Search

Abstract Background The diagnostic accuracy of computed tomography (CT)-guided percutaneous core needle biopsy (CNB) for small (≤ 20 mm) ground-glass opacity (GGO) lesions has not been reported in detail. Objectives To evaluate factors that affect the diagnostic accuracy of CT-guided percutaneous CNB for small (≤ 20 mm) GGO pulmonary lesions. Methods From January 2014 to February 2018, 156 patients with a small (≤ 20 mm) GGO pulmonary lesion who underwent CT-guided CNB were enrolled in this study. Factors affecting diagnostic accuracy were evaluated by analyzing patient and lesion characteristics and technical factors. Significant factors were identified by multivariate logistic regression. Results The diagnostic accuracy of CT-guided percutaneous CNB was 90.4% for small (≤ 20 mm) GGO pulmonary lesions. The diagnostic accuracy was higher for larger lesions (72.5% for lesions ≤ 10 mm, 96.6% for lesions between 11 and 20 mm [P 90% GGO components and 97.2% for lesions with 50–90% GGO components (P 90% GGO components; 95% CI: 1.4 to 25.7). Conclusions Lesion size and GGO component are factors affecting diagnostic accuracy. The diagnostic accuracy was higher for larger lesions and lesions with 50–90% GGO components.

Abstract Background Renal schwannomas are very rare and are usually benign. Its clinical symptoms and imaging features are nonspecific, and the diagnosis is usually confirmed by pathology after surgical resection. Case presentation A 46-year-old Chinese female was admitted to the hospital with right flank pain that had persisted for the six months prior to admission. This pain had worsened for 10 days before admission, and dyspnea occurred when she was supine and agitated. A right abdominal mass could be palpated on physical examination. Computed tomography and magnetic resonance imaging examinations revealed a large, nonenhanced, cystic and solid mass in the right kidney. The patient received radical nephrectomy for the right kidney. The diagnosis of schwannoma was confirmed by pathological examination. Conclusions We report a case of a large renal schwannoma with obvious hemorrhage and cystic degeneration, which can be used as a reference for further study.

The emergence of pandrug-resistant bacteria breaks through the last line of defense and raises fear among people of incurable infections. In the post-antibiotic era, the pharmaceutical field turns to seek non-conventional anti-infective agents. Antimicrobial peptides are considered a prospective solution to the crisis of antimicrobial resistance. In this study, we evaluated the antimicrobial efficiency of an ApoE mimetic peptide, COG1410, which has been confirmed to exhibit strong neural protective activity and immunomodulatory function. COG1410 showed potent antimicrobial activity against pandrug-resistant Acinetobacter baumannii, even eliminating large inocula (108 CFU/ml) within 30 min. LC99.9 in PBS and 50% pooled human plasma was 2 μg/ml (1.4 μM) and 8 μg/ml (5.6 μM), respectively. Moreover, COG1410 exhibited biofilm inhibition and eradication activity, excellent stability in human plasma, and a low propensity to induce resistance. Although COG1410 easily entered bacterial cytoplasm and bound to DNA nonspecifically, the major mechanism of COG1410 killing was to disrupt the integrity of cell membrane and lead to leakage of cytoplasmic contents, without causing obvious pores on the cell surface or cell lysis. Additionally, transcriptome analysis showed that treatment with COG1410-enriched genes involved a series of oxidation–reduction processes. DCFH-DA probe detected an increased ROS level in the presence of COG1410, indicating ROS was another hit of this AMP. Furthermore, the action of COG1410 did not depend on the electronic interaction with the LPS layer, in contrast to polymyxin B. The strong synergistic interaction between COG1410 and polymyxin B dramatically reduced the working concentration of COG1410, expanding the safety window of the application. C. elegans infection model showed that combined therapy of COG1410 and polymyxin B was capable of significantly rescuing the infected nematodes. Taken together, our study demonstrates that COG1410 is a promising drug candidate in the battle against pandrug-resistant A. baumannii.

Existing design models of soil pressure at the top of buried steel pipes are limited to small-diameter pipes. This study aims to investigate the behavior and design model on the soil pressure for large-diameter pipes considering the pipe diameter, diameter-to-thickness ratio, and cover depth. The distribution and size of soil pressure are obtained from finite element models and compared with traditional design models. Sensitivity studies of soil parameters, trench parameters, and friction coefficients are discussed. Furthermore, an innovative design model of soil pressure for large-diameter pipes is proposed. The results indicate that the basic distribution pattern of soil pressure is the “inverted basin”/parabola for large/small-diameter pipes, respectively. Peak soil pressure typically appears in the pleura of pipes with great flexibility and deep cover depth. The modulus and Poisson's ratio of backfill and soil-soil friction coefficient have an influence range of within 10% for soil pressure, while trench parameters have a more significant influence. Prism load is too large at high cover depth, and Marston load is small at low cover depth. The proposed basin model for soil pressure adopts the form of “straight line + parabola” for distribution and “Marston + pleura” load for size, with high accuracy and strong adaptability.

Excessive nitrogen (N) fertilization with a high basal N ratio in wheat can result in lower N use efficiency (NUE) and has led to environmental problems in the Yangtze River Basin, China. However, wheat requires less N fertilizer at seedling growth stage, and its basal N fertilizer utilization efficiency is relatively low; therefore, reducing the N application rate at the seedling stage and postponing the N fertilization period may be effective for reducing N application and increasing wheat yield and NUE. A 4-year field experiment was conducted with two cultivars under four N rates (240 kg N ha−1 (N240), 180 kg N ha−1 (N180), 150 kg N ha−1 (N150), and 0 kg N ha−1 (N0)) and three basal N application stages (seeding (L0), four-leaf stage (L4), and six-leaf stage (L6)) to investigate the effects of reducing the basal N application rate and postponing the basal N fertilization period on grain yield, NUE, and N balance in a soil-wheat system. There was no significant difference in grain yield between the N180L4 and N240L0 (control) treatments, and the maximum N recovery efficiency and N agronomy efficiency were observed in the N180L4 treatment. Grain yield and NUE were the highest in the L4 treatment. The leaf area index, flag leaf photosynthesis rate, flag leaf nitrate reductase and glutamine synthase activities, dry matter accumulation, and N uptake post-jointing under N180L4 did not differ significantly from those under N240L0. Reduced N application decreased the inorganic N content in the 0–60-cm soil layer, and the inorganic N content of the L6 treatment was higher than those of the L0 and L4 treatments at the same N level. Surplus N was low under the reduced N rates and delayed basal N application treatments. Therefore, postponing and reducing basal N fertilization could maintain a high yield and improve NUE by improving the photosynthetic production capacity, promoting N uptake and assimilation, and reducing surplus N in soil-wheat systems.

Background. Fine-needle aspiration biopsy (FNAB) is diagnostic standard for thyroid nodules. However, the influence of adequate sample rate of US-guided FNAB for subcentimeter thyroid nodules is not known well. Objectives. To assess the factors affecting adequate sample rate of US-guided FNAB for subcentimeter thyroid nodules. Methods. Three hundred and forty-nine consecutive US-guided FNAB procedures were performed in 344 patients with subcentimeter thyroid nodules. The adequate sample rate was analyzed for all nodules on the basis of nodule-related and technical factors. The factors affecting adequate sample rate of US-guided FNAB for subcentimeter thyroid nodules were determined by multivariate logistic regression. Results. The adequate sample rate increased with larger nodules (72.7% for 3–6 mm nodules and 84.9% for 7–10 mm nodules (P=0.007)). The adequate sample rate was 63.9%, 81.3%, and 90.6% in nodules with macrocalcifcation, microcalcification, and no calcification, respectively (P

Objectives: In China, the epidemic pattern of acute hepatitis E virus (HEV) infection has changed from waterborne outbreaks to foodborne sporadic cases. However, the clinical course of sporadic acute hepatitis E (AHE) has not been well defined. Methods: Consecutive patients with AHE who were admitted to the Jinan Infectious Disease Hospital, Jinan, Shandong Province between January 2003 and December 2014 were evaluated and followed. Demographic data, clinical manifestations, results of laboratory tests, and outcomes were recorded. Risk factors for liver failure and death were analyzed. Results: A total of 680 patients with AHE were identified during the study period. The incidence was highest in February, March, and April, accounting for about 41% of the cases. The male to female ratio was 5.1:1 (574/106). The average age was 50.9 ± 12.8 years. The prevalence rates of prodromal fever, fatigue, loss of appetite, and jaundice were 25.6%, 85.6%, 83.8%, and 92.8%, respectively. The median (range) serum alanine aminotransferase, aspartate aminotransferase, bilirubin, albumin, and platelet levels were 727 (8–6270) U/l, 300 (17–6226) U/l, 196.8 (8.0–1083) μmol/l, 33.0 (15.2–45.8) g/l, and 162 (10–589) × 109/l, respectively. The prevalence of hepatitis B surface antigen (HBsAg) was 18.5% (126/680) and of liver cirrhosis was 9.4% (64/680). Thirteen percent (89/680) of the cases progressed to liver failure, including 4.1% (28/680) with acute liver failure (ALF) and 9.0% (61/680) with acute-on-chronic liver failure (ACLF). Among patients with HBsAg positivity or cirrhosis, 28.6% (36/126) and 36.0% (23/64), respectively, progressed to ACLF. Multiple logistic regression analysis indicated that age >53 years, prodromal fever, HBsAg positivity, cirrhosis, and thrombocytopenia (platelet count 500 μmol/l, international normalized ratio (INR) >2, and severe thrombocytopenia (platelet count

Objectives: The role of prodromal fever in the clinical course of acute hepatitis B virus (HBV) infection is still largely unclear. This study was conducted to investigate the factors associated with prodromal fever and its role in the development of acute liver failure (ALF) in patients with acute hepatitis B (AHB). Methods: Inpatients with AHB diagnosed between January 2006 and December 2010 were evaluated and followed. Clinical manifestations, results of laboratory tests, and outcomes were compared between patients with and without prodromal fever. The diagnosis of AHB was based on the discrete onset of symptoms, jaundice, abnormal liver function tests, the detection of high-titer IgM antibody to hepatitis B core antigen (anti-HBc), and a compatible clinical history. Results: A total of 618 AHB inpatients were identified during the study period, of whom 102 (16.5%) had prodromal fever and 41 (6.6%) developed ALF. Prodromal fever indicated more severe liver injury and was independently associated with hepatitis B e antigen (HBeAg) negativity. The occurrence of ALF was more common in febrile patients than in non-febrile patients (18.6% vs. 4.3%, p 38.0 °C to be independently associated with the risk of ALF, with an odds ratio (95% confidence interval) of 3.5 (1.4–8.6) and 7.1 (2.6–19.7), respectively. Conclusions: AHB patients with prodromal fever, which is associated with a lack of HBeAg due to HBV mutation, are at high risk of ALF. Febrile patients with AHB should be managed with particular care.

Marine traditional Chinese medicines (MTCMs) hold a significant place in the rich cultural heritage in China. It plays an irreplaceable role in addressing human diseases and serves as a crucial pillar for the development of China's marine economy. However, the rapid pace of industrialization has raised concerns about the safety of MTCM, particularly in relation to heavy metal pollution. Heavy metal pollution poses a significant threat to the development of MTCM and human health, necessitating the need for detection analysis and risk assessment of heavy metals in MTCM. In this paper, the current research status, pollution situation, detection and analysis technology, removal technology and risk assessment of heavy metals in MTCM are discussed, and the establishment of a pollution detection database and a comprehensive quality and safety supervision system for MTCM is proposed. These measures aim to enhance understanding of heavy metals and harmful elements in MTCM. It is expected to provide a valuable reference for the control of heavy metals and harmful elements in MTCM, as well as the sustainable development and application of MTCM. Highlights: An overview of the research on heavy metals and hazardous elements in marine traditional Chinese medicine (MTCMs) was analyzed. The current status of heavy metal pollution in marine traditional Chinese medicine (MTCMs) and its hazards were studied. The corresponding morphological and valence studies of heavy metals and hazardous elements in marine traditional Chinese medicine (MTCMs) and marine organisms were analyzed. The risk assessment of heavy metals and harmful elements in marine traditional Chinese medicine (MTCMs) and marine organisms was conducted. A pollution detection database and quality and safety supervision system for marine traditional Chinese medicine (MTCMs) were analyzed and established. [ABSTRACT FROM AUTHOR]