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Objective To investigate CT features and reasons for the misdiagnosis of nodular or mass-like type pulmonary cryptococcosis（PC）. Methods The clinical manifestations and imaging data of 60 cases with nodular or mass-like type PC confirmed by pathology in the Affiliated Hospital of Nanjing University of Chinese Medicine from June 2011 to December 2021were analyzed retrospectively. Results Clinical manifestations: respiratory symptoms were associated with 28 cases, whereas 26 cases were asymptomatic. Imaging findings: 22 cases were in unilateral single lung lesion, 22 cases were in unilateral multiple lung lesions, 16 cases were in bilateral multiple lesions. Fifty-five cases with oval shape, including 38 cases with the long axis are parallel to the pleura, 28 cases with clustering and fusion tendency. Fifty-two cases were uniform in density. Thirteen cases with moderate enhancement, 4 cases with avid enhancement. Moreover, there were 24 cases with proximal air bronchogram, 45 cases with halo sign. Thirteen cases were followed and the volume doubling time ranged from 3.9 to 236.8 days, with the median 24.9 days. Thirty-seven cases were initially misdiagnosed. Conclusions Nodular or mass-like type of PC lesions usually occurs in the inferior lobe of both lungs and close to the pleura, and the long axis is parallel to the pleura. Halo sign and proximal air bronchogram are more specific manifestations. Multiple nodular masses with clustering and fusion tendency are highly suggestive of a PC. Cryptococcal capsular polysaccharide antigen detection can be used in clinical, and puncture biopsy can be performed if necessary.

In this study, we used the Sanya Incoherent Scatter Radar (SYISR) to observe the altitude profiles of traveling ionospheric disturbances (TIDs) during a moderate magnetic storm from 13 to 15 March 2022. Three TIDs were recorded, including two large-scale TIDs (LSTIDs) and one medium-scale TID (MSTID). These LSTIDs occurred during the storm recovery phase, characterized by periods of ~110–155 min, downward phase velocities of 22–60 m/s, and a relative amplitude of 17–25%. A nearly vertical front was noted at ~350–550 km, differing from AGW theory predictions. This structure is more attributed to the combined effects of sunrise-induced electron density changes and pre-sunrise uplift. Moreover, GNSS observations linked this LSTID to high-latitude origins, indicating a connection to polar magnetic storm excitation. However, the second LSTID was observed at lower altitudes (150–360 km) with a higher elevation angle (~17°). This LSTID, observed by the SYISR, was absent in the GNSS data from mainland China and Japan, suggesting a potential local source. The MSTID exhibited a larger relative amplitude of 29–36% at lower altitudes (130–210 km) with severe upward attenuation. The MSTID may be related to atmospheric gravity waves from the lower atmosphere. AGWs are considered to be the perturbation source for this MSTID event. [ABSTRACT FROM AUTHOR]

Patients with locally advanced head and neck squamous cell carcinoma (LA‐HNSCC) have poor survival outcomes. The real‐world efficacy of nimotuzumab plus intensity modulated radiotherapy (IMRT)‐based chemoradiotherapy in patients with LA‐HNSCC remains unclear. A total of 25,442 HNSCC patients were screened, and 612 patients were matched by propensity score matching (PSM) (1:1). PSM was utilized to balance known confounding factors. Patients who completed at least five doses of nimotuzumab were identified as study group. The primary end point was 3‐year overall survival (OS) rate. Log‐rank test examined the difference between two survival curves and Cloglog transformation test was performed to compare survival at a fixed time point. The median follow‐up time was 54.2 (95% confidence interval [CI]: 52.7–55.9) months. The study group was associated with improved OS (hazard ratio [HR] = 0.75, 95% CI: 0.57–0.99, p = 0.038) and progression‐free survival (PFS) (HR = 0.74, 95% CI: 0.58–0.96, p = 0.021). Subgroup analysis revealed that aged 50–60 year, IV, N2, radiotherapy dose ≥ 60 Gy, without previous surgery, and neoadjuvant therapy have a trend of survival benefit with nimotuzumab. Nimotuzumab showed favorable safety, only 0.2% had nimotuzumab‐related severe adverse events. Our study indicated the nimotuzumab plus chemoradiotherapy provides survival benefits and safety for LA‐HNSCC patients in an IMRT era. [ABSTRACT FROM AUTHOR]

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic airway diseases in the world. OBJECTIVE: To predict the degree of mixed venous oxygen saturation (SvO2) impairment in patients with COPD by modeling using clinical-CT radiomics data and to provide reference for clinical decision-making. METHODS: A total of 236 patients with COPD diagnosed by CT and clinical data at Xiangyang No. 1 People's Hospital (n = 157) and Xiangyang Central Hospital (n = 79) from June 2018 to September 2021 were retrospectively analyzed. The patients were divided into group A (SvO ⩾ 2 62%, N = 107) and group B (SvO < 2 62%, N = 129). We set up training set and test set at a ratio of 7/3 and time cutoff spot; In training set, Logistic regression was conducted to analyze the differences in general data (e.g. height, weight, systolic blood pressure), laboratory indicators (e.g. arterial oxygen saturation and pulmonary artery systolic pressure), and CT radiomics (radscore generated using chest CT texture parameters from 3D slicer software and LASSO regression) between these two groups. Further the risk factors screened by the above method were used to establish models for predicting the degree of hypoxia in COPD, conduct verification in test set and create a nomogram. RESULTS: Univariate analysis demonstrated that age, smoking history, drinking history, systemic systolic pressure, digestive symptoms, right ventricular diameter (RV), mean systolic pulmonary artery pressure (sPAP), cardiac index (CI), pulmonary vascular resistance (PVR), 6-min walking distance (6MWD), WHO functional classification of pulmonary hypertension (WHOPHFC), the ratio of forced expiratory volume in the first second to the forced vital capacity (FEV1%), and radscore in group B were all significantly different from those in group A (P < 0.05). Multivariate regression demonstrated that age, smoking history, digestive symptoms, 6MWD, and radscore were independent risk factors for SvO2 impairment. The combined model established based on the abovementioned indicators exhibited a good prediction effect [AUC: 0.903; 95%CI (0.858–0.937)], higher than the general clinical model [AUC: 0.760; 95%CI (0.701–0.813), P < 0.05] and laboratory examination-radiomics model [AUC: 0.868; 95%CI (0.818–0.908), P = 0.012]. The newly created nomogram may be helpful for clinical decision-making and benefit COPD patients. CONCLUSION: SvO2 is an important indicator of hypoxia in COPD, and it is highly related to age, 6MWD, and radscore. The combined model is helpful for early identification of SvO2 impairment and adjustment of COPD treatment strategies. [ABSTRACT FROM AUTHOR]