Objective To explore the predictive value of contrast-enhanced ultrasound(CEUS)pa-rameters combined with blood lipids in evaluating vulnerable carotid plaques in patients with is-chemic stroke.Methods A prospective trial was conducted on 120 patients diagnosed with vulner-able carotid plaques in our hospital from January 2023 to May 2024.According to having ischemic stroke or not,60 of them were assigned into ischemic stroke(study group),and the other 60 into control group.Routine ultrasound,CEUS and blood lipid examinations were performed respective-ly in the two groups.The unstable plaque integral ratio,maximum plaque length,maximum plaque thickness,ulceration plaque,area stenosis,peak velocity at stenosis,resistance index and blood lipid levels between the study group and the control group and in the study group with different blood flow grades were analyzed.ROC curve analysis was used to calculate the AUC value.Results There were statistical differences between the study group and the control group in terms of unstable plaque integral ratio,maximum plaque length,maximum plaque thickness,ulceration plaque,area stenosis,peak velocity at stenosis,resistance index and blood flow characteristics(P＜0.01).The study group had significantly higher TC,TG and LDL levels and lower HDL level than the control group(P＜0.01).Obvious differences were observed in unstable plaque integral ratio,maximum plaque length,maximum plaque thickness,ulceration plaque,area stenosis,peak velocity at stenosis and resistance index among the patients from the study group with different blood flow grades(P＜0.05,P＜0.01),so were their TC,TG,LDL and TG levels in them(P＜0.01).For above these patients,the TC,TG and LDL levels were gradually decreased,while that of HDL was increased in turn in the patients with blood flow grades Ⅲ,Ⅱ to Ⅰ(P＜0.01).The blood flow grade was positively correlated with TC,TG and LDL levels(r=0.456,r=0.652,r=0.362,P=0.000),while negatively with HDL level(r=-0.256,P=0.000).ROC curve analysis showed that the AUC value of the combination in the diagnosis was significantly higher than that detected by single detection.Cutoff analysis suggested that CEUS blood flow grade of over Ⅱ,and TC of 5.22 mmol/L,TG of 2.33 mmol/L,LDL of 2.78 mmol/L,and HDL of 0.82 mmol/L were the cutoff values in diagnosing vulnerable carotid plaque for ischemic stroke patients.Conclusion High grade of CEUS blood flow combined with abnormal blood lipid levels may serve as predic-tive indicators for ischemic stroke patients.

Objective To explore the predictive value of contrast-enhanced ultrasound(CEUS)pa-rameters combined with blood lipids in evaluating vulnerable carotid plaques in patients with is-chemic stroke.Methods A prospective trial was conducted on 120 patients diagnosed with vulner-able carotid plaques in our hospital from January 2023 to May 2024.According to having ischemic stroke or not,60 of them were assigned into ischemic stroke(study group),and the other 60 into control group.Routine ultrasound,CEUS and blood lipid examinations were performed respective-ly in the two groups.The unstable plaque integral ratio,maximum plaque length,maximum plaque thickness,ulceration plaque,area stenosis,peak velocity at stenosis,resistance index and blood lipid levels between the study group and the control group and in the study group with different blood flow grades were analyzed.ROC curve analysis was used to calculate the AUC value.Results There were statistical differences between the study group and the control group in terms of unstable plaque integral ratio,maximum plaque length,maximum plaque thickness,ulceration plaque,area stenosis,peak velocity at stenosis,resistance index and blood flow characteristics(P＜0.01).The study group had significantly higher TC,TG and LDL levels and lower HDL level than the control group(P＜0.01).Obvious differences were observed in unstable plaque integral ratio,maximum plaque length,maximum plaque thickness,ulceration plaque,area stenosis,peak velocity at stenosis and resistance index among the patients from the study group with different blood flow grades(P＜0.05,P＜0.01),so were their TC,TG,LDL and TG levels in them(P＜0.01).For above these patients,the TC,TG and LDL levels were gradually decreased,while that of HDL was increased in turn in the patients with blood flow grades Ⅲ,Ⅱ to Ⅰ(P＜0.01).The blood flow grade was positively correlated with TC,TG and LDL levels(r=0.456,r=0.652,r=0.362,P=0.000),while negatively with HDL level(r=-0.256,P=0.000).ROC curve analysis showed that the AUC value of the combination in the diagnosis was significantly higher than that detected by single detection.Cutoff analysis suggested that CEUS blood flow grade of over Ⅱ,and TC of 5.22 mmol/L,TG of 2.33 mmol/L,LDL of 2.78 mmol/L,and HDL of 0.82 mmol/L were the cutoff values in diagnosing vulnerable carotid plaque for ischemic stroke patients.Conclusion High grade of CEUS blood flow combined with abnormal blood lipid levels may serve as predic-tive indicators for ischemic stroke patients.

With the optimization of surgical technologies and postoperative management regimens, the number of lung transplantation has been significantly increased, which has become an important treatment for patients with end-stage lung disease. However, due to the impact of comprehensive factors, such as bronchial ischemia and immunosuppression, the incidence of airway stenosis after lung transplantation is relatively high, which severely affects postoperative survival and quality of life of lung transplant recipients. In recent years, with the improvement of perioperative management, organ preservation and surgical technologies, the incidence of airway stenosis after lung transplantation has been declined, but it remains at a high level. Early diagnosis and timely intervention play a significant role in enhancing clinical prognosis of patients with airway stenosis. In this article, the general conditions, diagnosis, treatment and prevention of airway stenosis after lung transplantation were reviewed, aiming to provide reference for comprehensive management of airway stenosis after lung transplantation and improving clinical prognosis of lung transplant recipients.

The survey on the hesitant status of rubella-containing vaccine (RCV) vaccination was conducted among 2 141 women of childbearing age in four provinces, Liaoning, Jiangsu, Zhejiang, and Anhui, from May 2017 to March 2018. Among the 2 141 study participants, a total of 38.21% (818) of women of childbearing age were aware of rubella and 21.25% (455) of women of childbearing age knew about RCV. Among the 455 women of childbearing age who were aware of RCV, 262 (57.58%) were willing to be vaccinated with RCV; 304 women of childbearing age (66.81%) tended to be vaccinated with RCV free of charge. Among the 193 women of childbearing age who did not want to be vaccinated or did not decide whether they preferred to be vaccinated with RCV, no one around them was vaccinated (89, 46.11%) and fear of vaccine safety (70, 36.27%) were the main reasons for hesitation to receive RCV.

The survey on the hesitant status of rubella-containing vaccine (RCV) vaccination was conducted among 2 141 women of childbearing age in four provinces, Liaoning, Jiangsu, Zhejiang, and Anhui, from May 2017 to March 2018. Among the 2 141 study participants, a total of 38.21% (818) of women of childbearing age were aware of rubella and 21.25% (455) of women of childbearing age knew about RCV. Among the 455 women of childbearing age who were aware of RCV, 262 (57.58%) were willing to be vaccinated with RCV; 304 women of childbearing age (66.81%) tended to be vaccinated with RCV free of charge. Among the 193 women of childbearing age who did not want to be vaccinated or did not decide whether they preferred to be vaccinated with RCV, no one around them was vaccinated (89, 46.11%) and fear of vaccine safety (70, 36.27%) were the main reasons for hesitation to receive RCV.

Humans ; Melanoma/therapy* ; Skin Neoplasms/therapy* ; Methylation ; Prognosis ; Immunotherapy ; RNA ; Biomarkers, Tumor ; Melanoma, Cutaneous Malignant

Objective:To investigate the changes of quadriceps femoris thickness with the length of stay in intensive care unit (ICU) in patients with sepsis, and to evaluate the diagnostic value of muscle changes in mortality.Methods:A prospective study was conducted, and 92 patients with sepsis who were admitted to the ICU of the Affiliated Hospital of Jining Medical College from January 2020 to December 2021 were enrolled. The thickness of quadriceps femoris [including the quadriceps femoris muscle thickness at the midpoint of the anterior superior iliac spine and the upper edge of the patella (M-QMLT), and at the middle and lower 1/3 of the patella (T-QMLT)] measured by ultrasound 1 day (D1), 3 days (D3), and 7 days (D7) after admission to the ICU were collected. The atrophy rate of quadriceps femoris was calculated 3 and 7 days after admission to the ICU compared with 1 day [(D3-D1)/D1 and (D7-D1)/D1, (TD3-TD1)/TD1 and (TD7-TD1)/TD1, respectively]. The demographic information, underlying diseases, vital signs when admission to the ICU and in-hospital mortality of all patients were recorded, and the differences of the above indicators between the two groupswere compared. Multivariate Logistic regression was used to analyze the influence of quadriceps femoris muscle thickness and atrophy rate on in-hospital mortality of septic patients. The receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of quadriceps femoris muscle thickness and atrophy rate on in-hospital mortality of septic patients.Results:A total of 92 patients with severe sepsis were included, of which 41 patients died in hospital, 51 patients discharged. The in-hospital mortality was 44.6%. The muscle thickness of quadriceps femoris in severe septic patients decreased with the prolongation of ICU stay, and there was no significant difference between the two groups at the first and third day of ICU admission. The muscle thickness of quadriceps femoris at different measuring positions in the survival group was significantly greater than those in the death group 7 days after admission to the ICU [M-QMLT D7 (cm): 0.50±0.26 vs. 0.39±0.19, T-QMLT D7 (cm): 0.58±0.29 vs. 0.45±0.21, both P < 0.05]. The atrophy rate of quadriceps femoris muscle thickness at different measuring positions 3 and 7 days after admission to ICU in the survival group was significantly lower than those in the death group [(D3-D1)/D1: (8.33±3.44)% vs. (9.74±3.91)%, (D7-D1)/D1: (12.21±4.76)% vs. (19.80±6.15)%, (TD3-TD1)/TD1: (7.83±4.26)% vs. (10.51±4.75)%, (TD7-TD1)/TD1: (11.10±5.46)% vs. (20.22±6.05)%, all P < 0.05]. Multivariate Logistic regression analysis showed that M-QMLT D7, T-QMLT D7, (D3-D1)/D1, (D7-D1)/D1, (TD3-TD1)/TD1, (TD7-TD1)/TD1 were independent risk factors for in-hospital mortality (all P < 0.05). The results were stable after adjusting for confounding factors. ROC curve analysis showed that (TD7-TD1)/TD1 [area under the ROC curve (AUC) was 0.853, 95% confidence interval (95% CI) was 0.773-0.934] was superior to (D7-D1)/D1, T-QMLT D7, M-QMLT D7, (TD3-TD1)/TD1 and (D3-D1)/D1 [AUC was 0.821 (0.725-0.917), 0.692 (0.582-0.802), 0.683 (0.573-0.794), 0.680 (0.569-0.791), 0.622 (0.502-0.742)]. Conclusions:For septic patients in ICU, bedside ultrasound monitoring of quadriceps femoris muscle thickness and atrophy rate has a certain predictive value for in-hospital mortality, and a certain guiding significance in clinical treatment and predicting the prognosis of sepsis.

Integrated TOF-PET/MR is a multimodal imaging system which can acquire high-quality magnetic resonance (MR) and positron emission tomography (PET) images at the same time, and it has time of flight (TOF) function. The TOF-PET system usually features better image quality compared to traditional PET because it is capable of localizing the lesion on the line of response where annihilation takes place. TOF technology measures the time difference between the detectors on which the two 180-degrees-seperated photons generated from positron annihilation are received. Since every individual crystal might be prone to its timing bias, timing calibration is needed for a TOF-PET system to work properly. Three approaches of timing calibration are introduced in this article. The first one named as fan-beam method is an iterative method that measures the bias of the Gaussian distribution of timing offset created from a fan-beam area constructed using geometric techniques. The second one is to find solutions of the overdetermination equations set using L1 norm minimization and is called L1-norm method. The last one called L2-norm method is to build histogram of the TOF and find the peak, and uses L2 norm minimization to get the result. This article focuses on the comparison of the amount of the data and the calculation time needed by each of the three methods. To avoid location error of the cylinder radioactive source during data collection, we developed a location calibration algorithm which could calculate accurate position of the source and reduce image artifacts. The experiment results indicate that the three approaches introduced in this article could enhance the qualities of PET images and standardized uptake values of cancer regions, so the timing calibration of integrated TOF-PET/MR system was realized. The fan-beam method has the best image quality, especially in small lesions. In integrated TOF-PET/MR timing calibration, we recommend using fan-beam method.
Algorithms ; Calibration ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Multimodal Imaging ; Positron-Emission Tomography

Objectives: To evaluate the safety of inactivated enterovirus A71(EV-A71) vaccines after large-scale immunization in the community. Methods: We selected EV-A71 susceptible people (healthy children) aged 6-59 months in vaccination clinics from 89 counties in Zhejiang Province between April 2016 and March 2018. All local and systematic adverse actions were collected by 30 min on-site inspection, within 3 days and 4-30 days follow-up. Chi-square test and Fisher′s exact test were used to compare the difference of AEs incidence in various characteristics among two groups. Results: A total of 71 663 doses of vaccines were included for active safety analysis, which included 37 331 doses in boys and 34 332 doses in girls. Among all the doses, children aged 6 to 11 months, 12 to 23 months and 24 to 59 months were received 13 707, 32 639 and 25 317 doses respectively. The incidence of adverse reactions within 30 min, 3 days and 4-30 days were 0.33% (239 doses), 1.58% (1 133 doses) and 0.34% (244 doses) respectively. Adverse reactions within 3 days were 1 372 doses, with a incidence of 1.91%; among all the cases, 539 doses (0.75%) were grade 1, 677 doses (0.94%) were grade 2 and 156 doses (0.22%) were grade 3, no grade-4 adverse reaction was reported. The common local adverse reactions were redness, swelling and pruritus, with the incidence rates were 0.05% (39 doses), 0.02% (16 doses) and 0.02% (12 doses), respectively, while the most common systemic adverse reaction was pyrexia with an incidence of 1.19% (856 doses), followed by diarrhea and anorexia with the incidence rates were 0.15% (104 doses) and 0.13% (90 doses) respectively. Conclusion Most adverse actions of EV-A71 vaccines were mild and moderate and majority of them were common adverse actions. No new adverse reactions were found in the study.

Objective To investigate the indirect decompression effect of oblique lateral interbody fusion (OLIF) in the treatment of mild to moderate degenerative lumbar stenosis.Methods From October 2014 to November 2016,23 patients with mild to moderate lumbar spinal stenosis underwent OLIF combined with or without posterior pedicle screw fixation;9 males and 14 females with average age of 59.2±11.6 years old;8 cases at L3,4 segment and 15 cases at L4,5 segment.All cases were followed up for more than 6 months.Thin layer scanning of CT and two-dimensional reconstruction images were used to measure the vertical diameter and area of intervertebral foramen.Intervertebral disc height and spinal canal anteroposterior diameter were measured on median sagittal MRI sequence,and the anteroposterior diameter and the cross-sectional area of the spinal canal were measured on cross-sectional MRI sequence.The clinical effects were assessed by the visual analogue score (VAS) and the Oswestry disability index (ODI) for low back pain,lower limb pain and lower limb numbness.Results Compared with those measurements pre-operatively,the post-operative intervertebral disc height increased by 78.6％±13.4％.The post-operative left vertical diameter of intervertebral foramen increased by 36.7％±7.8％,and the post-operative left area of intervertebral foramen increased by 36.6％± 8.7％,and the post-operative right vertical diameter of intervertebral foramen increased by 40.7％±9.6％,and the post-operative right area of intervertebral foramen increased by 40.0％±8.9％.The post-operative anteroposterior diameter of sagittal spinal canal were increased 32.6％ ± 5.9％,and the post-operative anteroposterior diameter of cross-sectional spinal canal were increased 34.4％±6.8％,and the post-operative cross-sectional area of the spinal canal were increased 47.5％±7.2％.All of the differences were statistically significant between pre-operative and post-operative measurements.The VAS score for low back pain was 6.2± 1.7 pre-operatively,and 1.1±0.5 post-operatively.The ODI for low back pain was 81.2％± 18.2％ pre-operatively,and 6.1％±2.0％ post-operatively.The VAS score for lower limb pain was 5.6±1.4 pre-operatively,and 0.8±0.3 post-operatively.And the VAS score for lower limb numbness was 6.6±2.0 pre-operatively,and 3.4± 1.2 post-operatively.All of the differences were statistically significant between pre-operative and post-operative evaluations.Conclusion There were obvious radiological evidences and remarkable clinical effect of indirect decompression using OLIF technique in treatment of mild to moderate lumbar spinal stenosis at early post-operative stage.However further long-term follow-up studies with multicenter large sample were still needed.