Disease burden of esophageal cancer attributable to low fruit intake in China and globally from 1990 to 2019.

OBJECTIVE: To understand the disease burden of esophageal cancer (EC) attributable to inadequate fruit intake in China and global from 1990 to 2019 stratified by age and sex. METHODS: Global Burden of Disease Study (GBD 2019) were pooled to calculate the number of deaths, standardized mortality rate, disability-adjusted life years (DALY) and DALY rate of EC attributed to low fruit intake in China and globally by age and sex from 1990 to 2019. The population attributable fractions (PAF) were applied to estimate the proportion of EC caused by low fruit intake. Joinpoint was used to estimate average annual percentage of change (AAPC) to reflect the time change trend of the EC burden attributable to inadequate fruit intake in China and globally. RESULTS: In the Chinese population in 2019, the attributable DALY of EC in males was 356,000 person-years, while it was 80,600 person-years in females. The attributable standardized mortality and DALY rates for different age groups in China increased with age, peaking in the group aged 70 years and above. From 1990 to 2019 in China, the number of deaths, standardized mortality rates, DALY and standardized DALY rates of EC attributable to inadequate fruit intake showed a decreasing trend (AAPCs: -1.62%, -4.54%, -2.10% and -4.88%, respectively), with statistical significance (P<0.001). CONCLUSION: The overall burden of EC attributed to inadequate fruit intake in China has demonstrated a downward trend. However, due to the aging population, the disease burden in China remains higher than the global average. Hence, prevention and health education efforts should focus on the population with low fruit intake.

Developing portable and controllable fluorescence capillary imprinted sensor for visual detection Crohn's disease biomarkers.

Simultaneous detection of multiple biomarker levels is essential to improve the accuracy of early diagnosis. Introducing capillary will simplify procedure, less time, and reduce reagent consumption for point-of-care testing of biomarkers. Here, we developed a portable and controllable smartphone-integrated fluorescence capillary imprinted sensing platform for the accuracy visual detection of Crohn's disease biomarkers (lysozyme, Fe3+) using single-excitation/double-signal detection. A novel controllable capillary coating strategy was developed by static gas-driven coating method for synthesis uniform fluorescence capillary imprinted sensor (Si-CD/g-CdTe@MIP capillary sensor). When Fe3+ and lysozyme were added, the fluorescence intensity of Si-CD/g-CdTe@MIP capillary sensor was quenched at 426 nm and enhanced at 546 nm, respectively. This Si-CD/g-CdTe@MIP capillary sensor has high sensitivity and selectivity for quantification lysozyme and Fe3+ simultaneously with the detection limit of 0.098 nM and 0.20 nM, respectively. In addition, the smartphone-integrated Si-CD/g-CdTe@MIP capillary sensor was applied for the intelligent detection of lysozyme and Fe3+, in which the detection limit was calculated as 0.32 nM and 0.65 nM. The smartphone-integrated visual Si-CD/g-CdTe@MIP capillary sensor realized ultrasensitive microanalysis (18 µL/time) of biomarkers in health man and Crohn 's patients, providing a novel strategy for early diagnosis of Crohn 's disease.

The effect of L-cysteine on starch and protein degradation during barley germination.

OBJECTIVES: In order to investigate the impact of L-cysteine (L-Cys) on starch and protein degradation during barley germination. The amylase activities, degradation of macromolecules during germination were determined in this study. METHODS: Barley was germinated in petri dish for 0 to 5 days with different levels of L-Cys (0 mM, 2.5 mM, 5 mM, 10 mM). RESULTS: L-Cys addition increased the total limit dextrinase (LD) activities and decreased the LD inhibitor activities during whole germination stage. The activities of α-amylase, ß-amylase and free LD were increased with the addition of 2.5, 5 mM L-Cys at germination days 1 to 4. Due to higher amylase in malt with the addition of L-Cys, the non-fermentable sugars were reduced and the glucose, maltotriose were improved. Furthermore, the protein degradation analysis showed that low molecular weight protein increased and middle molecular weight protein decreased obviously in wort from the malt germinated with L-Cys, demonstrating that the L-Cys promote the protein degradation. Lastly, the filtration performance of malt with the addition of L-Cys during malting was better than the control. CONCLUSION: In conclusion, L-Cys can promote the degradation of storage material (starch, protein) during barley germination, leading to a better green malt quality.

Function of homocysteine and HE4 in endometrial carcinoma: verified by prospective experiment.

Background: Timely diagnosis is the key factor to improve the prognosis of endometrial carcinoma (EC). To date, no particularly good markers could significantly improve the detection rate of EC. This study aimed to assess the utility of serum markers homocysteine (Hcy), human epididymal protein 4 (HE4), cancer antigen 199 (CA199), cancer antigen 125 (CA125), fibrinogen (Fib), and D-dimer (D-D) for EC diagnosis, especially Hcy of which its role in EC has not been noticed. Methods: Pre-test and verification tests were performed. In Pre-test, the diagnostic value of the included markers was evaluated and the right marker was chosen to establish an efficient new risk index for screening EC. In verification tests, the applicability of the new risk index was tested. Several evaluation indices including receiver operating characteristic (ROC) curve, Youden Index, sensitivity (SN), and specificity (SP), were adopted to assess the diagnostic value of the included markers for EC. Results: Hcy may be useful in the diagnosis of EC. Its diagnostic value was not significantly lower than that of HE4. Based on the diagnostic value of Hcy and HE4, a new risk index was established, which demonstrated high value in EC diagnosis (ROC, 0.801), especially among young female patients (age ≤50 years, ROC, 0.871). Furthermore, the level of Hcy, but not HE4, was notably different in normal or benign endometrial lesions, atypical endometrial hyperplasia (AEH), and EC. Conclusions: The change of Hcy levels could be used to diagnose EC and when taken into consideration together with the detection of HE4, the diagnostic accuracy of EC is further improved.

Cardiac magnetic resonance imaging detection of intramyocardial hemorrhage in patients with ST-elevated myocardial infarction: comparison between susceptibility-weighted imaging and T1/T2 mapping techniques.

Background: Susceptibility-weighted imaging (SWI) and T1/T2 mapping can be used to detect reperfusion intramyocardial hemorrhage (IMH) in ST-segment elevation myocardial infarction (STEMI) patients. However, the sensitivity and accuracy of the SWI and T1/T2 mapping sequences were not systematically compared. The study aimed to evaluate image quality and diagnostic performance of SWI in patients with IMH, compared with T1/T2 mapping. Methods: A prospective study was conducted on consecutive acute STEMI patients who were recruited from January to July 2022. Within 2-6 days after reperfusion treatment, all patients underwent a 3T cardiac magnetic resonance (CMR) examination, including T2-weighted short-tau inversion recovery (T2W-STIR), T1/T2 mapping, and SWI. A total of 36 patients [age, 56.50±17.25 years; males, 83.33% (30/36)] were enrolled. The relative infarct-remote myocardium signal intensity ratio (SIinfarct-remote) and contrast-to-noise ratio (CNR) were calculated for each patient on T1/T2 mapping and SWI, and the difference between relative signal intensity-to-noise ratio (rSNR) in the IMH (rSNRIMH) was measured for IMH patients on T1/T2 mapping and SWI. SIinfarct-remote, CNR, and rSNRIMH were compared among the three sequences. Receiver operating characteristic (ROC) analyses were used to evaluate the diagnostic performance of three sequences by SIinfarct-remote and visual assessment. Results: A total of 26 (72.22%) patients had IMH. Quantitatively, the SIinfarct-remote of three sequences had excellent diagnostic performance for detecting IMH [SWI area under the curve (AUC) =1.000, 95% confidence interval (CI): 1.000-1.000 vs. T1 mapping AUC =0.954, 95% CI: 0.885-1.000 vs. T2 mapping AUC =0.985, 95% CI: 0.955-1.000; SWI vs. T1 mapping, P=0.300; SWI vs. T2 mapping, P=0.188; T1 mapping vs. T2 mapping, P=0.302). Qualitatively, three sequences had similar performance on detecting IMH (SWI AUC =0.895, 95% CI: 0.784-1.000; T1 mapping AUC =0.835, 95% CI: 0.711-0.958; and T2 mapping AUC =0.855, 95% CI: 0.735-0.974; SWI vs. T1 mapping, P=0.172; SWI vs. T2 mapping, P=0.317; T1 mapping vs. T2 mapping, P=0.710). The rSNRIMH was highest in T1 mapping, followed by T2 mapping and SWI, but SWI had the highest CNR. Conclusions: SWI, as well as T1/T2 mapping, is a feasible and accurate approach for clinical diagnosis of IMH with excellent performance.

A double-tuned 1 H/31 P coil for rabbit heart metabolism detection at 3 T.

Magnetic resonance imaging (MRI)/magnetic resonance spectroscopy (MRS) employing proton nuclear resonance has emerged as a pivotal modality in clinical diagnostics and fundamental research. Nonetheless, the scope of MRI/MRS extends beyond protons, encompassing nonproton nuclei that offer enhanced metabolic insights. A notable example is phosphorus-31 (31 P) MRS, which provides valuable information on energy metabolites within the skeletal muscle and cardiac tissues of individuals affected by diabetes. This study introduces a novel double-tuned coil tailored for 1 H and 31 P frequencies, specifically designed for investigating cardiac metabolism in rabbits. The proposed coil design incorporates a butterfly-like coil for 31 P transmission, a four-channel array for 31 P reception, and an eight-channel array for 1 H reception, all strategically arranged on a body-conformal elliptic cylinder. To assess the performance of the double-tuned coil, a comprehensive evaluation encompassing simulations and experimental investigations was conducted. The simulation results demonstrated that the proposed 31 P transmit design achieved acceptable homogeneity and exhibited comparable transmit efficiency on par with a band-pass birdcage coil. In vivo experiments further substantiated the coil's efficacy, revealing that the rabbit with experimentally induced diabetes exhibited a lower phosphocreatine/adenosine triphosphate ratio compared with its normal counterpart. These findings emphasize the potential of the proposed coil design as a promising tool for investigating the therapeutic effects of novel diabetes drugs within the context of animal experimentation. Its capability to provide detailed metabolic information establishes it as an indispensable asset within this realm of research.

Identification of subgroups of patients with gastrointestinal cancers based on symptom severity and frequency: A latent profile and latent class analysis.

PURPOSE: Identify subgroups of patients with gastrointestinal cancer with different frequency and severity of symptoms and assess differences in demographics, clinical characteristics, and degree of interference with daily life. METHODS: This was a cross-sectional study. A total of 202 patients with gastrointestinal cancers completed the Chinese version of the MD Anderson Symptom Inventory for Gastrointestinal Cancer Module by convenience sampling. Subgroups of patients were identified using latent profile analysis and latent class analysis. Chi-squared, Mann-Whitney-U, and Kruskal-Wallis tests assessed differences among subgroups. RESULTS: In terms of symptom severity, low (70.3%), Moderate (13.4%), and high (16.3%) classes were identified. Compared with the other two classes, the Moderate group had a higher proportion of patients with a history of tobacco and alcohol, esophageal cancer, and gastric cancer (P < 0.05). In terms of symptom frequency, all -high (57.9%), high physical symptoms (9.9%), and all-low (32.2%) classes were identified. All-high groups had a younger age and a higher proportion of patients with cancer stage IV (P < 0.05). The high group had the most interference with daily life in both perspectives (P < 0.001), and psycho-emotional symptoms were frequent and severe. CONCLUSIONS: The two perspectives of symptom severity and frequency can play a complementary role in identifying high-risk groups. Clinical practitioners should strengthen psychological interventions in young and advanced cancer patients and provide pharmaceutical and non-pharmaceutical interventions for dysphagia symptoms in esophageal and gastric cancer patients with a history of tobacco and alcohol.

Identification of Core Symptom Cluster in Patients With Digestive Cancer: A Network Analysis.

BACKGROUND: A lack of identified core symptom clusters in digestive cancer patients hinders achieving precision symptom intervention. There are few studies on identifying digestive cancer symptom clusters based on network analysis. OBJECTIVES: The aims of this study were to construct the symptom network of digestive cancer patients and identify the core symptom cluster. METHODS: A cross-sectional study was conducted among 202 digestive cancer patients. The Chinese version of the MD Anderson Symptom Inventory for gastrointestinal cancer scale was used to assess the symptoms by convenience sampling. R software was used to construct a symptom network and identify core symptom clusters. Edge weight and centrality difference tests were used to test the accuracy of core symptom cluster identification. RESULTS: The most common symptoms were distress, poor appetite, and sadness. The most serious symptoms were poor appetite, disturbed sleep, and fatigue. The core symptom cluster of the psychoemotional symptom group was distress, sadness, and numbness. The centrality index showed that the top 3 in strength were distress (Rs = 1.11), fatigue (Rs = 1.09), and sadness (Rs = 1.04). The edge weight difference test showed that the psychoemotional symptom group had high stability. CONCLUSIONS: The psychoemotional symptoms of digestive cancer patients should be given priority for intervention. Network analysis must be extended to the symptom research of cancer patients as soon as possible to provide a scientific basis for symptom management. IMPLICATIONS FOR PRACTICE: Nurses must perform comprehensive psychological and emotional assessments, initiate referrals for psychoemotional symptom management and psychological services, and administer pharmacologic and nonpharmacologic interventions to improve appetite loss in digestive cancer patients.

The correlation of left atrial dysfunction and amyloid load in patients with immunoglobulin light-chain cardiac amyloidosis: a 3T cardiac magnetic resonance study.

OBJECTIVE: To investigate the left atrial (LA) changes in immunoglobulin light-chain cardiac amyloidosis (AL-CA) patients with different risk stratifications and to explore the correlation between LA function and the degree of amyloid load using cardiac magnetic resonance (CMR) imaging. METHODS: Forty-three AL-CA patients were retrospectively enrolled and were divided into low-to-moderate-risk group (n = 16, increased NT-proBNP or troponin I, or both normal) and high-risk group (n = 27, increased NT-proBNP and troponin I). 20 healthy individuals matched for age and gender were included. The function, myocardial deformation of left heart, and left ventricular (LV) tissue characterization among the three groups were compared. The correlation between LA function and LV tissue characterization was investigated. RESULTS: Compared with the controls, the AL-CA patients had a larger LA volume, lower left atrial emptying fraction (LAEF) and impaired left atrial strain (LAS). The high-risk group exhibited lower reservoir and booster function and increased LV extracellular volume (LV-ECV) than the low-to-moderate-risk group (p < 0.05). LV-ECV was significantly correlated with LAS and LAEF (all p < 0.05) but not LAEFconduit. The LAS and LAEF had a good diagnostic ability for risk stratification of AL-CA patients (area under the curve, 0.70 ~ 0.72). CONCLUSION: High-risk AL-CA patients showed more severe LA function impairment than low-to-moderate-risk AL-CA patients. LAS and LAEF were closely associated with LV-ECV in AL-CA patients, LAS and LAEF exhibited good capability to differentiate AL-CA patients of different risk stratifications. ADVANCES IN KNOWLEDGE: CMR-derived LAS and LAEF were correlated with amyloid load, allowing for differentiation of AL-CA patients at different risk stages.

Dark blood T2-weighted imaging of the human heart with AI-assisted compressed sensing: a patient cohort study.

Background: Dark blood T2-weighted (DB-T2W) imaging is widely used to evaluate myocardial edema in myocarditis and inflammatory cardiomyopathy. However, this technique is sensitive to arrhythmia, tachycardia, and cardiac and respiratory motion due to the long scan time with multiple breath-holds. The application of artificial intelligence (AI)-assisted compressed sensing (ACS) has facilitated significant progress in accelerating medical imaging. However, the effect of DB-T2W imaging on ACS has not been elucidated. This study aimed to examine the effects of ACS on the image quality of single-shot and multi-shot DB-T2W imaging of edema. Methods: Thirty-three patients were included in this study and received DB-T2W imaging with ACS, including single-shot acquisition (SS-ACS) and multi-shot acquisition (MS-ACS). The resulting images were compared with those of the conventional multi-shot DB-T2W imaging with parallel imaging (MS-PI). Quantitative assessments of the signal-to-noise ratio (SNR), tissue contrast ratio (CR), and contrast-to-noise ratio (CNR) were performed. Three radiologists independently evaluated the overall image quality, blood nulling, free wall of the left ventricle, free wall of the right ventricle, and interventricular septum using a 5-point Likert scale. Results: The total scan time of the DB-T2W imaging with ACS was significantly reduced compared to the conventional parallel imaging [number of heartbeats (SS-ACS:MS-ACS:MS-PI) =19:63:99; P<0.001]. The SNRmyocardium and CNRblood-myocardium of MS-ACS and SS-ACS were higher than those of MS-PI (all P values <0.01). Furthermore, the CRblood-myocardium of SS-ACS was also higher than that of MS-PI (P<0.01). There were significant differences in overall image quality, blood nulling, left ventricle free wall visibility, and septum visibility between the MS-PI, MS-ACS, and SS-ACS protocols (all P values <0.05). Moreover, blood in the heart was better nulled using SS-ACS (P<0.01). Conclusions: The ACS method shortens the scan time of DB-T2W imaging and achieves comparable or even better image quality compared to the PI method. Moreover, DB-T2W imaging using the ACS method can reduce the number of breath-holds to 1 with single-shot acquisition.

The major factor of left ventricular systolic dysfunction in patients with cardiac amyloidosis: Amyloid overload or microcirculation impairment?

Purpose: Amyloid overload and microcirculation impairment are both detrimental to left ventricular (LV) systolic function, while it is not clear which factor dominates LV functional remodeling in patients with cardiac amyloidosis (CA). The purpose of this study was to investigate the major factor of LV systolic dysfunction using cardiac magnetic resonance imaging. Materials and methods: Forty CA patients and 20 healthy controls were included in this study. The CA group was divided into two subgroups by the left ventricular ejection fraction (LVEF): patients with reduced LVEF (LVEF < 50%, rLVEF), and patients with preserved LVEF (LVEF ≥ 50%, pLVEF). The scanning sequences included cine, native and post-contrast T1 mapping, rest first-pass perfusion and late gadolinium enhancement. Perfusion and mapping parameters were compared among the three groups. Correlation analysis was performed to evaluate the relationship between LVEF and mapping parameters, as well as the relationship between LVEF and perfusion parameters. Results: Remarkably higher native T1 value was observed in the rLVEF patients than the pLVEF patients (1442.2 ± 85.8 ms vs. 1407.0 ± 93.9 ms, adjusted p = 0.001). The pLVEF patients showed significantly lower slope dividing baseline signal intensity (slope%BL; rLVEF vs. pLVEF, 55.1 ± 31.0 vs. 46.2 ± 22.3, adjusted p = 0.001) and a lower maximal signal intensity subtracting baseline signal intensity (MaxSI-BL; rLVEF vs. pLVEF, 43.5 ± 23.9 vs. 37.0 ± 18.6, adjusted p = 0.003) compared to the rLVEF patients. CA patients required more time to reach the maximal signal intensity than the controls did (all adjusted p < 0.01). There was no significant correlation between LVEF and first-pass perfusion parameters, while significant negative correlation was observed between LVEF and native T1 (r = -0.434, p = 0.005) in CA patients. Conclusion: Amyloid overload in the myocardial interstitium may be the major factor of LV systolic dysfunction in CA patients, other than microcirculation impairment.

The Effect of Sanyrene Liquid Dressing in Preventing Radiation Dermatitis: A Systematic Review and Meta-analysis.

OBJECTIVE: To assess the efficacy of Sanyrene liquid dressing (Urgo Medical) in preventing radiation dermatitis (RD) among patients with cancer after radiotherapy. DATA SOURCES: The authors searched the China National Knowledge Infrastructure, SinoMed, WanFang Data, PubMed, Web of Science, EMBASE, and the Cochrane Library databases for articles published from inception to January 2021. STUDY SELECTION: The preliminary search identified 146 studies. After removing duplicates, applying exclusion criteria, and screening titles and abstracts, 19 studies met the inclusion criteria. DATA EXTRACTION: A standardized form was constructed to extract data from eligible studies. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. DATA SYNTHESIS: The authors identified a total of 19 studies involving 1,508 patients that assessed the effectiveness of Sanyrene liquid dressing in preventing RD in patients with cancer after radiotherapy. The findings suggested that Sanyrene decreases the total incidence of RD (odds ratio [OR], 5.00; 95% CI, 2.77-9.03; P < .00001), as well as the incidence of RD grade 2 (OR, 0.55; 95% CI, 0.36-0.85; P = .007), grade 3 (OR, 0.22; 95% CI, 0.09-0.57; P = .002), and grade 4 (OR, 0.32; 95% CI, 0.13-0.78; P = .01). In addition, in comparison with controls, Sanyrene liquid dressing improves the cure rate (OR, 8.18; 95% CI, 4.03-16.60; P < .00001) and delays the occurrence of RD (mean difference, 3.69; 95% CI, 3.03-4.36; P < .00001). CONCLUSIONS: Sanyrene liquid dressing can decrease both the total incidence of RD and the incidence of RD above grade 2. It also improves the cure rate and delays the occurrence of RD. Thus, Sanyrene may be a superior option for preventing RD after radiotherapy. However, the findings were assessed as moderate- to low-quality evidence and more high-quality trials are needed to support this result.

Process Optimization, Amino Acid Composition, and Antioxidant Activities of Protein and Polypeptide Extracted from Waste Beer Yeast.

Repurposing of waste beer yeast (WBY) that a main by-product of brewing industry has attracted considerable attention in recent years. In this study, the protein and polypeptide were extracted by ultrasonic-assisted extraction and enzymatic hydrolysis with process optimization, which resulted in a maximum yield of 73.94% and 61.24%, respectively. Both protein and polypeptide of WBY were composed of 17 Amino acids (AA) that included seven essential amino acids (EAA), and typically rich in glutamic acid (Glu) (6.46% and 6.13%) and glycine (Gly) (5.26% and 6.02%). AA score (AAS) revealed that the threonine (Thr) and SAA (methionine + cysteine) were the limiting AA of WBY protein and polypeptide. Furthermore, the antioxidant activities of WBY polypeptide that lower than 10 kDa against hydroxyl radical, DPPH radical, and ABTS radical were 95.10%, 98.37%, and 69.41%, respectively, which was significantly higher than that of WBY protein (25-50 kDa). Therefore, the protein and polypeptide extracted from WBY can be a source of high-quality AA applying in food and feed industry. Due to small molecular weight, abundant AA, and great antioxidant activity, WBY polypeptide can be promisingly used as functional additives in the pharmaceutical and healthcare industry.

Extracellular Volume Fraction Based on Cardiac Magnetic Resonance T1 Mapping: An Effective Way to Evaluate Cardiac Injury Caused by Cardiac Amyloidosis in Patients with Multiple Myeloma.

Multiple myeloma (MM) is a hematological malignancy of plasma cell origin. Cardiac amyloidosis (CA) is a common form of heart damage caused by MM and is associated with a poor prognosis. This study was a prospective cohort study and was aimed at evaluating the clinical predictive value of extracellular volume fraction (ECV) based on cardiovascular magnetic resonance (CMR) T1 mapping for cardiac amyloidosis and cardiac dysfunction in MM patients. Fifty-one newly diagnosed MM patients in Zhongnan Hospital of Wuhan University were enrolled in the study. A total of 19 patients (19/51; 37.25%) developed CA. The basal ECV of CA group was significantly higher than that of the non-CA group (p < 0.01). Multivariate logistic regression analysis showed that basal ECV (OR = 1.551, 95% CI 1.084-2.219, p < 0.05) and LDH1 level (OR = 1.150, 95% CI 1.010-1.310, p < 0.05) were two independent risk factors for CA. Further study demonstrated that basal ECV in the heart failure group was significantly higher than that of the nonheart failure group (p < 0.01). Notably, ROC curve showed that basal ECV had a good predictive value for CA and heart failure, with AUC of 0.911 and 0.893 (all p < 0.01), and the best cutoff values of 38.35 and 37.45, respectively. Taken together, basal ECV is a good predictor of CA and heart failure for MM patients.

Classification and quantification of double superior vena cava evaluated by computed tomography imaging.

BACKGROUND: A double superior vena cava (DSVC) may cause technical difficulties in some cardiovascular procedures. However, no quantitative data exist to describe the morphological features of this anomaly. METHODS: From January 2015 to January 2019, the data of 128 consecutive patients diagnosed with DSVC on computed tomography (CT) images were retrospectively analyzed. We proposed an easy and rational method for DSVC classification based on the presence or absence of the left brachiocephalic vein (LBCV), the presence or absence of an anastomotic vein bridging the bilateral superior vena cava (SVC), and the drainage pattern of the left superior vena cava (LSVC). The following classifications were established: type I, LBVC absent, LSVC drainage into the right atrium via the coronary sinus; type II, LBCV present, LSVC drainage into the right atrium via the coronary sinus; type III, LBCV absent, LSVC drainage into the right atrium via the anastomosis; type IV, LBCV present, LSVC drainage into the right atrium via the anastomosis. The length, diameter, and area of the bilateral SVC and the coronary sinus were carefully measured across the 4 types. RESULTS: Type I was the most frequently occurring type (66 of 128, 51.6%), followed by type II (43 of 128, 33.6%), then type III (15 of 128, 11.7%), and type IV (4 of 128, 3.1%). The LSVC was significantly longer than the right SVC (RSVC) in all 4 types, and the diameters of the LSVC were significantly larger in types without the LBCV (i.e., types I and III) (P<0.0001 for all). Additionally, the diameter of the coronary sinus in types I and II was triple that in types III and IV (P<0.0001), which was thought to be due to increased venous blood reflux through the coronary sinus. CONCLUSIONS: The anatomical features of DSVC can be satisfactorily depicted on CT. The quantitative measurement of this anomaly by the reporting radiologists could assist clinicians to minimize the procedure-associated risks.

Non-Hodgkin's Lymphoma Presenting as Isolated Peritoneal Lymphomatosis: A Case Report and Literature Review.

Peritoneal lymphomatosis is extremely rare and associated with poor prognosis. Most practitioners only pay more attention to peritoneal carcinomatosis. However, peritoneal lymphomatosis can be neglected and misdiagnosed. We report a teenager with 10 days of abdominal distension and pain accompanied by computed tomography scan suggesting diffuse thickening of the peritoneum and omentum and abdominopelvic effusion. Tuberculous peritonitis and peritoneal carcinomatosis were initially suspected. However, it was finally confirmed as non-Hodgkin's B-cell lymphoma by omentum biopsies. He achieved complete remission after chemotherapy and autologous stem cell transplantation. But unfortunately, he suffered a relapse and died 10 months after diagnosis. Following a review of the literature, it can be concluded that the discovery of lymphomatosis in peritoneum is a rare finding. Lymphoma should be considered in the differential diagnosis of unexplained peritoneal thickening on computed tomography, and this case emphasizes the importance of early pathological diagnosis to make sure that the right treatment can be started opportunely.

Fully automated magnetically controlled capsule endoscopy for examination of the stomach and small bowel: a prospective, feasibility, two-centre study.

BACKGROUND: The use of magnetically controlled capsules for gastroscopy is in the early stages of clinical adoption. We aimed to evaluate the safety and efficacy of a fully automated magnetically controlled capsule endoscopy (FAMCE) system in clinical practice for gastroscopy and small bowel examination. METHODS: We did a prospective, comparative study to evaluate the safety and efficacy of FAMCE. Patients from two hospitals in Chongqing, China were consecutively enrolled. Eligible participants were aged 18-80 years with suspected gastric pathology and no previous surgery. Participants underwent FAMCE for screening of gastric lesions, then conventional transoral gastroscopy 2 h later, and stomach examination results were compared. The primary outcome was the rate of complete detection of gastric anatomy landmarks (cardia, fundus, body, angulus, antrum, and pylorus) by FAMCE. Secondary outcomes were the time required for gastric completion by FAMCE, the rate of detection of gastric lesions by FAMCE compared with conventional transoral gastroscopy, and the rate of complete small bowel examination. Adverse events were also evaluated. The study was registered in the Chinese Clinical Trial Registry, ChiCTR2000040507. FINDINGS: Between May 12 and Aug 17, 2020, 114 patients (mean age 44·0 years [IQR 34·0-55·0]; 63 [55%] female) were enrolled. The rate of complete detection of gastric anatomical structures by FAMCE was 100% (95% CI 99·3-100·0). The concordance between FAMCE and conventional transoral gastroscopy was 99·61% (99·45-99·78). The mean completion time of a gastroscopy with FAMCE was 19·17 min (SD 1·43; median 19·00, IQR 19·00-20·00), compared with 5·21 min (2·00; 5·18, 3·68-6·45) for conventional transoral gastroscopy. In 114 enrolled patients, 214 lesions were detected by FAMCE and conventional transoral gastroscopy. Of those, 193 were detected by both modalities. FAMCE missed five pathologies (four cases of gastritis and one polyp), whereas conventional transoral gastroscopy missed 16 pathologies (12 cases of gastritis, one polyp, one fundal xanthoma, and two antral erosions). FAMCE was able to provide a complete small bowel examination for all 114 patients and detected intestinal lesions in 50 (44%) patients. During the study, two (2%) patients experienced adverse events. No serious adverse events were recorded, and there was no evidence of capsule retention. INTERPRETATION: The performance of FAMCE is similar to conventional transoral gastroscopy in completion of gastric examination and lesion detection. Furthermore, it can provide a complete small bowel examination. Therefore, FAMCE could be effective method for examination of the gastrointestinal tract. FUNDING: Chinese National Key Research and Development Program.

The reliability and validity of the Scott Triggers for patients in China undergoing gastrointestinal surgery.

OBJECTIVE: Scott Triggers is designed to identify potential surgical patients at risk for development of pressure injuries. But it has not been validated for sensitivity and positive predictive value to date. This study aimed to evaluate the reliability and validity of the Scott Triggers for the gastrointestinal surgery patients in China. METHODS: 447 gastrointestinal surgery patients were enrolled by convenience sampling and investigated by Scott Triggers from March to November 2019. RESULTS: 8 patients (1.780%) develop pressure injuries. The Cronbach's alpha was 0.701 and the interrater reliability was 0.915. The content validity of each item of Scott Triggers ranged from 0.667 to 1.0 and the content validity of the whole scale was 0.832, which showed a significant positive relationship and good internal consistent validity. The accumulative variance contribution ratio of common factor was 53.194%. Pearson correlation between Scott Triggers and 3S intraoperative risk assessment scale was -0.708 (P < 0.001). The Youden index was 0.374, the optimal predictive threshold of Scott Triggers was 5.5, the area under receiver operating characteristic (ROC) curve was 0.762, the sensitivity was 0.875, the specificity was 0.499, the positive predictive value was 0.027, and the negative predictive value was 0.996. CONCLUSION: Scott Triggers shows good reliability, validity, and predictive validity in this study, which can be used to assess the risk of stress injury in surgical patients. However, the body mass index needs to be taken into account in further study.

Association between gastroesophageal reflux disease and vocal fold polyps.

ABSTRACT: The aim of this study is to explore the relationship between gastroesophageal reflux disease (GERD) and vocal fold polyps (VFPs).This is a Case-Control study and was performed with the help of The Second Affiliated Hospital of Chongqing Medical University.Twenty-seven patients with VFP and 20 controls without VFP were recruited between May and October 2018. All the subjects underwent a saliva pepsin test, completed the GerdQ questionnaire and 24-hour multichannel intraluminal impedance with pH (24-h MII-pH) monitoring. Twenty-five resected VFP specimens were examined with immunohistochemical (IHC) and double immunofluorescence (IF) staining.The incidence of GERD in the VFP group was significantly higher than that in the control group (P = .003). Patients with VFP had significantly higher GerdQ scores, pepsin concentrations, and pepsin-positive rates (P < .05). Moreover, the number of proximal and upright reflux events was significantly higher in the VFP group (P < .05). The pepsin concentration in saliva showed a significant positive correlation with the pepsin levels in tissues (r2 = 0.50, P = .011). Pepsin and TGF-ß1-positive cells were colocalized with CD45RO-positive cells. IHC staining showed that the majority of VFP patients had a positive expression of pepsin (20/25, 80%) and pepsin-positive cells were found in both the squamous epithelium and mesenchymal tissues. IHC staining of TGF-ß1 in VFP revealed findings similar to those of pepsin staining.GERD is an important risk factor for VFP. Pepsin may promote the aggregation of immune cells, increase the local cytokines, and promote inflammatory reaction, suggesting a potential new pathogenesis for VFP. The saliva pepsin test is a reliable method for GERD diagnosis.

A Massive Right Hemisphere Infarction After Autologous Fat Grafting for Facial Filling.

ABSTRACT: Cerebral fat embolism following facial autologous fat injection is a rare and serious complication. There are limited long-term follow-up data on the motion, cognitive and mental outcomes of surviving patients with cerebral fat embolism following facial autologous fat injection. In this study, the authors reported a patient with a 22-year-old woman with a massive right hemisphere infarction following facial autologous fat injection had normal cognitive function, independent living ability, and social function at 5 years follow-up visit, even though computed tomography showed her entire right cerebral hemisphere had atrophied with softening lesions.