Imaging features of ALK-positive histiocytosis with neurological involvement: a case report and literature review

BackgroundALK-positive histiocytosis is an exceptionally rare neoplasm of histiocytes that predominantly involves the nervous system and can also affect the skin and other parts of the body. Previous relevant literature has provided limited information regarding the imaging manifestations of this disease with neurological involvement.MethodsWe reported a case of ALK-positive histiocytosis with multisystem involvement. Together with a comprehensive literature review, the imaging characteristics of this disease in the nervous system were summarized.ResultsA 3-year-old girl with abdominal pain and ambulation difficulty checked in at the Department of Pediatric Neurology. The initial diagnosis was “acute cerebellitis with ataxia” based on the elevated protein level in the cerebrospinal fluid (CSF). However, despite 3 months of treatment, her condition deteriorated. MRI showed an oval-shaped, intradural extramedullary nodule at the T6–T7 level. The patient was ultimately diagnosed as ALK-positive histiocytosis, accompanied by cauda equina and skin involvement. The literature review showed a total of 23 patients who had involvement of the nervous system and provided imaging descriptions. Together with our case, the imaging features were summarized as follows: iso-dense or slightly hyperdense on computed tomography (CT), isointense or iso-hypointense on T2-weighted imaging (T2WI), moderate homogeneous enhancement with mildly/markedly punctate enhancement or/and smooth ring enhancement on contrast-enhanced T1-weighted imaging (T1WI), restricted diffusion on diffuse weighted imaging (DWI), and elevated fluorodeoxyglucose (FDG) uptake on positron-emission tomography/computed tomography (PET/CT).ConclusionThe multimodal imaging findings of ALK-positive histiocytosis exhibit distinct characteristics, familiarity with which will enhance radiologists’ expertise and facilitate accurate diagnosis of this disease

Bis(1,3-diethyl­benzimidazolium) tetra­bromidomercurate(II)

In the title compound, (C11H15N2)2[HgBr4], the tetra­coordinated HgII center of the complex anion adopts a distorted tetra­hedral geometry [Hg—Br = 2.5755 (8)–2.623 (11) Å and Br—Hg—Br = 103.78 (19)–116.4 (3)°]. One of the Br atoms is disordered over two sites [site-occupancy factors = 0.51 (6) and 0.49 (6)]. The N—C—N angles in the cations are 110.7 (6) and 111.4 (7)°. In the crystal packing, a supra­molecular chain is formed via both weak inter­molecular C—H⋯Br hydrogen bonds and π–π aromatic ring stacking inter­actions [centroid–centroid separation = 3.803 (1) Å]

Invasive reperfusion after 12 hours of the symptom onset remains beneficial in patients with ST-segment elevation myocardial infarction: Evidence from a meta-analysis of published data

Background: Early myocardial reperfusion therapy (< 12 h) in patients with acute myocardial infarc­tion (AMI) can significantly improve their prognosis. However, the effect of late reperfusion (> 12 h) remains controversial. In this study, the effects of late reperfusion versus standard drug therapy on the outcomes of patients with AMI were evaluated by systematic review and meta-analysis. Methods: PubMed, Embase, Medline, Cochrane, Wanfang, and CNKI databases were searched for eligible studies for the present study. Meta-analysis was performed using RevMan 5.3.3 software. Rela­tive risk (RR) and the 95% confidence interval (CI) were used to compare the outcomes between the two groups. The main outcome measures were major adverse cardiac events (MACEs), all-cause mortality, recurrent myocardial infarction (MI), and heart failure. Results: Eighteen studies were identified including 14,677 patients, of whom 5157 received late reperfusion with percutaneous coronary intervention (PCI) and 9520 received medication therapy (MT). Compared to MT, late PCI was associated with decreased all-cause mortality (RR 0.60, 95% CI 0.44–0.83; p = 0.002), MACEs (RR 0.67; 95% CI 0.50–0.89; p < 0.001), and heart failure (RR 0.76; 95% CI 0.60–0.97; p = 0.03), while there was also a trend toward decreased recurrent MI (RR 0.70; 95% CI 0.47–1.05; p = 0.08). However, subgroup analysis according to time to PCI showed that the clinical benefit was only from PCI after 12 h but not from 2 to 60 days of the onset of symptoms. Conclusions: The present meta-analysis suggested that PCI performed > 12 h but not 2–60 days after AMI is associated with significant improvement in clinical outcomes. However, these results need further rigorously designed large sample size clinical trials to be validated

Medical personnel to the implementation of patient care integration management pattern recognition

目的  调查医护人员对实施医护一体化共同管理病人模式的认可程度，寻找实施过程中存在的问题，以更好的提高病人的管理质量，得到患者的认可。方法  对本院各抽取2个科所有医、护、技术人员共63名医护人员进行问卷调查。结果  100%的医护人员知晓科室目前开展了医护一体化工作模式，医护一体化小组的成员组成，熟悉医护一体化工作模式的流程，人员的岗位职责及认为实施医护一体化工作模式后医、护、技工作配合更加默契。98.7%医护人员认为实施医护一体化工作模式后病人的医疗护理质量得到明显提高。98%的医护人员认为实施医护一体化管理病人模式后自我效能感得到明显提高。97.8%自我管理病人的能力得到提高且认同实施医护一体化工作模式。结论  医护一体化管理病人模式的实施提高了医护人员的工作积极性，拓展了知识，提高了临床思维能力，得到了广大医护人员的认可。同时还应加大宣传、培训的力度，使更多的医护人员了解医护一体化的益处。Objective: To Investigate the implementation of management mode among the medical personnel, to find the existing problems in the implementation process, to manage better quality accepted by patients. Methods: Set a total of 63 questionnaires for all the medical technical personnel. Results: 100% staffs know that now integration mode is carried out in the department, member of medical integration group, familiar with the medical work pattern of the integration process, the post responsibility, and the implementation of medical integration of medical integration made. Doctors and nurses technicians work with more understanding. 98.7% staff believes that the quality of medical care of the patient was obviously improved after the implementation of medical integration work mode. 98% the medical staff believes that self-efficacy has been improved obviously. 97.8% the medical staff think that self-management ability of patients is improved and the implementation of the medical integration mode identification. Conclusion: The implementation model of integrated management of patient care improves the medical staffs’ activeness, expanding knowledge, improving the clinical thinking ability, the majority of doctors and nurses recognition. At the same time publicity and training should be enhanced so that more medical personnel understand the medical integration efforts

A phylogenetic model for understanding the effect of gene duplication on cancer progression

As biotechnology advances rapidly, a tremendous amount of cancer genetic data has become available, providing an unprecedented opportunity for understanding the genetic mechanisms of cancer. To understand the effects of duplications and deletions on cancer progression, two genomes (normal and tumor) were sequenced from each of five stomach cancer patients in different stages (I, II, III and IV). We developed a phylogenetic model for analyzing stomach cancer data. The model assumes that duplication and deletion occur in accordance with a continuous time Markov Chain along the branches of a phylogenetic tree attached with five extended branches leading to the tumor genomes. Moreover, coalescence times of the phylogenetic tree follow a coalescence process. The simulation study suggests that the maximum likelihood approach can accurately estimate parameters in the phylogenetic model. The phylogenetic model was applied to the stomach cancer data. We found that the expected number of changes (duplication and deletion) per gene for the tumor genomes is significantly higher than that for the normal genomes. The goodness-of-fit test suggests that the phylogenetic model with constant duplication and deletion rates can adequately fit the duplication data for the normal genomes. The analysis found nine duplicated genes that are significantly associated with stomach cancer

1-[4-(2,3,4,6-Tetra-O-acetyl-β-d-allo­pyranos­yloxy)benzyl­idene]thio­semi­carbazide

The title compound, C22H27N3O10S, was synthesized by reaction of an ethanol solution of helicid (systematic name: 4-formylphenl-β-d-allopyranoside), thio­semicarbazide and acetic acid. The mol­ecule exhibits a trans conformation with respect to the C=N double bond. The pyran ring adopts a chair conformation. In the crystal structure, the mol­ecules are linked into chains parallel to the b axis by inter­molecular N—H⋯O hydrogen bonds