BACKGROUND Posterior ankle impingement syndrome(PAIS)is a cause of ankle pain due to pinching of bony or soft tissue structures in the hindfoot.The diagnosis is primarily made based on detailed history and accurate cl...BACKGROUND Posterior ankle impingement syndrome(PAIS)is a cause of ankle pain due to pinching of bony or soft tissue structures in the hindfoot.The diagnosis is primarily made based on detailed history and accurate clinical examination.The delay in its diagnosis has not yet been described in the pediatric and adolescent population.AIM To identify and characterize misdiagnosed cases of PAIS in pediatric and adolescent patients.METHODS This descriptive prospective study at a tertiary children’s hospital included patients≤18 years who underwent posterior ankle arthroscopy after presenting with chronic posterior ankle pain after being diagnosed with PAIS.Collected data included:Demographics,prior diagnoses and treatments,providers seen,time to diagnosis from presentation,and prior imaging obtained.Visual Analogue Scale(VAS)for pain and American Orthopedic Foot Ankle Society(AOFAS)ankle-hindfoot scores were noted at initial presentation and follow-up.RESULTS 35 patients(46 ankles)with average age of 13 years had an average 19 mo(range 0-60 mo)delay in diagnosis from initial presentation.25(71%)patients had previously seen multiple medical providers and were given multiple other diagnoses.All 46(100%)ankles had tenderness to palpation over the posterior ankle joint.Radiographs were reported normal in 31/42(72%)exams.In 32 ankles who underwent MRI,the most common findings included os trigonum(47%)/Stieda process(47%).Conservative treatment had already been attempted in all patients.Ankle impingement pathology was confirmed during arthroscopy in 46(100%)ankles.At an average follow-up of 13.1 mo,there was an improvement of VAS(pre-op 7.0 to post-op 1.2)and AOFAS scores(pre-op 65.1 to post-op 94).CONCLUSION This is the first study which shows that PAIS is a clinically misdiagnosed cause of posterior ankle pain in pediatric and adolescent population;an increased awareness about this diagnosis is needed amongst providers treating young patients.展开更多
Cerebral Venous Sinus Thrombosis (CVST/CSVT) is occlusion of cerebral veins and venous sinuses of brain secondary to blood clot formation resulting in hindrance in the blood drainage system in brain, leading to distur...Cerebral Venous Sinus Thrombosis (CVST/CSVT) is occlusion of cerebral veins and venous sinuses of brain secondary to blood clot formation resulting in hindrance in the blood drainage system in brain, leading to disturbances the internal homeostasis of brain, raised intracranial pressure, cerebral edema, and 50% of cases will have venous infarction or venous hemorrhage (stroke). CVST although being a Rare disorder but may be more common in children than adults with greater risk in neonatal period i.e. first 28 days of life. Here we are discussing a case of Pediatric CVST in a 7-month-old baby boy who presented to Emergency Room (ER) with recurrent discrete episodes of vomiting, fever, seizures, drowsiness and respiratory distress. The fatal outcome in our child was attributed to delayed presentation in a tertiary care center, hence missed early diagnosis and treatment. In this child the CVST could be result of amalgamation of complex underlying ongoing multiple pathological processes: an acute systemic illness like sepsis, severe dehydration, undiagnosed and untreated complex congenital heart disease, tetralogy of fallot with osteum secondum atrial septal defect, worsening the coagulopathy. It takes this case even more unique. This discussion is to bring focus on the importance of knowledge about CVST amongst emergency physicians and primary care physicians, specially managing this rare disorder with flummox presentation mimicking other more common disorders, especially in pediatric and neonatal population where definitive history and chief complaints are often vague and difficult to obtain, making it more difficult to diagnose. We the authors hence reporting this case with intent to spread awareness of CVST, how to doubt it, detect it and then manage it, especially in places like Chhattisgarh, India, where CVST is not so uncommon. We believe early diagnosis, early presentation to tertiary care center with aggressive early treatment can significantly reduce the mortality. Should the parents brought the baby early to any tertiary care center owing to his complex deteriorating symptoms like high grade fever progressed to drowsiness and seizure episodes, could there be a different outcome for this child as well as his parents.展开更多
Oxidative stress(OS)is intimately associated with tumorigenesis and has been considered a potential therapeutic strategy.However,the OS-associated therapeutic target for esophageal squamous cell carcinoma(ESCC)remains...Oxidative stress(OS)is intimately associated with tumorigenesis and has been considered a potential therapeutic strategy.However,the OS-associated therapeutic target for esophageal squamous cell carcinoma(ESCC)remains unconfirmed.In our study,gene expression data of ESCC and clinical information from public databases were downloaded.Through LASSO-Cox regression analysis,a risk score(RS)signature map of prognosis was constructed and performed external verification with the GSE53625 cohort.The ESTIMATE,xCell,CIBERSORT,TIMER,and ImmuCellAI algorithms were employed to analyze infiltrating immune cells and generate an immune microenvironment(IM).Afterward,functional enrichment analysis clarified the underlying mechanism of the model.Nomogram was utilized for forecasting the survival rate of individual ESCC cases.As a result,we successfully constructed an OS-related genes(OSRGs)model and found that the survival rate of high-risk groups was lower than that of low-risk groups.The AUC of the ROC verified the strong prediction performance of the signal in these two cohorts further.According to independent prognostic analysis,the RS was identified as an independent risk factor for ESCC.The nomogram and follow-up data revealed that the RS possesses favorable predictive value for the prognosis of ESCC patients.qRT-PCR detection demonstrated increased expression of MPC1,COX6C,CYB5R3,CASP7,and CYCS in esophageal cancer patients.In conclusion,we have constructed an OSRGs model for ESCC to predict patients’prognosis,offering a novel insight into the potential application of the OSRGs model in ESCC.展开更多
Background:Osteosarcoma(OS),recognized as the predominant malignant tumor originating from bones,necessitates an in-depth comprehension of its intrinsic mechanisms to pinpoint novel therapeutic targets and enhance tre...Background:Osteosarcoma(OS),recognized as the predominant malignant tumor originating from bones,necessitates an in-depth comprehension of its intrinsic mechanisms to pinpoint novel therapeutic targets and enhance treatment methodologies.The role of fat mass and obesity-associated(FTO)in OS,particularly its correlation with malignant traits,and the fundamental mechanism,remains to be elucidated.Materials and Methods:1.The FTO expression and survival rate in tumors were analyzed.2.FTO in OS cell lines was quantified utilizing western blot and PCR.3.FTO was upregulated and downregulated separately in MG63.4.The impact of FTO on the proliferation and migration of OS cells was evaluated using CCK-8,colony formation,wound healing,and Transwell assays.5.The expression of miR-150-5p in OS cells-derived exosomes was identified.6.The binding of miR-150-5p to FTO was predicted by TargetScan and confirmed by luciferase reporter assay.7.The impact of exosome miR-150-5p on the proliferation and migration of OS cells was investigated.Results:The expression of FTO was higher in OS tissues compared to normal tissues correlating with a worse survival rate.Furthermore,the downregulation of FTO significantly impeded the growth and metastasis of OS cells.Additionally,miR-150-5p,which was downregulated in both OS cells and their derived exosomes,was found to bind to the 3′-UTR of FTO through dual luciferase experiments.Exosomal miR-150-5p was found to decrease the expression of FTO and inhibit cell viability.Conclusions:We identified elevated levels of FTO in OS,which may be attributed to insufficient miR-150-5p levels in both the cells and exosomes.It suggests that the dysregulation of miR-150-5p and its interaction with FTO could potentially promote the development of OS.展开更多
报道1例表现为多系统萎缩小脑型的脊髓小脑性共济失调8型(spinocerebellar ataxia type 8,SCA8)患者。该患者为57岁男性,病程4年,以头晕、共济失调为首发症状,后出现自主神经功能障碍、快速眼动睡眠障碍等表现。神经系统查体提示自主神...报道1例表现为多系统萎缩小脑型的脊髓小脑性共济失调8型(spinocerebellar ataxia type 8,SCA8)患者。该患者为57岁男性,病程4年,以头晕、共济失调为首发症状,后出现自主神经功能障碍、快速眼动睡眠障碍等表现。神经系统查体提示自主神经功能障碍、眼球震颤、构音障碍、共济失调,颅脑核磁共振见脑干、小脑对称性萎缩及脑桥“十字征”。基因检测结果显示ATXN8OS的两个等位基因CTA/CTG重复次数异常增多,确诊为SCA8。治疗上予以改善共济失调、自主神经功能障碍等对症治疗后患者反应良好。SCA8为罕见的运动障碍性疾病,临床异质性高。本报道旨在提示临床医师,SCA8也可表现为自主神经功能障碍、共济失调、脑桥“十字征”等类似多系统萎缩小脑型的特点,临床工作中要避免误诊、漏诊。展开更多
目的分析脊髓小脑共济失调8型(Spinocerebellar ataxia type 8,SCA8)患者的基因检测结果,总结有效治疗方法。方法对1例拟诊SCA8患者的基因检测结果和治疗方法作回顾性分析。结果18岁男性患者,因“步态不稳12年”就诊,临床表现为行走不...目的分析脊髓小脑共济失调8型(Spinocerebellar ataxia type 8,SCA8)患者的基因检测结果,总结有效治疗方法。方法对1例拟诊SCA8患者的基因检测结果和治疗方法作回顾性分析。结果18岁男性患者,因“步态不稳12年”就诊,临床表现为行走不稳、剪刀步态、双下肢肌张力增高。抽取患者及其父母的外周静脉血,行遗传性共济失调Panel基因检测、全外显子测序以及Sanger测序验证,基因检测结果显示:患者的ATXN8/ATXN8OS基因CAG重复分别是18次和68次,其母亲ATXN8/ATXN8OS基因CAG重复分别是24次和67次,患者父亲基因检测结果未见异常。结合患者临床症状、生物信息学软件预测结果,明确诊断为SCA8。为改善患者双下肢痉挛症状,实施选择性脊神经背根切断术(SDR)及脊神经根粘连松解术治疗,并进行术后康复锻炼。术后6个月,患者剪刀步态明显改善,行走基本平稳,MAS评分、VAS评分、坐位平衡及立位平衡均有改善。结论ATXN8/ATXN8OS基因串联重复区的CAG异常重复扩增可导致SCA8,临床表现为痉挛性步态不稳,结合基因检测结果可明确诊断,SDR可有效改善SCA8患者的痉挛性步态。展开更多
By the analysis of vulnerabilities of Android native system services,we find that some vulnerabilities are caused by inconsistent data transmission and inconsistent data processing logic between client and server.The ...By the analysis of vulnerabilities of Android native system services,we find that some vulnerabilities are caused by inconsistent data transmission and inconsistent data processing logic between client and server.The existing research cannot find the above two types of vulnerabilities and the test cases of them face the problem of low coverage.In this paper,we propose an extraction method of test cases based on the native system services of the client and design a case construction method that supports multi-parameter mutation based on genetic algorithm and priority strategy.Based on the above method,we implement a detection tool-BArcherFuzzer to detect vulnerabilities of Android native system services.The experiment results show that BArcherFuzzer found four vulnerabilities of hundreds of exception messages,all of them were confirmed by Google and one was assigned a Common Vulnerabilities and Exposures(CVE)number(CVE-2020-0363).展开更多
本研究设计一个基于数字孪生技术的伺服电机控制系统,以实现对伺服电机的高效远程控制。通过构建伺服电机的虚拟模型与伺服电机实体建立映射,再利用数字孪生技术实现实体和虚拟模型的实时交互及对伺服电机的准确控制。在研究过程中,主...本研究设计一个基于数字孪生技术的伺服电机控制系统,以实现对伺服电机的高效远程控制。通过构建伺服电机的虚拟模型与伺服电机实体建立映射,再利用数字孪生技术实现实体和虚拟模型的实时交互及对伺服电机的准确控制。在研究过程中,主要采用了超文本50(Hyper Text Markup Language 5,HTML5)、Three.js等前端技术构建用户界面,通过Node.js搭建后端服务,利用树莓派(Raspberry Pi OS)开发平台实现物理设备的控制逻辑,确保了系统的高效运行和便捷的用户控制界面,实现了基于Web的实时控制和监测系统,推动了传统自动化控制技术向数字化、网络化发展。展开更多
文摘BACKGROUND Posterior ankle impingement syndrome(PAIS)is a cause of ankle pain due to pinching of bony or soft tissue structures in the hindfoot.The diagnosis is primarily made based on detailed history and accurate clinical examination.The delay in its diagnosis has not yet been described in the pediatric and adolescent population.AIM To identify and characterize misdiagnosed cases of PAIS in pediatric and adolescent patients.METHODS This descriptive prospective study at a tertiary children’s hospital included patients≤18 years who underwent posterior ankle arthroscopy after presenting with chronic posterior ankle pain after being diagnosed with PAIS.Collected data included:Demographics,prior diagnoses and treatments,providers seen,time to diagnosis from presentation,and prior imaging obtained.Visual Analogue Scale(VAS)for pain and American Orthopedic Foot Ankle Society(AOFAS)ankle-hindfoot scores were noted at initial presentation and follow-up.RESULTS 35 patients(46 ankles)with average age of 13 years had an average 19 mo(range 0-60 mo)delay in diagnosis from initial presentation.25(71%)patients had previously seen multiple medical providers and were given multiple other diagnoses.All 46(100%)ankles had tenderness to palpation over the posterior ankle joint.Radiographs were reported normal in 31/42(72%)exams.In 32 ankles who underwent MRI,the most common findings included os trigonum(47%)/Stieda process(47%).Conservative treatment had already been attempted in all patients.Ankle impingement pathology was confirmed during arthroscopy in 46(100%)ankles.At an average follow-up of 13.1 mo,there was an improvement of VAS(pre-op 7.0 to post-op 1.2)and AOFAS scores(pre-op 65.1 to post-op 94).CONCLUSION This is the first study which shows that PAIS is a clinically misdiagnosed cause of posterior ankle pain in pediatric and adolescent population;an increased awareness about this diagnosis is needed amongst providers treating young patients.
文摘Cerebral Venous Sinus Thrombosis (CVST/CSVT) is occlusion of cerebral veins and venous sinuses of brain secondary to blood clot formation resulting in hindrance in the blood drainage system in brain, leading to disturbances the internal homeostasis of brain, raised intracranial pressure, cerebral edema, and 50% of cases will have venous infarction or venous hemorrhage (stroke). CVST although being a Rare disorder but may be more common in children than adults with greater risk in neonatal period i.e. first 28 days of life. Here we are discussing a case of Pediatric CVST in a 7-month-old baby boy who presented to Emergency Room (ER) with recurrent discrete episodes of vomiting, fever, seizures, drowsiness and respiratory distress. The fatal outcome in our child was attributed to delayed presentation in a tertiary care center, hence missed early diagnosis and treatment. In this child the CVST could be result of amalgamation of complex underlying ongoing multiple pathological processes: an acute systemic illness like sepsis, severe dehydration, undiagnosed and untreated complex congenital heart disease, tetralogy of fallot with osteum secondum atrial septal defect, worsening the coagulopathy. It takes this case even more unique. This discussion is to bring focus on the importance of knowledge about CVST amongst emergency physicians and primary care physicians, specially managing this rare disorder with flummox presentation mimicking other more common disorders, especially in pediatric and neonatal population where definitive history and chief complaints are often vague and difficult to obtain, making it more difficult to diagnose. We the authors hence reporting this case with intent to spread awareness of CVST, how to doubt it, detect it and then manage it, especially in places like Chhattisgarh, India, where CVST is not so uncommon. We believe early diagnosis, early presentation to tertiary care center with aggressive early treatment can significantly reduce the mortality. Should the parents brought the baby early to any tertiary care center owing to his complex deteriorating symptoms like high grade fever progressed to drowsiness and seizure episodes, could there be a different outcome for this child as well as his parents.
基金Natural Science Foundation of Ningbo(Grant No.2021J261).
文摘Oxidative stress(OS)is intimately associated with tumorigenesis and has been considered a potential therapeutic strategy.However,the OS-associated therapeutic target for esophageal squamous cell carcinoma(ESCC)remains unconfirmed.In our study,gene expression data of ESCC and clinical information from public databases were downloaded.Through LASSO-Cox regression analysis,a risk score(RS)signature map of prognosis was constructed and performed external verification with the GSE53625 cohort.The ESTIMATE,xCell,CIBERSORT,TIMER,and ImmuCellAI algorithms were employed to analyze infiltrating immune cells and generate an immune microenvironment(IM).Afterward,functional enrichment analysis clarified the underlying mechanism of the model.Nomogram was utilized for forecasting the survival rate of individual ESCC cases.As a result,we successfully constructed an OS-related genes(OSRGs)model and found that the survival rate of high-risk groups was lower than that of low-risk groups.The AUC of the ROC verified the strong prediction performance of the signal in these two cohorts further.According to independent prognostic analysis,the RS was identified as an independent risk factor for ESCC.The nomogram and follow-up data revealed that the RS possesses favorable predictive value for the prognosis of ESCC patients.qRT-PCR detection demonstrated increased expression of MPC1,COX6C,CYB5R3,CASP7,and CYCS in esophageal cancer patients.In conclusion,we have constructed an OSRGs model for ESCC to predict patients’prognosis,offering a novel insight into the potential application of the OSRGs model in ESCC.
文摘Background:Osteosarcoma(OS),recognized as the predominant malignant tumor originating from bones,necessitates an in-depth comprehension of its intrinsic mechanisms to pinpoint novel therapeutic targets and enhance treatment methodologies.The role of fat mass and obesity-associated(FTO)in OS,particularly its correlation with malignant traits,and the fundamental mechanism,remains to be elucidated.Materials and Methods:1.The FTO expression and survival rate in tumors were analyzed.2.FTO in OS cell lines was quantified utilizing western blot and PCR.3.FTO was upregulated and downregulated separately in MG63.4.The impact of FTO on the proliferation and migration of OS cells was evaluated using CCK-8,colony formation,wound healing,and Transwell assays.5.The expression of miR-150-5p in OS cells-derived exosomes was identified.6.The binding of miR-150-5p to FTO was predicted by TargetScan and confirmed by luciferase reporter assay.7.The impact of exosome miR-150-5p on the proliferation and migration of OS cells was investigated.Results:The expression of FTO was higher in OS tissues compared to normal tissues correlating with a worse survival rate.Furthermore,the downregulation of FTO significantly impeded the growth and metastasis of OS cells.Additionally,miR-150-5p,which was downregulated in both OS cells and their derived exosomes,was found to bind to the 3′-UTR of FTO through dual luciferase experiments.Exosomal miR-150-5p was found to decrease the expression of FTO and inhibit cell viability.Conclusions:We identified elevated levels of FTO in OS,which may be attributed to insufficient miR-150-5p levels in both the cells and exosomes.It suggests that the dysregulation of miR-150-5p and its interaction with FTO could potentially promote the development of OS.
文摘报道1例表现为多系统萎缩小脑型的脊髓小脑性共济失调8型(spinocerebellar ataxia type 8,SCA8)患者。该患者为57岁男性,病程4年,以头晕、共济失调为首发症状,后出现自主神经功能障碍、快速眼动睡眠障碍等表现。神经系统查体提示自主神经功能障碍、眼球震颤、构音障碍、共济失调,颅脑核磁共振见脑干、小脑对称性萎缩及脑桥“十字征”。基因检测结果显示ATXN8OS的两个等位基因CTA/CTG重复次数异常增多,确诊为SCA8。治疗上予以改善共济失调、自主神经功能障碍等对症治疗后患者反应良好。SCA8为罕见的运动障碍性疾病,临床异质性高。本报道旨在提示临床医师,SCA8也可表现为自主神经功能障碍、共济失调、脑桥“十字征”等类似多系统萎缩小脑型的特点,临床工作中要避免误诊、漏诊。
文摘目的分析脊髓小脑共济失调8型(Spinocerebellar ataxia type 8,SCA8)患者的基因检测结果,总结有效治疗方法。方法对1例拟诊SCA8患者的基因检测结果和治疗方法作回顾性分析。结果18岁男性患者,因“步态不稳12年”就诊,临床表现为行走不稳、剪刀步态、双下肢肌张力增高。抽取患者及其父母的外周静脉血,行遗传性共济失调Panel基因检测、全外显子测序以及Sanger测序验证,基因检测结果显示:患者的ATXN8/ATXN8OS基因CAG重复分别是18次和68次,其母亲ATXN8/ATXN8OS基因CAG重复分别是24次和67次,患者父亲基因检测结果未见异常。结合患者临床症状、生物信息学软件预测结果,明确诊断为SCA8。为改善患者双下肢痉挛症状,实施选择性脊神经背根切断术(SDR)及脊神经根粘连松解术治疗,并进行术后康复锻炼。术后6个月,患者剪刀步态明显改善,行走基本平稳,MAS评分、VAS评分、坐位平衡及立位平衡均有改善。结论ATXN8/ATXN8OS基因串联重复区的CAG异常重复扩增可导致SCA8,临床表现为痉挛性步态不稳,结合基因检测结果可明确诊断,SDR可有效改善SCA8患者的痉挛性步态。
基金This work was supported by the National Key R&D Program of China(2023YFB3106800)the National Natural Science Foundation of China(Grant No.62072051).We are overwhelmed in all humbleness and gratefulness to acknowledge my depth to all those who have helped me to put these ideas.
文摘By the analysis of vulnerabilities of Android native system services,we find that some vulnerabilities are caused by inconsistent data transmission and inconsistent data processing logic between client and server.The existing research cannot find the above two types of vulnerabilities and the test cases of them face the problem of low coverage.In this paper,we propose an extraction method of test cases based on the native system services of the client and design a case construction method that supports multi-parameter mutation based on genetic algorithm and priority strategy.Based on the above method,we implement a detection tool-BArcherFuzzer to detect vulnerabilities of Android native system services.The experiment results show that BArcherFuzzer found four vulnerabilities of hundreds of exception messages,all of them were confirmed by Google and one was assigned a Common Vulnerabilities and Exposures(CVE)number(CVE-2020-0363).
文摘本研究设计一个基于数字孪生技术的伺服电机控制系统,以实现对伺服电机的高效远程控制。通过构建伺服电机的虚拟模型与伺服电机实体建立映射,再利用数字孪生技术实现实体和虚拟模型的实时交互及对伺服电机的准确控制。在研究过程中,主要采用了超文本50(Hyper Text Markup Language 5,HTML5)、Three.js等前端技术构建用户界面,通过Node.js搭建后端服务,利用树莓派(Raspberry Pi OS)开发平台实现物理设备的控制逻辑,确保了系统的高效运行和便捷的用户控制界面,实现了基于Web的实时控制和监测系统,推动了传统自动化控制技术向数字化、网络化发展。
