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Objective To report the diagnosis and treatment of a patient with meningeal metastases from lung adenocarcinoma, and explore the significance of cerebrospinal fluid (CSF) gene detection for clinical treatment and the efficacy and safety of double⁃dose icotinib in the treatment of meningeal metastases from lung adenocarcinoma with EGFR gene sensitive mutation. Methods and Results A 56⁃year⁃old female patient with meningeal metastasis from lung adenocarcinoma was examined for CSF and blood double⁃sample genes. The CSF had an exon 19 deletion mutation in the EGFR gene, and no sensitive mutations were found in blood sample. Oral icotinib hydrochloride 250 mg/time (3 times/d), and chest CT and head MRI enhanced scans were re⁃examined every 8 weeks, suggesting that the lung tumor was significantly reduced, and the degree of jumbo meningeal enhancement was lessened than before. Right lateral ventricle⁃peritoneal shunt was performed to effectively reduce intracranila pressure (ICP) and relieve clinical symptoms. Up to September 21, 2019, patient had been taking double doses of icotinib for 589 d, and her condition was stable. The main adverse drug reaction is rash. She is still taking medication and is being followed up. Conclusions For patients with meningeal metastases from lung adenocarcinoma, CSF gene detection of EGFR gene sensitive mutation can guide clinical development of treatment strategies. Double⁃dose icotinib is effective in treating meningeal metastases from lung adenocarcinoma with EGFR gene sensitive mutation, and is well tolerated and safe.

In location-based services of continuous query, it is easier than snapshot to confirm whether a location belongs to a particular user, because sole location can be composed into a trajectory by profile correlation. In order to cut off the correlation and disturb the sub-trajectory, an un-detective region called mix-zone was proposed. However, at the time of this writing, the existing algorithms of this type mainly focus on the profiles of ID, passing time, transition probability, mobility patterns as well as road characteristics. In addition, there is still no standard way of coping with attacks of correlating each location by mining out query content and time interval from the sub-trajectory. To cope with such types of attack, users have to generalize their query contents and time intervals similarity. Hence, this paper first provided an attack model to simulate the adversary correlating the real location with a higher probability of query content and time interval similarity. Then a user collaboration mix-zone (CoMix) that can generalize these two types of profiles is proposed, so as to achieve location privacy. In CoMix, each user shares the common profile set to lowering the probability of success opponents to get the actual position through the correlation of location. Thirdly, entropy is utilized to measure the level of privacy preservation. At last, this paper further verifies the effectiveness and efficiency of the proposed algorithm by experimental evaluations.

Background: Plating of the posterior malleolus (PM) is a common procedure for treatment of PM fracture but its osteology was seldom mentioned. In this study, we evaluated the anatomy of the PM in relation to the choice of plate. Method: A total of 122 adult patients with normal distal tibia computed tomography films were recruited. The width available for PM plating, total width of the PM, the inclination angle of the groove for the posterior tibial tendon, and the proportions of the width available for plating with reference to the total width were obtained. Results: Presence of the groove was found in 98.4% of the patients (n=120). The mean width available for plating was 20.4 mm for male patients and 18.4 mm for female patients (p

Three cyst-forming Sarcocystis species have been identified in horsemeat; however, there exists considerable confusion concerning their relationships. Here, 74% (34/46) of the examined tissue samples from horses contained sarcocysts based on examination by light microscopy (LM), and the organism was identified as Sarcocystis bertrami based on cyst structure. The S. bertrami cysts were microscopic (up to 6750 μm in length) and exhibited a striated wall with 2.0–5.1 μm villar protrusions (vps) under LM. Transmission electron microscopy (TEM) observations showed that the vps were tightly packed, similar to “type 11c”. Four genetic markers (18S, 28S, ITS1 and the mitochondrial cox1 gene) of S. bertrami were sequenced and analyzed. The 28S and ITS1 sequences are the first records for Sarcocystis in horses. The newly obtained sequences of the 18S and cox1 genes both shared the highest similarities with those of S. bertrami and S. fayeri obtained from horses. Phylogenetic analysis based on the 18S, 28S and cox1 sequences revealed that S. bertrami and S. fayeri formed an independent clade within a group comprising Sarcocystis spp. from ruminants and pigs. Therefore, S. bertrami and S. fayeri are considered to represent the same species of Sarcocystis in horses, and S. fayeri is a junior synonym of Sarcocystis bertrami.

Background: The medicinal herb, Pinellia ternate, is purported to be an anti-emetic with analgesic and sedative effects. Alkaloids are the main biologically active compounds in P. ternata, especially ephedrine that is a phenylpropylamino alkaloid specifically produced by Ephedra and Catha edulis. However, how ephedrine is synthesized in plants is uncertain. Only the phenylalanine ammonia lyase (PAL) and relevant genes in this pathway have been characterized. Genomic information of P. ternata is also unavailable. Results: We analyzed the transcriptome of the tuber of P. ternata with the Illumina HiSeqTM 2000 sequencing platform. 66,813,052 high-quality reads were generated, and these reads were assembled de novo into 89,068 unigenes. Most known genes involved in benzoic acid biosynthesis were identified in the unigene dataset of P. ternate, and the expression patterns of some ephedrine biosynthesis-related genes were analyzed by reverse transcription quantitative real-time PCR (RT-qPCR). Also, 14,468 simple sequence repeats (SSRs) were identified from 12,000 unigenes. Twenty primer pairs for SSRs were randomly selected for the validation of their amplification effect. Conclusion: RNA-seq data was firstly used to provide a comprehensive gene information on P. ternata at the transcriptional level. These data will advance molecular genetics in this valuable medicinal plant.

The usefulness of virtual reality (VR) technology in physiology education is largely unexplored. Although VR has the potential to enrich learning experience by enhancing the spatial awareness of students, it is unclear whether VR contributes to active learning of physiology. In the present study, we used a mixed-method research approach to investigate students' perceptions of physiology learning based on VR simulations. Quantitative and qualitative data indicate that the implementation of VR learning environments improves the quality of physiology education by promoting active learning in terms of interactive engagement, interest, problem-solving skills, and feedback. In the Technology-Enabled Active Learning Inventory, which consisted of 20 questions to which students responded along a 7-point Likert scale, the majority of students agreed that VR learning of physiology not only stimulated their curiosity (77%; P < 0.001) but also allowed them to obtain knowledge through diverse formats (76%; P < 0.001), participate in thought-provoking dialogue (72%; P < 0.001), and interact better with peers (72%; P < 0.001). Positive responses in the social, cognitive, behavioral, and evaluative domains of active learning were received from students across different disciplines, including medicine, Chinese medicine, biomedical sciences, and biomedical engineering. Their written feedback showed that VR enhanced their interest in physiology and facilitated the visualization of physiological processes to improve their learning. Overall, this study supports that the integration of VR technology into physiology courses can be an effective teaching strategy.