Objective To investigate the value of diffusion kurtosis imaging (DKI) in differential diagnosis of parotid gland disease and diagnosis of parotid adenolymphoma (PAL).Methods DKI and DWI data of 57 patients with parotid gland disease were etrospectively analyzed.Totally 57 cases were divided into infectious lesions group (n=10),pleomorphic adenoma group (n=19),PAL group (n=14),other benign parotid tumor group (n=4) and malignant parotid tumor group (n=10).Contralateral normal parotid glands in 19 patients with unilateral parotid gland lesions were treated as control group.The quantitative parameters including kurtosis concerning parameters (K Krad,Kax),diffusivity concerning parameters (D Drad,Dax),fractional anisotropy (FA) and conventional apparent diffusion coefficient (ADC) values were retrospectively reviewed.The binary Logistic regression method was used to confirm parameters with significant difference in diagnosing PAL.And Logistic regression equation was constructed to diagnose PAL.ROC analysis was conducted to evaluate the diagnostic value of the confirmed parameters and the Logistic regression equation.Results Significant difference of the parameters including K Krad,Kax,D Drad,Dax,FA and ADC values were found among different groups (all P＜0.05).ROC analysis demonstrated a higher area under the curve (AUC) for FA+Kax [0.88±0.06 (0.79-0.94)] than Kax[0.80±0.07 (0.70-0.88)] and FA [0.63±0.10 (0.52-0.73)],respectively (both P＜0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value was 71.43％,95.78％,91.77％,76.92％ and 94.44％.Conclusion DKI showed high diagnostic capacity in differential diagnosis of parotid gland disease.The combination of FA and Kaxcan improve the diagnostic accuracy in diagnosis of PAL.

Objective To investigate the clinical and MRI features of primary non-urachal adenocarcinoma of the bladder.Methods The clinical and MRI data of 9 patients with histopathologically confirmed primary non-urachal adenocarcinoma of the bladder were analyzed retrospectively.Results Clinical symptoms of hematuria were present in 7 cases and urinary irritation symptoms in 5 cases among all patients.On MRI,1 case showed diffuse thickening of the bladder wall,8 cases showed a solitary nodular/cauliflower-like mass in the bladder with iso-hypointensity on T1WI and slight hyperintensity on T2WI,and patchy areas of hyperintensity on T2WI were seen in some patients.The apparent diffusion coefficient(ADC)ranging from 0.83× 10 3 mm2/s to 1.85× 10 3 mm2/s,mean ADC was approximately 1.23×10-3 mm2/s.Dynamic enhancement showed mild to marked enhancement,with some rim or compartmentalized enhancement,and patchy or diffusely distributed areas of no enhancement can be seen.No cystic changes and necrosis were seen in all patients,invasion of the muscularis propria and above were seen in 7 cases,lymph node metastasis was seen in 3 cases,and distant metastasis was seen in 2 cases.Conclusion Primary non-urachal adenocarcinoma of the bladder has certain clinical and MRI features.Patients often present with hematuria and urinary irritation symptoms,and some may present with blennuria.MRI shows that the lesion is solitary and more aggressive,with some hyperintensity on T2 WI,cystic changes and necrosis are rare.These features help to improve the accuracy of preoperative diagnosis to some extent,and the final diagnosis still relies on pathology.

Objective This study investigated lower limb biomechanics and lateral asymmetry during the continuous vertical jump(CVJ)landing process in individuals with unilateral functional ankle instability(FAI)and compared these characteristics with those of healthy individuals.Methods Fourteen males with unilateral FAI were selected as the experimental group,and 14 males without ankle joint injury were matched to the control group.Both the groups performed 30 CVJ landing tasks.Lower limb kinematic and kinetic characteristics during the 1st,15th,and 30th CVJ landings were synchronously collected using Vicon and Kistler equipment,and a 2×3 mixed analysis of variance was adopted for the data.Results In the execution of CVJ landing tasks,patients with FAI demonstrated no significant differences in the kinematic and kinetic characteristics of the affected limbs compared with healthy controls.However,a greater degree of lateral asymmetry was observed in the FAI group,particularly in the symmetry index(SI)of the vGRF peak.Despite the increase in the number of jump landings and consequent increase in fatigue levels,which led to adjustments in lower limb movement patterns,these adjustments did not appear to have a significant impact on the biomechanical characteristics and asymmetry of the affected limb in patients with FAI.Conclusions This study provides a theoretical basis for the prevention of recurrent ankle sprains in patients with FAI,as well as rehabilitation training prior to their return to sports.These findings underscore the importance of addressing lower limb asymmetry in the rehabilitation training of patients with FAI to reduce the risk of potential long-term injuries.When formulating rehabilitation plans for patients with FAI,particular attention should be paid to the correction of lower limb asymmetry with consideration of biomechanical adaptability under different states to achieve a more comprehensive rehabilitation outcome.

Objective:To explore the impact of hypophosphatemia on the occurrence and prognosis of critically ill patient.Methods:The clinical data of critically ill patients admitted to the intensive care unit (ICU) of Tianjin First Central Hospital from October 2021 to April 2022 were retrospectively analyzed. Patients were divided into hypophosphatemia group (serum phosphorus level < 0.80 mmol/L) and non-hypophosphatemia group (serum phosphorus level ≥ 0.80 mmol/L) when they were admitted to the ICU. The following variables were also collected, including gender, age, acute physiology and chronic health evaluationⅡ(APACHE Ⅱ), sequential organ failure assessment (SOFA), serum phosphorus level, serum calcium level, serum magnesium level, white blood cell count (WBC), neutrophil count (NEU), lymphocyte count (LYM), neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP), presence of infection and infection site, length of hospital stay, ICU stay, 28-day mortality, and mechanical ventilation time. Multivariate Logistic regression analysis was used to evaluate the relationship between each variable and the 28-day mortality. The receiver operator characteristic curve (ROC curve) was drawn, and the area under the ROC curve (AUC) and 95% confidence interval (95% CI) were calculated to evaluate the predictive value of serum phosphorus levels for the prognosis of ICU patients. Results:A total of 263 patients were enrolled, including 54 patients with hypophosphatemia and 209 patients without. The SOFA score, LYM level and the infection rate of patients in the hypophosphatemia group were significantly higher than those in the non-hypophosphatemia group [SOFA score: 6.70±3.17 vs. 5.64±3.59, LYM (×10 9/L): 0.99±0.54 vs. 0.77±0.54, infection rate: 77.78% (42/54) vs. 59.33% (124/209), all P < 0.05], the NLR was significantly lower than that of the non-hypophosphatemia group [10.67 (7.08, 18.02) vs. 12.25 (7.25, 21.68), P < 0.05]. The length of hospital stay, ICU stay, and mechanical ventilation duration in the hypophosphatemia group were significantly longer than those in the non-hypophosphatemia group [length of hospital stay (days): 15 (11, 28) vs. 12 (6, 21), length of ICU stay (days): 10.35±7.80 vs 7.15±6.61, mechanical ventilation duration (days): 3 (0, 12) vs. 2 (0, 5), all P < 0.05]. There was no significant difference in the 28-day mortality between the hypophosphatemia group and the non-hypophosphatemia group [9.26% (5/54) vs. 11.00% (23/209), P > 0.05]. Multivariate Logistic regression analysis showed that APACHE Ⅱ score [odds ratio ( OR) = 1.188, 95% CI was 1.110-1.271], CRP ( OR = 1.016, 95% CI was 1.007-1.026), and NLR ( OR = 1.002, 95% CI was 0.996-1.008) were independent risk factors affecting the 28-day mortality of critically ill patients in ICU (all P < 0.05). ROC curve analysis showed that the AUC of serum phosphorus levels for predicting the length of hospital stay of critically ill patients in ICU > 10 days, ICU stay > 5 days, and mechanical ventilation duration > 5 days were 0.701 (95% CI was 0.632-0.770), 0.771 (95% CI was 0.691-0.852), 0.617 (95% CI was 0.541-0.692), respectively, all P < 0.01. Conclusion:Hypophosphatemia has some predictive value for the length of hospital and ICU stay and mechanical ventilation time in critically ill patients, but it cannot predict the 28-day mortality.

Objective:To investigate the clinical efficacy of percutaneous vertebral-disc plasty (PVDP) in the treatment of very severe osteoporotic vertebral compression fractures (vsOVCF).Methods:A total of 26 patients with vsOVCF were treated by PVDP at Department of Spine Surgery, The Second Affiliated Hospital, Nantong University from November 2019 to August 2021. They were 8 males and 18 females with an age of (77.9±5.2) years. Fracture sites: T11 in 9 cases, T12 in 13 cases, L1 in 7 cases, and L2 in 2 cases. The loss of vertebral height exceeded 2/3 of its original height. The curative effects were evaluated by comparing the visual analogue scale (VAS), Oswestry disability index (ODI) and local kyphosis angle (LKA) at preoperation, 1 day postoperation and the last follow-up.Results:This cohort was followed up for 12(10, 15) months. No obvious neurological damage or other serious complications occurred. The VAS scores [(2.9±0.7) and (2.2±0.7) points] and ODIs [28.0%±4.8% and 16.9%±4.0%] at 1 day postoperation and the final follow-up were significantly lower than the preoperative values respectively [(6.7±0.8) points and 66.7%±6.0%], and the values at the last follow-up were significantly lower than those at 1 day postoperation ( P<0.05). The LKAs at 1 day postoperation and the last follow-up (18.1°±4.1° and 19.5°±4.4°) were significantly smaller than that before operation (32.0°±5.2°) ( P<0.05), but there was no significant difference between 1 day postoperation and the last follow-up in LKA ( P>0.05). Conclusion:PVDP is an effective surgical treatment of vsOVCF, because it can relieve pain and improve local kyphosis with satisfactory clinical outcomes.

Objective To investigate the epidemic strains of biological type, drug resistance, and the basic clinical characteristics of haemophilus influenzae(Hi)isolated from hospitalized adults with lower respiratory tract infection in Chengdu area.Methods A prospective cross-sectional study was conducted to analyze the biological typing,capsular genes detected by PCR technique,and drug resistance tested by drug sensitive test of Hi epidemic strains isolated from the sputum of adults aged above 18 years who were hospitalized in two tertiary hospitals of west Sichuan in China.Results The positive rate of pathogenic bacteria in adults aged above 18 years who were hospitalized in the two hospitals was 46.71%(15 447/33 069)between November 2013 and October 2014.The positive rate of Hi isolated from the sputum of 100 adults with lower respiratory tract infection was 0.31%(101/33 069).The constituent ratio of Hi in lower respiratory tract infection pathogens was 0.65%(101/15 447).The Hi were all undifferentiated type detected by PCR,and the biological typing of Hi were typeⅠ(42.57%),Ⅳ(29.7%),Ⅱ(15.84%),Ⅲ(9.9%),Ⅶ(1.98%), and Ⅵ(0.9%).The diseases of Hi positive were acute phase of chronic obstructive pulmonary disease(59%), pneumonia(35%), and bronchitis(6%), in which community acquired infection was 55%.The rate of β-lactamase enzyme production was 38.61%.The frequencice of β-lactamase -nonproducing-ampicillin-resistant(BLNAR)strains was 2.97%,and of intermediary strains was 4.95%(5/101).The drug resistance rate of amoxicillin and clavulafiate was 2.97%.The drug resistance rate of cefuroxime was 12.87%, and intermediary rate was 12.87%.The drug resistance rate of cefaclor was 29.7%,and intermediary rate was 8.91%.The drug resistance rate of cefotaxime and ofloxacin was 6.93%and 1.99%.There were no obvious statistical differences between the drug resistance rates of the two hospitals.Conclusions The Hi epidemic strains isolated from the sputum of adults with lower respiratory tract infection were all undifferentiated type,and the common biological types were Ⅰ,Ⅳ,Ⅱ, andⅢ in west Sichuan in China.It should pay attention to the BLNAR strains and ofloxacin-resistant strains.

Immunothrombosis refers to the innate immune response caused by thrombosis in blood vessels(especially microvessels).Immunothrombosis is related to immune cells and specific thrombosis related molecules,producing intravascular scaffolds that promote pathogen recognition,inhibition,and destruction,thereby protecting the integrity of the host.However,abnormal or uncontrolled activation of immunothrombosis may be harmful to the host and serve as the foundation for various infectious and inflammatory related thrombotic diseases.Therefore,understanding the potential mechanisms of immunothrombosis plays a decisive role in developing more effective therapies for thrombosis treatment and prevention.This review provides an overview of the mechanisms of immunothrombosis in order to understand new treatment strategies for reducing the risk of immunothrombosis.