Comparison between sepsis-induced coagulopathy and sepsis-associated coagulopathy criteria in identifying sepsis-associated disseminated intravascular coagulation

BACKGROUND:Disseminated intravascular coagulation(DIC)is associated with increased mortality in sepsis patients.In this study,we aimed to assess the clinical ability of sepsis-induced coagulopathy(SIC)and sepsis-associated coagulopathy(SAC)criteria in identifying overt-DIC and preDIC status in sepsis patients.METHODS:Data from 419 sepsis patients were retrospectively collected from July 2018 to December 2022.The performances of the SIC and SAC were assessed to identify overt-DIC on days 1,3,7,or 14.The SIC status or SIC score on day 1,the SAC status or SAC score on day 1,and the sum of the SIC or SAC scores on days 1 and 3 were compared in terms of their ability to identify pre-DIC.The SIC or SAC status on day 1 was evaluated as a pre-DIC indicator for anticoagulant initiation.RESULTS:On day 1,the incidences of coagulopathy according to overt-DIC,SIC and SAC criteria were 11.7%,22.0%and 31.5%,respectively.The specificity of SIC for identifying overt-DIC was significantly higher than that of the SAC criteria from day 1 to day 14(P<0.05).On day 1,the SIC score with a cut-off value>3 had a significantly higher sensitivity(72.00%)and area under the curve(AUC)(0.69)in identifying pre-DIC than did the SIC or SAC status(sensitivity:SIC status 44.00%,SAC status 52.00%;AUC:SIC status 0.62,SAC status 0.61).The sum of the SIC scores on days 1 and 3 had a higher AUC value for identifying the pre-DIC state than that of SAC(0.79 vs.0.69,P<0.001).Favorable effects of anticoagulant therapy were observed in SIC(adjusted hazard ratio[HR]=0.216,95%confidence interval[95%CI]:0.060–0.783,P=0.018)and SAC(adjusted HR=0.146,95%CI:0.041–0.513,P=0.003).CONCLUSION:The SIC and SAC seem to be valuable for predicting overt-DIC.The sum of SIC scores on days 1 and 3 has the potential to help identify pre-DIC.

Clinical and pathological characteristics and expression of related molecules in patients with airway disseminated lung adenocarcinoma

Objective:Lung adenocarcinoma exhibits diverse genetic and morphological backgrounds,in addition to considerable differences in clinical pathology and molecular biological characteristics.Among these,the phenomenon of spread through air space(STAS),a distinct mode of lung cancer infiltration,has rarely been reported.Therefore,this study aimed to explore the relationship between STAS tumor cells and the clinical and molecular characteristics of patients with lung adenocarcinoma,as well as their impact on prognosis.Methods:This study included 147 patients who were diagnosed with lung adenocarcinoma at the Inner Mongolia Autonomous Region Cancer Institute between January 2014 and December 2017.Surgical resection specimens were retrospectively analyzed.Using univariate and multivariate Cox analyses,we assessed the association between STAS and the clinicopathological features and molecular characteristics of patients with lung adenocarcinoma.Furthermore,we investigated the effects on patient prognosis.In addition,we developed a column–line plot prediction model and performed internal validation.Results:Patients with positive STAS had a significantly higher proportion of tumors with a diameter≥2 cm,with infiltration around the pleura,blood vessels,and nerves,and a pathological stage>IIB than in STAS-negative patients(P<0.05).Cox multivariate survival analysis revealed that clinical stage,STAS status,tumor size,and visceral pleural invasion were independent prognostic factors influencing the 5-year progression-free survival in patients with lung adenocarcinoma.The predictive values and P values from the Hosmer-Lemeshow test were 0.8 and 0.2,respectively,indicating no statistical difference.Receiver operating characteristic curve analysis demonstrated areas under the curve of 0.884 and 0.872 for the training and validation groups,respectively.The nomogram model exhibited the best fit with a value of 192.09.Conclusions:Clinical stage,pleural invasion,vascular invasion,peripheral nerve invasion,tumor size,and necrosis are independent prognostic factors for patients with STAS-positive lung adenocarcinoma.The nomogrambased on the clinical stage,pleural invasion,vascular invasion,peripheral nerve invasion,tumor size,and necrosis showed good accuracy,differentiation,and clinical practicality.

Improving creep strength of the fine-grained heat-affected zone of novel 9Cr martensitic heat-resistant steel via modified thermo-mechanical treatment

The infamous type Ⅳ failure within the fine-grained heat-affected zone (FGHAZ) in G115 steel weldments seriously threatens the safe operation of ultra-supercritical (USC) power plants.In this work,the traditional thermo-mechanical treatment was modified via the replacement of hot-rolling with cold rolling,i.e.,normalizing,cold rolling,and tempering (NCT),which was developed to improve the creep strength of the FGHAZ in G115 steel weldments.The NCT treatment effectively promoted the dissolution of preformed M_(23)C_(6)particles and relieved the boundary segregation of C and Cr during welding thermal cycling,which accelerated the dispersed reprecipitation of M_(23)C_(6) particles within the fresh reaustenitized grains during post-weld heat treatment.In addition,the precipitation of Cu-rich phases and MX particles was promoted evidently due to the deformation-induced dislocations.As a result,the interacting actions between precipitates,dislocations,and boundaries during creep were reinforced considerably.Following this strategy,the creep rupture life of the FGHAZ in G115 steel weldments can be prolonged by 18.6%,which can further push the application of G115 steel in USC power plants.

Disseminated tuberculosis presenting as meningitis and spondylodiscitis in an immunocompetent adult

Rationale:Disseminated tuberculosis involves the central nervous system in up to a third of cases.However,meningitis and spondylodiscitis due to miliary tuberculosis rarely occur together,particularly in the immuno-competent population.Patient concerns:A 37-year-old immunocompetent male presented with altered level of consciousness for one week and lower back pain with evening pyrexia for one month.Examination revealed spastic paraplegia and left hemiparesis.Diagnosis:Disseminated tuberculosis presenting with meningitis and spondylodiscitis.Interventions:Category I anti-tuberculous therapy with a tapering regimen of intravenous dexamethasone was administered.Outcomes:There was clinical improvement after nine months of treatment.Lessons:Tuberculosis may present with atypical clinical manifestations.Contrast enhanced computed tomography scan or magnetic resonance imaging combined with histopathological features,a high index of suspicion and clinical improvement with anti-tuberculous treatment can confirm the diagnosis in the absence of microbiological evidence,especially in extrapulmonary tuberculosis.

Recurred forehead osteoma disseminated after previous osteoma excision:A case report

BACKGROUND Forehead osteoma is a commonly encountered benign facial bone tumor.Endoscopic excision of benign forehead masses is widely performed.Here,we report a rare case of recurrent forehead osteoma that disseminated after a previous osteoma excision.CASE SUMMARY A 54-year-old female patient had previously undergone endoscopic removal of a single forehead osteoma at 30 years of age.However,she had a recurrent osteoma around the same site and underwent another endoscopic resection at 40 years of age.During her first visit to our outpatient clinic,she presented with a cobblestone-like irregular surface on the forehead and a 3D facial bone computed tomography scan revealed a widely ragged surface of the inoculated osteoma on the outer table of the frontal bone.Under general anesthesia,we performed a radical complete excision of the disseminated osteoma through a bicoronal incision using an osteotome,chisel,mallet,and rasping.We hypothesized that the recurrence may have been caused by the inoculation of residual osteoma remnants from the previous procedure.Craniofacial surgeons should be cautious when removing osteoma particles,particularly when using an endoscopic approach.CONCLUSION To prevent recurrence,it is essential to conduct additional meticulous burring and a thorough inspection of the surface after copious irrigation.

Angioimmunoblastic T-cell lymphoma induced hemophagocytic lymphohistiocytosis and disseminated intravascular coagulopathy: A case report

BACKGROUND Angioimmunoblastic T-cell lymphoma(AITL) is a subtype of peripheral T-cell lymphoma, with heterogenous clinical manifestations and poor prognosis. Here,we report a case of AITL induced hemophagocytic lymphohistiocytosis(HLH)and disseminated intravascular coagulopathy(DIC).CASE SUMMARY An 83-year-old man presented with fever and purpura of both lower limbs for one month. Groin lymph node puncture and flow cytometry indicated a diagnosis of AITL. Bone marrow examination and other laboratory related indexes indicated DIC and HLH. The patient rapidly succumbed to gastrointestinal bleeding and septic shock.CONCLUSION This is the first reported case of AITL induced HLH and DIC. AITL is more aggressive in older adults. In addition to male gender, mediastinal lymphadenopathy, anaemia, and sustained high level of neutrophil-to-lymphocyte ratio may indicate a greater risk of death. Early diagnosis, early detection of severe complications, and prompt and effective treatment are vital.

Fine-Grained Ship Recognition Based on Visible and Near-Infrared Multimodal Remote Sensing Images: Dataset,Methodology and Evaluation

Fine-grained recognition of ships based on remote sensing images is crucial to safeguarding maritime rights and interests and maintaining national security.Currently,with the emergence of massive high-resolution multi-modality images,the use of multi-modality images for fine-grained recognition has become a promising technology.Fine-grained recognition of multi-modality images imposes higher requirements on the dataset samples.The key to the problem is how to extract and fuse the complementary features of multi-modality images to obtain more discriminative fusion features.The attention mechanism helps the model to pinpoint the key information in the image,resulting in a significant improvement in the model’s performance.In this paper,a dataset for fine-grained recognition of ships based on visible and near-infrared multi-modality remote sensing images has been proposed first,named Dataset for Multimodal Fine-grained Recognition of Ships(DMFGRS).It includes 1,635 pairs of visible and near-infrared remote sensing images divided into 20 categories,collated from digital orthophotos model provided by commercial remote sensing satellites.DMFGRS provides two types of annotation format files,as well as segmentation mask images corresponding to the ship targets.Then,a Multimodal Information Cross-Enhancement Network(MICE-Net)fusing features of visible and near-infrared remote sensing images,has been proposed.In the network,a dual-branch feature extraction and fusion module has been designed to obtain more expressive features.The Feature Cross Enhancement Module(FCEM)achieves the fusion enhancement of the two modal features by making the channel attention and spatial attention work cross-functionally on the feature map.A benchmark is established by evaluating state-of-the-art object recognition algorithms on DMFGRS.MICE-Net conducted experiments on DMFGRS,and the precision,recall,mAP0.5 and mAP0.5:0.95 reached 87%,77.1%,83.8%and 63.9%,respectively.Extensive experiments demonstrate that the proposed MICE-Net has more excellent performance on DMFGRS.Built on lightweight network YOLO,the model has excellent generalizability,and thus has good potential for application in real-life scenarios.

Flume experiments to study fine-grain migration and its impact on slope stability

Fine grains migration is a primary cause of landslides and debris flows.This study investigates the effect of fine-grain migration on slope failure through flume experiments,focusing on the spatiotemporal characteristics and mechanisms of slope stability.A series of artificial rainfall flume experiments with varying rainfall intensities and slopes were conducted using soil samples collected from Wei Jia Gully.The experiments monitored pore-water pressure,grain migration,and failure sequences.Grain-size distribution parameters(μand Dc)were analyzed to understand the migration path and accumulation of fine grains.The experiments reveal that fine-grain migration significantly alters soil structure,leading to random blockage and interconnection of internal pore channels.These changes result in fluctuating pore-water pressure distributions and uneven fine-grain accumulation,critical factors in slope stability.Slope failures occur randomly and intermittently,influenced by fine-grain content in runoff and resulting pore-water pressure variations.This study highlights that fine-grain migration plays a vital role in slope stability,with significant implications for predicting and mitigating slope failures.The stochastic nature of fine-grain migration and its impact on soil properties should be incorporated into predictive models to enhance their accuracy and reliability.

Fine-grained grid computing model for Wi-Fi indoor localization in complex environments

The fingerprinting-based approach using the wireless local area network(WLAN)is widely used for indoor localization.However,the construction of the fingerprint database is quite time-consuming.Especially when the position of the access point(AP)or wall changes,updating the fingerprint database in real-time is difficult.An appropriate indoor localization approach,which has a low implementation cost,excellent real-time performance,and high localization accuracy and fully considers complex indoor environment factors,is preferred in location-based services(LBSs)applications.In this paper,we proposed a fine-grained grid computing(FGGC)model to achieve decimeter-level localization accuracy.Reference points(RPs)are generated in the grid by the FGGC model.Then,the received signal strength(RSS)values at each RP are calculated with the attenuation factors,such as the frequency band,three-dimensional propagation distance,and walls in complex environments.As a result,the fingerprint database can be established automatically without manual measurement,and the efficiency and cost that the FGGC model takes for the fingerprint database are superior to previous methods.The proposed indoor localization approach,which estimates the position step by step from the approximate grid location to the fine-grained location,can achieve higher real-time performance and localization accuracy simultaneously.The mean error of the proposed model is 0.36 m,far lower than that of previous approaches.Thus,the proposed model is feasible to improve the efficiency and accuracy of Wi-Fi indoor localization.It also shows high-accuracy performance with a fast running speed even under a large-size grid.The results indicate that the proposed method can also be suitable for precise marketing,indoor navigation,and emergency rescue.

The Dissemination, Acceptance and Evolution of The Romance of the Three Kingdoms in Japan

As one of the Four Great Masterpieces of China,The Romance of the Three Kingdoms has become a landmark of ancient Chinese literature with vivid and profound character images,ups and downs of politics and war descriptions,and appealing historical plots.After being introduced to Japan in the second half of the 17th century,it was spread in Japanese society and was accepted for literary value,social needs and other reasons,then a series of evolutions were produced by combining with local culture,eventually becoming a national culture in Japan.This paper selects the most popular text of The Romance of the Three Kingdoms with 24 chapters and 120 verses in the Wanli period of the Ming Dynasty,and the Japanese translation of The Popular Romance of the Three Kingdoms published by Hunan Wenshan in 1689 as the objects,guided by Ralph Linton’s“Manifestation,Selection,Integration”cultural communication research method,to analyze the dissemination,acceptance and evolution of The Romance of the Three Kingdoms in 17-20 centuries’Japan,which started from the field of literature,then combined with various cultural forms and spread to the civic class,and finally entered politics area and produced a series of evolutions under the influence of Japanese values to become the representative culture of Japan.This paper suggests that in today’s world of frequent cultural exchanges,China should,based on strengthening cultural self-confidence,actively and appropriately select and accept foreign cultures with the attitude of prioritizing our own culture and utilizing foreign culture for our own purposes.The research outcome can provide experience for the current Chinese culture to go to the world with high quality.

On the Dissemination and Acceptance of Dongpo Culture in the UK and the US

This study delves into the intricate dissemination and acceptance of Dongpo Culture,epitomized by Su Shi,in the UK and the US,aiming to bolster the global recognition of Chinese literary and cultural values and advance the national strategy of“Going Out”.Su Shi’s multifaceted contributions—spanning literature,philosophy,calligraphy,and art—serve as a pinnacle of Northern Song Dynasty culture.This research evaluates the varied translations,monographs,biographies,journal articles,and doctoral dissertations about Su Shi in these Western nations,using literature analysis,typical analysis,and comparative methods.The findings reveal a robust interest in Su Shi studies in the US,marked by a proliferation of scholarly works and translations across diverse disciplines,such as literature,art,and aesthetics,establishing the US as a leading center for Dongpo Culture studies.Conversely,the UK,despite its early engagement,shows limited scholarly outputs and significant research papers on the subject.By examining Dongpo Culture’s overseas communication path and influence paradigm,this paper seeks to enhance China’s cultural soft power and self-confidence.It underscores the vital role of international cultural exchange in constructing a positive image of China’s national identity,facilitating its peaceful rise,and providing strategic insights for the global promotion of Chinese culture.

On the International Dissemination of Zhuang Medicine

As an important part of Chinese culture,Zhuang medicine has a long history and unique diagnosis and treatment.With the international dissemination of Chinese culture,the international dissemination of Zhuang medicine has become an increasing concern.This paper aims to discuss the status quo,challenges of the international dissemination of Zhuang medicine,then puts forwards corresponding solutions and recommendations,so as to make Zhuang medicine known by the world.

Experimental Study on the Effect of Fine-Grained Soil Content on the Freezing Strength of Aeolian Sand-Cement Interface

In cold regions,understanding the freezing strength of the interface between soil and structure is crucial for designing frost-resistant foundations.To investigate how the content of cement powder in aeolian sand affects this strength,we conducted direct shear tests under various conditions such as different fine-grained soil content,normal stress,and initial moisture content of the soil.By analyzing parameters like soil properties,and volume of ice content,and using the Mohr-Coulomb strength theory to define interface strength,we aimed to indirectly measure the cementation strength of the interface.Our findings revealed that as the particle content increased,the interface stress-strain curves became noticeably stiffer.We also observed a positive linear relationship between freezing strength and silt content,while the initial moisture content of the soil did not significantly impact the strengthening effect of fine-grained soil on freezing strength.Moreover,we discovered that as the powder content increased,the force binding the ice to the interface decreased,while the friction angle at the interface increased.However,the cohesion force at the interface remained relatively unchanged.Overall,our analysis suggests that the increase in freezing strength due to fine-grained soil content is primarily due to the heightened friction between aeolian sand and the interface.

A Study on the Path of Promoting External Dissemination of Regional Culture with Translation Technology under the Background of New Quality Productivity

With the introduction of the concept of new quality productivity characterized by high technology,efficiency,and quality,various industries in China have ignited a high spirit of innovation and development.Against this background,this article analyzes the significance and current situation of the external dissemination of regional culture and combines the application of translation technology empowered by new quality productivity to explore a path suitable for the wider,more effective,and higher-quality external dissemination of regional culture.The aim is to provide practical experience for promoting the effective dissemination of regional culture in China to the world and better build a cultural power.

Recent aspects for disseminated carcinomatosis of the bone marrow associated with gastric cancer: What has been done for the past, and what will be needed in future?

Disseminated carcinomatosis of the bone marrow is characterized by widespread bone metastasis(bone marrow infiltration) from solid tumors with hematological disorders coexisted. This disease is frequently complicated with gastric cancer among solid tumors although its incidence is very rare. In recent years,technological innovations in diagnosis and treatment for cancer have remarkably improved,which made survival rates of various cancers prolonged. Prognosis of disseminated carcinomatosis of the bone marrow associated with gastric cancer,however,is still poor(less than a year),possibly because this disease has not been given attention due to low incidence. In this review,I summarize the results obtained for the past,and propose ways to improve the prognosis of this disease.

Atractylenolide Ⅰ protects against lipopolysaccharide-induced disseminated intravascular coagulation by anti-inflammatory and anticoagulation effect

Objective:To investigate whether atractylenolide Ⅰ(ATL-Ⅰ) has protective effect on lipopolysaccharide(LPS)-induced disseminated intravascular coagulation(DIC) in vivo and in vitro,and explore whether NF-κB signaling pathway is involved in ATL-Ⅰ treatment.Methods:New Zealand white rabbits were injected with LPS through marginal ear vein over a period of 6h at a rate of 600 μg/kg(10 mL/h).Similarly,in the treatment groups,1.0,2.0,or 5.0 mg/kg ATL-Ⅰ were given.Both survival rate and organ function were tested,including the level of alanine aminotransferase(ALT),blood urine nitrogen(BUN),and TNF-α were examined by ELISA.Also haemostatic and fibrinolytic parameters in serum were measured.RAW 264.7 macrophage cells were administered with control,LPS,LPS + ATL-Ⅰ and ATL-Ⅰ alone,and TNF-α,phosphorylation(P)-IκBα,phosphorylation(P)-NF-κB(P65) and NF-κB(P65) were determined by Western blot.Results:The administration of LPS resulted in 73.3%mortality rate,and the increase of serum TNF-α,BUN and ALT levels.When ATL-Ⅰ treatment significantly increased the survival rate of LPS-induced DIC model,also improved the function of blood coagulation.And protein analysis indicated that ATL-Ⅰ remarkably protected liver and renal as decreasing TNF-α expression.In vitro,ATL-Ⅰ obviously decreased LPS-induced TNF-αproduction and the expression of P-NF-κB(P65),with the decrease of P-IκBα.Conclusions:ATL-Ⅰ has protective effect on LPS-induced DIC,which can elevate the survival rate,reduce organ damage,improve the function of blood coagulation and suppress TNF-α expression by inhibiting the activation of NF-κB signaling pathway.

Thrombomodulin in the management of acute cholangitisinduced disseminated intravascular coagulation

AIM: To evaluate the need for thrombomodulin(r TM) therapy for disseminated intravascular coagulation(DIC) in patients with acute cholangitis(AC)-induced DIC. METHODS: Sixty-six patients who were diagnosedwith AC-induced DIC and who were treated at our hospital were enrolled in this study. The diagnoses of AC and DIC were made based on the 2013 Tokyo Guidelines and the DIC diagnostic criteria as defined by the Japanese Association for Acute Medicine, respectively. Thirty consecutive patients who were treated with r TM between April 2010 and September 2013(r TM group) were compared to 36 patients who were treated without r TM(before the introduction of r TM therapy at our hospital) between January 2005 and January 2010(control group). The two groups were compared in terms of patient characteristics at the time of DIC diagnosis(including age, sex, primary disease, severity of cholangitis, DIC score, biliary drainage, and anti-DIC drugs), the DIC resolution rate, DIC score, the systemic inflammatory response syndrome(SIRS) score, hematological values, and outcomes. Using logistic regression analysis based on multivariate analyses, we also examined factors that contributed to persistent DIC. RESULTS: There were no differences between the r TM group and the control group in terms of the patients' backgrounds other than administration. DIC resolution rates on day 9 were higher in the r TM group than in the control group(83.3% vs 52.8%, P < 0.01). The mean DIC scores on day 7 were lower in the r TM group than in the control group(2.1 ± 2.1 vs 3.5 ± 2.3, P = 0.02). The mean SIRS scores on day 3 were significantly lower in the r TM group than in the control group(1.1 ± 1.1 vs 1.8 ± 1.1, P = 0.03). Mortality on day 28 was 13.3% in the r TM group and 27.8% in the control group; these rates were not significantly different(P = 0.26). Multivariate analysis identified only the absence of biliary drainage as significantly associated with persistent DIC(P < 0.01, OR = 12, 95%CI: 2.3-60). Although the difference did not reach statistical significance, primary diseases(malignancies)(P = 0.055, OR = 3.9, 95%CI: 0.97-16) and the non-use of r TM had a tendency to be associated with persistent DIC(P = 0.08, OR = 4.3, 95%CI: 0.84-22).CONCLUSION: The add-on effects of r TM are anticipated in the treatment of AC-induced DIC, although biliary drainage for AC remains crucial.

Organic Geochemistry of Sedimentary Rock-hosted Disseminated Gold Deposits in Southwestern Guizhou Province, China

Sedimentary rock-hosted disseminated gold (SRHDG) deposits in the Youjiang-Nanpanjiang Basin, southwestern Guizhou Province are commonly hosted by the same fold crests that commonly contain a remarkable amount of organic material. The total organic carbon (TOC) contents of the ores and host rocks are usually less than 1%. The reflectance of vitrinite and pyrobitumen in the ores and the host rocks ranges from 1.5% to 4.5%, often in the range of 2% to 3%. In the Lannigou deposit, the reflectance of vitrinite and pyrobitumen in the ores is usually somewhat higher than those within the host rocks, indicating a hydrothermal impact on the organic matter in the altered host rocks. On the contrary, the estimated maximum paleotemperatures of the Getang and Zimudang deposits are higher than the homogenization temperatures of the fluid inclusions in the ores, signifying that the organic matter maturation predated Au mineralization. No correlation between the organic matter contents and Au concentrations were recognized in the ores. However, the most striking observation is that there is a positive correlation between the S2 (a parameter of Rock-Eval analysis), Au and As contents of the ores in the Lannigou deposit. Organic matter maturation and migration is apparent from the TOC vs. HCI diagram. Furthermore, group analysis of the dichloromethane extractable organic component of the ores and host rocks shows that the maturation degree of the organic matter in the ores is slightly higher than that of the host rocks in the Lannigou gold deposit. However, the compositions of their alkanes, steranes and terpenes, which serve as biomarkers, are quite similar; this suggests that the organic matter found in the ores and host rocks has a common marine source. Organic matter probably contributed to the preconcentration of Au in the host rocks. Hydrocarbons in the system, on the other hand, clearly contributed to the emplacement of the gold mineralization through thermal sulfate reduction. Organic matter in the solution might have increased the potential of the hydrothermal solution to transport Au.

Alteration and mineralization styles of the orogenic disseminated Zhenyuan gold deposit, southeastern Tibet: Contrast with carlin gold deposit

Orogenic disseminated and Carlin gold deposits share much similarity in alteration and mineralization.The disseminated orogenic Zhenyuan Au deposit along the Ailaoshan shear zone,southeastern Tibet,was selected to clarify their difference.The alteration and mineralization from the different lithologies,including meta-quartz sandstone,carbonaceous slate,meta-(ultra)mafic rock,quartz porphyry and lamprophyre were researched.According to the mineral assemblage and replacement relationship in all types of host rocks,two reactions show general control on gold deposition:(1) replacement of earlier magnetite by pyrite and carbonaceous material;(2) alteration of biotite and phlogopite phenocrysts in quartz porphyry and lamprophyre into dolomite/ankerite and sericite.Despite the lamprophyre is volumetrically minor and much less fractured than other host rocks,it contains a large portion of Au reserve,indicating that the chemically active lithology has played a more important role in gold precipitation compared to structure.LA-ICP-MS analysis shows that Au mainly occurs as invisible gold in fine-grained pyrite disseminated in the host rocks,with Au content reaching to 258.95 ppm.The diagenetic core of pyrite in meta-quartz sandstone enriched in Co,Ni,Mo,Ag and Hg is wrapped by hydrothermal pyrite enriched in Cu,As,Sb,Au,Tl,Pb and Bi.Different host rock lithology has much impact on the alteration and mineralization features.Carbonate and sericite in altered lamprophyre show they have higher Mg than those developed in other of host rocks denoting that the carbonate and sericite incorporated Mg from phlogopite phenocrysts in the primary lamprophyre during alteration.The ore fluid activated the diagenetic pyrite in meta-quartz sandstone leading the hydrothermal pyrite enriched in Cu,Mo,Ag,Sb,Te,Hg,Tl,Pb and Bi,but the hydrothermal pyrite in meta-(ultra)mafic rock is enriched in Co and Ni as the meta-(ultra)mafic rock host rock contain high content of Co and Ni.However,Au and As shear similar range in both types of host rocks indicating that these two elements most likely come from the deep source fluid rather than the host rocks.It was shown in the disseminated orogenic gold deposit that similar hydrothermal alteration with mineral assemblage of carbonate (mainly dolomite and ankerite),sericite,pyrite and arsenopyrite develops in all types of host rocks.This is different from the Nevada Carlin type,in which alteration is mainly dissolution and silicification of carbonate host rock.On the other hand,Au mainly occur as invisible gold in both disseminated orogenic and Carlin gold deposits.

Detection of disseminated pancreatic cells by amplification of cytokeratin-19 with quantitative RT-PCR in blood,bone marrow and peritoneal lavage of pancreatic carcinoma patients

AIM： To evaluate the diagnostic potential of cytokeratin-19 （CK-19） mRNA for the detection of disseminated tumor cells in blood, bone marrow and peritoneal lavage in patients with ductal adenocarcinoma of the pancreas. METHODS： Sixty-eight patients with pancreatic cancer （/7 = 37）, chronic pancreatitis （n = 16）, and non-pancreatic benign surgical diseases （/7 = 15, control group） were included in the study. Venous blood was taken preoperatively, intraoperatively and at postoperative d 1 and 10. Preoperative bone marrow aspirates and peritoneal lavage taken before mobilization of the tumor were analyzed. All samples were evaluated for disseminated tumor cells by CK-19-specific nested-PCR and quantitative fluorogenic RT-PCR. RESULTS： CK-19 mRNA expression was increased in 24 （64%） blood samples and 11 （30%） of the peritoneal lavage samples in the patients with pancreatic cancer. In 15 （40%） of the patients with pancreatic cancer, disseminated tumor cells were detected in venous blood and bone marrow and/or peritoneal lavage. In the peritoneal lavage, the detection rates were correlated with the tumor size and the tumor differentiation. CK-19 levels were increased in pT3/T4 and moderately/poorly differentiated tumors （G2/G3）. Pancreatic cancer patients with at least one CK-19 mRNA-positive sample showed a trend towards shorter survival. Pancreatic cancer patients showed significantly increased detection rates of disseminated tumor cells in blood and peritoneal lavage compared to the controls and the patients with chronic pancreatitis. CONCLUSION： Disseminated tumor cells can be detected in patients with pancreatic ductal adenocarcinorna by CK-19 fluorogenic RT-PCR. In peritoneal lavage, detection rate is correlated with tumor stage and differentiation. In the clinical use, CK-19 is suitable for the distinction between malignant and benign pancreatic disease in combination with other tumor-specific markers.