RNA sequencing steps toward the first line

• DNA is the sequence that codes for proteins.
• Messenger RNA is transcribed from the DNA sequence of genes and translated into protein.
• It can be difficult to predict how a change in the DNA sequence will affect messenger RNA and protein quantity and quality.
• DNA translocation changes can cause the joining of sequences from two different genes or different parts of the same gene.
• DNA sequencing is often used clinically to predict how DNA changes might affect proteins.
• Alternatively, RNA sequencing can be used as a more direct measure of the effect of DNA changes on the protein products.
• This sequencing is important for identifying changes in cancer that may indicate response to targeted therapy, prognosis, or diagnosis.

     

1例富血小板血浆治疗外阴Paget′s病术后创面感染的护理体会

总结1例外阴Paget’s病术后创面感染的护理体会,利用伤口评估三角工具对患者创面进行评估,通过使用液体伤口敷料联合银离子敷料控制感染,富血小板血浆技术促进伤口愈合,个体化健康教育提高患者治疗依从性的整体干预方案对伤口进行有效管理,结果显示伤口愈合效果良好。     

全方位护理干预对ERCP围术期患儿及家属应激及心理状况的影响

目的探讨全方位护理干预对ERCP围术期患儿及家属应激及心理状况的影响。方法选取2018年1月10日至2019年10月10日行ERCP患儿100例,采用抽签法分为观察组及对照组各50例,分别对两组实施全方位护理及常规护理干预,观察ERCP围术期患儿应激情况和并发症发生率,对患儿家属进行焦虑和抑郁评分。结果观察组患儿轻度应激30例(60.00%)、中度应激20例(40.00%),应激程度低于对照组患儿(P<0.05);观察组患儿并发症发生率为4.00%,低于对照组患儿(P<0.05);观察组患儿家属的焦虑评分14.01±0.11、抑郁评分15.23±1.48,低于对照组患儿家属(P<0.05)。结论全方位护理干预能有效减少ERCP围术期患儿应激,降低并发症发生率,改善患儿家属负面情绪,从而促进患儿早期康复。     

Photodynamic therapy during second surgery for recurrent gliomas improves survival

BackgroundGlioma accounts for most central nervous system tumors, and the degree of invasion and malignancy are higher in the recurrent glioma. Photodynamic therapy (PDT) is an effective strategy in glioma. This study aimed to explore the risk factors for re-recurrence after a second glioma surgery and the effects of PDT on re-recurrence.MethodsThis was a retrospective study in the Second Affiliated Hospital of Harbin Medical University in China, and 43 patients that received the secondary surgery for recurrent glioma were included. The Kaplan-Meier test and Cox proportional hazard method were used to analyze.ResultsThe total re-recurrence rate after the second surgery for recurrent glioma was 48.84%. When the age increased by 1, the risk of re-recurrence increased 1.065 times (95% CI 1.000–1.134, P = 0.049). High matrix metalloproteinase (MMP) 2 expression was associated with a significantly higher risk of re-recurrence than low MMP2 expression (HR = 25.550, 95% CI 3.190–204.650, P = 0.002). Pathological grades IV and III were associated with a significantly higher risk of re-recurrence than pathological grade II (HR = 17.121, 95% CI 2.345–124.986, P = 0.005; HR = 2863.470, 95% CI 100.697–81,427.197, P < 0.001). PDT decreased the risk of re-recurrence (HR = 25.550, 95% CI 3.190–204.650, P = 0.002) and increased survival time (HR = 3.611, 95% CI 1.012–12.888, P = 0.048).ConclusionThe age, MMP2 expression, and pathological grade are independent risk factors for re-recurrence after a second surgery for recurrent glioma. PDT during the second surgery decreased the risk of re-recurrence and increased survival time.     

An MRI sequence independent convolutional neural network for synthetic head CT generation in proton therapy

A magnetic resonance imaging (MRI) sequence independent deep learning technique was developed and validated to generate synthetic computed tomography (sCT) scans for MR guided proton therapy. 47 meningioma patients previously undergoing proton therapy based on pencil beam scanning were divided into training (33), validation (6), and test (8) cohorts. T₁, T₂, and contrast enhanced T₁ (T1CM) MRI sequences were used in combination with the planning CT (pCT) data to train a 3D U-Net architecture with ResNet-Blocks. A hyperparameter search was performed including two loss functions, two group sizes of normalisation, and depth of the network. Training outcome was compared between models trained for each individual MRI sequence and for all sequences combined. The performance was evaluated based on a metric and dosimetric analysis as well as spot difference maps. Furthermore, the influence of immobilisation masks that are not visible on MRIs was investigated. Based on the hyperparameter search, the final model was trained with fixed features per group for the group normalisation, six down-convolution steps, an input size of 128 × 192 × 192, and feature loss. For the test dataset for body/bone the mean absolute error (MAE) values were on average 79.8/216.3 Houndsfield unit (HU) when trained using T1 images, 71.1/186.1 HU for T2, and 82.9/236.4 HU for T1CM. The structural similarity metric (SSIM) ranged from 0.95 to 0.98 for all sequences. The investigated dose parameters of the target structures agreed within 1% between original proton treatment plans and plans recalculated on sCTs. The spot difference maps had peaks at ±0.2 cm and for 98% of all spots the difference was less than 1 cm. A novel MRI sequence independent sCT generator was developed, which suggests that the training phase of neural networks can be disengaged from specific MRI acquisition protocols. In contrast to previous studies, the patient cohort consisted exclusively of actual proton therapy patients (i.e. “real-world data”).     

Cuantificación y tratamiento de la congestión en insuficiencia cardíaca: una visión clínica y fisiopatológica

Renal sodium and water retention with resulting extracellular volume expansion and redistribution are hallmark features of heart failure syndromes. However, congestion assessment, monitoring, and treatment represent a real challenge in daily clinical practice. This document reviewed historical and contemporary evidence of available methods for determining volume status and discuss pharmacological aspects and pathophysiological principles that underlie diuretic use.