Objective:To explore changes in the along the perivascular space (ALPS) index in patients with relapsing-remitting multiple sclerosis (RRMS) and investigate its association with cerebral injury.Methods:The study was a cross-sectional investigation. A total of 32 patients diagnosed with RRMS (RRMS group) and 30 healthy controls (HC) were retrospectively collected from March 2023 to July 2024 at the Affiliated Hospital of Inner Mongolia Medical University. All participants underwent MRI scans, including high-resolution three-dimensional (3D) T 1-weighted magnetization-prepared rapid gradient echo sequence, 3D fluid-attenuated inversion recovery sequence, and diffusion spectrum imaging. Regions of interest (ROI) were manually placed on the axial plane of the lateral ventricular body based on fractional anisotropy (FA) maps to obtain diffusion rates along the x, y, and z axes for ALPS index calculation. Tract-based spatial statistics was used to extract diffusion values from the white matter skeleton of the participants, including FA, mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and quantitative anisotropy (QA). Lesion growth algorithms were employed to extract white matter lesion volume (WMLV) and number (WMLN). After lesion filling on T 1 images, brain segmentation was performed, and normalized gray matter volume (nGMV), normalized white matter volume (nWMV), and normalized cerebrospinal fluid volume (nCSFV) were obtained by normalizing with total intracranial volume(TIV). Independent sample t-tests, Mann-Whitney U tests, and χ2 tests were used to assess differences in clinical and imaging indicators between the RRMS and HC groups. Spearman′s rank correlation analysis was performed to evaluate the relationship between the ALPS index and clinical and imaging indicators. Results:The ALPS index, FA, and nGMV values were lower in the RRMS group compared to the HC group ( t=2.42, P=0.019; Z=4.85, P<0.001; t=2.56, P=0.013), while the RD value was significantly higher in the RRMS group ( Z=-2.42, P=0.015). No significant difference was found in other clinical and imaging indicators between the two groups ( P>0.05). In the RRMS group, the ALPS index was negatively correlated with WMLV ( r=-0.43, P=0.018) and positively correlated with FA ( r=0.45, P=0.012). There was no correlation between ALPS index and MD values, AD values, RD values, QA values, WLMN values, nGMV values, nMWV values, nCSFV values, TIV values, and duration of the disease ( P>0.05). Conclusions:Patients with RRMS exhibit abnormal diffusion in the perivascular spaces at the lateral ventricular body, suggesting possible glymphatic system dysfunction. The ALPS index is associated with demyelination and neurodegeneration.

OBJECTIVE To evaluate the efficacy and safety of letermovir in preventing cytomegalovirus(CMV)infection after allogeneic hematopoietic stem cell transplantation(allo-HSCT).METHODS A retrospective cohort study was conducted,enrolling patients who underwent allo-HSCT at the Department of Hematology,Shanghai General Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,from August 30,2022,to February 21,2024.Patients who initiated letermovir prophylaxis within 28 days post-transplantation were assigned to the experimental group(99 cases),while those who did not initiate letermovir within this period were assigned to the control group(18 cases).The incidence and clinical characteristics of CMV infection(including the number of CMV infection cases,the number of cases progressing to CMV disease,recurrent CMV disease,onset time of CMV infection,and treatment duration),immune function recovery within 120 days post-transplantation,and the occurrence of transplantation-related complications(including CD4+and CD8+T-cell recovery,Epstein-Barr virus infection,acute graft-versus-host disease,human herpesvirus 6 infection,and posttransplant lymphoproliferative disorders)and adverse events were recorded.Univariate and multivariate Cox regression analyses were performed to identify factors influencing CMV infection.RESULTS A total of 117 patients were included,among whom 15 developed CMV infection,5 progressed to CMV disease,and 2 experienced recurrent CMV disease.The CMV infection rate in the experimental group was significantly lower than that in the control group(P＜0.001),and the onset time of CMV infection was significantly delayed(P=0.014).The proportion of patients with CD4+T-cell counts≥200 cells/μL in the experimental group was significantly lower than that in the control group(P=0.022).During the follow-up period,elevated creatinine levels were observed in 1 patient,and nausea and vomiting were observed in 2 patients.Multivariate Cox regression analysis revealed that the use of high-dose corticosteroids was a risk factor for CMV infection(HR=6.230,95%CI of 1.255-30.926,P=0.025),while initiating letermovir within 28 days post-transplantation was a protective factor(HR=0.125,95%CI of 0.045-0.348,P＜0.001).CONCLUSIONS Early initiation of letermovir after allo-HSCT significantly reduces the CMV infection rate and delays the onset of infection,with favorable short-term safety.

Objective:To explore changes in the along the perivascular space (ALPS) index in patients with relapsing-remitting multiple sclerosis (RRMS) and investigate its association with cerebral injury.Methods:The study was a cross-sectional investigation. A total of 32 patients diagnosed with RRMS (RRMS group) and 30 healthy controls (HC) were retrospectively collected from March 2023 to July 2024 at the Affiliated Hospital of Inner Mongolia Medical University. All participants underwent MRI scans, including high-resolution three-dimensional (3D) T 1-weighted magnetization-prepared rapid gradient echo sequence, 3D fluid-attenuated inversion recovery sequence, and diffusion spectrum imaging. Regions of interest (ROI) were manually placed on the axial plane of the lateral ventricular body based on fractional anisotropy (FA) maps to obtain diffusion rates along the x, y, and z axes for ALPS index calculation. Tract-based spatial statistics was used to extract diffusion values from the white matter skeleton of the participants, including FA, mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and quantitative anisotropy (QA). Lesion growth algorithms were employed to extract white matter lesion volume (WMLV) and number (WMLN). After lesion filling on T 1 images, brain segmentation was performed, and normalized gray matter volume (nGMV), normalized white matter volume (nWMV), and normalized cerebrospinal fluid volume (nCSFV) were obtained by normalizing with total intracranial volume(TIV). Independent sample t-tests, Mann-Whitney U tests, and χ2 tests were used to assess differences in clinical and imaging indicators between the RRMS and HC groups. Spearman′s rank correlation analysis was performed to evaluate the relationship between the ALPS index and clinical and imaging indicators. Results:The ALPS index, FA, and nGMV values were lower in the RRMS group compared to the HC group ( t=2.42, P=0.019; Z=4.85, P<0.001; t=2.56, P=0.013), while the RD value was significantly higher in the RRMS group ( Z=-2.42, P=0.015). No significant difference was found in other clinical and imaging indicators between the two groups ( P>0.05). In the RRMS group, the ALPS index was negatively correlated with WMLV ( r=-0.43, P=0.018) and positively correlated with FA ( r=0.45, P=0.012). There was no correlation between ALPS index and MD values, AD values, RD values, QA values, WLMN values, nGMV values, nMWV values, nCSFV values, TIV values, and duration of the disease ( P>0.05). Conclusions:Patients with RRMS exhibit abnormal diffusion in the perivascular spaces at the lateral ventricular body, suggesting possible glymphatic system dysfunction. The ALPS index is associated with demyelination and neurodegeneration.

Objective To analyze the thyroid hormone levels in patients with acute ischemic stroke (AIS) and non-valvular atrial fibrillation (NVAF). Methods A total of 121 patients with AIS were selected, and were divided into NVAF group (AIS patients with NVAF) and control group (AIS patients without atrial fibrillation). Serum levels of triiodothyronine (T₃), free triiodothyronine (FT₃), thyroxine (T₄), free thyroxine (FT₄) and thyroid stimulating hormone (TSH) in two groups were measured and compared. The survival of the two groups was compared. Results The serum T₃ level in the NVAF group was significantly lower than that in the control group (P < 0.05). There were no significant differences in serum FT₃, T₄, FT₄ and TSH levels between the two groups (P>0.05). There was no significant difference in survival between the two groups (P>0.05). Conclusion NVAF is associated with serum T₃ levels in AIS patients. There is no correlation between the risk of death and NVAF in AIS patients.

Objective:To explore independent predictors of postoperative delirium in elderly patients by PRe-Operative Prediction of postoperative DElirium by appropriate SCreening (PROPDESC) and Mayo Delirium Prediction (MDP) , and analyze the predictive power of the two models.Methods:This study was a prospective Cohort study. Using the convenient sampling method, a total of 636 elderly surgical patients admitted to the Orthopedics, Gastroenterology, Cardiothoracic and Oncology Departments of Shantou Central Hospital from May to August 2022 were selected as the research objects. PROPDESC and MDP were used to predict postoperative delirium in elderly patients. The area under the receiver operating characteristic ( AUC) and diagnostic characteristics of the two predictive models were compared, and the single factor analysis and Logistic regression analysis were performed on 19 predictive factors of the two models to determine the independent influencing factors of postoperative delirium. Results:The AUC for external verification of the PROPDESC and MDP were 0.87 (95% CI: 0.84-0.90) and 0.89 (95% CI: 0.86-0.92) , respectively. The sensitivity of 71.79% and 80.34%, and specificity of 85.16% and 81.12%, respectively. Logistic regression analysis showed that emergency admission, age, sentence repetition and sequence subtraction in Montreal Cognitive Assessment (MoCA) were independent influencing factors for postoperative delirium ( P<0.05) . Conclusions:The predictive ability of PROPDESC and MDP models to predict postoperative delirium in elderly patients is satisfactory. On this basis, delirium risk assessment tools suitable for different surgical elderly populations in China can be constructed.

Rotavirus (RV) is one of the leading causes of acute gastroenteritis in infants and young animals worldwide. Rotavirus infection has obvious species specificity and mainly causes diarrhea in infants and young animals. The host innate responses suppress the infection and replication of rotavirus through activating multiple signaling pathways. Meanwhile, rotavirus also antagonizes the innate immune responses in various ways. This article reviewed the mechanisms of host innate immune responses to rotavirus infection and the antagonistic mechanism of rotavirus against host innate immunity with a view to providing reference for the development of therapeutic drugs and the prevention of rotavirus infection.

Objective: To investigate the molecular characterization of adult diarrhea cases caused by enterotoxic Escherichia coli (ETEC) and explore the practical model of epidemiology for laboratory technique and data needs based on the surveillance network. Methods: Epidemiological design and sampling targeted adult cases ETEC caused diarrhea in epidemic season. The enterotoxin type, serogroup, resistance, colonization factor and molecular type of ETEC were identified. Multiple dynamic phenotypic characteristics of ETEC were indicated by multidimensional and multivariable data. Results: From 2016 to 2018, 84 eligible ETEC strains were detected. The dominant serums/toxins were O∶6 (STh), O∶25 (LT), O∶159 (STh), O∶153 (STh). O∶6 (STh+CS21), which replaced O∶25 and O∶159 as the popular clones in 2018. Six cases of O∶153 (STh+CFA/I+CS8+PT34) in outbreak in 2017 were imported ones. The resistance rates of ETEC strains detected in adults to sulfasoxazole, naproxinic acid, ampicillin and azithromycin were more than 30%, multidrug resistance (MDR) reached 58.3%. Serum/toxin types suggested that attenuated strains were more likely to become MDR. Molecular typing confirmed that the genetic similarity of the dominant clone of O∶6 serogroup (PT20-24) was higher than O∶25 and O∶159. There was a high correlation between the minimal inhibitory concentration (MIC) of azithromycin and the resistant gene mphA (87.5%, 28/32). O∶6 (STh+CS21+mphA) resistant clone was first detected in 2016. Conclusion A new epidemic clone in adult ETEC diarrhea cases in Shanghai was O∶6 (STh+CS21+mphA). For the first time the association between azithromycin resistance gene mphA and a serum group of ETEC was observed. Multidimensional and multivariate analysis techniques based on epidemiology can help reveal the potential transmission pattern of ETEC for the accurate surveillance and early warning of outbreaks.

This paper presents a probability segmentation algorithm for lung nodules based on three-dimensional features. Firstly, we computed intensity and texture features in region of interest (ROI) pixel by pixel to get their feature vector, and then classified all the pixels based on their feature vector. At last, we carried region growing on the classified result, and got the final segmentation result. Using the public Lung Imaging Database Consortium (LIDC) lung nodule datasets, we verified the performance of proposed method by comparing the probability map within LIDC datasets, which was drawn by four radiology doctors separately. The experimental results showed that the segmentation algorithm using three-dimensional intensity and texture features would be effective.
Algorithms ; Databases, Factual ; Humans ; Imaging, Three-Dimensional ; Lung ; pathology ; Probability