statement: In patients suspected of having COVID-19, the initial chest CT showed high sensitivity, but low specificity. Key Results:(1) The sensitivity, specificity, positive predictive value, and negative predictive value (with 95% confidence intervals) were 93% (85-97%), 53% (27-77%), 92% (83-96%), 42% (18-70%), respectively. Similar results were shown in both geographic regions studied.(2) There were no significant differences in the distribution of positive rates of tests in the two geographic regions between CT (P=0.423) and reverse transcription polymerase chain reaction testing (P=0.931). AbbreviationsPPV= positive predictive value (PPV) NPV= negative predictive value (NPV) 95% CI=95% confidence interval RT-PCR = reverse transcription polymerase chain reaction CT=computed tomography (CT) Abstract Background: Coronavirus disease 2019 (COVID-19) is a new viral respiratory disease that has recently emerged from China, becoming a pandemic. However, few studies have analyzed 3data regarding the clinical performance of chest computed tomography (CT) obtained in subjects with suspected COVID-19 at the initial presentation to medical facilities. Objective:The purpose of the present study was to evaluate the performance of chest CT the initial presentation of patients with suspected COVID-19.Methods: Data from 103 patients who were under investigation for COVID-19 based on inclusion criteria according to WHO Interim Guidance were retrospectively collected from January 21, 2020 to February 14, 2020. All patients underwent chest CT scanning and reverse transcription polymerase chain reaction testing (RT-PCR) for COVID-19 at hospital presentation. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) (with 95% confidence intervals) were calculated to evaluate the performance of CT. Subgroup analyses were also performed based on the geographical distribution of these cases in the province of Henan, China.Results: There were 88 /103 (85%) patients with COVID-19 confirmed by RT-PCR. The overall sensitivity, specificity, PPV, and NPV were 93% (85-97%), 53% (27-77%), 92% (83-96%), and 42% (18-70%), respectively. Similar results were shown in both geographic regions. The respective sensitivity, specificity, PPV, and NPV for chest CT in the districts of Xinyang and Zhumadian (n = 56) were 92% (80-97%), 63% (26-90%), 93% (81-98%), and 56% (23-85%), while these indicators in the district of Anyang (n = 47) were 95% (81-99%), 43% (12-80%), 90% (76-97%), and 60% (17-93%). There were no significant differences in the prevalence of positive exams in the two geographic subgroups for CT (P=0.423) or RT-PCR (P=0.931). 4Conclusion: Although initial chest CT obtained at hospital presentation showed high sensitivity in patients under investigation for COVID-19 in the two geographic regions in Henan province, the NPV was only modest, suggesting low value of CT as a screening tool.

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The aim of the present study was to analyze and improve the understanding of computed tomography (CT) and positron emission tomography (PET)/CT imaging and the pathological features of solitary thin-walled cavity lung cancer. A total of 16 patients with pathologically confirmed solitary thin-walled cavity lung cancer were included in the present study. All of the patients received CT scans. Among these, two patients underwent an additional PET/CT examination. The CT and PET/CT images were analyzed and a cross-check analysis of the pathological results was conducted. In total, 16 cases of lesions demonstrated thin-walled cavities on the CT images. Among these cases, three presented with an uneven thickening of the cavity walls, 10 cases exhibited wall nodules and three cases presented with compartments in the cavity. The standard uptake value (SUV) of the cavity wall increased in two patients who underwent PET/CT examinations. The 16 cases of lesions were pathologically confirmed as adenocarcinomas. Light microscopy revealed that the tumor cells, which were observed in 12 cases of lesions, had diffused along the inner cavity wall and the tumor cells of four cases had invaded the bronchial wall. Images of the chest that demonstrated a single thin-walled cavity accompanied by uneven thickening of the cavity wall or wall nodules, in addition to an increase in the SUV and compartments in the cavity, indicated potential lung cancer. Valves formed as a result of bronchial wall damage may have led to the cavity.

This study investigated the kidney‐protective ability of N6‐(2‐hydroxyethyl)‐adenosine (HEA) in alloxan‐induced diabetic rats. Diabetes was induced in the rats by the administration of alloxan monohydrate (150 mg/kg, i.p) and treated with HEA for 6 weeks. Diabetic rats displayed marked increase in blood glucose, serum creatinine (Scr), and blood urea nitrogen (BUN), in addition to high excretion of urinary protein and albumin. Furthermore, diabetic rats showed decreased renal levels of glutathione (GSH), catalase (CAT), superoxide dismutase (SOD), and increased malondialdehyde (MDA) as well as renal concentrations of pro‐inflammatory mediators (TNF‐α, IL‐6, IL‐1β, and TGF‐β1). Treatment of diabetic rats with HEA (20 and 40 mg/kg) significantly increased the renal antioxidant level, reduced the levels of blood glucose, Scr, BUN, urinary protein, albumin, and pro‐inflammatory mediators in a dose‐dependent fashion. Histological evaluation of the kidney of diabetic rats indicated that HEA also ameliorated glomerular and tubular changes. Practical applications HEA is a bioactive constituent isolated from Cordyceps cicadae and has been shown to possess antihyperglycemic, kidney protective, antioxidant, and antiinflammatory effects in diabetic rats. HEA stimulated the antioxidant enzymes’ activities in the kidney tissues as well as reduced pro‐inflammatory mediators, indicating its antidiabetic and renoprotective effects in diabetic models. The results showed that HEA attenuated oxidative stress and inflammation in kidney tissues.

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BackgroundDiabetes mellitus (DM) is an incurable metabolic disease constituting a major threat to human health. Insulin-producing cells (IPCs) differentiated from mesenchymal stem cells (MSCs) hold great promise in the treatment of DM. The development of an efficient IPC induction system is a crucial step for the clinical application of IPCs for DM. Laminin 411 is a key component of the basement membrane and is involved in the regulation of cell differentiation; however, little is known about a role of laminin 411 in the regulation of IPC differentiation from human MSCs.MethodsMSCs were isolated from human umbilical cord (UC-MSCs) and expanded in an in vitro culture system. UC-MSCs were then cultured in the IPC induction and differentiation medium in the presence of laminin 411. Flow cytometry, Quantitative realtime PCR, immunofluorescence staining, ELISA, Western blotting and other techniques were applied to determine IPC generation, insulin expression and related mechanisms. To evaluate potential therapeutic efficacy of IPCs induced from UC-MSCs, a type-1 diabetes (T1DM) rat model was generated using streptozotocin. Blood glucose, insulin levels, and survival of rats were monitored periodically following intravenous injection of the tested cells.ResultsLaminin 411 markedly induced the expression of the genes Foxa2 and Sox17, markers for pancreatic precursor cells, efficiently induced IPC differentiation from MSCs, and up-regulated insulin expression at both mRNA and protein levels. Furthermore, the expression of the genes known to govern insulin expression including Pdx1 and Ngn3 was markedly induced by laminin 411, which suggests that Pdx1 and Ngn3 signaling pathways are involved in laminin 411 induced-insulin expression machinery. More importantly, administration of laminin 411-induced IPCs rapidly and significantly down-regulated fasting blood glucose levels, significantly reduced the HbA1c concentration and markedly improved the symptoms and survival of T1DM rats.ConclusionsOur results demonstrate that laminin 411 acts as a potent differentiation inducer of IPCs from UC-MSCs via the Pdx1 and Ngn3 signaling pathways. Moreover, transfusion of laminin 411 induced-IPCs more efficiently improves symptoms and survival of T1DM rats. These novel finding highlights a potential clinical application of laminin 411 induced-IPCs in the treatment of T1DM, which calls for further studies.

In the brain, Neuromedin U2 receptor (NMU2R) is prominent in the hypothalamic regions and is known to be associated with regulation of several important physiological functions, including food intake, energy balance, stress response, and nociception. In this article, by random screening of compounds using the model of high-throughput screening for NMU2R stable expression, NMU2R negative and NMU2R short hairpin RNA (shRNA) knockdown HEK293 cell lines, for the first time, we discovered that p-synephrine, which is the primary protoalkaloid in Citrus aurantium (bitter orange) and is widely used in weight loss and weight management products, is a highly potent and selective NMU2R agonist. In NMU2R activating ability experiments, p-synephrine was found binding to NMU2R with high efficacy and potency; the efficacy, 50% of the maximum possible effect (EC 50 ) and potency values were determined to be 7.207, 6.604 and 0.227 µmol/L for the NMU2R, respectively. Our researches have important theoretical value for elucidating the mechanisms of p-synephrine in body weight and energy balance regulation. These data provide further evidence for widespread roles for p-synephrine and its receptors in the brain.

[Purpose] This study investigated the effects of a 12-hour neuromuscular electrical stimulation program in the evening hours on upper extremity function in sub-acute stroke patients. [Subjects and Methods] Forty-five subjects were randomized to one of three groups: 12-hour neuromuscular electrical stimulation group (n=15), which received 12 hours of neuromuscular electrical stimulation and conventional rehabilitation for the affected upper extremity; neuromuscular electrical stimulation group (n=15), which received 30 min of neuromuscular electrical stimulation and conventional rehabilitation; and control group (n=15), which received conventional rehabilitation only. The Fugl-Meyer assessment, Action Research Arm Test, and modified Ashworth scale were used to evaluate the effects before and after intervention, and 4 weeks later. [Results] The improvement in the distal (wrist-hand) components of the Fugl-Meyer assessment and Action Research Arm Test in the 12-hour neuromuscular electrical stimulation group was more significant than that in the neuromuscular electrical stimulation group. No significant difference was found between the two groups in the proximal component (shoulder-elbow) of the Fugl-Meyer assessment. [Conclusion] The 12-hour neuromuscular electrical stimulation group achieved better improvement in upper extremity motor function, especially in the wrist-hand function. This alternative therapeutic approach is easily applicable and can be used in stroke patients during rest or sleep.