Alterations and Significance of Computed Tomography Pulmonary Angiography-Derived Parameters in Older Patients With Acute Pulmonary Embolism.

OBJECTIVE: This study aimed to investigate changes of computed tomography pulmonary angiography (CTPA)-derived parameters in older adults with acute pulmonary embolism (APE). METHODS: According to the pulmonary artery obstruction index (PAOI), patients with APE were divided into the A1 (PAOI ≥30%, n = 57) and A2 (PAOI <30%, n = 40) groups. Participants without APE were placed in group B (n = 170). The left atrial (LA) and left ventricular (LV) parameters among the three groups were compared, and the parameter changes in the 44 patients with APE were analyzed before and after treatment. The correlation between APE severity and the parameters was analyzed using correlation analysis. RESULTS: The left-to-right diameters (LR) of LA, and LR × anteroposterior diameters (AP) of LA and LV: A1 < A2 < B; LR of LV: A1 < A2, B; AP of LA and LV: A1, A2 < B. After treatment, LR and LR × AP of the LA and LV were significantly increased in the group A1 and LR of the LV and LR × AP of the LA and LV were elevated in the group A2. Acute pulmonary embolism severity was closely associated with LR × AP ( r = -0.557) and LR ( r = -0.477) of LA. CONCLUSIONS: With an increase in the degree of obstruction, older adults had a smaller LA and LV. Furthermore, the LR and LR × AP values of the LA were significantly decreased. These results contribute to in-time risk stratification.

Pancreatic duodenal stromal tumor presenting as a mass in the head of the pancreas.

A 48-year-old woman was incidentally found to have a pancreatic mass during a health examination.In the past, she had been in good physical health. Laboratory investigations including tumor markers and blood glucose were within normal range.CT imaging revealed a 3.6cm × 3.5cm mass in the head of the pancreas with multiple irregular calcifications and cystic lesions within it.

Hemangioendothelioma of the spleen and liver in a 1-year-old child.

Concurrent occurrence of hemangioendothelioma in the spleen and liver of a 1-year-old child is a rare clinical case.She had a history of good health. Laboratory tests showed elevated inflammatory markers, but all other parameters were within normal range. In this article, we exhibit the typical clinical presentation and Pathology imaging features of this disease.CT imaging revealed a 9.8 cm×8.6 cm mass in the spleen, with areas of non-enhancing liquefactive necrosis. The mass exhibited heterogeneous enhancement during the arterial phase and progressive enhancement during the venous phase. Multiple nodules were observed in liver segments S2 and S4, the largest being approximately 3.7 cm×3.5 mm, with enhancement patterns similar to the splenic lesion. The patient underwent splenectomy, left hemihepatectomy, and cholecystectomy. Intraoperatively, the splenic mass exhibited some areas appearing spongy. Multiple nodules were observed in the left liver, presenting as gray-brown solid masses with a spongy texture. Pathology confirmed a diagnosis of hemangioendothelioma, supported by positive immunohistochemical staining for CD31, CD34, ERG, and FLI-1.

Cervicocerebral Computed Tomography Angiography for Older Patients Based on Time to Peak and Number of Time Points to Peak in the Test Bolus Technique.

OBJECTIVE: This study sought to optimize image quality and reduce the contrast dose by adjusting contrast agent and normal saline doses used in cervicocerebral computed tomography angiography (CTA) of older patients. METHODS: Older patients who underwent cervicocerebral CTA were divided into group A (n = 110) and group B (n = 124). In the angiography scan, patients in group A were injected with 1.0 mL/kg contrast agent, followed by 40 mL saline chaser. In group B, contrast agent and normal saline doses were adjusted based on time to peak and number of time points to peak in the test bolus technique. The CT attenuation values, noise, signal-to-noise ratio, and contrast-to-noise ratio of target arteries and the right transverse sinus were objectively compared. RESULTS: Compared with group A, the contrast retention and artifacts in the right subclavian vein, right brachiocephalic veins, and superior vena cava were significantly decreased in group B. Furthermore, in group B, the noise at the bifurcation of the right common carotid artery increased by 1.7%, and the signal-to-noise ratio of the left middle cerebral artery M1 segment decreased by 6.6%. The contrast dose in group B decreased significantly (18.2%) as compared with group A. CONCLUSION: Based on time to peak and number of time points to peak with the test bolus, adjusting contrast and normal saline doses in cervicocerebral CTA for older people reduces contrast retention and artifacts in the veins of the injection side. Further, it also decreases the contrast dose needed to obtain image quality that satisfies diagnostic requirements.

Optimization of the Parameters for the Test Bolus Technique in Computed Tomography Angiography of Head and Neck.

OBJECTIVE: The aim of the study was to optimize low-dose scanning protocols for the test bolus technique in 64-detector computed tomography (CT) angiography (CTA) of the head and neck. METHODS: A total of 250 patients were randomly divided into 5 groups of 50 patients each: conventional group (group A: 120 kV, 100 mA) and low-dose groups (group B: 100 kV, 100 mA; group C: 100 kV, 50 mA; group D: 80 kV, 100 mA; and group E: 80 kV, 50 mA). Subjective scores and objective measurements (CT values of the aortic arch, image noise, and signal-to-noise ratio) were used to evaluate the image quality and compare the radiation doses of the 5 groups. RESULTS: The image quality of the 5 groups met the diagnostic requirements, with no significant difference in the subjective evaluation findings (P > 0.05). There were significant differences in the CT values between the conventional group and low-dose groups (P < 0.05); however, there was no significant difference between groups B and C and between groups D and E (P > 0.05). Moreover, the volume CT dose index and dose length product of groups B, C, D, and E decreased by 37.62%, 70.45%, 65.28%, and 83.39%, respectively, compared with those of group A. Although the image noise of the low-dose groups increased, an appropriate reduction in the tube voltage enhanced the contrast medium-induced x-ray attenuation and increased the CT value, which resulted in a nonsignificant difference in the signal-to-noise ratio. Therefore, the image quality of the low-dose groups was not affected compared with that of the conventional group. CONCLUSIONS: In the test bolus technique in 64-detector CTA, the low-dose protocol of using 80 kV and 50 mA reduces the radiation dose by 83.39% compared with the conventional scan, without affecting the image quality.

Association between PRDM16, MEF2D, TRPM8, LRP1 gene polymorphisms and migraine susceptibility in the She ethnic population in China.

BACKGROUND: The prevalence of migraines in the She population, a minority in China, is significantly higher than that in Han Chinese and other Asian populations. Two single nucleotide polymorphisms (SNPs) have been found to be associated with migraine susceptibility in the She population. PURPOSE: This study investigated four SNPs, identified in genome-wide association studies, within migraine-susceptible loci in Han Chinese for their association with migraine susceptibility in the She population. METHODS: Two-hundred unrelated migraine patients and 200 healthy controls were recruited. The SNPs examined included rs2651899 (PRDM16 ), rs2274316 (MEF2D ), rs7577262 (TRPM8) and rs11172113 (LRP1). Genotyping of the SNPs was performed by allele-specific polymerase chain reaction and direct sequencing. RESULTS: No significant differences between the participants with migraines and controls (participants without migraines) were demonstrated in genotypes, alleles and allele carriage frequencies for the four SNPs. A subgroup analysis found that migraine with aura had a lower frequency of C allele positivity in rs2651899 than in healthy controls (59.6% vs. 74.5%, respectively; P < 0.034). Univariate analyses indicated that no genotype of the four SNPs had a significant association with migraines. Males had a lower risk of migraines, and advanced age was a significant risk factor for migraines in females. CONCLUSION: The SNPs in four migraine susceptible loci in Han Chinese were not risk factors for migraines in a relatively small sample of the She population.

Benthic clade II-type nitrous oxide reducers suppress nitrous oxide emissions in shallow lakes.

Shallow lakes, recognized as hotspots for nitrogen cycling, contribute to the emission of the potent greenhouse gas nitrous oxide (N2O), but the current emission estimates for this gas have a high degree of uncertainty. However, the role of N2O-reducing bacteria (N2ORB) as N2O sinks and their contribution to N2O reduction in aquatic ecosystems in response to N2O dynamics have not been determined. Here, we investigated the N2O dynamics and microbial processes in the nitrogen cycle, which included both N2O production and consumption, in five shallow lakes spanning approximately 500 km. The investigated sites exhibited N2O oversaturation, with excess dissolved N2O concentrations (ΔN2O) ranging from 0.55 ± 0.61 to 53.17 ± 15.75 nM. Sediment-bound N2O (sN2O) was significantly positively correlated with the nitrate concentration in the overlying water (p < 0.05), suggesting that nitrate accumulation contributes to benthic N2O generation. High N2O consumption activity (RN2O) corresponded to low ΔN2O. In addition, a significant negative correlation was found between RN2O and nir/nosZ, showing that bacteria encoding nosZ contributed to N2O consumption in the benthic sediments. Redundancy analysis indicated that benthic functional genes effectively reflected the variations in RN2O and ∆N2O. qPCR analysis revealed that the clade II nosZ gene was more sensitive to ΔN2O than the clade I nosZ gene. Furthermore, four novel genera of potential nondenitrifying N2ORB were identified based on metagenome-assembled genome analysis. These genera, which are affiliated with clade II, lack genes responsible for N2O production. Collectively, benthic N2ORB, especially for clade II-type N2ORB, harnesses N2O consumption activity leading to low N2O emissions from shallow lakes. This study advances our knowledge of the role of benthic clade II-type N2ORB in regulating N2O emissions in shallow lakes.

Meta-omics characteristics of intestinal microbiota associated to HBeAg seroconversion induced by oral antiviral therapy.

Tenofovir and entecavir are currently designated as the preferred oral antiviral drugs for chronic hepatitis B. However, only less than 40% of patients can achieve HBeAg seroconversion. We aim at investigating the role of intestinal microbiome in HBeAg seroconversion induced by oral antiviral therapy and describe multi-omics characteristics of HBeAg seroconversion associated intestinal flora. In this study, we prospectively collected fecal samples at baseline from the patients with HBeAg positive chronic hepatitis B who would have oral antiviral therapy. 16S rDNA sequencing and metabolomics were performed. We identified HBeAg seroconversion-related microbial signature and constructed prediction model for HBeAg seroconversion. Thirty-seven of these subjects achieved HBeAg seroconversion within 156 weeks after the initiation of oral antiviral therapy, while 41 subjects remained HBeAg positive even after over 156 weeks of therapy. A computational statistical and machine learning approach allowed us to identify a microbial signature for HBeAg seroconversion. Using random forest method, we further constructed a classifier based on the microbial signature, with area under curve being 0.749 for the test set. Patients who achieved HBeAg seroconversion tended to have lower abundance of certain fecal metabolites such as essential amino acids, and several dipeptides. By analyzing the fecal microbiota from the patients with and without HBeAg seroconversion, we showed intestinal microbiome play a critical role in HBeAg seroconversion induced by oral antiviral therapy. We also identified intestinal microbial signature that is associated with HBeAg seroconversion after oral antiviral therapy.

Prevalence of migraine in Han Chinese of Fujian province: An epidemiological study.

Migraine is a relatively common disease that is associated with high disability and reduced quality-of-life. This study aimed to investigate the prevalence, epidemiological characteristics, and risk factors of migraine in Han Chinese from Fujian Province, China.A cross-sectional epidemiological survey study was conducted to evaluate characteristics of migraine in Han Chinese. Demographic and clinical data were collected through a survey administered in face-to-face interviews by trained investigators, and a physical exam and symptom review were performed. Univariate and multivariate regression analyses were performed to assess independent risk factors for migraine.A total of 7860 subjects aged 15 years and older were surveyed, of which 9.1% (n = 717) were diagnosed with migraine. Among these, a higher percentage was female (12.6%) than male (5.3%). Only 114 subjects (15.9%) were diagnosed as having migraine with aura, which was closely associated with family history of migraine. Multivariate regression analysis showed that the odds of migraine were significantly lower in subjects aged ≥50 years compared with those aged <30 years (odds ratio [OR] ranged from 0.40 to 0.64; P ≤.013) and was higher in females compared with males (OR = 2.89, P <.001). The odds of migraine was significantly greater in subjects with a history of alcohol consumption (OR = 1.81, P <.00) and insomnia (OR = 2.77, P <.001).Han Chinese in Fujian province has a relatively high prevalence of migraine, and female gender, <50 years of age, insomnia, and use of alcohol are associated with increased odds of having migraine in this population.

Down-regulation of ABCG2 and ABCB4 transporters in the placenta of rats exposed to cadmium.

As a maternal and developmental toxicant, cadmium (Cd) possesses weak penetrability through the placental barrier. However, the underlying mechanism remains unclear. To gain insight into the protein molecules associated with Cd toxicity in placenta and explore their roles in Cd transportation, a reproductive animal experiment was carried out using Sprague-Dawley rats. We performed proteomic analysis of the placenta by Difference Gel Electrophoresis (DIGE) combined with Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Tandem Mass Spectroscopy (MALDI-TOF/TOF MS). The DIGE assay identified 15 protein spots that were differentially expressed with a greater than 1.5-fold change in placenta of Cd-treated rats compared to the control rats. Based on the expression patterns and biological functions of the proteins, we selected the ABCG2 and ABCB4 transporter proteins for further analysis. Western blot analysis showed that Cd exposure could down-regulate the expression of ABCG2 and ABCB4 in the placenta. There was a negative dose-response relationship between Cd exposure and the expression of ABCG2 or ABCB4 protein. These results indicated that down-regulation of ABCG2 and ABCB4 transporters may regulate Cd across through placenta and thus affect the in vivo toxic effect of Cd to fetus.