Objective ToexplorethevalueofMR DKIinevaluationofmicrostructuredamageincervicalspinalcordinjury(CSCI) Methods 32casesofCSCIpatientsconfirmedbyclinicalexaminationand20casesofhealthycontrolgroupwereinvestigatedbyconventional MRIandDKIexamination.AccordingtoT2WIsignal,theinjurygroupweredividedintoA,Bgroup,Agroupofhighsignalgroup(n＝14)andBgroupofnegativegroup (n＝18).A,BgroupsandcontrolgroupweremeasuredbyFA,meandiffusivity(MD)and mean kurtosis(MK)valuesatdifferenttimes (acute,4 weeksafterinjury,2to3 monthsafterinjury)andthedata wereanalyzedby SPSS17.0statisticalsoftware.TheROCcurvewasusedtoevaluatetheabilityofdifferentparametersindiagnosingCSCI.Results In A,BgroupsFAvaluesdecreasedearlyandincreasedgradually,butwerealwayslowerthanthecontrolgroup,andthedifferencewas statisticallysignificant(P＜0.001).InAgroup MDvalueincreasedearlyanddecreasedgradually,butwashigherthanthecontrol group (P＜0.001).InAgroup MKvaluedecreasedearlyandincreasedsignificantly(P＜0.001).InBgroup MDvalueincreasedand MKvaluedecreasedintheacutephase(P＜0.001),lateron MDand MKvaluesgraduallytendtothecontrolgroup,thedifference wasnotstatisticallysignificant(P＞0.05).Conclusion DKIcannoninvasivelyreflectthemicroGdamageofCSCI,whichcannotbedisplayed byconventionalMRIfortheearlydetectionofspinalcordabnormalities.TheFAvalueisofhighdiagnosticvalue.

Objective To evaluate the diagnostic value of diffusion tensor imaging(DTI)and diffusion kurtosis imaging(DKI)in marchiafava bignami disease(MBD)of chronic alcoholism.The ROC curve was used to analyze the diagnostic significance of each parameter (FA,ADC and MK values).Methods Sixty-eight patients with chronic alcoholism were enrolled in this study,sixty normal middle-aged people were selected as the control group.The ROC curves of differentparameters in the diagnosis of chronic alcoholism were drawn,after whichthe thresholds were determined to evaluate the clinical significance of FA,ADC and MK values in the diagnosis of the disease.Results The FA and MK values of patients with chronic alcoholism were found to be significantly lower than those of the normal control group(P<0.01).ROC curve analysis showed that the critical values for the FA,ADC and MK parameters were 0.274,5.55 and 0.874,respectively.Conclusion Compared with the ADC and MK parameters,FA parameter has a high clinical significance in the diagnosis of MBD.

Objective To explore the changes in diffusion kurtosis imaging(DKI)and diffusion tensor imaging(DTI)parameters and their relationship with cognitive ability in patients with mild traumatic brain injury(mTBI).Methods Forty-one mTBI patients(mTBI group)and 40 normal controls(normal control group)were examined by head MRI.Fractional anisotropy(FA),mean diffusivity(MD)of DTI parameters and mean kurtosis(MK),axial kurtosis(AK),radial kurtosis(RK),fractional kurtosis anisotropy(FKA),axonal water fraction(AWF),axial extra-axonal dispersion(AxEAD),radial extra-axonal dispersion(RadEAD)and tortuosity(TORT)of DKI parameters were calculated in region of interest(ROI).MMSE and Montreal cognitive assessment(MoCA)were used to evaluate the cognitive ability of the two groups.Results Compared with those in normal control group,AK in all lesion areas in mTBI group were increased,AWF,RK,AxEAD and RadEAD,FKA,MK were decreased(all P<0.05).Compared with those in normal control group,FA of pontine,corpus callosum and posterior limb of internal capsule in mTBI group were significantly decreased(all P<0.05);MD of putamen,posterior limb of internal capsule and thalamus in mTBI group were significantly increased(all P<0.05).Pearson correlation analysis showed that FKA was positively correlated with MMSE score at enrollment(r=0.81,P<0.05)and MMSE,MoCA scores at 3 months of treatment(r=0.88,r=0.89;all P<0.05).FA was positively correlated with MoCA score at enrollment and 3 months of treatment(r=0.82,P<0.05;r=0.76,P<0.05).MK was correlated with MMSE and MoCA scores at enrollment(r=0.77,r=0.76;all P<0.05)and 3 months after treatment(r=0.90,r=0.90;all P<0.05).MD was positively correlated with MMSE score at 3 months after treatment(r=0.90,P<0.05).Conclusion DKI combined with DTI can determine the degree of lesion by reflecting the changes of brain tissue microstructure,and is positively correlated with the cognitive ability of TBI patients.

Objective:To analyze the survival status and death factors of confirmed HIV-infected patients in Hangzhou to provide a basis for the formulation of AIDS prevention and treatment strategies.Methods:A retrospective cohort study was conducted. The data were from the HIV/AIDS Comprehensive Response Information Management System of the Chinese Disease Control and Prevention Information System.Epidemiological characteristics of HIV-infected patients were comparied in Hangzhou City from 2004 to 2023 by using chi-square Test. The survival rate of HIV-infected patients in Hangzhou was calculated by the life table method, the survival curves of different subgroups were described by the Kaplan-Meier method, and the Cox proportional hazard regression model was used to analyze the influencing factors of death risk. The SPSS 26.0 software was used for statistical analysis.Results:Among the 9 457 subjects, the total follow-up time was 58 004.18 person-years, 494 patients died, fatality rate of all-cause cases was 0.85 per 100 person-years.The average survival time was 18.59 (95% CI:18.40-18.78) years. Malignant neoplasms and pneumocystis pneumonia were the first (14.37%,71/494) and second (10.73%, 53/494) causes of death, respectively. Death within 6 months after diagnosis accounted for 42.51% (210/494), and suicide accounted for 4.25% (21/494). Multivariate Cox regression analysis showed that compared with those who received antiviral treatment (ART) within 3 months of diagnosis, those who received ART outside 3 months and those who did not receive ART had a 1.65 (95% CI:1.25-2.19) and 20.68 (95% CI:15.80-27.06) times risk of death, respectively. The HIV-infected patients with high CD4 +T lymphocytes (CD4) counts for the first time had a lower risk of death. The risk of death of patients with baseline CD4 counts of 200-349 cells/μl, 350-499 cells/μl, and ≥500 cells/μl was 0.38 (95% CI:0.29-0.49), 0.26 (95% CI:0.19-0.36), 0.21 (95% CI:0.14-0.31) times higher than that of baseline CD4 counts <200 cells/μl, respectively. Conclusions:The overall survival of the HIV-infected patients was good in Hangzhou from 2004 to 2023. Early detection of HIV infection and timely mobilization to participate in ART was the key to improving the survival rate of patients. At the same time, given the suicide problem of HIV-infected patients, suicide surveillance and depression and anxiety screening of HIV-infected patients should be further strengthened, and targeted psychological intervention policies should be implemented.