Case report and literature review: Orally ingested toothpick perforating the lower rectum.

Introduction: Most foreign bodies (FBs) can spontaneously pass through the gastrointestinal tract. Sharp FBs are believed to be able to puncture any part of the gastrointestinal tract, causing perforation and potentially secondary damage to adjacent organs. Case description: A 44-year-old man complained of having persistent dull pain in the perianal region. He was diagnosed with a toothpick impacted into the wall of the lower rectum after accepting a digital rectal examination of the lower rectum and a pelvic computed tomography (CT). The surgeon extracted the FB using vascular forceps guided by the operator's index finger. The patient was discharged after intravenous ceftriaxone was given for 6 days. A follow-up pelvic CT performed 2 weeks after surgery revealed that the perirectal fat and muscles had already normalized. Conclusion: A systematic review of relevant literature from the past decade was performed to summarize the imaging features of an orally ingested toothpick perforating the gastrointestinal tract. The location of abdominal pain is an important clue for the diagnosis of toothpick perforation, and a CT examination is recommended as the first option for the detection of an ingested toothpick. Determining the location of the toothpick perforation and assessing the severity of local inflammation are important bases for the selection of treatment.

Effect of biochar on biochemical properties of saline soil and growth of rice.

To amend physical properties of coastal saline soil for rice production, six biochar treatments (0, 0.5, 1, 2, 4 and 6 kg biochar per m2 soil) were set up as CK, T1, T2, T3, T4 and T5, respectively and their effect on the biochemical properties of coastal saline soil and rice growth characteristics were evaluated in a barrel planting experiment. The results showed that compared with CK (with no biochar added), the soil EC of T1 and T2-T5 was reduced by 11.5 %, but increased by 8.8-62.9 %, respectively. The available potassium and organic matter contents of T1-T5 increased ranging from 3.7-10.2 % to 8.0-46.8 %, respectively. With the increase of the biochar amount, the urease activity of soil in the 0-10 cm deep soil showed an increasing trend by 194.8-744.6 % with T1-T5, compared with that of the CK treatment. The activity of alkaline phosphatase in soil increased first and then decreased, and its increment with T1-T5 was between 28.2 and 64.8 % in comparison with that of CK. With more biochar added to soil, the leaf dry weight, root dry weight, total dry matter mass, total root length, single panicle quality and weight per 100 grains showed a trend of increase first and then decrease. The highest incremental values of all measurements were obtained with T1 by 21.8 %, 23.9 %, 13.8 %, 33.9 %, 30.8 % and 11.6 % respectively, compared with those with CK. However, adding biochar in soil demonstrated insignificant effect on the weight of single panicle, panicle length, stem thickness, tillers, setting rate, soil hydrolyzable nitrogen, available phosphorus content, rice protein, amylose, and taste quality among all treatments. In summary, the application of 0.5 kg m-2 biochar can improve the biochemical properties of saline soil and therefore increase rice yield.

Whole-brain in vivo base editing reverses behavioral changes in Mef2c-mutant mice.

Whole-brain genome editing to correct single-base mutations and reduce or reverse behavioral changes in animal models of autism spectrum disorder (ASD) has not yet been achieved. We developed an apolipoprotein B messenger RNA-editing enzyme, catalytic polypeptide-embedded cytosine base editor (AeCBE) system for converting C·G to T·A base pairs. We demonstrate its effectiveness by targeting AeCBE to an ASD-associated mutation of the MEF2C gene (c.104T>C, p.L35P) in vivo in mice. We first constructed Mef2cL35P heterozygous mice. Male heterozygous mice exhibited hyperactivity, repetitive behavior and social abnormalities. We then programmed AeCBE to edit the mutated C·G base pairs of Mef2c in the mouse brain through the intravenous injection of blood-brain barrier-crossing adeno-associated virus. This treatment successfully restored Mef2c protein levels in several brain regions and reversed the behavioral abnormalities in Mef2c-mutant mice. Our work presents an in vivo base-editing paradigm that could potentially correct single-base genetic mutations in the brain.

NEXMIF variants are associated with epilepsy with or without intellectual disability.

OBJECTIVES: Variants in NEXMIF had been reported associated with intellectual disability (ID) without epilepsy or developmental epileptic encephalopathy (DEE). It is unkown whether NEXMIF variants are associated with epilepsy without ID. This study aims to explore the phenotypic spectrum of NEXMIF and the genotype-phenotype correlations. MATERIALS AND METHODS: Trio-based whole-exome sequencing was performed in patients with epilepsy. Previously reported NEXMIF variants were systematically reviewed to analyze the genotype-phenotype correlations. RESULTS: Six variants were identified in seven unrelated cases with epilepsy, including two de novo null variants and four hemizygous missense variants. The two de novo variants were absent in all populations of gnomAD and four hemizygous missense variants were absent in male controls of gnomAD. The two patients with de novo null variants exhibited severe developmental epileptic encephalopathy. While, the patients with hemizygous missense variants had mild focal epilepsy with favorable outcome. Analysis of previously reported cases revealed that males with missense variants presented significantly higher percentage of normal intellectual development and later onset age of seizure than those with null variants, indicating a genotype-phenotype correlation. CONCLUSION: This study suggested that NEXMIF variants were potentially associated with pure epilepsy with or without intellectual disability. The spectrum of epileptic phenotypes ranged from the mild epilepsy to severe developmental epileptic encephalopathy, where the epileptic phenotypes variability are potentially associated with patients' gender and variant type.

Review Article Imaging Evaluation for the Size of Saccular Intracranial Aneurysm.

BACKGROUND: In addition to evaluate the morphologic characteristics of intracranial aneurysms, the dimension of the aneurysm is an important parameter for selecting treatment strategies, determining follow-up period, and predicting the risk of rupture. High-resolution vessel wall imaging has an increasingly dominant role in measuring aneurysm size and assessing the risk of rupture accurately. The size of saccular intracranial aneurysm may play an important role as a predictor of the rupture risk. With the rapid improvement in radiological techniques, different noninvasive imaging methods have respective characteristics in saccular intracranial aneurysms (sIA) measurement and morphologic description. Although most studies believe that the larger the aneurysm, the higher the risk of rupture, there is still a synergistic effect of multiple factors (such as location, morphology, history of aneurysmal subarachnoid hemorrhage, and even patient factors) to explain the rupture of small aneurysms. METHODS: A literature search was performed of intracranial aneurysm size and risk of rupture. RESULTS: The specificity and sensitivity of different imaging methods for evaluating intracranial aneurysms varied based on sizes. Rupture risk of aneurysms was associated with multiple factors. A comprehensive assessment that considered aneurysm size in conjunction with other relevant factors would be helpful in guiding options of management. CONCLUSIONS: Accurate measurement of the dimension of sIA is an important basis in the selection of appropriate treatment including intravascular intervention or surgical clipping, as well as for determining the follow-up cycles for conservative or postoperative treatment. A uniform definition of sIA size is recommended to facilitate the integration of similar studies and to accomplish rapid and effective screening of cases in sIA treatment.

Engineering of cytosine base editors with DNA damage minimization and editing scope diversification.

Cytosine base editors (CBEs), which enable precise C-to-T substitutions, have been restricted by potential safety risks, including DNA off-target edits, RNA off-target edits and additional genotoxicity such as DNA damages induced by double-strand breaks (DSBs). Though DNA and RNA off-target edits have been ameliorated via various strategies, evaluation and minimization of DSB-associated DNA damage risks for most CBEs remain to be resolved. Here we demonstrate that YE1, an engineered CBE variant with minimized DNA and RNA off-target edits, could induce prominent DSB-associated DNA damage risks, manifested as γH2AX accumulation in human cells. We then perform deaminase engineering for two deaminases lamprey LjCDA1 and human APOBEC3A, and generate divergent CBE variants with eliminated DSB-associated DNA damage risks, in addition to minimized DNA/RNA off-target edits. Furthermore, the editing scopes and sequence preferences of APOBEC3A-derived CBEs could be further diversified by internal fusion strategy. Taken together, this study provides updated evaluation platform for DSB-associated DNA damage risks of CBEs and further generates a series of safer toolkits with diversified editing signatures to expand their applications.

Aloe-Emodin Derivative, an Anthraquinone Compound, Attenuates Pyroptosis by Targeting NLRP3 Inflammasome in Diabetic Cardiomyopathy.

Diabetic cardiomyopathy (DCM) is widely recognized as a major contributing factor to the development of heart failure in patients with diabetes. Previous studies have demonstrated the potential benefits of traditional herbal medicine for alleviating the symptoms of cardiomyopathy. We have chemically designed and synthesized a novel compound called aloe-emodin derivative (AED), which belongs to the aloe-emodin (AE) family of compounds. AED was formed by covalent binding of monomethyl succinate to the anthraquinone mother nucleus of AE using chemical synthesis techniques. The purpose of this study was to investigate the effects and mechanisms of AED in treating DCM. We induced type 2 diabetes in Sprague-Dawley (SD) rats by administering a high-fat diet and streptozotocin (STZ) injections. The rats were randomly divided into six groups: control, DCM, AED low concentration (50 mg/kg/day), AED high concentration (100 mg/kg/day), AE (100 mg/kg/day), and positive control (glyburide, 2 mg/kg/day) groups. There were eight rats in each group. The rats that attained fasting blood glucose of ˃16.7 mmol/L were considered successful models. We observed significant improvements in cardiac function in the DCM rats with both AED and AE following four weeks of intragastric treatment. However, AED had a more pronounced therapeutic effect on DCM compared to AE. AED exhibited an inhibitory effect on the inflammatory response in the hearts of DCM rats and high-glucose-treated H9C2 cells by suppressing the pyroptosis pathway mediated by the nucleotide-binding oligomerization domain (NOD)-like receptor pyrin domain 3 (NLRP3) inflammasome. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of differentially expressed genes showed a significant enrichment in the NOD-like receptor signaling pathway compared to the high-glucose group. Furthermore, overexpression of NLRP3 effectively reversed the anti-pyroptosis effects of AED in high-glucose-treated H9C2 cells. This study is the first to demonstrate that AED possesses the ability to inhibit myocardial pyroptosis in DCM. Targeting the pyroptosis pathway mediated by the NLRP3 inflammasome could provide a promising therapeutic strategy to enhance our understanding and treatment of DCM.

Dual-energy computed tomography in reducing the effective radiation dose of computed tomography urography in patients with urinary calculi.

Background: To evaluate the diagnostic performance of split-bolus single-phase dual-energy computed tomography (DECT) with virtual non-contrast computed tomography (VNCT) compared to three-phase computed tomography (CT) urography in patients with urinary calculi, and to examine the performance of split-bolus single-phase DECT when reducing the effective dose. Methods: A total of 48 patients with abdominal pain or hematuria suggestive of unilateral urinary calculi were enrolled and randomly divided into the experimental and control groups, with 24 cases in each group. Patients in the experimental group underwent split-bolus single-phase DECT to obtain a mixed nephrographic excretory phase. Patients in the control group accepted a single-bolus three-phase CT urography scan (non-contrast, nephrographic phase, and excretory phase). The CT values and the contrast-to-noise ratio (CNR) of 7 segments of the urinary tract were measured and compared between the two groups by using the Mann-Whitney U test. The dose-length product (DLP) and effective dose of each patient were compared between the two groups using an independent t-test. Results: Among all 48 patients, 35 calculi were detected in the experimental group (n=24), and 47 calculi were detected in the control group (n=24). There was no significant difference between the two groups in both CT value measurements and the CNR. The mean DLP and mean effective dose of the experimental group were significantly lower than those of the control group, and the effective dose in the experimental group was decreased by 40% compared with the control group. Conclusions: The application of DECT combined with split-bolus nephrographic excretory phase CT urography can reveal the urinary calculi covered by a contrast medium and also reduce the effective dose exposure to patients.

TadA orthologs enable both cytosine and adenine editing of base editors.

Cytidine and adenosine deaminases are required for cytosine and adenine editing of base editors respectively, and no single deaminase could enable concurrent and comparable cytosine and adenine editing. Additionally, distinct properties of cytidine and adenosine deaminases lead to various types of off-target effects, including Cas9-indendepent DNA off-target effects for cytosine base editors (CBEs) and RNA off-target effects particularly severe for adenine base editors (ABEs). Here we demonstrate that 25 TadA orthologs could be engineered to generate functional ABEs, CBEs or ACBEs via single or double mutations, which display minimized Cas9-independent DNA off-target effects and genotoxicity, with orthologs B5ZCW4, Q57LE3, E8WVH3, Q13XZ4 and B3PCY2 as promising candidates for further engineering. Furthermore, RNA off-target effects of TadA ortholog-derived base editors could be further reduced or even eliminated by additional single mutation. Taken together, our work expands the base editing toolkits, and also provides important clues for the potential evolutionary process of deaminases.

TadA reprogramming to generate potent miniature base editors with high precision.

Although miniature CRISPR-Cas12f systems were recently developed, the editing efficacy and targeting range of derived miniature cytosine and adenine base editors (miniCBEs and miniABEs) have not been comprehensively addressed. Moreover, functional miniCBEs have not yet be established. Here we generate various Cas12f-derived miniCBEs and miniABEs with improved editing activities and diversified targeting scopes. We reveal that miniCBEs generated with traditional cytidine deaminases exhibit wide editing windows and high off-targeting effects. To improve the editing signatures of classical CBEs and derived miniCBEs, we engineer TadA deaminase with mutagenesis screening to generate potent miniCBEs with high precision and minimized off-target effects. We show that newly designed miniCBEs and miniABEs are able to correct pathogenic mutations in cell lines and introduce genetic mutations efficiently via adeno-associated virus delivery in the brain in vivo. Together, this study provides alternative strategies for CBE development, expands the toolkits of miniCBEs and miniABEs and offers promising therapeutic tools for clinical applications.

Morphological and molecular evidence reveals a new species of Anteaeolidiella (Mollusca, Nudibranchia, Aeolidiidae) from the Yellow Sea, China.

During an investigation of nudibranch gastropods in the Yellow Sea, several specimens were collected from the intertidal zone of Qingdao, Shandong Province, China. Morphological observation of their external and internal anatomy revealed that they represent an undescribed species belonging to the genus Anteaeolidiella M. C. Miller, 2001. This new species, Anteaeolidiella decorus sp. nov., can be differentiated from other congeners by both external morphology and internal anatomy. Phylogenetic analyses of two mitochondrial (COI, 16S rRNA) and a nuclear (H3) gene using Bayesian inference, maximum likelihood analysis, and species delimitation analyses also support the separation of Anteaeolidiella decorus sp. nov. from its congeners.

Case Report: Misdiagnosis of Lung Carcinoma in Patients with Shrunken Lung Cyst After High Altitude Travel.

Background: Lung cancer associated with cystic airspace is a rare disease, and the imaging understanding of lung cancer with cystic cavity is still unclear. Little is known in the literature on whether cystic lung cancer is caused by emphysema or ruptured bullae. Case Reports: We report the case of a 50-year-old female patient after finishing a business trip in November 2021, when another chest CT demonstrated an unexpected reduction in the cyst, with a solid mural nodule on the posterior wall. The airspace of the cyst is only about 13 mm × 12 mm × 6 mm in size. The size of the mural nodule in the posterior wall is about 10 mm × 6 mm × 5 mm. The patient felt anxious due to suspicion of lung cancer. 2.5 months after the last chest CT, she accepted minimally invasive thoracoscopic surgery on the posterior basal segment of the left lower lobe. The postoperative pathology showed benign lesions. Conclusion: For radiologists, it is important to recognize the process from lung cysts or bullae to LC-CAS, especially the morphological changes of the cyst airspace and the cyst wall, in order to identify the malignant features of lung cysts in time.

Epidemiological studies of accessory cardiac bronchus and a new variant.

Accessory cardiac bronchus (ACB) is a rare tracheobronchial branching abnormality which originates from the medial wall of the intermediate or main bronchus and is directed to the heart. Three types of ACB have been recognized: type (a) is similar to a short diverticulum, type (b) is a long bronchus ventilating a small undeveloped lobule, and type (c) is an intermediate type with a long diverticulum but no bronchial or alveolar arborization. Herein, we report 40 consecutive cases of ACB detected in 10,287 routine spiral computed tomography (CT) examinations of the chest. The frequency of the anomaly was 0.39%. The study included 17 females and 23 males (female to male ratio 1:1.35). A total of 24 cases belonged to type (a), 14 cases were type (b), and 2 cases were type (c). The mean largest diameter of ACB was 7.9 (range, 4.0 to 12.0) mm and the mean length was 7.5 (range, 3.0 to 18.0) mm. The mean ratio of the largest diameter to length was 1.1, the ratio for (a) was often greater than 1, and the ratios of (b) and (c) were often less than 1. The ACB originated from the intermediate bronchus in 29 cases, which accounted for the largest proportion. The ACB originated from the basal bronchus of the lower lobe in 11 cases (6 cases from the right lower lobe and 5 from the left), which has never been reported before and may be a new variant.

The mitochondrial genome of Lamellomphalus manusensis Zhang & Zhang, 2017 (Gastropoda: Neomphalida) from deep-sea hydrothermal vent.

We report the nearly complete mitochondrial genome sequence of Lamellomphalus manusensis Zhang and Zhang 2017, a deep-sea snail inhabiting hydrothermal vent. The mitogenome is 15,990 bp in length, has a base composition of A (35.7%), T (33.5%), C (15.4%) and G (15.4%), and contains 13 protein-coding genes, 2 ribosomal RNA genes, and 22 tRNA genes. Phylogenetic analyses show that the family Peltospiridae is not monophyletic, suggesting that its genera need to be redefined.

A bioinspired solar evaporator with a horizontal channel-like framework for efficient and stable high-salinity brine desalination.

In recent years, solar steam generation has been one of the most promising and sustainable techniques for water desalination. However, the heat loss to bulk water dramatically decreases the evaporation rate. Besides, salt deposition on the evaporation surface during brine treatment limits the long-term operation of evaporators. Herein, solar evaporators with a horizontal channel-like framework are reported and high efficiency and outstanding salt resistance are achieved. Firstly, eggplants with a hollow fiber alignment structure were carbonized as CEP evaporators. The CEP-H evaporator with a horizontal fiber growth direction shows a high evaporation efficiency of 90.6% and excellent salt resistance when treating high-salinity brine (20 wt%). The low thermal conductivity perpendicular to the fiber growth direction impedes the conductive heat transfer into bulk water, and fast water transport along the fiber growth direction is beneficial for salt resistance. In addition, a proof-of-concept evaporator polypyrrole-coated polypropylene hollow fiber membrane with a horizontal channel-like framework (PPy/PP-H) has also been developed. This hollow fiber membrane shows a high evaporation rate of 1.64 kg m-2 h-1 due to multiangle evaporation and also demonstrates excellent salt-resisting performance for high-salinity brine treatment (20 wt%). The study demonstrates the effect of the horizontal channel-like framework for high evaporation performance and salt resistance, providing new insights into the solar evaporator design for seawater desalination and wastewater treatment.

Evaluation of ultralow-dose computed tomography on detection of pulmonary nodules in overweight or obese adult patients.

PURPOSE: To evaluate the accuracy of pulmonary nodule (PN) detection in overweight or obese adult patients using ultralow-dose computed tomography (ULDCT) with tin filtration at 100 kV and advanced model-based iterative reconstruction (ADMIRE). METHODS: Eighty-one patients with body mass indices of ≥25 kg/m2 were enrolled. All patients underwent low-dose chest CT (LDCT), followed by ULDCT. Two radiologists experienced in LDCT established the standard of reference (SOR) for PNs. The number, type, size, and location of PNs were identified in the SOR. Effective dose, objective image quality (IQ), and subjective IQ based on two radiologists' scores were compared between ULDCT and LDCT. The detection performances of radiologists based on ULDCT were calculated according to the nodule analyses. Logistic regression was used to test for independent predictors of PN detection sensitivity. RESULTS: Both the effective dose and objective IQ were lower for ULDCT than for LDCT (both p < 0.001). Both radiologists rated the subjective IQ of the overall IQ on ULDCT to be diagnostically sufficient. In total, 234 nodules (mean diameter, 3.4 ± 1.9 mm) were classified into 32 subsolid, 149 solid, and 53 calcified nodules according to the SOR. The overall sensitivity of ULDCT for nodule detection was 93.6%. Based on multivariate analyses, the nodule types (p = 0.015) and sizes (p = 0.013) were independent predictors of nodule detection. CONCLUSIONS: Compared with LDCT, ULDCT with tin filtration at 100 kV and ADMIRE could significantly reduce the radiation dose in overweight or obese patients while maintaining good sensitivity for nodule detection.

Diagnostic value of chest computed tomography images in adult Poland syndrome: a report of two cases.

Poland syndrome is a rare congenital developmental deformity characterized by unilateral agenesis or hypoplasia of thoracic wall soft tissue. We report two adult cases of Poland syndrome detected by computed tomography (CT) images. CT images of the two cases depicted an asymmetric chest wall with the absence of a breast and agenesis of the pectoralis muscles. A physical examination of case 1 showed a thin right chest wall with depression of the right nipple region. Hand deformities were also observed, including brachydactyly and syndactyly. In case 2, hand deformities were not found in a physical examination. Using multi-planar reconstruction, the size, position, origin, and termination of bilateral pectoral muscles could be compared symmetrically. For patients with Poland syndrome, a timely diagnosis and treatment are important. The use of chest CT in clinical practice could play an important role in the early diagnosis and treatment of Poland syndrome.

Gray matter volume reduction with different disease duration in trigeminal neuralgia.

PURPOSE: Structural magnetic resonance imaging is widely used to explore brain gray and white matter structure in trigeminal neuralgia (TN) but has yielded conflicting findings. This study investigated the relationship between disease duration as a clinical feature of TN and changes in brain structure. METHODS: We divided 49 TN patients into three groups (TN1-TN3) based on disease duration (TN1 = 1.1 ± 0.7 (0-2) years, TN2 = 4.8 ± 1.5 (3-7) years, TN3 = 15.1 ± 5.5 (10-30) years). We used voxel-based morphometry (VBM) to compare the gray matter volume (GMV) across groups and between TN patients and 18 matched healthy control subjects. RESULTS: The TN1 group showed reduced GMV of pain-related regions in the cerebellum; the TN2 group showed reduced GMV in the thalamus and the motor/sensory cortex; and the TN3 group showed reduced GMV in the emotional and reward circuits compared with healthy controls. Similar brain regions, including bilateral hippocampi, caudate, left insular cortex, and medial superior frontal cortex, were affected in TN2 and TN3 compared with TN1. CONCLUSION: Disease duration can explain differences in structural alterations-especially in pain-related brain regions-in TN. These results highlight the advanced structural neuroimaging method that are valuable tools to assess the trigeminal system in TN and may further our current understanding of TN pathology.

Further evidence for Zenker's diverticulum in a slim woman with body figure predisposition: a case report and literature review.

Zenker's diverticulum (ZD) is a bag-like pharyngeal pouch that protrudes to the outside of the pharynx. It is thought to be an acquired disease that occurs following the dysfunction of laryngopharynx muscle, and certain body shapes may be predisposed to this condition. We report a 56-year-old female of slim build with ZD. Computed tomography scanning revealed a hypodense lesion on the left posterior side of her upper esophagus that was filled with air and had no obvious wall. To verify this finding, a barium esophagogram was carried out which showed a round pouch at the level of the 6th cervical vertebral body that communicated with the esophagus through a narrow neck. ZD was subsequently confirmed by endoscopy. These findings provide further evidence in support of a body shape predisposition for ZD.