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They had higher 1-year mortality (60.6% vs 18.3% vs 4.1%, respectively; P less then 0.0001) when compared to MAO and young patients. Selleck Trichostatin A CONCLUSION Elderly patients with STEMI have poorer outcomes than MAO and young patients. This is potentially attributable to a myriad of factors including age, higher burden of comorbidities and a lesser likelihood of receiving revascularisation and guideline-recommended medical therapy.BACKGROUND Carcinosarcoma of the sinonasal tract is an extremely rare malignant neoplasm; it is often designated as carcinoma with spindle cell or sarcomatoid features. We report a case of carcinosarcoma arising in a pre-existing inverted Schneiderian papilloma in the left maxillary antrum and nasal cavity of a 72-year old male patient. CASE REPORT The patient had a significant history of radiotherapy for squamous cell carcinoma in the sinonasal area, 3 decades ago. The patient presented with chief complaints of left nasal blockage, nasal discharge, anosmia, and occasional epistaxis. Computed tomography scan displayed a lobular soft tissue mass resulting in narrowing of the nasopharyngeal airway with massive destruction of palatal tissue. The lesion was resected via endoscopic surgery. Macroscopically, a white fleshy appearance with necrosis was noted in the submitted specimen. Microscopically, the tumor was composed of pleomorphic epithelial and spindle cells with numerous mitoses and remarkable tissue necrooid features in this neoplasm should also be considered.Circulating tumor DNA (ctDNA) describes the fragmented DNA released from tumor cells into the blood. The ctDNA may have the same genetic changes as the primary tumor. Currently, ctDNA has become a popular biomarker for diagnosis, treatment, real-time clinical response monitoring, and prognosis, for solid tumors. Detection of ctDNA is minimally invasive, and repeat sampling can easily be performed. However, due to its low quality and short DNA fragment length, ctDNA detection still faces challenges and requires highly sensitive analytical techniques. Recently, liquid biopsies for the analysis of circulating tumor cells (CTCs) and circulating tumor-derived exosomes have been studied, and nanotechnology techniques have rapidly developed. Compared to traditional analytical methods, these nanotechnology-based platforms have the advantages of sensitivity, multiplex detection, simplicity, miniaturization, and automation, which support their potential use in clinical practice. This review aims to discuss the recent nanotechnological strategies for ctDNA analysis and the design of reliable techniques for ctDNA detection and to identify the potential clinical applications.BACKGROUND To facilitate early treatment, we constructed a nomogram to predict risk of postoperative fever before prostate biopsy in patients with high risk of fever. MATERIAL AND METHODS We collected information on patients undergoing prostate biopsy from January 2015 to December 2018 from their medical records, including clinical characteristics and laboratory test results. Finally, after strict screening, the prediction model was established in 440 patients who underwent a transrectal prostate biopsy (TRPB). We divided these patients into a training group and validation group at a ratio of 7 3, respectively. Univariate analysis and multivariate logistic regression analysis were used to select the predictors and to develop the model. Calibration curve and C-index were used to evaluate the accuracy of the nomogram, while DCA was used to assess the clinical value. RESULTS The individualized predictive nomogram contained 3 clinical features - Biopsy-positive rate (BPR), Hematuria, and Urine WBC - significantly associated with post-biopsy fever. The nomogram had good discriminating ability in both the training group and validation group - the C-index was 0.774 (95% CI=0.717-0.832) in the training group and 0.808 (95% CI=0.706-0.909) in the validation group. Hosmer-Lemeshow test proved a good calibration curve fit. The DCA curve suggested that the nomogram would have good clinical utility. CONCLUSIONS This is the first study to develop a nomogram to predict fever after prostate biopsy via Biopsy-positive rate (BPR), Hematuria, and Urine WBC. Use of this nomogram might help prevent fever and infection, and could facilitate individualized medical treatment after prostate biopsy.BACKGROUND Hepatocellular carcinoma (HCC) is one of the most prevalent cancers in the world. Bioinformatics studies have been widely used for screening genes involved in the initiation and progression of HCC. MATERIAL AND METHODS We obtained liver cancer microarray raw data from the GEO database (GSE54238). Next, weighted gene co-expression network analysis (WGCNA) was used to assess the critical modules. Then, we assessed the gene significance by calculating survival, expression level, and receiver operating characteristic (ROC) in the TCGA database. We also validated the expression of selected genes in the Oncomine database and calculated the relationship between 4 hub genes and immune infiltration. Finally, GSEA enrichment analysis was used to explore the potential mechanism. RESULTS We identified the red and blue modules as the critical modules, and found 176 candidate genes by assessing gene significance. GO and KEEG results suggested that the candidate genes are involved in the cell cycle. Four hub genes - SOX4, STK39, TARBP1, and TDRKH - were eventually screened after validating their expression and power in diagnosing HCC in the TCGA database. Immune infiltration analysis and GSEA enrichment analysis showed that these 4 hub genes were correlated with the immune cell populations infiltration and that multiple mechanisms were involved, such as angiogenesis and epithelial-mesenchymal transition. CONCLUSIONS Our findings revealed that these 4 genes can be regarded as potential prognosticators and therapeutic targets for HCC.INTRODUCTION The aim of this study was to investigate and compare the auditory findings in migraine, vestibular migraine (VM), and healthy controls. METHODS Twenty-eight migraine patients (56 ears), 18 VM (36 ears), and 25 healthy controls (50 ears) were included. Audiometry, speech discrimination scores, distortion product optoacoustic emission (DPOAE), and auditory brainstem response were tested. RESULTS The pure tone in the VM group showed higher thresholds at lower frequencies (250, 500, 1,000, 2,000 Hz) than the control group, with statistical differences observed (P250 Hz = 0.001, P500 Hz = 0.003, P1,000 Hz = 0.016, P2,000 Hz = 0.002). Compared with the healthy controls, the patients with VM had significantly lower amplitudes of DPOAE at 1 kHz (p less then 0.001) and 2 kHz (p = 0.020), and the patients with migraine had lower amplitudes at 2 kHz (p = 0.042). Compared with the control group, the patients with migraine reported prolonged latency of wave V (p = 0.016) and IPL I-V (p = 0.003). The patients with VM had significant prolongation of IPL I-V (p = 0.024). CONCLUSION Not only the peripheral, but also the central auditory system was involved in patients with migraine and VM. In particular, lower frequencies of the auditory system were more likely to be involved in VM. The history of migraine may be a cause of low-tone sudden sensorineural hearing loss. © 2020 S. Karger AG, Basel.BACKGROUND The current effective delivered dose is a quality indicator for continuous renal replacement therapy. Its periodic assessment might enable physicians to deliver personalised treatments. Yet, its quantification as by extracorporeal urea clearance (Cl) is cumbersome and thus often neglected in routine practice. The aim of this in vitro study is to demonstrate the non-inferior effectiveness of assessing the current effective delivered dose using a simpler, cheaper and faster approach based on measurement of fluoride rather than urea extracorporeal Cl. METHODS We compared urea and fluoride removal in 3 post-dilution continuous veno-venous haemofiltration (CVVH) and 3 continuous veno-venous haemodialysis (CVVHD) in vitro experimental models. Experiments ran for 180 min, using 3 L of human blood, heparin anticoagulation and a machine dose of 30 mL/kg/h. Urea and fluoride were measured in the inflow, outflow and effluent lines to compare sieving coefficients (SC), saturation coefficients (SA) and transmem0 S. Karger AG, Basel.INTRODUCTION The plaques formed by amyloid-β (Aβ) accumulation and neurofibrillary tangles formed by hyper-phosphorylated tau protein are the 2 major pathologies of Alzheimer's disease (AD). Recently, autophagy is considered to be a self-degradation process of preserved cytoplasmic abnormal substances, including Aβ and tau. METHODS α-Screen assay is used to discover a new mammalian target of rapamycin (mTOR) signaling inhibitor, and laser scanning confocal microscopic analysis is used to investigate the autophagy formation. Lastly, ELISA and Western blot assays are used to identify the mTOR signaling inhibitor effect on Aβ and tau and the underlying mechanism. RESULTS In the current study, we discover that dihydrotanshinone I (DTS I), extracted from Radix Salviae, can obviously inhibit mTOR phosphorylation and increase autophagy via increasing AMPK phosphorylation. Further study demonstrates that DTS I increases Aβ clearance and decreases Tau phosphorylation through autophagy enhancement involved with AMPK/mTOR pathway. CONCLUSION Our study indicates that DTS I can increase Aβ clearance and decrease Tau phosphorylation via autophagy enhancing involved with AMPK/mTOR pathway, which highlights the therapeutic potential of DTS I for the treatment of AD. © 2020 S. Karger AG, Basel.BACKGROUND Adequate collateral circulation improves the clinical outcome of ischemic stroke patients. We evaluated the influence of ipsilateral carotid stenosis on intracranial collateral circulation in acute stroke patients. METHODS We collected the data of 385 consecutive acute stroke patients who underwent mechanical thrombectomy after multimodal computed tomography (CT) imaging in a single high-volume stroke center. Patients with occlusion of the first segment (M1) segment of the middle cerebral artery were included. We recorded baseline clinical, laboratory, procedural, and imaging variables and technical, imaging, and clinical outcomes. The effect of carotid stenosis on intracranial collateral circulation was studied with appropriate statistical tests and ordinal regression analysis. RESULTS Fifty out of the 247 patients eligible for analysis had severe ipsilateral carotid stenosis (≥75%). These patients were 4-times more likely to have very good intracranial collaterals (Collateral Score 3-4, p = 0.001) than the nonstenotic and slightly stenotic ( less then 75%) patients. The severely stenotic patients had a longer mean operation time (41 vs. 29 min to reperfusion, respectively, p = 0.001). Nevertheless, 54% of severely stenotic patients had good 3-month clinical outcome (modified Rankin Scale ≤2) with no significant difference between the 2 groups. CONCLUSIONS Carotid artery stenosis of over 75% of vessel diameter was associated with better intracranial collateral circulation of patients with acute ischemic stroke. This did not significantly change the 3-month clinical outcome. © 2020 S. Karger AG, Basel.
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