Objective To assess the value of cardiac magnetic resonance(CMR)imaging for predicting adverse left ventricular remodeling in patients with ST-segment elevation myocardial infarction(STEMI).Methods We retrospectively analyzed the clinical data and serial CMR(cine and LGE sequences)images of 86 STEMI patients within 1 week and 5 months after percutaneous coronary intervention(PCI),including 25 patients with adverse LV remodeling and 61 without adverse LV remodeling,defined as an increase of left ventricular end-systolic volume(LVESV)over 15%at the second CMR compared to the initial CMR.The CMR images were analyzed for LV volume,infarct characteristics,and global and infarct zone myocardial function.The independent predictors of adverse LV remodeling following STEMI were analyzed using univariate and multivariate Logistic regression methods.Results The initial CMR showed no significant differences in LV volume or LV ejection fraction(LVEF)between the two groups,but the infarct mass and microvascular obstructive(MVO)mass were significantly greater in adverse LV remodeling group(P<0.05).Myocardial injury and cardiac function of the patients recovered over time in both groups.At the second CMR,the patients with adverse LV remodeling showed a significantly lower LVEF,a larger left ventricular end-systolic volume index(LVESVI)and a greater extent of infarct mass(P<0.001)with lower global peak strains and strain rates in the radial,circumferential,and longitudinal directions(P<0.05),infarct zone peak strains in the 3 directions,and infarct zone peak radial and circumferential strain rates(P<0.05).The independent predictors for adverse LV remodeling following STEMI included the extent of infarct mass(AUC=0.793,95%CI:0.693-0.873;cut-off value:30.67%),radial diastolic peak strain rate(AUC=0.645,95%CI:0.534-0.745;cut-off value:0.58%),and RAAS inhibitor(AUC= 0.699,95%CI:0.590-0.793).Conclusion The extent of infarct mass,peak radial diastolic strain rate,and RAAS inhibitor are independent predictors of adverse LV remodeling following STEMI.

Objective To investigate the application efficiency and potential of CT radiomics in differentiating malignant and benign sub-centimeter solid pulmonary nodules. Methods A retrospective study was performed on the sub-centimeter ( ≤ 10 mm) solid pulmonary nodules detected by enhanced CT in our hospital from March 2020 to January 2023. Malignancy was confirmed by surgical pathology, and benignity was confirmed by surgical pathology or follow-up. Lesions were manually segmented and radiomic features were extracted. The feature dimension was reduced via feature correlation analysis and least absolute shrinkage and selection operator (LASSO). The 5-fold cross validation was used to validate the model. Support vector machine, logistic regression, linear classification support vector machine, gradient boosting, and random forest models were established for CT radiomics. Receiver operating characteristic curves were drawn. Delong test was used to compare the diagnostic performance of the five classifiers. The optimal model was selected and compared to radiologists with medium and high seniority. Results A total of 303 nodules, 136 of which were malignant, were examined. Radiomics models were established after feature extraction and selection. On test set, the areas under the receiver operating characteristic curves of support vector machine, logistic regression, linear classification support vector machine, random forest, and gradient boosting models were 0.922 (95%CI: 0.893, 0.950), 0.910 (95%CI: 0.878, 0.942), 0.905 (95%CI: 0.872, 0.938), 0.899 (95%CI: 0.865, 0.933), and 0.896 (95%CI: 0.862, 0.930), respectively. Delong test indicated no significant differences in the performance of the five radiomics models, and the support vector machine model showed the highest accuracy and F1 score. The support vector machine model showed significantly higher diagnostic accuracy as compared to radiologists (83.8% vs. 55.4%, P < 0.001). Conclusion The radiomics models achieved high diagnostic efficiency and may help to reduce the uncertainty in diagnosis of malignant and benign sub-centimeter solid nodules by radiologists.

Objective To assess the value of cardiac magnetic resonance(CMR)imaging for predicting adverse left ventricular remodeling in patients with ST-segment elevation myocardial infarction(STEMI).Methods We retrospectively analyzed the clinical data and serial CMR(cine and LGE sequences)images of 86 STEMI patients within 1 week and 5 months after percutaneous coronary intervention(PCI),including 25 patients with adverse LV remodeling and 61 without adverse LV remodeling,defined as an increase of left ventricular end-systolic volume(LVESV)over 15%at the second CMR compared to the initial CMR.The CMR images were analyzed for LV volume,infarct characteristics,and global and infarct zone myocardial function.The independent predictors of adverse LV remodeling following STEMI were analyzed using univariate and multivariate Logistic regression methods.Results The initial CMR showed no significant differences in LV volume or LV ejection fraction(LVEF)between the two groups,but the infarct mass and microvascular obstructive(MVO)mass were significantly greater in adverse LV remodeling group(P<0.05).Myocardial injury and cardiac function of the patients recovered over time in both groups.At the second CMR,the patients with adverse LV remodeling showed a significantly lower LVEF,a larger left ventricular end-systolic volume index(LVESVI)and a greater extent of infarct mass(P<0.001)with lower global peak strains and strain rates in the radial,circumferential,and longitudinal directions(P<0.05),infarct zone peak strains in the 3 directions,and infarct zone peak radial and circumferential strain rates(P<0.05).The independent predictors for adverse LV remodeling following STEMI included the extent of infarct mass(AUC=0.793,95%CI:0.693-0.873;cut-off value:30.67%),radial diastolic peak strain rate(AUC=0.645,95%CI:0.534-0.745;cut-off value:0.58%),and RAAS inhibitor(AUC= 0.699,95%CI:0.590-0.793).Conclusion The extent of infarct mass,peak radial diastolic strain rate,and RAAS inhibitor are independent predictors of adverse LV remodeling following STEMI.

OBJECTIVE: To quantitatively assess cardiac functions in patients with cardiac amyloidosis (CA) and hypertrophic cardiomyopathy (HCM) using cardiac magnetic resonance-feature tracking (CMR-FT) technique and evaluate the prognostic value of CMR-FT in patients with CA. METHODS: We retrospectively collected the data from 31 CA patients with systemic amyloidosis confirmed by Congo red staining and serum immunohistochemistry after extracardiac tissue biopsy undergoing CMR at our hospital from March, 2013 to June, 2021.Thirty-one age and gender matched patients with asymmetric left ventricular wall hypertrophy and 31 healthy individuals without organic or functional heart disease served as the controls.Radial, circumferential and longitudinal strains and strain rates of the left ventricle at the global level and in each myocardial segment (basal, middle and apical) were obtained with CMR-FT technique and compared among the 3 groups.The predictive value of myocardial strains and strain rates for all-cause mortality in CA patients was analyzed using a stepwise COX regression model. RESULTS: The left ventricular volume, myocardial mass, ejection fraction and cardiac output differed significantly among the groups (P < 0.05).Except for apical longitudinal strain, the global and segmental strains were all significantly lower in CA group than in HCM group (P < 0.05).The global and segmental strains were all significantly lower in CA group than in the healthy individuals (P < 0.05).The basal strain rates in the 3 directions were significantly lower in CA group than in the healthy individuals (P < 0.05), but the difference in apical strain rates was not statistically significant between the two groups.Multivariate stepwise COX analysis showed that troponin T (HR=1.05, 95%CI: 1.01-1.10, P=0.017) and middle peak diastolic circumferential strain rate (HR=6.87, 95%CI: 1.52-31.06, P=0.012) were strong predictors of death in CA patients. CONCLUSION Strain and strain rate parameters derived from CMR-FT based on cine sequences are new noninvasive imaging markers for assessing cardiac impairment in CA and cardiac function changes in HCM, and provide independent predictive information for all-cause mortality in CA patients.
Humans ; Retrospective Studies ; Magnetic Resonance Imaging, Cine/methods* ; Cardiomyopathy, Hypertrophic/diagnostic imaging* ; Ventricular Function, Left ; Stroke Volume ; Amyloidosis/diagnostic imaging* ; Magnetic Resonance Spectroscopy ; Prognosis ; Predictive Value of Tests

Objective:To understand the profile type of serum Epstein-Barr virus (EBV) antibodies in children with infectious mononucleosis (IM), and to analyze the significance of viral capsid antigen (VCA) IgG antibody affinity in the diagnosis of IM.Methods:Retrospective analysis was performed on the results of the serum anti-EBV antibody profile and plasma EBV nucleic acid test of 150 hospitalized children with IM diagnosed in Beijing Children′s Hospital, Capital Medical University, from May 2016 to May 2019.Anti-EBV antibody profiles, including anti-VCA-IgG, anti-VCA-IgM, anti-early antigen (EA) IgA, anti-EBV nuclear antigen (EBNA) IgG, and anti-VCA-IgG affinity, were detected by enzyme-linked immunosorbent assay (ELISA). Plasma EBV nucleic acids were detected by real-time quantitative PCR.Results:There were mainly two types of anti-EBV antibody profiles in 150 children with IM: (1)130 cases who were positive for anti-VCA-IgM/IgG, negative for anti-EBNA-IgG and positive for anti-VCA-IgG antibodies with low affinity, accounting for 86.7% (130/150 cases), of which 50 cases were positive for anti-early antigen IgA; (2)18 cases who were negative for anti-VCA-IgM, positive for anti-VCA-IgG, negative for anti-EBNA-IgG and positive for anti-VCA-IgG antibody with low affinity, accounting for 12.0% (18/150 cases), of which 5 cases were positive for anti-EA IgA.EBV DNA was measured in 132 children, with a posi-tive rate of 37.9% (50/132 cases).Conclusions:There were several types of serum EBV antibody profiles in children with IM, 12.0% of patients with IM in this study were negative for anti-VCA-IgM, and the diagnosis of IM was confirmed by the affinity of anti-VCA IgG.

Traumatic brain injury (TBI)-induced coagulopathy has increasingly been recognized as a significant risk factor for poor outcomes, but the pathogenesis remains poorly understood. In this study, we aimed to investigate the causal role of acrolein, a typical lipid peroxidation product, in TBI-induced coagulopathy, and further explore the underlying molecular mechanisms. We found that the level of plasma acrolein in TBI patients suffering from coagulopathy was higher than that in those without coagulopathy. Using a controlled cortical impact mouse model, we demonstrated that the acrolein scavenger phenelzine prevented TBI-induced coagulopathy and recombinant ADAMTS-13 prevented acrolein-induced coagulopathy by cleaving von Willebrand factor (VWF). Our results showed that acrolein may contribute to an early hypercoagulable state after TBI by regulating VWF secretion. mRNA sequencing (mRNA-seq) and transcriptome analysis indicated that acrolein over-activated autophagy, and subsequent experiments revealed that acrolein activated autophagy partly by regulating the Akt/mTOR pathway. In addition, we demonstrated that acrolein was produced in the perilesional cortex, affected endothelial cell integrity, and disrupted the blood-brain barrier. In conclusion, in this study we uncovered a novel pro-coagulant effect of acrolein that may contribute to TBI-induced coagulopathy and vascular leakage, providing an alternative therapeutic target.

Traumatic brain injury (TBI) triggers the activation of the endogenous coagulation mechanism, and a large amount of thrombin is released to curb uncontrollable bleeding through thrombin receptors, also known as protease-activated receptors (PARs). However, thrombin is one of the most critical factors in secondary brain injury. Thus, the PARs may be effective targets against hemorrhagic brain injury. Since the PAR1 antagonist has an increased bleeding risk in clinical practice, PAR4 blockade has been suggested as a more promising treatment. Here, we explored the expression pattern of PAR4 in the brain of mice after TBI, and explored the effect and possible mechanism of BMS-986120 (BMS), a novel selective and reversible PAR4 antagonist on secondary brain injury. Treatment with BMS protected against TBI in mice. mRNA-seq analysis, Western blot, and qRT-PCR verification in vitro showed that BMS significantly inhibited thrombin-induced inflammation in astrocytes, and suggested that the Tab2/ERK/NF-κB signaling pathway plays a key role in this process. Our findings provide reliable evidence that blocking PAR4 is a safe and effective intervention for TBI, and suggest that BMS has a potential clinical application in the management of TBI.

Clinical advances in the treatment of intracranial hemorrhage (ICH) are restricted by the incomplete understanding of the molecular mechanisms contributing to secondary brain injury. Acrolein is a highly active unsaturated aldehyde which has been implicated in many nervous system diseases. Our results indicated a significant increase in the level of acrolein after ICH in mouse brain. In primary neurons, acrolein induced an increase in mitochondrial fragmentation, loss of mitochondrial membrane potential, generation of reactive oxidative species, and release of mitochondrial cytochrome c. Mechanistically, acrolein facilitated the translocation of dynamin-related protein1 (Drp1) from the cytoplasm onto the mitochondrial membrane and led to excessive mitochondrial fission. Further studies found that treatment with hydralazine (an acrolein scavenger) significantly reversed Drp1 translocation and the morphological damage of mitochondria after ICH. In parallel, the neural apoptosis, brain edema, and neurological functional deficits induced by ICH were also remarkably alleviated. In conclusion, our results identify acrolein as an important contributor to the secondary brain injury following ICH. Meanwhile, we uncovered a novel mechanism by which Drp1-mediated mitochondrial oxidative damage is involved in acrolein-induced brain injury.

Objective: To compare the preoperative and postoperative dosimetric parameters in the treatment of spinal metastasis, and to verify the accuracy of 3D-printing non-coplanar template (3D-PNCT) combined with CT-guided ¹²⁵I seed implantation for the treatment of spinal metastasis. Methods: The treatment plans of 7 patients with spinal metastasis (9 lesions) from 2016 to 2018 receiving 3D-PNCT in combination with CT-guided ¹²⁵I seed implantation were retrospectively analyzed. The dosimetric parameters including homogeneity index (HI), conformal index (CI), external index (EI), dose of 90% target volume(D₉₀), mPD, volume percent of 100%, 150%, and 200% prescribed dose V₁₀₀、V₁₅₀、V₂₀₀ and D_2cm³ of spinal cord were compared before and after operation. The british columbia cancer ageny particle implantation quality evaluation standard was applied to evaluate the quality of implantation. Results: The HI, EI and CI, D₉₀, mPD, V₁₀₀, V₁₅₀, V₂₀₀ and D_2cm³ of spinal cord did not significantly differ before and after the plan (all P>0.05). Five were evaluated as excellent and 4 were assessed as good. Conclusion The postoperative dosimetric parameters of 3D-PNCT combined with CT guided ¹²⁵I seed implantation of spinal metastasis are basically consistent with preoperative dosimetric parameters. The postoperative plans are evaluated as excellent or good, suggesting that the technology has a good therapeutic accuracy in the treatment of spinal metastasis.