Clinical Diagnostic Methods Research Articles

Progress of Photodynamic Therapy in Hepatocellular Carcinoma Using Nano/Microtechnology

This article aims to examine the research advancements in photodynamic therapy (PDT) for hepatocellular carcinoma (HCC) utilizing nano/microtechnology. The objective is to provide valuable insights for disease prevention and control in patients with liver cancer (LC). LC is a prevalent form of cancer that inflicts significant suffering on patients. Early treatment plays a crucial role in improving the prognosis and enhancing the quality of life (QoL) for LC patients. While PDT has proven effective in treating surface and intracerebral tumors, studies focusing on intra-abdominal tumors, particularly liver tumors, are limited. Hence, it is essential to comprehend the clinical value and therapeutic outcomes of PDT for LC, particularly in the context of nano/microtechnology. With rapid advancements in nanotechnology, its integration into the medical field has grown extensively. By leveraging nanotechnology, the analysis of PDT’s effects on HCC yields significant clinical value. This article reviews the clinical diagnostic methods and therapeutic approaches for LC, emphasizes the impact of PDT on clinical outcomes for LC patients, and analyzes the progress of PDT applied to HCC under the framework of nano/microtechnology. The findings aim to offer valuable references for the clinical treatment of LC patients.

Sporotrichosis in Argentina: clinical and epidemiological analysis

Sporotrichosis is an implantation mycosis caused by Sporothrix spp. It is distributed worldwide and can be found in vegetation and soil. The most frequent route of infection is by trauma with elements contaminated with fungal propagules. Since domestic cats are the most affected animals and can transmit this infection to humans, sporotrichosis is considered a zoonosis. Clinical presentations include nodular lymphangitis, fixed cutaneous, pulmonary (rare), and disseminated (exceptional). To analyze the epidemiology of sporotrichosis in Argentina during 2010 and 2022. To describe the clinical presentation, diagnostic methods, and treatment of cases diagnosed during this period. To know the circulating genotypes and to observe possible associations with the geographic location where the infection was acquired. Analytical, retrospective, and observational study. We analyzed the medical records of patients with sporotrichosis from 12 health institutions in Argentina, between 2010 and 2022. We present 54 cases in which the most frequent clinical form was nodular lymphangitis, and the treatment of choice was itraconazole. Conventional diagnosis was made in all cases. Culture of clinical samples was more sensitive than direct examination because it allowed the isolation of Sporothrix spp. in all 54 cases. Molecular identification was performed in 22 cases, with Sporothrix schenkii sensu stricto being the most frequently isolated species. This study allowed to know the epidemiology of this mycosis in Argentina, as well as the availability of diagnostic methods and the treatment of choice.

Paranasal Schwannomas: A Comprehensive Study of 2 Cases.

Paranasal sinus tumors are a heterogeneous group of neoplasms (with paranasal schwannomas being a rare subtype) that are often present with non-specific symptoms, such as nasal obstruction and epistaxis. Thus, early diagnosis is crucial for optimal management. This study presents 2 cases of paranasal schwannomas, detailing their clinical presentation, diagnostic methods, and treatment approaches. Both patients underwent endoscopic sinus surgery with successful tumor excision and had no significant complications or recurrences during follow-up. Diagnosis was based on a combination of clinical examination, radiological imaging (computed tomography and magnetic resonance imaging), and histopathological confirmation with immunohistochemical staining. Treatment consisted primarily of endonasal resection, with consideration of frontal craniotomy if necessary. This study aims to contribute to the understanding of paranasal schwannomas and emphasizes the importance of early detection and treatment to improve patient outcomes.

Pediatric Spinal Cord Injury: A Review.

A spinal cord injury (SCI) can be a devastating condition in children, with profound implications for their overall health and quality of life. In this review, we aim to provide a concise overview of the key aspects associated with SCIs in the pediatric population. Firstly, we discuss the etiology and epidemiology of SCIs in children, highlighting the diverse range of causes. We explore the unique anatomical and physiological characteristics of the developing spinal cord that contribute to the specific challenges faced by pediatric patients. Next, we delve into the clinical presentation and diagnostic methods, emphasizing the importance of prompt and accurate diagnosis to facilitate appropriate interventions. Furthermore, we approach the multidisciplinary management of pediatric SCIs, encompassing acute medical care, surgical interventions, and ongoing supportive therapies. Finally, we explore emerging research as well as innovative therapies in the field, and we emphasize the need for continued advancements in understanding and treating SCIs in children to improve their functional independence and overall quality of life.

Evaluation of the features of cystic echinococcosis with concurrent super-infection: a retrospective study in Southern Iran

ObjectiveSuperinfection of cystic echinococcosis (CE) is a life-threatening complication with significant morbidities, which can be prevented with early diagnosis and treatment. This study aims to examine the clinical characteristics, diagnostic methods, and treatment options for superinfected CE, as there is currently limited information available on the differences between superinfected and non-infected CE in terms of clinical features, serological and radiologic findings.MethodsThis cross-sectional study was conducted on hospital records of patients who were diagnosed with hydatid cysts in a 15-year period (2004 to 2018) in two main university-affiliated referral centers in Fars province, southern Iran. Patients’ information regarding the demographical and clinical features related to CE, age, sex, previous history of CE or recurrence, size and location of CE, and length of hospital stay were collected. Moreover, the characteristics of concurrent infections with hydatid cysts were recorded.ResultsA total of 586 surgeries due to CE were performed on 501 patients, of which 67 (11.43%) had reoperations due to the recurrence of the disease. A total of 30 (5.99%) incidences of superinfection were observed. There were no statistically significant differences in terms of laboratory and imaging findings between CE patients with concurrent infections and other CE patients (p-value > 0.05). Among the patients with super-infection, four had fungal infections of the lungs. Aspergillus fumigatus was the causative pathogen in all four patients that were diagnosed with fungal superinfection. All patients underwent surgical excision with favorable long-term outcomes.ConclusionOur study revealed a 5.99% incident rate of CE superinfection. Regarding the concurrent fungal infections in hydatid cysts, the patient’s symptoms and laboratory and imaging findings are inconclusive and histopathological evaluation seems to be the most reliable option. Surgical resection is the gold-standard treatment option with favorable outcomes and potentially can be curative.

A multiplex blood-based assay targeting DNA methylation in PBMCs enables early detection of breast cancer

The immune system can monitor tumor development, and DNA methylation is involved in the body’s immune response to tumors. In this work, we investigate whether DNA methylation alterations in peripheral blood mononuclear cells (PBMCs) could be used as markers for early detection of breast cancer (BC) from the perspective of tumor immune alterations. We identify four BC-specific methylation markers by combining Infinium 850 K BeadChips, pyrosequencing and targeted bisulfite sequencing. Based on the four methylation markers in PBMCs of BC, we develop an efficient and convenient multiplex methylation-specific quantitative PCR assay for the detection of BC and validate its diagnostic performance in a multicenter cohort. This assay was able to distinguish early-stage BC patients from normal controls, with an AUC of 0.940, sensitivity of 93.2%, and specificity of 90.4%. More importantly, this assay outperformed existing clinical diagnostic methods, especially in the detection of early-stage and minimal tumors.

EpilepsyNet: Novel automated detection of epilepsy using transformer model with EEG signals from 121 patient population

BackgroundEpilepsy is one of the most common neurological conditions globally, and the fourth most common in the United States. Recurrent non-provoked seizures characterize it and have huge impacts on the quality of life and financial impacts for affected individuals. A rapid and accurate diagnosis is essential in order to instigate and monitor optimal treatments. There is also a compelling need for the accurate interpretation of epilepsy due to the current scarcity in neurologist diagnosticians and a global inequity in access and outcomes. Furthermore, the existing clinical and traditional machine learning diagnostic methods exhibit limitations, warranting the need to create an automated system using deep learning model for epilepsy detection and monitoring using a huge database. MethodThe EEG signals from 35 channels were used to train the deep learning-based transformer model named (EpilepsyNet). For each training iteration, 1-min-long data were randomly sampled from each participant. Thereafter, each 5-s epoch was mapped to a matrix using the Pearson Correlation Coefficient (PCC), such that the bottom part of the triangle was discarded and only the upper triangle of the matrix was vectorized as input data. PCC is a reliable method used to measure the statistical relationship between two variables. Based on the 5 s of data, single embedding was performed thereafter to generate a 1-dimensional array of signals. In the final stage, a positional encoding with learnable parameters was added to each correlation coefficient's embedding before being fed to the developed EpilepsyNet as input data to epilepsy EEG signals. The ten-fold cross-validation technique was used to generate the model. ResultsOur transformer-based model (EpilepsyNet) yielded high classification accuracy, sensitivity, specificity and positive predictive values of 85%, 82%, 87%, and 82%, respectively. ConclusionThe proposed method is both accurate and robust since ten-fold cross-validation was employed to evaluate the performance of the model. Compared to the deep models used in existing studies for epilepsy diagnosis, our proposed method is simple and less computationally intensive. This is the earliest study to have uniquely employed the positional encoding with learnable parameters to each correlation coefficient's embedding together with the deep transformer model, using a huge database of 121 participants for epilepsy detection. With the training and validation of the model using a larger dataset, the same study approach can be extended for the detection of other neurological conditions, with a transformative impact on neurological diagnostics worldwide.

Clinico-epidemiological profile and treatment outcome of craniopharyngioma: a case series

Craniopharyngioma is a rare type of benign (non-cancerous) brain tumor that primarily affects children and young adults. It arises from remnants of the Rathke's pouch, which is an embryonic structure that forms during the development of the pituitary gland. Craniopharyngiomas typically develop near the pituitary gland, in the area known as the sellar region. These tumors can cause various symptoms depending on their size and location, including hormonal imbalances, vision problems, headaches, and growth abnormalities. The management of craniopharyngioma involves a multidisciplinary approach, including surgery, radiation therapy, and hormone replacement therapy. Long-term outcomes can be influenced by the tumor's size, location, and the treatment modality used. Therefore, early recognition, accurate diagnosis, and appropriate treatment are crucial for optimizing the quality of life and long-term prognosis for individuals with craniopharyngioma. A detailed review of a number of craniopharyngioma cases is presented in this case series publication, with an emphasis on the clinical presentation, diagnostic methods, therapeutic options, and long-term results. This study's goal is to give doctors and researchers who work with patients who have this difficult malignancy useful information.

Adaptive Critical Region Extraction Net via relationship modeling for bone age assessment

Bone age assessment is an efficient clinical practice to diagnose children’s endocrine, genetic, and growth disorders. Guided by clinical diagnostic methods, local critical regions cropped from original hand radiography images have significant biological identification meaning in skeletal maturity analysis. However, existing methods crop local regions without maintaining the relationship between cropped regions and the global image, which results in discarding essential information. To address this problem, we propose an Adaptive Critical Region Extraction Net (ACRE-Net) for bone age assessment, which can automatically locate local critical regions from global images and calibrate features by relationship modeling. Unlike existing two-stage methods, which crop global images in the first stage and analyze cropped parts in the second stage separately, our ACRE-Net maintains the relationships between global images and cropped regions and further integrates such relationship information into relationship-guided features. With the relationship-guided features, we propose a novel cross-graph feature calibration module which is consisted of a bigraph structure to supplementary and calibrate features extracted from cropped parts by also modeling the relationship between cropped parts. Meanwhile, we offer a novel localization strategy in the patch-based region localization module, which aggregates and leverages multi-scale attention maps to locate patches of interest as critical regions to be cropped. In practical application, our ACRE-Net can free clinicians from time-consuming manual annotations on local critical regions and automatically assess bone age through radiography images. Extensive experiments illustrate that our ACRE-Net achieves state-of-the-art performance with Mean Absolute Error (MAE) 3.78 months on the public RSNA2017 dataset.

Medical imaging in rheumatoid arthritis: A review on deep learning approach.

Arthritis is a musculoskeletal disorder. Millions of people have arthritis, making it one of the most common joint disorders. Osteoarthritis (OA) and rheumatoid arthritis (RA) are the most common types of arthritis among the many different types available. Pain, stiffness, and inflammation are among the early signs of arthritis, which can progress to severe immobility at a later stage if left untreated. Although arthritis cannot be cured at any point in time, it can be managed if diagnosed and treated correctly. Clinical diagnostic and medical imaging methods are currently used to evaluate OA and RA, both debilitating conditions. This review is focused on deep learning approaches used by taking medical imaging (X-rays and magnetic resonance imaging) as input for the detection of RA.

Postoperative complications in patients with intracranial meningiomas who underwent surgery

Introduction and Aim: A benign tumor of the central nervous system known as a meningioma of the brain can be effectively treated surgically to assure complete patient recovery. The objective of this study was to investigate intracranial postoperative complications in meningiomas, identify factors that are prognostically significant, assess the results of surgical therapy, and provide rational solutions for difficulties associated with brain meningiomas. Materials and Methods: The 202 observations of patients with supratentorial meningiomas who had surgery provided the basis for the current study. In the 20 patients who survived, we looked at a number of surgical problems. Clinical evaluation and instrumental diagnostic methods were used to confirm their nature. Results: Most patients with basal located meningiomas experience surgical issues. Meningiomas were discovered to be basal in 12 (60.0%) of the survivors who encountered postoperative complications. Patients with postoperative complications from meningiomas frequently encountered many cumulative issues, with a death rate of 5 (2.5%) and one or occasionally two complications in survivors. Conclusion: The growth of tumors, surgical trauma, and the body's general reaction to the removal of neoplasms all affect the body's activity at all levels (subcellular, cellular, organ, and systemic) in patients with supratentorial meningiomas, leading to postoperative complications.

Carbon dot/Co-MOF nanocoral mediated fluorescence-scattering ratiometric sensor for highly sensitive detection of alkaline phosphatase

Abnormal expression of alkaline phosphatase (ALP) in serum has received considerable attention in health monitoring and disease diagnosis. However, conventional optical analysis based on a single signal must compromise background interference and limited sensitivity in trace analysis. As an alternative candidate, the ratiometric approach depends on the self-calibration of two independent signals in a single test to minimize interferences from the background for accurate identification. Here, a carbon dot/cobalt-metal organic framework nanocoral (CD/Co-MOF NC) mediated fluorescence-scattering ratiometric sensor has been developed for simple, stable, and highly sensitive detection of ALP. ALP-responsive phosphate production was used to coordinate cobalt ion and collapse the CD/Co-MOF NC, resulting in the recovery of fluorescence signal from dissociative CDs and the decrease of second-order scattering (SOS) signal from the cracked CD/Co-MOF NC. The ligand-substituted reaction and the optical ratiometric signal transduction provide a rapid and reliable chemical sensing mechanism. The ratiometric sensor effectively converted ALP into a ratio signal of fluorescence-scattering dual emission throughout a wide linear concentration range of six orders of magnitude with a detection limit of 0.6 mU/L. In addition, self-calibration of fluorescence-scattering ratiometric method can reduce background interference and improve sensitivity in serum, approaching recoveries of ALP from 98.4% to 101.8%. Due to the above advantages, the CD/Co-MOF NC mediated fluorescence-scattering ratiometric sensor readily provides rapid and stable quantitative detection of ALP as a promising in vitro analytical method for clinical diagnostics.

The "Bubble Test" in the Arthroscopic Diagnosis of Triangular Fibrocartilage Central Lesion: Description and Relevance to Treatment.

Background Ulnarly sided wrist pain is a common and challenging symptom. Arthroscopy has become a safe and effective tool for the correct diagnosis and treatment, proving to be better than all other clinical and imaging diagnostic methods. Some tests have been described for the diagnosis of triangular fibrocartilage (TFC) lesions, such as the trampoline test for peripheral lesions and the hook, ghost, and suction tests for foveal detachments. In tears at the disc level, when they affect all layers of the TFC (complete lesion) at the same point, testing with the probe will usually suffice for the diagnosis. However, in some apparently partial lesions, the probe cannot pass through all layers because the proximal and distal sites of the lesion are not aligned. There has been no arthroscopic test described for such cases. Case Description We describe a simple and practical test that we have called the "bubble test" in a typical case to diagnose TFC central injuries, aiming to discriminate partial from complete lesions, which are eventually hard to differentiate through direct vision and arthroscopic probing, leading to a direct influence onto the treatment. The bubble test is performed with external compression of the distal radioulnar joint (DRUJ) aspect, with the thumb on the back of the DRUJ and the index and middle fingers onto the volar aspect. The abrupt compression of this region causes the passage of air mixed with synovial fluid from the DRUJ to the radiocarpal joint, generating bubble formation. Clinical Relevance The bubble test should correlate to physical examination and imaging (magnetic resonance imaging [MRI]) findings and is particularly useful in central and degenerative (Type II) TFC lesions in patients complaining of chronic pain on the ulnar region of the wrist, with no history of trauma and with inconclusive MRI findings. Once the diagnosis is confirmed, arthroscopic treatment consists of wide debridement of the lesion with resection of the injured tissue and the local inflammatory reaction. Thus, it is essential for the correct treatment to define the exact location of the lesion and to know whether the disc injury is complete.

Contrast-Enhanced Multispectral Optoacoustic Tomography for Functional Assessment of the Gastrointestinal Tract.

Real-time imaging and functional assessment of the intestinal tract and its transit pose a significant challenge to conventional clinical diagnostic methods. Multispectral optoacoustic tomography (MSOT), a molecular-sensitive imaging technology, offers the potential to visualize endogenous and exogenous chromophores in deep tissue. Herein, a novel approach using the orally administered clinical-approved fluorescent dye indocyanine green (ICG) for bedside, non-ionizing evaluation of gastrointestinal passage is presented. The authors are able to show the detectability and stability of ICG in phantom experiments. Furthermore, ten healthy subjects underwent MSOT imaging at multiple time points over eight hours after ingestion of a standardized meal with and without ICG. ICG signals can be visualized and quantified in different intestinal segments, while its excretion is confirmed by fluorescent imaging of stool samples. These findings indicate that contrast-enhanced MSOT (CE-MSOT) provides a translatable real-time imaging approach for functional assessment of the gastrointestinal tract.

Trimethylamine N-oxide Promotes Atherosclerosis by Regulating Low-Density Lipoprotein-Induced Autophagy in Vascular Smooth Muscle Cells Through PI3K/AKT/mTOR Pathway.

The research aimed to study the mechanism of how trimethylamine N-oxide (TMAO) regulates autophagy to promote atherosclerosis (AS). The AS in vitro model was constructed with vascular smooth muscle cells (VSMCs) treated with ox-LDL. The Cell Counting Kit-8 (CCK-8) trial was chosen to examine VSMCs' absorbance (OD) value. A transmission electron microscope (TEM) was selected for monitoring autophagosomes. Western blotting (WB) was adopted for examining the expression of Beclin-1, p62, LC3, α-SMA, SM22-α, OPN, PI3K, AKT, mTOR, p-PI3K, p-AKT, and p-mTOR proteins. Real-time fluorescent quantitative PCR (RT-qPCR) was accepted for testing the expression of α-SMA, SM22-α, OPN, PI3K, AKT, mTOR, Beclin-1, p62, and LC3 genes. The transwell assay was employed to examine the ability of migration in VSMCs. Oil red O staining assay was accepted to stain lipid droplets in VSMCs. TMAO noticeably promoted autophagy inhibition and the phenotypic transformation of AS. Protein expressions of p-PI3K/PI3K, p-AKT/AKT, p-mTOR/mTOR, and p62 of the TMAO+ox-LDL group were higher than the ox-LDL group, while Beclin-1 and LC3 were lower than the ox-LDL group. Gene expressions of PI3K, AKT, mTOR, and p62 of the TMAO+ox-LDL group were higher than the ox-LDL group, while Beclin-1 and LC3 were lower than the ox-LDL group. The intervention of LY294002 reversed the regulation of the corresponding proteins and genes. The study proved that TMAO could promote autophagy inhibition of AS via activating the PI3K/AKT/mTOR pathway. It supplied a reliable basis for improving clinical diagnostic methods and developing targeted AS drugs.

Clinical Features of Extragenital Scar Endometriosis: A Cross-Sectional Study

Objective: Abdominal wall endometriosis (AWE) is a rare form of extragenital endometriosis that usually develops in association with a prior surgical scar. The purpose of the study was to review the clinical characteristics, diagnostic methods, treatment modalities, and outcomes of patients with AWE. Methods: A descriptive cross-sectional study was performed in a Gynecology Department of a Portuguese tertiary hospital, concerning patients with histologic-proven AWE, between January 2012 and December 2020 (n = 22). Statistical analysis was performed using IBM SPSS Statistics Version 27.00, with a significance level of p < 0.05. Results: The most common locations of extrapelvic endometrial ectopic implants were cesarean delivery scar (n = 13, 59.1%) and the umbilicus (n = 5, 22.7%). The median (range) age was 36 (30-42) years old, and all patients had a history of previous surgery but one. Nineteen patients had undergone a previous cesarean section, and the mean (range) time from surgery to the onset of symptoms was 100 (32-168) months. All patients were symptomatic and presented with a palpable mass at physical examination. The majority complained of a painful abdominal mass (n = 20, 90.9%) which was associated with cyclic pain in thirteen patients (65%). Ultrasound scan was performed in all patients and the nodules had a median size of 20.5 mm (5-93 mm). One patient received hormonal therapy and surgical resection was performed in the remaining patients. The nodule’s median (range) size was 31 (12-50) mm on gross examination. Conclusion: AWE should be considered in the presence of a previous pelvic surgery history associated with abdominal scar cyclic pain and swelling. A careful history and clinical examination are essential for diagnosis to avoid unnecessary delay before surgical intervention.

Whole-course management strategies for gastroesophageal reflux disease: an evidence mapping study based on clinical practice guidelines

Gastroesophageal reflux disease (GERD) is one of the most common digestive diseases with high incidence, complicated clinical symptoms, difficulties in standard treatment, and heavy medical burden. At present, some GERD-relevant clinical practice guidelines (CPGs) have been issued by different countries and academic organizations, but some recommendations were inconsistent, which has caused some problems for the current clinical whole-course management of GERD. To summarize the relevant evidence among the CPGs on GERD and formulate the whole- course management strategies, we included GERD-relevant CPGs published or updated after 2010 by searching websites of guidelines, relevant professional societies, and electronic databases. We extracted the recommendations and summarized the evidence from the aspects of symptoms, epidemiology, diagnosis and treatment, which was presented in the form of evidence mapping. We included 24 CPGs, including three in Chinese and 21 in English. The clinical practice management strategies of GERD were formulated based on the evidence from the aspects of clinical symptoms, diagnostic methods, medical treatment, anti-reflux surgery and endoscopic treatment, psychological treatment, and traditional Chinese medicine treatment.

Clinical and histological characteristics of bursitis in the area of the tarsal joint in cattle.

Orthopedic pathologies are widespread in cattle (cattle) and cause significant economic damage to livestock. According to the literature, lesions of the limbs of varying severity in dairy cows are recorded in 70% of the livestock. Cattle with orthopedic pathologies lose exercise, their feed intake decreases, which leads to a decrease in their milk and meat productivity. One of the pathologies requiring close attention is aseptic and purulent bursitis of the tarsal joint. Despite the wide distribution of bursitis, the question of effective methods for diagnosing and treating sick animals remains open. This is important, since bursitis tends to progress to a complicated stage, and very often doctors have to deal with purulent bursitis, which can be prevented at an earlier stage of pathology development. In our opinion, when diagnosing and monitoring the treatment of bursitis, it is advisable to use such methods of clinical diagnostics as microscopy of synovial fluid, determination of sensitivity to antibiotics, cytological and histological studies, studies on markers of rheumatoid arthritis, C-reactive protein, diphenylamine test, antistreptolysin- Oh, rheumatoid factor. In addition, it seems relevant to conduct histological studies aimed at improving theoretical knowledge about the pathogenesis of bursitis in the early stages. It should be noted that today the treatment of bursitis by conservative and surgical methods requires large physical and material costs, is lengthy and does not always guarantee a positive result. The paper presents the results of studying the structure and characteristics of orthopedic pathologies in cattle in the Moscow region and information on the prevalence of bursitis. Based on complex studies carried out using clinical, morphological and microbiological methods, the characteristics of reactive and purulent bursitis are presented. In addition, data are presented on the information content of pathomorphological studies and the feasibility of their use in the algorithm for the complex diagnosis of bursitis. The proposed algorithm makes it possible to verify the diagnosis and start treatment in a timely manner, which in turn leads to the preservation of animal productivity.

Polysaccharide storage myopathy in two Percheron horses

Polysaccharide storage myopathy (PSSM) is a genetic disorder or by undetermined cause characterized by the abnormal accumulation of glycogen and polysaccharides in skeletal muscle fibers. The present report describes two Percheron horses, from different properties in the municipality of Pouso Redondo - SC, with locomotor clinical signs that started after work. The clinical signs observed were rigid gait, mainly of the pelvic limbs, muscle weakness, and recumbency. In the first case, the animal was diagnosed with severe multifocal rhabdomyonecrosis, moderate multifocal myoglobin nephrosis and severe diffuse transmural fibrinonecrotic gastritis. PSSM was confirmed by the presence of polysaccharide inclusions in myofiber sarcolemma visualized by periodic acid-Schiff (PAS) staining. In the second case, the horse presented two episodes of muscle disorder after work. The therapeutic protocol was based on penicillin, flunixin meglumine and fluid therapy with ringer lactate. An increase in creatine kinase (669.0 UI/L) and aspartate aminotransferase (669.0 UI/L) was observed in the serum biochemical evaluation. Research for mutation in the GYS1 gene was performed, with a positive heterozygote result. After rest and gradual recovery, the horse was only submitted to light work, with no return of the clinical condition since then. Thus, this report describes two cases of PSSM with distinct clinical evolution and diagnostic methods.

A Combined Method Based on the FIPV N Monoclonal Antibody Immunofluorescence Assay and RT-nPCR Method for the Rapid Diagnosis of FIP-Suspected Ascites

Feline infectious peritonitis (FIP), which is caused by feline infectious peritonitis virus (FIPV), is a fatal and immunologically mediated infectious disease among cats. At present, due to the atypical clinical symptoms and clinicopathological changes, the clinical diagnosis of FIP is still difficult. The gold standard method for the differential diagnosis of FIP is immunohistochemistry (IHC) which is time-consuming and requires specialized personnel and equipment. Therefore, a rapid and accurate clinical diagnostic method for FIPV infection is still urgently needed. In this study, based on the etiological investigation of FIPV in parts of southern China, we attempted to explore a new rapid and highly sensitive method for clinical diagnosis. The results of the etiological investigation showed that the N gene of the FIPV BS8 strain had the highest homology with other strains. Based on this, a specific FIPV BS8 N protein monoclonal antibody was successfully prepared by expression of the recombinant proteins, immunization of mice, fusion and selection of hybridoma cell lines, and screening and purification of monoclonal antibodies. Furthermore, we carried out a time-saving combination method including indirect immunofluorescence assay (IFA) and nested reverse transcription polymerase chain reaction (RT-nPCR) to examine FIP-suspected clinical samples. These results were 100% consistent with IHC. The results revealed that the combined method could be a rapid and accurate application in the diagnosis of suspected FIPV infection within 24 hours. In conclusion, the combination of IFA and RT-nPCR was shown to be a fast and reliable method for clinical FIPV diagnosis. This study will provide insight into the exploitation of FIPV N antibodies for the clinical diagnosis of FIP-suspected ascites samples.