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Objective To analyze the clinical characteristics of anti - neuronal antibody positive paraneoplastic neurological syndrome related to immune checkpoint inhibitors (ICI - PNS). Methods and Results A total of 5 patients with anti - neuronal antibody positive ICI - PNS in Peking Union Medical College Hospital from January 2012 to March 2024 were included. Tumor types included small cell lung cancer (2 cases), malignant melanoma (one case), Hodgkin lymphoma (one case) and cervical cancer (one case). Immune checkpoint inhibitors (ICIs) included programmed death 1 (PD - 1) inhibitors (3 cases), programmed cell death ligand 1 (PD-L1) inhibitors (one case) and bispecific PD-1/cytotoxic T lymphocyte- associated antigen 4 (CTLA -4) inhibitors (one case). All 5 patients presented with high -risk neurologic phenotypes of paraneoplastic neurological syndrome (PNS), of which 4 presented with limbic encephalitis and one presented with rapidly progressive cerebellar syndrome. Anti - neuronal antibodies detected in serum and/or cerebrospinal fluid of patients included anti - Hu, γ - aminobutyric acid receptor type B (GABABR), sex-determining region of Y chromosome-related high mobility group box 1 (SOX1), metabotropic glutamate receptor 5 (mGluR5) and Yo antibodies. Neurological syndromes occurred within 2 weeks after receiving ICIs in 4 patients. The modified Rankin Score (mRS) of 4 patients was 3 at peak of illness, and one patient was 5 at peak of illness. The Common Terminology Criteria for Adverse Events (CTCAE) was grade 3 in all 5 patients. After withdrawal of ICIs and treatment with glucocorticoids and intravenous immunoglobulin (IVIg), the neurological symptoms of the patients were improved. Conclusions High/ intermediate - risk anti - neuronal antibodies are diagnostic markers of ICI - PNS. Evaluation of ICI - PNS clinical phenotypes and CTCAE grading are important for immunotherapy. Discontinuation of ICIs, administration of glucocorticoids and IVIg can improve the prognosis of patients.

Background Central nervous system aspergillosis is clinically rare. We present one case of central nervous system aspergillosis diagnosed by pathology, analyze its clinical features, review the literature，and summarize key diagnostic and therapeutic points. Methods and Results The patient, a 50- year-old woman, presented clinically with progressive weakness in limbs, epileptic seizures, and cognitive decline. Systemic inflammation - immune markers and cerebrospinal fluid (CSF) analysis showed no significant abnormalities. Head MRI revealed abnormal signals in both frontal and parietal lobes with patchy and ring-enhancing lesions and meningeal enhancement. Neuropathology suggested vasculitis and brain tissue necrosis with hemorrhage. Periodic acid methenamine staining revealed fungal hyphae with apparent septation and branching at 45° angles. The final diagnosis was central nervous system aspergillosis. Following antifungal and other symptomatic treatments, the patient's symptoms improved, and follow-up brain MRI showed reduction in lesion size. Conclusions Patients with central nervous system aspergillosis may not have a clear underlying immunodeficiency, and clinical manifestations are lack of specificity. CSF may show no inflammatory changes, and metagenomic next-generation sequencing (mNGS) may be negative. Brain biopsy is the primary diagnostic method. Early, adequate and full-course antifungal treatment with voriconazole can improve the prognosis.

Objective To investigate the effects of low-esmketamine combined with dexmedetomidine on intra-venous analgesia, sedation in elderly patients undergoing percutaneous vertebroplasty (PVP). Methods A total of seventy-two elderly patients aged 70-90 years old who underwent PVP in Beijing Chuiyangliu hospital between March to November 2021 were enrolled in this study. Patients were assigned randomly by a random number table method into controll group (SF-DEX, n=36) and test group (ES-DEX, n=36) for the seddative analgesia anesthesia. All patients were accepted a 0.5 μg/kg dexmedetomidine by pump into venous within 10 min, the other 5 μg sufentanil was gived venously and then 0.5 μg/(kg·h) dexmedetomidine by pump in SF-DEX. 0.1 mg/kg esketamine was gived venously and then 0.1 mg/(kg·h) by pump in EK-DEX. The changes of circulatory indexes systolis arterial pressure(SAP),diastolis arterial pressure(DAP),mean arterial pressure(MAP),heart rate(HR), saturated oxygen (SpO2), BIS indexes, pain intensity (VAS), Ramsay score for sedation level, blood pressure variation, arrhythmia and decrease range of SpO2, were measured respectively at four time points before administration (T1), at time of operation start (T2), filling bone cement (T3), at the end of operation (T4) between two groups. Results SAP,MAP was significantly lower at T3 than that at T1 (P＜0.05) in SF-DEX; the Ramsay score was increased at T2 and T3 (P＜0.05).The VAS score in EK-DEX group was significantly lower than that in SF-DEX group at T2 and T3 (P＜0.05); the Ramsay score in EK-DEX group was significantly increased than that in SF-DEX group at T3 (P＜0.05). The incidences and hemodynamic adverse effects such as hypotension, bradycardia and desaturation, were not significantly different between the groups. Conclusions Low-dose esketamine combined with low-dose dexmedetomidine for anesthesia produces satisfactory analgesic and sedation effect in elderly patients with PVP without obvious complications. It is a safe and feasible method.

In this study,by measuring the white light interference images,scanning electron microscope pictures and whiteness,transmittance,fine whiteness,L value,a value and b value of japonica rice with different bran degrees,the changed of japonica rice appearance and characteristics were studied.Studies showned that the grain cortex on both sides of the rice grain is ground first,and the abdomen and back of the rice grain are difficult to grind; the surface roughness increases first and then decreases with the bron degree;Aleurone layer and endosperm cell structure,as the decreases of bran degrees,are milled layer by layer; the whiteness,permeability,fine whiteness and L value of the sample are gradually increased,and the a value and b value are gradually reduced.

Actinomycetes are important producers of novel bioactive compounds. New sources need to be explored for isolating previously unknown bioactive compound-producing actinomycetes. Here we evaluated the potential of bark as a natural source of novel bioactive actinomycete species. Bark samples were collected from nine tree species at different elevations (1600-3400 ma.s.l.) on Qin Mountain, Shaanxi Province, China. Actinomycetes were cultivated, enumerated and isolated using serial dilution and spread-plate techniques. The antimicrobial activity of actinomycete isolates was analyzed using an agar block method against 15 typical bacterial and fungal species and plant pathogens. The dominant isolates were identified by 16S rRNA-based sequence analysis. Results showed that actinomycete counts in bark samples of Quercus liaotungensis Koidz. was the highest among all trees species tested. The numbers of actinomycete species in bark samples were highest in Q. aliena var. acutiserrata and Spiraea alpina Pall. Antagonistic activity wasdetected in approximately 54% of the actinomycete isolates. Of these, 20 isolates (25%) showed broad-spectrum antagonistic activity against ≥5 of the microorganisms tested. In conclusion, the bark on coniferous and broadleaf trees possesses a high diversity of actinomycetes and serves as a natural source of bioactive compound-producing actinomycetes.

Determination of trace elements in minerals usually requires pre-concentration and separation with many spectral line interferences during measurement. The concentrate ores were calcined at high temperature to remove the C and S. The calcinates were then digested by using the HCl-auqa regia-HF acids system. The D290 anion exchange resin and activated charcoal procedures were conducted to enrich Pt and Pd. The contents of Pt and pd were obtained by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) with internal standard elements of Y, In and Bi and measured isotopes of 105Pd and 195Pt. The absorption property and separation conditions of D290 anion exchange resin to trace Pt and Pd in copper concentrate ores were studied. The enrichment effects of Pt and Pd were above 90%, the recoveries were 92.0% and 96.0%, and the relative standard deviations (RSD, n=6) were smaller than 4%. The detection limits of the method were 0.126 ng/g and 0.105 ng/g for Pt and Pd. The presented method mostly reduced the inferences from other ions to the target elements of Pt and Pd. Moreover, the collision reaction between the internal standard elements and high purity Ar effectively reduced the matrix effect and isobaric interference. Five random geological samples were analyzed by this method in comparison with the method of NiS fire assay ICP-MS and the established method had the advantages of simple pretreatment and high enrichment of Pt and Pd with lower detection limits.