Analysis of risk factors for intra-cystic hemorrhage in microwave ablation of partially cystic thyroid nodules

ObjectiveThe aim of this study is to identify risk factors of intra-cystic hemorrhage in microwave ablation of mixed solid and cystic microwave ablation s, and to design a preoperative nomogram to predict the risk value of intraoperative bleeding with the goal of individualizing the surgical approach toward different types of cystic and solid thyroid nodules.MethodsA total of 241 patients with cystic-solid thyroid nodules who underwent ultrasound-guided percutaneous microwave ablation were retrospectively divided into a bleeding group and a non-bleeding group to compare the diameter, cystic proportion, cystic fluid nature, color Doppler flow imaging, Contrast-enhanced ultrasound (CEUS) findings, and operative methods. Based on univariate and multivariate analysis, the important risk factors of nodular intracapsular hemorrhage in the ablation procedure were projected to a nomogram for predicting the possibility of intraoperative hemorrhage in the thyroid cystic solid nodules.ResultsIntra-cystic hemorrhage was developed in 37 cases during the ablation of mixed thyroid nodules with a total incidence of 15% (37/241). Significant differences were found statistically between the two groups on the diameter of the lesions, CEUS findings, the cystic fluid ratio, and operative methods (P = 0.000, P = 0.001, P = 0.024, P = 0.002). The possibility of intraoperative nodular intracapsular hemorrhage was predicted by the model based on the risk factors with the accuracy of 81% and prediction consistency index (C-index) of 0.78.ConclusionA new and efficient prediction model was developed based on the identified risk factors for intracapsular hemorrhage during microwave ablation of mixed thyroid nodules, which will aid in the development of targeted surgical planning for different types of cystic thyroid nodules, thus reducing the risk of hemorrhage during ablation

Metagenomic insights into the abundance and composition of resistance genes in aquatic environments:Influence of stratification and geography

A global survey was performed with 122 aquatic metagenomic DNA datasets (92 lake water and 30 seawater) obtained from the Sequence Read Archive (SRA). Antibiotic resistance genes (ARGs) and metal resistance genes (MRGs) were derived from the dataset sequences via bioinformatic analysis. The relative abundances of ARGs and MRGs in lake samples were in the ranges ND (not detected)-1.34x10(0) and 1.22x10(-3) -1.98x10(-1) copies per 16S rRNA, which were higher than those in seawater samples. Among ARGs, multidrug resistance genes and bacitracin resistance genes had high relative abundances in both lake and sea water samples. Multimetal resistance genes, mercury resistance genes and copper resistance genes had the greatest relative abundance for MRGs. No significant difference was found between epilimnion and hypolimnion in abundance or the Shannon diversity index for ARGs and MRGs. Principal coordinates analysis and permutational multivariate analysis of variance (PERMANOVA) test showed that stratification and geography had significant influence on the composition of ARGs and MRGs in lakes (p < 0.05, PERMANOVA). Coastal seawater samples had significantly greater relative abundance and a higher Shannon index for both ARGs and MRGs than deep ocean and Antarctic seawater samples (p < 0.05, Kruskal-Wallis one-way ANOVA), suggesting that human activity may exert more selective pressure on ARGs and MRGs in coastal areas than those in deep ocean and Antarctic seawater

The diagnostic value of blood metagenomic next-generation sequencing in patients with acute hematogenous osteomyelitis

AimsThis study aims to evaluate the diagnostic value of blood metagenomic next-generation sequencing (mNGS) in detecting pathogens from patients clinically diagnosed as acute hematogenous osteomyelitis (AHO).MethodsThis retrospective study enrolled 66 patients with AHO. The test results of mNGS and bacterial culture on different samples, including blood and puncture fluid samples, from patients with AHO were compared to explore the diagnostic value of blood mNGS. Besides, this study also explored the efficacy of blood mNGS in decision making for antibiotic administration and analyzed the factors associated with the positive result of blood mNGS.ResultsThe most common causative pathogens were Staphylococcus and Streptococcus. The sensitivity of blood mNGS (77.3%) was higher than that of blood culture (42.4%) (P&lt;0.001), while the turnaround time of blood mNGS (2.1 ± 0.4 d) is much less than that of blood culture (6.0 ± 2.1 d) (P&lt;0.001). Besides, the sensitivity of blood mNGS tests (77.3%) was slightly lower than that of puncture fluid mNGS (89.4%). Furthermore, detection comparison at pathogen level unravels that blood mNGS might be suitable for diagnosing AHO caused by common pathogens, while puncture fluid mNGS could be considered as preferred examination in diagnosing AHO caused by uncommon pathogens. Finally, three independent factors associated with the true positive result of blood mNGS in patients with AHO were identified, including Gram-positive pathogens (OR=24.4, 95% CI = 1.4-421.0 for Staphylococcus; OR=14.9, 95%CI= 1.6-136.1 for other Gram-positive bacteria), body temperature at sampling time (OR=8.2, 95% CI = 0.6-107.3 for body temperature of &gt;38.5°C; OR=17.2, 95% CI = 2.0-149.1 for patients who were chilling), and no use of antibiotics before sampling (OR=8.9, 95% CI =1.4-59.0).ConclusionThis is the first report on evaluating and emphasizing the importance of blood mNGS in diagnosing AHO. Blood sample might be an alternative sample for puncture fluid for mNGS, and its extensive application in diagnosing AHO could be expected

Genetic and Biochemical Investigation of Seed Fatty Acid Accumulation in Arabidopsis

As a vegetable oil, consisting principally of triacylglycerols, is the major storage form of photosynthetically-fixed carbon in oilseeds which are of significant agricultural and industrial value. Photosynthesis in chlorophyll-containing green seeds, along with photosynthesis in leaves and other green organs, generates ATP and reductant (NADPH and NADH) needed for seed fatty acid production. However, contribution of seed photosynthesis to fatty acid accumulation in seeds have not been well-defined. Here, we report the contribution of seed-photosynthesis to fatty acid production by probing segregating green (photosynthetically-competent) and non-green or yellow (photosynthetically-non-competent) seeds in siliques of an Arabidopsis chlorophyll synthase mutant. Using this mutant, we found that yellow seeds lacking photosynthetic capacity reached 80% of amounts of oil in green seeds at maturity. Combining this with studies using shaded siliques, we determined that seed-photosynthesis accounts for 20% and silique and leaf/stem photosynthesis each account for ~40% of the ATP and reductant for seed oil production. Transmission electron microscopy (TEM) and pyridine nucleotides and ATP analyses revealed that seed photosynthesis provides ATP and reductant for oil production mostly during early development, as evidenced by delayed oil accumulation in non-green seeds. Transcriptomic analyses suggests that the oxidative pentose phosphate pathway could be the source of carbon, energy and reductants required for fatty acid synthesis beyond the early stages of seed development

Co-Disposal of Coal Gangue and Red Mud for Prevention of Acid Mine Drainage Generation from Self-Heating Gangue Dumps

The seepage and diffusion of acid mine drainage (AMD) generated from self-heating coal gangue tailings caused acid pollution to the surrounding soil and groundwater. Red mud derived from the alumina smelting process has a high alkali content. To explore the feasibility of co-disposal of coal gangue and red mud for prevention of AMD, coal gangue and red mud were sampled from Yangquan (Shanxi Province, China), and dynamic leaching tests were carried out through the automatic temperature-controlled leaching system under the conditions of different temperatures, mass ratios, and storage methods. Our findings indicated that the heating temperature had a significant effect on the release characteristics of acidic pollutants derived from coal gangue, and that the fastest rate of acid production corresponding to temperature was 150 &deg;C. The co-disposal dynamic leaching tests indicated that red mud not only significantly alleviated the release of AMD but also that it had a long-term effect on the treatment of acid pollution. The mass ratio and stacking method were selected to be 12:1 (coal gangue: red mud) and one layer was alternated (coal gangue covered with red mud), respectively, to ensure that the acid-base pollution indices of leachate reached the WHO drinking-water quality for long-term discharge. The results of this study provided a theoretical basis and data support for the industrial field application of solid waste co-treatment

Effects of Health Qigong Exercises on Relieving Symptoms of Parkinson’s Disease

The purpose of this study was to investigate the effects of Health Qigong on the treatment and releasing symptoms of Parkinson’s disease (PD). Fifty-four moderate PD patients (N=54) were randomly divided into experimental and control groups. Twenty-eight PD patients were placed in the experimental group in which the prescribed medication plus Health Qigong exercise will be used as intervention. The other 26 PD patients as the control group were treated only with regular medication. Ten-week intervention had been conducted for the study, and participants completed the scheduled exercises 5 times per week for 60 minutes each time (10 minutes for warm-up, 40 minutes for the exercise, and 10 minutes for cooldown). Data which included the muscle hardness, one-legged blind balance, physical coordination, and stability was collected before, during, and after the intervention. Comparisons were made between the experimental and control groups through the Repeated Measures ANOVA. The results showed that PD patients demonstrate a significant improvement in muscle hardness, the timed “up and go,” balance, and hand-eye coordination (the turn-over-jars test). There were no significant differences between the two groups in gender, age, and course of differences (P<0.05). The study concluded that Health Qigong exercises could reduce the symptoms of Parkinson’s disease and improve the body functions of PD patients in both the mild and moderate stages. It can be added as an effective treatment of rehabilitation therapy for PD

Abnormal interruption of water flow from an artesian well prior to 2008 Wenchuan earthquake

Water flow from an artesian well stopped on December 17, 2007 but recovered when the Wenchuan Ms 8.0 earthquake occurred on May 12, 2008. This well is located 90 km south of the epicenter in an extensional tectonic setting, where similar changes of water level and resistivity were observed at two other nearby sites. Our investigation suggests that this phenomenon was not caused by environmental disturbances, such as drought or borehole-drilling activity, but might be a precursor to the earthquake

Schmidt reaction of ketones in dme solution in a continuous-flow microreactor

peer reviewedThe Schmidt reaction, the treatment with hydroazoic acid in the presence of a strong acid, converts ketones to amides directly and has been broadly applied in organic synthesis. In this communication, the Schmidt reaction of ketones was carried out in DME solution in a continuous-flow microreactor and gave the amide products. The enclosed small-volume feature of the microreactor made this reaction safe, fast, and cost-effective

Comparison of minimally-invasive fibular supporting of T-type with traditional bloody iliac flap metastasis for osteonecrosis of the femoral head at ARCO stage II

Purpose: Our research mainly evaluates the clinical efficacy of two surgical methods in the treatment of osteonecrosis of the femoral head (ONFH) at ARCO stage II, aiming to provide optimal hip-preserving treatment of ONFH. Method: From October 2018 to September 2020, 48 patients (59 hips) met the inclusion criteria and randomized. 24 cases (29 hips) in experimental group were treated with minimally-invasive fibular supporting of T-type; 24 cases (30 hips) in control group were treated with traditional bloody iliac flap metastasis. We will compare some intraoperative and postoperative conditions. Result: The operation time in experimental group was 37 (6) minutes, in control group was 130 (21.75) minutes; the length of surgical incision in two groups was 3.7 (0.7) cm and 12.85 (2.68) cm. The intraoperative blood loss in two groups was 69 (21) ml and 363 (87) ml; the postoperative VAS score of the experimental group on day 1, day 3, day 7 after surgery was 5.5 (2), 3.5 (1), 0 (1); the control group was 6 (1.75), 4 (1), 3 (1). The data differences between above groups have statistically significant. The follow-up time of two groups was (33.86 ± 5.66) months and (35.67 ± 4.69) months. The bone graft healing time in two groups was (14.21 ± 1.93) months and (13.83 ± 2.34) months. The Harris hip scores of two groups at the last follow-up were 90 (7.5) and 86.5 (8.5). The survival rates of two groups were 79.31% (23/29) and 76.67% (23/30). The difference was no statistically significant in above groups (P > 0.05). Conclusion: The two different bone graft implantation showed satisfactory early outcomes. Compared to the control group, the experimental group has the advantages of lesser pain, lesser blood loss, lesser trauma and shorter operation time. It may be a choice as bone graft for the treatment of ONFH at early stage