Rapidly Progressive, Fata Infection Caused by Bacillus Cereus in a Patient with Acute Lymphoblastic Leukemia

BACKGROUND

We herein report a fatal case of fulminant septicemia caused by Bacillus cereus in a 49-year-old female with T-cell acute lymphoblastic leukemia receiving chemotherapy.

METHODS

Her two blood culture sets were positive for Gram-positive, rod-shaped bacterium. Bacillus cereus was identified by high-throughput MALDI-TOF mass spectrometry and 16S ribosomal RNA gene sequencing.

RESULTS

The patient died within 12 hours from the onset of B cereus infection.

CONCLUSIONS

Patients with acute leukemia presented with fever and unexplained multiple organ lesions, especially accompanied by CNS symptoms, should alert to the possibility of Bacillus cereus infection.

Strain Elastography: A Valuable Additional Method to BI-RADS?

BACKGROUND

 Breast lesions classified as BI-RADS-US 3 are probably benign and observation was recommended, while a considerable number of BI-RADS-US 4 lesions were benign, resulting in excessive biopsies. We focus exclusively on BI-RADS-US 3 and 4 lesions and hypothesize that improved diagnostic performance can be achieved by integrating real-time elastography (strain ratio) into the BI-RADS-US classification system.

METHOD

 From April 2010 to September 2015, 1071 lesions were included in the final analysis. After the conventional ultrasound examination, the BI-RADS-US (2013) classification was used to evaluate the lesions. Then the strain ratios were calculated, and the final diagnosis was made on the basis of histological results. The sensitivity, specificity, accuracy, PPV and NPV were calculated and the AUCs were compared. Additionally, an analysis of the diagnostic performance expressed by the pretest and posttest probability of disease (POD) was performed in BI-RADS-US 3 and 4A lesions.

RESULTS

 With the cutoff point of 2.98, the sensitivity, specificity and accuracy of the strain ratio method were 86.9 %, 86.6 % and 82.6 %, respectively. In BI-RADS-US 3 lesions, a suspicious strain ratio significantly modified the POD from 1.3 % to a posttest POD of 29.8 %. In BI-RADS-US 4A lesions, a suspicious strain ratio significantly modified the POD from 8.5 % to a posttest POD of 48.7 %.

CONCLUSION

 Ultrasonographic elastography (strain ratio) yields additional diagnostic information in the evaluation of BI-RADS-US 3 and 4 breast lesions. The strain ratios should be integrated into the BI-RADS-US classification system and into daily practice.

[Statistical parametric mapping analysis of 18F-FDG PET in Parkinson's disease with mild cognitive impairment]

Objective: To investigate the characteristics of cerebral metabolism associated with mild cognitive impairment (MCI) Parkinson's disease (PD), cognitive normal PD and normal control to find a PET biomarker for the diagnose and estimate of PD-MCI. Methods: Forty-seven patients diagnosed with PD (included 15 with mild cognitive impairment) and 20 control subjects were enrolled. All the subjects were evaluated with FDG-PET and clinical scale. The statistical parametric mapping (SPM) were analyzed to determine metabolic patterns that may be useful in differentiating between the three groups. Results: SPM analysis showed that significant hypometabolism were observed in both side of front lobe, parietal lobe, left temporal lobe and left occipital lobe; in the contrast, the relative hypermetabolism had been observed in the cerebellum, vermis, hippocampus and supplement motor area (SMA) in patients with PD-MCI. PD without MCI showed hypometabolism in both side of front lob, caudate and putamen. PD-MCI showed that the significant hypermetabolism were in the insular and cerebellum while hypometabolism were in the both side of occipital compared to PD without MCI. Conclusion: A voxel-by-voxel based SPM method i. e. SPM8 analysis by PET scan is an effective way to analysis the FDG uptake pattern of PD patients. The hypermetabolism in the insula and cerebellum and hypometabolism in the both side of occipital may be a biomarker for make a diagnosis of PD-MCI.

What Help Could Ultrasound Elastography Give to the Diagnosis of Breast Papillary Lesions?

On the basis of results of our previous studies and the findings of other scholars, the most common histologic type of false-positive diagnosis with strain elastography (SE) was papilloma. The objectives of our study were to evaluate whether SE could contribute to conventional ultrasound differentiation between benign and malignant papillary lesions and between papillary lesions and other common benign breast lesions. Data on 89 papillary lesions at our hospital, including 74 benign and 15 malignant papillary lesions, were included in our study. In addition, 198 non-papillary benign tumors were selected as the control group, including 126 fibroadenomas and 72 cases of fibrocystic mastopathy. All patients gave written informed consent. All patients with breast lesions underwent conventional ultrasound and SE examination. Breast Imaging Recording and Data System (BI-RADS) category and SE score were compared with respect to sensitivity, specificity and accuracy in differentiating between benign and malignant papillary lesions. We then explored the possibility of using BI-RADS combined with SE to differentiate papillary lesions from non-papillary benign tumors. For differentiating between benign and malignant papillary lesions, the area under the receiver operating characteristic curve (AUC) of BI-RADS was 0.568, whereas the AUC values of SE score, strain ratio and BI-RADS combined with SE were 0.517, 0.584 and 0.509, respectively (p > 0.05). For differentiating between papillary lesions and non-papillary benign lesions, the AUC of BI-RADS combined with SE was 0.835, which was higher than the values for BI-RADS (0.775) and SE (SE score: 0.648, strain ratio: 0.661) (p < 0.001). The specificity and accuracy of BI-RADS combined with SE were significantly higher than those for BI-RADS alone without a decrease in sensitivity (p < 0.05). SE could not improve the diagnostic efficiency of BI-RADS in differentiating between benign and malignant papillary lesions. However, BI-RADS combined with SE could improve the specificity of BI-RADS without decrease in sensitivity for differentiating breast papillary lesions from non-papillary benign lesions.

Ultrasound Elastography Combined With BI-RADS-US Classification System: Is It Helpful for the Diagnostic Performance of Conventional Ultrasonography?

PURPOSE

To evaluate the additive diagnostic performance of ultrasound elastography (UE) to ultrasound (US) with the 2003 or 2013 Breast Imaging Reporting and Data System (BI-RADS)-US classification systems for the differentiation of benign and malignant breast lesions.

METHODS

From June 2010 to December 2012, 738 women with 770 breast lesions were recruited into this retrospective study. Breast lesions were evaluated separately by US, UE, and both. US assessment was based on the 2003 or 2013 BI-RADS-US, and UE assessment was based on a previously reported 5-point scale. Diagnostic performance of US, UE, and both was compared.

RESULTS

Before category 4 lesions were subdivided, the area under the receiver operating characteristic curve (AUC) for US, UE, and both were, respectively, 0.735, 0.877, 0.878 (P < .01). When subcategories of 4 lesions were considered, the AUC for US, UE, and both were, respectively, 0.865, 0.877, and 0.883 (P > .05). Adding UE to analysis of 4A lesions can decrease the percentages of malignancy to 2.56%.

CONCLUSION

When the 2003 BI-RADS was considered, UE could give US some help in differentiating breast lesions. However, when the 2013 BI-RADS was considered, UE gave little help to US, although it reduced unnecessary biopsies of benign category 4A lesions.

Study of optimal scheme of spinal image-guided radiotherapy based on expression of caspase-3 in spinal cord neurons by orthogonal design

The aim of the study was to optimize the biological safety scheme of spinal image-guided radiotherapy (IGRT) by determining the expression of caspase-3 in spinal cord neurons after IGRT. Thirty-six adult male beagles were assigned according to a random number table and subjected to IGRT to the 7th-12th canine thoracic vertebral bodies under a total dose of 80 Gy over 5 weeks. An immunohistochemical method was used to detect the expression of caspase-3 protein in spinal cord tissues, and real-time quantitative RT-PCR with SYBR Green I was used to detect the expression of caspase-3 mRNA in spinal cord tissues. Analysis of the orthogonal experiment results showed that caspase-3 expression in the spinal cord neurons was lowest when a single dose of 16 Gy was applied at a dose rate of 4 Gy/min, and field number of 9, with ray angle being equal. Thus, spinal IGRT showed high biological safety, and the best radiotherapy scheme for biological safety was single dose of 16 Gy at 4 Gy/min, with 9 fields and equal ray angle.

Ultrasonic elastography features of phyllodes tumors of the breast: a clinical research

The purpose of this study was to analyze the ultrasonic elastography features of phyllodes tumors of the breast comparing with fibroadenomas. A retrospective database was queried for the patients diagnosed as phyllodes tumors and fibroadenomas at Sun Yat-sen Memorial Hospital from January 2008 to August 2012. Three hundred and fifty lesions from 323 consecutive patients were included in the study. All the cases were examined by conventional ultrasonography and ultrasound elastography. Ultrasound elastography was used to calculate strain ratio of the lesions with bilateral breast tissue at the same depth as reference. There were 36 phyllodes tumors (27 benign, 8 borderline, 1 malignant) and 314 fibroadenomas (158 the pericanalicular type, 103 the intracanalicular type, 53 other special types). The strain ratio for phyllodes tumors (3.19±2.33) was significantly higher than for fibroadenomas (1.69±0.88) (p<0.05). The Spearman^.s correlation coefficient between strain ratio of ultrasound elastography and pathological groups was significant, with a value of 0.17 (p<0.05). Ultrasound elastography could provide additional information to differentiate phyllodes tumors from fibroadenoma in breast.

Association with TGF-β1 gene polymorphisms and reproductive performance of Large white pig

As a multifunctional cytokine, transforming growth factor-beta1 (TGF-β1) was detected in the utero-placental interface during early pregnancy in the pig and believed to enhance trophoblast attachment to the endometrium. In this experiment, we selected TGF-β1 as the candidate gene affecting litter size in pigs. Four polymorphic loci of TGF-β1 gene were found by PCR-SSCP (single-strand conformation polymorphism) in Large white sows (n = 567): C→T mutation at 33nt in the intron 4; G→A mutation at 179nt in the intron 6; C→T mutation at 1043nt in the intron 6; GG→AA linkage mutations at 2490nt and 2494nt respectively. We haplotyped these SNPs as: CGCAA (denote as P) and TATGG (denote as K). The effects of three haplotypic combinations (HCs) of PP, PK and KK on litter sizes were investigated by a linear model. It was found that for the first parity litters, the least squares mean for total number born (TNB) of KK was 1.02 piglets/litter, higher than that of PK (p < 0.05), 0.49 piglets/litter higher than that of PP (p > 0.1). There were no significant differences between HCs on the second parity. The result indicated that KK HCs was significantly associated with pig litter size.

Hemocompatibility and antibacterial properties of lanthanum oxide films synthesized by dual plasma deposition

Lanthanum oxide (La(2)O(3)) films with good hemocompatibility and antibacterial properties have been fabricated using dual plasma deposition. X-ray photoelectron spectroscopy (XPS) shows that La exists in the +3 oxidation state. The band gap of the materials is determined to be 3.6 eV. Activated partial thromboplastin time (APTT) and blood platelet adhesion tests were used to evaluate the blood compatibility. The bacteria, Staphylococcus aureus, were used in plate counting tests to determine the surface antibacterial properties. The APTT is a little longer than those of blood plasma and stainless steel (SS). Furthermore, the numbers of adhered, aggregated, and morphologically changed platelets are reduced compared with those on low-temperature isotropic carbon and SS. The antibacterial plate-counting test indicates that La(2)O(3) has good antibacterial activity against S. aureus. These unique hemocompatibility and antibacterial properties make La(2)O(3) useful in many biomedical applications.

Nanostructures in high-performance (GeTe)(x)(AgSbTe(2))(100-x) thermoelectric materials

The thermoelectric properties of (GeTe)(x)(AgSbTe(2))(100-x) compounds (x = 75, 80, 85 and 90; TAGS-x) have been studied as a function of temperature from 300 to 720 K. At 720 K the dimensionless figure of merit ZT reaches the state-of-the-art value of 1.53 for TAGS-75 and 1.50 for TAGS-80 and TAGS-85 samples, respectively. But the ZT value of the TAGS-90 sample is only 0.50 at 720 K due to the high carrier concentration. Utilizing high-resolution transmission electron microscope and selected area electron diffraction techniques, we identify a considerable number of nanoscale domains with typical size ∼10 nm in the samples that show high ZT values. It is suggested that the presence of nanoscale domains, like the situation in PbTe-AgSbTe(2) compounds, should make a slight contribution to the low lattice thermal conductivity of TAGS compounds due to the enhanced mid-frequency phonon scattering.

Hydrogen Adsorption on Functionalized Nanoporous Activated Carbons

There is considerable interest in hydrogen adsorption on carbon nanotubes and porous carbons as a method of storage for transport and related energy applications. This investigation has involved a systematic investigation of the role of functional groups and porous structure characteristics in determining the hydrogen adsorption characteristics of porous carbons. Suites of carbons were prepared with a wide range of nitrogen and oxygen contents and types of functional groups to investigate their effect on hydrogen adsorption. The porous structures of the carbons were characterized by nitrogen (77 K) and carbon dioxide (273 K) adsorption methods. Hydrogen adsorption isotherms were studied at 77 K and pressure up to 100 kPa. All the isotherms were Type I in the IUPAC classification scheme. Hydrogen isobars indicated that the adsorption of hydrogen is very temperature dependent with little or no hydrogen adsorption above 195 K. The isosteric enthalpies of adsorption at zero surface coverage were obtained using a virial equation, while the values at various surface coverages were obtained from the van't Hoff isochore. The values were in the range 3.9-5.2 kJ mol(-1) for the carbons studied. The thermodynamics of the adsorption process are discussed in relation to temperature limitations for hydrogen storage applications. The maximum amounts of hydrogen adsorbed correlated with the micropore volume obtained from extrapolation of the Dubinin-Radushkevich equation for carbon dioxide adsorption. Functional groups have a small detrimental effect on hydrogen adsorption, and this is related to decreased adsorbate-adsorbent and increased adsorbate-adsorbate interactions.

Blood response to plasticized poly(vinyl chloride): dependence of fibrinogen adsorption on plasticizer selection and surface plasticizer level

The high level of plasticizer in plasticized poly(vinyl chloride) (PVC) ensures that plasticizer selection has an important influence on the suitability of PVC to function in blood-contacting applications. In this study, three types of plasticized PVC in sheet form, with di-(2-ethylhexyl)phthalate (DEHP), tri-(2-ethylhexyl)trimellitate (TEHTM) and n-butyryltri-n-hexyl citrate (BTHC) as plasticizer, were selected for assessment and single solute fibrinogen adsorption was utilized as an initial index of interactions with blood components. Fibrinogen adsorption behavior shows a strong dependence on the plasticizer selection, plasticizer level at the surface and the adsorption conditions, such as adsorption time and fibrinogen solution concentration. Results indicate that BTHC plasticized PVC possesses the lowest adsorption capacity in the three types of plasticized PVC, while TEHTM plasticized PVC seems to have the strongest reactivity in certain fibrinogen solution concentrations. The alteration of surface plasticizer level was achieved by a methanol-cleaning treatment with a variety of cleaning times and the fibrinogen adsorption on plasticized PVC decreases with the reduction of surface plasticizer level. The migration behavior of two phthalate esters (DEHP and TEHTM) was evaluated using UV-Spectrophotometer to determine the plasticizer level at the surfaces. In addition, the fibrinogen adsorption mechanism was examined with Freundlich adsorption modeling.

Modification of polymer surfaces: optimization of approaches

Modification of polymer surfaces to achieve a surface with enhanced compatibility is an important means of obtaining improved biomaterials. Techniques are available for altering the hydrophilicity or charge of a surface, attaching macromolecules or attempting to resemble cell membranes. Relevant to the clinical success of a modified surface is the modification procedure and a procedure based on incorporation as opposed to surface treatment has potential advantages. The modification of plasticized vinyl chloride (PVC) by the incorporation of cyclodextrins is described. In comparison to unmodified PVC controls, cyclodextrin incorporation reduced fibrinogen adsorption, with the extent of reduction dependent on the type and quantity of cyclodextrin incorporated.

Synthesis and characterization of a novel double crosslinked hyaluronan hydrogel

Hyaluronan has great potential in medicine as a biomaterial. However, in its native form, hyaluronan is rapidly metabolized in vivo by free radicals and enzymes such as hyaluronidase, and it is highly soluble. Various methods have been adopted therefore, to modify the physicochemical properties of hyaluronan, while maintaining biocompatibility, and thereby widen its spectrum of therapeutic applications. Hyaluronan has four reactive groups (acetamido, carboxyl, hydroxyl and the reducing end) available for crosslinking to itself or other polymers. Using a variety of crosslinking agents, researchers have developed a host of crosslinked hyaluronan derivatives with an increased in vivo residence time. This chemical modification has enabled the production of gels and films, which can be used in applications such as the prevention of post-surgical adhesions, wound healing and dermal augmentation. We have found that if hyaluronan is crosslinked to itself, or to other polymers (either synthetic or biopolymer), in two stages, then a high degree of crosslinking is achieved, conferring improved biostability. In each of the two stages, the same crosslinking agent is used, but different functional groups are bound by altering the reaction conditions. The novel process can be tailored to yield water insoluble gels and films with a broad range of physical and chemical characteristics, and greater resistance to degradation by hyaluronidase and free radicals. These derivatives are currently undergoing biocompatibility testing, and should ultimately lead to a series of innovative second-generation medical products.

[PCR-SSCP and sequencing analysis on 5' terminal region of mtDNA control region in sheep]

PCR-SSCP and sequencing of the left domain in ovine mitochondrial control region revealed that all 202 sheep from Small Tail Han sheep, Wuzhumuqin sheep, Hu Yang, Suffol, Sharolai and hybrids between Dorset (Male) and Small Tail Han sheep (Female) can be classified into two types: common type and mutation type, this result suggested that modern domestic sheep originate from two main ancestors.

Blood interactions with plasticized poly(vinyl chloride): relevance of plasticizer selection

An investigation has been made of blood interactions with plasticized poly(vinyl chloride) (PVC) biomaterials in tubular form, taking into account the influence on the blood response of the polymer, antithrombotic agent, blood condition and test procedure. In vitro and ex vivo procedures were used to achieve a comparison between PVC plasticized with di- (2-ethylhexyl)phthalate (DEHP) and with tri-(2-ethylhexyl)trimellitate (TEHTM). The blood response was monitored in terms of the measurement of fibrinogen adsorption capacity, thrombin-antithrombin III complex (TAT) and the complement component C3a. Surface characterization of the polymers was performed by X-ray photoelectron spectroscopy (XPS). The data obtained indicate that in comparison with DEHP-PVC, there is a higher reactivity for TEHTM-PVC, which correlates with the plasticizer distribution at the polymer surface.

The Influence of Bureaucratic Behavior on Land Apportionment in China: The Informal Process

In the early 1990s China experienced phenomenal, massive, speculative land development that had long range impacts on China's sustainable development. The authors attempt to examine the administrative framework of the current land-apportionment system from the perspectives both of formal or legal and of informal or quasi-legal processes. In particular, they focus on the detrimental consequences of the informal process of land apportionment, which has virtually overridden the formal process in recent years. They also cautiously scrutinize the underlying reasons for land misapportionment. They argue that the informal process is difficult to control and it will continue to impede the normal and healthy development of China's land market in the foreseeable future.

Measurement and Calculation of Three-Dimensional Grain Sizes and Size Distribution Functions

: Three-dimensional (3D) grain sizes and size distribution functions (SDFs) are generally obtained by converting the 2D or 1D grain sizes to 3D with the methods based on a spherical grain shape model (S-model), which can produce large systematic errors. In this report, a new polyhedral grain model (P-model) is developed and experimentally checked with the directly measured 3D grain sizes. The results show that the systematic error originating from the S-model can be corrected by using the new polyhedral grain model.

Artificial cell containing superoxide dismutase--selection of folding aids for stabilisation of SOD

Superoxide dismutase (abbreviated as SOD) has been vigorously studied in the fields of radical chemistry and related life science. One of practical problems is how to keep its activity in certain adverse conditions causing denaturation. Artificial cell containing SOD can be prepared by polymer encapsulation or nanocapsulation which has been found to be effective to improve the stability of SOD. For construction of an ideal artificial cell system, some folding aids or aggregation inhibitors were utilised to enhance SOD stability. In this study, three groups of biopolymers are selected as folding aids or aggregation inhibitors for stabilisation of SOD, i.e. albumin, carbohydrates and glycoproteins. Results indicate that the thermostability of SOD is affected by different sort of albumin while some carbohydrates such as cyclodextrins are found to be able to enhance SOD stability. In addition, it is firstly found that selected glycoproteins such as alpha-macroglobulin and ovalbumin are several types of effective folding aids for stabilisation of SOD. They can protect SOD against denaturation even at very high temperature(over 100 degrees C). The stability was tested by the measurement of SOD activity loss using autooxidation method in different adverse conditions such as high temperature, extreme pH medium, proteolytic hydrolysis and long shelf life storage. The possible stabilisation mechanism of using cyclodextrins and glycoproteins as folding aids were discussed.

[Changing fetal position through maternal posture]

The fetal position of 249 cases in their late pregnancy was detected by ultrasound. The results showed that the position of fetal spine tended to lie on the same side as mother's posture during bedrest just before examination. Fetal posterior or transverse spinal position was prone to occur when mother was on her supine position. The fetal cephalic presentation did not correspond entirely with the fetal spinal position. Eighty of the 249 cases presenting fetal spinal posterior or transverse position were chosen at random and corrected by Sims' or hand-knee posture. The better results were obtained especially by the latter. The success rate of correction by maternal posture was affected by the engagement of fetal head and the volume of amniotic fluid. The mechanism of hand-knee posture was discussed. The result indicated that maternal posturing is a clinically valuable procedure. It may be done during pregnancy or in labor to prevent fetal malpresentation.

[Determination of hydroxygenkwanin and genkwanin in flos Genkwa before and after processing by a TLC-scanner]

Thin-layer chromatography and a dual wavelength TLC-scanner (Shimadzu CS-910) were used for the determination of hydroxygenkwanin and genkwanin in flos Genkwa before and after processing with vinegar. The result shows that the amounts of hydroxygenkwanin and genkwanin in processed products were increased. The amounts of the said two constituents were different in various products.

Acute infectious torticollis

Acute torticollis has occurred in epidemics in eastern and northern China since 1975, but has not yet been reported in other countries. A general account of this disease, including its terminology, epidemiology, clinical features, laboratory findings, diagnosis, differential diagnosis, and treatment, is presented. The etiology, though highly suggestive of a virus infection, remains to be determined.