Primary Anterior Medistinal Choriocarcinoma in Male with Lung Metastasis and Pituitary Microadenoma: A Case Report

The authors report a case of a 29-year-old male presented with bilateral breast enlargement with no significant past medical history or estrogen exposure. Serum β-human chorionic gonadotropin (HCG) was 14,306.60 mIU and positron emission tomography-computed tomography discovered a malignant mass on the right side of anterior superior mediastinum. Magnetic resonance imaging demonstrated pituitary microadenoma. Pathological biopsy showed poorly differential pituitary adenoma and immunohistochemical staining displayed that CK(+), PLAP(−), AFP(−), HCG(+), CD30(−), Oct3/4(−), CK7(+), TTF-1(−), CD117(−), Ki 67(80+), CK5/6(−), EMA(partial+), inhibin(partial+). A diagnosis of primary anterior mediastinal choriocarcinoma metastasis to bilateral lungs accompanied with pituitary microadenoma was confirmed. Then the patient received chemotherapy combined with immunotherapy. But serum β-HCG level was still above the normal, and unfortunately, the patient died 6 months after his diagnosis. This case inspires us to think of the possibility of choriocarcinoma when a man presents gynecomastia or lung metastatic symptoms, adding Opdivo to the chemotherapy might not improve the poor treatment outcomes

Event Related Potential Evidence of Enhanced Visual Processing in Auditory Associated Cortex in Adults with Hearing Loss

Objective: The present study investigated the characteristics of visual processing in the auditory-associated cortex in adults with hearing loss using event-related potentials. Methods: Ten subjects with bilateral postlingual hearing loss were recruited. Ten age- and sex-matched normal-hearing subjects were included as controls. Visual (“sound” and “non-sound” photos)-evoked potentials were performed. The P170 response in the occipital area as well as N1 and N2 responses in FC3 and FC4 were analyzed. Results: Adults with hearing loss had higher P170 amplitudes, significantly higher N2 amplitudes, and shorter N2 latency in response to “sound” and “non-sound” photo stimuli at both FC3 and FC4, with the exception of the N2 amplitude which responded to “sound” photo stimuli at FC3. Further topographic mapping analysis revealed that patients had a large difference in response to “sound” and “non-sound” photos in the right frontotemporal area, starting from approximately 200 to 400 ms. Localization of source showed the difference to be located in the middle frontal gyrus region (BA10) at around 266 ms. Conclusions: The significantly stronger responses to visual stimuli indicate enhanced visual processing in the auditory-associated cortex in adults with hearing loss, which may be attributed to cortical visual reorganization involving the right frontotemporal cortex

Efficacy and safety of low-dose IL-2 in the treatment of systemic lupus erythematosus: A randomised, double-blind, placebo-controlled trial

Objectives Open-labelled clinical trials suggested that low-dose IL-2 might be effective in treatment of systemic lupus erythematosus (SLE). A double-blind and placebocontrolled trial is required to formally evaluate the safety and efficacy of low-dose IL-2 therapy. Methods A randomised, double-blind and placebocontrolled clinical trial was designed to treat 60 patients with active SLE. These patients received either IL-2 (n=30) or placebo (n=30) with standard treatment for 12 weeks, and were followed up for additional 12 weeks. IL-2 at a dose of 1 million IU or placebo was administered subcutaneously every other day for 2 weeks and followed by a 2-week break as one treatment cycle. The primary endpoint was the SLE Responder Index-4 (SRI-4) at week 12. The secondary endpoints were other clinical responses, safety and dynamics of immune cell subsets. Results At week 12, the SRI-4 response rates were 55.17% and 30.00% for IL-2 and placebo, respectively (p=0.052). At week 24, the SRI-4 response rate of IL-2 group was 65.52%, compared with 36.67% of the placebo group (p=0.027). The primary endpoint was not met at week 12. Low-dose IL-2 treatment resulted in 53.85% (7/13) complete remission in patients with lupus nephritis, compared with 16.67% (2/12) in the placebo group (p=0.036). No serious infection was observed in the IL-2 group, but two in placebo group. Besides expansion of regulatory T cells, low-dose IL-2 may also sustain cellular immunity with enhanced natural killer cells. Conclusions Low-dose IL-2 might be effective and tolerated in treatment of SThe work was supported by the National Natural Science Foundation of China (31530020,31570880,81471601,81601417 and 81701598), Peking-Tsinghua Center for Life Sciences to ZG LI, Beijing Sci-Tech Committee Z171100000417007,Clinical Medicine Plus X-Young Scholars Project of Peking University (PKU2019LCXQ013) supported by the Fundamental Research Funds for the Central Universities, Beijing Nova Program Z171100001117025, National Key Research and Development Program of China (2017YFC0909003 to DY), BellberryViertel Senior Medical Research Fellowship to DY and Beijing SL PHARM

Fuzzy Clustering and Routing Protocol With Rules Tuned by Improved Particle Swarm Optimization for Wireless Sensor Networks

Fuzzy clustering and routing protocols have been proven to improve energy efficiency, extend network scalability, increase network throughput, balance network load as well as prolong network lifetime. However, rules defined manually according to field experts are impossible or impractical to achieve the optimal solution for a Fuzzy Inference System (FIS). Therefore, a Novel Fuzzy Clustering and Routing Protocol called NFCRP is proposed in this paper by using an improved Particle Swarm Optimization (PSO) algorithm to tune the fuzzy rules. Firstly, one FIS is used to complete clustering based on effective input parameters including residual energy, node degree deviation, and distance to centrality, thereby forming optimal clusters and minimizing the intra-cluster energy consumption. Secondly, the other FIS is adopted to perform routing with descriptors residual energy, distance to BS, and data load deviation, hence addressing the inter-cluster energy consumption. Finally, the rules of both FISs are tuned by an improved PSO algorithm whose parameters are updated by introducing chaotic mapping and adaptive inertia weight. Simulation experiments were conducted to verify the performance of NFCRP against LEACH, EFUCA, EEFUC, FBCR and FMSFLA. According to the results, the average network lifetime of NFCRP increased by 79.59%, 47.99%, 50.35%,15.66 and 13.04%, compared to LEACH, EEFUC, EFUCA, FBCR and FMSFLA. For the average standard deviation of CH’s traffic load, NFCRP decreased it by 29.29% over EEFUC, 31.42% over EFUCA, and 25.28% over FMSFLA. For network throughput, NFCRP outperformed LEACH, EEFUC, EFUCA, FBCR and FMSFLA by 16.87%, 46.52%, 48.18%, 29.97 and 71.79%. In addition, NFCRP also reduced energy consumption by 53.95%, 23.76%, 38.72%, 15.71 and 27.18% as compared to LEACH, EEFUC, EFUCA, FBCR and FMSFLA, respectively