Targeted gene sequencing and bioinformatics analysis of patients with gallbladder neuroendocrine carcinoma:A case report

BACKGROUND Gallbladder neuroendocrine carcinoma(NEC)represents a subtype of gallbladder malignancies characterized by a low incidence,aggressive nature,and poor prognosis.Despite its clinical severity,the genetic alterations,mechanisms,and signaling pathways underlying gallbladder NEC remain unclear.CASE SUMMARY This case study presents a rare instance of primary gallbladder NEC in a 73-year-old female patient,who underwent a radical cholecystectomy with hepatic hilar lymphadenectomy and resection of liver segments IV-B and V.Targeted gene sequencing and bioinformatics analysis tools,including STRING,GeneMANIA,Metascape,TRRUST,Sangerbox,cBioPortal and GSCA,were used to analyze the biological functions and features of mutated genes in gallbladder NEC.Twelve mutations(APC,ARID2,IFNA6,KEAP1,RB1,SMAD4,TP53,BTK,GATA1,GNAS,and PRDM3)were identified,and the tumor mutation burden was determined to be 9.52 muts/Mb via targeted gene sequencing.A protein-protein interaction network showed significant interactions among the twelve mutated genes.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses were used to assess mutation functions and pathways.The results revealed 40 tumor-related pathways.A key regulatory factor for gallbladder NEC-related genes was identified,and its biological functions and features were compared with those of gallbladder carcinoma.CONCLUSION Gallbladder NEC requires standardized treatment.Comparisons with other gallbladder carcinomas revealed clinical phenotypes,molecular alterations,functional characteristics,and enriched pathways.

Prenatal ultrasonography and genetic analysis of fetal cleidocranial dysplasia:A case report

BACKGROUND Cleidocranial dysplasia(CCD)is an infrequent clinical condition with an autosomal dominant inheritance pattern.It is characterized by abnormal clavicles,patent sutures and fontanelles,supernumerary teeth,and short stature.Approximately 60%-70%of patients with CCD have mutations in the RUNX family transcription factor 2 gene.However,prenatal diagnosis of CCD is difficult when the family history is unknown.CASE SUMMARY We report a rare case of fetal CCD with an unknown family history,confirmed by prenatal ultrasonography and genetic testing at a gestational age of 16 weeks.The genetic reports indicated that the fetus carried pathogenic mutations in the RUNX family transcription factor 2 gene(c.674G>A).After careful consideration,the pregnant woman and her family decided to continue the pregnancy.CONCLUSION Definitive prenatal diagnosis of CCD should include family history,ultrasound diagnosis,and genetic analysis,especially if family history is unknown.

Clinical review and literature analysis of hepatic epithelioid angiomyolipoma in alcoholic cirrhosis: A case report

BACKGROUND Hepatic epithelioid angiomyolipoma(HEA)has a low incidence and both clinical manifestations and imaging lack specificity.Thus,it is easy to misdiagnose HEA as other tumors of the liver,especially in the presence of liver diseases such as hepatitis cirrhosis.This article reviewed the diagnosis and treatment of a patient with HEA and alcoholic cirrhosis,and analyzed the literature,in order to improve the understanding of this disease.CASE SUMMARY A 67-year-old male patient with a history of alcoholic cirrhosis was admitted due to the discovery of a space-occupying lesion in the liver.Based on the patient’s history,laboratory examinations,and imaging examinations,a malignant liver tumor was considered and laparoscopic partial hepatectomy was performed.Postoperative pathology showed HEA.During outpatient follow-up,the patient showed no sign of recurrence.CONCLUSION HEA is difficult to make a definite diagnosis before surgery.HEA has the poten-tial for malignant degeneration.If conditions permit,surgical treatment is recom-mended.

A Study of the Teaching Effects of Case Analysis in Cross-Cultural Communication Class-Taking Individualism-Collectivism Cultural Dimension Class as an Example

This study introduces the individualism-collectivism dimension of the cultural dimension of cross-cultural communication initiated by Geert Hofstede.Different cultures must develop a way of correlating that strikes a balance between caring for themselves and showing concern for others.Individualist culture encourages uniqueness and independence while collectivist culture emphasizes conformity and mutual assistance.This article introduces how to use case analysis method to effectively carry out classroom teaching in this cultural dimension.

Analysis of a Typical Case of Meteorological Service in Tangpu Reservoir

The continuous rainy precipitation process from February to March in 2019 was selected to analyze the effect of meteorological service in Tangpu Reservoir basin,so as to sum up service experience and then lay a better foundation for subsequent services.In response to the rainy weather from December 2018 to early 2019,three rounds of flood discharge were carried out in Tangpu Reservoir.During February-March in 2019,the hit rate of short-term area rainfall forecast for Tangpu Reservoir was 80.0%.Compared with the median of forecast interval,the average absolute error was 7.6 mm,and the relative error was 32.7%.The large deviation in the forecast from March 27 to 28 was deeply analyzed,and it is found that the main reasons were excessive reliance on and trust in a single model,insufficient correction of the actual situation,and insufficient judgment of the nature of precipitation.For the future reservoir meteorological service,three aspects of thinking were put forward,such as further strengthening the sharing of hydrological and meteorological information,improving the forecasting ability,and deepening the research of runoff forecast models.

Probabilistic approach for open pit bench slope stability analysis——A mine case study

The geotechnical slope design of an open pit wall starts at the bench scale configuration.At this scale,the rock slope stability is governed primarily by the geological discontinuities within the rock mass and as a result,structurally-controlled failures(e.g.planar,wedge or toppling)are most likely to occur.The probabilistic approach offers a major advantage over the traditional deterministic method in that it accounts for the different degrees of variability and uncertainty often encountered in rock properties.This paper presents a bench slope stability assessment for an open pit mine in Peru using a probabilistic-based approach by coupling a kinematic analysis based on stereographic projection techniques followed by a kinetic analysis by means of the limit equilibrium method.Finally,these two probabilities are combined to provide an overall measure of the probability of failure(PoF)of the bench slope system.The case study is characterized by significant scatter in the geometrical and mechanical properties of the joints.Extensive surface mapping was conducted at 36 different sites following the ISRM suggested procedures.Several direct shear tests were carried out.It is shown that by combining field and laboratory measurements and engineering judgment,the probability density functions(PDF)of the discontinuity parameters can be obtained.These are then used in a Monte Carlo simulation process to compute both kinematic and kinetic probabilities of failure.The overall probability of failure aims to provide the design engineer with a tool to critically evaluate the bench performance from a geotechnical risk perspective and to provide a basis for future bench design optimization.

Epidemiological Analysis on Reported Hepatitis C Cases in China from 2012 to 2016

Viral hepatitis is an important challenge to public health worldwide.As hepatitis B is well controlled due to vaccination,the disease burden caused by the spread of hepatitis C has become increasingly prominent.Hepatitis C is an infectious disease that is mainly blood-borne.The rate of chronicity ranges from 55% to 85% after people are infected with the hepatitis C virus （HCV）.

Analysis of mechanical strengths of extreme line casing joint considering geometric, material, and contact nonlinearities

To address the challenges associated with difficult casing running,limited annular space,and poor cementing quality in the completion of ultra-deep wells,the extreme line casing offers an effective solution over conventional casings.However,due to its smaller size,the joint strength of extreme line casing is reduced,which may cause failure when running in the hole.To address this issue,this study focuses on the CST-ZTΦ139.7 mm×7.72 mm extreme line casing and employs the elastic-plastic mechanics to establish a comprehensive analysis of the casing joint,taking into account the influence of geometric and material nonlinearities.A finite element model is developed to analyze the forces and deformations of the extreme line casing joint under axial tension and external collapse load.The model investigates the stress distribution of each thread tooth subjected to various tensile forces and external pressures.Additionally,the tensile strength and crushing strength of the extreme line casing joint are determined through both analytical and experimental approaches.The findings reveal that,under axial tensile load,the bearing surface of each thread tooth experiences uneven stress,with relatively high equivalent stress at the root of each thread tooth.The end thread teeth are valuable spots for failure.It is observed that the critical fracture axial load of thread decreases linearly with the increase of thread tooth sequence.Under external pressure,the circumferential stress is highest at the small end of the external thread,leading to yield deformation.The tensile strength of the joint obtained from the finite element model exhibits a relative error of less than 7%compared to the analytical and experimental values,proving the reliability of the finite element model.The tensile strength of the joint is 3091.9 k N.Moreover,in terms of anti-collapse capability,the joints demonstrate higher resistance to collapse compared to the casing body,which is consistent with the test results where the pipe body experiences collapse and failure while the joints remain intact during the experiment.The failure load of the casing body under external collapse pressure is 87.4 MPa.The present study provides a basic understanding of the mechanical strengths of extreme line casing joint.

Oxaliplatin-induced severe anaphylactic reactions in metastatic colorectal cancer: Case series analysis

AIM: To investigate oxaliplatin-induced severe anaphylactic reactions (SAR) in metastatic colorectal cancer in a retrospective case series analysis and to conduct a systemic literature review. METHODS: During a 6-year period from 2006 to 2011 at Kaohsiung Veterans General Hospital, a total of 412 patients exposed to oxaliplatin-related chemotherapy were retrospectively reviewed. Relevant Englishlanguage studies regarding life-threatening SAR following oxaliplatin were also reviewed in MEDLINE and PubMed search. RESULTS: Eight patients (1.9%, 8 of 412 cases) were identified. Seven patients were successful resuscitated without any sequelae and one patient expired. We changed the chemotherapy regimen in five patients and rechallenged oxaliplatin use in patient 3. Twenty-three relevant English-language studies with 66 patients were reported. Patients received a median of 10 cycles of oxaliplatin (range, 2 to 29). Most common symptoms were respiratory distress (60%), fever (55%), and hypotension (54%). Three fatal events were reported (4.5%). Eleven patients (16%) of the 66 cases were rechallenged by oxaliplatin. CONCLUSION: SAR must be considered in patients receiving oxaliplatin-related chemotherapy, especially in heavily pretreated patients. Further studies on the mechanism, predictors, preventive methods and management of oxaliplatin-related SAR are recommended.

Comparative Analysis of Profit Model of Typical Pharmaceutical O2O Enterprises in China

Objective To study the profit model of Chinese pharmaceutical O2O enterprises.Methods A case study of three typical pharmaceutical O2O enterprises was conducted,and their profit models were compared.Results and Conclusion The pharmaceutical O2O enterprises in China are divided into three categories according to the profit models.It is found that the current pharmaceutical O2O enterprises have problems such as simple profit model and low corporate profits.Based on these problems,it is recommended that relevant enterprises develop various business models to increase profit channels.Besides,they should establish and improve internal cost control systems.

The Finite Element Analysis and Computer Simulation of the Composite Case

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AN HARMONIC ANALYSIS FOR OPERATORS IN THE CASE OF A LOCALLY COMPACT ABELIAN GROUP：F．AND M．RIESZ THEOREMS

Let G be a locally compact Abelian group, B a homogeneous Banach algebra without the order on G. at denotes the set of all integrable operators with respect to right translation on B(see [2]). Under some convenient conditions we obtain the following results:both the first F. and M. Riesz Theorem for operators in and the second F. and M. Riesz Theorem for operators in hold.

Effect of CBL Combined with Case Analysis in the Teaching of Clinical Anesthesia

Objective:To evaluate the effect of CBL(case-based learning)combined with case analysis in the teaching of clinical anesthesia.Methods:From June 2018 to June 2020,a total of 100 clinical anesthesia interns in Shaanxi Provincial People’s Hospital were selected as the research subjects.They were divided into two groups,the reference group(50 interns)and the study group(50 interns),by random sampling method.The reference group was under the traditional teaching method,whereas for the study group,CBL combined with case analysis was implemented.The teaching satisfaction and achievement of the interns in both the groups were evaluated.Results:The teaching satisfaction of the study group was 98%,which was significantly higher than that of the reference group(86%)(P<0.05);before teaching,there was no significant difference in the theoretical and clinical practice scores between the two groups(P>0.05);however,after teaching,the theoretical and clinical practice scores of the two groups increased significantly,in which the change of the research group was significantly greater than that of the reference group(P<0.05).Conclusion:The application of CBL combined with case analysis in the teaching of clinical anesthesia has an ideal effect,improving the teaching satisfaction and achievement.It is a high-quality teaching method and is worthy of application.

Case Study of Four Vehicle Reliability Comparison Based on Survival Analysis

The paper is written to analyze the behavior of a selected set of vehicles with different makes, on how they survive after each owner change. The data come from Github. The four cars are Honda Accord, Mini Cooper, Chevy Cavalier, and Toyota Avalon. The two faults are Engine System and Transmission System. The data are from 1996 to 2012. The paper used the Kaplan-Meier curve to survival analysis;the paper also calculates and discusses the self-comparison of each car’s four time periods, the four-stage failure rate through median comparison, and the median comparison of fault conditions in all years. We find that all the vehicle types have gotten better with the years and Toyota vehicles are more reliable than Honda.

Public Participation in Land Use Planning:Values and Case Analysis

Objective:we want to explore values and methods of public participation in land use planning through analysis on values of public participation and case of Ji'an County in Jiangxi Province.Methods:document and data method,case analysis method,qualitative and quantitative combined methods.Results:public participation in land use plays a positive role in improving science and practice of planning.Conclusions:preparation and implementation of land use planning should manifest human-oriented,public participation,wisdom of the masses,scientific demonstration,and democratic decision-making.

The Spatial Distribution Pattern Analysis of City Infrastructure Cases of Urban Management

The effective disposal of daily city infrastructure cases is an important issue for urban management. To more effectively utilize a large amount of historical cases data collected and accumulated in the urban grid management system, and to analyze their spatial distribution pattern information for city managers, this study used the comparative kernel density analysis method in two types of cases (i.e. power facilities and traffic guardrail) in Xicheng District, Beijing for the year 2016 and 2017. This research analyzes them at different scales (300 m, 600 m, 1,200 m), and the experiment results show that the method of comparative kernel density analysis is able to provide an intuitively spatial visualization distribution analysis of city infrastructure related cases. The quantitative information of spatial agglomeration degree is helpful for city managers making decision.

Focal nodular hyperplasia with concomitant hepatocellular carcinoma: a case report and clonal analysis

This report describes a hepatocellular carcinoma (HCC) with concomitant focal nodular hyperplasia (FNH) in a 56 years old Chinese man. There were two well circumscribed tumours measuring 3×2.5×2 cm and 2×1.5×1.5 cm. The larger mass was grey and soft with a small area of bleeding and necrosis and an intact capsule. The smaller mass was yellow and had no capsule. Clonal analysis was carried out to clarify the relation between the HCC and the adjacent FNH. The clonal analysis was based on the methylation pattern of the polymorphic X chromosome linked androgen receptor gene (HUMARA). In FNH, after Hpa Ⅱ digestion, the allelic bands showed two well defined peaks. The intensity of the two peaks in the DNA from cirrhotic tissue did not differ significantly, consistent with a random pattern of X chromosome inactivation. However, in HCC, after Hpa Ⅱ digestion, the allelic bands differed significantly in intensity. Therefore, there was a typical polyclonal pattern of inactivation in FNH but the HCC was interpreted as being monoclonal.

Clinical characteristics and prognosis of traumatic basal ganglia hematomas: A retrospective analysis of 40 cases

AIM： To retrospectively analyze the pathogenesis, clinical characteristics, treatment and prognostic characteristics in patients with traumatic basal ganglia hematomas （TBGH）. METHODS： A retrospective analysis of the clinical data was performed in 40 patients with TBGH who were selected from 1 250 patients with closed brain injury, who admitted to the Department of Neurosurgery of Shangqiu First People＇s Hospital from January 1990 to January 2004. The pathogenesis, clinical characteristics and signs, results of radiological examination, treatment and prognostic characteristics were analyzed. The patients all had definite history of brain injury, manifested by neurological functional disturbance to different extent after brain injury, and basal ganglia hemorrhage was identified by CT after brain injury, and hemorrhagic volume were more than or equal to 2 mL. Totally 34 males and 6 females were enrolled, aged 16-72 years and 28 cases of them were younger than 40 years old. The prognosis of the patients was evaluated with Glasgow outcome scale （GOS） at 6 months after injury, and GOS scoring standard was 1-5 points （1 for dead; 2 for vegetative survival, long-term coma, manifestations of decorticate rigidity or decerebrate rigidity; 3 for severely disabled, should be look after by others; 4 for moderately disabled, be able in self-care; 5 for good recovery, adults can work and study）. RESULTS： The enrolled cases accounted for 3.20% of the 1250 patients with closed brain injury admitted at the same period. ① The causes of injury included traffic accident in 36 cases, fall in 2 cases, and assault in 2 cases. ②At admission, the Glasgow coma scale （GCS） scores were as follow： 13-15 scores （mild） in 10 cases, 9-12 scores （moderate） in 20 cases, and 3-8 scores （severe） in 10 cases. Hemiplegia presented in 37 cases, aphasia in 20 cases, conscious disturbance in 10 cases, unilateral mydriasis in 6 cases, and decerebrate rigidity in 2 cases. ③ TBGH was detected by CT within 30 minutes to 24 hours after injury in 37 cases, and delayed TBGH was diagnosed by serial CT reexamination at 24 to 48 hours after injury in 3 cases. Apart from the TBGH, signs of diffuse axonal injury （DAI） were observed in 22 cases and the criterion of CT diagnosis was that apart from TBGH, small hemorrhagic loci were found in the deep white matter of the hemisphere, corpus callosum, dorsolateral quadrants of the midbrain and the upper pons, internal capsule, basal ganglia area, intraventricle, and cerebellum, etc., but there was no obvious mass effect （clinically manifested by conscious disturbance immediately after brain injury, and primary coma lasted for longer than 6 hours）. Secondary intraventricular hemorrhage occurred in 19 cases, acute subdural hematoma in 3 cases, acute epidural hematoma in 1 case, cerebral contusion in 7 cases, and diffuse cerebral swelling in 3 cases. TBGH located at contralateral to the side of impact in 29 cases. The volume of TBGH was 3-9 mL in 8 cases, 10-19 mL in 10 cases, 20-29 mL in 12 cases, and more than 30 mL in 9 cases. ④Ten patients underwent surgical treatment, including TBGH were evacuated by craniotomy in 7 cases, drained by drilling hole in 2 cases, and hematoma drainage combined with extraventricular drainage in 1 case. 30 patients received conservative treatment, including hyperbaric oxygen treatment in 22 cases. ⑤At 6 months after injury, good recovery obtained in 10 cases （25%）, moderately disabled in 17 cases （42.5%）, severely disabled in 2 cases （5%） and dead in 11 cases （27.5%） respectively. CONCLUSION： In our study, the proportion of TBGH in closed brain injury was 3.2%, and it had a higher incidence of disability. Most of the patients were young people and injured in traffic accident, and TBGH mostly oc- curred at contralateral to the side of impact. The patients suffered from hemiplegia and long-term coma, incidence rate of diffuse axonal injury was higher, but conscious disturbance was milder. Conservative treatment was mainly applied in our study. CT scan can not only establish the position, volume of TBGH, but also establish if it combines with other intracranial injury, and it is helpful to detect delayed TBGH.

Typhoon Case Comparison Analysis Between Heterogeneous Many-Core and Homogenous Multicore Supercomputing Platforms

In this paper,a typical experiment is carried out based on a high-resolution air-sea coupled model,namely,the coupled ocean-atmosphere-wave-sediment transport(COAWST)model,on both heterogeneous many-core(SW)and homogenous multicore(Intel)supercomputing platforms.We construct a hindcast of Typhoon Lekima on both the SW and Intel platforms,compare the simulation results between these two platforms and compare the key elements of the atmospheric and ocean modules to reanalysis data.The comparative experiment in this typhoon case indicates that the domestic many-core computing platform and general cluster yield almost no differences in the simulated typhoon path and intensity,and the differences in surface pressure(PSFC)in the WRF model and sea surface temperature(SST)in the short-range forecast are very small,whereas a major difference can be identified at high latitudes after the first 10 days.Further heat budget analysis verifies that the differences in SST after 10 days are mainly caused by shortwave radiation variations,as influenced by subsequently generated typhoons in the system.These typhoons generated in the hindcast after the first 10 days attain obviously different trajectories between the two platforms.