Objective To explore the value of the corrected-size ratio(c-SR)value of intracranial volume computed tomography angiography(CTA)in predicting the risk of intracranial aneurysm rupture.Methods A total of 81 patients with aneurysms who had follow-up records were selected.Among them,39 patients with unruptured aneurysms and underwent regular follow-ups,while 9 patients with unruptured aneurysms opted for surgical intervention.Additionally,surgery was performed on 33 patients with ruptured aneu-rysms.Three-dimensional reconstruction of CTA was performed to obtain the morphological parameters of aneurysms.The initial size ratio(SR)value of aneurysm and the follow-up SR value or postoperative c-SR value were obtained.The changes in SR values of unruptured aneurysms were analyzed,the preoperative SR values and postoperative c-SR values of aneurysms were analyzed.Finally,the correla-tion between the intial SR value of unruptured aneurysms and the c-SR value of ruptured aneurysms was compared.Results No sig-nificant difference was observed between the initial SR value of unruptured aneurysms and the follow-up SR value(P>0.05).Simi-larly,no significant difference was noted between the preoperative SR value of unruptured aneurysms and the postoperative c-SR value(P>0.05).The preoperative SR value of ruptured aneurysms differed significantly from the postoperative c-SR value(P<0.05).There was a significant difference between the initial SR value of unruptured aneurysms and the postoperative c-SR value of ruptured aneurysms(P<0.05).The receiver operating characteristic(ROC)curve analysis was performed on the initial SR value of unrup-tured aneurysms and the postoperative c-SR value of ruptured aneurysms.The area under the curve(AUC)was 0.860 and the best cut-off value was 1.045.Conclusion Unruptured aneurysms remain stable for an extended period of time,exhibiting no significant change in morphological parameters.It can be concluded that surgical intervention does not affect the SR value of aneurysms.In the case of subarachnoid hemorrhage caused by ruptured aneurysms,the parent artery become thinner,then the preoperative SR value of ruptured aneurysms may be exaggerated,which results in the distortion of the preoperative SR value of ruptured aneurysms.However,the postoperative c-SR value is the true SR value before the rup-ture of aneurysms.

To perform the phylogenetic characterization of an isolated porcine rotavirus(PoRV)and investigate its pathogenicity in suckling mice and piglets.A G4P[23]genotype PoRV strain JSJR2023 was successfully isolated from the diarrheic piglet feces through propagation in MA104 cells.The viral proliferation kinetics were analyzed using TCID50 assays,followed by complete genome sequencing through Sanger sequencing platforms.Comprehensive genotyping and phylogenetic reconstruction were conducted using MEGA7.0 with maximum likelihood algorithms.Pathogenicity was assessed in the following animal models:5-day-old C57BL/6 mice and 3-day-old piglets.Multidimensional evaluation included clinical monitoring(diarrhea scoring,growth parameters),virological detection,and histopathological analysis of intestinal tissues.The virus strain JSJR2023 could replicate efficiently in MA104 cells,achieving peak titers of 107.5 TCID50/mL.Whole genome genotype analysis showed that the strain belonged to G4-P[23]-I5-R1-C1-M1-A8-N1-T1-E1-H1.Phylogenetic analysis indicated that the VP3 and NSP4 genes of JSJR2023 strain were most closedrelated to human species rotaviruses,suggesting genetic reassortment between human and porcine RV strains.The animal experiments in suckling mice showed that the JSJR2023 strain infection caused diarrhea symptoms,intestinal edema and congestion,and shedding of intestinal villus epithelial cells.The pathogenicity experiments in piglets showed that compared with the control group,the challenged group of pig-lets had severe diarrhea symptoms,accompanied by reduced appetite and listlessness.Post-mortem examination revealed that the intes-tines were significantly thinner,congested,and filled with yellow watery contents.The challenged piglets showed typical pathological changes such as thinning of the intestinal wall and shortening and shedding of intestinal villi.In conclusion,this study successfully iso-lated a human-porcine recombinant G4P[23]PoRV strain and established the infection models in suckling mice and piglets,providing important tools for investigating the pathogenic mechanism of PoRV,evaluating vaccines and developing antiviral drug.

To perform the phylogenetic characterization of an isolated porcine rotavirus(PoRV)and investigate its pathogenicity in suckling mice and piglets.A G4P[23]genotype PoRV strain JSJR2023 was successfully isolated from the diarrheic piglet feces through propagation in MA104 cells.The viral proliferation kinetics were analyzed using TCID50 assays,followed by complete genome sequencing through Sanger sequencing platforms.Comprehensive genotyping and phylogenetic reconstruction were conducted using MEGA7.0 with maximum likelihood algorithms.Pathogenicity was assessed in the following animal models:5-day-old C57BL/6 mice and 3-day-old piglets.Multidimensional evaluation included clinical monitoring(diarrhea scoring,growth parameters),virological detection,and histopathological analysis of intestinal tissues.The virus strain JSJR2023 could replicate efficiently in MA104 cells,achieving peak titers of 107.5 TCID50/mL.Whole genome genotype analysis showed that the strain belonged to G4-P[23]-I5-R1-C1-M1-A8-N1-T1-E1-H1.Phylogenetic analysis indicated that the VP3 and NSP4 genes of JSJR2023 strain were most closedrelated to human species rotaviruses,suggesting genetic reassortment between human and porcine RV strains.The animal experiments in suckling mice showed that the JSJR2023 strain infection caused diarrhea symptoms,intestinal edema and congestion,and shedding of intestinal villus epithelial cells.The pathogenicity experiments in piglets showed that compared with the control group,the challenged group of pig-lets had severe diarrhea symptoms,accompanied by reduced appetite and listlessness.Post-mortem examination revealed that the intes-tines were significantly thinner,congested,and filled with yellow watery contents.The challenged piglets showed typical pathological changes such as thinning of the intestinal wall and shortening and shedding of intestinal villi.In conclusion,this study successfully iso-lated a human-porcine recombinant G4P[23]PoRV strain and established the infection models in suckling mice and piglets,providing important tools for investigating the pathogenic mechanism of PoRV,evaluating vaccines and developing antiviral drug.

The American Institute of Ultrasound in Medicine(AIUM)practice parameter for the performance of an ultrasound examination of the neonatal and infant spine was revised and published by the AIUM in collaboration with other academic organizations in the United States,to intend to provide the medical ultrasound community with recommendations for the performance of high-quality ultrasound examination of the neonatal and infant spine.The practice parameter propose indications and contraindications for the performance of an ultrasound examination of the neonatal and infant spine,elaborate on specifications of the spinal ultrasound examination,especially the methods for determining the vertebral body level of the end of the spinal cord and key points for evaluating the movement of nerve roots.Following this practice parameter will maximize the detection of abnormalities of the infant spine.This interpretation aims to help beginners and primary care practitioners more easily master the techniques of an ultrasound examination of the neonatal and infant spine,promote the standardized implementation and popularization of this examination,and enhance the diagnostic accuracy for intraspinal pathologies.

OBJECTIVE: To explore the molecular cytogenetic characteristics of three fetuses with psu idic(Y)(q11.22) using a combination of multiple methods. METHODS: A total of 11 000 pregnant women who underwent prenatal diagnosis at the Prenatal Diagnosis Center of Taizhou City from January 2019 to October 2024 were selected as the study subjects. Chromosome karyotype analysis (G-banding) and copy number variation analysis based on next-generation sequencing (NGS) were performed on the amniotic fluid/cord blood samples of the 11 000 fetuses. For cases suspected of Y chromosome abnormalities, C-banding and/or fluorescence in situ hybridization (FISH) and AZF microdeletion testing were additionally conducted. This study has been reviewed and approved by the Medical Ethics Committee of Taizhou Hospital, Zhejiang Province (Ethics No. KL20240860). RESULTS: Among the 11,000 prenatal samples undergoing concurrent karyotype and copy number variation analysis, two fetuses with 45,X/46,X,psu idic(Y)(q11.22) mosaicism and one fetus with 46,X,psu idic(Y)(q11.22) were detected. FISH detection indicated that approximately 66.7% of the cells in fetus 2 exhibited a dicentric Y chromosome, and the metaphase karyotype supported the presence of a pseudodicentric chromosome. AZF testing revealed complete deletion of the AZFb+AZFc regions in fetus 2 and fetus 3. CONCLUSION Conventional G-banding karyotype analysis for psu idic(Y)(q11.22) is prone to misdiagnosis or missed diagnosis. The combined application of chromosome karyotype analysis (G+C banding), copy number variation analysis, and FISH detection in clinical practice can accurately diagnose fetuses with psu idic(Y).
Humans ; Female ; Pregnancy ; Prenatal Diagnosis/methods* ; DNA Copy Number Variations/genetics* ; Adult ; Chromosomes, Human, Y/genetics* ; Karyotyping ; In Situ Hybridization, Fluorescence ; Cytogenetic Analysis/methods* ; Fetus ; High-Throughput Nucleotide Sequencing ; Male

OBJECTIVE: To assess the clinical value of digital PCR (dPCR) for the prenatal diagnosis of common fetal aneuploidies. METHODS: A dPCR-based assay was developed for detecting trisomies 21, 18, and 13. A retrospective analysis was carried out on 173 amniotic fluid samples collected by the Prenatal Diagnosis Center of Taizhou Hospital between January 2017 and December 2023. By using chromosomal karyotyping as the gold standard, the diagnostic performance of the multiplex dPCR system was evaluated in a double-blind manner. This study has been approved by the Ethics Committee of Taizhou Hospital (Ethics No. K20250339). RESULTS: Chromosomal karyotyping has identified 59 cases of trisomy 21, 5 cases of trisomy 18, 2 cases of trisomy 13, 6 cases with chromosomal structural abnormalities or mosaicisms, and 101 cases with a normal karyotype. The dPCR results (Z-score cutoff = 4.0, CI = 99.997%) showed full concordance with karyotyping (sensitivity = 100%, specificity = 100%, Kappa = 1). Among the 6 structurally abnormal or mosaicism samples, dPCR has accurately detected 4 cases, but mis-classified 2 cases of trisomy 21 with very low-level mosaicisms (3.3%, 6.9%, respectively) as normal. CONCLUSION The established multiplex dPCR system demonstrated high diagnostic accuracy for common chromosomal aneuploidies, with results available within 24 hours. It can serve as an efficient supplementary tool to conventional chromosomal karyotyping, providing reliable support for time-sensitive clinical decision-making in prenatal diagnosis.
Humans ; Female ; Pregnancy ; Aneuploidy ; Prenatal Diagnosis/methods* ; Karyotyping ; Retrospective Studies ; Polymerase Chain Reaction/methods* ; Chromosome Disorders/genetics* ; Adult ; Trisomy 13 Syndrome/diagnosis* ; Trisomy 18 Syndrome/genetics* ; Down Syndrome/genetics*

Objective To investigate the features of non-motor symptoms and transcranial substantia nigra ultrasound in essential tremor （ET）. Methods General data were collected from 50 patients with ET and 50 healthy controls，and non-motor symptom scales and transcranial nigra sonography （TCS） were used for assessment. The t-test，the non-parametric test，and the chi-square test were used for comparison of general data，scale assessment results，and TCS findings between the two groups. Results There were significant differences between the ET group and the healthy control group in the total scores of NMSS，MoCA，HAMA，HAMD，PSQI，ESS，and FSS and the incidence rates of cognitive impairment，moderate or severe anxiety，poor sleep，and daytime sleepiness，while there were no significant differences in the incidence rates of moderate or severe depression and fatigue between the two groups. There were no significant differences between the two groups in terms of “hyperechoic area of the left side” “hyperechoic area of the right side” “hyperechoic area of both sides” “S/M value” “the number of cases with a hyperechoic area of >0.2 cm2 for at least one side” “the number of cases with an S/M ratio of >7%” and “the number of cases with positive TCS results”. Conclusion Compared with healthy controls，ET patients are more susceptible to cognitive impairment，anxiety，depression，poor sleep quality，daytime sleepiness，and fatigue，and the non-motor symptoms of ET should be taken seriously in clinical practice. TCS examination has a relatively low diagnostic value in ET patients and healthy individuals.

Objective To explore the value of the corrected-size ratio(c-SR)value of intracranial volume computed tomography angiography(CTA)in predicting the risk of intracranial aneurysm rupture.Methods A total of 81 patients with aneurysms who had follow-up records were selected.Among them,39 patients with unruptured aneurysms and underwent regular follow-ups,while 9 patients with unruptured aneurysms opted for surgical intervention.Additionally,surgery was performed on 33 patients with ruptured aneu-rysms.Three-dimensional reconstruction of CTA was performed to obtain the morphological parameters of aneurysms.The initial size ratio(SR)value of aneurysm and the follow-up SR value or postoperative c-SR value were obtained.The changes in SR values of unruptured aneurysms were analyzed,the preoperative SR values and postoperative c-SR values of aneurysms were analyzed.Finally,the correla-tion between the intial SR value of unruptured aneurysms and the c-SR value of ruptured aneurysms was compared.Results No sig-nificant difference was observed between the initial SR value of unruptured aneurysms and the follow-up SR value(P>0.05).Simi-larly,no significant difference was noted between the preoperative SR value of unruptured aneurysms and the postoperative c-SR value(P>0.05).The preoperative SR value of ruptured aneurysms differed significantly from the postoperative c-SR value(P<0.05).There was a significant difference between the initial SR value of unruptured aneurysms and the postoperative c-SR value of ruptured aneurysms(P<0.05).The receiver operating characteristic(ROC)curve analysis was performed on the initial SR value of unrup-tured aneurysms and the postoperative c-SR value of ruptured aneurysms.The area under the curve(AUC)was 0.860 and the best cut-off value was 1.045.Conclusion Unruptured aneurysms remain stable for an extended period of time,exhibiting no significant change in morphological parameters.It can be concluded that surgical intervention does not affect the SR value of aneurysms.In the case of subarachnoid hemorrhage caused by ruptured aneurysms,the parent artery become thinner,then the preoperative SR value of ruptured aneurysms may be exaggerated,which results in the distortion of the preoperative SR value of ruptured aneurysms.However,the postoperative c-SR value is the true SR value before the rup-ture of aneurysms.

Objective:To explore the relationship between gallbladder polyps and colorectal polyps, providing insights into whether the presence of gallbladder polyps can serve as an indicator for colonoscopy screening.Methods:Clinical data from 2 542 patients who underwent colonoscopy and abdominal ultrasound at the First Affiliated Hospital of Shihezi University between January and December 2022 were retrospectively analyzed. Patients were divided into colorectal polyp group ( n=1 266) and non-colorectal polyp group ( n=1 276) based on colonoscopy findings. Univariate and multivariate Logistic regression models were used to analyze the relationship between gallbladder polyps and colorectal polyps. Results:The prevalence rates of gallbladder polyp in colorectal polyp group and non-colorectal polyp group were 16.67% (211/1 266) and 11.21% (143/1 276). Multivariate Logistic regression analysis showed a lower risk of colorectal polyps in women ( P<0.001, OR=0.523, 95% CI: 0.440-0.622). Age ( P<0.001, OR=1.059, 95% CI: 1.050-1.068), and hypertriglyceridemia ( P=0.013, OR=1.350, 95% CI: 1.066-1.709), low level of high-density lipoprotein ( P<0.001, OR=1.588, 95% CI: 1.280-1.969), and gallbladder polyp ( P<0.001, OR=1.712, 95% CI: 1.344-2.180) were independent risk factors for colorectal polyp. There was no significant difference in hypercholesterolemia, elevated low-density lipoprotein, hyperuricemia, or cholecystectomy between colorectal polyp group and non-colorectal polyp group ( P>0.05). Conclusion:The identification of gallbladder polyps via abdominal ultrasound may indicate a higher likelihood of colorectal polyps in patients, underscoring the need for further colonoscopy screening in individuals with gallbladder polyps.

Objective To explore the delirium incidence and risk factors among patients undergoing abdominal surgery in the post-anesthesia care unit(PACU),and establish a column chart prediction model.Methods A total of 1851 patients who underwent abdomi-nal surgery,with a surgery duration exceeding 4hours and were routinely transferred to the PACU after surgery in the First Affiliated Hos-pital of Wenzhou Medical University from January 2022 to December 2023 were selected.The patients were divided into a delirium group and a non-delirium group based on a nursing delirium screening scale score≥2.The relative factors of before and during the surgery were analyzed retrospectively.The LASSO regression was used to screen the variables,and the independent influencing factors were deter-mined using univariate and multivariate Logistic regression before creating a forest plot.The predictive efficacy of the column chart predic-tion model was evaluated by area under the curve(AUC)of receiver operating characteristic(ROC)and the Hosmer-Lemeshow test.Results A total of 113(6.1％)patients experienced delirium in the PACU.The result of the multivariate Logistic regression analysis in-dicated that gender,age,flurbiprofen,hypotension,hypothermia,hypercapnia,and surgery duration were independent influencing factors for delirium in the PACU,while a long surgery duration and using flurbiprofen were protective factors.The nomogram model was construc-ted based on the result and the AUC value of this model was 0.738.The Hosmer-Lemeshow goodness-of-fit test for the model demon-strated a good fit(P=0.686).Conclusion Medical staff should enhance intraoperative management,ensure sufficient analgesia,main-tain hemodynamic stability,reduce the incidence of intraoperative adverse events,pay attention to elderly male patients,and decrease the occurrence of delirium in the PACU.