Objective To explore the application of diagnostic system with artificial intelligence(AI)in the evaluation of patients with coronary heart disease(CHD)at high altitude.Methods A total of 318 pa-tients underwent coronary CT angiography(CTA)at the hospital from January to December 2022 were pro-spectively collected.According to the altitude gradient,the patients were divided into the 2 000-3 000 m group and>3 000 m group.Coronary angiography(CAG)was used as the gold standard to verify the diag-nostic performance of AI diagnostic system.Coronary artery diagnosis system with AI technology and CT de-rived fractional flow reserve(CT-FFR)measurement system were used to evaluate the plaque structure char-acteristics and hemodynamic changes in the two groups of patients.Results Calcified plaques and vulnerable plaques in the>3 000 m group were more than those in the 2 000-3 000 m group(χ2=3.976,6.482,P= 0.046,0.011).The incidence of multi-vessel coronary artery disease,moderate stenosis,severe stenosis and complete occlusion in the>3 000 m group was higher than that in the 2 000-3 000 m group,and the inci-dence of single-vessel coronary artery disease and mild stenosis in the 2 000-3 000 m group was higher than that in the>3 000 m group(P<0.05).The incidence of CT-FFR≤0.80 and<0.70 in the>3 000 m group was higher than that in the 2 000-3 000 m group(χ2=4.782,28.118,P=0.029,<0.001).The comparison with the gold standard showed that this method has high sensitivity,specificity,and diagnostic consistency(P<0.001).Conclusion The coronary diagnosis system with AI technology has certain value in the system-atic evaluation of coronary artery characteristics and hemodynamic changes in CHD patients at high altitude.

Objective To investigate the predictive value of early efficacy of neoadjuvant chemotherapy(NAC)in patient with breast cancer via full quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI).Methods Forty patients with breast cancer were selected.The 18 fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG PET/CT)and DCE-MRI were performed before and after two cycles of NAC.According to the decrease rate of maximum standardized uptake value(ΔSUVmax)of PET/CT before and after two cycles of NAC,all patients were divided into two groups,including good response group(24 cases)(ΔSUVmax>40%)and general response group(16 cases)(ΔSUVmax≤40%).The changes of full quantitative parameters of DCE-MRI between the two groups were observed and analyzed.Results There were statistically significant differences in changes of Ktrans and Kep between the two groups(P<0.05),however,there was no significant difference in the change of Ve between the two groups(P>0.05).There was a significant positive correlation between ΔKtrans and ΔSUVmax(r=0.850,P<0.001).There was a high positive correlation between ΔKtrans and ΔKep(r=0.727,P<0.001).Conclusion The full quantitative parameters of DCE-MRI are helpful to evaluate the early efficacy of NAC in breast cancer,which can reflect the changes of microcirculation in the lesion,further reflect the therapeutic effect of NAC,guide the clinical optimization of treatment plan in time,and achieve accurate evaluation and individualized treatment.

Objective To explore artificial reconstruction vs artificial intelligence reconstruction in coronary artery volume rendering(VR).Methods A total of 110 coronary heart disease(CHD)patients were enrolled in the study,and underwent computed tomography arteriography.Artificial reconstruction(artificial group)and artificial intelligence reconstruction(intelligent group)were conducted in coronary artery VR.The image quality of VR and curved planar reconstruction(CPR),the diagnosis coincidence rate of arterial stenosis,and vascular reconstruction score were compared between two groups.Results The VR image quality of intelligent group was significantly higher than that of artificial group,with excellence rate of 90.91%vs 80.00%;and intelligent group scored higher than artificial group in CPR image quality(P<0.05).The differences in the diagnostic coincidence rates of arterial vessels(RCA,LAD,LCX)with no stenosis,slight stenosis,moderate stenosis,and vascular occlusion between two groups were trivial(P>0.05),while the two groups differed significantly in the diagnosis coincidence rates of mild stenosis and severe stenosis(P<0.05).The mean total score,the median value of the 3 main branches+posterior descending branch+intermediate branch+diagonal branch+blunt margin branch,and the median value of the other vascular branches were all significantly increased in intelligent group as compared with artificial group(P<0.05).Conclusion Artificial intelligence reconstruction has higher application value than artificial reconstruction in coronary artery VR.

Enterotoxigenic Escherichia coli（ETEC）infection can induce watery diarrhea，leading to dehydration，electrolyte disturbance，and even death in severe cases. Recombinant B subunit/inactivated whole-cell cholera（rBS/WC）vaccine is effective in preventing ETEC infectious diarrhea. On the basis of the latest evidence on etiology and epidemiology of ETEC，as well as the effectiveness，safety，and health economics of rBS/WC vaccine，National Clinical Research Center for Child Health（The Children’s Hospital，Zhejiang University School of Medicine）and Zhejiang Provincial Center for Disease Control and Prevention invited experts to develop expert consensus on rBS/WC vaccine in prevention of ETEC infectious diarrhea. It aims to provide the clinicians and vaccination professionals with guidelines on using rBS/WC vaccine to reduce the incidence of ETEC infectious diarrhea.

OBJECTIVE: To establish a micellar electrokinetic capillary chromatography-based method for identification and quantitative detection of interleukin-12 (IL-12) and analysis of its unfolding process. METHODS: An uncoated fused-silica capillary (inner diameter 50 μm) with a total length of 48.5 cm (40 cm to the detector) was used for the experiment. The factors influencing the separation efficiency of IL-12 were analyzed, and a standard curve of IL-12 concentration was established. The mixture of IL-12 and anti-IL-12 antibody was incubated in a water bath at 38 ℃ for 40 min, and capillary electrophoresis was then performed under the same conditions. The results were compared with those of IL-12 and anti-IL-12 antibody to identify IL-12. IL-12 and dithiothreitol (DTT) were incubated at 60 ℃ in water bath for different lengths of times, and the unfolding process of IL-12 was analyzed based on electrophoresis results of IL-12 in different states. RESULTS: A micellar capillary electrophoresis on-line sweep method was established with 80 mmol/L borate (pH=9.3) containing 30 mmol/L sodium dodecyl sulfate (SDS) as the buffer solution. This system showed a good linear relationship between the peak area and the mass concentration of IL-12 with a linear correlation coefficient of 0.9991 within the linear range of 2 to 120 ng/L. As the incubation time of IL-12 and DTT prolonged, the disulfide bond of IL-12 gradually opened and resulted in distinct changes in the protein peak. CONCLUSIONS This capillary electrophoresis-based method is simple and sensitive for IL-2 analysis and allows rapid detection of changes in IL-12 content in the setting of tumors and analysis of the possible causes.

Objective Toinvestigatethehemodynamicchangesofthegraymatterandwhitematterinpatientswithchronicmountain sickness(CMS).Methods 14CMSpatientsand12healthyvolunteerswererecruitedinthisstudy.Allofthem wereperformedbyroutineMRI andperfusionweightedimaging(PWI)scans.Aftertheappropriatepost-processing,therelevanthemodynamicparametersofdifferent graymatternucleiandwhitematteroffrontallobewereobtained,andthedifferenceofeachvaluebetweenthetwogroupswascompared.Results Therelativecerebralbloodflow (rCBF)decreasedinthebraingraymatterandwhitematterinCMSpatientswhencomparedwith normalgroup(P<0.05)[rCBFofthespleniumofthecorpuscallosum was(40.57±18.89)mL·100g-1·min-1forCMSpatients, and (64.56±18.55)mL·100g-1·min-1fornormalgroup],andatthesametime,meantransittime (MTT)andtimetopeak (TTP)werebothprolonged(P<00.5)[MTTofthespleniumofthecorpuscallosumwas(66.3±19.5)sforCMSpatients,and(48.0±2.17)sfor normalgroup;TTPofthespleniumofthecorpuscallosum was(26.86±4.67)sforCMSpatients,and (23.17±3.01)sfornormal group].Conclusion Collateralcirculation mayexistinCMSpatients’brain.Therearecerebralhemodynamicdifferencesbetween CMSpatientsandhealthyvolunteers.MRPWIisanimportantwayfordiagnosisofCMS.

Objective To compare the diagnostic value of spiral CT scans at different doses for COPD, and to provide reference for the clinical selection of diagnostic method of COPD. Methods A total of 120 patients with a preliminary diagnosis of COPD were enrolled. The clinical symptoms, exposure history of risk factors, and family history were recorded in detail. All patients were given pulmonary function tests. The patients were randomly divided into two groups, the conventional-dose spiral CT group and the low-dose spiral CT group, and were given conventional-dose spiral CT scan and low-dose spiral CT scan, respectively. The results were read and graded by two separated radiologists, and the differences in imaging quality, radiation dose and diagnostic accuracy between the two groups were compared, and the diagnostic value of spiral CT scans at different doses for COPD was evaluated. Results There was no significant difference in the excellent rate of the images and the accuracy of the diagnosis results between the two groups (P>0.05). The radiation dose of the low-dose spiral CT was significantly lower than that of the conventional-dose spiral CT, and the difference was statistically significant (P<0.05). Conclusion The accuracy of low-dose spiral CT scan is comparable to that of conventional-dose spiral CT, and the low radiation dose has little damage to the human body, which has good reference value for the diagnosis of COPD. The excellent rates of conventional dose spiral CT and lowdose spiral CT are similar, but the image quality of the former is better.

Objective To investigate the CT and MR imaging feature of osseous metastasis of hepatic alveolar hydatida.Methods CT and MR imaging features of osseous metastasis of hepatic alveolar hydatid were retrospectively analyzed in 14 cases confirmed by clinic and radiology. Results Of the 10 vertebral metastasises,three vertebral bodies were involved in 6 cases,two adjacent vertebral bodies were involved in 2 cases, single vertebral body was involved in 1 case, corresponding vertebral accessory was involved in 9 cases,irregular mass was formed in paravertebral muscles with ill-defined margins in 9 cases, adjacent ribs were involved in 6 cases. On CT scans, the lesions of vertebral body showed osteolytic and geographical bone destruction with bone sclerosis. The lesions of vertebral accessory showed swelling and osteolytic bone destruction, small cystic density and calcification of cystic wall and irregular calcification were found in 7 cases.The lesions of scapula,costal cartilage,ribs and pelvis showed swelling and osteolytic bone destruction,and bone sclerosis,and revealed cystic density with calcified speckles.On MR scans,the lesions of vertebral body and paravertebral muscles showed high and low mixed signal,with hypointensity on T1WI and T2WI, vertebral accessory and adjacent ribs were involved in 6 cases. Small cyst with T2 hyperintensity was found in 4 cases. The lesions of ribs and pelvis showed swelling and osteolytic bone destruction and adjacent medullary appeared hypointensity on T1WI and T2WI, cystic signal of T2 hyperintensity was identified. There were 5 cases of pulmonary metastasis and 6 cases of retroperitoneal metastasis. Conclusion Imaging features of osteolytic,geographical bone destruction with bone sclerosis, small cystic density or cystic signal and calcified speckles or arc calcification in mass are helpful for the diagnosis of osseous metastasis of hepatic alveolar hydatid.

Objective To explore the physiological characteristics of vascular invasion of hepatic alveolar echinococcosis(HAE) and the growth pattern of lesion.Methods 120 cases with HAE were all scanned by 256 slices MSCT,then the images were taken three-dimensional reconstruction.A comparison between pathology and images were made for the evaluation of vascular invasion.Results Pathological examination showed that the invasion rate of intrahepatic vein(left hepatic vein,middle hepatic vein,right hepatic vein, inferior vena cava),portal vein and hepatic artery were 34.38%,31.11%,22.50%,respectively.176 branches of the intrahepatic vein, 67 branches of the hepatic artery and 127 branches of portal vein were involved.Combined with the pathology,the Kappa values were 0.868,0.725 and 0.844.Conclusion HAE is easy to involve the intrahepatic veins as it grows,considering its"indulgence of vein"feature.In order to improve the targeting effect,the mode of administration could be changed.MSCT can exactly evaluate the invasion of intrahepatic vessels,providing important basis for clinical treatment.

Objective To explore the adaptive modulation of brain in structure and function when moving to high altitude areas based on voxel-based morphometry (VBM),amplitude of low frequency fluctuation (ALFF)and regional homogeneity (ReHo) method.Methods Resting-state functional magnetic resonance imaging (fMRI)of brain was respectively performed in 1 9 normal adults who moved to high altitude areas within a week,and they have matched age and education level.The subj ects were performed the same scanning after one year.The VBM,ALFF and ReHo methods were adopted to analyze the functional MRI data.Results There were no significant differences in brain structure between the two groups.There were significant differences in brain function in resting state.Subj ects staying in high altitude areas for one year had increased ALFF in left middle frontal gyrus,decreased ALFF in right lingual gyrus(P<0.01),increased ReHo in the left orbital frontal gyrus,and decreased ReHo in right cuneus and right superior parietal gyrus(P<0.05).Conclusion There are significant changes in brain function of normal adult after stayed in high altitude for one year,which might be associated with long-term chronic hypoxia.