A Nomogram Based on Conventional Ultrasound Radiomics for Differentiating Between Radial Scar and Invasive Ductal Carcinoma of the Breast.

ABSTRACT: We aimed to develop and validate a nomogram based on conventional ultrasound (CUS) radiomics model to differentiate radial scar (RS) from invasive ductal carcinoma (IDC) of the breast. In total, 208 patients with histopathologically diagnosed RS or IDC of the breast were enrolled. They were randomly divided in a 7:3 ratio into a training cohort (n = 145) and a validation cohort (n = 63). Overall, 1316 radiomics features were extracted from CUS images. Then a radiomics score was constructed by filtering unstable features and using the maximum relevance minimum redundancy algorithm and the least absolute shrinkage and selection operator logistic regression algorithm. Two models were developed using data from the training cohort: one using clinical and CUS characteristics (Clin + CUS model) and one using clinical information, CUS characteristics, and the radiomics score (radiomics model). The usefulness of nomogram was assessed based on their differentiating ability and clinical utility. Nine features from CUS images were used to build the radiomics score. The radiomics nomogram showed a favorable predictive value for differentiating RS from IDC, with areas under the curve of 0.953 and 0.922 for the training and validation cohorts, respectively. Decision curve analysis indicated that this model outperformed the Clin + CUS model and the radiomics score in terms of clinical usefulness. The results of this study may provide a novel method for noninvasively distinguish RS from IDC.

A review of 10 patients treated with the masquelet technique and microsurgical technique combined for Gustilo type III open tibial fractures.

BACKGROUND: Open tibial fractures often include severe bone loss and soft tissue defects and requires complex reconstructive operations. However, the optimal treatment is unclear. METHODS: This retrospective study enrolled patients with Gustilo type III open tibial fractures from January 2018 to January 2021 to assess the clinical utility of Masquelet technique together with microsurgical technique as a combined strategy for the treatment of open tibial fractures. The demographics and clinical outcomes including bone union time, infection, nonunion and other complications were recorded for analysis. The bone recovery quality was evaluated by the AOFAS Ankle-Hindfoot Scale score and the Paley criteria. RESULTS: We enrolled 10 patients, the mean age of the patients and length of bone defects were 31.7 years (range, 23-45 years) and 7.5 cm (range, 4.5-10 cm) respectively. Bone union was achieved for all patients, with an average healing time of 12.2 months (range, 11-16 months). Seven patients exhibited a bone healing time of less than 12 months, whereas 3 patients exhibited a bone healing time exceeding 12 months. No significant correlation was found between the length of bone loss and healing time. In addition, no deep infection or nonunion was observed, although 2 patients experienced wound fat liquefaction with exudates and 1 patient presented with a bloated skin flap. The average AOFAS Ankle-Hindfoot Scale score was 80.5 (range, 74-85), and all patients were evaluated as good or exellent based on the Paley criteria. CONCLUSIONS: Our study indicated that the use of the Masquelet technique and the microsurgical technique as a combined strategy is safe and effective for the treatment of Gustilo type III open tibial fractures.

An ultrasound-based histogram analysis model for prediction of tumour stroma ratio in pleomorphic adenoma of the salivary gland.

OBJECTIVES: Preoperative identification of different stromal subtypes of pleomorphic adenoma (PA) of the salivary gland is crucial for making treatment decisions. We aimed to develop and validate a model based on histogram analysis (HA) of ultrasound (US) images for predicting tumour stroma ratio (TSR) in salivary gland PA. METHODS: A total of 219 PA patients were divided into low-TSR (stroma-low) and high-TSR (stroma-high) groups and enrolled in a training cohort (n = 151) and a validation cohort (n = 68). The least absolute shrinkage and selection operator regression algorithm was used to screen the most optimal clinical, US, and HA features. The selected features were entered into multivariable logistic regression analyses for further selection of independent predictors. Different models, including the nomogram model, the clinic-US (Clin + US) model, and the HA model, were built based on independent predictors using logistic regression. The performance levels of the models were evaluated and validated on the training and validation cohorts. RESULTS: Lesion size, shape, cystic areas, vascularity, HA_mean, and HA_skewness were identified as independent predictors for constructing the nomogram model. The nomogram model incorporating the clinical, US, and HA features achieved areas under the curve of 0.839 and 0.852 in the training and validation cohorts, respectively, demonstrating good predictive performance and calibration. Decision curve analysis and clinical impact curves further confirmed its clinical usefulness. CONCLUSIONS: The nomogram model we developed offers a practical tool for preoperative TSR prediction in PA, potentially enhancing clinical decision-making.

Ultrasound characteristics of breast fibromatosis mimicking carcinoma.

PURPOSE: To explore the value of ultrasound (US) characteristics in diagnosing breast fibromatosis (BF) and evaluate their differences from breast carcinoma. METHODS: A total of 121 patients with BF (n = 24, 29 lesions) or invasive ductal carcinoma (IDC) (n = 97, 102 lesions) of the breast were included. Their clinical and US findings were recorded and analyzed. RESULTS: The mean age of BF was younger than that of IDC (28.75 ± 5.55 vs. 50.19 ± 9.87, p < 0.001). The mean size of the BF was smaller than that of IDC (2.09 ± 0.91 vs. 2.71 ± 1.20, p = 0.011). Compared to IDC, BF had more frequency of posterior echo attenuation (p < 0.001), less frequency of peripheral hyperechoic halo (p = 0.002), calcification (p = 0.001), US reported axillary lymph node positive (p = 0.025), and grade 2-3 vascularity (p < 0.001). The Breast Imaging Reporting and Data System categorized BF at a lower level than IDC (p < 0.001). After adjusting for age, the peripheral hyperechoic halo, posterior echo feature, and vascularity could independently identify the differences between these two entities. CONCLUSION: Some differences were observed between BF and IDC in terms of patient age, lesion size, and US characteristics.

Postnatal eye size in mice is controlled by SREBP2-mediated transcriptional repression of Lrp2 and Bmp2.

Eye size is a key parameter of visual function, but the precise mechanisms of eye size control remain poorly understood. Here, we discovered that the lipogenic transcription factor sterol regulatory element-binding protein 2 (SREBP2) has an unanticipated function in the retinal pigment epithelium (RPE) to promote eye size in postnatal mice. SREBP2 transcriptionally represses low density lipoprotein receptor-related protein 2 (Lrp2), which has been shown to restrict eye overgrowth. Bone morphogenetic protein 2 (BMP2) is the downstream effector of Srebp2 and Lrp2, and Bmp2 is suppressed by SREBP2 transcriptionally but activated by Lrp2. During postnatal development, SREBP2 protein expression in the RPE decreases whereas that of Lrp2 and Bmp2 increases as the eye growth rate reduces. Bmp2 is the key determinant of eye size such that its level in mouse RPE inversely correlates with eye size. Notably, RPE-specific Bmp2 overexpression by adeno-associated virus effectively prevents the phenotypes caused by Lrp2 knock out. Together, our study shows that rapid postnatal eye size increase is governed by an RPE-derived signaling pathway, which consists of both positive and negative regulators of eye growth.

Nano-Aromatic Drugs Based on Mesoporous Silica Nanoparticles and Bergamot Essential Oil for Anti-Depression.

Depression is a mental disorder characterized by low mood as the main pathological feature. Current medications for depression have long treatment cycles and serious side effects. Aromatherapy can alleviate depression in a "moistening things silently" way, but the fast evaporation rate of aromatic drugs weakens the effect of aromatherapy. In this study, we designed and prepared nano-aromatic drugs with slow release for anti-depressant application. We first synthesized rod-shaped mesoporous silica nanoparticles (MSNs) and encapsulated bergamot essential oil. These nanoaromatic drugs were named BEO@MSNs. Subsequently, we analyzed the pore properties of MSNs and BEO@MSNs. Further, we explored the thermal stability, encapsulation efficiency, and slow-release properties of bergamot essential oil in BEO@MSNs. Finally, we used BEO@MSNs to alleviate depression in mice while constructing depression model mice via corticosterone. The results showed that BEO@MSNs had excellent anti-depressant effects and biosafety.

The Antiresection Activity of the X Protein Encoded by Hepatitis Virus B.

Chronic infection of hepatitis B virus (HBV) is associated with an increased incidence of hepatocellular carcinoma (HCC). HBV encodes an oncoprotein, hepatitis B x protein (HBx), that is crucial for viral replication and interferes with multiple cellular activities including gene expression, histone modifications, and genomic stability. To date, it remains unclear how disruption of these activities contributes to hepatocarcinogenesis. Here, we report that HBV exhibits antiresection activity by disrupting DNA end resection, thus impairing the initial steps of homologous recombination (HR). This antiresection activity occurs in primary human hepatocytes undergoing a natural viral infection-replication cycle as well as in cells with integrated HBV genomes. Among the seven HBV-encoded proteins, we identified HBx as the sole viral factor that inhibits resection. By disrupting an evolutionarily conserved Cullin4A-damage-specific DNA binding protein 1-RING type of E3 ligase, CRL4WDR70 , through its H-box, we show that HBx inhibits H2B monoubiquitylation at lysine 120 at double-strand breaks, thus reducing the efficiency of long-range resection. We further show that directly impairing H2B monoubiquitylation elicited tumorigenesis upon engraftment of deficient cells in athymic mice, confirming that the impairment of CRL4WDR70 function by HBx is sufficient to promote carcinogenesis. Finally, we demonstrate that lack of H2B monoubiquitylation is manifest in human HBV-associated HCC when compared with HBV-free HCC, implying corresponding defects of epigenetic regulation and end resection. Conclusion: The antiresection activity of HBx induces an HR defect and genomic instability and contributes to tumorigenesis of host hepatocytes.

Steady thermocapillary migration of a droplet in a uniform temperature gradient combined with a radiation energy source at large Marangoni numbers.

Steady thermocapillary droplet migration in a uniform temperature gradient combined with a radiation energy source at large Reynolds and Marangoni numbers is studied. To reach a terminal quasisteady process, the magnitude of the radiation energy source is required to preserve the conservative integral thermal flux across the surface. Under a quasisteady state assumption, an analytical result for the steady thermocapillary migration of a droplet at large Reynolds and Marangoni numbers is derived by using the method of matched asymptotic expansions. It is shown that the thermocapillary droplet migration speed increases as the Marangoni number increases, while a radiation energy source with a sine square dependence is provided.

Hyperbaric Oxygen Therapy in Liver Diseases.

Hyperbaric oxygen therapy (HBOT) is an efficient therapeutic option to improve progress of lots of diseases especially hypoxia-related injuries, and has been clinically established as a wide-used therapy for patients with carbon monoxide poisoning, decompression sickness, arterial gas embolism, problematic wound, and so on. In the liver, most studies positively evaluated HBOT as a potential therapeutic option for liver transplantation, acute liver injury, nonalcoholic steatohepatitis, fibrosis and cancer, especially for hepatic artery thrombosis. This might mainly attribute to the anti-oxidation and anti-inflammation of HBOT. However, some controversies are existed, possibly due to hyperbaric oxygen toxicity. This review summarizes the current understandings of the role of HBOT in liver diseases and hepatic regeneration. Future understanding of HBOT in clinical trials and its in-depth mechanisms may contribute to the development of this novel adjuvant strategy for clinical therapy of liver diseases.

Characterization of Aroma-Active Components and Antioxidant Activity Analysis of E-jiao (Colla Corii Asini) from Different Geographical Origins.

E-jiao (Colla Corii Asini, CCA) has been widely used as a healthy food and Chinese medicine. Although authentic CCA is characterized by its typical sweet and neutral fragrance, its aroma components have been rarely investigated. This work investigated the aroma-active components and antioxidant activity of 19 CCAs from different geographical origins. CCA extracts obtained by simultaneous distillation and extraction were analyzed by gas chromatography-mass spectrometry (GC-MS), gas chromatography-olfactometry (GC-O) and sensory analysis. The antioxidant activity of CCAs was determined by ABTS and DPPH assays. A total of 65 volatile compounds were identified and quantified by GC-MS and 23 aroma-active compounds were identified by GC-O and aroma extract dilution analysis. The most powerful aroma-active compounds were identified based on the flavor dilution factor and their contents were compared among the 19 CCAs. Principal component analysis of the 23 aroma-active components showed 3 significant clusters. Canonical correlation analysis between antioxidant assays and the 23 aroma-active compounds indicates strong correlation (r = 0.9776, p = 0.0281). Analysis of aroma-active components shows potential for quality evaluation and discrimination of CCAs from different geographical origins.

[Vertical Migration Characteristics of Organochlorine Pesticides in Overlying Soil in Karst Terranes and Its Impact on Groundwater].

Five soil profiles and four typical epikarst springs were selected in Nanchuan District, Chongqing Municipality as objects of the study on vertical migration of organochlorine pesticides (OCPs) in the soils and its impact on groundwater. OCPs in soil and epikarst spring water samples were quantitatively analyzed by gas chromatography. The results showed that HCHs and DDTs were detected in all the 5 soil profiles, varying in the range of 0.77-18.3 and 0.34-226 ng · g(-1), and averaging 5.16 and 16 ng · g(-1) in concentration, respectively. The highest concentrations of HCHs and DDTs were found in the subsoil (10-40 cm) in most sampling sites. The detection ratios of HCHs and DDTs in four springs were 100%. The concentrations of HCHs and DDTs fluctuated greatly in epikarst spring water during the one-year observation, and the concentration ranged from 2.09 to 60.1 and from N. D. to 79.8 ng · L(-1), with a mean value of 12 and 9.16 ng · L(-1), respectively. The concentrations of HCHs and DDTs in Hougou, Baishuwan and Lanhuagou spring in rainy season were all. higher than those in dry season in these three epikarst springs. There were no good corresponding relationship between HCHs and DDTs contents in spring water and those in corresponding spring catchment soil. TOC, soil water content, clay content and pH all inhibited the vertical migration of OCPs in Hougou spring catchment, which led to the lowest content of OCPs in spring water, although the OCPs content in Hougou spring catchment soils was the highest in the four spring catchments. However, the four factors didn't inhibit the vertical migration of OCPs in Shuifang spring catchment, which led to higher OCPs content in spring water, although the OCPs content in spring catchment soils was the lowest in the four spring catchments.

[Altitudinal Gradient Distribution and Source Analysis of PAHs Content of Topsoil in Jinfo Mountain, Chongqing].

The condensation effect has made high mountains the storage vault of durable organic pollutants. This research measured the content and constitutes of polycyclic aromatic hydrocarbons (PAHs) in 10 topsoil samples collected at different altitudes from the south slope of Chongqing Jinfo Mountain by gas chromatograph-mass spectrometer (GC/MC). And the pollution source of PAHs was analyzed by ratio method and principal component regression. The ecological risk of PAHs was evaluated using BaP toxic equivlants (TEQ(BaP)) The results showed that the concentrations of 16 priority PAHs in topsoil ranged from 240-2 121 ng x g(-1). The average value of PAHs was 849 ng x g(-1), and 2 to 3-ring PAHs were the dominant compounds. The concentrations of 7 carcinogenic PAHs accounted for 17.8% of total PAHs averagely. In the research area, various-ring PAHs and gross PAHs increased with the rise of altitude. The increase of low-ring PAHs was most obvious, and the volatility of high-ring PAHs was relatively high. But the ratio of different-ring PAHs in gross PAHs showed no regularity with the rise of altitude. The PAHs of soil in the research area mainly came from the oil sources, oil products, and combustion sources of coal and biomass. In the research area, the soil has been polluted to a certain extent, but the toxicity risk is relatively low.

[Variation Characteristics and Sources of Polycyclic Aromatic Hydrocarbons in Karst Subterranean River During Rainfall Events].

The water samples were continuously collected at the outlet of Nanshan Laolongdong subterranean river basin, which is located in Chongqing, during the rainfall event in June 2014. Sixteen priority polycyclic aromatic hydrocarbons (PAHs) in water were quantitatively analyzed by gas chromatography-mass spectrometry (GC-MS). The objectives of this study were to reveal the variation characteristics and sources of PAH16 in karst subterranean river during the rainfall event. The results showed that the subterranean river responded promptly to the rainfall, and there were four peaks of the total concentrations of PAH16, two peaks occurred during the flow rise stage, the others were in the maximum flow and flow decline stages. The total concentrations of PAH16 ranged 101-3 624 ng x L(-1), with a mean of 578 ng x L(-1), the total concentrations of 7 carcinogenic PAHs ranged ND-336 ng x L(-1), with a mean of 31.1 ng x L(-1). The PAH compositional profiles were dominated by 2,3-ring compounds, which accounted for 86.17% of the total concentrations of PAH16. The total concentrations of PAH16 were most influenced by the rainfall, through the cleaning of atmospheric pollutants by the rain and the scouring of the surface contaminants by the rainfall runoff. The PAHs in water mainly originated from the incomplete combustion of petroleum products and fossil fuels such as coal, as well as natural digenetic process. Compared to other areas in the world, the concentrations of PAH16 were generally at moderately polluted and heavily polluted levels.

[Application of ultrathin transnasal gastroscopy in percutaneous endoscopic gastrostomy].

OBJECTIVE: To assess the application of ultrathin transnasal gastroscopy in transnasal percutaneous endoscopic gastrostomy (nPEG) in patients with trimus and/or pharyngeal narrowing. METHODS: Nine consecutive patients underwent PEG with the Introducer method using conventional gastroscopy (5 cases) or ultrathin transnasal gastroscopy (4 cases). Among the 4 patients undergoing nPEG, 3 received radiotherapy for nasopharyngeal cancer, including two with trimus and one with trimus and pharyngeal narrowing. The procedure time, safety, discomfort and complications in these cases were compared and evaluated. RESULTS: The average procedure time of PEG was 17+/-3.5 min in conventional gastroscopy group and 17+/-3.1 min in nPEG group. No complications were observed in these patients, but the patients in nPEG group reported less discomfort associated with the procedure. CONCLUSIONS: Ultrathin transnasal gastroscopy reduces the discomfort of the procedure and is safer than conventional gastroscopy for PEG, especially in patients with trimus and/or pharyngeal narrowing.

Albumin resuscitation protects against traumatic/hemorrhagic shock-induced lung apoptosis in rats.

OBJECTIVE: To determine the effects of albumin administration on lung injury and apoptosis in traumatic/hemorrhagic shock (T/HS) rats. METHODS: Studies were performed on an in vivo model of spontaneously breathing rats with induced T/HS; the rats were subjected to femur fracture, ischemia for 30 min, and reperfusion for 20 min with Ringer's lactate solution (RS) or 5% (w/v) albumin (ALB), and the left lower lobes of the lungs were resected. RESULTS: Albumin administered during reperfusion markedly attenuated injury of the lung and decreased the concentration of lactic acid and the number of in situ TdT-mediated dUTP nick-end labelling (TUNEL)-positive cells. Moreover, immunohistochemistry performed 24 h after reperfusion revealed increases in the level of nuclear factor kappaB (NF-kappaB), and phosphorylated p38 mitogen-activated protein kinase (MAPK) in the albumin-untreated group was down-regulated by albumin treatment when compared with the sham rats. CONCLUSION: Resuscitation with albumin attenuates tissue injury and inhibits T/HS-induced apoptosis in the lung via the p38 MAPK signal transduction pathway that functions to stimulate the activation of NF-kappaB.

Can albumin administration relieve lung injury in trauma/hemorrhagic shock?

AIM: To study the effect of albumin administration on lung injury in trauma/hemorrhagic shock (T/HS). METHODS: Sixty experimental animals were randomly divided into three groups: rats undergoing laparotomy without shock (T/SS); rats with T/HS and resuscitation with blood plus twice the volume of shed blood as Ringer's lactate (RL), and rats with T/HS and resuscitation with blood plus additional 3 mL of 50 g/L human albumin. Expression of polymorphonuclear neutrophil (PMN) CD11b/CD18, intercellular adhesion molecule-1 (ICAM-1) of jugular vein blood and the severity of lung injuries [determined mainly by measuring activity of lung tissue myeloperoxidase (MPO) and lung injury score (LIS)] were measured after a 3-h recovery period. RESULTS: All three groups showed a significant difference in the expressions of CD11b/CD18, ICAM-1, and severity of lung injury. The expressions of CD11b/CD18 in T/SS group, T/HS + RL group, T/HS + albumin group were 17.76% +/- 2.11%, 31.25% +/- 3.48%, 20.36% +/- 3.21%, respectively (F = 6.25, P < 0.05). The expressions of ICAM-1 (U/mL) in T/SS group, T/HS + RL group, T/HS + albumin group were 258.76 +/- 98.23, 356.23 +/- 65.6, 301.01 +/- 63.21, respectively (F = 5.86, P < 0.05). The expressions of MPO (U/g) in T/SS group, T/HS + RL group, T/HS + albumin group were 2.53 +/- 0.11, 4.63 +/- 1.31, 4.26 +/- 1.12, respectively (F = 6.26, P < 0.05). Moreover, LIS in T/HS + RL group, T/HS + albumin group was 2.62 +/- 0.23, 1.25 +/- 0.24, respectively. The expressions of CD11b/CD18, ICAM-1 and MPO in T/HS + RL group were significantly increased compared to T/SS group (P = 0.025, P = 0.036, P = 0.028, respectively). However, administration of 3 mL of 50 g/L albumin significantly down-regulated the expressions of CD11b/CD18, ICAM-1 and lung injury index (MPO and LIS) when compared with the T/HS + RL rats (P = 0.035, P = 0.046, P = 0.038, P = 0.012, respectively). CONCLUSION: The infusion of albumin during resuscitation period can protect lung from injury and decrease the expressions of CD11b/CD18, ICAM-1 in T/HS rats.

Liver fibrosis caused by choledocholith to regress after biliary drainage.

AIM: To study the correlation between liver fibrosis severity and biliary drainage in patients with choledocholith. METHODS: A follow-up study on seven patients with liver fibrosis due to choledocholith was made. The data, including biochemical tests (aspartate aminotransferase, alanine aminotransferase) and liver histological features before and after biliary drainage, were collected and studied. The fibrosis severity was scored on a scale from 0 to 3, with 0 denoting none, 1 portal and periportal fibrosis, 2 the presence of numerous fiber septa, and 3 cirrhosis. The average liver fibrosis severity scores of the first and second biopsy were compared with statistical method. RESULTS: The first, second liver fibrosis severity scores of these seven patients were 2,1; 2,1; 1,0; 1,1; 2,1; 2,1; 1,0 respectively. The results showed that the average liver fibrosis severity score of the second liver biopsy decreased significantly compared with the first liver biopsy (n = 7, t = 4.25, P<0.05). CONCLUSION: Liver fibrosis due to choledocholith may regress after biliary drainage.

Regression of liver fibrosis after biliary drainage in patients with choledocholith: a preliminary report.

BACKGROUND: Choledocholith is prevalent in some Asian countries and may lead to liver fibrosis and portal vein hypertension. Biliary drainage is an effective treatment for choledocholith. The aim of this study was to assess the impact of biliary drainage on liver fibrosis due to choledocholith. METHODS: Eight patients with liver fibrosis caused by choledocholith were followed up by biochemical tests (aspartate aminotransferase, alanine aminotransferase) and liver biopsy before and after biliary drainage, respectively. The severity of the fibrosis was scored on a scale from 0 to 3 (0: denoting none; 1: portal and periportal fibrosis; 2: the presence of numerous fiber septa; and 3: cirrhosis). The results were analyzed statistically. RESULTS: The severity scores of liver fibrosis in the 8 patients were 2,1; 2,1; 1,0; 1,1; 2,1; 1,1; 2,1; 1,0 before and after biliary drainage, respectively. The results showed that the average severity of liver fibrosis decreased significantly after biliary drainage (n=8, t=4.573, P=0.003). CONCLUSION: Liver fibrosis due to choledocholith may regress after biliary drainage.