[Treatment of anterior megalophthalmos cataract with reverse optic capture intraocular lens implantation: a case report]

A 56-year-old male patient sought medical attention due to a gradual decline in bilateral visual acuity, which had been ongoing for a year and had rapidly worsened over the past three months. He received an initial diagnosis of bilateral concurrent cataracts and bilateral anterior megalophthalmos. Subsequently, cataract removal surgery was performed. During the surgery, it was observed that the patient had lax and fragile zonules of the crystalline lens. To address this issue, the surgical team employed reverse optic capture technique for the implantation of a three-piece intraocular lens. Following the surgery, the patient experienced a substantial improvement in uncorrected visual acuity. Remarkably, the patient remained free from adverse reactions, such as elevated intraocular pressure, during a follow-up period extending to 11 years.

[A phase I study of subcutaneous envafolimab (KN035) monotherapy in Chinese patients with advanced solid tumors]

Objective: To evaluate the safety and antitumor activity of envafolimab monotherapy in Chinese patients with advanced solid tumors. Methods: This open-label, multicenter phase I trial included dose escalation and dose expansion phases. In the dose escalation phase, patients received subcutaneous 0.1, 0.3, 1.0, 2.5, 5.0 or 10.0 mg/kg envafolimab once weekly (QW) following a modified "3+ 3" design. The dose expansion phase was performed in the 2.5 mg/kg and 5.0 mg/kg (QW) dose cohorts. Results: At November 25, 2019, a total of 287 patients received envafolimab treatment. During the dose escalation phase, no dose-limiting toxicities (DLT) was observed. In all dose cohorts, drug-related treatment-emergent adverse events (TEAEs) for all grades occurred in 75.3% of patients, and grade 3 or 4 occurred in 20.6% of patients. The incidence of immune-related adverse reactions (irAE) was 24.0% for all grades, the most common irAEs (≥2%) included hypothyroidism, hyperthyroidism, immune-associated hepatitis and rash. The incidence of injection site reactions was low (3.8%), all of which were grades 1-2. Among the 216 efficacy evaluable patients, the objective response rate (ORR) and disease control rate (DCR) were 11.6% and 43.1%, respectively. Median duration of response was 49.1 weeks (95% CI: 24.0, 49.3). Pharmacokinetic (PK) exposure to envafolimab is proportional to dose and median time to maximum plasma concentration is 72-120 hours based on the PK results from the dose escalation phase of the study. Conclusion: Subcutaneous envafolimab has a favorable safety and promising preliminary anti-tumor activity in Chinese patients with advanced solid tumors.

[CT imaging analysis of 33 cases with the 2019 novel coronavirus infection]

Objective: To explore the CT imaging features of the 2019 novel coronavirus (2019-nCoV) infection in order to summarize the imaging characteristics of the disease and improve the ability of imaging diagnosis and early diagnosis of the disease. Methods: From January 13, 2020 to January 31, 2020, a total of 33 patients with 2019-nCoV infection diagnosed and treated by Suzhou Fifth People's Hospital were analyzed retrospectively, including 20 males and 13 females, with an average age of (50±12) years, ranging from 20 to 70 years old. There were 3 cases of mild type, 27 cases of common type and 3 cases of severe type.There were 2 cases with hypertension, 1 case with postoperative lung,1 case with diabetes, 1 case with chronic bronchitis, and 1 case with bronchiectasis.SPSS25.0 Chi-square test was used to analyze the distribution of lesions in each lung lobe; SPSS25.0 Spearman correlation coefficient was used to analyze the image score and clinical classification. Results: There were 3 cases (9.1%) with normal lung and 30 cases (90.9%) with Novel Coronavirus Pneumonia(COVID-19) of the 2019-nCoV infected patients. In the distribution of COVID-19, 29 cases (87.9%) were involved in bilateral lung and 1 case (3.0%) in unilateral lung. There was no statistically significant difference in the distribution of lesions in each lobe. The correlation coefficient between the degree of lesion distribution and clinical classification was 0.819, and the two were highly correlated.There were 30 cases (90.9%) with subpleural lesions, 17 cases (51.5%) with central lesions. There were many kinds of lesions, 25 cases (75.8%) had ground glass density shadow, 16 cases (48.5%) had consolidation, 12 cases (36.4%) had interstitial change, and 18 cases (54.5%) had interlobular septal thickening. Among the 22 cases, 10 cases had more lesions, 6 cases had no changes and 6 cases had less lesions. Conclusion: Most of the patients with 2019-nCoV infection have pulmonary inflammation.CT manifestations include multiple parts, subpleural area or middle and lateral field of lung, ground glass shadow and consolidation, or coexistence. Some cases have pleural thickening or interlobular septal thickening. CT images can indicate the diagnosis of COVID-19 and provide important basis for early detection and disease monitoring.

[Establishment of a CT image radiomics-based prediction model for the differential diagnosis of silicosis and tuberculosis nodules]

Objective: To establish a CT image radiomics-based prediction model for the differential diagnosis of silicosis and tuberculosis nodules. Methods: A total of 53 patients with silicosis and 89 patients with tuberculosis who underwent routine CT scans in Suzhou Fifth People's Hospital from January to August, 2018 were enrolled in this study. AK/ITK software was used to segment the images to obtain 139 silicosis lesions and 119 tuberculosis lesions. For each lesion image, 396 features were extracted, and feature dimension reduction was applied to select the most characteristic feature subset. Support vector machine (SVM) , feedforward back propagation neural network (FNN-BP) , and random forest (RF) were implemented using R software (Rstudio V1.1.463) , and the algorithm that achieved the largest area under of the receiver operating characteristic (ROC) curve (AUC) was selected as the final prediction model. Results: RF was the best prediction model for the differential diagnosis of silicosis and tuberculosis nodules, with an accuracy of 83.1%, a sensitivity of 0.76, a specificity of 0.9, and an AUC of 0.917 (95% confidence interval: 0.8431-0.9758) . RF had a significantly larger AUC than SVM and FNN-BP (P<0.05) . Conclusion: CT image-based RF prediction model can be used to differentially diagnose silicosis and tuberculosis nodules.

[Clinical analysis of autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation in thalassemia major]

目的

探讨重型地中海贫血（地贫）患者异基因造血干细胞移植（allo-HSCT）后并发自身免疫性溶血性贫血（AIHA）诊断、治疗及转归，以提高地贫患者造血干细胞移植疗效。

方法

回顾性分析2007年7月至2017年12月共计291例行allo-HSCT重型地贫患者的临床资料。

结果

重型地贫allo-HSCT后AIHA发生率为1.72%（5/291）；AIHA中位发生时间为移植后7（5~12）个月，5例移植后AIHA患者直接和间接Coombs试验均阳性，患者主要表现为头晕、乏力、面色苍白、皮肤巩膜黄染、酱油色尿。228例HLA相合同胞供者移植患者有1例（0.43%）移植后发生AIHA，而63例非亲缘供者移植患者有4例（6.36%）移植后发生AIHA。非亲缘供者移植患者AIHA发生率高于HLA相合同胞供者移植患者。1例患者单用泼尼松治疗死亡，4例患者采用甲泼尼龙联合利妥昔单抗治疗有效，目前生存良好，其中2例Coombs试验转阴。

结论

该组重型地贫患者allo-HSCT后AIHA发生率为1.72%，Coombs试验有助于诊断移植后AIHA，非亲缘供者移植病例移植后AIHA发生率高于HLA相合同胞供者移植组，利妥昔单抗联合糖皮质激素是治疗重型地贫allo-HSCT后AIHA的有效方法。

Method using a co-culture system with high-purity intramuscular preadipocytes and satellite cells from chicken pectoralis major muscle

Intramuscular fat is important in improving meat quality; however, the lack of high-purity intramuscular preadipocyte (IMP) in vitro has severely limited the in-depth research on the mutual regulation of myocytes and adipocytes in chicken. In this study, we establish a new method by combining the mature adipocyte ceiling method and the transwell co-culture system. Mature intramuscular adipocyte (MIA) and muscle satellite cell (MSC) were obtained from digested pectoralis major, and MIAs were transformed into IMPs by dedifferentiation with ceiling culture. MSCs were then purified by differential adhesion for 2 h. The results by inverted-microscope observation, MTT assay, Oil Red O staining, and q-PCR revealed that the de-differentiated cells from MIA were identified as the IMPs, and had the same the cellular morphology, the capacity on differentiation, proliferation and passage with the abdominal fat preadipocytes (P > 0.05). The applicability of the obtained IMPs in co-cultured experiment with the MSC revealed that it could meet the requirements of the experimental study. Finally, a co-culture system of IMPs and MSCs was established using a transwell chamber. The co-cultured results indicated that MSCs in the proliferative stage tend to accelerate the differentiation of IMPs to induce more fat content in co-cultured IMPs than in single-culture IMPs (P < 0.05), in the non-proliferative stage, the results tend to show the opposite (P < 0.05). The mRNA levels of related genes significantly changed in accordance with the fat content in cells. The results strongly supported the view that the established co-culture system was effective and feasible. In summary, we successfully found a new method to explore the interaction between myocytes and adipocytes of chicken. Our findings can deepen research on the regulation of chicken myocytes and adipocytes.

Expression and effect of Calpain9 gene genetic polymorphism on slaughter indicators and intramuscular fat content in chickens

Calpain 9 (CAPN9) is expressed in the stomach and small intestine. CAPN9 has regulatory roles in hypertension, heart disease, gastric mucosal defense, and kidney disease. The involvement of CAPN9 has not been reported in the development of chickens. CAPN9 mRNA was found in adipose and muscle tissue in this study. Two linkage single nucleotide polymorphisms (SNP; G7518A and C7542G) in intron 4 were screened from 160 birds of the D2 chicken line. The 2 mutation sites were associated with carcass weight, evisceration weight, abdominal fat weight (AFW), abdominal fat percentage (AFP), and breast muscle percentage (all P < 0.05). Intramuscular fat (IMF) content was not significantly different in the 3 genotypes. But, the AA(7518)/GG(7542) genotype had the highest IMF content, highest breast muscle weight, and lower AFW and AFP. Moreover, the mRNA level of CAPN9 in abdominal fat tissue was significantly different (P < 0.05 or P < 0.01) between any 2 genotypes, consistent with AFW and AFP. In summary, the expression of CAPN9 in adipose and breast muscle tissue is reported for the first time. CAPN9 affected production performance of chickens. As a marker, the linkage G7518A and C7542G polymorphisms in intron 4 of CAPN9 could affect the production traits by regulating mRNA expression. The findings concerning the marker enrich the theoretical foundation for molecular breeding of high-quality broilers.

Brain Natriuretic Peptide Stimulates Lipid Metabolism through Its Receptor NPR1 and the Glycerolipid Metabolism Pathway in Chicken Adipocytes

Brain natriuretic peptide (BNP) is related to lipid metabolism in mammals, but its effect and the molecular mechanisms underlying it in chickens are incompletely understood. We found that the level of natriuretic peptide precursor B (NPPB, which encodes BNP) mRNA expression in high-abdominal-fat chicken groups was significantly higher than that of low-abdominal-fat groups. Partial correlations indicated that changes in the weight of abdominal fat were positively correlated with NPPB mRNA expression level. In vitro, compared with the control group, preadipocytes with NPPB interference showed reduced levels of proliferation, differentiation, and glycerin in media. Treatments of cells with BNP led to enhanced proliferation and differentiation of cells and glycerin concentration, and mRNA expression of its receptor natriuretic peptide receptor 1 (NPR1) was upregulated significantly. In cells exposed to BNP, 482 differentially expressed genes were identified compared with controls without BNP. Four genes known to be related to lipid metabolism (diacylglycerol kinase; lipase, endothelial; 1-acylglycerol-3-phosphate O-acyltransferase 1; and 1-acylglycerol-3-phosphate O-acyltransferase 2) were enriched in the glycerolipid metabolism pathway and expressed differentially. In conclusion, BNP stimulates the proliferation, differentiation, and lipolysis of preadipocytes through upregulation of the levels of expression of its receptor NPR1 and key genes enriched in the glycerolipid metabolic pathway.

[Application of spark erosion technology in manufacture of implant prosthesis]

OBJECTIVE

To evaluate the influence of the implant-supported porcelain bridges made from non-precious metals using spark erosion techniques, and to discuss the feasibility and details of making the implant restoration by spark erosion technique.

METHODS

The study included 12 patients (9 males and 3 females) with 92 units implant-supported non-precious porcelain bridge from Sep. 2011 to Feb. 2013. All the patients received implant treatment in Department of Oral Implantology, Peking University School and Hospital of Stomatology. The total of 52 implants, were from Nobel Biocare implant system, Camlog implant system and Ankylos implant system. The implant analogs were connected in sequence with a copper wire to guarantee conductivity. The implant electrodes represented one electrode and the superstructure the other. During spark-erosion machining, the cast holding the implant electrodes and the prosthetic framework were moved toward one another, causing an electrical erosion of the protruding elements.

RESULTS

After the spark-erosion machining, the minimum gap between the framework and abutment was 0.21 mm, which was two units bridge. The maximum was 2.59 mm, which was 11 units bridge with 6 implants. The average gap was 0.68 mm. After the spark-erosion machining, the bridge fitted well with the passive position stability.

CONCLUSION

The method of making implant-supported non-precious porcelain bridge reduces costs on patients. Spark erosion has the potential to provide implant framework with an excellent fit. The patients are satisfied with the clinical results.

Expression profiles of key transcription factors involved in lipid metabolism in Beijing-You chickens

Intramuscular fat (IMF) is a crucial factor for the meat quality of chickens. With the aim of studying the molecular mechanisms underlying IMF deposition in chickens, the expression profiles of five candidate transcription factors involved in lipid metabolism in several tissues were examined in Beijing-You (BJY) chickens at five ages (0, 4, 8, 14 and 20 wk). Results showed that accumulation of IMF in breast (IMFbr), thigh (IMFth) and abdominal fat weight increased significantly (P<0.01) after 8 wk. Accumulation of both IMFbr and IMFth from 8 to 14 wk exceeded that from 14 to 20 wk; IMFth was 4-7 times of IMFbr. As for the expression profiles of key transcription factors: 1) expression of C/EBPα and PPARγ in abdominal fat was significantly higher than that in breast and thigh muscles at all ages. The expression of C/EBPα was positively correlated with PPARγ in both breast and thigh muscles, which indicated that both C/EBPα and PPARγ promoted fat deposition and might act through a unified pathway; 2) the expression of SREBP-1 in 0, 4, and 8 wk in thigh muscle was significantly higher than that in breast; 3) expression of C/EBPβ at 4 and 8 wk was significantly higher than that at 14 and 20 wk; and it was positively correlated with IMFth and IMFbr from 0 to 8 wk; 4) expression of PPARα in breast and thigh muscles was significantly higher than that in abdominal fat. Taken together, all five transcription factors studied play roles in lipid metabolism in chickens with C/EBPα and PPARγ being important effectors.

Comparison of breast muscle meat quality in 2 broiler breeds

On the basis of meat quality traits, muscle fiber characteristics, and nutrient components and contents in chickens at market age, 120-d-old Beijing-you (BJY) chickens (the Chinese local breed) had distinct breast muscle features when compared with 42-d-old Arbor Acres (AA) chickens (the genetically improved broiler line). The phospholipid (P < 0.05) and essential fatty acid (P < 0.05) contents in BJY chickens were significantly higher than those in AA chickens. No differences (P > 0.05) were found between the breeds in the contents of polyunsaturated fatty acids, unsaturated fatty acids, protein, or amino acids. Breast muscle fiber diameter was significantly smaller (~55.76%) and fiber density was higher (~174.86%) in BJY chickens than in AA chickens (P < 0.05). In this study, breast muscle from 120-d-old BJY chickens was judged to have better quality of phospholipids and essential fatty acid contents and muscle fiber characteristics than breast muscle from 42-d-old AA chickens.

Cytogenesis in the adult rat dentate gyrus is increased following kindled seizures but is unaltered in pharmacological models of absence seizures

The production of new neurons continues throughout adulthood in the dentate gyrus of the hippocampal formation, and is believed to play a role in hippocampus-dependent learning and memory. Seizure-induced changes in adult neurogenesis have been examined primarily in convulsive rodent seizure models, but not in models of nonconvulsive absence seizures. This study examined progenitor cell proliferation in the gamma-hydroxybutyrate (GHB) model of typical absence seizures and the AY-9944 model of atypical absence seizures, and compared these results with changes seen in the rat amygdala kindling model. Kindled subjects were found to have 189% more proliferating cells than sham-kindled control subjects, whereas no significant difference was found between the GHB or AY-9944 model and control subjects. These results suggest that changes in adult neurogenesis in models of absence seizures do not occur, and that seizure-induced enhancement of neurogenesis could depend on the characteristics of the seizure discharge.

Super-global distortion correction for a rotational C-arm x-ray image intensifier

Image intensifier (II) distortion changes as a function of C-arm rotation angle because of changes in the orientation of the II with the earth's or other stray magnetic fields. For cone-beam computed tomography (CT), distortion correction for all angles is essential. The new super-global distortion correction consists of a model to continuously correct II distortion not only at each location in the image but for every rotational angle of the C arm. Calibration bead images were acquired with a standard C arm in 9 in. II mode. The super-global (SG) model is obtained from the single-plane global correction of the selected calibration images with given sampling angle interval. The fifth-order single-plane global corrections yielded a residual rms error of 0.20 pixels, while the SG model yielded a rms error of 0.21 pixels, a negligibly small difference. We evaluated the accuracy dependence of the SG model on various factors, such as the single-plane global fitting order, SG order, and angular sampling interval. We found that a good SG model can be obtained using a sixth-order SG polynomial fit based on the fifth-order single-plane global correction, and that a 10 degrees sampling interval was sufficient. Thus, the SG model saves processing resources and storage space. The residual errors from the mechanical errors of the x-ray system were also investigated, and found comparable with the SG residual error. Additionally, a single-plane global correction was done in the cylindrical coordinate system, and physical information about pincushion distortion and S distortion were observed and analyzed; however, this method is not recommended due to a lack of calculational efficiency. In conclusion, the SG model provides an accurate, fast, and simple correction for rotational C-arm images, which may be used for cone-beam CT.