Effect of probiotic administration during pregnancy on the functional diversity of the gut microbiota in healthy pregnant women.

Our study aims to investigate the impact of probiotic consumption during pregnancy on gut microbiota functional diversity in healthy pregnant women. Thirty-two pregnant women were randomly assigned to two groups. The probiotic group (PG) consisted of pregnant women who consumed triple viable Bifidobacterium longum, Lactobacillus delbrueckii bulgaricus, and Streptococcus thermophilus tablets from the 32nd week of pregnancy until delivery. The functional profiles of the gut microbiota were predicted through high-throughput 16S rRNA sequencing results using PICRUSt software and referencing the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. In the gut microbiota of the PG, the genera Blautia and Ruminococcus, as well as the species Subdoligranulum, showed significantly higher relative abundances compared to the control group (CG) (P < 0.05). At Level 1 of the KEGG signaling pathways, there was a significant reduction in the functional genes of the gut microbiota involved in Organismal Systems in the PG (P < 0.05). In Level 2 of the KEGG signaling pathways, there was a significant reduction in the functional genes of the gut microbiota involved in Infectious Disease in the PG (P < 0.05). In Level 3 of the KEGG signaling pathways, the PG exhibited a significant increase in the functional genes of the gut microbiota involved in ABC transporters, Oxidative phosphorylation, Folate biosynthesis, and Biotin metabolism (P < 0.05). The CG showed a significant increase in the functional genes related to Cysteine and methionine metabolism, Vitamin B6 metabolism, Tuberculosis, and Vibrio cholerae pathogenic cycle (P < 0.05). In conclusion, our findings suggest that probiotic supplementation during pregnancy has a significant impact on functional metabolism in healthy pregnant women. IMPORTANCE: Probiotics are considered beneficial to human health. There is limited understanding of how probiotic consumption during pregnancy affects the functional diversity of the gut microbiota. The aim of our study is to investigate the impact of probiotic consumption during pregnancy on the functional diversity of the gut microbiota. Our findings suggest that probiotic supplementation during pregnancy has a significant impact on functional metabolism. This could potentially open up new avenues for preventing various pregnancy-related complications. This also provides new insights into the effects of probiotic consumption during pregnancy on the gut microbiota and offers a convenient method for exploring the potential mechanisms underlying the impact of probiotics on the gut microbiota of pregnant women.

Solitary bone plasmacytoma: Long-term clinical outcomes in a single center.

BACKGROUND: A solitary plasmacytoma is classified into a solitary plasmacytoma of the bone (SBP) and a solitary extramedullary (soft tissue mass) plasmacytoma, based on the site of the lesion. Despite the high local control rate with radiotherapy, approximately half of patients' conditions progress to multiple myeloma (MM) within 3-5 years after diagnosis, with SBP having a worse prognosis. PATIENTS AND METHODS: We retrospectively assessed the treatment and outcomes of patients with SBP in a hospital in China from 2008 to 2021. Twenty-four patients treated over 13 years with SBP were enrolled in this retrospective study. RESULTS: The most common sites for SBP were the axial skeleton and femur. The M protein was detected in 11 patients (46 %), of which 8 (33 %) had light chains, 2 (8 %) had immunoglobulin G kappa and 1 (4 %) had immunoglobulin D kappa. Flow cytometry revealed that 5 patients (21 %) had minimal bone marrow involvement. The treatment included chemotherapy, surgery, and radiotherapy in 18 (75 %), 12 (50 %), and 9 (38 %) patients, respectively, of whom 13 (54 %) received combined treatment. Over a median follow-up period of 67.2 months, 9 patients (38 %) developed MM in a median time of 101.5 months. The 5- and 10-year progression-free survival rates were 67.3 % and 37.4 %, respectively. One patient died due to pneumonia without progression and the other died due to relapse. CONCLUSION: This study confirmed the high rate of progression of SBP to MM, indicating a need for adjunct chemotherapy for the management of SBP.

Life cycle assessment of carbon footprint in dual-phase automotive strip steel production.

As the demand for automotive materials grows more stringent in environmental considerations, it becomes imperative to conduct thorough environmental impact assessments of dual-phase automotive strip steel (DP steel). However, the absence of detailed and comparable studies has left the carbon footprint of DP steel and its sources largely unknown. This study addresses this gap by establishing a cradle-to-gate life cycle model for DP steel, encompassing on-site production, energy systems, and upstream processes. The analysis identifies and scrutinizes key factors influencing the carbon footprint, with a focus on upstream mining, transportation, and on-site production processes. The results indicate that the carbon footprint of DP steel is 2.721 kgCO2-eq/kgDP, with on-site processes contributing significantly at 88.1%. Sensitivity analysis is employed to assess the impact of changes in resource structure, on-site energy, CO2 emission factors, and byproduct recovery on the carbon footprint. Proposals for mitigating carbon emissions in DP steel production include enhancing process gas recovery, transitioning to cleaner energy sources, and reducing the hot metal-to-steel ratio. These findings offer valuable insights for steering steel production towards environmentally sustainable practices.

Multi-omics analysis reveals the associations between altered gut microbiota, metabolites, and cytokines during pregnancy.

For embryo implantation and fetal development, the maternal immune system undergoes dramatic changes. The mechanisms involved in inducing alterations of maternal immunity have not been fully clarified. Gut microbiome and metabolites were thought to influence the host immune response. During normal pregnancy, notable changes occur in the gut microbiota and metabolites. However, the relationship of these alterations to immune function during pregnancy remains unclear. In this study, we examined gut microbiota, fecal metabolites, plasma metabolites, and cytokines in pregnant women and non-pregnant women. Our findings revealed that, in comparison to non-pregnant women, pregnant women exhibit a significant increase in the relative abundance of Actinobacteriota and notable differences in metabolic pathways related to bile acid secretion. Furthermore, there was a marked reduction in pro-inflammatory cytokines levels in pregnant women. Correlation analyses indicated that these alterations in cytokines may be linked to specific gut bacteria and metabolites. Bacteria within the same microbial modules exhibited consistent effects on cytokines, suggesting that gut bacteria may function as functional groups. Mediation analysis further identified that certain bacteria might influence cytokines through metabolites, such as bile acids and arachidonic acid. Our findings propose potential biological connections between bacteria, metabolites, and immunity, which require further validation in future studies.IMPORTANCEA great number of studies have focused on diseases induced by intestinal microecological disorders and immune imbalances. However, the understanding of how intestinal microbiota interacts with immunity during normal pregnancy, which is fundamental to studying pathological pregnancies related to intestinal microbiota disturbances, has not been well elucidated. Our study employed multi-omics analysis to discover that changes in gut microbiota and metabolites during pregnancy can impact immune function. In addition, we identified several metabolites that may mediate the effect of gut microbes on plasma cytokines. Our study offered new insights into our understanding of the connections between the gut microbiome, metabolome, and the immune system during pregnancy.

Biochemical characterization and mutational analysis of the NurA protein from the hyperthermophilic euryarchaeon Thermococcus barophilus Ch5.

Archaeal NurA protein plays a key role in producing 3'-single stranded DNA used for homologous recombination repair, together with HerA, Mre11, and Rad50. Herein, we describe biochemical characteristics and roles of key amino acid residues of the NurA protein from the hyperthermophilic euryarchaeon Thermococcus barophilus Ch5 (Tba-NurA). Tba-NurA possesses 5'-3' exonuclease activity for degrading DNA, displaying maximum efficiency at 45 °C-65 °C and at pH 8.0 in the presence of Mn2+. The thermostable Tba-NurA also possesses endonuclease activity capable of nicking plasmid DNA and circular ssDNA. Mutational data demonstrate that residue D49 of Tba-NurA is essential for exonuclease activity and is involved in binding ssDNA since the D49A mutant lacked exonuclease activity and reduced ssDNA binding. The R96A and R129A mutants had no detectable dsDNA binding, suggesting that residues R96 and R129 are important for binding dsDNA. The abolished degradation activity and reduced dsDNA binding of the D120A mutant suggest that residue D120 is essential for degradation activity and dsDNA binding. Additionally, residues Y392 and H400 are important for exonuclease activity since these mutations resulted in exonuclease activity loss. To our knowledge, it is the first report on biochemical characterization and mutational analysis of the NurA protein from Thermococcus.

Factors affecting the early establishment of neonatal intestinal flora and its intervention measures.

In recent years, it has become evident that early-life intestinal flora plays a pivotal role in determining human health. Consequently, it is imperative to explore the establishment of neonatal intestinal flora and its influencing factors. Early neonatal intestinal flora is influenced by a multitude of factors, including maternal and infant-related factors, as well as external environment. This review summarizes the colonization mechanism of intestinal flora in the early life of newborns and discussed their influence on the establishment of neonatal intestinal flora, taking into account factors such as delivery mode, gestational age and feeding mode. Additionally, this review delves into the natural or artificial reconstruction of intestinal flora colonization defects in infants born via cesarean section and premature infants, with the goal of establishing a theoretical foundation for preventing and treating issues related to neonatal intestinal flora colonization and associated diseases.

Effect of a High-Fat Diet and Probiotic Supplementation on the Gut Microbiota of Maternal Mice at Term Pregnancy and Offspring at Three-Week Postpartum.

The effects of probiotics on the gut microbiota in maternal mice-fed high-fat diet (HFD) during pregnancy and offspring are still unknown. We aimed to evaluate the effect of high-fat diet and probiotic supplementation on the gut microbiota of maternal mice at term pregnancy and offspring at three-week postpartum. Female pregnant Kunming mice were randomly divided into four groups: mice on a control diet (MC), mice on HFD (MHF), mice on a control diet and probiotics (MCP), and mice on HFD and probiotics (MHFP). The result showed that MHF had significantly reduced Bacteroidetes and Muribaculaceae (P < 0.05) and increased Firmicutes/Bacteroidetes ratio vs. MC. Lachnospiraceae_NK4A136_group and Alistipes reduced (P < 0.05), and Firmicutes/Bacteroidetes ratio significantly increased in MCP vs. MC. There was no significant difference between MHF and MHFP. Higher levels of Prevotella, Prevotellaceae, and Streptococcaceae were found in mice offspring on HFD (OHF) vs. mice offspring on a control diet (OC) (P < 0.05, respectively). Bacteroidia, Bacteroidota, Bacteroidales, and Muribaculaceae decreased markedly in mice offspring on a control diet and probiotics (OCP) vs. OC (P < 0.05, respectively), while Firmicutes, Lactobacillales, Lactobacillaceae, and Lactobacillus significantly increased in OCP (P < 0.05, respectively). There was no significant difference between the OHF and mice offspring on HFD and probiotics (OHFP). The findings suggest that the gut microbial composition of pregnant mice and offspring were altered to some extent due to HFD or probiotic intervention. Further, maternal mice on HFD and offspring were less affected by probiotic supplementation.

Association of preoperative frailty with pulmonary complications after cardiac surgery in elderly individuals: a prospective cohort study.

BACKGROUND: The relationship between preoperative frailty and pulmonary complications after cardiac surgery in elderly patients is unclear. This study was designed to evaluate the relationship between frailty and postoperative pulmonary complications (PPCs) in elderly patients undergoing cardiac surgery and to provide a basis for their prevention and treatment. AIMS: This study aimed to investigate the predictive value of preoperative frailty on pulmonary complications after cardiac surgery in elderly patients. METHODS: Frailty was assessed using the CAF. The diagnosis of PPCs was based on the criteria defined by Hulzebos et al., and patients were classified into a PPCs group and a non-PPCs group. Factors with clinical significance and P < 0.05 in univariate regression analysis were included in multivariate logistic regression analysis to determine the relationship between preoperative frailty and PPCs. The area under the receiver operating characteristic (ROC) curve (AUC) was used to compare the predictive effects of the CAF, EuroSCORE II, and ASA + age on the occurrence of PPCs. RESULTS: A total of 205 patients were enrolled in this study, 31.7% of whom developed PPCs. Univariate logistic regression analysis showed that frailty, ASA grade, EuroSCORE II, hemoglobin concentration, FVC, time of operation, and postoperative AKI were associated with the development of PPCs. However, after adjustments for all possible confounding factors, multivariate logistic regression results showed that frailty, prolonged operation time, and postoperative AKI were risk factors for PPCs, and the risk of postoperative PPCs in frail patients was approximately 4.37 times that in nonfrail patients (OR = 4.37, 95%CI: 1.6-11.94, P < 0.05). The predictive efficacy of the traditional perioperative risk assessment tools EuroSCORE II and ASA + age was lower than that of CAF. CONCLUSIONS: Frailty before surgery, prolonged operation time, and postoperative AKI were independent risk factors for pulmonary complications after heart surgery in elderly individuals, and CAF was more effective than the traditional risk predictors EuroSCORE II and ASA + age.

Corrigendum: The role of 18F-FDG PET in predicting the pathological response and prognosis to unresectable HCC patients treated with lenvatinib and PD-1 inhibitors as a conversion therapy.

[This corrects the article DOI: 10.3389/fimmu.2023.1151967.].

Bombyx mori nucleopolyhedrovirus induces BmFABP1 downregulation to promote viral proliferation.

Fatty acid binding proteins (FABPs) play an important role as endogenous cytoprotectants. However, studies on FABPs in invertebrates are scarce. Previously, we discovered Bombyx mori fatty acid binding protein 1 (BmFABP1) through co-immunoprecipitation. Here, we cloned and identified BmFABP1 from BmN cells. The results of immunofluorescence indicated that BmFABP1 was localized in the cytoplasm. The tissue expression profile of silkworms showed that BmFABP1 was expressed in all tissues except hemocytes. The expression level of BmFABP1 gradually decreases in BmN cells and B. mori larvae after infection with B. mori nucleopolyhedrovirus (BmNPV). Upregulation of BmFABP1 expression through overexpression or WY14643 treatment significantly inhibited the replication of BmNPV, while downregulation of BmFABP1 expression by RNA interference promoted the replication of BmNPV. The same results were obtained in experiments on silkworm larvae. These results suggest that BmNPV induces BmFABP1 downregulation to promote its proliferation and that BmFABP1 has a potential anti-BmNPV role. This is the first report on the antiviral effect of BmFABP1 in silkworms and provides new insights into the study of the FABP protein family. Also, it is important to study BmNPV resistance in silkworms to breed transgenic silkworms with BmNPV resistance.

The role of 18F-FDG PET in predicting the pathological response and prognosis to unresectable HCC patients treated with lenvatinib and PD-1 inhibitors as a conversion therapy.

Purpose: To investigate the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET), as an imaging biomarker, for predicting pathological response and prognosis of unresectable hepatocellular carcinoma (HCC) patients treated with Lenvatinib and programmed cell death protein 1 (PD-1) inhibitors as a conversion therapy. Methods: A total of 28 unresectable HCC patients with BCLC stage B or C were treated with Lenvatinib and PD-1 inhibitors before surgery. The 18F-FDG PET/CT scans were acquired before pre- (scan-1) and post-conversion therapy (scan-2). The maximum standardized uptake value (SUVmax), TLR (tumor-to-normal liver standardized uptake value ratio), and the percentages of post-treatment changes in metabolic parameters (ΔSUVmax [%] and ΔTLR [%]) were calculated. Major pathological response (MPR) was identified based on the residual viable tumor in the resected primary tumor specimen (≤10%). Differences in the progression-free survival (PFS) and overall survival (OS) stratified by ΔTLR were examined by the Kaplan-Meier method. Results: 11 (11/28, 39.3%) patients were considered as MPR responders and 17 (17/28, 60.7%) patients as non-MPR responders after conversion therapy. ΔSUVmax (-70.0 [-78.8, -48.8] vs. -21.7 [-38.8, 5.7], respectively; P<0.001) and ΔTLR (-67.6 [-78.1, -56.8] vs. -18.6 [-27.9, 4.0], respectively; P<0.001) were reduced in the responder group than those in the non-responder group. According to the results of the receiver operating characteristic curve analysis, ΔTLR showed an excellent predictive value for the MPR of primary HCC lesions (area under curve=0.989, with the optimal diagnostic threshold of -46.15). When using ΔTLR of -21.36% as a threshold, patients with ΔTLR-based metabolic response had superior PFS (log-rank test, P=0.001) and OS (log-rank test, P=0.016) compared with those without ΔTLR-based metabolic response. Conclusion: 18F-FDG PET is a valuable tool for predicting pathological response and prognosis of unresectable HCC patients treated by Lenvatinib combined with PD-1 as a conversion therapy.

Biochemical characterization and mutational studies of endonuclease Q from the hyperthermophilic euryarchaeon Thermococcus gammatolerans.

Endonuclease Q (EndoQ) can effectively cleave DNA containing deaminated base(s), thus providing a potential pathway for repair of deaminated DNA. EndoQ is ubiquitous in some Archaea, especially in Thermococcales, and in a small group of bacteria. Herein, we report biochemical characteristics of EndoQ from the hyperthermophilic euryarchaeon Thermococcus gammatolerans (Tga-EndoQ) and the roles of its six conserved residues in DNA cleavage. The enzyme can cleave uracil-, hypoxanthine-, and AP (apurinic/apyrimidinic) site-containing DNA with varied efficiencies at high temperature, among which uracil-containing DNA is its most preferable substrate. Additionally, the enzyme displays maximum cleavage efficiency at above 70 oC and pH 7.0 ∼ 8.0. Furthermore, Tga-EndoQ still retains 85% activity after heated at 100 oC for 2 hrs, suggesting that the enzyme is extremely thermostable. Moreover, the Tga-EndoQ activity is independent of a divalent ion and NaCl. Mutational data demonstrate that residues E167 and H195 in Tga-EndoQ are essential for catalysis since the E167A and H195A mutants completely abolish the cleavage activity. Besides, residues S18 and R204 in Tga-EndoQ are involved in catalysis due to the reduced activities observed for the S18A and R204A mutants. Overall, our work has augmented biochemical function of archaeal EndoQ and provided insight into its catalytic mechanism.

Targeted sequencing reveals the relationship between mutations and patients' clinical indicators, blood cell counts and early progression in diffuse large-B cell lymphoma.

In the current study, we assessed the relationship between mutations and the blood cell counts and early progression of patients with diffuse large-B cell lymphoma (DLBCL). A total of 109 patients with newly diagnosed DLBCL were included in this study. UBE2A mutation was only found in patients with bone marrow involvement. The mutations of ZNF608, SF3B1, DTX1, and NCOR2 were related to blood cell counts. NCOR2 mutations were only detected in patients of the noncomplete response group (PR + SD + PD). In addition, the mutations of ATM, BTG2, TBL1XR1, and TP53 were linked to lower PFS/OS rate, while SGK1, SCOS1, and NFKBIE were related to higher PFS/OS rate. Importantly, we identified that Ann Arbor stage (III-IV), B symptoms, absolute lymphocyte count (ALC) abnormity, and MTOR mutation were the four independent influencing factors of the 12-month progression of DLBCL patients. Overall, this study revealed that mutations were associated with the early progression of DLBCL.

Apolipoprotein D facilitate the proliferation of BmNPV.

The silkworm, Bombyx mori, a model Lepidopteran specie, is an important economic insect. It is specifically infected by Bombyx mori nucleopolyhedrovirus (BmNPV), causing huge losses to the sericulture industry. Therefore, the understandings of the interaction mechanism between BmNPV and the host will help to provide the theoretical basis for the sericulture industry to control BmNPV. Apolipoprotein D (ApoD) is a member of lipid transport family and capable of binding to a variety of lipophilic ligands. ApoD is mainly used in neurodegenerative disease research in mammals, and there is little research on ApoD against viruses. Here, we explored the effects of Bombyx mori Apolipoprotein D (BmApoD) on BmNPV replication. We knocked out and overexpressed BmApoD in BmN cells and infected them with Bombyx mori nucleopolyhedrovirus (BmNPV). The results showed that BmApoD promote the replication of BmNPV in BmN cells. It was also confirmed that BmApoD promote the replication of BmNPV after knocking down BmApoD in silkworm larvae. This study is the first to explore the role of ApoD in insect-virus interactions, providing new insights into the functional role of ApoD.

Potential Proteins Interactions with Bombyx mori Nucleopolyhedrovirus Revealed by Co-Immunoprecipitation.

Virus-host interactions are critical for virus replication, virulence, and pathogenicity. The Bombyx mori nucleopolyhedrovirus (BmNPV) is a typical model baculovirus, representing one of the most common and harmful pathogens in sericulture. Herein, we used co-immunoprecipitation to identify candidate proteins with potential interactions with BmNPV. First, a recombinant BV virus particle rBmBV-egfp-p64-3×flag-gp64sp was constructed using a MultiBac baculovirus multigene expression system. Co-immunoprecipitation experiments were then performed with the recombinant BV virus infected with BmN cells and Dazao silkworms. LC-MS/MS analysis revealed a total of 845 and 1368 candidate proteins were obtained from BmN cells and silkworm samples, respectively. Bioinformatics analysis (Gene Ontology, KEGG Pathway) was conducted for selection of proteins with significant enrichment for further confirmation of the effects on BmNPV replication. Overall, the results showed that SEC61 and PIC promoted the replication of BmNPV, while FABP1 inhibited the replication of BmNPV. In summary, this study reveals the potential proteins involved in BmNPV invasion and proliferation in the host and provides a platform for identifying the potential receptor proteins of BmNPV.

Pretreatment Metabolic Parameters Measured by 18F-FDG PET to Predict the Pathological Treatment Response of HCC Patients Treated With PD-1 Inhibitors and Lenvatinib as a Conversion Therapy in BCLC Stage C.

Objectives: This study aimed to assess the pretreatment 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) as a predictor of the pathological treatment response (PTR) of hepatocellular carcinoma (HCC) patients treated with PD-1 inhibitors and lenvatinib as a conversion therapy in BCLC stage C. Methods: All patients (n=20) underwent pretreatment 18F-FDG PET/CT and were treated with conversion therapy and surgery. Patients were categorized into responders (n=9) and non-responders (n=11) according to PTR. The parameters of PET/CT, including lesion size, SUVmean (mean standard uptake value), MTV (metabolic tumor volume), TLG (total lesion glycolysis), SUVpeak (peak standard uptake value), and TLR (tumor-to-normal liver standardized uptake value ratio), were calculated. The diagnostic efficacy was evaluated by receiver operating characteristic analysis (ROC). PTR was compared with pretreatment PET/CT parameters by using Spearman correlation analysis. The patients were followed up. Results: There was significant difference in TLR (5.59 ± 1.90 vs. 2.84 ± 1.70, respectively; P=0.003) between responders and non-responders, with the largest area under the curve (sensitivity=100%, specificity=72.7%, AUC=0.899, 95%CI: 0.759-1.000, optimal diagnostic threshold of 3.09). The relationship between 18F-FDG PET/CT parameters and PTR indicated TLR was moderately and positively correlated with pathological treatment response, with correlation coefficients (rs) of 0.69 (P<0.01). During the follow-up, no patients died, and tumor recurrence was found in one of the responders (11.1%). In all 11 non-responders, tumor recurrence was found in six patients (54.5%) and four patients (36.4%) died. Conclusions: TLR may be a powerful marker to predict PTR of HCC patients with BCLC stage C who were treated with conversion therapy.

The Pathogenesis and Influencing Factors of Adult Hypertension Based on Structural Equation Scanning.

Explore the pathogenesis and influencing factors of adult hypertension based on structural equation scanning. Using a multistage random sampling method, randomly select 2 community health service centers in each administrative area of a certain city and conduct a sample survey of residents in the community. According to the predetermined sample size n, multiply by 1.3 (1.3n) to draw a sample. Community doctors and medical students who have been uniformly trained form an investigation team draw up a questionnaire by consulting the literature, seek expert opinions, and then make changes based on the questions in the preinvestigation. Experiment result shows that the average systolic blood pressure of the experimental subjects was 126.13 + 15.36 mmHg and the average diastolic blood pressure was 79.52 + 8.81 mmHg; males are higher than females and increase with age. The prevalence rate of hyperemia is 26.3%, and the prevalence rate of prehypertension among the survey subjects is 55.4%; that of males (62.6%) is higher than that of females (49.2%). The prevalence of isolated systolic hypertension was 7.5%, and that of men (6.9%) was lower than that of women (7.9%). The awareness rate of hypertension was 66.5%, and the treatment rate of hypertension was 62.7%; the control rate of hypertension was 13.2%, and the control rate of hypertension treatment was 25.7%; all the abovementioned rates are higher for women than for men, and they all tend to increase with age which proved that being overweight is a risk factor for hypertension, dyslipidemia, and hypertension. Hypertension, dyslipidemia, and family history of hypertension are risk factors for hypertension. There is a positive correlation between hypertension and dyslipidemia.

Prediction of Renal Function Damage in Patients with Essential Hypertension Based on Stepwise Regression Equation Scanning by AASI.

Detection of arterial stiffness is an important method to predict the occurrence of hypertension complications and to screen patients with high cardiovascular risk. In order to predict the damage of AASI to the renal function of patients with essential hypertension, the prediction of AASI based on stepwise Regression equation scanning for renal function damage in patients with essential hypertension is proposed. Measure the 24 h ambulatory blood pressure of the selected subjects, establish a linear Regression equation scanning, and calculate the slope of the straight line, and finally, the slope is AASI. According to the quartiles, AASI is divided into four parts: group I < 0.53 (n = 49); 0.53 ≤ group II < 0.60 (n = 51); 0.60 ≤ group III < 0.69 (n = 48); group IV ≥ 0.69 (n = 44). Experiment result shows the following: with the increase of AASI, cystatin (CysC) also increased significantly, while CysC-eGFR decreased significantly (P < 0.05). Compared with groups I, II, and III, Scr and CysC in group IV increased (P < 0.05), and Ccr, CysC-eGFR, and (CKD-EPI)-eGFR all decreased (P < 0.05). AASI is positively correlated with CysC performance, and the correlation coefficient r is 0.637. It is negatively correlated with Ccr performance, and r is -0.361. It is negatively correlated with CysC-eGFR, and r is -0.698. And it is negatively correlated with (CKD-EPI)-eGFR, and r is -0.331. Age and 24 h PP also showed an increasing trend with the increase of AASI, and it suggests that age may be an influencing factor that promotes kidney damage caused by hypertension; it also suggests that AASI can be used as a new indicator of arterial compliance; AASI is linearly related to various indicators of renal damage and can be used as a predictive indicator of renal damage caused by essential hypertension; cystatin C and the estimated glomerular filtration rate CysC-eGFR based on cystatin C are better than other indicators reflecting glomerular filtration rate, more sensitively assess the degree of early renal damage. Obesity may also be a factor that promotes kidney damage caused by hypertension.

Quantitative analysis of 68Ga-DOTA(0)-Tyr(3)-octreotate positron emission tomography/computed tomography imaging for the differential diagnosis of primary pheochromocytoma and paraganglioma.

Background: Pheochromocytomas/paragangliomas (PPGLs) predominantly express somatostatin receptors (SSTRs) 2 and 3. 68Ga-DOTA(0)-Tyr(3)-octreotate (68Ga-DOTA-TATE) is an imaging radiopharmaceutical that selectively targets SSTR 2 with high affinity. The purpose of this study was to evaluate the utility of 68Ga-DOTA-TATE in the differential diagnosis of suspected PPGLs, and determine the optimal threshold for differential diagnoses. Methods: This retrospective study reviewed consecutive patients referred to the Chinese PLA General Hospital, Beijing between April 2018 and December 2020 who underwent both biochemical testing for catecholamine and 68Ga-DOTA-TATE positron emission tomography/computed tomography (PET/CT) for suspected PPGLs, without prior history. Patients with pathologic confirmation were selected for analysis. The following values were obtained for a quantitative analysis of 68Ga-DOTA-TATE imaging: maximal standardized uptake value (SUVmax), the ratio between the SUVmax of the lesion and the mean SUV (SUVmean) of the liver (SUVR), and the Krenning score (KS) of the lesion. According to their location, tumors were grouped as adrenal or extra-adrenal. Receiver operating characteristic (ROC) curves of the SUVR and KS were determined, and their diagnostic performance was calculated using general and subgroup-specific optimal thresholds. Concordance between the SUVR and KS was analyzed using a McNemar test. Results: A total of 38 patients with PPGLs and 21 with non-PPGLs tumors were included in the final analysis. When a general optimal threshold for adrenal tumors was applied in pheochromocytoma (PCC) diagnosis, the sensitivity, specificity, and accuracy of the SUVR and KS were 86.4% (19/22) and 90.9% (20/22), 92.9% (13/14) and 78.6% (11/14), and 88.9% (32/36) and 86.1% (31/36), respectively. The SUVR and KS diagnostic results showed no differences in paraganglioma (PGL) diagnosis, with a sensitivity, specificity, and accuracy of 43.8% (7/16), 100.0% (7/7), and 60.9% (14/23), respectively. Using PPGL-specific optimal thresholds improved the diagnostic accuracy for extra-adrenal tumors. The diagnostic results of the SUVR and KS showed high concordance in both general and subgroup analyses. When PPGL-specific optimal thresholds were used, 68Ga-DOTA-TATE PET/CT correctly diagnosed 1 PCC with negative biochemical test results, and 5 PCCs and 1 PGL with borderline biochemical test results. Conclusions: Applying PPGL-specific thresholds of 68Ga-DOTA-TATE in diagnosing adrenal and extra-adrenal tumors is recommended for the differential diagnosis of PPGLs. When biochemical tests are negative or borderline, 68Ga-DOTA-TATE PET/CT should be included in the diagnostic procedure. The visual KS method has almost the same diagnostic efficiency as the quantitative SUVR method and has potential for recommendation in 68Ga-DOTA-TATE image analysis.