Objective To explore the expression of peripheral blood Nod-like receptor protein 3(NLRP3)inflammasomes,serum caveolin-1(Cav-1),and sphingosine 1-phosphate receptor 1(S1P1)in children with Kawasaki disease(KD),and to elucidate their associations with coronary artery lesion(CAL).Methods A total of 223 children diagnosed with KD were recruited from our hospital between March 2023 and December 2024 and served as the KD study group.These children were classified into the CAL group(n=71)and the non-CAL group(n=152)based on their CAL status.Additionally,223 healthy children who underwent physical examinations at our hospital were selected as the healthy control group.Clinical data,levels of routine laboratory test indices,peripheral blood NLRP3 inflammasomes,serum Cav-1,and S1P1 were compared among the groups.Risk factors for CAL in children with KD were analyzed,and the diagnostic value of peripheral blood NLRP3 inflammasomes,serum Cav-1,and S1P1 levels for CAL in children with KD was evaluated.Results The levels of NLRP3,caspase-1,ASC in peripheral blood and messenger ribonucleic acid(mRNA)of serum Cav-1 were significantly higher in the KD study group than in the healthy control group(P<0.05).Conversely,the serum level of S1P1 was significantly lower in the KD study group compared to the healthy control group(P<0.05).In the CAL group,the levels of peripheral blood white blood cell count(WBC),NLRP3,caspase-1,ASC mRNA,serum C-reactive protein(CRP),and Cav-1 were all higher than those in the non-CAL group(P<0.05),while the serum level of S1P1 was lower than that in the non-CAL group(P<0.05).The levels of NLRP3,caspase-1,ASC mRNA in peripheral blood,along with serum Cav-1 and S1P1,were identified as independent risk factors for CAL in children with KD(P<0.05).The results of receiver operating characteristic(ROC)analysis indicated that the combined test of the levels of NLRP3,caspase-1,ASC mRNA in peripheral blood,serum Cav-1,and S1P1 for diagnosing CAL in children with KD had an area under the curve(AUC)value of 0.926.This value was significantly higher than that of each individual index(0.844,0.785,0.821,0.843,0.833,P<0.05).Conclusions The levels of NLRP3 inflamma-tory vesicles in peripheral blood and serum Cav-1 were highly expressed in children with KD,whereas the serum S1P1 was poorly expressed.These indices may be involved in the development process of CAL in children with KD.Moreover,the combination of these indices is more beneficial for the diagnosis of CAL in children with KD.

In order to adapt to teaching reform of Medical Immunology and create a"golden course",through teaching prac-tice,our research group proposes a"three-dimensional curriculum teaching system",which organically combines teaching concepts with teaching design and process,with construction of various resources(material libraries),and finally,multi-level teaching evalua-tion is completed to achieve overall unity of teaching.

Objective:To analyze the value of diffusion tensor imaging (DTI) combined with magnetic resonance spectroscopy (MRS) in the clinical grading and prognosis assessment of brain glioma.Methods:A retrospective analysis was conducted on the clinical data of 72 patients with brain glioma admitted to Yan'an People's Hospital from January 2010 to December 2023. The cohort included 40 males and 32 females, with ages ranging from 25 to 76 years and an average age of (40.3 ± 6.8) years. All patients underwent routine magnetic resonance imaging plain scans, contrast-enhanced ultrasound examination, DTI, and MRS prior to surgery. Measurements were conducted for fractional anisotropy (FA), N-acetyl aspartate (NAA), choline compounds (Cho), and creatinine (Cr). Additionally, the ratios of NAA/Cho, Cho/Cr, and NAA/Cr were calculated. The imaging characteristics of brain glioma were analyzed, and the clinical utility of these indicators for grading and prognosis assessment of brain glioma was evaluated.Results:DTI results of the 72 included patients revealed disruption of the white matter fiber tracts surrounding the tumors. MRS of the 72 included patients showed either approximately normal values or indicated elevated Cho and Cr levels, along with decreased NAA levels. Diffuse mild to moderate enhancement was observed in 35 patients (48.61%), presenting with a patchy pattern that suggested a higher tumor grade. When comparing low-grade gliomas (LGG) and high-grade gliomas (HGG) to the corresponding healthy tissue, significant differences were observed in FA value in the peritumoral edema region [(0.20 ± 0.06) × 10 -3 mm2/s vs. (0.62 ± 0.08) × 10 -3 mm2/s for LGG, and (0.17 ± 0.05) × 10 -3 mm2/s vs. (0.62 ± 0.09) × 10 -3 mm2/s for HGG] , NAA/Cho ratio [(0.36 ± 0.11) vs. (1.41 ± 0.33) for LGG, and (0.19 ± 0.06) vs. (1.42 ± 0.35) for HGG], Cho/Cr ratio [(2.39 ± 0.51) vs. (1.12 ± 0.26) for LGG, and (3.81 ± 0.94) vs. (1.12 ± 0.28) for HGG], and NAA/Cr ratio [(0.75 ± 0.24) vs. (1.52 ± 0.31) for LGG, and (0.38 ± 0.12) vs. (1.52 ± 0.29) for HGG]. All observed differences were statistically significant ( tLGG = 26.56, 19.09, 14.03, 12.42; tHGG = 27.64, 21.90, 17.34, 22.97, all P < 0.05). There were statistically significant differences in FA [(0.20 ± 0.06) × 10 -3 mm2/s vs. (0.17 ± 0.05) × 10 -3 mm2/s], NAA/Cho [(0.36 ± 0.11) vs. (0.19 ± 0.06)], Cho/Cr [(2.39 ± 0.51) vs. (3.81 ± 0.94)], and NAA/Cr [(0.75 ± 0.24) vs. (0.38 ± 0.12)] between LGG and HGG ( t = 2.26, 7.85, 8.17, 7.95, all P < 0.05). Follow-up conducted 6 months to 3 years postoperatively revealed that the Cho/Cr ratio in the death group was significantly higher than that in the survival group [2.172 (1.662, 2.863) vs. 2.729 (2.431, 3.689), U = 2.17, P < 0.05]. However, there were no statistically significant differences in FA, NAA/Cho, and NAA/Cr values between survival and death groups ( P > 0.05). Conclusions:Combined DTI and MRS can reveal specific imaging characteristics of brain gliomas, providing valuable information for clinical grading of brain gliomas. Furthermore, the Cho/Cr ratio is associated with prognosis and may serve as a potential imaging biomarker for predicting the outcome of brain gliomas.

Objective To explore the expression of peripheral blood Nod-like receptor protein 3(NLRP3)inflammasomes,serum caveolin-1(Cav-1),and sphingosine 1-phosphate receptor 1(S1P1)in children with Kawasaki disease(KD),and to elucidate their associations with coronary artery lesion(CAL).Methods A total of 223 children diagnosed with KD were recruited from our hospital between March 2023 and December 2024 and served as the KD study group.These children were classified into the CAL group(n=71)and the non-CAL group(n=152)based on their CAL status.Additionally,223 healthy children who underwent physical examinations at our hospital were selected as the healthy control group.Clinical data,levels of routine laboratory test indices,peripheral blood NLRP3 inflammasomes,serum Cav-1,and S1P1 were compared among the groups.Risk factors for CAL in children with KD were analyzed,and the diagnostic value of peripheral blood NLRP3 inflammasomes,serum Cav-1,and S1P1 levels for CAL in children with KD was evaluated.Results The levels of NLRP3,caspase-1,ASC in peripheral blood and messenger ribonucleic acid(mRNA)of serum Cav-1 were significantly higher in the KD study group than in the healthy control group(P<0.05).Conversely,the serum level of S1P1 was significantly lower in the KD study group compared to the healthy control group(P<0.05).In the CAL group,the levels of peripheral blood white blood cell count(WBC),NLRP3,caspase-1,ASC mRNA,serum C-reactive protein(CRP),and Cav-1 were all higher than those in the non-CAL group(P<0.05),while the serum level of S1P1 was lower than that in the non-CAL group(P<0.05).The levels of NLRP3,caspase-1,ASC mRNA in peripheral blood,along with serum Cav-1 and S1P1,were identified as independent risk factors for CAL in children with KD(P<0.05).The results of receiver operating characteristic(ROC)analysis indicated that the combined test of the levels of NLRP3,caspase-1,ASC mRNA in peripheral blood,serum Cav-1,and S1P1 for diagnosing CAL in children with KD had an area under the curve(AUC)value of 0.926.This value was significantly higher than that of each individual index(0.844,0.785,0.821,0.843,0.833,P<0.05).Conclusions The levels of NLRP3 inflamma-tory vesicles in peripheral blood and serum Cav-1 were highly expressed in children with KD,whereas the serum S1P1 was poorly expressed.These indices may be involved in the development process of CAL in children with KD.Moreover,the combination of these indices is more beneficial for the diagnosis of CAL in children with KD.

In order to adapt to teaching reform of Medical Immunology and create a"golden course",through teaching prac-tice,our research group proposes a"three-dimensional curriculum teaching system",which organically combines teaching concepts with teaching design and process,with construction of various resources(material libraries),and finally,multi-level teaching evalua-tion is completed to achieve overall unity of teaching.

Objective:To analyze the value of diffusion tensor imaging (DTI) combined with magnetic resonance spectroscopy (MRS) in the clinical grading and prognosis assessment of brain glioma.Methods:A retrospective analysis was conducted on the clinical data of 72 patients with brain glioma admitted to Yan'an People's Hospital from January 2010 to December 2023. The cohort included 40 males and 32 females, with ages ranging from 25 to 76 years and an average age of (40.3 ± 6.8) years. All patients underwent routine magnetic resonance imaging plain scans, contrast-enhanced ultrasound examination, DTI, and MRS prior to surgery. Measurements were conducted for fractional anisotropy (FA), N-acetyl aspartate (NAA), choline compounds (Cho), and creatinine (Cr). Additionally, the ratios of NAA/Cho, Cho/Cr, and NAA/Cr were calculated. The imaging characteristics of brain glioma were analyzed, and the clinical utility of these indicators for grading and prognosis assessment of brain glioma was evaluated.Results:DTI results of the 72 included patients revealed disruption of the white matter fiber tracts surrounding the tumors. MRS of the 72 included patients showed either approximately normal values or indicated elevated Cho and Cr levels, along with decreased NAA levels. Diffuse mild to moderate enhancement was observed in 35 patients (48.61%), presenting with a patchy pattern that suggested a higher tumor grade. When comparing low-grade gliomas (LGG) and high-grade gliomas (HGG) to the corresponding healthy tissue, significant differences were observed in FA value in the peritumoral edema region [(0.20 ± 0.06) × 10 -3 mm2/s vs. (0.62 ± 0.08) × 10 -3 mm2/s for LGG, and (0.17 ± 0.05) × 10 -3 mm2/s vs. (0.62 ± 0.09) × 10 -3 mm2/s for HGG] , NAA/Cho ratio [(0.36 ± 0.11) vs. (1.41 ± 0.33) for LGG, and (0.19 ± 0.06) vs. (1.42 ± 0.35) for HGG], Cho/Cr ratio [(2.39 ± 0.51) vs. (1.12 ± 0.26) for LGG, and (3.81 ± 0.94) vs. (1.12 ± 0.28) for HGG], and NAA/Cr ratio [(0.75 ± 0.24) vs. (1.52 ± 0.31) for LGG, and (0.38 ± 0.12) vs. (1.52 ± 0.29) for HGG]. All observed differences were statistically significant ( tLGG = 26.56, 19.09, 14.03, 12.42; tHGG = 27.64, 21.90, 17.34, 22.97, all P < 0.05). There were statistically significant differences in FA [(0.20 ± 0.06) × 10 -3 mm2/s vs. (0.17 ± 0.05) × 10 -3 mm2/s], NAA/Cho [(0.36 ± 0.11) vs. (0.19 ± 0.06)], Cho/Cr [(2.39 ± 0.51) vs. (3.81 ± 0.94)], and NAA/Cr [(0.75 ± 0.24) vs. (0.38 ± 0.12)] between LGG and HGG ( t = 2.26, 7.85, 8.17, 7.95, all P < 0.05). Follow-up conducted 6 months to 3 years postoperatively revealed that the Cho/Cr ratio in the death group was significantly higher than that in the survival group [2.172 (1.662, 2.863) vs. 2.729 (2.431, 3.689), U = 2.17, P < 0.05]. However, there were no statistically significant differences in FA, NAA/Cho, and NAA/Cr values between survival and death groups ( P > 0.05). Conclusions:Combined DTI and MRS can reveal specific imaging characteristics of brain gliomas, providing valuable information for clinical grading of brain gliomas. Furthermore, the Cho/Cr ratio is associated with prognosis and may serve as a potential imaging biomarker for predicting the outcome of brain gliomas.

Objective:To investigate the value of quantitative parameters of amide proton transfer-weighted (APTw) imaging and dynamic contrast-enhanced (DCE)-MRI for preoperative assessment of human epidermal growth factor receptor 2 (Her-2) gene expression in endometrial cancer (EC).Methods:This research conducted a diagnostic pilot study involving 68 patients with pathologically confirmed EC at the First Hospital of Dalian Medical University from August 2019 to August 2023. Patients were categorized into Her-2-positive group (33 cases) and Her-2-negative group (35 cases) based on postoperative Her-2 gene expression results. Utilizing the APTw and DCE-MRI sequences, quantitative parameters including the asymmetric magnetization transfer ratio (MTR asym) for APTw and the volumetric transfer constant (K trans), plasma volume fraction (V p), extracellular mesenchymal space (V e), and rate constant (K ep) for DCE-MRI were acquired for the lesion site. Statistical differences in the values of each quantitative parameter between the two groups were evaluated using two independent sample t test or Mann-Whitney U test. The study incorporated quantitative parameters and clinicopathological data of patients to identify independent predictors of EC Her-2 gene expression through logistic regression analysis. A diagnostic model was developed using binary logistic regression analysis. The effectiveness of the parameters and diagnostic model was evaluated using receiver operating characteristic curves. DeLong test was used to compare the differences between the areas under the curves (AUC). Results:The study found statistically significant differences in MTR asym, K trans, and V e between the Her-2-positive group and the Her-2-negative group ( Z=2.55, P=0.011; t=-2.03, P=0.047; t=-2.13, P=0.037). However, the differences in V p and K ep were not statistically significant ( Z=0.58, P=0.560; Z=0.19, P=0.849). MTR asym emerged as a significant independent predictor of Her-2 gene expression in EC ( OR=1.016, 95% CI 1.003-1.030, P=0.014). Incorporating MTR asym, K trans, and V e, the diagnostic model yielded an AUC (95% CI) of 0.745 (0.625-0.864). The AUC (95% CI) for MTR asym, K trans, and V e alone were 0.680 (0.551-0.808), 0.623 (0.485-0.760), and 0.656 (0.523-0.789) respectively. The differences in AUC between the diagnostic model and individual predictors MTR asym, K trans, and V e were not found to be statistically significant ( Z=1.40, 1.92, 1.37, P=0.163, 0.055, 0.171). Conclusion:The quantitative parameters of APTw and DCE-MRI sequences can preoperatively assess EC Her-2 gene expression from a different perspective, with MTR asym potentially serving as a valuable independent predictor.

Purpose To explore the application value of 1 024×1 024 reconstruction matrix combined with iterative reconstruction algorithm(Karl)in computed tomography angiography(CTA)of gastric vessels and tumor-supplying arteries.Materials and Methods Thirty patients with gastric tumors who underwent clinical gastric CTA from March to June 2022 at the First Affiliated Hospital of Dalian Medical University were prospectively collected.The original data of CT scan images were grouped and reconstructed.Group A used the conventional 512×512 matrix combined with Karl-5 reconstruction;group B used 1 024×1 024 large reconstruction matrix combined with different levels of Karl algorithm reconstruction,obtaining three subgroups:B1(Karl 5),B2(Karl 7)and B3(Karl 9).The CT and SD values of abdominal aorta at the origin of the left gastric artery,celiac trunk,splenic artery,hepatic artery and the subcutaneous fat tissue of the abdominal wall were measured,and the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated.The image quality of each group was assessed by two observers using a 5-point scale.Results The two observers had good consistency in the evaluation of image quality(Kappa=0.782-0.789,P<0.05).Subjective scores for groups B1 to B3 were all better than those for group A,with the highest score in group B2(two-dimensional scores:χ2=27.309,24.250;three-dimensional scores:χ2=21.964,21.294;all P<0.05).The gastric artery system was involved in tumor blood supply in 25 cases of 30 gastric tumors,with the clarity rate of each vessel in group B2 being superior to group A.There were no statistically significant differences in CT values of vessels between groups A,B1 and B2(t=-1.918-2.720,P>0.05),and apart from the SD of the abdominal aorta and CNR of the hepatic artery,differences in SD values,SNR,CNR,and background noise between group B2 and group A were not significant(t=-5.909-5.768,P>0.05);images from B1 to B3 showed a gradual decrease in SD values(F=2.881-27.109,P<0.05)and a gradual increase in SNR and CNR(F=3.612-12.149,P<0.05)as the level of Karl algorithm increased.Conclusion 1 024×1 024 reconstruction matrix combined with Karl-7 can improve the image quality and enhance the display effect of gastric microvessels and tumor-supplying artery branches,which have good clinical application value.

Purpose To study the changes of white matter microstructure in moderate and severe obstructive sleep apnea-hypopnea syndrome(OSAHS)via synthetic MRI.Materials and Methods A total of 30 patients with moderate and severe OSAHS diagnosed for the first time and 30 healthy controls were prospectively collected in General Hospital of Taiyuan Iron&Steel(Group)Co.,LTD from October 2022 to September 2023.Both groups underwent routine MRI,3D-T1 MPRAGE and synthetic MRI scans.The T1,T2 and proton density(PD)values of multiple white matter regions in the two groups were compared,and the correlation between T1,T2 and PD values in different brain regions and sleep parameters was analyzed.Results Compared with the control group,the T1 value were increased in various white matter regions,including the right cerebral peduncle,cingulate fasciculus,posterior thalamic radiation,external capsule,bilateral internal capsule,corona radiata,superior longitudinal fasciculus and superior frontal-occipital fasciculus(t/Z=-3.267-3.286,all P<0.05).The T2 value of the left inferior cerebellar peduncle was decreased(Z=2.114,P=0.035),and the T2 value of the right posterior thalamic radiation and bilateral external capsule were increased(Z=-2.410,-2.484,-2.306,all P<0.05).Furthermore,the PD value were increased in corpus callosum,left internal capsule,sagittal layer,hippocampus,right posterior thalamic radiation,cingulate fasciculus,bilateral corona radiata and superior longitudinal fasciculus(t/Z=-3.726-2.757,all P<0.05).The apnea hypopnea index of patients with moderate and severe OSAHS was positively correlated with the T1 value(r=0.387,P=0.035)and PD value(r=0.382,P=0.037)of the right cingulate bundle,and there was no correlation between the lowest oxygen saturation and the quantitative parameters in moderate and severe OSAHS(P>0.05).Conclusion Synthetic MRI can sensitively observe the changes of white matter relaxation values in moderate and severe OSAHS,and has high application value in evaluating the damage of white matter in OSAHS.

Objective:To explore potential predictors of refractory Mycoplasma pneumoniae pneumonia (RMPP) in early stage. Methods:The prospective multicenter study was conducted in Zhejiang, China from May 1 st, 2019 to January 31 st, 2020. A total of 1 428 patients with fever >48 hours to <120 hours were studied. Their clinical data and oral pharyngeal swab samples were collected; Mycoplasma pneumoniae DNA in pharyngeal swab specimens was detected. Patients with positive Mycoplasma pneumoniae DNA results underwent a series of tests, including chest X-ray, complete blood count, C-reactive protein, lactate dehydrogenase (LDH), and procalcitonin. According to the occurrence of RMPP, the patients were divided into two groups, RMPP group and general Mycoplasma pneumoniae pneumonia (GMPP) group. Measurement data between the 2 groups were compared using Mann-Whitney U test. Logistic regression analyses were used to examine the associations between clinical data and RMPP. Receiver operating characteristic (ROC) curves were used to analyse the power of the markers for predicting RMPP. Results:A total of 1 428 patients finished the study, with 801 boys and 627 girls, aged 4.3 (2.7, 6.3) years. Mycoplasma pneumoniae DNA was positive in 534 cases (37.4%), of whom 446 cases (83.5%) were diagnosed with Mycoplasma pneumoniae pneumonia, including 251 boys and 195 girls, aged 5.2 (3.3, 6.9) years. Macrolides-resistant variation was positive in 410 cases (91.9%). Fifty-five cases were with RMPP, 391 cases with GMPP. The peak body temperature before the first visit and LDH levels in RMPP patients were higher than that in GMPP patients (39.6 (39.1, 40.0) vs. 39.2 (38.9, 39.7) ℃, 333 (279, 392) vs. 311 (259, 359) U/L, both P<0.05). Logistic regression showed the prediction probability π=exp (-29.7+0.667×Peak body temperature (℃)+0.004×LDH (U/L))/(1+exp (-29.7+0.667×Peak body temperature (℃)+0.004 × LDH (U/L))), the cut-off value to predict RMPP was 0.12, with a consensus of probability forecast of 0.89, sensitivity of 0.89, and specificity of 0.67; and the area under ROC curve was 0.682 (95% CI 0.593-0.771, P<0.01). Conclusion:In MPP patients with fever over 48 to <120 hours, a prediction probability π of RMPP can be calculated based on the peak body temperature and LDH level before the first visit, which can facilitate early identification of RMPP.