Diagnostic significance of HRCT imaging features in adult mycoplasma pneumonia: a retrospective study.

Mycoplasma pneumoniae pneumonia (MPP) often overlaps with the clinical manifestations and chest imaging manifestations of other types of community-acquired pneumonia (CAP). We retrospectively analyzed the clinical and imaging data of a group of patients with CAP, summarized their clinical and imaging characteristics, and discussed the diagnostic significance of their certain HRCT findings. The HRCT findings of CAP researched in our study included tree-in-bud sign (TIB), ground-glass opacity (GGO), tree fog sign (TIB + GGO), bronchial wall thickening, air-bronchogram, pleural effusion and cavity. The HRCT findings of all cases were analyzed. Among the 200 cases of MPP, 174 cases showed the TIB, 193 showed the GGO, 175 showed the tree fog sign, 181 lacked air-bronchogram. In case taking the tree fog sign and lack of air-bronchogram simultaneously as an index to distinguish MPP from OCAP, the sensitivity was 87.5%, the specificity was 97.5%, the accuracy was 92.5%. This study showed that that specific HRCT findings could be used to distinguish MPP from OCAP. The combined HRCT findings including the tree fog sign and lacked air-bronchogram simultaneously would contribute to a more accurate diagnosis of MPP.

Effectiveness of different antithrombotic agents in combination with tranexamic acid for venous thromboembolism prophylaxis and blood management after total knee replacement: a prospective randomized study.

BACKGROUND: Tranexamic acid (TXA) has been widely applied in total knee arthroplasty (TKA) to significantly reduce perioperative blood loss and improve knee function recovery in patients after surgery. The choice of antithrombotic agents for venous thromboembolism (VTE) prevention after TKA is controversial. Therefore, this study aimed to compare the effects of different antithrombotic agents on patients after primary unilateral TKA in the context of applied TXA. METHODS: A total of 180 patients undergoing primary unilateral TKA from October 2020 to December 2021 were included in this study. All patients were given an intraoperative drip of 60 mg/kg TXA. Thereafter, patients were divided into three groups (n = 60 each). Baseline data were comparable among the three groups. The average follow-up time was 3.02 ± 0.09 months. Group 1 enrolled patients receiving oral rivaroxaban (RA) at 10 mg, Group 2 included patients who received subcutaneous Dalteparin sodium at 2500 IU, while Group 3 included patients taking oral aspirin (ASA) at 100 mg. Patients in all the three groups received treatment once a day for 30 days at 12 h postoperatively. The primary outcomes in this study were post-treatment drainage volume and thrombotic complication rate. The secondary outcomes included hematologic parameters, transfusion rate, intraoperative blood loss, total blood loss (TBL), and bleeding complication rate. RESULTS: The average drainage volume after treatment was significantly lower in Group 3 than in Group 1 and Group 2 (205.2 ± 69.0 vs 243.4 ± 72.5 vs 295.4 ± 72.5 ml, P < 0.001), and there was a significant difference between Group 1 and Group 2 (243.4 ± 72.5 mL vs 295.4 ± 72.5 mL, P < 0.001). The blood transfusion rate of Group 2 dramatically increased compared with Group 1 and Group 3 (20.0% vs 6.7% vs 5.0%, P = 0.01). The bleeding complication rate in Group 1 apparently increased relative to Group 2 and Group 3 (26.7% vs 10.0% vs 8.3%, P = 0.008). Besides, there was no significant difference in the thrombotic complication rate among the three groups. CONCLUSION: Under the background of TXA application, ASA, RA, and Dalteparin sodium were all effective on preventing VTE after TKA. In addition, ASA effectively reduced post-treatment Hemoglobin (Hb) loss, drainage volume, TBL, transfusion rate, and bleeding complications compared with RA and Dalteparin sodium. TRIAL REGISTRATION: The trial was registered at the Chinese Clinical Trial Registry (ChiCTR2200060169). Date of Registration: 21/05/2022.

Chondrosarcoma of the toe: A case report and literature review.

BACKGROUND: Chondrosarcoma of the foot is a rare malignant bone tumour, and it is even rarer when it originates in a toe bone. Surgical excision is the only effective treatment. The osteolytic destruction of the tumour severely affects limb function and carries the risk of distant metastasis. Most such tumours are removed surgically to minimize local recurrence and distant metastases, maximize limb function, and prolong the patient's tumour-free survival time. The main objective of this article is to present the case of a chondrosarcoma that invaded the first phalanx of the left foot and formed a large phalangeal mass with osteolytic destruction of the distal bone. CASE SUMMARY: A 74-year-old man suffered from swelling of his left toe for six months, with pain and swelling for two months. Computed tomography and magnetic resonance imaging showed that the tumour on the first phalanx of the left foot was approximately 54.9 mm × 44.6 mm, surrounded by a significant soft tissue signal mass, with osteolytic destruction of the distal phalanx and a speckled bone-like high-density shadow within it. CONCLUSION: Chondrosarcoma occurring in a toe bone is extremely rare. In this case, extensive surgical resection of the large low-grade chondrosarcoma, which showed osteolytic destruction and invaded the distal metatarsal bone, was safe and effective.

Cytotoxic sesquiterpenoid dimers from the resin of Commiphora myrrha Engl.

Seven undescribed sesquiterpenoid dimers, commiphomyrones A - G, together with three known analogs, were isolated from the resin of Commiphora myrrha Engl.. The structures of the undescribed compounds were elucidated based on a comprehensive analysis of spectroscopic data (NMR, UV, IR, and MS), and the absolute configurations were defined by comparing the experimental and calculated ECD spectra as well as by performing X-ray crystallographic analysis. All the isolated dimeric sesquiterpenoids feature a 7-oxabicyclo [2.2.1] hept-2-ene moiety formed by the [4 + 2] cycloaddition of two sesquiterpenoids. Commiphomyrones C and G and commiphoratone D showed cytotoxic activity against the HGC-27 cell line with IC50 values of 22.76, 25.01, and 27.51 µM, respectively.

[One new cembranoid diterpene from gum resin of Boswellia carterii].

This study aims to study the chemical components from the gum resin of Boswellia carterii. Five cembranoid diterpenes were isolated from the gum resin of B. carterii by various of column chromatographies including silica gel, Sephadex LH-20, and semi-preparative HPLC. Their structures were identified on the basis of physicochemical properties, mass spectrometry(MS), nuclear magnetic resonance(NMR), Ultraviolet(UV) and infrared(IR) spectroscopic data. These compounds were identified as(1S,2E,4R,5S,7E,11E)-4-methoxy-5-hydroxycembrane(1),(1R~*,4R~*,5E,8E,12E,15E)-4-hydroxycembra-5,8,12,15-tetraene(2), cembrene A(3),(3S,4S,7R)-4-hydroxycembrane(4), and pavidolide D(5). Compound 1 was a new compound. Compounds 2, 4, and 5 were obtained from the gum resin of B. carterii for the first time. Compound 2 showed weak inhibition on the human liver cancer cell line HepG2.

[Rapid Start-up and Stability of Partial Denitrification Based on Different Waste Sludge Sources].

To explore the feasibility of the rapid start-up of partial denitrification and the stable accumulation of NO2--N in different waste sludge sources, three identical SBR reactors (S1, S2, and S3) were inoculated respectively with sludge discharged from a laboratory municipal wastewater denitrifying phosphorus removal system, surplus sludge from a municipal wastewater treatment plant, and river sediment sludge. The characteristics of the partial denitrification start-up and NO2--N accumulation were compared, and the partial denitrification activity of the system or NO3--N→NO2--N transformation performance were investigated by analyzing the characteristics of the functional bacteria genera of the reactor from the perspective of microbiology. The results showed that all three SBR partial denitrification reactors could be launched successfully in a short time with sodium acetate as the sole carbon source, under a high alkalinity, and by using a suitable COD/NO3--N ratio. The average NO3--N→NO2--N transformation ratio of the system was ranked as:S1 > S2 > S3 (75.92% > 73.36% > 69.90%). It was found that S1 and S2 had different degrees of partial denitrification performance deterioration under a continuous low temperature, but that S3 could maintain a good NO2--N accumulation performance. High throughput sequencing showed that Proteobacteria and Bacteroidetes were dominant in the partial denitrification system, and that the abundance of Thauera was significantly different in the three PD reactors:S3 > S1 > S2 (25.09% > 4.71% > 3.60%), thus indicating that S3 had stable and efficient NO2--N accumulation performance and that a high abundance of Thauera might play a significant role in maintaining low temperature partial denitrification activity.

Near-Infrared Light-Triggered Chlorine Radical (. Cl) Stress for Cancer Therapy.

Free radicals with reactive chemical properties can fight tumors without causing drug resistance. Reactive oxygen species (ROS) has been widely used for cancer treatment, but regrettably, the common O2 and H2 O2 deficiency in tumors sets a severe barrier for sufficient ROS production, leading to unsatisfactory anticancer outcomes. Here, we construct a chlorine radical (. Cl) nano-generator with SiO2 -coated upconversion nanoparticles (UCNPs) on the inside and Ag0 /AgCl hetero-dots on the outside. Upon near-infrared (NIR) light irradiation, the short-wavelength emission UCNP catalyzes . Cl generation from Ag0 /AgCl with no dependence on O2 /H2 O2 . . Cl with strong oxidizing capacity and nucleophilicity can attack biomolecules in cancer cells more effectively than ROS. This . Cl stress treatment will no doubt broaden the family of oxidative stress-induced antitumor strategies by using non-oxygen free radicals, which is significant in the development of new anticancer agents.

[A new nor-sesquiterpene glycoside from Corydalis edulis].

This study is to investigate the chemical constituents from the whole plant Corydalis edulis. The chemical constituents were separated and purified by macroporous resin D101, silica gel, Sephadex LH-20, ODS, and semi-preparative HPLC. Their structures were determined by physicochemical properties and spectroscopic data. Four compounds were isolated from the dichloromethane and water extracts of the whole plant C. edulis, and identified as 6'-ß-D-xylosylicariside B2(1),(3S,5R,6S,7E)-5,6-epoxy-3-hydroxy-7-megastigmen-9-one(2), loliolide(3), and 5,5'-dimethoxybiphenyl-2,2'-diol(4), respectively. Compound 1 is a new compound, of which the absolute configuration was established by electronic circular dichroism(ECD) calculations. Compound 4 is obtained from the plants of Papaveraceae family for the first time. Compounds 2 and 3 are firstly isolated from the Corydalis genus.

Benzophenone glycosides from the pericarps of Aquilaria yunnanensis S. C. Huang.

Two new benzophenone glycosides, aquilarisides A (1) and B (2), together with six known analogues (3-8) were isolated from the pericarps of Aquilaria yunnanensis S. C. Huang. Their structures were elucidated on the basis of 1D and 2D NMR and mass spectroscopic analyses, and the absolute configuration of compound 1 was determined by experimental and calculated electronic circular dichroism (ECD) spectra. Anti-inflammatory activities of all compounds 1-8 were evaluated for their inhibitory activities against lipopolysaccharide (LPS)-stimulated induced nitric oxide (NO) production in RAW 264.7 cells using the Griess assay. Compound 2 indicated a weak inhibition of NO production.

Slot Self-Allocation Based MAC Protocol for Energy Harvesting Nano-Networks.

Nano-networks are composed of interconnected nano-nodes and can enable unprecedented applications in various fields. Due to the peculiarities of nano-networks, such as high density, extremely limited energy and computational resources, traditional carrier-sensing based Media Access Control (MAC) protocols are not suitable for nano-networks. In this paper, a Slot Self-Allocation based MAC protocol (SSA-MAC) is proposed for energy harvesting nano-networks. Two transmission schemes for centralized and distributed nano-networks are designed, respectively. In centralized nano-networks, nano-nodes can only send packets to the nano-controller in their Self-Allocation Slots (SASs), while, in distributed nano-networks, nano-nodes can only receive packets from surrounding nano-nodes in their SASs. Extensive simulations were conducted to compare the proposed SSA-MAC with PHysical LAyer aware MAC (PHLAME), Receiver-Initiated Harvesting-aware MAC (RIH-MAC) and Energy Efficient Wireless NanoSensor Network MAC (EEWNSN). From the results, it can be concluded that the proposed SSA-MAC achieves better performance and can reduce the collision probability, while improving the energy efficiency of nano-networks.

[Identification of active components in Longxue Tongluo Capsules against ischemic brain injury based on component-activity relationship].

Ten fractions(A-J) were prepared by separation of Longxue Tongluo Capsules(LTC) by using silica gel column chromatography and orthogonal experimental design,showing similar chemical profiles with different abundances of peaks.These ten samples were assessed with UHPLC-QE OrbitrapHRMS for 97 common peaks.For the pharmacological activity experiment,three kinds of in vitro cell models including lipopolysaccharide(LPS)-induced BV-2 microglial cells NO release model,oxygen-glucose deprivation/reoxygenation(OGD/R)-treated HUVEC vascular endothelial cells injury model,and OGD/R-treated PC-12 nerve cells injury model were employed to evaluated the bioactivity of each fraction.Based on the contribution of each identified component,grey relation analysis and partial least squares(PLS) analysis were performed to establish component-activity relationship of LTC,identify the potential active components.After that,validation of the potential active components in LTC was carried out by using the same models.The results indicated that 4 phenolic compounds including 7,4'-dihydroxyhomoisoflavanone,loureirin C,4,4'-dihydroxy-2,6-dimethoxydihydrochalcone,and homoisosocotrin-4'-ol,might be the active components for anti-neuroinflammation effect;five phenolic compounds such as 3,5,7,4'-tetrahydroxyhomoisoflavanone,loureirin D,7,4'-dihydroxyhomoisoflavane,and 5,7-dihydroxy-4'-methoxy-8-methyflavane,might have positive effects on the vascular endothelial injury;three phenolic compounds including 5,7,4'-trihydroxyflavanone,7,4'-dihydroxy-5-methoxyhomoisoflavane,and loureirin D,might be the active components in LTC against neuronal injury.

Follow-up Results and Clinical Significance of Magnetic Resonance Spectroscopy Combined with Fluorescence Microscopy in Resection of High Grade Supra-tentoria Gliomas.

Objective To investigate the clinical effectiveness of magnetic resonance spectroscopy (MRS) combined with sodium fluorescein(FL) in the treatment of high grade gliomas(HGG). Methods From August 2013 to 2015 November,the clinical data of 72 supratentorial HGG(WHO grade Ⅲ-Ⅳ) patients who had received surgical treatment in our hospital were retrospectively studied,among whom 43 cases received MRS combined with intra-perative FL navigation(observation group),and 29 cases only received conventional surgery(control group). Post-operative radiotherapy and chemotherapy were applied for more than 3 months. Routine enhanced MRI were performed 24-48 hours after the operation to investigate the extent of tumor resection. Six months after the operation,the quality of life of patients was evaluated by using the Karnofsky score,and 1-year postoperative survival rate and progression-free survival(PFS) were observed. Results Postoperative MRI showed that the rate of gross total resection(GTR) in observation group was significantly higher than that in control group(72.09%vs.51.72%;χ2=23.88,P=0.001),and the GTR rate of WHO grade Ⅳ tumors was significantly higher than that of WHO grade Ⅲ tumors in observation group(92.86% vs.62.07%;χ2=6.06,P=0.042). The postoperative Karnofsky score in the observation group was significantly higher than that in control group(µ=2.34,P=0.021). The mean time of follow-up was(16.4±2.4) months(8-21 months) and there was no statistical significant difference between observation group and control group in 1-year survival rate(74.07% vs.77.50%;χ2=4.90,P=0.165) and PFS [(13.2±1.2) months vs.(12.7±2.0) months;χ2=7.26,P=0.067]. In observation group,the PFS of WHO grade Ⅳ patients was significantly higher than that in control group [(14.2±0.3) months vs.(10.0±1.1) months;χ2=11.03,P=0.031]. There was also no statistical significant difference between WHO grade Ⅳ tumors in two groups in terms of 1-year survival rate(71.43% vs.72.54%;χ2=5.33,P=0.089),and there was no statistical significant difference between WHO grade Ⅲ tumors in two groups in 1-year survival rate(75.86% vs. 72.22%;χ2=3.78,P=0.250) and in PFS [(13.7±1.4) months vs.(12.4±0.8) months;χ2=4.85,P=0.083]. Conclusions MRS combined with intraoperative FL navigation technology can improve the resection rate and improve survival quality of patients,and there is no evidence that MRS combined with intraoperative FL navigation prolong the overall survival of patients with high-grade gliomas. Different outcome may be found with longer follow-up and increased simple size.

Major Metabolite Levels of Preoperative Proton Magnetic Resonance Sectroscopy and Intraoperative Fluorescence Intensity in Glioblastoma.

Objective To compare the intraoperative major metabolite level of preoperative proton magnetic resonance spectroscopy(1H-MRS)and fluorescence intensity marked with fluorescein sodium(FLs)in glioblastoma(GBM)and thus provide an objective basis for fluorescence surgical treatment of GBM. Methods All newly diagnosed patients by plain and enhanced magnetic resonance imaging from the April 1,2014 to December 31,2015 were enrolled in this study.All of them received 1H-MRS and marked with FLs.The expression of Ki67 in tumor boundary were confirmed by postoperative pathology and determined by immunostaining assay.The relationship between 1H-MRS metabolite levels and tumor fluorescence intensity was analyzed. Results Totally 33 patients were included in the study.Preoperative 1H-MRS revealed high-grade gliomas in 25 cases.The N-acetylaspartate(NAA)decreased significantly and choline(Cho)increased significantly in high-grade gliomas.The ratios of Cho/NAA,NAA/creatine(Cr),and Cho/Cr significantly differed in different tumor regions(P=0.02,P=0.01,and P=0.00,respectively).Surgical results were marked with FLs intraoperatively.Tissue fluorescence were clearly seen.There were 29 patients undergoing total resection and 4 cases undergoing subtotal resection.No acute encephalocele occured after operation,while 2 patients suffered from epilepsy.Postoperative pathology results included:28 cases were diagnosed as GBM(22 cases consistent with 1H-MRS diagnosis).The results of GBM fluorescence imaging included:the level of fluorescence intensity in tumor parenchyma was significantly higher than that in tumor boundary and peritumoral edema(P=0.01).The result of 1H-MRS metabolite analysis included:The kurtosis of NAA and of Cho and the ratio of Cho/NAA were significantly different according the fluorescence intensity in tumor parenchyma(P=0.01,P=0.02,and P=0.01).While there was no difference in the kurtosis of NAA,the kurtosis of Cho and the ratio of Cho/NAA were significantly different according the fluorescence intensity in tumor boundary(P=0.02, P=0.00).In peritumoral edema,there was no significant different in kurtosis of NAA and of Cho and in the ratio of Cho/NAA(P=0.23,P=0.09,P=0.14).Immunohistochemistry in GBM tumor boundary showed different Ki67 expressions according to different fluorescence imaging(P=0.03). Conclusions The fluorescence intensity in GBM parenchyma is higher than that in other tumor regions,and there are different metabolic levels in different fluorescence intensity.The metabolic information marked by FLs and provided by 1H-MRS before operationis are important,and the correlation between them should be further investigated.

[Analysis of 163 rib fractures by imaging examination].

OBJECTIVE: To explore the applications of imaging examination on rib fracture sites in forensic identification. METHODS: Features including the sites, numbers of the processed imaging examination and the first radiological technology at diagnosis in 56 cases of rib fractures from 163 injuries were retrospectively analyzed. RESULTS: The detection rate of the rib fractures within 14 days was 65.6%. The initial detection rate of anterior rib fracture proceeded by X-ray was 76.2%, then 90.5% detected at a second time X-ray, while the detection rate of CT was 66.7% and 80.0%, respectively. The initial detec- tion rate of rib fracture in axillary section proceeded by X-ray was 27.6%, then 58.6% detected at a second time X-ray, while the detection rate of CT was 54.3% and 80.4%, respectively. The initial detection rate of posterior rib fracture proceeded by X-ray was 63.6%, then 81.8% detected at a second time X-ray, while the detection rate of CT was 50.0% and 70.0%, respectively. CONCLUSION: It is important to pay attention to the use of combined imaging examinations and the follow-up results. In the cases of suspicious for rib fracture in axillary section, CT examination is suggested in such false X-ray negative cases.

A Convenient Synthesis of γ-Amino-Ynamides via Additions of Lithiated Ynamides to Aryl Imines. Observation of an Aza-Meyer-Schuster Rearrangement.

Efforts in developing an expeditious and convenient method for synthesizing γ-amino-ynamides via nucleophilic addition of lithiated ynamides to aryl imines are described. This work also features an aza-variant of a Meyer-Schuster rearrangement of γ-amino-ynamides and the synthetic utility of γ-amino-ynamides in an intramolecular ketenimine-[2 + 2] cycloaddition.