Usefulness of ultrasound in the management of aortic dissection.

Aortic dissection is an acute large vessel disease characterized by sudden onset, rapid disease progression and high mortality. Color doppler ultrasound analyzed the morphological and hemodynamic status of aortic branches before and after aortic dissection surgery, including carotid, subclavian, renal, celiac, superior mesenteric and iliac arteries. Transthoracic echocardiography, vascular ultrasound, transesophageal echocardiography, intravascular ultrasound and contrast-enhanced ultrasonography are complementary to aortic multi-slice spiral computed tomography angiography for diagnosis, treatment and prognostic evaluation.

Noninvasive carotid ultrasound for predicting vulnerable plaques of the coronary artery based on optical coherence tomography images.

Background: The risk factors for coronary and carotid plaque development are consistent. Coronary plaque rupture is a major cause of adverse cardiovascular events. Ultrasound can evaluate vulnerable carotid plaques and provide information for predicting vulnerable coronary plaques identified by optical coherence tomography (OCT). This study aimed to investigate the predictive role of non-invasive carotid ultrasound in OCT diagnosis of atherosclerotic vulnerable plaque. Methods: A total of 70 participants, including 35 patients with and 35 without vulnerable coronary plaque, were enrolled in this case-control study at Beijing Anzhen Hospital from 2016 to 2021. The data of 70 patients with suspected coronary heart disease who had undergone OCT examination during percutaneous coronary intervention (PCI) surgery and completed carotid ultrasound examination within 3 days before PCI were analyzed retrospectively. According to the OCT diagnostic criteria for vulnerable plaques, the patients were divided into the vulnerable-plaque group and the stable-plaque group. Univariate and binary logistic regression analyses assessed risk factors for vulnerable coronary plaque. Receiver operating characteristic (ROC) curve analysis was used to determine the predictive power of carotid plaque features. Results: The univariate analysis demonstrated that the differences in high-sensitivity C-reactive protein levels and carotid plaque characteristics (irregular fibrous cap, heterogeneous plaque, hypoechoic plaque, plaque calcification, and a plaque thickness of greater than 3 mm) between the two groups were statistically significant. The logistic multivariate regression analysis revealed that an irregular fibrous cap of a carotid plaque [odds ratio (OR) =4.819; 95% confidence interval (CI): 1.106-22.867; P=0.048] and a hypoechoic plaque (OR =9.632; 95% CI: 2.138-43.384; P<0.05) were independent risk factors for predicting vulnerable plaques of the coronary artery. Conclusions: Noninvasive carotid ultrasound is feasible and clinically valuable for predicting vulnerable and asymptomatic coronary plaques defined by OCT. With this method, adverse events can be diagnosed and treated in advance.

Assessment of the re-entry tear index as a prognostic indicator for renal perfusion improvement after thoracic endovascular aortic repair in patients with acute and subacute Stanford type b aortic dissection with renal artery involvement.

Background: Aortic dissection is the most common acute aortic syndrome, and renal artery is the most common involved artery. The size and location of the re-entry tear directly affect the blood flow enhancement of the false lumen branch artery after surgery. In this study, the morphology and hemodynamics of the re-entry tear were comprehensively analyzed, and the location and size of the re-entry tear were quantitatively evaluated to calculate the re-entry tear index (RTI). This study aimed to assess the predictive capability of a comprehensive quantitative RTI for improvement in renal perfusion following thoracic endovascular aortic repair (TEVAR) in cases of acute and subacute Stanford type B aortic dissection with renal artery involvement. Methods: In this prospective cohort study, 137 patients diagnosed with acute or subacute type B aortic dissection with concomitant renal artery involvement who underwent TEVAR at Anzhen Hospital in Beijing from October 2017 to November 2021 were enrolled. Renal blood flow was estimated quantitatively with ultrasound. Based on the ultrasound findings of renal artery flow, the patients were classified into two groups: group A [postoperative volume flow (VolFlow) reduced compared to preoperative VolFlow] and group B (postoperative VolFlow increased compared to preoperative VolFlow). All re-entry tears present in the aortic trunk according to reconstructed computed tomography angiography (CTA) obtained preoperatively were included in the analysis. The general information of patients, whether the involved renal artery arose partially or wholly from the false lumen, the proximal diameter and length of the covered stent, the diameter of primary entry tear, the RTI, etc. were analyzed. Univariate and multivariate logistic regression analyses were executed to assess the risk factors associated with increased renal arterial blood flow subsequent to TEVAR. Additionally, receiver operating characteristic (ROC) curve analysis was used to ascertain the optimal cutoff value and predictive efficacy of the RTI. Results: A total of 137 patients, comprising of 32 with acute and 105 with subacute type B aortic dissection accompanied by renal artery involvement, underwent TEVAR. Among these patients, 44 (32.1%) were assigned to group A and 93 (67.9%) to group B. Renal blood flow exhibited an increase in 67.9% of the patients after TEVAR. The results of multivariate analysis indicated that the RTI is an independent risk factor for postoperative renal perfusion improvement [odds ratio =17.66; 95% confidence interval (CI): 2.13-78.55; P=0.020]. The optimal cutoff value for RTI, determined to be 0.033, demonstrated the ability to identify renal perfusion improvement in patients without hypertension with a sensitivity of 53.7% and a specificity of 68.9%. In patients with concomitant hypertension, RTI exhibited a sensitivity of 96.6% and a specificity of 60.0%, with an area under the ROC curve (AUC) of 0.792 (95% CI: 0.643-0.941; P=0.021) for identifying renal perfusion improvement. Conclusions: RTI demonstrated a favorable predictive value for improving renal malperfusion following TEVAR in cases of aortic dissection with renal artery involvement.

Discovery and identification of a novel Ligon lintless-like mutant (Lix) similar to the Ligon lintless (Li1) in allotetraploid cotton.

Mutants are a powerful resource for studying gene structure, function, and evolution. In this present study, a novel Ligon lintless-like mutant (Lix), that has short fibers and deformed leaves and stems, was isolated from the progeny of transgenic cottons. The Lix mutant is similar in morphology to the Ligon lintless (Li1) mutant. Genetic analysis and molecular mapping were performed for the Lix and Li1 mutants. These two mutants are monogenic dominant mutants with distorted growth of vegetative and reproductive structures. Seedlings of the dominant homozygote Li 1 Li 1 genotype are lethal, while LixLix plants are viable but show no reproductive growth. Molecular tagging showed that the Lix gene is located on Chr. 04 in a 30.9-cM region spanned by NAU8376 and NAU3469. In a previous study, the Li 1 gene was mapped to Chr. 22, and Chr. 04 and Chr. 22 are homoelogous chromosomes in tetraploid cotton. So, we propose that Lix and Li1 mutants have similar mutated morphology, and Lix is mapped to a homoelogous chromosome carrying Li 1 . The identification and genetic mapping of Lix/Li 1 genes using mutants provides a foundation for isolating these genes. In turn, this will permit studies to elucidate the functional and evolutionary roles for these genes in cotton growth and development.

Clinical study of carotid superb microvascular imaging in evaluating the activity of Takayasu's arteritis.

Objective: The goal of this study is to use superb microvascular imaging (SMI) to observe neovascularization in the carotid vessel wall to identify potential Takayasu's arteritis (TAK) inflammation markers. Methods: Bilateral carotid arteries from 96 patients with TAK were imaged by a Doppler ultrasound and SMI. The one-way analysis of variance (ANOVA) was used to document significant differences between the activity and inactivity stages of TAK and the factors closely related to its activity in the binary logistics regression equation. Clinical and laboratory data included age, gender, duration of disease, treatment history, NIH score, erythrocyte sedimentation rate (ESR), and high-sensitivity C-reactive protein. Imaging data included the arterial wall thickness, degree of lesion, SMI grade, and arterial aneurysm formation. Results: There were 45 patients in the active TAK stage and 51 in the inactive stage. The one-way ANOVA showed significant differences in SMI (p = 0.001) and ESR (p = 0.022) between the active and inactive groups. The binary logistics regression analysis showed that SMI was an independent risk factor for TAK activity (B = -1.505, S.E = 0.340, Wald = 19.528, OR = 0.222 95%, CI = 0.114-0.433, p < 0.01). Using SMI G1 or G2 as the cutoff values for the diagnosis of active TAK, the positive predictive value, sensitivity, and specificity were 60 and 86%, 84% and 56%, and 54% and 92%, respectively. Conclusion: The SMI grade is a potential marker of disease activity in patients with TAK.

Smaller amygdala subnuclei volume in schizophrenia patients with violent behaviors.

To investigate the association between the volume of amygdala subnuclei and violent behaviors in patients with schizophrenia (SCZ). In the present study, we recruited 40 SCZ patients with violent behaviors (VS), 26 SCZ patients without violent behaviors (NVS), and 28 matched healthy controls (HC) who completed T1-weighted magnetic resonance imaging. Both the total amygdala and amygdala subnuclei volumes were estimated with FreeSurfer. When comparing the SCZ patients with HC, SCZ patients had a smaller volume of the left basal nucleus (P < 0.05, uncorrected). Further, the VS patients had a smaller volume of the left amygdala central nucleus than the NVS group (P < 0.05, Bonferroni corrected). Our study suggests that a smaller volume of the left amygdala basal nucleus may be a biomarker for SCZ and that a smaller volume of the left central nucleus may be relevant to violence risk in patients with schizophrenia.

Diagnostic value of serum human epididymis protein 4 (HE4) in ovarian carcinoma: a systematic review and meta-analysis.

OBJECTIVE: Human epididymis protein 4 (HE4), a precursor of human epididymis protein, has been recently identified as a new promising serum biomarker for ovarian carcinoma. We performed a systematic review of studies that investigated the use of HE4 in the diagnosis of ovarian cancer in patients with pelvic or gynecological masses. We also evaluated the diagnostic performance of HE4 for differentiating between patients with benign gynecological disease and those with ovarian cancer. METHODS: We searched PubMed database (1990-2011) to collect articles in English that evaluated the diagnostic value of HE4 in patients with gynecological or pelvic masses. Two reviewers independently assessed the methodological quality of each study using the quality assessment of diagnostic accuracy studies tool. The data were analyzed using Meta-Disc1.4 software. Meta-analysis of the reported sensitivity and specificity of each study and summary receiver operating characteristic (SROC) curve were performed. RESULTS: A total of 9 studies involving 1807 women were included. When the control group was composed of healthy women, the pooled sensitivity and specificity for HE4 in diagnosing ovarian cancer were 83% (95% confidence interval [CI], 77%-88%) and 90% (95% CI, 87%-92%), respectively. The area under the SROC curve was 0.9271. When the control group was composed of women with benign disease, the pooled sensitivity and specificity for HE4 were 74% (95% CI, 69%-78%) and 90% (95% CI, 87%-92%). The area under the SROC curve was 0.8853. CONCLUSION: The current analysis indicated that HE4 may be a valuable marker in the diagnosis of ovarian carcinoma. Serum HE4 detection is not only a useful preoperative test for predicting the benign or malignant nature of pelvic masses but has a potential to be used as an initial step in ovarian cancer screening strategy.

Effect of Saccharomyces cerevisiae boulardii on sows' farrowing duration and reproductive performance, and weanling piglets' performance and IgG concentration.

We studied the effects of Saccharomyces cerevisiae boulardii CNCM I-1079 (LSB) supplemented to lactating sows on reproductive traits and farrowing duration and to piglets from day 7 of life on post-weaning performance and IgG concentration. Ninety-six Landrace × Yorkshire sows started the trial 5 days before the expected farrowing date. Sows were distributed into 2 groups according to parity number and backfat thickness: control (CON: regular lactation diet) and LSB (CON + LSB at 2 × 109 colony forming units [CFU]/kg of feed). Seven days after birth, litters were randomly selected from each group and supplemented creep feed with or without LSB at 2 × 109 CFU/kg. At weaning, piglets from CON sows were shifted to a commercial farm and allocated to 14 pens in groups of 25 piglets/pen according to the creep feed supplemented during lactation. Piglets followed a 3-phase feeding program: creep, pre-starter and starter, with or without LSB at 2 × 109 CFU/kg LSB in creep and pre-starter, and 1 × 109 CFU/kg LSB in starter. The piglets were vaccinated against classical swine fever on days 41 and 72 of life. One day before each vaccination and at the end of the trial, blood samples were collected from 15 randomly selected piglets per treatment and assessed for total IgG. Supplemented sows with non-supplemented litters displayed the lowest backfat thickness loss during lactation (p < 0.05). The LSB supplementation shortened farrowing duration (p < 0.05) and increased feed intake (p < 0.05) during the first week of lactation. The LSB-fed piglets were heavier at the end of creep (p < 0.05), pre-starter (p < 0.05), and the trial (p < 0.05); grew faster during creep (p < 0.05), starter (p < 0.05), and overall (p < 0.05); and displayed an improved feed conversion ratio during creep (p < 0.05). Total IgG content was higher at days 40 (p < 0.05) and 71 (p < 0.05) in LSB-fed piglets. We conclude that supplementing sows with Saccharomyces cerevisiae boulardii CNCM I-1079 from late gestation until weaning shortens farrowing duration, increases feed intake, and minimizes backfat losses during lactation. When supplemented to piglet diet, post-weaning performance is improved. This improvement observed could be linked to a better immune status, as suggested by the higher IgG.

Integrative Pan-Cancer Analysis of KIF15 Reveals Its Diagnosis and Prognosis Value in Nasopharyngeal Carcinoma.

Background: KIF15 plays a vital role in many biological processes and has been reported to influence the occurrence and development of certain human cancers. However, there are few systematic evaluations on the role of KIF15 in human cancers, and the role of KIF15 in the diagnosis and prognosis of nasopharyngeal carcinoma (NPC) also remains unexplored. Therefore, this study aimed to conduct a pan-cancer analysis of KIF15 and evaluate its diagnostic and prognostic potential in NPC. Methods: The expression pattern, prognostic value, molecular function, tumor mutation burden, microsatellite instability, and immune cell infiltration of KIF15 were examined based on public databases. Next, the diagnostic value of KIF15 in NPC was analyzed using the Gene Expression Omnibus (GEO) database and immunohistochemistry (IHC). Kaplan-Meier curves, Cox regression analyses, and nomograms were used to evaluate the effects of KIF15 expression on NPC prognosis. Finally, the effect of KIF15 on NPC was explored by in vitro experiments. Results: The expression of KIF15 was significantly upregulated in 20 out of 33 cancer types compared to adjacent normal tissue. Kyoto Encyclopedia of Genes and Genomes enrichment (KEGG) analysis showed that KIF15 could participate in several cancer-related pathways. The increased expression level of KIF15 was correlated with worse clinical outcomes in many types of human cancers. Additionally, KIF15 expression was related to cancer infiltration of immune cells, tumor mutation burden, and microsatellite instability. In the analysis of NPC, KIF15 was significantly upregulated based on the GEO database and immunohistochemistry. A high expression of KIF15 was negatively associated with the prognosis of patients with NPC. A nomogram model integrating clinical characteristics and KIF15 expression was established, and it showed good predictive ability with an area under the curve value of 0.73. KIF15 knockdown significantly inhibited NPC cell proliferation and migration. Conclusions: Our findings revealed the important and functional role of KIF15 as an oncogene in pan-cancer. Moreover, high expression of KIF15 was found in NPC tissues, and was correlated with poor prognosis in NPC. KIF15 may serve as a potential therapeutic target in NPC treatment.

APOE E4 is associated with hyperlipidemia and obesity in elderly schizophrenic patients.

Obesity is a critical issue in patients with schizophrenia, which is considered to be brought about by both environmental and genetic factors. Apolipoprotein E (APOE) gene polymorphisms might be involved in the pathogenesis of schizophrenia, however, the effect of APOE gene polymorphism on obesity has never been investigated in Chinese aging with schizophrenia. This cross-sectional study was to investigate the effect of obesity on cognitive and psychiatric symptoms in elderly participants with schizophrenia. At the same time, we also discussed the inner link between APOE E4 and obesity. 301 elderly participants with schizophrenia and 156 normal controls were included in the study. Their cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), psychiatric symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS), and APOE gene polymorphism was determined by polymerase chain reaction (PCR). The prevalence of obesity in elderly schizophrenic patients and healthy controls accounted for 15.9% (48/301) and 10.3% (16/156), respectively, with no statistically significant difference. By using stepwise linear regression analysis, we found that elevated fasting blood glucose, hypertension, and hyperlipidemia were risk factors for obesity in elderly schizophrenic patients. Although there was no direct correlation between APOE E4 and obesity in patients with schizophrenia, it was significantly correlated with hyperlipemia(r = - 0.154, p = 0.008), suggesting that APOE E4 may induce obesity in elderly patients with schizophrenia through hyperlipemia, However, the above conclusions do not apply to the normal elderly. What's more, we did not find a link between obesity and cognitive function or mental symptoms for both patients with schizophrenia and normal controls. APOE E4 is associated with hyperlipidemia in elderly schizophrenic patients, which may be a risk factor for obesity, however, the above conclusion does not apply to the normal elderly.

Volumetric Abnormalities in Violent Schizophrenia Patients on the General Psychiatric Ward.

BACKGROUND: In recent years, neuroimaging has been used increasingly to explore the biological underpinnings of violence carried out by schizophrenia patients (SPs). Studies have focused mostly on patients with a history of carrying out severe physical assaults, or comorbid with substance abuse/personality disorder (SA/PD). As a result, participants were unrepresentative and the interpretation of brain-structure changes was confusing. Here, we concentrated on SPs on a general psychiatric ward with a history of relatively lower violence, and individuals comorbid with SA or PD were excluded. We expected to identify the characteristics of brain morphometry in this population, and to explore whether the morphometric changes were universal. METHODS: Forty-eight violent schizophrenia patients (VSPs), twenty-seven non-VSPs (nVSPs) and 28 nonviolent healthy controls (HCs) were investigated. Voxel-based morphometry was used to evaluate the gray matter volume (GMV) of all study participants. Whole-brain analyses were used to reveal group effects and differences between any two groups. Correlation analyses were undertaken between significant brain regions and behavioral measurements in the VSP group. RESULTS: Patients showed a significantly smaller GMV in widespread frontal, temporal, and limbic regions compared with HCs. No region was found in which the two patient groups had significantly larger volumes compared with that in HCs. A significant decrease in the GMV of the right fusiform gyrus was found in the VSP group compared with that in the nVSP group (p = 0.004), where the GMV of this region had a negative correlation with the Physical Aggression [subscale of the Modified Overt Aggression Scale (MOAS)] or Hostility score. The VSP group showed a trend of GMV decrease in the left middle temporal cortex compared with that in the nVSP group (p = 0.077). Negative correlation was also found between the GMV of left inferior temporal gyrus/left Superior frontal gyrus, medial and the Hostility score. CONCLUSIONS: Our results provide initial evidence demonstrating the generalizability of GMV abnormalities in SPs engaged in varying levels of violence, even when SA or PD have not been implicated. GMV reduction was correlated with only the Physical Aggression subscale score of the MOAS, suggesting that this change in brain morphology may be dependent upon different types of violent actions.

Effects of Omega-3 in the treatment of violent schizophrenia patients.

OBJECTIVE: This study was designed to explore the relationship in between the daily consumption of fish oil (360mg DHA+540mg EPA), and reduction of symptoms and violent behavior among patients with schizophrenia. METHOD: Fifty inpatients meeting ICD-10 criteria for schizophrenia and scoring more than four of Modified Overt Aggression Scale (MOAS) with antipsychotics treatment were randomly assigned to receive either fish oil (N=28) or a placebo (N=22) in a twelve week, double-blind supplementation trial. Assessments were performed at baseline and at weeks 4, 8 and 12. RESULTS: The PANSS and CGI scores decreased at the week of 4, 8 and 12, but no differences were found between the two groups. MOAS scores declined significantly at weeks 4, 8 and 12. At week 12, MOAS scores of the fish oil group declined significantly than the placebo group (t=-2.40, P<0.05). CONCLUSIONS: violent schizophrenia patients treated with fish oil (360mg DHA+540mg EPA) demonstrated a decrease in violence, but improvement in positive and negative symptoms was no greater than patients treated with the placebo after twelve weeks.

Real-time tissue elastography for the detection of vulnerable carotid plaques in patients undergoing endarterectomy: a pilot study.

We examined the utility of ultrasonic real-time tissue elastography (RTE) and conventional B-mode ultrasound (US) in the detection of vulnerable carotid atherosclerotic plaques. This prospective study comprised 19 patients scheduled for carotid endarterectomy. Results obtained from pre-operative RTE and B-mode US and post-operative pathology were compared. RTE encoded low, average and high deformability as blue, green and red, respectively. Tissue hardness was scored on a 5-point scale, and relative strains were calculated. The relative strain was 1.12 ± 0.14 for fibrous plaques (n = 4), 0.28 ± 0.07 for atherosclerotic plaques (n = 5), 0.47 ± 0.31 for intraplaque hemorrhage/thrombosis (n = 5) and 0.98 ± 1.04 for complex plaques (n = 5). The sensitivity, specificity and accuracy of detection of vulnerable plaques were 25%, 100% and 84.2% for B-mode US, 50%, 100% and 89.4% for RTE and 62.5%, 100% and 94.7% for the combination. Ultrasonic RTE is a potential candidate for a non-invasive and effective approach to identify vulnerable atherosclerotic plaques in the carotid artery.