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BackgroundTuberculous meningitis (TBM) is the most severe form of tuberculosis (TB) and can be difficult to diagnose and treat. We aimed to describe the clinical presentation, diagnosis, disease spectrum, outcome, and prognostic factors of patients treated for TBM in China.MethodsA multicenter retrospective study was conducted from 2009 to 2019 enrolling all presumptive TBM patients referred to Xijing tertiary Hospital from 27 referral centers in and around Shaanxi province, China. Patients with clinical features suggestive of TBM (abnormal CSF parameters) were included in the study if they had adequate baseline information to be classified as “confirmed,” “probable,” or “possible” TBM according to international consensus TBM criteria and remained in follow-up. Patients with a confirmed alternative diagnosis or severe immune compromise were excluded. Clinical presentation, central nervous system imaging, cerebrospinal fluid (CSF) results, TBM score, and outcome—assessed using the modified Barthel disability index—were recorded and compared.FindingsA total of 341 presumptive TBM patients met selection criteria; 63 confirmed TBM (25 culture positive, 42 Xpert-MTB/RIF positive), 66 probable TBM, 163 possible TBM, and 49 “not TBM.” Death was associated with BMRC grade III (OR = 5.172; 95%CI: 2.298–11.641), TBM score ≥ 15 (OR = 3.843; 95%CI: 1.372–10.761), age > 60 years (OR = 3.566; 95%CI: 1.022–12.442), and CSF neutrophil ratio ≥ 25% (OR = 2.298; 95%CI: 1.027–5.139). Among those with confirmed TBM, nearly one-third (17/63, 27.0%) had a TBM score 60 years) have higher TBM scores or CSF neutrophil ratios, have signs of disseminated/miliary TB, and are at greatest risk of death. In general, more effort needs to be done to improve early diagnosis and treatment outcome in TBM patients.

Abstract Noninflammatory clearance of dying cells by professional phagocytes, termed efferocytosis, is fundamental in both homeostasis and inflammatory fibrosis disease but has not been confirmed to occur in chronic pancreatitis (CP). Here, we investigated whether efferocytosis constitutes a novel regulatory target in CP and its mechanisms. PRSS1 transgenic (PRSS1 Tg ) mice were treated with caerulein to mimic CP development. Phospholipid metabolite profiling and epigenetic assays were performed with PRSS1 Tg CP models. The potential functions of Atp8b1 in CP model were clarified using Atp8b1-overexpressing adeno-associated virus, immunofluorescence, enzyme-linked immunosorbent assay(ELISA), and lipid metabolomic approaches. ATAC-seq combined with RNA-seq was then used to identify transcription factors binding to the Atp8b1 promoter, and ChIP-qPCR and luciferase assays were used to confirm that the identified transcription factor bound to the Atp8b1 promoter, and to identify the specific binding site. Flow cytometry was performed to analyze the proportion of pancreatic macrophages. Decreased efferocytosis with aggravated inflammation was identified in CP. The lysophosphatidylcholine (LPC) pathway was the most obviously dysregulated phospholipid pathway, and LPC and Atp8b1 expression gradually decreased during CP development. H3K27me3 ChIP-seq showed that increased Atp8b1 promoter methylation led to transcriptional inhibition. Atp8b1 complementation substantially increased the LPC concentration and improved CP outcomes. Bhlha15 was identified as a transcription factor that binds to the Atp8b1 promoter and regulates phospholipid metabolism. Our study indicates that the acinar Atp8b1/LPC pathway acts as an important “find-me” signal for macrophages and plays a protective role in CP, with Atp8b1 transcription promoted by the acinar cell-specific transcription factor Bhlha15. Bhlha15, Atp8b1, and LPC could be clinically translated into valuable therapeutic targets to overcome the limitations of current CP therapies.

A inducible fluorescent ligand 2-(2-(2-amino-ethylamino) ethyl)-3′,6′- bis (ethylamino)-2′, 7′-dimethy-lspiro[isoindoline-1,9′-xanthen]-3-one was synthesized and used as a fluorescent probe to detect Er3+. Er3+ could induce the structural transformation of the fluorescent ligand, resulting in a sharp fluorescence emission in a buffered solution. The fluorescence intensity of the fluorescent ligand was enhanced quantitatively with an increase in the concentration of erbium ion. The detection limit of Er3+ was 3.0 × 10−10 mol L−1 (50 ng L−1) under optimized conditions. The method applied for the determination of Er3+ in four alloy samples had achieved satisfactory results. Keywords: Fluorescence probe, Rhodamine 6G, Diethylenetriamine, Enhancement, Erbium ion

Abstract. Background:. The detection of polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) syndrome at early stage is challenging for neurologists. Since polyneuropathy could be the first manifestation, it could be misdiagnosed as chronic inflammatory demyelinating polyneuropathy (CIDP). The present study aimed to determine the clinical and electrophysiological features of POEMS syndrome to distinguish from CIDP. Methods:. The data of a group of patients with POEMS (n = 17) and patients with CIDP (n = 17) in Zhongshan Hospital Fudan University from January 2015 to September 2017 were analyzed in this retrospective study. The clinical features, neurological symptoms, and electrophysiological findings were compared between the two groups. Results:. Clinically, patients with POEMS demonstrated significantly more neuropathic pain in the lower extremities than patients with CIDP (58.8% vs. 11.8%, P = 0.01). Multisystem features like edema, skin change, organomegaly, and thrombocytosis were also pointed towards the diagnosis of POEMS syndrome. Electrophysiologically, terminal latency index (TLI) was significantly higher in patients with POEMS than that in patients with CIDP (median nerve: 0.39 [0.17–0.52] vs. 0.30 (0.07–0.69), Z = –2.413, P = 0.016; ulnar nerve: 0.55 [0.23–0.78] vs. 0.42 [0.12–0.70], Z = –2.034, P = 0.042). Patients with POEMS demonstrated a higher frequency of absent compound muscle action potential of the tibial nerve (52.9% vs. 17.6%, P = 0.031), less conduction block (ulnar nerve: 0 vs. 35.3%, P = 0.018), and less temporal dispersion (median nerve: 17.6% vs. 58.8%, P = 0.032) than CIDP group. The combination of positive serum monoclonal protein and high TLI (if either one or both were present) discriminated POEMS from CIDP with a sensitivity of 94.1% and 47.1% and specificity of 76.5% and 100.0%, respectively. Conclusions:. POEMS syndrome could be distinguished from CIDP through typical clinical and electrophysiological characteristics in practice. The combination of serum monoclonal protein and high TLI might raise the sensitivity of detecting POEMS syndrome.

Objective To investigate the clinical and EEG features of ischemic stroke patients with abnormal discharges. Methods Clinical data and 24-hour EEG monitoring of 162 ischemic stroke patients were analyzed retrospectively. One-year follow-up was carried out and post-ischemic epilepsy was diagnosed. Results Among 162 ischemic stroke patients, 24-hour EEG was abnormal in 87 cases (53.70%). According to the correspondence of site of infarcts and abnormal discharges, these 87 cases were classified into 2 groups: matched group (N = 24, 27.59%) and unmatched group (N = 63, 72.41%). There was no significant difference between 2 groups in terms of Oxfordshire Community Stroke Project (OCSP) and TOAST classification (P = 0.792, 0.111), while there was significant difference between 2 groups on the site of infarcts (P = 0.000). In matched group, the infarcts were mainly located in cortex (N = 23, 95.83%). However, in unmatched group, the infarcts were mainly located in cortex and basal ganglia (N = 27, 42.86%), or in basal ganglia only (N = 24, 38.10%). In matched group, 24-hour EEG showed slowing of background activities, and sharp waves and sharp and slow wave complex which were corresponding to the infarct sites. The abnormal discharges could only be recorded around the infarct unilaterally. In unmatched group, the epileptiform discharges were recorded in both contralateral and ipsilateral ischemic hemispheres, usually with widespread slow waves and asymmetric background. The infarcts were limited, but abnormal discharges were widespread. For example, the infarct was located in deep brain, while scalp abnormal discharges were recorded. Although there was no significant difference in terms of epilepsy incidence between 2 groups (P = 0.908), the types of epilepsy were statistically different between 2 groups (P = 0.000). In matched group, the main type was partial seizure. But in unmatched group, the main types of epilepsy were secondary generalized seizure and generalized seizure. Conclusions Infract site has an influence on the abnormal EEG pattern, and the unmatched location of ischemic region and abnormal EEG may be indicative for the seizure type of post-ischemic epilepsy. DOI: 10.3969/j.issn.1672-6731.2016.05.008

Although tung oil is renewable, with an abundant production and low price in China, and it is used to synthesize different polyols for rigid polyurethane foam (RPUF), it remains a challenge to improve the properties of RPUF by redesigning the formula. Therefore, we propose four novel compounds to strengthen the properties of RPUF, such as the catalyst-free synthesis of tung oil-based polyol (PTOK), aluminum phosphate micro-capsule (AM), silica micro-capsule (SiM), and grafted epoxidized monoglyceride of tung oil on the surface of SiO2 (SiE), which were designed and introduced into the RPUF. Because of the PTOK with a catalytic function, the foaming process of some RPUF samples was catalyst-free. The results show that the incorporation of AM, SiM, and SiE, respectively, endow RPUF with a better thermal stability at a high temperature, and the T5%, Tmax1, and Tmax2 of RPUF appeared to be reduced, however, the Tmax3 and residue rate at 800 °C were improved, which may have a positive effect on the extension of the rescue time in case of fire, and the limiting oxygen index (LOI) value was increased to 22.6%. The formula, containing 25% PTOK made the RPUF environment-friendly. The results were obtained by comparing the pore size and mechanical properties of the RPUF—the AM had a better dispersion in the foam, and the foam obtained a better mechanical, thermal, and flame retardancy.

doi: 10.3969/j.issn.1672-6731.2014.08.001

The title compound, C17H17N4+·C9H5O6−·C9H6O6·H2O, contains a protonated 2,2′-(1,3-propanediyl)bis(1H-benzimidazole) cation, a deprotonated benzene-1,3,5-tricarboxylic acid anion, a neutral benzene-1,3,5-tricarboxylic acid molecule and a water molecule, which are linked together through N—H...O, O—H...O and weak C—H...O hydrogen bonds into almost double sheets parallel to (4overline{4}overline{1}). These hydrogen-bonded sheets are packed in the crystal with the formation of centrosymmetric voids of 25.5 Å3, which are filled by the water molecules.

Context: It is necessary to explore a minimally invasive, effective, and efficient treatment for those lung cancer patients who are poor candidates for surgery.Aim: This study aimed to investigate the application of microwave ablation (MWA) in the treatment of lung cancer.Settings and Design: A total of 43 patients with 44 pulmonary lesions were examined following identical procedures before being randomly divided into two groups. The experimental group consists of 17 patients with a total of 18 pulmonary lesions, while the control group consists of 26 patients with a total of 26 pulmonary lesions.Materials and Methods: The experimental group was treated using magnetic resonance imaging (MRI)-guided MWA while the control group was treated using computer tomography (CT)-guided MWA. A transverse relaxation time-turbo spin echo (T2-TSE) sequence was used for signal collection in the experimental group to determine puncture location and microwave needle position while T2-TSE, T1-turbo field echo, and diffusion-weighted MRI (DWI) sequences were used for timely efficacy evaluation. Whereas in the control group, CT axial scanning was performed to serve similar purposes.Statistical Analysis Used: A nonparametric Wilcoxon test, median (M [25%, 75%]).Results: All of the 44 lesions were successfully located on the first attempt. The mean time for scanning and locating lung lesions under MRI and CT guidance were 64.53 and 42.96 min, the mean times of positioning were 12 and 18 min, and the mean durations of MWA were 12.48 and 15.06 min, respectively.Conclusions: As a minimally invasive method for treating lung tumors, MRI-guided MWA requires fewer localization scans, a shorter MWA duration, no radiation, real-time observation of the curative effect, and it prevents overtreatment. [ABSTRACT FROM AUTHOR]

Background: Microbiological confirmation of tuberculous meningitis (TBM) remains problematic. We assessed the diagnostic performance of a modified Ziehl-Neelsen (MZN) staining method that showed promise in earlier studies. Methods: Patients evaluated for TBM in Shaanxi province, China, were prospectively enrolled from May, 2011 to April, 2013. Cerebrospinal fluid (CSF) specimens were evaluated using the Xpert MTB/RIF® assay, MZN staining, and standard biochemical and microbiological tests, together with detailed clinical and radiological assessment. Results: Among 316 patients included in the study, 38 had definite TBM, 66 probable TBM, 163 possible TBM and 49 "no TBM," using consensus uniform research case definition criteria. Comparing "definite or probable TBM" to "no TBM" MZN staining had higher sensitivity than Xpert MTB/RIF® (88.5 vs. 36.5%), but greatly reduced specificity (71.4 vs. 100.0%); 14/49 (28.6%) cases with "no TBM" tested positive on MZN. Mycobacterium tuberculosis culture was performed in 104/179 (58.1%) of MZN positive samples; 12.5% (13/104) were positive. Using Xpert MTB/RIF® as the reference standard, MZN had a sensitivity of 92.1% (95% CI 79.2-97.3) and specificity of 71.4% (95% CI 57.6-82.2). Conclusion: Xpert MTB/RIF® offered a rapid and specific TBM diagnosis, but sensitivity was poor. MZN was mainly hampered by false positives. Strategies to enhance the sensitivity of Xpert MTB/RIF® or improve the diagnostic accuracy of MZN should be explored. [ABSTRACT FROM AUTHOR]

A novel N--P-containing soybean-oil-based fire-retardant plasticizer was synthesized using soybean oil methyl ester, 9,10-dihydro-9-oxa-phosphaphenanthrene-10-oxide (DOPO), and tris(2-hydroxyethyl) isocyanurate (THEIC). The structure was verified by Fourier transform infrared (FTIR) spectrometry and nuclear magnetic resonance (NMR) spectroscopy. The blends were characterized by thermogravimetric analysis (TGA), FTIR spectrometry, scanning electron microscopy (SEM), and dynamic mechanical analysis (DMA). TGA showed that the thermal stability of the blends were acceptable. DMA indicated that the plasticizer had good plasticity for PVC. The limiting oxygen index (LOI) of the blends ranged from 21.3 to 29.6. The flammability and thermal stability of PVC/THEIC-DOPO-ESOME was better than that of PVC/TCPP. [ABSTRACT FROM AUTHOR]

An epoxy oil-based plasticizer with a triazine ring structure (THEIC-ESBO) has been prepared using tris(2-hydroxyethyl) isocyanurate (THEIC) and soybean oil methyl ester as the main raw materials. The structure of THEIC-ESBO has been characterized by 1 H NMR and 13 C-NMR and elemental analysis. THEIC-ESBO substituting epoxy soybean oil (ESO) was used to plasticize PVC blends (PVC/THEIC-ESBO). when 60-70% ESO was substituted by THEIC-ESBO in PVC blends, the results of the mechanical properties and the dynamic thermomechanical analysis (DMA) indicate that plasticizing and compatibility of the plasticizer with PVC remained excellent, and the glass transition temperature ( T g) was 46.4 °C. The thermal stability of PVC blends was investigated by thermogravimetric analysis (TGA). The Fire performance of the PVC/THEIC-ESBO was investigated by the limiting oxygen index (LOI) and cone calorimeter test. When THEIC-ESBO was used as plasticizers alone, the LOI of the PVC blend reached 26.1%. The cone calorimetric data show that with increasing THEIC-ESBO, the time to ignition prolong, the value of the heat release rate (HRR) and the total heat release (THR) were reduced, the total smoke of release (TSR) was increased, both of the release rate of CO and CO 2 were increased, but the value of CO/CO 2 was decreased, the value of the residual char yield (C-Y) was significantly enhanced. All the data indicated that flame retardant of PVC blends using THEIC-ESBO substitute ESO was significantly improved, and THEIC-ESBO exhibits flame inhibition in the gaseous phase. The mechanism of flame retardancy of PVC/THEIC-ESBO was investigated by pyrolysis gas chromatographymass spectrometry (Py–GC/MS). The results indicate that nitrogen-containing compounds from THEIC-ESBO pyrolysis dilute the concentration of combustible gases, the cross-linking reaction is also promoted the char yield. SO, during PVC blends combustion process, the flame retardant of PVC/THEIC-ESBO was enhanced. [ABSTRACT FROM AUTHOR]

B cell activating factor (BAFF) is a cytokine of tumor necrosis factor family mainly produced by monocytes and dendritic cells. BAFF can regulate the proliferation, differentiation, and survival of B lymphocytes by binding with BAFF-R on B cell membrane. Accumulating evidences showed that BAFF played crucial roles and was overexpressed in various autoimmune diseases such as systemic lupus erythematous (SLE) and rheumatoid arthritis (RA). This suggests that BAFF may be a therapeutic target for these diseases. In the present study, we developed a BAFF therapeutic vaccine by coupling a T helper cell epitope AKFVAAWTLKAA (PADRE) to the N terminus of BAFF extracellular domains (PADRE-BAFF) and expressed this fusion protein in Escherichia coli. The purified vaccine can induce high titer of neutralizing BAFF antibodies and ameliorate the syndrome of complete Freund's adjuvant (CFA) induced rheumatoid arthritis in rats. Our data indicated that the BAFF autovaccine may be a useful candidate for the treatment of some autoimmune diseases associated with high level of BAFF. [ABSTRACT FROM AUTHOR]