Abstract While tuberculosis (TB) in pregnant women is reported globally, clinical data is unavailable in China. To describe clinical features and identify difficulties in the diagnosis of pregnancy-related TB, we performed a retrospective study of 28 TB inpatients at Beijing Chest Hospital. The results were presented in terms of interquartile range (IQR) for age, and medians and percentages with respect to the categorical variables. One patient (3.6%) was immediately diagnosed; for 27 patients (96.4%), the median interval from the initial onset of symptoms to diagnosis was five weeks. Eight cases (28.6%) were microbiologically confirmed. 22 (78.6%) were pulmonary TB (PTB), while six (21.4%) were extrapulmonary TB (EPTB). In addition, eight (28.6%) were miliary TB and six (21.4%) were cerebral TB. 27 (96.4%) were cured and one (3.6%) died. 15 neonates were identified, nine of which were healthy. Two were small for the gestational age (SGA) and one was a stillbirth. Three had neonatal TB, one of which died. Nine were legal abortions and four were spontaneous abortions. Indeed, there was a substantial delay in the diagnosis of TB in the pregnant women and a high incidence of both miliary and cerebral TB was evident. With timely treatment, prognosis is positive.
The self-healing phenomenon can be found in the elastase-induced abdominal aortic aneurysm (AAA) model, and an enlarging AAA model was successfully induced by coarctation. Unfortunately, aortic coarctation in these enlarging models is generally not found in human AAA disease. This study aimed to create an experiment model of enlarging AAA in rabbits to better mimic human aortic aneurysm disease. Eighty-four male New Zealand white rabbits were randomly divided into three equal groups: two aneurysm groups (A and B) and a SHAM group. Aneurysm group rabbits underwent extrinsic aortic stenosis below the right renal artery and received a 10-minute incubation of 60 μl elastase (1 unit/μl). Absorbable suture was used in Group A and nonabsorbable cotton thread was used in Group B. A sham operation was performed in the SHAM group. Aortic diameter was measured after 1, 3, 7, and 15 weeks; thereafter animals were sacrificed for histopathological, immunohistochemical and quantitative studies. Two rabbits died at 29 and 48 days, respectively, after operation in Group B. All aneurysms formed and enlarged progressively by 3 weeks in the Aneurysm groups. However, diameter enlargement in Group A was significantly lower than that in Group B at 7 weeks. Aneurysm groups developed intimal hyperplasia; intima-media thickness (IMT) increased significantly by week 7, and aortic media thickness and intima-media ratio (IMR) increased significantly by week 15. Marked destruction of elastin fibers and smooth muscle cells (SMCs) occurred 1 week later and increased progressively thereafter. Intimal hyperplasia and SMCs content in Group A increased significantly by week 15 compared with Group B. Aneurysm groups exhibited strong expression of matrix metalloproteinases 2 and 9 and RAM11 by week 1, and decreased progressively thereafter. In conclusion, this novel rabbit AAA model enlarges progressively without coarctation and is capable of better mimicking human aortic aneurysm disease.
This study aimed to present long-term results of a 12-year patient follow-up of recoverable stents for BCS complicated by inferior vena cava (IVC) thrombosis. Forty consecutive patients with BCS complicated by IVC thrombosis were treated with recoverable stents. The median duration of symptoms was 24 months. Recoverable stents was placed after predilation of the obstructed IVC, and then agitation thrombolysis or catheter-directed thrombolysis of IVC was performed. The recoverable stents was removed eventually after thrombus disappeared. Clinical patency was defined as absence or improvement of symptoms. Patients were subsequently followed-up by color Doppler ultrasound. Recoverable stents placement, balloon angioplasty and thrombolysis were technically successful in all patients. Stents were successfully removed in 92.1% of patients. A few serious related complications including one acute pulmonary thromboembolism, one stent migration, and one failure retrieval stents occurred. The median follow-up was 43.7 months. The long-term results were satisfactory except 2 patients who presented with a restenosis or re-obstruction and underwent additional therapy. There were 5 deaths owing to pulmonary embolism or underlying malignant disease 0.4-101.8 months after the procedures, including one procedure-related death. In conclusion, Recoverable stents treatment is safe and effective for BCS complicated by IVC thrombosis, with a good long-term outcome.
Background Diabetes has been regarded as an inflammatory condition which is associated with left ventricular diastolic dysfunction (LVDD). The purpose of this study was to examine the expression levels of macrophage migration inhibitory factor (MIF) and G protein-coupled receptor kinase 2 (GRK2) in patients with early diabetic cardiomyopathy, and to investigate the mechanisms involved in MIF expression and GRK2 activation. Methods 83 patients in the age range of 30-64 years with type 2 diabetes and 30 matched healthy men were recruited. Left ventricular diastolic function was evaluated by cardiac Doppler echocardiography. Plasma MIF levels were determined by ELISA. To confirm the clinical observation, we also studied MIF expression in prediabetic rats with impaired glucose tolerance (IGT) and relationship between MIF and GRK2 expression in H9C2 cardiomyoblasts exposed to high glucose. Results Compared with healthy subjects, patients with diabetes have significantly increased levels of plasma MIF which was further increased in diabetic patients with Left ventricular diastolic dysfunction (LVDD). The increased plasma MIF levels in diabetic patients correlated with plasma glucose, glycosylated hemoglobin and urine albumin levels. We observed a significant number of TUNEL-positive cells in the myocardium of IGT-rats but not in the control rats. Moreover, we found higher MIF expression in the heart of IGT with cardiac dysfunction compared to that of the controls. In H9C2 cardiomyoblast cells, MIF and GRK2 expression was significantly increased in a glucose concentration-dependant manner. Furthermore, GRK2 expression was abolished by siRNA knockdown of MIF and by the inhibition of CXCR4 in H9C2 cells. Conclusions Our findings indicate that hyperglycemia is a causal factor for increased levels of pro-inflammatory cytokine MIF which plays a role in the development of cardiomyopathy occurring in patients with type 2 diabetes. The elevated levels of MIF are associated with cardiac dysfunction in diabetic patients, and the MIF effects are mediated by GRK2.
Hemodynamics may play an essential role in the initiation and progression of abdominal aortic aneurysm (AAA). We aimed to study the mechanism of self-healing process by the changes of hemodynamics and pathology in an enlarging AAA in rabbits. Seventy-two rabbits were randomly divided into three groups. Rabbits underwent extrinsic coarctation and received a 10-minute elastase incubation in Group A and Group B. Absorbable suture used in Group A was terminated by balloon dilation at week 4. Diameter was measured after 1, 3, 5, and 15 weeks, computational fluid dynamics analysis was performed at week 3 and week 15. Rabbits were sacrificed after 1, 5, and 15 weeks for pathological and quantitative studies. The higher velocity magnitude, intensified bulk flow and obvious vortex formation were observed in Group A at week 3 instead of week 15. Both low wall shear stress and high relative residence time increased in Group B, however, high oscillatory shear index had relatively less increase compared with Group A. Aortic diameter reached a plateau at 5 weeks in Group A, which was significantly lower than in week 15 in Group B. Intimal hyperplasia, intima-media thickness increased significantly in Group A at week 5, significantly higher than in week 15 in Group B. Marked destruction of elastin fibers and smooth muscle cells occurred at week 1, and increased significantly at week 15 in Group A. Aneurysm exhibited strong expression of matrix metalloproteinase 9 and mouse anti-rabbit macrophage 11 at week 1, and showed a tendency to decrease. Matrix metalloproteinase 2 expression decreased significantly in Group B at week 15 compared with week 5 and Group A. In conclusion, the self-healing of rabbit AAA may attributed to the regeneration of smooth muscle cells. The turbulence flow caused by coarctation is associated with continuous growth of rabbit AAA and prevents the self-healing phenomenon.
Abstract Background and Aim The aim of this study is to compare long‐term outcomes of retrievable stents (RSs) and permanent stents (PSs) for Budd–Chiari syndrome (BCS) due to long‐segment obstructive inferior vena cava (IVC). Methods Between July 2000 and August 2016, 42 patients with BCS due to long‐segment obstructive IVC were treated with RSs, and 41 patients were treated with PSs. The RSs were removed eventually after thrombus disappeared. Patients were subsequently followed up by color Doppler sonography or computed tomography scanning. Results All RS placements were successful, and 37 RSs were retrieved 8 to 29 days later. Forty‐two stents were implanted in PS group. One failure retrieval of RSs occurred, and two failures of cannulations were found in PS group. Two deaths may be procedure related and died from acute pulmonary thromboembolism perioperatively. One patient developed acute cerebral infarction and recovered after treatment. In PS group, minor complications were found in three patients. The length of IVC lesion segment and length and thickness of IVC thrombus decreased significantly, and diameter of retrocaval IVC and diaphragm IVC increased significantly in both groups. During follow‐up, three patients died from liver failure in RS group, and two patients died in PS group. RS group showed a significantly higher primary patency rate than PS group. Cumulative 1‐, 3‐, and 5‐year secondary patency rates were 95.2%, 89.6%, and 89.6% in RS group and 100%, 96.6%, and 96.6% in PS group ( P = 0.7109). Conclusions Retrievable stents are effective for BCS because of long‐segment obstructive IVC, with a higher primary patency rate.
Marcona, the preeminent Andean magnetite deposit (1.9 Gt @ 55.4% Fe and 0.12% Cu), is located in the iron oxide copper-gold (IOCG) subprovince of littoral south-central Peru. Fe oxide and Cu (-Zn-Pb) sulfide mineralization was controlled by northeast-striking faults transecting a Middle Jurassic (Aalenian-to-Oxfordian) andesitic, shallow-marine arc and a succession of contiguous, plate boundary-parallel, Late Jurassic to mid-Cretaceous volcanosedimentary basins.
At Marcona, hydrothermal activity was initiated in the earliest Middle Jurassic (161–177 Ma) by high-temperature Mg-Fe metasomatism represented by cummingtonite and phlogopite-magnetite assemblages. Subsequently, during the terminal eruptions (156–162 Ma) of the arc, widespread albite-marialite alteration (Na-Cl metasomatism) was followed by the emplacement of an en echelon swarm of massive magnetite ore-bodies with subordinate, overprinted magnetite-sulfide assemblages, hosted largely by Paleozoic metasilici-clastics. The magnetite orebodies exhibit abrupt, smoothly curving contacts, dike-like to tubular apophyses, and intricate, amoeboid interfingering with dacite porphyry intrusions. There is no convincing megascopic or microscopic evidence for large-scale Fe metasomatism associated with the main, sulfide-poor mineralization. The largest, 400 Mt Minas 2-3-4 orebody is interpreted as a bimodal magnetite-dacite intrusion comprising commingled immiscible melts generated through the dissolution of metasedimentary quartz in parental andesitic magma. Oxygen and sulfur stable-isotope geothermometry indicates that the evolution at ca. 159 Ma from magnetite-biotite-calcic amphibole ± phlogopite ± fluorapatite to magnetite-phlogopite-calcic amphi-bole-pyrrhotite-pyrite assemblages coincided with quenching from above 800° C to below 450°C and the concomitant exsolution of dilute aqueous brines. Subsequently, chalcopyrite-pyrite-calcite ± pyrrhotite ± sphalerite ± galena assemblages, in part metasomatic, were deposited from lower temperature (≤360°C) brines.
The Cu-poor Marcona (“Kiruna-type”) magnetite and Cu-rich IOCG deposits in the district, therefore, although spatially contiguous, represent contrasting ore deposit types. The former are interpreted as the product of Fe oxide melt coexisting with dacite magma within an andesitic arc which failed during the closure of a back-arc basin. The weak associated magmatic-hydrothermal Cu sulfide mineralization at Marcona was generated through melt vesiculation and contrasts with the considerably higher grade Cu- and Ag-rich orebodies of the major Cu-rich IOCG deposits in the Central Andes, e.g., La Candelaria-Punta del Cobre, Mantoverde, Raul-Condestable, and Mina Justa, which were the products of cool, oxidized, hydrothermal fluids plausibly expelled from the adjacent basins during tectonic inversion.
Background To study the long-term effects of low-dosage strontium-90 (Sr90) irradiation on the recurrence of pterygium. Methodology/Principal Findings One hundred twenty eyes from 104 patients with primary or recurrent pterygia were treated with surgery followed by Sr90 irradiation. In brief, starting on the sixth day after surgery, patients were treated with irradiation three times every other day at a total combined dosage of 2000 cGy to 3000 cGy. Corneal topography was used to evaluate ocular surface regularity before and after treatment. Patient follow-up was performed 2 days, 5 days, 2 weeks, 1 month, 3 months, 1 year, 5 years, and 10 years after surgery. Recurrence of pterygium was not observed in any of the patients in this study. Obvious cataract progression was observed in 6 eyes, which may be due to aging. During follow-up studies, only one eye was reported with dryness and foreign-body sensation. Significant pterygium-induced astigmatism was observed in corneal topography, which decreased after surgery. Conclusions/Significance Sr90 irradiation is effective in preventing the recurrence of primary and recurrent pterygia. We recommend delivering a total combined dosage of 2000 cGy to 3000 cGy of Sr90 irradiation administered in three batches every other day starting from the sixth day after surgery. Surgery is important in the rapid recovery of the cornea from pterygium-induced astigmatism.
Tuberculous meningitis (TBM) is the most serious type of tuberculosis infection, and there is a lack of accurate diagnostic targets for TBM. Therefore, it is of great clinical and public health significance to find a specific target for early diagnosis and prediction of the prognosis of TBM. From January 2021 to February 2024, 110 TBM patients and 122 patients with non-tumor, non-infectious headaches were admitted to Hunan Chest Hospital. To compare the two groups, cerebrospinal fluid (CSF) levels of sCD163 and MMP-9, as well as serum NCAM1 protein levels, were detected by ELISA. Multivariate logistic regression analysis or Spearman analysis was then performed to investigate the correlation between these protein levels and the MRC (Medical Research Council) stage or the short-term prognosis in TBM patients. sCD163 and MMP-9 were elevated in the CSF of TBM patients compared to controls. Oppositely, the protein levels of serum NCAM1 was decreased. The levels of CSF sCD163, MMP-9 and serum NCAM1 are associated with MRC stage and short-term prognosis of TBM patients, and the combined CSF sCD163, MMP-9 and serum NCAM1 have the best value in predicting the short-term prognosis of TBM patients.
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)
