Objective To analyze the significance of CT perfusion imaging combined with artificial intelli-gence (AI) in evaluating reperfusion injury after cerebral infarction. Methods 106 patients with cerebral infarc-tion admitted to the hospital from January 2019 to October 2023 were prospectively selected as the study objects. Patients were divided into reperfusion injury group and no perfusion injury group according to whether reperfusion injury occurred after 14 days of thrombolytic therapy. CT perfusion imaging and AI parameters were compared between reperfusion injury group and non-perfusion injury group. The factors affecting reperfusion injury in cerebral infarction patients after thrombolytic therapy were analyzed. The value of CT perfusion imaging parameters combined with AI in predicting reperfusion injury after thrombolytic therapy in cerebral infarction patients was analyzed. Results 31 cases had reperfusion injury,and the other 75 cases had no perfusion injury. CBF,average CT value and entropy level in the reperfusion injury group were lower than those in the non-perfusion injury group (P<0.05),CBV,MTT,TTP and kurtosis were higher than those in the non-perfusion injury group (P<0.05). Logistic regression analysis showed that NIHSS (OR=5.228,95％CI:2.151～12.705),CBF(OR=3.777,95％CI:1.554～9.180),CBV(OR=3.699,95％CI:1.522～9.989) and average CT value (OR=4.125,95％CI:1.697～10.024) were the influencing factors of reperfusion injury in cerebral infarction patients after thrombolytic therapy (P<0.05). ROC curve results showed that the sensitivity of CBF,CBV,average CT value and their com-bination in predicting reperfusion injury after thrombolytic therapy in cerebral infarction patients were 67.74％,70.97％,77.42％,87.10％,and the specificity were 70.67％,74.67％,77.33％,90.67％,AUC values were 0.665,0.667,0.744 and 0.908. Conclusion CT perfusion imaging combined with AI is effective in evaluating reperfusion injury after cerebral infarction.

Objective To analyze the significance of CT perfusion imaging combined with artificial intelli-gence (AI) in evaluating reperfusion injury after cerebral infarction. Methods 106 patients with cerebral infarc-tion admitted to the hospital from January 2019 to October 2023 were prospectively selected as the study objects. Patients were divided into reperfusion injury group and no perfusion injury group according to whether reperfusion injury occurred after 14 days of thrombolytic therapy. CT perfusion imaging and AI parameters were compared between reperfusion injury group and non-perfusion injury group. The factors affecting reperfusion injury in cerebral infarction patients after thrombolytic therapy were analyzed. The value of CT perfusion imaging parameters combined with AI in predicting reperfusion injury after thrombolytic therapy in cerebral infarction patients was analyzed. Results 31 cases had reperfusion injury,and the other 75 cases had no perfusion injury. CBF,average CT value and entropy level in the reperfusion injury group were lower than those in the non-perfusion injury group (P<0.05),CBV,MTT,TTP and kurtosis were higher than those in the non-perfusion injury group (P<0.05). Logistic regression analysis showed that NIHSS (OR=5.228,95％CI:2.151～12.705),CBF(OR=3.777,95％CI:1.554～9.180),CBV(OR=3.699,95％CI:1.522～9.989) and average CT value (OR=4.125,95％CI:1.697～10.024) were the influencing factors of reperfusion injury in cerebral infarction patients after thrombolytic therapy (P<0.05). ROC curve results showed that the sensitivity of CBF,CBV,average CT value and their com-bination in predicting reperfusion injury after thrombolytic therapy in cerebral infarction patients were 67.74％,70.97％,77.42％,87.10％,and the specificity were 70.67％,74.67％,77.33％,90.67％,AUC values were 0.665,0.667,0.744 and 0.908. Conclusion CT perfusion imaging combined with AI is effective in evaluating reperfusion injury after cerebral infarction.

Objective To compare the clinical features and auxiliary examination results of sinus-originated intracranial aspergillosis（ICA）and rhino-orbito-cerebral mucormycosis（ROCM）. Methods A retrospective analysis was performed for the clinical data of seven patients with sinus-originated ICA and six patients with ROCM who were diagnosed and treated in our hospital from January 2018 to January 2023. Results The pathogenic factor of CNS fungal infection was observed in all patients with ROCM and 57.1% of the patients with sinus-originated ICA. Compared with the patients with sinus-originated ICA，the patients with ROCM were more likely to develop ocular symptoms and signs such as exophthalmos，periorbital swelling，and intraocular inflammation，as well as non-ocular symptoms and signs including fever，facial swelling，and facial nerve palsy. Compared with the patients with sinus-originated ICA，the patients with ROCM had significantly greater increases in blood glucose，erythrocyte sedimentation rate，C-reactive protein，and procalcitonin. Cranial magnetic resonance imaging showed that sinus-originated ICA often affected the paranasal sinuses，orbital apices，retro-orbital regions，and cavernous sinuses，while the patients with ROCM were more likely to have sinusitis，bone destruction，and mucormycosis invading cerebral vessels. As for treatment，50% of the patients with ROCM and 42.9% of the patients with sinus-originated ICA received antifungal therapy alone，while 50% of the patients with ROCM and 57.1% of the patients with sinus-originated ICA received a combination of medication and surgery. By follow-up to September 2023，50% of the patients with ROCM and 28.6% of the patients with sinus-originated ICA had no response to treatment and died. Conclusion Both sinus-originated ICA and ROCM have rapid progression，and ROCM survivors with diabetes are more likely to experience disabilities. Timely diagnosis and initiation of antifungal therapy，correction of underlying predisposing factors，and active surgical debridement are essential for the treatment of CNS fungal infections.
Aspergillus ; Mucormycosis

Objective:To assess the diagnostic value of anti-salivary gland protein-1(SP1)antibody combined with anti-parotid secretory protein(PSP)antibody for Sj?gren's syndrome(SS).Methods:A total of 60 patients with primary SS(pSS)who were treated in the outpatient and inpatient department of Department of Rheumatology and Immunology of the Second Hospital of Hebei Medical University from January 2020 to December 2022 were collected.Thirty patients with other autoimmune diseases accompa-nied by dry mouth and/or dry eyes were collected as disease control group.Thirty healthy subjects from the physical examination center were collected for healthy control group,serum samples were obtained from all of them.Their general features and clinical information including clinical manifestations,labora-tory examinations and other examinations were recorded.The 2016 American College of Rheumatology(ACR)/European League against Rheumatism(EULAR)classification criteria were adopted as the diag-nostic standard of pSS.Immunoglobulin G(IgG)subtype of anti-SP1 antibody and anti-PSP antibody were detected by chemiluminescence immunoassay.The receiver operating characteristic(ROC)curve was used to evaluate the accuracy of anti-SP1 antibody and anti-PSP antibody in diagnosing pSS.The cli-nical characteristics of anti-SP1 antibody and anti-PSP antibody positive patients and negative patients in pSS group were further compared.Independent samples t test,Mann-Whitney U test,variance analysis,Kruskal-Wallis test,Chi-square test or Fisher's exact test and Spearman correlation analysis were used for statistical analysis.Results:There was no significant difference in age(F=1.406,P=0.495)and gender(x2=2.105,P=0.349)among pSS group,disease control group and healthy control group.The expression levels of anti-SP1 antibody(H=16.73,P＜0.001)and anti-PSP antibody(H=26.09,P＜0.001)were statistically different among the three groups.An intergroup comparison of anti-SP1 antibody expression levels showed that there was a statistically significant difference between pSS and healthy con-trol group(P＜0.001),but no statistically significant difference between the other groups.Comparison of anti-PSP antibody expression levels between the groups showed that there were statistically significant differences between pSS and healthy control group(P＜0.001),and between disease control group and healthy control group(P=0.009),while no statistically significant differences between the other groups.The positive rate of anti-SP1 antibody in pSS group was significantly higher than that in disease control group and healthy control group(58.33％vs.40.00％vs.13.33％,P＜0.001).The positive rate of anti-PSP antibody in pSS group was significantly higher than that in disease control group and healthy control group(75.00％vs.56.17％vs.16.67％,P＜0.001).The area under the curve for anti-SP1 antibody was 0.688(P＜0.001).The sensitivity and specificity of anti-SP1 antibody were 58.33％(35/60)and 70.00％(42/60)respectively,the positive predictive value was 66.04％(35/53)and the negative predictive value was 54.55％(42/77)of anti-SP1 antibody.The area under the curve of anti-PSP antibody was 0.720(P＜0.001),with a sensitivity was 75.00％(45/60),and spe-cificity was 63.33％(38/60).The positive predictive value and negative predictive value of anti-PSP an-tibody were 67.16％(45/67)and 71.70％(38/53)respectively.All the 13 pSS patients were negative for anti-Sjogren's syndrome A(SSA,including SSA52 and SSA60)antibody and anti-Sjogren's syn-drome B(SSB)antibody.Among them,11 patients were positive for both anti-SP1 antibody and anti-PSP antibody,1 patient was positive for anti-SP1 antibody and 1 patient was positive for anti-PSP anti-body.The clinical features of anti-SP1 antibody and anti-PSP antibody positive and negative groups were compared in pSS patients.The duration of disease in anti-SP1 antibody positive group was shorter(Z=-2.277,P=0.023)when compared with the negative patients.The patients with positive anti-PSP an-tibody were younger than those in the negative group(t=2.598,P＜0.05),the positive rate of rheuma-toid factor(P=0.002)and the serum level of IgG(t=3.806,P=0.003)in anti-PSP antibody positive group were higher than in the negative group.Analysis of the correlation between anti-SP1 antibody and anti-PSP antibody in the pSS patients showed that there was significant correlation between them(r=0.801,P＜0.001).Conclusion:Both anti-SP1 antibody and anti-PSP antibody are valuable in the diag-nosis of SS,and anti-SP1 antibody is helpful for the early diagnosis of pSS.The combined detection of anti-SP1 antibody and anti-PSP antibody is helpful for the early diagnosis of pSS patients with negative anti-SSA antibody and anti-SSB antibody.

Low-intensity pulsed ultrasound(LIPUS)is a low-cost,non-invasive and safe treatment method mainly used for musculoskeletal diseases,especially for fractures and nonunion.This article reviews the therapeutic effects of LIPUS on various musculoskeletal and nervous system diseases and analyzes its mechanism and potential targets.It is found that besides fracture and nonunion,LIPUS also has clinical application prospect in treating osteoporosis,muscle injury,and motor nervous system diseases.

Objective:To explore the clinical characteristics of neurological syndrome associated with anti-glutamic acid decarboxylase (GAD) antibodies (Abs).Methods:Six patients with neurological syndrome associated with anti-GAD-Abs admitted to Department of Neurology, Henan Provincial People's Hospital from January 2019 to October 2022 were chosen. The clinical manifestations, imaging and laboratory results, therapeutic schedules, and follow-up prognoses of these patients were collected and summarized.Results:Three females and 3 males were included, with onset age of (54.3±17.7) years. Three patients had stiff-person syndrome (SPS), 1 had limbic encephalitis+generalized epilepsy, 1 had extralimbic encephalitis+occipital epilepsy, and 1 had cerebellar ataxia who was diagnosed with paraneoplastic syndrome associated with small cell lung cancer. Four patients had elevated level of thyroid peroxidase antibodies, and 1 patient was positive for overlapping anti-gamma aminobutyric acid B receptor antibodies and Amphiphysin antibodies. Two patients with SPS had failed lumbar puncture; 1 had slightly increased white blood cells and proteins in cerebrospinal fluid (CSF); the remaining 3 patients were basically normal. Specific oligoclonal bands in CSF were observed in 2 patients. Brain MRI showed abnormal signals in the bilateral occipital lobes in 1 patient, and no specific inflammatory lesions in other patients. All patients accepted corticosteroids and intravenous immunoglobulin/plasma exchange therapies; except for the one with paraneoplastic syndrome associated with small cell lung cancer, the remaining 5 patients had improved modified Rankin scale (mRs) scores at discharge and received long-term immunotherapy. Two patients with SPS had gradually aggravated symptoms, and mRs scores reached 5 at the last follow-up (one for 3 years and the other one for 2 years).Conclusions:The clinical manifestations of patients with neurological syndrome associated with anti-GAD-Abs include SPS, limbic encephalitis, extralimbic encephalitis, epilepsy and cerebellar ataxia; some of these patients have paraneoplastic syndromes. Immunotherapies are effective except for these patients with paraneoplastic syndromes. Some patients with SPS tend to have a chronic course and a poor prognosis.

Objective:To explore any effect of repeated transcranial magnetic stimulation (rTMS) on the recovery of neurological functioning and the expression of NOD-like receptor family pyrin domain containing 3 (NLRP3) and inflammatory factors after ischemic stroke.Methods:Sixty-four C57BL/6J mice were randomly divided into a normal control group, a model group, a sham stimulation group and an observation group, each of 16. All mice except those of the normal control group received middle cerebral artery occlusion using the suture method to model an ischemic stroke. After the modeling the observation group was given 1Hz rTMS daily for 7 consecutive days, while the sham stimulation group was given sham rTMS. After the intervention, Zea-Longa scores were used for all of the groups, and the size of the cerebral infarct was measured using triphenyltetrazolium chloride staining. The expression of NLRP3 around the cerebral infarction was detected using immunofluorescence, while that in the brain tissue was measured using Western blotting. The expression of interleukin-1β and IL-18 in the brain tissue was detected using enzyme-linked immunosorbent assays.Results:Compared with the normal control group, a significant increase was observed in the other groups′ average neurological function impairment scores. Expression of NLRP3, IL-1β and IL-18 in the model and sham stimulation groups also increased, with large cerebral infarcts in the cortex and hippocampus. Compared with the sham stimulation and model groups, there was a significant decrease in the average neurological dysfunction scores, the area of cerebral infarction in the cortex and hippocampus, as well as the expression of NLRP3, IL-1β and IL-18 in the observation group.Conclusions:Low-frequency rTMS can promote the recovery of damaged nerve function after an ischemic stroke, at least in mice. It can reduce the size of cerebral infarction, and inhibit neuronal pyroptosis, which is closely related to the down-regulation of NLRP3, IL-1β and IL-18 expression.

Objective:To investigate the prognoses of pulmonary adenocarcinoma patients with leptomeningeal metastases (LM) and explore their influencing factors.Methods:A retrospective analysis was performed. The clinical data, imaging features and treatment plans of pulmonary adenocarcinoma patients with LM admitted to our hospital from January 2010 to June 2021 were collected. Overall survival (OS) was used as the prognostic evaluation criterion and patients were divided into good prognosis group (OS≥6 months) and poor prognosis group (OS<6 months) accordingly. Logistic regression analysis was used to evaluate the influencing factors for prognoses of pulmonary adenocarcinoma patients with LM. These patients were grouped according to different Karnofsky performance status (KPS) scores and different treatment methods, and survival curves were drawn to compare their OS.Results:A total of 173 pulmonary adenocarcinoma patients with LM were enrolled in the study, including 75 with good prognosis and 87 with poor prognosis. There were significant differences in the KPS scores, pulmonary adenocarcinoma lesion controlled status, giving third generation tyrosine kinase inhibitor (TKI) therapy or not, giving systemic chemotherapy and/or whole brain radiotherapy or not between the two groups ( P<0.05). Multivariate Logistic regression analysis showed that KPS scores and pulmonary adenocarcinoma lesion controlled status were independent influencing factors for prognoses ( OR=4.186, 95%CI: 1.583-11.070, P=0.004; OR=4.198, 95%CI: 1.499-11.760, P=0.006). Survival curves showed median OS of 8.2 months for all patients ( 95%CI: 6.5-9.8). The OS in patients with low-risk(KPS scores≥60) was significantly higher than that in patients with high-risk(KPS scores<60), that in patients accepted TKI treatment was significantly higher than that in patients not accepted TKI treatment, and that in patients accepted TKI and systemic chemotherapy was significantly higher than that in patients accepted TKI alone ( P<0.05). Conclusion:Patients with high KPS scores and controlled pulmonary adenocarcinoma can have relatively good prognosis; TKI treatment and combination therapy may prolong OS of these patients.

Objective To investigate the population dynamics and Echinococcus infections in small rodents around human settlement in Yushu City, Qinghai Province. Methods Rodents were captured using the mouse trap method in pastures from Batang Township and Longbao Township of Yushu City, Qinghai Province on May, August and October, 2018. The body weight and snout-vent length of all captured rodents were measured, and the species was identified according to the rodent morphology. Genomic DNA was extracted from rodent liver specimens and lesion specimens, and the mitochondrial cox1 gene of Echinococcus was amplified using PCR assay for identification of parasite species. In addition, the tissue specimens positive for PCR assay were sampled for pathological examinations. The prevalence of Echinococcus infections was estimated in rodents, and a phylogenetic tree was created based on Echinococcus cox1 gene sequences. Results A total of 285 small rodents were captured, including 143 Ochotona curzoniae (50.2%), 141 Lasiopodomys fuscus (49.5%), and 1 Neodon irene (0.3%), and there was a remarkable variation in habitat selection among these three rodent species. The number of L. fuscus correlated positively with vegetation coverage (r = 0.350, P = 0.264), with the greatest number seen in August, and the number of O. curzoniae negatively with vegetation coverage (r = −0.371, P = 0.235), with the highest number seen in August and the lowest number in May. The female/male ratios of O. curzoniae and voles were 1:0.96 and 0.82:1, respectively. The body weight (r = 0.519, P < 0.01) and snout-vent length (r = 0.578, P < 0.01) of O. curzoniae showed a tendency towards a rise with month, while the body weight (r = −0.401, P < 0.01) and snout-vent length (r = −0.570, P < 0.01) of voles presented a tendency towards a reduction with month. No Echinococcus infection was detected in voles, while 2.1% prevalence of E. shiquicus infection was seen in O. curzoniae. Phylogenetic analysis revealed consistent sequences of cox1 gene from E. shiquicus in Yushu City of Qinghai Province and Shiqu County, Ganzi Tibetan Autonomous Prefecture of Sichuan Province. Conclusions The small rodents around the human settlement in Yushu City of Qinghai Province mainly include O. curzoniae and L. fuscus, with the greatest numbers seen in May and August, respectively. Following the concerted efforts for echinococcosis control, the prevalence of Echinococcus infections is low in small rodents around the human settlement in Yushu City; however, there is still a risk of echinococcosis transmission.

OBJECTIVE: A failed electrocardiography (ECG)-trigger often leads to a long acquisition time (TA) and deterioration in image quality. The purpose of this study was to evaluate and optimize the technique of self-gated (SG) cardiovascular magnetic resonance (CMR) for cardiac late gadolinium enhancement (LGE) imaging of rats with myocardial infarction/reperfusion. MATERIALS AND METHODS: Cardiovascular magnetic resonance images of 10 rats were obtained using SG-LGE or ECG with respiration double-gating (ECG-RESP-gating) method at 7T to compare differences in image interference and TA between the two methods. A variety of flip angles (FA: 10°–80°) and the number of repetitions (NR: 40, 80, 150, and 300) were investigated to determine optimal scan parameters of SG-LGE technique based on image quality score and contrast-to-noise ratio (CNR). RESULTS: Self-gated late gadolinium enhancement allowed successful scan in 10 (100%) rats. However, only 4 (40%) rats were successfully scanned with the ECG-RESP-gating method. TAs with SG-LGE varied depending on NR used (TA: 41, 82, 154, and 307 seconds, corresponding to NR of 40, 80, 150, and 300, respectively). For the ECG-RESP-gating method, the average TA was 220 seconds. For SG-LGE images, CNR (42.5 ± 5.5, 43.5 ± 7.5, 54 ± 9, 59.5 ± 8.5, 56 ± 13, 54 ± 8, and 41 ± 9) and image quality score (1.85 ± 0.75, 2.20 ± 0.83, 2.85 ± 0.37, 3.85 ± 0.52, 2.8 ± 0.51, 2.45 ± 0.76, and 1.95 ± 0.60) were achieved with different FAs (10°, 15°, 20°, 25°, 30°, 35°, and 40°, respectively). Optimal FAs of 20°–30° and NR of 80 were recommended. CONCLUSION: Self-gated technique can improve image quality of LGE without irregular ECG or respiration gating. Therefore, SG-LGE can be used an alternative method of ECG-RESP-gating.
Animals ; Electrocardiography ; Gadolinium* ; Magnetic Resonance Imaging ; Methods ; Myocardial Infarction* ; Rats* ; Respiration