Objective To investigate the diagnostic value of the T2WI gray scale ratio for Hashimoto's thyroiditis(HT).Methods The T2WI-iterative decomposition of water and fat with echo asymmetry and least square estimation(IDEAL)quantitation sequence water images of 22 HT cases were analyzed retrospectively.The gray scale ratio of the thyroid,sternocleidomastoid muscle,trachea cavity,and subcutaneous fat at the same layer were measured on the picture archiving and communication systems(PACS).The gray scale ratios of thyroid/sternocleidomastoid muscle(T/M),thyroid/trachea cavity(T/Tr),and thyroid/lipid(T/L)were calculated.The intraclass correlation coefficient(ICC)was used to evaluate the consistency among the measurements,and the optimal threshold for distinguishing HT from non-HT was determined via the receiver operating characteristic(ROC)curve.The Spearman correlation analysis was used to analyze the correlation between T/M,T/Tr,T/L ratios,and titers of thyroid peroxidase antibody(TPO-Ab)and thyroglobulin antibody(Tg-Ab),respectively.Results On the T2WI-IDEAL quantitation sequence water images,the(x)±s of T/M,T/Tr,T/L ratios for HT and non-HT were 2.17±0.47 and 1.62±0.21(t=14.90,P<0.001),9.40±3.24 and 4.87±2.93(t=11.42,P<0.001),1.66±0.32 and 1.21±0.31(t=7.51,P<0.001),respectively.The area under the curve(AUC)of T/M,T/Tr,and T/L ratios for diagnosing HT were 0.89,0.86,and 0.85,respectively;the optimal thresholds were 1.90,3.50,and 1.36,and the sensitivity and specificity were 72.7%and 100%,100%and 40.5%,95.5%and 29.7%,respectively.The T/M ratio had a moderate correlation with TPO-Ab(r=0.513,P<0.05),and T/Tr,T/L ratios had a mild correlation with TPO-Ab,respectively.Conclusion The T/M ratio in the T2WI gray scale ratio can quantitatively and objectively distinguish HT from non-HT to some extent and is correlated with TPO-Ab.It has extremely high specificity and holds promise as a non-invasive imaging method for the diagnosis of incidental HT.

Objective To investigate the effect and mechanism of astragaloside Ⅳ(AS-Ⅳ) activating ROCK/JNK to regulate autophagy in improving isoproterenol (ISO) induced myocardial fibrosis (MF) in mice. Methods The mice were randomly divided into control operation group (Control group), ISO induced myocardial fibrosis group (MF group), AS-Ⅳ treatment group (AS-Ⅳ group) and combination group of astragaloside IV and Y-33075 (ROCK inhibitor) (astragaloside IV+Y-33075 group). After repeated administration for 30 days. The serum levels of LDH, BNP, CTGF in each group were detected. The cardiac function was detected by ultrasound. Myocardial structure and tissue fibrosis degree in each group were detected by Sirius Red and Masson staining. Oxidative stress (ROS) levels in myocardial tissue of each group were detected by DHE staining and the expression of ROCK, JNK, Atg5, Beclin 1, and LC3 Ⅰ/Ⅱ in myocardial tissue were detected by Western blotting. Results Compared with AS-Ⅳ group, the EF value of AS-Ⅳ+Y-33075 group decreased and the degree of myocardial fibrosis increased (P<0.05). The serum level of LDH, BNP, CTGF increased and the level of ROS in myocardial tissue increased while the expression of ROCK, JNK, Atg5, Beclin 1, LC3 Ⅰ/Ⅱ decreased (P<0.05). Y-33075 could block the protective effect of AS-Ⅳ on myocardial injury induced by MF and inhibit the regulation of AS-Ⅳ on ROCK and JNK. Conclusion AS-Ⅳ could attenuate myocardial fibrosis in mice by activating ROCK/JNK signal and promoting autophagy.

With the widespread clinical use of immune checkpoint inhibitors (ICIs), the risk of thrombotic events has also increased, which is related to the poor survival rate. Most studies indicate that ICIs treatment may increase the risk of thrombotic events in tumor patients, but the correlation is still controversial. The incidence and risk factors of thrombotic events are various in different studies. Patients with malignant tumors of lung, skin, and genitourinary system are at high risk of thrombotic events. The clinical types of thrombotic events are mainly pulmonary embolism, myocardial infarction, and deep vein thrombosis. The mortality rate in patients with thrombotic events is high. At present, there are no guidelines or consensus on the management of thrombosis risk related to ICIs. To improve the understanding of these adverse effects in clinic, this article reviews the correlation between ICIs and thrombotic events, and the incidence, risk factors, pathogenesis, prevention, and treatment of relevant thrombotic events.

With the widespread clinical use of immune checkpoint inhibitors (ICIs), the risk of thrombotic events has also increased, which is related to the poor survival rate. Most studies indicate that ICIs treatment may increase the risk of thrombotic events in tumor patients, but the correlation is still controversial. The incidence and risk factors of thrombotic events are various in different studies. Patients with malignant tumors of lung, skin, and genitourinary system are at high risk of thrombotic events. The clinical types of thrombotic events are mainly pulmonary embolism, myocardial infarction, and deep vein thrombosis. The mortality rate in patients with thrombotic events is high. At present, there are no guidelines or consensus on the management of thrombosis risk related to ICIs. To improve the understanding of these adverse effects in clinic, this article reviews the correlation between ICIs and thrombotic events, and the incidence, risk factors, pathogenesis, prevention, and treatment of relevant thrombotic events.

Objective To illustrate the semiological characteristics of the three sub-types within the broad bilateral asymmetric tonic seizures (BATS),summarize their predictive values on lateralization and localization of seizure onset zone (SOZ),and analyze the difference between BATS and asymmetrical tonic limb posturing (ATLP).Methods A retrospective review of 385 patients who underwent stereotactic electrode implantation in the Sanbo Brain Hospital,Capital Medical University from September 2011 to May 2018 was performed.As long as there was a clinical epileptic seizure in the presence of BATS or ATLP,the patients were classified into the corresponding groups.Postoperative prognosis was assessed using Engel's grading criteria for a follow-up of no less than six months.Seizure descriptions were based on the classification of epileptic seizures introduced by Lüiders,which used arrows to connect the symptoms in chronological order.Results There was no statistically significant difference between the classic BATS and bilateral proximal tonic seizure in terms of whether it could be an independent seizure,as the onset and end of the seizure,with version and generalized tonic-clonic seizure (P＞0.05).Compared with the ATLP,except for whether it could be an independent seizure (P=1.000) and onset before versive seizure (P=0.068),the BATS showed significantly different semiological features (P＜0.05).The classic BATS and secondary motor area epilepsy had a 100.0％ predictive accuracy on the lateralization of SOZ.In the patients with broad BATS,the SOZ distribution was more extensive,but it was rare in the orbitofrontal gyrus,frontal pole and mesial temporal lobe.Compared with the bilateral proximal tonic seizures from the other regions,those originated from supplementary somatosensory motor area and its adjacent areas were rare and showed no statistically significant difference (0/8 vs 40.0％ (18/45),x2=3.226,P=0.072) but a low trend.The predictive value of BATS on lateralization of SOZ was higher than that of ATLP (84.9％ (45/53) vs 57.1％ (24/42),x2=9.086,P=0.003),and BATS was less originated from temporal lobe than ATLP (3.8％ (2/53) vs 23.8％ (10/42),x2=8.523,P=0.004).Conclusion Different from ATLP,the broad BATS are characterized by tonic proximal upper limb posturing,and have a higher predictive value on lateralization and localization of SOZ.

BACKGROUND AND PURPOSE: Both genetic factors and smoking are associated with ischemic stroke (IS) risk. However, little is known about the potential interaction of these factors. We aimed to assess whether smoking and a positive family history interact to increase the risk of IS. METHODS: The nationwide prospective study recruited 210,000 men and 300,000 women in 2004 to 2008 at ages 30 to 79 years. During 9.7 years of follow-up, we documented 16,923 and 20,656 incident IS cases in men and women without major chronic diseases at baseline, respectively. Multivariable Cox regression models were used to examine associations between family history and IS. Likelihood ratio tests were used to test the smoking-family history interactions on IS. RESULTS: About 67.8% (n=135,168) of men ever smoked regularly compared with 2.7% (n=7,775) of women. Among men, a significant interaction between family history and smoking on IS was observed (P for interaction=0.03), with more pronounced association between family history and IS among ever-regular smokers (hazard ratio [HR], 1.21; 95% confidence interval [CI], 1.16 to 1.27) than among never-smokers (HR, 1.11; 95% CI, 1.01 to 1.23). The association between family history and IS among ex-smokers after more than 10 years of cessation (HR, 1.01; 95% CI, 0.85 to 1.20) appeared similar to that among never-smokers. Among women, a similar but not significant interaction between family history and smoking on IS was observed. Ever-regular smokers who had a family history of stroke had the highest risk of IS. CONCLUSIONS: Among Chinese men, the association of family history with IS was accentuated by smoking, and such accentuation tended to be lowered by cessation.
Asian Continental Ancestry Group ; Chronic Disease ; Cohort Studies ; Family Health ; Female ; Follow-Up Studies ; Gene-Environment Interaction ; Humans ; Male ; Prospective Studies ; Smoke ; Smoking ; Stroke ; Tobacco

Objective To explore the rehabilitation effect of emergency whole-course optimized nursing in the first aid of patients with acute myocardial infarction (AMI).Methods A total of 94 patients with AMI treated in our hospital from October 2014 to October 2016 were divided into observation group and control group according to the order of admission, with 47 cases in each group.Patients in the control group were given routine nursing, and patients in the observation group were given emergency whole-course optimized nursing.The time of first aid and rehabilitation effects were compared between the two groups.Results The time of triage evaluation, time of venous blood collection, time of establishing venous access, time of emergency operation, total time of emergency treatment and the length of hospital stay in the observation group were significantly shorter than those in the control group (P<0.05).After treatment, LVEF, LVEDV, LVFS and other cardiac function levels in the two groups were significantly improved (P<0.05).And levels of LVEF and LVFS were significantly higher and LVEDV level was significantly lower in the observation group than the control group (P<0.05).The recurrence rate of AMI in the observation group was significantly lower than that in the control group (P<0.05).The re-operation rate of percutaneous coronary intervention surgery (PCI) was significantly lower in the observation group than the control group (10.64% vs.27.66%) (P<0.05).Conclusion The application of whole-course optimized nursing in AMI patients can guarantee the smooth implementation of rescue, effectively shorten the time of first aid, save the ischemic myocardium, ensure smooth operation, improve the success rate of first aid, and significantly improve the prognosis of patients.

Objective To investigate the prevalence and cardiovascular risk factors of silent brain infarct (SBI) in Shunyi Cohort.Methods This study was based on the population based Shunyi Study in China.One thousand and twenty-seven stroke-free participants older than 35 years,who completed cerebral MRI,were included.Cardiovascular risk factors were assessed by interview,physical examination and blood sample tests.SBI was evaluated on 3D-T1WI,T2WI and FLAIR sequences.Associations between risk factors and SBI were analyzed by Logistic regression and adjusted for age,sex,and relevant confounders.Results One thousand and twenty-seven participants,aged (55.9 ± 9.4) years,37.7％ male,were assessed.One hundred sixty-four participants(16.0％) had SBI on MRI.The prevalence of SBI increased by age (every 10 years,OR=2.12,95％ CI 1.74-2.58,P＜0.01).Hypertension(OR =2.67,95％ CI 1.77-4.04,P＜0.01),diabetes(OR=2.48,95％ CI 1.64-3.76,P＜0.01) and smoking(OR=1.98,95％ CI 1.08-3.62,P =0.028) were significantly associated with SBI.Conclusions The prevalence of SBI in this Chinese population is 16.0％,which increases with age.Hypertension,diabetes and smoking are associated with SBI.

Objective To explore the rehabilitation effect of emergency whole-course optimized nursing in the first aid of patients with acute myocardial infarction (AMI).Methods A total of 94 patients with AMI treated in our hospital from October 2014 to October 2016 were divided into observation group and control group according to the order of admission, with 47 cases in each group.Patients in the control group were given routine nursing, and patients in the observation group were given emergency whole-course optimized nursing.The time of first aid and rehabilitation effects were compared between the two groups.Results The time of triage evaluation, time of venous blood collection, time of establishing venous access, time of emergency operation, total time of emergency treatment and the length of hospital stay in the observation group were significantly shorter than those in the control group (P<0.05).After treatment, LVEF, LVEDV, LVFS and other cardiac function levels in the two groups were significantly improved (P<0.05).And levels of LVEF and LVFS were significantly higher and LVEDV level was significantly lower in the observation group than the control group (P<0.05).The recurrence rate of AMI in the observation group was significantly lower than that in the control group (P<0.05).The re-operation rate of percutaneous coronary intervention surgery (PCI) was significantly lower in the observation group than the control group (10.64% vs.27.66%) (P<0.05).Conclusion The application of whole-course optimized nursing in AMI patients can guarantee the smooth implementation of rescue, effectively shorten the time of first aid, save the ischemic myocardium, ensure smooth operation, improve the success rate of first aid, and significantly improve the prognosis of patients.