Cardiac amyloidosis presenting as pulmonary arterial hypertension:A case report

BACKGROUND Pulmonary hypertension is a rare cardiopulmonary disease,with an insidious onset that usually worsens rapidly.Amyloid light chain(AL)amyloidosis is a rare systemic disease caused by extracellular deposition of pathologic,insoluble,and proteinaceous fibrils in organs and tissues;however,it is difficult to diagnose given its varied and nonspecific symptoms.To date,rare cases of amyloidosis with pulmonary hypertension have been reported.Of note,the optimal treatments for cardiac amyloidosis complicated with pulmonary hypertension remain unclear.CASE SUMMARY We report a case of a 51-year-old woman who presented with progressively worsening dyspnea.Transthoracic echocardiography indicated severe pulmonary hypertension.Twenty-seven months after first admission,the patient returned with symptoms of progressive heart failure.A myocardial tissue sample stained with Congo red was positive,and the patient was ultimately diagnosed with AL amyloidosis with cardiac involvement.CONCLUSION Although pulmonary hypertension may be idiopathic,it is frequently associated with other conditions.In rare cases,pulmonary hypertension can be a complication of AL amyloidosis,which should be seriously considered in any adult presenting with nonspecific signs or symptoms of cardiac distress.

Study on the operational safety of high-speed trains exposed to stochastic winds

The characteristic wind curve （CWC） was com- monly used in the previous work to evaluate the operational safety of the high-speed trains exposed to crosswinds. How- ever, the CWC only provide the dividing line between safety state and failure state of high-speed trains, which can not evaluate the risk of derailment of high-speed trains when ex- posed to natural winds. In the present paper, a more realistic approach taking into account the stochastic characteristics of natural winds is proposed, which can give a reasonable and effective assessment of the operational safety of high-speed trains under stochastic winds. In this approach, the longitudi- nal and lateral components of stochastic winds are simulated based on the Cooper theory and harmonic superposition. An algorithm is set up for calculating the unsteady aerody- namic forces （moments） of the high-speed trains exposed to stochastic winds. A multi-body dynamic model of the rail vehicle is established to compute the vehicle system dynamic response subjected to the unsteady aerodynamic forces （mo- ments） input. Then the statistical method is used to get the mean characteristic wind curve （MCWC） and spread range of the high-speed trains exposed to stochastic winds. It is found that the CWC provided by the previous analyticalmethod produces over-conservative limits. The methodol- ogy proposed in the present paper can provide more signif- icant reference for the safety operation of high-speed trains exposed to stochastic winds.

An unusual case of aggressive systemic mastocytosis mimicking hepatic cirrhosis

Hepatic involvement in aggressive systemic mastocytosis(ASM) is relatively common, and the main clinical features of this disease include hepatomegaly, portal hypertension, ascites, and fibrosis. Cirrhosis is a rare ASM symptom. We report an ASM case that initially mimicked cirrhosis based on clinical and radiographic analyses. The portal tract was expanded by mononuclear inflammatory cells, and an increase in collagen amount was observed in routine histological sections of the biopsied liver. A diagnosis of systemic mastocytosis(SM) was made after ancillary tests for mast cells using bone marrow aspirates. Extensive involvement of the liver and gastrointestinal tract was observed. Clinicians and pathologists need to consider ASM as a diagnosis or differential diagnosis in a clinical case of cirrhosis with unknown etiology. The diagnosis can be confirmed or disregarded by immunohistochemical staining and molecular analysis.

Changes of Nerve Growth Factor in Amniotic Fluid and Correlation with Ventriculomegaly

Objective To detect the change of nerve growth factor (NGF) level in human amniotic fluid during gestation, and to explore the relationship between this change and fetal ventriculo-megaly (VM). Methods The studied subjects (collected from 2004 to 2007) were divided into four groups, including the second-trimester pregnancy group (n=113), third-trimester pregnancy group (n=110), fetal cerebral VM group (n=12), and healthy control group (n=12) which matched with the VM group in gestational weeks. The amniotic fluid specimens were obtained during amniocentesis or cesarean section. The NGF levels in amniotic fluid were detected with en-zyme-linked immunosorbent assay. Results A significantly negative correlation was found between gestational age and the NGF level in amniotic fluid (r= 0.6149, P<0.0001). The NGF level in patients with fetal VM was significantly lower than that in healthy controls (33.95±29.24 pg/mL vs. 64.73±16.21 pg/mL, P=0.024). Conclusion NGF levels in amniotic fluid may be a sensitive marker for fetal VM.

Elevated Arsenic Exposure Is Associated with an Increased Risk of Chronic Hepatitis B Virus Infection： NHANES （2003-2014） in U.S. Adults

Studies concerning the association between arsenic exposure and hepatitis B virus （HBV） infection have been lacking. The present study aimed to examine the association between total urinary arsenic （TUA） and infection ofHBV. A total of 5186 participants from National Health and Nutrition Examination Survey （NHANES） 2003-2014 were included in the analysis. We used logistic regression to evaluate the association. We defined two measures of TUA. TUA1 was the sum of arsenous acid, arsenicacid, monomethylarsonic acid and dimethylarsenic acid. TUA2 was defined as TUA minus arsenobetaine and arsenocholine. The results showed that the weighted overall prevalence of HBV infection was 6.08%. For NHANES 2003-2014, the medians （interquartile range） of TUA1 and TUA2 were 5.60 μg/L （3.97-8.09 μg/L） and 4.91 μg/L （2.36-9.11 μg/L）, respectively. Comparing the highest quartile to the lowest quartile after multivariable adjustment showed that the odds ratios （ORs） and 95% confidence intervals （CIs） for TUA1 and TUA2 were 2.44 （1.40-4.27） and 2.84 （1.60-5.05）, respectively. In conclusion, elevated urinary arsenic was associated with the risk of HBV infection. Further studies, especially prospective studies, are needed to confirm the causal relationship between arsenic exposure and HBV infection.

Fatigue characteristics and microcosmic mechanism of Al-Si-Mg alloys under multiaxial proportional loadings

With the increasing use of Al-Si-Mg alloys in the automotive industry,the fatigue performance of Al-Si-Mg alloy has become a major concern with regard to their reliability.The fatigue characteristics and microcosmic mechanism of an Al-Si-Mg alloy under multiaxial proportional loadings were investigated in this research.As low cycle fatigue life and material strengthening behavior are closely related,the effect of equivalent strain amplitude on the multiaxial fatigue properties was analyzed.Fatigue tests were conducted to determine the influence of equivalent strain amplitude on the multiaxial proportional fatigue properties.The fatigue life exhibits a stable behavior under multiaxial proportional loadings.The dislocation structures of the Al-Si-Mg alloy were observed by transmission electron microscopy（TEM）.The dislocation structure evolution of the Al-Si-Mg alloy under multiaxial proportional loadings during low cycle fatigue develops step by step by increasing fatigue cycles.Simultaneously,the dislocation structure changes with the change in equivalent strain amplitude under multiaxial proportional loadings.The experimental evidence indicates that the multiaxial fatigue behavior and life are strongly dependent on the microstructure of the material,which is caused by multiaxial proportional loadings.

特殊整平剂甲基橙在通孔电镀铜的应用(英文)

甲基橙具有两种基团,可以同时起到加速和抑制作用,可作为特殊的整平剂应用与通孔电镀铜实验中。通过分子动力学模拟和量子化学计算来表征甲基橙在通孔电镀铜中的作用,结果表明甲基橙可以很好地吸附在阴极表面并抑制铜的电沉积。通过恒电流测试和循环伏安测试结果显示,甲基橙由于同时具有磺酸基的去极化和其分子结构部分的极化作用,形成协同分子内对铜加速还原和阻碍传质的竞争效应,所以几乎不影响电位。在板厚孔径为10:1的通孔电镀铜实验中,仅以甲基橙和环氧乙烷和环氧丙烷嵌段共聚物作为添加剂,TP值可达到92.34%。

Endoscopic clipping for the secondary prophylaxis of bleeding gastric varices in a patient with cirrhosis:A case report

BACKGROUND Bleeding from gastroesophageal varices(GOV)is a serious complication in patients with liver cirrhosis,carrying a very high mortality rate.For secondary prophylaxis against initial and recurrent bleeding,endoscopic therapy is a critical intervention.Endoscopic variceal clipping for secondary prophylaxis in adult GOV has not been reported.CASE SUMMARY A 66-year-old man with cirrhosis was admitted to our hospital complaining of asthenia and hematochezia for 1 wk.His hemoglobin level and red blood cell counts were significantly decreased,and his fecal occult blood test was positive.An enhanced computed tomography of the abdomen showed GOV.The patient was diagnosed with hepatitis B cirrhosis-related GOV bleeding.A series of palliative treatments were administered,resulting in significant clinical improvement.Subsequently,an endoscopic examination revealed severe gastric fundal varices,prompting endoscopic variceal clipping.There were no further episodes of gastrointestinal bleeding.The GOV improved significantly on follow-up imaging and was confirmed as improved on endoscopy at the 5th post-operative month.CONCLUSION Our results suggest that endoscopic clipping is an inexpensive,safe,easy,effective,and tolerable method for the secondary prophylaxis of bleeding from gastric type 2 GOV.However,additional research is indicated to confirm its longterm safety and efficacy.

Pediatric acute myeloid leukemia patients with i(17)(q10)mimicking acute promyelocytic leukemia:Two case reports

BACKGROUND Chromosome i(17)(q10)abnormality is mainly associated with chronic myeloid leukemia(CML),myelodysplastic syndrome/myeloproliferative tumors(MDS/MPD),and acute myeloid leukemia(AML).The role of i(17)(q10)in AML is still unknown,the differences between AML and acute promyelocytic leukemia(APL)-like AML with i(17)(q10)need more research.This study aimed to investigate the clinical characteristics and laboratory evidence of 2 AML cases with i(17)(q10),similar to APL phenotype.CASE SUMMARY Both pediatric patients were males;case 1 had newly diagnosed AML,and case 2 showed relapsed tumor after 1 year of drug withdrawal.Bone marrow cell morphology,chromosome karyotype analysis,Fully-instrumented submersible housing test,immunological assays,molecular biological methods,and blood tumor panoramic gene test were performed.All-trans retinoic acid(ATRA)combined with arsenic acid(As2O3)were used in the first course of treatment.Bone marrow was dominated by abnormal promyelocytic granulocytes.Karyotype test revealed i(17)(q10)isochromosome.Immunological phenotype mainly included positive expressions of CD9,CD13,CD33,and CD38.Case 1 suffered intracranial hemorrhage after re-chemotherapy and died on D162.For case 2,on D145 and D265,bone marrow promyelocytic granulocytes accounted for 2%.Flow cytometric residual lesion detection showed no abnormal immunophenotype cells.The copy number of WT1 gene in two cases were 1087 and 1010,respectively,and the expression rates were 55.29% and 59.5%,respectively.CONCLUSION ATRA,As2O3,and chemotherapy may be ineffective in treating APL-like AML with i(17)(q10)but without t(15;17)and PML-RARA fusion gene.

Multi-objective optimization design method of the high-speed train head

With the continuous improvement of the train speed, the dynamic environment of trains turns out to be aerodynamic domination. Solving the aerodynamic problems has become one of the key factors of the high-speed train head design. Given that the aerodynamic drag is a significant factor that restrains train speed and energy conservation, reducing the aerodynamic drag is thus an important consideration of the high-speed train head design. However, the reduction of the aerodynamic drag may increase other aerodynamic forces (moments), possibly deteriorating the operational safety of the train. The multi-objective optimization design method of the high-speed train head was proposed in this paper, and the aerodynamic drag and load reduction factor were set to be optimization objectives. The automatic multi-objective optimization design of the high-speed train head can be achieved by integrating a series of procedures into the multi-objective optimization algorithm, such as the establishment of 3D parametric model, the aerodynamic mesh generation, the calculation of the flow field around the train, and the vehicle system dynamics. The correlation between the optimization objectives and optimization variables was analyzed to obtain the most important optimization variables, and a further analysis of the nonlinear relationship between the key optimization variables and the optimization objectives was obtained. After optimization, the aerodynamic drag of optimized train was reduced by up to 4.15%, and the load reduction factor was reduced by up to 1.72%.

A numerical approach to the interaction between airflow and a high-speed train subjected to crosswind

Aerodynamic forces and dynamic performances of railway vehicles are coupled and affected by each other. On the one hand, aerodynamic forces change the displacements of a train. On the other hand, displacements affect aerodynamic forces. Based on vehicle-track coupling dynamics and aerodynamics, a numerical approach to the interaction between airflow and a high-speed train is presented in this paper. Aerodynamic forces and dynamic performances of a high-speed train subjected to crosswind were numerically simulated. Results showed that the interaction between airflow and a high-speed train has a significant influence on displacements and aerodynamic forces of the head coach. Therefore, it is necessary to consider the interaction between airflow and a high-speed train subjected to crosswind.

Revisiting Newton’s rings with a plasmonic optical flat for high-accuracy surface inspection

Two parallel optical surfaces often exhibit colorful fringes along the lines of equal thickness because of the interference of light.This simple phenomenon allows one to observe subwavelength corrugations on a reflective surface by simply placing on it a flat reference dielectric surface,a so-called optical flat,and inspecting the resultant interference pattern.In this work,we extend this principle from dielectric surfaces to two-dimensional plasmonic nanostructures.Optical couplings between an Au nanodisk array and an Au thin film were measured quantitatively using two different techniques,namely,the classical Newton’s rings method and a closed-loop nano-positioning system.Extremely high spectral sensitivity to the inter-surface distance was observed in the near-field coupling regime,where a 1-nm change in distance could alter the resonance wavelength by almost 10 nm,440 times greater than the variation in the case without near-field coupling.With the help of a numerical fitting technique,the resonance wavelength could be determined with a precision of 0.03 nm,corresponding to a distance precision as high as 0.003 nm.Utilizing this effect,we demonstrated that a plasmonic nanodisk array can be utilized as a plasmonic optical flat,with which nanometer-deep grooves can be directly visualized using a low-cost microscope.

A comparison between 18F-FDG PET/CT and classical physical examination package for cancer screening in asymptomatic Chinese patients

To the Editor:Cancer is the leading cause of death in China.[1]With rapid economic development,18F-fluorodeoxyglucose(FDG)positron emission tomography(PET)/computed tomography(CT)for screening cancer in asymptomatic patients is gaining popularity in China.PET/CT is a type of molecular imaging technology,which uses a specific tracer for localization and quantification of the disease at a molecular level.[2]However,the utility of such screening is still controversial.[3]Based on the past clinical experience,the previous physical examination protocol has been optimized,and a classical physical examination protocol has been set up at the author’s study center.So far,there is no evidence to know which approach was better for cancer screening in asymptomatic individuals.