Metabolic dysfunction-associated fatty liver disease and nonalcoholic fatty liver disease from clinical to pathological characteristics: a multi-center cross-sectional study in real world.

BACKGROUND: The evaluation of patients with fatty liver as defined by metabolic dysfunction-associated fatty liver disease (MAFLD) in the real world remains poorly researched. This study aimed to analyse the clinical and histological features of patients with MAFLD and nonalcoholic fatty liver disease (NAFLD) and to characterize each metabolic subgroup of MAFLD. METHODS: A total of 2563 patients with fatty liver confirmed by ultrasonography and/or magnetic resonance tomography and/or liver biopsy-proven from three hospitals in China were included in the study. Patients were divided into different groups according to diagnostic criteria for MAFLD and NAFLD, and MAFLD into different subgroups. RESULTS: There were 2337 (91.2%) patients fitting the MAFLD criteria, and 2095 (81.7%) fitting the NAFLD criteria. Compared to patients with NAFLD, those with MAFLD were more likely to be male, had more metabolic traits, higher liver enzyme levels, and noninvasive fibrosis scores. Among the patients with liver biopsy, the extent of advanced fibrosis in cases with MAFLD was significantly higher than those with NAFLD, 31.8% versus 5.2% (P < .001); there was no significant difference in advanced fibrosis between obese cases and lean individuals in MAFLD (P > .05); MAFLD complicated with diabetes had significantly higher advanced fibrosis than those without diabetes (43.3% and 17.2%, respectively; P < .001). CONCLUSIONS: Patients with MAFLD have a higher degree of liver fibrosis than NAFLD patients. In addition, diabetic patients should be screened for fatty liver and liver fibrosis degree.

Effect of light intensity on negative air ion under phytotron control.

Negative air ion (NAI) is an important index for measuring air quality and has been widely recognized to be influenced by photosynthesis processes. However, vegetation type and light intensity are also known to impact NAI, contributing to significant uncertainties in the relationship between light and NAI. In this paper, we selected Pinus bungeana, Platycladus orientalis and Buxus sinica as research subjects and obtained their NAI, light intensity, and meteorological data through synchronous observation under the relatively stable condition of the phytotron. We analyzed the change characteristics of NAI and the difference of NAI production ability in needle and broadleaf vegetation under different light intensities. Finally, we determined the relationship and underlying mechanism governing light intensity and NAI using diverse tree species. The results showed that the influence of light on NAI was significant. In the environment without vegetation, the influence of different light intensities on NAI was not significant, and the mean NAI concentration was 310 ions·cm-3. Conversely, in the presence of vegetation, NAI showed a "single-peak" trend with increasing light intensity. The NAI concentration of the three tree species was significantly higher than under different light intensities when vegetation was not present. The NAI promoting ability of P. bungeana was the highest (675 ions·cm-3), followed by P. orientalis (478 ions·cm-3) and B. sinica (430 ions·cm-3), which increased by 117.5%, 53.9% and 38.6% compared to the environment without vegetation. The NAI growth rate was significantly different between needle and broadleaf vegetation based on the specific tridimensional green biomass. Additionally, the NAI growth rates of P. bungeana and P. orientalis were 647 and 295 ions·cm-3·m-3, respectively, which were 3.06 and 1.39 times that of B. sinica (211 ions·cm-3·m-3). The piecewise equation fitting effect of NAI and light intensity was better for different tree species, the determination coefficients (R2) of P. bungeana, P. orientalis and B. sinica were 0.926, 0.916 and 0.880, and the root mean square errors (RMSE) were 7.157, 6.008 and 5.389 ion·cm-3, respectively. Altogether, our study provides a theoretical basis as well as technical support for the construction of healthy vegetation stands, the selection of preferred tree species, and the optimization of vegetation models, and promotes air quality and the provision of ecosystem functions and services.

Effects of peach branch organic fertilizer on the soil microbial community in peach orachards.

Peach branches is a by-product of peach industry. Making peach branch waste into peach branch organic fertilizer (PBOF) is a promising strategy of ecological utilization. In this study, the effects of PBOF on the yield and quality of peach fruit, chemical properties of bulk soil, and soil bacterial communities were investigated in a peach orchard. The results showed that the yield and sugar/acid ratio of two high-level PBOF treatments (SDH.4 and SKR.4) was higher than no fertilization treatment (CK), but there was no significant difference compared to the commercial organic fertilizer treatment (SYT.4). Moreover, the three fertilizer treatments increased soil nutrients such as soil organic matter (SOM) and available potassium (AK), compared to CK. Furthermore, PBOF increased the relative abundance of beneficial bacteria, and enhanced the soil bacterial co-occurrence pattern and the potential function of bacterial communities to degrade exogenous compounds. In addition, thanks to the local policy of encouraging the use of PBOF, the use cost of PBOF is lower than commercial organic fertilizer, which is conducive to the development of ecological agriculture.

A hyperspectral evaluation approach for quantifying salt-induced weathering of sandstone.

Salt-induced weathering is a common phenomenon in stone relics, and its traditional artificial evaluation of severity is greatly affected by subjective consciousness and lacks systematic standards. Here, we propose a hyperspectral evaluation method for quantifying salt-induced weathering on sandstone surfaces in laboratory tests. Our novel approach consists of two parts: data acquisition of microscopic observations of sandstone in salt-induced weathering environments, and machine learning technology for a predictive model. We first obtain the microscopic morphology of sandstone surfaces by near-infrared hyperspectral imaging technique. Then, a salt-induced weathering reflectivity index is proposed according to analyses of spectral reflectance variation. Next, a principal components analysis-Kmeans (PCA-Kmeans) algorithm is applied to bridge the gaps between the salt-induced weathering degree and the associated hyperspectral images. Furthermore, machine learning technologies, such as Random Forest (RF), Support Vector Machine (SVM), Artificial Neural Network (ANN), and K-Nearest Neighbors (KNN), are trained for better evaluating the salt-induced weathering degree of sandstone. Tests demonstrate that the RF algorithm is feasible and active in weathering classification based on spectral data. The proposed evaluation approach is finally applied to the analysis of salt-induced weathering degree on Dazu Rock Carvings.

The Epigenetic Regulation of RNA N6-Methyladenosine Methylation in Glycolipid Metabolism.

The highly conserved and dynamically reversible N6-methyladenine (m6A) modification has emerged as a critical gene expression regulator by affecting RNA splicing, translation efficiency, and stability at the post-transcriptional level, which has been established to be involved in various physiological and pathological processes, including glycolipid metabolism and the development of glycolipid metabolic disease (GLMD). Hence, accumulating studies have focused on the effects and regulatory mechanisms of m6A modification on glucose metabolism, lipid metabolism, and GLMD. This review summarizes the underlying mechanism of how m6A modification regulates glucose and lipid metabolism-related enzymes, transcription factors, and signaling pathways and the advances of m6A regulatory mechanisms in GLMD in order to deepen the understanding of the association of m6A modification with glycolipid metabolism and GLMD.

Circular RNA circRNF169 functions as a miR-30c-5p sponge to promote cellular senescence.

Circular RNAs (circRNAs), characterized as single-stranded closed circular RNA molecules, have been established to exert pivotal functions in various biological or pathological processes. Nonetheless, the effects and underlying mechanisms concerning circRNAs on the aging and aging-related diseases remain elusive. We herein compared the expression patterns of circRNAs in young and senescent mouse embryonic fibroblasts (MEFs), and uncovered that circRNF169 was dramatically up-regulated in senescent MEFs compared with that in young MEFs. Therefore, we further digged into the role and potential mechanisms of circRNF169 in the senescence of MEFs. The results of senescence-associate-ß-galactosidase staining and BrdU incorporation assay showed that silencing of circRNF169 significantly delayed MEFs senescence and promoted cell proliferation, while ectopic expression of circRNF169 exhibited the opposite effects. Moreover, the dual-luciferase reporter assay confirmed that circRNF169 acted as an endogenous miR-30c-5p sponge, which accelerated cellular senescence by sequestering and inhibiting miR-30c-5p activity. Taken together, our results suggested that circRNF169 exerted a crucial role in cellular senescence through sponging miR-30c-5p and represented a promising target for aging intervention.

Efficacy of CTPV for Diagnostic and Therapeutic Assessment: Comparison with Endoscopy in Cirrhotic Patients with Gastroesophageal Varices.

BACKGROUND AND AIMS: Computed tomography portal venography (CTPV) shows potential in detecting varices that need treatment and their drainage pathways. However, its agreement with endoscopy requires further study. We investigated the feasibility of CTPV as an alternative tool to endoscopy in screening gastroesophageal varices (GEVs) and developed a CTPV-based model to provide a less invasive assessment of endotherapy for cirrhotic patients with GEVs. METHODS: The study included 33 cirrhotic patients with a recent history of variceal hemorrhage. The presence, grade, and classification of GEVs on endoscopy and CTPV were compared (kappa test). Twenty-four patients were treated endoscopically, including 12 for esophageal varices (EVs), 8 for gastric varices (GVs), and 4 for GEVs. Treatment efficacies were assessed with the newly developed CTPV-based method at 1 week and 1 month after treatment. Efficiency evaluated by CTPV and endoscopy was compared by Fisher's exact test to determine whether CTPV is efficient in the assessment of endotherapy efficacy. RESULTS: For the screening and grading/classification of EVs and GVs, substantial agreement (EV kappa: 0.63 and 0.68; GV kappa: 0.62 and 0.75, respectively) was noted between endoscopy and CTPV. The therapeutic efficacy of EVs was higher when assessed by CTPV than when evaluated by endoscopy (37.50% vs. 12.50% at 1 week postoperation, P = 0.22; 62.50% vs. 25.00% at 1 month postoperation, P = 0.07), but without statistical significance. The same trend was also found in the assessment of therapeutic efficacy for GVs (25.00% vs. 16.67% at 1 week postoperation, P = 1; 58.33% vs. 41.67% at 1 month postoperation, P = 0.68). CONCLUSION: CTPV is comparable to endoscopy in the detection of GEVs and in the evaluation of endotherapy efficacy, which suggests that it could be a less invasive alternative for endoscopy in cirrhotic patients with GEVs needing treatment.

Genome-wide identification of the ARF (auxin response factor) gene family in peach and their expression analysis.

Auxin response factors (ARFs) are important transcription factors to relay auxin signaling. From the Genome Database for Rosaceae (GDR), we identified 17 peach ARF genes (PpARFs) encoding the proteins with three conserved domains. Their gene structure and functional domains were analyzed. Their transcriptional response to exogenous auxin treatment was tested and confirmed. We also expressed PpARF-GFP fusion reporters in tobacco leaves and observed their nuclear localization by fluorescence microscopy. It has been known that ARFs are widely involved in fruit development. We compared the expression pattern of all PpARFs in different tissues including the fruits at different developmental stages of two peach cultivars, "melting" and "stony hard". We found eight PpARFs were more highly expressed in the "melting" peaches compared to "stony hard" peaches, while three PpARFs were more highly expressed in "stony hard" peaches. Among them, the expression difference of PpARF4, PpARF7 and PpARF12 was large, and their function in regulating fruit development and fruit quality was discussed. Our work provides a basis for further exploring the mechanisms underlying auxin regulated peach fruit ripening.

Study on the optimal antagonistic effect of a bacterial complex against Monilinia fructicola in peach.

Peach brown rot caused by Monilinia fructicola is one of the most economically destructive diseases of peach (Prunus persica L.) in some orchards of China. Biocontrol is a significant strategy that exhibits strong levels of control and ecologically sound concepts in disease management. The purpose of this study was to investigate the combined suppressive effects of three endophytic bacterial strains (xj-14, xj-15, and xj-16) and two soil rhizosphere bacterial strains (xj-A and xj-C) that were shown to have strong inhibitory activity toward M. fructicola in our previous study. The optimal strains and the optimized combination of strains were determined. The combination of strains xj-15 and xj-C inhibited M. fructicola more intensively for a longer period of time. Following the application of 1 × 109 CFU/mL bacterial complex to the fruits, leaves, and shoots of peach trees infected with M. fructicola, the rate of inhibition reached 73.80%, 83.33%, and 90.43%, respectively. A pot experiment using lettuce (Lactuca sativa) showed that inoculation with the bacterial complex significantly increased the growth of seedlings. In this study, some compound bacteria were more effective than those in previous study in suppressing disease and promoting growth, which have the potential to be further applied in the field.

Modeling nitrogen and phosphorus export with InVEST model in Bosten Lake basin of Northwest China.

Bosten Lake is an important region of Northwest China that has transformed from a freshwater lake to a saltwater lake since the 1970s. The water quality in the Bosten Lake basin is important for social and economic development, and nitrogen (N) and phosphorus (P) are the key indicators of water quality. The land use data, precipitation data and Digital Elevation Model (DEM) data with the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) model were used to simulate the N and P exports of the Bosten Lake basin. The spatial and temporal dynamics of nitrogen and phosphorus exports, and the response of nitrogen and phosphorus exports to land use change and precipitation change were analyzed between 2000 and 2015. The results show that the amount of N and P exports increased during 2000-2015, and the N and P exports are mainly distributed around Bosten Lake. The N and P exports are greatly affected by cultivated land, built-up areas and grassland, while they are less affected by other land use types. The high precipitation areas with small exports of N and P are mainly distributed in mountain areas, while small precipitation areas with large exports of N and P are distributed in plains where the cultivated land and built-up areas are concentrated. The InVEST model can be used in Northwest China, and the statistical downscaling of reanalysis precipitation data can be used in the InVEST model to improve the simulation accuracy in the data scarce regions of Northwest China.

Disrupted brain connectivity networks in acute ischemic stroke patients.

Neuroimaging studies have shown that local brain lesions could result in abnormal information transfer far from the lesion site in acute ischemic stroke (AIS) patients; yet, little is known about alternations of the topological organization of whole-brain networks in AIS. By using resting state functional magnetic resonance imaging (MRI) and graph theory analysis, we systematically investigated the topological properties of the functional brain networks of 28 healthy controls (HC, age: 56.9 ± 0.45 years) and 29 AIS (age: 57.6 ± 0.21 years) with proximal anterior circulation occlusion within 12 h of symptom onset. In our results, both the AIS and HC groups exhibited small-world network organization, suggesting a functional balance between local specialization and global integration. However, compared with the HC, the AIS patients had a lower shortest path length and higher global efficiency, indicating a tendency of randomization in patients' functional brain networks. The AIS patients had an increased nodal degree in the precuneus (PCUN), middle frontal gyrus (MFG), medial part of the superior frontal gyrus (SFGmed), orbital part of the middle frontal gyrus, and the opercular part of the inferior frontal gyrus, and increased nodal efficiency in the PUCN, MFG, SFGmed, and the angular gyrus. The decreased nodal degree in AIS was found in the heschl gyrus (HES), and no significant decreased nodal efficiency was observed. The dysfunctional connections were mainly concentrated in the HES and prefrontal cortex. Furthermore, the altered nodal centrality of the MFG and abnormal functional connectivity in AIS were associated with patients' Mini-Mental State Examination scores. These results suggested that interrupted functional connectivity in language system organization after focal brain lesions could also result in disruptions in the topological organization of other brain circuits, and this may contribute to disturbances in cognition in AIS patients.

Morphologic classification of the right auricule on 256-slice computed tomography.

PURPOSE: To investigate the shape of right auricule on 256-slice computed tomography (CT). MATERIALS AND METHODS: Five hundred people (250 men, age range 16-84 years) who had cardiac multidetector CT angiography were recruited in this study. All patients had normal sinus rhythm with normal blood pressure (<140/90 mmHg for systolic/diastolic pressure). The morphology of the right auricule was studied and compared after reconstruction of the raw images. RESULTS: All patients successfully had cardiac CT angiography (100%), and the right auricule morphology was divided into five types and nine subtypes, including Type I of triangular shape (Ia and Ib), Type II of M shape (IIa and IIb), Type III of L shape (IIIa and IIIb), Type IV of reverse L shape (IVa and IVb), and Type V of balanced shape. The most common type of right auricule is Type IV (28.4%) followed by Type II (24.0%), whereas the least common is Type V (11.0%). Type Ia was present significantly (P < 0.0001) more frequently in females than in males, whereas Type IIa significantly (P = 0.042) more frequently in males than females. No other significant (P > 0.05) sex difference existed in the constitution ratio of the types. The normal angle was greater in Type Ib than in Ia. The greater the normal angle in Type I, the greater the deviation of the right auricule tip towards the left. CONCLUSION: A good understanding of the right auricule anatomical morphology can better guide atrial pacing, radiofrequency ablation and other surgical procedures while preventing possible intra-procedural complications.

Combining arterial-spin labeling with functional magnetic resonance imaging measurement for characterizing patients with minimal hepatic encephalopathy.

AIM: Our objective is to explore key changes in brain functions in relation to minimal hepatic encephalopathy (MHE). We incorporated both resting-state functional magnetic resonance imaging (fMRI) and arterial spin labeling (ASL) to enhance the detection of MHE. METHODS: We undertook fMRI scanning for 56 MHE patients and 66 healthy controls. Region functional connectivity was carried out to assess the connectivity status between pairs of regions among 90 brain regions. Additionally, blood flow (BF) status was measured by ASL for all subjects. Spearman's correlation test was implemented to identify any correlation among z-values, results from number connection test type A, and digit symbol tests. Finally, the receiver operating characteristic curve was generated for assessing the accuracy of BF in MHE diagnosis. RESULTS: The corresponding functional connectivity was significantly different between MHE and control groups in 15 regions. For MHE patients, BF showed an increasing pattern in regions of interest. Blood flood in the putamen was positively correlated with number connection test type A neuropsychological performance, whereas it was negatively correlated with the digit symbol test. Blood flood in the right putamen showed the highest value of area under the curve with a sensitivity of 85.7% and specificity of 89.4%. CONCLUSION: Connectivity impairment resulting from ganglia-thalamo-cortical circuits may play important roles in mediating the development of MHE patients. An increase in the BF, particularly in the right putamen, may be considered as evidence for the presence of MHE.

Increased inter-hemispheric resting-state functional connectivity in acute lacunar stroke patients with aphasia.

Aphasia is a devastating neurological condition affecting a person's ability to communicate and reintegrate into the society. It may occur in 20% or more of patients after stroke. The recovery of language function is accompanied by brain reorganization, and identifying the inter-hemispheric interaction post-stroke will conduce to more targeted treatments. Previous studies suggested that robust homotopic resting-state functional connectivity is a key characteristic of the brain's intrinsic functional architecture, and communication between the left and right cerebral hemispheres is important for language processing. In this study, voxel-mirrored homotopic connectivity (VMHC) was used to examine the inter-hemispheric resting-state functional connectivity (RSFC) differences between 37 patients with acute lacunar stroke in the left hemisphere and 28 healthy controls. Besides, correlation analyses were carried out to investigate the relationship between VMHC values of brain regions showing abnormal inter-hemispheric RSFC and clinical variables [i.e., aphasia quotient (AQ) scores, National Institutes of Health Stroke Scale (NIHSS) and Mini-Mental State Examination of patients]. Compared with healthy controls, patients showed significantly increased VMHC in the pars orbitalis of the inferior frontal gyrus, anterior part of the superior temporal gyrus (STG) and lingual gyrus. No brain region showed decreased VMHC in the patient group than in the healthy control group. The AQ scores were negatively correlated with VMHC values in the STG. NIHSS scores were positively correlated with VMHC values in the lingual gyrus. We hope these results could shed new insights into the pathology of aphasia in patients with acute lacunar stroke.

Evaluation of left gastric vein in Chinese healthy adults with multi-detector computed tomography.

OBJECTIVES: To evaluate the classification and diameter of left gastric vein (LGV) in healthy Chinese adults with multi-detector computed tomography (MDCT). METHODS: MDCT angiography was performed in 234 healthy adults for the portal venous system. CT cross-sectional thin-layer reconstruction combined with maximum intensity projection, volume rendering and multiplanar reconstruction were applied. The diameter of LGV was measured at the point within 2 cm from LGV origination. RESULTS: Of 234 subjects, 11 subjects (4.70%) who did not have clear images were excluded, and 223 subjects (95.30%) with excellent images were included. The LGV was originated from the portal vein in 46.15%, splenic vein in 30.77%, portal splenic angle in 14.53%, and the left branch of the portal vein in 3.85%. The maximal diameter of LGV was 4.74 ± 0.84 mm with a 95% confidence interval of 4.63-4.85 mm, and the LGV diameter was positively correlated with the weight of patients (R = 0.26, P = 0.006). No significant difference existed in the maximal diameter of LGV at different origination sites (P = 0.35). The diameter of LGV was significantly greater in males than in females (4.90 ± 0.85 vs. 4.56 ± 0.80 mm, P = 0.002), and the maximal diameter of LGV was significantly (P = 0.02) greater in the age range of 30-39 and 40-49 years than in the range of >70 years. No statistical significance (P = 0.36) was detected in the other groups. CONCLUSION: MDCT can clearly display the detailed anatomy and variation of LGV in healthy adults, providing a normal range of LGV diameter for clinical reference for diagnosing possible portal hypertension and for possible intervention.

[DESIGN AND BIOMECHANICAL STUDY OF TRANSARTICULAR CUBOID BONE PLATE].

OBJECTIVE: To design a new type of transarticular cuboid bone plate by measuring and collecting the anatomic data of the articular surface around cuboid, and to carry out comparative biomechanical study. METHODS: The angle α (between the fifth metatarsocuboid joint and the fifth metatarsal bone) and the angle ß (between the fifth metatarsocuboid joint and the calcaneocuboid joint) were measured in 100 adults on medial oblique X-ray film and 30 adult foot specimens. Based on literature data, the transarticular cuboid bone plate was designed with an angle α of 70° and an angle ß of 30°. Six adult cadaver feet were chosen and were transected approximately 15 cm proximal to the ankle. Five strain gauges were placed at the calcaneus, cuboid, and the fourth and fifth metatarsal bones. The vertical pressure was loaded on the foot at 0-600 N, the strain value was measured. Then the cuboid fracture model was established and 600 N load was given on foot to measure the strain value and compare with the strain value before fracture. The specimens were randomly divided into groups A and B (n=3). Fracture was fixed with transarticular cuboid bone plate and 9 screws in group A and with double plate and 8 screws in group B, then the 600 N load was given to measure the strain value and vertical displacement of the fracture fragments. RESULTS: After loads of 0-600 N on the foot, the strain value of the 5 points showed an increased trend. No significant difference was found in the strain value between pre- and post-fracture at a, d, and e points P>0.05), but it was significantly larger at post-fracture than pre-fracture at b and c points (P<0.05). After fracture fixation, no significant difference was shown in the strain value at 5 points between groups A and B when loads of 0-600 N was given P>0.05). The experimental data showed that the strain value change mainly focused on the fracture site under the same load, so the strain value after fracture fixation was similar to that before fracture at b and c points P>0.05). The vertical displacement values of medial and lateral fracture fragments in group A[(0.804±0.011) mm and (0.672±0.036) mm] were significantly less than those in group B[(1.126±0.083) mm and (1.007±1.103) mm] (t=-6.711, P=0.003; t=-5.307, P=0.006). CONCLUSIONS: Through biomechanical study, a new type of transarticular cuboid bone plate has better fixation effect.

Reduced Serum Level of Interleukin-10 is Associated with Cerebral Infarction: A Case-Control and Meta-Analysis Study.

IL-10 expression limits inflammation and restricts the size of CNS damage from stroke. In this study, we examined the correlation between cerebral infarction (CI) and serum levels of interleukin-10 (IL-10) using a combination of case-control study and meta-analysis of published data, with an aim of understanding the relevance of serum IL-10 levels to CI development. This study enrolled a total of 169 CI patients admitted to the Second Hospital of Hebei Medical University between May 2011 and November 2014. During the same period, a group of 145 individuals were recruited at the same hospital as healthy controls after thorough physical examination. Serum IL-10 levels were measured by enzyme-linked immunosorbent assay (ELISA). SPSS 19.0 (IBM, 2010, Chicago, IL, USA) and Comprehensive Meta-Analysis 2.0 (CMA 2.0) software were used for data analysis. Serum levels of IL-10 (pg/mL) were significantly lower in CI patients when compared to healthy controls (15.36 ± 3.21 vs. 21.64 ± 5.17, t = 13.12, P < 0.001). In addition, patients with large artery atherosclerosis (LAAS), cardioembolic infarct (CEI), and lacunar infarct (LAC) displayed drastically reduced serum levels of IL-10 (pg/mL) compared to healthy controls (LAAS 14.77 ± 5.21, CEI 15.25 ± 5.10, LAC 16.58 ± 4.92, all P < 0.001). Interestingly, no significant differences were observed in the serum IL-10 levels when pair-wise comparisons were made between these three clinical subtypes of CI (all P > 0.05). Logistic regression analysis indicated that, with the exception of triglyceride (TG) and uric acid (UA) levels (both P > 0.05), the other seven parameters, including fasting blood glucose (FPG), total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), creatinine (Cr), systolic blood pressure (SBP), and diastolic blood pressure (DBP), strongly correlated with CI development (all P < 0.05). Meta-analysis of pooled data from nine case-control studies revealed an inverse correlation between the serum IL-10 levels and CI (SMD = 1.797, 95% CI 0.785~2.810, P = 0.001). Subgroup analysis based on country showed that low serum levels of IL-10 may be the major risk factor for CI in Croatia (SMD = 2.961, 95% CI 2.480~3.443, P < 0.001) and India (SMD = 1.440, 95% CI 1.129-1.750, P < 0.001). Further, subgroup analysis based on ethnicity showed that IL-10 serum levels and CI displayed negative relationship in Asians (SMD = 2.522, 95% CI 0.468~4.576, P = 0.016) but not in Caucasians (P > 0.05). Our study provided convincing evidence that the patients with CI exhibit consistently reduced serum levels of IL-10, and IL-10 may be a major player in the development and progression of CI.

Hashimoto's encephalopathy: a report of three cases and relevant literature reviews.

Hashimoto's encephalopathy (HE) is a very rate condition characterized by various clinical features consisting of psychiatric manifestations, seizures and focal neurologic deficits. In this study, three Hashimoto's encephalopathy cases were reported, including two female patients and one male patient. The two female patients (22-year-old and 49-year-old) were presented with brainstem involvement and the symptoms progressed gradually. The 70-year-old male patient was diagnosed with space-occupying lesion that seemed to be malignant, but the symptom was substantially ameliorated right after glucocorticoid therapy. Pathological studies indicate abnormal blood vessels are important in the progression of the disease. Compared with current reports, the male case was the first patient diagnosed of Hashimoto's encephalopathy but presented with malignant features and local occupying effect. Intracranial lesions were found in all of the three patients, but these lesions responded well to glucocorticoid therapy. And the lesions were remarkably reduced after treatment. Meanwhile, the prognosis of diffuse Hashimoto's encephalopathy is better than the vascular type.

Quantitative Evaluation of the Substantially Variable Morphology and Function of the Left Atrial Appendage and Its Relation with Adjacent Structures.

OBJECTIVE: To investigate quantitatively the morphology, anatomy and function of the left atrial appendage (LAA) and its relation with adjacent structures. MATERIALS AND METHODS: A total of 860 patients (533 men, 62.0%, age 55.9±10.4 year) who had cardiac multidetector computed tomography angiography from May to October 2012 were enrolled for analysis. RESULTS: Seven types and 6 subtypes of LAA morphology were found with Type 2 being the most prevalent. Type 5 was more significantly (P<0.05) present in women (8.0%) than in men (4.2%). LAA orifice was oval in 81.5%, triangular in 7.3%, semicircular in 4%, water drop-like in 3.2%, round in 2.4% and foot-like in 1.6%. The LAA orifice had a significantly greater (P<0.01) major axis in men (24.79±3.81) than in women (22.68±4.07). The LAA orifice long axis was significantly (P<0.05) positively correlated with the height, weight and surface area of the patient. The LAA morphology parameters displayed strong positive correlation with the left atrium volume, aortic cross area long axis or LSPV long axis but poor correlation with the height, weight, surface area and vertebral body height of the patients. Four types of LAA ridge were identified: AI, AII, B and C with the distribution of 17.6%, 69.9%, 5.9% and 6.6%, respectively. The LAA had a significantly (P<0.05) greater distance from its orifice to the mitral ring in women than in men. The LAA had two filling and two emptying processes with the greatest volume at 45% phase but the least volume at 5% phase. The LAA maximal, minimal and emptying volumes were all significantly (P<0.05) positively correlated with the body height, weight and surface area, whereas the LAA ejection fraction had an inverse correlation with the LAA minimal volume but no correlation with the maximal volume. CONCLUSION: The LAA has substantially variable morphologies and relation with the adjacent structures, which may be helpful in guiding the LAA trans-catheter occlusion or catheter ablation procedures.