Purpose To demonstrate the advantages of non-contrast-enhanced whole-heart coronary magnetic resonance angiography(NCE-CMRA)in evaluating coronary arteries by comparing ultrasonography(US),and to explore the clinical value of NCE-CMRA in the diagnosis of coronary artery lesions of Kawasaki disease(KD)in children.Materials and Methods NCE-CMRA and US imaging data of 41 children with KD from June 2017 to June 2021 who were diagnosed clinically in Lanzhou University Second Hospital were analyzed retrospectively.The display ability of US and NCE-CMRA in coronary arteries were compared.At the same time,the imaging characteristics of NCE-CMRA were analyzed,and the imaging characteristics such as the range and degree of coronary artery lesions displayed by NCE-CMRA were summarized.Results The overall segment display rate of NCE-CMRA in 41 children with KD was 75.6%;the overall segment display rate of US was 46.3%,with statistical difference between the two techniques(χ2=59.04,P<0.001).Regarding the display of the middle and distal segments of coronary arteries,NCE-CMRA had a clear imaging advantage over US(χ2=57.98 and 161.47,P<0.001).In all cases,25 patients(200 segments)had coronary artery lesions,and 94 segments of coronary artery showed different degrees of dilatation,including 8 segments(8.6%)of giant coronary artery aneurysm,35 segments(37.2%)of medium coronary artery aneurysm,and 51 segments(54.2%)of small coronary artery aneurysm or coronary artery dilation.Conclusion NCE-CMRA technology can objectively and accurately display coronary artery in children,and it can specifically evaluate the degree of damage caused by KD.It has important clinical significance in the diagnosis and evaluation of coronary artery lesions in children with KD.

Recent advancements in the field of medical artificial intelligence (AI) have led to the widespread adoption of foundational and large language models. This review paper explores their applications within medical AI, introducing a novel classification framework that categorizes them as disease-specific, general-domain, and multi-modal models. The paper also addresses key challenges such as data acquisition and augmentation, including issues related to data volume, annotation, multi-modal fusion, and privacy concerns. Additionally, it discusses the evaluation, validation, limitations, and regulation of medical AI models, emphasizing their transformative potential in healthcare. The importance of continuous improvement, data security, standardized evaluations, and collaborative approaches is highlighted to ensure the responsible and effective integration of AI into clinical applications.

Objective:To construct a special training program for oncology nurses on immunotherapy, and to lay the foundation for the promotion of standardized care of immunotherapy.Methods:The first draft of the immunotherapy training program for oncology nurses was initially constructed through literature review and semi-structured interviews; the final draft of the immunotherapy training program for oncology nurses was determined by using the Delphi expert correspondence method from October to December, 2023.Results:Two rounds of expert correspondence were conducted, and the effective recovery rates of the questionnaires were 15/15, with the expert authority coefficients of 0.847 and 0.867, and Kendall harmony coefficients of 0.207 and 0.212, respectively (both P<0.01). The final established special training program for immunotherapy for oncology nurses included 3 primary indicators, 17 secondary indicators, and 58 tertiary indicators. Conclusions:The construction process of the special training program for oncology nurses′immunotherapy is rigorous and scientific, with obvious speciality characteristics, which can provide a feasible program for the training of oncology nurses′immunotherapy nursing.

Objective:To understand the status, evaluation methods and risk factors of economic toxicity in patients with head and neck cancer, in order to provide reference for the construction of follow-up intervention programs.Methods:This scoping review was conducted under the Joanna Briggs Institute in Australia guidelines. Relevant studies were searched in PubMed, Embase, Web of Science, Cochrane Library, Scopus, CINAHL, China National Knowledge Infrastructure, Wanfang Database, VIP Database and Chinese Biomedical Literature Database. Chinese and English literature was screened and summarized from inception to September 21, 2023.Results:A total of 14 articles were included, and the economic toxicity of patients with head and neck cancer was more serious.The evaluation methods were mainly divided into scale evaluation and database data calculation. The risk factors of economic toxicity in patients with head and neck cancer included three aspects: demographic factors such as young age, low education and low income; disease and treatment-related factors such as tumor location in larynx/hypopharynx, current/past use of tube feeding, advanced tumor/distant metastasis; social support factors such as insufficient social security, and so on.Conclusions:Future studies should pay more attention to economic toxicity in patients with head and neck cancer, standardize the selection of assessment tools to reduce heterogeneity, and develop individualized intervention measures for the risk factors of economic toxicity in patients with head and neck cancer, in order to reduce the occurrence of economic toxicity in patients with head and neck cancer.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Norovirus is the global leading cause of epidemic and endemic acute gastroenteritis in people of all ages.To inves-tigate the genetic diversity of GⅡ genogroup noroviruses linked to clustered infections in northeast Chongqing,we collected anal swabs or environmental smears from 11 norovirus outbreaks during 2021-2022.Norovirus RNA was detected by quantitative real-time PCR(qRT-PCR),and partial viral RdRp/capsid genes were amplified by reverse transcription PCR(RT-PCR)and sequenced.Among samples from 11 outbreaks in 4 districts and counties,55 strains of GⅡ genogroup norovirus were detected.Six genotypes were identified with an online norovirus genotyping tool(http://www.rivm.nl/mpf/norovirus/typingtool).Genotype GⅡ.17[P17]was associated with four outbreaks;the co-circulating GⅡ.17[P17]and GⅡ.1[P16]caused another out-break;GⅡ.6[P7]and GⅡ.8[P8]respectively were linked to two outbreaks;and GⅡ.3[P12]and GⅡ.2[P16]respectively ac-counted for one outbreak.Phylogenetic analysis also indicated that 55 GⅡ genogroup strains formed five clusters,with norovir-uses of identical genotypes from diverse events belonging to the same cluster,and that genetically distinct genotypes from di-verse events belonged to different clusters.Therefore,our results revealed that multiple genotypes associated with norovirus outbreaks were circulating in northeast Chongqing,and GⅡ.17[P17]was the predominant genotype linked to these out-breaks during 2021-2022.Most norovirus outbreak events were caused by single sources,and genetic relationships were demonstrated among noroviruses of identical genotypes from diverse events.

Vaccination is a main measure for protecting chickens against Marek's disease,while it is not able to suppress the infection,proliferation,transmission,and virulence enhancement on Marek's disease virus.Inhibiting the proliferation of Marek's disease virus in chicken is therefore an im-portant option for enhancing defense effectiveness.In this study,a compound,DUBs-IN-1,was found to inhibit the activity of MDV049,a protease encoded by Marek's disease virus,via screening a protease inhibitor library using MDV049 as target and ubiquitin probe.Molecular docking re-vealed that DUBs-IN-1 can interact with the residues which formed the catalytic pocket of MDV049,blocking the interaction between Ub substrate and the catalytic center of MDV049,then suppress the activity of MDV049 with competitive inhibition.Using the CPE model,it was found that DUBs-IN-1 at the concentration of 0.35 and 0.70 μmol/L significantly inhibited the CPE in-duced by Marek's disease virus in CEF cells.Quantitative analysis revealed that DUBs-IN-1 inhibi-ted the proliferation of Marek's disease virus in CEF cells(P＜0.01).Furthermore,it was found that the administration of 80 and 150 pg/(kg·d)of DUBs-IN-1 in chicken infected by Marek's disease virus significantly inhibited the proliferation of MDV in T cells(P＜0.01).In summary,this study demonstrated that the compound DUBs-IN-1 is able to inhibit the proliferation of Marek's disease virus in chicken cells,laying a theoretical and practical foundation for further de-velopment of the drugs against Marek's disease virus.

Objective:To explore the role of NK cells in allogeneic hematopoietic stem cell micro-transplantation(MST)in the treatment of patients with acute myeloid leukemia(AML).Methods:Data from 93 AML patients treated with MST at our center from 2013-2018 were retrospectively analyzed.The induction regimen was anthracycline and cytarabine combined with peripheral blood stem cells transplantation mobilization by granulocyte colony stimulating factor(GPBSC),followed by 2-4 courses of intensive treatment with medium to high doses of cytarabine combined with GPBSC after achieving complete remission(CR).The therapeutic effects of one and two courses of MST induction therapy on 42 patients who did not reach CR before transplantation were evaluated.Cox proportional hazards regression analysis was used to analyze the impact of donor NK cell dose and KIR genotype,including KIR ligand mismatch,2DS1,haplotype,and HLA-Cw ligands on survival prognosis of patients.Results:Forty-two patients received MST induction therapy,and the CR rate was 57.1％after 1 course and 73.7％after 2 courses.Multivariate analysis showed that,medium and high doses of NK cells was significantly associated with improved disease-free survival(DFS)of patients(HR=0.27,P=0.005;HR=0.21,P=0.001),and high doses of NK cells was significantly associated with improved overall survival(OS)of patients(HR=0.15,P=0.000).Donor 2DS1 positive significantly increases OS of patients(HR=0.25,P=0.011).For high-risk patients under 60 years old,patients of the donor-recipient KIR ligand mismatch group had longer DFS compared to the nonmismatch group(P=0.036);donor 2DS1 positive significantly prolonged OS of patients(P=0.009).Conclusion:NK cell dose,KIR ligand mismatch and 2DS1 influence the therapeutic effect of MST,improve the survival of AML patients.

Objective:To explore changes of acid-base metabolism in the brain tissue of patients with chronic ischemic cerebrovascular disease (CICVD) using MRI amide proton transfer-weighted (APTw) imaging.Methods:This was a cross-sectional study. From January 2021 to July 2022, thirty-nine patients with CICVD at West China Hospital, Sichuan University were retrospectively included. All patients received CT perfusion (CTP) and APTw imaging. NeuBrainCARE brain perfusion software was used to analyze the impaired perfusion sites and measure the mean transit time (MTT) and time to peak (TTP). Standard spatial matching between CTP and APTw images was performed to measure the APTw values of the same sites. For comparison with normal tissue, APTw values were measured for normal-appearing white matter (NAWM) in the ipsilateral cerebral hemisphere, the contralateral cerebral hemisphere, and the ipsilateral cerebellar hemisphere in areas of impaired perfusion. ANOVA was used to compare the APTw values of impaired perfusion brain tissue, ipsilateral cerebral NAWM, contralateral cerebral NAWM, and ipsilateral cerebellar NAWM. The Bonferroni method was used to correct for multiple comparisons. Pearson correlation coefficient was used to analyze the correlation between APTw values and MTT and TTP in the cerebral tissue with impaired perfusion.Results:In 39 patients with CICVD, both the mean and minimum APTw values of cerebral tissue with impaired perfusion were significantly lower than those in the NAWM of the ipsilateral cerebral hemisphere, the contralateral cerebral hemisphere, and the ipsilateral cerebellar hemisphere ( P<0.001). In the NAWM of the cerebellar hemispheres with unimpaired perfusion, both the mean and minimum APTw values were significantly higher than those in the ipsilateral cerebral hemispheres and the contralateral cerebral hemisphere ( P<0.001). Correlation analysis showed that MTT was significantly negatively correlated with both the mean APTw and the minimum APTw ( r values were -0.90 and -0.82, P<0.001). TTP was significantly negatively correlated with both the mean APTw and the minimum APTw ( r values were -0.86 and -0.78, P<0.001). Conclusion:APTw value can reflect acidosis in cerebral tissue with impaired perfusion in patients with CICVD.

The acquired immunodeficiency syndrome patients with compromised immunity are prone to hemophagocytic syndrome secondary to opportunistic infections.This paper reports a rare case of hemophagocytic syndrome secondary to human parvovirus B19 infection in an acquired immunodeficiency syndrome patient,and analyzes the clinical characteristics,aiming to improve the diagnosis and treatment of the disease and prevent missed diagnosis and misdiagnosis.
Humans ; Lymphohistiocytosis, Hemophagocytic/drug therapy* ; Erythema Infectiosum/complications* ; Acquired Immunodeficiency Syndrome/complications* ; Parvoviridae Infections/diagnosis* ; Parvovirus B19, Human