A Case of Waldenström’s Macroglobulinemia Complained of Anorexia

It has been reported that an 82-year-old man had complained of “anorexia with wasting away (weight loss of 35 pounds) over the past six months”. The cause was unknown, and his appetite dropped to only liquid milk and soy milk every day. On further examination, his CA-199 (a tumor marker) was in the normal range, but the serum IgM level was found to be 4 times higher than normal, and lymphoplasmacytic cells in his bone marrow were 2 times higher than normal. His myeloid differentiation factor (MYD88) was detected to be positive in gene mutations, confirming a diagnosis of “Waldenström’s macroglobulinemia” (WM) complicated with “Bing-Neel syndrome” (BNS); as a result, the anorexia was attributed to it, and the symptomatic treatment with Traditional Chinese Medicine (TCM) was proposed to improve his condition

An Analysis of Two Aged Patients with Pulmonary Tuberculosis

What methods would you choose apart from purified protein derivative (PPD) skin test and culture for acid-fasting bacilli (AFB) to make a clinical diagnosis of pulmonary tuberculosis (TB) in an aged patient with possible TB? These are two cases of pulmonary TB, that occurred with persistent low-grade fever, fatigue and anorexia due to a mild toxemia of tuberculosis. A final diagnosis of pulmonary tuberculosis was established on the basis of mild toxemia(low-grade fever), debilitation and characteristic pulmonary CT imaging, free of PPD and interferon-gamma release assay (T-spot). The authors realized that the dosage of anti-tuberculosis drugs should be carefully controlled and the improvement of their overall nutritional status to gain better efficacy is much more needed

Space-time accessibility measures: A geocomputational algorithm with a focus on the feasible opportunity set and possible activity duration.

Abstract. Space-time accessibility measures have received much attention in recent years due to their sensitivity to differences in individual ability to participate in activities in space and time. Despite the conceptual attractiveness and robustness of space-time measures, only few attempts have been made to operationalize them to date. Research that seeks to improve space-time accessibility measures is still sorely needed. This study seeks to enhance space-time accessibility measures through developing a new operational method and GIS-based algorithm that better represents the space-time characteristics of urban opportunities (e.g. their geographical distribution and opening hours) and human activity-travel behavior (e.g. delay times, minimum activity participation time, and maximum travel time threshold). The proposed method not only takes into account the number and size of opportunities, but also the possible activity duration at each activity location given its opening hours and the effect of transport network topology (e.g. one-way streets, turn restrictions and over-pass). Incorporating these elements into space-time measures helps overcome several shortcomings of previous approaches to evaluating space-time accessibility. Key words: Individual accessibility, space-time accessibility measures, spacetime constraint, space-time prism, GIS JEL classification: C60, R40 A version of this paper was presented at the 98th Annual Meeting of the Association of American Geographers, Los Angeles, March 19-23, 2002. We thank Joe Weber for providing the digital transport network with travel speeds and a version of the geocomputational algorithm he used in his study (Weber 2001), upon which our developmental effort has been based. We are also grateful to the helpful comments and suggestions of the reviewers

A New Guide Lifter for the Transceiver of USBL

A new guide lifter has been put forward for the transceiver of Ultra Short Base Line (USBL) with a worm gear reducer applied as self-locking of the lifter and a chain structure applied to drive the sliding shaft moving up and down. The new device is 7500 mm long and connected to the end of the transceiver. Linear motion products are introduced to ensure the shaft unable to rotate and the position measurements are provided by position sensors. A heavy self-sealing sliding bearing, which is 800 mm in length, keeps the shaft running reliably. Then the three-dimensional model is built and the structure parameters of the lifter are calculated. Later, the working process of the lifter is simulated to guarantee the movement parameters meet the request of USBL. Finally, the experiment on the intensity and stiffness of the lifter is carried out via the finite element model of the lifter built in ANSYS with the maximum load conditions and the result has been experimentally verified. This device provides a reliable approach of operating USBL which plays a vitally important role in ocean exploration and the research results are successfully applied to the scientific research vessels of Dayang No. 1 as well as Xiangyanghong No. 9

Carbapenem and cefoxitin resistance of Klebsiella pneumoniae strains associated with porin OmpK36 loss and DHA-1 β-lactamase production

Clinical isolates of carbapenem-resistant Klebsiella pneumoniae (K. pneumoniae) strains are being increased worldwide. Five pan-resistant K. pneumoniae strains have been isolated from respiratory and ICU wards in a Chinese hospital, and reveal strong resistance to all β-lactams, fluoroquinolones and aminoglycosides. Totally 27 β-lactamase genes and 2 membrane pore protein (porin) genes in 5 K. pneumoniae strains were screened by polymerase chain reaction (PCR). The results indicated that all of 5 K. pneumoniae strains carried blaTEM-1 and blaDHA-1 genes, as well as base deletion and mutation of OmpK35 or OmpK36 genes. Compared with carbapenem-sensitive isolates by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), the resistant isolates markedly lacked the protein band of 34-40 kDa, which might be the outer membrane proteins of OmpK36 according to the electrophoresis mobility. In addition, the conjugation test was confirmed that blaDHA-1 mediated by plasmids could be transferred between resistant and sensitive strains. When reserpine (30 µg/mL) and carbonyl cyanide m-chlorophenylhydrazone (CCCP) (50 µg/mL) were added in imipenem and meropenem, the MICs had no change against K. pneumoniae strains. These results suggest that both DHA-1 β-lactamase and loss or deficiency of porin OmpK36 may be the main reason for the cefoxitin and carbapenem resistance in K. pneumoniae strains in our hospital

Adiponectin and Leptin Metabolic Biomarkers in Chinese Children and Adolescents

Objective. To evaluate leptin and adiponectin as biomarkers of metabolic syndrome (MS) risk factors even in nonobese children/adolescents. Methods. Serum leptin, adiponectin, leptin:adiponectin ratio, lipids, glucose, and insulin concentrations as well as body size parameters and pubertal development were evaluated in a large population of Chinese children/adolescents (n = 3505, 6–18 years, 1722 girls and 1783 boys). Results. Leptin concentration increased while adiponectin decreased with obesity, both were influenced by pubertal development. Central obesity had an additive effect on leptin levels (above obesity alone). Leptin/adiponectin increased 8.4-fold and 3.2-fold in overweight/obesity, and 15.8- and 4.5-fold with obesity plus MS, in early and late puberty, respectively. Even in normal weight children/adolescents, higher leptin and lower adiponectin concentrations associated with increased risk profile. Conversely, overweight/obese with lower leptin or higher adiponectin concentrations had a less compromised metabolic profile. Conclusion. Leptin, adiponectin, and leptin:adiponectin ratio are informative biomarkers for obesity, central obesity, MS, and abnormal metabolic profile even in normal weight children/adolescents