Clinical and imaging characteristics of patients with bronchogenic cysts: a single-center retrospective analysis.

BACKGROUND: Bronchogenic cysts (BCs) are rare and usually asymptomatic malformations detected during imaging examinations. We aimed to investigate the clinical and imaging characteristics of patients with BCs. METHODS: We retrospectively evaluated patients who received surgery to remove their BCs from January 2015 to January 2019. Their baseline characteristics, clinical information, and imaging results were reviewed. RESULTS: Our study included 129 patients, with 57 males and 72 females and a mean age of 42.7 years old. The most common location for BCs was the mediastinum (67 patients, 51.9%). Fewer than half of the patients (53 patients, 41.1%) reported clinical symptoms, with chest pain being the most common (16 patients, 30.2%). Neck BCs were more frequently observed in young patients (P = 0.002) and were more often associated with thyroid cancer (P = 0.007). A computed tomography scan was the most commonly used method to diagnose BCs in the lung and mediastinum, whereas ultrasound was the most commonly used diagnostic method for neck BCs. The characteristic images were well-defined, thin-wall cystic lesions in varying densities. A few lesions showed small, calcified spots along the rim or cavities. CONCLUSIONS: Although most BCs were found in the mediastinum, their locations could vary in different sex and age groups. Particular attention should be paid to young patients with BCs in the neck to rule out thyroid cancer.

Two previously undescribed phthalides from Talaromyces amestolkiae, a symbiotic fungus of Syngnathus acus.

Amestolkins A (1) and B (2), two previously undescribed phthalides sharing the same planar structure of (1, 5-dihydroxyhexyl)-7-hydroxyisobenzofuran-1(3H)-one were isolated from Talaromyces amestolkiae. Their absolute configurations were elucidated by comprehensive analyses of spectroscopic evidences in high-resolution electrospray mass spectra (HRESIMS) and nuclear magnetic resonance (NMR) combined with electronic circular dichroism (ECD) and NMR calculations. 1 and 2 showed anti-neuroinflammatory activity by inhibiting the gene expressions of proinflammatory factors including C-C motif chemokine ligand 2 (CCL-2), tumor necrosis factor-α (TNF-α) and interleukin 6 (IL-6), as well as attenuating the excretion of inducible nitric oxide synthase (iNOS) in BV-2 microglial cells at the concentration of 30 µM.

[Chemical constituents and anti-liver fibrosis mechanism of Meconopsis quintuplinervia based on UPLC-Q-Exactive-MS/MS and network pharmacology].

In this study, UPLC-Q-Exactive-MS/MS was used to rapidly analyze the chemical constituents of Meconopsis quintupli-nervia, and the anti-liver fibrosis mechanism of M. quintuplinervia was preliminarily analyzed by network pharmacology, molecular docking, and cell experiments. The chemical constituents of M. quintuplinervia were identified according to the information of MS~1 and MS~2, as well as the data in the literature and databases. SwissTargetPrediction and TargetNet were used to predict the potential targets. The targets related to liver fibrosis were collected from GeneCards and OMIM. The protein-protein interaction(PPI) network was constructed by STRING. Cytoscape 3.6.1 was used to construct and analyze the "constituent-target-disease" network to obtain key targets and their corresponding constituents in the network. DAVID 6.8 was used for GO analysis and KEGG signaling pathway enrichment analysis. Finally, the preliminary verification was carried out by molecular docking and cell experiments. As a result, 106 chemical constituents were identified from M. quintuplinervia, including 66 flavonoids, 16 alkaloids, 18 phenolic acids, 1 anthocyanin, and 5 other constituents. Among them, 3 constituents were identified as potential new compounds, and 59 constituents were reported in M. quintuplinervia for the first time. Network pharmacology analysis showed that M. quintuplinervia presumably acted on AKT1, SRC, JUN, EGFR, STAT3, HSP90 AA1, MAPK3, and other core targets through luteolin, isorhamnetin, quercetin, apigenin, kaempferide, amurine, 2-methylflavinantine, allocryptopine, the multi and other active compounds, thereby regulating the PI3 K/AKT signaling pathway, pathways in cancer, proteoglycans in cancer, FoxO signaling pathway, and other pathways to exert anti-liver fibrosis effects. M. quintuplinervia extract(MQE) could significantly down-regulate PI3 K and AKT protein levels in the HSC-T6 cell model induced by TGF-ß1, suggesting that MQE may have the ability to regulate the PI3 K/AKT signaling pathway. The findings of this study indicated that the anti-liver fibrosis effect of M. quintuplinervia had multi-constituent, multi-target, and multi-pathway characteristics, which may provide a scientific basis for the research on the pharmacodynamic materials, action mechanism, and quality markers of M. quintupli-nervia.

Renal ectopic lipid deposition in rats with early-stage diabetic nephropathy evaluated by the MR mDixon-Quant technique: association with the expression of SREBP-1 and PPARα in renal tissue.

Background: Renal ectopic lipid deposition (ELD) plays a significant role in the development of diabetic nephropathy (DN). This study aimed to use the magnetic resonance (MR) mDixon-Quant technique to evaluate renal ELD and its association with the expression of sterol regulatory element binding protein 1 (SREBP-1) and peroxisome proliferator-activated receptor alpha (PPARα) in renal tissue. Methods: Seventy male Sprague-Dawley (SD) rats were randomly divided into experimental (n=50) and control groups (n=20). A high-fat diet combined with low-dose streptozotocin (STZ) was administered to the experimental group to establish a type 2 diabetes mellitus (T2DM) model. The rats received renal mDixon-Quant scans and blood lipid and histopathological examinations in batches after the T2DM model was established. According to the histopathological findings, the included rats were stratified into control and early DN groups. Renal fat fraction (FF), blood lipid level, the ratio of the integrated optical density of intracellular lipid droplets and the total area of all the cells (IOD/TAC), and the expression of SREBP-1 and PPARɑ in renal tissue were analyzed. Results: Compared to the controls, renal FF, IOD/TAC, the expression of SREBP-1 in renal tissue, and serum total cholesterol (TC), triglyceride (TG) and low-density lipoprotein (LDL) levels were higher in the early DN group, while the expression of PPARɑ in renal tissue and the high-density lipoprotein (HDL) level were lower (all P values <0.001). Renal FF gradually increased with the progression of disease [r=0.810 (95% CI: 0.675-0.928), P<0.001]. Positive correlations between renal FF and each of the following: TC, TG, LDL, IOD/TAC, and the expression of SREBP-1 [r=0.479 (95% CI: 0.353-0.640, P=0.012), 0.576 (95% CI: 0.283-0.842, P=0.002), 0.441 (95% CI: 0.305-0.606, P=0.021), 0.911 (95% CI: 0.809-0.964, P<0.001) and 0.800 (95% CI: 0.640-0.910, P<0.001), respectively] and negative correlations between renal FF and each of the following: HDL and the expression of PPARɑ [r=-0.611 (95% CI: -0.809 to -0.469, P=0.001) and -0.748 (95% CI: -0.886 to -0.585, P<0.001), respectively] were found. Conclusions: Renal lipid deposition evaluated by the MR mDixon-Quant technique is associated with the blood lipid level, histological fat quantification, and the expression of SREBP-1 and PPARɑ in renal tissue. The renal FF value might serve as a biomarker for better understanding of renal lipid metabolism in early-stage DN.

[Dose distributions of proton beam therapy for hepatocellular carcinoma: a comparative study of treatment planning with 3D-conformal radiation therapy or intensity-modulated radiation therapy].

OBJECTIVE: A comparative dose distribution study has been undertaken between proton beam therapy (PBT), 3-dimensional conformal radiation therapy (3D-CRT) and intensity-modulated radiation therapy (IMRT) in the treatment of hepatocellular carcinoma (HCC), so as to assess the potential advantages of PBT. METHODS: Dose volume histograms (DVHs) were compared between PBT and 3D-CRT or IMRT planning at total dose of 66 Gy and 86 Gy in stage I patients (n = 10, diameter < or = 5 cm), 60 Gy and 72 Gy in stage IIA patients (n = 12, diameter = 5.1-10 cm). RESULTS: For patients with stage I, the mean liver dose (Dmean), V10, V20 and V30 were 13.01 Gy, 51.89%, 36.13% and 21.24% for 3D-CRT, whereas they were 6.34 Gy, 30.23%, 17.86% and 10.66%, respectively, for PBT (P < 0.002). With dose escalation to 86 Gy, the Dmean, V10, V20 and V30 were 16.91 Gy, 67.51%, 46.84% and 27.61% for 3D-CRT, whereas they were 8.26 Gy, 39.31%, 23.22% and 13.86%, respectively, for PBT (P < 0.002). Compared with 3D-CRT with dose of 66 Gy, PBT reduced the Dmean, V10, V20 and V30 even with dose escalation to 86 Gy (P < 0.042). For patients with stage IIA, the Dmean, V10, V20 and V30 were 29.18 Gy, 72.25%, 58.17%, 44.01% and 24.92 Gy, 73.32%, 56.15%, 37.75% for 3D-CRT and IMRT, respectively, with dose of 60 Gy, whereas they were 16.28 Gy, 43.93%, 33.54% and 22.78%, respectively, for PBT (P < 0.002). With dose escalation to 72 Gy, the Dmean, V10, V20, V30 were 35.02 Gy, 86.70%, 69.80%, 52.81% and 29.90 Gy, 87.98%, 67.74% and 45.30% for 3D-CRT and IMRT, respectively, whereas they were 19.54 Gy, 52.72%, 40.25% and 27.34%, respectively, for PBT (P < 0.002). Compared with 3D-CRT and IMRT with total dose of 60 Gy, PBT reduced the Dmean, V10, V20 and V30 even with dose escalation to 72 Gy (P < 0.05). In all of the 22 cases, compared with 3D-CRT, PBT reduced the doses to the nonliver OARs (organs at risks) including spinal cord, right kidney and stomach (P < 0.002). Compared with IMRT, PBT also reduced the dose to the right kidney and stomach significantly, while no significant difference was found respect to the dose to spinal cord (P > 0.05). CONCLUSION: Compared with 3D-CRT, PBT reduced the dose to the normal liver tissues and nonliver OARs significantly, even with 20 to 30.3 percent of dose escalation. Compared with IMRT, PBT reduced the dose to the normal liver tissues significantly, even with 20 to 30.3 percent of dose escalation. PBT reduced the dose to the right kidney and stomach significantly. No significant difference was observed respect to the dose to spinal cord.

[Clinical features and strategies for the treatment of cervical spinal injury in aged patients].

OBJECTIVE: To investigate clinical features and treatments of cervical spinal injury in aged patients. METHODS: From July 2006 to October 2011, 27 patients with cervical spinal cord injury were divided into experiment group, including 20 males and 7 females with an average age of 69 years old (ranged 65 to 78 years old). The other 22 patients with the same degree of cervical spianl cord injury and the same period hospitalization were chosen to regard as control group, including 16 males and 6 females with an average age of 47 years old (ranged 38 to 65 years old). All of them had clear history of trauma, and were admitted to hospital within one week. Clinical data and result of follow up were evaluated between two group. The function of the spinal cord was measured by Frankel classification at admission and final follow-up. RESULTS: All patients were followed up for 1 year except 6 died in aged group, among which 3 paients with complications were died during hospitalization and others were out of hospital. Twenty-three cases had accompanied diseases and 24 cases occurred complications in aged group. Contrast to control group, this difference was statistically significant. At the final follow-up, there were 2 cases at Frankel grade E in aged group and 6 cases in control group. CONCLUSION: In comparison with control group, there are more accompany diseases and higher complications and mortality rates in aged group, while poor improvement of spinal cord function. This patients were mainly treated with operation, but operation method should simplify and mainly focus on effective decompression and reconstuction stability and avoid expansion operation. It's nesscerry to pay more attention to prevent and treatment of respiratory complication.

[Pedicle fixation without bone fusion for the treatement of thoracolumbar fractures through paraspinal approach].

OBJECTIVE: To evaluate clinical effects of pedicle fixation without bone fusion in treating thoracolumbar fractures through paraspinal approach. METHODS: From January 2006 to January 2009, 25 patients (15 males and 10 females) with thoracolumbar fractures were treated. The average age was 39.3 years,ranged from 17 to 49 years. According to classification, flexion fracture in 7 cases, brust fracture in 18 cases. There were no nervous injury, and radiology information showed the angle of sagittal vertebral body >20 degrees or collapse of vertebral body >40%,without vertebral injury. The operation were performed at 3 to 7 days after injury (mean 5 day). Internal fixation implants were removed at 8 to 12 months after operation. The height, kyphosis angle were measured before operation, 1 week and 24 months after operation,and Oswestry disability index (ODI) were compared before and after operation. RESULTS: All patients were followed up for 24 months. Among them, 1 case was followed up at 30 months after operation. The operation time ranged from 70 to 110 (mean 90) minutes, the blood loss was 120 to 280 (mean 200) ml. The height of vertebral body and kyphosis angle were obviously corrected, and had significant differences between postoperation immediately and at the final follow-up (P<0.05). There were no differences after remove of internal fixation (P>0.05). The final ODI was (5.36 +/- 1.21)%, had statistical differences compared with preoperation (P<0.05). CONCLUSION: For flexion and burst thoracolumbar fractures without nervous injury, pedicle fixation without bone fusion is a good method,which has advantages of minimally invasive, rapid recovery, and maintain spinal motion segment.

Identification of flavonoid glycosides in Rosa chinensis flowers by liquid chromatography-tandem mass spectrometry in combination with ¹³C nuclear magnetic resonance.

Flowers of Rosa chinensis are widely used in traditional Chinese medicine as well as in food industry. Flavonoid glycosides are believed to be the major components in R. chinensis that are responsible for its antioxidant activities. In this work, a liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method was developed for analysis of flavonoid glycosides presented in ethyl acetate extract of dried R. chinensis flowers. Twelve flavonoid glycosides were separated and detected. By comparing the retention times, UV spectra, and tandem MS fragments with those of respective authentic compounds, eight flavonoid glycosides were unequivocally identified. Although the other four were also identified as flavonoid glycosides, the glycosylation positions could not be determined due to lack of authentic compounds. Fortunately, the glycosylation effects were clearly observed in the (13)C NMR spectrum of the extract. The detailed structural information was, therefore, obtained to identify the four flavonoid glycosides as quercetin-3-O-D-glucoside, quercetin-3-O-D-xyloside, kaempferol-3-O-D-xyloside and quercetin-3-O-D-(6″-coumaroyl)-galactoside. These flavonoid glycosides were detected and identified for the first time in this botanic material. This work reports on the first use of (13)C NMR of a mixture to enhance a rapid HPLC-MS/MS analysis. The proposed analytical protocol was validated with a mixture of authentic flavonoid glycosides.