Amide proton transfer-weighted (APTw) imaging is a kind of new magnetic resonance molecular imaging that rapidly developed in recent years. APTw imaging reflects the protein concentration and acid-base changes in tissues by detecting amide protons in free proteins and peptides in tissues. APTw imaging is a complementary technique to the existing magnetic resonance techniques, which can provide new molecular biological information for central nervous system diseases. In this article, the basic principle of APTw imaging and its application in common central nervous system diseases such as brain tumor, ischemic stroke, and neurodegenerative diseases are reviewed to provide new methods for promoting the transformation of APTw imaging from the research stage to routine clinical application, and facilitating the precise diagnosis and treatment of central nervous system diseases.

BACKGROUND: The achievement of an optimal return to sport (RTS) has remained a key goal after sports-related injuries, with the ongoing debate on the effectiveness of different surgical approaches for anterior cruciate ligament (ACL) rupture. This study aims to assess clinical outcomes and RTS across various surgical methods, such as anatomical single-bundle reconstruction (ASBR), central-axial single-bundle reconstruction (CASBR), and double-bundle reconstruction (DBR). METHODS: A randomized clinical trial was conducted, comprising 191 patients who underwent ACL rupture. These patients were divided into three groups based on the ACL reconstruction techniques they received (ASBR, CASBR, DBR). Over the 2-year follow-up period, the study assessed RTS through four single-hop tests, isokinetic extension tests, and limb asymmetry indices. Postoperative graft status was determined using the signal-to-noise quotient (SNQ), while knee function was evaluated using the International Knee Documentation Committee 2000 (IKDC-2000) score, Lysholm score, Tegner score, and degree of knee laxity. A binary logistic regression model was developed to forecast the factors influencing ideal RTS. RESULTS: DBR (67.63%) and CASBR (58.00%) exhibited higher RTS passing rates compared to ASBR (30.39%; χ2 = 19.57, P <0.05). Quadriceps strength symmetry in the lower limbs was identified as the key determinant of RTS ( χ2 = 17.08, P <0.05). The RTS rate was influenced by SNQs of the graft's tibial site (odds ratio: 0.544) and quadriceps strength of the reconstructed knee joint at 60°/s (odds ratio: 6.346). Notably, the DBR group showed enhanced knee stability, evidenced by superior results in the Lachman test ( χ2 = 13.49, P <0.01), objective IKDC-2000 ( χ2 = 27.02, P = 0.002), and anterior instability test ( χ2 = 9.46, P <0.01). Furthermore, DBR demonstrated superior clinical outcomes based on the Lysholm score (DBR: 89.57 ± 7.72, CASBR: 83.00 ± 12.71, ASBR: 83.21 ± 11.95; F = 10.452, P <0.01) and IKDC-2000 score (DBR: 90.95 ± 7.00, CASBR: 84.64 ± 12.68, ASBR: 83.63 ± 11.41; F = 11.78, P <0.01). CONCLUSION: For patients with ACL rupture, more ideal RTS rate and clinical outcomes were shown in the DBR group than in the ASBR and CASBR groups. Autograft status and quadriceps strength are postively related to RTS. TRIAL REGISTRATION ClinicalTrials.gov (NCT05400460).
Humans ; Anterior Cruciate Ligament Reconstruction/methods* ; Male ; Female ; Adult ; Anterior Cruciate Ligament Injuries/surgery* ; Young Adult ; Return to Sport ; Adolescent ; Anterior Cruciate Ligament/surgery* ; Treatment Outcome

Right atrial diverticulum is a rare congenital cardiac malformation with a very low incidence and few reports in the literature. It is a sac-like structure originating from the free wall of the right atrium or the right auricle，and the wall of the diverticulum is mostly composed of normal myocardial tissue. Patients with diverticulumare asymptomatic in the early stage of the disease，and it is mostly detected by imaging examinations. The patient was a 96-year-old male admitted to the Second Hospital of Hebei Medical University with intermittent chest tightness，shortness of breath，and dizziness for more than half a month. Echocardiography and contrast echocardiography were performed 1 d after the patient was admitted to the hospital，suggesting the diagnasis of right atrial diverticulum with thrombosis，and coronary CT angiography was performed 4 d after the patient was admitted to the hospital，which considered right atrial diverticulum，with an internal filling defect，and suspected thrombus formation. The patient was older and did not receive further diagnosis and treatment，and cardiac ultrasound was repeated 1 month later，with no significant change in the size and morphology of the mass within the right atrial diverticulum. By analyzing in detail a case with right atrial diverticulum initially misdiagnosed as pericardial effusion，this article aimed to raise cardiac sonographers' awareness of the diagnosis of right atrial diverticulum and to explore the key role of cardiac acoustic contrast technology in cardiac ultrasound diagnosis.

Objective:To utilize the left ventricular myocardial work（LVMW）technique for early identification of myocardial damage in patients with fabry disease（FD）.Methods:In an observational cross-sectional study，35 patients with FD who visited the Second Hospital of Hebei Medical University from February 2023 to April 2024 were included. They were categorized into two groups based on left ventricular mass index（LVMI）：the non-left ventricular hypertrophy group（LVH-FD group，14 cases）and the left ventricular hypertrophy group（LVH+FD group，21 cases）. Further gender-stratified analysis was performed on parameters related to left ventricular global longitudinal strain（LVGLS）and LVMW. Additionally，for the FD group with normal LVGLS，a comparison of their LVMW-related parameters was made with a control group. A control group consisting of 28 healthy subjects from the same period was selected for comparison. The LVGLS，global work index（LVGWI），global constructive work（LVGCW），global wasted work（LVGWW），and global work efficiency（LVGWE）of the three groups were analyzed using two-dimensional speckle tracking and non-invasive myocardial work techniques，and intergroup comparisons of these parameters were performed. Pearson's linear correlation was applied to analyse the correlation between LVGWI，LVGWE and LVMI.Results:① According to the LVMI grouping results，compared with the control group，the LVH-FD group showed decreased LVGWI（ P<0.05），while the LVH+FD group exhibited reductions in LVGLS，LVGWI，and LVGWE（all P<0.05）. Compared to the LVH-FD group，the LVH+FD group demonstrated lower LVGLS，LVGWI，and LVGWE（all P<0.05）. ② Gender subgroup analysis revealed that in the female subgroup，no statistically significant differences were observed in LVGLS，LVGWI，and LVGWE between the female control group and the female LVH-FD group（all P>0.05）. However，the female LVH+ FD group showed decreased LVGLS，LVGWI，and LVGWE compared to both the female control group（all P<0.05）and the female LVH-FD group（all P<0.05）. In the male subgroup，compared to the male control group，the male LVH-FD group had reduced LVGWI（ P<0.05）but no significant differences in LVGLS or LVGWE（both P>0.05）. The male LVH+ FD group displayed lower LVGLS，LVGWI，and LVGWE compared to both the male control group（all P<0.05）and the male LVH- FD group（all P<0.05）. ③Compared with the control group，the LVGLS-normal FD group had a reduced LVGWI（ P<0.05），while there were no statistically significant differences in LVGLS，LVGWE，LVGCW，and LVGWW between these two groups（all P>0.05）. ④LVGWI and LVGWE were negatively correlated with LVMI（ r=-0.617，-0.707；both P<0.001）. Conclusions:LVMW can detect early cardiac dysfunction in patients with FD and is of guiding value for their clinical management.

Objective To compare the image quality of readout-segmented diffusion weighted imaging(RESOLVE-DWI)and integrated slice-by-slice shimming diffusion weighted imaging(iShim-DWI)in patients with nasopharyngeal carcinoma.Methods A retrospective study was conducted on 26 patients with nasopharyngeal carcinoma confirmed by pathology.The imaging data included RESOLVE-DWI and iShim-DWI.The signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the two sequences were compared by one deputy chief imaging technician.And two experienced radiologists used the 5-point scoring scheme to compare the lesion clarity,image artifacts,and antideformation ability of the two sequences,repectively.Results The SNR and CNR of the iShim-DWI sequence were significantly higher than those of RESOLVE-DWI sequence(P＜0.01).While the subjective scores of lesion clarity,image artifacts,and antideformation ability on RESOLVE-DWI were significantly better than those of iShim-DWI,and the differences were statistically significant(P＜0.01).Conclusion Both RESOLVE-DWI and iShim-DWI obtained good images.With sufficient SNR and CNR,RESOLVE-DWI has clearer lesions and surrounding structures,higher image resolution,fewer artifacts,and better antideformation ability,thus providing clinical advantages in evaluating patients with good physical tolerance.

Objective To compare the image quality of readout-segmented diffusion weighted imaging(RESOLVE-DWI)and integrated slice-by-slice shimming diffusion weighted imaging(iShim-DWI)in patients with nasopharyngeal carcinoma.Methods A retrospective study was conducted on 26 patients with nasopharyngeal carcinoma confirmed by pathology.The imaging data included RESOLVE-DWI and iShim-DWI.The signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the two sequences were compared by one deputy chief imaging technician.And two experienced radiologists used the 5-point scoring scheme to compare the lesion clarity,image artifacts,and antideformation ability of the two sequences,repectively.Results The SNR and CNR of the iShim-DWI sequence were significantly higher than those of RESOLVE-DWI sequence(P＜0.01).While the subjective scores of lesion clarity,image artifacts,and antideformation ability on RESOLVE-DWI were significantly better than those of iShim-DWI,and the differences were statistically significant(P＜0.01).Conclusion Both RESOLVE-DWI and iShim-DWI obtained good images.With sufficient SNR and CNR,RESOLVE-DWI has clearer lesions and surrounding structures,higher image resolution,fewer artifacts,and better antideformation ability,thus providing clinical advantages in evaluating patients with good physical tolerance.

Right atrial diverticulum is a rare congenital cardiac malformation with a very low incidence and few reports in the literature. It is a sac-like structure originating from the free wall of the right atrium or the right auricle，and the wall of the diverticulum is mostly composed of normal myocardial tissue. Patients with diverticulumare asymptomatic in the early stage of the disease，and it is mostly detected by imaging examinations. The patient was a 96-year-old male admitted to the Second Hospital of Hebei Medical University with intermittent chest tightness，shortness of breath，and dizziness for more than half a month. Echocardiography and contrast echocardiography were performed 1 d after the patient was admitted to the hospital，suggesting the diagnasis of right atrial diverticulum with thrombosis，and coronary CT angiography was performed 4 d after the patient was admitted to the hospital，which considered right atrial diverticulum，with an internal filling defect，and suspected thrombus formation. The patient was older and did not receive further diagnosis and treatment，and cardiac ultrasound was repeated 1 month later，with no significant change in the size and morphology of the mass within the right atrial diverticulum. By analyzing in detail a case with right atrial diverticulum initially misdiagnosed as pericardial effusion，this article aimed to raise cardiac sonographers' awareness of the diagnosis of right atrial diverticulum and to explore the key role of cardiac acoustic contrast technology in cardiac ultrasound diagnosis.

Objective:To utilize the left ventricular myocardial work（LVMW）technique for early identification of myocardial damage in patients with fabry disease（FD）.Methods:In an observational cross-sectional study，35 patients with FD who visited the Second Hospital of Hebei Medical University from February 2023 to April 2024 were included. They were categorized into two groups based on left ventricular mass index（LVMI）：the non-left ventricular hypertrophy group（LVH-FD group，14 cases）and the left ventricular hypertrophy group（LVH+FD group，21 cases）. Further gender-stratified analysis was performed on parameters related to left ventricular global longitudinal strain（LVGLS）and LVMW. Additionally，for the FD group with normal LVGLS，a comparison of their LVMW-related parameters was made with a control group. A control group consisting of 28 healthy subjects from the same period was selected for comparison. The LVGLS，global work index（LVGWI），global constructive work（LVGCW），global wasted work（LVGWW），and global work efficiency（LVGWE）of the three groups were analyzed using two-dimensional speckle tracking and non-invasive myocardial work techniques，and intergroup comparisons of these parameters were performed. Pearson's linear correlation was applied to analyse the correlation between LVGWI，LVGWE and LVMI.Results:① According to the LVMI grouping results，compared with the control group，the LVH-FD group showed decreased LVGWI（ P<0.05），while the LVH+FD group exhibited reductions in LVGLS，LVGWI，and LVGWE（all P<0.05）. Compared to the LVH-FD group，the LVH+FD group demonstrated lower LVGLS，LVGWI，and LVGWE（all P<0.05）. ② Gender subgroup analysis revealed that in the female subgroup，no statistically significant differences were observed in LVGLS，LVGWI，and LVGWE between the female control group and the female LVH-FD group（all P>0.05）. However，the female LVH+ FD group showed decreased LVGLS，LVGWI，and LVGWE compared to both the female control group（all P<0.05）and the female LVH-FD group（all P<0.05）. In the male subgroup，compared to the male control group，the male LVH-FD group had reduced LVGWI（ P<0.05）but no significant differences in LVGLS or LVGWE（both P>0.05）. The male LVH+ FD group displayed lower LVGLS，LVGWI，and LVGWE compared to both the male control group（all P<0.05）and the male LVH- FD group（all P<0.05）. ③Compared with the control group，the LVGLS-normal FD group had a reduced LVGWI（ P<0.05），while there were no statistically significant differences in LVGLS，LVGWE，LVGCW，and LVGWW between these two groups（all P>0.05）. ④LVGWI and LVGWE were negatively correlated with LVMI（ r=-0.617，-0.707；both P<0.001）. Conclusions:LVMW can detect early cardiac dysfunction in patients with FD and is of guiding value for their clinical management.

Amide proton transfer-weighted (APTw) imaging is a kind of new magnetic resonance molecular imaging that rapidly developed in recent years. APTw imaging reflects the protein concentration and acid-base changes in tissues by detecting amide protons in free proteins and peptides in tissues. APTw imaging is a complementary technique to the existing magnetic resonance techniques, which can provide new molecular biological information for central nervous system diseases. In this article, the basic principle of APTw imaging and its application in common central nervous system diseases such as brain tumor, ischemic stroke, and neurodegenerative diseases are reviewed to provide new methods for promoting the transformation of APTw imaging from the research stage to routine clinical application, and facilitating the precise diagnosis and treatment of central nervous system diseases.

The purpose of this study was to investigate the damage mechanism of pathogenic E.coli on mouse brain microvascular endothelial cells(BMEC cells)and mouse alveolar macrophages(MH-S cells),as well as the lung and brain of healthy mice.In this study,BMEC cells and MH-S cells were infected with pathogenic E.coli strains,and cell morphological changes were observed.Plate counting method was used to detect the adhesion and invasion ability of the strains to cells and the number of bacteria in the lungs and brains of mice.RT-qPCR was used to detect the ex-pression of TNF-α,IL-1β and IL-6 genes in cells and mouse organs at different time periods.West-ern blot was used to detect the expression of p-NF-κB,p-JAK2 and p-STAT3 proteins related to inflammation in cells and mouse organs after infection.The results showed that the cell culture medium of the infection group was turbid,the cell vision became dark and blurred,some cells shrank and died,and more fragments were produced.The adhesion rate and invasion rate of BMEC cells at 3 h were significantly lower than those at 6 h(P＜0.050),and the adhesion rate and inva-sion rate of MH-S cells at 3 h were significantly higher than those at 6 h(P＜0.010).Infected mice had a large area of swelling and bleeding in the brain,and the lungs had different degrees of swell-ing and bleeding.The bacterial load in the brain and lung was the highest at 12 h.Compared with the control group,the mRNA expression levels of IL-1β,IL-6 and TNF-α in the infection group were significantly increased at 3 h and 6 h(P＜0.050),and the mRNA expression levels of inflam-matory factors in BMEC cells and MH-S cells were the highest at 6 and 3 h,respectively.The mR-NA expression of inflammatory factors in the brain and lung of infected mice showed a trend of in-creasing first and then decreasing with time,with the highest expression at 12 h after infection.The expression levels of p-NF-κB protein in BMEC cells,MH-S cells,lung and brain tissues of mice in the infection group were significantly higher than those in the control group(P＜0.001),and the expression levels of p-JAK2 protein and p-STAT3 protein were significantly lower than those in the control group(P＜0.050).The above results showed that pathogenic E.coli could adhere and invade BMEC cells and MH-S cells,colonize in lung and brain tissues of mice,promote the expres-sion of NF-κB protein in cells and tissues,inhibit the expression of JAK2 protein and STAT3 pro-tein,and then stimulate cells and tissues to produce inflammatory response.