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BACKGROUND AND OBJECTIVE The influence of cerebral large artery stenosis (CLAS) on ischemic leukoaraiosis (LA) remains elusive. Based on the proposed stages of the preinfarction period, this study aimed to adopt the staging system to assess the correlation between ischemic LA and CLAS. MATERIALS AND METHODS Patients with unilateral CLAS ≥50% and without cerebral stroke were screened. The severity and distribution of stenosis were evaluated on computed tomography angiography images. The degree of regional cerebral perfusion was rated according to the stages of preinfarction period: 0=normal, 1=stage Ia, 2=stage Ib, 3=stage IIa, 4=stage IIb. Stage I included stage Ia and stage Ib. Stage II included stage IIa and stage IIb. LA was scored with Fazakas scale on T2-weighted image and/or fluid-attenuated inversion recovery sequences. RESULTS The cohort consisted of 212 patients (mean age, 66.89±11.39 y), including 145 (68.40%) males. CLAS severity and distribution did not differ between patients with and without LA (P>0.05). Normal, stage I, and stage II had significantly different incidences of LA and hemispheric LA scores in the left and right hemispheres (P

Background A carotid web (CW), an atypical fibromuscular dysplasia, is rare and may cause ischemic stroke. It is challenging to recognize a CW promptly and treat it accordingly. We report a case of an initially misdiagnosed CW. Case Description A 48-year-old man with recurrent cerebral infarction was transferred to our hospital for bypass surgery. Imaging performed at our facility showed multiple old infarct lesions and cerebral tissue hypoperfusion in the occluded left middle cerebral artery territory. Bypass surgery was performed without perioperative complications. While searching for the cause of his stroke, we found a thin intraluminal filling defect along the posterior wall of the left carotid bulb just beyond the carotid bifurcation on sagittal maximal intensity projection images, axial thin-cut images, and volume rendering images. The defect was diagnosed as a CW. It was also detected on follow-up ultrasonography. Owing to our initial unawareness, we did not photograph the carotid bulb during preoperative digital subtraction angiography and postoperative computed tomography angiography. Although the patient was treated with bypass, the persistence of the factors underlying the CW may induce further thrombosis and subsequent occlusion of his ipsilateral anterior cerebral artery. Conclusions Clinicians should be aware of CW as a potential cause of ischemic stroke. Head and neck computed tomography angiography is a reliable imaging method to detect CWs.

In this paper, a visualization and modeling method for the internal fixation plate in personalized and minimally invasive long bone fracture surgery is presented. This framework mainly includes six sub-steps: firstly, the Principal Component Analysis (PCA) method is used to extract the 3D axis of the broken bone; secondly, the Gauss mapping method is utilized to segment the end surfaces of the broken bone; thirdly, the maximum common subgraph strategy is utilized to complete the end surface matching; fourthly, the OBB (Oriented Bounding Box) method is utilized to accomplish the pre-registration of the fracture surface; fifthly, the ICP (Iterative Closest Point) algorithm is utilized to achieve the fracture surface models’ accurate alignment; lastly, the personalized bent internal fixation plate model can be reconstructed based on anchor points. Via this method, doctors can obtain the accurate and personalized internal fixation plate model that has the best matching geometric form to the patient’s broken bones. This method can provide a well technique base and computational solution for the minimally invasive long bone fracture surgery.

Purpose Cerebral venous thrombosis (CVT) has various clinical presentations and has a median onset delay of 7 days. So it is important to find more identifiable early imaging manifestations for CVT. Method This was a retrospective study. Patients with CVT (CVT group, n = 26) diagnosed by conventional imaging techniques (magnetic resonance imaging and/or digital subtraction angiogram) and patients with symptomatic intracranial atherosclerosis (control group, n = 30) were included. Magnetic resonance black-blood thrombus imaging (MRBTI) technique had been performed in both groups. The CVT group was divided into 3 groups based on the duration of clinical onset: ≤7 days (group 1), between 7 and 30 days (group 2), and >30 days (group 3). Pathological pachymeningeal enhancement and its characteristics were analyzed between the CVT group and the control group. Results Pathological pachymeningeal enhancement was found in 14 CVT patients (54 %) and none in control group (P value = 0.000). The bilateral pathological pachymeningeal enhancement was involved in 10 CVT patients, 6 patients were asymmetric, and 4 patients had ipsilateral enhancement. Asymmetric pathological pachymeningeal enhancement was 71 % and predominantly located on the thrombosed sinus side. Strong enhancement was found in the venous sinus wall beside the thrombus. Pathological pachymeningeal enhancement percentages of three subgroups were 75 % in group 1, 55 % in group 2, and 29 % in group 3 and had no statistical differences (p value = 0.198). Conclusions Current findings suggest asymmetrical pathological pachymeningeal enhancement was associated was CVT and may be a new imaging feature for CVT.

A fluorescence microsphere suspension array technique has been developed as a promising tool for the molecular detection of Listeria monocytogene (LM), which is a dangerous food borne pathogen that can cause severe food intoxication in both humans and animals. In such a technique, fluorescent microspheres as the key matrix for detection are often decorated with neutral organic dyes, which usually suffer from instability, easy photobleaching and loss from the matrix. Herein, we design and synthesize a new organic–inorganic hybrid POM–pyrene compound [N(C4H9)4]2[V6O13{(OCH2)3CNH–CH2–C16H9}2] (1), which is employed as a negatively-charged fluorescent material to prepare a new class of fluorescent microspheres by a layer-by-layer electrostatic self-assembly method. As a result, such POM–pyrene-decorated fluorescent microspheres possess obvious luminescence properties, superior photo-stability and long-term stability. Therefore, the POM–pyrene-decorated fluorescent microspheres are conjugated by monoclonal anti-LM antibodies, and introduced into the fluorescence microsphere-based suspension immunoassay system for the detection of LM in food, which exhibits a high sensitivity. The lowest limit of detection (LOD) of LM in artificially contaminated meat is down to 6 CFU g−1 without cross-reactivity with other pathogens. Furthermore, the suspension immunoassay based on PS@POM–pyrene microspheres shows excellent specificity to LM, good repeatability and high efficiency in contrast to the conventional culture-based method.

It is challenging to achieve high implant accuracy in dental implant placement, because high risk tissues need to be avoided. In this study, we present an augmented reality (AR) surgical navigation with an accurate cone beam computed tomography (CBCT)-patient registration method to provide clinically desired dental implant accuracy. A registration device is used for registration between preoperative data and patient outside the patient's mouth. After registration, the registration device is worn on the patient's teeth for tracking the patient. Naked-eye 3D images of the planning path and the mandibular nerve are superimposed onto the patient in situ to form an AR scene. Simultaneously, a 3D image of the drill is overlaid accurately on the real one to guide the implant procedure. Finally, implant accuracy is evaluated postoperatively. A model experiment was performed by an experienced dentist. Totally, ten parallel pins were inserted into five 3D-printed mandible models guided by our AR navigation method and through the dentist's experience, respectively. AR-guided dental implant placement showed better results than the dentist's experience (mean target error = 1.25 mm vs. 1.63 mm; mean angle error = 4.03° vs. 6.10°). Experimental results indicate that the proposed method is expected to be applied in the clinic. Graphical abstract ᅟ.

Escherichia coli O157: H7 (E. coli O157: H7) has become one of the most dangerous foodborne pathogenic bacteria around the world. Currently, because of the tedious, high-cost and stringent laboratory conditions required, the conventional E. coli O157: H7 detection methods, such as culture-based methods and polymerase chain reaction (PCR), have much limitation. Thus, we developed a novel paper-based enzyme-linked immunosorbent assay (p-ELISA) with shorter operation duration, lower cost, relatively higher sensitivity and wider application. This method required less than 3 h and 5 μL of sample to complete the detection. The limit of detection (LOD) for E. coli O157: H7 reached 1 × 104 CFU/mL with high specificity. To be more suitable for on-site testing, the readout could be rapidly obtained without any expensive instruments. In this study, we chose E. coli O157:H7 as the representative, and our method could provide a platform for determination of other pathogenic bacteria.

To evaluate the efficacy and safety of hybrid revascularization by carotid endarterectomy and endovascular intervention in the treatment of chronic internal carotid artery occlusion (ICAO).We performed a retrospective analysis of patients who received hybrid treatment for symptomatic chronic ICAO between December 2016 and December 2018. Fifty-six patients with long-segment ICAO were enrolled and divided into the short duration (1-3 months) and long ICAO duration (3 months) groups, and their clinical and angiographic data were analyzed.The mean duration was 106.8 ± 36.1 days from the date of ICAO diagnosis to revascularization. Totally, 10 patients (17.8%, n = 56) in the short duration group while no patients in the long duration group failed recanalization (n = 7). Perioperative complications included intraoperative thromboembolism in 1 (1.8%) patient and subarachnoid hemorrhage in 2 (3.6%) patients. Early phase postoperative hypertension was noted in 11 (19.6%) patients and cervical hemorrhage in 1 (1.8%) patient. No severe neurological deficits occurred. Overall, the 6-month modified Rankin score, Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores in patients with successful recanalization significantly improved versus the baseline (P 0.05). After successful recanalization, the long duration group demonstrated more stents for revascularization compared with the short duration group (P 0.05). Five (10.8%) patients had recurrent transient ischemic attack, and 1 (2.2%) patient developed stroke in the successful revascularization group during 6 months of follow-up. ICA restenosis occurred in 5 (8.9%) patients and re-occlusion was noted in 1 (1.8%) patient.Hybrid operation may be feasible and effective for patients with symptomatic chronic complete ICAO according to our limited data. The original occlusion site from the carotid bifurcation and the duration of ICAO should be considered as independent indicators for successful recanalization as well as perioperative outcomes.

PURPOSE This research aimed to propose a three-dimensional (3D) augmented reality navigation method with point cloud-based image-patient registration that could merge virtual images in the real environment for dental implants using a 3D image overlay and to evaluate its feasibility. MATERIALS AND METHODS A total of 12 rapid prototyping mandibular models were fabricated using a 3D printing method and were divided into two groups: 3D augmented reality-guided group and traditional two-dimensional (2D) image-guided group. A point cloud-based preoperative image-to-patient registration method was introduced to replace the traditional point-to-point registration. After the registration, dental implant surgery was performed in the two model groups using an augmented reality-guided navigation method and a traditional two-dimensional image-guided navigation method. The planned and actual postoperative implant positions were compared for measuring positional implantation errors. The surgery time was also recorded and compared between the two groups. RESULTS In the model experiment, the root-mean-square deviation of registration was 0.54 mm, and the implant surgery results showed < 1.5-mm mean linear deviation and < 5.5-degree angular deviation. The augmented reality-guided implantation showed smaller horizontal, vertical, and angular errors in the apical areas of the central incisor and the canine region. The surgery time using the augmented reality-guided navigation method was significantly shorter than that using the two-dimensional (2D) image-guided navigation method (P < .05). Moreover, the volunteer experiment demonstrated that the preoperative 3D models in situ accurately overlaid onto the surgical site. CONCLUSION The proposed point cloud-based registration method can achieve excellent registration accuracy. Dental implant placement guided by the proposed 3D augmented reality navigation method showed better accuracy and applicability, as well as higher efficiency, than the traditional 2D image navigation method.

Background and Purpose— Early diagnosis of cerebral venous thrombosis (CVT) is currently a major clinical challenge. We proposed a novel magnetic resonance black-blood thrombus imaging technique (MRBTI) for detection and quantification of CVT. Methods— MRBTI was performed on 23 patients with proven CVT and 24 patients with negative CVT confirmed by conventional imaging techniques. Patients were divided into 2 groups based on the duration of clinical onset: ≤7 days (group 1) and between 7 and 30 days (group 2). Signal/noise ratio was calculated for the detected thrombus, and contrast/noise ratio was measured between thrombus and lumen and also between thrombus and brain tissue. The feasibility of using MRBTI for thrombus volume measurement was explored, and total thrombus volume was calculated for each patient. Results— In 23 patients with proven CVT, MRBTI correctly identified 113 of 116 segments with a sensitivity of 97.4%. Thrombus signal/noise ratio was 153±57 and 261±95 for group 1 (n=10) and group 2 (n=13), respectively ( P P Conclusions— The current findings support that with effectively suppressed blood signal, MRBTI allows selective visualization of thrombus as opposed to indirect detection of venous flow perturbation and can be used as a promising first-line diagnostic imaging tool.

Objective We report a rare case of atherosclerotic-moyamoya syndrome (A-MMS) in an adult female with genetic variant of both ring finger 213 (RNF213) p.R4810K and p.T1727M. Case report A 46-year-old previously healthy, right-handed woman displayed transient slurred speech, which started to worsen four years ago. Initial magnetic resonance angiography (MRA) revealed stenosis in left middle cerebral artery (MCA), bilateral anterior cerebral artery (ACA), and left posterior cerebral artery (PCA). The patient subsequently underwent catheter angiography, which confirmed the formation of moyamoya vessels, with Suzuki's angiographic staging of grade-3 on the left side. Although the patient had been on both anti-platelet and statin therapy at the time, a follow-up examination showed further exacerbation of left MCA stenosis, along with enhanced moyamoya vessel formation. On black-blood imaging using DANTE-SPACE, there were eccentric, evolving lesions in the left MCA. We next screened for potential genetic variants, using genomic DNA samples isolated from both the patient and her immediate family members. The results showed that the patient, along with her mother, sister, and brother, possessed the heterozygous variant of the RNF213 gene, including c.14429G > A (p.R4810K) and c.5180C > T (p.T1727M). The patient's daughter did not have the variant. Conclusion Collectively, we present a unique case of A-MMS with genetic variant of RNF213 p.R4810K and p.T1727M, manifesting as progression. Based on the family tree, these two mutations are on the same RNF213 haplotype. Whether atherosclerosis is the cause of A-MMS or it further exacerbates the injury of MMD to the A-MMS patients with RNF213 gene variant is a question to be investigated.

Background Cs2K4Na [SiW9Nb3O40] (POM93) is a novel broad-spectrum antiviral agent with high activity, high stability, and low toxicity in vitro. Most toxicity studies for POM93 have been performed in cultured cell lines rather than in animals. Like other POMs, there is a lack of evidence for in vivo toxicity limits, oral bioavailability, and therapeutic applications. Methods The toxic properties of POM93 were evaluated comprehensively in vivo, including the acute and subchronic oral toxicity studies and genotoxicity tests. Results The acute toxicity study showed no abnormal changes or mortality in rats treated with POM93 even at the single high dose of 5000 mg/kg body weight. In the subchronic toxicity study, regardless of the body weight, the organ weight, and the hematological parameters, similar results were observed between the control group and the experimental groups. POM93 produced mild changes in rare hematological parameters in the liver and kidneys, but did not induce the clinical symptoms of liver or kidneys injury in rats as confirmed by histopathological analysis. Moreover, neither mutagenicity nor clastogenicity was caused by POM93 treatment in vitro and in vivo. Conclusions The present study demonstrates that the oral administration of POM93 is presumed safe and poses a low risk of potential health risks. Electronic supplementary material The online version of this article (doi:10.1186/s40360-017-0133-x) contains supplementary material, which is available to authorized users.

Recent studies have examined the impact of phosphodiesterase type 5 inhibitors (PDE5-Is) use on the risk of prostate cancer, and biochemical recurrence (BCR) in prostate cancer patients, but the results were inconsistent. A meta-analysis was conducted to assess the associations with all published studies. Databases (PubMed, Web of Science and MEDLINE) were retrieved to identify relevant studies which explored the impact of PDE5-Is use on the risk of prostate cancer, and BCR in prostate cancer patients. The summary results along with 95% confidence intervals (CIs) were calculated. Nine articles were eligible for the inclusion criteria. The pooled analysis showed that PDE5-Is use was not related to the increased risk of prostate cancer (odds ratio (OR), 0.71; 95% CI, 0.40-1.29). Moreover, PDE5-Is use was not linked to BCR risk in prostate cancer patients with erectile dysfunction (ED) following radical prostatectomy or radiation therapy (relative risk (RR), 1.09; 95% CI, 0.89-1.34). The heterogeneity test suggested moderate heterogeneity across studies. PDE5-Is use does not influence the risk of prostate cancer, and BCR in prostate cancer patients. More well-designed studies are warranted to confirm the findings of our analyses.

Background In epidemic regions of the world, brucellosis is a reemerging zoonosis with minimal mortality but is a serious public hygiene problem. Currently, there are various methods for brucellosis diagnosis, however few of them are available to be used to diagnose, especially for serious cross-reaction with other bacteria. Method To overcome this disadvantage, we explored a novel multi-epitope recombinant protein as human brucellosis diagnostic antigen. We established an indirect enzyme-linked immunosorbent assay (ELISA) based on this recombinant protein. 248 sera obtained from three different groups including patients with brucellosis (146 samples), non-brucellosis patients (82 samples), and healthy individuals (20 samples) were tested by indirect ELISA. To evaluate the assay, a receiver-operating characteristic (ROC) analysis and immunoblotting were carried out using these characterized serum samples. Results For this test, the area under the ROC curve was 0.9409 (95 % confidence interval, 0.9108 to 0.9709), and a sensitivity of 88.89 % and a specificity of 85.54 % was given with a cutoff value of 0.3865 from this ROC analysis. The Western blot results indicate that it is feasible to differentiate human brucellosis and non-brucellosis with the newly established method based on this recombinant protein. Conclusion Our results obtained high diagnostic accuracy of the ELISA assay which encourage the use of this novel recombinant protein as diagnostic antigen to implement serological diagnosis of brucellosis. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1552-9) contains supplementary material, which is available to authorized users.

Polyoxometalates are non-nucleoside analogs that have been proven to exhibit broad-spectrum antiviral activity. In particular, Cs2K4Na[SiW9Nb3O40].H2O 1 shows low toxicity and high activity against HBV. The preclinical pharmacokinetics of Compound 1 in rats were characterized by establishing and applying inductively coupled plasma-mass spectrometry method to determine the concentration of W in plasma, urine, feces, bile and organ samples. The quantitative ICP-MS method demonstrated good sensitivity and application in the pharmacokinetics study of polyoxometalates. The pharmacokinetic behavior of Compound 1 after intravenous or oral administration fit a two-compartment model. Tmax ranges from 0.1 h to 3 h and the T1/2 of Compound 1 is between 20 h and 30 h. The absolute bioavailability of Compound 1 at 45, 180 and 720 mg/kg groups were 23.68%, 14.67% and 11.93%, respectively. The rates of plasma protein binding of Compound 1 at 9, 18 and 36 mg/ml of Compound 1 are 62.13±9.41%, 71.20±24.98% and 49.00±25.59%, respectively. Compound 1 was widely distributed throughout the body, and high levels of compound 1 were found in the kidney and liver. The level of Compound 1 in excretion was lower: 30% for urine, 0.28% for feces and 0.42% for bile, respectively. For elaborate pharmacokinetic characteristics to be fully understood, the metabolism of Compound 1 needs to be studied further.

Di-(2-ethylhexyl) phthalate (DEHP), an environmental endocrine disruptor, is widely present in the environment and some products with phthalate plasticizer. It has become a serious problem in recent years. The effect of DEHP on female reproductive system is still not well-studied. This study was to investigate the effects of DEHP on hypothalamus-pituitary-ovarian axis in adult female rats. Compared with control rats, the DEHP-treated rats showed: (1) lower body weight; (2) lower organ coefficient of ovary; (3) higher GnRH level in the hypothalamus; (4) higher mRNA and protein levels of GnRHR in the pituitary; and (5) lower serum sex hormone levels. Our data reveal that DEHP exposure may lead to the disruption of estrogen biosynthesis pathways in female rats and imbalance of hypothalamus-pituitary-ovarian axis. DEHP may impose negative influence on the development and function of the reproductive system in female rats.

Background Cerebral venous thrombosis (CVT) is a disorder potentially leading to devastating disability and even death if not timely diagnosed and treated. While TOF MR venography is most commonly used for diagnosis, the accuracy can be compromised by the flow voids caused by a slow or complex flow pattern and in-plane flow saturation. Several other MR techniques, relying on characteristic image contrast of CVT, may also underor over-estimate the thrombus due to the signals from venous flow and other structures. High-spatial resolution dark-blood CMR could address the above issues, but, to our knowledge, has not been attempted. In this work, a fast dark-blood CMR technique was developed and validated in CVT patients.