MRI quantitative assessment of the effects of low-carbohydrate therapy on Hashimoto's thyroiditis.

Objective: Hashimoto's thyroiditis is an inflammatory disease, and research suggests that a low-carbohydrate diet may have potential anti-inflammatory effects. This study aims to utilize Dixon-T2-weighted imaging (WI) sequence for a semi-quantitative assessment of the impact of a low-carbohydrate diet on the degree of thyroid inflammation in patients with Hashimoto's thyroiditis. Methods: Forty patients with Hashimoto's thyroiditis were recruited for this study and randomly divided into two groups: one with a normal diet and the other with a low-carbohydrate diet. Antibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) were measured for all participants. Additionally, thyroid water content was semi-quantitatively measured using Dixon-T2WI. The same tests and measurements were repeated for all participants after 6 months. Results: After 6 months of a low-carbohydrate diet, patients with Hashimoto's thyroiditis showed a significant reduction in thyroid water content (94.84 ± 1.57% vs 93.07 ± 2.05%, P < 0.05). Concurrently, a decrease was observed in levels of TPOAb and TgAb (TPOAb: 211.30 (92.63-614.62) vs 89.45 (15.9-215.67); TgAb: 17.05 (1.47-81.64) vs 4.1 (0.51-19.42), P < 0.05). In contrast, there were no significant differences in thyroid water content or TPOAb and TgAb levels for patients with Hashimoto's thyroiditis following a normal diet after 6 months (P < 0.05). Conclusion: Dixon-T2WI can quantitatively assess the degree of thyroid inflammation in patients with Hashimoto's thyroiditis. Following a low-carbohydrate diet intervention, there is a significant reduction in thyroid water content and a decrease in levels of TPOAb and TgAb. These results suggest that a low-carbohydrate diet may help alleviate inflammation in patients with Hashimoto's thyroiditis.

Prospects and challenges for the application of salty and saltiness-enhancing peptides in low-sodium meat products.

A long-term high-sodium diet has been reported to increase the incidence of cardiovascular diseases and other diseases, including osteoporosis, gastric cancer, stomach cancer, and kidney stones. Meat products contain high NaCl content and contribute to approximately 20% of the total sodium intake, so reducing its sodium content has always been the critical focus of industries and researchers. Salty and saltiness-enhancing peptides (SSEP) are a potential salt substitute that exhibits a salt taste or saltiness-enhancing activity. The partial replacement of NaCl by SSEP in low-sodium meat products has been a technological challenge. This review discussed the salt taste transduction mechanism of SSEP. The current studies about preparing SSEP based on different protein sources were summarized. Further, the effects of SSEP combined with other chloride salts, such as KCl and CaCl2, on the sensory properties of meat products were summarized. Finally, the challenges associated with applying the peptide to low-sodium meat products were discussed, focusing on the efficient preparation method and the effect of meat product processing methods and matrices on the efficacy of SSEP.

Primary vaginal signet ring cell carcinoma.

Primary vaginal cancer is rare, accounting for only 2% of all gynecological malignant tumors. Primary vaginal cell carcinoma is mainly squamous cell carcinoma, accounting for about 90%, and adenocarcinoma only accounts for 8-10%. Primary signet ring cell carcinoma of vagina is rare and has not been reported in the literature. This paper reports a case of signet ring cell carcinoma in vagina.

A diagnostic scoring model of ENKTCL in the nose-Waldeyer's ring based on logistic regression: Differential diagnosis from DLBCL.

Objective: To establish a logistic regression model based on CT and MRI imaging features and Epstein-Barr (EB) virus nucleic acid to develop a diagnostic score model to differentiate extranodal NK/T nasal type (ENKTCL) from diffuse large B cell lymphoma (DLBCL). Methods: This study population was obtained from two independent hospitals. A total of 89 patients with ENKTCL (n = 36) or DLBCL (n = 53) from January 2013 to May 2021 were analyzed retrospectively as the training cohort, and 61 patients (ENKTCL=27; DLBCL=34) from Jun 2021 to Dec 2022 were enrolled as the validation cohort. All patients underwent CT/MR enhanced examination and EB virus nucleic acid test within 2 weeks before surgery. Clinical features, imaging features and EB virus nucleic acid results were analyzed. Univariate analyses and multivariate logistic regression analyses were performed to identify independent predictors of ENKTCL and establish a predictive model. Independent predictors were weighted with scores based on regression coefficients. A receiver operating characteristic (ROC) curve was created to determine the diagnostic ability of the predictive model and score model. Results: We searched for significant clinical characteristics, imaging characteristics and EB virus nucleic acid and constructed the scoring system via multivariate logistic regression and converted regression coefficients to weighted scores. The independent predictors for ENKTCL diagnosis in multivariate logistic regression analysis, including site of disease (nose), edge of lesion (blurred), T2WI (high signal), gyrus like changes, EB virus nucleic acid (positive), and the weighted score of regression coefficient was 2, 3, 4, 3, 4 points. The ROC curves, AUCs and calibration tests were carried out to evaluate the scoring models in both the training cohort and the validation cohort. The AUC of the scoring model in the training cohort were 0.925 (95% CI, 0.906-0.990) and the cutoff point was 5 points. In the validation cohort, the AUC was 0.959 (95% CI, 0.915-1.000) and the cutoff value was 6 points. Four score ranges were as follows: 0-6 points for very low probability of ENKTCL, 7-9 points for low probability; 10-11 points for middle probability; 12-16 points for very high probability. Conclusion: The diagnostic score model of ENKTCL based on Logistic regression model which combined with imaging features and EB virus nucleic acid. The scoring system was convenient, practical and could significantly improve the diagnostic accuracy of ENKTCL and the differential diagnosis of ENKTCL from DLBCL.

Comparative evaluation of an innovative deflectable percutaneous kyphoplasty versus conventional bilateral percutaneous kyphoplasty for osteoporotic vertebral compression fractures: a prospective, randomized and controlled trial.

BACKGROUND CONTEXT: Osteoporotic vertebral compression fractures (OVCFs) can be treated with percutaneous kyphoplasty (PKP). In contrast to conventional PKP, the novel deflectable percutaneous kyphoplasty (DPKP), is a unilateral transpedicular approach procedure allowing a similar bilateral puncture effect, which owes to the deflectable curved bone expander creating a transcentral line cavity to achieve uniform distribution of cement and biomechanical balance while reducing operative time and radiation exposure. PURPOSE: The purpose of this study was to prospectively compare and evaluate an innovative surgical procedure, DPKP, versus conventional bilateral percutaneous kyphoplasty (BPKP). STUDY DESIGN: This is a prospective randomized controlled trial (RCT). SAMPLE: The totality of the participants (n=90) suffering from OVCFs between May 2019 and October 2020, were randomized by SAS 9.3 to generate a block randomization sequence, which was utilized to randomize the groups in a 1:1 ratio, assigned to the DPKP group (n=45) and the BPKP group (n=45) to undergo accordingly procedures. OUTCOME MEASURES: The primary outcome was the total operative time. The secondary outcomes included: comparative assessment of visual analog scale (VAS) scores, Oswestry disability index (ODI), kyphosis angle (KA), anterior border height (AH) of the injured vertebra, frequency of intraoperative X-ray fluoroscopy, the injection volume, distribution pattern and leakage rate of bone cement. METHODS: All subjects underwent assessment by at least one senior orthopedist and radiologist for the VAS scores, ODI, KA, AH of the injured vertebra, total operative time, the injection volume, distribution pattern, leakage rate of bone cement at preoperative and 24 hours, 6 months, and 1 year postoperatively. Inclusion criteria for subjects in this prospective study were as follows: (1) 60 < age < 80 years old; (2) preoperative spinal X-ray, CT, and MRI confirmed as single-segment, fresh thoracolumbar OVCFs (T5-L5, 15% < collapse < 80%); MRI shows low signal on T1-WI and high signal on T2-WI, especially with STIR high signal characterized by vertebral edema; (3) painful OVCFs refractory to medical treatment, 2 weeks < Symptom duration < 3 months;(4) With significant physical signs of local tenderness; (5) T score of bone mineral density (BMD) < -2.5. RESULTS: The total operative time was significantly reduced in the DPKP group (43.3±19.58 minutes, 95% CI: 37.23-49.37) compared to the BPKP group (55.16±11.56 minutes, 95% CI: 51.78-58.54) (p<.001). Compared to the BPKP group (frequency of intraoperative X-ray fluoroscopy: 43.42±8.64, 95% CI: 40.90-45.95; the volume of bone cement injected: 5.56±0.85 mL, 95% CI: 5.31-5.81), the frequency of intraoperative X-ray fluoroscopy (30.05±17.41, 95% CI: 24.66-35.45) and volume of bone cement injected (5.08±0.97 mL, 95% CI: 4.78-5.38) significantly reduced in the DPKP group compared to the (p<.001). In addition, compared to the preoperative period, both groups showed significant improvements in the postoperative VAS scores, ODI, KA, and AH (p<.001), but there was no statistical difference between the DPKP and BPKP groups (p>.05) at any time-point. Interestingly, although without statistical differences, a tendency towards a lower rate of bone cement leakage was observed in the DPKP group. CONCLUSION: Our study results indicate that the innovative DPKP is as safe and effective as BPKP in relieving pain, improving the patient's quality of life, and reconstructing vertebral body height. Particularly, DPKP did reduce operative time and radiation exposure compared to BPKP, which correlated with unilateral and bilateral exposure procedures. Moreover, the final cement distribution was less predictable in DPKP, and further studies are warranted to clarify the advantages of DPKP versus conventional unilateral percutaneous kyphoplasty (UPKP) and BPKP.

MRI Extraprostatic Extension Grade: Accuracy and Clinical Incremental Value in the Assessment of Extraprostatic Cancer.

Objective: The purpose was to compare the accuracy of extraprostatic extension (EPE) grade on MRI predicting EPE with Partin tables, Memorial Sloan Kettering Cancer Center nomogram (MSKCCn), and combined models and to analyze the clinical incremental value of EPE grade. Materials and Methods: 105 prostate cancer patients confirmed by pathology after radical prostatectomy in our hospital from 2017 to 2021 were selected. The clinical stage, PSA, Gleason score, number of positive biopsy cores, and percentage of positive biopsy cores were recorded. Evaluate EPE grade according to EPE grade criteria, and calculate the probability of predicting EPE with Partin tables and MSKCCn. EPE grade is combined with Partin tables and MSKCCn to construct EPE grade+Partin tables and EPE grade+MSKCCn models. Calculate the area under the curve (AUC), sensitivity, and specificity of EPE grade, Partin tables, MSKCCn, EPE grade+Partin tables, and EPE grade+MSKCCn and compare their diagnostic efficacy. The clinical decision curve was used to analyze the clinical net income of each prediction scheme. Results: The AUC of EPE grade was 0.79, Partin tables was 0.50, MSKCCn was 0.78, the EPE grade+Partin table model was 0.79, and the EPE grade+MSKCCn model was 0.83. After EPE grade was combined with Partin tables and MSKCCn, the diagnostic efficiency of clinical model was significantly improved (P < 0.05). There was no significant difference in the diagnostic efficacy of the combined model compared with the single EPE grade (P > 0.05). The calibration curve of the combined model shows that it has a good calibration degree for EPE. In the analysis of the decision curve, the net income of the EPE grade is higher than that of Partin tables and MSKCCn and is equal to the EPE grade+Partin tables and is slightly lower than that of EPE grade+MSKCCn. The clinical net income of the combined model is obviously higher than that of individual clinical models. Conclusion: The accuracy of EPE classification in predicting prostate cancer EPE is high, and combined with the clinical model, it can significantly improve the diagnostic efficiency of the clinical model and increase the clinical benefit.

Childhood Maltreatment, Stressful Life Events, Cognitive Emotion Regulation Strategies, and Non-suicidal Self-Injury in Adolescents and Young Adults With First-Episode Depressive Disorder: Direct and Indirect Pathways.

Introduction: Childhood maltreatment (CM), stressful life events (SLE), and cognitive emotion regulation strategies (CERS) have been considered crucial in the development of non-suicidal self-injury (NSSI) and major depressive disorder (MDD), but the pathways of this association are not clear. We aim to identify direct effects of CM and SLE on NSSI and depression severity and its indirect effects via CERS in adolescents and young adults with a diagnosis of MDD. Methods: A total of 114 patients (aged 14-24 years) with first episode MDD were included and further divided into the NSSI group (n = 56) and non-NSSI group (n = 58) according to the DSM-5 criteria. Diagnostic interviews and self-report measures were conducted to assess CM, SLE, CERS, and diagnose NSSI. Severity of depressive symptoms was measured using the Hamilton Rating Scale (HAMD). The structural equation model was used to assess the pathways. Results: MDD patients with NSSI had more frequent family history of mental illness, more experience of CM and SLE, more serious depression, less use of adaptive CERS, and more use of maladaptive CERS. In the final structural equation model (χ2 = 4.82, df = 6, p = 0.57, CFI = 1.0, TLI = 1.10, and RMSEA = 0), the experience of CM and SLE showed a significant indirect effect on NSSI through adaptive CERS. CM and SLE only had direct effects on depression severity. Conclusions: NSSI are prevalent in adolescents and young adults with MDD and highly intertwined with CM, SLE, and CERS. Adaptive CERS, not maladaptive CERS may be a possible mechanism relating CM and SLE to NSSI in MDD patients.

Cervical spondylotic myelopathy with syringomyelia presenting as hip Charcot neuroarthropathy: A case report and review of literature.

BACKGROUND: Charcot neuroarthropathy (CN) is a systemic disease characterized by progressive bone loss and destruction, which is usually closely related to diabetes, HIV, etc. However, CN caused by syringomyelia accounts for only 5% of CN cases; the shoulder and elbow are most often involved, and the hip joint is rarely affected. As a rare factor, cervical spondylotic myelopathy (CSM) can be associated with syringomyelia, which is scarcely reported in the literature. Here, we present the first case report to date of CN of the hip caused by syringomyelia secondary to CSM. CASE SUMMARY: We describe a 76-year-old male patient who was diagnosed with CSM due to neck pain and weakness of limbs 16 years ago. Four years ago, he noticed recurrent swelling of the right hip with pain and was diagnosed with degenerative arthritis. Recently, however, his symptoms gradually worsened, and because of progressive pain, destabilization and weakness of the right hip, he was admitted to our hospital. Through systematic physical, radiographic and laboratory examinations, we finally reached a diagnosis: CN of the right hip associated with syringomyelia secondary to CSM. After comprehensive evaluation of the patient's condition, we performed right total hip arthroplasty. During the follow-up, the patient felt well clinically and could walk independently with a knee brace. CONCLUSION: We suggest a possible etiological association between CSM and syringomyelia, which may reflect a potential pathogenesis of CN. We encourage clinicians to actively carry out a detailed medical history and comprehensive physical and imaging examinations in patients with joint lesions, especially chronic shoulder neck pain, to rule out the possibility of this association, which plays a crucial role in the early diagnosis of CN. Arthroplasty may no longer be an absolute contraindication to surgical treatment of CN. Reasonable selection of the surgical strategy can markedly improve the clinical symptoms and quality of life of patients.

Multimodality magnetic resonance imaging for the diagnosis of high-flow priapism following a straddle injury: A case report.

RATIONALE: Priapism is a common urologic emergency, but high-flow penile priapism (HFP) caused by trauma is very rare. Therefore, HFP diagnosis and treatment are still not standardized. PATIENT CONCERNS: A 29-year-old man was admitted to the urology department of our hospital on August 01, 2019, due to "persistent penile erection caused by a straddle injury." DIAGNOSIS: On July 17, 2019, the patient underwent Doppler ultrasonography, which indicated swollen corpus cavernosum. INTERVENTIONS: The patient took over-the-counter anti-inflammatory drugs but the erectile state of the penis remained unchanged. A second perineal injury resulted in hospital admission. Multimodality magnetic resonance imaging (MRI) scan showed nodular abnormal signals at the right corpus cavernosum root. Subsequently, selective arterial interventional angiography confirmed the MRI findings. Spring coils were then inserted for embolization, and the pseudoaneurysm, fistula, and priapism disappeared. OUTCOMES: Two months after surgery, sexual stimuli could normally cause penile erection, with normal hardness. The patient's sexual life returned to normal 3 months after surgery. CONCLUSION: Multimodality MRI is very effective in detecting high blood flow priapism. Its application would improve the clinical management of this ailment.

Tungsten disulfide nanosheets-based colorimetric assay for glucose sensing.

We have developed a glucose oxidase (GOx)-mediated strategy for glucose detection, which is based on the intrinsic peroxidase-like activity of WS2 as a catalyst for the 3,3',5,5'-tetramethylbenzidine­hydrogen peroxide (TMB-H2O2) reaction. The colorimetric assay involves two parts: generation of H2O2 from the oxidation of glucose catalyzed by GOx, and WS2 nanosheets that catalyze the reaction between TMB and H2O2. In this colorimetric assay, the enhancement of colorimetric signals depends directly on the increased H2O2 concentration, which, in turn, relies on the glucose concentration. The results show that the concentrations of the glucose were directly proportional to absorbance of the TMB solutions over a range of 1 nM-500 µM with a limit of detection of 0.1445 nM. In addition, this new colorimetric assay has been utilized for glucose detection in human serum with a satisfactory result.

Gold nanoparticle-engineered electrochemical aptamer biosensor for ultrasensitive detection of thrombin.

In order to obtain a lower detection limit in electrochemical detection, the choice of signal amplification strategy is of great importance. In this work, we describe an electrochemical sandwich aptasensor based on a signal amplification system involving two thrombin (TB) aptamers (TBA1 and TBA2), gold nanoparticles (AuNPs) as aptamer carriers, and [Ru(NH3)6]3+ for signal conversion. In the presence of the target thrombin, TBA1 and TBA2 specifically bind to TB, and the TBA1-TB-TBA2 complexes cause the formation of a sandwich structure, meaning more [Ru(NH3)6]3+ can be adsorbed on the negatively charged phosphate backbone of the aptamers, resulting in an increase in the differential pulse voltammetry (DPV) current. Under optimal conditions, the aptasensor exhibited a linear range of 1 fM to 6 pM and a limit of detection of 0.1429 fM (S/N = 3) for TB. The proposed aptasensor displayed an excellent selectivity and reproducibility. Importantly, the aptasensor was capable of detecting TB in serum samples successfully.

Mechanical thrombectomy using a Solitaire stent retriever in the treatment of pediatric acute ischemic stroke.

OBJECTIVE Mechanical thrombectomy using a Solitaire stent retriever has been widely applied as a safe and effective method in adult acute ischemic stroke (AIS). However, due to the lack of data, the safety and effectiveness of mechanical thrombectomy using a Solitaire stent in pediatric AIS has not yet been verified. The purpose of this study was to explore the safety and effectiveness of mechanical thrombectomy using a Solitaire stent retriever for pediatric AIS. METHODS Between January 2012 and December 2017, 7 cases of pediatric AIS were treated via mechanical thrombectomy using a Solitaire stent retriever. The clinical practice, imaging, and follow-up results were reviewed, and the data were summarized and analyzed. RESULTS The ages of the 7 patients ranged from 7 to 14 years with an average age of 11.1 years. The preoperative National Institutes of Health Stroke Scale (NIHSS) scores ranged from 9 to 22 with an average of 15.4 points. A Solitaire stent retriever was used in all patients, averaging 1.7 applications of thrombectomy and combined balloon dilation in 2 cases. Grade 3 on the modified Thrombolysis In Cerebral Infarction scale of recanalization was achieved in 5 cases and grade 2b in 2 cases. Six patients improved and 1 patient died after thrombectomy. The average NIHSS score of the 6 cases was 3.67 at discharge. The average modified Rankin Scale score was 1 at the 3-month follow-up. Subarachnoid hemorrhage after thrombectomy occurred in 1 case and that patient died 3 days postoperatively. CONCLUSIONS This study shows that mechanical thrombectomy using a Solitaire stent retriever has a high recanalization rate and excellent clinical prognosis in pediatric AIS. The safety of mechanical thrombectomy in pediatric AIS requires more clinical trials for confirmation. ABBREVIATIONS ACA = anterior cerebral artery; AIS = acute ischemic stroke; CTA = CT angiography; ICA = internal carotid artery; MCA = middle cerebral artery; mRS = modified Rankin Scale; mTICI = modified Thrombolysis In Cerebral Infarction; NIHSS = National Institutes of Health Stroke Scale; rt-PA = recombinant tissue plasminogen activator.

Mineralogical characterisation and magnetic separation of vanadium-bearing converter slag.

The recycling of metallic iron is commonly the first step to fully use the converter slag, which is the biggest waste discharge in the steelmaking process. This study presents a proposed improved process of separating metallic iron from vanadium-bearing converter slag more efficiently. The mineralogical and morphological characteristics of the converter slag were first investigated, and the results showed that most of the iron was incorporated in the spinel and olivine. Grinding, sieving and magnetic separation were combined to recover metallic iron from the converter slag, and yielded approximately 41.5% of iron in which the iron content was as high as 85%, and the non-magnetic concentrate contains 8.56% vanadium with a yield of 95.3% and 8.63% titanium with a yield of 85.3%. The magnetic part can be used as the raw materials in the steel making process, whereas the non-magnetic part can be used as the raw materials for the further extraction of vanadium.

Recovery of tailings from the vanadium extraction process by carbothermic reduction method: Thermodynamic, experimental and hazardous potential assessment.

A cleaner process is tremendously required to deal with the vanadium tailings, which may cause serious environmental problem due to the high content of water soluble hazardous elements such as V and Cr. This problem can be possibly solved by proposed high temperature reduction-magnetic separation process, in which, V, Cr and Fe can be recycled as ferroalloy. The thermodynamic calculation results reveal that a higher temperature (>1127.8 °C) promotes the reduction of Fe, V and Cr, and improves the recovery rates of V and Cr in liquid iron. The reduction behavior of vanadium tailings was investigated using XRD, TG/DSC, SEM, EDS and ICP-OES techniques. The EDS results show that a small portion of V was remained in the slag phase when roasted at 1300 °C, while nearly all of V and Cr can concentrate in ferroalloy at 1400 °C. Approximatly 90% of V and 95% of Cr recovery in magnetic fraction can be obtained for the magnetic separation step. A small portion of V and Cr is remained in the non-magnetic final tailings, however, the hazardous potential assessments results indicate that such kind of tailings can safely use as secondary materials or stockpiled as an end-waste.

Multistage utilization process for the gradient-recovery of V, Fe, and Ti from vanadium-bearing converter slag.

A multistage utilization process was developed to fully recover valuable metals from vanadium-bearing converter slag and reduce the content of hazardous elements, such as vanadium and chromium, in the tailings. A mechanical activation-calcification roasting-acid leaching process was firstly employed to recover vanadium. This process generated two products, viz. a V-bearing solution accounting for ∼95% V recovery and vanadium tailings with Fe and Ti contents of 31.85% and 8.94%, respectively. Then, based on theoretical calculations and physical measurements, a coal-based direct reduction-magnetic separation process and a hydrochloric acid leaching process were employed for the stepwise recovery of iron and titanium, respectively, from the vanadium tailings. Iron was recovered in the form of high chromium-vanadium iron with 81.53% Fe, 1.31% Cr, and 2.04% V, and titanium was recovered as titanium dioxide pigment with 85-90% yield. Such a comprehensive and clean utilization of vanadium-bearing converter slag has great potential for practical application.

[CT findings of tuberous sclerosis associated with hepatic and renal angiomyolipomas].

OBJECTIVE: To summarize the clinical and computed tomographic(CT) findings of tuberous sclerosis(TS) associated with hepatic and renal angiomyolipomas. METHOD: We retrospectively analyzed the clinical and CT findings of 7 TS patients with hepatic and renal angiomyolipomas. RESULTS: Brain CT showed calcified nodules and/or the uncalcified nodule in the lateral ventricle subependymal in 7 patients. Abdominal CT showed bilateral renal angiomyolipomas in 7 cases and hepatic angiomyolipomas in 2 cases. Chest CT showed lymphangioleiomyomatosis in one case. CONCLUSIONS: TS associated with merger hepatic and/or renal angiomyolipomas have typical CT findings. Liver angiomyolipomas shows certain correlation with bilateral renal angiomyolipomas.