The global, regional, and national burden of appendicitis in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide, and its burden has been changing. We report the level and trends of appendicitis prevalence, and incidence; and years lived with disability (YLD) in 204 countries and territories from 1990 to 2019, based on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS: The numbers and age-standardized prevalence, incidence, and YLD rates per 100,000 population of appendicitis were estimated across regions and countries by age, sex, and sociodemographic index (SDI). All the estimates were reported with 95% uncertainty intervals (UIs). RESULTS: Globally, the age-standardized prevalence and incidence rates of appendicitis in 2019 were 8.7 (95% UI 6.9 to 11.0) and 229.9 (95% UI 180.9 to 291.0) per 100,000 population, with increases of 20.8% (95% UI 18.9 to 23.0%) and 20.5% (95% UI 18.7 to 22.8%) from 1990 to 2019, respectively. Additionally, the age-standardized YLDs rate was 2.7 (95% UI 1.8 to 3.9) in 2019, with an increase of 20.4% (95% UI 16.2 to 25.1%) from 1990 to 2019. In 2019, the age-standardized prevalence, incidence, and YLD rates peaked in the 15-to-19-year age groups in both male and female individuals. However, no statistically significant differences were observed between the male and female individuals in all groups. Ethiopia, India, and Nigeria showed the largest increases in the age-standardized prevalence rate between 1990 and 2019. Generally, positive associations were found between the age-standardized YLD rates and SDI at the regional and national levels. CONCLUSIONS: Appendicitis remains a major public health challenge globally. Increasing awareness of appendicitis and its risk factors and the importance of early diagnosis and treatment is warranted to reduce its the burden.

Study on water resources carrying capacity based on Pressure-State-Response modeling: An empirical study of the urban agglomeration in Central Yunnan, China.

Water resources carrying capacity (WRCC) is the basis for sustainable regional development and an important indicator of core competitiveness, and its quantitative assessment and comparison is a key link in clarifying the development capacity of the region. The study comprehensively considers economic, social, resource, environmental and ecological factors, constructs a WRCC evaluation index system based on the Pressure-State-Response (PSR) model, adopts the entropy value method to assign weights to each index, and utilizes the set-pair analysis method and the obstacle diagnostic model to evaluate WRCC of the urban agglomerations in central Yunnan (UACY) in the period from 2008 to 2020. The results show that the comprehensive development of WRCC of UACY is characterized by stage-by-stage evolution in the time dimension, with a decreasing trend in the carrying capacity from 2008 to 2012, and an overall fluctuating upward development trend from 2013 to 2020. In the spatial dimension, Kunming's WRCC is generally poor, and Honghe and Yuxi have the greatest advantages in water resources storage and conservation capacity. The stress of water use in Kunming is higher, but Kunming has advantages in industrial structure and water resources development and utilization rate. Through the diagnosis of obstacle degree, the main obstacle factors of WRCC have large differences among cities (states), but the main subsystems constraining WRCC are all pressure subsystems. The results of the study can provide data support for water resources related policies and rational water resources dispatching in the UACY.

A rabbit bone tumor model for high-intensity focused ultrasound therapy.

The incidence of malignant bone tumor increases every year. Because the application of high-intensity focused ultrasound (HIFU) for the treatment of bone tumors is still at a nascent stage, it is essential to study the effectiveness of this technique in ideal animal models in order to obtain a beneficial reference for imaging studies. In this study, we established a VX2 malignant bone tumor model and evaluated this model by contrast-enhanced sonography and magnetic resonance imaging (MRI). The results show that all tumors were enhanced after injection of SonoVue. A contrast-enhanced MRI scan revealed obvious enhancement within the tumors. Histological examination revealed the presence of a large number of tumor cells. The model can serve as an ideal experimental model for the study of HIFU therapy in the treatment of malignant bone tumors and as a reference for imaging studies during follow-ups.

Sonographic imaging of the puborectalis.

INTRODUCTION: The aim of the present study was to compare the appearance of the normal male puborectalis using transrectal ultrasound with anatomy examinations to enhance the understanding of the relationship of the prostate to the adjacent pelvic floor. This information may help prevent damage to the puborectalis during transperineal ultrasound-guided biopsies and interventional therapies. METHODS: Ten formalin-fixed cadavers were dissected to examine the appearance and structure of the puborectalis and its relationship with the peripheral organs. The puborectalis was also observed in a fresh male cadaver using transrectal ultrasound. In the fresh male cadaver, the puborectalis was located using transrectal sonography, the muscle was confirmed by anatomy, and the thickness was measured. RESULTS: The ultrasonographic observations of the location of the puborectalis were confirmed by anatomy for the fresh cadaver. Bilateral, symmetrical, hypoechoic strips were observed beside the prostate in cross-section, and strip fibers were observed in the longitudinal section. The right and left puborectalis thickness measurements were 6.1 and 6.2 mm, respectively, in the sonographic image, and the measurements were 5.85 and 5.89 mm, respectively, in the formalin-fixed fresh cadaver. CONCLUSIONS: Transrectal ultrasound provides a new imaging method to observe the male puborectalis, establishing a foundation for recognizing pelvic floor abnormalities with ultrasonography in the future.

High-intensity focused ultrasound in ovarian cancer xenografts.

INTRODUCTION: The purpose of this study was to determine whether high-intensity focused ultrasound (HIFU) is an effective treatment for ovarian carcinoma in an athymic nude mouse model. METHODS: Thirty-nine female athymic nude mice were inoculated subcutaneously with 5-7 x 10(6) SKOV3 human ovarian cancer cells. Thirty-two animals developed tumours and were randomly divided into three groups: HIFU (n=18), sham treatment (n=8) and control (n=6). The sonographic appearance of the tumours during therapy was recorded. After therapy, the tumours were examined transcutaneously by ultrasound every 4 days for 4 weeks. Tissue samples were taken from the treatment sites and histopathologically examined by light or electron microscopy. RESULTS: Three weeks after HIFU treatment, a 100% reduction in tumour volume was observed in all animals in the HIFU group, whereas tumours in the sham-treated and control groups continued to grow. Pathological examination of HIFU-treated tumour tissue samples showed complete coagulation necrosis of the tumour. CONCLUSION: Our results indicate that HIFU appears to be an effective therapy for ovarian carcinoma tumours in the athymic nude mouse model. We suggest that it may hold promise for the clinical treatment of late-stage and recurrent ovarian cancer.

Noninvasive evaluation of hepatic fibrosis in children with infant hepatitis syndrome.

AIM: To elucidate the impact of hemodynamic para-meters on ultrasonography and serum fibrosis markers for the assessment of liver fibrosis in the children with infant hepatitis syndrome (IHS). METHODS: Forty-one children with IHS and 46 healthy infants were examined by ultrasonography, and several hemodynamic indices such as peak systolic velocity (PSV) and resistant index (RI) of proper hepatic artery (PHA) were measured. Serum fibrosis markers including hyaluronic acid (HA), pre-collagen type-III (PC-III), collagen type IV (C-IV), and laminin (LN) were assayed by radioimmunoassays. In children with IHS, liver tissues were obtained either by ultrasound-guided liver biopsy (n = 35) or in the course of operation (n = 6). The stages of hepatic fibrosis were scored as mild (S1 and S2), moderate (S3), or severe (S4) according to liver histological diagnosis. Multiple groups comparative and Spearman correlative analyses were carried out. RESULTS: Histopathologically, 39 children (95.1%) were found to have hepatic fibrosis, 12 of them stage S1 or S2, 12 stage S3, and 15 stage S4. PSV, RI of the PHA, and serum HA showed a consecutive increase from mild to severe hepatic fibrosis and a close positive correlation with hepatic fibrosis in IHS group (r = 0.717, 0.745 and 0.712, respectively, P = 0.001). The Doppler waveform of HV was also positively correlated with the degree of hepatic fibrosis in IHS group (r = 0.783, P < 0.001). CONCLUSION: Combination of ultrasonic studies on the hepatic hemodynamics with the evaluation of serum HA may provide an indicator for hepatic fibrosis in patients with IHS. This may be a useful noninvasive method for the diagnosis and evaluation of the prognosis of IHS.

Early sonographic assessment of Budd-Chiari syndrome after orthotopic liver transplantation.

Budd-Chiari syndrome is a rare vascular complication of liver transplantation that may result in loss of the graft and a high mortality risk. Therefore, early diagnosis is extremely important to allow preservation of the graft and improve the prognosis. We describe the sonographic findings in a patient in whom Budd-Chiari syndrome occurred 2 days after orthotopic liver transplantation.