Pyoderma gangrenosum confused with congenital preauricular fistula infection: A case report

BACKGROUND Pyoderma gangrenosum resulting from or associated with congenital preauricular fistula is rarely reported.CASE SUMMARY We report a rare case of pyoderma gangrenosum misdiagnosed as preauricular fistula infection.To our knowledge,this is the first report to describe pyoderma gangrenosum originating from the site of preauricular fistula.The lesion continued expanding even after combined treatment of systemic antibiotics and thorough debridement.Taking into account the possibility of pyoderma gangrenosum,we applied soft care with normal saline and Vaseline gauze dressing.Systemic corticosteroids were not used until intestinal Clostridium difficile was controlled.No local recurrence was noted at the 12-mo follow-up.CONCLUSION This case highlights the necessity of considering rare diseases,such as pyoderma gangrenosum,when the preauricular sinus deteriorates with general management.The treatment strategy is mutually conflicting between pyoderma gangrenosum and infection of the preauricular sinus.

内镜与手术治疗坏死性胰腺炎疗效和安全性的Meta分析

背景消化内镜和外科手术是治疗坏死性胰腺炎的两种主要有创方式,但比较二者疗效和安全性的研究尚缺乏.目的系统评价消化内镜和外科手术治疗坏死性胰腺炎的疗效和安全性.方法检索PubMed、EMBASE、Cochrane Library、中国知网、万方和中国生物医学文献数据库2000-01/2019-06发表的比较内镜和手术治疗坏死性胰腺炎的随机对照研究(randomized control trials,RCT)和队列研究,使用Revman5.3软件进行数据分析.结果共纳入8篇文献,其中3篇为RCT,5篇为队列研究.患者总数366例,其中内镜组167例,手术组199例.Meta分析结果显示:内镜组和手术组在临床缓解率(OR=1.3,95%CI:0.58-2.92,P=0.52)、复合结局变量——主要并发症或死亡(RR=0.46,95%CI:0.17-1.27,P=0.14)和死亡率(OR=0.78,95%CI:0.37-1.56,P=0.52)上无统计学差异.术后并发症中,内镜组相比于手术组,新发器官衰竭(OR=0.40,95%CI:0.18-0.90,P=0.03)、肠皮瘘或消化道穿孔(OR=0.46,95%CI:0.23-0.91,P=0.02)、胰瘘(OR=0.09,95%CI:0.03-0.24,P<0.00001)的发生率显著降低;而两组间术后腹腔出血、胰腺内分泌和胰腺外分泌功能不全的发生率无统计学差异.结论内镜和手术治疗坏死性胰腺炎的疗效无显著差异,但内镜可显著降低术后并发症的发生率.

Nomogram for predicting non-proliferative vitreoretinopathy probability after vitrectomy in eyes with rhegmatogenous retinal detachment

AIM:To identify the risk factors for postoperative proliferative vitreoretinopathy(PVR)in patients with primary rhegmatogenous retinal detachment(RRD)and develop a nomogram for predicting postoperative PVR-free probability.METHODS:A total of 741 patients(741 eyes)diagnosed with primary RRD who underwent first surgery in the same hospital were retrospectively reviewed and randomly assigned with 521 to the training set and 220 to the validation set.Univariate and multivariate logistic regression analyses were performed in the training cohort to determine risk factors to construct a nomogram for predicting the 3-,4-,5-,and 6-month postoperative PVR-free probabilities.Nomogram performance was estimated by the concordance index(C-index),calibration plot,and the area receiver operating characteristic(ROC)curve.RESULTS:A nomogram was constructed based on the preoperative PVR,silicone oil tamponade time(SOTT),photocoagulation energy(PE),retinal tear size(RTS),and hypertension.In the training set,the C-index of the nomogram was 0.896,0.936,0.961,and 0.972 at 3,4,5,and 6mo,respectively.The C-index values in the validation set were 0.860,0.936,0.951,and 0.965 at 3,4,5,and 6mo,respectively.Decision-curve analysis indicated that only the 4-,5-,and 6-month nomograms had significant net benefits over a large threshold probabilities interval.CONCLUSION:Preoperative PVR,SOTT,PE,RTS,and hypertension are significant risk factors for postoperative PVR formation in patients with primary RRD.The proposed nomogram can effectively predict the 4-,5-,and 6-month PVR-free probabilities after surgery and assist in making clinical decisions during follow-up.

Mapping and Comparative Analysis of QTL for Rice Plant Height Based on Different Sample Sizes within a Single Line in RIL Population

To clarify the most appropriate sample size for obtaining phenotypic data for a single line,we investigated the main-effect QTL(M-QTL) of a quantitative trait plant height(ph) in a recombinant inbred line(RIL) population of rice(derived from the cross between Xieqingzao B and Zhonghui 9308) using five individual plants in 2006 and 2009.Twenty-six ph phenotypic datasets from the completely random combinations of 2,3,4,and 5 plants in a single line,and five ph phenotypic datasets from five individual plants were used to detect the QTLs.Fifteen M-QTLs were detected by 1 to 31 datasets.Of these,qph7a was detected repeatedly by all the 31 ph datasets in 2006 and explained 11.67% to 23.93% of phenotypic variation;qph3 was detected repeatedly by all the 31 datasets and explained 5.21% to 7.93% and 11.51% to 24.46% of phenotypic variance in 2006 and 2009,respectively.The results indicate that the M-QTL for a quantitative trait could be detected repeatedly by the phenotypic values from 5 individual plants and 26 sets of completely random combinations of phenotypic data within a single line in an RIL population under different environments.The sample size for a single line of the RIL population did not affect the efficiency for identification of stably expressed M-QTLs.

Exact Convergence Rate of the Local Limit Theorem for a Branching Random Walk in Z^(d)with a Random Environment in Time

Consider a branching random walk with a random environment in time in the d-dimensional integer lattice.The branching mechanism is governed by a supercritical branching process,and the particles perform a lazy random walk with an independent,non-identical increment distribution.For A■Z^(d),let Z_(n)(A)be the number of offsprings of generation n located in A.The exact convergence rate of the local limit theorem for the counting measure Z_(n)(·)is obtained.This partially extends the previous results for a simple branching random walk derived by Gao(2017,Stoch.Process Appl.).

Clinical Features and Neuroimaging Findings in Patients with Cerebral Fat Embolism

INTRODUCTIONCerebral fat embolism （CFE） is a rare but potentially lethal disease that is usually complicated by long bone fracture, which can develop over 12-72 h. Since the main fbrm of treatment for CFE is supportive, early diagnosis, prevention, and appropriate treatment can reduce mortality and the development of complications. However, due to symptom heterogeneity and imprecise diagnostic methods, CFE may be masked by other clinical conditions that make early detection challenging. Given its low incidence, most clinical studies of CFE are single cases or small case series. To characterize the features of CFE, clinical manifestations, laboratory examinations, and neuroimaging data were evaluated in a large sample of patients with CFE.

Over-expressing root-specific β-amyrin synthase gene increases glycyrrhizic acid content in hairy roots of glycyrrhiza uralensis

Objsective: Glycyrrhizia uralensis, one of the most widely-used traditional Chinese medicines, is mainly cropped in China. However, many cultivars are less in glycyrrhizic acid than Chinese Pharmacopoeia requires. In this paper, we improved glycyrrhizic acid by regulating β-amyrin synthase gene(GuBAS).Methods: Tobacco root-specific promoter TobRB7 and Gu BAS c DNA were obtained and combined with linearized pCAMBIA1305.1 to construct root-specific plant expression vector which was later transformed into Agrobacterium rhizogenes ACCC10060 by electrotransformation. The cotyledons and hypocotyls of G.uralensis were infected by the recombinant A. rhizogenes ACCC10060 to induce hairy roots. The GA content was quantified by HPLC.Results: The PCR and sequencing results both showed that three transgenic hairy root lines were obtained. The copy number of Gu BAS in these transgenic hairy roots was intended by q RT-PCR to be 3, 7,and 4. GA was detected by HPLC, and the results showed that GA was present in the three transgenic hairy roots, while absent in wild hairy roots.Conclusion: Over-expressing Gu BAS root-specifically in hairy roots of G. uralensis enhanced GA accumulation.

Asymptotic expansions in the central limit theorem for a branching Wiener process

We consider a branching Wiener process in R^(d),in which particles reproduce as a super-critical Galton-Watson process and disperse according to a Wiener process.For B⊂R^(d),let Z_(n)(B) be the number of particles of generation n located in B.The study of the central limit theorem and related results about the counting measure Z_(n)(·)is important because such results give good descriptions of the con guration of the branching Wiener process at time n.In earlier works,the exact convergence rate in the central limit theorem and the asymptotic expansion until the third order have been given.Here,we establish the asymptotic expansion of any order in the central limit theorem under a moment condition of the form EX(logX)^(1+λ)<∞.