Multi-slice computed tomographic analysis and identification of remarkable anatomical types of segmental bronchi in bilateral inferior lobes: based on extensive data.

Background: The progress of interventional respiratory medicine necessitates a comprehensive knowledge of the segmental bronchi because of their complexity in branching patterns. Therefore, based on extensive research data, we aimed to examine the anatomical diversity and sex-related variations of the segmental bronchial branching patterns in the bilateral inferior lobes. Methods: Following the exclusion and inclusion criteria, a total of 10,000 participants who underwent multi-slice computed tomography (MSCT) scans from September 2019 to December 2021 at Cheeloo College of Medicine, Shandong University were enrolled in this retrospective study. The computed tomography (CT) data were utilized to generate three-dimensional (3D) and virtual bronchoscopy (VB) simulations of a bronchial tree using the syngo.via post-processing workstation. The distinct bronchial patterns in the bilateral inferior lobes were then found and categorized using the reconstructed images. The proportions of different types of bronchial branches and their sex-related correlations were analyzed by cross-tabulation and chi-square analysis. Results: Our findings primarily identified four types of bronchial branching patterns in the right inferior lobe (RIL), i.e., (B6, B7, B8, B9+10), 71.44%; (B6, B7, B8+9, B10), 16.06%; (B6, B7+8, B9+10), 7.40%; (B6, B7, B8+9+10), 5.10%; and four types in the left inferior lobe (LIL), i.e., (B6, B7+8, B9+10), 82.89%; (B6, B7+8, B9, B10), 13.53%; (B6, B7, B8+9, B10), 2.88%; (B6, B7, B8+9+10), 0.70%. Besides various research methods and outcomes, this study has revealed the types of bronchial branches that were not seen in previous studies. In addition, the proportion of bronchial branches in the LIL did not differ significantly between males and females (P>0.05). However, there was a significant difference in the proportion of bronchial branches in the RIL between sexes (P<0.05). Conclusions: The current study has validated the segmental bronchial variations in the bilateral inferior lobes. The diagnosis of symptomatic patients as well as the performance of interventions like bronchoscopies, endotracheal intubation, and lung resections may be significantly influenced by our findings in the clinical setting.

Multi-slice CT Analysis and Identification of Anatomical Types of Segmental Bronchi in Right Superior Lobe.

PURPOSE: The aims were to assess different branching patterns of segmental bronchi in the right superior lobe (RSL), as well as to investigate the anatomical diversity and sex-related variations of these branches in a large sample of the research population. METHODS: 10,000 participants (5428 males, and 4,572 females, mean age 50+/-13.5 years [SD] years; age range: 3-91 years) who underwent multi-slice CT (MSCT) scans from September 2019 to December 2021 were retrospectively included. The data were applied to generate three-dimensional (3D) and virtual bronchoscopy (VB) simulations of a bronchial tree using the syngo.via post-processing workstation. Following that, the reconstructed images were interpreted to identify and categorize various bronchial patterns in the RSL. Cross-tabulation analysis and the Pearson chi-square test (χ2) were used to calculate the component ratios of bronchial branch types and determine their relevance between male and female groups. RESULTS: Our results revealed mainly six types for the RSL bronchial tree, i.e., (B1, B2, B3, 60.70%); (B1+2, B3, 18.72%); (B2+3, B1, 6.68%); (B1+3, B2, 7.57%); (B1, B2, B3, B*, 3.19%); (B1a+B3, B1b+B2, 3.14%). There were significant sex-related differences in the proportion of bronchial branches in the RSL (P< 0.05). CONCLUSION: The current study has validated the presence of segmental bronchial variations in the RSL. These findings may have significant implications for diagnosing symptomatic patients and performing particular procedures, including bronchoscopy, endotracheal intubation, and lung resection.

Identification of anatomical types of segmental bronchi in left superior and lingular lobes using multi-slice CT.

PURPOSE: The objectives of this study were to evaluate various branching patterns of segmental bronchi in the left superior and lingular lobes and to survey the anatomical diversity and sex-related differences of these branches in a large sample of the study population. MATERIALS AND METHODS: Overall, 10,000 participants (5428 males, and 4572 females, mean age 50 ± 13.5 years [SD] years; age range: 3-91 years) who underwent multi-slice CT (MSCT) scans between September 2019 and December 2021 were retrospectively included. Using the syngo.via post-processing workstation, the data were applied to generate three-dimensional (3D) and virtual bronchoscopy (VB) simulations of a bronchial tree. The reconstructed images were then interpreted to identify and categorize distinct bronchial patterns in the left superior and lingular lobes. Cross-tabulation analysis and the Pearson Chi-square (χ2) test were used to calculate the constituent ratios of bronchial branch types and determine their significance between male and female groups. RESULTS: Our results revealed mainly four distinct types for the left superior lobe (LSL) bronchial tree, i.e., (B1 + 2, B3, 76.13%); (B1 + 2 + 3, 17.32%); (B1 + 3, B2, 5.74%); (B1a + B3, B1b + B2, 0.81%) and two types for the left lingular lobe (LLL) bronchial tree, i.e., (B4, B5, 91.05%); (B4, B5, B*, 8.95%). There were no significant sex-related differences in the proportion of bronchial branches in LLL (P > 0.05). However, sex-related differences were significant in the proportion of bronchial branches in LSL (P < 0.05). CONCLUSION: The current study has validated the presence of segmental bronchial variations in the left superior and lingular lobes. These findings may have a crucial effect on the diagnosis of symptomatic patients, as well as in carrying out procedures such as lung resections, endotracheal intubation, and bronchoscopies.

Identification of anatomical types of segmental bronchi in right middle lobe using multi-slice CT.

PURPOSE: The objectives of this study were to evaluate the various branching patterns of segmental bronchi in the right middle lobe (RML) and to survey the anatomical diversity and sex-related differences of these branches in a large sample of the study population. MATERIALS AND METHODS: In this retrospective board-approved study with informed consent, 10,000 participants (5428 males and 4,572 females, mean age 50 ± 13.5 years [SD]; age range: 3-91 years) who underwent multi-slice CT (MSCT) scans from September 2019 to December 2021 were retrospectively included. The data were applied to generate three-dimensional (3D) and virtual bronchoscopy (VB) simulations of a bronchial tree using the syngo.via post-processing workstation. The reconstructed images were then interpreted to locate and classify distinct bronchial patterns in the RML. Cross-tabulation analysis and the Pearson chi-square test were used to calculate the constituent ratios of bronchial branch types and determine their significance between male and female groups. RESULTS: Our results revealed that the segmental bronchial ramifications of the RML were classified into two types mainly, i.e., bifurcation (B4, B5, 91.42%) and trifurcation (B4, B5, B*, 8.58%). There were no significant sex-related differences in the proportion of bronchial branches in the RML (P > 0.05). CONCLUSION: The current study has confirmed the presence of segmental bronchial variations in the RML lobe using 3D reconstruction and virtual bronchoscopy. These findings may have significant implications for the diagnosis of symptomatic patients and for carrying out specific procedures like bronchoscopy, endotracheal intubation, and lung resection.

Downregulation of RIP3 Improves the Protective Effect of ATF6 in an Acute Liver Injury Model.

BACKGROUND: Activating transcription factor 6 (ATF6) and receptor-interacting protein 3 (RIP3) are important signaling proteins in endoplasmic reticulum (ER) stress and necroptosis, respectively. However, their regulatory relationship and clinical significance are unknown. We investigate the impact of ATF6 on RIP3 expression, and its role in hepatocyte necroptosis in an acute liver injury model. METHODS: In vivo and in vitro experiments were carried out. LO2 cells were treated with thapsigargin (TG). In vivo, male BALB/c mice were treated with carbon tetrachloride (CCl4, 1 mL/kg) or tunicamycin (TM, 2 mg/kg). Then, the impact of ATF6 or RIP3 silencing on liver injury, hepatocyte necroptosis, and ER stress-related protein expression was examined. RESULTS: TG induced ER stress and necroptosis and ATF6 and RIP3 expression in LO2 cells. The knockdown of ATF6 significantly decreased RIP3 expression (p < 0.05) and increased ER stress and necroptosis. The downregulation of RIP3 significantly reduced necroptosis and ER stress (p < 0.05). Similar results were observed in CCl4 or the TM-induced mouse model. The knockdown of ATF6 significantly decreased CCl4-induced RIP3 expression and increased liver injury, necroptosis, and ER stress in mice livers (p < 0.05). In contrast, the downregulation of RIP3 significantly reduced liver injury, hepatocyte necroptosis, and ER stress. CONCLUSIONS: Hepatocyte ATF6 has multiple roles in acute liver injury. It reduces hepatocyte necroptosis via negative feedback regulation of ER stress. In addition, ATF6 can upregulate the expression of RIP3, which is not helpful to the recovery process. However, downregulating RIP3 reduces hepatocyte necroptosis by promoting the alleviation of ER stress. The findings suggest that RIP3 could be a plausible target for the treatment of liver injury.