Intestinal tuberculosis with small bowel stricture and hemorrhage as the predominant manifestation: Three case reports

BACKGROUND Intestinal tuberculosis is a chronic disease caused by Mycobacterium tuberculosis that mainly affects the ileum and cecum.Small bowel tuberculosis,characterized by predominant involvement of the small intestine,is an extremely rare condition with highly atypical clinical presentations,making diagnosis even more challenging.CASE SUMMARY We report three cases of small intestinal tuberculosis,two of the patients pre-sented primarily with abdominal pain,and one presented with gastrointestinal bleeding.All patients underwent blood tests and imaging examinations.Small bowel endoscopy(SBE)revealed that the main lesions in these patients were in-testinal stenosis or gastrointestinal bleeding caused by small intestinal ulcers.One patient ultimately underwent surgical treatment.Following a complex diagnostic process and comprehensive analysis,all patients were confirmed to have small intestinal tuberculosis and received standard antituberculosis treatment,leading to an improvement in their condition.CONCLUSION Patients with SBTs present with nonspecific symptoms such as abdominal pain,weight loss,and occasional gastrointestinal bleeding.Accurate diagnosis requires a thorough evaluation of clinical symptoms and various tests to avoid misdiagno-sis and complications.

Targeting metabolism in breast cancer: How far we can go?

Adjuvant therapies for breast cancer have achieved great success in recent years and early breast cancer is now a curable or chronic disease. Targeted therapies, including endocrine therapy and human epidermal growth factor receptor-2 targeted therapy, marked a new era of breast cancer treatment. However, except for chemotherapy, an efficient drug treatment to improve the overall survival of breast cancer patients is still lacking for triple negative breast cancer. Furthermore, a certain proportion of breast cancer patients present with resistance to drug therapy, making it much more difficult to control the deterioration of the disease. Recently, altered energy metabolism has become one of the hallmarks of cancer, including breast cancer, and it may be linked to drug resistance. Targeting cellular metabolism is becoming a promising strategy to overcome drug resistance in cancer therapy. This review discusses metabolic reprogramming in breast cancer and the possible complex mechanism of modulation. We also summarize the recent advances in metabolic therapy targeted glycolysis, glutaminolysis and fatty acids synthesis in breast cancer.

Hydrogen-Assisted C-C Coupling on Reaction of CuC3H-Cluster Anion with CO

A fundamental study on C-C coupling,that is the crucial step in the Fischer-Tropsch synthesis(FTS)process to obtain multi-carbon products,is of great importance to tailor catalysts and then guide a more promising pathway.It has been demonstrated that the coupling of CO with the metal carbide can represent the early stage in the FTS process,while the related mechanism is elusive.Herein,the reactions of the CuC3H-and CuC3-cluster anions with CO have been studied by using mass spectrometry and theoretical calculations.The experimental results showed that the coupling of CO with the C3H-moiety of CuC3H can generate the exclusive ion product COC3H-.The reactivity and selectivity of this reaction of CuC3H-with CO are greatly higher than that of the reaction of CuC3-with CO,and this H-assisted C-C coupling process was rationalized by theoretical calculations.

基于注意力机制和Pix2Pix网络的术后角膜地形图生成

目的:探索使用注意力机制和Pix2Pix生成对抗网络预测年龄相关性白内障患者术中行飞秒激光弧形角膜切开术后角膜地形图。方法:回顾性病例系列研究。选取2018-03/2020-03山西省眼科医院年龄相关性白内障患者术中行飞秒激光弧形角膜切开术患者87例105眼。收集患者术前及术后角膜地形图210张分为训练集(180张)、测试集(30张)用于模型训练和测试。采用峰值信噪比(PSNR)、结构相似性(SSIM)、Alpins散光矢量分析,比较不同注意力机制下术后角膜地形图预测结果的准确性。结果:基于注意力机制和Pix2Pix网络可以预测术后角膜地形图,其中基于Self-Attention注意力机制的模型预测效果最好,PSNR和SSIM达到了16.048、0.7661。真实的和生成的角膜地形图在3mm和5mm环上的误差矢量,误差矢量轴位,术源性散光和矫正比比较差异均无统计学意义(均P>0.05)。结论:基于Self-Attention注意力机制和Pix2Pix网络可以对术后角膜地形图做到良好的预测,可以为眼科临床医生的手术规划和术后效果提供参考。

超声引导下穿刺活检对不同病理类型乳腺炎性病灶的鉴别诊断价值

目的探讨超声引导下穿刺活检(US-CNB)对不同病理类型乳腺炎性病灶的鉴别诊断价值。方法选取2017年9月-2019年2月锦州医科大学附属第一医院就诊的疑似乳腺炎患者64例作为研究对象。所有患者于彩色多普勒超声(以下简称彩超)检查后行US-CNB,且经择期手术后切除病灶。以手术后组织病理学结果作为确诊的金标准,分析对比US-CNB与彩超检查结果的准确性。结果64例临床疑似乳腺炎的患者中,与手术后病理学结果比较,US-CNB诊断的准确率为96.9%(62/64),彩超检查诊断的准确率为75.0%(48/64),2种方法比较,差异有统计学意义(P<0.05),US-CNB诊断的准确率高于彩超检查的准确率。结论US-CNB对乳腺炎病理分型的鉴别诊断较准确,该技术对临床医生有较重要的参考价值。

High-flow nasal cannula oxygen therapy during anesthesia recovery for older orthopedic surgery patients: A prospective randomized controlled trial

BACKGROUND Hypoxemia is a common complication in older patients during postoperative recovery and can cause pulmonary complications.Therefore,reducing the incidence of postoperative hypoxemia is a clinical concern.AIM To investigate the clinical efficacy of high-flow nasal cannula oxygen(HFNCO)in the resuscitation period of older orthopedic patients.METHODS In this prospective randomized controlled trial,60 older patients who underwent orthopedic surgery under general anesthesia were randomly divided into two groups:those who used conventional face mask and those who used HFNCO.All patients were treated with 60%oxygen for 1 h after extubation.Patients in the conventional face mask group were treated with a combination of air(2 L)and oxygen(2 L)using a traditional mask,whereas those in the HFNCO group were treated with HFNCO at a constant temperature of 34℃ and flow rate of 40 L/min.We assessed the effectiveness of oxygen therapy by monitoring the patients’arterial blood gas,peripheral oxygen saturation,and postoperative complications.RESULTS The characteristics of the patients were comparable between the groups.One hour after extubation,patients in HFNCO group had a significantly higher arterial partial pressure of oxygen(paO_(2))than that of patients in conventional face mask group(P<0.001).At extubation and 1 h after extubation,patients in both groups showed a significantly higher arterial partial pressure of carbon dioxide(paCO_(2))than the baseline levels(P<0.001).There were no differences in the saturation of peripheral oxygen,paO_(2),and paCO_(2) between the groups before anesthesia and before extubation(P>0.05).There were statistically significant differences in paO_(2) between the two groups before anesthesia and 1 h after extubation and immediately after extubation and 1 h after extubation(P<0.001).However,there were no significant differences in the oxygen tolerance score before leaving the room,airway humidification,and pulmonary complications 3 d after surgery between the two groups(P>0.05).CONCLUSION HFNCO can improve oxygen partial pressure and respiratory function in elderly patients undergoing orthopedic surgery under general endotracheal anesthesia.Thus,HFNCO can be used to prevent postoperative hypoxemia.

CO Oxidation by Neutral Gold-Vanadium Oxide Clusters

Oxidation of CO by gas-phase atomic clusters is being actively studied to understand the molecular-level mechanisms of heterogeneous CO oxidation over related catalytic surfaces. However, it is experimentally challenging to study CO oxidation by neutral heteronuclear metal oxide clusters because of the difficulty of cluster ionization and detection without fragmentation. Herein, the neutral AuVO2-4 clusters were experimentally generated and their reactions with CO and O2 were studied. The experimental results showed that CO adsorption is the dominant channel on the interactions of AuVO4 and AuVO3 with CO, and AuVO2 can pick up an O2 molecule to generate AuVO4. Theoretical studies indicated that the oxidation of the trapped CO in AuVO3,4CO into CO2 is exothermic while the reaction barriers have to be overcome at the elevated temperatures. A catalytic cycle for CO oxidation by AuVO2-4 is proposed.

H2 Dissociation by Au1-Doped Closed-Shell Titanium Oxide Cluster Anions

Dissociation of molecular hydrogen （H2） is extensively studied to understand the mechanism of hydrogenation reactions. In this study, H2 dissociation by Aul-doped closed-shell titanium oxide cluster anions AuTi3O7 and AuTi3O8 has been identified by mass spectrometry and quantum chemistry calculations. The clusters were generated by laser ablation and mass- selected to react with H2 in art ion trap reactor. In the reaction of AuTi3O8 with H2, the ion pair Au＋-O22 rather than Au＋-O2 is the active site to promote H2 dissociation. This finding is in contrast with the previous result that the lattice oxygen is usually the reactive oxygen species in H2 dissociation. The higher reactivity of the peroxide species is further supported by frontier molecular orbital analysis. This study provides new insights into gold catalysis involving H2 activation and dissociation.

MCSTransWnet:A new deep learning process for postoperative corneal topography prediction based on raw multimodal data from the Pentacam HR system

This work provides a new multimodal fusion generative adversarial net(GAN)model,Multiple Conditions Transform W-net(MCSTransWnet),which primarily uses femtosecond laser arcuate keratotomy surgical parameters and preoperative corneal topography to predict postoperative corneal topography in astigmatism-corrected patients.The MCSTransWnet model comprises a generator and a discriminator,and the generator is composed of two sub-generators.The first sub-generator extracts features using the U-net model,vision transform(ViT)and a multi-parameter conditional module branch.The second sub-generator uses a U-net network for further image denoising.The discriminator uses the pixel discriminator in Pix2Pix.Currently,most GAN models are convolutional neural networks;however,due to their feature extraction locality,it is difficult to comprehend the relationships among global features.Thus,we added a vision Transform network as the model branch to extract the global features.It is normally difficult to train the transformer,and image noise and geometric information loss are likely.Hence,we adopted the standard U-net fusion scheme and transform network as the generator,so that global features,local features,and rich image details could be obtained simultaneously.Our experimental results clearly demonstrate that MCSTransWnet successfully predicts postoperative corneal topographies(structural similarity=0.765,peak signal-to-noise ratio=16.012,and Fréchet inception distance=9.264).Using this technique to obtain the rough shape of the postoperative corneal topography in advance gives clinicians more references and guides changes to surgical planning and improves the success rate of surgery.

Characterization of Generalized Pustular Psoriasis in Northwest China: A Single-Center Retrospective Study

Objective:This study was performed to investigate the clinical characteristics of patients with generalized pustular psoriasis(GPP)in Northwest China.Methods:The clinical data of patients with GPP were retrospectively collected in the Second Affiliated Hospital of Xi’an Jiaotong University from January 1,2017,to December 31,2021 and analyzed using the chi-square test and Mann-Whitney U test.Results:In total,179 hospitalized patients were included.The male:female ratio was 1.16:1.00,and the mean age at onset was 35.05±19.11 years.Psoriasis vulgaris was also present in 76.0%of patients,and a family history of psoriasis was present in 15.6%.The mean duration of hospitalization was 10.67±4.31 days,and the mean duration of flares was 29.58±24.32 days.Infections and suspected drugs were predisposing factors.A fever developed in 54.7%of patients,and pruritus developed in 70.9%.Some patients had involvement of the nails(38.0%),scalp(46.9%),and tongue(4.5%).Cardiovascular disease,hypertension,and gallbladder-related disease were common comorbidities.The efficacy of acitretin was 84.7%,that of methotrexate was 66.7%,and that of cyclosporine was 100%.Fifteen patients were treated with secukinumab or adalimumab and responded well.The mean response time was 6.34±2.91 days based on the combination treatments.The mean duration of the treatment regimen was 111.35±94.25 days,and approximately 46.6%(n=131)of patients developed recurrence.Conclusion:Our retrospective study showed that most cases of GPP were accompanied by psoriasis vulgaris and associated with fever or pruritus.Acitretin had good therapeutic efficacy,but recurrence should be noted.Biologics are increasingly becoming effective treatments,but their superiority and safety need further research.

Recent research progress in the study of catalytic CO oxidation by gas phase atomic clusters

Oxidation of CO into CO2 is a major solution to reduce CO emission into the atmosphere and to remove CO in fuel gas cleanup.Furthermore,CO oxidation serves as a prototypical reaction for heterogeneous catalysis.This review provides an overview and an update on how to study catalytic CO oxidation at a strictly molecular level by performing wellcontrolled gas-phase experiments in combination with quantum chemistry calculations.The advances in the unique catalytic reactivity of single-atom cluster catalysts are emphasized.The catalytically active sites and various mechanistic aspects in the redox couples N2O/CO and O2/CO for the seemingly simple oxidation reaction are described.

Surface alloying of Al films/Ti substrate based on high-current pulsed electron beams irradiation

Ti–Al surface alloy was fabricated using a cyclic pulsed liquid-phase mixing of predeposited 100 nm Al film with a-Ti substrate by low-energy high-current electron beam. Electron probe micro-analysis（EPMA）,grazing incidence X-ray diffraction analysis（GIXRD）,transmission electron microscopy（TEM）, and nanoindentation were used to investigate the characterization of Ti–Al surface alloy. The experimental results show that the thickness of alloy layer is ＊3 lm, and the content of Al in the ＊1 lm thickness surface layer is ＊60 at%. The tetragonal TiAl and TiAl2intermetallics were synthesized at the top surface, which have nanocrystalline structure.The main phase formed in the ＊2.5 lm thick surface is TiAl, and there are few TiAl2and Ti3Al phase for the alloy.Dislocation is enhanced in the alloyed layer. The nanohardness of Ti–Al surface alloy increased significantly compared with a-Ti substrate due to the nanostructure and enhanced dislocation. Since the e-beam remelted repeatedly, the Ti–Al surface alloy mixed sufficiently with Ti substrate. Moreover, there is no obvious boundary between the alloyed layer and substrate.