Are Both Preoperative Full‐Spine 3Dimensional Computed Tomography Scans and X‐Ray Films Necessary for Patients with Ankylosing Spondylitis Kyphosis?

ObjectiveThis study is aimed to investigate whether both pre‐operative full‐spine 3Dimensional computed tomography scan (3D CT) and X‐ray film were necessary for patients with severe ankylosing spondylitis (AS) kyphosis deformity.MethodsThe research objects were selected from the inpatients with AS in our hospital from 2017 to 2019. A total of 42 patients were included in the study. On both the synthesized 2Dimensional (2D) lateral radiograph and X‐ray film, the globe kyphosis (GK), the lumber lordosis (LL), the thoracolumbar kyphosis (TLK) and the thoracic kyphosis (TK) were measured. And the angle seventh thoracic vertebra (T7), the angle twelfth thoracic vertebra (T12) and the angle third lumber vertebra (L3) were also measured. Two researchers with professional medical education were randomly selected to perform the measurement method and record the measurement data. Two researchers independently completed, recorded, and evaluated the accuracy and consistency of the measurement data. This study used intraclass correlation coefficient (ICC) to analyze the synthesized 2D lateral radiograph and general X‐ray film of 42 subjects by two researchers, in order to evaluate the consistency of data measurement results between the examiners. Through the comparison of the above parameters that the GK, LL, TLK, TK, angle T7, angle T12 and angle L3, the evaluation was made both pre‐operative full‐spine 3D CT and X‐ray film were necessary for patients with severe AS kyphosis deformity.ResultsThere was no significant difference between the GK, LL, TLK, TK, angle T7, angle T12, angle L3 on the synthesized 2D lateral radiograph and that on X‐ray film (P = 0.240, 0.324, 0.199, 0.095, 0.421, 0.087, 0.478). Agreement two researchers was excellent with ICC of the GK, LL, TLK, TK, angle T7, angle T12, angle L3 (0.977, 0.969, 0.986, 0.945, 0.947, 0.915, 0.857) on the synthesized 2D lateral radiograph. The Bland–Altman plot results that the measurement results of examiners are reliable and stable.ConclusionBy estimating the degree of spinal sagittal imbalance and measuring the Cobb angle, we can see that full‐length spine radiographs of the patients are unnecessary for patients with severe AS kyphosis deformity who will or have undergone preoperative spine 3D CT.     

First- and Second-Line Treatments for Patients with Advanced Hepatocellular Carcinoma in China: A Systematic Review

Chinese national guidelines recommend various systemic therapies for patients with advanced hepatocellular carcinoma (HCC), but optimal treatment selection remains uncertain. To summarize the evidence supporting the systemic treatment of Chinese patients with advanced HCC, we performed a systematic review using a literature search of PubMed, Embase, China National Knowledge Infrastructure, and the Chinese Scientific Journal Database between 1 January 2009 and 15 June 2021, and abstracts from ASCO 2020, ASCO GI 2021, ESMO 2020, and ESMO GI 2020. The inclusion criteria were: Chinese patients aged ≥18 years with advanced HCC; first- or second-line systemic therapy; an evaluation of the efficacy or safety outcomes; and a randomized controlled, non-randomized controlled, prospective, or retrospective design. Thirty reports were identified for the following therapies: the single-agent tyrosine kinase inhibitor (TKI; n = 10), single-agent programmed death-1 (PD-1) inhibitor (n = 4), chemotherapy (n = 5), PD-1/programmed death-ligand 1 (PD-L1) inhibitor plus TKI (n = 6), PD-1/PD-L1 inhibitor plus bevacizumab or biosimilar (n = 4), and PD-1/PD-L1 inhibitor plus chemotherapy (n = 1). The heterogeneity between the studies precluded statistical analysis and the data were summarized using tables. In the first-line setting, evidence supported the use of atezolizumab or sintilimab plus bevacizumab or a biosimilar. There remains insufficient evidence to determine the optimal approved TKI-based therapeutic option, and active controlled trials in the second-line setting were lacking.     

Heat-Treated Meat Origin Tracing and Authenticity through a Practical Multiplex Polymerase Chain Reaction Approach

Meat adulteration have become a global issue, which has increasingly raised concerns due to not only economic losses and religious issues, but also public safety and its negative effects on human health. Using optimal primers for seven target species, a multiplex PCR method was developed for the molecular authentication of camel, cattle, dog, pig, chicken, sheep and duck in one tube reaction. Species-specific amplification from the premixed total DNA of seven species was corroborated by DNA sequencing. The limit of detection (LOD) is as low as 0.025 ng DNA for the simultaneous identification of seven species in both raw and heat-processed meat or target meat: as little as 0.1% (w/w) of the total meat weight. This method is strongly reproducible even while exposed to intensively heat-processed meat and meat mixtures, which renders it able to trace meat origins in real-world foodstuffs based on the authenticity assessment of commercial meat samples. Therefore, this method is a powerful tool for the inspection of meat adulterants and has broad application prospects.     

Serum and tissue proteinase-like peptidase activities in women undergoing total mastectomy for breast cancer

Serum proteinase-like peptidases and proteinase inhibitor activities have been determined in 40 women with breast cancer at presentation and following total mastectomy. Activities of these enzymes have also been determined in homogenates of malignant (n = 13) and non-malignant (n = 11) breast tissue and benign breast lesions (n = 10). Following surgical treatment, the serum collagenase-like, cathepsin B-like and cathepsin H-like peptidase activities were significantly reduced. In addition, the activities of collagenase-like, cathepsin B-like and elastase-like peptidases were significantly higher in malignant breast tissue than in either non-malignant tissue from the same breast, or benign breast lesions. These findings are consistent with the suggestion that proteinases may have a role in tumour invasion.     

Multicystic renal cell carcinoma

This is a case report of a patient with cystic renal cell carcinoma that had all of the ultrasound and computed tomographic features of benign multicystic renal disease. Although this benign entity is a possibility in some patients, thick-wall cystic lesions of the kidney must be considered malignant until proven otherwise and surgery cannot be avoided.     

Occurrence of Intracranial Hemorrhage and Associated Risk Factors in Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy: A Systematic Review and Meta-Analysis

Background and PurposeIntracranial hemorrhage (ICH) is thought to be a rare but probably underestimated presentation of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). We conducted a systematic review and meta-analysis with the aim of comprehensively revealing the occurrence of ICH in patients with CADASIL.MethodsEnglish-language studies published up to September 30, 2021 were searched for in the MEDLINE (PubMed), Web of Science, and Cochrane Library databases. The design, patient characteristics, occurrence rate of ICH, and associated risk factors were retrieved for each identified relevant study.ResultsWe enrolled 13 studies in the final meta-analysis, which included 1,310 patients with CADASIL. The probability of ICH occurrence in patients with CADASIL was 10.1% (95% confidence interval [CI]=5.6%–18.0%, I²=85.1%). When stratified by geographic region, the occurrence rate of ICH was much higher in Asians (17.7%; 95% CI=11.0%–28.5%, I²=76.3%) than in Europeans (2.0%; 95% CI=0.4%–10.8%, I²=82.8%). A higher burden of cerebral microbleeds (CMBs) and a history of hypertension were the most commonly recorded risk factors for ICH, which were available for three and two of the included studies, respectively.ConclusionsOur study suggests that ICH is an important clinical manifestation of CADASIL, especially in Asians. A higher burden of CMBs and the existence of hypertension were found to be associated with a higher probability of ICH occurrence in patients with CADASIL.     

Nucleotide sequence of the 26 S mRNA of the virulent Trinidad donkey strain of Venezuelan equine encephalitis virus and deduced sequence of the encoded structural proteins

A cDNA clone containing all of the 26 S mRNA coding region of the RNA genome of Venezuelan equine encephalitis (VEE) virus, virulent strain Trinidad donkey (TRD), has been constructed and sequenced. The nucleotide and deduced amino acid sequences of the 26 S RNA of VEE virus conform to the general organization of the alphavirus subgenomic mRNA. Excluding the poly(A) tail, the VEE 26 S RNA is 3913 nucleotides long with a protein coding region of 3762 nucleotides. Codon usage in the translated region is nonrandom and correlates well with that reported for Sindbis (SIN), Semliki Forest (SF), and Ross River (RR) alphaviruses. Highly conserved sequences of 19 to 22 nucleotides representing putative replicase recognition sites occur at the 26 S RNA junction region of the 42 S genomic RNA and at the 3′ terminus immediately preceding the poly(A) tail. The conserved sequence at the 26 S/42 S junction region of VEE virus differs from that of other alpha-viruses in that an ochre termination codon (UAA) is substituted for a GGU (Gly) codon present in the other viruses. The 5′ and 3′ noncoding regions (30 and 121 nucleotides, respectively) of the VEE 26 S RNA are shorter than has been reported for several other alphaviruses. The approximate transmembrane domains of the VEE E1 and E2 envelope glycoproteins have been identified. VEE E1 contains a single asparagine-linked glycosylation site, whereas E2 has three such sites, all of which are apparently glycosylated. The deduced amino acid sequence of the VEE polyprotein shows an overall homology of 44 to 46% with the precursor polyproteins of SIN, SF, and RR viruses. VEE virus capsid, E1, and E2 structural proteins show 43 to 46%,50 to 53%,and 36 to 41% homology, respectively, with the cognate proteins of SIN, SF, and RR viruses.     

Heterotopic lung transplant: a feasible approach to compensate for organ shortages

Lung transplants are still limited by the shortage of suitable donor lungs, especially during the coronavirus disease 2019 pandemic. A heterotopic lung transplant (HLTx), as a flexible surgical procedure, can maximize the potential of donor lungs in an emergency, but its widespread use is hindered by difficulties in anastomosis and paucity of outcome data. We performed a retrospective review of 4 patients, each of whom received an HLTxs over 1 year, including 1 left-to-right single HLTx, 2 right-to-left single HLTxs and 1 lobar HLTx (right upper lobe-to-left). The median recipient age was 58.5 years (46–68); 3 patients were male. The postoperative hospital stay was 33 days (30–42). One recipient lived for 10 years and died of bronchiolitis obliterans syndrome; the others were alive with no major morbidity at 12 to 31 months after the operation with a 1-year survival of 100%. The follow-up chest images showed that transplanted lungs could be inflated well and adapted morphologically to fill the thoracic cavity in the short and long term. This study demonstrates that an HLTx is a feasible alternative to a conventional lung transplant in emergency cases and could be considered in selected patients at advanced medical centres.     

基于挥发油含量和抗菌活性的樟树叶最佳采摘期研究

目的:分析樟树叶挥发油在不同采摘时间段中含量成分及抗菌活性的变化,确定樟树叶的最佳采摘期,为合理开发综合利用樟树挥发油资源提供科学依据。方法:每月采集浙江杭州滨江高教园区的樟树叶,用水蒸气蒸馏法提取挥发油,测定总挥发油得率;用气相色谱归一化法测定龙脑樟脑的含量;用液体稀释法测定挥发油对金黄色葡萄球菌、大肠杆菌、白色念珠和绿脓杆菌的最低抑菌浓度。结果:不同月份的樟树挥发油总含量最高3.0987%(4月)、最低0.8504%(5月);龙脑最高13.5910%%(6月)、最低0.4032%(5月);樟脑最高14.8126%(9月)、最低0.0172%(6月);不同月份的樟树挥发油对4种菌株的最低抑菌浓度有差异,以9月份的最好,对金黄色葡萄球菌、大肠杆菌、白色念珠具和绿脓杆菌的MIC(ul/mL)分别是:0.195、0.781、0.098、50.00。结论:综合考虑挥发油含量和抗菌活性两个因素,一年的最佳采摘期依次是9、10和4月份。