PURPOSE:To present the different findings of Chlamydia psittaci (C. psittaci) pneumonia on computed tomography (CT) according to the progression of the disease, to improve diagnostic accuracy, guide early clinical diagnosis, evaluate treatment efficacy, and reduce the mortality associated with the disease. METHODS:In total, 80 cases of C. psittaci pneumonia diagnosed through next-generation sequencing from January 2019 to December 2023 in multiple hospitals in China were collected according to the inclusion criteria and analyzed. The study discussed important CT findings and their dynamic changes. RESULTS:The most common manifestations of C. psittaci pneumonia are lobar pneumonia and spherical pneumonia types with interstitial changes. The most common signs are the intralobular lines, air bronchogram sign, and reverse halo sign. In addition, necrosis, cavitation, and the tree-in-bud sign are rare but often associated with pleural effusion and splenomegaly. In the ultra-early stage, vascular inflammation changes were observed on imaging, often manifesting as ground-glass opacities around small core vessels or thickening of pulmonary hilar vessels. In the early stage, secondary lobules showed high-density shadows, which rapidly fused into large areas in the progressive stage, easily forming lobar pneumonia. The repair and absorption period tended to show the formation of the reverse halo sign centrally, and the dissipation period might have led to the formation of fibrous bands. CONCLUSION:Combining clinical manifestations, laboratory tests, contact history, and imaging findings contribute to the diagnosis of C. psittaci pneumonia.

Piwei Peiyuan (PWPY) prescription is a traditional Chinese medicine prescription and has been efficiently used in the clinics to treat chronic atrophic gastritis (CAG) for many years. However, the mechanism of action underlying PWPY for treating CAG remains elusive. A CAG rat animal and cell model was constructed in this study to explore the action mechanism of PWPY prescription in treating CAG. Here we show that PWPY attenuates the progression of CAG by eliciting MAPK10-mediated mitochondrial autophagy. Experimental model of CAG was introduced using N-methyl-n'-nitro-n-nitroguanidine (MNNG). Our histological analyses reveal that MNNG-induced CAG in rat undergoes classical morphological alterations judged by immunohistochemistry and serum level of PGⅠ, PGⅡ, and G17. Importantly, PWPY treatment prevents the progression of MNNG-induced CAG judged by serum level of PGⅠ, PGⅡ, and G17. Interestingly, PWPY treatment inhibits MAPK10 activity judged by biochemical assays and promotes mitochondrial autophagy judged by electron microscopic analyses. Thus, we conclude that PWPY attenuates the progression of MNNG-induced CAG and prevents precancerous lesions by harnessing MAPK10-elicited mitochondrial autophagy. The MNNG-induced experimental CAG model provides a robust platform for further delineating therapeutic targets underlying PWPY regimen.

Background:Currently, there is limited research on the prognosis and influencing factors of non-cardia gastric adenocarcinoma (NCGAC) patients. This study aims to explore the factors influencing overall survival (OS) in Helicobacter pylori (H. pylori)-positive NCGAC patients and to develop a nomogram model to provide guidance for clinicians. Methods:We retrospectively analyzed clinicopathological data from 413 H. pylori-positive NCGAC patients who underwent radical gastrectomy at the General Hospital of Ningxia Medical University. The dataset was randomly split into a training cohort (70%) and a validation cohort (30%). Univariate Cox proportional hazards regression analysis was used to identify prognostic factors, and factors with multicollinearity [variance inflation factor (VIF) >4] were excluded using the VIF. Factors of interest and those with P<0.05 were included in the multivariate Cox proportional hazards regression model. A nomogram prediction model was constructed based on factors with P<0.05. The model's performance was finally assessed using the area under the receiver operating characteristic curve (AUC) and calibration curves. The Kaplan-Meier survival curves visualize the impact of independent prognostic factors. Results:Univariate Cox regression analysis was performed on the training cohort to select variables with P<0.5, including alcohol consumption, tumor size, differentiation grade, lymph node metastasis, tumor (T) stage, node (N) stage, and tumor node metastasis (TNM) stage. Multicollinearity was assessed, and covariates with VIF >4, such as lymph node metastasis, were excluded. The remaining factors were included in the multivariate Cox regression model. Significant variables (P<0.05), including alcohol consumption, differentiation grade, and T stage, were used to construct a nomogram, which showed a concordance index (C-index) of 0.727 in the training cohort and 0.728 in the validation cohort. The model's performance was validated with AUC and calibration curves (training cohort: 1-year AUC: 0.74, 3-year AUC: 0.78, 4-year AUC: 0.80; validation cohort: 1-year AUC: 0.67, 3-year AUC: 0.71, 4-year AUC: 0.72). Kaplan-Meier survival curves illustrated the impact of independent prognostic factors. Conclusions:We developed a nomogram to predict survival in H. pylori-positive NCGAC patients, based on alcohol consumption, tumor differentiation, and T stage. The model showed strong predictive performance, with C-index values of 0.727 in the training cohort and 0.728 in the validation cohort. AUC values and calibration curves further confirmed its accuracy, suggesting the nomogram is a reliable tool for predicting prognosis and guiding treatment decisions.

ABSTRACTRenal angiomyolipoma has two histological variants: classical and epithelioid. Epithelioid angiomyolipoma is considered as a potential malignant tumor, often leading to recurrence and metastasis, with rapid progression in most of the cases. The lung is one of the most commonly reported sites of metastasis, and pulmonary metastasis of renal angiomyolipoma is usually diagnostic by computed tomography (CT) scans. Here, we report for the first time renal angiomyolipoma with lung metastasis by combining CT and magnetic resonance imaging (MRI).

The optimal barrier dividend problem under excess of loss reinsurance strategy has rarely been studied so far. We combine the risk factors such as market friction and terminal residual value with risk investment and risk control strategy, and study the resulting optimal investment-excess of loss reinsurance-barrier dividend problem. Based on the dynamic programming principle, we establish the Hamilton-Jacobi-Bellman equation, and obtain the explicit solutions for the optimal investment-excess of loss reinsurance strategy. The optimal dividend function is solved by the differential-integral method. The existence and uniqueness of the optimal dividend boundary is proved.

OBJECTIVE:To investigate the value of dual-energy dual-source computed tomography (DSCT) in evaluating pulmonary perfusion changes before and after radiotherapy for esophageal cancer, and its clinical use in the early diagnosis of acute radiation pneumonia (ARP). METHODS:We selected 45 patients with pathologically confirmed esophageal cancer who received radiotherapy (total irradiation dose of 60 Gy). Dual-energy DSCT scans were performed before and after radiotherapy and the normalized iodine concentrations (NIC) in the lung fields of the areas irradiated with doses of > 20 Gy, 10-20 Gy, 5-10 Gy, and < 5 Gy were measured. We also checked for the occurrence of ARP in the patients, and the differences in NIC values and NIC reduction rates before and after radiotherapy were calculated and statistically analyzed. RESULTS:A total of 16 of the 45 patients developed ARP. The NIC values in the lung fields of all patients decreased at different degrees after radiotherapy, and the NIC values in the area where ARP developed, decreased significantly. The rate of NIC reduction and incidence rate of ARP increased gradually with the increasing irradiation dose, and the inter-group difference in NIC reduction rate was statistically significant (P < 0.05). Based on the receiver operating characteristic (ROC) curve analysis, the areas under the curves of NIC reduction rate versus ARP occurrence in the V5-10 Gy, V10-20 Gy, and V> 20 Gy groups were 0.780, 0.808, and 0.772, respectively. Sensitivity of diagnosis was 81.3%, 75.0%, and 68.8% and the specificity was 65.5%, 82.8%, and 79.3%, when taking 12.50%, 16.50%, and 26.0% as the diagnostic thresholds, respectively. The difference in NIC values in the lung fields of V<5 Gy before and after radiotherapy was not statistically significant (P > 0.05). CONCLUSION:The dual-energy DSCT could effectively evaluate pulmonary perfusion changes after radiotherapy for esophageal cancer, and the NIC reduction rate was useful as a reference index to predict ARP and provide further reference for decisions in clinical practice.

In recent years, clinical cases of Chlamydia psittaci pneumonia have gradually increased. Chlamydia psittaci pneumonia can quickly progress to severe pneumonia, leading to respiratory failure. Chlamydia psittaci cannot be detected by commonly used detection methods, leading to difficulties in clinical diagnosis and treatment, which may eventually develop into severe Chlamydia psittaci pneumonia. Therefore, we should improve our diagnostic and treatment capabilities for this disease. This article retrospectively studied 61 cases of pneumonia from 12 different provinces in China, and classified them into severe pneumonia and non-severe pneumonia. Divided into two groups, with 23 cases of severe pneumonia and 38 cases of non-severe pneumonia. We compared the two groups in terms of imaging, laboratory testing, treatment, prognosis, etc., hoping to provide better explanations and help clinical physicians better diagnose the disease. There is no difference in age, gender, contact history, smoking history, or basic disease between severe and non-severe Chlamydia psittaci pneumonia. The most prominent symptom is fever, with a median body temperature of 39.7 ℃, and other symptoms similar to common respiratory infections. White blood cells and neutrophils may not show significant elevation, but C-reactive protein (CRP) and procalcitonin (PCT) will both show significant elevation, often accompanied by a decrease in arterial oxygen pressure. Some patients may experience liver and kidney dysfunction, but there is no statistically significant difference between the two groups. Doxycycline remains the preferred drug for severe Chlamydia psittaci pneumonia. The imaging mainly shows consolidation and bronchial inflation sign, and may also present with pleural effusion. The imaging of Chlamydia psittaci pneumonia usually shows consolidation with bronchial inflation sign, which can also be manifested as ground glass changes or solid masses. Atypical images are prone to misdiagnosis in the early stages. There are some differences in laboratory examination and imaging between severe pneumonia and non-severe pneumonia, which can help identify severe patients in the early stage. Metagenomic next-generation sequencing (mNGS) played an important role in the diagnosis of all cases in this article. Timely treatment has a good prognosis for the disease, and imaging lesions can be completely absorbed.

Background Increased use of multislice computed tomography (CT) scans has revealed that minute pulmonary meningothelial-like nodules (MPMNs) showed as ground-glass nodules (GGNs) are frequent in patients. However, little is known about the incidence and fate of nodules. By using a cross-sectional design, this study compared the multislice CT signs and pathological results of MPMNs, and further used pathological results to explain the formation mechanism of the CT signs of MPMNs to improve the clinical understanding of the disease. Methods The clinicopathological data of 93 cases diagnosed as MPMNs in the Jiangsu Province Hospital from January 2016 to September 2019 and the Nanjing First Hospital from January 2017 to December 2019 were examined. The related literature was reviewed, and each case’s age, gender, medical history, and preoperative CT examinations were classified. Based on CT signs, this study analyzed the imaging features, including size, shape, boundary, distribution, opacity, and their relationship with pulmonary blood vessels. Results A total of 13 cases had immunohistochemistry results among which the lesions showed consistent positive expression of vimentin (100%), followed by epithelial cell membrane antigen (92.3%) and progesterone (8%). The MPMNs mainly occurred in individuals aged 50–59 years (32.6%). Most patients (82.6%) had neoplastic disease. All nodules (100%) manifested with a round shape and well-demarcated borders on images. The size of the nodules on CT scans ranged from 2.5 to 5.0 mm, with an average size of 3.04±1.12 mm. Most nodules were subpleural (89.1%) and showed ground-glass opacity (97.8%). The follow-up results of postoperative clinical manifestations and chest CT examination were negative in 12 patients. Conclusions This study suggested that the pathological findings of MPMNs could explain the formation mechanism of the CT signs. The results can provide guidance for the diagnosis of the disease in the future.

In recent years, microRNAs (miRNAs) derived from exosomes have been attracting attention as novel clinical biomarkers in a variety of cancers. In this study, plasma samples from 60 gastric cancer (GC) patients and 63 healthy individuals were collected, and the exosomal microRNAs (ex-miRNAs) were isolated. We determined the specific ex-miRNAs through miRNA microarray and a database of differentially expressed miRNAs called dbDEMC. Then, the expression levels of exosomal miR-31, miR-192, and miR-375 were analyzed by quantitative polymerase chain reaction (qRT-PCR). Compared to the matched controls, exosomal miR-31, miR-375, and miR-192 were significantly upregulated in GC patients. Also, they were found to be associated with gender, with miR-192 being significantly upregulated in male GC patients. Kaplan–Meier analysis indicated that high expressions of exosomal miR-31, miR-375, and miR-192 were positively correlated with poor clinical outcomes of GC patients. Cox univariate and multivariate analysis found that ex-miR-375 expression and TNM stage were independent prognostic factors of overall survival (OS). Our findings revealed that exosomal miR-31, miR-192, and miR-375 might serve as noninvasive, sensitive, and specific biomarkers for the diagnosis and prognosis of GC patients.

Objective: The objective of this study was to address whether preoperative chemotherapy (PECT) plus surgery prolongs overall survival (OS) compared with surgery plus postoperative chemotherapy (POCT) among gastric cancer (GC) patients in Northwest China. Materials and Methods: The authors included 157 GC patients confirmed histologically or by gastroscopic pathological examination treated at the General Hospital of Ningxia Medical University of China between 2012 and 2018. All patients were followed up by telephone in January 2019 within a 2-week period. The endpoint was death due to GC or its complications. Results: Thirty-eight patients received PECT, 41 patients received POCT, 40 patients received surgery alone, and 38 patients received chemotherapy alone. Surgery was performed with R0 resection and subsequent extended lymph node dissection. Chemotherapy was performed with the S-1, oxaliplatin capecitabine regimen. Patients who received PECT had longer OS than those with POCT treatment (hazard ratio = 2.409, p = 0.037). The 5-year OS rate was 32.7% higher in the PECT group than in the POCT group. Conclusions: PECT was associated with better OS in GC patients and should be considered by clinicians in GC treatment, although prospective studies are needed for confirmation.

<p>XLSX file, 863K, Lists of differentially expressed genes (DEGs) from comparisons of PAR_TKO and active_inactive groups and overlapping DEGs (p<0.05).</p>

Background:This is a retrospective cross-sectional study aiming to explore the clinical and imaging manifestations of Chlamydia psittaci pneumonia (CPP), thus improving its diagnosis, guiding its early clinical treatment, and reducing its mortality rate.Methods:Fifty cases of CPP diagnosed by hospitals across the country with metagenomics next-generation sequencing (mNGS) from January 2019 to March 2021 were collected. Its clinical symptoms, laboratory test results, and computed tomography (CT) features were discussed.Results:Forty patients had a history of poultry exposure; 37 experienced respiratory symptoms, 48 had a fever, 14 experienced gastrointestinal symptoms, and 12 experienced neurological symptoms; 34 patients had normal blood cell counts, 49 patients had elevated C-reactive protein, and 24 showed decreased serum sodium. Imaging manifestations: (I) Distribution: lesions were limited to a single lung in 31 patients, lesions were distributed in bilateral lungs in 19 patients; (II) Signs: 37 patients developed the "fine mesh sign". Necrosis, cavity and "tree-in-bud" were not observed. Pleural effusion occurred in 33 patients, mediastinal lymphadenopathy in 18, and splenomegaly in 15 patients.Conclusions:Patients with CPP often have a history of poultry exposure and present with fever and increased C-reactive protein. White blood cells may be slightly increased or completely normal. Hyponatremia may occur in some patients, and multiple systems may be clinically involved. The imaging can show lesions with unilateral or bilateral lung distribution and a rapid progression. Both the lung parenchyma and the interstitium are involved. Fine mesh sign is the most common sign. Necrosis, cavitation, and tree-in-bud signs are not observed. In conclusion, imaging examinations are helpful for the early diagnosis of this disease and the evaluation of the treatment effect.

Busulfan is an antineoplastic, which is always accompanied with the abnormal of spermatogonia self-renewal and differentiation. It has been demonstrated that the omega-3 polyunsaturated fatty acids (PUFAs) benefits mature spermatozoa. However, whether omega-3 can protect endogenous spermatogonia and the detailed mechanisms are still unclear. Evaluate of spermatogenesis function (in vivo) were examined by histopathological analysis, immunofluorescence staining, and western blotting. The levels of lipid metabolites in testicular tissue were determined via liquid chromatography. We investigated the effect of lipid metabolites on Sertoli cells provided paracrine factors to regulate spermatogonia proliferation and differentiation using co-culture system. In our study, we showed that omega-3 PUFAs significantly improved the process of sperm production and elevated the quantity of both undifferentiated Lin28+ spermatogonia and differentiated c-kit+ spermatogonia in a mouse model where spermatogenic function was disrupted by busulfan. Mass spectrometry revealed an increase in the levels of several omega-3 metabolites in the testes of mice fed with omega-3 PUFAs. The eicosapentaenoic acid metabolite 12-hydroxyeicosapentaenoic acid (12-HEPE) up-regulated bone morphogenic protein 4 (BMP4) expression through GPR120-ERK1/2 pathway activation in Sertoli cells and restored spermatogonia proliferation and differentiation. Our study provides evidence that omega-3 PUFAs metabolite 12-HEPE effectively protects spermatogonia and reveals that GPR120 might be a tractable pharmacological target for fertility in men received chemotherapy or severe spermatogenesis dysfunction.

PDF file, 989K, Depletion of NSD2 has only mild effects on myeloma cell proliferation. Supplementary Figure S2. NSD2 is important for tumorigenesis of t(4;14)+ myeloma cells. Supplementary Figure S3. PHD domains are important for cellular H3K36me2 activity of NSD2 but not in vitro enzymatic activity. Supplementary Figure S4. NSD2 activity mediates transcription activation of t(4;14)+ specific myeloma gene set. Supplementary Figure S5. NSD2 overexpression driven by t(4;14) translocation abolished global association of H3K36me2 with gene transcription. Supplementary Figure S6. NSD2 overexpression driven by t(4;14) translocation abolished positive correlation of H3K36me2 with gene transcription.

Background Peritoneal loose body (PLB) which is also called "peritoneal mouse" is a rare disease, with only a few cases reported. PLB is mostly found due to unplanned examination, surgery, or autopsy. With the increase in abdominal imaging examinations, it was gradually recognized by us. The diagnosis of PLB has three major characteristics: free movement, no blood supply, and pathological exclusion of other tumors. Case Presentation We reported a 66-year-old male patient with an asymptomatic freely moving peritoneal loose body. The size of the lesion was about 4*4cm. The imaging data were complete including Ultrasound, Magnetic resonance (MR), Computed tomography (CT) plain scan and enhancement. Interestingly, changes in the location of the lesion were found on follow-up CT. The lesion showed concentric circles changes on CT without obvious enhancement. MR also appeared as a multi-layer signal of concentric circles. In addition, the imaging manifestations were compared with histological pathology in this article to explain imaging characteristics. Conclusion PLB is an uncommon disease. Through the complete imaging examination of this case, we can further understand the mobility of the lesion by changing the position. The CT and MR have characteristic concentric circle changes without obvious enhancement. The diagnosis could be confirmed before surgery, which prompted the clinical early diagnosis of the disease, and an appropriate choice between surgery and conservative treatment.

Background: Sarcoidosis is a systemic non-caseous necrotizing granulomatous disease with unknown etiology. It can involve multiple organs throughout the body, most commonly affecting lungs and/or bilateral hilar lymph nodes. Sjögren's syndrome is a multi-system autoimmune disease. The main clinical symptoms include dry mouth and dry eyes. The combination of the two diseases with the involvement of multiple systems is very rare, and the final diagnosis is mainly based on the comprehensive judgment of clinical history, imaging manifestations and pathological examination. Case presentation: We report a case of multiple sarcoidosis (lung, hilar, mediastinal, inguinal, liver, and spleen) with Sjögren syndrome. The patient had a dry mouth, dry eyes, and bilateral parotid gland enlargement. The first computed tomography (CT) scan of the chest and abdomen showed multiple nodules in the lungs, multiple enlarged lymph nodes, and low-density shadows in the liver and spleen. After a one-year interval, the re-examination showed that the lung lesions increased with bead-like changes, and the lymph nodes shrunk. Through pathological puncture and comprehensive judgment, considering the coexistence of the two diseases, the patient improved after hormone therapy and was finally diagnosed. Conclusion: Multisystem sarcoidosis combined with Sjögren's syndrome has rarely been reported in the literature. This case has multiple imaging examinations, pathological data and a follow-up review after treatment. The dynamic changes in different periods will help us to better understand the situation of sarcoidosis and explore the connection between the two diseases so as to reduce misdiagnosis.

<p>XLSX file, 450K, Gene set enrichment analysis (GSEA) reports for comparisons of PAR_TKO and active_inactive groups.</p>

In December 2019, a new type of virus, coronavirus disease 2019 broke out globally and caused great harm. The virus mutates rapidly, and more research reports are urgently needed to increase our understanding of the disease. We found the reversed halo sign (RHS) occurred in the imaging manifestations of severe acute respiratory syndrome coronavirus 2 delta variant of concern pneumonia. In the absence of pathology, the mechanism is unknown. Therefore, we reported two cases of RHS and tried to speculate the pathological mechanism through multiple computed tomography follow-up comparisons to judge the prognosis of the disease.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, has led to the rapid development of Coronavirus disease 2019 (COVID-19) pandemic. COVID-19 represents a fatal disease with a great global public health importance. This study aims to develop a three-parameter Weibull mathematical model using continuous functions to represent discrete COVID-19 data. Subsequently, the model was applied to quantitatively analyze the characteristics for the mortality of COVID-19, including the age, sex, the length of symptom time to hospitalization time (SH), hospitalization date to death time (HD) and symptom time to death time time (SD) and others. A three-parameter mathematical model was developed by combining the reported cases in the Data Repository from the Center for Systems Science and Engineering at Johns Hopkins University and applied to estimate and analyze the characteristics for mortality of COVID-19. We found that the scale parameters of males and females were 5.85 and 5.45, respectively. Probability density functions in both males and females were negative skewness. 5% of male patients died under the age of 43.28 (44.37 for females), 50% died under 69.55 (73.25 for females), and 95% died under 86.59 (92.78 for females). The peak age of male death was 67.45 years, while that of female death was 71.10 years. The peak and median values of SH, HD and SD in male death were correspondingly 1.17, 5.18 and 10.30 days, and 4.29, 11.36 and 16.33 days, while those in female death were 1.19, 5.80 and 12.08 days, and 4.60, 12.44 and 17.67 days, respectively. The peak age of probability density in male and female deaths was 69.55 and 73.25 years, while the high point age of their mortality risk was 77.51 and 81.73 years, respectively. The mathematical model can fit and simulate the impact of various factors on IFR. From the simulation results of the model, we can intuitively find the IFR, peak age, average age and other information of each age. In terms of time factors, the mortality rate of the most susceptible population is not the highest, and the distribution of male patients is different from the distribution of females. This means that Self-protection and self-recovery in females against SARS-CoV-2 virus might be better than those of males. Males were more likely to be infected, more likely to be admitted to the ICU and more likely to die of COVID-19. Moreover, the infection fatality ration (IFR) of COVID-19 population was intrinsically linked to the infection age. Public health measures to protect vulnerable sex and age groups might be a simple and effective way to reduce IFR.

Malignant pancreatic tumors have early metastasis, aggressive behavior and poor prognosis. Surgeons often need to judge whether a patient needs prompt surgery when a pancreatic lesion is found. The accessory spleen is a congenital developmental malformation rather than a tumor and does not require surgical resection. Here, we report a 47-year-old man who underwent routine gastroscopic examination, and a submucosal eminence of the duodenal bulb was detected. The patient was asymptomatic and laboratory tests were unremarkable. Duodenal neuroendocrine neoplasm (G2) was considered following endoscopic submucosal dissection (ESD). Further examination showed a lesion in the tail of the pancreas and multiple accessory spleens. The lesion in the tail of the pancreas was Ga-68 positive and was highly considered a pancreatic neuroendocrine tumor (pNET). Based on this clinical evidence, laparoscopic spleen-preserving distal pancreatectomy (Kimura) was performed. However, the results of the postoperative pathological diagnosis indicated an intrapancreatic accessory spleen (IPAS). Given the findings of this case, we should explore more accurate diagnostic methods for IPAS to avoid unnecessary surgery.