Natural phosphorus-ferromanganese ore-based composites for the simultaneous remediation of arsenic- and lead-co-contaminated groundwater: synergistic effectiveness, kinetics, and mechanisms.

Natural phosphorus-ferromanganese ore (NPO-NFMO) based composites by mechanical ball milling method, applying for the simultaneous remediation of arsenic (As) and lead (Pb) co-contaminated groundwater. Kinetic behavior adopted pseudo-second-order adsorption mechanism attaining equilibrium in 120 min over a wide pH range (2.0-6.0). NPO-NFMO realized higher adsorption capacity for As(III) (6.8 mg g-1) and Pb(II) (26.5 mg g-1) than those of single NPO (1.7 and 7.8 mg g-1) and NFMO (2.9 and 5.1 mg g-1), indicating that synergistic effects of NPO and NFMO considerably enhanced the adsorption capacity in mixed adsorption system. Fresh and used NPO-NFMO were characterized, and indicated that NPO-NFMO formed stable minerals of PbAs2O6 and PbFe2(AsO4)2(OH)2. The underlying adsorption mechanism indicated that As(III) and Pb(II) removal was involved with multiple mechanisms, including electrostatic adsorption, oxidation, complexation, and coprecipitation. The effects of key reaction parameters including mass ratios of NPO and NFMO, initial metal ion concentration, dosage, solution pH, and co-existing anions in groundwater were systematically investigated. The novel designed NPO-NFMO-based composites can be deemed as a promising amendment for simultaneous immobilization of As(III) and Pb(II) in co-contaminated soil and groundwater.

Evolutionary history of the Arctic flora.

The Arctic tundra is a relatively young and new type of biome and is especially sensitive to the impacts of global warming. However, little is known about how the Arctic flora was shaped over time. Here we investigate the origin and evolutionary dynamics of the Arctic flora by sampling 32 angiosperm clades that together encompass 3626 species. We show that dispersal into the Arctic and in situ diversification within the Arctic have similar trends through time, initiating at approximately 10-9 Ma, increasing sharply around 2.6 Ma, and peaking around 1.0-0.7 Ma. Additionally, we discover the existence of a long-term dispersal corridor between the Arctic and western North America. Our results suggest that the initiation and diversification of the Arctic flora might have been jointly driven by progressive landscape and climate changes and sea-level fluctuations since the early Late Miocene. These findings have important conservation implications given rapidly changing climate conditions in the Arctic.

Characteristics of persulfate gel materials in groundwater remediation: Column and tank experiments investigations.

Using persulfate and environment-friendly gel solution as raw materials, persulfate gel sustained-release material (PGSR) and persulfate gelatin gel sustained-release material (G-PGSR) were developed. The main purpose of this study was to evaluate the potential of PGSR and G-PGSR in sustained release, migration and removal performance through column and tank experimental investigations. Results showed that the maximum release rates of PGSR and G-PGSR in water columns were 1.34 and 0.58 mg min-1 and the cumulative release amounts achieved 2950 and 2818 mg within 75 h, representing release efficiencies of 98.3 % and 93.9 %, respectively. In three sand columns, the maximum release rate was 0.32, 0.21, and 0.16 mg min-1 and the cumulative release achieved 473, 426, and 359 mg within 90 h with release efficiencies of 94.7 %, 85.3 %, and 71.7 %, respectively. Release time and rate of PGSR and G-PGSR are constrained by the permeability of porous media. G-PGSR in the sand tank exhibited migration and release characteristic with the slow-release diffusion effect. Lateral diffusion produced higher S2O82- concentration far beyond what was allowed in the tank. The saturated hydraulic conductivity decreased from 4.9 × 10-3, 1.1 × 10-3, and 4.9 × 10-4 cm s-1 to 2.4 × 10-3, 7.4 × 10-4, and 2.1 × 10-4 cm s-1 in columns filled with medium, fine, and silt, respectively. G-PGSR injection did not significantly change the order of magnitude of hydraulic conductivity. 2,4-dinitrotoluene removal performance was affected with the inlet flow rates, which decreased from 92 %, 82 %, and 78 % to 42 %, 28 %, and 8 % during 24 PV at the flow rate of 0.5, 1.5, and 4.5 mL min-1, respectively. Moreover, the removal efficiency was enhanced by G-PGSR with activated carbon as an activator. This study expands our understanding and ability of persulfate gel materials for groundwater remediation and provides a certain research basis for practical applications.

A novel thermosensitive persulfate controlled-release hydrogel based on agarose/silica composite for sustained nitrobenzene degradation from groundwater.

The increasing risk of organic contamination of groundwater poses a serious threat to the environment and human health, causing an urgent need to develop long-lasting and adaptable remediation materials. Controlled-release materials (CRMs) are capable of encapsulating oxidants to achieve long-lasting release properties in aquifers and considered to be effective strategies in groundwater remediation. In this study, novel hydrogels (ASGs) with thermosensitive properties were prepared based on agarose and silica to achieve controlled persulfate (PS) release. By adjusting the composition ratio, the gelation time and internal pore structure of the hydrogels were regulated for groundwater application, which in turn affected the PS encapsulated amount and release properties. The hydrogels exhibited significant temperature responsiveness, with 6.8 times faster gelation rates and 2.8 times longer controlled release ability at 10 â„ƒ than at 30 â„ƒ. The ASGs were further combined with zero-valent iron to achieve long-lasting degradation of the typical nitrobenzene compound 2,4-dinitrotoluene (2,4-DNT), and the degradation performance was maintained at 50 % within 14 PV, which was significantly improved compared with that of the PS/ZVI system. This study provided new concepts for the design of controlled-release materials and theoretical support for the remediation of organic contamination.

Efficient utilization of biogenic manganese oxides in bioaugmentation columns for remediation of thallium(I) contaminated groundwater.

Little attention has been paid to the in situ-generated biogenic manganese oxides (BMnOx) for practical implementation in continuous groundwater remediation systems. The enrichment effects of manganese oxidizing bacteria (MOB) in bioaugmentation columns and the in situ-generated BMnOx for continuous thallium(I) (Tl(I)) removal from groundwater were investigated. Results indicated that Pseudomonas Putida MnB1 (strain MnB1) attached on the groundwater sediments (GS) can achieve a maximum of 97.37 % Mn(II) oxidation and generate 29.6 mg/L BMnOx, which was superior than that of traditional quartz sand (QS). The in situ-generated BMnOx in MOB_GS column effectively removed 10-100 µg/L Tl(I) under the interference of high concentrations of Fe(II) and Mn(II) in groundwater. Distinctive microbial enrichment effects occurred in the bioaugmentation columns under the competition of indigenous microbes in groundwater. The release of Mn(II) from the BMnOx inhibited with the decrease in Tl(I) removal efficiency. XAFS analysis revealed Tl(I) was effectively adsorbed by BMnOx and Mn-O octahedra with Tl-O tetrahedral coordination existed in BMnOx. This study provides an in-depth understanding of the in situ-generated BMnOx for the Tl(I) removal and contributes to the application of BMnOx in groundwater remediation.

Efficacy and safety of secondary allogeneic hematopoietic stem cell transplantation in 70 patients with recurrent hematologic malignancies after transplantation / 中华血液学杂志

Objectives: To investigate the role of donor change in the second hematopoietic stem cell transplantation (HSCT2) for hematological relapse of malignant hematology after the first transplantation (HSCT1) . Methods: We retrospectively analyzed patients with relapsed hematological malignancies who received HSCT2 at our single center between Mar 1998 and Dec 2020. A total of 70 patients were enrolled[49 males and 21 females; median age, 31.5 (3-61) yr]. Results: Forty-nine male and 21 female patients were enrolled in the trial. At the time of HSCT2, the median age was 31.5 (3-61) years old. Thirty-one patients were diagnosed with acute myeloid leukemia, 23 patients with ALL, and 16 patients with MDS or other malignant hematology disease. Thirty patients had HSCT2 with donor change, and 40 patients underwent HSCT2 without donor change. The median relapse time after HSCT1 was 245.5 (26-2 905) days. After HSCT2, 70 patients had neutrophil engraftment, and 62 (88.6%) had platelet engraftment. The cumulative incidence of platelet engraftment was (93.1±4.7) % in patients with donor change and (86.0±5.7) % in patients without donor change (P=0.636). The cumulative incidence of CMV infection in patients with and without donor change was (64.0±10.3) % and (37.0±7.8) % (P=0.053), respectively. The cumulative incidence of grade Ⅱ-Ⅳ acute graft versus host disease was (19.4±7.9) % vs (31.3±7.5) %, respectively (P=0.227). The cumulative incidence of TRM 100-day post HSCT2 was (9.2±5.1) % vs (6.7±4.6) % (P=0.648), and the cumulative incidence of chronic graft versus host disease at 1-yr post-HSCT2 was (36.7±11.4) % versus (65.6±9.1) % (P=0.031). With a median follow-up of 767 (271-4 936) days, 38 patients had complete remission (CR), and three patients had persistent disease. The CR rate was 92.7%. The cumulative incidences of overall survival (OS) and disease-free survival (DFS) 2 yr after HSCT2 were 25.8% and 23.7%, respectively. The cumulative incidence of relapse, OS, and DFS was (52.6±11.6) % vs (62.4±11.3) % (P=0.423), (28.3±8.6) % vs (23.8±7.5) % (P=0.643), and (28.3±8.6) % vs (22.3±7.7) % (P=0.787), respectively, in patients with changed donor compared with patients with the original donor. Relapses within 6 months post-HSCT1 and with persistent disease before HSCT2 were risk factors for OS, DFS, and CIR. Disease status before HSCT2 and early relapse (within 6 months post-HSCT1) was an independent risk factor for OS, DFS, and CIR post-HSCT2. Conclusion: Our findings indicate that changing donors did not affect the clinical outcome of HSCT2.

Preparation and properties of the persulfate gel materials and application for the remediation of 2,4-dinitrotoluene contaminated groundwater.

This study aims to develop persulfate new gel sustaining-release material (PGSR) and gelatin-gel sustaining-release material (G-PGSR) that can be injected into aquifers and slowly release S2O82- to groundwater. Compatibility and miscibility of colloidal silica gels and gelatin with S2O82- were tested. Morphologies of the as-prepared PGSR and G-PGSR were observed by scanning electron microscope (SEM) and Fourier transform infrared spectrometer (FT-IR). Release characteristics of PGSR containing variable persulfate concentrations (from 1.25 wt% to 5 wt%), silica sol (from 30 wt% to 40 wt%), and gelatin (from 0.5 wt% to 2.0 wt%) were monitored. Viscosities of PGSR solution increased from 5 to 112 cP with increasing silica sol from 30 wt% to 40 wt% during the first 10 min. Viscosities of PGSR solution in 40 wt% silica sol increased to 346 cP within the 30 min and rapidly increased to 8000 cP within the next 30 min followed by the gelation phase. Gelation rates of the PGSR solution increased with increased persulfate concentrations from 1.25 wt% to 5.0 wt%. The maximum release rates achieved at 5 h in G-PGSR were 1.98 mg of S2O82- per min similar to that in PGSR. The release persulfate concentrations in G-PGSR suggested that gelatin and colloidal silica were both compatible and miscible with S2O82-. Meanwhile, the PGSR exhibits a characteristic two-phase increase in viscosity with increased silica sol concentrations, persulfate concentrations, and gelatin concentrations. Compared with the persulfate only system, the degradation efficiency of 2,4-dinitrotoluene (2,4-DNT) was achieved 91.5 % within 3 h, while 78.6 % and 66.9 % degradation efficiency were shown in PGSR and G-PGSR, respectively. The PGSR and G-PGSR both could create persistent oxidation degradation of 2,4-DNT. Results suggested that colloidal silica and gelatin could be used to create PGSR and G-PGSR for persistent oxidation in groundwater remediation.

Insights into the synergistic removal mechanisms of thallium(I) by biogenic manganese oxides in a wide pH range.

The behavior and mechanism of thallium (Tl) adsorption by biogenic manganese oxides (BMnOx) are poorly understood. In this study, BMnOx was applied for Tl(I) removal from aqueous solution, and the adsorption interactions were systematically revealed for the first time. BMnOx was successfully prepared with high productivity by effectively oxidizing Mn(II) with a manganese oxide bacterium in an optimal Mn(II) concentration range of 4.0-28 mg/L. Compared with other adsorbents, the prepared BMnOx achieved high Tl(I) adsorption capacity over a wide pH range from 3.0 to 9.0 and high humic acid (HA) concentration (40 mg/L) interference. The experimental results were well depicted by pseudo-second-order kinetics and the Langmuir isotherm model, indicating that chemisorption played the dominant role during the adsorption process. The adsorption mechanisms were verified as synergetic interactions of oxidation-precipitation, electrostatic attraction, ion exchange and surface complexation. X-ray photoelectron spectroscopy (XPS) and transmission electron microscopy (TEM) results suggested that 19.46% of the highly toxic Tl(I) was transformed into the much less toxic product Tl2O3 after adsorption onto BMnOx. This study provides theoretical guidance for high-concentration Tl(I) decontamination from groundwater by biogenic manganese oxides.

Microwave-assisted functionalization of PAN fiber by 2-amino-5-mercapto-1,3,4-thiadiazol with high efficacy for improved and selective removal of Hg2+ from water.

Mercury (Hg2+) contamination in water is associated with potential toxicity to human health and ecosystems. Many research studies have been ongoing to develop new materials for the remediation of Hg2+ pollution in water. In this study, a novel thiol- and amino-containing fibrous adsorbent was prepared by grafting 2-amino-5-mercapto-1,3,4-thiadiazol (AMTD) onto PAN fiber through a microwave-assisted method. The synthesized functional fiber was characterized by FTIR, SEM, and elemental analysis. Adsorption tests depicted that for mercury uptake, PANMW-AMTD fiber exhibited enhanced adsorption capacity compared with other fibrous adsorbents and selective adsorption feature under the interference of other metal ions, including Pb2+, Cu2+, Cd2+, and Zn2+. The influence of pH on the adsorption process was investigated and the effect of temperature revealed that the adsorption sorption process was endothermic and the adsorption performance of PANMW-AMTD was elevated with the increase of temperature. Kinetic studies of PANMW-AMTD fiber followed the pseudo-second-order and the adsorption isotherm of Hg2+ was well fitted by Sips and Langmuir equations, given the maximum adsorption amount of 332.9 mg/g. XPS results suggested that a synergetic coordination effect of sulfur and nitrogen in functional fiber with mercury took responsibility for the adsorption mechanism in the uptake process. In addition, the prepared PANMW-AMTD fiber could easily be regenerated with 0.1 M HCl for five times without significant reduction of mercury removal efficiency. Thus, this study will facilitate the research on novel functional material for the removal of mercury from water.

Hydrogeochemical and statistical analysis of high fluoride groundwater in northern China.

Understanding the formation of high fluoride (F-) groundwater in water-scarce northern China is critical for the sustainable development of the region. This study investigates the effects of F- enrichment in groundwater from seven typical regions of northern China, including Datong, Guide, Junggar, Yinchuan, Taiyuan, and Tarim basins and the North China Plain. A literature survey of 534 samples of selected regions showed that 45.13% of groundwater F- exceeded the 1.0 mg/L of Chinese drinking water guideline. Based on the geological background and hydrogeochemical analysis, in Datong and Yinchuan basins and part of the North China Plain, the main types of groundwater are soda water and controlling processes of F- enrichment are salinization, mineral dissolution, and desorption. In Taiyuan and Guide basins with Cl-Na water type, F- enrichment is mainly affected by salinization, cation exchange, and evaporation. The hydrogeochemical characteristics of high F- groundwater in Tarim and Junggar basins reflect the extent of salinization and weathering dissolution of minerals in groundwater. According to PCA, the contribution of salinization and mineral dissolution to F- enrichment is relatively high. Under the alkaline condition, groundwater with high Cl-, HCO3-, and Na+ concentration favors F- enrichment. Based on HCA, index clustering category I explains the influence of pH and buried depth on F- enrichment, and category II explains the effect of different ions. It is concluded that F- enrichment in groundwater is related to hydrogeochemical processes and hydrogeological conditions. The hydrogeochemical and alkaline conditions of groundwater are regulated by mineral dissolution, ion exchange, and evaporation, resulting in different degrees of F- enrichment.

A comparative study on the treatment of 2,4-dinitrotoluene contaminated groundwater in the combined system: efficiencies, intermediates and mechanisms.

In this study, scrap irons (SI)/granular activated carbons (GAC) micro-electrolysis treatment and persulfate-releasing materials (PRM) treatment were employed to construct the combination reduction and oxidation system to treat 2,4-dinitrotoluene (2,4-DNT) contaminated groundwater. The 2,4-DNT treatment efficiencies in the PRM pre-treatment before SI/GAC micro-electrolysis treatment (FM-1 = PRM + SI/GAC) and SI/GAC micro-electrolysis pre-treatment before the PRM treatment (FM-3 = SI/GAC + PRM) were investigated in two separated columns. As control groups, the separated SI and GAC instead of the SI/GAC mixture were used in another two separated columns (FM-2 = PRM + SI + GAC; FM-4 = SI + GAC + PRM). The highest treatment efficiencies of 2,4-DNT in the FM-1 and FM-3 systems reached 79% and 93% during 5 PV, respectively. We found that the filling position of SI, GAC and PRM significantly affected the variations of pH, oxidation-reduction potential, Fe2+ and S2O82- concentrations in the combined systems. These results indicated that the SI/GAC micro-electrolysis pre-treatment of 2,4-DNT before the PRM treatment (FM-3) is more beneficial. The fifteen main intermediates in the combined system were identified by the detection of liquid chromatograph mass spectrometer. Furthermore, the possible treatment pathways of 2.4-DNT were proposed on the basis of identified intermediates. The treatment mechanisms in the FM-1 and FM-3 systems were proposed with the reduction mechanism in the SI/GAC micro-electrolysis system and the oxidation mechanism in the PRM treatment. Therefore, the combination of the reduction pre-treatment with the SI/GAC micro-electrolysis system and the oxidation post-treatment with persulfate can effectively treat the nitroaromatic compounds contaminated groundwater.

Assisting Scalable Diagnosis Automatically via CT Images in the Combat against COVID-19

Introductory paragraphThe pandemic of coronavirus Disease 2019 (COVID-19) caused enormous loss of life globally. 1-3 Case identification is critical. The reference method is using real-time reverse transcription PCR (rRT-PCR) assays, with limitations that may curb its prompt large-scale application. COVID-19 manifests with chest computed tomography (CT) abnormalities, some even before the onset of symptoms. We tested the hypothesis that application of deep learning (DL) to the 3D CT images could help identify COVID-19 infections. Using the data from 920 COVID-19 and 1,073 non-COVID-19 pneumonia patients, we developed a modified DenseNet-264 model, COVIDNet, to classify CT images to either class. When tested on an independent set of 233 COVID-19 and 289 non-COVID-19 patients. COVIDNet achieved an accuracy rate of 94.3% and an area under the curve (AUC) of 0.98. Application of DL to CT images may improve both the efficiency and capacity of case detection and long-term surveillance.

Clinical Observation on Effect of Toujie Quwen Granules in Treatment of COVID-19 / 中国实验方剂学杂志

Objective:To analyze the clinical efficacy of traditional Chinese medicine（TCM） Toujie Quwen granules in the treatment of coronavirs disease-2019（COVID-19） in the early stage, and its effect on relevant inflammatory index expression of COVID-19. Method:A total of 65 COVID-19 cases were diagnosed and divided into 2 groups: the treatment group （n=32） and the control group （n=33）. Before and after treatment，TCM syndrome score，WBC，LYM，LYM%，NEU%，PCT，CRP and D-dimer were compared. Result:After 10 days of treatment，the TCM syndrome score of the treatment group was significantly reduced（P<0.05），while the absolute value of lymphocyte was up-regulated，with statistically significant differences（P<0.05）， according to the inter-group comparison, there were statistically significant differences in the absolute value of LYM and NEU%（P<0.05）. There was no significant difference in WBC count and LYM%. The levels of CRP，PCT and D-dimer in the two groups were reduced after treatment，with statistically significant differences between two groups （P<0.05）. After treatment，the differences of CRP and PCT was statistically significant between both groups（P<0.05），but the difference in D-dimer was not statistically significant. There was no difference in the effect of chest CT examination between the both groups. Conclusion:The clinical syndrome and inflammatory particles of COVID-19 can be alleviated by early and timely use of Toujie Quwen granules.

Research status of polycythemia vera in China / 中国实用内科杂志

Polycythemia vera is a clonal malignant hematopoietic disorder that results from genetic alterations in hematopoietic stem cells, which is characterized by two or three-line blood cells increase, and mainly by erythrocytosis. This article reviews research situation of PV in China, including pathogenesis, clinical features, disease progression and therapeutic options, which helps clinical specialists to carry out precise diagnosis and treatment.

Treatment strategies for myeloproliferative neoplasms in Ruxolitinib era / 中国实用内科杂志

The different types of Ph-negative myeloproliferative neoplasm(MPN) possess the same JAK2V617 F mutation. JAK2 inhibitor, ruxolitinib, is only valid in some of MPN, which indicates JAK2 target is not the only molecular pathway of MPN. Epigenetic genes mutations, including TET2 and ASXL1, are involved in the progression and transformation of MPN. In addition, avoiding thromboembolism and reducing the risk of transformation into acute leukemia(AL) or myelofibrosis(MF) still is the therapeutic goal of polycythemia vera(PV) and essential thrombocytosis(ET). The goal of treatment in primary myelofibrosis(PMF) is to improve the quality of life and prolong the survival of patients. For the patients with PMF, stratification based on the efficacy of ruxolitinib and profound genetic detection is a reasonable supplement to the existing of stratification of clinical risk.

[Study on diagnosis of atypical cerebral cysticercosis].

OBJECTIVE: To analyze the characteristics of the results of serum immunological tests and brain CT image examinations of atypical cerebral cysticercosis patients, so as to provide the reference for improving the diagnosis of the disease. METHODS: Totally 446 suspected cerebral cysticercosis patients were chosen as the study objects, all of them were given experimental treatment with praziquantel, and then the patients with atypical cerebral cysticercosis were diagnosed according to the treatment effect and review results of brain CT or MRI. Meanwhile, all the 446 patients were tested for serum specific IgG and IgG4 antibodies and cysticercus circulating antigen (CAg) by ELISA, McAb ELISA and PEG-ELISA respectively, and the IHA test was also performed. All the patients received the brain CT examinations. The test results were analyzed statistically and the test performances of the methods above-mentioned were calculated. RESULTS: Among the 446 suspected cerebral cysticercosis patients, after the praziquantel treatment, there were 315 patients whose symptoms were alleviated, and they were diagnosed as atypical cerebral cysticercosis. Among the 446 suspected cerebral cysticercosis patients, the positive rates of specific IgG and IgG4 antibodies, and CAg were 15.47%, 15.02%, and 11.21% respectively, and the positive rate of IHA was 28.47% (χ2 = 52.45, P ＜ 0.01). The brain CT examinations showed that there were 79.14% (353/446) of patients with suspected cysticercus foci. The sensitivities of ELISA, McAb-ELISA, PEG-ELISA, IHA test and brain CT examination (suspected cysticercus foci) for the diagnosis of atypical cerebral cysticercosis were 15.36%-96.82%, the specificities were 63.36%-99.24%, the positive predictive values were 86.40%-98.52%, the negative predictive values were 32.83%-98.25%, the positive likelihood ratios were 2.64-27.86, the negative likelihood ratios were 0.05-0.81, and the OR values were 7.16-52.80. The consolidation of the five tests above-mentioned showed the OR value was 108.00, which was 2 times of the OR value of CT examination. CONCLUSIONS: Atypical cerebral cysticercosis is definitely diagnosed mainly by means of evaluating the effect of the diagnostic therapy (anti-cysticercus), and the serum immunological examinations and brain CT examination also have important reference values.

Polyketides and Alkaloids from the Marine-Derived Fungus Dichotomomyces cejpii F31-1 and the Antiviral Activity of Scequinadoline A against Dengue Virus.

In our continuous chemical investigation on the marine-derived fungus Dichotomomyces cejpii F31-1, two new polyketides dichocetides B-C (1, 2), two new alkaloids dichotomocejs E-F (3, 4), and three known fumiquinozalines: scequinadoline A (5), quinadoline A (6), and scequinadoline E (7) were discovered from the culture broth and the mycelium in the culture medium, by the addition of l-tryptophan and l-phenylalanine. Their chemical structures were established by one dimensional (1D), two dimensional (2D) nuclear magnetic resonance (NMR) and high resolution mass spectrometry (HR-MS) data. Among them, scequinadoline A (5) exhibited significant inhibitory activity against dengue virus serotype 2 production by standard plaque assay, equivalent to the positive control andrographlide. Scequinadoline A (5) possesses the potential for further development as a dengue virus inhibitor.

Histogram Analysis of Diffusion Kurtosis Magnetic Resonance Imaging for Diagnosis of Hepatic Fibrosis

OBJECTIVE: To investigate the diagnostic value of diffusion kurtosis imaging (DKI) histogram analysis in hepatic fibrosis staging. MATERIALS AND METHODS: Thirty-six rats were divided into carbon tetrachloride-induced fibrosis groups (6 rats per group for 2, 4, 6, and 8 weeks) and a control group (n = 12). MRI was performed using a 3T scanner. Histograms of DKI were obtained for corrected apparent diffusion (D), kurtosis (K) and apparent diffusion coefficient (ADC). Mean, median, skewness, kurtosis and 25th and 75th percentiles were generated and compared according to the fibrosis stage and inflammatory activity. RESULTS: A total of 35 rats were included, and 12, 5, 5, 6, and 7 rats were diagnosed as F0–F4. The mean, median, 25th and 75th percentiles, kurtosis of D map, median, 25th percentile, skewness of K map, and 75th percentile of ADC map demonstrated significant correlation with fibrosis stage (r = −0.767 to 0.339, p < 0.001 to p = 0.039). The fibrosis score was the independent variable associated with histogram parameters compared with inflammatory activity grade (p < 0.001 to p = 0.041), except the median of K map (p = 0.185). Areas under the receiver operating characteristic curve of D were larger than K and ADC maps in fibrosis staging, although no significant differences existed in pairwise comparisons (p = 0.0512 to p = 0.847). CONCLUSION: Corrected apparent diffusion of DKI histogram analysis provides added value and better diagnostic performance to detect various liver fibrosis stages compared with ADC.

Study on diagnosis of atypical cerebral cysticercosis / 中国血吸虫病防治杂志

To analyze the characteristics of the results of serum immunological tests and brain CT image examinations of atypical cerebral cysticercosis patients, so as to provide the reference for improving the diagnosis of the disease.Totally 446 suspected cerebral cysticercosis patients were chosen as the study objects, all of them were given experimental treatment with praziquantel, and then the patients with atypical cerebral cysticercosis were diagnosed according to the treatment effect and review results of brain CT or MRI. Meanwhile, all the 446 patients were tested for serum specific IgG and IgG4 antibodies and cysticercus circulating antigen (CAg) by ELISA, McAb ELISA and PEG-ELISA respectively, and the IHA test was also performed. All the patients received the brain CT examinations. The test results were analyzed statistically and the test performances of the methods above-mentioned were calculated.Among the 446 suspected cerebral cysticercosis patients, after the praziquantel treatment, there were 315 patients whose symptoms were alleviated, and they were diagnosed as atypical cerebral cysticercosis. Among the 446 suspected cerebral cysticercosis patients, the positive rates of specific IgG and IgG4 antibodies, and CAg were 15.47%, 15.02%, and 11.21% respectively, and the positive rate of IHA was 28.47% (χ2 = 52.45, P ＜ 0.01). The brain CT examinations showed that there were 79.14% (353/446) of patients with suspected cysticercus foci. The sensitivities of ELISA, McAb-ELISA, PEG-ELISA, IHA test and brain CT examination (suspected cysticercus foci) for the diagnosis of atypical cerebral cysticercosis were 15.36%–96.82%, the specificities were 63.36%–99.24%, the positive predictive values were 86.40%–98.52%, the negative predictive values were 32.83%–98.25%, the positive likelihood ratios were 2.64–27.86, the negative likelihood ratios were 0.05–0.81, and the OR values were 7.16–52.80. The consolidation of the five tests above-mentioned showed the OR value was 108.00, which was 2 times of the OR value of CT examination.Atypical cerebral cysticercosis is definitely diagnosed mainly by means of evaluating the effect of the diagnostic therapy (anti-cysticercus), and the serum immunological examinations and brain CT examination also have important reference values.

Sex-Related Differences in Short- and Long-Term Outcome among Young and Middle-Aged Patients for ST-Segment Elevation Myocardial Infarction Underwent Percutaneous Coronary Intervention / 中华医学杂志(英文版)

<p><b>Background</b>Females with ST-segment elevation myocardial infarction (STEMI) have higher in-hospital and short-term mortality rates compared with males in China, suggesting that a sex disparity exists. The age of onset of STEMI is ahead of time and tends to be younger. However, there are relatively little data on the significance of sex on prognosis for long-term outcomes for adult patients with STEMI after percutaneous coronary intervention (PCI) in China. This study sought to analyze the sex differences in 30-day, 1-year, and long-term net adverse clinical events (NACEs) in Chinese adult patients with STEMI after PCI.</p><p><b>Methods</b>This study retrospectively analyzed 1920 consecutive STEMI patients (age ≤60 years) treated with PCI from January 01, 2006, to December 31, 2012. A propensity score analysis between males and females was performed to adjust for differences in baseline characteristics and comorbidities. The primary endpoint was the incidence of 3-year NACE. Survival curves were constructed with Kaplan-Meier estimates and compared by log-rank tests between the two groups. Multivariate analysis was performed using a Cox proportional hazards model for 3-year NACE.</p><p><b>Results</b>Compared with males, females had higher risk profiles associated with old age, longer prehospital delay at the onset of STEMI, hypertension, diabetes mellitus, and chronic kidney disease, and a higher Killip class (≥3), with more multivessel diseases (P < 0.05). The female group had a higher levels of low-density lipoprotein (2.72 [2.27, 3.29] vs. 2.53 [2.12, 3.00], P < 0.001), high-density lipoprotein (1.43 [1.23, 1.71] vs. 1.36 [1.11, 1.63], P = 0.003), total cholesterol (4.98 ± 1.10 vs. 4.70 ± 1.15, t = -3.508, P < 0.001), and estimated glomerular filtration rate (103.12 ± 22.22 vs. 87.55 ± 18.03, t = -11.834, P < 0.001) than the male group. In the propensity-matched analysis, being female was associated with a higher risk for 3-year NACE and major adverse cardiac or cerebral events compared with males. In the multivariate model, female gender (hazard ratio [HR]: 2.557, 95% confidence interval [CI]: 1.415-4.620, P = 0.002), hypertension (HR: 2.017, 95% CI: 1.138-3.576, P = 0.016), and family history of coronary heart disease (HR: 2.256, 95% CI: 1.115-4.566, P = 0.024) were independent risk factors for NACE. The number of stents (HR: 0.625, 95% CI: 0.437-0.894, P = 0.010) was independent protective factors of NACE.</p><p><b>Conclusions</b>Females with STEMI undergoing PCI have a significantly higher risk for 3-year NACE compared with males in this population. Sex differences appear to be a risk factor and present diagnostic challenges for clinicians.</p>