Analysis of early renal injury in COVID-19 and diagnostic value of multi-index combined detection

ObjectivesThe aim of the study was to analyze the incidence of COVID-19 with early renal injury, and to explore the value of multi-index combined detection in diagnosis of early renal injury in COVID-19. DesignThe study was an observational, descriptive study. SettingThis study was carried out in a tertiary hospital in Guangdong, China. Participants12 patients diagnosed with COVID-19 from January 20, 2020 to February 20, 2020. Primary and secondary outcome measuresThe primary outcome was to evaluate the incidence of early renal injury in COVID-19. In this study, the estimated glomerular filtration rate (eGFR), endogenous creatinine clearance (Ccr) and urine microalbumin / urinary creatinine ratio (UACR) were calculated to assess the incidence of early renal injury. Secondary outcomes were the diagnostic value of urine microalbumin (UMA), 1-microglobulin (A1M), urine immunoglobulin-G (IGU), urine transferring (TRU) alone and in combination in diagnosis of COVID-19 with early renal injury. ResultsWhile all patients had no significant abnormalities in serum creatinine (Scr) and blood urea nitrogen (BUN), the abnormal rates of eGFR, Ccr, and UACR were 66.7%, 41.7%, and 41.7%, respectively. Urinary microprotein detection indicated that the area under curve (AUC) of multi-index combined to diagnose early renal injury in COVID-19 was 0.875, which was higher than UMA (0,813), A1M (0.813), IGU (0.750) and TRU (0.750) alone. Spearman analysis showed that the degree of early renal injury was significantly related to C-reactive protein (CRP) and neutrophil ratio (NER), suggesting that the more severe the infection, the more obvious the early renal injury. Hypokalemia and hyponatremia were common in patients with COVID-19, and there was a correlation with the degree of renal injury. ConclusionsEarly renal injury was common in patients with COVID-19. Combined detection of UMA, A1M, IGU, and TRU was helpful for the diagnosis of early renal injury in COVID-19.

[Value of CT imaging of inferior vena cava and hepatic vein in patients with hepatic cystic echinococcosis].

OBJECTIVE: To evaluate the accuracy of CT imaging of inferior vena cava and hepatic vein in patients with hepatic cystic echinococcosis. METHODS: A total of 100 patients with hepatic cystic echinococcosis were given triple-phase abdominal CT scan, and the reconstructed images of the inferior vena cava and hepatic vein were obtained and compared to the real situation during the surgical operation. The reliability of the CT evaluation of the echinococcus cyst lesion invading inferior vena cava and hepatic vein was analyzed. RESULTS: The compression displacement, half-globular, no clear demarcation between the lesion and blood vessel and narrowing of the vessel detected by CT evaluation were in accordance with the real situation under the surgical sight. However, four cases of clear demarcation between the lesion and blood vessel were affirmed wrong under the surgical sight. There were three cases of over diagnosis of vascular stenosis judgments. CONCLUSIONS: The CT images of hepatic vein and inferior vena cava can clearly show the relationship between the hepatic echinococcus cyst and hepatic vein and inferior vena cava.

[Imaging analysis of 79 cases of hepatic echinococcosis].

OBJECTIVE: To analyze the imaging manifestations of 79 cases of hepatic echinococcosis retrospectively, so as to provide evidences for improving the diagnosis and differential diagnosis of the disease. METHODS: Seventy-nine patients with hepatic echinococcosis who underwent imaging examinations and pathologic confirmation in Qinghai Provincial People's Hospital from 2014 to 2017 were chosen as the investigation objects, and the data of their medical records and imaging manifestations were collected and analyzed. RESULTS: Among the 79 cases of hepatic echinococcosis, 57 were suffered from cystic echinococcosis (CE) and 22 were suffered from alveolar echinococcosis (AE) . Among the patients with CE, those in single cystic type, multiple cysts type, internal capsule collapse type, solid type, and calcification type were 21, 16, 9, 4 cases and 7 cases respectively. The imaging signs of 62 cases were common. The image of the single cystic type was characterized by intrahepatic cystic water-like lesions, the cystic wall was thin and uniform without any enhancement. The multiple cysts were characterized by "cyst in the cyst", "rose petals", and "spoke wheel". The collapse and separation of the internal capsule was manifested as "drift belt sign" and "double ring sign", the calcification of the cyst wall was curved and eggshell-shaped, the contents of the cyst were cotton-shaped or the whole lesion was calcific. The image of the patients with AE was manifested as a solid mass in the liver, the density and signal were heterogeneous, the edge was irregular and not obviously enhanced, the "small vesicles" scattered in the lesion were often accompanied by calcification, and the whole lesion showed a map appearance. The other 17 cases of hepatic echinococcosis showed complex and rare imaging features. The capsules of 6 cases of CE contained fat, the images presented single or multiple fat density nodules in the hepatic hydatid cyst, and CT value was -28 to -84 HU; in 4 cases of echinococcosis, the lesions were broken into the bile duct, the density of adjacent bile duct was increased, with bile duct wall thickening and peripheral biliary dilatation. For the 4 cases of echinococcosis combined with primary liver cancer, the imaging manifestations of the hepatic cysts presented solid-mass enhancement, with "fast forward and fast out" performance. For the image of the 3 cases of CE with infection, the cystic wall was thickening and enhanced obviously, of these, 2 cases had gaseous shadows in the cyst, 1 patient's cyst was complicated with infection and it invaded the abdominal wall. CONCLUSIONS: The imaging manifestations of hepatic echinococcosis are varied and complicated, which need careful analysis for differential diagnosis.

[Revolution CT hepatic perfusion imaging assessment of peripheral infiltration zone of hepatic alveolar echinococcosis].

OBJECTIVE: To analyze the blood supply and metabolism in the marginal area of foci of hepatic alveolar echinococcosis by quantitative perfusion parameters. METHODS: Thirty patients with hepatic alveolar echinococcosis were scanned with the Revolution CT and the images were analyzed. The perfusion parameters, such as the bloodflow (BF), time to peak (TTP), blood volume (BV), mean transit time (MTT) and hepatic arterial fraction (HAF) were compared among different groups. RESULTS: The BF, TTP, BV and MTT values of the peripheral infiltration zone and the values of the surrounding normal liver tissues were significantly different (F = 24.579, 8.343, 20.535 and 21.843, all P<0.05), but the HAF values of the peripheral infiltration zone and the values of the surrounding normal liver tissues were not significantly different in the hepatic alveolar echinococcosis patients (F = 2.621, P> 0.05) . CONCLUSIONS: The whole hepatic perfusion Revolution CT can accurately and quantitatively analyze the alveolar echinococcosis foci, especially the peripheral infiltration zone, which has important guiding significance for the formulation of surgical plan.

Application value of Revolution CT combining three-dimensional visualization technique in precision resection of hepatic alveolar echinococcosis / 中国血吸虫病防治杂志

Objective To explore the application value of Revolution CT combining three -dimensional visualization technique in the precision resection of hepatic alveolar echinococcosis. Methods Totally 12 patients with surgical treatment and pathologically confirmed hepatic alveolar echinococcosis in Qinghai Provincial People’s Hospital were retrospectively analyzed. All the patients underwent the Revolution CT plain and enhancement scan before surgery, and the 0.625 millimeter scan data were obtained. The DICOM format data were imported into MI-3DVS for three-dimensional reconstruction, simulated cutting, volume measurement, and surgical planning. Results The data of 12 patients were reconstructed successfully, and the sizes and locations of the lesions as well as the hepatic vascular systems were clearly displayed. The liver volume, hydatid volume, simulated resection volume, and residual liver ratio were measured accurately. The average whole liver volume and the lesion volume of the 11 surgical treated patients were (2 429.8 ± 335.9) mL and (919.6 ± 262.8) mL respectively. The average actually removed volume was highly associated with the average simulated resection volume (r = 0.979, P < 0.01). Conclusion Revolution CT combining three-dimensional visualization technique can achieve accurate diagnosis as well as optimal surgical planning before operation, which is of great value for the precision resection of difficult hepatic alveolar echinococcosis.

Revolution CT hepatic perfusion imaging assessment of peripheral infiltration zone of hepatic alveolar echinococcosis / 中国血吸虫病防治杂志

Objective To analyze the blood supply and metabolism in the marginal area of foci of hepatic alveolar echinococcosis by quantitative perfusion parameters. Methods Thirty patients with hepatic alveolar echinococcosis were scanned with the Revolution CT and the images were analyzed. The perfusion parameters, such as the bloodflow (BF), time to peak (TTP), blood volume (BV), mean transit time (MTT) and hepatic arterial fraction (HAF) were compared among different groups. Results The BF, TTP, BV and MTT values of the peripheral infiltration zone and the values of the surrounding normal liver tissues were significantly different (F = 24.579, 8.343, 20.535 and 21.843, all P<0.05), but the HAF values of the peripheral infiltration zone and the values of the surrounding normal liver tissues were not significantly different in the hepatic alveolar echinococcosis patients (F = 2.621, P> 0.05) . Conclusion The whole hepatic perfusion Revolution CT can accurately and quantitatively analyze the alveolar echinococcosis foci, especially the peripheral infiltration zone, which has important guiding significance for the formulation of surgical plan.

Imaging analysis of 79 cases of hepatic echinococcosis / 中国血吸虫病防治杂志

Objective To analyze the imaging manifestations of 79 cases of hepatic echinococcosis retrospectively, so as to provide evidences for improving the diagnosis and differential diagnosis of the disease. Methods Seventy-nine patients with hepatic echinococcosis who underwent imaging examinations and pathologic confirmation in Qinghai Provincial People’s Hospital from 2014 to 2017 were chosen as the investigation objects, and the data of their medical records and imaging manifestations were collected and analyzed. Results Among the 79 cases of hepatic echinococcosis, 57 were suffered from cystic echinococcosis (CE) and 22 were suffered from alveolar echinococcosis (AE) . Among the patients with CE, those in single cystic type, multiple cysts type, internal capsule collapse type, solid type, and calcification type were 21, 16, 9, 4 cases and 7 cases respectively. The imaging signs of 62 cases were common. The image of the single cystic type was characterized by intrahepatic cystic water-like lesions, the cystic wall was thin and uniform without any enhancement. The multiple cysts were characterized by "cyst in the cyst", "rose petals", and "spoke wheel". The collapse and separation of the internal capsule was manifested as "drift belt sign" and "double ring sign", the calcification of the cyst wall was curved and eggshell-shaped, the contents of the cyst were cotton-shaped or the whole lesion was calcific. The image of the patients with AE was manifested as a solid mass in the liver, the density and signal were heterogeneous, the edge was irregular and not obviously enhanced, the "small vesicles" scattered in the lesion were often accompanied by calcification, and the whole lesion showed a map appearance. The other 17 cases of hepatic echinococcosis showed complex and rare imaging features. The capsules of 6 cases of CE contained fat, the images presented single or multiple fat density nodules in the hepatic hydatid cyst, and CT value was –28 to –84 HU; in 4 cases of echinococcosis, the lesions were broken into the bile duct, the density of adjacent bile duct was increased, with bile duct wall thickening and peripheral biliary dilatation. For the 4 cases of echinococcosis combined with primary liver cancer, the imaging manifestations of the hepatic cysts presented solid-mass enhancement, with "fast forward and fast out" performance. For the image of the 3 cases of CE with infection, the cystic wall was thickening and enhanced obviously, of these, 2 cases had gaseous shadows in the cyst, 1 patient’s cyst was complicated with infection and it invaded the abdominal wall. Conclusion The imaging manifestations of hepatic echinococcosis are varied and complicated, which need careful analysis for differential diagnosis.

Value of CT imaging of inferior vena cava and hepatic vein in patients with hepatic cystic echinococcosis / 中国血吸虫病防治杂志

Objective To evaluate the accuracy of CT imaging of inferior vena cava and hepatic vein in patients with hepatic cystic echinococcosis. Methods A total of 100 patients with hepatic cystic echinococcosis were given triple-phase abdominal CT scan, and the reconstructed images of the inferior vena cava and hepatic vein were obtained and compared to the real situation during the surgical operation. The reliability of the CT evaluation of the echinococcus cyst lesion invading inferior vena cava and hepatic vein was analyzed. Results The compression displacement, half-globular, no clear demarcation between the lesion and blood vessel and narrowing of the vessel detected by CT evaluation were in accordance with the real situation under the surgical sight. However, four cases of clear demarcation between the lesion and blood vessel were affirmed wrong under the surgical sight. There were three cases of over diagnosis of vascular stenosis judgments. Conclusion The CT images of hepatic vein and inferior vena cava can clearly show the relationship between the hepatic echinococcus cyst and hepatic vein and inferior vena cava.

Value of three-dimensional visualization technology in preoperative evaluation of liver autotransplantation for end-stage hepatic alveolar echinococcosis / 中国血吸虫病防治杂志

Objective To evaluate the value of the three-dimensional visualization technology for the preoperative assessment of liver autotransplantation for end-stage hepatic alveolar echinococcosis. Methods A total of 8 patients with end-stage hepatic alveolar echinococcosis undergoing liver autotransplantation in Qinghai Provincial People’s Hospital from May 2013 to July 2017 were collected. All cases received preoperative abdominal CT scanning and dynamic three-phase enhanced CT scanning, and the original CT data were transferred to the human 3D visualization virtual surgical planning system. The volumes of Echinococcus multilocularis and pre-resected liver were measured using the 3D visualization reconstruction, and the relationship between the lesion and the neighboring tissues was observed. The value of the 3D visualization technology for the preoperative assessment of liver autotransplantation for end-stage hepatic alveolar echinococcosis was assessed by comparing with the intraoperative findings. Results The 3D visualization reconstruction model clearly displayed the adjacent relationship between the lesions of end-stage hepatic alveolar echinococcosis and the neighboring tissues, and no significant difference was seen between the pre-resected liver volume in 3D visualization reconstruction model and the actually resected liver volume (t = 1.083, P > 0.05). Conclusions 3D visualization technology is feasible to develop a reasonable scheme for liver resection and vascular anastomosis for end-stage hepatic alveolar echinococcosis prior to liver autotransplantation, which may increase the success of surgery and improve the prognosis.

Application value of Revolution CT combining three-dimensional visualization technique in precision resection of hepatic alveolar echinococcosis / 中国血吸虫病防治杂志

Objective To explore the application value of Revolution CT combining three -dimensional visualization technique in the precision resection of hepatic alveolar echinococcosis. Methods Totally 12 patients with surgical treatment and pathologically confirmed hepatic alveolar echinococcosis in Qinghai Provincial People’s Hospital were retrospectively analyzed. All the patients underwent the Revolution CT plain and enhancement scan before surgery, and the 0.625 millimeter scan data were obtained. The DICOM format data were imported into MI-3DVS for three-dimensional reconstruction, simulated cutting, volume measurement, and surgical planning. Results The data of 12 patients were reconstructed successfully, and the sizes and locations of the lesions as well as the hepatic vascular systems were clearly displayed. The liver volume, hydatid volume, simulated resection volume, and residual liver ratio were measured accurately. The average whole liver volume and the lesion volume of the 11 surgical treated patients were (2 429.8 ± 335.9) mL and (919.6 ± 262.8) mL respectively. The average actually removed volume was highly associated with the average simulated resection volume (r = 0.979, P < 0.01). Conclusion Revolution CT combining three-dimensional visualization technique can achieve accurate diagnosis as well as optimal surgical planning before operation, which is of great value for the precision resection of difficult hepatic alveolar echinococcosis.

[Value of three-dimensional visualization technology in preoperative evaluation of liver autotransplantation for end-stage hepatic alveolar echinococcosis].

OBJECTIVE: To evaluate the value of the three-dimensional visualization technology for the preoperative assessment of liver autotransplantation for end-stage hepatic alveolar echinococcosis. METHODS: A total of 8 patients with end-stage hepatic alveolar echinococcosis undergoing liver autotransplantation in Qinghai Provincial People's Hospital from May 2013 to July 2017 were collected. All cases received preoperative abdominal CT scanning and dynamic three-phase enhanced CT scanning, and the original CT data were transferred to the human 3D visualization virtual surgical planning system. The volumes of Echinococcus multilocularis and pre-resected liver were measured using the 3D visualization reconstruction, and the relationship between the lesion and the neighboring tissues was observed. The value of the 3D visualization technology for the preoperative assessment of liver autotransplantation for end-stage hepatic alveolar echinococcosis was assessed by comparing with the intraoperative findings. RESULTS: The 3D visualization reconstruction model clearly displayed the adjacent relationship between the lesions of end-stage hepatic alveolar echinococcosis and the neighboring tissues, and no significant difference was seen between the pre-resected liver volume in 3D visualization reconstruction model and the actually resected liver volume (t = 1.083, P > 0.05). CONCLUSIONS: 3D visualization technology is feasible to develop a reasonable scheme for liver resection and vascular anastomosis for end-stage hepatic alveolar echinococcosis prior to liver autotransplantation, which may increase the success of surgery and improve the prognosis.

Revolution CT hepatic perfusion imaging assessment of peripheral infiltration zone of hepatic alveolar echinococcosis / 中国血吸虫病防治杂志

Objective To analyze the blood supply and metabolism in the marginal area of foci of hepatic alveolar echinococcosis by quantitative perfusion parameters. Methods Thirty patients with hepatic alveolar echinococcosis were scanned with the Revolution CT and the images were analyzed. The perfusion parameters, such as the bloodflow (BF), time to peak (TTP), blood volume (BV), mean transit time (MTT) and hepatic arterial fraction (HAF) were compared among different groups. Results The BF, TTP, BV and MTT values of the peripheral infiltration zone and the values of the surrounding normal liver tissues were significantly different (F = 24.579, 8.343, 20.535 and 21.843, all P<0.05), but the HAF values of the peripheral infiltration zone and the values of the surrounding normal liver tissues were not significantly different in the hepatic alveolar echinococcosis patients (F = 2.621, P> 0.05) . Conclusion The whole hepatic perfusion Revolution CT can accurately and quantitatively analyze the alveolar echinococcosis foci, especially the peripheral infiltration zone, which has important guiding significance for the formulation of surgical plan.

Imaging analysis of 79 cases of hepatic echinococcosis / 中国血吸虫病防治杂志

Objective To analyze the imaging manifestations of 79 cases of hepatic echinococcosis retrospectively, so as to provide evidences for improving the diagnosis and differential diagnosis of the disease. Methods Seventy-nine patients with hepatic echinococcosis who underwent imaging examinations and pathologic confirmation in Qinghai Provincial People’s Hospital from 2014 to 2017 were chosen as the investigation objects, and the data of their medical records and imaging manifestations were collected and analyzed. Results Among the 79 cases of hepatic echinococcosis, 57 were suffered from cystic echinococcosis (CE) and 22 were suffered from alveolar echinococcosis (AE) . Among the patients with CE, those in single cystic type, multiple cysts type, internal capsule collapse type, solid type, and calcification type were 21, 16, 9, 4 cases and 7 cases respectively. The imaging signs of 62 cases were common. The image of the single cystic type was characterized by intrahepatic cystic water-like lesions, the cystic wall was thin and uniform without any enhancement. The multiple cysts were characterized by "cyst in the cyst", "rose petals", and "spoke wheel". The collapse and separation of the internal capsule was manifested as "drift belt sign" and "double ring sign", the calcification of the cyst wall was curved and eggshell-shaped, the contents of the cyst were cotton-shaped or the whole lesion was calcific. The image of the patients with AE was manifested as a solid mass in the liver, the density and signal were heterogeneous, the edge was irregular and not obviously enhanced, the "small vesicles" scattered in the lesion were often accompanied by calcification, and the whole lesion showed a map appearance. The other 17 cases of hepatic echinococcosis showed complex and rare imaging features. The capsules of 6 cases of CE contained fat, the images presented single or multiple fat density nodules in the hepatic hydatid cyst, and CT value was –28 to –84 HU; in 4 cases of echinococcosis, the lesions were broken into the bile duct, the density of adjacent bile duct was increased, with bile duct wall thickening and peripheral biliary dilatation. For the 4 cases of echinococcosis combined with primary liver cancer, the imaging manifestations of the hepatic cysts presented solid-mass enhancement, with "fast forward and fast out" performance. For the image of the 3 cases of CE with infection, the cystic wall was thickening and enhanced obviously, of these, 2 cases had gaseous shadows in the cyst, 1 patient’s cyst was complicated with infection and it invaded the abdominal wall. Conclusion The imaging manifestations of hepatic echinococcosis are varied and complicated, which need careful analysis for differential diagnosis.

Value of CT imaging of inferior vena cava and hepatic vein in patients with hepatic cystic echinococcosis / 中国血吸虫病防治杂志

Objective To evaluate the accuracy of CT imaging of inferior vena cava and hepatic vein in patients with hepatic cystic echinococcosis. Methods A total of 100 patients with hepatic cystic echinococcosis were given triple-phase abdominal CT scan, and the reconstructed images of the inferior vena cava and hepatic vein were obtained and compared to the real situation during the surgical operation. The reliability of the CT evaluation of the echinococcus cyst lesion invading inferior vena cava and hepatic vein was analyzed. Results The compression displacement, half-globular, no clear demarcation between the lesion and blood vessel and narrowing of the vessel detected by CT evaluation were in accordance with the real situation under the surgical sight. However, four cases of clear demarcation between the lesion and blood vessel were affirmed wrong under the surgical sight. There were three cases of over diagnosis of vascular stenosis judgments. Conclusion The CT images of hepatic vein and inferior vena cava can clearly show the relationship between the hepatic echinococcus cyst and hepatic vein and inferior vena cava.

Value of three-dimensional visualization technology in preoperative evaluation of liver autotransplantation for end-stage hepatic alveolar echinococcosis / 中国血吸虫病防治杂志

Objective To evaluate the value of the three-dimensional visualization technology for the preoperative assessment of liver autotransplantation for end-stage hepatic alveolar echinococcosis. Methods A total of 8 patients with end-stage hepatic alveolar echinococcosis undergoing liver autotransplantation in Qinghai Provincial People’s Hospital from May 2013 to July 2017 were collected. All cases received preoperative abdominal CT scanning and dynamic three-phase enhanced CT scanning, and the original CT data were transferred to the human 3D visualization virtual surgical planning system. The volumes of Echinococcus multilocularis and pre-resected liver were measured using the 3D visualization reconstruction, and the relationship between the lesion and the neighboring tissues was observed. The value of the 3D visualization technology for the preoperative assessment of liver autotransplantation for end-stage hepatic alveolar echinococcosis was assessed by comparing with the intraoperative findings. Results The 3D visualization reconstruction model clearly displayed the adjacent relationship between the lesions of end-stage hepatic alveolar echinococcosis and the neighboring tissues, and no significant difference was seen between the pre-resected liver volume in 3D visualization reconstruction model and the actually resected liver volume (t = 1.083, P > 0.05). Conclusions 3D visualization technology is feasible to develop a reasonable scheme for liver resection and vascular anastomosis for end-stage hepatic alveolar echinococcosis prior to liver autotransplantation, which may increase the success of surgery and improve the prognosis.

DAZL gene polymorphisms and astheno-teratozoospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the association between single nucleotide polymorphism (SNP) of the DZAL gene in infertile Han Chinese males with astheno-teratozoospermia.</p><p><b>METHODS</b>We collected semen samples from 173 infertile Han Chinese men with astheno-teratozoospermia (case group) and 175 age-matched normal male volunteers (control group) for semen routine and morphological analyses. We obtained genomic DNA, genotyped the polymorphisms of the DAZL gene A260G and A386G via the Sequenom MassARRAY system, and compared the frequencies of the genotypes between the case and control groups.</p><p><b>RESULTS</b>The AA nucleotide variant was found in the A260G and A386G polymorphisms of the DZAL gene in both the cases and controls, but the heterozygous AG variant in neither.</p><p><b>CONCLUSION</b>The A260G and A386G polymorphisms of the DAZL gene are not correlated with astheno-teratozoospermia-induced male infertility in the Han Chinese population, and therefore could not be considered as molecular markers of male infertility.</p>