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Mesh-based image warping techniques typically represent image deformation using linear functions on triangular meshes or bilinear functions on rectangular meshes. This enables simple and efficient implementation, but in turn, restricts the representation capability of the deformation, often leading to unsatisfactory warping results. We present a novel, flexible polygonal finite element (poly-FEM) method for content-aware image warping. Image deformation is represented by high-order poly-FEMs on a content-aware polygonal mesh with a cell distribution adapted to saliency information in the source image. This allows highly adaptive meshes and smoother warping with fewer degrees of freedom, thus significantly extending the flexibility and capability of the warping representation. Benefiting from the continuous formulation of image deformation, our poly-FEM warping method is able to compute the optimal image deformation by minimizing existing or even newly designed warping energies consisting of penalty terms for specific transformations. We demonstrate the versatility of the proposed poly-FEM warping method in representing different deformations and its superiority by comparing it to other existing state-of-the-art methods.

IntroductionTumor immunity is a hot topic in tumor research today, and human immunity is closely related to tumor progression. T lymphocyte is an important component of human immune system, and the changes in their subsets may influence the progression of colorectal cancer (CRC) to some extent. This clinical study systematically describes and analyzes the association of CD4+ and CD8+ T-lymphocyte content and CD4+/CD8+ T-lymphocyte ratio with CRC differentiation, clinical pathological stage, Ki67 expression, T-stage, N-stage, carcinoembryonic antigen (CEA) content, nerve and vascular infiltration, and other clinical features, as well as preoperative and postoperative trends. Furthermore, a predictive model is constructed to evaluate the predictive value of T-lymphocyte subsets for CRC clinical features.MethodsStrict inclusion and exclusion criterion were formulated to screen patients, preoperative and postoperative flow cytometry and postoperative pathology reports from standard laparoscopic surgery were assessed. PASS and SPSS software, R packages were invoked to calculate and analyze.ResultsWe found that a high CD4+ T-lymphocyte content in peripheral blood and a high CD4+/CD8+ ratio were associated with better tumor differentiation, an earlier clinical pathological stage, lower Ki67 expression, shallower tumor infiltration, a smaller number of lymph node metastases, a lower CEA content, and a lower likelihood of nerve or vascular infiltration (P + T-lymphocyte content indicated an unpromising clinical profile. After effective surgical treatment, the CD4+ T-lymphocyte content and CD4+/CD8+ ratio increased significantly (P + T-lymphocyte content decreased significantly (P + T-lymphocyte content, CD8+ T-lymphocyte content, and CD4+/CD8+ ratio in predicting the clinical features of CRC. We then combined the CD4+ and CD8+ T-lymphocyte content to build models and predict major clinical characteristics. We compared these models with the CD4+/CD8+ ratio to explore their advantages and disadvantages in predicting the clinical features of CRC.DiscussionOur results provide a theoretical basis for the future screening of effective markers in reflecting and predicting the progression of CRC. Changes in T lymphocyte subsets affect the progression of CRC to a certain extent, while their changes also reflect variations in the human immune system.

This study systematically and comprehensively analyzed the characteristics of matrix metalloproteinases (MMPs) in gastric cancer (GC) and revealed the relationship between MMPs and prognoses, clinicopathological features, tumor microenvironment, gene mutations, and drug therapy response in patients with GC. Based on the mRNA expression profiles of 45 MMP-related genes in GC, we established a model that classified GC patients into three groups based on cluster analysis of the mRNA expression profiles. The 3 groups of GC patients showed significantly different prognoses as well as tumor microenvironmental characteristics. Next, we used Boruta’s algorithm and PCA method to establish an MMP scoring system and found that lower MMP scores were associated with better prognoses, lower clinical stages, better immune cell infiltration, lower degrees of immune dysfunction and rejection, and more genetic mutations. Whereas a high MMP score was the opposite. These observations were further validated with data from other datasets, showing the robustness of our MMP scoring system. Overall, MMP could be involved in the tumor microenvironment (TME), clinical features, and prognosis of GC. An in-depth study of MMP patterns can better understand the indispensable role of MMP in the development of GC and reasonably assess the survival prognosis, clinicopathological features, and drug efficacy of different patients, thus providing clinicians with a broader vision of GC progression and treatment.

This article presents a low-power (LP) area-efficient implantable neural recording system that supports high-density neural implant (HDNI) applications. The system uses a time-division multiple access method to record from 16-neural electrodes simultaneously. A least mean squares (LMSs) algorithm is used to cancel the slowly varying electrode offsets from all channels simultaneously by using a single-tap digital adaptive filter (AF). The presented technique is fabricated in 65-nm CMOS technology and achieves a per-channel area of 0.00248 mm²; 68% of which is digital circuitry (and is thus scalable with technology). The overall system consumes 3.38 μW per channel while achieving 2.6 μV ${_{{rms}}}$ of input referred noise (IRN) in 10 kHz of bandwidth. The proposed system has a noise efficiency factor (NEF) of 1.83 and is fully integrated on-chip.

This article presents a voltage-controlled oscillator (VCO)-based analog front end (AFE) for ExG readout applications with both a wide dynamic range (DR) and high linearity. By using a differential pulse code modulation (DPCM) technique, VCO non-linearity is mitigated by operating the VCO in the small-signal linear regime. To minimize power consumption from the power-hungry gain error calibration, the effect of VCO gain variation within the DPCM loop is investigated, leading to a calibration-free DPCM via a $\Delta \Sigma $ truncator. At the circuit level, a coarse–fine phase decoding scheme is proposed to increase signal-to-quantization-noise ratio (SQNR) while avoiding metastability issues. Fabricated in 65 nm, the AFE occupies an area of 0.056 mm2. It achieves 94.2-dB SNDR and 95.1-dB DR in 500 Hz of bandwidth while dissipating 1.68- $\mu \text{W}$ power from a single 0.8-V supply, yielding a Schreier FoM of 178.9 dB. Importantly, the techniques enable a virtually distortion-less spectrum with a noise-floor limited spurious-free dynamic range (SFDR) of 128 dB. In addition, the AFE is validated with ECG and EOG recording, demonstrating complete signal capturing in the presence of motion/stimulation artifacts.

Purpose Colorectal cancer is a high incidence tumor, immunotherapy has become a hot topic of research in recent years, at the same time, the dysregulation of intestinal microbiota is also gaining attention because it can lead to changes in body immunity. So, we want to explore the relationship between gut microbiota and colorectal cancer. Methods We performed 16S rRNA high-throughput sequencing of tumors and paraneoplastic tissues from 30 patients, followed by at least 5 years of follow-up. Microbiome analysis, survival analysis, and then immunohistochemistry and its correlation with microbiota were performed in 19 of these patients. Results OTU13530 and OTU17086, both representing g_Sediminibacterium, showed significant differences in normalized abundance in tumor and paraneoplastic tissues (FDR 2FC > 1). Both of them correlated with T-stage (p = 0.016, p = 0.024) and Her-2 expression (p = 0.034, p = 0.001). The former correlated with HIF expression (p = 0.017), and the latter with EGFR expression (p = 0.003). OTU3504, representing o_Myxococcales, had a correlation with patient survival (p = 0.015, HR = 28.5(1.9–425.0)), its abundance correlated with tumor neural invasion (p = 0.005) and vascular invasion (p = 0.005). Conclusion There is no statistical difference in the diversity and homogeneity of the microbiota between tumor and paraneoplastic tissues. But the abundance of some specific microbiota differed significantly between tumor and paraneoplastic tissues, and these microbiota correlated with patient survival, Her-2, HIF and other proteins expression, T-stage, neurovascular invasion and other clinical traits.

Multichannel electrophysiological sensors and stimulators—particularly those used to study the nervous system—are usually based on monolithic microelectrode arrays. However, the architecture of such arrays limits flexibility in electrode placement and scaling to a large number of nodes, especially across non-contiguous locations. Here we report wirelessly networked and powered electronic microchips that can autonomously perform neural sensing and electrical microstimulation. The microchips, which we term neurograins, have an ~1 GHz electromagnetic transcutaneous link to an external telecom hub, providing bidirectional communication and control at the individual device level. To illustrate the potential of the approach, we show that 48 neurograins can be individually addressed on a rat cortical surface and used for the acute recording of neural activity. Theoretical calculations and experimental measurements show that the link configuration could potentially be scaled to 770 neurograins using a customized time-division multiple access protocol. Wirelessly powered microchips, which have an ~1 GHz electromagnetic transcutaneous link to an external telecom hub, can be used for multichannel in vivo neural sensing, stimulation and data acquisition.

Background Sporadic lymphangioleiomyomatosis (S-LAM) is a rare neoplasm with heterogeneous clinical features that is conventionally considered to be related to TSC2. This study serves to elucidate the mutation landscape and potential correlation between S-LAM genomic profiles and clinical phenotypes. Methods Genomic profiles of 22 S-LAM patients were obtained by sequencing genomic DNA and cell-free DNA from various specimens using an NGS (next-generation sequencing)-based tumor-driver gene panel. Detected mutations were summarized. Symptoms, serum vascular endothelial growth factor D (VEGF-D) values, pulmonary function, and six-minute walk distance (6MWD) were compared among groups with different TSC2 status and genotypes to analyze genotype–phenotype correlations. Results 67 Variants in 43 genes were detected, with a TSC2 mutation detection rate of 68.2%. The TSC2 detection rate was similar in specimens obtained either through transbronchial lung biopsy (TBLB) or surgical lung biopsy (70.0% vs. 69.2%, p > 0.05). A novel mutation in VEZF1 (c.A659G) was detected in four participants and may represent a mild disease state. TSC2 mutation was significantly related to a shorter 6MWD (p p Conclusions Tumor-driver mutations in genes other than TSC2 may have a role in S-LAM, and TBLB specimens are practical alternatives for genomic analysis. TSC2 mutation detectability and types are related to the disease severity and phenotypes of S-LAM.

ImportanceMyopia is a global concern, but effective prevention measures remain limited. Premyopia is a refractive state in which children are at higher risk of myopia, meriting preventive interventions.ObjectiveTo assess the efficacy and safety of a repeated low-level red-light (RLRL) intervention in preventing incident myopia among children with premyopia.Design, Setting, and ParticipantsThis was a 12-month, parallel-group, school-based randomized clinical trial conducted in 10 primary schools in Shanghai, China. A total of 139 children with premyopia (defined as cycloplegic spherical equivalence refraction [SER] of −0.50 to 0.50 diopter [D] in the more myopic eye and having at least 1 parent with SER ≤−3.00 D) in grades 1 to 4 were enrolled between April 1, 2021, and June 30, 2021; the trial was completed August 31, 2022.InterventionsChildren were randomly assigned to 2 groups after grade stratification. Children in the intervention group received RLRL therapy twice per day, 5 days per week, with each session lasting 3 minutes. The intervention was conducted at school during semesters and at home during winter and summer vacations. Children in the control group continued usual activities.Main Outcomes and MeasuresThe primary outcome was the 12-month incidence rate of myopia (defined as SER ≤−0.50 D). Secondary outcomes included the changes in SER, axial length, vision function, and optical coherence tomography scan results over 12 months. Data from the more myopic eyes were analyzed. Outcomes were analyzed by means of an intention-to-treat method and per-protocol method. The intention-to-treat analysis included participants in both groups at baseline, while the per-protocol analysis included participants in the control group and those in the intervention group who were able to continue the intervention without interruption by the COVID-19 pandemic.ResultsThere were 139 children (mean [SD] age, 8.3 [1.1] years; 71 boys [51.1%]) in the intervention group and 139 children (mean [SD] age, 8.3 [1.1] years; 68 boys [48.9%]) in the control group. The 12-month incidence of myopia was 40.8% (49 of 120) in the intervention group and 61.3% (68 of 111) in the control group, a relative 33.4% reduction in incidence. For children in the intervention group who did not have treatment interruption secondary to the COVID-19 pandemic, the incidence was 28.1% (9 of 32), a relative 54.1% reduction in incidence. The RLRL intervention significantly reduced the myopic shifts in terms of axial length and SER compared with the control group (mean [SD] axial length, 0.30 [0.27] mm vs 0.47 [0.25] mm; difference, 0.17 mm [95% CI, 0.11-0.23 mm]; mean [SD] SER, –0.35 [0.54] D vs –0.76 [0.60] D; difference, –0.41 D [95% CI, –0.56 to –0.26 D]). No visual acuity or structural damage was noted on optical coherence tomography scans in the intervention group.Conclusions and RelevanceIn this randomized clinical trial, RLRL therapy was a novel and effective intervention for myopia prevention, with good user acceptability and up to 54.1% reduction in incident myopia within 12 months among children with premyopia.Trial RegistrationClinicalTrials.gov Identifier: NCT04825769

This article presents a high-dynamic-range (DR) voltage-controlled oscillator (VCO)-based front end for sensor readout applications. Unlike conventional VCO-based quantizers, which suffer from large voltage-to-frequency non-linearities, the proposed design leverages differential pulse-code modulation (DPCM) from compression theory to substantially reduce the amplitude of the signal incident to the VCO quantizer, thereby achieving an ultra-low total harmonic distortion (THD) of −112 dB. In addition, background digital gain calibration is employed to overcome gain deviation of the VCO, thus ensuring a robust design. Together with dynamic element matching (DEM), the techniques enable a high DR using only the first-order noise shaping inherent in VCO-based quantizers and a moderate $32\times $ oversampling ratio. Fabricated in 65 nm, the sensor front end consumes 3.2- $\mu \text{W}$ power and achieves an SNDR of 89 dB and a DR of 94 dB in 500 Hz of bandwidth. Together with a 1.18- $\mu \text{V}~_{\text {rms}}$ integrated input-referred noise, it achieves a noise efficiency factor (NEF) of 4 and a Schreier FoM of 171 dB.

Background: Many biological clocks related to aging have been linked to the development of cancer. A recent study has identified that the inflammatory aging clock was an excellent indicator to track multiple diseases. However, the role of the inflammatory aging clock in glioblastoma (GBM) remains to be explored. This study aimed to investigate the expression patterns and the prognostic values of inflammatory aging (iAge) in GBM, and its relations with stem cells.Methods: Inflammation-related genes (IRG) and their relations with chronological age in normal samples from the Cancer Genome Atlas (TCGA) were identified by the Spearman correlation analysis. Then, we calculated the iAge and computed their correlations with chronological age in 168 patients with GBM. Next, iAge was applied to classify the patients into high- and low-iAge subtypes. Next, the survival analysis was performed. In addition, the correlations between iAge and stem cell indexes were evaluated. Finally, the results were validated in an external cohort.Results: Thirty-eight IRG were significantly associated with chronological age (|coefficient| > 0.5), and were used to calculate the iAge. Correlation analysis showed that iAge was positively correlated with chronological age. Enrichment analysis demonstrated that iAge was highly associated with immune cells and inflammatory activities. Survival analysis showed the patients in the low-iAge subtype had significantly better overall survival (OS) than those in the high-iAge subtype (p < 0.001). In addition, iAge outperformed the chronological age in revealing the correlations with stem cell stemness. External validation demonstrated that iAge was an excellent method to classify cancer subtypes and predict survival in patients with GBM.Conclusions: Inflammatory aging clock may be involved in the GBM via potential influences on immune-related activities. iAge could be used as biomarkers for predicting the OS and monitoring the stem cell.

This letter presents a voltage-controlled oscillator (VCO)-based analog-to-digital converter (ADC) for audio applications using differential pulse code modulation (DPCM) to mitigate VCO voltage-to-frequency nonlinearity. To overcome VCO gain variation, a split-ADC architecture is employed where two sub-ADCs share one calibration unit, thereby enabling a quasideterministic background gain calibration with small delay and fast convergence speed. In addition, a hybrid dynamic element matching (DEM) is employed, which offers a lower delay and a smaller in-band mismatch noise compared to the segmented-tree DEM. Fabricated in 65 nm, the ADC achieves 94.2-dB SNDR, 97.3-dB SNR, and 100.3-dB DR in 20-kHz bandwidth while dissipating 142.6-μW power, yielding a DR-based FoM of 181.8 dB.

To evaluate the relationship between ocular magnification correction and macular choroidal thickness (ChT) measurements in children, and to demonstrate when ocular magnification correction is necessary. Chinese children aged 6–9 years with various refractive statuses were included. Swept-source optical coherence tomography was used to measure macular ChT. A self-designed program was adopted to simulate ChT changes in each sector of the ETDRS grid in the macula under various simulated axial lengths (ALs). ChT measurements were not affected for all simulated ALs in over 95% of the individuals in the central fovea. In the inferior, superior, and temporal parafoveal sectors, the extent of AL that may include 95% of the individuals narrowed from approximately 22.0 mm to 27.2 mm. In the nasal parafoveal sector and inferior, superior, and temporal perifoveal sectors, the extent of AL that may include 95% of the individuals became even narrower, from approximately 22.8 mm to 26.0 mm. The narrowest extent was observed in the perifoveal nasal sector, ranging from 23.3 mm to 25.5 mm. The effect of ocular magnification was more significant in hyperopes than in myopes in the inferior parafoveal sector and temporal, superior, and nasal perifoveal sectors. During macular ChT measurements, ocular magnification correction is not necessary in the central fovea. However, ocular magnification should be corrected normally in the nasal perifoveal region and in individuals with ALs shorter than 22.8 mm or longer than 26.0 mm in the remaining macular regions.

Objective: With the continuing increase of the aged population, neurosurgeons face increasing numbers of chronic subdural haematoma (CSDH) patients using antithrombotic (AT) drugs, i.e., anticoagul...

This paper presents a second-order voltage-controlled oscillator (VCO)-based front-end for the direct digitization of biopotential signals. This work addresses the non-linearity of VCO-based ADC architectures with a mismatch resilient, multi-phase quantizer, a gated-inverted-ring oscillator (GIRO), achieving110-dB SFDR. Leveraging the time-domain encoding of the first integrator, the ADC's power is dynamically scaled with the input amplitude enabling up to 35% power savings in the absence of motion artifacts or interference. An auxiliary input-impedance booster increases the ADC's input impedance to 50 MΩ across the entire bandwidth. Fabricated in a 65-nm CMOS process, this ADC achieves 92.3-dB SNDR in a 1 kHz BW while consuming 5.8 µW for a 174.7 dB Schreier FoM.

Background Lymphangioleiomyomatosis (LAM) is a rare disease that almost exclusively affects women of reproductive age. Patients are warned of the increased risks if they become pregnant. However, information on pregnancy in patients after the diagnosis of LAM is limited. Methods Patients were collected from the LAM registry study at Peking Union Medical College Hospital, Beijing, China. Patients with a history of pregnancy after the diagnosis of LAM were included. Medical records were reviewed, and baseline information and data during and after pregnancy were collected in May 2018. Results Thirty patients with a total of 34 pregnancies after the diagnosis of LAM were included. Livebirth, spontaneous abortion and induced abortion occurred in 10, 6 and 18 pregnancies, respectively. Sirolimus treatment was common (17/34). A total of 6/10, 5/6, and 6/18 patients with livebirths, spontaneous abortions, and induced abortions respectively, had a history of sirolimus treatment. Ten pregnancies (29.4%) had LAM-associated complications during pregnancy, including the exacerbation of dyspnea in 7 patients, pneumothorax in 3 patients (2 resulting in induced abortion and 1 successful parturition), and spontaneous bleeding of renal angiomyolipomas in 2 patients (both having successful parturition). No chylothorax was found during pregnancy. There were six pregnancies in six patients (17.6%) who had a history of livebirth after sirolimus treatment for LAM (all having successful parturition and healthy infants); two of these patients reported exacerbated dyspnea after parturition compared with before pregnancy. Conclusions Patients with LAM, especially those taking sirolimus before pregnancy, were at a higher risk of spontaneous abortion. Complications such as pneumothorax, bleeding of renal angiomyolipoma, and exacerbated dyspnea during pregnancy were common. In patients without spontaneous abortion, sirolimus discontinuation before or during pregnancy did not lead to increased adverse neonatal outcomes.

Motion and stimulation artifacts encountered in wearable sensors present difficult dynamic range (DR) and linearity challenges: AFEs need to be able to resolve $\mu \mathrm{V} -$ level signals in the presence of artifacts up to 100s of mV in amplitude while maintaining linearity without saturation, such that the signal of interest can be readily recovered during post-processing. Since it is not possible to build an amplifier with appreciable gain and linearity for $ \gt 100$ mV inputs under $ \lt 1\mathrm{V}$ SoC-compatible supply, most high-DR AFEs instead incorporate an LNA into $\mathrm{a}\Delta \sum -$ based ADC-direct architecture [1] –[3]. However, as many emerging wearable devices desire single-chip integration in scaled CMOS for size and digital performance considerations, conventional $\Delta \sum$ Ms, which rely on voltage-domain building blocks, suffer from reduced intrinsic gain and headroom. Instead, time-domain quantization through VCO-based AFEs benefits from scaled CMOS and offers intrinsic $1 ^{st} -$ order noise shaping. However, the non-linear V-F conversion of conventional VCO-based AFEs makes achieving a large and linear DR difficult [1]. To address this, [3] adopts a differential pulse code modulation (DPCM) technique that enables the VCO to process only a small prediction error, V ERR , by subtracting from $V_{IN}\mathrm{a}$ digital predictor value fed through a DAC (Fig. 28.1.1 top). Maximal linearity would be achieved if the predictor was perfect, resulting in $V_{ERR},\approx 0$; however, this requires a highperformance and power-expensive DAC. Therefore, [3] truncates the predictor’s output, reducing the DAC requirements to 9b, but adding truncation error, E T . If the gain of paths P 1 and P 2 are made equal, which is enforced in [3] via a gain error calibration (GEC) circuit, E T will ideally cancel at the output. However, it is not possible to achieve perfect E T cancellation, and any residual E T will degrade SQNR, limiting the extent to which truncation can be used to relax the DAC’s resolution. In addition, GEC itself introduces power overhead.

Next-generation wearable devices will enable clinical-grade, continuous ExG (ECG, EEG, EMG, etc.) biopotential monitoring, providing medical professionals with valuable longitudinal data outside of hospital settings. These devices must be ultra-low power $(\lt 10 \mu W)$ to enable long battery life while accurately digitizing sub-kHz, $\mu V-$level ExG signals in the presence of large motion and/or stimulation artifacts $(\gt 100$ mV) with high input-impedance $(Z_{in}\gt 10M\Omega)$ to avoid signal attenuation. Achieving such performance with conventional PGA + ADC architectures is challenging due to the conflicting low-power and $\gt 90$ dB dynamic-range (DR) requirements [1]. To address this, several direct digitization analog front-ends (AFEs) have been reported [2]–[4]. While these offer wide DR, they typically have low input-impedance $(\lt 5 M\Omega)$ and/or low power-efficiency (FoM $\le 172$ dB). This paper presents a scalable $2^{nd}-$order voltage-controlled oscillator (VCO)-only $\Delta \sum$ ADC that achieves 92.3dB SNDR in a 1kHz bandwidth using a mismatch tolerant, multiphase gated-inverted ring-oscillator (GIRO) quantizer with dynamic power-scaling. The ADC uses an impedance-booster to maintain $\gt 50 M\Omega$ input-impedance over the entire bandwidth while consuming $4.25 \mu W$ during nominal operation and $5.8 \mu W$ in the presence of artifacts resulting in an FoM of 174.7dB.

Background The differential diagnosis of diffuse cystic lung disease (DCLD) is a clinical challenge. We wish to analyze the distribution of the etiology of DCLD based on data from a single lymphangioleiomyomatosis (LAM) clinic. Methods All DCLD patients at the LAM Clinic of Peking Union Medical College Hospital between January 2006 and December 2019 were analyzed. Information on the demographic, clinical, radiological, and pathological features was collected. Results A total of 1010 patients with DCLD on CT scan were evaluated. A sum of 711(70.4%) patients were diagnosed with definite or probable LAM. Other diagnoses included Birt–Hogg–Dubé syndrome (46), Sjogren's syndrome (38), pulmonary Langerhans cell histiocytosis (14), lung tumors (3), Castleman disease (2), antineutrophil cytoplasmic antibody-associated vasculitis (2), systemic lupus erythematosus (1), Marfan syndrome (1), amyloidosis (1), congenital cystic adenomatoid malformation of the lung (1), and pleuroparenchymal fibroelastosis (1). In the 38 patients diagnosed with Sjogren's syndrome, 2 were diagnosed with light-chain deposition disease, 2 were diagnosed with amyloidosis and 1 was diagnosed with lymphocytic interstitial pneumonia. One hundred and eighty-nine patients (18.7%) were undiagnosed. Lung biopsy results were available in 27 patients in the undiagnosed DCLD group but did not provide a diagnosis. Conclusion Approximately 70% of DCLD patients in our LAM clinic had LAM. The common differential diagnoses included Birt–Hogg–Dubé syndrome, Sjogren’s syndrome, and pulmonary Langerhans cell histiocytosis. Detailed clinical information and laboratory, genetic, and pathological investigations provide correct diagnoses in most patients with DCLD.

Multichannel electrophysiological sensors and stimulators, especially those used for studying the nervous system, are most commonly based on monolithic microelectrode arrays. Such architecture limits the spatial flexibility of individual electrode placement, posing constraints for scaling to a large number of nodes, particularly across non-contiguous locations. We describe the design and fabrication of sub-millimeter size electronic microchips (“Neurograins”) which autonomously perform neural sensing or electrical microstimulation, with emphasis on their wireless networking and powering. An ∼1 GHz electromagnetic transcutaneous link to an external telecom hub enables bidirectional communication and control at the individual neurograin level. The link operates on a customized time division multiple access (TDMA) protocol designed to scale up to 1000 neurograins. The system is demonstrated as a cortical implant in a small animal (rat) model with anatomical limitations restricting the implant to 48 neurograins. We suggest that the neurograin approach can be generalized to overcome many scalability issues for wireless sensors and actuators as implantable microsystems.

This paper presents a VCO-based sensor front-end utilizing differential pulse-code modulation (DPCM) to substantially reduce the amplitude of the input signal to the VCO quantizer so that high linearity is achieved. Together with a background digital gain calibration and DEM, the techniques enable a high dynamic range (DR) using only 1st order noise-shaping and 32× oversampling. Fabricated in 65nm, the AFE consumes 3.2μW and achieves 1.18μV RMS input-referred noise in 500Hz BW. It also achieves an SNDR/DR/THD of 88/94/-105dB respectively with a NEF of 4 and Schreier FoM of 170dB.

This letter presents a miniaturized neural recording analog front-end (AFE) suitable for distributed sub-mm neural recording implants. Including reference generators, this AFE occupies an area of only 0.01 mm2, thanks to a mostly digital architecture with more than half of area being scalable digital logic. Implemented in 65-nm CMOS, the AFE is measured to consume 3.2 $ {\mu }\text{W}$ of power from 0.6-V supply, and achieves an input-referred noise of 2.2 $ {\mu {\mathrm{ V}}}_{\mathrm{rms}}$ over 500 Hz of bandwidth. The AFE is validated by integrating it into a neural sensing SoC with wireless power and data telemetry. In vitro experiments demonstrate reliable recording of the AFE in a fully wireless environment.

Hexarelin, a synthetic growth hormone-releasing peptide, has been proven to possess cardioprotective actions through its binding to the growth hormone secretagogue receptor (GHSR) 1a and the non-GHSR receptor CD36. However, its effect on myocardial ischemia/reperfusion (I/R) injury has not been fully clarified in vivo. We aimed to determine whether hexarelin treatment could protect cardiomyocytes from I/R injury and to examine the underlying mechanisms. In vivo hearts of male SD rats underwent 30 minutes of ischemia by left coronary artery ligation followed by reperfusion. The rats were then treated subcutaneously twice daily with hexarelin [100 μg/kg·day], ghrelin [400 μg/ kg·day], or saline for 7 days. Echocardiography, malondialdehyde detection, and histochemical staining were performed after treatment. In addition, Western blot was used to examine the expression levels of IL-1β, IL-1Ra, and IL-1RI. Our study showed that hexarelin treatment improved cardiac systolic function, decreased malondialdehyde production, and increased the number of surviving cardiomyocytes. The beneficial effects of hexarelin treatment were slightly superior to those of equimolar ghrelin treatment. We meanwhile confirmed that hexarelin induced down-regulation of IL-1β expression and up-regulation of IL-1Ra expression in I/R myocardium, which could be neutralized by the GHSR antagonist [D-Lys3]-growth hormone releasing peptide-6 ([D-Lys3]-GHRP-6). These findings suggest that hexarelin protects in vivo cardiomyocytes from I/R injury partly by modification of the IL-1 signaling pathway through the activation of cardiac GHSR1a receptors.

1. Anthocyanins are a subgroup of flavonoids responsible for the blue, purple and red color of many fruits, flowers and leaves. Consumption of foods rich in anthocyanins is associated with a reduced risk of cardiovascular disease and cancer. Most food intervention studies employ once or twice per day dose schedules. 2. The current study demonstrated that plasma concentrations of cyanidin-3-galactoside and cyanidin-3-xyloside, the two major components of saskatoon berries, were significantly increased following three consecutive saskatoon berry supplements 4 hours apart. This accumulation is due to the residual concentrations of anthocyanins at the time of second and third supplements. 3. Accumulation was especially pronounced for peonidin-3-glucoside and peonidin-3-galactoside, the methylated metabolites of cyanidin-3-glucoside and cyanidin-3-galactoside, respectively. Little or no accumulation was observed for cyanidin-3-arabinoside and cyanidin-3-glucoside, two other components of saskatoon berries, possibly due to their short half-lives. 4. Thus, taking anthocyanin supplements with every meal would provide higher plasma concentrations for some anthocyanins and their metabolites than the once or twice-a-day dose regimens.

To dramatically increase the scale and spatial resolution for future chronic electrocorticography (ECoG) applications, we propose a wireless brain-machine interface (BMI) system based on a high number (up to 1000) of freely distributed, sub-mm sized (0.25 mm2) IC implants. The chip features an onchip antenna for RF energy harvesting at 900 MHz and data backscattering at 10 Mbps. In order to synchronize and time-multiplex the uplink data transmission of the untethered chips, while allowing their oscillators to free-run to save power, a robust Mbps ASK-PWM downlink data protocol based on digital counters was implemented. To the best of our knowledge, this paper presents the first experimental validation of simultaneous wireless power transfer and bi-directional RF data communications on a network of (32) brain implant ICs over a single inductive coupling link.

A vastly enhanced capability to bi-directionally interface with cortical microcircuits in a clinically viable way is the ultimate aspiration in neuroengineering. This necessitates a paradigm shift in neural interface system design beyond current bulky, monolithic constructs which are challenging to scale past 100-200 channels due to anatomic and engineering design constraints. A neural interface system relying on a spatially-distributed network of wireless microscale implantable sensors offers a highly scalable, robust and adaptive architecture for next-generation neural interfaces. We describe the development of a wireless network of sub-mm, untethered, individually addressable, fully wireless "Neurograin" sensors, in the context of an epicortical implant. Individual neurograin chiplets integrate a ~ 1 GHz wireless link for energy harvesting and telemetry with analog and digital electronics for neural signal amplification, on-chip storage, and networked communications via a TDMA protocol. Each neurograin thus forms a completely self-contained single channel of neural access and is implantable after post-process atomic layer deposition of thin-film (100 nm thick) barriers for hermetic sealing. Finally, ensembles of implantable neurograins form a fully wireless cortico-computer communication network (utilizing their unique device IDs). The implanted network is coordinated by a compact external "Epidermal Skinpatch" RF transceiver and data processing hub, which is implemented as a wearable module in order to be compatible with clinical implant considerations. We describe neurograin performance specifications and proof-of-concept in bench top and ex vivo and in vivo rodent platforms.

Purpose To explore the cost-utility of cataract surgery in patients with advanced age-related macular degeneration (AMD). Methods Patients who were diagnosed as having and treated for age-related cataract and with a history of advanced AMD at the Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, were included in the study. All of the participants underwent successful phacoemulsification with foldable posterior chamber intraocular lens implantation under retrobulbar anesthesia. Best-corrected visual acuity (BCVA) and utility value elicited by time trade-off method from patients at 3-month postoperative time were compared with those before surgery. Quality-adjusted life years (QALYs) gained in a lifetime were calculated at a 3% annual discounted rate. Costs per QALY gained were calculated using the bootstrap method, and probabilities of being cost-effective were presented using a cost-effectiveness acceptability curve. Sensitivity analyses were performed to test the robustness of the results. Results Mean logarithm of the minimum angle of resolution BCVA in the operated eye increased from 1.37 ± 0.5 (Snellen, 20/469) to 0.98 ± 0.25 (Snellen, 20/191) (p < 0.001); BCVA in the weighted average from both eyes (=75% better eye + 25% worse eye) was changed from 1.13 ± 0.22 (Snellen, 20/270) to 0.96 ± 0.17 (Snellen, 20/182) (p < 0.001). Utility values from both patients and doctors increased significantly after surgery (p < 0.001 and p = 0.007). Patients gained 1.17 QALYs by cataract surgery in their lifetime. The cost per QALY was 8835 Chinese yuan (CNY) (1400 U.S. dollars [USD]). It is cost-effective at the threshold of 115,062 CNY (18,235 USD) per QALY in China recommended by the World Health Organization. The cost per QALY varied from 7045 CNY (1116 USD) to 94,178 CNY (14,925 USD) in sensitivity analyses. Conclusions Visual acuity and quality of life assessed by utility value improved significantly after surgery. Cataract surgery was a cost-effective intervention for patients with coexistent AMD.

In order to improve the adsorption of heavy metals in polyacrylic hydrogels, the experiment uses acrylic acid and styrene as raw materials, potassium per sulfate as initiator, and ethylene glycol as crosslinker to synthesize polyacrylic acid/styrene hydrogel. The effects of monomer ratio, acrylic acid neutralization degree, crosslinker dosage and temperature on product properties were studied by orthogonal test. In addition, the copolymer was characterized by fourier transform infrared spectroscopy. The adsorption of heavy metal performance test found that when the ratio of acrylic acid and styrene is 1:0.2, the degree of neutralization is 65%, the crosslinker accounts for 1.0% of the monomer mass fraction, and the temperature is 65 °C, the polyacrylic acid/styrene copolymer hydrogel is optimal. The adsorption of Pb2 + in the optimal group was 328.25 mg/g.

To observe the long-term changes in dry eye symptoms and vision-related quality of life in age-related cataract patients after phacoemulsification. A total of 101 cataract patients after phacoemulsification combined with IOL implantation (Ph-IOL) in one eye were enrolled. Visual acuity, tear film breakup time (BUT), and Schirmer test 1 (ST1) were measured before and 1, 3, and 6 months after surgery. Ocular Surface Disease Index (OSDI) scores were used to evaluate the severity of dry eye symptoms. Utility values were assessed by the time trade-off (TTO), standard gamble for death (SGD), standard gamble for blindness (SGB) and rating scale (RS). The average LogMAR visual acuity in the operated eye was 1.35 ± 0.50 and increased rapidly after Ph-IOL, approaching a peak at 3 months (0.26 ± 0.15). The BUT and ST1 results decreased abruptly 1 month after surgery and gradually recovered until 6 months. OSDI scores increased significantly after surgery and gradually decreased until 6 months. Utility values evaluated by TTO, SGD, SGB and RS before surgery were 0.67 ± 0.19, 0.75 ± 0.15, 0.67 ± 0.20 and 0.2 ± 0.18, respectively, and increased to 0.91 ± 0.06, 0.98 ± 0.04, 0.92 ± 0.52 and 0.91 ± 0.06, 6 months after. Utility values measured with TTO, SGB or RS correlated significantly (P

Objectives: To compare the recently used phacoemulsification systems using a health technology assessment (HTA) model.Methods: A self-administered questionnaire, which included questions to gauge on the opinions of the recently used phacoemulsification systems, was distributed to the chief cataract surgeons in the departments of ophthalmology of eighteen tertiary hospitals in Shanghai, China. A series of senile cataract patients undergoing phacoemulsification surgery were enrolled in the study. The surgical results and the average costs related to their surgeries were all recorded and compared for the recently used phacoemulsification systems.Results: The four phacoemulsification systems currently used in Shanghai are the Infiniti Vision, Centurion Vision, WhiteStar Signature, and Stellaris Vision Enhancement systems. All of the doctors confirmed that the systems they used would help cataract patients recover vision. A total of 150 cataract patients who underwent phacoemulsification surgery were enrolled in the present study. A significant difference was found among the four groups in cumulative dissipated energy, with the lowest value found in the Centurion group. No serious complications were observed and a positive trend in visual acuity was found in all four groups after cataract surgery. The highest total cost of surgery was associated with procedures conducted using the Centurion Vision system, and significant differences between systems were mainly because of the cost of the consumables used in the different surgeries.Conclusions: This HTA comparison of four recently used phacoemulsification systems found that each of system offers a satisfactory vision recovery outcome, but differs in surgical efficacy and costs.

The photosensitive polyimide film, Durimide, is a common component of retinal prostheses; however, retinal cell response to Durimide has not been effectively studied This work assessed the in vitro biocompatibility of a retinal prosthesis containing platinum-electrode embedded Durimide film.Biocompatibility evaluation assessed cytotoxicity, attachment, and proliferation of two cell lines: a human retinal pigmented epithelium cell line (CRL) and a rhesus monkey choroid- retinal endothelial cell line (RF/6A). Cells were cultured with the platinum-electrode embedded Durimide film, with tissue-culture treated polystyrene plates (TCPS) used as a control substrate for cell growth. The effect of a Durimide-exposed medium on cell apoptosis and life cycle was assessed using flow cytometry (FCM).The indirect cytotoxicity evaluation revealed no toxic effect of the prosthesis on cells. The attachment and proliferation of CRL and RF/6A cells cultured with the Durimide prostheses showed no significant differences to the control. The FCM experiments demonstrated a liquid medium exposed to the prosthesis had no effects on apoptosis or cell life cycle in comparison with the control (p0.05).The results demonstrate that Durimide has good biocompatibility with retinal cell lines CRL and RF/6A. In conclusion, while further in vitro and in vivo studies are required to clarify long-term effects, Durimide is indicated as a promising material with suitable biocompatibility for retinal implants.

Apparent digestibility coefficients (ADC) of dry matter, crude protein, lipid, gross energy, amino acids, and fatty acids in white fish meal, brown fish meal, soybean meal, peanut meal, and yeast were determined for grouper Epinephelus coioides. Apparent digestibility was determined using a reference diet with 0.5% chromic oxide indicator and test diets that contained 70% reference diet and 30% of the feed ingredient being evaluated. The fish, averaging 12.0 g, were held in 250-L tanks at a density of 30 fish per tank. Feces were collected from three replicate groups-of fish. Apparent dry matter digestibility of ingredients was 78.85 ± 2.43, 79.11 ± 0.61, 69.85 ± 3.60, 73.67 ± 2.30 and 57.70 ± 4.69% for white fish meal, brown fish meal, soybean meal, peanut meal, and yeast, respectively. Apparent gross energy digestibility of ingredients was 93.27 ± 2.90, 89.48 ± 1.78, 70.52 ± 4.01, 73.13 ± 2.41 and 51.67 ± 2.01% for white fish meal, brown fish meal, soybean meal, peanut meal, and yeast, respectively. Apparent protein digestibility of ingredients was 89.82 ± 1.24, 87.34 ± 1.25, 83.97 ± 1.92, 80.79 ± 1.95, and 61.14 ± 0.54% for white fish meal, brown fish meal, soybean meal, peanut meal, and yeast, respectively. White fish meal and brown fish meal showed higher protein digestibility among ingredients tested (P ± 0.01). Lipid digestibility of ingredients was high (90.66-94.48%) and not significantly different except for yeast. Amino acid availability values for test ingredients were similar to values of protein digestibility. Amino acid availability values of white fish meal and brown fish meal were higher than other ingredients. Fatty acid availability values for test ingredients were similar to values of lipid digestibility. In general, the digestibility of most fatty acids was over 80% in all ingredients, except for 14:0 in yeast and 18:0 in peanut meal, PUFA + HUFA > MUFA > SFA. Longer-chain saturated fatty acids were less digestibility, except for 14:0, with digestibilities diminishing as fatty acid chain length increased. Apparent digestibility of dry matter, crude protein, lipid, gross energy, amino acids, and fatty acids in yeast was the lowest among the ingredients.

To measure the change in visual acuity and vision-related quality of life in patients with both age-related cataract and bilateral age-related macular degeneration (AMD) after cataract surgery.Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.Prospective case series.Patients with age-related cataract and bilateral advanced AMD who were diagnosed and treated between January 2006 and January 2012 were enrolled. The patients had successful phacoemulsification with foldable posterior chamber intraocular lens implantation. The corrected distance visual acuity (CDVA) and vision-related quality of life measured by the Chinese-version Low Vision Quality of Life (CLVQOL) questionnaire were collected. The Wilcoxon signed-rank test was used to compare the differences. Binary logistic regression analysis was performed to explore potential factors associated with the change in CLVQOL scores.Sixty eyes of 51 patients were included. The CDVA improved significantly (median difference 0.30 logMAR; range 0 to 1.38 logMAR; P.001). The CLVQOL composite scores and the 4 subscale scores improved significantly (all P.001). A greater increase in the CLVQOL scores was associated with inferior preoperative logMAR CDVA in the more severely affected eye (regression coefficient 3.36; P.001).Cataract surgery improved visual acuity and the vision-related quality of life in patients with both age-related cataract and bilateral advanced AMD. Thus, it is beneficial for patients with coexistent advanced AMD to have cataract surgery.No author has a financial or proprietary interest in any material or method mentioned.

PURPOSE We obtained retinal nerve fiber layer (RNFL) thickness measurements in normal Chinese students aged 6 to 17 years, and investigated the relationship between RNFL thickness and sex, eye laterality, age, axial length, and refractive error. METHODS A total of 4648 eyes in 2324 normal, randomly-selected Chinese students aged 6 to 17 years was examined in this study. The RNFL thickness was measured by optical coherence tomography. The effects of sex, eye laterality (left or right), age, refractive error, and axial length on RNFL thickness were assessed. RESULTS The average age of the subjects was 12.82 ± 3.11 years. The global average RNFL thickness (±SD) was 106.89 ± 12.84 μm. The thickest RNFL measurements were found at the superior (133.22 ± 19.48 μm) and inferior (129.23 ± 20.30 μm) quadrants of the retina, followed by the temporal (93.58 ± 29.15 μm) and nasal (77.10 ± 14.89 μm) quadrants. In the 1529 participants aged 12 to 17, there were no significant differences in RNFL thickness values between the right and left eyes (P > 0.05); significant differences in RNFL were found only in the inferior and temporal quadrants of the retina in different sex groups (P < 0.05). Linear regression analysis revealed that the RNFL thickness values were correlated independently with axial length and refractive error (P < 0.05). CONCLUSIONS For clinical assessment of RNFL thickness, the influence of refractive error and axial length should be taken into account.

For a wireless sensor network, the limited sensing and communication resources give rise to the distinct challenges to the target tracking problem, which is well known for their energy consumption when compared with other applications. This paper investigates the characteristics of the wireless sensor networks, and provides a fully-distributed framework for the energy-efficient target tracking problem in the three-dimensional space. The proposed cross-layer framework includes five modules, namely, detection, election, location, prediction and routing module. We have shown that our proposed framework can be easily extended to the case with multiple targets by assuming that each target has distinct tag. Simulation result has also shown the good performance of the proposed cross-layer framework.

To discuss a effective method of nasal septum deviation.One hundred and sixteen subjects with nasal septum deviation were divided into treatment group (69 subjects) and control group (47 subjects) randomly. The combination therapy of correction of deviated nasal septum and plasma radiofrequency ablation were used in the treatment group. The combination therapy of deviated nasal septum and partial inferior turbinectomy were used in the control group. The data were analyzed by statistical method.The effective rate of physical signs and symptoms of the treatment group was 100.0%, while the control group was 85.1%. There was significant difference of two effective rates (P0.05). Furthermore, hyperventilation and nasal adhesion were not happened in treatment group 6 months after treatments.The correction of deviated nasal septum and plasma radiofrequency ablation combination therapy had the satisfied and safety treatment effect, which was and plasma radiofrequency ablation combination therapy had the satisfied and safety treatment effect, which was easy for observation as well as the minimal tissue damage. The combination therapy method was according with the principle of functional minimally invasive surgery.

To investigate the effects of radioactive ray on transmission capability of nose mucociliary.Forty-six patients with NPC were selected and saccharin clearance time (SCT) for 7 phases were detected in both pre- and post-radiotherapy respectively.Among 46 patients with NPC, the shortest SCT was 247 seconds and the longest 601 seconds in pre-radiotherapy phases; from 4th week of introradiotherapy to 18 months of postradiotherapy, the longest SCT was in 12 months after radiotherapy, which was 903 seconds. There were no significant differences in SCT before radiotherapy and 18 months after radiotherapy. There were significant differences in SCT of preradiotherapy and introdiotherapy, post radiotherapy, after radiotherapy 3 months, 6 months, 12 months after radiotherapy.Radiotherapy is the important factors in influencing transmission capability of nose cavity and sinus mucociliary and hints that gender and nasal cavity side don't affect SCT. Detection of SCT in different stages of NPC patients can be helpful to protect nasal mucous membrane effectively, and to reduce incidence rate of RNS.

Upon T cell activation, IkappaB kinases (IKKs) are transiently recruited to the plasma membrane-associated lipid raft microdomains for activation of NF-kappaB in promoting T cell proliferation. Retroviral Tax proteins from human T cell leukemia virus type 1 and type 2 (HTLV-1 and -2) are capable of activating IKK, yet only HTLV-1 infection causes T cell leukemia, which correlates with persistent activation of NF-kappaB induced by Tax1. Here, we show that the Tax proteins exhibit differential modes of IKK activation. The subunits of IKK are constitutively present in lipid rafts in activated forms in HTLV-1-infected T cells that express Tax. Disruption of lipid rafts impairs IkappaB kinase activation by Tax1. We also show that the cytoplasmic Tax1 protein persistently resides in the Golgi-associated lipid raft microdomains. Tax1 directs lipid raft translocation of IKK through selective interaction with IKKgamma and accordingly, depletion of IKKgamma impairs Tax1-directed lipid raft recruitment of IKKalpha and IKKbeta. In contrast, Tax2 activates NF-kappaB in a manner independent of lipid raft recruitment of IKK. These findings indicate that Tax1 actively recruits IKK to the lipid raft microdomains for persistent activation of NF-kappaB, thereby contributing to HTLV-1 oncogenesis.

To study the diagnosis and treatment of parotid Lymphoepithelioma-like carcinoma (LELC), and improve the rate of the diagnosis and treatment.Eighteen cases with parotid LELC confirmed pathologically were collected in our department, and the clinical presentation, diagnosis, treatment and prognosis were retrospectively summarized and analyzed from 1982 to 2002.All of these LELC patients were found in unilateral side. All cases received Epstein-Barr virus serological test except 2 cases because of refusing, and the testing result displayed: EBV-VCA-IGA positive rate in 93% (15/16); EBV-EA-IGA in 75% (12/ 16); EBV-DNA enzyme in 63% (10/16). Of 16 cases with facial nerve reserved, parotid superficial lobectomy were undertaken in 6 cases, resecting a majority of parotid in 5 cases, whole lobectomy in 5 cases. Facial never resection and whole lobectomy in 2 cases due to facial nerve trunk involved. Functional neck lymph dissection in superior and middle part was undertaken in 14 cases and radical neck lymph dissection in 4 cases, total neck lymph node metastasis rate was 67% (12/18). All of patients received radiotherapy to 50-70 Gy. The follow up were over 1 year, and local recurrence occurred in 2-4 years after operation for 4 cases and had to undergo reoperation. The 1, 3, 5 years survival rates of the 18 cases were 94% (17/18), 72% (13/18) and 50% (9/18), respectively. The chief Causes of death were distant metastasis and local recurrence.There maybe be close relationship between occurrence of LELC and Epstein-Barr virus infection. Its histopathologic feature is similar to undifferentiated nasopharyngeal carcinoma and nasopharynx biopsy must be demanded before confirming diagnosis for eliminating metastasis focus. The neck lymph node metastasis rate of LELC is high and local invasion is strong. It is important to undergo enlarged local resection, neck lymph dissection and postoperative radiotherapy.

Sepsis causes extensive apoptosis of lymphocytes, a pathological condition that is frequently associated with hyperthermia. Heat stress has been implicated to repress the activation of an inflammatory mediator, nuclear factor of kappaB (NF-kappaB), which sensitizes cells to apoptosis mediated by inflammatory cytokine, tumor necrosis factor alpha. However, the molecular mechanism of hyperthermia-associated loss of T cells remains unclear. We show that hyperthermia causes rapid translocation of IkappaB kinase (IKK) and NF-kappaB complexes into the plasma membrane-associated lipid rafts in T cells. Heat stress induces aggregation of Carma1 in lipid rafts, which in turn recruits protein kinase C theta (PKC theta) and Bcl10 to the microdomains, causing subsequent membrane translocation of the IKK and NF-kappaB signalosomes. Depletion of Carma1 and inhibition of PKC theta impair accumulation of NF-kappaB complexes in lipid rafts. Heat stress prohibits IkappaB kinase activity by sequestrating the IKK and NF-kappaB complexes in lipid rafts and by segregating the chaperone protein Hsp90, an essential cofactor for IKK, from the IKK complex. This process ultimately results in functional deficiency of NF-kappaB and renders T cells resistant to tumor necrosis factor alpha-induced activation of IKK, thereby contributing to the apoptotic loss of T lymphocytes in sepsis-associated hyperthermia.

Background Pigment epithelium-derived factor(PEDF)is expressed in several normal organs and identified as an inhibitor of neovascularization.In the present study,we investigated the effect of PEDF in an in vitro model of ocular choroidal neovascularization. Methods Microdissection was used to isolate the human choroidal endothelial cells(CECs),followed by the use of superparamagnetic beads(Dynabeads)coated with the CD31 antibody,which selectively binds to the endothelial cell surface.The mitogenic and motogenic effects of vascular endothelial growth factor(VEGF)on cultured choroidal capillary endothelial cells were examined in the presence or absence of PEDF(1,10,100,and 1000 ng/ml)using cell counts and migration assays. Results Cells bound to the beads were isolated using a magnetic particle concentrator and they were successfully cultured and characterized to be endothelial cells that possessed greater than 95% immunoreactivity to von Willebrand factor.PEDF suppressed the proliferation and migration of VEGF-induced choroidal capillary endothelial cells.However, the concentration of PEDF which we used has little effect on normal CECs. Conclusions PEDF played an important role on the growth and migration of VEGF-stimulated choroidal endothelial cell These findings suggest that PEDF may be an effective approach to the treatment of choroidal neovascular disorders. Chin Med J 2007;120(17):1534-1538

Rhegmatenous retinal detachment (RRD) is one of the most serious complications after phacoemulsification combined with intraocular lens implantation surgery. It has been reported that vision-related quality of life (VRQoL), as well as visual acuity rapidly decreased when RRD developed. However, little is known of the VRQoL in those RRD patients after anatomical retinal re-attachment, especially whether or not the VRQoL is higher than that before cataract surgery. In this prospective case series study, we use the Chinese-version low vision quality of life questionnaire (CLVQOL) to assess the changes of VRQoL in age-related cataract patients who suffered from RRD after phacoemulsification with intraocular lens (phaco-IOL) implantation. All participants were asked to complete questionnaires in face- to-face interviews one day before and two weeks after cataract surgery, as well as one day before and three months after RRD surgery. A total of 10,127 consecutive age-related cataract patients were followed up to one year after phaco-IOL implantation; among these patients, 17 were diagnosed as RRD. The total CLVQOL scores and subscale scores except "Mobility" decreased significantly when RRD developed. After retinal surgery, only the score of "General vision and lighting" in the CLVQOL questionnaires improved when compared to the scores two weeks after cataract surgery, although the best corrected visual acuity of all patients significantly raised up. However, the mean CLVQOL scores and subscale scores were still considerably higher than the level prior to cataract surgery. Our study suggests that cataract patients at high risk of postoperative RRD should not deny the opportunity to undergo phaco-IOL implantation, even though potential VRQoL impairment induced by RRD exists.

To explore the diagnosis and treatment of maxillary aneurysmal bone cyst.For 4 cases with maxillary aneurysmal bone cyst, 1 case underwent radical maxillary sinusotomy in local anaesthesia and 3 cases underwent lateral rhinotomy in general anaestesia.The 4 cases were followed up for 13 months to 2 years after operation and no patient was found recurrence.The main treatment of aneurysmal bone cyst was radical operation, to strive for thorough treatment. Confirming and embolizing the feed artery by DSA preoperatively can reduce bleeding during operation and shorten the time of operation and general anesthesia obviously.

To study the value of laryngeal endoscopic system in the treatment of laryngeal diseases with minimally invasive surgery.This paper was to summarized retrospectively the clinical experience of 34 cases suffered from laryngeal diseases treated by minimally invasive surgery with laryngeal endoscopic system. The remain tumor and hemorrhage were treated by microwave machine. The malignant tumors were treated by radiotherapy with 60Co in 40 Gy, postoperatively.The tumors were totally resected and no serious complications were revealed. Followed-up these 34 cases, 26 cases with benign pathological changes who had hoarseness preoperatively recovered to normal 1-month after operation. In 2 cases with vocal cord carcinoma at the early stage, the functions and construction of throat were retained and no recurrence was founded after 6-12 month postoperatively.The laryngeal endoscopic system is valuable in treating laryngeal pathological regions and early stage carcinoma for its minimally invasion, wide operative field, good illuminative degree and normal construction and function reserved.

Selecting carotid tumors and preventing the fatal bleeding of intraoperation.The carotid compression test and inspection of angiography with transcranial Doppler sonography and keeping intraoperative awake after relieving pain anesthetization.Ten cases of carotid artery were occluded for 2 hours within operation, and 4 carotids were resected and 6 carotid body tumor were peeled and their carotid were reserved. No neurological problems were encountered in the 10 patients for 5 years.Our experience proved that the carotid compression test and inspection of angiography with transcranial Doppler sonography and keeping intraoperative awake after relieving pain anesthetization can help to supervise the selective carotid resection.