Unveiling the early stage evolution of local atomic structures in the crystallization process of a metallic glass

The early stage evolution of local atomic structures in a multicomponent metallic glass during its crystallization process has been investigated via molecular dynamics simulation.It is found that the initial thermal stability and earliest stage evolution of the local atomic clusters show no strong correlation with their initial short-range orders,and this leads to an observation of a novel symmetry convergence phenomenon,which can be understood as an atomic structure manifestation of the ergodicity.Furthermore,in our system we have quantitatively proved that the crucial factor for the thermal stability against crystallization exhibited by the metallic glass is not the total amount of icosahedral clusters,but the degree of global connectivity among them.

Safety and effectiveness of lurasidone in the treatment of Chinese schizophrenia patients:An interim analysis of post-marketing surveillance

BACKGROUND Schizophrenia is a psychiatric disorder characterized by chronic or recurrent symptoms.Lurasidone was licensed in China in 2019 for the treatment of adult schizophrenia in adults with a maximum dose of 80 mg/d.However,post-market surveillance(PMS)with an adequate sample size is required for further validation of the drug’s safety profile and effectiveness.AIM To conduct PMS in real-world clinical settings and evaluate the safety and effectiveness of lurasidone in the Chinese population.METHODS A prospective,multicenter,open-label,12-wk surveillance was conducted in China's Mainland.All patients with schizophrenia from 10 sites who had begun medication with lurasidone between September 2019 and August 2022 were eligible for enrollment.Safety assessments included adverse events(AEs),adverse drug reactions(ADRs),extrapyramidal symptoms(EPS),akathisia,use of EPS drugs,weight gain,and laboratory values as metabolic parameters and the QTc interval.The effectiveness was assessed using the brief psychiatric rating scale(BPRS)from baseline to the end of treatment.RESULTS A total of 965 patients were enrolled in the full analysis set and 894 in the safety set in this interim analysis.The average daily dose was 61.7±19.08 mg(mean±SD)during the treatment.AEs and ADRs were experienced by 101 patients(11.3%)and 78 patients(8.7%),respectively,which were mostly mild.EPS occurred in 25 individuals with a 2.8%incidence,including akathisia in 20 individuals(2.2%).Moreover,59 patients received drugs for treating EPS during the treatment,with an incidence of 6.6%which dropped to 5.4%at the end of the treatment.The average weight change was 0.20±2.36 kg(P=0.01687)with 0.8%of patients showing a weight gain of≥7%at week 12 compared with that at the baseline.The mean values of metabolic parameters and the QTc interval at baseline and week 12 were within normal ranges.The mean changes in total BPRS scores were-8.9±9.76(n=959),-13.5±12.29(n=959),and-16.8±13.97(n=959)after 2/4,6/8,and 12 wk,respectively(P<0.001 for each visit compared with the baseline)using the last-observation-carried-forward method.CONCLUSION The interim analysis of the PMS of adult patients with schizophrenia demonstrate the safety and effectiveness of lurasidone in the Chinese population.No new safety or efficacy concerns were identified.

基于灰色关联度与TOPSIS模型分析不同配伍比例的知母对石膏中6种无机元素溶出的影响

目的基于灰色关联度和逼近理想解排序(TOPSIS)法探讨配伍不同比例的知母对石膏中钾(K)、钛(Ti)、锶(Sr)、钡(Ba)、钙(Ca)、镁(Mg)6种无机元素溶出的影响,为临床提供一定参考。方法建立电感耦合等离子体质谱(ICP-MS)法同时分析石膏-知母药对中K、Ti、Sr、Ba、Ca、Mg 6种无机元素含量,并用灰色关联度法和TOPSIS综合分析,与不同比例知母配伍前后,石膏中6种无机元素溶出的变化。结果ICP-MS法测定石膏-知母药对中无机元素的线性、精密度、重复性和稳定性试验结果良好,平均加样回收率为81.78%~104.13%,RSD为2.10%~4.62%(n=6)。与不同比例知母配伍后石膏中6种无机元素的溶出均显著高于石膏单煎(P<0.05),石膏-知母30∶9配伍比例时石膏中6种无机元素溶出得分最高。结论ICP-MS法灵敏度高、准确性好,可用于石膏-知母药对中K、Ti、Sr、Ba、Ca、Mg等6种无机元素的溶出量测定。石膏-知母最佳配伍比例为30∶9时,可有效提高石膏中6种无机元素的溶出,为两者进一步的配伍研究提供依据。

Glucocorticoid-induced thrombotic microangiopathy in paroxysmal nocturnal hemoglobinuria:A case report and review of literature

BACKGROUND Thrombotic microangiopathy(TMA)is a group of disorders that converge on excessive platelet aggregation in the microvasculature,leading to consumptive thrombocytopenia,microangiopathic hemolysis and ischemic end-organ dysfunction.In predisposed patients,TMA can be triggered by many environmental factors.Glucocorticoids(GCs)can compromise the vascular endothelium.However,GC-associated TMA has rarely been reported,which may be due to the lack of awareness of clinicians.Given the high frequency of thrombocytopenia during GC treatment,particular attention should be given to this potentially fatal complication.CASE SUMMARY An elderly Chinese man had a 12-year history of aplastic anemia(AA)and a 3-year history of paroxysmal nocturnal hemoglobinuria(PNH).Three months earlier,methylprednisolone treatment was initiated at 8 mg/d and increased to 20 mg/d to alleviate complement-mediated hemolysis.Following GC treatment,his platelet counts and hemoglobin levels rapidly decreased.After admission to our hospital,the dose of methylprednisolone was increased to 60 mg/d in an attempt to enhance the suppressive effect.However,increasing the GC dose did not alleviate hemolysis,and his cytopenia worsened.Morphological evaluation of the marrow smears revealed increased cellularity with an increased percentage of erythroid progenitors without evident dysplasia.Cluster of differentiation(CD)55 and CD59 expression was significantly decreased on erythrocytes and granulocytes.In the following days,platelet transfusion was required due to severe thrombocytopenia.Observation of platelet transfusion refractoriness indicated that the exacerbated cytopenia may have been caused by the development of TMA due to GC treatment because the transfused platelet concentrates had no defects in glycosylphosphatidylinositol-anchored proteins.We examined blood smears and found a small number of schistocytes,dacryocytes,acanthocytes and target cells.Discontinuation of GC treatment resulted in rapidly increased platelet counts and steady increases in hemoglobin levels.The patient’s platelet counts and hemoglobin levels returned to the levels prior to GC treatment 4 weeks after GC discontinuation.CONCLUSION GCs can drive TMA episodes.When thrombocytopenia occurs during GC treatment,TMA should be considered,and GCs should be discontinued.

Tuberculosis-induced aplastic crisis and atypical lymphocyte expansion in advanced myelodysplastic syndrome:A case report and review of literature

BACKGROUND Myelodysplastic syndrome(MDS)is caused by malignant proliferation and ineffective hematopoiesis.Oncogenic somatic mutations and increased apoptosis,necroptosis and pyroptosis lead to the accumulation of earlier hematopoietic progenitors and impaired productivity of mature blood cells.An increased percentage of myeloblasts and the presence of unfavorable somatic mutations are signs of leukemic hematopoiesis and indicators of entrance into an advanced stage.Bone marrow cellularity and myeloblasts usually increase with disease progression.However,aplastic crisis occasionally occurs in advanced MDS.CASE SUMMARY A 72-year-old male patient was definitively diagnosed with MDS with excess blasts-1(MDS-EB-1)based on an increase in the percentages of myeloblasts and cluster of differentiation(CD)34+hematopoietic progenitors and the identification of myeloid neoplasm-associated somatic mutations in bone marrow samples.The patient was treated with hypomethylation therapy and was able to maintain a steady disease state for 2 years.In the treatment process,the advanced MDS patient experienced an episode of progressive pancytopenia and bone marrow aplasia.During the aplastic crisis,the bone marrow was infiltrated with sparsely distributed atypical lymphocytes.Surprisingly,the leukemic cells disappeared.Immunological analysis revealed that the atypical lymphocytes expressed a high frequency of CD3,CD5,CD8,CD16,CD56 and CD57,suggesting the activation of autoimmune cytotoxic T-lymphocytes and natural killer(NK)/NKT cells that suppressed both normal and leukemic hematopoiesis.Elevated serum levels of inflammatory cytokines,including interleukin(IL)-6,interferon-gamma(IFN-γ)and tumor necrosis factor-alpha(TNF-α),confirmed the deranged type I immune responses.This morphological and immunological signature led to the diagnosis of severe aplastic anemia secondary to large granule lymphocyte leukemia.Disseminated tuberculosis was suspected upon radiological examinations in the search for an inflammatory niche.Antituberculosis treatment led to reversion of the aplastic crisis,disappearance of the atypical lymphocytes,increased marrow cellularity and 2 mo of hematological remission,providing strong evidence that disseminated tuberculosis was responsible for the development of the aplastic crisis,the regression of leukemic cells and the activation of CD56+atypical lymphocytes.Reinstitution of hypomethylation therapy in the following 19 mo allowed the patient to maintain a steady disease state.However,the patient transformed the disease phenotype into acute myeloid leukemia and eventually died of disease progression and an overwhelming infectious episode.CONCLUSION Disseminated tuberculosis can induce CD56+lymphocyte infiltration in the bone marrow and in turn suppress both normal and leukemic hematopoiesis,resulting in the development of aplastic crisis and leukemic cell regression.

Leukemic transformation during anti-tuberculosis treatment in aplastic anemia-paroxysmal nocturnal hemoglobinuria syndrome:A case report and review of literature

BACKGROUND Accumulating evidence demonstrates that autoimmune hematopoietic failure and myeloid neoplasms have an intrinsic relationship with regard to clonal hematopoiesis and disease evolution.In approximately 10%-15%of patients with severe aplastic anemia(SAA),the disease phenotype is transformed into myeloid neoplasms following antithymocyte globulin plus cyclosporine-based immunosuppressive therapy.In some of these patients,myeloid neoplasms appear during or shortly after immunosuppressive therapy.Leukemic transformation in SAA patients during anti-tuberculosis treatment has not been reported.CASE SUMMARY A middle-aged Chinese female had a 6-year history of non-SAA and a 2-year history of paroxysmal nocturnal hemoglobinuria(PNH).With aggravation of systemic inflammatory symptoms,severe pancytopenia developed,and her hemoglobinuria disappeared.Laboratory findings in cytological,immunological and cytogenetic analyses of bone marrow samples met the diagnostic criteria for“SAA.”Definitive diagnosis of disseminated tuberculosis was made in the search for infectious niches.Remarkable improvement in hematological parameters was achieved within 1 mo of anti-tuberculosis treatment,and complete hematological remission was achieved within 4 mo of treatment.Frustratingly,the hematological response lasted for only 3 mo,and pancytopenia reemerged.At this time,cytological findings(increased bone marrow cellularity and an increased percentage of myeloblasts that accounted for 16.0%of all nucleated hematopoietic cells),immunological findings(increased percentage of cluster of differentiation 34+cells that accounted for 12.28%of all nucleated hematopoietic cells)and molecular biological findings(identification of somatic mutations in nucleophosmin-1 and casitas B-lineage lymphoma genes)revealed that“SAA”had transformed into acute myeloid leukemia with mutated nucleophosmin-1.The transformation process suggested that the leukemic clones were preexistent but were suppressed in the PNH and SAA stages,as development of symptomatic myeloid neoplasm through acquisition and accumulation of novel oncogenic mutations is unlikely in an interval of only 7 mo.Aggravation of inflammatory stressors due to disseminated tuberculosis likely contributed to the repression of normal and leukemic hematopoiesis,and the relief of inflammatory stressors due to anti-tuberculosis treatment contributed to penetration of neoplastic hematopoiesis.The concealed leukemic clones in the SAA and PNH stages raise the possibility of an inflammatory stress-fueled antileukemic mechanism.CONCLUSION Aggravated inflammatory stressors can repress normal and leukemic hematopoiesis,and relieved inflammatory stressors can facilitate penetration of neoplastic hematopoiesis.

Flared inflammatory episode transforms advanced myelodysplastic syndrome into aplastic pancytopenia:A case report and literature review

BACKGROUND Myelodysplastic syndrome(MDS)is a hematological neoplasm,and an increase in myeloblasts is representative of leukemic hematopoiesis in advanced MDS.Lowrisk MDS usually exhibits deranged autoimmunity resembling that of aplastic anemia(AA),whereas advanced MDS is characterized by a phenotype of immune exhaustion.MDS can be normo/hyperplastic or hypoplastic.Generally,bone marrow cellularity and myeloblasts increase with disease progression.Transformation from advanced MDS to AA-like syndrome with leukemic cell regression has not previously been reported.CASE SUMMARY A middle-aged Chinese woman had a 4-year history of leukocytopenia.Six months prior to admission,the patient developed gradually worsening fatigue and performance status.The leukocytopenia further progressed.She was diagnosed with MDS with excess blasts-2 based on increased bone marrow cellularity and an increased percentage of myeloblasts on marrow and blood smears,an increased percentage of cluster of differentiation(CD)34+CD33+progenitors in immunotyping analysis,a normal karyotype in cytogenetic analysis,and the identification of somatic mutations in CBL,KMT2D and NF1 in molecular analysis.Initially,neutropenia was the predominant hematological abnormality,with mild anemia and thrombocytosis,and the degree of fatigue was far more severe than the degree of anemia.In the following months,the patient experienced several febrile episodes.Intravenous antibiotic treatments were able to control the febrile episodes,but the elevated inflammatory indices persisted.The hematological parameters dramatically fluctuated with the waxing and waning of the inflammatory episodes.With recurrent flares of the inflammatory condition,agranulocytosis and severe anemia developed,with mild thrombocytopenia.During the patient’s hospitalization,computed tomography(CT)scans revealed the presence of extensive inflammatory lesions involving the lungs,mediastinum,pleura,gastrointestinal tract,peritoneum and urinary tract,with imaging features suggestive of the reactivation of disseminated tuberculosis.Reevaluation of the bone marrow smears revealed that the cellularity became hypoplastic,and the leukemic cells regressed,suggesting that both normal and leukemic hematopoiesis had been heavily suppressed.Immunological analysis of the bone marrow samples revealed a decreased percentage of CD34+cells and an immunological signature resembling that of severe AA(SAA),confirming the regression of the leukemic cells by autoimmune-mediated attacks.The patient demonstrated resistance to multiple drugs,including antituberculotics,recombinant human granulocyte colony-stimulating factor,broad-spectrum antibiotics,voriconazole,ganciclovir,immune suppressants,eltrombopag and intravenous immunoglobulin,which further worsened the hematological injury and patient’s performance status.The patient eventually died of overwhelming infection and multidrug resistance.CONCLUSION Advanced MDS can transform to aplastic cytopenia with leukemic cell regression and an immunological signature of SAA during inflammatory flare-ups.

Free vibration analysis of a spinning piezoelectric beam with geometric nonlinearities

The linear and non-linear free vibrations of a spinning piezoelectric beam are studied by considering geometric nonlinearities and electromechanical coupling effect. The non-linear differential equations of the spinning piezoelectric beam governing two transverse vibrations are derived by using two Euler angles transformation and extended Hamilton principle, wherein an additional piezoelectric coupling term and different linear terms are present in contrast to the traditional shaft model. Linear frequencies are obtained by solving the standard eigenvalues of the linearized system directly, and the non-linear frequencies and non-linear complex modes are achieved by using the method of multiple scales. For free vibrations analysis of a spinning piezoelectric beam, the non-linear modal motions are investigated as forward and backward precession with different spinning speeds. The responses to the initial conditions for such a gyroscopic system are studied,and a beat phenomenon is found, which are then validated by numerical simulation. The influences of some parameters such as electrical resistance, rotary inertia and spinning speeds to the non-linear dynamics of a spinning piezoelectric beam are investigated.

Hierarchically mesoporous carbon spheres coated with a single atomic Fe-N-C layer for balancing activity and mass transfer in fuel cells

Novel cost-effective fuel cells have become more attractive due to the demands for rare and expensive platinum-group metal(PGM)catalysts for mitigating the sluggish kinetics of the oxygen reduction reaction(ORR).The high-cost PGM catalyst in fuel cells can be replaced by earth-abundant transition-metalbased catalysts,that is,an Fe-N-C catalyst,which is considered one of the most promising alternatives.However,the performance of the Fe-N-C catalyst is hindered by the low catalytic activity and poor stability,which is caused by insufficient active sites and the lack of optimization of the triple-phase interface for mass transportation.Herein,a novel Fe–N–C catalyst consisting of mono-dispersed hierarchically mesoporous carbon sphere cores and single Fe atom-dispersed functional shells are presented.The synergistic effect between highly dispersed Fe-active sites and well-organized porous structures yields the combination of high ORR activity and high mass transfer performance.The half-wave potential of the catalyst in 0.1M H_(2)SO_(4) is 0.82 V versus reversible hydrogen electrode,and the peak power density is 812 mW·cm^(−2) in H_(2)–O_(2) fuel cells.Furthermore,it shows superior methanol tolerance,which is almost immune to methanol poisoning and generates up to 162 mW·cm^(−2) power density in direct methanol fuel cells.

Design of an efficient collector for the HIAF electron cooling system

A collector with high perveance,efficient recu-peration,and low secondary emissions is required for the 450-keV electron cooler in the HIAF accelerator complex.To optimize the collection efficiency of the collector,a simulation program,based on the Monte Carlo simulations,was developed in the world’s first attempt to calculate the electron collection efficiency.In this program,the backscattering electrons and secondary electrons generated on the collector surface are calculated using a Monte Carlo approach,and all electron trajectories in the collector region are tracked by the Runge–Kutta method.In this paper,the features and structure of our program are described.The backscattering electron yields,with various collector surface materials,are calculated using our pro-gram.Moreover,the collector efficiencies for various col-lector structures and electromagnetic fields are simulated and optimized.The measurement results of the collection efficiency of the HIAF collector prototype and the CSRm synchrotron are also reported.These experimental results were in good agreement with the simulation results of our program.

SMAC exhibits anti-tumor effects in ECA109 cells by regulating expression of inhibitor of apoptosis protein family

BACKGROUND The poor prognosis and rising incidence of esophageal cancer highlight the need for improved therapeutics that are essential prior to treatment.LCL161 is an SMAC(second mitochondrial activator of caspases)mimic and inhibitor of apoptosis protein(IAP)antagonist which exhibits anti-tumor effects and improves the chemical sensitivity of many cancers.AIM To ascertain the effects and mechanisms of the SMAC analog LCL161 on esophageal cancer cells.METHODS MTT assay and TUNEL assay were used to detect cell proliferation and apoptosis,respectively.Western blot analysis was used to study the molecular mechanisms of LCL161-induced death of ECA109 cells.RESULTS LCL161 decreased ECA109 cell proliferation in dose-and time-dependent manner and induced apoptosis of ECA109 cells in a dose-dependent manner.Also,LCL161 induced a significant decrease in the expression of the XIAP and significant increase in the expression of Caspase-3.In addition,Bax increased significantly with increasing concentrations of LCL161,and the relative expression of Bax was significantly different between groups.CONCLUSION These findings support the hypothesis that LCL161 can inhibit proliferation and induce apoptosis in esophageal cancer cells by regulating the expression of IAP family members,suggesting that it has potential to be an effective treatment for esophageal squamous cell carcinoma.

Clinical features of multiple gastrointestinal stromal tumors:A pooling analysis combined with evidence and gap map

BACKGROUND Multiple gastrointestinal stromal tumors(MGISTs)are a very rare type of gastrointestinal stromal tumor(GIST)and are usually observed in syndrome.AIM The paper aimed to describe the clinical and oncological features of MGISTs and to offer evidence for the diagnosis and treatment.METHODS Data of consecutive patients with MGISTs who were diagnosed at Peking University People’s Hospital(PKUPH)from 2008 to 2019 were retrospectively evaluated.Further,a literature search was conducted by retrieving data from PubMed,EMBASE,and the Cochrane library databases from inception up to November 30,2019.RESULTS In all,12 patients were diagnosed with MGISTs at PKUPH,and 43 published records were ultimately included following the literature review.Combined analysis of the whole individual patient data showed that female(59.30%),young(14.45%),and syndromic GIST(63.95%)patients comprised a large proportion of the total patient population.Tumors were mainly located in the small intestine(58.92%),and both CD117 and CD34 were generally positive.After a mean 78.32-mo follow-up,the estimated median overall survival duration(11.5 years)was similar to single GISTs,but recurrence-free survival was relatively poorer.CONCLUSION The clinical and oncological features are potentially different between MGISTs and single GIST.Further studies are needed to explore appropriate surgical approach and adjuvant therapy.

Parametric resonance orbit analysis for irregular shaped asteroids based on the perturbed particle-linkage model

There are plentiful asteroids moving periodically around their central primaries, such as the Sun. Due to the perturbation of the central primary, the gravitational force of the perturbed asteroid system varies periodically. In this paper, based on the idea of integrating the solar gravitational force as a part of the system instead of treating it as perturbation, the parametric resonance response is investigated. A novel type of stable parametric resonance orbits has been detected. It is found that the steady-state motion amplitude of parametric resonance orbit is determined by the frequency-response equation. The stability of the novel orbits has also been demonstrated. The new type of orbits may contribute to possible asteroid exploration missions.

Parameter Estimation of Linear Frequency Modulated Signals Based on Holder Coefficient

The current parameter estimation algorithms of chirp rate have high complexity and long calculation time,meantime they are difficult to achieve high estimation rate. Therefore,in order to overcome these problems,in this paper,a new parameter estimation algorithm based on Holder coefficient is presented. Firstly,this algorithm calculates the correlation curve of the Holder coefficient value under different chirp rate. Secondly,this algorithm calculates the correlation curve under different SNR. Finally,the fitting curve expression can be got by the correlation curve,and then the estimation value of chirp rate can also be got. The theory analysis and simulation results show that this algorithm is simple and easy to realize,and has much better application value for real-time estimation.

Role of non-coding RNAs in pancreatic cancer: The bane of the microworld

Our understanding of the mechanisms underlying the development of pancreatic cancer has been greatly advanced. However, the molecular events involved in the initiation and development of pancreatic cancer remain inscrutable. None of the present medical technologies have been proven to be effective in significantly improving early detection or reducing the mortality/morbidity of this disease. Thus, a better understanding of the molecular basis of pancreatic cancer is required for the identification of more effective diagnostic markers and therapeutic targets. Non-coding RNAs (ncRNAs), generally including microRNAs and long non-coding RNAs, have recently been found to be deregulated in many human cancers, which provides new opportunities for identifying both functional drivers and specific biomarkers of pancreatic cancer. In this article, we review the existing literature in the field documenting the significance of aberrantly expressed and functional ncRNAs in human pancreatic cancer, and discuss how oncogenic ncRNAs may be involved in the genetic and epigenetic networks regulating functional pathways that are deregulated in this malignancy, particularly of the ncRNAs&#x02019; role in drug resistance and epithelial-mesenchymal transition biological phenotype, with the aim of analyzing the feasibility of clinical application of ncRNAs in the diagnosis and treatment of pancreatic cancer.

Expression of granulocyte colony-stimulating factor receptor in rectal cancer

AIM: To evaluate whether granulocyte colony-stimulating factor receptor (G-CSFR) expression before preoperative irradiation can predict the radiosensitivity of rectal cancer.

Antibiotic and glucocorticoid-induced recapitulated hematological remission in acute myeloid leukemia:A case report and review of literature

BACKGROUND Leukemic hematopoietic cells acquire enhanced self-renewal capacity and impaired differentiation.The emergence of symptomatic leukemia also requires the acquisition of a clonal proliferative advantage.Untreated leukemia patients usually experience an aggressive process.However,spontaneous remission occasionally occurs in patients with acute myeloid leukemia(AML),most frequently after recovery from a febrile episode,and this is generally attributed to the triggering of antineoplastic immunity.There may be another explanation for the spontaneous remission as implicated in this paper.CASE SUMMARY A 63-year-old Chinese man presented with high fever,abdominal pain and urticaria-like skin lesions.He was diagnosed with AML-M4 with t(8;21)(q22;q22)/RUNX1-RUNX1T1 based on morphological,immunological,cytogenetic and molecular analyses.He had a complex chromosome rearrangement of 48,XY,t(8;21)(q22;q22),+13,+13[9]/49,idem,+mar[9]/49,idem,+8[2].He also had a mutated tyrosine kinase domain in fms-like tyrosine kinase 3 gene.He was treated with antibiotics and glucocorticoids for gastrointestinal infection and urticaria-like skin lesions.The infection and skin lesions were quickly resolved.Unexpectedly,he achieved hematological remission along with resolution of the febrile episode,gastrointestinal symptoms and skin lesions.Notably,after relapse,repeating these treatments resulted in a return to hematological remission.Unfortunately,he demonstrated strong resistance to antibiotic and glucocorticoid treatment after the second relapse and died of sepsis from bacterial infection with multidrug resistance.The main clinical feature of this patient was that symptomatic AML emerged with flaring of the gut inflammatory disorder and it subsided after resolution of the inflammation.Learning from the present case raises the possibility that in a subgroup of AML patients,the proliferative advantage of leukemia cells may critically require the presence of inflammatory stresses.CONCLUSION Inflammatory stresses,most likely arising from gastrointestinal infection,may sustain the growth and survival advantage of leukemic cells.

Linear,nonlinear dynamics,and sensitivity analysis of a vibratory ring gyroscope

The linear and nonlinear dynamic responses of a vibratory ring gyroscope are investigated in this study focusing on the response mechanism of such a vibratory gyroscope. It is found that the nonlinear equations governing the drive and sense directions are coupled through both inertial linear and geometric nonlinear terms. Nonlinear responses are studied based on the full coupled nonlinear dynamic equations. The varying amplitude on the sense direction is analyzed for different input angular rates. The effect of nonlinearity on the ring gyroscope system is performed by comparing the results of nonlinear responses to those of linear responses. The contributions of some parameters to the amplitude responses and gyroscope sensitivity are analyzed, the conclusions of which provide guidelines to improve the sensitivity of the vibratory ring gyroscopes.

Tumor-like disorder of the brachial plexus region in a patient with hemophilia:A case report

BACKGROUND Various tumors and tumor-like disorders,originating from the neural sheath,as well as other types,may affect the brachial plexus region.Due to the infrequent presentation,brachial plexus palsy caused by spontaneous hematoma in patients with hemophilia might miss the treatment by early surgical decompression and progress to permanent nerve damage.CASE SUMMARY The case reported here was a 30-year-old man with hemophilia,as well as both sensory and motor dysfunction of the left upper extremity.A presumptive diagnosis of brachial plexus tumor was initially made,which was subsequently confirmed to be an organized chronic hematoma rather than a neoplasm.The hemophilia-induced expanding hematoma compressing the brachial plexus was considered to be the main reason for the patient’s complaints.The clinical symptoms were alleviated and the involved nerves partially recovered at a follow-up of 1 year.CONCLUSION Early surgical intervention is crucial and it seems to be an essential precondition for recovery of nerve function in brachial plexus lesions.

Oxidative dearomatic approach towards the synthesis of erythrina skeleton:a formal synthesis of demethoxyerythratidinone

A concise synthetic route leading to highly functional erythrina alkaloid skeletons has been developed.The key process is an oxidative carbon-carbon coupling followed by a conjugated addition.Based on this new strategy,a formal synthesis of demethoxyerythratidinone was completed in only 6 steps from 4-aminophenol.