Clinical efficacy of sequential therapy with voriconazole on COPD patients in acute phase with pulmonary aspergillosis and effects on cytokines and pulmonary functions

OBJECTIVE

To explore the clinical efficacy of sequential therapy with voriconazole on chronic obstructive pulmonary disease (COPD) patients in acute phase with pulmonary aspergillosis and its effects on cytokines and pulmonary functions.

PATIENTS AND METHODS

A total of 110 COPD patients in acute phase with pulmonary aspergillosis who were admitted to the hospital between February 2015 and November 2016 were enrolled. We divided them randomly into two groups, i.e., the control group (n = 55) and the treatment group (n = 55). Patients in the control group took itraconazole capsules orally (200 mg/time, twice per day for three days followed by once per day). Patients in treatment group underwent sequential treatment with voriconazole through intravenous infusion at a dose of 5 mg/kg/time twice a day for 3 days followed by a dose of 4 mg/kg/time, twice a day for 8 days. Then, patients took voriconazole orally at a dose of 150 mL/time, twice a day for 6 days. Patients in two groups received the treatment for a total of 14 days. After treatment, we evaluated the levels of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and IL-8. The total lung capacity (TLC), diffusing capacity of the lung for carbon monoxide (DLco), and arterial oxygen saturation (SaO2), were measured as well.

RESULTS

The total effectiveness rates of the treatment group and the control group were 83.63% and 61.82%. The differences had statistical significance (p < 0.01). After treatment, the incidence of chest pain, cough, sputum-coughing, hemoptysis, cyanosis, and dyspnea in the treatment group was significantly fewer than that in the control group (p < 0.05). TCL, DLco, and SaO2 in the two groups were significantly ameliorated by treatment (p < 0.05). The amelioration in the treatment group was more prominent than that in the control group (p < 0.05). The levels of TNF-α, IL-8, and IL-6 in the two groups were decreased dramatically by the treatments. The decrease in the treatment group was significantly lower than those in the control group (p < 0.05). Occurrence of adverse reactions in treatment group and control group were 8.33% and 6.25%, respectively; (p > 0.05).

CONCLUSIONS

Sequential therapy with voriconazole exhibits promising clinical efficacy in COPD patients in acute phase with pulmonary aspergillosis. The treatment ameliorated the clinical symptoms and vital signs of patients significantly. It also improved the pulmonary functions and inhibited the inflammatory responses of patients with evident clinical efficacy.

Dissection of a circulating CD3+ CD20+ T cell subpopulation in patients with psoriasis

CD3⁺ CD20⁺ T cells are a population of CD3⁺ T cells that express CD20 and identified in healthy donors and autoimmune diseases. However, the nature and role of these cells in patients with psoriasis remain unclear. In this study, we aimed to investigate the level, phenotype, functional and clinical relevance of CD3⁺ CD20⁺ T cells in the peripheral blood of patients with psoriasis. We found that a small subset of CD3⁺ T cells expressed CD20 molecule in the peripheral blood of patients with psoriasis, and their levels were similar to those in healthy donors. Circulating CD3⁺ CD20⁺ T cells in patients with psoriasis were enriched in CD4⁺ cells and displayed an activated effector phenotype, as these cells contained fewer CD45RA⁺ -naive and CCR7⁺ cells with increased activity than those of CD3⁺ T cells lacking CD20. In addition, compared with healthy donors, circulating CD3⁺ CD20⁺ T cells in patients with psoriasis produced more cytokines, interleukin (IL)-17A, tumour necrosis factor (TNF)-α and IL-21, but not IL-4 and IFN-γ. Furthermore, a significantly positive correlation was found between the levels of IL-17A, TNF-α and IL-21-production CD3⁺ CD20⁺ T cells with Psoriasis Area and Severity Index scores. Our findings suggest that CD3⁺ CD20⁺ T cells may play a role in the pathogenesis of psoriasis.

[Effects of ovalbumin exposure during pregnancy of mice on the ovalbumin re-exposure in adult progeny]

Objective: To observe the immunoreaction of offspring mice by ovalbumin (OVA) re-exposure after their mothers exposed to OVA during pregnancy. Method: A prospective controlled study was conducted to observe mice after repeated OVA exposures at 6-8 weeks.Their mothers were exposed to OVA during different stages of pregnancy.The symptoms were recorded and scored.The levels of OVA-specific IgE in serum, interferon-γ(IFN-γ) and interleukin-4(IL-4) in supernatant of spleen primary lymphocytes in vitro were measured by ELISA.The results were analyzed by single factor analysis of variance or rank sum test. Result: All the mice in each group had acute diarrhea.The diarrhea happened earliest (2 days) and most severe in the late pregnancy group (early pregnancy group 7.0±1.0; middle pregnancy group: 7.1±1.1; late pregnancy group: 9.9±2.2, P<0.01). The levels of absorbance of OVA-specific IgE in the pregnancy groups were higher than those of the control group.The absorbance of OVA-specific IgE in late pregnancy group was the highest (control: 0.27±0.06; early pregnancy group: 0.51±0.13; middle pregnancy group: 0.50±0.09; late pregnancy group: 0.63±0.13, P<0.01). There was no significant change in IFN-γ expression in cultured supernatant of spleen lymphocytes in each group (control: (133±7) pg/ml; early pregnancy group: (133±4) pg/ml; middle pregnancy group: (134±6) pg/ml; late pregnancy group: (132±4) pg/ml, all P value >0.05). The expression of IL-4 in the experimental groups was higher than that in the control group, especially in late pregnancy group(control: (25.3±2.4) pg/ml; early pregnancy group: (32.4±4.4) pg/ml; middle pregnancy group: (35.0±5.4) pg/ml; late pregnancy group: (47.1±5.8) pg/ml; P value all<0.01). Conclusion: The allergic reaction of the OVA re-exposure progeny whose mothers were exposed to OVA in the late pregnancy period was most severe, suggesting that late pregnancy period might be the high risk stage of intrauterine sensitization, or"window period".

Abdominal wall reconstruction following resection of large abdominal aggressive neoplasms using tensor fascia lata flap with or without mesh reinforcement

PURPOSE

Abdominal wall defects caused by neoplasms with large extended resection defects remain a challenging problem. Autologous flaps, meshes, and component separation techniques are effective in reconstructing these defects. We retrospectively reviewed and assessed the success of reconstruction using tensor fascia lata flap with or without meshes.

METHODS

18 patients with abdominal wall neoplasms were identified during the period from 2007 to 2016. A retrospective review of office charts and hospital records was performed.

RESULTS

A total of 18 patients received corresponding treatment according to the degree of defects, with a mean age of 53.89 ± 14.56 years old, a mean body mass index (BMI) of 22.89 ± 4.09 kg/m², and a mean American Society of Anesthesiologist (ASA) score of 2.18 ± 0.75. Operative details included the mean defect size (303.44 ± 175.67 cm²), the mean mesh size (265.92 ± 227.99 cm²), and the mean operative time (382.33 ± 180.38 min). Postoperative wound complications were identified in 7 (39%) patients, including incisional infection, edema and thrombus. Neoplasm recurrence was observed in 2 (13%) primary neoplasms patients. No hernias were present in any patient.

CONCLUSIONS

Abdominal wall defects caused by neoplasms should be repaired by autologous flaps combined with or without mesh reinforcement. Most type I defects should be primary sutured; type II or III defects should be repaired well by flaps, with or without mesh; if the incision is infected or contaminated, biological mesh or flaps are the best choice.

Topological gapless phase in Kitaev model on square lattice

We study the topological feature of gapless states in the fermionic Kitaev model on a square lattice. There are two types of gapless states which are topologically trivial and nontrivial. We show that the topological gapless phase lives in a wide two-dimensional parameter region and are characterized by two vertices of an auxiliary vector field de-fined in the two-dimensional momentum space, with opposite winding numbers. The isolated band touching points, as the topological defects of the field, move, emerge, and disappear as the parameters vary. The band gap starts to open only at the merg-ing points, associated with topologically trivial gapless states. The symmetry protect-ing the topological gapless phase and the robustness under perturbations are also discussed.

Co-occurrence of DSM-IV mental disorders and alcohol use disorder among adult Chinese males

BACKGROUND

Studies from high-income countries report moderate-to-strong positive associations between alcohol use disorder (AUD) and other mental disorders, but there is little evidence about the comorbidity of AUD from low-and-middle-income countries.

METHODS

A sample of 74 752 adults from five provinces that account for >12% of China's adult population was screened using the General Health Questionnaire, and the Structured Clinical Interview for DSM-IV was administered by psychiatrists to a subsample of 9619 males. The associations between AUD and other mental disorders at each site and the characteristics of men with AUD with and without comorbid mental disorders were estimated using logistic regression and summarized across sites using meta-analysis. Generalized estimation equations estimated the associations between the clinical features of alcohol dependence and comorbidity.

RESULTS

Robust inverse associations were found between current AUD and any mood disorder (adjusted OR = 0.6, 95% CI = 0.4-0.8) and any anxiety disorder (OR = 0.5, 95% CI = 0.3-1.0). Compared with men without AUD, men with AUD without comorbid disorders were more likely to be middle-aged, to be currently married, and to have higher family incomes. Men with comorbid AUD and other disorders were more likely to have the clinical features of alcohol dependence than men with AUD without comorbid disorders.

CONCLUSIONS

Inverse associations between AUD and other mental disorders and the higher social status of men with AUD than men without AUD found in this large, representative sample of community-dwelling Chinese males highlight the importance of considering the local substance-use culture when designing clinical or preventive interventions for addictive conditions.

Anomalous Evolution of the Near-Side Jet Peak Shape in Pb-Pb Collisions at sqrt[s_{NN}]=2.76 TeV

The measurement of two-particle angular correlations is a powerful tool to study jet quenching in a p_{T} region inaccessible by direct jet identification. In these measurements pseudorapidity (Δη) and azimuthal (Δφ) differences are used to extract the shape of the near-side peak formed by particles associated with a higher p_{T} trigger particle (1<p_{T,trig}<8  GeV/c). A combined fit of the near-side peak and long-range correlations is applied to the data allowing the extraction of the centrality evolution of the peak shape in Pb-Pb collisions at sqrt[s_{NN}]=2.76  TeV. A significant broadening of the peak in the Δη direction at low p_{T} is found from peripheral to central collisions, which vanishes above 4  GeV/c, while in the Δφ direction the peak is almost independent of centrality. For the 10% most central collisions and 1<p_{T,assoc}<2  GeV/c, 1<p_{T,trig}<3  GeV/c a novel feature is observed: a depletion develops around the center of the peak. The results are compared to pp collisions at the same center of mass energy and ampt model simulations. The comparison to the investigated models suggests that the broadening and the development of the depletion is connected to the strength of radial and longitudinal flow.

Majorana charges, winding numbers and Chern numbers in quantum Ising models

Mapping a many-body state on a loop in parameter space is a simple way to characterize a quantum state. The connections of such a geometrical representation to the concepts of Chern number and Majorana zero mode are investigated based on a generalized quantum spin system with short and long-range interactions. We show that the topological invariants, the Chern numbers of corresponding Bloch band, is equivalent to the winding number in the auxiliary plane, which can be utilized to characterize the phase diagram. We introduce the concept of Majorana charge, the magnitude of which is defined by the distribution of Majorana fermion probability in zero-mode states, and the sign is defined by the type of Majorana fermion. By direct calculations of the Majorana modes we analytically and numerically verify that the Majorana charge is equal to Chern numbers and winding numbers.

Su-Schrieffer-Heeger chain with one pair of [Formula: see text]-symmetric defects

The topologically nontrivial edge states induce [Formula: see text] transition in Su-Schrieffer-Heeger (SSH) chain with one pair of gain and loss at boundaries. In this study, we investigated a pair of [Formula: see text]-symmetric defects located inside the SSH chain, in particular, the defects locations are at the chain centre. The [Formula: see text] symmetry breaking of the bound states leads to the [Formula: see text] transition, the [Formula: see text]-symmetric phases and the localized states were studied. In the broken [Formula: see text]-symmetric phase, all energy levels break simultaneously in topologically trivial phase; however, two edge states in topologically nontrivial phase are free from the influence of the [Formula: see text]-symmetric defects. We discovered [Formula: see text]-symmetric bound states induced by the [Formula: see text]-symmetric local defects at the SSH chain centre. The [Formula: see text]-symmetric bound states significantly increase the [Formula: see text] transition threshold and coalesce to the topologically protected zero mode with vanishing probabilities on every other site of the left-half chain and the right-half chain, respectively.

Measurement of azimuthal correlations of D mesons with charged particles in pp collisions at [Formula: see text] TeV and p-Pb collisions at [Formula: see text] TeV

The azimuthal correlations of D mesons with charged particles were measured with the ALICE apparatus in pp collisions at [Formula: see text] and p-Pb collisions at [Formula: see text] at the Large Hadron Collider. [Formula: see text], [Formula: see text], and [Formula: see text] mesons and their charge conjugates with transverse momentum [Formula: see text] and rapidity in the nucleon-nucleon centre-of-mass system [Formula: see text] (pp collisions) and [Formula: see text] (p-Pb collisions) were correlated to charged particles with [Formula: see text]. The yield of charged particles in the correlation peak induced by the jet containing the D meson and the peak width are compatible within uncertainties in the two collision systems. The data are described within uncertainties by Monte-Carlo simulations based on PYTHIA, POWHEG, and EPOS 3 event generators.

Genetic analysis of PITX3 variants in patients with essential tremor

BACKGROUND

A clinical overlap between essential tremor (ET) and Parkinson's disease (PD) has prompted investigation whether these disorders share common genetic factors. The paired-like homeodomain transcription factor 3 gene (PITX3) has been shown to play an important role for the differentiation and survival of midbrain dopaminergic neurons in the substantia nigra pars compacta. The preferential degeneration of those dopaminergic neurons is the pathological hallmark in PD.

AIMS OF THE STUDY

The purpose of this study was to evaluate whether PITX3 variants are related to susceptibility of ET in Chinese Han population.

METHODS

Genetic analysis of two variants rs3758549 and rs4919621 of the PITX3 gene was conducted in 200 Chinese Han patients with ET and 426 controls.

RESULTS

We did not identify any statistically significant difference in either genotypic or allelic frequencies of variants between the ET patients and control cohort (all P > 0.05). Haplotype analysis of two variants in the PITX3 gene showed no potential association between the haplotypes and risk of ET (all P > 0.05).

CONCLUSIONS

Our data suggest that PITX3 variants rs3758549 and rs4919621 are not associated with ET in Chinese Han population.

Quantum phase transition induced by real-space topology

A quantum phase transition (QPT), including both topological and symmetry breaking types, is usually induced by the change of global parameters, such as external fields or global coupling constants. In this work, we demonstrate the existence of QPT induced by the real-space topology of the system. We investigate the groundstate properties of the tight-binding model on a honeycomb lattice with the torus geometry based on exact results. It is shown that the ground state experiences a second-order QPT, exhibiting the scaling behavior, when the torus switches to a tube, which reveals the connection between quantum phase and the real-space topology of the system.

Computed tomography-guided percutaneous microwave ablation treatment for lung metastases from nasopharyngeal carcinoma

BACKGROUND

The objective of this retrospective study was to evaluate the safety and efficacy of percutaneous microwave ablation (MWA) for treating lung metastases from nasopharyngeal carcinoma (NPC).

PATIENTS AND METHODS

From December 2012 to November 2014, 17 patients (15 males, and two females, averaged 45.7 years old) with lung metastases from NPC accepted computed tomography (CT)-guided percutaneous MWA. The average number of lung metastases was 1.7 (range: 1-4), and the biggest tumor diameter was 4.2 cm (range: 0.8-4.2 cm). Nineteen nodules located in the right lung and 10 nodules located in the left lung. A total of 29 ablation sites were performed to 29 lung metastases in 22 MWA sessions. Postoperative assessments of complete tumor necrosis rate, safety, local tumor progression, and survival period were carried out.

RESULTS

Of the 29 lesions, complete response was achieved for 27 lesions; residual tumor was found in one lesion 3 months postoperatively; and another lesion was found enlarged 3-month postoperatively with obvious enhancement. Four patients had a small amount of postoperative parenchyma bleeding and two patients had a small amount of pneumothorax. Six months after MWA treatment, new metastatic lesions appeared in six patients, five patients had new metastatic lesions inside the lung, and the other patient had metastatic lesions in the thoracic vertebra. The time for the appearance of new pulmonary metastases for the five patients was 4-20 months, averaged 7.2 months.

CONCLUSION

CT-guided MWA is a promising treatment alternative for local tumor control in selected patients with lung metastases from NPC.

Correlated Event-by-Event Fluctuations of Flow Harmonics in Pb-Pb Collisions at sqrt[s_{NN}]=2.76 TeV

We report the measurements of correlations between event-by-event fluctuations of amplitudes of anisotropic flow harmonics in nucleus-nucleus collisions, obtained for the first time using a new analysis method based on multiparticle cumulants in mixed harmonics. This novel method is robust against systematic biases originating from nonflow effects and by construction any dependence on symmetry planes is eliminated. We demonstrate that correlations of flow harmonics exhibit a better sensitivity to medium properties than the individual flow harmonics. The new measurements are performed in Pb-Pb collisions at the center-of-mass energy per nucleon pair of sqrt[s_{NN}]=2.76  TeV by the ALICE experiment at the Large Hadron Collider. The centrality dependence of correlation between event-by-event fluctuations of the elliptic v_{2} and quadrangular v_{4} flow harmonics, as well as of anticorrelation between v_{2} and triangular v_{3} flow harmonics are presented. The results cover two different regimes of the initial state configurations: geometry dominated (in midcentral collisions) and fluctuation dominated (in the most central collisions). Comparisons are made to predictions from Monte Carlo Glauber, viscous hydrodynamics, ampt, and hijing models. Together with the existing measurements of the individual flow harmonics the presented results provide further constraints on the initial conditions and the transport properties of the system produced in heavy-ion collisions.

A comparison of adaptive iterative dose reduction 3D and filtered back projection in craniocervical CT angiography

AIM

To compare the effects of exposure parameters on image quality and radiation dose for craniocervical computed tomography angiography (CTA) using adaptive iterative dose reduction in three dimensions (AIDR 3D) and filtered back projection (FBP) algorithms.

MATERIALS AND METHODS

One hundred and eighty patients were divided into three groups; group A (120 kV, 300 mA, FBP), group B (100 kV, automatic mA, AIDR 3D) and group C (80kV, automatic mA, AIDR 3D). Image quality and radiation dose were evaluated for each group.

RESULTS

For both cervical and intracranial vessels, CT attenuation, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were higher in the AIDR 3D groups. The difference in mean vascular noise was also statistically significant (p<0.001), with group B having the lowest value at 16.5±3.2 HU and group C having the highest at 19.1±2.9 HU. FBP reconstruction resulted in lower image-quality scores for the common carotid artery. Parenchymal image-quality scores also varied significantly different between groups with group C partially failing to meet the minimum standards for diagnostic use. For the middle cerebral artery, image-quality scores were significantly better in group A, although images from groups B and C also satisfied clinical diagnostic requirements. The image quality of the internal carotid artery was the best in group B. Image-quality scores between groups were not significantly different for the carotid sinus. Radiation doses in the groups using AIDR 3D were >70% lower than in the FBP group.

CONCLUSION

AIDR 3D (100 kV, automatic modulation) provides optimal image quality of vascular and parenchymal tissues at significantly lower radiation doses (mSV) than FBP in craniocervical CTA. For cases in which highly accurate parenchymal assessment is not required, the tube voltage can be lowered to 80 kV to further decrease radiation dose.

Effect of sevoflurane anaesthesia on hepatic blood flow in infants with obstructive hepatobiliary disease

BACKGROUND

Currently most studies on anaesthetic effects on hepatic blood flow of cirrhotic patients have been performed on adults or experimental animals. We performed this study to evaluate the effect of sevoflurane anaesthesia on hepatic blood flow in infants with obstructive jaundice by Doppler ultrasound.

METHODS

Forty-four infants with biliary atresia (1-3 months of age) scheduled for a Kasai procedure were enrolled. Hepatic blood flow was calculated by Doppler ultrasound measurements before induction, and after inhalation of 2% and 3% sevoflurane. Infants were allocated to three groups according to baseline portal blood flow/hepatic artery blood flow: group A (portal blood flow/hepatic artery blood flow < 1), group B (1 ≤ portal blood flow/hepatic artery blood flow < 2) and group C (portal blood flow/hepatic artery blood flow ≥ 2). Changes in portal blood flow, hepatic artery blood flow and hepatic blood flow were compared among groups.

RESULTS

In group A (n = 9), the median (IQR) hepatic blood flow increased after inhalation of 2% sevoflurane compared to that before induction (from 49.7 (32.0-89.0) to 116.1 (40.4-159.1) ml/min; P = 0.035). Whereas in groups B and C in whom the ratio of portal blood flow and hepatic artery blood flow was normal or mildly changed, the increases in hepatic blood flow after sevoflurane anaesthesia were not significant.

CONCLUSIONS

For infants with obstructive jaundice that had reduced portal blood flow and compensatory increase in hepatic artery blood flow, sevoflurane may produce a protective effect on hepatic blood flow.

Magnetic-flux-driven topological quantum phase transition and manipulation of perfect edge states in graphene tube

We study the tight-binding model for a graphene tube with perimeter N threaded by a magnetic field. We show exactly that this model has different nontrivial topological phases as the flux changes. The winding number, as an indicator of topological quantum phase transition (QPT) fixes at N/3 if N/3 equals to its integer part [N/3], otherwise it jumps between [N/3] and [N/3] + 1 periodically as the flux varies a flux quantum. For an open tube with zigzag boundary condition, exact edge states are obtained. There exist two perfect midgap edge states, in which the particle is completely located at the boundary, even for a tube with finite length. The threading flux can be employed to control the quantum states: transferring the perfect edge state from one end to the other, or generating maximal entanglement between them.