Publications by authors named "Di Jin"

165 Publications

Explainable deep learning in healthcare: A methodological survey from an attribution view.

WIREs Mech Dis 2022 Jan 17:e1548. Epub 2022 Jan 17.

Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.

The increasing availability of large collections of electronic health record (EHR) data and unprecedented technical advances in deep learning (DL) have sparked a surge of research interest in developing DL based clinical decision support systems for diagnosis, prognosis, and treatment. Despite the recognition of the value of deep learning in healthcare, impediments to further adoption in real healthcare settings remain due to the black-box nature of DL. Therefore, there is an emerging need for interpretable DL, which allows end users to evaluate the model decision making to know whether to accept or reject predictions and recommendations before an action is taken. In this review, we focus on the interpretability of the DL models in healthcare. We start by introducing the methods for interpretability in depth and comprehensively as a methodological reference for future researchers or clinical practitioners in this field. Besides the methods' details, we also include a discussion of advantages and disadvantages of these methods and which scenarios each of them is suitable for, so that interested readers can know how to compare and choose among them for use. Moreover, we discuss how these methods, originally developed for solving general-domain problems, have been adapted and applied to healthcare problems and how they can help physicians better understand these data-driven technologies. Overall, we hope this survey can help researchers and practitioners in both artificial intelligence and clinical fields understand what methods we have for enhancing the interpretability of their DL models and choose the optimal one accordingly. This article is categorized under: Cancer > Computational Models.
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http://dx.doi.org/10.1002/wsbm.1548DOI Listing
January 2022

Ginseng in vascular dysfunction: A review of therapeutic potentials and molecular mechanisms.

Phytother Res 2022 Jan 13. Epub 2022 Jan 13.

Jilin Ginseng Academy, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efficacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China.

Vascular dysfunction can lead to a variety of fatal diseases, including cardiovascular and cerebrovascular diseases, metabolic syndrome, and cancer. Although a large number of studies have reported the therapeutic effects of natural compounds on vascular-related diseases, ginseng is still the focus of research. Ginseng and its active substances have bioactive effects against different diseases with vascular dysfunction. In this review, we summarized the key molecular mechanisms and signaling pathways of ginseng, its different active ingredients or formula in the prevention and treatment of vascular-related diseases, including cardiac-cerebral vascular diseases, hypertension, diabetes complications, and cancer. Moreover, the bidirectional roles of ginseng in promoting or inhibiting angiogenesis have been highlighted. We systematically teased out the relationship between ginseng and vascular dysfunction, which could provide a basis for the clinical application of ginseng in the future.
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http://dx.doi.org/10.1002/ptr.7369DOI Listing
January 2022

Direct measurement of the viscoelectric effect in water.

Proc Natl Acad Sci U S A 2022 Jan;119(1)

Department of Molecular Chemistry and Materials Science, Weizmann Institute of Science, Rehovot 76100, Israel;

The viscoelectric effect concerns the increase in viscosity of a polar liquid in an electric field due to its interaction with the dipolar molecules and was first determined for polar organic liquids more than 80 y ago. For the case of water, however, the most common polar liquid, direct measurement of the viscoelectric effect is challenging and has not to date been carried out, despite its importance in a wide range of electrokinetic and flow effects. In consequence, estimates of its magnitude for water vary by more than three orders of magnitude. Here, we measure the viscoelectric effect in water directly using a surface force balance by measuring the dynamic approach of two molecularly smooth surfaces with a controlled, uniform electric field between them across highly purified water. As the water is squeezed out of the gap between the approaching surfaces, viscous damping dominates the approach dynamics; this is modulated by the viscoelectric effect under the uniform transverse electric field across the water, enabling its magnitude to be directly determined as a function of the field. We measured a value for this magnitude, which differs by one and by two orders of magnitude, respectively, from its highest and lowest previously estimated values.
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http://dx.doi.org/10.1073/pnas.2113690119DOI Listing
January 2022

Predicting Cancer-Specific Survival Among Patients With Prostate Cancer After Radical Prostatectomy Based on the Competing Risk Model: Population-Based Study.

Front Surg 2021 26;8:770169. Epub 2021 Nov 26.

Department of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, Institute of Urology, West China Hospital of Sichuan University, Chengdu, China.

We aimed to develop an easy-to-use individual survival prognostication tool based on competing risk analyses to predict the risk of 5-year cancer-specific death after radical prostatectomy for patients with prostate cancer (PCa). We obtained the data from the Surveillance, Epidemiology, and End Results (SEER) database (2004-2016). The main variables obtained included age at diagnosis, marital status, race, pathological extension, regional lymphonode status, prostate specific antigen level, pathological Gleason Score. In order to reveal the independent prognostic factors. The cumulative incidence function was used as the univariable competing risk analyses and The Fine and Gray's proportional subdistribution hazard approach was used as the multivariable competing risk analyses. With these factors, a nomogram and risk stratification based on the nomogram was established. Concordance index (C-index) and calibration curves were used for validation. A total of 95,812 patients were included and divided into training cohort ( = 67,072) and validation cohort ( = 28,740). Seven independent prognostic factors including age, race, marital status, pathological extension, regional lymphonode status, PSA level, and pathological GS were used to construct the nomogram. In the training cohort, the C-index was 0.828 (%95CI, 0.812-0.844), and the C-index was 0.838 (%95CI, 0.813-0.863) in the validation cohort. The results of the cumulative incidence function showed that the discrimination of risk stratification based on nomogram is better than that of the risk stratification system based on D'Amico risk stratification. We successfully developed the first competing risk nomogram to predict the risk of cancer-specific death after surgery for patients with PCa. It has the potential to help clinicians improve post-operative management of patients.
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http://dx.doi.org/10.3389/fsurg.2021.770169DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8660757PMC
November 2021

A Novel Immune-Gene Pair Signature Revealing the Tumor Microenvironment Features and Immunotherapy Prognosis of Muscle-Invasive Bladder Cancer.

Front Genet 2021 26;12:764184. Epub 2021 Nov 26.

Department of Urology, West China Hospital, Sichuan University, Chengdu, China.

Immunotherapy has been a milestone for muscle-invasive bladder cancer (MIBC), but only a small portion of patients can benefit from it. Therefore, it is crucial to develop a robust individualized immune-related signature of MIBC to identify patients potentially benefiting from immunotherapy. The current study identified patients from the Cancer Genome Atlas (TCGA) and immune genes from the ImmPort database, and used improved data analytical methods to build up a 45 immune-related gene pair signature, which could classify patients into high-risk and low-risk groups. The signature was then independently validated by a Gene Expression Omnibus (GEO) dataset and IMvigor210 data. The subsequent analysis confirmed the worse survival outcomes of the high-risk group in both training ( < 0.001) and validation cohorts ( = 0.018). A signature-based risk score was proven to be an independent risk factor of overall survival ( < 0.001) and could predict superior clinical net benefit compared to other clinical factors. The CIBERSORT algorithm revealed the low-risk group had increased CD8 T cells plus memory-activated CD4 T-cell infiltration. The low-risk group also had higher expression of PDCD1 (PD-1), CD40, and CD27, and lower expression of CD276 (B7-H3) and PDCD1LG2 (PD-L2). Importantly, IMvigor210 data indicated that the low-risk group had higher percentage of "inflamed" phenotype plus less "desert" phenotype, and the survival outcomes were significantly better for low-risk patients after immunotherapy ( = 0.014). In conclusion, we proposed a novel and promising prognostic immune-related gene pair (IRGP) signature of MIBC, which could provide us a panoramic view of the tumor immune microenvironment of MIBC and independently identify MIBC patients who might benefit from immunotherapy.
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http://dx.doi.org/10.3389/fgene.2021.764184DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8664435PMC
November 2021

The Association between Evidence-Based Healthcare Practices and Outcomes among Preterm Births in China.

Neonatology 2021 Dec 9:1-7. Epub 2021 Dec 9.

Department of Neonatology, The First Hospital of Jilin University, Changchun, China.

Introduction: Very preterm infants are at high risk of early death or severe brain injury, with potential for impaired long-term neurodevelopmental function and physical health. There are evidence-based healthcare practices that can reduce the incidence.

Materials And Methods: Infants born at 24-316 weeks gestational age and admitted within 24 h to NICUs participating in the Chinese Neonatal Network in 2019 were included. We examined the association between 4 evidence-based practices: inborn (born in a tertiary hospital in the Chinese Neonatal Network), ACS (any antenatal corticosteroid), MgSO4 (prenatal magnesium sulfate), and NT (normothermic temperature [36.0-37.5°C] at admission) and early death and/or severe brain injury in the study population.

Results: Of 6,035 eligible infants, the incidence of early death and/or severe brain injury was 10.6%. Exposure to ACS only was associated with significant lower incidence of death and/or severe brain injury than none (aOR, 0.71; 95% CI: 0.57-0.88), but not MgSO4 only (aOR, 0.97; 95% CI: 0.81-1.17), NT only (aOR, 0.91; 95% CI: 0.76-1.08), or inborn only (aOR, 0.91; 95% CI: 0.72-1.15). The association between number of practices and incidence of early death and/or severe brain injury is as follows: none = 23% (31/138), any 1 = 14% (84/592), any 2 = 12% (185/1,538), any 3 = 9% (202/2,285), and all 4 = 9% (140/1,482).

Discussion/conclusion: More comprehensive use of evidence-based practices was associated with improved survival without severe brain injury among very preterm infants born at <32 weeks gestational age.
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http://dx.doi.org/10.1159/000519846DOI Listing
December 2021

Continuous-Variable Quantum Key Distribution Based on Heralded Hybrid Linear Amplifier with a Local Local Oscillator.

Entropy (Basel) 2021 Oct 24;23(11). Epub 2021 Oct 24.

School of Automation, Central South University, Changsha 410083, China.

An improved continuous variable quantum key distribution (CVQKD) approach based on a heralded hybrid linear amplifier (HLA) is proposed in this study, which includes an ideal deterministic linear amplifier and a probabilistic noiseless linear amplifier. The CVQKD, which is based on an amplifier, enhances the signal-to-noise ratio and provides for fine control between high gain and strong noise reduction. We focus on the impact of two types of optical amplifiers on system performance: phase sensitive amplifiers (PSA) and phase insensitive amplifiers (PIA). The results indicate that employing amplifiers, local local oscillation-based CVQKD systems can enhance key rates and communication distances. In addition, the PIA-based CVQKD system has a broader application than the PSA-based system.
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http://dx.doi.org/10.3390/e23111395DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8618900PMC
October 2021

Systematic review and meta-analysis based on the composition of risk factors of chronic atrophic gastritis under gastroscopy detection.

Ann Palliat Med 2021 Sep;10(9):9742-9751

Gastroenterology Department, Wuhan Hospital of Integrated Traditional Chinese and Western Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Background: This meta-analysis explored the diagnostic value of gastroscopy in the diagnosis of patients with chronic atrophic gastritis (CAG).

Methods: The Chinese and English medical databases were searched using a combination of the following search terms: "gastroscope", "chronic atrophic gastritis", "endoscope", and "diagnose". The Review Manager 5.3 software was used for meta-analysis.

Results: A total of 10 articles were included. The funnel charts showed that the circles of some articles were basically symmetrical with the midline, suggesting that there was no publication bias and the conclusions are credible. There were 6 randomized controlled trials (RCTs) analyzing clinical symptoms [Chi2 =5.33; degree of freedom (df) =5; I2=6%; P=0.38] and tested the overall heterogeneity [Z=7.94; odds ratio (OR) =9.42; 95% confidence interval (CI): 5.42 to 16.39; P<0.01]. A total of 10 articles analyzed the efficacy of gastroscopy (Tau2 =2.96; Chi2 =70.00; df =9; I2=87%; P<0.01) and tested the overall heterogeneity (Z=4.38; OR =13.44; 95% CI: 4.20 to 42.98; P<0.01). A total of 8 articles analyzed the pathological efficacy (Chi2 =11.93; df =7; I2=41%; P=0.10) and tested the overall heterogeneity (Z=10.59; OR =13.36; 95% CI: 8.27 to 21.59; P<0.01). The combined sensitivity and the specificity were 69.34% (95% CI: 0.526 to 0.784) and 96.45% (95% CI: 0.785 to 0.952), respectively. The area under the receiver operating characteristic (ROC) curve (AUC) of the combined sensitivity and combined specificity was 0.759 and 0.846, respectively.

Discussion: The results of the GRADE quality assessment revealed that although the sample size of this meta-analysis was small, the research was of sufficient medium and high quality, and the included experiments were of relatively good quality.
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http://dx.doi.org/10.21037/apm-21-2063DOI Listing
September 2021

Tumor-derived microparticles promote the progression of triple-negative breast cancer via PD-L1-associated immune suppression.

Cancer Lett 2021 12 30;523:43-56. Epub 2021 Sep 30.

State Key Laboratory of Biotherapy and Cancer Center, Sichuan University, Chengdu, 610041, China. Electronic address:

Membrane vesicles, including exosomes and microparticles (MPs), serve to package and transfer the cellular cargo during inter/extracellular communication, which is of great interest in cancer development, especially in the dissemination of signal transduction-associated traits from donor cells to recipient cells. Although increasing evidence suggests that microparticles (MPs) contribute to the development of cancer, their unique characteristics remain to be exploited. Here, we examined the secretion of MPs in tumor tissues from triple-negative breast cancer (TNBC) patients and found that the tumor cells could release MPs loaded with immune checkpoint molecular programmed cell death ligand 1 (PD-L1), especially in patients treated with traditional clinical interventions, such as chemotherapy and radiotherapy. These PD-L1-loading MPs contribute to the suppressive immune microenvironment, eventually resulting in the tumor progression in TNBC. Mechanically, we proved that PD-L1-loading MPs could suppress the activation and function of functional cluster of differentiation CD8 T cells. Meanwhile, the PD-L1-loading MPs could mediate the differentiation of macrophages toward the immune-suppressive M2 phenotype via the activation of the TANK-binding kinase 1 (TBK1)/signal transducer and activator of transcription 6 (STAT6) signal and suppression of the serine-threonine kinase (AKT)/mammalian target of rapamycin (mTOR) signal. Given the increasing MP production induced by traditional clinical interventions, we further combined chemotherapy with the PD-L1 inhibitor atezolizumab (ATZ) to efficiently abrogate the immunosuppression caused by the PD-L1-loading MPs. Therefore, our study unveils the mechanism by which tumor cells systemically evade immune surveillance by releasing the PD-L1-loading MPs, and provides new insights into clinical TNBC immunotherapy.
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http://dx.doi.org/10.1016/j.canlet.2021.09.039DOI Listing
December 2021

The comparison of survival between active surveillance or watchful waiting and focal therapy for low-risk prostate cancer: a real-world study from the SEER database.

Asian J Androl 2021 Sep 24. Epub 2021 Sep 24.

Department of Urology, Institute of Urology, West China Hospital of Sichuan University, Chengdu 610041, China.

To reduce treatment-related side effects in low-risk prostate cancer (PCa), both focal therapy and deferred treatments, including active surveillance (AS) and watchful waiting (WW), are worth considering over radical prostatectomy (RP). Therefore, this study aimed to compare long-term survival outcomes between focal therapy and AS/WW. Data were obtained and analyzed from the Surveillance, Epidemiology, and End Results (SEER) database. Patients with low-risk PCa who received focal therapy or AS/WW from 2010 to 2016 were included. Focal therapy included cryotherapy and laser ablation. Multivariate Cox proportional hazards models were used to compare overall mortality (OM) and cancer-specific mortality (CSM) between AS/WW and focal therapy, and propensity score matching (PSM) was performed to reduce the influence of bias and unmeasured confounders. A total of 19 292 patients with low-risk PCa were included in this study. In multivariate Cox proportional hazards model analysis, the risk of OM was higher in patients receiving focal therapy than those receiving AS/WW (hazard ratio [HR] = 1.35, 95% confidence interval [CI]: 1.02-1.79, P = 0.037), whereas no significant difference was found in CSM (HR = 0.98, 95% CI: 0.23-4.11, P = 0.977). After PSM, the OM and CSM of focal therapy and AS/WW showed no significant differences (HR = 1.26, 95% CI: 0.92-1.74, P = 0.149; and HR = 1.26, 95% CI: 0.24-6.51, P = 0.782, respectively). For patients with low-risk PCa, focal therapy was no match for AS/WW in decreasing OM, suggesting that AS/WW could bring more overall survival benefits.
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http://dx.doi.org/10.4103/aja202159DOI Listing
September 2021

Efficacy of Tripterygium wilfordii Hook F on animal model of Diabetic Kidney Diseases: A systematic review and meta-analysis.

J Ethnopharmacol 2021 Dec 19;281:114536. Epub 2021 Aug 19.

Endocrinology Department, First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, 130021, China. Electronic address:

Ethnopharmacological Relevance: Tripterygium wilfordii Hook F (TwHF) has been clinically applied in the treatment of Diabetic Kidney Diseases (DKD). A large number of animal experiments focused on the TwHF treatment of DKD were conducted every year, but the evidence for these preclinical studies is unclear.

Aim Of The Study: This study aims to evaluate the efficacy of TwHF on diabetic nephropathy through a stematic reviews and meta-analysis of animal models, and whether it has an effect on improving kidney pathology, renal function indicators and blood sugar levels, it also summarizes the use of TwHF for treatment the underlying mechanism of DKD.

Materials And Methods: We systematically searched studies from PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang database from inception to May 2020. Chinese studies from the list of Chinese Core Journals would be included. SYRCLE's risk of bias tool for animal studies was applied to assess the methodological quality of studies. A meta-analysis was performed by using RevMan 5.3.

Results: Out of 429 records identified in the initial search, 32 studies were selected. The results indicated that, compared with control group, TwHF treatment improved 24 h urine protein (24 h-UP) level (SMD - 4.21, 95% CI - 5.38 to - 3.04, P < 0.001), serum creatinine (Scr) (MD - 14.97, 95% CI - 20.42 to - 9.53, P < 0.001), blood urea nitrogen (BUN) (MD - 4.07, 95% CI - 5.49 to - 2.66, P < 0.001), blood glucose (Glu) (MD - 2.40, 95% CI - 4.304 to - 0.49, P = 0.01), Triglyceride (TG) (MD - 1.57, 95% CI - 2.06 to - 1.08, P < 0.001), and Cholesterol (TC) (MD - 1.49, 95% CI - 2.23 to - 0.75 P < 0.001); and increased the level of albumin (Alb) (MD 3.40, 95% CI 1.69 to 5.11, P < 0.001) and weight (MD 30.89, 95% CI 24.35 to 37.42, P < 0.001). There were no statistical difference on Alanine aminotransferase (ALT) (MD 3.00, 95% CI - 7.80 to 13.81, P = 0.59) and Aspartate aminotransferase (AST) (MD 0.77, 95% CI -15.05 to 16.60, P = 0.92) after TwHF. Meta regression analysis showed that the DKD model induced by different methods (type I/II), the dose of Tripterygium wilfordii and the intervention time were not the reasons for the heterogeneity of 24 h-UP, Alb, Glu, Scr, and BUN (p > 0.05).

Conclusions: TwHF is an effective and safe to treat DKD, which can protect the kidneys through anti-inflammation, improving oxidative stress and podocyte damage, and inhibiting mesangial cell proliferation and extracellular matrix proliferation.
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http://dx.doi.org/10.1016/j.jep.2021.114536DOI Listing
December 2021

Role Discovery-Guided Network Embedding Based on Autoencoder and Attention Mechanism.

IEEE Trans Cybern 2021 Aug 18;PP. Epub 2021 Aug 18.

Recently, network embedding (NE) is an amazing research point in complex networks and devoted to a variety of tasks. Nearly, all the methods and models of NE are based on the local, high-order, or global similarity of the networks, and few studies have focused on the role discovery or structural similarity, which is of great significance in spreading dynamics and network theory. Meanwhile, existing NE models for role discovery suffer from two limitations, that is: 1) they fail to model the varying dependencies between each node and its neighbor nodes and 2) they cannot capture the effective node features which are helpful to role discovery, which makes these methods ineffective when applied to the role discovery task. To solve the above problems of NE for role discovery or structural similarity, we propose a unified deep learning framework, called RDAA, which can effectively represent features of nodes and benefit the Role Discovery-guided NE with a deep autoencoder, while modeling the local links with an Attention mechanism. In addition, we design an elaborately binding technique to combine both parts and optimize the framework in a unified way. We conduct different experiments, including visualization, role classification, role discovery, and running time compared to popular NE methods for both proximity and structural similarity. The RDAA has better performance on all the datasets and achieves good tradeoffs.
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http://dx.doi.org/10.1109/TCYB.2021.3094893DOI Listing
August 2021

Reversine inhibits proliferation, invasion and migration and induces cell apoptosis in gastric cancer cells by downregulating TTK.

Exp Ther Med 2021 Sep 30;22(3):929. Epub 2021 Jun 30.

Department of Liver-Gallbladder and Gastric Diseases, Wuhan Hospital of Traditional Chinese Medicine, Wuhan, Hubei 430061, P.R. China.

Reversine (Rev) has been used for the treatment of a number of cancers. However, there have been no previous reports for the use of Rev for gastric cancer (GC). The aim of the present study was to investigate the effect of Rev on cell proliferation, migration, invasion and cell apoptosis in human GC cells and TTK expression. Cell Counting Kit-8 and colony formation were used to assess cell proliferation. Wound healing and Transwell assays were performed to examine cell migration and invasion, respectively. Cell apoptosis was measured using TUNEL staining and western blotting. Reverse transcription-quantitative PCR and western blotting were performed to determine TTK expression in AGS and NCI-N87 GC cells. Rev treatment inhibited the viability of the two GC cells lines in a dose-dependent manner and suppressed their capacities of clone formation, migration and invasion. Rev-treated cells exhibited reduced matrix metalloproteinase (MMP)2/9 expression and increased apoptosis compared with those in control cells. In addition, expression of the anti-apoptotic protein Bcl-2 was significantly decreased, whilst the expression levels of the pro-apoptotic factors Bax and cleaved-caspase-3/9 were increased by Rev treatment compared with that in the control group that were not treated with Rev. In addition, TTK protein expression was decreased in cells treated with Rev compared with that in untreated cells. However, overexpression of TTK significantly reversed the aforementioned effects of Rev in GC cells. These results suggest that Rev may inhibit the proliferation, invasion and migration of GC cells whilst inducing cell apoptosis by suppressing TTK expression. Therefore, Rev may confer potential properties as a therapeutic anti-cancer agent. Additionally, TTK may serve as a molecular target for the treatment of gastric cancer.
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http://dx.doi.org/10.3892/etm.2021.10361DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8281506PMC
September 2021

Mutations of predict response to neoadjuvant chemotherapy in muscle-invasive bladder cancer.

J Clin Transl Res 2021 Jun 5;7(3):386-413. Epub 2021 Jun 5.

Core Facility for Protein Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China.

Background And Aim: Neoadjuvant chemotherapy (NAC) followed by radical cystectomy is the current gold standard treatment for muscle-invasive urothelial bladder cancer (MIBC). Nonetheless, some MIBC patients showed limited pathological response after NAC. Herein, we used whole-exome sequencing (WES) to identify genetic mutations in MIBC that can predict NAC response.

Methods: Forty MIBC patients were enrolled in this study, in which 33 were successfully examined by WES and Sanger sequencing in the discovery cohort (=13) and the validation cohort (=20), respectively. ANNOVAR software was used to identify the potential mutations based on the data of WES. In addition, tumor-specific somatic mutations including single nucleotide variants and indels were called with the muTECT and Strelka software. The mutational analysis of specific genes was carried out based on the data from cBioPortal for Cancer Genomics.

Results: In the discovery cohort, the mutation frequencies of , , , , , , and were significantly higher in 13 MIBC patients. Specifically, the presence of somatic mutations of , , , , , , , , and in NAC responder signifies that these mutations were potential predictors of pathological response to NAC. Furthermore, somatic mutations of , , , , , , and were exclusively identified in NAC nonresponders, suggesting that these mutations may participate in the process of NAC resistance. In the validation cohort, the somatic mutations of , , and were significantly enriched in NAC responders while the somatic mutation of was significantly enriched in NAC nonresponders. Furthermore, survival analysis revealed that the patients expressing mutated have a longer overall survival and disease- or progression-free survival than the patients acquiring wild-type .

Conclusion: The somatic mutation of can be a potential predictive biomarker of NAC response in MIBC patients.

Relevance For Patients: MIBC patients bearing mutated display a pathological response to NAC and have a significantly longer overall survival or disease/progression-free survival as compared to the patients bearing wild-type . Thus, the somatic mutation of is a potential biomarker for predicting response to NAC in MIBC patients, assisting doctors in making the clinical decision.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8259609PMC
June 2021

Gastric emptying of preoperative drinks is slower in adults with chronic energy deficiency: A 2 hour cross-over study among Chinese.

Asia Pac J Clin Nutr 2021 Jun;30(2):206-212

Department of Nutrition, General Hospital of Southern Theater Command, PLA, Guangzhou, China. Email:

Background And Objectives: To investigate the effects of oral preoperative regimens on gastric emptying time in relation to BMI in Chinese adults.

Methods And Study Design: The enrolled 56 adults were divided into three groups (normal-weight, underweight, and overweight) and completed a regimen of two drinks after a 2-week interval. After drinking a carbohydrate regimen (CD, 50 g carbohydrates) or a carbohydrate glutamine regimen (CGD, 44 g carbohydrates and 6 g glutamine) labelled with 99mTc-DTPA (99mTc-diethylenetriaminepentaacetic acid), gastric emptying times T50 and T90 were measured using a curve derived from scintigraphic images.

Results: T50 and T90 had no significant difference between the CD and CGD regimens. T50 was significantly delayed in the underweight participants (BMI <18.5 kg/m2, as Chronic Energy Deficiency, CED) compared with the normal-weight participants after drinking CD (p=0.003) or CGD (p=0.002), as well as T90 after CD (p=0.019). There was no difference in glucose concentrations between the three groups. There are negative correlations between body weight and gastric emptying time T50 (r=-0.461, p=0.016) or T90 (r=-0.553, p=0. 003) after drinking CD, as well as T50 (r=-0.553, p=0.003) after drinking CGD.

Conclusions: Underweight adults should be careful to take oral preoperative regimens 2 hours before surgery and consider reducing the volume because of a slower gastric emptying rate.
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http://dx.doi.org/10.6133/apjcn.202106_30(2).0004DOI Listing
June 2021

Primary Central Nervous System Lymphoma Mimicking Wernicke's Encephalopathy.

Neurol India 2021 May-Jun;69(3):740-743

Department of Neurology, the 1st Medical Center of Chinese PLA General Hospital, Beijing, China.

Primary central nervous system lymphoma (PCNSL) is a rare disease that can be confused with Wernicke encephalopathy (WE). We have reported here the case of a 31-year-old malnourished man who presented with headache, fever, vomiting, diarrhea, and confusion. His imaging and laboratory findings were indicative of WE. His condition improved after treatment with a high dose of vitamin B1 and intravenous administration of methylprednisolone. However, after continuing to take vitamin B1 for 2 weeks, his symptoms and neuroimaging findings worsened. Increased standardized uptake values of positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro-D-glucose integrated with computed tomography (F-FDG-PET) and interleukin-10 (IL-10) in the cerebrospinal fluid led to the diagnosis of PCNSL. After treatment with methotrexate and calcium leucovorin, the symptoms and neuroimaging abnormalities disappeared at the 6-month follow-up examination. The possibility of PCNSL should be considered if the routine treatment for WE are ineffective. F-FDG PET and IL-10 may provide a new method for the early diagnosis of PCNSL.
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http://dx.doi.org/10.4103/0028-3886.319202DOI Listing
June 2021

Cerebellar venous thrombosis mimicking a cerebellar tumor due to polycythemia vera: a case report.

BMC Neurol 2021 Jun 16;21(1):225. Epub 2021 Jun 16.

Department of Neurology, Aerospace Center Hospital, Beijing, China.

Background: Cerebral venous thrombosis (CVT) occurs rarely in the general population and is frequently associated with confused clinical findings and delayed diagnosis. Isolated cerebellar cortical vein thrombosis is a very rare phenomenon.

Case Presentation: This report describes a case with CVT, which is manifested as space-occupying lesions of the cerebellar hemisphere and mimics a cerebellar tumor at the beginning. The diagnosis of CVT was finalized given the laboratory and brain biopsy findings. The etiology may be related to polycythemia vera with Janus Kinase 2 V617F mutation.

Conclusion: Isolated cerebellar vein thrombosis should be considered when swelling and enhancing cerebellar lesions are detected. Polycythemia vera, especially with a positive JAK2 V617F mutation, may be a rare risk factor for CVT.
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http://dx.doi.org/10.1186/s12883-021-02261-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8207742PMC
June 2021

Surface modification of manganese monoxide through chemical vapor deposition to attain high energy storage performance for aqueous zinc-ion batteries.

J Colloid Interface Sci 2021 Nov 26;601:617-625. Epub 2021 May 26.

School of Information Science and Technology, Northwest University, Xi'an 710127, PR China.

Surface modification of the manganese-based oxide electrode is considered to be a viable strategy to improve electrochemical property in aqueous zinc-ion batteries (ZIBs). However, the modification method through traditional wet-chemical technology can hardly to satisfy high rate capability for aqueous ZIBs due to unhomogeneous and nonconformal coating originates from surface energy mismatch. Herein, a surface modification strategy based on chemical vapor deposition is developed to enhance the electrochemical property of the inactive MnO in aqueous ZIBs. The constructed carbon coating modified MnO electrode shows excellent reversible capacity and superior rate capability with remarkable energy density of 351 Wh kg at 625 W kg. The energy storage mechanism of the electrode during the charge and discharge processes is elucidated according to the ex-situ measurements of X-ray diffraction and photoelectron spectroscopy, Fourier transform infrared spectra, and galvanostatic intermittent titration techniques. Moreover, soft-packaged batteries are fabricated with the carbon coating modified MnO, which shows great promises for the practical application of the material. The work paves the way for the exploitation of high performance surface-modified electrode through chemical vapor deposition for aqueous ZIBs.
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http://dx.doi.org/10.1016/j.jcis.2021.05.142DOI Listing
November 2021

Development and implementation of an LIS-based validation system for autoverification toward zero defects in the automated reporting of laboratory test results.

BMC Med Inform Decis Mak 2021 06 2;21(1):174. Epub 2021 Jun 2.

Clinical Laboratory Medicine, Guangzhou Medical University, Guangzhou, 510006, China.

Background: Validation of the autoverification function is one of the critical steps to confirm its effectiveness before use. It is crucial to verify whether the programmed algorithm follows the expected logic and produces the expected results. This process has always relied on the assessment of human-machine consistency and is mostly a manually recorded and time-consuming activity with inherent subjectivity and arbitrariness that cannot guarantee a comprehensive, timely and continuous effectiveness evaluation of the autoverification function. To overcome these inherent limitations, we independently developed and implemented a laboratory information system (LIS)-based validation system for autoverification.

Methods: We developed a correctness verification and integrity validation method (hereinafter referred to as the "new method") in the form of a human-machine dialog. The system records personnel review steps and determines whether the human-machine review results are consistent. Laboratory personnel then analyze the reasons for any inconsistency according to system prompts, add to or modify rules, reverify, and finally improve the accuracy of autoverification.

Results: The validation system was successfully established and implemented. For a dataset consisting of 833 rules for 30 assays, 782 rules (93.87%) were successfully verified in the correctness verification phase, and 51 rules were deleted due to execution errors. In the integrity validation phase, 24 projects were easily verified, while the other 6 projects still required the additional rules or changes to the rule settings. Taking the Hepatitis B virus test as an example, from the setting of 65 rules to the automated releasing of 3000 reports, the validation time was reduced from 452 (manual verification) to 275 h (new method), a reduction in validation time of 177 h. Furthermore, 94.6% (168/182) of laboratory users believed the new method greatly reduced the workload, effectively controlled the report risk and felt satisfied. Since 2019, over 3.5 million reports have been automatically reviewed and issued without a single clinical complaint.

Conclusion: To the best of our knowledge, this is the first report to realize autoverification validation as a human-machine interaction. The new method effectively controls the risks of autoverification, shortens time consumption, and improves the efficiency of laboratory verification.
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http://dx.doi.org/10.1186/s12911-021-01545-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8170738PMC
June 2021

Tumor microenvironment-based drug discovery: a novel insight into bladder cancer immunotherapy.

Chin Med J (Engl) 2021 Jun 1;134(15):1885-1886. Epub 2021 Jun 1.

Department of Urology, Institute of Urology, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, China.

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http://dx.doi.org/10.1097/CM9.0000000000001535DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8367065PMC
June 2021

Estimated assessment of dietary exposure to artificial sweeteners from processed food in Nanjing, China.

Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2021 Jul 14;38(7):1105-1117. Epub 2021 May 14.

Department of Nutrition and Food Hygiene, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China.

The objective of this study was to measure the concentrations of three intensity sweeteners (Acesulfame-K, cyclamate and saccharin) in different categories of food available on the Nanjing market, and to investigate whether the Nanjing general population was at risk for exceeding the ADI of sweeteners. A set of 1885 foods was collected and analysed using the National Food Safety Standard procedure in order to establish the concentration levels of the sweeteners. Dietary exposure was estimated using probabilistic modelling software and compared directly with each sweetener's ADI. Consumption data from the China National Nutrition and Health Survey (conducted in 2010-2013) and the actual concentrations of sweeteners in the collected food products were used to perform the intake assessment. The results indicated that Acesulfame-K and cyclamate were commonly used in processed food, and processed nuts, preserved fruit, beverages, and bakery products are the main sources of sweeteners in Nanjing. The estimated exposure of sweeteners in Nanjing was well below the ADIs, as relative intakes at the 95th percentile were 29.7% for saccharin, 79.8% for cyclamate, and 35.9% for Acesulfame-K of the respective ADIs. It was concluded that adults were not at risk of exceeding ADIs for these sweeteners, but the intake of cyclamate at the higher percentiles by children may approach or slightly exceed ADI values.
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http://dx.doi.org/10.1080/19440049.2021.1905883DOI Listing
July 2021

Validation of Digital Evaluation in Systematic Training on Tooth Preparation in Aesthetic Veneer Rehabilitation.

Chin J Dent Res 2021 Apr;24(1):55-60

Objective: To evaluate the outcome of systematic video training on tooth preparation in veneer restoration and the practicability of the application of the digital evaluation system of scan design and assessment software.

Methods: Ten residents were selected from a group enrolled on the first-year programme for the National Standard Training of Dentistry in the Department of Prosthodontics, College of Stomatology, Ninth People's Hospital Affliated with Shanghai Jiao Tong University, School of Medicine. First, each student prepared five teeth based on their knowledge and clinical experience, and then received systematic video training on veneer preparation. Before and after the training, the evaluation of the effects of training was conducted on the prepared teeth by measuring the continuity of the finishing line and tooth reduction amount automatically using the prepCheck 2.0 (Dentsply Sirona, Charlotte, NC, USA) CAD/CAM system.

Results: The results showed a significant difference in the quality of finishing line continuity pre- and post-training. Furthermore, the data for tooth reduction after training, which met standard values, improved remarkably, increasing from 32.40 ± 7.82% to 60.50 ± 5.48%.

Conclusions: Video training could significantly enhance the quality of tooth preparation for veneers. Moreover, the digital evaluation system could serve as an ideal alternative for tooth preparation evaluation for preclinical students, offering new insights for clinical education.
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http://dx.doi.org/10.3290/j.cjdr.b1105879DOI Listing
April 2021

Cardiac energy metabolism may play a fundamental role in congenital diaphragmatic hernia-associated ventricular dysfunction.

J Mol Cell Cardiol 2021 08 18;157:14-16. Epub 2021 Apr 18.

Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center and Children's Memorial Hermann Hospital, Houston, TX, United States of America. Electronic address:

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http://dx.doi.org/10.1016/j.yjmcc.2021.04.001DOI Listing
August 2021

Overexpression of circ_0021739 in Peripheral Blood Mononuclear Cells in Women with Postmenopausal Osteoporosis Is Associated with Reduced Expression of microRNA-194-5p in Osteoclasts.

Med Sci Monit 2021 Apr 20;27:e929170. Epub 2021 Apr 20.

Department of Geriatrics, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China (mainland).

BACKGROUND Postmenopausal osteoporosis, a common disease among elderly women, is linked to estrogen deficiency, mechanical loading, and genotype. Circular RNAs (circRNAs) are formed through reverse splicing of the splice donor at the 3' end and the splice accepter at the 5' end in pre-mRNA and have been shown to be involved in the development of multiple diseases. Based on their high sequence conservation and stability, circRNAs may be useful biomarkers in different diseases. However, the roles of circRNAs in postmenopausal osteoporosis remain incompletely understood. MATERIAL AND METHODS Fifty-three postmenopausal women were assigned to either the postmenopausal osteoporosis group (n=28) or the control group (n=25). Reverse-transcriptase quantitative polymerase chain reaction (RT-qPCR) analysis was performed to determine the differential expression of circRNAs between the 2 groups. Receiver-operating characteristic (ROC) curve analysis was conducted to evaluate the clinical diagnostic value of circRNA. Prediction of the binding sites between circRNA and miRNAs was conducted using miRanda and RNAhybrid. The function of the circRNA in osteoclastogenesis was determined by circRNA overexpression followed by tartrate-resistant acid phosphatase staining and RT-qPCR analysis. RESULTS Among 4 circRNAs previously identified by RNA-sequencing analysis as differentially expressed in patients with postmenopausal osteoporosis, only hsa_circ_0021739 showed a significant difference in expression between the groups and was downregulated in patients with postmenopausal osteoporosis. The hsa_circ_0021739 expression level was determined to be correlated with the lumbar vertebra, femur, and forearm T-scores. Overexpression of hsa_circ_0021739 decreased the level of hsa-miR-502-5p and inhibited the differentiation of osteoclasts. CONCLUSIONS The circRNA hsa_circ_0021739 is a potential blood biomarker for postmenopausal osteoporosis. In addition, hsa-miR-502-5p is a likely target of hsa_circ_0021739, which acts to regulate the differentiation of osteoclasts.
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http://dx.doi.org/10.12659/MSM.929170DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8067671PMC
April 2021

High spatial and temporal resolution synthetic aperture phase microscopy.

Adv Photonics 2020 Nov 26;2(6). Epub 2020 Nov 26.

The Chinese University of Hong Kong, Department of Biomedical Engineering, Hong Kong, China.

A new optical microscopy technique, termed high spatial and temporal resolution synthetic aperture phase microscopy (HISTR-SAPM), is proposed to improve the lateral resolution of wide-field coherent imaging. Under plane wave illumination, the resolution is increased by twofold to around 260 nm, while achieving millisecond-level temporal resolution. In HISTR-SAPM, digital micromirror devices are used to actively change the sample illumination beam angle at high speed with high stability. An off-axis interferometer is used to measure the sample scattered complex fields, which are then processed to reconstruct high-resolution phase images. Using HISTR-SAPM, we are able to map the height profiles of subwavelength photonic structures and resolve the period structures that have 198 nm linewidth and 132 nm gap (i.e., a full pitch of 330 nm). As the reconstruction averages out laser speckle noise while maintaining high temporal resolution, HISTR-SAPM further enables imaging and quantification of nanoscale dynamics of live cells, such as red blood cell membrane fluctuations and subcellular structure dynamics within nucleated cells. We envision that HISTR-SAPM will broadly benefit research in material science and biology.
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http://dx.doi.org/10.1117/1.ap.2.6.065002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8049284PMC
November 2020

PRMT1 is a novel molecular therapeutic target for clear cell renal cell carcinoma.

Theranostics 2021 12;11(11):5387-5403. Epub 2021 Mar 12.

Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China.

Epigenetic alterations are common events in clear cell renal cell carcinoma (ccRCC), and protein arginine methyltransferase 1 (PRMT1) is an important epigenetic regulator in cancers. However, its role in ccRCC remains unclear. We investigated PRMT1 expression level and its correlations to clinicopathological factors and prognosis in ccRCC patients based on ccRCC tissue microarrays (TMAs). Genetic knockdown and pharmacological inhibition using a novel PRMT1 inhibitor DCPT1061 were performed to investigate the functional role of PRMT1 in ccRCC proliferation. Besides, we confirmed the antitumor effect of PRMT1 inhibitor DCPT1061 in ccRCC cell-derived tumor xenograft (CDX) models as well as patient-derived tumor xenograft (PDX) models. We found PRMT1 expression was remarkably upregulated in tumor tissues and associated with poor pathologic characters and outcomes of ccRCC patients. Furthermore, genetic knockdown and pharmacological inhibition of PRMT1 by a novel potent inhibitor DCPT1061 dramatically induced G1 cell cycle arrest and suppressed ccRCC cell growth. Mechanistically, RNA sequencing and further validation identified Lipocalin2 (LCN2), a secreted glycoprotein implicated in tumorigenesis, as a crucial regulator of ccRCC growth and functional downstream effector of PRMT1. Epigenetic silencing of LCN2 autocrine secretion by PRMT1 deficiency decreased downstream p-AKT, leading to reduced p-RB and cell growth arrest through the neutrophil gelatinase associated lipocalin receptor (NGALR). Moreover, PRMT1 inhibition by DCPT1061 not only inhibited tumor growth but also sensitized ccRCC to sunitinib treatment by attenuating sunitinib-induced upregulation of LCN2-AKT-RB signaling. Taken together, our study revealed a PRMT1-dependent epigenetic mechanism in the control of ccRCC tumor growth and drug resistance, indicating PRMT1 may serve as a promising target for therapeutic intervention in ccRCC patients.
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http://dx.doi.org/10.7150/thno.42345DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8039964PMC
July 2021

GOLM1 restricts colitis and colon tumorigenesis by ensuring Notch signaling equilibrium in intestinal homeostasis.

Signal Transduct Target Ther 2021 04 14;6(1):148. Epub 2021 Apr 14.

State Key Laboratory of Medical Molecular Biology, Department of Physiology, Institute of Basic Medical Sciences and School of Basic Medicine, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

Intestinal epithelium serves as the first barrier against the infections and injuries that mediate colonic inflammation. Colorectal cancer is often accompanied with chronic inflammation. Differed from its well-known oncogenic role in many malignancies, we present here that Golgi membrane protein 1 (GOLM1, also referred to as GP73) suppresses colorectal tumorigenesis via maintenance of intestinal epithelial barrier. GOLM1 deficiency in mice conferred susceptibility to mucosal inflammation and colitis-induced epithelial damage, which consequently promoted colon cancer. Mechanistically, depletion of GOLM1 in intestinal epithelial cells (IECs) led to aberrant Notch activation that interfered with IEC differentiation, maturation, and lineage commitment in mice. Pharmacological inhibition of Notch pathway alleviated epithelial lesions and restrained pro-tumorigenic inflammation in GOLM1-deficient mice. Therefore, GOLM1 maintains IEC homeostasis and protects against colitis and colon tumorigenesis by modulating the equilibrium of Notch signaling pathway.
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http://dx.doi.org/10.1038/s41392-021-00535-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044123PMC
April 2021

GOLM1 restricts colitis and colon tumorigenesis by ensuring Notch signaling equilibrium in intestinal homeostasis.

Signal Transduct Target Ther 2021 04 14;6(1):148. Epub 2021 Apr 14.

State Key Laboratory of Medical Molecular Biology, Department of Physiology, Institute of Basic Medical Sciences and School of Basic Medicine, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

Intestinal epithelium serves as the first barrier against the infections and injuries that mediate colonic inflammation. Colorectal cancer is often accompanied with chronic inflammation. Differed from its well-known oncogenic role in many malignancies, we present here that Golgi membrane protein 1 (GOLM1, also referred to as GP73) suppresses colorectal tumorigenesis via maintenance of intestinal epithelial barrier. GOLM1 deficiency in mice conferred susceptibility to mucosal inflammation and colitis-induced epithelial damage, which consequently promoted colon cancer. Mechanistically, depletion of GOLM1 in intestinal epithelial cells (IECs) led to aberrant Notch activation that interfered with IEC differentiation, maturation, and lineage commitment in mice. Pharmacological inhibition of Notch pathway alleviated epithelial lesions and restrained pro-tumorigenic inflammation in GOLM1-deficient mice. Therefore, GOLM1 maintains IEC homeostasis and protects against colitis and colon tumorigenesis by modulating the equilibrium of Notch signaling pathway.
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http://dx.doi.org/10.1038/s41392-021-00535-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044123PMC
April 2021

Lung ultrasound predicts the development of bronchopulmonary dysplasia: a prospective observational diagnostic accuracy study.

Eur J Pediatr 2021 Sep 23;180(9):2781-2789. Epub 2021 Mar 23.

Department of Neonatology, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun, 130021, China.

This study aimed to evaluate the predictive ability of lung ultrasound (LU) in the development of bronchopulmonary dysplasia (BPD) in very low birth weight (VLBW) infants. A total of 130 VLBW infants with gestational age < 32 weeks were included; LU was performed at days 1, 2, 3, 6, 9, 12, and 15 postnatally. We calculated the LU score by 12-region, 10-region, and 6-region protocols. The incidence of BPD according to the National Institutes of Health (NIH) 2001 definition and 2019 criteria was 38.5% and 64.6%, respectively. By 12-region and 10-region protocols, LU predicted BPD from the 9 to 15 days of life (DOLs) regardless of the criteria used, with an area under the curve (AUC) ranging from 0.826 (95% confidence interval (CI): 0.750-0.887) to 0.877 (95% CI: 0.807-0.928). According to the 2019 BPD definition, the LU score incorporated gestational age, and invasive mechanical ventilation >6 days predicted BPD on the 6 DOL with an AUC of 0.862 (95% CI: 0.790-0.916). The 6-region protocol had significantly smaller AUC values on the 6 and 9 DOLs than the other two protocols.Conclusion: The 12-region and 10-region LU scoring protocols are superior to the 6-region protocol in the prediction of BPD. LU can predict the development of BPD from the 9 to 15 DOLs. With the addition of clinical variables, the earliest prediction time was the 6 DOL. What is Known: • Bronchopulmonary dysplasia is the most common and adverse complication of prematurity. Recent four studies found that lung ultrasound score or findings predicted the development of bronchopulmonary dysplasia. What is New: • We present analysis by classical 6-region and the other two lung ultrasound score (10-region and 12-region) which include an assessment of the posterior lung to allow to understand what is the best score to be used. In addition, we explore whether LU-incorporated clinical variables could improve the predictive value for BPD.
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http://dx.doi.org/10.1007/s00431-021-04021-2DOI Listing
September 2021

Neurobrucellosis with ischemic stroke and spinal cord involvement: a case report.

BMC Neurol 2021 Mar 20;21(1):129. Epub 2021 Mar 20.

Department of Neurology, Aerospace Center Hospital, 100049, Beijing, China.

Background: Brucellosis is a common zoonotic disease that may have a variety of clinical manifestations when it affects the nervous system. Ischemic stroke is a rare clinical symptom, but if it is not diagnosed and treated early, it may cause more severe consequences.

Case Presentation: We report a 38-year-old man presenting with hearing impairment for four years and sudden weakness of the right limb for two years, recurrent aphasia, and gradual weakness of bilateral lower limbs for nine months. He had bilateral positive Babinski's sign. Cerebrospinal fluid (CSF) showed raised protein and pleocytosis. Magnetic resonance imaging (MRI) showed ischemic infarcts in the pons and extensive enhancement of spinal meninges combined with spinal cord atrophy and ischemia. The tests revealed Brucella Rose Bengal positive in serum and CSF. Brucella culture in CSF was also positive. Next-generation sequencing (NGS) of CSF revealed positive for Brucella with 105 species were detected. He showed significant improvement with antibiotics at five months follow-up.

Conclusions: Neurobrucellosis may mimic stroke and transverse myelitis like syndromes. NB is a treatable infectious condition and should always be considered in the differentials, especially if there are risk factors, as in our case.
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http://dx.doi.org/10.1186/s12883-021-02155-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980546PMC
March 2021
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