The diagnosis of cerebral small vessel disease (CSVD) is highly dependent on neuroimaging, and its imaging changes include lacune, lacunar infarction, white matter hyperintensity (WMH), perivascular space (PVS), cerebral microbleed, etc. In previous studies, the definitions of these imaging changes were quite different, resulting in misdiagnosis of lacuna, WMH and PVS. This comment will summarize the clinical, imaging, and pathological characteristics of CSVD, sort out the process and effectiveness of the gradually normalized diagnostic standards, and propose errors that should be avoided, aiming to improve the accuracy and consistency of clinical diagnosis and research.

Objective To observe the effect of three-step sequential therapy on the pathomorphology of the bronchial lung tissues of rat asthmatic model with airway remodeling after hormone intervention using light microscope and electron microscope.Methods The airway remodeling of asthmatic rats model was induced by hormone intervention to simulate hormone withdrawal (HW)of steroid dependent asthma (SDA)patients.Altogether 150 rats randomly divided into five groups (each n =30)of airway remode-ling group,dexamethasone intervention group,pulmicort group,three-step sequential therapy group and normal control group.Morphological changes of the bronchial lung tissues of rats of all groups were ob-served under light microscope and electron microscope,and thicknesses of the bronchial walls and the bronchial smooth muscle and the number of the cell nucleus in the bronchial smooth muscle were meas-ured.Results Using HE staining,the lung tissues of rats except for those in normal control group were infiltrated by inflammation cells with different degrees,but the rats of three-step sequential therapy group were observed significantly slight inflammatory reaction.Using Masson trichromatic staining,massive col-lagen fiber in pulmonary interstitial of airway remodeling group deposited,while deposition increased dur-ing hormone withdrawal in dexamethasone intervention group,and significantly less deposition was ob-served in both three-step sequential therapy group and pulmicort group.Before HW,the thickness of the bronchial walls in three-step sequential therapy group decreased significantly compared with that in airway remodeling group(P <0.01);during and after HW,the thickness of the bronchial walls in three-step se-quential therapy group decreased compared with dexamethasone intervention group and airway remodeling group(P <0.01,P <0.05).Before HW,there is no difference (P >0.05)of bronchial smooth muscle thickness observed in all the medication groups;during and after HW,bronchial smooth muscle thickness decreased compared with dexamethasone intervention group and airway remodeling group(P <0.01,P <0.05).The number of cell nucleus in the bronchial smooth muscle of three-step sequential therapy group decreased significantly,regardless of HW,compared with dexamethasone intervention group and airway remodeling group(P <0.01).Using electron microscope,airway epithelial cilia falling off was remark-ably alleviated during HW in three-step sequential therapy group and pulmicort group,while that in dexa-methasone intervention group during or after HW was the same as the airway remodeling group. Conclusion Three-step sequential therapy could inhibit the airway remodeling by the way of relieving inflammatory changes of the bronchial lung pathomorphology of rat asthmatic model.

BACKGROUND: Acquired immune deficiency syndrome (AIDS)-related non-Hodgkin lymphoma (AR-NHL) is a high-risk factor for morbidity and mortality in patients with AIDS. This study aimed to determine the prognostic factors associated with overall survival (OS) and to develop a prognostic nomogram incorporating computed tomography imaging features in patients with acquired immune deficiency syndrome-related non-Hodgkin lymphoma (AR-NHL). METHODS: A total of 121 AR-NHL patients between July 2012 and November 2019 were retrospectively reviewed. Clinical and radiological independent predictors of OS were confirmed using multivariable Cox analysis. A prognostic nomogram was constructed based on the above clinical and radiological factors and then provided optimum accuracy in predicting OS. The predictive accuracy of the nomogram was determined by Harrell C-statistic. Kaplan-Meier survival analysis was used to determine median OS. The prognostic value of adjuvant therapy was evaluated in different subgroups. RESULTS: In the multivariate Cox regression analysis, involvement of mediastinal or hilar lymph nodes, liver, necrosis in the lesions, the treatment with chemotherapy, and the CD4 ≤100 cells/μL were independent risk factors for poor OS (all P < 0.050). The predictive nomogram based on Cox regression has good discrimination (Harrell C-index = 0.716) and good calibration (Hosmer-Lemeshow test, P = 0.620) in high- and low-risk groups. Only patients in the high-risk group who received adjuvant chemotherapy had a significantly better survival outcome. CONCLUSION A survival-predicting nomogram was developed in this study, which was effective in assessing the survival outcomes of patients with AR-NHL. Notably, decision-making of chemotherapy regimens and more frequent follow-up should be considered in the high-risk group determined by this model.
Acquired Immunodeficiency Syndrome ; Humans ; Lymphoma, Non-Hodgkin ; Neoplasm Staging ; Nomograms ; Prognosis ; Retrospective Studies