Tracking changes in image-defined risk factors during neoadjuvant chemotherapy and their predictive value for surgical outcomes based on the International Neuroblastoma Surgical Report Form.

BACKGROUND: The capacity of presurgical image-defined risk factors (IDRFs) to predict secondary surgical outcomes in patients with neuroblastoma is controversial. METHODS: The International Neuroblastoma Surgical Report Form (INSRF) was employed to retrospectively collect the clinical data of 53 patients diagnosed with neuroblastoma at our hospital from April 2014 to April 2020. IDRFs were identified at the time of diagnosis and reassessed during the course of neoadjuvant chemotherapy. Various statistical tests were used to evaluate the correlation between IDRFs and secondary surgical outcomes. RESULTS: A total of 195 IDRFs were identified. Notably, by two courses of neoadjuvant chemotherapy, the number of "two body compartments," "intraspinal tumor extension," and "trachea-compressing" IDRFs decreased significantly (p = .001). The primary tumor volumes and the number of IDRFs decreased significantly by four courses of neoadjuvant chemotherapy, especially in "intraspinal tumor extension" IDRFs (p = .034). The median number of IDRF per patient was four (interquartile range [IQR]: 1-5) at diagnosis, which diminished to one (IQR: 1-3) subsequent to neoadjuvant chemotherapy. The presence of preoperative IDRFs was not associated with surgical complications (p = .286) or the extent of surgery (p = .188). However, the number of preoperative IDRFs linked to the extent of surgery (p = .002), not to operative complications (p = .669). Specifically, presurgery "renal vessel contact" IDRFs were predictive of surgical complications, while presurgery "infiltration of vital structures" IDRFs were associated with the extent of surgery. CONCLUSION: The number of IDRFs decreased significantly by four courses of neoadjuvant chemotherapy. The number and type of presurgery IDRFs may predict secondary surgical outcomes, surpassing the mere consideration of their presence or absence.

Psychometric Properties of the Chinese Version of Multidimensional Scale of Perceived Social Support.

Aim: The purpose of this study is to revise the Multidimensional Scale of Perceived Social Support and validate the reliability and validity of the Chinese version of the scale for Chinese college students. Methods: A total of 2830 Chinese college students were tested with the Chinese version of MSPSS. Four weeks after the formal test, 80 randomly selected subjects were retested. Results: The item analysis shows that the total correlation between each item and the total score is 0.525~0.806, higher than the standard of 0.30; the difference between the high group and the low group in all items has reached the significant level. Exploratory factor analysis shows that the scale includes three factors with a cumulative contribution rate of 69.185%; confirmatory factor analysis shows that the data is well fitted. The total score and three factors of social support scale are positively correlated with self-esteem, with a correlation value of 0.367~0.433, and negatively correlated with depression and anxiety, with correlation values of -0.356~-0.428 and -0.253~-0.308; all are significant at 0.01 level. The internal consistency coefficient of the scale is 0.911, the split-half coefficient is 0.865, and the test-retest coefficient is 0.837-0.914. Conclusion: The Chinese version of the MSPSS has good reliability and validity, and is suitable for Chinese college students.

Anti-NSCLC role of SCN4B by negative regulation of the cGMP-PKG pathway: Integrated utilization of bioinformatics analysis and in vitro assay validation.

Non-small cell lung cancer (NSCLC) is a malignant tumor with low overall cure and survival rates. Uncovering abnormally expressed genes is significantly important for developing novel targeted therapies in NSCLC. This study aimed to discover new differentially expressed genes (DEGs) of NSCLC. The DEGs of NSCLC were identified in eight data sets from Gene Expression Omnibus (GEO) database. The expression profiles and the prognostic significance of SCN4B in LUAD and LUSC were analyzed using GEPIA database. LinkedOmics was used to identify co-expressed genes with SCN4B, which were further subjected to KEGG pathway enrichment analysis. SCN4B-overexpressing plasmid (pcDNA/SCN4B) was transfected into A549 and NCI-H2170 cells to elevate the expression of SCN4B. MTT and TUNEL assays were performed to evaluate cell viability and apoptosis. Relying on the screened DEGs from GEO database, we identified that SCN4B was significantly downregulated in LUAD and LUSC. We confirmed the downregulation of SCN4B in NSCLC tissues using GEPIA database. SCN4B has a prognostic value in LUAD, but not LUSC. KEGG pathway enrichment analysis of SCN4B-related genes showed that cGMP-PKG signaling pathway might be involved in the role of SCN4B in NSCLC. Overexpression of SCN4B in A549 and NCI-H2170 cells inhibited the cell viability. Besides, SCN4B overexpression induced apoptosis of A549 and NCI-H2170 cells. SCN4B inhibited the expression of PKG1 and p-CREB in NSCLC cells. Moreover, the inhibitory effects of SCN4B on tumor malignancy were attenuated by the activator of PKG. In conclusion, integrated bioinformatical analysis proved that SCN4B was downregulated and had a prognostic significance in NSCLC. In vitro experimental studies demonstrated that SCN4B regulated NSCLC cells viability and apoptosis via inhibiting cGMP-PKG signaling pathway.

Evaluation of clinical and imaging features for differentiating rhabdomyosarcoma from neuroblastoma in pediatric soft tissue.

Background: In this study, we developed a nomogram predictive model based on clinical, CT, and MRI parameters to differentiate soft tissue rhabdomyosarcoma (RMS) from neuroblastoma (NB) in children preoperatively. Materials and methods: A total of 103 children with RMS (n=37) and NB (n=66) were enrolled in the study from December 2012 to July 2023. The clinical and imaging data (assessed by two experienced radiologists) were analyzed using univariate analysis, and significant factors were further analyzed by multivariable logistic regression using the forward LR method to develop the clinical model, radiological model, and integrated nomogram model, respectively. The diagnostic performances, goodness of fit, and clinical utility of the integrated nomogram model were assessed using the area under the curve (AUC) of the receiver operator characteristics curve (ROC) with a 95% confidence interval (95% CI), calibration curve, and decision curve analysis (DCA) curves, respectively. Diagnostic efficacy between the model and radiologists' interpretations was examined. Results: The median age at diagnosis in the RMS group was significantly older than the NB group (36.0 months vs. 14.5 months; P=0.003); the fever rates in RMS patients were significantly lower than in patients with NB (0.0% vs.16.7%; P=0.022), and the incidence of palpable mass was higher in patients with RMS compared with the NB patients (89.2% vs. 34.8%; P<0.001). Compare NB on image features: RMS occurred more frequently in the head and neck and displayed homogeneous density on non-enhanced CT than NB (48.6% vs. 9.1%; 35.3% vs. 13.8%, respectively; all P<0.05), and the occurrence of characteristics such as calcification, encasing vessels, and intraspinal tumor extension was significantly less frequent in RMS children compared to children with NB (18.9% vs. 84.8%; 13.5% vs. 34.8%; 2.7% vs. 50.0%, respectively; all P <0.05). Two, three, and four features were identified as independent parameters by multivariate logistic regression analysis to develop the clinical, radiological, and integrated nomogram models, respectively. The AUC value (0.962), calibration curve, and DCA showed that the integrated nomogram model may provide better diagnostic performance, good agreement, and greater clinical net benefits than the clinical model, radiological model, and radiologists' subjective diagnosis. Conclusion: The clinical and imaging features-based nomogram has potential for helping radiologists distinguish between pediatric soft tissue RMS and NB patients preoperatively, and reduce unnecessary interventions.

Unraveling crop enzymatic browning through integrated omics.

Enzymatic browning reactions, triggered by oxidative stress, significantly compromise the quality of harvested crops during postharvest handling. This has profound implications for the agricultural industry. Recent advances have employed a systematic, multi-omics approach to developing anti-browning treatments, thereby enhancing our understanding of the resistance mechanisms in harvested crops. This review illuminates the current multi-omics strategies, including transcriptomic, proteomic, and metabolomic methods, to elucidate the molecular mechanisms underlying browning. These strategies are pivotal for identifying potential metabolic markers or pathways that could mitigate browning in postharvest systems.

CT and MR imaging features of soft tissue rhabdoid tumor: compared with rhabdomyosarcoma in children.

Objective: To assess the computed tomography (CT) and magnetic resonance (MR) imaging characteristics of soft tissue rhabdoid tumors (RT) and compare them with those of rhabdomyosarcoma (RMS). Methods: We conducted a retrospective analysis of 49 pediatric patients from 2011 to 2022, comprising 16 patients with soft tissue RT and 33 patients with RMS who underwent CT or MRI scans. Key imaging features, as well as clinical and pathological data, were compared between the two groups. The multivariate logistic regression analysis was used to determine independent differential factors for distinguishing soft tissue RT from RMS, and the model was established. The final prediction model was visualized by nomograms and verified internally by using a bootstrapped resample 1,000 times. The diagnostic accuracy of the combined model was assessed in terms of discrimination, calibration, and clinical utility. Results: Age, sex, number of lesions, and primary locations were similar in both groups. The imaging characteristics, including margin, calcification, surrounding blood vessels, and rim enhancement, were associated with the two groups of soft tissue tumors, as determined by univariate analysis (all p < 0.05). On multivariate logistic regression analysis, the presence of unclear margin (p-value, adjusted odds ratio [95% confidence interval]: 0.03, 7.96 [1.23, 51.67]) and calcification (0.012, 30.37 [2.09, 440.70]) were independent differential factors for predicting soft tissue RT over RMS. The presence of rim enhancement (0.007, 0.05 [0.01, 0.43]) was an independent differential factor for predicting RMS over soft tissue RT. The comprehensive model established by logistic regression analysis showed an AUC of 0.872 with 81.8% specificity and 81.3% sensitivity. The decision curve analysis (DCA) curve displayed that the model achieved a better net clinical benefit. Conclusion: Our study revealed that the image features of calcification, indistinct margins, and a lack of rim enhancement on CT and MRI might be reliable to distinguish soft tissue RT from RMS.

The influence of resilience on stress reaction of college students during COVID-19: the mediating role of coping style and positive adaptive response.

The COVID-19 pandemic was a stressful event for all. It threatened people's physical and mental health. Previous studies have found that resilience can help people deal with stress and difficulties more effectively and prevent them from mental health problems. Coping style mediates the relationship between resilience and psychological well-being. Given the novelty and recency of the COVID-19, it is unknown whether resilience can also protect individuals in new difficulties, and whether the previous effective coping styles can be applied to new situations. The current study aimed to explore the influence mechanism of college students' resilience on negative stress response during the pandemic, and the chain mediation of coping style and positive adaptive response. A questionnaire survey was conducted among 910 college students (Mage = 20.58 years; 41.1% men, 58.9% women) studying in Shanghai by stratified random cluster sampling. At that time, they were in 27 different provinces and cities because of the COVID-19 pandemic lockdown. The research tools included Connor-Davidson Resilience Scale (CD-RISC), Simplified Coping Style Questionnaire (SCSQ), Positive Adaptive Response Questionnaire (PARQ), and Negative Stress Reaction Questionnaire (NSRQ). The results showed that: (1) College students' resilience, coping style, positive adaptive response and negative stress reaction were significantly correlated with each other; (2) Resilience could not directly affect negative stress reaction, but it could affect negative stress reaction through the chain mediation of coping style and positive adaptive response. These findings suggest that resilience enhancement intervention programs need to focus on the cultivation of individual positive coping style; In response to major emergencies such as the COVID-19 pandemic, officials can help people reduce negative stress reaction by disseminating positive coping strategies through the media.

Brain Age Prediction in Developing Childhood with Multimodal Magnetic Resonance Images.

It is well known that brain development is very fast and complex in the early childhood with age-based neurological and physiological changes of brain structure and function. The brain maturity is an important indicator for evaluating the normal development of children. In this paper, we propose a multimodal regression framework to combine the features from structural magnetic resonance imaging (sMRI) and diffusion tensor imaging (DTI) data for age prediction of children. First, three types of features are extracted from sMRI and DTI data. Second, we propose to combine the sparse coding and Q-Learning for feature selection from each modality. Finally, the ensemble regression is performed by random forest based on proximity measures to fuse multimodal features for age prediction. The proposed method is evaluated on 212 participants, including 76 young children less than 2 years old and 136 children aged from 2-15 years old recruited from Shanghai Children's Hospital. The results show that integrating multimodal features has achieved the highest accuracies with the root mean squared error (RMSE) of 0.208 years and mean absolute error (MAE) of 0.150 years for age prediction of young children (0-2), and RMSE of 1.666 years and MAE of 1.087 years for older children (2-15). We have shown that the selected features by Q-Learning can consistently improve the prediction accuracy. The comparison of prediction results demonstrates that the proposed method performs better than other competing methods.

A retrospective study of estrogen in the pretreatment for medical management of early pregnancy loss and the inference from intrauterine adhesion.

BACKGROUND: Estrogen has been usually used in clinic for medical pretreatment of early pregnancy loss. There was little reported the effect of estrogen combined with prostaglandin analogs in the medical management of early pregnancy loss. This retrospective study aimed to evaluate the efficacy of estrogen pretreatment for medical management of early pregnancy loss and explore the confounding factor of intrauterine adhesion (IUA) on the outcome of medical management. METHODS: A total of 226 early pregnancy loss patients who received pretreatment with estradiol valerate and/or mifepristone, followed by carboprost methylate suppositories (study groups), or carboprost methylate suppositories alone (control group) in a regional central institution from March 2020 to February 2021 were retrospectively studied. All patients were evaluated by hysteroscopy 6 h after carboprost methylate suppositories use to assess whether the gestational sac was complete expulsion and assess the morphology of uterine cavity. RESULTS: The complete expulsion rate was 56.94% in the mifepristone and estradiol valerate-pretreatment group, 20.69% in the estradiol valerate-pretreatment group, 62.5% in the mifepristone-pretreatment group, and 12.5% in the control group. Compared with the control group, pretreatment with estradiol valerate did not increase the complete expulsion rate significantly (P = 0.297), pretreatment with mifepristone increased the complete expulsion rate significantly (P < 0.001). Pretreatment with mifepristone combined with estradiol valerate did not increase the complete expulsion rate significantly comparing with pretreatment with mifepristone (P = 0.222). The data of IUA showed that the complete expulsion rate in patients with IUA was lower than that in those patients without IUA (P < 0.001). CONCLUSIONS: Pretreatment with estrogen was not a sensible substitute for mifepristone in the medical management of early pregnancy loss. Mifepristone followed by carboprost methylate suppositories was likelihood of the ideal medical scheme in early pregnancy loss. IUA decreased the complete expulsion rate of medical management, it is cautious about medical management for early pregnancy loss with risk of IUA. TRIAL REGISTRATION NUMBER: ChiCTR2100046503. Date of registration (retrospectively registered): May 18, 2021. Trial registration website: http://www.chictr.org.cn/ .

Multimodal Image Analysis of Sexual Dimorphism in Developing Childhood Brain.

It is well known that there exist great differences in human brain anatomy and functions between males and females. With the development of noninvasive neuroimaging techniques, the sex differences in adult human brain have been well studied in some researches. However, the sexual dimorphism of human brain anatomy and functions has not been sufficiently described during the developmental period of early childhood brain when the sex differences emerge in behavior. This study was to identify specific patterns of the sexual dimorphism in developing brain structure of early childhood using multimodal brain image analysis. We have performed a multivariate and data-driven analysis by combining multiple neuroimaging technologies including the 3D T1-weighted structural MR images (sMRI) and diffusion tensor imaging (DTI) in a prospective cohort of 188 children (128 males and 60 females) between the ages of 0 and 15. First, the brain images were segmented into 90 regions of interest (ROIs) based on the AAL template to extract the ROI volume and connectivity features. Then, the individual multimodal imaging biomarkers were identified associated with the sex differences. Finally, the selected features from multi-modality neuroimages were combined using multi-kernel support vector machine for classifications of male or female. The method achieved sex classification accuracy 72% for the children between the ages of 0 and 15. And the volumes of right precuneus and right postcentral were more related to sexual dimorphism of developing brain structure than those of other regions in sMRI (p < 0.002). In DTI, the connections between right middle occipital gyrus and right inferior occipital gyrus, between left superior marginal gyrus and left middle temporal gyrus, and between right triangle inferior frontal gyrus and right putamen are also more relevant to the sexual dimorphism than others (p < 0.005). The brain regions and connections related to the sexual differences were identified with sMRI and DTI in early developing brain structure by using the multimodal image analysis. And these sexually dimorphic patterns of brain may be related to the observed sex differences in developing childhood brain structure and connectivity.

[Technical Realization of Integrating Bone Age Artificial Intelligence Assessment System with Hospital RIS-PACS Network].

OBJECTIVE: To explore the integration method and technical realization of artificial intelligence bone age assessment system with the hospital RIS-PACS network and workflow. METHODS: Two sets of artificial intelligence based on bone age assessment systems (CHBoneAI 1.0/2.0) were developed. The intelligent system was further integrated with RIS-PACS based on the http protocol in Python flask web framework. RESULTS: The two sets of systems were successfully integrated into the local network and RIS-PACS in hospital. The deployment has been smoothly running for nearly 3 years. Within the current network setting, it takes less than 3 s to complete bone age assessment for a single patient. CONCLUSIONS: The artificial intelligence based bone age assessment system has been deployed in clinical RIS-PACS platform and the "running in parallel", which is marking a success of Stage-I and paving the way to Stage-II where the intelligent systems can evolve to become more powerful in particular of the system self-evolution and the "running alternatively".

[Application of multi-slice spiral CT in the diagnosis of children's parotid cleft deformity].

Objective:The aim of this study is to evaluate the value of multi-slice spiral CT （CT） and multi-planar reconstruction （MPR） in the diagnosis of children with parotid cleft deformity. Method:The CT images of 55 cases of branchial cleft deformity confirmed by surgery and pathology were retrospectively analyzed. Result:CT examination showed that 37 cases had strip-like, tubular fistula or cystic mass located in the anterior cervical triangle, anterior margin of sternocleidomastoid muscle, and 2 of them had bilateral fistula structure. In 16 casescystic mass and tubular fistula were found in the parotid gland or at the edge of the parotid gland. One case was accompanied by atresia of the lateral auditory meatus. After contrast enhancement, the cystic wall（tube wall） of 55 patients were enhanced. In 9 patients with infection, the boundary of the lesion was blurred, and the density of the cyst or lumen increased after contrast enhancement. MSCT diagnosed 6 cases of parotid cleft cyst with fistula, 35 cases of branchial cleft cyst, 13 cases of parotid fistula, and 1 case misdiagnosed as lymphadenitis. Among all the cases, 15 were type Ⅰ, 36 were type Ⅱand 4 were type Ⅲ. Compared with the results of pathological diagnosis and clinical operation, the accuracy of qualitative diagnosis and localization was 99.9% and 100.0%. Conclusion:Multi-slice spiral CT thin-slice images combined with MPR image post-processing technology can better display the location of branchial cyst and the course of branchial fistula.

Tissue expander capsule as an induced vascular bed to prefabricate an axial vascularized buccal mucosa-lined flap for tubularized posterior urethral reconstruction: preliminary results in an animal model.

Surgical repair of complex posterior urethral disruptions remains one of the most challenging problems in urology. The efficacy of using a tissue expander capsule as an induced vascular bed to prefabricate axial vascularized buccal mucosa-lined flaps for tubularized posterior urethral reconstruction in a rabbit model was tested. The experiments were performed in three stages. First, silicone tissue expanders were inserted into the groin to induce vascularized capsule pouch formation. Next, buccal mucosa grafts were transplanted into the newly formed capsular tissue supplied by axial vessels for buccal mucosa-lined flap prefabrication. Then, circumferential posterior urethral defects were created and repaired with the buccal mucosa graft (Group 1), the capsule flap (Group 2), and the prefabricated capsule buccal mucosa composite flap (Group 3). After surgery, notable contracture of the tubularized buccal mucosa graft was observed in the neourethra, and none of the rabbits in Group 1 maintained a wide urethral caliber. In Group 2, the retrieved neourethra showed little evidence of epithelial lining during the study period, and the lumen caliber was narrowed at the 3-month evaluation. In Group 3, the buccal mucosa formed the lining in the neourethra and maintained a wide urethral caliber for 3 months. The capsule may serve as an induced vascular bed for buccal mucosa-lined flap prefabrication. The prefabricated buccal mucosa-lined flap may serve as a neourethra flap for posterior urethral replacement.

Tubularized urethral reconstruction using a prevascularized capsular tissue prelaminated with buccal mucosa graft in a rabbit model.

Tubularized graft urethroplasty fails largely because of inadequate graft take. Prefabrication of buccal mucosa lined flap has theoretical indications for constructing neourethra with an independent blood supply. The efficacy of using a tissue expander capsule as an induced vascular bed to prefabricate an axial vascularized buccal mucosa-lined flap for tubularized urethral reconstruction in a rabbit model was tested. The experiments were performed in three stages. First, silicone tissue expanders were inserted into the groin to induce vascularized capsule pouch formation. Next, buccal mucosa grafts were transplanted to the newly formed capsular tissue supplied by the axial vessel for buccal mucosa-lined flap prefabrication. Then, circumferential urethral defects were created and repaired by buccal mucosa graft (Group 1), capsule flap (Group 2) and prefabricated capsule buccal mucosa composite flap (Group 3). With retrograde urethrography, no rabbits in Group 1 maintained a wide urethral caliber. In Group 2, the discontinued epithelial layer regenerated at 1 month, and the constructed neourethra narrowed even though the lumen surface formed intact urothelial cells at 3 months. In Group 3, buccal mucosa formed the lining in the neourethra and kept a wide urethral caliber for 3 months. The capsule may serve as an induced vascular bed for buccal mucosa-lined flap prefabrication. The prefabricated buccal mucosa-lined flap may serve as a neourethra flap for circumferential urethral replacement.

Regression Convolutional Neural Network for Automated Pediatric Bone Age Assessment From Hand Radiograph.

Skeletal bone age assessment is a common clinical practice to investigate endocrinology, and genetic and growth disorders of children. However, clinical interpretation and bone age analyses are time-consuming, labor intensive, and often subject to inter-observer variability. This advocates the need of a fully automated method for bone age assessment. We propose a regression convolutional neural network (CNN) to automatically assess the pediatric bone age from hand radiograph. Our network is specifically trained to place more attention to those bone age related regions in the X-ray images. Specifically, we first adopt the attention module to process all images and generate the coarse/fine attention maps as inputs for the regression network. Then, the regression CNN follows the supervision of the dynamic attention loss during training; thus, it can estimate the bone age of the hard (or "outlier") images more accurately. The experimental results show that our method achieves an average discrepancy of 5.2-5.3 months between clinical and automatic bone age evaluations on two large datasets. In conclusion, we propose a fully automated deep learning solution to process X-ray images of the hand for bone age assessment, with the accuracy comparable to human experts but with much better efficiency.

Multicenter evaluation of membrane-based smear microscopy for detecting acid-fast bacilli in China.

OBJECTIVE: To assess the feasibility and reliability of using membrane-based smear microscopy at peripheral laboratories in China. METHODS: The clinical case control study was conducted in five tuberculosis (TB) dispensaries from September 2014 to May 2016. The membrane-based microscopy and direct smear microscopy were performed to compare the sensitivity, specificity, and the examination time for both methods was also analyzed. RESULTS: A total of 5359 TB suspects were consecutively enrolled from 5 TB dispensaries, and 9915 specimens were finally analyzed. The sensitivity for membrane-based microscopy and direct smear microscopy was 76.9% (95% CI, 75.4-78.4) and 53.8% (95% CI, 52.1-55.6) respectively, and the specificity was 96.8% (95% CI, 96.4-97.2) and 99.2% (95% CI, 99.0-99.4) respectively. The sensitivity and specificity were both significantly different (P<0.001) between the two methods. The examination time for membrane-based smear microscopy (209.1±112.0 seconds) was significantly shorter than that for direct smear microscopy (253.1±79.4 seconds) (P<0.05). CONCLUSIONS: Membrane-based smear microscopy showed higher sensitivity and a shorter examination time in comparison with direct smear microscopy and it could be used at peripheral laboratories in China.

The burden of MDR/XDR tuberculosis in coastal plains population of China.

BACKGROUND: We conducted a first baseline survey in Jilin Province of China to determine the proportion of drug-resistant tuberculosis (TB), and to analyze risk factors associated with the emergence of drug-resistance. METHODOLOGY/PRINCIPAL FINDINGS: Thirty counties in Jilin Province were randomly selected as survey sites using a stratified cluster sampling method. People enrolled in the survey were new and re-treated, smear-positive pulmonary TB patients newly enrolled in local TB control and prevention institutions during the survey period. Sputum samples were collected, and the susceptibility of bacterial strains to anti-TB drugs was analyzed by proportion method. Based on the survey results, we estimated the number of drug-resistant TB patients and analyzed the risk factors associated with the emergence of drug resistance. Of 1,174 new TB patients and 597 re-treated TB patients, 8.6% and 23.2% were multi-drug resistant (MDR)-TB patients, respectively. Approximately 12% of MDR-TB patients were extensively drug-resistant. We estimate that approximately 1,290 new MDR-TB cases develop in Jilin Province every year. Of these, 810 cases would be new patients, and 480 cases would involve re-treated patients. Risk factors associated with MDR-TB include employment status, educational background, and income level. CONCLUSIONS/SIGNIFICANCE: Jilin Province remains one of the highest-burden areas in China for drug-resistant TB. The higher number of MDR-TB among new cases suggested that the transmission of drug-resistant strains in Jilin is an urgent problem in the MDR-TB control and prevention system of Jilin Province. Improving the treatment compliance of TB patients and the quality of medical care in public health institutions is urgently needed.

Percutaneous Retrieval of Foreign Bodies Around Vital Vessels Aided with Vascular Intervention: A Technical Note.

OBJECTIVE: To describe a new interventional technique to remove foreign bodies (FBs) embedded in soft tissues around vital vessels. METHODS: Under fluoroscopic guidance and using local anesthesia, percutaneous removal of FBs was performed using forceps in nine patients. All patients suffered from a metallic soft tissue FB located in close proximity to important vessels and one also had a small traumatic pseudoaneurysm adjacent to the FB. Prior to removal of the FB, the position of the nearest vessel was identified using a guide wire or catheter placed into the vessel. Balloon catheter was also simultaneously used to temporarily stop the blood flow of the nearest artery during the FB removal in three of the nine patients. RESULTS: All of the nine FBs with 0-2 mm interval to the nearest vessel were successfully removed in the nine patients without any serious complications. The removed FBs measured 3-12 mm in length and 1-3 mm in width. The total fluoroscopic time of retrieval of each FB was 5-9 min (mean, 6.4 min). The volume of intraoperative bleeding ranged from 5 to 12 ml (mean, 7.5 ml). The length of hospital stay for each patient ranged from 4 to 8 days (mean, 5.5 days). CONCLUSION: Vascular intervention-aided percutaneous FB removal is minimally invasive and an effective method for removal of FBs around vital vessels.

Molecular subtyping and antimicrobial susceptibilities of Campylobacter coli isolates from diarrheal patients and food-producing animals in China.

The aim of this study was to determine the molecular subtyping and antimicrobial susceptibility characteristics of Campylobacter coli isolates from different sources in China. One hundred thirteen C. coli isolates were subtyped by pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and porA and flaA short variable region (SVR) nucleotide sequences. Cluster analysis was performed based on the PFGE and sequence types (ST). Eighty-four PFGE patterns (SmaI) were observed in 113 isolates. Fifty-four STs (28 novel) and three clonal complexes (CC), 86% of which were clustered to CC828, were observed, as well as 52 porA and 37 flaA-SVR sequence alleles. MLST, porA, and flaA-SVR analysis demonstrated that many isolates from diarrheal patients shared identical genotypes with chicken isolates. Minimum inhibitory concentration values of 10 antibiotics were analyzed for 109 isolates isolated in 2011 using the E-test method. The most frequently observed resistance agents were nalidixic acid (100%) and ciprofloxacin (100%), followed by levofloxacin (99%), tetracycline (94%), metronidazole (93%), erythromycin (61%), streptomycin (72%), gentamicin (59%), ampicillin (50%), and chloramphenicol (29%). Multidrug resistance was detected in 108 of 109 C. coli isolates (99%).

Value of 3-dimensional CT virtual anatomy imaging in complex foreign body retrieval from soft tissues.

OBJECTIVE: To investigate the value of 3-dimensional (3D) CT virtual anatomy imaging (VAI) in the complex foreign body (FB) retrieval of the soft tissues. MATERIALS AND METHODS: Four hundred and seventy-five patients with radiopaque FB(s) diagnosed by radiograph underwent contrast-enhanced 3D CT examination. VAI was reconstructed by volume-rendering opacity software, by sliding down the lowest threshold from -600 to 100 HU. The imaging was grouped into three groups: A (axial and multi-planar reformation [MPR] images), B (standard 3D imaging with axial and MPR images), and C (VAI with axial and MPR images). They were analyzed to reveal the type, size, number, location, complications, and the interventional removability of the object, with the comparisons in the management and clinical outcomes on the patient follow-up studies. The data were subjected to chi-square tests, with p value < 0.05 indicating significant statistical difference. RESULTS: The FB shape, size, number, site distribution and vessels around FB, as well as the FB-associated vascular complications and the FB interventional removability were assessed more accurately in Group C than in Group B or Group A (p < 0.005). There was no significant difference in disclosing the type and depth of the FB among the three groups (p > 0.75). On the basis of the 3D CT, especially the enhanced 3D CT VAI, the followings were processed: the recommendation of interventional removal in 286 (60.47%) and non-intervention in 187 (39.53%) of the 473 patients with soft-tissue FB(s); in 352 (56.50%) of the 623 radiopaque FBs patients, 258 (54.55%) patients accurately detected on 3D CT and the successful removal by intervention (343 FBs) or surgery (9 FBs) without any sequela; and 215 (45.45%) patients with 271 FBs lost in the follow-up, with their departure from the hospital. CONCLUSION: The 3D CT, especially 3D enhanced CT VAI, has great incremental value in further diagnosis and management of complex FB extraction from soft tissues.