Novel Patterns in High-Resolution Computed Tomography in Whipple Pneumonia.

With the use of metagenomic next-generation sequencing, patients diagnosed with Whipple pneumonia are being increasingly correctly diagnosed. We report a series of 3 cases in China that showed a novel pattern of movable infiltrates and upper lung micronodules. After treatment, the 3 patients recovered, and lung infiltrates resolved.

Psychological distress of cancer patients caused by treatment delay during the COVID-19 pandemic in China: A cross-sectional study.

OBJECTIVE: The currents study sought to explore the impact of treatment delay on the mental health for patients with cancer during the 2019 coronavirus disease (COVID-19) pandemic. METHODS: Travel restrictions were imposed in most areas of the country between 23 January 2020 and 25 February 2020 owing to the COVID-19 epidemic. Travel restrictions were lifted from 26 February 2020 to 12 March 2020. The number of new confirmed cases significantly reduced after 12 March 2020. Study participants, comprised of individuals from three distinct groups: (1) 835 cancer patients who attended Zhejiang Cancer Hospital between 26 February 2020 and 12 March 2020; (2) 185 healthy volunteers recruited between 26 February 2020 and 12 March 2020; (3) 168 cancer patients who attended the hospital during the non-epidemic period (after 12 March 2020). Two outcome measures including patients' posttraumatic stress responses and general psychological distress (GPD) were assessed using the Chinese versions of the Impact of Events Scale-Revised and the Kessler Psychological Distress Scale (K10). Treatment delay was assessed via counting the time interval from diagnosis to treatment initiation, or from planned treatment date to actual date of therapy. Communication satisfaction was evaluated via a self-report questionnaire. An independent sample t-test or Wilcoxon rank sum test was used for comparison. Statistical analysis included Chi-square test, Mann-Whitney test and multivariate logistic regression. RESULTS: All 1188 participants (835 patients with cancer and 185 controls during the outbreak, and 168 patients with cancer during the non-epidemic period) completed and submitted the questionnaires. A positive association was observed between treatment delays and increased GPD levels (OR 1.716; 95% confidence interval ,CI 1.254-2.348; p = 0.001) as well as posttraumatic stress disorder (PTSD) symptoms (OR: 1.545, 95% CI: (1.166-2.047), p = 0.002). Patients who reported good communication with their doctors showed a significantly lower risk of GPD (OR: 0.526, 95% CI (0.348-0.794), p = 0.002) and PTSD (OR: 0.683, 95% CI (0.490-0.951), p = 0.024) compared with patients who reported unsatisfactory communication or had no contact with their doctors. Multivariate logistic regression analysis showed that treatment at a local hospital, treatment delays and unsatisfactory or no communication with cancer-care professionals were significantly correlated with severe GPD and PTSD symptoms of patients (all p ≤ 0.05). CONCLUSION: The findings indicate that cancer patients who underwent treatment delays during the COVID-19 pandemic may become vulnerable to psychological distress. The results showed that effective communication with doctors and cancer-care professionals during outbreak significantly reduces GPD levels and PTSD symptoms.

Fetal Ductus Arteriosus Premature Constriction.

This study aimed to investigate the connections between the echocardiography indices of fetal ductus arteriosus premature constriction and newborn prognosis by analyzing 22 cases of spontaneous fetal ductus arteriosus premature constriction.An ultrasonic instrument was used to observe prenatal fetal heart state, combine clinical examination data and echocardiographic results after delivery, summarize the ultrasound manifestations and imaging characteristics, and analyze the prognosis of the fetus.In all cases, fetal ductus arteriosus premature constriction occurred in the third trimester of pregnancy (34 + 1 to 41 weeks), and no abnormality in extracardiac organs were observed. Seven neonates required respiratory support due to the accompanying severe tricuspid regurgitation. The remaining 15 neonates did not receive respiratory support, including 4 with severe tricuspid regurgitation, 5 with moderate regurgitation, and 6 with mild regurgitation. Significant differences were observed in the fetal right atrium size and tricuspid regurgitation severity between the neonatal respiratory support group and non-respiratory support group. Furthermore, there were statistical differences in the ductus arteriosus inner diameter and pulsation index between the two groups.The severity of fetal ductus arteriosus premature contraction accompanied by tricuspid regurgitation and right atrium enlargement can predict the immediate prognosis of the newborn and provide guidance for the clinical judgment of the timing of pregnancy termination.

Fisher Information Based Meteorological Factors Introduction and Features Selection for Short-Term Load Forecasting.

Weather information is an important factor in short-term load forecasting (STLF). However, for a long time, more importance has always been attached to forecasting models instead of other processes such as the introduction of weather factors or feature selection for STLF. The main aim of this paper is to develop a novel methodology based on Fisher information for meteorological variables introduction and variable selection in STLF. Fisher information computation for one-dimensional and multidimensional weather variables is first described, and then the introduction of meteorological factors and variables selection for STLF models are discussed in detail. On this basis, different forecasting models with the proposed methodology are established. The proposed methodology is implemented on real data obtained from Electric Power Utility of Zhenjiang, Jiangsu Province, in southeast China. The results show the advantages of the proposed methodology in comparison with other traditional ones regarding prediction accuracy, and it has very good practical significance. Therefore, it can be used as a unified method for introducing weather variables into STLF models, and selecting their features.

Seasonal Dynamics of the Upper Respiratory Tract Microbiome in Chronic Obstructive Pulmonary Disease.

Introduction: Increasing evidence suggests that seasonal changes can trigger the alternation of airway microbiome. However, the dynamics of the upper airway bacterial ecology of chronic obstructive pulmonary disease (COPD) patients across different seasons remains unclear. Methods: In this study, we present a 16S ribosomal RNA survey of the airway microbiome on 72 swab samples collected in different months (March, May, July, September, and November) in 2019 from 18 COPD patients and from six resampled patients in November in 2020. Results: Our study uncovered a dynamic airway microbiota where changes appeared to be associated with seasonal alternation in COPD patients. Twelve clusters of temporal patterns were displayed by differential and clustering analysis along the time course, systematically revealing distinct microbial taxa that prefer to grow in cool and warm seasons, respectively. Moreover, the upper airway microbiome composition was relatively stable in the same season in different years. Discussion: Given the tight association between airway microbiome and COPD disease progression, this study can provide useful information for clinically understanding the seasonal trend of disease phenotypes in COPD patients.

A novel mitochondrial tRNA(Val) T1658C mutation identified in a CPEO family.

PURPOSE: To analyze mitochondrial DNA (mt DNA) gene mutations in a 19-year-old female patient, who presented with chronic progressive external ophthalmoplegia (CPEO), together with her mother and younger sister. METHODS: The diagnosis of mitochondrial myopathy was made based on clinical and biologic analysis. Histochemical methods were used to detect ragged-red fibers (RRFs) and ragged-blue fibers (RBFs) on a muscle biopsy of the patient. All mitochondrial gene DNA fragments of the patient, her mother, and younger sister were amplified by polymerase chain reaction. The products were sequenced and compared with reference databases. RESULTS: A novel T1658C mutation and a known A10006G mutation were identified in the mitochondrial tRNA(Val) gene and the tRNA(Gly) gene, respectively, in the patient, her mother, and younger sister. The T1658C mutation changes the T loop structure of mitochondrial tRNA(Val) and the A10006G mutation disturbs the D loop of mitochondrial tRNA(Gly). CONCLUSIONS: The T1658C and A10006G mutations of mtDNA may be responsible for the pathogenesis of the patient with CPEO.

Comparison of the cardiovascular impacts of transnasal versus transoral gastroscopy in the aged patients with or without hypertension.

BACKGROUND/AIMS: The cardiovascular impacts of gastroscopy in the aged patients are not neglectable, especially for those with hypertension. The aim of this study was to evaluate the different cardiovascular impacts of transnasal and transoral gastroscopy in the aged patients with or without hypertension. METHODS: 120 aged patients (age >65 years) who had gastroscopy indication were recruited. Transnasal or transoral gastroscopy was employed for each subject. Heart rate (HR), blood pressure (BP), blood oxygen saturation (SaO2) and electrocardiogram (ECG) were recorded. RESULTS: In those patients with normal-tension during transoral gastroscopy examination, HR and BP increased and SaO, decreased, about 1/3-1/2 patients exhibited ECG changes of sinus tachycardia, ectopic rhythm and myocardial ischemia. The changes of HR and BP were more marked in those patients with hypertension during transoral gastroscopy examination, and a greater proportion of patients exhibited the above ECG changes. The maximal increment of HR, systolic BP, diastolic BP and SaO2, as well as ECG changes, significantly decreased in those hypertension patients during transnasal gastroscopy compared with those during transoral gastroscopy, and these changes remained similar to those normal-tension patients during transoral gastroscopy examination. CONCLUSIONS: The cardiovascular impacts of transoral gastroscopy in the aged patients are not neglectable, transnasal gastroscopy examination, the cardiovascular impacts of which are smaller, is relatively safe for those aged hypertension patients.

Distributions of angiogenesis and lymphangiogenesis in gastrointestinal intramucosal tumors.

BACKGROUND: Although angiogenesis and lymphangiogenesis in gastrointestinal cancers has been investigated in many studies, their distribution characteristics in gastrointestinal intramucosal tumors have not been well addressed. METHODS: We evaluated the blood microvessel density (BMVD) and lymphatic microvessel density (LMVD) by immunostaining with monoclonal antibodies of CD34 and D2-40 in 37 patients with stomach intramucosal carcinoma and 28 patients with colorectal intramucosal neoplasia. Microvessels with endothelial cells labeled by CD34 but not by D2-40 were recognized as blood microvessels; and microvessels with endothelial cells labeled by both CD34 and D2-40 were recognized as lymphatic vessels. Furthermore, the relationships between expression of vascular endothelial growth factor (VEGF), VEGF-C, and BMVD, LMVD were investigated as well. RESULTS: The LMVD was significantly higher in peritumoral tissues than in corresponding normal tissues in gastrointestinal intramucosal tumors (20.87 versus 14.56, P = 0.003). However, there was no significant difference in the BMVD between peritumoral tissues and corresponding normal tissues (P = 0.166). The BMVD in peritumoral tissues was higher in patients with lymph node metastases than in patients without lymph nodes metastases (P = 0.047). Our results did not show significant association between VEGF, VEGF-C and BMVD, LMVD. CONCLUSIONS: Our results suggested that the increase of lymphangiogenesis seems superior to the increase of angiogenesis in gastrointestinal intramucosal tumors.

[Prenatal diagnosis and prognosis of fetal nephrohydrosis].

OBJECTIVE: To explore the clinical significance of prenatal ultrasonic diagnosis of fetal nephrohydrosis and its prognosis. METHODS: Prenatal ultrasonography was performed on 9526 women at more than 20 weeks gestation, and 162 women whose anteroposterior diameter of the renal pelvis was > or = 8 mm were included in this study. The grade of fetal nephrohydrosis was classified according to Grignon grading method. The changes in fetal nephrohydrosis were observed regularly until delivery. RESULTS: (1) The incidence of fetal encephalic fluid and Grignon grade: there were 162 fetuses with fetal nephrohydrosis among 9526 fetuses, with an incidence of 1.7%. The numbers of fetuses with Grades 1 to 5 were 71, 59, 7, 3 and 22, respectively. (2) The distribution in gestational weeks of fetal nephrohydrosis: generally, fetal nephrohydrosis was first diagnosed at (33 +/- 5) weeks, and the maximum degree of nephrohydrosis was observed at (36 +/- 3) weeks. One hundred and ten fetuses with nephrohydrosis recovered during the process of gestation, at about (37 +/- 4) weeks. (3) Poor terminations of pregnancy: there were 40 (25%) fetuses with poor terminations among totally 162 cases. Among these 40 fetuses, 3 (27%) were first diagnosed at 20 to 24 weeks within 11 fetuses, 6 (24%) were first diagnosed at 25 to 28 weeks within 20 fetuses, 14 (26%) were first diagnosed at 29 to 32 weeks within 53 fetuses, 11 (23%) were first diagnosed at 33 to 36 weeks within 48 fetuses, and 6 (20%) were first diagnosed at 37 to 40 weeks within 30 fetuses. The results demonstrate that high grade of fetal nephrohydrosis according to Grignon grading method indicates a poorer prognosis of the fetus. (4) Follow-up results: there were 122 (75%, 122/162) live and healthy neonates in total, including 110 neonates whose nephrohydrosis recovered prior to birth and 12 neonates whose nephrohydrosis recovered within 1 week after birth. These neonates all developed well without any urinary sequela within the first 2 years. There were also 20 (12%, 20/162) hydronephrotic neonates who were still diagnosed as nephrohydrosis within 1 week after birth, including 11 fetuses graded below Grignon grade 3, whose nephrohydrosis recovered 3 to 12 months after birth and who developed well without any urinary symptoms. CONCLUSIONS: The study demonstrates that hydronephrotic fetuses who are diagnosed at earlier gestational weeks and with higher grading have poorer prognosis. The Grignon grading method can be used in the prenatal evaluation of fetal nephrohydrosis to predict the prognosis of the fetus.

[Ultrasonic diagnosis and prognosis of fetal multicystic kidney dysplasia].

OBJECTIVE: To explore the diagnosis, clinical course and prognosis of fetal multicystic kidney dysplasia (MCDK). METHODS: 24 858 pregnant women detected by prenatal ultrasound, here were 41 cases with fetal multicystic kidney dysplasia, these fetuses were diagnosed at average 29.8 weeks of gestation, Carried on an observation to fetuses with multicystic kidney dysplasia and postnatal follow-up study. RESULTS: T17 cases were induced abortion. Of 13 infants, 1 case involute, 3 cases decrease, 9 cases no change. CONCLUSION: Prenatal ultrasonography can actual diagnosis for fetal multicystic kidney dysplasia, the key of management of multicystic kidney dysplasia is assessment of fetal prognosis, the natural history of unilateral MCDK is usually benign, the affected kidneys tend to show involution after birth. But bilateral MCDK often associated with impairement of renal function, abnormal chromosome or other anomalies, which indicates a poor prognosis.

[Clinical study on fetal encephalic fluid].

OBJECTIVE: To discuss the clinical significance of fetal encephalic accumulated fluid revealed by prenatal ultrasonography. METHODS: Prenatal ultrasonography was performed on 8426 women at more than 20 weeks' gestation. Totally 150 women with fetal encephalic accumulated fluid more than 5 mm were included in this study. The changes of fetal encephalic accumulated fluid and the associated anomalies were observed regularly every 2 weeks until delivery. The live infants were followed up regularly. RESULTS: The incidence of fetal encephalic fluid was 1.8%, including 72 cases with fluid in the fetal anterior or posterior cornu of unilateral ventricle, 46 cases with accumulated fluid in fetal posterior fossa, 32 cases with fluid in more than 2 sites. Generally, the accumulated fluid in fetal encephalus was first diagnosed at 17 - 40 gestational weeks, with a median of (26 +/- 5) weeks. Most of them were found between 29 - 32 gestational weeks (63 cases, 42.0%), and the maximum amount of accumulated fluid was also found between 29 - 32 weeks (70 cases, 46.7%). Spontaneous regression of intracranial fluid could be seen in 111 fetuses (74.0%). The period of fluid regression ranged from 29 to 40 weeks of gestation, of which the average gestational week was (36 +/- 2) weeks. Additionally, the most frequent period of regression was in the first two thirds of the three trimesters of pregnancy. The incidence of defected infants was 3.8%, 10.2% and 67.4%, respectively, when the amount of accumulated fluid was less than 10 mm, 10 - 14 mm and more than 15 mm. And the accumulated fluid in more than 2 sites was also a risk factor of defected fetuses, with an incidence of 60.0%. CONCLUSIONS: Most cases could be diagnosed between 29 - 32 gestational weeks, and the maximum amount of accumulated fluid is also observed in this period. The more fluid in fetal encephalus, the more sites the fluid distributed in, the more defected fetuses or infants would be observed. So in cases of more than 15 mm of fluid, or accumulated fluid in more than 2 sites, anomalies should be observed extremely carefully.

[Expression of osteopontin mRNA and its clinical significance in gastric cancer].

OBJECTIVE: To investigate the expression of osteopontin mRNA and its correlation with clinicopathologic features of gastric cancer and elucidate its role in tumor invasion and distant metastasis. METHODS: The expression of OPN mRNA was detected by semi-quantitive RT-PCR. The relationship between the relative content of OPN mRNA and clinicopathologic features of gastric cancer was analyzed. RESULTS: In 66 cancer tissue samples, a 330 bp band was detected in 50 cases, the positive rate of OPN mRNA expression was 75.8% (50/66). The expression in all 20 cases of normal gastric mucosa was negative. The expression was associated with the depth of tumor invasion, diameter, lymph node metastasis and but had no correlation with differentiation grades. The 66 patients were followed up for 10 approximately 27 months (mean 16 months). The OPN mRNA expression positive group (50 cases) had recurrence in 15 patients and the negative group (16 cases) had only 1 case with recurrence (P = 0.05); 10 patients died in OPN mRNA expression positive group but no patient died in OPN staining negative group (P = 0.05). CONCLUSION: OPN mRNA is over-expressed in gastric cancer. It reflects the progression of disease and association with poor prognosis of gastric cancer. OPN may play an important role in the process of distant metastasis in gastric cancer.

Diagnostic value of endoscopic ultrasonography for gastrointestinal leiomyoma.

AIM: To investigate the clinical pathologic features of gastrointestinal leiomyoma and the diagnostic value of endoscopic ultrasonography (EUS) on gastrointestinal leiomyoma. METHODS: A total of 106 patients with gastrointestinal leiomyoma diagnosed with EUS were studied. The location, size and layer origin of gastric and esophageal leiomyomas were analyzed and compared. The histological diagnosis of the resected specimens by endoscopy or surgery in some patients was compared with their results of EUS. RESULTS: The majority of esophageal leiomyomas were located in the middle and lower part of the esophagus and their size was smaller than 1.0 cm, and 62.1 % of esophageal leiomyomas originated from the muscularis mucosae. Most of the gastric leiomyomas were located in the body and fundus of the stomach with a size of 1-2 cm. Almost all gastric leiomyomas (94.2 %) originated from the muscularis propria. The postoperative histological results of 54 patients treated by endoscopic resection or surgical excision were completely consistent with the preoperative diagnosis of EUS, and the diagnostic specificity of EUS to gastrointestinal leiomyoma was 94.7 %. CONCLUSION: The size and layer origin of esophageal leiomyomas are different from that of gastric leiomyomas. Being safe and accurate, EUS is the best method not only for gastrointestinal leiomyoma diagnosis but also for the follow-up of patients.

Endoscopic retrograde cholangiopancreatography in evaluation of choledochal dilatation in patients with obstructive jaundice.

OBJECTIVE: To determine the causes of choledochal dilatation in patients with obstructive jaundice. METHODS: One hundred and sixty-four patients with obstructive jaundice were investigated by endoscopic retrograde cholangiopancreatography(ERCP), and patients with choledochal dilatation (group I, n=110) were compared with those without choledochal dilatation (group II, n=54). RESULTS: The causes of common bile duct dilatation were choledocholith, juxtapapillary duodenal diverticula and congenital dilatation of the common bile duct. The distal common bile duct and its surroundings were abnormal in 104 (94.55%) of the 110 patients and in 13 (24.08%) of the 54 patients (P<0.01). Juxtapapillary duodenal diverticulum accounted for 24.55% in group I, and only in 9.26% in group II (P<0.05). Post-cholecystectomy patients were 13.64% in group I, and only 5.56% in group II. CONCLUSIONS: The abnormalities of the distal common bile duct and its surroundings can usually be detected as underlying causes of common bile duct dilatation. ERCP is necessary before cholecystectomy, since it is considered the "gold standard" for the diagnosis of distal common bile duct abnormalities.

Correlated or not: Glaucoma prevalence and modern industrialization.

The higher prevalence of primary angle-closure glaucoma (PACG) among Eskimos, Chinese and Mongolians has long been acknowledged, while primary open-angle glaucoma (POAG) is common in blacks and Caucasians. However, in recent years, the incidence of Chinese POAG has increased to a level similar to that of Western countries, and the urban prevalence is higher than the rural one. Is this a coincidental result, or is it a consequence of modern industrialization? The etiology of glaucoma is believed to be due to both genetic and environmental factors. Genetics plays an important role in the growth of the eye, as demonstrated in ethnic variations in glaucoma prevalence and family studies. At the same time, changes in environmental factors have resulted in countries experiencing one of the most rapid epidemiological transitions in history. For the modern human eye to adapt to a more close-up working environment, and with more education requiring close reading, there have been some changes in the eye structure, including a deepening of the anterior chamber, an increase in myopia, a decrease of hyperopia, etc. The changes in these factors were closely associated with the pathogenesis of glaucoma. And of these factors, myopia may have been the most important contributor. Myopia, as an independent risk factor, may increase susceptibility to glaucomatous damage of the optic nerve in myopic eyes. Myopic eyes are more sensitive to intraocular pressure (IOP) (even normal IOP)-induced stress for the thinner lamina cribrosa and larger scleral canal than emmetropic eyes. Axial myopia has longer axial length of the eye and deeper anterior chamber than the normal eye, leading to a less chance to develop angle-closure glaucoma. Due to the increase in myopia among the younger generation in the process of industrialization and urbanization, we hypothesize that the prevalence of glaucoma is correlated with these changes, and that POAG could become more common in Eskimos, Chinese and other Asian descendants in the future.

Human T lymphoblast cell line expresses FP receptor.

PURPOSE: To identify the presence of prostanoid FP receptor in human T lymphoblast (MOLT-3) cell line, which was known not to express FP receptor. METHODS: Western blot analysis and mass spectrometry were performed on the cell lysates. RESULTS: The expression of FP receptor was detected by western blot analysis and mass spectrometry. CONCLUSIONS: MOLT-3 cell does express prostanoid FP receptor.