Objective To explore the magnetic resonance(MR)imaging characteristics of joint damage caused by Chikungunya virus(CHIKV)and its correlation with pain severity,and analyze the value of T2-Mapping in asse-ssing the severity and prognosis of such damage.Methods A multicenter retrospective study design was adopted,and patients with CHIKV infection accompanied by joint pain were included in analysis.Multi-joint MR scans were performed to assess joint effusion,synovial thickening,bone marrow edema,and cartilage damage.T2-Mapping values were measured.Pain severity was assessed using the Visual Analog Scale(VAS),and imaging findings were independently assessed by two radiologists.Results A total of 131 patients were included in the study.The inci-dence of joint cavity and/or synovial sac effusion was the highest(77.1％,n=101),with knee and ankle joint effu-sion accounting for 81.2％(severe,mild-moderate were 17 and 65 cases,respectively),other joint effusion were mild.78 cases had synovial thickening(14 and 64 were severe and mild-moderate cases,respectively),27 cases had tenosynovitis,21 cases had bone marrow edema(primarily in the knee and ankle joints).19 cases had cartilage damage,114 cases presented muscle soft tissue edema(17 and 97 were severe and mild-moderate cases,respective-ly),28 cases had Kager's fat pad edema.Patients with elevated T2-Mapping values exhibited more pronounced chronic joint pain,with T2-Mapping values in the cartilage damage site increasing by 40％-60％compared with normal cartilage site(19 cases in total).The T2-Mapping value for severely damaged soft tissue was(52.3+6.7)ms,while for mildly to moderately damaged soft tissue was(42.3±5.2)ms,both significantly higher than normal refe-rence values(＜35 ms,both P＜0.05).Among 17 patients with severe soft tissue damage,12 experienced persistent pain for over one month,with statistically significant differences in T2 values compared with those with mild-mode-rate damage(P＜0.05).This further suggested that the degree of elevation in T2-Mapping values was closely related to the duration of pain and the severity of damage.After one-month follow-up,103 patients had pain relief.Among the 28 patients with ongoing pain,17 developed into subacute bone joint pain.Bone marrow edema(81.0％),ele-vation of T2-Mapping value of cartilage(89.5％),and severe synovial thickening(71.4％)were high-risk MR manifestations of subacute bone joint pain.The incidences of subacute joint cavity/sac effusion and subacute tenosy-novitis were 3.0％and 7.4％,respectively.Conclusion MR can clearly display the inflammatory and structural changes in CHIKV joint damage,and T2-Mapping values may serve as a potential imaging measurement parameter for assessing severity and prognosis of damage.

Objective:To investigate the effectiveness of combined teaching method integrating case-based teaching method(CBL),problem-based teaching method(PBL),and team-based teaching method(TBL)in clinical nursing teaching in pediatric intensive care unit(PICU).Methods:A total of 60 nursing students who trained in our PICU from Jan 2021 to Jun 2022 were selected as the control group,and 60 nursing students who trained in our PICU from Jul 2022 to Jun 2024 were selected as the research group.The control group received conventional nursing teaching mode,while the research group received combined teaching mode of CBL,PBL,and TBL.The scores of academic performance,logical thinking ability,self-learning ability,and clinical nursing comprehensive ability between the two groups were compared.Result:The scores of theoretical knowledge,operational skills,post-teaching Critical Thinking Disposition Inventory-Chinese Version(CTDI-CV)scale,self-directed learning readiness scale for nursing,and Mini-clinical evaluation exercise scale(Mini-CEX)in the research group were higher than those in the control group(P＜0.05).Conclusion:The combined teaching method of CBL,PBL,and TBL can effectively improve clinical nursing teaching results and comprehensive abilities of nursing students.

Objective This study aimed to investigate the relationship between multiple inflammatory markers and poor outcome in patients with intracerebral hemorrhage,and to compare their predictive abilities.Methods We retrospectively analyzed the patients with intracerebral hemorrhage admitted to the Department of Neurology of the First Affiliated Hospital of Nanchang University from January 1,2015 to March 31,2023.According to the Modified Rankin Scale at 90 days after onset,the patients were divided into good outcome(mRS≤2 points)and poor outcome(mRS score≥3 points).Clinical information,laboratory examinations and follow-up data were compared between the two groups.Inflammatory markers include neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),monocyte to high-density lipoprotein ratio(MHR),systemic inflammatory response index(SIRI),systemic immune-inflammation index(SII),white blood cell count to mean platelet volume ratio(WMR),lymphocyte to monocyte ratio(LMR),and systemic coagulation-inflammation index(SCI).Univariate and multivariate logistic regression analysis were used to analyze the predictors of poor prognosis after intracerebral hemorrhage,and receiver operating characteristic curve(ROC)was constructed to compare their predictive ability.Results A total of 510 patients with intracerebral hemorrhage were included.Of those,297(58.2%)had good outcome,and 213(41.8%)had poor outcome.Comparison of baseline characteristics demonstrated that patients with poor prognosis had higher levels of white blood cells,neutrophils,high-density lipoprotein,fibrinogen,NLR,PLR,SIRI,SII,WMR at admission,larger baseline hematoma volume and baseline perihematomal edema volume,a higher proportion of lobar hemorrhage,older age,and lower levels of platelets,lymphocytes,LMR,and SCI(P<0.05).Multivariate regression analysis showed that NLR(OR:1.081,95%CI:1.032～1.1131,P=0.001),SIRI(OR:1.089,95%CI:1.014～1.169,P=0.019),SII(OR:1.000,95%CI:1.000～1.001,P=0.011),WMR(OR:2.627,95%CI:1.267～5.445,P=0.009)were independently associated with poor prognosis in patients with ICH.In ROC analysis,the area under the curve of NLR(0.729,95%CI:0.685～0.774)was higher than SIRI(0.692,95%CI:0.645～0.738),SII(0.688,95%CI:0.641～0.735)and WMR(0.65,95%CI:0.602～0.698)for predicting poor outcomes.Conclusion NLR,SIRI,SII and WMR at admission are independently associated with poor outcomes in patients with intracerebral hemorrhage,and NLR has the strongest predictive ability.

Objective This study aimed to investigate the relationship between multiple inflammatory markers and poor outcome in patients with intracerebral hemorrhage,and to compare their predictive abilities.Methods We retrospectively analyzed the patients with intracerebral hemorrhage admitted to the Department of Neurology of the First Affiliated Hospital of Nanchang University from January 1,2015 to March 31,2023.According to the Modified Rankin Scale at 90 days after onset,the patients were divided into good outcome(mRS≤2 points)and poor outcome(mRS score≥3 points).Clinical information,laboratory examinations and follow-up data were compared between the two groups.Inflammatory markers include neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),monocyte to high-density lipoprotein ratio(MHR),systemic inflammatory response index(SIRI),systemic immune-inflammation index(SII),white blood cell count to mean platelet volume ratio(WMR),lymphocyte to monocyte ratio(LMR),and systemic coagulation-inflammation index(SCI).Univariate and multivariate logistic regression analysis were used to analyze the predictors of poor prognosis after intracerebral hemorrhage,and receiver operating characteristic curve(ROC)was constructed to compare their predictive ability.Results A total of 510 patients with intracerebral hemorrhage were included.Of those,297(58.2%)had good outcome,and 213(41.8%)had poor outcome.Comparison of baseline characteristics demonstrated that patients with poor prognosis had higher levels of white blood cells,neutrophils,high-density lipoprotein,fibrinogen,NLR,PLR,SIRI,SII,WMR at admission,larger baseline hematoma volume and baseline perihematomal edema volume,a higher proportion of lobar hemorrhage,older age,and lower levels of platelets,lymphocytes,LMR,and SCI(P<0.05).Multivariate regression analysis showed that NLR(OR:1.081,95%CI:1.032～1.1131,P=0.001),SIRI(OR:1.089,95%CI:1.014～1.169,P=0.019),SII(OR:1.000,95%CI:1.000～1.001,P=0.011),WMR(OR:2.627,95%CI:1.267～5.445,P=0.009)were independently associated with poor prognosis in patients with ICH.In ROC analysis,the area under the curve of NLR(0.729,95%CI:0.685～0.774)was higher than SIRI(0.692,95%CI:0.645～0.738),SII(0.688,95%CI:0.641～0.735)and WMR(0.65,95%CI:0.602～0.698)for predicting poor outcomes.Conclusion NLR,SIRI,SII and WMR at admission are independently associated with poor outcomes in patients with intracerebral hemorrhage,and NLR has the strongest predictive ability.

Objective To explore the magnetic resonance(MR)imaging characteristics of joint damage caused by Chikungunya virus(CHIKV)and its correlation with pain severity,and analyze the value of T2-Mapping in asse-ssing the severity and prognosis of such damage.Methods A multicenter retrospective study design was adopted,and patients with CHIKV infection accompanied by joint pain were included in analysis.Multi-joint MR scans were performed to assess joint effusion,synovial thickening,bone marrow edema,and cartilage damage.T2-Mapping values were measured.Pain severity was assessed using the Visual Analog Scale(VAS),and imaging findings were independently assessed by two radiologists.Results A total of 131 patients were included in the study.The inci-dence of joint cavity and/or synovial sac effusion was the highest(77.1％,n=101),with knee and ankle joint effu-sion accounting for 81.2％(severe,mild-moderate were 17 and 65 cases,respectively),other joint effusion were mild.78 cases had synovial thickening(14 and 64 were severe and mild-moderate cases,respectively),27 cases had tenosynovitis,21 cases had bone marrow edema(primarily in the knee and ankle joints).19 cases had cartilage damage,114 cases presented muscle soft tissue edema(17 and 97 were severe and mild-moderate cases,respective-ly),28 cases had Kager's fat pad edema.Patients with elevated T2-Mapping values exhibited more pronounced chronic joint pain,with T2-Mapping values in the cartilage damage site increasing by 40％-60％compared with normal cartilage site(19 cases in total).The T2-Mapping value for severely damaged soft tissue was(52.3+6.7)ms,while for mildly to moderately damaged soft tissue was(42.3±5.2)ms,both significantly higher than normal refe-rence values(＜35 ms,both P＜0.05).Among 17 patients with severe soft tissue damage,12 experienced persistent pain for over one month,with statistically significant differences in T2 values compared with those with mild-mode-rate damage(P＜0.05).This further suggested that the degree of elevation in T2-Mapping values was closely related to the duration of pain and the severity of damage.After one-month follow-up,103 patients had pain relief.Among the 28 patients with ongoing pain,17 developed into subacute bone joint pain.Bone marrow edema(81.0％),ele-vation of T2-Mapping value of cartilage(89.5％),and severe synovial thickening(71.4％)were high-risk MR manifestations of subacute bone joint pain.The incidences of subacute joint cavity/sac effusion and subacute tenosy-novitis were 3.0％and 7.4％,respectively.Conclusion MR can clearly display the inflammatory and structural changes in CHIKV joint damage,and T2-Mapping values may serve as a potential imaging measurement parameter for assessing severity and prognosis of damage.

ObjectiveTo investigate the effects of artemisinin （ART） on histopathological damage and salivary secretion in the submandibular gland （SMG） of mice with Sjögren's syndrome （SS） model，and on the expression of aquaporin 5 （AQP5） in SMG cells. MethodsThe NOD/Ltj mice were used as a model of SS and randomly divided into the SS model group，the ART group，and the hydroxychloroquine sulfate （HCQ） group，with six mice per group. Another 6 female BALB/c mice at the same week were selected as the control group. Mice in the ART group was fed with the ART solution daily in the dosage of 50 mg·kg^-1，and mice in the HCQ group was given with the HCQ solution （1 300 mg·kg^-1）. Mice in the SS model and control groups were given saline daily. The treatment lasted for 8 weeks. The 24-hour average water intake，salivary flow rate，SMG pathology scores of mice in each group were measured，as well as the expression levels of AQP5 protein and gene in the SMG tissues. ResultsCompared with the control group，the 24-hour average water intake of mice in the model group was significantly increased （P<0.01），and the saliva flow rate was significantly decreased （P<0.01）. Compared to the SS model group，the 24-hour average water intake of mice in the ART and HCQ groups was significantly reduced （P<0.01），and the salivary flow rate was significantly increased in the ART group（P<0.01），comparisons between groups showed that the ART was superior to the HCQ in reducing water intake and improving saliva flow rate in SS model mice （P<0.05）. The HE staining results showed that，compared with the normal group，the number of lymphocyte infiltration foci in SMG tissue in the model group increased，and the pathological score increased （P<0.01）. Compared to the SS model group，after the intervention of the ART and HCQ，the number of lymphocytic infiltration foci in the SMG tissue decreased，the area of the lymphocytic infiltration foci was reduced，and the pathology score of the SMG tissues was lowered in the ART group（P<0.01）. However，there was no difference in pathological scores between the ART and HCQ groups . The results of IHC，Western blot，and Real-time PCR showed that，compared with the normal group，the expression levels of AQP5 protein and gene in SMG tissue in the model group significantly decreased （P<0.05）. Comparing with the SS model group，the ART and HCQ groups could significantly up-regulated the expression levels of AQP5 protein and mRNA in the SMG tissue，and the treatment effect was better than that of HCQ. ConclusionART was able to ameliorate SMG structural damage and salivary secretion function in SS model mice，and its mechanism of action may be related to the up-regulation of AQP5 protein and gene expression levels in SMG cells.

This case report describes a 68-year-old male patient diagnosed with primary hepatocellular carcinoma (HCC). After receiving Yttrium-90 microsphere selective internal radiation therapy (⁹⁰Y-SIRT), the tumor significantly reduced in size, and tumor markers alpha fetoprotein (AFP) and abnormal prothrombin (PIVKA-Ⅱ) decreased. Postoperative pathological results showed minimal residual tumor cells, indicating that ⁹⁰Y-SIRT has good efficacy and safety in downstaging and conversion of HCC, thereby facilitating subsequent surgical resection.

Objective To analyze the disease burden of hip osteoarthritis(HOA)and its changing trends in China from 1990 to 2021.Methods Utilizing the Global Burden of Disease(GBD)2021 database,age-standardized incidence rate(ASIR),age-standardized prevalence rate(ASPR),and age-standardized disability adjusted life years(DALY)rate(ASDR)of HOA were compared and analyzed in China,globally,and in regions with high sociodemographic index(SDI)from 1990 to 2021.Joinpoint regression model was used to analyze the temporal trend of disease burden,and age and gender were combined to deeply analyze the disease burden of HOA in China.Meanwhile,the age-period-cohort model was used to analyze the influencing factors and the Bayesian age-period-cohort model to predict the trend of China's HOA disease burden in the next 10 years.Results The ASIR,ASPR,and ASDR of HOA in China showed an increasing trend from 1990 to 2021[average annual percentage change(AAPC)were 0.87％,0.82％,and 0.81％,respectively,P＜0.001],and their AAPCs were higher than those of the global and high SDI regions,but in 2021,the ASIR,ASPR,and ASDR of China were lower than those of the global and high SDI regions.Crude incidence,crude prevalence,and crude DALY rate in Chinese HOA increased with age,with the highest number of incidence in the 55-59 age group and the highest number of prevalence,DALY,in the 65-69 age group.In 2021,the ASIR,ASPR and ASDR of HOA in Chinese males were 1.25,1.24 and 1.25 times higher than those in females.Changes in the incidence of HOA in China from 1990 to 2021 were influenced by age,period,and birth cohort.Compared with 2021,new cases of HOA are expected to increase by 37.78％by 2035,and the number of incidence cases in people aged 60 years and above will increase significantly.Conclusion The disease burden of HOA in China continued to rise from 1990 to 2021,and prevention and control need to be strengthened,with a focus on men,high BMI,and middle-aged and older populations.

Objective:To optimize the image quality of PET/CT following 90Y-selective internal radiation therapy ( 90Y-SIRT) using block-sequential regularized expectation maximization (BSREM) reconstruction algorithm, and to evaluate its impact of different β values on image quality and quantitative analysis. Methods:A retrospective study was conducted on 8 male patients with hepatic tumors (age: 62(52, 71) years) treated at Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine Tsinghua University, between June 2024 and January 2025. All patients were treated with 90Y resin microspheres (2.6(0.9, 3.6)GBq) and underwent post-treatment 90Y PET/CT liver imaging. Imaging data were reconstructed using BSREM with different noise penalty weighting factors ( β values: 0, 300, 1000, 1500, 2500, 3500, 4000, 6000, 8000, 10000). Visual assessment was independently performed by two nuclear medicine physicians, using a 4-point scale (1=worst, 4=best). The mean score was considered as the final score. The consistency of the 2 reviewers was calculated and analyzed by Kappa test. Visual scores of different β value groups were compared by Friedman test. The β value demonstrating highest mean score and optimal consistency was selected as the optimal. Quantitative analysis was performed using MIM software to calculate the maximum absorbed dose ( Dmax) and the mean absorbed dose ( Dmean) for tumor, normal liver, and whole liver regions, and the CV was used to evaluate the impact of β values. Results:The visual assessment consistency of reviewers in 3 β value groups (0, 3500, 6000) were the highest (7/8) (all kappa=0.88, all P<0.05). Visual scores of the 10 β value groups were significantly different ( χ2=28.74, P<0.001), and the visual scores of 2 β value groups (3500, 4000) were the highest, both of which were 4.0(4.0, 4.0). Overall, visual assessment identified β=3500 as the optimal. Quantitative analysis revealed that, (1) Dmax in all regions (tumor, normal liver, whole liver) decreased with the increasing β values, stabilizing when β>1000 ( CV 56%-67%); (2) Dmean remained stable across different β values ( CV 0.04%-5.00%). Conclusions:In BSREM reconstruction, β=3500 is the optimal parameter for improving 90Y-PET image quality. β values significantly affect Dmax (stabilizing at β > 1000), but have no significant impact on Dmean, suggesting that reconstruction parameters primarily influence dose distribution morphology rather than average dose assessments.

Objective To analyze the disease burden of hip osteoarthritis(HOA)and its changing trends in China from 1990 to 2021.Methods Utilizing the Global Burden of Disease(GBD)2021 database,age-standardized incidence rate(ASIR),age-standardized prevalence rate(ASPR),and age-standardized disability adjusted life years(DALY)rate(ASDR)of HOA were compared and analyzed in China,globally,and in regions with high sociodemographic index(SDI)from 1990 to 2021.Joinpoint regression model was used to analyze the temporal trend of disease burden,and age and gender were combined to deeply analyze the disease burden of HOA in China.Meanwhile,the age-period-cohort model was used to analyze the influencing factors and the Bayesian age-period-cohort model to predict the trend of China's HOA disease burden in the next 10 years.Results The ASIR,ASPR,and ASDR of HOA in China showed an increasing trend from 1990 to 2021[average annual percentage change(AAPC)were 0.87％,0.82％,and 0.81％,respectively,P＜0.001],and their AAPCs were higher than those of the global and high SDI regions,but in 2021,the ASIR,ASPR,and ASDR of China were lower than those of the global and high SDI regions.Crude incidence,crude prevalence,and crude DALY rate in Chinese HOA increased with age,with the highest number of incidence in the 55-59 age group and the highest number of prevalence,DALY,in the 65-69 age group.In 2021,the ASIR,ASPR and ASDR of HOA in Chinese males were 1.25,1.24 and 1.25 times higher than those in females.Changes in the incidence of HOA in China from 1990 to 2021 were influenced by age,period,and birth cohort.Compared with 2021,new cases of HOA are expected to increase by 37.78％by 2035,and the number of incidence cases in people aged 60 years and above will increase significantly.Conclusion The disease burden of HOA in China continued to rise from 1990 to 2021,and prevention and control need to be strengthened,with a focus on men,high BMI,and middle-aged and older populations.