Special electromyographic features in a child with paramyotonia congenita: A case report and review of literature

BACKGROUND Paramyotonia congenita(PMC)stands as a rare sodium channelopaty of skeletal muscle,initially identified by Eulenburg.The identification of PMC often relies on electromyography(EMG),a diagnostic technique.The child’s needle EMG unveiled trains of myotonic discharges with notably giant amplitudes,alongside irregular wave trains of myotonic discharges.This distinctive observation had not surfaced in earlier studies.CASE SUMMARY We report the case of a 3-year-old female child with PMC,who exhibited la-ryngeal stridor,muffled speech,myotonia from birth.Cold,exposure to cool water,crying,and physical activity exacerbated the myotonia,which was relieved in warmth,yet never normalized.Percussion myotonia was observable in bilateral biceps.Myotonia symptoms remained unchanged after potassium-rich food consumption like bananas.Hyperkalemic periodic paralysis was excluded.Cranial magnetic resonance imaging yielded normal results.Blood potassium remained within normal range,while creatine kinase showed slight elevation.Exome-wide genetic testing pinpointed a heterozygous mutation on chromosome SCN4A:c.3917G>A(p.G1306E).After a six-month mexiletine regimen,symptoms alleviated.CONCLUSION In this case revealed the two types of myotonic discharges,and had not been documented in other studies.We underscore two distinctive features:Giant-amplitude potentials and irregular waves.

儿童干眼症相关因素的研究进展

干眼症是成年人最常见的眼部疾病之一,目前对成年人干眼症的临床研究已相对完善,然而对于儿童干眼症的研究报道却十分匮乏,导致儿童干眼症在临床工作中十分容易被忽视。了解儿童干眼症相关因素的研究进展,对于提高临床医师重视儿童这一特殊人群的干眼症意义重大。因此,有必要将目前儿童干眼症相关因素研究进展予以综述。

An overview on ethical issues about sperm donation

Beyond the scientific progress in assisted reproductive technologies （ART）, it is necessary to discuss the ethical considerations behind these advances. Ethical issues concerning sperm donation have been considered and discussed by government and non-governmental agencies, the public, media and academic institutions in many countries. Recommendations and guidelines concerning sperm donation issues vary from country to country and between professional groups within countries. This paper attempts to present an overview of findings and reports from various agencies concerning the ethics of sperm donation. The following topics are considered： limiting the number of donor offspring; minimizing risk of infection and genetics from sperm donors; age requirements for sperm donors; and anonymity versus non-anonymity of sperm donors. The diversity of policies shows that each country has its unique set of guidelines tailored toward its own specific needs. Similarly, countries designing their own procedures and guidelines concerning reproductive medicine must tailor them toward their own needs and practical considerations. In China's Mainland, the anonymous policy for sperm donation should still be carried out, and the number of donor offspring should be revaluated. ART procedures must be conducted in a way that is respectful of those involved. Ethical principles must respect the interests and welfare of persons who will be born as well as the health and psychosocial welfare of all participants, including sperm donors.

Feasibility of MRI Radiomics for Predicting KRAS Mutation in Rectal Cancer

The mutation status of KRAS is a significant biomarker in the prognosis of rectal cancer.This study investigated the feasibility of MRI-based radiomics in predicting the mutation status of KRAS with a composite index which could be an important criterion for KRAS mutation in clinical practice.In this retrospective study,a total of 127 patients with rectal cancer were enrolled.The 3D Slicer was used to extract the radiomics features from the MRI images,and sparse support vector machine(SVM)with linear kernel was applied for feature reduction.The radiomics classifier for predicting the KRAS status was then constructed by Linear Discriminant Analysis(LDA)and its performance was evaluated.The composite index was determined with LDA model.Out of 127 rectal cancer subjects,there were 44 KRAS mutation cases and 83 wild cases.A total of 104 radiomics features were extracted,54 features were filtered by linear SVM with L1-norm regularization and 6 features that had no significant correlations within them were finally selected.The radiomics classifier constructed using the 6 features featured an AUC value of 0.669(specificity:0.506;sensitivity:0.773)with LDA.Furthermore,the composite index(Radscore)had statistically significant difference between the KRAS mutation and wild groups.It is suggested that the MRI-based radiomics has the potential in predicting the KRAS status in patients with rectal cancer,which may enhance the diagnostic value of MRI in rectal cancer.

Microstructure and mechanical properties of a hot-extruded Al-based composite reinforced with core–shell-structured Ti/Al3Ti

An Al-based composite reinforced with core–shell-structured Ti/Al_3Ti was fabricated through a powder metallurgy route followed by hot extrusion and was found to exhibit promising mechanical properties. The ultimate tensile strength and elongation of the composite sintered at 620°C for 5 h and extruded at a mass ratio of 12.75:1 reached 304 MPa and 14%, respectively, and its compressive deformation reached 60%. The promising mechanical properties are due to the core–shell-structured reinforcement, which is mainly composed of Al_3Ti and Ti and is bonded strongly with the Al matrix, and to the reduced crack sensitivity of Al_3Ti. The refined grains after hot extrusion also contribute to the mechanical properties of this composite. The mechanical properties might be further improved through regulating the relative thickness of Al–Ti intermetallics and Ti metal layers by adjusting the sintering time and the subsequent extrusion process.

MiR-214-3p Prevents the Development of Perioperative Neurocognitive Disorders in Elderly Rats

Objective:This study aimed to identify microRNAs(miRNAs)involved in the development of perioperative neurocognitive disorders(PND).Methods:Plasma exosomal miRNA expression was examined in patients before and after cardiopulmonary bypass(CPB)using microarray and qRT-PCR and these patients were diagnosed as PND later.Elderly rats were subjected to CPB,and the cognitive functions were examined.Bioinformatics analysis was conducted to predict the targets of miR-214-3p.Rats were administered rno-miR-214-3p agomir before or after CPB to investigate the role of miR-214-3p in PND development.Results:We identified 76 differentially expressed plasma exosomal miRNAs in PND patients after surgery(P<0.05,|log2FC|>0.58),including the upregulated hsa-miR-214-3p(P=0.002399392).Prostaglandin-endoperoxide synthase 2(PTGS2)was predicted as a miR-214-3p target.In rats,CPB reduced the platform crossing numbers and target quadrant stay time,accompanied with hippocampal neuronal necrosis.The rno-miR-214-3p level was significantly increased in plasma exosomes but decreased in rat hippocampus after surgery,exhibiting a negative correlation(P<0.001,r=-0.762).A negative correlation between miR-214-3p and PTGS2 protein expression was also observed in the hippocampus after surgery.Importantly,rno-miR-214-3p agomir treatment,before or after surgery,significantly increased the platform crossing numbers(P=0.035)and target quadrant stay time(P=0.029)compared with negative control.Hippocampal PTGS2 protein level was increased in the untreated surgery group and decreased in response to rno-miR-214-3p agomir treatment before or after surgery(both P<0.05 vs.negative control).Conclusion:These data suggest that miR-214-3p/PTGS2 signaling contributes to the development of PND,serving as a potential therapeutic target for PND.

Effect of Cr content and cooling rate on the primary phase of Al-2.5Mn alloy

The effect of Cr content and cooling rate on the microstructure of Al-Mn alloy was studied using well resistance furnace melting,and the alloy was analyzed using scanning electron microscopy(SEM)and X-ray diffraction(XRD).The experimental results showed that adding Cr could significantly improve the morphology of the primary phase in the Al-2.5Mn alloy.Without Cr,the primary phase in the alloy was thick,needle-like,and strip-like structure.After adding 0.2wt%-0.5wt%Cr,the primary phase in the upper part of the alloy was gradually fined and reached the best effect at 0.35wt%Cr.When the content of Cr was 0.5wt%,the microstructure of the primary phase in the upper part began to coarsen.The bottom of the alloy was a large bulk phase,but still much finer than that without adding Cr.XRD and SEM analysis showed that the precipitation phase at the bottom was mainly Al85Mn7Cr8,while the fine microstructure at the top was Al6Mn and Al3Mn.The results of the cooling rate experiments showed that the primary phase of Al-2.5Mn-0.35Cr was further refined,and the eutectic microstructure was partly achieved,under air-cooling condition.And when the cooling method was iron die-cooling,the microstructure of the Al-2.5Mn-0.35Cr alloy was changed into a eutectic microstructure.

Large pelvic mass arising from the cervical stump: A case report

BACKGROUND A large cervical cyst with a cervical high-grade squamous intraepithelial lesion arising from the cervical stump is rare.After supracervical hysterectomy,there is a risk of various lesions occurring in the cervical stump.We review the types and characteristics of cervical stump lesions and compare total hysterectomy with subtotal hysterectomy.Gynecologists should choose the most suitable surgical method based on both the patient’s condition and wishes.If the cervix is retained,patients require a close follow-up.CASE SUMMARY A 57-year-old woman was admitted to the Gynecology Department for a large pelvic mass.Her chief complaint was abdominal distention for two months.She had undergone subtotal supracervical hysterectomy for leiomyoma 14 years prior.Abdominal ultrasonography detected a 9.1 cm×8.5 cm×8.4 cm anechoic mass with silvery fluid in the pelvic cavity and high-risk human papilloma virus 53(HPV53)was positive.The admission diagnosis we first considered was a pelvic mass mimicking carcinoma of the cervical stump.We performed a laparotomy and a rapid frozen biopsy was suggestive of a fibrous cyst wall coated with a high squamous intraepithelial lesion.The pelvic mass was removed,and a bilateral adnexectomy was implemented.Final pathology confirmed that the pelvic mass was a large inflammatory cyst with a cervical high-grade squamous intraepithelial lesion.After successful intervention,the patient was discharged one week after surgery and there was no recurrence of the vaginal stump at 43 mo.CONCLUSION When addressing benign uterine diseases,gynecologists should pay adequate attention to retaining the cervix.If the cervix is retained,patients require a close follow-up.

角膜屈光术后角膜瓣下上皮细胞植入的研究进展

角膜瓣下上皮细胞植入或内生是角膜屈光术后并发症之一,近年来随着手术设备和技术的提高,其发生率已经明显降低。但外伤致角膜瓣移位发生角膜瓣下上皮植入病例仍时有报道。若上皮细胞植入处理不及时可引起患者屈光状态改变、角膜瓣融解等严重并发症。故本文对角膜屈光术后角膜层间上皮植入研究进展予以综述。

超声引导下RISS阻滞对胸腔镜手术患者术后镇痛的影响

目的评价超声引导下RISS阻滞在胸腔镜手术中的安全性和有效性。方法选取2019年7月-2019月11月于西南医科大学附属医院择期行胸腔镜手术的患者60例,根据不同麻醉方法将患者分为RP组、LP组。两组均行全身麻醉,RP组全身麻醉前实施超声引导下RISS阻滞,LP组由手术医生在术毕行切口局部麻醉。记录RP组RISS阻滞20 min后在锁中线处的感觉阻滞范围;记录术中舒芬太尼用量、血管活性药物使用情况及瑞芬太尼用量;比较术后舒芬太尼消耗总量、24 h镇痛泵按压次数、补救性镇痛;比较入PACU时及术后2 h、6 h、12 h、24 h静息和咳嗽时VAS评分及各时间点咳嗽能力评分;比较PACU停留时间、术后首次下床活动时间、拔除引流管时间及术后住院时间;比较不良反应及患者满意度等。结果RP组瑞芬太尼用量较LP组低(P<0.05)。RP组不同时间点的静息时或咳嗽时VAS评分均低于或等于LP组(P<0.05)。RP组或LP组咳嗽时不同时间点的VAS评分较静息时高。两组患者咳嗽能力评分比较,差异有统计学意义(P<0.05)。RP组术后舒芬太尼用量、24 h镇痛泵按压次数较LP组少,补救性镇痛较LP组低(P<0.05),满意度较LP组高(P<0.05)。RP组术后PACU停留时间、首次下床活动时间较LP组短(P<0.05)。RP组术后1例(3.3%)发生头晕,LP组为2例(6.7%)。RP组2例(6.7%)发生恶心呕吐,LP组为8例(26.7%),两组各发生低血压1例(3.3%),两组均无呼吸抑制、皮肤瘙痒;RP组没有发生神经阻滞相关并发症。结论超声引导下RISS阻滞用于胸腔镜手术中是安全有效的,可以作为术后镇痛的辅助技术。

气管狭窄手术麻醉插管与手术方式的特点分析

目的探讨在气管狭窄的外科治疗中如何正确选择麻醉插管方式与手术方式。方法选取1998年1月—2018年12月在西南医科大学附属医院胸外科手术治疗的32例气管狭窄患者的临床资料,按不同致气管狭窄原因分为肿瘤组、非肿瘤组。比较两组患者临床资料的差异。记录并比较两组患者麻醉插管方式、手术方式、手术时间、手术出血量、术后插管时间、术后住院日及术后并发症等情况。随访1个月~20年,统计分析两组气管吻合口狭窄发生率、疾病复发率等指标。结果肿瘤组气管修补术较非肿瘤组低(P<0.05),气管环形切除+端端吻合及单腔插管+全麻较非肿瘤组高(P<0.05)。两组手术切口比较,差异无统计学意义(P>0.05)。两组中、下段气管狭窄的麻醉方式和手术方式比较,差异无统计学意义(P>0.05)。肿瘤组手术时间、术中出血量较非肿瘤组高(P<0.05)。两组术后并发症比较,差异无统计学意义(P>0.05)。患者均治愈出院,两组患者均未发生手术及围手术期死亡。结论气管狭窄往往是亚急诊或急诊性病种,手术治疗是最有效的方法。麻醉插管及手术方式应依据气管狭窄的特点而灵活选择,若能正确选择,将有效提高气管狭窄手术成功率。

Unveiling thermal properties and pump-out blocking in diamond/GaInSn composites as thermal interface materials

Gallium-based liquid metal,as a high-performance thermal interface material,can improve the performance and service life of electronic equipment.This study focuses on the use of diamond as a thermal conductivity enhancement phase to improve the thermal conductivity of GaInSn liquid metal and avoid the overflow of liquid metal during application.In this study,diamond/GaInSn composites were prepared by an ultrasonic-assisted wetting method.The thermal conductivity and contact thermal resistance of diamond/GaInSn composites were characterized by the transient method.The morphology and thermal conductivity of diamond/GalnSn composites were investigated when diamond particles of different diameters were added to GaInSn liquid metal.The addition of large-sized diamond particles can effectively improve the thermal conductivity of thermal interface materials (TIMs) but willcause liquid metal to pump out.

Microstructure and mechanical properties of Al-5.5Fe-1.1V-0.6Si alloy solidified under near-rapid cooling and with Ce addition

Al-Fe-V-Si alloys were developed for use at elevated temperature and usually produced through a rapid solidification-powder metallurgy route. In this work, effort was made to produce the material via casting route. The studied alloys were cast under the condition of near-rapid cooling. The influence of Ce addition on microstructure and mechanical properties of near-rapid solidified alloys were investigated. The results indicate that the as-cast microstructure of Al-5.5 Fe-1.1 V-0.6 Si alloy is significantly refined when the alloy was solidified under nearrapid cooling. Adding Ce results in the further refinement of intermetallic compound and the formation of an Al-V-Ce phase which replaces the primary phase Al(Fe,V)Si. The mechanical properties of the alloy are significantly improved by Ce addition: More than 70% increase in tensile strength and elongation is achieved by adding 1.00 wt% Ce to the alloy. It is concluded that near-rapid cooling and Ce addition are effective in improving mechanical properties of cast Al-5.5 Fe-1.1 V-0.6 Si alloy.

Recent Advances of Nanoelectrodes for Single-Cell Electroanalysis:From Extracellular, Intercellular to Intracellular

Detection at single-cell level plays a critical role in revealing cell behavior in different organisms.Nanoelectrodes with high temporal–spatial resolution can precisely and dynamically monitor the physiological and pathological processes of various single cells.The field of using nanoelectrodes in single-cell electroanalysis is blooming in recent years.In this review,we mainly summarize the recent advances of nanoelectrodes for single-cell electroanalysis from extracellular,intercellular to intracellular levels in the past decade.First,we introduce the main types of nanoelectrodes based on their geometry and characteristics for single-cell electroanalysis.Then,the representative works of using nanoelectrodes to investigate cellular signaling biomolecules and to understand various cellular processes from the extracellular,intercellular,and intracellular levels are introduced.Finally,the challenges and future prospects of nanoelectrodes for single-cell electroanalysis are proposed.This review gives a comprehensive summary of nanoelectrodes for single-cell electroanalysis in the prospects of monitoring cell physiological topography,understanding communication mechanism and revealing physiological functions,which can provide new insights into cell-based pharmacological screening and fundamental studies of disease development mechanisms.