Objective:To evaluate the performance of deep learning reconstruction (DLR) in visualizing lenticulostriate arteries (LSAs) on cerebral CT angiography (CTA).Methods:This cross-sectional study retrospectively analyzed cerebral CTA from 38 patients who underwent cerebral CTA at the Fourth Affiliated Hospital of Harbin Medical University between January and December 2023. Images were reconstructed using filtered back projection (FBP), three-dimensional adaptive iterative dose reduction (AIDR), and DLR-advanced inteuigent clear-IQ engine(AiCE) algorithms (FBP group, AIDR group, DLR-AiCE group). On axial images, the mean CT values, standard deviation (SD), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured at the origin of LSAs, cerebrospinal fluid in lateral ventricles, temporal muscle, and head of the caudate nucleus. Subjective evaluations were performed for overall vascular visualization and LSAs delineation. Comparisons of subjective and objective evaluation indexes among the 3 groups were performed using the complex measurement ANOVA, Friedman test, or χ2 test. Results:The CT, SD, SNR and CNR values at the origin of LSAs, cerebrospinal fluid in lateral ventricles, temporal muscle, and head of the caudate nucleus demonstrated statistically significance among DLR-AiCE group, AIDR group and FBP group ( P<0.001), in which, except for the difference between the FBP group and the AIDR group in the CT value of the head of the caudate nucleus and the CT value of the cerebrospinal fluid of the lateral ventricle which was not statistically significant ( P>0.05), the remaining pairwise comparisons between the groups for each site measurements were statistically significant ( P<0.001). The difference in the overall comparison of the subjective scores of the overall vessels and LSAs in the images of the DLR-AiCE group, the AIDR group, and the FBP group was statistically significant ( P<0.001), and the two-by-two comparisons showed a statistically significant difference ( P<0.001) except for the difference in the subjective scores of LSAs between the FBP group and the AIDR group. Conclusion:The DLR-AiCE algorithm significantly reduces image noise and improves image quality, enabling superior visualization of LSAs, thereby enhancing diagnostic confidence.

Objective:To evaluate the performance of deep learning reconstruction (DLR) in visualizing lenticulostriate arteries (LSAs) on cerebral CT angiography (CTA).Methods:This cross-sectional study retrospectively analyzed cerebral CTA from 38 patients who underwent cerebral CTA at the Fourth Affiliated Hospital of Harbin Medical University between January and December 2023. Images were reconstructed using filtered back projection (FBP), three-dimensional adaptive iterative dose reduction (AIDR), and DLR-advanced inteuigent clear-IQ engine(AiCE) algorithms (FBP group, AIDR group, DLR-AiCE group). On axial images, the mean CT values, standard deviation (SD), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured at the origin of LSAs, cerebrospinal fluid in lateral ventricles, temporal muscle, and head of the caudate nucleus. Subjective evaluations were performed for overall vascular visualization and LSAs delineation. Comparisons of subjective and objective evaluation indexes among the 3 groups were performed using the complex measurement ANOVA, Friedman test, or χ2 test. Results:The CT, SD, SNR and CNR values at the origin of LSAs, cerebrospinal fluid in lateral ventricles, temporal muscle, and head of the caudate nucleus demonstrated statistically significance among DLR-AiCE group, AIDR group and FBP group ( P<0.001), in which, except for the difference between the FBP group and the AIDR group in the CT value of the head of the caudate nucleus and the CT value of the cerebrospinal fluid of the lateral ventricle which was not statistically significant ( P>0.05), the remaining pairwise comparisons between the groups for each site measurements were statistically significant ( P<0.001). The difference in the overall comparison of the subjective scores of the overall vessels and LSAs in the images of the DLR-AiCE group, the AIDR group, and the FBP group was statistically significant ( P<0.001), and the two-by-two comparisons showed a statistically significant difference ( P<0.001) except for the difference in the subjective scores of LSAs between the FBP group and the AIDR group. Conclusion:The DLR-AiCE algorithm significantly reduces image noise and improves image quality, enabling superior visualization of LSAs, thereby enhancing diagnostic confidence.

OBJECTIVES: Electroacupuncture can enhance autophagic flow, promote neuronal regeneration, axonal and myelin remodeling to achieve the protection of spinal cord injury, but its role in neurogenic urine retention is not completely clear. This study aims to investigate whether the mechanism of electroacupuncture in the treatment of neurogenic urine retention is through autophagy mediated by adenosine monophosphate activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR) pathway. METHODS: A rat model of neurogenic urine retention after sacral spinal cord injury was established. The rats with successful model were randomly divided into a model group, an electroacupuncture group (electro-acupuncture for Ciliao, Zhongji, and Sanyinjiao by electronic stimulation, once a day, 20 min each time for 7 days), and an electroacupuncture+AMP-activated protein kinase (AMPK) inhibitor group (on the basis of the treatment of electroacupuncture group, 100 μg of AMPK inhibitor compound C was injected intramuscularly around the L_2-3 intervertebral space on the 1st and 4th day). The normal group did not receive any treatment. The maximum bladder volume, bladder basal pressure, leak point pressure, and bladder compliance were recorded by multi-channel physiological recorder; the morphology of bladder tissue was observed by HE staining; autophagy was observed under transmission electron microscope; the expressions of LC3II and Beclin1 protein were observed by immunofluorescence staining; the protein levels of AMPK, phosphorylated-AMPK (p-AMPK), mTOR, phosphorylated-mTOR (p-mTOR), microtubule associated protein 1 light chain 3 (LC3) II and Beclin1 in bladder tissue were detected by Western blotting. RESULTS: Compared with the normal group, the maximum bladder capacity, leak point pressure, bladder compliance, p-AMPK, LC3II, Beclin1 protein expressions in the bladder tissue of the model group increased, and the p-mTOR protein expressions were decreased (all P<0.05); compared with the model group, the maximum bladder capacity, bladder compliance, p-mTOR protein expression in the bladder tissue of the electroacupuncture group were decreased, and the p-AMPK, LC3II, and Beclin1 protein expressions were increased (all P<0.05); compared with the electroacupuncture group, the maximum bladder capacity, bladder compliance, p-mTOR protein expression in the bladder tissue of the electroacupuncture+AMPK inhibitor group were increased, the p-AMPK, LC3II, and Beclin1 protein expressions were decreased (all P<0.05). In the model group, the bladder became larger, with unclear and varying degrees of degeneration, severe tissue damage and autophagosome appeared; the bladder of the electroacupuncture group was smaller than that of the model group, and all levels were clearly visible with autophagy bodies; the layers were slightly disordered and damaged in the electroacupuncture + AMPK inhibitor group. CONCLUSIONS Electroacupuncture can activate autophagy through AMPK/mTOR pathway, thereby reducing neurogenic urine retention caused by spinal cord injury.
AMP-Activated Protein Kinases ; Animals ; Autophagy ; Beclin-1 ; Electroacupuncture ; Mammals ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; TOR Serine-Threonine Kinases

This paper aims to detect the antigens in porcine circovirus type 2 (PCV2) vaccines by high-performance size-exclusion chromatography (HPSEC) coupled with multi-angle laser light scattering (MALLS). With purified inactivated PCV2 and PCV2 virus-like particles (VLP) as references, two inactivated vaccines (a and b) and two VLP vaccines (c and d) for PCV2 from four manufacturers were analyzed by HPSEC-MALLS after demulsification. The antigen peaks in HPSEC-MALLS were identified by PCV2 antigen test strips, Western blotting and transmission electron microscope (TEM). The repeatability and linearity of the method were investigated. The results showed the virus antigens in the two inactivated vaccines were eluted at about 13.3 min in HPSEC. The molecular weight of these antigens was 2.61×10⁶ (±4.34%) Da and 2.40×10⁶ (±2.51%) Da, respectively, as calculated by MALLS. The antigen peaks of the two VLP vaccines also appeared at 13.3 min and the molecular weight was 2.09×10⁶ (±2.94%) Da and 2.88×10⁶ (±11.85%) Da, respectively, which was close to the theoretical molecular weight of PCV2. Moreover, an antigen peak of VLP vaccine c was observed at 11.4 min and the molecular weight was 4.37×10⁶ (±0.42%) Da. The antigen was verified to be the dimer of VLP by TEM. Vaccine d and purified Cap VLP antigens were tested repeatedly, and the RSD of the peak area (n=3) was all < 1.5%, indicating that the method was repeatable. The purified VLP were diluted in serial and tested for linearity. The result suggested good linear relationship between the peak area of VLP or VLP aggregates and the protein concentration of the sample with R² of 0.999 and 0.997, respectively. Thus, the method met the requirement for quantification and aggregate analysis. This method is accurate and efficient in in vitro quality evaluation and improvement of PCV2 vaccine.
Animals ; Antibodies, Viral ; Capsid Proteins ; Chromatography, Gel ; Circoviridae Infections/prevention & control* ; Circovirus ; Lasers ; Swine ; Vaccines, Inactivated ; Vaccines, Virus-Like Particle ; Viral Vaccines

ObjectiveTo investigate the characteristics of polysomnography （PSG） in depression patients complicating moderate-to-severe obstructive sleep apnea hypopnea syndrome （OSAHS）. MethodsA retrospective analysis was conducted on the outpatients， inpatients and physical examination population who completed overnight PSG monitoring in the sleep medicine center of Suzhou Guangji Hospital from December 2017 to October 2019. Four groups of subjects were finally enrolled， including depression patients with moderate-to-severe OSAHS （n=31）， depression patients without OSAHS （n=79）， moderate-to-severe OSAHS patients （n=96） and normal control group （n=32）. The sleep process related indicators （total sleep time， sleep latency， number of awakenings）， sleep structure related indicators （N1， N2， N3， percentage of REM sleep， REM latency， REM sleep duration）， sleep-related respiratory variables （oxygen reduction index） and other polysomnographic parameters of the four groups were compared. ResultsIn terms of sleep process， the total sleep time， sleep latency and number of awakenings yielded significant differences among the four groups （F=2.874， 3.959， 12.291， P<0.05 or 0.01）. In terms of sleep structure， the percentage of total sleep time in N2 and N3 stages demonstrated significant differences among the four groups （F=13.885， 48.013， P<0.01）. The REM latency， REM sleep duration and percentage of REM sleep manifested significant differences among the four groups （F=41.492， 11.827， 10.552， P<0.01）. In terms of sleep-related respiratory variables， the oxygen reduction index exhibited significant differences among the four groups （F=170.585， P<0.05）. ConclusionDepression patients complicating moderate-to-severe OSAHS suffer from severe sleep process and structural disturbances， accompanied by quite frequent and severe sleep-related respiratory events.

Objective Toanalyzetheclinicalefficiencyofendovascularinterventionaltherapyinthetreatmentofsolitarykidney withrenalaneurysm.Methods FromJune2014toDecember2017,7casesofsolitarykidneypatientscombinedwithrenalaneurysm werecollected,including4casesofrenalaneurysmlocatedinthemainrenalartery,1caseinrenalsegmentalarteryand2casesinthe renalparenchyma.4casesofmainrenalarteryaneurysmsweretreatedwithstentimplantation;1caseofrenalsegmentalarteryaneurysm was treatedwithstent-assistedcoilembolization;2casesofrenalparenchymaaneurysm wererespectivelytreatedwithpolyvinylalcohol (PVA)embolizationandPVA withcoilembolization.After1month,3months,6monthsandevery6months,therenaldopplerexamination,blood routine,urineroutine,renalfunctionandotherbiochemicalexaminationswerereviewed,andrenalarterialCTAorrenalangiographywereperformed whennecessary.Results Thesuccessrateofoperationwas100%in7solitarykidneypatientswithrenalaneurysm,andtheaneurysmswere graduallyreducedafteroperationwithoutseriousadversereactionsandcomplications.Norecanalizationorrecurrenceofrenalaneurysmwasfound duringthefollow-up,andtherenalfunctionwasbetterthanbefore.Conclusion Endovascularinterventionaltherapyinthetreatment ofsolitarykidneywithrenalaneurysmisminimallyinvasiveandlessrisky.Anditismoretargetedandflexibleforthetreatmentof solitarykidneywithdifferenttypesofrenalaneurysm.

Objective To study the operational techniques and feasibility of superior rectal artery preserving laparoscopic resection of sigmoid colon carcinoma.Methods From Jan 2015 to Nov 2016,85 patients with sigmoid colon carcinoma were divided into artery preserving group (27 cases) and traditional surgical group (58 cases).Results The mean operation time was (283 ± 51) min,the mean lymph node dissection was (15 ± 8) and the mean blood loss was (62 ± 17) ml in the artery preserving group.The mean operation time was (179 ±e63) min,the mean lymph node dissection was (15 ±7) and the mean blood loss was (67 ± 17) ml in the traditional surgery group.The number of resected lymph nodes and blood loss had no statistical significance between these two groups (t =0.058,P ＞0.05).Longer operating time were observed in the retained vascular group as compared to the traditional surgical group (t =7.530,P ＜ 0.05).There was no anastomotic fistula in the retained vascular group,however,two anastomotic fistula cases occurred in the traditional surgical group (x2 =0.043,P ＞ 0.05).Conclusions Preservation of superior rectal artery was safe and feasible for laparoscopic resection of sigmoid colon carcinoma.

Objective To evaluate the clinical efficacy of combination of transjugular intrahepatic portosystemic shunt (TIPS) and catheter-directed thrombolysis (CDT) in the treatment of acute portal vein thrombosis (PVT) accompanied by Budd-Chiari syndrome (BCS) with extensive occlusion of the hepatic veins.Methods From March 2013 to December 2015,nine patients of acute PVT accompanied by BCS with extensive occlusion of the hepatic veins were collected,and the patients were treated by the combination of TIPS and CDT.The clinical symptoms,liver function and portal vein hemodynamics of patients were observed.After operation,portal vein and shunt patency was followed up by Doppler ultrasound.The patients were followed up seven days,one,three,six months,and every six months after the operation.Paired sample t test was performed for statistically analysis.Results The study enrolled nine patients,six male and three female,with an average age of (41.6 ± 10.9) years old.Operation was successfully performed in eight patients,and of whom three were completed under the assist of perctaneous transhepatic approach.After operation,the blood flow of portal vein was unobstructed and clinical symptoms of portal vein hypertension were obviously improved.There was no significant difference in portal vein diameter between pre-operation ((13.6 ± 2.1) cm) and seven days ((12.5±1.7) cm),one month ((12.1±2.9) cm),three months ((12.9±3.2) cm),six months ((11.6± 1.8) cm) after operation (all P＞0.05).And the portal vein velocity after operation were (79.3± 14.6),(84.4±17.3),(87.3±21.4) and (80.1±12.6) cm/s,respectively,which were higher than that before operation ((9.8 ± 3.1) cm/s),and the differences were statistically significant (t=28.169,34.713,36.519,30.314,all P＜0.01).The maximum cross sectional area ratios of the thrombus to the lumen after operation were (17.1±6.9)％,(19.1±6.2)％,(16.2±±5.5)％ and (16.7±5.1)％,respectively,which were lower than that before operation ((78.2 ±14.5)％),and the differences were statistically significant (t=26.182,23.931,29.371,27.471,all P＜0.01).At the seventh day after operation,the pressure of portal vein decreased from (42.2±8.9) cmH2O (1 cmH2O=0.098 kPa) to (19.6±4.2) cmH2O (t=17.410,P＜0.01).At seven days,one month,three months and six months after operation,albumin levels ((30.7±3.9),(30.9±4.2),(29.9±3.1) and (33.1±4.7) g/L) were all higher than that before operation ((26.5 ± 4.8) g/L),and the differences were statistically significant (t =4.785,4.874,2.874,5.402,all P＜0.05).The levels of transaminase after operation (32.9±21.6),(39.5±22.4),(24.8± 19.8),(37.1±26.9) U/L) were all lower than that before operation ((99.6±31.7) U/L),and the differences were statistically significant (t=27.624,24.913,33.671 and 25.019,all P＜0.01).During eight to 17 months follow-up,TIPS stent shunt stenosis was found in one case at three months after operation and the blood flow recovered after treatment of balloon dilation.The shunt and blood flow of portal vein of the other seven cases were clear.None of the eight patients had the symptoms of hepatic encephalopathy and pulmonary embolism.Operation was not successfully performed in one case,and 29 days later the patient died of hepatic and renal failure.Conclusion The combination of TIPS and CDT is safe and effective in the treatment of acute PVT accompanied by BCS with extensive occlusion of the hepatic veins,which maintain the blood flow of portal vein clear during short-and medium-term follow-up.

Objective To evaluate the clinical effect of endovascular interventional therapy in treating Cockett syndrome associated with deep vein thrombosis (DVT) of left lower extremity.Methods The clinical data of a total of 256 patients with Cockett syndrome complicated by DVT of left lower extremity,who were admitted to authors' hospital during the period from January 2011 to January 2015,were retrospectively analyzed.The patients were treated with catheter-directed thrombolysis,balloon dilatation of the occluded or narrowed venous segment,and/or stent implantation.The circumference differences of the affected limbs before and after treatment and the long-term patency rates were compared.Results Of the 256 patients with Cockett syndrome complicated by DVT of left lower extremity,complete dissolution of thrombus was achieved in 232 (90.6％) and partial dissolution of thrombus in 24 (9.4％).The circumference difference of thigh and calf was (7.12±2.15) and (4.57±2.81) cm respectively before and after treatment.Iliac vein reconstruction was carried out in 206 patients,among them simple balloon dilatation was employed in 46 and balloon dilatation together with stent implantation was adopted in 160.The patients were followed up for 9-24 months with a mean of 15 months.In simple balloon dilatation group,3 patients lost touch with the authors during the following-up period,26 patients (60.5％) developed iliac vein occlusion and post-embolization syndrome occurred in 21 patients (48.8％).In balloon dilatation plus stent implantation group,11 patients lost touch with the authors during the following-up period,stenosis or occlusion of the stent was seen in 13 patients (8.7％),post-embolization syndrome was observed in 15 patients (10.1％).The differences in vascular stenosis or occlusion and in the occurrence of post-embolization syndrome between the two groups were statistically significant (P＜0.001).Conclusion For the treatment of Cockett syndrome complicated by DVT of left lower extremity,catheter-directed thrombolysis and balloon dilatation combined with stent implantation carry definite clinical curative effect.

Objective: To explore prognostic significance of early assessment of minimal residual leukemia (MRD) in adult patients with de novo acute myeloid leukemia (AML) with mutated NPM1. Methods: The response, NPM1 mutated transcript level after induction chemotherapy and the first 2 cycles of consolidation chemotherapy, disease-free survival (DFS) and overall survival (OS) in 137 patients with AML with NPM1 mutations of A, B and D were retrospectively analyzed. Results: Data of 137 patients were collected, 67 were male, the median age was 49 years (16-67 years) , 107 (78.1%) had normal karyotype, 57 (41.6%) had positive FLT3-ITD mutation, the median NPM1 mutated transcript level at diagnosis was 84.1%. Among the 134 evaluable patients, 115 (85.8%) achieved a complete remission (CR) . Multivariate analyses revealed that WBC<100×10⁹/L (OR=0.3, 95% CI 0.1-0.9, P=0.027) and first induction therapy with "IA10" protocol (OR=0.3, 95% CI 0.1-0.8, P=0.015) were factors associated with achieving a CR. With a median follow-up period of 24 months (range, 2 to 91 months) in 77 survived CR patients, the probabilities of DFS and OS at 3 years were 48.0% and 63.9%, respectively. Multivariate analyses showed that positive FLT3-ITD (HR=3.2, 95% CI 1.6-6.7, P=0.002) , high MRD level after 2 cycles of consolidation chemotherapy (NPM1 mutation transcript level <3-log reduction from the individual baseline, HR=23.2, 95% CI 7.0-76.6, P<0.001) and chemotherapy or autologous hematopoietic stem cell transplantation (auto-HSCT) rather than allogeneic HSCT (allo-HSCT) (HR=2.6, 95% CI 1.0-6.6, P=0.045) were the unfavorable factors affecting DFS, high MRD level at the time of achieving the first CR (NPM1 mutation transcript level <2-log reduction from the individual baseline, OR=2.5, 95% CI 1.0-6.1, P=0.040) and after 2 cycles of consolidation chemotherapy (HR=4.5, 95% CI 2.0-10.3, P<0.001) were the unfavorable factors affecting OS. Furthermore, DFS and OS rates at 3 years in those receiving chemotherapy or auto-HSCT were 39.7% and 59.1%, respectively; positive FLT3-ITD and high MRD level after 2 cycles of consolidation chemotherapy were independent factors associated with both shorter DFS (HR=3.5, 95% CI 1.6-7.6, P=0.002 and HR=8.9, 95% CI 3.8-20.7, P<0.001) and OS (HR=2.7, 95% CI 1.1-6.9, P=0.036 and HR=3.1, 95% CI 1.2-8.0, P=0.021) ; meanwhile, high MRD level at the time of achieving the first CR associated with shorter OS (HR=3.1, 95% CI 1.2-8.0, P=0.022) . Conclusion Positive FLT3-ITD mutation and high MRD level after induction or consolidation chemotherapy associated with poor outcomes in AML patients with mutated NPM1.