简介：AbstractBackground:Intravenous thrombolysis (IVT) is an effective way for treating acute ischemic stroke (AIS). However, its effects have not been established among AIS patients with unclear stroke symptoms or with stroke onset for >4.5 h.Methods:We searched PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials and Google Scholar databases for randomized controlled trials that compared IVT (IVT group) and placebo or usual care (control group [CG]) in AIS patients with disease onset for >4.5 h. The outcomes of interest included the favorable functional outcome (defined as modified Rankin Scale [mRS] scores 0-1) at 90 days, the functional independence (defined as mRS scores 0-2) at 90 days, proportion of patients with symptomatic intracerebral hemorrhage (sICH) and death at 90 days. We assessed the risk of bias using the Cochrane tool. Pre-specified subgroup analyses were performed by age (≤70 years or >70 years), National Institute of Health Stroke Scale (NIHSS, ≤10 or >10) and time window (4.5-9.0 h or >9.0 h).Results:Four trials involving 848 patients were eligible. The risk of bias of included trials was low. Patients in the IVT group were more likely to achieve favorable functional outcomes (45.8% vs. 36.7%; OR 1.48, 95% CI 1.12-1.96) and functional independence (63.8% vs. 55.7%; OR 1.43, 95% CI 1.08-1.90) at 90 days, but had higher risk of sICH (3.0% vs. 0.5%; OR 5.28, 95% CI 1.35-20.68) at 90 days than those in the CG. No significant difference in death at 90 days was found between the two groups (7.0% vs. 4.1%; OR 1.80; 95% CI 0.97-3.34).Conclusions:Use of IVT in patients with extended time window may improve their functional outcomes at 90 days, although IVT may induce increased risk of sICH. Care of these patients should well balance the potential benefits and harms of IVT.

简介：Anewwaveletvarianceanalysismethodbasedonwindowfunctionisproposedtoinvestigatethedynamicalfeaturesofelectroencephalogram(EEG).TheexprienmentalresultsshowthatthewaveletenergyofepilepticEEGsaremorediscretethannormalEEGs,andthevariationofwaveletvarianceisdifferentbetweenepilepticandnormalEEGswiththeincreaseoftime-windowwidth.Furthermore,itisfoundthatthewaveletsubbandentropy(WSE)oftheepilepticEEGsarelowerthanthenormalEEGs.

简介：白羊座（3月21日-4月20日）本月白羊的工作情绪基本稳定，就算遇到挫折也能重拾信心，不过工作激情有所减退,也许是爱情太甜蜜，让你有点心不在焉。整理好情绪，尽量避免感情用事，找回工作的最佳状态。

简介：AbstractTumor biomarkers play important roles in tumor growth, invasion, and metastasis. Imaging of specific biomarkers will help to understand different biological activities, thereby achieving precise medicine for each head and neck squamous cell carcinoma (HNSCC) patient. Here, we describe various molecular targets and molecular imaging modalities for HNSCC imaging. An extensive search was undertaken in the PubMed database with the keywords including "HNSCC," "molecular imaging," "biomarker," and "multimodal imaging." Imaging targets in HNSCC consist of the epidermal growth factor receptor, cluster of differentiation 44 variant 6 (CD44v6), and mesenchymal-epithelial transition factor and integrins. Targeted molecular imaging modalities in HNSCC include optical imaging, ultrasound, magnetic resonance imaging, positron emission tomography, and single-photon emission computed tomography. Making the most of each single imaging method, targeted multimodal imaging has a great potential in the accurate diagnosis and therapy of HNSCC. By visualizing tumor biomarkers at cellular and molecular levels in vivo, targeted molecular imaging can be used to identify specific genetic and metabolic aberrations, thereby accelerating personalized treatment development for HNSCC patients.

简介：AbstractObjective:To determine anatomic relationships and variation of the round window membrane to bony surgical landmarks on computed tomography.Study design:Retrospective imaging review.Methods:100 temporal bone images were evaluated. Direct measurements were obtained for membrane position. Vector distances and angulation from umbo and bony annulus were calculated from image viewer software coordinates.Results:The angle of round window membrane at junction with cochlear basal turn was (42.1 ± 8.6)°. The membrane’s position relative to plane of the facial nerve through facial recess was (14.7 ± 5.2)° posterior from a reference line drawn through facial recess to carotid canal. Regarding transtympanic drug delivery, the round window membrane was directed 4.1 mm superiorly from the inferior annulus and 5.4 mm anteriorly from the posterior annulus. The round window membrane on average was angled superiorly from the inferior annulus (77.1 ± 27.9)° and slightly anteriorly from the posterior annulus (19.1 ± 11.1°). The mean distance of round window membrane from umbo was 4 mm and posteriorly rotated 30° clockwise from a perpendicular drawn from umbo to inferior annulus towards posterior annulus. Together, these measurements approximate the round window membrane in the tympanic membrane’s posteroinferior quadrant.Conclusions:These radiologic measurements demonstrate normal variations seen in round window anatomy relative to facial recess approach and bony tympanic annulus, providing a baseline to assess round window insertion for cochlear implantation and outlines anatomic factors affecting transtympanic drug delivery.

简介：AbstractBackground:As COVID-19 makes its way around the globe, each nation must decide when and how to respond. Yet many knowledge gaps persist, and many countries lack the capacity to develop complex models to assess risk and response. This paper aimed to meet this need by developing a model that uses case reporting data as input and provides a four-tiered risk assessment output.Methods:We used publicly available, country/territory level case reporting data to determine median seeding number, mean seeding time (ST), and several measures of mean doubling time (DT) for COVID-19. We then structured our model as a coordinate plane with ST on the x-axis, DT on the y-axis, and mean ST and mean DT dividing the plane into four quadrants, each assigned a risk level. Sensitivity analysis was performed and countries/territories early in their outbreaks were assessed for risk.Results:Our main finding was that among 45 countries/territories evaluated, 87% were at high risk for their outbreaks entering a rapid growth phase epidemic. We furthermore found that the model was sensitive to changes in DT, and that these changes were consistent with what is officially known of cases reported and control strategies implemented in those countries.Conclusions:Our main finding is that the ST/DT Model can be used to produce meaningful assessments of the risk of escalation in country/territory-level COVID-19 epidemics using only case reporting data. Our model can help support timely, decisive action at the national level as leaders and other decision makers face of the serious public health threat that is COVID-19.

简介：Weinvestigatedthepharmacokineticsofcaroverineintheperilymph,cerebrospinalfluidandplasmaaftersystemicandlocaladministrationsinguineapigsbyusinghigh-performanceliquidchromatography.Auditorybrainstemresponsesweremeasuredtoevaluateauditoryfunctionaleffect.Theresultsshowedthatlocalapplicationwasabothsafeandefficientmethod.Wefurtherreviewedliteratureandpinpointedthattheroundwindowiseffectivelylocaldrugdeliverymeansforfutureinnereartreatment.

简介：Livercelltransplantationpresentsclinicalbenefitinpatientswithinbornerrorsofmetabolismasanalternative,oratleastasabridge,toorthotopiclivertransplantation.Thesuccessofsuchatherapeuticapproachremainslimitedbythequalityofthetransplantedcells.Cryopreservationremainsthebestoptionforlong-termstorageofhepatocytes,providingapermanentandsufficientcellsupply.However,isolatedadulthepatocytesarepoorlyresistanttosuchaprocess,withasignificantalterationboth...

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简介：Azathioprine当前是在煽动性的肠疾病的维护治疗的关键药。然而，仍然有要决定的一些实际问题：一个人是我们多长必须维持这药。给疾病是标明日期长期的、非可医好的条件的那煽动性的肠，治疗应该是不定的，仅仅功效的损失或严肃的副作用的外观可以引起退却。关于到功效和他们的维护随着时间的过去，证据从长远的观点看支持这药的连续实用性：事实上，它的退却很实质地增加恶化的风险。关于副作用，azathioprine是一很好相对容忍了药和甚至不定的使用似乎安全。延长使用的主要理论风险将是癌症的骨髓中毒性，hepatotoxicity，和发展。事实上，严肃的骨髓抑制或严肃的肝损坏是不平常的，并且能与这药的合适的使用被最小化。最近的遇见的分析建议淋巴瘤的风险是真实的，但是单个风险是相当低的，并且决定分析从长远的观点看建议有利利益/风险比率。在有azathioprine谁有效、很好容忍的煽动性的肠疾病的病人，因此，这药不应该被停止。这个建议作为单个维护药使azathioprine的使用担心，并且对收到伴随物生物制品疗法的病人未必适用。

简介：Objective:Toreportascalatympanidrill-outtechniqueformanagingmalformedfacialnervecoveringtheentireovalwindow(OW).Methods:DatafromthreecaseswithOWatresia,malformedstapesandabnormalfacialnervecourseswerereported,inwhichascalatympanidrill-outtechniquewasemployedwithaTORPbetweenthetympanicmembraneandscalatympanifenestrationforhearingreconstruction.Results:Airconductionhearingimprovedintwoofthethreecasesfollowingsurgery.Inthethirdcase,therewasnoimprovementinairconductionhearingfollowingacanalwallupmastoidectomyandtympanoplasty.Therewerenovertigo,tinnitusorsensorineuralhearinglossinthethreecases.Conclusion:Thescalatympanidrill-outtechnique,whichisbasicallyfenestrationattheinitialpartofthebasalturn,providesachoiceinhearingreconstructionwhentheOWiscompletelycoveredbyabarrentlycoursedfacialnerve.

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简介：AbstractImportance:There is a high incidence of iron deficiency in children worldwide. Notably, however, while iron deficiency is the most common cause of anemia, little is known about the prevalence and different types of iron deficiency in neuroblastoma patients.Objective:The aim of the present study was to investigate the prevalence of iron deficiency in patients newly diagnosed with neuroblastoma.Methods:A total of 195 newly diagnosed neuroblastoma patients from November 2015 to January 2018 were analyzed retrospectively. The survival analysis was estimated by the Kaplan-Meier method.Results:Of the 195 neuroblastoma patients included in the study, 121 (62.1%) had iron deficiency, 55 (28.2%) had absolute iron deficiency, and 66 (33.9%) had functional iron deficiency. Being aged ≥ 18 months, tumor originating in the abdomen, International Neuroblastoma Risk Group Staging System M, high-risk neuroblastoma, lactate dehydrogenase ≥ 1500 U/L, neuron-specific enolase ≥ 100 U/L, unfavorable histologic category, MYCN amplification, chromosome 1p loss, and bone marrow metastasis were associated with significantly higher rates of functional iron deficiency (P < 0.05).Interpretation:Functional iron deficiency at the time of initial neuroblastoma diagnosis predicted lower event-free survival. Long-term effects of iron supplementation in neuroblastoma patients with different types of iron deficiency need to be further studied.

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