Unilateral adrenal tuberculosis whose computed tomography imaging characteristics mimic a malignant tumor: A case report.

BACKGROUND: Adrenal tuberculosis usually presents with bilateral involvement. It has special characteristics in computed tomography (CT) images, such as small size, low attenuation in the center, and peripheral rim enhancement, which differ from those of primary tumors. CASE SUMMARY: A 42-year-old female presented to the hospital with low back pain. She had been diagnosed with hypertension as well as pulmonary and cerebral tuberculosis but denied having any fever, fatigue, anorexia, night sweats, cough, or weight loss. Abdominal CT revealed an irregular 6.0 cm × 4.5 cm mass with uneven density in the right adrenal gland, while the left adrenal gland was normal. No abnormalities were observed in plasma total cortisol (8 am), adrenocorticotropic hormone, aldosterone/renin ratio, blood catecholamines, or urine catecholamines. A fine-needle aspiration biopsy of the right adrenal gland provided evidence of tuberculosis. After three years of anti-tuberculosis treatments, the large mass in the right adrenal gland was reduced to a slight enlargement. CONCLUSION: This is a case of unilateral adrenal tuberculosis with CT imaging characteristics mimicking those of a malignant tumor. Extended anti-tuberculosis therapy is recommended in such cases.

Integrated Transcriptional and Proteomic Profiling Reveals Potential Amino Acid Transporters Targeted by Nitrogen Limitation Adaptation.

Nitrogen (N) is essential for plant growth and crop productivity. Organic N is a major form of remobilized N in plants' response to N limitation. It is necessary to understand the regulatory role of N limitation adaption (NLA) in organic N remobilization for this adaptive response. Transcriptional and proteomic analyses were integrated to investigate differential responses of wild-type (WT) and nla mutant plants to N limitation and to identify the core organic N transporters targeted by NLA. Under N limitation, the nla mutant presented an early senescence with faster chlorophyll loss and less anthocyanin accumulation than the WT, and more N was transported out of the aging leaves in the form of amino acids. High-throughput transcriptomic and proteomic analyses revealed that N limitation repressed genes involved in photosynthesis and protein synthesis, and promoted proteolysis; these changes were higher in the nla mutant than in the WT. Both transcriptional and proteomic profiling demonstrated that LHT1, responsible for amino acid remobilization, were only significantly upregulated in the nla mutant under N limitation. These findings indicate that NLA might target LHT1 and regulate organic N remobilization, thereby improving our understanding of the regulatory role of NLA on N remobilization under N limitation.

A multiomics approach reveals the pivotal role of subcellular reallocation in determining rapeseed resistance to cadmium toxicity.

Oilseed rape (Brassica napus) has great potential for phytoremediation of cadmium (Cd)-polluted soils due to its large plant biomass production and strong metal accumulation. Enhanced plant Cd resistance (PCR) is a crucial prerequisite for phytoremediation through hyper-accumulation of excess Cd. However, the complexity of the allotetraploid genome of rapeseed hinders our understanding of PCR. To explore rapeseed Cd-resistance mechanisms, we examined two genotypes, 'ZS11' (Cd-resistant) and 'W10' (Cd-sensitive), that exhibit contrasting PCR while having similar tissue Cd concentrations, and characterized their different fingerprints in terms of plant morphophysiology (electron microscopy), ion abundance (inductively coupled plasma mass spectrometry), DNA variation (whole-genome resequencing), transcriptomics (high-throughput mRNA sequencing), and metabolomics (ultra-high performance liquid chromatography-mass spectrometry). Fine isolation of cell components combined with ionomics revealed that more Cd accumulated in the shoot vacuoles and root pectins of the resistant genotype than in the sensitive one. Genome and transcriptome sequencing identified numerous DNA variants and differentially expressed genes involved in pectin modification, ion binding, and compartmentalization. Transcriptomics-assisted gene co-expression networks characterized BnaCn.ABCC3 and BnaA8.PME3 as the central members involved in the determination of rapeseed PCR. High-resolution metabolic profiles revealed greater accumulation of shoot Cd chelates, and stronger biosynthesis and higher demethylation of root pectins in the resistant genotype than in the sensitive one. Our comprehensive examination using a multiomics approach has greatly improved our understanding of the role of subcellular reallocation of Cd in the determination of PCR.

[Comparing overnight dexamethasone suppression test, urine free cortisol, and midnight serum cortisol for the initial diagnosis of Cushing' s syndrome].

OBJECTIVE: To identify retrospectively the optimal cut-off points and the values of overnight dexamethasone suppression test, urine free cortisol, and midnight serum cortisol in the initial diagnosis of Cushing's syndrome in Chinese people. METHODS: The results of overnight low-dose dexamethasone suppression test (PTC-DST), urine free cortisol (UFC) and late-night plasma total cortisol (PTC-24 h) of 102 patients who had clinically confirmed Cushing's syndrome and 102 patients without Cushing's syndrome were extracted from West China Hospital. Receiver operating characteristic (ROC) curves were drawn to identify optimal cut-off points of the three assays and their values in diagnosing Cushing' s syndrome. RESULTS: The optimal cut-off point (the point on the ROC curve closest to 1) for PTC-DST was set at 86 nmol/L, with 98. 7% sensitivity and 97. 2% specificity (100% sensitivity and 94. 4% specificity was achieved at 50 nmol/L 100%o sensitivity and 95. 8% specificity was achieved at 60 nmol/L). The optimal cut-off point for PTC-24 h was set at 347 nmol/L, with 93. 4% sensitivity and 98. 4% specificity (98. 9% sensitivity and 85. 2% specificity was achieved at 207 nmol/L). The optimal cut-off point for UFC was set at 230. 15 icrog/24 h, with 92. 2 sensitivity and 95. 7% specificity (96. 1% sensitivity and 85. 1% specificity was achieved at 127. 55 microg/24 h). There was no significant difference between PTC-DST and PTC-24 h in the areas under the ROC curves, whereas both had a greater area under the ROC curve than that of UFC (P< 0. 05). CONCLUSION: Compared with the recommended 50 nmol/L cut-off point for PTC-DST in the USA and the European countries, the same sensitivity and a higher specificity can be achieved at a cut-off at 60 nmol/L for the Chinese people. PTC-DST and PTC-24 h have similar values in the initial diagnosis of Cushing's syndrome, but PTC-DST is more convenient to be used in outpatient environment.