Diagnostic Value of Ultrasound Endoscopy-Guided Fine-Needle Aspiration for Peritoneal Lesions.

Background: Peritoneal lesions present diagnostic challenges, necessitating precise imaging techniques. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) offers a promising approach for accurate diagnosis, aiding in optimal patient management and treatment planning. Objective: This study aims to assess the diagnostic efficacy of EUS-FNA in peritoneal lesions to offer insight in guiding optimal patient management. Methods: A prospective observational study was conducted, and a total of 58 patients who underwent EUS-FNA of the peritoneum at our hospital between October 2021 and November 2021 were included. The ultrasound diagnostic instrument facilitated puncture guidance, with 2-5 punctures performed in various parts of the selected peritoneal lesion areas. The analysis encompassed evaluating the sensitivity, specificity, positive predictive value, and negative predictive value of biopsy for diagnosing peritoneal-associated lesions, alongside assessing the number of punctures, puncture satisfaction, and incidence of postoperative complications. Results: The included patients undergoing EUS-FNA revealed that 41 (70.69%) had malignant lesions, while 17 (29.31%) presented with benign lesions. The diagnostic accuracy of EUS-FNA for peritoneal lesions was determined to be 94.83%, with a diagnostic sensitivity of 97.30% for malignant tumors, specificity of 90.48%, positive predictive value of 94.74%, and negative predictive value of 95%. Lesions exhibited a size range of 2.5cm × 2.9cm to 15.2cm × 9.8cm. Each patient underwent 2-5 punctures (3.3 ± 1.4), with a puncture satisfaction rate of 96.55%. The incidence of postoperative complications following EUS-FNA was found to be 3.45%. Conclusion: EUS-FNA exhibits substantial diagnostic utility for peritoneal-related lesions, marked by exceptional accuracy, sensitivity, specificity, and favorable safety. Its clinical adoption is warranted, promising improved patient care and management.

Efficacy of Shu-yi-ning-chang decoction on IBS-D: Modulating Nr4a3 pathway to reduce visceral hypersensitivity.

AIM OF THE STUDY: To evaluate the therapeutic effect of SYNC in diarrhea irritable bowel syndrome (IBS-D) and explore its underlying mechanism through transcriptomic sequencing (RNA-Seq). MATERIALS AND METHODS: A rat model of IBS-D was constructed to elucidate the effects of SYNC. Abdominal withdrawal reflex (AWR), fecal water content (FWC), and recording body weight were calculated to assess visceral sensitivity in rats. Histopathological changes in the colon and alterations in mast cell (MC) count were determined. Immunohistochemistry was employed to assess mast cell tryptase (MCT) expression in rat colons. Serum levels of corticotropin-releasing Hormone (CRH), interleukin-6 (IL-6), calcitonin gene-related peptide (CGRP), and 5-hydroxytryptamine (5-HT) were quantified using ELISA. RNA-Seq of colon tissue was performed, followed by Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. Western blot analysis was conducted to quantify the expression levels of key proteins in the Nr4a3 pathway in the colon and hypothalamus tissues of rats. RESULTS: SYNC alleviated visceral hypersensitivity and mood disorders in rats with IBS-D. Moreover, it was positively correlated with its dosage and the observed effects, such as the enhancement of the colon's mucosal lining condition and reduction in the number and activation of MCs within the model group. SYNC reduced the expression levels of factors related to the brain-gut axis and inflammatory markers in the bloodstream. RNA-Seq analysis indicated that SYNC down-regulated the expression of Nr4a3 and PI3K. These SYNC-targeted genes primarily played roles in immune regulation and inflammatory responses, correlating with the modulation of Nr4a3 and the PI3K/AKT pathway. Western blot analysis further confirmed SYNC's influence on inflammation-related MC activation by downregulating key proteins in the Nr4a3/PI3K pathway. CONCLUSIONS: SYNC inhibited mast cell activation and attenuated visceral hypersensitivity in the colon tissues of IBS-D rats. These effects were mediated by the Nr4a3/PI3K signaling pathway.

Effect of arsenic on the risk of gestational diabetes mellitus: a systematic review and meta-analysis.

BACKGROUND: Gestational diabetes mellitus (GDM) is a complication of pregnancy associated with numerous adverse outcomes. There may be a potential link between GDM and arsenic (As) exposure, but this hypothesis remains controversial. This meta-analysis summarizes the latest studies evaluating the association between As and GDM. METHODS: A comprehensive search of the PubMed, Embase, and Scopus databases up to September 2023 was performed. The pooled estimates with 95% CIs were presented using forest plots. Estimates were calculated with random effects models, and subgroup and sensitivity analyses were conducted to address heterogeneity. RESULTS: A total of 13 eligible studies involving 2575 patients with GDM were included in this meta-analysis. The results showed that women exposed to As had a significantly increased risk of GDM (OR 1.47, 95% CI: 1.11 to 1.95, P = 0.007). Subgroup analyses suggested that the heterogeneity might be attributed to the years of publication. In addition, sensitivity analysis confirmed the robust and reliable results. CONCLUSIONS: This analysis suggested that women exposed to As have a greater risk of GDM. However, the significant heterogeneity across studies requires careful interpretation. REGISTRATION: The PROSPERO registration ID is CRD42023461820.

A rapid multi-parametric quantitative MR imaging method to assess Parkinson's disease: a feasibility study.

BACKGROUND: MULTIPLEX is a single-scan three-dimensional multi-parametric MRI technique that provides 1 mm isotropic T1-, T2*-, proton density- and susceptibility-weighted images and the corresponding quantitative maps. This study aimed to investigate its feasibility of clinical application in Parkinson's disease (PD). METHODS: 27 PD patients and 23 healthy control (HC) were recruited and underwent a MULTIPLEX scanning. All image reconstruction and processing were automatically performed with in-house C + + programs on the Automatic Differentiation using Expression Template platform. According to the HybraPD atlas consisting of 12 human brain subcortical nuclei, the region-of-interest (ROI) based analysis was conducted to extract quantitative parameters, then identify PD-related abnormalities from the T1, T2* and proton density maps and quantitative susceptibility mapping (QSM), by comparing patients and HCs. RESULTS: The ROI-based analysis revealed significantly decreased mean T1 values in substantia nigra pars compacta and habenular nuclei, mean T2* value in subthalamic nucleus and increased mean QSM value in subthalamic nucleus in PD patients, compared to HCs (all p values < 0.05 after FDR correction). The receiver operating characteristic analysis showed all these four quantitative parameters significantly contributed to PD diagnosis (all p values < 0.01 after FDR correction). Furthermore, the two quantitative parameters in subthalamic nucleus showed hemicerebral differences in regard to the clinically dominant side among PD patients. CONCLUSIONS: MULTIPLEX might be feasible for clinical application to assist in PD diagnosis and provide possible pathological information of PD patients' subcortical nucleus and dopaminergic midbrain regions.

Fast and sensitive CRISPR detection by minimized interference of target amplification.

Despite the great potential of CRISPR-based detection, it has not been competitive with other market diagnostics for on-site and in-home testing. Here we dissect the rate-limiting factors that undermine the performance of Cas12b- and Cas13a-mediated detection. In one-pot testing, Cas12b interferes with loop-mediated isothermal amplification by binding to and cleaving the amplicon, while Cas13a directly degrades the viral RNA, reducing its amplification. We found that the protospacer-adjacent motif-interacting domain engineered Cas12b accelerated one-pot testing with 10-10,000-fold improved sensitivity, and detected 85 out of 85 SARS-CoV-2 clinical samples with a sensitivity of 0.5 cp µl-1, making it superior to wild-type Cas12b. In parallel, by diminishing the interference of Cas13a with viral RNA, the optimized Cas13a-based assay detected 86 out of 87 SARS-CoV-2 clinical samples at room temperature in 30 min with a sensitivity of 0.5 cp µl-1. The relaxed reaction conditions and improved performance of CRISPR-based assays make them competitive for widespread use in pathogen detection.

[Internal carotid artery pseudoaneurysm caused by parapharyngeal abscess: A case report].

Pseudoaneurysms of the neck are seldom, and those caused by neck infections especially parapharyngeal abscess are even rarer. However, it is life-threatening and may bring sudden death due to the obstruction of airway and the pseudoaneurysms rupture. We analyzed the clinical features, diagnosis and treatment of the disease through a case summary and literature review in order to guide clinical diagnosis and treatment of pseudoaneurysms. The patient, whom we presented was an 87-year-old male and admitted in emergency of our hospital with the chief complaint of neck swelling for 7 days and shortness of breath for 2 days. Cervical ultrasound examination showed that there was an liquid dark area next to the left common carotid artery which was approximately 8.0 cm × 5.0 cm, consideration of formation of left carotid artery pseudoaneurysm, and the liquid dark area which was visible on the right considered of pseudoaneurysm or infection. Angiography of neck showed a clustered high-density shadow around the bifurcation of the left carotid artery, with an overall range of approximately 65 mm × 52 mm × 72 mm, the pseudoaneurysms for sure, while on the right side of the lesion, mixed low density shadows with air could be seen, the parapharyngeal abscess for sure.Then he was diagnosed as the pseudoaneurysm of left internal carotid artery which was caused by parapharyngeal abscess. After tracheal intubation and anti-infection treatment, the patient died due to hemorrhagic shock of the ruptured of the pseudoaneurysm. Morever we performed literature search on PubMed, Wanfang database and CNKI with keywords of "neck pseudoaneurysm, neck infection, parapharyngeal abscess" and enrolled 10 cases. Then we summarized the clinical characteristics and treatment. We analyzed and summarized the 10 case reports, in which the number of male was 7. Among them, there were 4 pediatric, and 6 adults were enrolled overall. Most of the symptoms were neck swelling, and the diseased blood vessel was mainly the right internal carotid artery which accounted for half overall. All the patients underwent surgical intervention, and recovered well. So we draw the conclusion that the clinical incidence of cervical pseudoaneurysms is low and can be caused by a variety of factors, especially caused by infectious factors. When a patient has a progressive pulsating mass in the neck, the preliminary diagnosis should be made by ultrasound as soon as possible, and the aortic enhancement CT should be used to further confirm.For a patient with cervical pseudo-aneurysms caused by parapharyngeal infections, he should take operation timely combined with antibiotic treatment in time.

The efficacy and safety of selective RET inhibitors in RET fusion-positive non-small cell lung cancer: a meta-analysis.

BACKGROUND: Rearranged during transfection (RET) fusion-positive occurs in approximately 2% of non-small cell lung cancer (NSCLC). This mutation often predicts metastasis risk and poor prognosis, and current mainstream therapies provide limited patient benefit. Selective RET inhibitors Pralsetinib and Selpercatinib are targeted drugs approved by the US Food and Drug Administration for treating RET-mutated tumors. The phase I/II clinical trial results of their treatment of NSCLC have been published. However, the clinical effect of selective RET inhibitors on RET fusion-positive NSCLC remains controversial. Purpose Meta-analysis was performed to investigate the efficacy and safety of selective RET inhibitors in treating RET fusion-positive NSCLC. Methods Qualified literature was searched in Pubmed, Cochrane Library, Embase, and Web of Science. Outcomes included objective response rate (ORR), median progression-free survival (mPFS), disease control rate (DCR), intracranial ORR, and adverse events. Stata 15.1 software was used to analyze the data. Results A total of 8 studies were included in this meta-analysis. The combined results showed that the ORR of patients treated with selective RET inhibitors was 67% (95% confidence interval:0.64 to 0.70, P < 0.01), DCR was 92% (95%CI: 0.91-0.94, P < 0.01), the mPFS was 16.09 months (95%CI: 11.66-20.52, P < 0.01). In treated patients with RET mutation, the intracranial ORR was 86% (95%CI:0.74 ~ 0.96, P < 0.01). ORR in untreated patients was more effective than untreated patients [HR = 0.44 (95%CI: 0.35-0.56, P < 0.01)]. The major adverse events (grade 3-4) are neutropenia (13%) and anaemia (13%). Conclusions Selective RET inhibitors Pralsetinib and Selpercatinib have shown a good effect on RET fusion-positive NSCLC, with a low incidence of adverse events.

A combined radiomic model distinguishing GISTs from leiomyomas and schwannomas in the stomach based on endoscopic ultrasonography images.

BACKGROUND: Endoscopic ultrasonography (EUS) is recommended as the best tool for evaluating gastric subepithelial lesions (SELs); nonetheless, it has difficulty distinguishing gastrointestinal stromal tumors (GISTs) from leiomyomas and schwannomas. GISTs have malignant potential, whereas leiomyomas and schwannomas are considered benign. PURPOSE: This study aimed to establish a combined radiomic model based on EUS images for distinguishing GISTs from leiomyomas and schwannomas in the stomach. METHODS: EUS images of pathologically confirmed GISTs, leiomyomas, and schwannomas were collected from five centers. Gastric SELs were divided into training and testing datasets based on random split-sample method (7:3). Radiomic features were extracted from the tumor and muscularis propria regions. Principal component analysis, least absolute shrinkage, and selection operator were used for feature selection. Support vector machine was used to construct radiomic models. Two radiomic models were built: the conventional radiomic model included tumor features alone, whereas the combined radiomic model incorporated features from the tumor and muscularis propria regions. RESULTS: A total of 3933 EUS images from 485 cases were included. For the differential diagnosis of GISTs from leiomyomas and schwannomas, the accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve were 74.5%, 72.2%, 78.7%, and 0.754, respectively, for the EUS experts; 76.8%, 74.4%, 81.0%, and 0.830, respectively, for the conventional radiomic model; and 90.9%, 91.0%, 90.6%, and 0.953, respectively, for the combined radiomic model. For gastric SELs <20 mm, the accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve of the combined radiomic model were 91.4%, 91.6%, 91.1%, and 0.960, respectively. CONCLUSIONS: We developed and validated a combined radiomic model to distinguish gastric GISTs from leiomyomas and schwannomas. The combined radiomic model showed better diagnostic performance than the conventional radiomic model and could assist EUS experts in non-invasively diagnosing gastric SELs, particularly gastric SELs <20 mm.

OsLUX Confers Rice Cold Tolerance as a Positive Regulatory Factor.

During the early seedling stage, rice (Oryza sativa L.) must overcome low-temperature stress. While a few cold-tolerance genes have been characterized, further excavation of cold-resistance genes is still needed. In this study, we identified a cold-induced transcription factor-LUX ARRHYTHMO (LUX)-in rice. OsLUX was found to be specifically expressed in leaf blades and upregulated by both cold stress and circadian rhythm. The full-length OsLUX showed autoactivation activity, and the OsLUX protein localized throughout the entire onion cell. Overexpressing OsLUX resulted in increased cold tolerance and reduced ion leakage under cold-stress conditions during the seedling stage. In contrast, the knockout of OsLUX decreased seedling cold tolerance and showed higher ion leakage compared to the wild type. Furthermore, overexpressing OsLUX upregulated the expression levels of oxidative stress-responsive genes, which improved reactive oxygen species (ROS) scavenging ability and enhanced tolerance to chilling stress. Promoter analysis showed that the OsLUX promoter contains two dehydration-responsive element binding (DREB) motifs at positions -510/-505 (GTCGGa) and -162/-170 (cCACCGccc), which indicated that OsDREB1s and OsDREB2s probably regulate OsLUX expression by binding to the motif to respond to cold stress. Thus, OsLUX may act as a downstream gene of the DREB pathway. These results demonstrate that OsLUX serves as a positive regulatory factor of cold stress and that overexpressing OsLUX could be used in rice breeding programs to enhance abiotic stress tolerance.

[Main sources of soil phosphorus and their seasonal changes across different vegetation restoration stages in karst region of southwest China]. / è¥¿å—å–€æ–¯ç‰¹åŒºåŸŸä¸åŒæ¤è¢«æ¢å¤é˜¶æ®µåœŸå£¤ç£·ä¸»è¦æ¥æºåŠå ¶å­£èŠ‚å˜åŒ–.

Investigating the main sources of soil phosphorus and their seasonal variations across different vegetation restoration stages in karst region of southwest China can deepen our understanding of soil phosphorus cycling during vegetation restoration, and provide scientific reference for the controlling of rocky desertification. Taking the typical karst ecosystems at different vegetation restoration stages in Guilin, Guangxi as the research objects, we conducted a one-year field experiment with three treatments: vegetation restoration for about 10 years (R10), 30 years (R30) and 50 years (R50). We collected rainfall based on precipitation frequency, as well as soil, fresh litter and root samples in each season to measure the concentrations of total phosphorus (TP) in rainfall, the contents of TP and available phosphorus (AP) in soil, and the contents of TP in fresh litter and roots. In combination with litter phosphorus storage and soil microbial biomass phosphorus (MBP), we analyzed the contributions of phosphorus input to soil from different phosphorus sources. The results showed that soil TP content increased initially and then decreased with vegetation restoration, with a seasonal pattern of autumn > summer > spring > winter. Soil AP content was low in all treatments, with higher levels in summer and winter than in spring and autumn. Soil MBP content increased with vegetation restoration, with a seasonal variation pattern of spring >autumn > summer > winter. The annual phosphorus input from rainfall was 0.78 kg·hm-2 with the highest value in spring. The annual phosphorus input from fresh litter in the R10, R30, and R50 treatments was 2.42, 10.64 and 5.03 kg·hm-2. Phosphorus storage in litter was 1.23, 5.32 and 3.45 kg·hm-2. The annual phosphorus input from plant roots was 5.18, 12.65, and 5.96 kg·hm-2, respectively. The highest levels of the above parameters always occurred in the R30 treatment. There was a significant positive correlation between soil TP content and plant root phosphorus input, and a significant negative correlation between soil AP content and rainfall phosphorus input. In summary, the contribution of phosphorus input from different sources to soil phosphorus pool varied across different vegetation restoration stages in the karst region of southwest China. Roots are the main source of soil phosphorus, followed by litters. Phosphorus entering the soil through wet deposition is very limited. Soil microorganisms also contribute to soil phosphorus reserve.

DNA topology regulates PAM-Cas9 interaction and DNA unwinding to enable near-PAMless cleavage by thermophilic Cas9.

CRISPR-Cas9-mediated genome editing depends on PAM recognition to initiate DNA unwinding. PAM mutations can abolish Cas9 binding and prohibit editing. Here, we identified a Cas9 from the thermophile Alicyclobacillus tengchongensis for which the PAM interaction can be robustly regulated by DNA topology. AtCas9 has a relaxed PAM of N4CNNN and N4RNNA (R = A/G) and is able to bind but not cleave targets with mutated PAMs. When PAM-mutated DNA was in underwound topology, AtCas9 exhibited enhanced binding affinity and high cleavage activity. Mechanistically, AtCas9 has a unique loop motif, which docked into the DNA major groove, and this interaction can be regulated by DNA topology. More importantly, AtCas9 showed near-PAMless editing of supercoiled plasmid in E. coli. In mammalian cells, AtCas9 exhibited broad PAM preference to edit plasmid with up to 72% efficiency and effective base editing at four endogenous loci, representing a potentially powerful tool for near-PAMless editing.

Cerebral blood flow network differences correlated with cognitive impairment in mild traumatic brain injury.

Purpose: To examine whether the cerebral blood flow (CBF) and CBF connectivity differences are sex-specific and whether these differences are correlated with cognitive impairment in mTBI. Methods: Resting-state perfusion magnetic resonance imaging was performed in 40 patients with acute mTBI and 40 healthy controls by using pseudocontinuous arterial spin labeling within 14 days following injury. The differences in normalized CBF were first compared and CBF connectivity of the brain regions with significant CBF differences were compared next. The association between the normalized CBF and CBF connectivity differences and cognitive function were further investigated. Results: Men patients had lower normalized CBF in the frontal gyrus, temporal gyrus and hippocampus and decreased negative CBF connectivity between brain regions including the hippocampus, temporal gyrus, postcentral gyrus and lenticular nucleus, putamen, compared with men controls. Women patients had lower normalized CBF in the frontal gyrus, however had higher normalized CBF in the temporal gyrus and hippocampus, compared with women controls. Additionally, women patients showed increased positive CBF connectivity between the seed region of interest (ROI) of the right inferior temporal gyrus and temporal gyrus and frontal gyrus, and had increased positive CBF connectivity between the seed ROI of the right hippocampus and the temporal gyrus. Furthermore, men patients had higher CBF in the right middle temporal gyrus and left precentral gyrus than women patients. Conclusion: This study provides evidence of sex differences in both decreased and increased CBF and CBF connectivity and association with cognitive outcome in the acute stage after mTBI.

Development and validation of the linked color imaging classification for endoscopic prediction of colorectal polyp histology.

OBJECTIVE: Linked color imaging (LCI) is a recently developed technique that emphasizes differences in mucosal color. In this study we aimed to develop a LCI classification based on the Narrow-band Imaging International Colorectal Endoscopic Classification for predicting colorectal polyp histology and evaluate the validity and performance of the endoscopists in differentiating hyperplastic polyps from adenomas using the LCI classification. METHODS: A workshop involving six international experts from China and Japan with substantial experience with LCI developed the classification. Three experienced and seven less-experienced endoscopists used the LCI images to predict the histology of polyps independently, recording their degrees of confidence in these predictions before and after completing the training test for the LCI classification. RESULTS: Of the 50 polyps included, 30 (60.0%) were adenomas. Overall diagnostic accuracy before training was 75.4% (95% confidence interval [CI] 71.4%-79.1%), which increased to 85.2% (95% CI 81.8%-88.2%) after training. After training, the experienced and less-experienced endoscopists achieved an overall accuracy of 87.3% and 84.3% for the prediction of polyp histology. Polyp prediction using the color criterion alone had the highest specificity and positive predictive value, whereas the vessel criterion achieved the highest accuracy and negative predictive value among all three individual LCI criteria. After training, both the experienced and less-experienced endoscopists had high degrees of interobserver agreement. CONCLUSIONS: We developed and validated the first LCI classification for endoscopic differentiation of adenomas and hyperplastic polyps. The LCI classification significantly improved the diagnostic accuracy of colorectal polyps.

Klebsiella pneumoniae invasion syndrome: a case of liver abscess combined with lung abscess, endophthalmitis, and brain abscess.

Klebsiella pneumoniae invasion syndrome (KPIS) is a critical multi-site infection that is usually caused by highly virulent Klebsiella pneumonia. It is relatively common in Asian patients with diabetes and leads to sepsis, which has a high mortality rate. We report the case of a man in his early 40s who presented to the hospital with blurred vision in his left eye of 7 days' duration and fever of 1 day's duration. After a complete examination, he was diagnosed with KPIS on the basis of his liver abscessation, lung abscessation, endophthalmitis of the left eye and brain abscessation. After needle puncture and drainage of the left eye and liver abscess and anti-bacterial treatment with meropenem, the patient recovered well. When KPIS is suspected, attention should be paid to the sites of infection and the selection of the most appropriate antibiotics, but the most important aim should be to drain the lesions in a timely manner to improve the patient's prognosis.

Graphene-enhanced polarization-insensitive all-optical wavelength conversion based on four-wave mixing.

All-optical wavelength conversion technology based on four-wave mixing (FWM) effect is a promising development need of the modern high-speed optical signal processing system. In this work, we report on the polarization insensitive four-wave mixing based on graphene for all optical wavelength conversion. To overcome the polarization sensitivity of FWM, a dual-pump configuration was proposed based on the combination of graphene and the optical fibers. Our experimental results illustrate that by using the dual pump configuration, the FWM-based wavelength conversion efficiency, can be enhanced by graphene with about 8 dB when the state of polarization of the two pumps are parallel. This proposed all-optical wavelength converter based on graphene may provide a new approach for the next generation optical communications and signal processing.

IL-27 mediates anti-inflammatory effect in cigarette smoke induced emphysema by negatively regulating IFN-γ producing cytotoxic CD8+ T cells in mice.

Chronic airway inflammation mediated by CD8+ T lymphocytes contributes to the pathogenesis of Chronic obstructive pulmonary disease (COPD). Deciphering the fingerprint of the chronic inflammation orchestrated by CD8+ T cells may allow the development of novel approaches to COPD management. Here, the expression of IL-27 and IFN-γ+ CD8+ Tc1 cells were evaluated in patients with COPD and in cigarette smoke-exposed mice. The production of IL-27 by marrow-derived dendritic cells (mDCs) in response to cigarette smoke extract (CSE) was assessed. The role of IL-27 in IFN-γ+ CD8+ Tc1 cells was explored. We demonstrated that elevated IL-27 was accompanied by an exaggerated IFN-γ+ CD8+ Tc1 response in a smoking mouse model of emphysema. We noted that lung dendritic cells were one of the main sources of IL-27 during chronic cigarette smoke exposure. Moreover, CSE directly induced the production of IL-27 by mDCs in vitro. IL-27 negatively regulated the differentiation of IFN-γ+ CD8+ Tc1 cells isolated from cigarette smoke-exposed mice in a STAT1- and STAT3-independent manner. Systemic administration of recombinant IL-27 attenuated IFN-γ+ CD8+ Tc1 response in the late phase of cigarette smoke exposure. Our results uncovered that IL-27 negatively regulates IFN-γ+ CD8+ Tc1 response in the late stage of chronic cigarette smoke exposure, which may provide a new strategy for the anti-inflammatory treatment of smoking-related COPD/emphysema.

The feasibility and efficacy of a community-based multifactorial intervention to improve the cardiovascular risk factor control among patients with type 2 diabetes: A 2-year cluster randomized trial.

TRIAL DESIGN: Our study is to investigate the feasibility and effectiveness of multiple cardiovascular factors intervention (MFI) in type 2 diabetes patients in China's primary care setting. METHODS: We performed a cluster randomized trial to compare the proportion of patients achieved the targets between usual care group (control, 9 sites, n = 868) and MFI group (8 sites, n = 739) among patients with type 2 diabetes in primary care setting. Logistic regression model with random effects was used to estimate the association of the effect of intervention and the proportion achieved the targets. RESULTS: At baseline, the end of 1 year, and 2 years follow-up, the proportion of patients achieved all 3 target goals (HbA1c < 7.0%, blood pressure < 130/80 mm Hg and low-density lipoprotein cholesterol < 2.6 mmol/L) were 5.7%, 5.9%, 5.7% in the control group and 5.9%, 10.6%, 12.3% in the MFI group. After adjusting sex, age, diabetes duration, body mass index, HbA1c, blood pressure, and low-density lipoprotein cholesterol at baseline, there was no difference between the 2 groups (OR (95% CI): 1.27 (0.38-4.27) and 1.86 (0.79-4.38) for the first year and second year, respectively). When stratified by payment method, the patients with medical insurance or public expenses had a higher proportion achieved target goals (6.9% vs 16.4%, OR (95% CI): 2.30 (1.04-5.08)) in the second year. CONCLUSIONS: The controlling of cardiovascular risk factor targets remains suboptimal among patients with type 2 diabetes in primary care setting. MFI in type 2 diabetes improved cardiovascular disease risk profile, especially in the patients with medical insurance.

Identification of Potential Biomarkers Associated with Acute Myocardial Infarction by Weighted Gene Coexpression Network Analysis.

BACKGROUND: In the general population, acute myocardial infarction (AMI) represents a significant cause of mortality. This study is aimed at identifying novel diagnostic biomarkers to aid in treating and diagnosing AMI. METHODS: The Gene Expression Omnibus (GEO) database was explored to extract two microarray datasets, GSE66360 and GSE48060, which were subsequently merged into a single cohort. Both AMI and control samples were analyzed for differentially expressed genes (DEGs), which were subsequently subjected to weighed gene coexpression network analysis (WGCNA) to identify the most significant module. Gene Ontology (GO) and pathway analyses subsequently carried out the most significant gene modules along with construction of a protein-protein interaction network (PPI). Cytoscape plugin cytoHubba allowed for the prediction of the top 4 key genes according to the network maximal clique centrality (MCC) algorithm. The expression levels and diagnostic value of the four key genes were additionally verified in the GSE62646 dataset. RESULTS: A WCGNA analysis revealed 878 DEGs which were clustered into 6 modules. The module with the most significance in AMI was colored blue. Subsequent GO and KEGG pathway enrichment analysis on blue module genes revealed that they were primarily enriched in the inflammation-related pathways. These findings, in combination with PPI and coexpression networks, resulted in the identification of the top four genes by cytoHubba, which included leukocyte immunoglobulin-like receptor B2 (LILRB2), toll-like receptor 2 (TLR2), neutrophil cytosolic factor 2 (NCF2), and S100A9. Among them, LILRB2, NCF2, and S100A9 were validated in the GSE62646 dataset. CONCLUSIONS: The results suggested that LILRB2, NCF2, and S100A9 could be potential gene biomarkers for AMI.

Features of CT and EUS in mesenteric plexiform neurofibroma with Neurofibromatosis type I: A case report.

Plexiform neurofibroma(PNF) is a rare benign tumor of the peripheral nerve, belonging to a subtype of neurofibroma. PNF is common in the head, neck and trunk. It is uncommonly observed in the mesentery. We report a case of mesenteric PNF in a 64-year-old man history of neurofibromatosis type I(NF1), which caused abdomen pain. In addition, the computer tomography(CT) and endoscopic ultrasonography(EUS) manifestations of mesenteric PNF were analyzed. The imaging appearance of a mesenteric plexiform neurofibroma is that many low-density (CT) /mixed echo (EUS) soft tissue masses surrounding the superior mesenteric artery, but not surrounding the superior mesenteric vein. Our case adds to the limited literature regarding NF1 presenting with mesenteric PNF. The computer tomography and endoscopic ultrasonography may facilitate confirma diagnosis of mesenteric PNF.

Klebsiella pneumoniae infection secondary to spontaneous renal rupture that presents only as fever: A case report.

BACKGROUND: Spontaneous renal rupture is a rare disease in the clinic. The causes of spontaneous renal rupture include extrarenal factors, intrarenal factors, and idiopathic factors. Reports on infection secondary to spontaneous renal rupture and the complications of spontaneous renal rupture are scarce. Furthermore, there are few patients with spontaneous renal rupture who present only with fever. CASE SUMMARY: We present the case of a 52-year-old female patient who was admitted to our hospital. She presented only with fever, and the cause of the disease was unclear. She underwent a contrast-enhanced computed tomography (CT) scan, which showed that the left renal capsule had a crescent-shaped, low-density shadow; the perirenal fat was blurred, and exudation was visible with no sign of calculi, malignancies, instrumentation, or trauma. Under ultrasound guidance, a pigtail catheter was inserted into the hematoma, and fluid was drained and used for the bacterial test, which proved the presence of Klebsiella pneumoniae. Two months later, abdominal CT showed that the hematoma was absorbed, so the drainage tube was removed. The abdominal CT was normal after 4 mo. CONCLUSION: Spontaneous renal rupture due to intrarenal factors causes a higher proportion of shock and is more likely to cause anemia.