Cerebral small vessel disease represents a group of common vascular disorders involving pathological changes in arterioles,capillaries and venules,with microvascular investigation remaining a key challenge in stroke.With high signal-to-noise ratio and high contrast enabled by enhanced field strength,7T MRI can surpass the resolution limits of 3T MRI,revealing structural and functional abnormalities in cerebral small vessels below 400 μm,as well as detecting subtle lesions in brain tissue.This paper reviews the research progress of multimodal high-resolution imaging techniques based on 7T MRI,such as time-of-flight angiography,phase contrast imaging and susceptibility imaging,in the study of cerebral small vessel disease.Utilizing these technologies,7T MRI can clearly display the structure of cerebral small vessels,such as the lenticulostriate arteries and deep medullary veins,and measure functional parameters like flow velocity and susceptibility.Additionally,it can sensitively detect cerebral microbleeds and cortical cerebral microinfarct.These imaging data provide valuable information for detecting early features of cerebral small vessel disease and assessing its progression,offering new insights into its pathogenesis.Combined with artificial intelligence-based image analysis methods,7T MRI holds great promise for early diagnosis and progression evaluation in cerebral small vessel disease.

Objective:To identify the relevant factors for the first-course remission of acute myeloid leukemia (AML) and to develop a predictive model as well as assess its predictive capability.Methods:Clinical data of 749 patients newly diagnosed with AML admitted to the Department of Hematology, the First Affiliated Hospital, Zhejiang University, School of Medicine from January 1, 2019, to April 30, 2023, were collected and randomly divided into training and validation sets. Multivariate logistic regression analysis was conducted to determine variables associated with complete remission in the first course of induction therapy, and a predictive model was established based on these variables. The receiver operating characteristic (ROC) curve of the predictive model was plotted, and the area under the curve (AUC) was calculated.Results:The indicators predicting the first remission course included peripheral blood white blood cell count during onset, CBF::MYH11 fusion gene, CEBPA bZIP region mutation, myelodysplastic syndrome-related gene mutation, and induction chemotherapy regimen selection as independent factors for the first remission course. The model’s area under the training and validation curves was 0.738 (95% CI: 0.696-0.780) and 0.726 (95% CI: 0.650-0.801), respectively. The Hosmer-Lemeshow test results yielded P-values of 0.993 and 0.335, respectively. Conclusion:In this study, the developed model demonstrates a strong predictive capability for the efficacy of the first course of patients with AML, providing valuable guidance to clinicians in assessing patient prognosis and selecting appropriate treatment strategies.

Focusing on effective methods and strategies for diabetes prevention in primary healthcare settings globally, this study constructs a comprehensive clinical prevention framework tailored for community health institutions. The framework encompasses continuous prevention services across the entire diabetes cycle, targeting all population segments—including healthy individuals, those with prediabetes, early-stage diabetes, and individuals in clinical or rehabilitation phases—to establish a systematic five-level prevention system. Through comprehensive and systematic implementation of preventive activities at all levels, this approach aims to achieve universal, systematic, and sustainable diabetes prevention and control, thereby offering insights for integrated diabetes management.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To analyze the clinical and genetic features of four children with pediatric acute liver failure (PALF) caused by neuroblastoma-amplified sequence ( NBAS) gene variant, as well as the correlation between clinical phenotype and genotype. Methods:The clinical data and genetic test results of four children with NBAS gene variants admitted to the Department of Gastroenterology, Children's Hospital Affiliated to Zhejiang University School of Medicine from August 2015 to June 2023 mainly presenting with pediatric acute liver failure (PALF) were retrospectively analyzed. The relevant literature from January 2015 to May 2024 was retrieved using the Chinese and English keywords " NBAS," "neuroblastoma amplified sequence," "SOPH," "short stature with optic nerve atrophy and Pelger Hu?t anomaly," "liver failure," and "neuroblastoma amplified sequence" indexed in the CNKI database, Wanfang Data Knowledge Service Platform, and PubMed database. The clinical features and gene mutation characteristics of domestic patients were summarized. Results:The age at which the initial PALF attack occurred in the four children varied from eight months to three years and seven months. All patients developed PALF within 1-2 days after the onset of fever, with symptoms such as vomiting, convulsions, and mental depression or confusion, accompanied by a sharp increase in transaminases, elevated bilirubin and blood ammonia, hyperlactatemia, and hepatomegaly. The PALF gradually improved, and three pediatric patients showed extrahepatic manifestations following antipyretic, fluid replacement, and other symptomatic supportive treatment. Long-term follow-up showed that active temperature control and symptomatic therapy reduced the recurrence of PALF. Genetic testing identified eight kinds of NBAS gene variants sites. Family testing validated compound heterozygous variants, which included four missense variants, one nonsense variants, and three frameshift mutations. A literature study revealed that out of 51 Chinese patients with NBAS gene variants, 98.0% (50/51) had liver involvement, and 37 cases showed PALF. A total of 61 mutation sites were identified, with c.3596G>A (45.1%, 23/51) as a hotspot variants. Conclusions:PALF caused by NBAS gene variant has obvious clinical and genetic characteristics, and there is a correlation between genotype and clinical phenotype. The c.3596G>A variant site is a hotspot mutation in China and is strongly correlated with the liver failure phenotype.

Objective:To construct a volume management program for peritoneal dialysis patients in the peridialysis period.Methods:The intervention map was used as a guiding framework to build a first draft of a volume management program for peritoneal dialysis patients during the peridialysis period based on semi-structured interviews and a literature review in conjunction with a health belief model. Between December 2023 and February 2024, the first draft of the volume management program was revised by two rounds of expert consultation to produce a final program.Results:A total of 15 peritoneal dialysis medical and nursing experts were invited to complete two rounds of Delphi expert consultation. In the two rounds of expert consultation, 15 questionnaires were issued, and 15 valid questionnaires were recovered; the effective recovery rate was 100.00%, and the expert authority coefficient was both 0.903. The final constructed volume management program for peritoneal dialysis patients during the peridialysis period consisted of four first-level items (knowledge training, volume management plan development, behavioral assessment, and belief support), 10 second-level items, and 30 third-level items.Conclusions:The volume management program for peritoneal dialysis patients in the peridialysis period constructed in this study is scientific and can provide a reference for healthcare professionals.

Experimental teaching is an important component of the course Medical Immunology,which requires the use of experimental animals and the execution of experimental animals by medical students.By applying the carbon dioxide euthanasia system,it can effectively reduce the pain of experimental animals,ensure their welfare,and meet ethical requirements.It can also improve the efficiency of experimental teaching in Medical Immunology,reduce environmental pollution,and promote medical students to estab-lish scientific values and worldviews that pay attention to experimental animals and respect life,which is conducive to becoming future medical service talents.In the experimental teaching of Medical Immunology,the appropriate application of carbon dioxide euthanasia system combined with effective ideological and political construction of the curriculum can further implement the Party's educational policy of cultivating morality and talents,and lay a good foundation for cultivating medical talents with comprehensive knowledge,high skills and excellent quality.

Cerebral small vessel disease represents a group of common vascular disorders involving pathological changes in arterioles,capillaries and venules,with microvascular investigation remaining a key challenge in stroke.With high signal-to-noise ratio and high contrast enabled by enhanced field strength,7T MRI can surpass the resolution limits of 3T MRI,revealing structural and functional abnormalities in cerebral small vessels below 400 μm,as well as detecting subtle lesions in brain tissue.This paper reviews the research progress of multimodal high-resolution imaging techniques based on 7T MRI,such as time-of-flight angiography,phase contrast imaging and susceptibility imaging,in the study of cerebral small vessel disease.Utilizing these technologies,7T MRI can clearly display the structure of cerebral small vessels,such as the lenticulostriate arteries and deep medullary veins,and measure functional parameters like flow velocity and susceptibility.Additionally,it can sensitively detect cerebral microbleeds and cortical cerebral microinfarct.These imaging data provide valuable information for detecting early features of cerebral small vessel disease and assessing its progression,offering new insights into its pathogenesis.Combined with artificial intelligence-based image analysis methods,7T MRI holds great promise for early diagnosis and progression evaluation in cerebral small vessel disease.

Objective:To identify the relevant factors for the first-course remission of acute myeloid leukemia (AML) and to develop a predictive model as well as assess its predictive capability.Methods:Clinical data of 749 patients newly diagnosed with AML admitted to the Department of Hematology, the First Affiliated Hospital, Zhejiang University, School of Medicine from January 1, 2019, to April 30, 2023, were collected and randomly divided into training and validation sets. Multivariate logistic regression analysis was conducted to determine variables associated with complete remission in the first course of induction therapy, and a predictive model was established based on these variables. The receiver operating characteristic (ROC) curve of the predictive model was plotted, and the area under the curve (AUC) was calculated.Results:The indicators predicting the first remission course included peripheral blood white blood cell count during onset, CBF::MYH11 fusion gene, CEBPA bZIP region mutation, myelodysplastic syndrome-related gene mutation, and induction chemotherapy regimen selection as independent factors for the first remission course. The model’s area under the training and validation curves was 0.738 (95% CI: 0.696-0.780) and 0.726 (95% CI: 0.650-0.801), respectively. The Hosmer-Lemeshow test results yielded P-values of 0.993 and 0.335, respectively. Conclusion:In this study, the developed model demonstrates a strong predictive capability for the efficacy of the first course of patients with AML, providing valuable guidance to clinicians in assessing patient prognosis and selecting appropriate treatment strategies.

Focusing on effective methods and strategies for diabetes prevention in primary healthcare settings globally, this study constructs a comprehensive clinical prevention framework tailored for community health institutions. The framework encompasses continuous prevention services across the entire diabetes cycle, targeting all population segments—including healthy individuals, those with prediabetes, early-stage diabetes, and individuals in clinical or rehabilitation phases—to establish a systematic five-level prevention system. Through comprehensive and systematic implementation of preventive activities at all levels, this approach aims to achieve universal, systematic, and sustainable diabetes prevention and control, thereby offering insights for integrated diabetes management.