Changes of Nitrate Activity and Byproduct Distribution Characteristics for Synergistic NOx and Dioxin Abatement over V2O5/AC Catalyst.

The simultaneous removal of NOx and dioxins has been considered an economical and effective technology of controlling multipollutant flue gas in the context of "carbon peaking and carbon neutrality". However, this technology has not yet been implemented in practical situations, because the interactive relationship between the selective catalytic reduction (SCR) reaction and dioxin catalytic oxidation lacks a deep understanding, especially on a carbon-based catalyst. In this research, the influence of NO and NH3 on the oxidation characteristics and byproducts distribution of dibenzofuran (DBF) was studied on V2O5/AC catalyst. Results indicated that NH3 has a stronger inhibition effect for DBF catalytic oxidation than NO due to obvious competitive adsorption between NH3 and DBF on the V2O5/AC catalyst. In addition, although both NO and NH3 inhibit the complete degradation of DBF, their effects on the byproduct distribution are not consistent. NO primarily affects the level of oxygen-containing byproducts, while NH3 primarily affects the level of alkane byproducts. Furthermore, the SCR reaction activity demonstrated a reduction when DBF was present. The occupation of V2O5 sites by DBF and its oxidizing intermediates has hindered the production of monodentate nitrate and the reactivity of bridged nitrate, resulting in a decrease in SCR activity via the L-H mechanism. This work aims to provide theoretical guidance for simultaneous removal of NOx and dioxins in industrial fumes.

Epidemiological patterns of chronic kidney disease attributed to type 2 diabetes from 1990-2019.

Background: This study investigates the burden of chronic kidney disease attributed to type 2 diabetes (CKD-T2D) across different geographical locations and time periods from 1990 to 2019. A total of 204 countries and regions are included in the analysis, with consideration given to their socio-demographic indexes (SDI). The aim is to examine both spatial and temporal variations in CKD-T2D burden. Methods: This research utilized data from the 2019 Global Burden of Diseases Study to evaluate the age-standardized incidence rates (ASIR), Disability-Adjusted Life Years (DALYs), and Estimated Annual Percentage Change (EAPC) associated with CKD-T2D. Results: Since 1990, there has been a noticeable increase of CKD age-standardized rates due to T2D, with an EAPCs of 0.65 (95% confidence interval [CI]: 0.63 to 0.66) for ASIR and an EAPC of 0.92 (95% CI: 0.8 to 1.05) for age-standardized DALYs rate. Among these regions, Andean Latin America showed a significant increase in CKD-T2D incidence [EAPC: 2.23 (95% CI: 2.11 to 2.34) and North America showed a significant increase in CKD-T2D DALYs [EAPC: 2.73 (95% CI: 2.39 to 3.07)]. The burden was higher in male and increased across all age groups, peaking at 60-79 years. Furthermore, there was a clear correlation between SDI and age-standardized rates, with regions categorized as middle SDI and High SDI experiencing a significant rise in burden. Conclusion: The global burden of CKD-T2D has significantly risen since 1990, especially among males aged 60-79 years and in regions with middle SDI. It is imperative to implement strategic interventions to effectively address this escalating health challenge.

Exploring the efficacy and safety of anti-BCMA chimeric antigen receptor T-cell therapy for multiple myeloma: Systematic review and meta-analysis.

Objective: Multiple myeloma (MM) is a bone marrow cancer that profoundly affects plasma cells involved in the immune response. Myeloma cells alter the average production of cells in the bone marrow. Anti-B-cell maturation antigen (BCMA) chimeric antigen receptor (CAR) T-cell therapy allows genetic modifications of an individual's T-cells to increase the expression of CARs used to identify and attach BCMA proteins to the malignant cells. Our main objective is to perform a systematic review and meta-analysis to explore the efficacy and safety of anti-BCMA CAR T-cell therapy for MM. Material and Methods: We searched five databases, PubMed, CNKI, EMBASE, Cochrane, Web of Science, and CNKI, for studies published on anti-BCMA,CAR-T-cell treatment for MM. Inclusion criteria involved prospective single-arm studies either single or multi-center, in various MM phases and studies that reported anti-BCMA,CAR-T-cell treatment for MM. We excluded non-English publications and conference papers. All statistical analyses were performed in R software and Review Manager 5.4.1. Results: Thirteen articles were included in the analysis. We found that the overall response survival complete response increase was statistically significant. Similarly, the reduction in cytokine release syndrome grades 3 and 4 and neurotoxicity after follow-up was statistically significant. However, the reduction in minimal residual disease negativity (MRDN) was not statistically significant. Conclusion: Using anti-BCMA CAR T-cell therapy in MM was highly efficacious and safe in lowering the adverse outcomes and improving the survival outcomes, complete response, and overall response.

Coupling experimental with simulation studies into the impact factors and reaction mechanism of sawdust char pressured hydrogasification on K-modified transition metal composite catalysts.

The utilization of biomass char was hindered by the low gasification activity due to thick ring structures and unclear gasification mechanism. Herein, the mechanism was elucidated by experimental and DFT to improve the activity. The results demonstrated that temperature increased the gasification activity but did not changed the order of gasification activity of samples. Pressure dominated the position of the highest point of instantaneous CH4 yield, and high pressure enhanced carbon conversion by 81.72 % and 7.32 times. Moreover, KNi exhibited an uppermost catalytic activity with the instantaneous CH4 yield 1.89 times higher than that of raw char at 750 °C. The formation of the CxNi structure lowered the activation barrier for the ring opening reaction. Possible transformation pathways of Ni species were as follows: Ni(NO3)2·6H2O â†’ NiO â†’ Ni. KNi changed the reaction pathways and the most energy-consuming step. The study could shed light on the hydrogasification reaction mechanism.

Unravelling the impacts of sulfur dioxide on dioxin catalytic decomposition on V2O5/AC catalysts.

Dioxins are high chlorine, toxic, and persistent organic pollutants that exert significant pressure on both human and the environment. From the analysis of current pollutant removal of the whole life cycle, such as integrated removal of NOx, SO2 and dioxins in a system, the dioxins oxidation activity as well as the distribution of oxidation products in the presence of SO2 are still a challenge. In this study, dibenzofuran (DBF) was regarded as a model dioxin compound, and V2O5/AC was used as a catalyst to investigate the impact of SO2 on degradation activity and the degradation path of DBF. Various characterization results showed that SO2 could promote the transformation of DBF to intermediates through a reaction with lattice oxygen and lower the apparent activated energy of DBF catalytic oxidation on V2O5/AC catalysts. The density functional theory (DFT) calculations confirmed that SO2 improved the oxidation ability of lattice oxygen on V2O5/AC. The ethyl hydrogen fumarate intermediate decreased and the small-molecule byproducts increased, providing further evidence that SO2 accelerates the degradation of DBF and its intermediates. However, the formation of VOSO4 would inevitably deteriorate the adsorption and oxidation abilities of V2O5/AC. A model is pioneered to describe the relationship between SO2 promotion and VOSO4 inhibition on DBF catalytic oxidation on a V2O5/AC catalyst. This study is expected to provide theoretical guidance for the collaborative abatement of multi-pollutants in flue gas.

Co-occurrence of Spondyloepiphyseal Dysplasia and X-Linked Hypophosphatemia in a Three-Generation Chinese Family.

Rare genetic skeletal disorders (GSDs) remain the major problem in orthopedics and result in significant morbidity in patients, but the causes are highly diverse. Precise molecular diagnosis will benefit management and genetic counseling. This study aims to share the diagnostic experience on a three-generation Chinese family with co-occurrence of spondyloepiphyseal dysplasia (SED) and X-linked hypophosphatemia (XLH), and evaluate the therapeutic effects of two third-generation siblings. The proband, his younger brother, and mother presented with short stature, skeletal problems, and hypophosphatemia. His father, paternal grandfather, and aunt also manifested short stature and skeletal deformities. Whole exome sequencing (WES) of proband-brother-parents initially only found the proband and his younger brother had a pathogenic c.2833G > A(p.G945S) variant in the COL2A1 gene inherited from their father. Re-analysis of WES uncovered the proband and his younger brother also harbored a pathogenic ex.12 del variant in the PHEX gene transmitted from their mother. Sanger sequencing, agarose gel electrophoresis, and quantitative polymerase chain reaction proved these results. The proband and his younger brother were confirmed to have a paternally inherited SED and a maternally inherited XLH. During a 2.8-year follow-up, these two siblings remained short stature and hypophosphatemia, but their radiographic signs and serum bone alkaline phosphatase levels were improved with treatment of oral phosphate and calcitriol. Our study presents the first report of co-occurrence of SED and XLH, shows the possibility that two different rare GSDs co-exist in a single patient, and alerts clinicians and geneticists to be cautious about this condition. Our study also suggests that next-generation sequencing has limit in detecting exon-level large deletions.

Comparability of JAK2 p.V617F allele burden in peripheral blood and that in bone marrow in patients with suspected myeloproliferative neoplasms: a single-center prospective study.

PURPOSE: To detect JAK2 p.V617F and measure allele burden in peripheral blood (PB) and bone marrow (BM) aspirates in patients with suspected myeloproliferative neoplasms (MPNs). METHODS: Patients with suspected MPNs were prospectively enrolled between August 2017 and May 2019, and their PB and BM were collected during the same period. Quantitative fluorescence polymerase chain reaction (PCR) was used to detect the copy number of JAK2 wild type and the V617F mutant; the JAK2 V617F proportion was also calculated. The JAK2 p.V617F proportion in PB was compared to that in BM by Chi-square test. RESULTS: Among 54 patients with suspected MPNs, 43 of them were eligible for analysis. The JAK2 p.V617F in PB had the same sensitivity and specificity as BM (all P>0.05). The Chi-square test suggested that the JAK2 p.V617F allele burden of PB was comparable to that of BM (Spearman Correlation =0.986; P=0.000). CONCLUSION: PB could be used as an alternative to BM for JAK2 p.V617F measurement in patients with suspected MPNs.

Production of Tetramethylpyrazine from Cane Molasses by Bacillus sp. TTMP20.

2,3,5,6-Tetramethylpyrazine (TTMP) is an active ingredient of Ligusticum wallichii Franch. It can be used in medicine and food fields. In this study, Bacillus sp. TTMP20 was applied to produce TTMP using cane molasses as a carbon source. After pretreatment with phosphoric acid, 170 mL/L treated molasses, combined with 10 g/L yeast powder, 30 g/L tryptone and 30 g/L (NH4)2HPO4 were used for fermentation. After 36 h, TTMP output reached the highest value of 208.8 mg/L. The yield of TTMP using phosphoric acid-treated molasses as carbon source was 145.59% higher than control. Under the sulfuric acid treatment process of molasses (150 g), the maximum yield of TTMP was 895.13 mg/L, which was 183.18% higher than that of untreated molasses (316.1 mg/L). This study demonstrated that molasses is a high-quality and inexpensive carbon source for the manufacture of TTMP, laying the groundwork for the future industrial production of TTMP.

Inverse Design of Mechanical Metamaterials with Target Nonlinear Response via a Neural Accelerated Evolution Strategy.

Materials with target nonlinear mechanical response can support the design of innovative soft robots, wearable devices, footwear, and energy-absorbing systems, yet it is challenging to realize them. Here, mechanical metamaterials based on hinged quadrilaterals are used as a platform to realize target nonlinear mechanical responses. It is first shown that by changing the shape of the quadrilaterals, the amount of internal rotations induced by the applied compression can be tuned, and a wide range of mechanical responses is achieved. Next, a neural network is introduced that provides a computationally inexpensive relationship between the parameters describing the geometry and the corresponding stress-strain response. Finally, it is shown that by combining the neural network with an evolution strategy, one can efficiently identify geometries resulting in a wide range of target nonlinear mechanical responses and design optimized energy-absorbing systems, soft robots, and morphing structures.

Heme induces inflammatory injury by directly binding to the complex of myeloid differentiation protein 2 and toll-like receptor 4.

Heme, as an essential component of hemoproteins, is a prosthetic co-factor found in many cells, which is essential for physiologically vital oxygen transport. However, extracellular or circulatory heme is cytotoxic and triggers inflammation. Although the proinflammatory role of heme has been reported to be associated with Toll-like receptor 4 (TLR4) signaling, the exact mechanism remains unknown. Here, we show that heme promotes TLR4 signaling and inflammation via directly physically interacting with TLR4 and its adaptor protein myeloid differentiation protein 2 (MD2). Genetic loss of MD2 ameliorates heme-induced inflammation and inflammatory cytokine production in the spleen of MD2 knockout (MD2-/-) mice. Using mouse macrophage RAW 264.7 cell line, we show that heme induces TLR4 dimerization and MD2/TLR4/MyD88 activation by physically interacting with TLR4 and MD2 in vitro. Genetic loss of MD2 inhibits heme-induced inflammation and MAPK/NF-κB pathway in mouse primary macrophages extracted from MD2-/- mice. Furthermore, pharmacological inhibition of MD2 by L6H9 ameliorates heme-induced inflammation in macrophages. These findings demonstrate that heme causes inflammation by directly binding to MD2/TLR4 complex, leading to activation of TLR4/MAPK/NF-κB signaling pathway and production of downstream effectors of inflammation.

Insight into the Transformation Behaviors of Dioxins from Sintering Flue Gas in the Cyclic Thermal Regeneration by the V2O5/AC Catalyst-sorbent.

Dioxins in the sintering flue gas are usually removed through integrated elimination technologies by carbonaceous catalysts. However, the regeneration of the used catalyst is poorly investigated, leading to the risk of leakage of dioxins. Herein, the influences of cyclic regenerations on the dioxin removal performance of a catalyst (V2O5/AC) were investigated systematically with dibenzofuran (DBF) as a model pollutant. It was demonstrated that the adsorption capacity and oxidation activity of catalysts significantly declined after several regeneration cycles due to the decreasing external specific surface area and V5+, respectively. Compared with 79.12% DBF directly emitted from a regenerator during N2 regeneration, the emission of DBF was only 29.93% with the modification of the regeneration process through O2 addition and temperature adjustment. The possible regenerated products were also analyzed to disclose the transformation behaviors of DBF. The regeneration mechanisms of DBF followed the transformation pathway of dibenzofuranol, benzofuran, anhydride species, and ultimately to CO2 and H2O. Moreover, the accumulated heavy aromatics on the surface could be decomposed by introducing O2. This research provides a comprehensive understanding of dioxin transformation behavior and a theoretical basis for efficient control of dioxin removal in the whole integrated removal technologies.

Microtubule Organization Is Essential for Maintaining Cellular Morphology and Function.

Microtubules (MTs) are highly dynamic polymers essential for a wide range of cellular physiologies, such as acting as directional railways for intracellular transport and position, guiding chromosome segregation during cell division, and controlling cell polarity and morphogenesis. Evidence has established that maintaining microtubule (MT) stability in neurons is vital for fundamental cellular and developmental processes, such as neurodevelopment, degeneration, and regeneration. To fulfill these diverse functions, the nervous system employs an arsenal of microtubule-associated proteins (MAPs) to control MT organization and function. Subsequent studies have identified that the disruption of MT function in neurons is one of the most prevalent and important pathological features of traumatic nerve damage and neurodegenerative diseases and that this disruption manifests as a reduction in MT polymerization and concomitant deregulation of the MT cytoskeleton, as well as downregulation of microtubule-associated protein (MAP) expression. A variety of MT-targeting agents that reverse this pathological condition, which is regarded as a therapeutic opportunity to intervene the onset and development of these nervous system abnormalities, is currently under development. Here, we provide an overview of the MT-intrinsic organization process and how MAPs interact with the MT cytoskeleton to promote MT polymerization, stabilization, and bundling. We also highlight recent advances in MT-targeting therapeutic agents applied to various neurological disorders. Together, these findings increase our current understanding of the function and regulation of MT organization in nerve growth and regeneration.

In vitro and in vivo research of atmosphere pressure nonequilibrium plasmas on root canal disinfection: implication for alternative strategy for irrigation.

OBJECTIVE: To investigate an intracanal disinfection methodology of APNPs (atmosphere pressure nonequilibrium plasmas) or modified APNPs in root canal treatment and evaluate the antimicrobial efficiency against in vitro infected dentinal tubules and in vivo experimental apical periodontitis. MATERIALS AND METHODS: Dentine specimens were centrifugated with Enterococcus faecalis to generate 1-day-old and 3-week-old biofilms, and were treated with 2% chlorhexidine (Chx), APNP or modified APNP for 3 and 10 min (n=4). LIVE/DEAD staining was employed to analyze the ratio of deactivated bacteria. Experimental apical periodontitis in beagles was induced. Root canal therapy with APNPs or modified APNPs was performed and the antimicrobial effect was evaluated by histological and radiographical analyses. RESULTS: APNP deactivated 1-day-old and 3-week-old E. feacalis in dentinal tubules as much as 2% Chx irrigating. Modified APNP significantly deactivated more E. faecalis biofilms in dentinal tubules for 3-min and 10-min treatments, without thermal damage or dentinal destruction being observed. In beagles' apical periodontitis, significantly increased BV/TV and decreased lesion volume of apical bone were found in modified APNP group than 2% Chx irrigation group according to µCT. Fewer inflammatory cells and bacterial residual in dentine were observed in modified APNP-treated apical tissue by histology staining compared with those in the 2% Chx irrigation group. CONCLUSION: The antimicrobial effect of APNP jet irradiation was comparable to that of 2% Chx irrigation. No structural damage in dentine or tissue necrosis at the periapical region was induced upon treatment. The modified APNP demonstrated an increased antimicrobial efficacy compared with 2% Chx irrigation both in vitro and in vivo. CLINICAL RELEVANCE: The modified APNPs can be used as an alternative intracanal disinfection strategy.

Follicular Lymphoma Presenting With Monoclonal IgM And MYD88 Mutation: A Case Report And Review Of The Literature.

MYD88 mutation has been reported in various lymphomas, specifically in lymphoplasmacytic lymphoma. Yet, the mutation has not been reported in primary follicular lymphoma. Here, we present a 62-year-old male with follicular lymphoma who had an MYD88 L265P somatic mutation and monoclonal IgM gammopathy. He received four cycles of R-CHOP immunochemotherapy. Interim PET/CT evaluation indicated a state of stable disease (SD). Neither did serum IgM remarkably drop. He was then given a bortezomib-contained regimen which significantly reduced the level of serum IgM. To the best of our knowledge, this is the first report of follicular lymphoma with monoclonal IgM and MYD88 L265P mutation. The present case indicated bortezomib may benefit these patients.

Prognostic value of EGFR and KRAS in resected non-small cell lung cancer: a systematic review and meta-analysis.

BACKGROUND: The prognostic value of EGFR and KRAS mutations in resected non-small cell lung cancer (NSCLC) has been reported. However, conflicting results were reported in these studies. The effect of mutations in these two genes in resected NSCLC remains controversial. METHODS: We searched Internet databases for studies reporting disease-free survival (DFS) and overall survival (OS) in resected NSCLC patients with EGFR or KRAS mutations. A meta-analysis calculating the pooled hazard ratio (HR) for DFS and OS was used to measure the association of EGFR or KRAS mutations with the prognosis of patients after surgery. RESULTS: A total of 9,635 patients from 32 studies were included in this analysis. The combined HR for EGFR mutations on DFS was 0.77 (95% CI 0.66-0.90, p=0.001) and on OS was 0.72 (95% CI 0.66-0.80, p<0.00001). In addition, the combined HR for KRAS mutations on DFS was 1.5 (95% CI 1.15-1.96, p=0.002) and on OS was 1.49 (95% CI 1.28-1.73, p<0.00001). Sensitivity analysis, subgroup analysis, and bias analysis proved the stability of the results. CONCLUSION: The analysis showed that EGFR mutations were significantly associated with DFS and OS. These findings indicated that surgically treated NSCLC patients with EGFR mutations were inclined to exhibit a prolonged DFS and OS. In addition, the results indicated that KRAS mutations predicted worse DFS and OS in patients with resected NSCLC.

Identifying key regulating miRNAs in hepatocellular carcinomas by an omics' method.

The miRNAs play important regulating roles in the pathogenesis of hepatocellular carcinoma (HCC). To uncover key regulating miRNAs in HCC that were neglected by traditional analyzing methods of transcriptomics data, we proposed a novel molecular-network-based omics' (MNBO) method. With this method, we predicted HCC-regulating miRNAs, and confirmed the role of a novel miR-590-3P/EED axis by a clinical study and in vitro, in vivo wet-experiments. The miR-590-3P is significantly down-regulated in HCC patients. And low level of miR-590-3P in HCC is associated with poor prognosis of patients. In HCC cell lines, the miR-590-3P suppressed cell proliferation by inhibiting the transformation G1 phase to S phases of the cell cycle. Moreover, the miR-590-3P inhibited migration and invasion of HCC cells. Further investigations indicated that miR-590-3P play its roles by inhibiting polycomb protein EED. The experiments in animal model implied miR-590-3P could be a potential therapeutic agent for HCC in the future. In conclusion, the discovery of miR-590-3P revealed the MNBO would be a useful strategy to uncover key regulating miRNAs in HCC.

Driver genes in non-small cell lung cancer: Characteristics, detection methods, and targeted therapies.

Lung cancer is one of the most common causes of cancer-related death in the world. The large number of lung cancer cases is non-small cell lung cancer (NSCLC), which approximately accounting for 75% of lung cancer. Over the past years, our comprehensive knowledge about the molecular biology of NSCLC has been rapidly enriching, which has promoted the discovery of driver genes in NSCLC and directed FDA-approved targeted therapies. Of course, the targeted therapies based on driver genes provide a more exact option for advanced non-small cell lung cancer, improving the survival rate of patients. Now, we will review the landscape of driver genes in NSCLC including the characteristics, detection methods, the application of target therapy and challenges.

Precision medicine for hepatocellular carcinoma: driver mutations and targeted therapy.

Hepatocellular carcinoma (HCC) is the third most frequent cause of tumor-related mortality and there are an estimated approximately 850,000 new cases annually. Most HCC patients are diagnosed at middle or advanced stage, losing the opportunity of surgery. The development of HCC is promoted by accumulated diverse genetic mutations, which confer selective growth advantages to tumor cells and are called "driver mutations". The discovery of driver mutations provides a novel precision medicine strategy for late stage HCC, called targeted therapy. In this review, we summarized currently discovered driver mutations and corresponding signaling pathways, made an overview of identification methods of driver mutations and genes, and classified targeted drugs for HCC. The knowledge of mutational landscape deepen our understanding of carcinogenesis and promise future precision medicine for HCC patients.

Long-range and regional transported size-resolved atmospheric aerosols during summertime in urban Shanghai.

In this study, the concentrations of water soluble ions (WSI), organic carbon (OC), and elemental carbon (EC) of size-resolved (0.056-18µm) atmospheric aerosols were measured in July and August 2015 in Shanghai, China. Backward trajectory model and potential source contribution function (PSCF) model were used to identify the potential source distributions of size-resolved particles and PM1.8-associated atmospheric inorganic and carbonaceous aerosols. The results showed that the average mass concentrations of PM0.1, PM1, and PM1.8 were 21.21, 82.90, and 100.1µgm-3 in July and 7.00, 29.21, and 35.10µgm-3 in August, respectively, indicating that the particulate matter pollution was more serious in July than in August in this study due to the strong dependence of the aerosol species on the air mass origins. The trajectory cluster analysis revealed that the air masses originated from heavily industrialized areas including the Pearl River Delta (PRD) region, the Yangtze River Delta (YRD) region and the Beijing-Tianjin region were characterised with high OC and SO42- loadings. The results of PSCF showed that the pollution in July was mainly influenced by long-range transport while it was mainly associated to local and intra-regional transport in August. Besides the contributions of anthropogenic sources from YRD and PRD region, ship emissions from the East China Sea also made a great contribution to the high loadings of PM1.8 and PM1.8-associated NO3-, NH4+, and EC in July. SO42- in Shanghai was dominantly ascribed to anthropogenic sources and the high PSCF values for PM1.8-associated SO42- observed in August was mainly due to the ship emissions of Shanghai port, such as Wusong port and Yangshan deep-water port. These results indicated that the particulate pollutants from long-range transported air masses and shipping made a significant contribution to Shanghai's air pollution.

Spontaneous Rupture of a Mediastinal Bronchial Artery Aneurysm Induced by Anticoagulant Agent.

Nontraumatic spontaneous rupture of a bronchial artery aneurysm is rarely seen. In this report, we described such a phenomenon in a patient induced by usage of anticoagulant agent. The patient had no antecedent history of trauma, hypertension, or apparent aortic pathology. The patient who had been taking low-molecular-weight heparin and warfarin to treat deep vein thrombosis complained of a sudden upper abdomen pain with shortness of breath and hypoxemia. The patient was diagnosed and treated for an acute hemomediastinum caused by a ruptured bronchial artery aneurysm. If the patient had continued to take the anticoagulant antithrombotic drugs, it may cause a more virulent bleeding. Taken together, CT angiography is a useful diagnosis tool for patients with sudden chest pain and abdominal pain, and rare cause should be considered.