Objective To investigate the impact of coronary myocardial bridge(MB)on parameters of proximal pericoronary adipose tissue(PCAT).Methods Totally 287 patients with clinically suspected coronary heart disease but no coronary plaque on CT angiography(CCTA)were retrospectively collected.According to the presence or not of MB in left anterior descending(LAD),the patients were divided into MB group(n=150)and non-MB group(n=137).The length and depth of LAD-MB in MB group were measured,and patients in MB group were divided into deep MB subgroup and superficial MB subgroup according to LAD-MB depth.LAD PCAT parameters,i.e.fat attenuation index(FAI)and fat volume(FV),were compared between groups and subgroups within MB subgroup.Univariate and multivariate linear regression were used to explore the correlations of clinical factors(age,sex,body mass index),MB length,MB depth and PCAT parameters in MB group.Results FAI in MB group was higher,while FV was lower than those in non-MB group(both P＜0.001).Among 150 cases of LAD-MB,superficial type were found in 99 cases(superficial subgroup),while deep type were found in 51 cases(deep subgroup).FAI in superficial subgroup was lower,while FV was higher than those in deep subgroup(both P＜0.001).The median length and median depth of LAD-MB in 150 cases was 20.10 mm and 0.80 mm,respectively.Univariate linear regression analysis showed that for all 287 patients,gender was negatively correlated with FAI,whereas LAD-MB length and LAD-MB depth were positively correlated with FAI but negatively correlated with FV in MB group(all P＜0.05).Multifactor linear regression analysis showed that in MB group,both LAD-MB length and depth were positively correlated with FAI(B=0.105,1.797,both P＜0.05)and negatively correlated with FV(B=-15.585,-162.343,both P＜0.05),while clinical factors were not significantly correlated with FAI and FV(all P＞0.05).Conclusion MB could increase FAI and decrease FV of proximal PCAT.

Objective:To explore the differences in bacterial community structure between proximal colon cancer (PC), distal colon cancer (DC), and rectal cancer (RC), and the values of featured microbiota in differentiating PC with tumor markers.Methods:This case-control study enrolled 85 newly diagnosed colorectal cancer patients, including 22 PC, 15 DC and 48 RC patients, and 8 colorectal adenoma patients from May 2019 to July 2022 at the Department of General Surgery, Anyang Oncology Hospital. The blood and fecal samples were collected before surgery and then subjected to biochemical tests for tumor markers and 16S rDNA tests, respectively. SPSS (27.0.1) was applied to perform the t-test, one-way ANOVA, Mann-Whitney U test, Kruskal-Wallis H test, and Chi-Squared Test. Also, the receiver operating characteristic curve (ROC) was plotted on tumor markers and/or f_Bacteroidaceae with SPSS software .Results:All groups had significant differences in the CA125 ( F=3.543, P<0.05), CA72-4 ( F=3.596, P<0.05), and serum tumor-associated materials (TAM) levels ( F=5.787, P<0.01). In PC group, the levels of CA125 [PC vs RC, (36.84±6.30) kU/L vs (12.73±4.21) kU/L, P<0.01] and CA72-4 [PC vs RC, (45.56±10.86) kU/L vs (3.30±7.63) kU/L, P<0.01] were significantly higher than that of the RC group, while the level of TAM was remarkably elevated in PC group than in RC group [PC vs RC, (124.84±5.19) U/ml vs (102.44±3.63) U/ml, P<0.001] and CRA group [PC vs CRA, (124.84±5.19) U/ml vs (95.39±8.42) U/ml, P<0.01]. The LEfSe analysis showed that the featured microbiota in the PC group included f_Bacteroidaceae, f_Neisseriaceae, f_Clostridiaceae_1, f_Spirochaetaceae, and so on. The largest area under the ROC belonged to the combination of TAM and f_Bacteroidaceae, which reached 0.845 (95% CI 0.747-0.944), with sensitivity being 0.857 and specificity being 0.815. Conclusions:There is heterogeneity in gut microbiota composition among PC, DC, RC, and CRA. The combination of gut microbiota and tumor biomarkers demonstrated good differentiating effects in proximal colon cancers.

Objective To understand the effects of ²⁴¹Am standard material powder with different matrices on the determination of gross alpha activity in water, and to provide a reference for the selection and use of alpha standard sources. Methods The alpha counting efficiency of ²⁴¹Am standard material powder with different matrices was measured by low-background alpha and beta measuring instrument. The radiochemical recovery rate and whole process efficiency of gross alpha activity in water were determined by spike experiments. Results The alpha counting efficiency of the ²⁴¹Am standard material powder with four matrices was in the descending order of calcium carbonate, calcium carbonate and silica mixed matrix, calcium sulfate, and silica. The default chemical recovery rate is 1 when gross alpha activity in water is measured by thick source method. The use of ²⁴¹Am standard material with calcium carbonate as a matrix resulted in about 35% decrease in gross alpha activity, and about 10% deviation was observed using ²⁴¹Am standard material with silica or calcium carbonate and silica mixed matrices. The whole process efficiency of alpha activity in four spiked water samples with ²⁴¹Am standard solution and ²⁴¹Am standard material powder with calcium carbonate, silica, or mixed matrix was 6.34%-7.30%. Conclusion Standard materials with different matrices demonstrate different self-absorption of alpha particles and various influence on the chemical recovery. When purchasing and using standard material powders for alpha activity measurement in laboratories, the composition of the matrix should be clarified as much as possible, and the gross alpha activity in water should be determined by measuring the whole process efficiency if necessary.

Objective To investigate the impact of coronary myocardial bridge(MB)on parameters of proximal pericoronary adipose tissue(PCAT).Methods Totally 287 patients with clinically suspected coronary heart disease but no coronary plaque on CT angiography(CCTA)were retrospectively collected.According to the presence or not of MB in left anterior descending(LAD),the patients were divided into MB group(n=150)and non-MB group(n=137).The length and depth of LAD-MB in MB group were measured,and patients in MB group were divided into deep MB subgroup and superficial MB subgroup according to LAD-MB depth.LAD PCAT parameters,i.e.fat attenuation index(FAI)and fat volume(FV),were compared between groups and subgroups within MB subgroup.Univariate and multivariate linear regression were used to explore the correlations of clinical factors(age,sex,body mass index),MB length,MB depth and PCAT parameters in MB group.Results FAI in MB group was higher,while FV was lower than those in non-MB group(both P＜0.001).Among 150 cases of LAD-MB,superficial type were found in 99 cases(superficial subgroup),while deep type were found in 51 cases(deep subgroup).FAI in superficial subgroup was lower,while FV was higher than those in deep subgroup(both P＜0.001).The median length and median depth of LAD-MB in 150 cases was 20.10 mm and 0.80 mm,respectively.Univariate linear regression analysis showed that for all 287 patients,gender was negatively correlated with FAI,whereas LAD-MB length and LAD-MB depth were positively correlated with FAI but negatively correlated with FV in MB group(all P＜0.05).Multifactor linear regression analysis showed that in MB group,both LAD-MB length and depth were positively correlated with FAI(B=0.105,1.797,both P＜0.05)and negatively correlated with FV(B=-15.585,-162.343,both P＜0.05),while clinical factors were not significantly correlated with FAI and FV(all P＞0.05).Conclusion MB could increase FAI and decrease FV of proximal PCAT.

Objective: Schizophrenia (SCZ) is a severe psychiatric disorder with unknown etiology and lacking specific biomarkers. Herein, we aimed to explore plasma biomarkers relevant to SCZ using targeted metabolomics. Methods: Sixty drug-naïve SCZ patients and 36 healthy controls were recruited. Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale. We analyzed the levels of 271 metabolites in plasma samples from all subjects using targeted metabolomics, and identified metabolites that differed significantly between the two groups. Then we evaluated the diagnostic power of the metabolites based on receiver operating characteristic curves, and explored metabolites associated with the psychotic symptoms in SCZ patients. Results: Twenty-six metabolites showed significant differences between SCZ patients and healthy controls. Among them, 12 metabolites were phosphatidylcholines and cortisol, ceramide (d18:1/22:0), acetylcarnitine, and γ-aminobutyric acid, which could significantly distinguish SCZ from healthy controls with the area under the curve (AUC) above 0.7. Further, a panel consisting of the above 4 metabolites had an excellent performance with an AUC of 0.867. In SCZ patients, phosphatidylcholines were positively related with positive symptoms, and cholic acid was positively associated with negative symptoms. Conclusion Our study provides insights into the metabolite alterations associated with SCZ and potential biomarkers for its diagnosis and symptom severity assessment.

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

OBJECTIVES: Tubulointerstitial diseases is one of the common causes of renal dysfunction. Some rare pathological types are easy to be misdiagnosed and missedly diagnosed because of their low prevalence and relatively insufficient understanding, which affects the treatment and prognosis of patients. This study aims to explore clinical manifestations and pathological characteristics of several rare tubulointerstitial diseases, and therefore to improve their diagnosis and treatment. METHODS: A total of 9 363 patients diagnosed by renal biopsy in the Department of Nephrology, Second Xiangya Hospital, Central South University from November 2011 to September 2021 were selected. Six cases of light chain cast nephropathy (LCCN), 2 cases of light chain proximal tubulopathy (LCPT), 1 case of LCCN with LCPT, 4 cases of genetic tubulointerstitial disease, and 6 cases of non-genetic related tubulointerstitial lesion were screened out, and their clinical manifestations and renal biopsy pathological results were collected, compared, and analyzed. RESULTS: Patients with LCCN presented with mild to moderate anemia, microscopic hematuria, and mild to moderate proteinuria. Compared with patients with LCPT, proteinuria and anemia were more prominent in patients with LCCN. Five patients with LCCN and 2 patients with LCPT had elevated serum free kappa light chain. Five patients with LCCN presented clinically with acute kidney injury (AKI). Two patients with LCPT and 1 patient with LCCN and LCPT showed CKD combined with AKI, and 1 LCPT patient presented with typical Fanconi syndrome (FS). Five patients with LCCN, 2 patients with LCPT, and 1 patient with LCCN and LCPT were diagnosed with multiple myeloma. Five patients with LCCN had kappa light chain restriction in tubules on immunofluorescence and a "fractured" protein casts with pale periodic acid-Schiff (PAS) staining on light microscopy. Immunohistochemical staining of 2 LCPT patients showed strongly positive kappa light chain staining in the proximal tubular epithelial cells. And monoclonal light chain crystals in crystalline LCPT and abnormal lysosomes and different morphological inclusion bodies in noncrystalline LCPT were observed under the electron microscope. Six patients with LCCN were mainly treated by chemotherapy. Renal function was deteriorated in 1 patient, was stable in 4 patients, and was improved in 1 patient. Two patients with LCPT improved their renal function after chemotherapy. Four patients with genetic tubulointerstitial disease were clinically presented as CKD, mostly mild proteinuria, with or without microscopic hematuria, and also presented with hyperuricemia, urine glucose under normal blood glucose, anemia, polycystic kidneys. Only 1 case had a clear family history, and the diagnosis was mainly based on renal pathological characteristics and genetic testing. Compared with patients with non-genetic related tubulointerstitial lesion, patients with genetic tubulointerstitial disease had an earlier age of onset, higher blood uric acid, lower Hb and estiated glomemlar fitration (eGFR), and less edema and hypertension. Renal pathology of genetic tubulointerstitial disease presented tubular atrophy and interstitial fibrosis, abnormal tubular dilation, glomerular capsuledilation, and glomerular capillary loop shrinkage. Glomerular dysplasia and varying degrees of glomerular sclerosis were observed. Genetic tubulointerstitial disease patients were mainly treated with enteral dialysis, hypouricemic and hypoglycemic treatment. Two genetic tubulointerstitial disease patients had significantly deteriorated renal function, and 2 patients had stable renal function. CONCLUSIONS Patients with AKI or FS, who present serum immunofixation electrophoresis and/or serum free kappa light chain abnormalities, should be alert to LCCN or LCPT. Renal biopsy is a critical detection for diagnosis of LCCN and LCPT. Chemotherapy and stem cell transplantation could delay progression of renal function in patients with LCCN and LCPT. If the non-atrophic area of the renal interstitium presents glomerular capsule dilatation, glomerular capillary loop shrinkage, and abnormal tubular dilatation under the light microscopy, genetic tubulointerstitial disease might be considered, which should be traced to family history and can be diagnosed by genetic testing.
Humans ; Hematuria ; Immunoglobulin Light Chains/analysis* ; Multiple Myeloma ; Proteinuria ; Nephritis, Interstitial ; Acute Kidney Injury ; Anemia ; Renal Insufficiency, Chronic

Chiari malformation type 1 (CM1) is a rare condition where agreed classification and treatment are still missing. In 2019, 34 international experts from Europe achieved a consensus on the definition, diagnosis, and treatment of CM1 in children, aiming to guide the clinical diagnosis and treatment of CM1 in children. Now the consensus is interpreted based on recent international research achievements, aiming to provide references for accurate clinical assessment and individualized treatment of CM1 in children.

Chiari malformation (CM) is the most common cause of syringomyelia, where agreed criterions on classification and treatment are still missing. In 2019, 29 international experts from Europe achieved a consensus on the definition, classification, diagnosis and treatment of CM and syringomyelia in adults, aiming to guide the clinical diagnosis and treatment of these diseases. Now the consensus is interpreted based on recently published literature at home and abroad, aiming to provide references for standardized diagnosis and treatment of CM and syringomyelia in adults.

Chiari malformation (CM) is the most common cause of syringomyelia, where agreed criterions on classification and treatment are still missing. In 2019, 29 international experts from Europe achieved a consensus on the definition, classification, diagnosis and treatment of CM and syringomyelia in adults, aiming to guide the clinical diagnosis and treatment of these diseases. Now the consensus is interpreted based on recently published literature at home and abroad, aiming to provide references for standardized diagnosis and treatment of CM and syringomyelia in adults.