Whole-Transcriptome Sequence Analysis of Verbena bonariensis in Response to Drought Stress.

Drought is an important abiotic factor that threatens the growth and development of plants. Verbena bonariensis is a widely used landscape plant with a very high ornamental value. We found that Verbena has drought tolerance in production practice, so in order to delve into its mechanism of drought resistance and screen out its drought-resistance genes, we used the RNA-Seq platform to perform a de novo transcriptome assembly to analyze Verbena transcription response to drought stress. By high-throughput sequencing with Illumina Hiseq Xten, a total of 44.59 Gb clean data was obtained from T01 (control group) and T02 (drought experiment group). After assembly, 111,313 unigenes were obtained, and 53,757 of them were annotated by compared databases. In this study, 4829 differentially expressed genes were obtained, of which 4165 were annotated. We performed GO (Gene Ontology) and KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway enrichment analyses, and explored a lot of differently expressed genes related to plant energy production, hormone synthesis, cell signal transduction, and metabolism to understand the stress response of Verbena in drought stress. In addition, we also found that a series of TFs related to drought-resistance of Verbena and provide excellent genetic resources for improving the drought tolerance of crops.

Dynamically Cross-Linked Double-Network Hydrogels with Matched Mechanical Properties and Ideal Biocompatibility for Artificial Blood Vessels.

Vessel transplantation is currently considered the "gold standard" treatment for cardiovascular disease. However, ideal artificial vascular grafts should possess good biocompatibility and mechanical strength that match those of native autologous vascular tissue to promote in vivo tissue regeneration. In this study, a series of dynamic cross-linking double-network hydrogels and the resultant hydrogel tubes were prepared. The hydrogels (named PCO), composed of rigid poly(vinyl alcohol) (PVA), flexible carboxymethyl chitosan (CMCS), and a cross-linker of aldehyde-based ß-cyclodextrin (OCD), were formed in a double-network structure with multiple dynamical cross-linking including dynamic imine bonds, hydrogen bonds, and microcrystalline regions. The PCO hydrogels exhibited superior mechanical strength, good network stability, and fatigue resistance. Additionally, it demonstrated excellent cell and blood compatibility. The results showed that the introduction of CMCS/OCD led to a significant increase in the proliferation rate of endothelial cells seeded on the surface of the hydrogel. The hemolysis rate in the test was lower than 0.3%, and both protein adsorption and platelet adhesion were reduced, indicating an excellent anticoagulant function. The plasma recalcification time test results showed that endogenous coagulation was alleviated to some extent. When formed into blood vessels and incubated with blood, no thrombus formation was observed, and there was minimal red blood cell aggregation. Therefore, this novel hydrogel tube, with excellent mechanical properties, exhibits antiadhesive characteristics toward blood cells and proteins, as well as antithrombotic properties, making it hold tremendous potential for applications in the biomedical and engineering fields.

[Pathological changes in rats with acute Dysosma versipellis poisoning].

OBJECTIVE: To observe the pathological changes of major organs in rats with acute Dysosma versipellis poisoning and investigate the toxic mechanism and the injuries of target tissues and organs. METHODS: Forty Sprague-Dawley (SD) rats were randomly divided into three experimental groups, which were given the gavage with 0.5, 1.0 and 2.0 LDo doses of Dysosma versipellis decoction, and one control group, which was given the gavage with 1.0 LD0 dose of normal saline. The rats were sacrificed 14 days after Dysosma versipellis poisoning and samples including brain, heart, liver, lung, and kidney were taken. After pathological process, the pathological changes of the major organs and tissues were observed by light microscope and electron microscope. The experimental data were statistical analyzed by chi2 test. RESULTS: The observations of light microscopy: loose cytoplasm of neurons with loss of most Nissl bodies; swelling of myocardial cells with disappearance of intercalated disk and striations; hepatocellular edema with ballooning degeneration; and swelling epithelial cells of renal proximal convoluted tubule with red light coloring protein-like substances in the tube. The observations of electron microscopy: the structures of cell membrane and nuclear membrane of neurons were destroyed; cytoplasm of neurons, obvious edema; and most organelles, destroyed and disappeared. The mortalities of rats after acute poisoning of the four groups increased with doses (P < 0.05). CONCLUSION: Acute Dysosma versipellis poisoning can cause multi-organ pathological changes. There is a positive correlation between the toxic effect and the dosage. The target tissues and organs are brain (neurons), heart, liver and kidney.

RSU-Net: U-net based on residual and self-attention mechanism in the segmentation of cardiac magnetic resonance images.

BACKGROUND: Automated segmentation techniques for cardiac magnetic resonance imaging (MRI) are beneficial for evaluating cardiac functional parameters in clinical diagnosis. However, due to the characteristics of unclear image boundaries and anisotropic resolution anisotropy produced by cardiac magnetic resonance imaging technology, most of the existing methods still have the problems of intra-class uncertainty and inter-class uncertainty. However, due to the irregularity of the anatomical shape of the heart and the inhomogeneity of tissue density, the boundaries of its anatomical structures become uncertain and discontinuous. Therefore, fast and accurate segmentation of cardiac tissue remains a challenging problem in medical image processing. METHODOLOGY: We collected cardiac MRI data from 195 patients as training set and 35patients from different medical centers as external validation set. Our research proposed a U-net network architecture with residual connections and a self-attentive mechanism (Residual Self-Attention U-net, RSU-Net). The network relies on the classic U-net network, adopts the U-shaped symmetric architecture of the encoding and decoding mode, improves the convolution module in the network, introduces skip connections, and improves the network's capacity for feature extraction. Then for solving locality defects of ordinary convolutional networks. To achieve a global receptive field, a self-attention mechanism is introduced at the bottom of the model. The loss function employs a combination of Cross Entropy Loss and Dice Loss to jointly guide network training, resulting in more stable network training. RESULTS: In our study, we employ the Hausdorff distance (HD) and the Dice similarity coefficient (DSC) as metrics for assessing segmentation outcomes. Comparsion was made with the segmentation frameworks of other papers, and the comparison results prove that our RSU-Net network performs better and can make accurate segmentation of the heart. New ideas for scientific research. CONCLUSION: Our proposed RSU-Net network combines the advantages of residual connections and self-attention. This paper uses the residual links to facilitate the training of the network. In this paper, a self-attention mechanism is introduced, and a bottom self-attention block (BSA Block) is used to aggregate global information. Self-attention aggregates global information, and has achieved good segmentation results on the cardiac segmentation dataset. It facilitates the diagnosis of cardiovascular patients in the future.

Traditional Chinese Manual Therapy (Tuina) reshape the function of default mode network in patients with lumbar disc herniation.

Purpose: Investigating the changes of regional homogeneity (ReHo) values and both static and dynamic functional connectivity (FC) before and after Traditional Chinese Manual Therapy (Tuina) in patients with lumbar disk herniation (LDH) through resting-state functional magnetic resonance imaging (RS-fMRI). Based on this, we observe the effect of Tuina on the above abnormal changes. Methods: Patients with LDH (n = 27) and healthy controls (HCs) (n = 28) were recruited. The functional magnetic resonance imaging (fMRI) scanning was performed two times in LDH patients, before Tuina (time point 1, LDH-pre) and after the sixth Tuina (time point 2, LDH-pos). And for one time in HCs which received no intervention. The ReHo values were compared between LDH-pre and HCs. The significant clusters detected by ReHo analysis were selected as seeds to calculate static functional connectivity (sFC). We also applied the sliding-window to perform dynamic functional connectivity (dFC). To evaluate the Tuina effect, the mean ReHo and FC values (both static and dynamic) were extracted from significant clusters and compared between LDH and HCs. Results: In comparison to HCs, LDH patients displayed decreased ReHo in the left orbital part middle frontal gyrus (LO-MFG). For sFC analysis, no significant difference was found. However, we found decreased dFC variance between LO-MFG and the left Fusiform, and increased dFC variance in the left orbital inferior frontal gyrus and left precuneus. Both ReHo and dFC values revealed after Tuina, the brain activities in LDH patients were similar to HCs. Conclusion: The present study characterized the altered patterns of regional homogeneity in spontaneous brain activity and those of functional connectivity in patients with LDH. Tuina can reshape the function of the default mode network (DMN) in LDH patients, which may contribute to the analgesic effect of Tuina in LDH patients.

Infliximab trough level combined with inflammatory biomarkers predict long-term endoscopic outcomes in Crohn's disease under infliximab therapy.

BACKGROUND: Infliximab trough level (ITL) severely affects therapeutic outcomes of Crohn's disease (CD) patients under infliximab (IFX). Recently, frontier research has focused on identifying ITL based on different therapeutic targets. Although previous studies have elaborated clinical value of ITL monitoring on short-term outcomes in CD patients during therapy, studies contraposing the predictive value of ITL on long-term endoscopic outcomes in CD patients are still scarce domestically and overseas. AIM: To explore the predictive value of ITL in combination with inflammatory biomarkers on long-term endoscopic outcomes in CD with clinical remission during IFX maintenance therapy. METHODS: CD patients with endoscopic remission under long-term IFX maintenance therapy in the First Affiliated Hospital of Zhejiang Chinese Medicine University from January 2012 to December 2020 were collected. ITL and inflammatory biomarkers were continuously monitored during the therapy. The Step I study was conducted from weeks 14 to 54 of IFX treatment. The Step II study was conducted from weeks 54 to 108 of IFX treatment. Endoscopic outcomes were defined as endoscopic activity (Crohn's disease endoscopic index of severity score > 2 points or Rutgeerts score > i1) and endoscopic remission (Crohn's disease endoscopic index of severity score ≤ 2 points or Rutgeerts ≤ i1). Endoscopic relapse free survival was defined as endoscopic remission at the beginning of the study stage and maintaining endoscopic remission during the study stage. RESULTS: At week 14, low ITL [odds ratio (OR) = 0.666, 95% confidence interval (CI): 0.514-0.862, P < 0.01] and high fecal calprotectin (FCP) level (OR = 1.002, 95%CI: 1.001-1.004, P < 0.01) increased the risk of endoscopic activity at week 54. At week 54, low ITL (OR = 0.466, 95%CI: 0.247-0.877, P < 0.01) and high C-reactive protein (CRP) level (OR = 1.590, 95%CI: 1.007-2.510, P < 0.01) increased the risk of endoscopic activity at week 108. At week 14, ITL ≤ 5.60 µg/mL [area under the curve (AUC) = 0.83, 95%CI: 0.73-0.90, P < 0.001] and FCP > 238 µg/g (AUC = 0.82, 95%CI: 0.72-0.89, P < 0.001) moderately predicted endoscopic activity at week 54. ITL ≤ 5.60 µg/mL in combination with FCP > 238 µg/g indicated 82.0% possibility of endoscopic activity. At week 54, ITL ≤ 2.10 µg/mL (AUC = 0.85, 95%CI: 0.72-0.93, P < 0.001) and CRP > 3.00 mg/L (AUC = 0.73, 95%CI: 0.60-0.84, P = 0.012) moderately predicted moderate endoscopic activity at week 108. ITL ≤ 2.10 µg/mL in combination with CRP > 3.00 mg/L indicated 100.0% possibility of endoscopic activity. From weeks 14 to 54 of IFX treatment, patients with ITL > 5.60 µg/mL had higher rate of endoscopic relapse free survival than those with ITL ≤ 5.60 µg/mL (95.83% vs 46.67%). From weeks 54 to 108 of IFX treatment, patients with ITL > 2.10 µg/mL had higher rate of endoscopic survival free relapsed rate than those with ITL ≤ 2.10 µg/mL (92.68% vs 30.77%). CONCLUSION: Combination of ITL, CRP, and FCP contribute to long-term endoscopic prognosis monitoring. During IFX maintenance treatment, low ITL, high CRP level, and high FCP level were independent risk factors of CD patients with clinical remission in adverse endoscopy outcomes within 1-year follow-up.

A spinal manipulative therapy altered brain activity in patients with lumbar disc herniation: A resting-state functional magnetic resonance imaging study.

Purpose: Lumbar disc herniation (LDH) is one of the leading causes of low-back pain and results in a series of clinical symptoms, including pain, reflex loss, and muscle weakness. Spinal manipulative therapy (SMT) can relieve pain and promote internal and external stabilization of the lumbar spine. In this study, we investigated whether the brain alterations of LDH patients with SMT were frequency-dependent based on the calculation of Amplitude of Low-Frequency Fluctuations (ALFF) and fractional ALFF (fALFF). Further, we established a cohort of LDH patients to evaluate the contribution of SMT treatments to brain functional reorganization. Methods: A total of 55 participants, including 27 LDH patients and 28 health controls (HCs), were collected. All LDH patients underwent two fMRI scans (before SMT and after the sixth SMT session). To represent LDH-related brain oscillatory activities, we calculated the ALFF and fALFF in the conventional band (0.01-0.08 Hz), the slow-4 band (0.027-0.073 Hz), and the slow-5 band (0.01-0.027 Hz). Moreover, we extracted ALFF and fALFF values in clusters with significant differences to evaluate the SMT effect. Results: Compared with HCs, the LDH patients before SMT (LDH-pre) exhibited increased fALFF in right lingual gyri in the conventional band, and showed increased fALFF in left Cerebelum_Crus1 in the slow-4 band. We further examined the abnormal brain activities changes before and after the SMT intervention. The ALFF and fALFF values of LDH-pre group were higher than those of the HCs and LDH-pos groups. After SMT, the increased ALFF and fALFF values were suppressed for patients in conventional band and slow-4 band. Conclusion: The present study characterized the altered regional patterns in spontaneous neural activity in patients with LDH. Meanwhile, SMT is an effective treatment of LDH, and we supposed that it might have been involved in modulating dysfunctional brain regions which are important for the processing of pain. The findings of the current study may provide new insights to understand pathological mechanism of LDH.

A software program for automated compressive vertebral fracture detection on elderly women's lateral chest radiograph: Ofeye 1.0.

Background: Because osteoporotic vertebral fracture (OVF) on chest radiographs is commonly missed in radiological reports, we aimed to develop a software program which offers automated detection of compressive vertebral fracture (CVF) on lateral chest radiographs, and which emphasizes CVF detection specificity with a low false positivity rate. Methods: For model training, we retrieved 3,991 spine radiograph cases and 1,979 chest radiograph cases from 16 sources, with among them in total 1,404 cases had OVF. For model testing, we retrieved 542 chest radiograph cases and 162 spine radiograph cases from four independent clinics, with among them 215 cases had OVF. All cases were female subjects, and except for 31 training data cases which were spine trauma cases, all the remaining cases were post-menopausal women. Image data included DICOM (Digital Imaging and Communications in Medicine) format, hard film scanned PNG (Portable Network Graphics) format, DICOM exported PNG format, and PACS (Picture Archiving and Communication System) downloaded resolution reduced DICOM format. OVF classification included: minimal and mild grades with <20% or ≥20-25% vertebral height loss respectively, moderate grade with ≥25-40% vertebral height loss, severe grade with ≥40%-2/3 vertebral height loss, and collapsed grade with ≥2/3 vertebral height loss. The CVF detection base model was mainly composed of convolution layers that include convolution kernels of different sizes, pooling layers, up-sampling layers, feature merging layers, and residual modules. When the model loss function could not be further decreased with additional training, the model was considered to be optimal and termed 'base-model 1.0'. A user-friendly interface was also developed, with the synthesized software termed 'Ofeye 1.0'. Results: Counting cases and with minimal and mild OVFs included, base-model 1.0 demonstrated a specificity of 97.1%, a sensitivity of 86%, and an accuracy of 93.9% for the 704 testing cases. In total, 33 OVFs in 30 cases had a false negative reading, which constituted a false negative rate of 14.0% (30/215) by counting all OVF cases. Eighteen OVFs in 15 cases had OVFs of ≥ moderate grades missed, which constituted a false negative rate of 7.0% (15/215, i.e., sensitivity 93%) if only counting cases with ≥ moderate grade OVFs missed. False positive reading was recorded in 13 vertebrae in 13 cases (one vertebra in each case), which constituted a false positivity rate of 2.7% (13/489). These vertebrae with false positivity labeling could be readily differentiated from a true OVF by a human reader. The software Ofeye 1.0 allows 'batch processing', for example, 100 radiographs can be processed in a single operation. This software can be integrated into hospital PACS, or installed in a standalone personal computer. Conclusions: A user-friendly software program was developed for CVF detection on elderly women's lateral chest radiographs. It has an overall low false positivity rate, and for moderate and severe CVFs an acceptably low false negativity rate. The integration of this software into radiological practice is expected to improve osteoporosis management for elderly women.

Spontaneous pneumomediastinum in an elderly COVID-19 patient: A case report.

BACKGROUND: Spontaneous pneumomediastinum (SPM) is more common in young adults, usually caused by external factors like trauma. It causes symptoms such as chest pain or dyspnea, but it is rare to see elderly patients who develop SPM. Here we report the case of an elderly patient diagnosed with coronavirus disease 2019 (COVID-19) who neither got mechanical ventilation nor had chest trauma but were found to develop SPM for unknown reason. CASE SUMMARY: A 62-year-old man complained of a 14-d history of fever accompanied by dry cough, shortness of breath, wheezing, myalgia, nausea, and vomiting. Real-time fluorescence polymerase chain reaction confirmed the diagnosis of COVID-19. The patient was treated with supplementary oxygen by nasal cannula and gamma globulin. Other symptomatic treatments included antibacterial and antiviral treatments. On day 4 of hospitalization, he reported sudden onset of dyspnea. On day 6, he was somnolent. On day 12, the patient reported worsening right-sided chest pain which eventually progressed to bilateral chest pain. He was diagnosed with SPM, with no clear trigger found. Conservative treatment was administrated. During follow-up, the pneumomediastinum had resolved and the patient recovered without other complications. CONCLUSION: We presume that aging lung changes and bronchopulmonary infection play an important part in the onset of SPM in COVID-19, but severe acute respiratory syndrome may represent a separate pathophysiologic mechanism for pneumomediastinum. Although the incidence of SPM in elderly patients is low, clinicians should be alert to the possibility of SPM in those infected with severe acute respiratory syndrome coronavirus 2 for life-threatening complications such as cardiorespiratory arrest may occur.

Application evaluation of DCE-MRI combined with quantitative analysis of DWI for the diagnosis of prostate cancer.

The present study aimed to investigate the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) combined with quantitative analysis of diffusion weighted imaging (DWI) for the diagnosis of prostate cancer (PCa). A total of 81 patients with prostatic diseases, including PCa (n=44) and benign prostatic hyperplasia (BPH, n=37), were imaged with T1 weighted imaging (T1WI), T2 weighted imaging (T2WI), DWI and DCE-MRI. The blood vessel permeability parameters volume transfer rate constant (Ktrans), back flow rate constant (Kep), extravascular extracellular space volume fraction (Ve), plasma volume fraction (Vp) and apparent diffusion coefficient (ADC) were measured, and compared between the two groups. The efficiency of these tools for the diagnosis of PCa was analyzed by receiver operating characteristic curve analysis. The efficiency of ADC combined with blood vessel permeability parameters in the diagnosis of PCa was analyzed by logistic regression. The correlation between these parameters and the Gleason score was evaluated by Spearman correlation analysis in the PCa group. The results demonstrated that, compared with the BPH group, Ktrans, Kep, Ve and Vp were higher, and ADC was lower in the PCa group (P<0.05). The combination of Kep and ADC offered the highest diagnosis efficiency [area under the curve (AUC=0.939)]. However, the combination of three parameters did not significantly improve the diagnostic efficiency. A subtle improvement in diagnostic efficiency was observed when four parameters (Ktrans + Kep + Ve + ADC) were combined (AUC=0.940), which was significantly higher than with one parameter. The ADC value of the PCa group was negatively correlated with the primary Gleason pattern, secondary Gleason pattern and the total Gleason score in PCa (r=-0.665, -0.456 and -0.714, respectively; P<0.001). The Vp in the PCa group was slightly negatively correlated with the primary Gleason pattern of PCa (r=-0.385; P<0.05); however, no significant correlation was found with secondary Gleason pattern and the total Gleason score. The present study revealed that the combination of DCE-MRI quantitative analysis and DWI was efficient for PCa diagnosis. This may be because DCE-MRI and DWI can noninvasively detect water motility in tumor tissues and alterations in permeability during tumor neovascularization. The present study demonstrated that Kep and ADC values may be used as predictive parameters for PCa diagnosis, which may help differentiate benign from malignant prostate lesions.

Primary Castleman's disease in the liver: A case report and literature review.

Castleman's disease (CD) is a lymphoproliferative abnormality, also referred to as giant lymph node hyperplasia or follicular lymphoid hyperplasia. The occurrence of CD in the liver is rare. Radiological diagnosis of hepatic CD by computed tomography (CT) and magnetic resonance imaging (MRI) remains difficult. On imaging, hepatic CD is often expressed as a single, well-defined soft tissue lesion, with rare cystic degeneration and focal necrosis. The CD lesions appear as hypervascular with abundant cell proliferation on CT and MRI. Polymorphic calcification is commonly identified in the lesion. However, these findings are non-specific for a definitive radiological diagnosis. We herein present a case of hepatic CD and review its pathological and imaging characteristics. In particular, a strip-like area was observed extending from the nodule, which may be helpful for the diagnosis of CD in the liver.

Brain changes detected by functional magnetic resonance imaging and spectroscopy in patients with Crohn's disease.

Crohn's disease (CD) is a chronic, non-specific granulomatous inflammatory disorder that commonly affects the small intestine and is a phenotype of inflammatory bowel disease (IBD). CD is prone to relapse, and its incidence displays a persistent increase in developing countries. However, the pathogenesis of CD is poorly understood, with some studies emphasizing the link between CD and the intestinal microbiota. Specifically, studies point to the brain-gut-enteric microbiota axis as a key player in the occurrence and development of CD. Furthermore, investigations have shown white-matter lesions and neurologic deficits in patients with IBD. Based on these findings, brain activity changes in CD patients have been detected by blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI). BOLD-fMRI functions by detecting a local increase in relative blood oxygenation that results from neurotransmitter activity and thus reflects local neuronal firing rates. Therefore, biochemical concentrations of neurotransmitters or metabolites may change in corresponding brain regions of CD patients. To further study this phenomenon, brain changes of CD patients can be detected non-invasively, effectively and accurately by BOLD-fMRI combined with magnetic resonance spectroscopy (MRS). This approach can further shed light on the mechanisms of the occurrence and development of neurological CD. Overall, this paper reviews the current status and prospects on fMRI and MRS for evaluation of patients with CD based on the brain-gut-enteric microbiota axis.

Astrocytes contribute to the effects of etomidate on synaptic transmission in rat primary somatosensory cortex.

Little is known about the mechanisms of unconsciousness induced by general anesthetics. Previous studies have shown that the primary somatosensory cortex (S1) is a sensitive region to a variety of intravenous general anesthetics. Etomidate is a widely used intravenous anesthetic that can influence synaptic transmission. Recently, there are some evidences suggesting that astrocytes, a type of glia cell, also contribute to information transmission in the brain, and modulate synaptic function by releasing neuroactive substances. However, it is unknown whether astrocytes influence the effects of etomidate on information transmission in S1 pyramidal neurons. In the present study, the role of astrocytes in etomidate-induced unconsciousness was investigated by using the whole-cell patch clamp technique. We observed etomidate at clinically relevant concentrations inhibited the spontaneous postsynaptic currents (sPSCs) of rat S1 pyramidal neurons in a concentration-dependent manner, and the EC50 value of etomidate for inhibiting sPSCs from the concentration-effect curve was 6.9µM. Furthermore, in the presence of fluorocitrate, a glia-selective metabolism inhibitor that blocks the aconitase enzyme, both the amplitude and frequency of sPSCs in rat S1 pyramidal neurons were reduced, and the inhibitory effects of etomidate on sPSCs amplitude was strengthened without affecting the effects of etomidate on frequency. From these data, we deduce that etomidate suppresses synaptic activity via presynaptic and postsynaptic components. Furthermore, astrocytes participate in synaptic transmission and influence the effects of etomidate on postsynaptic receptors. This study provides new insight into the role of astrocytes in etomidate-induced unconsciousness.

Susac syndrome: serial diffusion-weighted MR imaging.

Susac syndrome (SS) is a clinical triad of hearing loss, retinal artery occlusion and encephalopathy. The typical MR imaging findings of multiple focal lesions in the corpus callosum and subcortical white matter can be easily misdiagnosed as multiple sclerosis. On diffusion-weighted (DW) MR imaging, new lesions were hyperintense, with reduced apparent diffusion coefficient (ADC). These lesions later became less prominent or hypointense on subsequent DW MR imaging. Serial DW imaging and ADC maps may be useful in differentiating SS from demyelinating diseases.

[Eosinophilic cystitis in children:a report of six cases and review of literature].

OBJECTIVE: Eosinophilic cystitis is a very rare tumor-like inflammatory disease especially in children. It can involve any portion of the bladder and interfere with its function. Here we present 6 pediatric cases and review the literature. METHODS: Six children, with mean age of 8.3 years, were referred to our clinic. Their major complaints included voiding urgency, frequency, dysuria, enuresis, intermittent hematuria and abdominal pain. Ultrasound, CT scan and voiding cystourethrogram (VCUG) showed diffuse thickening of bladder wall and a filling-defect lesion. They all suggested the possibility of bladder tumor. The final diagnosis of eosinophilic cystitis was made by cystoscopic tissue biopsy or open surgery. Patients underwent bladder autoaugmentation, mass resection or mere oral administration of corticosteroid and antibiotics respectively. RESULTS: 5 among 6 patients were followed up for 5 - 28 months. Their voiding complaints and image changes gradually disappeared. Up to now, there is no relapse. CONCLUSIONS: The clinical presentation of eosinophilic cystitis includes irritative voiding symptoms, hematuria and abdominal pain. Tumor-like changes could be found in the imagination examinations. A biopsy is mandatory to establish the diagnosis. Treatment in general varies from the removal of the antigenic stimulus, if identifiable, to administration of corticosteroid and antibiotics. When patients fail to respond to the medication treatment, the opening operation could be required.

[Analysis of the risk factors of breast cancer].

OBJECTIVE: To explore the risk factors of breast cancer for better control and prevention of the malignancy. METHODS: The clinical data of 232 patients with pathologically established breast cancer were investigated in this 1:1 case-control study to identify the risk factors of breast cancer. RESULTS: The history of benign breast diseases, family history of carcinoma and multiple abortions were the statistically significant risk factors of breast cancer, while breast feeding was the protective factor. CONCLUSION: A history of benign breast diseases, family history of carcinoma and multiple abortions are all risk factors of breast cancer.