Diaphragm disease is rare and caused by intestinal obstruction due to nonsteroidal anti-inflammatory drugs (NSAIDs). Given the availability of video capsule endoscopy (VCE) and balloon enteroscopy (BE) this disease will be diagnosed more often.

A 73-year-old man was presented to our hospital for persistent nausea and vomiting. Abdominal ultrasound and computed tomography revealed small-bowel thickening, stricture in the terminal ileum, and dilation of the proximal small intestine. Differential diagnosis included ileal lymphoma and multiple ileal adenocarcinomas, and a diagnostic laparoscopy was performed. Twenty-centimeter of ileum was resected by primary ileo-ileal anastomosis. On pathological examination, fibrosis of the submucosa was identified, and erosions and numerous inflammatory cells reaching the submucosa were also identified from the specimen.

The preoperative diagnosis of diaphragm disease is sometimes challenging due to its uncharacteristic symptoms; moreover, radiological findings are usually indefinite and distinctive. Currently, the main treatment for diaphragm disease is surgery.

We have documented a case of intestinal obstruction by NSAIDs. However, it is desirable to determine the course of treatment based on small bowel endoscopic dilatation cases in the future.

We have documented a case of intestinal obstruction by NSAIDs. However, it is desirable to determine the course of treatment based on small bowel endoscopic dilatation cases in the future.

Pancreas angiosarcoma is a very aggressive malignant neoplasm. The symptoms are nonspecific and it is usually diagnosed at an advanced stage, which confers a poor prognosis.

We present a 56-year-old woman with abdominal epigastric pain and nausea. The abdominal CT-scan showed a 7 cm mass within the head of the pancreas and the pathology and immunochemistry analysis were positive for pancreas angiosarcoma. Intra-operatively the tumor was irresectable.

Pancreas angiosarcoma is an extremely rare neoplasm with non-specific diagnosis. The histology has a wide range of presentations and immunohistochemistry is required. The surgery appears to be the only effective treatment.

We report the seventh case of pancreas angiosarcoma in the English literature. Despite it’s irresectability, the patient was asymptomatic two months after surgery, initiating chemotherapy with paclitaxel, with good tolerance.

We report the seventh case of pancreas angiosarcoma in the English literature. Despite it’s irresectability, the patient was asymptomatic two months after surgery, initiating chemotherapy with paclitaxel, with good tolerance.It has become obvious that fluorinated drugs have a significant role in medicinal applications. In this study, the fluorination of 3-nitrotyrosine as an anti-Parkinson and anti-Alzheimer drug was explored using density functional theory calculations. We have investigated the most important chemical properties of 3-nitrotyrosine that affect the pharmacological activity of the drug. We found that the intramolecular hydrogen bonding and intramolecular charge of the drug were influenced by fluorine substitution. Our results also reveal that the fluorination altered the stability, solubility, and molecular polarity of the 3-nitrotyrosine drug. The density of state analysis also determines sharp resonance states of fluorine atoms with the 3-nitrotyrosine drug states particularly in the highest molecular orbital reigns, suggesting hybridization of the fluorine states with the state of the drug. Moreover, our results show that the electronic spectra of fluorinated derivatives of 3-nitrotyrosine drug exhibit a red shift toward higher wavelengths (lower energies). Our calculations show that the free energy transfers of fluorinated derivatives of the 3-nitrotyrosine drug in water were negative that it meant that the designed molecules dissolving in aqueous phase occurred simultaneously. Consequently, the results of the present study show that the fluorination of 3-nitrotyrosine drug could be considered as a promising strategy to design useful drugs with better pharmacological properties.

The aim of the study was to comprehensively evaluate the associations between tumor necrosis factor (TNF) gene polymorphism and influenza A (H1N1) susceptibility.

The relevant studies were identified through a search of PubMed, Embase, and Cochrane library database until February 29, 2020, without language restrictions. Two independent reviewers extracted the data, and any discrepancies were resolved by consensus. The quality of the eligible article was evaluated by Newcastle-Ottawa Quality Assessment Scale (NOS). Egger’s test was applied to evaluate publication bias. All these analyses were performed using Stata15.1 software.

A total of 5 studies with 474 cases and 805 controls were included. The results of meta-analysis showed that there were statistically significant for rs361525 in allelic model (A vs. G) [OR = 2.46 (1.10, 5.52)] and for rs1800750 in dominant model (AA + GA vs. GG) [OR = 2.42 (1.24, 4.71)] in cases vs. controls. Furthermore, subgroup analysis for race showed that for rs361525 in allelic model (A vs. G), there were significant differences for Caucasian [OR = 3.64 (1.18, 11.23)] and no significant difference for Mexican [OR = 2.25 (0.82, 6.13)] in cases vs. controls. There was publication bias for rs361525 in dominant model (AA + GA vs. GG, p = 0.042) and rs1800629 in recessive model (AA vs. GG + GA, p < 0.001).

Caucasian with A site mutation of -238TNF G/A (rs361525) was more susceptible to influenza A (H1N1).The -376 dominant model AA + GA of TNF genes was associated with the susceptibility to influenza A (H1N1). However, more studies with large sample size are needed to confirm the results.

Caucasian with A site mutation of -238TNF G/A (rs361525) was more susceptible to influenza A (H1N1).The -376 dominant model AA + GA of TNF genes was associated with the susceptibility to influenza A (H1N1). However, more studies with large sample size are needed to confirm the results.RUNX family transcription factor 2 (RUNX2) overexpression has been found in various human malignancies. However, the expression levels of RUNX2 mRNA and protein in lung adenocarcinoma (LUAD) were not investigated. This study aims to thoroughly analysis the expression level and potential mechanisms of RUNX2 mRNA in LUAD. We applied in-house immunohistochemistry, high-throughput RNA-sequencing, and gene microarrays to comprehensively investigate the expression level of RUNX2 in LUAD. A pool standard mean difference (SMD) and summary receiver operating characteristic curves (SROC) were calculated to assess the integrated expression value of RUNX2 in LUAD. The hazard ratios (HRs) were integrated to evaluate the overall prognostic effect of RUNX2 on the LUAD patients. The differentially expressed genes (DEGs) of LUAD, the potential target genes of RUNX2, and its co-expressed genes were overlapped to obtain a set of specific genes for GO and KEGG enrichment analyses. RUNX2 overexpression in LUAD was validated using a large number of cases (2 418 LUAD and 1 574 non-tumor lung samples). The pooled SMD was 0.85 (95 % CI 0.64-1.05) and the area under the curve (AUC) of the SROC was 0.86 (95 %CI 0.83-0.89). The integrated HR was 1.20 [1.04-1.38], indicating that increased expression of RUNX2 was an independent risk factor for the poor survival of the LUAD patients. RUNX2 and its transcriptionally regulates potential target genes may promote cell proliferation and drug resistance of LUAD by modulating the cell cycle and MAPK signaling pathways. RUNX2 can provide new research directions for targeted drug therapy and drug resistance for LUAD treatment.

First Contact Practitioner (FCP) roles have been developed for health professionals with advanced practice skills to take on many of the musculoskeletal responsibilities currently carried out by general practitioners. FCP roles are new and still developing. Currently there is little research that has investigated the experiences of FCPs. This knowledge could help stakeholders and other clinicians gain an understanding into what makes a successful FCP role. The aim of this research was to explore the experiences of FCP working in North West England to gain insight into the first point of contact service, and their experiences of this developing full time FCP role.

A qualitative design using in-depth semi-structured, face-to-face interviews was undertaken to explore the experiences of FCP providing a first point of contact service. The study took place in an economically deprived and ethnically diverse location in North West England.

Ten FCPs were recruited, four were appointed from Band 6 posts to FCP training posts, 9 were male. The mean years qualified was 12.8. Five themes were identified 1. 'It’s the level of clinical complexity that you’re dealing with’, 2. FCP role – rewards and challenges, 3. Own wellbeing, 4. Professional development and education, 5. Realities of working in practice governed by business.

FCP roles are an exciting development for people with MSK conditions, the physiotherapy profession, primary care providers and MSK physiotherapists. Mentorship support, workload and standards of training and practice are important when considering future expansion for the sustainability of these roles.

FCP roles are an exciting development for people with MSK conditions, the physiotherapy profession, primary care providers and MSK physiotherapists. Mentorship support, workload and standards of training and practice are important when considering future expansion for the sustainability of these roles.Technetium poses an environmental hazard because of its radioactivity and long half-life. It exists in the form of pertechnetate in the environment and can be modeled by the nonradioactive ion perrhenate, since pertechnetate and perrhenate have the same geometry and similar chemical properties. In this research, a new zinc cyclen resorcinarene cavitand (ZCR) column was used in ion chromatography (IC) to efficiently separate perrhenate. Ion chromatography has the advantage of requiring almost no sample preparation for water samples. The ZCR column demonstrated the ability to separate anions fluoride, chloride, nitrate, sulfate, phosphate, perchlorate, and perrhenate by gradient 2-60 mM NaOH. Unlike other columns, the new column material was selective in retaining perrhenate. The ZCR column also gave a linear range from 2.0 to 1000 mg L-1 for perrhenate with R2 > 0.997. There was a logarithmic relationship between the concentration of perrhenate and its retention time. Excellent perrhenate recovery was achieved on the ZCR column when river water was spiked with perrhenate and perrhenate was preconcentrated. The efficient separations of perrhenate by the ZCR column will potentially assist in pertechnetate separations.Routine handling of oysters is a common industry practice for off-bottom oyster aquaculture, which aims to produce a high-quality oyster. These practices expose oysters to elevated temperatures and interrupt filter feeding, which can increase Vibrio vulnificus and V. parahaemolyticus levels within the oyster. The resubmersion of oysters after exposure to conditions where the time-temperature controls are exceeded is as an effective mitigation strategy to allow elevated levels of Vibrio spp. to „recover”, or return to ambient levels, prior to harvest. Previous work examined the effect of desiccation on recovery times; the objective of this study was to evaluate the effect of additional handling treatments [tumbled and refrigerated (TR), tumbled and not refrigerated (TNR), not tumbled and refrigerated (NTR), and not tumbled and not refrigerated (NTNR)] on the time needed for V. vulnificus, total V. parahaemolyticus, and pathogenic V. parahaemolyticus (tdh+/trh+) to recover in oysters. A set of non-treated (control) oysters remained submerged throughout the study to determine the ambient Vibrio spp.