Multimodal Imaging for the Diagnosis of Massive Left Atrial Metastasis from Lung Cancer - A Case Report.

BACKGROUND: Secondary cardiac tumors are a rare disease that is hard to detect when the tumor is small and asymptomatic. This case report focuses on a massive pulmonary metastasis filling almost the entire left atrium. Multimodal enhancement imaging, cardiac contrast-enhanced ultrasound (CEUS), enhanced electron computed tomography, and positron emission tomography imaging were applied to detect the malignant origin of this case. The aim of this project was to provide an important basis for clinical treatment and decision-making with multimodal imaging. CASE PRESENTATION: The patient was hospitalized with suspected to be a lumbar spine fracture. According to the multimodal imaging, pathologically confirmed to suffer a cardiac metastasis from small cell lung cancer. EP-regimen (Etoposide 0.1gd 1-5+Nedaplatin 30mgd 1-4) was selected for the systemic chemotherapy of the patient. During three years of follow-up, the left intra-atrial occupancy was significantly reduced. CONCLUSION: Multimodality imaging can cover up the deficiencies of single imaging examinations and further clarify and enrich the understanding of the relationship between the location and the surrounding structure of the mass, thus providing a good reference for clinical treatment and decisionmaking.

A quantitative analysis of thyroid fine needle aspiration (FNA) using needles with different gauges.

OBJECTIVE: The aim of this study is to compare the results of three gauge (G) needles (22G, 23G and 25G) in terms of cell amount in thyroid fine needle aspiration (FNA). SUBJECTS AND METHODS: In the retrospective study, a total of 443 patients undergoing FNA for the first time between 2017 and 2018 were included in the study, and assigned to 3 groups with 22-gauge, 23-gauge and 25-gauge needles, respectively. RESULTS: The cell amount of a suspicion for the four diagnosis groups, including malignancy and malignant, benign nodules, follicular of undetermined significance (FLUS), and follicular neoplasia was mainly in the range of 0-10000, 0-300, 0-150, and 500-2500, respectively. The cut-off values of 22G needle 20000, 300, 1000, and 2500, while the cut-off values of 23G and 25G were 10000, 400, 1000, and 2500; 5000, 400, 1500, and 2000, respectively for the four diagnosis groups. CONCLUSION: Large-gauge needles resulted in more cellular specimens than small-gauge needles only in the cases of malignant tumors. Small-gauge needles resulted in a higher comfort level of the patients, and had no difference in cell number in nodules with abundant blood supply, compared with large-gauge needles.

Uncovering of potential molecular markers for cervical squamous cell carcinoma (CESC) based on analysis of methylated-differentially expressed genes.

OBJECTIVE: Cervical squamous cell carcinoma (CESC) is a cancer with high mortality caused by human papillomavirus. The aim of this study was to uncover potential CESC biomarkers to help early diagnosis and treatment. MATERIALS AND METHODS: The mRNA transcriptome data and DNA methylation data were downloaded from database for the identification of differentially expressed mRNAs (DEmRNAs) and DNA methylation analysis. Functional analysis was used to reveal the molecular functions. Then, the association between differential methylation and DEmRNA was analyzed. Protein-protein interaction (PPI) network analysis was performed on the selected differentially methylated genes (DEGs). Subsequently, we analyzed the prognosis and constructed a prognostic risk model. We also performed diagnostic analyses of risk model genes. In addition, we verified the protein expression level of identified DEGs. RESULTS: 1438 DEmRNAs, 1669 differentially methylated sites (DMSs), 46 differentially methylated CpG islands and 53 differential methylation genes (DMGs) were obtained. In PPI, the highest interaction scores were MX2 and IRF8, and their interaction score was 0.928. Interestingly, 5 DMGs were found to be associated with CESC prognosis. In addition, our results demonstrated that high risk score was associated with poor prognosis of CESC. Furthermore, it was found that ZIK1, ZNRF2, HHEX, VCAM1 could be diagnostic molecular markers for CESC. CONCLUSION: Analysis of methylated-differentially expressed genes may contribute to the identification of early diagnosis and therapeutic targets of CESC. In addition, a prognostic model based on 5 DMGs can be used to predict the prognosis of CESC.

miRNA-29 aggravates myocardial infarction via inhibiting the PI3K/mTOR/HIF1α/VEGF pathway.

INTRODUCTION: MI is defined by the presence of myocardial necrosis, which is caused by acute and persistent ischemia and hypoxia of the coronary artery. In recent years, its incidence rate has been on the rise in China. METHODS: GSE34198, GSE97320 and GSE141512 datasets were download for DEG analysis. KEGG pathway analysis, GO analysis, GSEA and PPI network construction were performed. Later, target genes of candidate miRNAs were predicted. Next, echocardiography was conducted to detect the effects of miR-29 on left ventricular structure and cardiac function in vivo, and H&E staining was adopted to study the effects of miR-29 on angiogenesis and fibrosis in vivo. Furthermore, Western blotting was employed to investigate the effects of miR-29 inhibition on the expressions of proteins related to the PI3K\mTOR\ HIF-1α\VEGF pathway. RESULTS: There were 162 DEGs involved in MI. GO analysis revealed that inflammatory responses, negative regulation of apoptosis and innate immune response were the main enriched biological processes. KEGG analysis manifested that DEGs were mainly enriched in the PI3K/Akt signaling pathway, and GSEA demonstrated that they were mainly enriched in the PI3K/Akt/mTOR, HIF and VEGF pathways. Moreover, target gene prediction showed that miR-29 was lowly expressed in MI. According to Masson's trichrome staining, miR-29 inhibition promoted angiogenesis, reduced fibrosis, and increased the protein expressions of p-PI3K, p-mTOR, HIF-1α, and VEGF. CONCLUSIONS: MiR-29 may play an important role in the growth and development of MI. After inhibition of miR-29, the PI3K/mTOR/HIF-1α/VEGF pathway is activated to alleviate MI.

miRNA-29a inhibits atherosclerotic plaque formation by mediating macrophage autophagy via PI3K/AKT/mTOR pathway.

BACKGROUND: miR-29a plays a vital role in AS, but the relationship between the miR-29a-targeted PI3K signaling pathway and AS remains unclear. Therefore, this study was carried out. METHODS: Gene expression profiles from the GEO database containing AS samples were analyzed. ApoE-/- mice and RAW264.7 cells were treated with miR-29a negative control (NC), miR-29a mimic and miR-29a inhibitor to establish the AS model. Then MOVAT staining, TEM, Western blotting, and immunofluorescence staining were adopted for testing target proteins. RESULTS: DEGs were identified from GSE137578, GSE132651, GSE113969, GSE43292, and GSE97210 datasets. It was found that there were targeted binding sites between miR-29a and PIK3CA. Besides, GO and KEGG analysis demonstrated that autophagy was an enriched pathway in AS. Later, PPI network was depicted, and hub genes were then determined. The results revealed that miR-29a suppressed the areas of plaques and lesional macrophages, but had no impact on VSMCs. TEM results showed the organelles pyknosis of lesional macrophages damaged morphological changes. Furthermore, miR-29a amplified the M2-like macrophages but suppressed the polarization of M1-like macrophages in atherosclerotic plaques. According to mouse and RAW 264.7 cell experiments, miR-29a significantly inhibited the protein expressions of PI3K, p-PI3K, p-AKT, and p-mTOR, which were consistent with the increased expressions of autophagy-related proteins, Beclin 1 and LC3II. However, the miR-29a suppression exhibited the contrary results. CONCLUSION: MiR-29a elevation induces the increase of autophagy by down-regulating the PI3K/AKT/mTOR pathway in the progression of AS, indicating that miR-29a is a novel therapeutic strategy for AS.

Inhibiting effect of miR-29 on proliferation and migration of uterine leiomyoma via the STAT3 signaling pathway.

AIM: Uterine leiomyoma is the most common benign tumor of female genitalia, and the incidence is rising gradually. This study explores the mechanism of miR-29 and STAT3 signaling pathways on uterine leiomyoma. METHODS: GSE64763 and GSE5244 datasets were downloaded. Enrichment analyses were performed in GSE64763. PPI network was constructed, and the significant module was identified. Uterine leiomyoma cell lines were divided into NC, miR-29 mimic, anti-NC, and miR-29 inhibitor groups. Plate clone formation and Transwell assays detected the proliferation, invasion, and migration of cells. The expression levels of STAT3, proliferation, EMT, invasion-associated proteins were determined by Western blotting. RESULTS: Differently expressed genes were mainly enriched in positive regulation of cell migration and gene expression, cell proliferation. Through GSEA, JAK-STAT is a significantly correlated enrichment pathway. A Venn diagram was drawn to identify the common miRNA (miR-29-3p). miR-29 inhibitors promoted protein expression of STAT-3, Cyclin D1, and c-Myc compared with the anti-NC control (P < 0.01), and miR-29 inhibitors promoted cell proliferation in uterine leiomyoma cells (P < 0.05). Furthermore, miR-29 inhibitors promoted the protein expression of MMP-2 and MMP-9 (P < 0.01), and EMT promoting proteins N-cadherin, snail, vimentin, and Transwell assay showed that miR-29 inhibitors promoted cell migration in uterine leiomyoma (P < 0.01). CONCLUSIONS: High expression of miR-29 could inhibit cell proliferation, invasion, and metastasis in uterine leiomyoma, which might be related to the inhibition of the STAT3 signaling pathway, and could provide a novel target for the treatment of uterine leiomyoma.

Heart Model A.I. Three-Dimensional Echocardiographic Evaluation of Left Ventricular Function and Parameter Setting.

OBJECTIVE: This study aims to explore the feasibility of HeartModel A.I. (HM) three-dimensional echocardiography (3DE) to assess left ventricular function and discover suitable border parameter settings. METHODS: A total of 113 patients that underwent echocardiography in our hospital were eligible for inclusion. The HM 3DE (HM method) and conventional 3DE (3D method) were used to analyze echocardiography images. The HM was set to different border settings (end-diastolic [ED] and end-systolic [ES] settings) to assess different left ventricular systolic function parameters including left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), and left ventricular ejection fraction (LVEF), and left ventricular diastolic function parameters including maximal left atrium volume (LAVMAX). All of these parameters were evaluated using the HM method and then compared with the 3D method. RESULTS: The differences in LVEDV, LVESV, and LVEF measured with different HM border settings were statistically significant (P<0.05) and were strongly correlated with the 3D method. For LVEF, the reading using the HM method with ED and ES = 70 and 30 showed the best agreement with the 3D method, and the difference in the readings was not statistically significant (P > 0.05). For LVEDV and LVESV, the reading using the HM method with ED and ES = 40 and 20 showed the best agreement with the 3D method, but the difference in the readings was statistically significant (P < 0.05). The measurements taken using the HM method were more reproducible than those taken using the 3D method (P<0.05). The measurement time when using the HM method was significantly less than the 3D method (P<0.05). In terms of LAVMAX, the correlation between the HM and 3D methods was strong, but the requirements for agreement were not satisfied. CONCLUSION: Evaluation of the left ventricular function using HM 3DE is feasible, saves time, and is reproducible. To assess the left ventricular function, the border parameter setting of ED and ES = 70 and 30 provided the best fit for the Chinese population.

The Value of Ultrasound-Guided Fine-Needle Aspiration Cytology Combined with Puncture Feeling in the Diagnosis of Thyroid Nodules.

INTRODUCTION: There are few studies on the role of puncture feeling in thyroid nodules during ultrasound-guided fine-needle aspiration cytology (US-FNAC), although it is expected to become a new predictive technique. We aimed to analyze the importance of puncture feeling in combination with US-FNAC and investigate whether it can be used as an indicator to predict the nature of thyroid nodules. MATERIALS AND METHODS: From January 1, 2018, to October 31, 2020, a total of 623 thyroid nodules were included. Puncture feeling was classified as "soft," "hard," or "hard with grittiness." The correlation between puncture feeling and postoperative pathology and the diagnostic value of FNAC combined with puncture feeling were analyzed, and the influence of thyroid nodule size on puncture feeling, FNAC, and FNAC combined with puncture feeling was studied. We further explored the correlation between puncture feeling and histopathology in Bethesda III and IV thyroid nodules. RESULTS: There was a significant correlation between puncture feeling and postoperative pathology (p < 0.001). The sensitivity, negative predictive value, and total coincidence rate of US-FNAC combined with puncture feeling for the diagnosis of thyroid nodules were higher than those of US-FNAC alone (96.1, 83.6, and 94.7% vs. 89.0, 65.5, and 89.7%, respectively). Thyroid nodule size was the influencing factor for puncture feeling, FNAC, and FNAC combined with puncture feeling (p < 0.05 for all). The area under the curve for puncture feeling, FNAC, and FNAC combined with puncture feeling for thyroid nodules of size ≤1 cm was greater than for modules of size >1 cm. Puncture feeling was of great value in diagnosing Bethesda III thyroid nodules (p < 0.001), and all Bethesda IV thyroid nodules had puncture feeling of soft. CONCLUSION: Puncture feeling is of great value during US-FNAC. "Hard" and "hard with grittiness" were indicators for malignancy, while "soft" indicated that the thyroid nodule was likely to be benign. The diagnostic value of US-FNAC combined with puncture feeling for thyroid nodules is higher than US-FNAC alone, especially when nodule size is ≤1 cm. Puncture feeling is of great value in predicting the nature of Bethesda III thyroid nodules.

Diagnostic value of puncture feeling combined with BRAF V600E mutation in repeat US-FNA biopsy of Bethesda III thyroid nodules.

BACKGROUND: The diagnosis and treatment of Bethesda III thyroid nodules has always been controversial. Our aim is to study the value of puncture feeling combined with BRAF V600E mutation detection in the diagnosis of Bethesda III thyroid nodules in repeat fine needle aspiration (FNA). METHODS: From January 1, 2017 to December 31, 2021, a total of 1,114 thyroid nodules were included, of which Bethesda III thyroid nodules accounted for 12.1%. We analyzed the correlation between puncture feeling and postoperative pathology. Then, the diagnostic value of puncture feeling in Bethesda III thyroid nodules and the mutation rate of BRAF V600E in repeated FNA and its correlation with puncture feeling were analyzed. RESULTS: The results showed that there was a significant correlation between puncture feeling and postoperative pathology in the 1114 thyroid nodules (P<0.001). Additionally, 93.4% (299/320) of the thyroid nodules with soft puncture feeling were benign, 89.0% (460/517) of the thyroid nodules with hard puncture feeling were malignant, and 93.1% (258/277) of the thyroid nodules with a puncture feeling of hard with grittiness were malignant. There was high consistency of puncture feelings among different operators (P<0.001). The distribution of puncture feeling between benign and malignant thyroid nodules was significantly different (P<0.001) in Bethesda III thyroid nodules. In the puncture feeling ROC curve of Bethesda III thyroid nodules based on pathology, the AUC was 0.895 (95% CI: 0.817-0.973, P<0.001). In repeat FNA, BRAF V600E was significantly correlated with puncture feeling (P<0.001). BRAF V600E mutation was found in 22 (68.8%) malignant nodules. CONCLUSIONS: Puncture feelings of hard and hard with grittiness were malignant risk factors. Repeated FNA and BRAF V600 mutation detection should be performed for Bethesda III thyroid nodules with a hard or hard with grittiness puncture feeling.

Ultrasonographic features of eccrine spiradenoma: A case report.

RATIONALE: Eccrine spiradenoma (ES) is a rare benign skin adnexal tumor originating from eccrine sweat glands. The features of ES on ultrasonography (US) have received little attention. Therefore, we report the sonographic findings in a case of an ES that originated from the abdominal wall and discuss the previously reported cases. PATIENT CONCERNS: A 53-year-old woman was admitted to our hospital with a complaint of a painful nodule on the right side of her abdominal wall of 1-year duration. DIAGNOSES: The mass on the right side of abdominal wall was diagnosed as ES by histopathological examination. INTERVENTIONS: The patient subsequently underwent total excision of the mass. OUTCOMES: The patient recovered well and had no complications during the 1-year follow-up. LESSONS: As eccrine spiradenoma (ES) is rare and most of the tumors are excised without prior imaging studies. Little is known regarding the features of ES on ultrasonography (US). Familiarizing with the clinical and US features of this rare tumor may increase awareness of the disease among sonographers and clinicians.

GPR39 promotes cardiac hypertrophy by regulating the AMPK-mTOR pathway and protein synthesis.

Hypertrophic growth of the cardiomyocytes is one of the core mechanisms underlying cardiac hypertrophy. However, the mechanism underlying cardiac hypertrophy remains not fully understood. Here we provided evidence that G protein-coupled receptor 39 (GPR39) promotes cardiac hypertrophy via inhibiting AMP-activated protein kinase (AMPK) signaling. GRP39 expression is overexpressed in hypertrophic hearts of humans and transverse aortic constriction (TAC)-induced cardiac hypertrophy in mice. In neonatal cardiomyocytes, adenovirus-mediated overexpression of GPR39 promoted angiotensin II-induced cardiac hypertrophy, while GPR39 knockdown repressed hypertrophic response. Adeno-associated virus 9-mediated knockdown of GPR39 suppressed TAC-induced decline in fraction shortening and ejection fraction, increase in heart weight and cardiomyocyte size, as well as overexpression of hypertrophic fetal genes. A mechanism study demonstrated that GPR39 repressed the activation of AMPK to activate the mammalian target of rapamycin (mTOR) and ribosomal protein S6 kinase ß-1 (S6K1), subsequently promoted de novo protein synthesis. Inhibition of mTOR with rapamycin blocked the effects of GPR39 overexpression on protein synthesis and repressed cardiac hypertrophy. Collectively, our findings demonstrated that GPR39 promoted cardiac hypertrophy via regulating the AMPK-mTOR-S6K1 signaling pathway, and GRP39 can be targeted for the treatment of cardiac hypertrophy.

Apert syndrome: A case report of prenatal ultrasound, postmortem cranial CT, and molecular genetic analysis.

Apert syndrome is characterized by craniosynostosis, mid-facial hypoplasia, and symmetric syndactyly. Prenatal diagnosis is challenging until the skull and facial anomalies become more pronounced during the third trimester. We present a case in which typical sonographic signs of Apert syndrome were observed after 23 weeks of gestation. Following termination of the pregnancy, both clinical features such as craniofacial abnormalities and syndactyly and cranial 3D-CT images showed high correlation with the previous sonographic findings. Furthermore, genetic analysis revealed a spontaneous mutation, c.755C≥G (p.S252W), in the FGFR2 gene, with this mutation implicated in the etiology of Apert syndrome.

Comparison of Superb Microvascular Imaging and Conventional Doppler Imaging Techniques for Evaluating Placental Microcirculation: A Prospective Study.

BACKGROUND Superb microvascular imaging (SMI) is a new blood flow imaging technique used to evaluate microvascular blood flow. This study evaluated whether SMI was superior to color Doppler flow imaging (CDFI) for evaluating placental microcirculation. MATERIAL AND METHODS This prospective study included pregnant women in their third trimester who were evaluated at General Hospital of Hebei Province from February to June 2017. The distribution of vascular patterns, including pulsatility index (PI), resistance index (RI), S/D, time average velocity (TAV), and vessels per unit area, were evaluated by SMI and CDFI. RESULTS This study evaluated 110 pregnant women of mean age 29.53 years. SMI and CDFI yielded statistically significant differences in PI (0.76 vs. 0.62), RI (0.71 vs. 0.47), S/D (2.23 vs. 1.71), TAV (14.35 vs. 22.45), and vessels per unit area (0.26 vs. 0.05) (P<0.001 each). The weight of the pregnant women correlated positively with RI (P=0.048) and negatively with vessels per unit area (P=0.040) as determined by SMI. Weeks of gestation correlated negatively correlated with PI (P=0.008), RI (P=0.004), S/D (P=0.015), and vessels per unit area (P=0.014) by CDFI, and positively with RI (P<0.001) and S/D (P=0.001) by SMI. The results of stratified comparisons of CDFI and SMI based on age, weight, and gestational weeks were consistent overall. CONCLUSIONS SMI, which has a higher rate of placental vascularity, a clearer display of capillaries, a greater sensitivity to low flow, and an advantage in displaying microcirculation of the placenta, can serve as a new and effective method of evaluating placental blood flow.