Artifact removal in the context of group ICA: A comparison of single‐subject and group approaches

Independent component analysis (ICA) has been widely applied to identify intrinsic brain networks from fMRI data. Group ICA computes group‐level components from all data and subsequently estimates individual‐level components to recapture intersubject variability. However, the best approach to handle artifacts, which may vary widely among subjects, is not yet clear. In this work, we study and compare two ICA approaches for artifacts removal. One approach, recommended in recent work by the Human Connectome Project, first performs ICA on individual subject data to remove artifacts, and then applies a group ICA on the cleaned data from all subjects. We refer to this approach as Individual ICA based artifacts Removal Plus Group ICA (IRPG). A second proposed approach, called Group Information Guided ICA (GIG‐ICA), performs ICA on group data, then removes the group‐level artifact components, and finally performs subject‐specific ICAs using the group‐level non‐artifact components as spatial references. We used simulations to evaluate the two approaches with respect to the effects of data quality, data quantity, variable number of sources among subjects, and spatially unique artifacts. Resting‐state test–retest datasets were also employed to investigate the reliability of functional networks. Results from simulations demonstrate GIG‐ICA has greater performance compared with IRPG, even in the case when single‐subject artifacts removal is perfect and when individual subjects have spatially unique artifacts. Experiments using test–retest data suggest that GIG‐ICA provides more reliable functional networks. Based on high estimation accuracy, ease of implementation, and high reliability of functional networks, we find GIG‐ICA to be a promising approach. Hum Brain Mapp 37:1005–1025, 2016. © 2015 Wiley Periodicals, Inc .     

Plasma metabolic profiling analysis of Cortex Periplocae-induced cardiotoxicity based on UPLC/Q-TOF-MS

Cortex Periplocae is a well-known form of traditional medicine with its unique cardiotonic action, anti-tumor activity and immune regulation effect. However, improper use of Cortex Periplocae often leads to cardiac toxicity, which in the most severe cases can even be life-threatening. Biochemical tests and histopathological examinations are primary methods for clinical trials. However, such approaches are time-consuming, lack specificity and have low sensitivity, which can easily lead to negative results in studies. Therefore, a more scientific and systematic evaluation of Cortex Periplocae cardiotoxicity is particularly important. In this study, we established a method that combines metabonomics with trend analysis of a gavage concentration series to find cardiac toxicity biomarkers of Cortex Periplocae. We created rat cardiotoxicity models, in which the toxicity was caused by Cortex Periplocae. We collected data from rat plasma samples based on metabonomics using ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry (UPLC/Q-TOF-MS). Multiple statistical analyses, such as principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA), were used to examine metabolite profile changes in plasma samples to screen potential cardiotoxicity biomarkers and metabolic pathways. Compared with the control group, after 7 days administration, the pathological sections showed cardiac toxicity. Moreover, some metabolites in the body changed significantly. Receiver operating characteristic curve (ROC) analysis showed that there are 11 metabolites related with cardiac toxicity, which play a role in “phenylalanine, tyrosine and tryptophan biosynthesis”; “phenylalanine metabolism”; “valine, leucine and isoleucine biosynthesis”; “glycerophospholipid metabolism” as well as “pantothenate and CoA biosynthesis”. These metabolites can better explain the cardiotoxicity mechanism of Cortex Periplocae and provide a scientific and systematic method to evaluate the cardiotoxicity of Cortex Periplocae.

The experimental design flow for screening the cardiotoxicity biomarkers induced by Cortex Periplocae.     

Leflunomide-associated pancytopenia with or without methotrexate

OBJECTIVE: To report 18 cases of pancytopenia associated with leflunomide use in Australia, 5 of which were treated at Princess Alexandra Hospital, Brisbane. case summaries: Leflunomide was used in the treatment of rheumatoid arthritis in 17 of 18 patients; the other patient was diagnosed with systemic lupus erythematosus. Median age was 65.5 years (range 18-79), and 15 of the patients were female. Fourteen patients were on combined treatment with methotrexate. Pancytopenia was typically severe, requiring hospital admission, withdrawal of the immunosuppressant(s), intensive supportive therapy, and treatment of neutropenic sepsis. Five patients died, 4 of whom were receiving concomitant methotrexate. Time to onset of pancytopenia ranged from 11 days to 4 years (median 4 mo). In one case in which the patient had been stable while receiving leflunomide, methotrexate, and hydroxychloroquine for 4 years, fatal pancytopenia was triggered by acute renal failure secondary to dehydration and use of nonsteroidal antiinflammatory drugs. The Naranjo probability scale suggested a probable causal association in 5 cases and possible association in the remainder. DISCUSSION: Leflunomide, indicated for treatment of active rheumatoid arthritis, inhibits pyrimidine synthesis in lymphocytes and other rapidly dividing cells and may rarely be associated with life-threatening pancytopenia. Combination therapy with methotrexate may increase the risk. Time to onset is variable, and clinicians should remain vigilant, particularly when there is a change in the patient's baseline health status. CONCLUSIONS: The risk of pancytopenia during leflunomide therapy appears to be increased when the drug is combined with methotrexate and in older patients. Onset may be delayed, and ongoing monitoring of blood counts is essential.     

肺放线菌病支气管镜下表现特征及分型

目的探讨肺放线菌病的临床特点、支气管镜下表现特征及分型,以提高对该病的认识和诊疗水平。方法回顾性分析该中心经病理确诊为肺放线菌病的65例患者的临床病史、影像特征、支气管镜下表现和治疗方法等。结果该病常见主诉为咯血和咳嗽,影像学表现缺乏特异性;支气管镜下可表现为乳白色脓液、坏死、新生物、异物或结石钙化侵蚀感染、非特异性充血、水肿等,通过支气管镜或其他形式的病理活检可确诊。结论肺放线菌病极易被误诊,支气管镜下可表现为隐匿表现型、化脓坏死型、腔内肿物型、机化侵蚀型和混合表现型。积极抗生素治疗或手术治疗后治愈率较高。     

Analysis of plasma trough level of imatinib in Chinese CML patients

OBJECTIVE: To evaluate the relationship between plasma trough level of imatinib and clinical outcomes in Chinese CML patients. Methods Plasma trough levels in 416 CML patients who received imatinib orally in six general hospitals were assessed. The correlations of imatinib plasma trough level with baseline characteristics including age, weight and BSA, and clinical response were evaluated. RESULTS: (1) Effects of age, body weight and BSA on imatinib plasma trough levels were not to be clinically significant. (2) Median imatinib plasma trough levels was 1271 (109-4329). Imatinib plasma trough level was related to dose of imatinib administration. Plasma trough levels at imatinib of dose < 400, 400 and > 400 mg were (969 ± 585), (1341 ± 595) and (1740 ± 748) μg/L (P < 0.01), respectively. (3) There was no statistic difference in imatinib plasma trough level with complete cytogenetic response [CCyR (1337 ± 571) μg/L vs no CCyR (1354 ± 689) μg/L, P = 0.255]. (4) Imatinib plasma trough level might be important for a good clinical response in some CML patients. Conclusion There was a large interpatient variability in imatinib plasma concentration in Chinese CML patients. No correlation of imatinib plasma trough level with CCyR was observed. However, higher doses of imatinib were shown to attain greater trough plasma concentration, suggesting that imatinib plasma trough level might be important for a good clinical response in some CML patients.     

Risk factors for post-endoscopic retrograde cholangiopancreatography cholangitis in patients with hepatic alveolar echinococcosis—an observational study

BackgroundHepatic alveolar echinococcosis (HAE) is considered to be one of the most deadly chronic parasitic diseases in the world. We have shown that the incidence of cholangitis in patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) was increased significantly. On this finding, we carried out, a preliminary study on the risk factors for cholangitis after ERCP.AimsTo retrospectively detect the risk factors for post-ERCP cholangitis in patients with biliary tract affected by HAE.MethodsThe study included data from 51 cases of AE who had undergone therapeutic ERCP between January 2015 and December 2019. Demographic and treatment data were extracted from the medical records, and the association between potential risk factors and the development of post-ERCP cholangitis was evaluated using a collected database.ResultsThere were five cases of mild cholangitis after ERCP (Tokyo criteria), and no moderate or severe cholangitis occurred. The incidence rate of cholangitis after ERCP was 9.8%. Univariate analysis showed hilar bile duct stenosis (p = .016), endoscopic retrograde biliary drainage (p = .007), a stent diameter ≥8.5 Fr (p = .000) and single stent implantation (p = .010) were risk factors for post -ERCP cholangitis. All cases of cholangitis improved under conservative treatment.ConclusionPatients with hilar bile duct compression or endoscopic retrograde biliary drainage appeared to be more likely to develop post-ERCP cholangitis. The number and diameter of biliary stents may influence post-ERCP cholangitis. Sample size and clinical heterogeneity are two insurmountable difficulties, and a larger sample size needs to be collected to verify the risk factors for screening.

KEY MESSAGES

• Many studies reported the post-ERCP complications in patients with hepatic alveolar echinococcosis and found that the incidence of post-ERCP cholangitis was significantly high. Therefore, we conducted a preliminary study on the risk factors of postoperative cholangitis in patients who underwent ERCP.
• The incidence rate of cholangitis after ERCP was 9.8%. We found that hilar bile duct stenosis, and endoscopic retrograde biliary drainage, were risk factors for cholangitis, and stent diameter and the number of stent implantation may influence the incidence rate of cholangitis after ERCP.
• Sample size and clinical heterogeneity are two insurmountable difficulties, and a larger sample size needs to be collected to verify the risk factors of screening.

     

结节大小对超声引导下甲状腺结节细针穿刺活检诊断结果有效率影响的对比研究

目的：应用超声引导下对超声诊断结果TI-RADS分级4级以上的不同大小的甲状腺结节行细针穿刺活检（ultrasound-guided fine needle aspiration biopsy,US-FNAB）,探讨结节尺寸大小对细针穿刺活检诊断效率的影响,旨在为如何准确选择甲状腺可疑恶性结节穿刺活检方式提供一定的指导价值。方法：选取2017年1月至2018年12月在我单位经手术病理证实的甲状腺患者332例（共342个结节）,根据结节的最大超声测量径线将结节分为5组（A组：≤5 mm; B组：5.1mm-10.0mm;C组：10.1mm-15.0mm;D组：15.1mm-20.0mm;E组：>20.0mm）,US-FNAB结果与最终手术病理结果进行对比分析。结果：手术病理结果中,254个结节为恶性,88个结节为良性。在A、B、C、D、E五组中,US-FNAB诊断的敏感性分别是61.9%、76.6%、89.8%、72.4%、62.7%(p=0.010 ),特异性分别是87.5%、 88.9%、78.9%、100.0%、91.2%(p=0.052),准确性分别是69.0%、78.6%、87.2%、78.9%、74.1%(p=0.443),阳性预测率分别是92.9%、97.3%、92.9%、100.0%、91.3%%( p=0.721),阴性预测率分别是 46.7%、42.1%、71.4%、52.9%、62.0%(p= 0.120), 恶性率分别是81.6%、 83.9%、75.6%、76.3%、60.0%（p=0.005）。结论：按结节大小所进行的分组中,US-FNAB对各组的诊断的敏感性差异具有统计学意义,C组（10.1mm-15.0mm）甲状腺结节敏感性较其他各组高,A组（≤5 mm）和E组（>20.0mm）甲状腺结节敏感性较其他各组低。但特异性、阳性预测值及准确性各组间差异不具统计学意义。因此,通过此研究,我们建议对≤5 mm的小结节应行隔期重复US-FNAB,对>20.0mm的结节可行直接行粗针穿刺,对10.1mm-15.0mm的结节首选US-FNAB。     

黄连对糖尿病肾病大鼠肾脏NF-κB及PPAR-γ表达的影响

目的:观察黄连对糖尿病肾病大鼠肾脏病理、肾小球NF-κB及PPAR-γmRNA的影响。方法:采用高脂饮食结合腹腔注射链脲佐菌素方法建立糖尿病SD大鼠模型,随机分为模型组、厄贝沙坦组[31.25 mg/(kg·d)]、黄连低、中、高剂量组[相当于人黄连饮片用量的83 mg/(kg·d)、500 mg/(kg·d)、1000 mg/(kg·d)],每组8只,另取8只正常大鼠作为对照,给药12周后,检测各组大鼠肾小球NF-κB及PPAR-γmRNA表达水平及肾脏病理变化。结果:黄连各剂量组可显著降低大鼠肾脏NF-κB表达(P0.05),黄连高剂量组及厄贝沙坦组可显著增强大鼠肾脏PPAR-γmRNA表达(P0.05),各用药组均有一定改善大鼠肾脏病变的作用。结论:黄连具有降低糖尿病肾病大鼠肾脏NF-κB表达及增强PPAR-γmRNA表达的作用,可缓解肾脏病变。     

银杏黄酮苷与复方丹参片对冠心病心绞痛患者心电图、心功能、血液流变学的影响对比分析

目的:对比分析银杏黄酮苷与复方丹参片对冠心病心绞痛患者心电图、心功能、血液流变学的影响。方法:对我院在2015年1月至2016年12月期间新疆医科大学第六附属医院收治的冠心病心绞痛患者88例的临床治疗进行回顾性分析。采用随机抽样的方式将患者分成观察组与对照组,每组44例。对照组患者予以复方丹参片治疗,观察组患者予以银杏黄酮苷治疗,2组患者共治疗1个月,观察2组患者治疗前后心电图、心功能、血液流变学改善情况以及有无发生不良反应情况。结果:治疗后观察组患者一般症状改善总有效率、心绞痛疗效、心电图疗效均高于对照组,差异有统计学意义(P0.05);治疗前2组患者心功能各指标比较差异无统计学意义(P0.05),治疗后心功能各指标均有改善情况,但观察组患者改善情况明显优于对照组,差异有统计学意义(P0.05);治疗前2组患者全血低切黏度、全血高切黏度、血浆高切黏度、红细胞压积、红细胞聚集指数比较差异无统计学意义(P0.05),治疗后2组患者全血低切黏度、全血高切黏度、血浆高切黏度、红细胞压积、红细胞聚集指数值均有改善,但观察组患者改善程度明显大于对照组,差异有统计学意义(P0.05);2组患者治疗期间未发生明显不适情况。结论:银杏黄酮苷治疗冠心病心绞痛的临床疗效明显优于复方丹参片,并且安全性高,更适合临床应用。