Objective To investigate the effects of circadian rhythm on interictal epileptiform discharges in patients with localization-related epilepsy.Methods Patients diagnosed with epilepsy in Sanbo Brain Hospital from January 2011 to January 2012 participated in this study.All patients were subjected to comprehensive evaluation,which included prolonged video-electroencephalogram (EEG),magnetic resonance imaging.Intracranial electrodes,PET,SPECT were also adopted if necessary.Circadian rhythm was divided into four stages:REM,NREM Ⅰ-Ⅱ,NREM Ⅲ-Ⅳ,and waking.The amount and distribution of ⅡD were compared by ANOVA.Results Significant differences in the amount and distribution of ⅡD were found among NREM Ⅰ-Ⅱ,NREM Ⅲ-Ⅳ,REM,and waking.However,no differences in the amount and distribution of ⅡD were noted between NREM Ⅰ-Ⅱ and NREM Ⅲ-Ⅳ as well as between REM and waking.Conclusion The amount of ⅡD is higher in NREM than in REM and waking;thus,NREM is more sensitive to diagnose epilepsy.The distribution of ⅡD in REM and waking is more restricted than that in NREM.

Objective To investigate the prevalence of mcr-1 gene,a plasmid-mediated polymyxin resistance gene,in Escherichia coli(E.coli) strains isolated in Dongyang of Zhejiang Province and to under-stand the epidemiological characteristics of E.coli strains carrying mcr-1 gene in order to provide local clini-cians with a theoretical basis for prevention and control of the spread of mcr-1-bearing E.coli strains. Meth-ods A total of 315 E.coli strains were collected in the People′s Hospital of Dongyang, Zhejiang Province from January to December 2016. All strains were isolated from specimens of blood,urine,respiratory tract, etc. PCR was performed to detect the genes confering resistance to polymyxin (mcr-1 gene), β-lactamase and carbapenem. Minimal inhibitory concentrations (MIC) of antibiotics against mcr-1-positive strains were determined by micro-broth dilution method. Conjugation test was performed to confirm whether the mcr-1 gene was located on the transferable plasmid. Multilocus sequence typing (MLST) was used for molecular typing of mcr-1-positive strains. Results Five mcr-1-positive strains were identified from 315 E.coli strains with a positive rate of 1.6%. Two out of the five mcr-1-positive E.coli strains contained β-lactamase resist-ance genes,blaTEM-1and blaCTX-M-14. Both of them were resistant to the first, second and third generation of cephalosporins and one was also resistant to cefepime. All of the five mcr-1-positive E.coli strains were sen-sitive to ciprofloxacin and levofloxacin,but resistant to ticarcillin/clavulanic acid. No carbapenem resistance genes were detected. One transconjugant was successfully obtained by transconjugation assay. MLST analysis showed that a total of four sequence types were identified, including ST131 (two strains), ST43 (one strain),ST69 (one strain) and ST349(one strain). Conclusion Only 1.6% of all E.coli strains isolated in Dongyang area of Zhejiang Province carry mcr-1 gene,indicating that there is no epidemic of mcr-1 gene-positive E.coli infection. The coexistence of mcr-1 gene and β-lactamase resistance genes in E.coli strains isolated in Dongyang suggests that local clinicians should avoid antibiotic abuse to prevent the spread of drug-resistant E.coli.

Objective:To investigate the value of quantitative ultrashort-echo-time (UTE) adiabatic T 1ρ (AdiabT 1ρ) in the diagnosis of articular cartilage degeneration of knee. Methods:A prospective case-control study was used. From March 2023 to September 2024, 30 healthy volunteers and 50 patients with osteoarthritis (OA) were recruited in the Second Affiliated Hospital, South China University of Technology and the Fifth Affiliated Hospital of Sun Yat-sen University. The unilateral knee joints were scanned by using three-dimensional (3D) UTE-Cones-AdiabT 1ρ sequence. The articular cartilages of knee were divided into 13 subregions slice by slice, with a total of 3 837 subregions. The whole-organ magnetic resonance-imaging score (WORMS) was evaluated in each subregion. According to the extent of lesions, the subregions cartilages were divided into normal group (WORMS 0, 2 589 subregions), localized lesion group (WORMS 1, 2, 2.5, 911 subregions) and diffuse lesion group (WORMS 3, 4, 5, 337 subregions). According to the depth of lesions, they were divided into normal group (WORMS 0, 2 589 subregions), partial cartilage layer lesions group (WORMS 1, 2, 3, 4, 1 108 subregions) and full-thickness lesion group (WORMS 2.5, 5, 140 subregions). WORMS 1 was early cartilage degeneration. The Kellgren-Lawrence (KL) grade of the knee joints was assessed and divided into normal group (KL grade 0, 1 323 subregions), suspicious or mild OA group (KL grades 1 and 2, 1 738 subregions), and moderate or severe OA group (KL grades 3 and 4, 776 subregions). The UTE-Cones-AdiabT 1ρ values and curves for each subregion were obtained by Matlab 2017b software. The ANOVA was used to compare the differences in UTE-Cones-AdiabT 1ρ between different WORMS groups and KL groups. Spearman correlation analysis was used to evaluate the correlation between UTE-Cones-AdiabT 1ρ and WORMS and KL groups. The receiver operating characteristic curve and area under the curve (AUC) were used to determine the efficacy of UTE-Cones-AdiabT 1ρ in diagnosing early cartilage degeneration and suspicious or mild OA. Results:Both normal volunteers and OA patients were able to obtain good cartilage images and well-fitting UTE-Cones-AdiabT 1ρ curves. There were 2 589, 569, 277, 65, 199, 63 and 75 cartilage subregions with WORMS scores of 0, 1, 2, 2.5, 3, 4 and 5, respectively, and the UTE-Cones-AdiabT 1ρ values were (36.1±5.1), (41.5±5.2), (42.3±5.3), (45.2±6.3), (43.0±5.2), (44.1±5.4) and (47.5±5.7) ms, respectively. The difference was statistically significant ( F=161.63, P<0.001). There was a statistically significant difference in UTE-Cones-AdiabT 1ρ among normal group, localized lesion group and diffuse lesion group ( F=450.92, P<0.001), and there was a significant difference in UTE-Cones-AdiabT 1ρ value among normal group, partial cartilage lesion group and full-thickness lesion group ( F=479.13, P<0.001). There was a statistically significant difference in UTE-Cones-AdiabT 1ρ among the normal group, the suspected or mild OA group, and the moderate or severe OA group ( F=36.91, P<0.001). The UTE-Cones-AdiabT 1ρ values in all subregions were positively correlated with WORMS and KL grades ( r=0.55, P<0.001; r=0.26, P<0.001). The AUC of UTE-Cones-AdiabT 1ρ in the diagnosis of early cartilage degeneration was 0.773 (95% CI 0.750-0.796), and the AUC in the diagnosis of suspicious or mild OA was 0.580 (95% CI 0.560-0.601). Conclusion:3D UTE-Cones-AdiabT 1ρ is positively correlated with the degree of cartilage degeneration, which can quantitatively evaluate cartilage degeneration and has the value of early diagnosis of articular cartilage degeneration.