Diagnosis and treatment of autoimmune pancreatitis: experience with 100 patients

BACKGROUND： Autoimmune pancreatitis （ALP） is increasingly recognized as a unique subtype of pancreatitis. This study aimed to analyze the diagnosis and treatment of AIP patients from a tertiary care center in China. METHODS： One hundred patients with AIP who had been treated from January 2005 to December 2012 in our hospital were enrolled in this study. We retrospectively reviewed the data of clinical manifestations, laboratory tests, imaging examinations, pathological examinations, treatment and outcomes of the patients. RESULTS： The median age of the patients at onset was 57 years （range 23-82） with a male to female ratio of 8.1：1. The common manifestations of the patients included obstructive jaundice （49 patients, 49.0%）, abdominal pain （30, 30.0%）, and acute pancreatitis （11, 11.0%）. Biliary involvement was one of the most extrapancreatic manifestations （64, 64.0%）. Fifty-six （56.0%） and 43 （43.0%） patients were classified into focal- type and diffuse-type respectively according to the imaging examinations. The levels of serum IgG and IgG4 were elevated in 69.4% （43/62） and 92.0% （69/75） patients. Pathological analysis of specimens from 27 patients supported the diagnosis of lymphoplasmacytic sclerosing pancreatitis, and marked （〉10 ceUs/HPF） IgG4 positive cells were found in 20 （74.1%） patients.Steroid treatment and surgery as the main initial treatments were given to 41 （41.0%） and 28 （28.0%） patients, respectively. The remission rate after the initial treatment was 85.0%. Steroid was given as the treatment after relapse in most of the patients and the total remission rate at the end of follow-up was 96.0%. CONCLUSIONS： Clinical manifestations, laboratory tests, imaging and pathology examinations in combination could increase the diagnostic accuracy of AIP. Steroid treatment with an initial dose of 30 or 40 mg prednisone is effective and safe in most patients with AIP.

Prevalence of Enterococcus faecalis in saliva and filled root canals of teeth associated with apical periodontitis

To investigate the prevalence of Enterococcus faecalis in saliva and filled root canals of patients requiring endodontic retreatment for apical periodontitis.Patients with apical periodontitis who were referred for endodontic retreatment were examined.The type and quality of the restoration,symptoms,quality of obturation were recorded.During retreatment,an oral rinse sample and root canal sample were cultured using brain-heart infusion agar and bile esculinazide agar to select for E.faecalis.The 16S rRNA technique was used to identify E.faecalis.A total of 32 women and 22 men（mean age：38 years;s.d.：11 years） and 58 teeth were studied.The prevalence of E.faecalis was 19% in the saliva and 38% in the root canals.The odds that root canals harbored E.faecalis were increased if the saliva habored this bacterium（odds ratio59.7;95% confidence interval51.8-51.6;P,0.05）.Teeth with unsatisfactory root obturation had more cultivable bacterial species in root canals than teeth with satisfactory root obturation（P,0.05）.E.faecalis is more common in root canals of teeth with apical periodontitis than in saliva.The prevalence of E.faecalis in root canals is associated with the presence of E.faecalis in saliva.

Nomogram for prediction of fatal outcome in patients with severe COVID-19:a multicenter study

Background:To develop an effective model of predicting fatal outcomes in the severe coronavirus disease 2019(COVID-19)patients.Methods:Between February 20,2020 and April 4,2020,consecutive confirmed 2541 COVID-19 patients from three designated hospitals were enrolled in this study.All patients received chest computed tomography(CT)and serological examinations at admission.Laboratory tests included routine blood tests,liver function,renal function,coagulation profile,C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),and arterial blood gas.The SaO2 was measured using pulse oxygen saturation in room air at resting status.Independent high-risk factors associated with death were analyzed using Cox proportional hazard model.A prognostic nomogram was constructed to predict the survival of severe COVID-19 patients.Results:There were 124 severe patients in the training cohort,and there were 71 and 76 severe patients in the two independent validation cohorts,respectively.Multivariate Cox analysis indicated that age≥70 years(HR=1.184,95%CI 1.061–1.321),panting(breathing rate≥30/min)(HR=3.300,95%CI 2.509–6.286),lymphocyte count<1.0×109/L(HR=2.283,95%CI 1.779–3.267),and interleukin-6(IL-6)>10pg/ml(HR=3.029,95%CI 1.567–7.116)were independent high-risk factors associated with fatal outcome.We developed the nomogram for identifying survival of severe COVID-19 patients in the training cohort(AUC=0.900,95%CI 0.841–0.960,sensitivity 95.5%,specificity 77.5%);in validation cohort 1(AUC=0.811,95%CI 0.763–0.961,sensitivity 77.3%,specificity 73.5%);in validation cohort 2(AUC=0.862,95%CI 0.698–0.924,sensitivity 92.9%,specificity 64.5%).The calibration curve for probability of death indicated a good consistence between prediction by the nomogram and the actual observation.The prognosis of severe COVID-19 patients with high levels of IL-6 receiving tocilizumab were better than that of those patients without tocilizumab both in the training and validation cohorts,but without difference(P=0.105 for training cohort,P=0.133 for validation cohort 1,and P=0.210 for validation cohort 2).Conclusions:This nomogram could help clinicians to identify severe patients who have high risk of death,and to develop more appropriate treatment strategies to reduce the mortality of severe patients.Tocilizumab may improve the prognosis of severe COVID-19 patients with high levels of IL-6.

Microstructure Evolution and Tensile Properties of the Alx(CoCrNi)100-x Medium-Entropy Alloys

A series of Alx(CoCrNi)100-x(x=0-21 at.%)medium-entropy alloys(MEAs)were designed and prepared to investigate the effects of Al addition on the microstructures and tensile properties.The results reveal that the lattice structure changes from the initial single FCC structure(x<10 at.%),to the FCC and disordered BCC structures(x=10 and 11 at.%),then to the FCC and BCC/B2 structures(11<x<21 at.%),finally to the duplex BCC/B2 structures(x≥21 at.%)with increasing Al addition.Consistent with microstructures,significant changes also occur in the corresponding tensile properties with Al addition,showing that the strength increases and the ductility decreases with increasing Al addition.Especially,the Al-15 MEA exhibits an acceptable balance of strength and ductility.Furthermore,the mechanism of microstructure evolution and the correlation between microstructures and tensile properties were also discussed and clarified.

New Staging Model for Radiation-based Hepatocellular Carcinoma Treatment:A National Multicenter Study

Background and Aims:The study aimed to create a new staging model for radiotherapy-based treatment for prognostic hepatocellular carcinoma(HCC)classification.Methods:The training cohort comprised 658 patients receiving stereotactic body radiotherapy and external validation cohort comprised 533 patients receiving three-dimensional conformal radiotherapy and intensity-modulated radiotherapy.We established a modified staging system as follows:stage I,solitary nodule without macrovascular invasion,or 2–3 nodules no more than 3.0 cm apart,and performance status(PS)0–2(Ia:ALBI-1 grade;Ib:ALBI-2 or 3 grade);stage II:2–3 nodules with any one nodule more than 3.0-cm apart,or≥4 nodules,and performance status 0–2(IIa:ALBI-1 grade;IIb:ALBI-2 grade);stage III:macrovascular invasion,regional lymph node metastasis or distant metastasis,and performance status 0–2(IIIa:ALBI-1 grade;IIIb:ALBI-2 grade);stage IV:performance status 3–4,or performance status 0–2 with ALBI-3 grade.We analyzed longterm overall survival based on different stages.Results:The staging model showed an excellent ability to discriminate patients according to four stages and seven substages with notably different curves in the training and validation cohort.The median survival decreased from stages I to IV with 63.0 months in stage I(not reached in Ia,and 53.0 months in Ib),24.0 months in stage II(28.0 months in IIa,and 22.0 months in IIb),11.0 months in stage III(18.0 months in IIIa,and 9.0 months in IIIb),and less than 9.0 months in stage IV in the training cohort.Conclusions:The modified staging model may provide an alternative for clinical radiation oncologists.

基于用户情感倾向感知的微博情感分析方法

微博言论往往带有强烈的情感色彩,对微博言论的情感分析是获取用户观点态度的重要方法。许多学者都是将研究的重点集中在句子词性、情感符号以及情感语料库等方面,然而用户自身的情感倾向性并没有受到足够的重视,因此,提出了一种新的微博情感分类方法,其通过建模用户自身的情感标志得分来帮助识别语句的情感特征,具体地讲,将带有情感信息的微博语句词向量序列输入到长短期记忆网络(LSTM),并将LSTM输出的特征表示与用户情感得分进行结合作为全连接层的输入,并通过Softmax层实现了对微博文本的情感极性分类。实验表明,提出的方法UA-LSTM在情感分类任务上的表现超过的所有基准方法,并且比最优的基准方法MF-CNN在F1值上提升了3.4%,达到0.91。

近红外发光的稀土分子探针在生物成像中的设计及应用

近红外生物成像是一种实时监测各种生理和病理过程、实现生物实体可视化的前沿技术,具有背景干扰少、时空分辨率高、组织穿透能力强等优点,在临床成像研究和应用方面具有巨大潜力,受到日益广泛的关注.其中,近红外发光分子探针的设计、性质及应用至关重要,已经成为决定近红外生物成像领域发展的关键因素.稀土配合物具有小尺寸、低毒性、长寿命、大Stokes位移、抗光漂白、独特的线状发射光谱(元素特征的f-f跃迁)等优点,成为新兴的近红外发光探针,展现出极好的生物医学应用前景.本文综述了近红外稀土分子探针的设计原理和研究进展,结合近年来其在生物医学方面的应用,展望了其发展的方向和趋势以及对稀土化学生物学发展的推动作用.

Electroanalytical method for determination of shikonin based on the enhancement effect of cyclodextrin functionalized carbon nanotubes

A simple and sensitive electroanalytical method for determination of shikonin, a widely used antitumoral agent, using β-cyclodextrin-functionalized multiwalled carbon nanotubes composite modified glassy carbon electrodes （MWCNTs/β-CD/GCE） was presented. CDs are water-soluble and environmentally friendly and can improve the dispersibility of MWCNTs/βCD functional materials, which was confirmed by SEM. The electrochemical behaviors of shikonin on different electrodes were investigated by cyclic voltammetry （CV） and differential pulse voltammograms （DPVs）. The results demonstrated that the redox peak currents of shikonin obtained at MWCNTs/fl-CD/GCE were much higher than those at the βCD/GCE and MWCNTs/GCE, which can be attributed to the combination of the excellent electrocatalytic properties of MWCNTs and the molecular recognition ability of βCD. At MWCNTs/ βCD/GCE, the response current exhibits a linear range from 5.0 nmol/L to 10.0 μmol/L with a detection limit of 1.0nmol/L （S/N=3）. As a practical application, the proposed method was applied to quantitatively determine shikoninin urine samples with satisfying results.

Emphysematous Pyelonephritis Treated with Vacuum Sealing Drainage

Emphysematous pyelonephritis （EPN） is a rare infectious disease, of which risk factors are poorly controlled diabetes mellitus, immunosuppression, and urinary tract obstruction. In comparison with simple pyelonephritis, EPN is an acute severe necrotizing and gas-forming infection of the renal parenchyma with a mortality rate of up to 25%. Among the reported cases of EPN, there has only been one report of the disease where the ＂invisible kidney＂ was detected in the lung windows on noneontrast abdominal computed tomography （CT）. This rare case was treated with vacuum sealing drainage （VSD, Weigao Holding, China） and recovered quickly.

Synthesis and Characterization of D-/L-methionine Grafted PEDOTs for Selective Recognition of 3,4-Dihydroxyphenylalanine Enantiomers

Two pairs of amino-acid functionalized poly（3,4-ethylenedioxythiophene）（PEDOT） derivatives, namely, poly（N-（tert-butoxycarbonyl）-L-methionyl（3,4-ethylenedioxythiophene-2＇-yl）methylamide）（L-PEDOT-Boc-Met） and poly（N-（tertbutoxycarbonyl）-D-methionyl（3,4-ethylenedioxythiophene-2＇-yl）methylamide）（D-PEDOT-Boc-Met）; poly（L-methionyl（3,4-ethylenedioxythiophene-2＇-yl）methylamide）（L-PEDOT-Met） and poly（D-methionyl（3,4-ethylenedioxythiophene-2＇-yl）methylamide）（D-PEDOT-Met） were synthesized via chemical oxidative polymerization of corresponding monomers. The structural characterization, spectroscopic properties and thermal stability of these monomers and polymers were systematically explored by FTIR spectra, Raman spectra, XRD spectra, UV-Vis spectra and thermogravimetric analysis. As chiral electrode materials, these polymers were employed to successfully recognize 3,4-dihydroxyphenylalanine（DOPA） enantiomers by cyclic voltammetry（CV） in sulphuric acid solution. The measurement results reveal that the tendency was hetero-chiral interaction between L-PEDOT-Met/PVA/GCE and D-DOPA, D-PEDOT-Met/PVA/GCE and L-DOPA, respectively. Also, the mechanism of chiral discrimination was discussed. All the results implied that the combination of electrochemical molecular recognition technology and chiral PEDOT materials can be a promising approach for chiral recognition and may open new opportunities for facile, biocompatible, sensitive and robust chiral assays in biochemical applications.

Electrosynthesis and Characterization of Aminomethyl Functionalized PEDOT with Electrochromic Property

We herein report the electrosynthesis of an aminomethyl functionalized poly（3,4-ethylenedioxythiophene）（PEDOT） derivative, poly（2＇-aminomethyl-3,4-ethylenedioxythiophene）（PEDOT-Me NH2）, in CH2Cl2-Bu4NPF6（0.1 mol·L^-1） system containing 2% boron trifluoride diethyl etherate（BFEE）. The electrochemical behavior, structure characterization, thermal properties and surface morphology of this novel polymer were systematically investigated by cyclic voltammetry（CV）, Fourier-transform infrared spectroscopy（FTIR）, thermogravimetry（TG） and scanning electron microscopy（SEM）, respectively. Electrochemistry results demonstrated that PEDOT-Me NH2 film displayed good redox properties and high electrochemical stability. Besides, PEDOT-Me NH2 films exhibited the electrochromic nature with obvious color changing from purple in the reduced form to blue upon oxidation. By further investigation, kinetic studies revealed that PEDOT-Me NH2 film had decent contrast ratio（41.8%）, favorable coloration efficiency（152.1 cm^2·C^-1）, low switching voltages and moderate response time（2.4 s）. Satisfactory results implied that the obtained PEDOT-Me NH2 film is a promising optoelectronic material and holds promise for electrochromic devices and display applications.