Spontaneous Tumor Lysis Syndrome Secondary to Iatrogenic Acute Kidney Injury: A Case Report

Spontaneous Tumor Lysis Syndrome (STLS) is a rare oncologic condition caused by the breakdown of neoplastic tissue in the absence of traditional anti-tumor therapy. It is postulated that cancers with rapidly dividing cells lead to increased cell turnover which exceeds the kidneys’ ability to adequately filtrate by-products of cellular breakdown (i.e., phosphate, potassium, anduric acid), leading to end organ damage. It has been reported in the past that kidney failure is a sequelae of Tumor Lysis Syndrome (TLS), but there have been no reports that demonstrate acute kidney injury (AKI) preceding TLS. The case presented here demonstrates TLS in a patient with no formal cancer diagnosis, who had received no chemotherapy or radiation that was precipitated by an iatrogenic AKI with chlorthalidone and ibuprofen. This unusual pattern of AKI preceding STLS may provide insight into the pathophysiology of the condition and could possibly lead to greater understanding of this phenomenon.

Clinical Study of Acupotomy Trinity Lysis Combined with Rehabilitation Training for Spastic Paralysis after Stroke

Objective:To study the clinical efficacy of acupotomy trinity lysis combined with rehabilitation training in the treatment of spastic paralysis after stroke,and to provide guidance for clinical diagnosis and treatment.Methods:From July 2019 to November 2020,119 patients with post-stroke spastic paralysis who were admitted to our hospital's encephalopathy department were selected as the research objects,and 61 patients were divided into acupuncture combined with rehabilitation training group as the observation group by random number table method.58 patients were divided into the rehabilitation training group as the control group.After 21 days of treatment,they passed the modified Ashworth Spasm Scale(MAS)grading scale score,Clinical Spasm Index(clinical spasm index,CSI)assessment,Fugl,Meyer exercise function scale(FMA)Score,Modified Barthel Index Score,and compare the clinical efficacy after treatment.Results:After treatment,the total effective rate of the observation group(95.08%)was higher than that of the control group(86.21%),and the difference was statistically significant(P<0.05);Before treatment,the contrast difference of MAS,FMA,CSI scores and modified Barthel index scores of the two groups of patients is not statistically significant;After treatment,the MAS scores and CSI scores of the elbow and knee joints of the observation group[(1.52±0.81)(1.46±0.83)(5.87±2.12)]were significantly lower than those of the control group[(2.17±0.68)(2.03±0.79)(8.36±2.41)];FMA upper limb and lower limb scores and modified Barthel index[(51.87±4.41)(30.21±5.05)(72.41±5.81)]of the observation group were significantly higher than those of the control group[(44.26±4.78)(28.45±4.23)(68.65±6.09)],the difference was statistically significant(P<0.05).Conclusion:Acupotomy trinity lysis combined with rehabilitation training is effective in treating patients with post-stroke spastic paralysis.It provides a safe,reliable and clinically effective new program,which is worthy of popularization and application.

Tumor lysis syndrome: A clinical review

Tumor lysis syndrome is an oncometabolic emergency resulting from rapid cell death. Tumor lysis syndrome can occur as a consequence of tumor targeted therapy or spontaneously. Clinicians should stratify every hospitalized cancer patient and especially those receiving chemotherapy for the risk of tumor lysis syndrome. Several aspects of prevention include adequate hydration, use of uric acid lowering therapies, use of phosphate binders and minimization of potassium intake. Patients at high risk for the development of tumor lysis syndrome should be monitored in the intensive care unit. Established tumor lysis syndrome should be treated in the intensive care unit by aggressive hydration, possible use of loop diuretics, possible use of phosphate binders,use of uric acid lowering agents and dialysis in refractory cases.

Endoscopic lysis of bladder scar associated with Hunner’s lesions:A new technique

Objective:Five to ten percent of interstitial cystitis/bladder pain syndrome(IC/BPS)patients have Hunner’s lesions(HL),areas of non-specific inflammation and scarring.The poor quality of life of patients with HL is entwined in associated pain and loss of bladder capacity.Although the decrease in bladder capacity is usually dependent on pain,it may also be dependent upon scarring and associated compliance changes produced by the inflammatory process.This report reviews the potential role of endoscopic scar lysis using the holmium laser in the management of these patients whose only other therapeutic option is urinary diversion.Methods:Two patients with HL and“end stage”bladders who underwent holmium laser division of bladder wall scar/tethering were identified.Clinical data were reviewed with emphasis on safety and efficacy.Results:Both patients selected for this procedure underwent holmium laser lysis of known scar tissue in an effort to increase bladder capacity and improve symptoms of urinary frequency and pain with bladder filling.The median age of patients who underwent the procedure was 63(59-67)years.Incisions were made with the holmium laser at frequencies of 3e10 Hz of 300e700 J along the region of scarring.All procedures were performed by the same practitioner.There was an increase in bladder capacity by 58.3%(50.0%-66.7%).During a mean follow-up of 4.2 years,there appeared to be a significant improvement with an increase in interval time between voids and a decrease in pain with bladder filling.Conclusion:Patients with IC/BPS may be severely debilitated by a clinically significant decrease in their bladder capacity,especially in the face of HL.The use of the holmium laser to incise regions of scar and bladder wall tethering may produce a clinically significant and durable increase in bladder capacity.The use of this technique as a means of treating bladder scarring poses an excellent adjunct to existing treatment strategies.

Maintainability Analysis Visualization System and Its Development in AutoCAD Environment

Maintainability is an important design characterist ic , and also is a design parameter. The essence of maintainability design is to ex pect and solve possible maintenance problems at early stage during product devel opment, maintainability must be designed into product simultaneously. But curren t maintainability methods do not support concurrent engineering. This paper anal yzes the deficiencies of existing maintainability technologies, and introduces t he concept of maintainability analysis visualization. The two major deficiencies are that maintainability analysis time lags behind product design, and the main tainability techniques do not accommodate modern product design concepts. After this, the infrastructure of maintainability analysis visualization system is dis cussed. The system are composed of four subsystems, they are product modeling, d isassembly process modeling, simulation and analysis, and user interface. Produc t modeling is accomplished with the capability of CAD system, disassembly proces s modeling is mainly a reason process based on assembly information. The system is integrated into AutoCAD so that designer can timely analyze their product des ign from the viewpoint of easy maintenance. Human model generation function, hum an task analysis function, tool analysis function, visibility analysis function is implemented, disassembly process planning function is still under developing.

The bacteriophage mu lysis system–A new mechanism of host lysis?

Bacteriophages are viruses that infect bacteria and can choose any one of the two alternative pathways for infection,i.e.,lysis or lysogeny.Phage lysis is one of the conventional biological processes required to spread infection from one bacterium to another.Our analysis suggests that in the paradigm bacteriophage Mu,six proteins might be involved in host cell lysis.Mu has a broad host range,and Mu-like phages were found in both Gram-negative and Gram-positive bacteria.An analysis of the genomes of Mu and Mu-like phages could be useful in elucidating the lysis mechanism in this group of phages.A detailed review of the various mechanisms of phage lysis and different proteins associated with the process will help researchers understand the phage biology and their life cycle in different bacteria.The recent increase in the number of multidrug-resistant(MDR)strains of bacteria and the usual long-term nature of new drug development has encouraged scientists to look for alternative strategies like phage therapy and the discovery of new lysis mechanisms.Understanding the lysis mechanism in the Mu-like phages could be exploited to develop alternative therapeutics to kill drug-resistant pathogenic bacteria.In this review article,we have analyzed the phage Mu-mediated host lysis system,which is unknown till now,and our analysis indicates a possibility of the existence of a new lysis mechanism operating in Mu.

Study on Genetic Inactivation Bacterial Ghosts of Pasteurella multocida based PhiX174 Gene E Lysis Cassette Mediated

[Objective] To study on genetic inactivation bacterial ghosts of Pasteurella multocida based PhiX174 gene E lysis cassette mediated. [ Method ] Recombinant pPBA1100-e was constructed by which the gene E of bacteriophage Phix174 and temperature sensitivity expressing control system hybridized with plasmid pPBA1100 by genetic engineering method. Recombinant was transformed to Pasteurella multocida and lysis gene E expressed by temperature induction. Recombinant was detected by restriction endonuclease. Cell morphology of bacterial ghost of Pasteurella mul- tocida was observed by scanning electron microscopy and inactivation ratio was estimated by CFU analysis. I Result~ The results indicated that the recombination plasmid presented three bands by restriction endonuclease and agarose electrophoresis and that molecular weight of every band ac- corded with theoretical value. The result of SEM observing showed that recombination plasmid expressed successfully in P. multocida and produced bacterial ghost. The result of CFU detecting demonstrated that inactivation ratio of P. multocida reached 99 per cent. ~Conclusion~ This study pro- vided technical bases for the preparation of antigen vaccine of natural bacterial outer membrane protein.

Tumour lysis syndrome:A rare acute presentation of locally advanced testicular cancer--Case report and review of literature

Tumour lysis syndrome(TLS)is a potentially fatal complication of malignancy or its treatment.This uncommon syndrome comprises laboratory findings of hyperuricaemia,hypocalcaemia,hyperkalaemia and hyperphosphataemia.A literature search revealed a total of eight patients,with testicular cancer,who had TLS.All these patients had metastatic disease.We present a unique case of a 47-year-old gentleman we saw in clinic,who presented with a rapidly growing right groin mass and acute breathlessness,and discuss the diagnosis and management of TLS.TLS is extremely rare in testicular cancer but necessitates the awareness of urologists.TLS can occur spontaneously in testicular malignancy.Cell lysis in a rapidly proliferating germ cell tumour is a possible mechanism.The prompt identification and institution of management for TLS is crucial to improve clinical outcomes.

Successful prevention of tumor lysis syndrome using recombinant urate oxidase in patient with metastasic and bulky prostate rhabdomyosarcoma

Tumor lysis syndrome (TLS) is a life-threatening oncological emergency that frequently occurs in patients with hematological malignancies. It is becoming more common in patients with solid tumors because of advances in molecular targeted therapies. Recombinant urate oxidase (rUO) is effective at preventing and treating hyperuricemia, but clinicians who treat adult patients with solid tumors are generally not aware of this. In addition, the treatment guidelines for TLS do not include indications for rUO treatment for chemosensitive sarcoma. We report an adolescent case of metastatic rhabdomyosarcoma (RMS), in which clinical TLS was successfully prevented using rUO. A 16-year-old Japanese male suffered from urinary retention and bone pain and was diagnosed with prostate RMS combined with multiple bone metastases and bone marrow involvement. He was judged to be at high risk of clinical TLS because his prostate tumor was bulky and he displayed laboratory TLS. rUO was administered during chemotherapy. Soon after the initiation of chemotherapy, his disseminated intravascular coagulation (DIC) got worse, and his lactate dehydrogenase (LDH) level was elevated due to tumor lysis. However, his serum uric acid levels remained low, and he was prevented from falling into acute renal failure. The planned regimen was successfully completed without life-threatening complications, and the patient achieved a complete response after 2 courses of chemotherapy. The international TLS consensus panel developed recommendations for TLS prophylaxis, but did not define the TLS risk classification of RMS. We recommend that RMS should be treated like neuroblastoma because it grows rapidly and is highly chemosensitive. Our patient was considered to be indicated for rUO because he displayed urinary retention, DIC, and laboratory TLS before chemotherapy. These features might be useful as indications for rUO therapy, which can safely support chemotherapy.

Tumor Lysis Syndrome in the Course of Burkitt Lymphoma Revealed by Medullar Compression

Background: Tumor lysis syndrome is unknown to many neurosurgical teams. A dreaded complication, especially in the course of hematological malignancies, like it was the case in two of our patients operated for spinal cord compression by Burkitt’s lymphoma. Objectives: To describe the clinical and biological presentation of this potentially fatal complication, which can be improved by early preventive or curative treatments. Case Reports: Patient 1: A 49-year-old woman was admitted for vertebral and intercostal pain and paraparesis. Myelography revealed epidural medullary compression at the 7th thoracic vertebrae (Th7) level. Patient 2: A 67-year-old woman was admitted for cervico-thoracic pain and paraparesis. MRI showed posterior epidural medullary compression between the 1st thoracic vertebrae (Th1) and 5th thoracic vertebrae (Th5). In both cases, an urgent decompressive laminectomy was performed. They had also received postoperative corticosteroid therapy. The multi-visceral failure occurred on the 1st day (D1) and 3rd day (D3) postoperatively, respectively. In the absence of adequate management, the outcome was fatal for the two patients respectively at D3 and D5 postoperatively. This syndrome was retained in the presence of glucocorticoid (triggering factor) and the histological result in favor of Burkitt lymphoma (target disease). Conclusion: Malignant hemopathies is a common cause of spinal cord compressions. From these two cases, the importance of biological and clinical surveillance emerges, with patients requiring urgent management for radiculo-medullar tumor compression.

Bacterial Lysis of Microalgal Cells

This short communication reports a pioneering research of using bacteria for simultaneous algal cell disruption and cell wall/membrane utilization. Microalgae are regarded as one of the most promising feedstock that can potentially address the twin challenges of energy security and environmental protection due to their fast growth rate, high lipid content and CO2 biofixation capabilities. However, different from their terrestrial oil crops, the extracellular coverings of algae vary significantly, ranging from multiple layers of elaborate scales to highly mineralized coats to complex cell walls consisting of structural fibrils enmeshed in complex matrices. These strong cellular walls and membranes are resistant to disintegration, which makes lipid extraction from microalgae difficult. A bacteria-assisted algal cell disruption and lipid extraction method was studied here. The bacteria Sagittula stellata showed strong algicidal activity against two microalgae, Nannochloropsis oculata and Dunaliella salina. The algicidal rate reached 64.7% on N. oculata and 52.4% on D. salina in six days. A decrease in chlorophyll-a fluorescence density of both algae and bacteria addition was also observed. After 6-day treatment by S. stellata, hexane-extracted crude lipid contents increased from 32.9% to 45.7% and from 19.6% to 36.4% for N. oculata and D. salina, respectively, when compared with no bacterial addition. The preliminary results concluded that S. stellata was effective in the lysis of microalgal cells for effective lipid recovery.

Clinical Study of Acupotomy Trinity Lysis on Cervical Spondylotic Myelopathy with Liver and Kidney Deficiency Syndrome

Objective:To compare the therapeutic effects of acupotomy trinity lysis and traditional acupotomy on cervical spondylotic myelopathy.Methods:A total of 205 patients with cervical spondylotic myelopathy of liver and kidney deficiency syndrome were randomly divided into the experimental group(105 cases)and the control group(100 cases).The experimental group was relaxed with acupotomy in three positions:Heaven(tian),Human(ren)and Earth(di).Traditional acupotomy was used to relax Ashi acupoints of the affected vertebra in the control group.One treatment was conducted in one week,and the duration of one course of treatment was three weeks.The VAS,JOA score and NDI index were observed after treatment.Results:Before and after treatment,the total treatment efficiency of the treatment group was 95.23%,and that of the control group was 80.00%,there was significant difference between the two groups,P<0.05;Before operation,there was no significant difference in JOA score,NDI index score,and VAS score between the treatment group and the control group(P>0.05);there was no significant difference after 1 week(P>0.05),but there were significant differences between the two groups 2 weeks and 3 weeks after operation(P<0.05).Conclusion:Acupotomy trinity lysis is a safe,effective and economical treatment for cervical spondylotic myelopathy.

Chemotherapy-Induced Tumour Lysis Syndrome in Gastric Adenocarcinoma with Diffuse Liver Metastases:A Case Report

Tumour Lysis Syndrome (TLS) is an important oncological emergency case which is often found together with haematological malignities and, much less often, with solid tumours. While TLS seen in solid tumour cases usually develops following a cytotoxic chemotherapy and its prognosis is poor. We present the case of a 60-year-old man with gastric adenocarcinoma with diffuse liver metastases (image shows diffuse liver metastatic lesions) and high serum LDH levels, who developed TLS after systemic chemotherapy. With urgent and proper supportive treatment (intravenous intensive hydration, sodium bicarbonate, diuretic, calcium gluconate, allopurinol and haemodialysis), an impressive recovery from TLS was achieved in the patient with an advanced stage gastric cancer. The purpose of this report is to emphasize that although the present case was a rare, high physician attention is required because significant morbidity or mortality may occur when the syndrome is not duly considered during the pre-cytotoxic evaluation of the patient, when preventive measures are not taken, or if the appropriate treatment is not applied immediately once the syndrome appears, especially in patients who have high tumour burden solid cancer.

Rasburicase in treating tumor lysis syndrome:An umbrella review

Tumor lysis syndrome(TLS)remains a debilitating cause of hospitalization and death in patients with cancer and is a significant challenge for healthcare providers despite advancements in its management.This umbrella review analyzed the results of meta-analyses on the use of rasburicase in the treatment of patients with cancer.A literature search was performed of five databases(PubMed,Google Scholar,Cochrane Library,Scopus,Global Index Medicus,and ScienceDirect)for articles with full texts available online.A measurement tool to assess systematic reviews 2(AMSTAR 2)was used to assess the quality of the included studies,and Review Manager software was used to conduct all statistical analyses.The systematic search identified eight relevant meta-analyses,with primary analyses including outcome data that analyzed mortality,renal failure,and comparisons with allopurinol.The pooled data showed that rasburicase effectively reduced TLS development and serum uric acid levels in children and adults with malignancies.Most outcomes did not differ significantly compared with those of allopurinol.Future trials should focus on the cost-effectiveness of rasburicase compared to that of allopurinol while including high-,intermediate-,and low-risk patients.Rasburicase is safe and effective for managing patients with TLS.However,recent large-scale meta-analyses have reported conflicting results.Most meta-analyses were graded as low to critically low as per AMSTAR 2.The analysis revealed that the benefit of rasburicase did not differ significantly from that of allopurinol,which has higher cost-effectiveness and fewer side effects.

Improved resolution of mixed STR profiles using a fully automated differential cell lysis/DNA extraction method

Sexual assault evidence often contains sperm cells,which are typically separated from nonsperm cells using manual differential lysis procedures.The goal of this study was to evaluate the automated QIAGEN QIAcube for this purpose and to compare it to manual QIAGEN and manual organic differential methods using DNA yields and STR profile data for assessment.DNA yields were determined by qPCR,followed by multiplex STR amplification,CE analysis,and mixture interpretation.The automated method was capable of effective cell separation,producing DNA yields sufficient for STR amplification.Further,sperm fraction human:male DNA ratios from the QIAcube samples were consistently closer to the desired 1:1 and STR profiles were less likely to result in mixtures,with 6–8fewer female alleles detected(median 1.5 alleles).Ultimately,using the QIAcube for automated differential processing of semen-containing mixtures reduces the need for downstream mixture interpretation and improves STR profile quality with substantially less hands-on time.

Take actions to bridge the gaps between China and other countries:in the aspect of markers of mineral bone disease from China Dialysis Outcomes and Practice Patterns Study phase 5

Chinese National Renal Data System111 is the first national database for Chinese hemodialysis(HD)population,but unfortunately,data of monitoring frequency of laboratory markers were not well recorded,and therapeutic information was not timely updated.So China Dialysis Outcomes and Practice Patterns Study(DOPPS)is a representative of Chinese HD patients with close following,as compared with data of other countries.

Reversible Posterior Leukoencephalopathy Syndrome Sometimes Could be Irreversible： A Case Following Tumor Lysis Syndrome in Childhood Burkitt＇s Lymphoma

Reversible posterior leukoencepbalopathy syndrome （RPLS） was first described by Hinchey eta/. in 1996 as a clinical radiologic syndrome consisting of reversible cortical neuroIogic dysIhnction and brain imaging findings involving the posterior circulation, especially the occipital lobes.

Miniaturized Cell Lysis Device Using Spherically Focused Ultrasound

A prototype of a miniaturized cell lysis device developed using a concave spherical transducer is capable of lysing bacteria without added chemical denaturants, enzymes or microparticles and is capable of efficiently lysing yeast without any mechanical or enzymatic pretreatment. The device is designed for miniature bio analysis systems where cell lysing is needed to obtain intracellular materials for further analysis such as DNA identification. The device lysis efficiency was evaluated using viable cell counts and microscopy. Additionally, the device efficiency was compared with that of traditional chemical cell lysis methods using standard molecular biological techniques such as agarose gels and ultraviolet (UV) spectroscopy. The results indicate that efficient bacteria and cell disruption can be achieved through a low voltage driven and spherically focused high frequency ultrasonic device.

Overexpressions of Lambda Phage Lysis Genes and Biosynthetic Genes of Poly-β-hydroxybutyrate in Recombinant E.coli

A plasmid (pTU9) containing the lambda (λ) phage lysis genes S( )RRz and the biosynthetic genes phb CAB of poly β hydroxybutyrate (PHB) was constructed and transformed into E.coli JM109. Cultured in Luria Bertani (LB) medium with 20 g/L glucose, E.coli JM109 (pTU9) could accumulate PHB in cells up to 40% (g PHB per g dry cells). A chelating agent EDTA was applied to induce a complete cell lysis and PHB granules were released. This method has a potential application in PHB separation.

Magnetocatalysis:The Interplay between the Magnetic Field and Electrocatalysis

Magnetic fields are known as clean,economic,and effective tools to modify band and magnetic structures of materials.When coupled with catalytic processes such as the hydrogen evolution reaction(HER),they have the potential to control catalytic efficiency.Herein,we studied the magnetic response of a series of materials as HER catalysts,specifically ferromagnetic Co_(2)VGa,Co_(2)MnGa,and Ni,ferrimagnetic Mn_(2)CoGa,and paramagnetic Pt.