Objective:To investigate the independent predictors of the long-term clinical outcomes in patients with branch atheromatous disease (BAD) in lenticulostriate artery (LSA) territory.Methods:Patients with LSA-BAD admitted to the Department of Neurology, Zhongnan Hospital of Wuhan University from January 1, 2016 to June 1, 2019 were enrolled retrospectively. Their demography, vascular risk factor, and baseline clinical data were collected. The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the severity of stroke. The clinical outcomes were evaluated by the modified Rankin Scale at 6 months. 0-2 was defined as good outcome, and >2 was defined as poor outcome. Multivariate logistic regression analysis was used to determine the independent influencing factors of clinical outcomes in patients with LSA-BAD. Results:A total of 81 patients with LSA-BAD were enrolled. Their age 59.20±11.75 years (range, 39-81 years), 53 were male (65.4%), and median baseline NIHSS score was 1.0 (interquartile range, 0-4.0). Forty-one patients (50.6%) received intravenous thrombolysis. At 6-month follow-up after the onset, 63 patients (77.8%) had a good outcome, and 18 (22.2%) had a poor outcome. The baseline NIHSS score of the poor outcome group was significantly higher than that of the good outcome group (6.5 [0-9.0] vs. 1.0 [0-3.0]; Z=2.395, P=0.017), while the proportion of mild stroke (61.6% vs. 98.4%; χ2=17.595, P<0.001) and patients receiving intravenous thrombolysis (38.9% vs. 54.0%; χ2=4.450, P=0.035) were significantly lower than those of the good outcome group. Multivariate logistic regression analysis showed that after adjusting for other confounding factors, venous thrombolysis was independently correlated with the good outcome (odds ratio 0.099, 95% confidence interval 0.011-0.924; P=0.042), while the high baseline NIHSS score was independently associated with the poor outcome (odds ratio 1.736, 95% confidence interval 1.262-2.388; P=0.001). Conclusion:Intravenous thrombolysis is helpful to improve the outcomes of patients with LSA-BAD, and a higher baseline NIHSS score is an independent predictor of the poor outcome.

Betacoronavirus ; China ; epidemiology ; Coronavirus Infections ; prevention & control ; Disease Outbreaks ; Emergencies ; Hospitals, General ; Humans ; Internet ; Pandemics ; prevention & control ; Pneumonia, Viral ; prevention & control

Objective:To investigate the clinical characteristics of carotid webs and prevention measurements of cerebral ischemic stroke caused by carotid webs.Methods:The clinical data of three patients with carotid webs admitted to our hospital from October 2017 to January 2019 were retrospectively studied, and publications (208 patients with carotid webs) reported from January 1, 2014 to June 30, 2019 in PubMed, Embase, Wanfang and CNKI databases were collected. The demographic and clinical characteristics of carotid webs and secondary prevention measurements of ischemic stroke caused by carotid webs were analyzed.Results:A total of 211 patients with carotid webs were enrolled, including 68 male (32.2%) and 143 female (67.8%), with an median age of 48 years. Prevalence of risk factors for cerebrovascular disease reported in 148 patients was as follows: hypertension ( n=43, 29.1%), dyslipidemia ( n=19, 12.8%), diabetes mellitus ( n=14, 9.5%), and smoking ( n=12, 8.1%); 89.8% of carotid webs(44/49) caused mild stenosis of carotid artery (stenosis degree<50%). In secondary stroke prevention, the recurrence rate of stroke patients treated with anticoagulation plus antiplatelet was obviously lower than that of patients treated with antiplatelet alone (11.1% vs. 49.3%). No ischemic stroke or surgical complications were noted in 23 patients underwent carotid endarterectomy and 54 patients underwent carotid stent implantation during the mean follow-up period of 12 months (one-60 months) and 11 months (3-144 months), respectively. Conclusions:Carotid web may be a vital risk factor for cryptogenic stroke. Anticoagulation plus antiplatelet is superior to antiplatelet alone in preventing stroke recurrence. Carotid endarterectomy and carotid stent implantation may be the perfect choices for carotid web patients with high risk of stroke recurrence.

BackgroundIncreasing evidence has supported the link of intestinal Fusobacterium nucleatum infection to colorectal cancer (CRC). However, the value of F. nucleatum as a biomarker in CRC detection has not been fully defined. In order to reduce the random error and bias of individual research, this meta-analysis aimed to evaluate the diagnostic performance of intestinal F. nucleatum in CRC patients and provide evidence-based data to clinical practice.

MethodsAn article search was performed from PubMed, Embase, Cochrane Library, and Web of Science databases up to December 2017, using the following key words: "Fusobacterium nucleatum", "Fusobacterium spp.", "Fn", "colorectal cancer(s)", "colorectal carcinoma(s)", "colorectal neoplasm(s)", and "colorectal tumor(s)". Articles on relationships between F. nucleatum and CRC were selected according to the preestablished inclusion and exclusion criteria. This meta-analysis was performed using STATA 12.0 software, which included mapping of forest plots, heterogeneity tests, meta-regression, subgroup analysis, sensitivity analysis, and publication bias. The sensitivity, specificity, positive likelihood ratio (LR), negative LR, diagnostic odds ratio (DOR), and their corresponding 95% confidence interval (CI) of each eligible study were summarized.

ResultsFinally, data for 1198 participants (629 CRC and 569 healthy controls) in 10 controlled studies from seven articles were included. The summary receiver operator characteristic curve was mapped. The diagnostic performance of intestinal F. nucleatum infection on CRC was as follows: the area under the curve: 0.86 (95% CI: 0.83-0.89), the pooled sensitivity: 0.81 (95% CI: 0.64-0.91), specificity: 0.77 (95% CI: 0.59-0.89), and DOR: 14.00 (95% CI: 9.00-22.00).

ConclusionIntestinal F. nucleatum is a valuable marker for CRC diagnosis.

Colonic Neoplasms ; microbiology ; Colorectal Neoplasms ; microbiology ; Fusobacterium nucleatum ; physiology ; Humans ; Intestines ; microbiology ; pathology

?AIM:To compare the coherence and difference on the fundus examination made with two kinds of optical coherence tomography ( OCT): Angio-OCT and fourier domain-optical coherence tomography ( FD-OCT) .?METHODS:Using Angio-OCT and FD-OCT to measure the retinal nerve fiber layer ( RNFL ) thickness, optic parameters, and ganglion cell complexes ( GCC ) thickness from 20 subjects respectively.The coherence was tested with Pearson's correlation coefficient, the difference was tested with paired Student t testing.?RESULTS:The total correlation of the RNFL thickness, optic parameters, GCC thickness made with two kinds of OCT was between 0.7-0.8;the RNFL thickness, optic disk area etc.made with the Angio-OCT were lower than those made with FD-OCT except for the GCC thickness.?CONCLUSION: The results made with two kinds of OCT from the same subject has certain coherence, but cannot be compared directly.

BACKGROUNDIn vivo quantification of choroidal neovascularization (CNV) based on noninvasive optical coherence tomography (OCT) examination and in vitro choroidal flatmount immunohistochemistry stained of CNV currently were used to evaluate the process and severity of age-related macular degeneration (AMD) both in human and animal studies. This study aimed to investigate the correlation between these two methods in murine CNV models induced by subretinal injection.

METHODSCNV was developed in 20 C57BL6/j mice by subretinal injection of adeno-associated viral delivery of a short hairpin RNA targeting sFLT-1 (AAV.shRNA.sFLT-1), as reported previously. After 4 weeks, CNV was imaged by OCT and fluorescence angiography. The scaling factors for each dimension, x, y, and z (μm/pixel) were recorded, and the corneal curvature standard was adjusted from human (7.7) to mice (1.4). The volume of each OCT image stack was calculated and then normalized by multiplying the number of voxels by the scaling factors for each dimension in Seg3D software (University of Utah Scientific Computing and Imaging Institute, available at http://www.sci.utah.edu/cibc-software/seg3d.html). Eighteen mice were prepared for choroidal flatmounts and stained by CD31. The CNV volumes were calculated using scanning laser confocal microscopy after immunohistochemistry staining. Two mice were stained by Hematoxylin and Eosin for observing the CNV morphology.

RESULTSThe CNV volume calculated using OCT was, on average, 2.6 times larger than the volume calculated using the laser confocal microscopy. The correlation statistical analysis showed OCT measuring of CNV correlated significantly with the in vitro method (R 2 =0.448, P = 0.001, n = 18). The correlation coefficient for CNV quantification using OCT and confocal microscopy was 0.693 (n = 18, P = 0.001).

CONCLUSIONSThere is a fair linear correlation on CNV volumes between in vivo and in vitro methods in CNV models induced by subretinal injection. The result might provide a useful evaluation of CNV both for the studies using CNV models induced by subretinal injection and human AMD studies.

Animals ; Choroidal Neovascularization ; pathology ; physiopathology ; Disease Models, Animal ; Fluorescein Angiography ; Humans ; Mice ; Mice, Inbred C57BL ; Tomography, Optical Coherence

Objective To discuss the blood perfusion characteristic of benign and malignant gallbladder disease by contrast-enhanced ultrasound(CEUS).Methods The enhancement characteristic of 62 patients with occupying lesions in gallbladder were observed.Four case of cholecystolithiasis accompany biliary sludge were proven by surgery and remaining 58 case were confirmed by histopathological examination.Their enhancement time and enhancement pattern were analyzed.Results The Time-to peak of benign and malignant disease were (22.4± 4.0)s and (27.7± 2.6)s (t =5.756,P ＜0.01),the Time-to-hypoenhancement of benign and malignant disease were (58.0 ± 7.3)s and (41.5 ± 4.0)s (t =10.33,P ＜0.01),respectively.The peak intensity of benign and malignant disease were (19.2 ± 3.6)dB and (25.1 ± 2.9) dB (t =6.85,P ＜0.01),the mean transit time of benign and malignant disease were (22.72 ± 4.7)s and (6.3± 6.4)s (t =15.001,P ＜0.01),respectively.The destruction of the gallbladder wall of benign and malignant disease were 0％ (0/36) and 57.7％ (15/26) (x2 =25.05,P ＜ 0.01),the inhomogeneous enhancement of benign except biliary sludge and malignant disease were 43.8％ (14/32) and 57.7％ (15/26) (x2 =1.115,P =0.291,respectively).In early phase,78.1％ (25/32) and 80.8 ％ (21/26) of benign disease except biliary sludge and malignant showed hyperenhancement respectively(x2 =3.15,P =0.207).In later phase,84.4％ (27/32) and 76.9％ (20/26) of benign disease except biliary sludge and malignant showed hypoenhancement respectively(x2 =3.615,P =0.164).Conclusions CEUS can obtain the information of blood perfusion and make quantitatively analysis about the enhancement time.It also facilitate the diagnosis of solid occupying lesion in gallbladder.

Follicular dendritic cell (FDC) sarcoma is rare and is classified either as conventional type or inflammatory pseudotumor (IPT)-like variant. Extranodal presentation is uncommon and nearly all gastrointestinal FDC tumors are of the conventional type. IPT-like variant tumors occur almost exclusively in the liver and spleen and are consistently associated with Epstein-Barr virus (EBV). Here we report the case of a 78-year-old woman with an IPT-like FDC sarcoma presenting as a pedunculated colonic polyp. Histologically, scanty atypical ovoid to spindle cells were mixed with a background of florid lymphoplasmacytic infiltrate, which led to an initial misdiagnosis of pseudolymphoma. These atypical cells expressed CD21, CD23, CD35, and D2-40, and were positive for EBV by in situ hybridization, confirming the diagnosis. The patient was free of disease five months after polypectomy without adjuvant therapy. Although extremely rare, the differential diagnosis for colonic polyp should include FDC sarcoma to avoid an erroneous diagnosis. A review of the 24 cases of IPT-like FDC sarcoma reported in the literature reveal that this tumor occurs predominantly in females with a predilection for liver and spleen, and has a strong association with EBV.
Aged ; Colonic Polyps* ; Dendritic Cell Sarcoma, Follicular* ; Dendritic Cells, Follicular ; Diagnosis ; Diagnosis, Differential ; Diagnostic Errors ; Female ; Granuloma, Plasma Cell ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Liver ; Pseudolymphoma ; Sarcoma ; Spleen ; Taiwan