Myelodysplastic Syndrome Secondary to Multiple Myeloma: A Case Report and Literature Review

Background: With the prolongation of survival in recent years, the accumulation of toxic and side effects of therapeutic drugs and the concomitant drug-related adverse reactions were reported in recent years. However, myelodysplastic syndrome secondary to multiple myeloma is rare. Objective: To improve the understanding of myelodysplastic syndrome secondary to multiple myeloma. Methods: The clinical data of a patient with myelodysplastic syndrome secondary to multiple myeloma after treatment were analyzed, and the related literature was reviewed. Results: A 54-year-old male patient was diagnosed as multiple myeloma in February 2014. After three courses of first-line induction chemotherapy, he achieved complete remission and received two courses of consolidation treatment. After that, he continued to take thalidomide orally. The disease recurred 13 months after complete remission (CR) with 6q+ karyotype change in 37 months. 21q- karyotype change was found in 39 months. The patient was finally diagnosed as treatment-related secondary myelodysplastic syndrome. Due to the poor effect of chemotherapy, the disease continued to deteriorate. Conclusion: In the course of multiple drug treatment, clinicians should pay attention to the changes of molecular genetics and the treatment-related secondary tumor.

Toxoplasmosis-Associated Secondary Hemophagocytic Syndrome: A Case Report and Literature Review

Background: Toxoplasmosis is an extremely rare disease that occurs in the hosts contact with cat and dog frequently. Most human acute infections go unnoticed in immunocompetent individuals, and gradually transformed into chronic infection. However, while host immunity significantly waned, the risk of reactivation of chronic toxoplasma infection is greatly increased. Reactivation of latent toxoplasmic infection often presents with fever, leukopenia, thrombocytopenia, neurological signs and pneumonia. However, for the non-specific clinical and biological signs and its fetal outcome, toxoplasmosis is often misdiagnosed and only revealed at autopsy. Case Presenation: We report a case hospitalized for a week history of cough, anorexia and fatigue with nasal bleeding for a day. After hospitalization, broad-spectrum antibiotherapy was started without a clear diagnosis of infection. Then the patient did a lot of investigations to search the cause of infection, but there were no positive findings. However, an unexpected discovery was detected from peripheral blood smears, shows 1 - 3 μm in diameter, scattered, short and bow like microorganisms on Day 39 of hospitalization. Combined with the medical history and clinical manifestation, toxoplasmosis was diagnosed finally. Unfortunately, secondary hemophagocytic syndrome (HPS) was diagnosed only two days after targeted anti-infection therapy, and the patient died on Day 45 of hospitalization. Conclusions: Patient with unexplained long-term fever and neurological symptoms, interstitial pneumonitis or myocarditis, toxoplasmosis should be positively considered. Only early diagnosis and treatment can increase the possibility of a successful cure and avoid other secondary diseases.

A Case of EBV-Associated Hemophagocytic Lymphohistiocytosis in Adult: Lessons from the Treatment Process

Hemophagocytic lymphohistiocytosis (HLH), which was first described in 1939 by paediatricians Scott and Robb-Smith, is a life-threatening disease. HLH is characterized as cytokine release syndrome which is caused by excessive but non-malignant activation of macrophages and/or histiocytes in bone marrow and other reticuloendothelial systems. EBV-HLH is the most common type of infection-associated HLH, has a high mortality rate without prompt and effective treatment. A previous study showed that the one-year mortality rate of EBV-HLH patients is 75%. Here we report a case of EBV-associated hemophagocytic syndrome in adult, and the lessons from the treatment process. Through this case, we think that for EBV-related HLH, EBV-DNA should also be monitored in addition to hemophagocytosis-related indicators during treatment. In addition, DEP regimen may not be suitable for patients who have received at least partial response, because impaired immunological functioning may lead to EBV and hemophagocytic re-activity.

The role of CALYPSO in the discovery of high-T_c hydrogen-rich superconductors

Hydrogen-rich compounds are promising candidates for high-Tc or even room-temperature superconductors. The search for high-Tc hydrides poses a major experimental challenge because there are many known hydrides and even more unknown hydrides with unusual stoichiometries under high pressure. The combination of crystal structure prediction and first-principles calculations has played an important role in the search for high-Tc hydrides, especially in guiding experimental synthesis. Crystal structure AnaLYsis by Particle Swarm Optimization(CALYPSO) is one of the most efficient methods for predicting stable or metastable structures from the chemical composition alone. This review summarizes the superconducting hydrides predicted using CALYPSO. We focus on two breakthroughs toward room-temperature superconductors initiated by CALYPSO: the prediction of high-Tc superconductivity in compressed hydrogen sulfide and lanthanum hydrides, both of which have been confirmed experimentally and have set new record Tc values. We also address the challenges and outlook in this field.

In situ construction of zinc-rich polymeric solid–electrolyte interface for high-performance zinc anode

With their excellent reliability and environmental friendliness,zinc-ion batteries(ZIBs)are regarded as potential energy storage technologies.Unfortunately,their poor cycling durability and low Coulombic effectiveness(CE),driven by dendritic growth and surface passivation on the Zn anode,severely restrict their commercialization.Herein,we describe the in situ construction of a Zn-rich polymeric solid–electrolyte interface(SEI)using poly-acrylic acid(PAA)as an electrolyte additive.On the one hand,the PAA SEI layer offers evenly distributed nucleation sites and promotes ion transport,hence suppressing dendrite growth.On the other hand,the SEI layer prevents direct contact between the Zn foil and the electrolyte,thus inhibiting side reactions.Additionally,the robust coordination of PAA with Zn^(2+)and the SEI layer's good adherence to the Zn foil provide long-term pro-tection to the Zn anode.As a result,symmetric cells and Zn/V_(2)O_(5)cells all deliver prolonged cycle life and superior electrochemical efficiency.

Pressure-induced phase transition in transition metal trifluorides

As a fundamental thermodynamic variable, pressure can alter the bonding patterns and drive phase transitions leading to the creation of new high-pressure phases with exotic properties that are inaccessible at ambient pressure. Using the swarm intelligence structural prediction method, the phase transition of TiF_(3), from R-3c to the Pnma phase, was predicted at high pressure, accompanied by the destruction of TiF_6 octahedra and formation of TiF_8 square antiprismatic units. The Pnma phase of TiF_(3), formed using the laser-heated diamond-anvil-cell technique was confirmed via high-pressure x-ray diffraction experiments. Furthermore, the in situ electrical measurements indicate that the newly found Pnma phase has a semiconducting character, which is also consistent with the electronic band structure calculations. Finally, it was shown that this pressure-induced phase transition is a general phenomenon in ScF_(3), VF_(3), CrF_(3), and MnF_(3), offering valuable insights into the high-pressure phases of transition metal trifluorides.

Application of endoscopic techniques in orbital blowout fractures

Minimally invasive surgical techniques,particularly endoscopic techniques,have revolutionized otolaryngeal surgery.Endoscopic techniques have been gradually applied in orbital surgery through the sinus inferomedial to the orbit and the orbital subperiosteal space.Endoscopic techniques help surgeons observe fractures and soft tissue of the posterior orbit to precisely place implants and protect vital structures through accurate,safe,and minimally invasive approaches.We reviewed the development of endoscopic techniques,the composition of endoscopic systems for orbital surgery,and the problems and developmental prospects of endoscopic techniques for simple orbital wall fracture repair.

Helium incorporation induced direct-gap silicides

The search of direct-gap Si-based semiconductors is of great interest due to the potential application in many technologically relevant fields.This work examines the incorporation of He as a possible route to form a direct band gap in Si.Structure predictions and first-principles calculations show that He and Si,at high pressure,form four dynamically stable phases of Si_(2)He(oP36-Si_(2)He,tP9-Si_(2)He,mC18-Si_(2)He,and mC12-Si_(2)He).All phases adopt host–guest structures consisting of a channel-like Si host framework filled with He guest atoms.The Si frameworks in oP36-Si2He,tP9-Si2He,and mC12-Si_(2)He could be retained to ambient pressure after removal of He,forming three pure Si allotropes.Among them,oP36-Si_(2)He and mC12-Si_(2)He exhibit direct band gaps of 1.24 and 1.34 eV,respectively,close to the optimal value(~1.3 eV)for solar cell applications.Analysis shows that mC12-Si_(2)He with an electric dipole transition allowed band gap possesses higher absorption capacity than cubic diamond Si,which makes it to be a promising candidate material for thin-film solar cell.

眼科手术机器人在视网膜手术中的研究进展

手术机器人可提高操作精确度、消除术者手部震颤、突破人类生理局限性,有助于提高微创手术效果,常被应用于普通外科、泌尿外科、胸外科、妇科等多个学科中。眼科手术以精细和微创为特点,其中视网膜手术对于双手的精确性和稳定性有极高的要求,因此将手术机器人应用于视网膜手术具有重要的临床价值。但基于显微视觉的视网膜手术精细程度高、操作范围小,对眼科手术机器人提出特殊的要求。笔者就各类眼科手术机器人的工作原理和技术特点,及其在视网膜静脉插管和黄斑部手术中的最新研究成果进行综述。