Intrahepatic bile duct stones located at the upper part of the hepatic duct.The percentage of intrahepatic biliary cholesterol calculus is increasing in recent years,and the incidence of this type of bile duct stones is free from infection or obstruction.The formation of intrahepatic bile duct stones might not only related to the micro-environment changes in the biliary tract,but also related to the changes of metabolic function of hepatocytes or cholangiocytes.In this article,the mechanism of biliary hydrodynamics on the formation of intrahepatic bile duct stones was reviewed.

Purpose To explore the 18F-FDG PET/CT imaging features of adrenal lymphoma and to improve the diagnosis of this disease.Materials and Methods A total of 13 cases with pathology-proven adrenal lymphoma and PET/CT examinationfrom December 2012 to March 2016 were retrospectively reviewed,The contents including the extent,shape,size and density of the adrenal lymphoma as well as the SUVmax value and affected lymph gland were recorded.The region of interesting (ROI) was delineated with the SUVmax value being calculated,which was compared with pathological diagnosis.Results All 13 cases were non-Hodgkins lymphoma,12 of which were secondary lymphoma,with the other case being primary lymphoma.Nine cases were diffuse large B-cell lymphoma (DLBCL);2 cases were mantle cell lymphoma;2 cases were NK/T-cell lymphoma.In 10 cases there were bilateral adrenal involvement,and unilateral involvement in 3 casesincluding on 2 the left and 1 on the right.A total of 23 adrenal glands were involved,with soft masses in 13,soft nodules in 8 and adrenal thickening in 2.The lesions were well-defined in 10 cases.In 3 cases there were cystic changes or necrosis.No hemorrhage,calcification or fat was identified.Extra-adrenal involvement was discovered in 9 cases.Lymphadenopathy was seen in 10 cases involving the neck,mediastinum and retroperitoneum.Adrenal lesions showed intense FDG uptake on PET/CT with SUVmax ranging from 5.7 to 30.8 and mean SUVmax of 15.8±8.9.Conclusion Most of the adrenal lymphoma cases were diffuse large B-cell non-Hodgkin's lymphoma.The features of PET/CT include bilateral involvement,well-defined soft tissue mass with intense FDG uptake.PET/CT can differentiate primary and secondary adrenal lymphoma and help with treatment planning.

A wireless transmission system for visual prosthesis is introduced. Power and data are transmitted through inductive link between only one pair of coils, in order to reduce the size of the device. The transmitter is based on Class-E power amplifier due to its high efficiency, and a modulation circuit is added to control the dc supply of the Class-E amplifier to achieve ASK modulation of data with modulation depth of 25%. In addition, an experimental system is implemented, and test shows that it sufficiently supports a 16-channel micro-stimulator on power delivery and data transfer rate.
Amplifiers, Electronic ; Automatic Data Processing ; Electric Power Supplies ; Electronics, Medical ; Prosthesis Design ; Telemetry ; Visual Prosthesis

Objective:To investigate the expression levels of serum miR-126 and miR-9 in patients with wet age-related macular degeneration (wAMD) and their relationship with vascular endothelial growth factor (VEGF) and central macular thickness (CMT).Methods:A total of 73 wAMD patients(observation group) admitted to the ophthalmology department of Taizhou Municipal Hospital from May 2020 to May 2021 and 60 healthy subjects (control group) who underwent physical examination during the same period were selected. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression levels of miR-126 and miR-9 in serum of the two groups. Serum angiogenesis regulatory factors [VEGF, tissue inhibitor of melalloproteinuses-1 (TIMP-1), endostatin (ES), platelet-derived growth factor (PDGF)] were detected by enzyme-linked immunosorbent assay (ELISA), and CMT and intraocular pressure (IOP) were measured. Pearson correlation analysis was performed to determine the correlation between miR-126 and miR-9 and serum angiogenesis regulatory factor levels, CMT and IOP. The diagnostic value of miR-126 and miR-9 in wAMD was analyzed by receiver operating characteristic (ROC) curve.Results:The relative expression level of serum miR-126 in observation group was significantly lower than that in control group ( P<0.05) , while the relative expression level of serum miR-9 was significantly higher than that in control group ( P<0.05). The levels of serum VEGF and PDGF in observation group were significantly higher than those in control group (all P<0.05), while the levels of serum TIMP-1 and ES were significantly lower than those in control group (all P<0.05). CMT and IOP in observation group were significantly higher than those in control group (all P<0.05). The expression level of serum miR-126 in observation group was negatively correlated with serum VEGF, PDGF, CMT and IOP ( r=-0.275, -0.523, -0.302, -0.542, all P<0.05), and was positively correlated with TIMP-1 and ES ( r=0.460, 0.263, all P<0.05). Serum miR-9 expression level was positively correlated with serum VEGF, PDGF, CMT and IOP ( r=0.434, 0.438, 0.396, 0.307, all P<0.05), and was negatively correlated with TIMP-1 and ES ( r=-0.256, -0.310, all P<0.05). The area under curve (AUC) values of serum miR-126 and miR-9 in diagnosing wAMD were 0.713 and 0.847 respectively. Conclusions:The expression level of serum miR-126 is significantly decreased while the expression level of miR-9 is significantly increased in patients with wAMD. miR-126 is negatively correlated with VEGF and CMT, and miR-9 is positively correlated with VEGF and CMT, which may aggravate the disease by promoting the inflammatory response. The detection of expression levels of serum miR-126 and miR-9 is helpful to provide the reference basis for early diagnosis of wAMD and early prevention and treatment.

Curdlan is a water insoluble exopolysaccharide produced by Alcaligenes faecalis under nitrogen-limiting conditions. After excretion, the polysaccharide is attached the cell wall. Thus enhancement of biomass production during the cell growth phase is important to curdlan production. A strategy of increasing nitrogen source to improve biomass production was adopted for curdlan production by Alcaligenes faecalis (ATCC 31749). In the batch fermentation of curdlan, a relatively higher NH4Cl level of 3.6 g/L with continuous glucose feeding increased the cell density leading to improvement of curdlan production. However, excessive NH4Cl would inhibit curdlan production and biomass production was not improved significantly. In addition, feeding of ammonia water at the initial phase replaced NaOH solution to control pH at 7.0. Subsequently, feeding of NaOH solution was resumed to control pH at 5.6 for curdlan production after ammonia was consumed. As a result, biomass production and curdlan yield were both enhanced remarkably. Feeding of ammonia water during the first 24 h led to biomass production of 18.8 g/L. However, higher cell density did not lead to increase in curdlan production. The maximum curdlan production (72 g/L) was obtained by feeding ammonia water for the first 14 h, during which the cell density was about 11.9 g/L.
Alcaligenes faecalis ; cytology ; metabolism ; Ammonium Chloride ; pharmacology ; Cell Culture Techniques ; methods ; Cell Proliferation ; Fermentation ; beta-Glucans ; metabolism

Objective To evaluate and explore the diagnostic value of focal liver lesion ( FLL) ( ≤2 cm) undetectable on conventional ultrasound by image fusion with contrast-enhanced ultrasound(CEUS) . Methods A total of 50 patients with 65 lesions( ≤2 cm) were enrolled . All lesions were undetectable on conventional ultrasound but showed clearly in CT/MRI images . Ultrasound-CT/MRI image fusion with CEUS was performed ,and the nodule detection rate and enhancement perfusion mode were analyzed . Results All the 50 patients were matched successfully ,56 lesions (86 .2% ) were detected by image fusion combined with CEUS ,among which 27 lesions (41 .5% ) were significantly different from surrounding parenchyma on conventional ultrasound , 54 lesions ( 83 .1% ) showed different enhancement from the surrounding parenchyma on CEUS . There were 46 lesions that were eventually diagnosed by surgical pathology or clinical comprehensive diagnosis . The diagnostic accuracy of image fusion with CEUS was 91 .3% (42/46) . According to different groups of MRI matching sequences ,the detection rates of T 2 sequence group and enhanced sequence group were 87 .5% (28/32) and 91 .3% (21/23) ,respectively ,there was no statistically significant difference between the two groups ( P ＝0 .686) . Conclusions CT/MRI image fusion combined with CEUS has high detection rate and diagnosis accuracy for small FLL undetectable on conventional ultrasound .

Objective To explore the clinical value of the Liver Imaging Report and Data System ( LI-RADS) with contrast enhanced ultrasound(CEUS) in the diagnosis of hepatocellular carcinoma ( HCC) . Methods From October 2012 to July 2018 , the CEUS data of patients at high risk for HCC were retrospectively analyzed . A total of 197 lesions in 178 patients were classified with reference to the 2017 version of CEUS LI-RADS classification standard . Diagnostic reference standard was surgical pathology . The relationship between the LI-RADS classification and the pathological diagnosis was evaluated . Results One hundred and ninety-seven lesions ,with an average size of ( 2 .9 ± 1 .6)cm ,were pathologically confirmed to be 170 HCC ( 86 .3% ) ,17 non-HCC malignant lesions ( 8 .6% ) ,and 10 liver benign lesions ( 5 .1% ) . There were 6 (3 .0% ) ,37(18 .8% ) ,134 (68 .0% ) and 20 (10 .2% ) lesions classified into LR-3 ,LR-4 ,LR-5 and LR-M category ,respectively . Positive predictive values of HCC in LR-3 ,LR-4 and LR-5 category were 16 .7% (1/6) ,89 .2% (33/37) ,97 .0% (130/134) ,respectively . LR-5 category had high positive predictive value of HCC( 97 .0% ) ,but low sensitivity ( 76 .5% ) . If LR-5 category combined with LR-4 category were diagnosed as HCC ,the diagnostic accuracy was significantly higher than that of LR-5 category ( 92 .4% vs 77 .7% ) ,and the difference was statistically significant ( P ＜ 0 .05 ) . 95 .0% ( 19/20 ) lesions of LR-M category were malignant ,of which 30 .0% ( 6/20 ) lesions were HCC . 76 .9% ( 10/13 ) of intrathecal cholangiocarcinoma was characterized by LR-M . Conclusions The LI-RADS classification of CEUS has high application value for diagnosis and differentiation of HCC .

Objective:To evaluate the clinical value of 18F-FDG PET/CT findings in patients with T1-2 lung adenocarcinoma spread through air spaces (STAS). Methods:From June 2018 to June 2020, a total of 80 patients (36 males, 44 females; age: 19-84 (59.9±11.8) years) with surgically and pathologically confirmed T1-2 lung adenocarcinomas in Jiangmen Central Hospital were enrolled retrospectively. All patients underwent 18F-FDG PET/CT examination preoperatively and were divided into STAS positive and negative groups according to the histopathological diagnosis. Independent-sample t test, Mann-Whitney U test, χ2 test and Fisher exact test were used to analyze differences of gender, age, tumor biomarker, SUV max, SUV mean, features showed on high resolution CT (HRCT; including diameter, lesion location, morphology, density, lobulated sharp, spiculated sign, vacuole sign, air bronchgram sign, pleural traction and para-emphysema), and pathologic findings (micropapillary pattern, lymphvascular inversion, pleural inversion and lymph node metastasis) between the two groups, and then multivariate logistic regression was performed. The ROC curve was employed to evaluate the predictive value of parameters for STAS of T1-2 lung adenocarcinomas. Results:Among the 80 patients with T1-2 lung adenocarcinomas, 12 (15.0%) were STAS positive and 68 (85.0%) were STAS negative. Significant differences were shown in SUV max, SUV mean, micropapillary pattern, lymphvascular inversion and lymph node metastasis between the two groups ( z values: -2.60, -2.17; χ2 values: 29.56, 9.28, 17.40, P<0.001 or P<0.05). SUV max (odds ratio ( OR): 1.348 (95% CI: 1.071-1.695), P=0.011), micropapillary pattern ( OR=47.444 (95% CI: 4.592-490.214), P=0.001) and lymph node metastasis ( OR=8.201 (95% CI: 1.129-59.576), P=0.038) were independent risk factors for STAS positive in multivariation logistic regression analysis. The optimum cut-off value for SUV max was 3.85 in the ROC analysis with the AUC of 0.737 (95% CI: 0.614-0.859), the sensitivity of 11/12, the specificity of 55.9%(38/68) and the accuracy of 61.2%(49/80). The AUC of the SUV max combined with micropapillary pattern and lymph node metastasis was 0.945 (95% CI: 0.892-0.999) with the sensitivity of 11/12, the specificity of 88.2%(60/68) and the accuracy of 88.7%(71/80). Conclusions:The PET/CT characteristics may be useful in differentiating STAS status among patients with T1-2 lung adenocarcinoma. SUV max >3.85, pathological papillary pattern and lymph node metastasis are independent risk factors to predict STAS.

Objective:To investigate epidemiological and clinical characteristics of botulism, and the adverse events among those received botulinum antitoxin treatment.Methods:Patients with discharge diagnosis as botulism in the Second Affiliated Hospital of Xinjiang Medical University were enrolled between 2017 and 2021. The epidemiological and clinical characteristics were evaluated. Infection and mechanical ventilation as in-hospital outcomes according to baseline characteristics were analyzed. Patients with and without the interested outcomes were compared. The adverse outcomes among those received botulinum antitoxin treatment were investigated. Those with and without the adverse outcomes were also compared.Results:Sixty-seven cases of botulism were enrolled, and most cases got sick between January and March (32/67, 47.8%); among them 62 cases were Han ethnicity (92.5%); prevalence was highest in Aksu region (15/67, 22.4%); commonly seen symptoms and signs included fatigue (58/67, 86.6%), dysphagia (48/67, 71.6%), dizziness (42/67, 62.7%), ptosis (42/67, 62.7%), blurred vision (41/67, 61.2%), and limb weakness (35/67, 52.2%). Compared with patients without in-hospital infection ( n=52), patients with in-hospital infection ( n=15) were more likely to have severe botulism (0/52 vs 5/15, χ 2=19.79, P<0.001), diplopia (16/52, 30.8% vs 11/15, χ 2=8.77, P=0.003), dysarthria (17/52, 32.7% vs 11/15, χ 2=7.91, P=0.005), consciousness disorder (1/52, 1.9% vs 4/15, χ 2=10.32, P=0.008). Compared with patients without mechanical ventilation (62/67, 92.5%), patients with mechanical ventilation (5/67, 7.5%) were more likely to have severe botulism (5/5 vs 0/62, χ 2=41.17, P<0.001), and consciousness disorder (4/5 vs 1/62, 1.6%, χ 2=29.58, P<0.001). Among 67 cases of botulism, 19 cases (28.4%) had adverse events after receiving antitoxin treatment, with an average of 6.5 days from the antitoxin treatment beginning to the adverse event onset; among the 19 cases, 18 cases (94.7%) had rash. Age, sex, and severity did not differ between the groups with ( n=19) and without adverse events ( n=48) after receiving antitoxin treatment. Conclusions:Fatigue, dysphagia, dizziness, ptosis were the most frequent symptoms and signs in the botulism in Xinjiang Uygur Autonomous Region, China. Infection was a commonly seen complication of botulism, and proactive prevention and close monitoring were needed. Adverse events after receiving antitoxin were prevalent, and might not be associated with age, sex, and severity of botulism.

Objective:To investigate the factors associated with delay in anticoagulant therapy in patients with cerebral venous sinus thrombosis (CVST) and its effect on outcome.Methods:Patients with CVST admitted to Changhai Hospital, Naval Medical University from January 2010 to August 2021 were retrospectively enrolled. Patients were divided into early anticoagulation group and late anticoagulation group by the median time interval from first symptom to initiation of anticoagulation. The modified Rankin Scale was used for outcome assessment at 90 d after onset. 0-2 scores were defined as good outcome and 3-6 were defined as poor outcome. Demographic and clinical data were compared for the early versus late anticoagulation group and for the good versus poor outcome groups. Multivariable logistic regression was used to identify independent influencing factors of delay in anticoagulation and the correlation of delay in anticoagulation with poor outcome. Results:A total of 131 patients were included, their age was 40.07±15.11 years old, and 68 (51.91%) were male. Of these, 65 patients (49.62%) were in the early anticoagulation group and 14 (10.69%) were in the poor outcome group. Compared with the late anticoagulation group, the early anticoagulation group had a significantly higher proportion of patients with seizures and brain parenchymal damage as well as higher D-dimer levels on admission, while the proportion of patients with visual impairment/papilloedema was significantly lower (all P<0.05). Compared with the good outcome group, the poor outcome group had significantly higher proportions of patients with seizures, dyskinesia, impaired consciousness, low Glasgow Coma Scale score, and brain parenchymal damage as well as higher D-dimer, total cholesterol and low density lipoprotein cholesterol levels, sites of thrombus involvement were more common in the superior sagittal and straight sinuses, and significantly lower proportions of patients with headache and lower albumin levels on admission (all P<0.05). Multivariate logistic regression analysis showed that visual impairment/papilloedema (odds ratio [ OR] 0.119, 95% confidence interval [ CI] 0.030-0.473; P=0.002) and brain parenchymal damage ( OR 1.341, 95% CI 1.042-1.727; P=0.023) were independently associated with a delay in anticoagulation treatment, and a delay in anticoagulation treatment ( OR 6.102, 95% CI 1.185-30.504; P=0.030) and D-dimer level on admission ( OR 1.299, 95% CI 1.141-1.480; P<0.001) were the independent predictors of poor outcome in patients with CVST. Conclusions:Visual impairment/papilloedema and absence of brain parenchymal damage on cranial imaging are the independent risk factors for delay in anticoagulation in patients with CVST. The delay in anticoagulation is strongly associated with the poor outcome in patients with CVST.