Value of the virtual monoenergetic image from dual-layer dual-energy computed tomography enterography in the preoperative assessment of the internal penetrating complication of Crohn's disease.

BACKGROUND: To determine the utility of virtual-monoenergetic imaging (VMI) at low energy levels from contrast-enhanced dual-layer dual-energy (DLDE) computed tomography enterography (CTE) in the preoperative assessment of internal penetrating lesions of Crohn's disease (CD). MATERIALS AND METHODS: Thirty-eight patients with penetrating lesions of CD by surgery undergoing contrast-enhanced DLDE CTE were retrospectively included. Polyenergetic imaging (PEI) and VMIs at low energy levels [40-70 kiloelectron volts (keV)] with 10 keV intervals were reconstructed. The objective parameters of image quality [noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR)] and the subjective parameter of image quality [diagnostic performance of lesions (DPL), overall image quality(OIQ)] of PEI and all VMIs at the low energy level were compared to determine the VMI on the optimal energy level. The lesion detection capability between PEI and the optimal VMI was compared. RESULTS: VMI40 was determined to be the optimal VMI among all VMIs at the low energy level for owning the best image quality. No significant difference was found in the detecting capability in penetrating lesions between VMI40 and PEI (p = 1.0), whereas a significant difference was found in the detecting capability in the bowel origin of the penetrating lesions (p = 0.004), the involved organ or structure by the fistula (p = 0.016) and the orifice of the fistula connected to the involved organ or structure ( p = 0.031) between them. CONCLUSIONS: Compared to conventional PEI, VMI40 improves the detection capability in anatomical details of penetrating lesions of CD, helping colorectal surgeons rationalizing preoperative plans of internal penetrating lesions of CD.

Transcriptome profiling based on larvae at different time points after hatching provides a core set of gene resource for understanding the immune response mechanisms of the egg-protecting behavior against Vibrio anguillarum infection in Amphioctopus fangsiao.

Mollusks have recently received increasing attention because of their unique immune systems. Mollusks such as Amphioctopus fangsiao are economically important cephalopods, and the effects of their egg-protecting behavior on the larval immune response are unclear. Meanwhile, little research has been done on the resistance response of cephalopod larvae infected with pathogenic bacteria such as Vibrio anguillarum. In this study, V. anguillarum was used to infect the primary hatching A. fangsiao larvae under different egg-protecting behaviors for 24 h, and a total of 7156 differentially expressed genes (DEGs) were identified at four time points after hatching based on transcriptome analysis. GO and KEGG enrichment analyses showed that multiple immune-related GO terms and KEGG signaling pathways were enriched. Protein-protein interaction networks (PPI networks) were used to search functional relationships between immune-related DEGs. Finally, 20 hub genes related to multiple gene functions or involved in multiple signaling pathways were identified, and their accuracy was verified using quantitative RT-PCR. PPI networks were first used to study the effects A. fangsiao larvae after infection with V. anguillarum under different egg-protecting behaviors. The results provide significant genetic resources for exploring invertebrate larval immune processes. The data lays a foundation for further study the immune response mechanisms for invertebrates after infection.

A rapid response near-infrared ratiometric fluorescent probe for the real-time tracking of peroxynitrite for pathological diagnosis and therapeutic assessment in a rheumatoid arthritis model.

Peroxynitrite (ONOO-) is a potent bio-oxidant involved in many physiological and pathological processes; however, most of the pathological effects associated with ONOO-in vivo are still ambiguous. Herein, we designed and synthesized two near-infrared ratiometric fluorescent probes, Ratio-A and Ratio-B, for the detection and biological evaluation of ONOO-. The recognition unit diene in the probes could be specifically cleaved by ONOO- with a 94-fold enhancement in the ratiometric fluorescence signal. By imaging ONOO- in immune stimulated cells and acute inflammation mice model using Ratio-A, we investigated the fluctuations of ONOO- levels in a rheumatoid arthritis (RA) model of mice. Ratio-A could be applied for the effective imaging of RA and could rapidly evaluate the response of the RA treatment with methotrexate (MTX). Thus, Ratio-A can be considered as a promising tool for pathological diagnosis and the therapeutic assessment of a wide range of diseases including RA.

[Multivariable analysis for flap-related complications in autologous breast reconstruction and economic analysis of intraoperative indocyanine green angiography].

OBJECTIVE: To investigate the influencing factors of flap-related complications and the economic benefits of intraoperative indocyanine green (ICG) angiography in the patients undergoing autologous breast reconstruction. METHODS: Between July 2013 and June 2018, the clinical data of 150 patients (152 breasts) who met the selection criteria after autologous breast reconstruction were analyzed retrospectively. Ten factors including age, body mass index, preoperative neoadjuvant chemotherapy (NC), chest radiation history, diabetes, abdominal operation history, chest wall reconstruction, reconstruction timing, flap type, intraoperative ICG angiography were analyzed by univariate analysis. Significant variables found in univariate analysis were used to perform backward multivariate logistic regression of flap related complications and local necrosis. According to the above multi factor analysis results, the patients were divided into 4 groups: ICG+NC group (group A), ICG+non-NC group (group B), non-ICG+NC group (group C), non-ICG+non-NC group (group D). The average extra costs of surgical treatment (including ICG imaging cost+cost of handling flap related complications) of each group was calculated. RESULTS: All the 152 flaps survived. There were 33 flap-related complications, including 22 regional necrosis, 9 regional infection, 5 hematoma, 5 simple fat liquefaction, and 2 anasto-motic thrombosis. Univariate analysis showed that preoperative NC, flap type, and intraoperative ICG angiography had significant influence on the incidence of flap-related complications ( P<0.05). Multivariate analysis showed that preoperative NC and non-ICG angiography were the risk factors of flap-related complications ( P<0.05), and also the risk factors of regional flap necrosis ( P<0.05). For patients who had NC, intraoperative ICG angiography could greatly save the average extra costs. The average extra costs in group A was 1 378 yuan less than that in group C. For the patients without NC, intraoperative ICG angiography would increase the average extra costs, which was 747 yuan in group B more than that in group D. CONCLUSION: In autologous breast reconstruction, ICG angiography can reduce the incidence of flap-related complications, especially the incidence of regional flap necrosis, while NC is the opposite. For patients without NC, ICG angiography is not cost-effective but still can be used if conditions permit. However, for those with NC, ICG angiography is cost-effective and recommended.