Molecular Imaging of Abdominal Aortic Aneurysms with Positron Emission Tomography: A Systematic Review.

OBJECTIVE: Previous studies on the relationship between positron emission tomography (PET) images and abdominal aortic aneurysm (AAA) progression have shown contradictory results, and the objective of this study was to systematically review the role of PET in predicting AAA prognosis. DATA SOURCES: PubMed, Embase, and Web of Science were searched for studies evaluating the correlation between PET imaging results and AAA growth, repair, or rupture. REVIEW METHODS: Two authors independently performed the study search, data extraction, and quality assessment following a standard method. RESULTS: Of the 11 studies included in this review, nine used 18F-fluorodeoxyglucose (18F-FDG) PET and computed tomography (CT) imaging, whereas the remaining two used 18F-sodium fluoride (18F-NaF) PET/CT and 18F-FDG PET/magnetic resonance imaging (MRI). Findings from the 18F-FDG PET/CT studies were contradictory. Six studies found no significant association or correlation, and two studies found a significant negative correlation between 18F-FDG uptake and AAA expansion. Additionally, one study found that the 18F-FDG uptake was statistically positively related to the expansion rate in a specific AAA subgroup whose AAAs expanded significantly. Two studies suggested that increased 18F-FDG uptake was significantly associated with AAA repair, while the other studies either found no association between 18F-FDG uptake and AAA rupture or repair or failed to report the occurrence of clinical events. One PET/CT study that used 18F-NaF as a tracer showed that an increased tracer uptake was significantly associated with AAA growth and clinical events. Finally, the 18F-FDG PET/MRI study indicated that 18F-FDG uptake was not significantly correlated with AAA expansion. CONCLUSION: A definitive role for 18F-FDG PET imaging for AAA prognosis awaits further investigation, and new PET tracers such as 18F-NaF have the potential to be a promising method for predicting AAA clinical outcomes.

Efficacy and safety of leflunomide versus cyclophosphamide for initial-onset Takayasu arteritis: a prospective cohort study.

BACKGROUND: Leflunomide (LEF) has been considered as an alternative treatment for Takayasu arteritis (TA); however, data on its efficacy are still scanty. OBJECTIVE: To investigate the efficacy and safety of LEF versus cyclophosphamide (CYC) for initial-onset TA. METHODS: Initial-onset TA patients with active disease were enrolled in this research. Patients enrolled from 1 January 2009 to 31 December 2015 were treated with glucocorticoids and CYC, while patients enrolled from 1 January 2016 to 31 October 2018 received glucocorticoids and LEF. Treatment response including complete remission (CR), partial remission (PR), and effectiveness rate (ER) and side effects were evaluated at 6 and 12 months. RESULTS AND CONCLUSION: In total, 92 patients were enrolled. A total of 47 patients were treated with LEF, while 45 patients were treated with CYC. The CR and ER rates were 75.55%, and 88.89% at 6 months, and 85.37% and 95.12% at 12 months in the LEF group. The CR and ER rates were 39.02% and 70.73% at 6 months, and 56.41% and 82.05% at 12 months in the CYC group. The CR rate was significantly higher in the LEF group than in the CYC group both at 6 months (75.61% versus 38.24%, p < 0.01) and 12 months (77.42% versus 53.33%, p < 0.05) after adjustment for propensity scores. The incidence of side effects in the LEF group was much lower than that in the CYC group (21.28% versus 44.44%). In conclusion, LEF provided a better treatment response, along with lower reproductive toxicity, compared with CYC in initial-onset TA.

Physiological and transcriptomic analysis highlight key metabolic pathways in relation to drought tolerance in Rhododendron delavayi.

Rhododendron delavayi is an alpine evergreen ornamental plant, but water shortage limits its growth and development in urban gardens. However, the adaptive mechanism of alpine evergreen rhododendrons to drought remains unclear. Here, a water control experiment was conducted to study the physiological and transcriptomic response of R. delavayi to drought. The drought treatment for 9 days decreased photosynthetic rate, induced accumulation of reactive oxygen species (ROS), and damaged chloroplast ultrastructure of R. delavayi. However, the photosynthetic rate quickly recovered to the level before treatment when the plants were re-watered. De novo assembly of RNA-Seq data generated 86,855 unigenes with an average length of 1870 bp. A total of 22,728 differentially expressed genes (DEGs) were identified between the control and drought plants. The expression of most DEGs related to photosynthesis were down-regulated during drought stress, and were up-regulated when the plants were re-watered, including the DEGs encoding subunits of light-harvesting chlorophyll-protein complex, photosystem II and photosystem I reaction center pigment-protein complexes, and photosynthetic electron transport. The expressions of many DEGs related to signal transduction, flavonoid biosynthesis and antioxidant activity were also significantly affected by drought stress. The results indicated that the response of R. delavayi to drought involved multiple physiological processes and metabolic pathways. Photosynthetic adjustment, ROS-scavenging system, abscisic acid and brassinosteroid signal transduction pathway may play important roles to improve drought tolerance of R. delavayi. Our findings provided valuable information for understanding the mechanisms of drought tolerance employed by Rhododendron species.

Application of gas cyclone-liquid jet absorption separator for purification of tail gas containing ammonia.

In this experiment, with stainless steel gas cyclone-liquid jet absorption separator as carrier, NH3 as experimental gas, and water and H3PO4 solution as absorbents, corresponding NH3 absorption rate change is obtained through the adjustment of experimental parameters, such as NH3 inlet concentration, inlet velocity of mixed gas, injection flow rate of absorbent, temperature of absorbent, and H3PO4 absorbent concentration. The NH3 absorption rate decreases with the increase in NH3 inlet concentration and inlet gas velocity. The NH3 absorption rate will increase first and then tends to remain unchanged after reaching a certain degree with the increase in liquid injection flow rate and absorbent concentration. The NH3 absorption rate will increase first and then decrease with the increase in the absorbent temperature. The maximum NH3 removal efficiencies of water and H3PO4 were 96% and 99%, respectively.

Clinical and Genetic Study of Children With Peutz-Jeghers Syndrome Identifies a High Frequency of STK11 De Novo Mutation.

OBJECTIVES: The present study aims to identify the genotype-phenotype correlation in children with Peutz-Jeghers Syndrome (PJS) through the analysis of STK11 gene mutations in the context of clinical and pathological characteristics. METHOD: In this observational cohort study, the clinical characteristics of 18 families diagnosed with pediatric PJS were collected. Genomic DNA from the peripheral blood of affected children and their family members was collected. The coding region of STK11 was amplified by PCR and screened for mutation by Sanger sequencing. The families that were negative for STK11 mutation were further assessed by multiplex ligation-dependent probe amplification (MLPA). RESULT: Initial presentation in affected children was at 1.6 to 14.2 years and included anemia in 8 patients whereas 6 presented for screening by virtue of family history. All patients underwent endoscopy, colonoscopy, and polypectomy. Polyps were distributed throughout the gastrointestinal (GI) tract, including the small intestine, stomach, colon, and rectum.In the 18 pediatric PJS families, STK11 mutations were detected in 8 families by Sanger sequencing, and large deletions were detected in 3 by MLPA, respectively. Nine of the 11 STK11 mutations were de novo, 3 were novel (c.419T>C:p.L140P, c.314T>G:p.L105X), and (c.488_489insACGG p.L164fs). CONCLUSIONS: Although the main clinical features of pediatric PJS were similar to those of PJS cases in adults, a high frequency of STK11 de novo mutations were encountered in our population of patients with PJS.

Outcomes of Laparoscopy Combined with Enhanced Recovery Pathway for Reversal of Hartmann's Procedure.

The objective of this study is to discuss the security and feasibility of the laparoscopic reversal of Hartmann's procedure (LRHP) on the concept of enhanced recovery after surgery (ERAS). The clinical data of 42 patients who underwent laparoscopic reversal of Hartmann's procedure was retrospectively analyzed, and the operative time, blood loss, intraoperative and postoperative complications, conversion to open surgery, postoperative hospital stay, and so on were observed. Twenty-nine patients (69.00 % of the study pool) received complete postoperative recovery courses as prescribed by enhanced recovery program (ERP). The postoperative length of stay (LOS) in the hospital was 5.6 (3-16 days). The overall and major (grades III to V) postoperative morbidities were 33.3 % (n = 14) and 4.8 % (n = 2), respectively. Our preliminary results showed that using the laparoscopic technology in reversal of Hartmann's colostomy on the concept of ERP is safe and feasible. Patients with intra- or postoperative complications were found to have statistically significant associations with greater risk of ERP failure.

An analysis of the current status of hospital emergency preparedness for infectious disease outbreaks in Beijing, China.

BACKGROUND: In the event of a large-scale infectious disease outbreak, hospitals will play a critical role. The objective of our study is to understand the current status of hospitals preparedness for infectious disease outbreaks in Beijing and to provide basic information for infectious disease prevention and control in hospitals. METHODS: One hundred fifty-two secondary and tertiary care hospitals in Beijing were surveyed by a standardized questionnaire. Data related to hospital demographic information and their emergency plans, laboratory diagnosis capacity, medical treatment procedures for infectious diseases, stockpiles of drugs and personal protective equipment, and staff training were collected. RESULTS: Responses were received from 134 (88.2%) of the 152 hospitals surveyed. Overall, hospitals reported that the number of physicians and nurses in infectious disease accounted for only 1.8% of the total physicians and 2.5% of the total nurses, and surgery beds accounted for 8.5% of all the fixed beds. Approximately 93.3% of the hospitals surveyed reported that they had an emergency plan, and none of those reported that their laboratories were able to isolate and identify all 8 kinds of common pathogens of infectious diseases: 22.4% of the hospitals had medical treatment procedures for all these infectious diseases, 23.1% had stored specific drugs for treatment, 2.2% had all personal protective equipment, and 30.6% reported that their health care staff had been trained in hospital emergency preparedness for infectious diseases. In general, emergency preparedness for infectious diseases in tertiary care hospitals was better than that in secondary care hospitals; the preparedness at general hospitals was better than that at specialized hospitals; and that at teaching hospitals was better than that at nonteaching hospitals. CONCLUSION: Emergency preparedness for infectious disease at hospitals in Beijing was in an early stage of development during this survey. Comprehensive measures should be developed and implemented to enhance their capacity for infectious disease emergency.