindness,aphasia,and parkinsonism)and systemic symptoms(confusion,seizures,and coma).However,if not accurately diagnosed and treated in a timely manner,CIE can cause irreversible damage to patients,especially critically ill patients.CASE SUMMARY A male in his 50 s,2 h after digital subtraction angiography,had a progressive disorder of consciousness,mixed aphasia,bilateral pupillary sluggish light reflex,and right limb weakness.Seven hours after the procedure,he developed unconsciousness,high fever(39.5°C),seizures,hemiplegia,neck stiffness(+),and right Babinski signs(+).computed tomography(CT)findings 2 h postprocedure were very confusing and led us to misdiagnose the patient with subarachnoid hemorrhage.Brain CT was performed again 7 h after the procedure.Compared with the CT 2 h after the procedure,the CT 7 h after the procedure showed that the manifestations of subarachnoid hemorrhage in the left cerebral hemisphere had disappeared and were replaced by brain tissue swelling,and the cerebral sulci had disappeared.Combined with the clinical manifestations of the patient and after the exclusion of subarachnoid hemorrhage and cerebrovascular embolism,we diagnosed the patient with CIE,and intravenous fluids were given for adequate hydration,as well as mannitol,albumin dehydration,furosemide and the glucocorticoid methylprednisolone.After 17 d of active treatment,the patient was discharged with no sequelae.CONCLUSION CIE should be taken seriously,but it is easily misdiagnosed,and once CIE is diagnosed,rapid,accurate diagnosis and treatment are critical steps.Whether a follow-up examination using a contrast agent can be performed should be closely evaluated,and the patient should be fully informed of the associated risks.

Efficacy of anlotinib combined with radioiodine to treat scalp metastasis of papillary thyroid cancer:A case report and review of literature

BACKGROUND Papillary thyroid cancer(PTC)is one of the well-differentiated thyroid tumors.Cutaneous metastasis from differentiated thyroid cancers occurs in<1%of primary thyroid carcinomas but produces the worst survival prognosis.The multi-targeting tyrosine kinase inhibitor anlotinib has been approved to treat refractory advanced non-small-cell lung cancer as well as advanced soft-tissue and clear cell sarcomas in China.CASE SUMMARY In a patient with scalp metastasis caused by PTC,thyroid and skull metastasis tumor sizes were significantly reduced after a trial of neoadjuvant anlotinib therapy for 3 cycles.Anlotinib maintenance medication after thyroidectomy further reduced the metastatic skull tumor size thereby preventing the requirement for craniotomy.CONCLUSION The outcome of the present trial confirmed the potential of anlotinib therapy to treat scalp metastasis induced by PTC and point the way for the treatment of similar diseases in the future.

Measurements ofthe 197Au(n, γ) crosssectionupto100keV at the CSNSBack-nfacility

The neutron capture cross section of 197 Au was measured using the time-of-flight(TOF)technique at the Back-n facility of the China Spallation Neutron Source(CSNS)in the 1 eV to 100 keV range.Prompt c-rays originating from neutron-induced capture events were detected by four C_(6)D_(6) liquid scintillator detectors.Pulse height weighting technology(PHWT)was used to analyze the data.The results are in good agreement with ENDF/B-VIII.0,CENDL-3.1,and other evaluated libraries in the resonance region,and in agreement with both n TOF and GELINA experimental data in the 5–100 keV range.Finally,the resonance peaks in the energy range from 1eV to 1 keV were fitted by the SAMMY R-matrix code.

Measurements of the ^(107)Ag neutron capture cross sections with pulse height weighting technique at the CSNS Back-n facility

Silver indium cadmium(Ag–In–Cd) control rod is widely used in pressurized water reactor nuclear power plants,and it is continuously consumed in a high neutron flux environment. The mass ratio of ^(107)Ag in the Ag–In–Cd control rod is 41.44%. To accurately calculate the consumption value of the control rod, a reliable neutron reaction cross section of the ^(107)Ag is required. Meanwhile,^(107)Ag is also an important weak r nucleus. Thus, the cross sections for neutron induced interactions with ^(107)Ag are very important both in nuclear energy and nuclear astrophysics. The(n, γ) cross section of ^(107)Ag has been measured in the energy range of 1–60 eV using a back streaming white neutron beam line at China spallation neutron source. The resonance parameters are extracted by an R-matrix code. All the cross section of ^(107)Ag and resonance parameters are given in this paper as datasets. The datasets are openly available at http://www.doi.org/10.11922/sciencedb.j00113.00010.

New experimental measurement of^(nat)Se(n,γ)cross section between 1 eV to 1 keV at the CSNS Back-n facility

The^(74)Se is one of 35 p-nuclei,and^(82)Se is a r-process only nucleus,and their(n,γ)cross sections are vital input parameters for nuclear astrophysics reaction network calculations.The neutron capture cross section in the resonance range of isotopes and even natural selenium samples has not been measured.Promptγ-rays originating from neutron-induced capture events were detected by four C_(6)D_(6) liquid scintillator detectors at the Back-n facility of China Spallation Neutron Source(CSNS).The pulse height weighting technique(PHWT)was used to analyze the data in the 1 e V to 100 ke V region.The deduced neutron capture cross section was compared with ENDF/B-VIII.0,JEFF-3.2,and JENDL-4.0,and some differences were found.Resonance parameters were extracted by the R-matrix code SAMMY in the 1 e V-1 ke V region.All the cross sections ofnatSe and resonance parameters are given in the datasets.The datasets are openly available at http://www.doi.org/10.11922/sciencedb.j00113.00019.

Combined surgical and interventional treatment of tandem carotid artery and middle cerebral artery embolus: A case report

BACKGROUND The 2018 American Heart Association/American Stroke Association guidelines for early management of acute ischemic stroke recommend the use of retrievable stents for mechanical thrombectomy in patients with acute internal carotid artery or middle cerebral artery M1 occlusion that can be treated within 6 h from onset.For cases of carotid artery with ipsilateral middle cerebral artery tandem embolization, the operation is more complicated and challenging. We here report a case of a tandem embolism, and the anatomy of the aortic arch was complex.Direct carotid artery incision and thrombectomy can not only prevent the escape of the carotid embolus but also save time during establishment of the thrombectomy access.CASE SUMMARY The patient was a 70-year-old man. He was admitted to hospital due to sudden inability to speak and inability to move his right limb for 3 h. Imaging confirmed a diagnosis of a tandem embolism in the left carotid artery with left M1 occlusion.Carotid artery incision thrombectomy combined with stent thrombectomy was performed. The operation was successful, and 24 h later the patient was conscious and mentally competent but had motor aphasia. His bilateral limb muscle strength level was 5, and his neurologic severity scores score was 2.CONCLUSION Carotid artery incision thrombectomy combined with stenting for carotid artery plus cerebral artery tandem embolization is clinically feasible. For patients with a complicated aortic arch and an extremely tortuous carotid artery, carotid artery incision can be chosen to establish the interventional path.

Stellar reaction rate of 55Ni（p,γ）56Cu in Type I X-ray bursts

^56Cu is close to the waiting-point nucleus ^56Ni and lies on the rapid proton capture (rp) process path in Type I X-ray bursts (XRBs). In this work, we obtained a revised thermonuclear reaction rate of ^55Niep;cT56Cu in the temperature region relevant to XRBs. This rate was recalculated based on the recent experimental level structure in ^56Cu, the recently measured proton separation energy of Sp = 579.8(7.1) keV, together with shell-model calculation, and the mirror nuclear structure in ^56Co. The associated uncertainties in the rates were estimated by a Monte Carlo method. Our revised rate is significantly different from the recent results, which were partially based on experimental results;in addition, we found that a result in a previous work was incorrect. We recommend our revised rate to be incorporated in the future astrophysical network calculations.