Objective To investigate the clinical and imaging features of myelin oligodendrocyte glycoprotein(MOG)antibody associated encephalitis.Methods A case of MOG antibody associated encephalitis with bilateral caudate nucleus lesions as imaging manifestations was reported.Clinical data were summarised,diagnostic,differential diagnosis and therapeutic analyses were performed,and a review of relevant literature was conducted.Results The patient was a 31-year-old male with acute onset of illness,mainly presenting with headache,fever,increased CSF cells and proteins,serum anti-MOG antibody IgG positivity(1∶100),CSF anti-MOG antibody IgG positivity(1∶10),and abnormal signals of bilateral caudate nucleus head on cranial MRI.After hormonal shock treatment,the headache was relieved rapidly and the body temperature returned to normal.However,the CSF protein and serum MOG antibody titre were higher than before,and tolizumab was given.Conclusion MOG antibody-associated encephalitis has a variety of clinical and imaging manifestations,and this case is instructive for enriching its clinical features,imaging spectrum and exploring its treatment.

Objective To investigate the clinical and imaging features of myelin oligodendrocyte glycoprotein(MOG)antibody associated encephalitis.Methods A case of MOG antibody associated encephalitis with bilateral caudate nucleus lesions as imaging manifestations was reported.Clinical data were summarised,diagnostic,differential diagnosis and therapeutic analyses were performed,and a review of relevant literature was conducted.Results The patient was a 31-year-old male with acute onset of illness,mainly presenting with headache,fever,increased CSF cells and proteins,serum anti-MOG antibody IgG positivity(1∶100),CSF anti-MOG antibody IgG positivity(1∶10),and abnormal signals of bilateral caudate nucleus head on cranial MRI.After hormonal shock treatment,the headache was relieved rapidly and the body temperature returned to normal.However,the CSF protein and serum MOG antibody titre were higher than before,and tolizumab was given.Conclusion MOG antibody-associated encephalitis has a variety of clinical and imaging manifestations,and this case is instructive for enriching its clinical features,imaging spectrum and exploring its treatment.

Objective To evaluate the safety and efficacy of RIC in the treatment of elderly patients with ICH.Methods A prospective trial was conducted on 40 elderly patients with spontaneous ICH admitted to our hospital from January to August 2024.They were randomly assigned to a RIC group(20 cases,conventional treatment combined with RIC intervention)and a control group(20 cases,conventional treatment combined with sham intervention).Hematoma absorption,prog-nosis,and adverse reactions were compared between the two groups.Results The hematoma ab-sorption rate at 7 d after admission was(44.80±14.40)％in the RIC group,which was higher than that of the control group(38.50±20.80)％,though no statistical difference was seen be-tween the two groups(P＞0.05).There was no significant difference in the NIHSS score on the 7th day between the two groups(P＞0.05).At 30 d,the proportion of the patients with mRS ≤2 was 50.0％in the RIC group and 35.0％in the control group,but there was no obvious difference between them(P＞0.05).The proportions of patients with cuff marks and skin petechiae were no-tably higher in the RIC group than the control group(40.0％vs 0.0％,P＜0.01;45.0％vs 0.0％,P＜0.01),but no skin ecchymosis or serious adverse events were observed in both groups.Conclu-sion RIC treatment shows good safety and tolerability in treatment of spontaneous ICH in elder-ly patients.Although it has a potential trend towards promoting hematoma absorption and neuro-logic improvement,its short-term therapeutic effect is not significant.

Cerebral small vessel disease (CSVD) is a series of diseases originating from pathological changes in cerebral microvessels, with a high prevalence in the population of advanced age. CSVD may significantly increase the risk of various neurological disorders, including cognitive impairment and stroke. With the development and application of advanced imaging techniques such as functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI), there has been a deeper understanding of the brain function and microstructural changes in patients with CSVD. This article reviews some new indicators and analysis methods of fMRI and DTI in CSVD research, and elaborates on their correlation with patient clinical manifestations.

Objective To evaluate the safety and efficacy of RIC in the treatment of elderly patients with ICH.Methods A prospective trial was conducted on 40 elderly patients with spontaneous ICH admitted to our hospital from January to August 2024.They were randomly assigned to a RIC group(20 cases,conventional treatment combined with RIC intervention)and a control group(20 cases,conventional treatment combined with sham intervention).Hematoma absorption,prog-nosis,and adverse reactions were compared between the two groups.Results The hematoma ab-sorption rate at 7 d after admission was(44.80±14.40)％in the RIC group,which was higher than that of the control group(38.50±20.80)％,though no statistical difference was seen be-tween the two groups(P＞0.05).There was no significant difference in the NIHSS score on the 7th day between the two groups(P＞0.05).At 30 d,the proportion of the patients with mRS ≤2 was 50.0％in the RIC group and 35.0％in the control group,but there was no obvious difference between them(P＞0.05).The proportions of patients with cuff marks and skin petechiae were no-tably higher in the RIC group than the control group(40.0％vs 0.0％,P＜0.01;45.0％vs 0.0％,P＜0.01),but no skin ecchymosis or serious adverse events were observed in both groups.Conclu-sion RIC treatment shows good safety and tolerability in treatment of spontaneous ICH in elder-ly patients.Although it has a potential trend towards promoting hematoma absorption and neuro-logic improvement,its short-term therapeutic effect is not significant.

Objective:To construct radiomics models of micro-calcification in carotid plaques, and compare their diagnostic values.Methods:Fifty-two patients with large atherosclerotic cerebral infarction admitted to Department of Neurology, Third Affiliated Hospital of Soochow University from May 2017 to November 2019 were enrolled. All patients underwent conventional carotid artery Doppler ultrasound to detect carotid plaques and Micropure? ultrasound to detect micro-calcifications in the plaques. A cross-section image with maximum numbers of micro-calcifications was chosen when there were micro-calcifications in carotid plaques; otherwise, a cross-section image with the largest area of the plaque was chosen. After all images were normalized by Photoshop software, the plaques were delineated as regions of interest using MaZda 4.6 software and 283 texture features of the plaques were automatically extracted. The texture features with the strongest predictive value were selected through consistency analysis (intrclass correlation coefficient [ICC]>0.75), two-sample t-test, Least absolute shrinkage and selection operator (Lasso) regression. The predictive models were constructed by RandomForest (RF) and Support vector machine (SVM) classifiers. The training set and test set were divided by 7: 3 to analyze the classification accuracy. Receiver operating characteristic (ROC) curves were used to calculate the area under the curve (AUC) to evaluate the diagnostic values of the models. Delong test was used to compare the difference between the diagnostic values of the 2 classifiers in test set. Results:A total of 148 plaque images from 52 patients were enrolled, including 104 plaques with micro-calcification and 44 plaques without micro-calcification. Nine texture features were finally selected after ICC analysis, T test and Lasso regression: 5 image gray histogram features were mean, variance, skewness, kurtosis and 99 th percentile (Perc. 99%); 1 autoregressive model feature was Teta3, and 3 wavelet transform features were WavEnLH_s-3, WavEnLH_s-4, and WavEnLH_s-6. With RF classifier, accuracy of the diagnostic model was 0.93, enjoying AUC of 0.92; with SVM classifier, that was 0.91, enjoying AUC of 0.90; Delong test showed that the diagnostic values of the 2 classifiers in test set were significantly different ( Z=1.000, P=0.320). Conclusion:Radiomic models constructed by RF and SVM classifiers can identify micro-calcification in carotid plaques, and the 2 classifiers share equivalent diagnostic values.

Objective:To investigate the correlation between the Type D personality and the severity of white matter hyperintensities (WMHs) in patients with cerebral small vessel disease (CSVD).Methods:Consecutive patients with CSVD admitted to the Changzhou First People's Hospital between November 2020 and June 2021 were enrolled prospectively. The patients were scored on the Type D Personality Scale at admission; the scores of negative affectivity (NA) and social inhibition (SI) dimension were calculated respectively. The general data, laboratory examination data and imaging data of the patients were collected. Periventricular and deep WMHs were scored using the Fazekas visual scoring method. The total score 0-2 was defined as low-WMHs (L-WMHs), and 3-6 was defined as high-WMHs (H-WMHs). Multivariate logistic regression analysis was used to determine the independent influencing factor of WMHs. Results:A total of 100 patients with CSVD were enrolled, including 51 males (51%), aged 67.21±9.38 years, 29 (29%) had Type D personality; 56 (56%) were in the L-WMHs group and 44 (44%) were in the H-WMHs group. Univariate analysis showed that the proportion of Type D personality, NA dimension score, the proportion of hypertension, diastolic blood pressure, triglyceride and homocysteine in the H-WMHs group were significantly higher than those in the L-WMHs group (all P<0.05). Multivariate logistic regression analysis showed that NA dimension score (odds ratio [ OR] 18.351, 95% confidence interval [ CI] 2.780-121.135; P=0.003), age ( OR 1.134, 95% CI 1.039-1.238; P=0.005) and hypertension ( OR 7.771, 95% CI 1.525-39.607; P=0.014) were significantly positively correlated with the severity of WMHs, while triglycerides were significantly negatively correlated with the severity of WMHs ( OR 0.306, 95% CI 0.130-0.722; P=0.007). Conclusion:Type D personality is closely associated with the severity of WMHs in patients with CSVD.

Objective:To evaluate the efficacy of stem cell transplantation in treatment of ischemic stroke.Methods:Randomized controlled studies about stem cell transplantation in the treatment of ischemic stroke were searched from Pubmed, Cochrane Library, Embase, Ovid, China National Knowledge Infrastructure (CNKI), Wanfang and VIP database from database establishment to March 2021. The literature was screened according to the inclusion and exclusion criteria and the clinical data of the stem cell transplantation patients and conventional treatment patients were extracted. The differences of baseline value and final value of National Institutes of Health Stroke Scale (NIHSS) scores, Function Independent Measurement (FIM) scores, Fugl-Meyer Measurement (FMA) scores, Barthel index (BI), Activity of Daily Living (ADL) scale scores, modified Rankin scale (mRS) scores between the two groups were combined for Meta analysis.Results:Eighteen articles were included in the study, including 1334 patients; 668 patients were from the stem cell transplantation group and 666 patients were from the conventional treatment group. The results showed that NIHSS scores (difference in means [ MD]=3.510, 95%CI: 2.540-4.480, P=0.000], FIM scores ( MD=11.380, 95%CI: 5.470-17.280, P=0.000), FMA scores ( MD=13.830, 95%CI: 12.590-15.070, P=0.000), BI ( MD=22.100, 95%CI: 19.430-24.770, P=0.000), ADL scores ( MD=9.290, 95%CI: 3.530-15.050, P=0.002), and mRS scores ( P=0.004) in the stem cell transplantation group were significantly higher as compared with those in the conventional treatment group ( P<0.05). Conclusion:Stem cell transplantation on the basis of conventional treatment has good clinical efficacy in the recovery of neurological function, improvement of activity of daily living, and improvement of limb motor function in patients with ischemic stroke.

Objective:To explore the correlations of micro-calcification load in carotid plaques and plaque vulnerability scores detected by Micropure? ultrasonic technology with 18F-sodium fluoride ( 18F-NaF) uptake ratio (tissue-background ratio [TBR]) in positron emission tomography-computed tomography (PET-CT). Methods:Baseline data of patients with carotid atherosclerotic plaques admitted to our hospital from March 2017 to November 2020 were collected. Carotid arteries of these patients simultaneously positive on Micropure? ultrasound examination and 18F-NaF PET-CT were included. The number of spots in carotid plaques detected by Micropure? ultrasonic technology was defined as load of micro-calcification: they were divided into large number of micro-calcifications group (≥5 spots) and small number of micro-calcifications group (1-4 spots). The scores of carotid plaque vulnerability were evaluated according to carotid atherosclerosis scores in Diagnostic Value of Carotid Atherosclerosis Score for Ischemic Stroke. Correlations of TBR with micro-calcification load and plaque vulnerability scores in these 39 carotid arteries were analyzed. Results:Thirty-nine carotid arteries from 28 patients were enrolled: 24 carotid arteries were classified into the large number of micro-calcifications group and 15 carotid arteries were classified into the small number of micro-calcifications group. TBR of the large number of micro-calcifications group (2.61±0.73) was significantly increased as cpmpared with that of the small number of micro-calcifications group (1.93±0.43, t=-3.657, P=0.001). In the 39 carotid arteries, micro-calcification load was 5(3, 5), while the carotid plaque vulnerability scores were 2 (2, 3); micro-calcification load was positively correlated with TBR (2.35±0.71, r s=0.519, P=0.001), but no correlation was noted between TBR and carotid plaque vulnerability scores ( r s=0.086, P=0.602). Conclusion:Carotid plaque micro-calcification load detected by Micropure? ultrasound examination is associated with 18F-NaF uptake ratio; the larger the micro-calcification load, the more obvious the uptake of 18F-NaF.

It has been previously thought that calcification is a feature of the stability of atherosclerotic plaques. However, recent studies have shown that microcalcification in atherosclerotic plaques is significantly associated with plaque vulnerability. The relationship between atherosclerotic plaques and calcification is unclear, and the specific role of calcification in atherosclerotic plaques remains controversial.