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关键词： 市政工程   路桥施工   伸缩缝  

摘要： 随着城市化进程不断的加快,我国市政道路工程数量也是更多,经过多年发展下,我国路桥工程建设已经获取一定成果,并且各新技术、新设备应用,为路桥工程施工质量奠定一定基础。伸缩缝是一项应用范围十分广泛的施工技术,为有效的保障伸缩缝的施工质量,我们必须加强研究伸缩缝的施工技术。本文介绍了道路桥梁施工中的伸缩缝施工技术运用情况,希望促进市政道路施工行业可持续发展。

关键词： cutaneous neoplasm   dermatology   dermatopathology   immunohistochemistry   PEComa  

摘要： Perivascular epithelioid cell tumors (PEComas) are mesenchymal neoplasms with characteristic epithelioid or spindled cytomorphology that typically grow around blood vessels. These tumors are phenotypically and immunohistochemically distinct, expressing markers of both melanocytic and smooth muscle differentiation. Herein, we describe a case of histopathologically malignant cutaneous PEComa without metastatic spread, with review of the pertinent literature. Telescoping punch biopsy demonstrated an epithelioid neoplasm with marked atypia, hypercellularity, and increased mitotic activity. Immunohistochemical stains for HMB-45, NK1-C3, PGP9.5, MiTF, CD10, and CD68 were positive within tumor cells. In addition, there was diffuse expression of caldesmon and focal cytoplasmic staining for smooth muscle actin on the excision specimen. The patient underwent treatment with surgical excision with adjuvant radiation and surveillance computed tomography (CT). The patient remains free of recurrence or metastatic disease after 10 months of follow-up. To our knowledge, this is only the third reported case of a malignant cutaneous PEComa reported in the literature to date.

关键词： CNS relapse   immunotherapy   pembrolizumab   primary mediastinal lymphoma  

摘要： Primary mediastinal large B-cell lymphoma (PMBCL) is a rare aggressive B-cell lymphoma characterized by the frequent presence of amplification and translocation events at 9p24.1, resulting in the expression of the programmed cell death-1 (PD-1) ligands PD-L1 and PD-L2. Pembrolizumab, a humanized anti-PD-1 monoclonal antibody, binds PD-1 and blocks this interaction, enhancing the activity of the immune system against tumor cells, and has shown activity in PMBCL and in some cases of primary and secondary central nervous system (CNS) lymphoma. We report the case of a 40-year-old woman diagnosed with relapsed PMBCL and secondary CNS involvement who responded to pembrolizumab monotherapy, allowing for a later allogeneic stem cell transplant.

关键词： Sickle cell disease   Primary prevention   Newborn screening   Ghana   Nigeria  

摘要： Sickle cell disease (SCD), an inherited blood disorder, impacts 2% of newborns in Nigeria and Ghana. Despite devastating health consequences, SCD prevention is not a priority in either country. This article describes our U.S. research team's feasibility assessment for adapting CHOICES, a computer-based SCD education program, for use in Ghana and Nigeria. We identified indigenous collaborators by reviewing published research and investigating advocacy organizations online. This led to a fact-finding trip to Africa to discuss SCD prevention with local boards of advisors. Three major recommendations emerged from the group discussions: design a culturally appropriate intervention;enlist community healthcare workers to deliver the CHOICES program;and collaborate with religious and community leaders and elders in public awareness campaigns. Based on extensive advisor input, we will modify the content and delivery of the CHOICES intervention to meet the needs of those impacted by SCD in Ghana and Nigeria.

关键词： intracranial germ cell tumor   platinum-based chemotherapy   radiotherapy   germinomatous   nongerminomatous   oncology  

摘要： OBJECTIVE The current study aimed to evaluate the treatment outcomes and toxicities of patients with intracranial germ cell tumors (GCTs). METHODS This study retrospectively included 110 consecutive patients (70 patients in the germinomatous group and 40 patients in the nongerminomatous GCT [ NGGCT] groups) receiving surgery, platinum-based chemotherapy, and radiotherapy for newly diagnosed primary intracranial GCTs. In the authors' protocol, patients with GCTs were further divided into the following four groups: the germinomatous group and the NGGCT groups (mature teratoma, intermediate prognosis, or poor prognosis). RESULTS The median overall survival (OS) and progression-free survival (PFS) rates of the patients in the germinomatous group were significantly higher than those in the NGGCT group (p < 0.001). The 5-, 10-, and 20-year OS rates in the germinomatous group were 97.1%, 95.7%, and 93.2%, respectively, with a median follow- up of 11.0 years. On the contrary, the 5-, 10-, and 20-year OS rates in the NGGCT group were 67.3%, 63.4%, and 55.4%, respectively. The 5-, 10-, and 20-year PFS rates were 91.4%, 86.6%, and 86.6%, respectively, in the germinomatous group, whereas those of the NGGCT group were approximately 67.4%, 60.2%, and 53.5%, respectively. Based on the four types of classification in our study, the 5-, 10-, and 20-year OS rates in the NGGCT intermediate prognosis group were 78.9%, 71.8%, and 53.8%, respectively. On the contrary, the 3- and 5-year OS rates in the NGGCT poor prognosis group were 42.9% and 34.3%, respectively. Moreover, toxicities with the treatment of intracranial GCTs were found to be tolerable in the present study population. The multivariate survival models for OS in the NGGCT intermediate prognosis and poor prognosis groups demonstrated that only the alpha-fetoprotein status was significantly associated with worsened OS (HR 3.88, 95% CI 1.29-11.66;p = 0.02). CONCLUSIONS The authors found that platinum-based chemotherapy and radio

摘要： Highlights•PMLBCL rarely extends to extranodal subdiaphragmatic (ES) sites at diagnosis. •Among 455 patients, 32 (7%) had such localization at baseline. •Kidney, liver, and adrenals were most frequently involved. •ES site involvement had not independent prognostic impact beyond that of stage IV.

关键词： Blood cells   COVID-19   Eosinophil   Monocyte   Phenome-wide association study  

摘要： Background: The genetic locus 3p21.31 has been associated with severe coronavirus disease 2019 (COVID-19), but the underlying pathophysiological mechanism is unknown. Methods: To identify intermediate traits associated with the 3p21.31 locus, we first performed a phenome-wide association study (PheWAS) with 923 phenotypes in 310 999 European individuals from the UK Biobank. For genes potentially regulated by the COVID-19 risk variant, we examined associations between their expression and the polygenic score (PGS) of 1263 complex traits in a meta-analysis of 31 684 blood samples. For the prioritized blood cell traits, we tested their associations with age and sex in the same UK Biobank sample. Results: Our PheWAS highlighted multiple blood cell traits to be associated with the COVID-19 risk variant, including monocyte count and percentage (p = 1.07 x 10(-8), 4.09 x 10(-13)), eosinophil count and percentage (p = 5.73 x 10(-3), 2.20 x 10(-3)), and neutrophil percentage (p = 3.23 x 10(-3)). The PGS analysis revealed positive associations between the expression of candidate genes and genetically predicted counts of specific blood cells: CCR3 with eosinophil and basophil (p = 5.73 x 10(-21), 5.08 x 10(-19));CCR2 with monocytes (p = 2.40 x 10(-10));and CCR1 with monocytes and neutrophil (p = 1.78 x 10(-6), 7.17 x 10(-5)). Additionally, we found that almost all examined white blood cell traits are significantly different across age and sex groups. Conclusions: Our findings suggest that altered blood cell traits, especially those of monocyte, eosinophil, and neutrophil, may represent the mechanistic links between the genetic locus 3p21.31 and severe COVID-19. They may also underlie the increased risk of severe COVID-19 in older adults and men.

关键词： Augmentation   Bayesian optimization   Brain tumor   Convolutional neural networks   Deep learning   Image processing  

摘要： Detecting and classifying a brain tumor is a challenge that consumes a radiologist's time and effort while requiring professional expertise. To resolve this, deep learning techniques can be used to help automate the process. The aim of this paper is to enhance the accuracy of brain tumor classification using a new layered architecture of deep neural networks rather than the current state-of-the-art algorithms. In this paper, we propose automated tumor classification by concatenating two convolutional neural network structures of layers and tuning the hyperparameters by utilizing Bayesian optimization. The proposed solution focuses on enhancing the accuracy of classifying tumors to increase the level of trust in the technologies employed in the medical field. The work is tested and evaluated to predict the classification of magnetic resonance imaging inputs and achieving a higher accuracy (97.37%) than other similar works, with accuracies between 84.19% and 96.13%, for the same dataset.

关键词： cardiomyocytes   NLRP3 inflammasome   noncoding RNA   vascular endothelial cells   ventricular remodeling  

摘要： Inflammasomes are a group of multiprotein signaling complexes located in the cytoplasm. Several inflammasomes have been identified, including NLRP1, NLRP2, NLRP3, AIM2, and NLRC4. Among them, NLRP3 was investigated in most detail, and it was reported that it can be activated by many different stimuli. Increased NLRP3 protein expression and inflammasome assembly lead to caspase-1 mediated maturation and release of IL-1 beta, which triggers inflammation and pyroptosis. The activation of the NLRP3 inflammasome has been widely reported in studies of tumors and neurological diseases, but relatively few studies on the cardiovascular system. Ventricular remodeling (VR) is an important factor contributing to heart failure (HF) after myocardial infarction (MI). Consequently, delaying VR is of great significance for improving heart function. Studies have shown that the NLRP3 inflammasome plays an essential role in the process of VR. Here, we reviewed the latest studies on the activation pathway of the NLRP3 inflammasome, focusing on the effects of the NLRP3 inflammasome in primary cells during VR, and finally discuss future research directions in this field.