Objective To evaluate the accuracy of MR diffusion weighted imaging (DWI) in the diagnosis of hyperacute cerebral infarction. Methods Twenty one patients with onset of strokelike symptoms underwent conventional MRI and DWI within 6 hours. Results DWI indicated cerebral infarction in 16 patients, all of whom had a final diagnosis of acute stroke. DWI was negative in 5 patients, all of whom had a final diagnosis of TIA. The abnormality seen at DWI was confirmed with follow up study. DWI had a sensitivity of 100% and a specificity of 100% in the diagnosis of hyperacute cerebral infarction, and conventional MRI interpretation yielded a sensitivity and specificity of 25% and 100%, respectively. Conclusion DWI is highly accurate in diagnosing hyperacute cerebral infarction and is superior to conventional MRI.

Purpose:To investigate the values of three newer contrast enhanced MRI sequences including gadolinium-enhanced FLAIR MRI(CE FLAIR), dynamic contrast-enhanced MRI (DCE MRI) and perfusion- weighted MRI(PWI) by comparing their advantages and disadvantages respectively in the diagnosis of intracranial tumors. Methods:43 patients with intracranial tumors underwent DCE MRI, CE FLAIR and PWI respectively. The gadolinium-enhanced FLAIR, dynamic enhanced MR and perfusion-weighted MR images were evaluated independently by two radiologists for the number of examinations with one or more enhancing lesions, the number and location of enhancing lesions per examination, the detectability for different lesions in different locations, size and extent of the lesions. Results:Perfusion-weighted MR images showed poor quality and could not give a diagnosis in 5 of 43 cases because of heavy susceptibility artifacts. There were 47 lesions in the 38 cases. However, 41 lesions were found on CE FLAIR MR images and 42 on DCE MRI and 45 on PWI. 3 lesions(2 located in the subcortical area and 1 in paraventricle) were only revealed on the CE FLAIR images. 4 lesions in the basal ganglia area were only found on dynamic enhanced images. 7 lesions in the cerebral hemisphere were only found on perfusion-weighted images. So there were significant differences in revealing lesions of different locations with the three MR modalities(P

0.05). Four lesions were only revealed on CE FLAIR whereas 7 lesions were only found on postcontrast T_1WI. Enhancing lesions located in cerebral hemisphere or the forth ventricle was revealed much more on T_1WI than that on CE FLAIR. However, postcontrast fast FLAIR images may be useful in detecting superficial abnormalities and those located in sulcus or lateral ventricle. The enhancement degree of enhanced T_1WI was much more intense than that of CE FLAIR(P0.05) and statistical significance in GWC, CNR and CER(P

Objective To study the expression of serum interleukin(IL)-17A,calcium binding protein S100A8 and S100A9 in children with severe Mycoplasma pneumoniae pneumonia(SMPP)and their prognostic significance.Methods A total of 116 children with SMPP who were diagnosed and treated in this hospital from March 2019 to March 2021 were enrolled as the SMPP group.According to the pediatric critical cases score,the SMPP children divided into non-critical group(43 cases),critial group(40 cases),extremely critical group(33 cases).According to the prognosis of 28 d after admission,the SMPP children were divided into a good prognosis group with 82 children and a poor prognosis group with 34 children.A total of 60 physical ex-amination of healthy children in the same hospital during the same period were enrolled as the control group.The levels of serum IL-17A,S100A8,S100A9,procalcitonin(PCT),C-reactive protein(CRP),IL-6 and tumor necrosis factor(TNF)-α were detected in each group.Pearson correlation analysis was used to analyze the cor-relation between serum levels of IL-17A,S100A8,S100A9 and PCT,CRP,IL-6,and TNF-α.Multivariate Lo-gistic regression analysis was used to analyze the factors affecting the poor prognosis of children with SMPP.The receiver operating characteristic(ROC)curve was used to analyze the value of each index in predicting the poor prognosis of children with SMPP.Results The SMPP group had significantly higher serum levels of IL-17A,S100A8,S100A9,PCT,CRP,IL-6,and TNF-α than the control group(P<0.05).In children with SMPP,the serum levels of IL-17A,S100A8,and S100A9 were positively correlated with PCT,CRP,IL-6,and TNF-α(P<0.05).The serum levels of IL-17A,S100A8 and S100A9 in extremely critical group were signifi-cantly higher than those in critical group and non-critical group(P<0.05).Elevated serum levels of IL-17A,S100A8 and S100A9 were independent risk factors for poor prognosis in children with SMPP.The area under the curve(AUC)of combined detection of serum IL-17A,S100A8 and S100A9 for predicting poor prognosis in children with SMPP was 0.895,which was higher than that of single detection of serum IL-17A,S100A8 and S100A9(0.833,0.764,0.810),the differences were all statistically significant(Z=3.780,6.723,5.012,P<0.059).The sensitivity and specificity of combined detection were 0.891 and 0.755,respectively.Conclu-sion The serum levels of IL-17A,S100A8 and S100A9 are increased in children with SMPP,which are related to the severity of SMPP.The combined detection of the three indicators has a high predictive value for the poor prognosis of SMPP.

Objective To study the levels and clinical significance of serum angiopoietin-like protein 8(ANGPTL8)and neopurine in children with hormone sensitive primary nephrotic syndrome(NS).Methods A total of 159 children with hormone sensitive primary NS treated in the hospital from January 2018 to January 2021 were selected as the study subjects(NS group).After 1 year of follow-up,based on whether frequent recurrence occurred,they were divided into the non frequent recurrence subgroup(n=93)and the frequent recurrence subgroup(n=66).Additionally,60 children with oblique hernia who underwent e-lective surgery in the Department of Pediatrics in the hospital were selected as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum levels of ANGPTL8 and neopterin.The ser-um levels of ANGPTL8 and neopterin in each group were compared.Multivariate Logistic regression analysis was used to analyze risk factors for frequent recurrence in children with hormone sensitive primary NS.The predictive value of serum ANGPTL8 and neopterin in predicting frequent recurrence in children with hormone sensitive primary NS was analyzed by receiver operating characteristic(ROC)curve.Results The serum lev-els of ANGPTL8 and neopterin in the NS group were higher than those in the control group,and the differ-ences were statistically significant(t=20.948,44.288,P＜0.001,0.001).The serum ANGPTL8,neopterin levels,CD8+T cells,24 h urine protein quantification,and urine protein conversion time in the frequent recur-rence subgroup were significantly higher than those in the non frequent recurrence subgroup,while the blood albumin,CD4+T cells,CD4+/CD8+T cell ratios were lower than those in the non frequent recurrence sub-group,and the differences were statistically significant(all P＜0.05).The serum levels of ANGPTL8 and neopterin in NS patients were significantly positively correlated with 24 h urine protein and CD8+T cells,while they were significantly negatively correlated with serum albumin,CD4+T cells,CD4l+/CD8+(all P＜0.05).Serum ANGPTL8 and neopterin were independent risk factors for frequent recurrence in children with hormone sensitive primary NS.The area under the curve(AUC)of the combined model of serum ANGPTL8 and neopurine for predicting frequent recurrence in hormone sensitive primary NS patients was 0.852(95％CI:0.813-0.889),which was higher than 0.764(95％CI:0.722-0.812)of ANGPTL8,and 0.749(95％CI:0.711-0.790)of neopurine,and the differences were statistically significant(Z=3.623,3.987,P=0.003,＜0.001).Conclusion Elevated levels of serum ANGPTL8 and neopterin are risk factors for frequent recurrence hormone sensitive primary NS.The combination detection of serum ANGPTL8 and neopterin has high predictive value for frequent recurrence in children with hormone sensitive primary NS.