Objective:To explore the application of COVID-19-specific IgG antibody in identifying epidemic Omicron BA.5 strain infection.Method:Omicron BF.7/BA.5 naturally infected population, healthy population vaccinated with the COVID-19 vaccine, and Omicron BF.7/BA.5 breakthrough cases were enrolled into this study. The serum WT-S-IgG and BA.5-S-IgG were detected by indirect ELISA, and the serum-specific IgG antibody levels of different populations were compared. The application value of the two antibody titers and the ratio of the two antibodies in identifying Omicron BA.5 epidemic strain infection were explored by the ROC curve, aiming to provide technical support for pathogen diagnosis.Results:The antibody titers of WT-S-IgG and BA.5-S-IgG in the breakthrough cases were higher than those in the naturally infected population and the healthy population ( P<0.05). The area under the curve (AUC) of WT-S-IgG and BA.5-S-IgG in identifying epidemic Omicron BA.5 strain infection was 0.947 and 0.961, respectively. The AUC of BA.5-S-IgG and WT-S-IgG antibody titer ratio was 0.873. When the antibody titer ratio was 0.855, the sensitivity and specificity were 80.00% and 90.00%, respectively. According to the interval since the last infection, the AUC of the ratio of BA.5-S-IgG to WT-S-IgG antibody titer to identify the infection of epidemic strains less than 30 days and more than 30 days was 0.887 and 0.863, respectively, and the sensitivity and specificity were both above 80%. Conclusion:Both BA.5-S-IgG and WT-S-IgG, as well as the combination of these two antibodies, are of high value in the identification of epidemic strains.

Objective To explore the correlation between peripheral blood microRNA-34a(miR-34a),mi-croRNA-431(miR-431),and microRNA-183(miR-183)levels with hemodynamics and hearing prognosis in patients with sudden deafness(SD).Methods A total of 132 patients with SD who visited the First Affiliated Hospital of Air Force Medical University(the hospital)from January 2021 to December 2023 were included as the disease group,132 healthy individuals(without SD)who came to the hospital for physical examination were used as the control group.Real-time fluorescence quantitative PCR(RT-qPCR)was used to detect the levels of miR-34a,miR-431,and miR-183 in peripheral blood.Pearson correlation was applied to analyze the correlation between peripheral blood miR-34a,miR-431,miR-183 levels and hemodynamic indicators.Multiple Logistic regression analysis(stepwise forward method)was applied to screen for factors affecting the hearing prognosis of patients with SD.Receiver operating characteristic(ROC)curve was plotted to obtain the area under the curve(AUC)of the single and combination of peripheral blood miR-34a,miR-431,and miR-183 in predicting hearing prognosis in patients with SD,and the AUC was compared using Z-test.Results The levels of miR-34a and miR-431 in the peripheral blood in the disease group were greatly higher than those in the con-trol group,while the level of miR-183 was greatly lower than that in the control group(P＜0.05).After treatment,the whole blood high shear viscosity(HSV),whole blood low shear viscosity(LSV),plasma vis-cosity(PV)of patients with SD were greatly lower than those before treatment(P＜0.05).The levels of miR-34a and miR-431 in peripheral blood of patients with SD were positively correlated with pre-treatment levels of HSV,LSV,and PV(P＜0.05),while the levels of miR-183 were negatively correlated with pre-treatment levels of HSV,LSV,and PV(P＜0.05).The miR-34a and miR-431 levels in the peripheral blood in the good prognosis group were greatly lower than those in the poor prognosis group,and the miR-183 level was greatly higher than that in the poor prognosis group(P＜0.05).The risk factors affecting the hearing prognosis of patients with SD included miR-34a and miR-431,and miR-183 was a protective factor affecting the hearing prognosis of patients with SD(P＜0.05).The AUC of peripheral blood miR-34a,miR-431,and miR-183 in predicting hearing prognosis in patients with SD was 0.969(95％CI:0.938-1.00),and the pre-dictive value of the the combination of the three was higher than that of miR-34a(Z=2.336,P=0.019),miR-431(Z=2.157,P=0.031),and miR-183(Z=2.351,P=0.019)alone.Conclusion The levels of miR-34a and miR-431 are abnormally elevated in peripheral blood of patients with SD,and are positively correlated with hemodynamic indicators.The level of miR-183 is abnormally reduced and is negatively correlated with hemodynamic indicators.The combination of the three has certain predictive value for the hearing prognosis of patients with SD.

Objective:To explore the application of COVID-19-specific IgG antibody in identifying epidemic Omicron BA.5 strain infection.Method:Omicron BF.7/BA.5 naturally infected population, healthy population vaccinated with the COVID-19 vaccine, and Omicron BF.7/BA.5 breakthrough cases were enrolled into this study. The serum WT-S-IgG and BA.5-S-IgG were detected by indirect ELISA, and the serum-specific IgG antibody levels of different populations were compared. The application value of the two antibody titers and the ratio of the two antibodies in identifying Omicron BA.5 epidemic strain infection were explored by the ROC curve, aiming to provide technical support for pathogen diagnosis.Results:The antibody titers of WT-S-IgG and BA.5-S-IgG in the breakthrough cases were higher than those in the naturally infected population and the healthy population ( P<0.05). The area under the curve (AUC) of WT-S-IgG and BA.5-S-IgG in identifying epidemic Omicron BA.5 strain infection was 0.947 and 0.961, respectively. The AUC of BA.5-S-IgG and WT-S-IgG antibody titer ratio was 0.873. When the antibody titer ratio was 0.855, the sensitivity and specificity were 80.00% and 90.00%, respectively. According to the interval since the last infection, the AUC of the ratio of BA.5-S-IgG to WT-S-IgG antibody titer to identify the infection of epidemic strains less than 30 days and more than 30 days was 0.887 and 0.863, respectively, and the sensitivity and specificity were both above 80%. Conclusion:Both BA.5-S-IgG and WT-S-IgG, as well as the combination of these two antibodies, are of high value in the identification of epidemic strains.

Objective:To explore the differences in gut microbiota and immune factors in fecal lysate of children with different clinical subtypes of Mycoplasma pneumoniae pneumonia (MPP). Methods:Children aged 3-14 years with MPP who visited Shanghai Ninth People′s Hospital from March 2023 to February 2024 were selected and divided into general group (GMPP group) and severe group (SMPP group) based on the severity of the condition. They were also divided into non-refractory group (NRMPP group) and refractory group (RMPP group) based on treatment response. 16S rRNA sequencing was used to analyze the characteristics of gut microbiota, and MSD electrochemiluminescence method was used to determine the levels of immune factors in fecal lysate. Differences in the clinical characteristics, gut microbiota, and fecal immune factors were analyzed. Spearman correlation analysis was performed. Receiver operating characteristic(ROC) curve was used to analyze the evaluation and predictive value of gut microbiota in clinical classification of MPP.Results:Among the 64 children with MPP, there were 34 cases in the GMPP group and 30 cases in the SMPP group. There were statistically significant differences between the two groups in terms of fever duration, presence or absence of hypoxemia, C-reactive protein(CRP), D-Dimer, and chest CT scores ( t=-4.94, P<0.001; χ2=5.33, P=0.021; z=-2.93, P=0.003; z=-3.93, P<0.001; z=-4.10, P<0.001). Among the 64 children with MPP, there were 50 cases in the NRMPP group and 14 cases in the RMPP group. There were statistically significant differences in age, fever duration, and chest CT scores between the two groups ( t=-3.21, P=0.002; t=-5.28, P<0.001; z=-2.95, P=0.003). There was no statistically significant difference in the alpha diversity analysis of gut microbiota between GMPP group and SMPP group( P>0.05). There was a statistically significant difference in beta diversity analysis between the two groups of gut microbiota ( R2=0.06, P=0.001). Species difference analysis showed that the relative abundance of Bifidobacterium in the SMPP group was significantly lower than that in the GMPP group, while the relative abundance of Blautia and Ruminococcus gnavus was significantly higher than that in the GMPP group, with statistical significance ( z=5.21, P<0.001, Q=0.039; z=1.56, P<0.001, Q=0.039; z=2.08, P=0.007, Q=0.700). There was no statistically significant difference in the alpha diversity analysis of gut microbiota between NRMPP and RMPP group( P>0.05). There was a statistically significant difference in beta diversity analysis between the two groups of gut microbiota ( R2=0.05, P=0.001). Analysis of species differences showed that the relative abundance of Bifidobacterium and Subdoligranulum in the RMPP group was significantly lower than that in the NRMPP group, while the relative abundance of Blautia and Ruminococcus gnavus was significantly higher than that in the NRMPP group, with statistical significance( z=3.44, P=0.012, Q=0.638; z=3.64, P=0.040, Q=0.638; z=5.80, P=0.001, Q=0.338; z=5.46, P=0.015, Q=0.638). The level of fecal immune factors IL-10 and IL-1β were statistically significant between GMPP group and SMPP group( z=-1.96, P=0.050; z=-2.46, P=0.014). The level of fecal immune factors IFN-γ, IL-10, IL-1β, IL-8, and TNF-α were statistically significant between NRMPP group and RMPP group ( z=-2.20, P=0.028; z=-2.17, P=0.030; z=-2.00, P=0.046; z=-2.14, P=0.032; z=-2.22, P=0.027). Sperman correlation analysis showed that Bifidobacterium was negatively correlated with fever duration and chest CT score ( r=-0.35, P=0.005; r=-0.30, P=0.017); Blautia was positively correlated with D-Dimer, fever duration, and chest CT score ( r=0.33, P=0.008; r=0.37, P=0.003; r=0.40, P=0.001); Ruminococcus gnavus and TNF-α, IL-10, IL-4, and IL-6 were negatively correlated ( r=-0.34, P=0.001; r=-0.29, P=0.021; r=-0.28, P=0.024; r=-0.28, P=0.027). ROC curve analysis showed that the area under curve(AUC) of Bifidobacterium abundance for assessing the severity of MPP was 0.767 (95% CI: 0.649-0.885, P<0.001). The AUC of Blautia abundance for assessing the severity of MPP was 0.774 (95% CI: 0.658-0.889, P<0.001), and the AUC for predicting treatment response to MPP was 0.787 (95% CI: 0.655-0.919, P=0.001). Conclusions:The levels of fecal immune factors vary among children with different clinical subtypes of MPP. The relative abundance analysis of Bifidobacterium and Blautia in the gut microbiota of children with MPP may have certain clinical value for evaluating the severity of MPP, adopting adjuvant therapy, and predicting treatment response.

Objective:To explore the effectiveness of deep learning image reconstruction (DLIR) algorithm compared to adaptive statistical iterative reconstruction (ASIR-V) algorithm in improving the quality of low-dose brain CT images.Methods:Retrospective inclusion of patients who underwent brain CT examination in the People's Liberation Army General Hospital from November 2021 to August 2022. Four different algorithms were used to reconstruct low-dose CT scans of all patients to obtain 30% intensity ASIR-V (ASIR-V-30%) images, low intensity DLIR (DLIR-L) images, medium intensity DLIR (DLIR-M) images, and high intensity DLIR (DLIR-H) images. The regions of interest were selected from four sets of images, including superficial white matter, superficial gray matter, deep white matter, and deep gray matter, and their CT values and standard deviations were measured for calculating signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR).Subjective evaluation of image quality was conducted by three neuroimaging physicians based on the Likert 5-component scale. The objective and subjective scores of the 4 groups of images were analyzed using ANOVA or Kruskal Wallis. If there are overall differences, pairwise comparisons were conducted within the group.Results:A total of 109 patients were enrolled, including 104 males and 5 females, aged 65-110 years (89.16 ± 9.53) years. The radiation exposure of brain CT low-dose scanning was (0.93 ± 0.01)mSv, significantly lower than that of conventional scanning (2.92 ± 0.01) mSv ( t = 56.15, P < 0.05). The differences in objective image quality analysis of ASIR-V-30%, DLIR-L, DLIR-M, and DLIR-H images of low-dose CT in SNR deep gray matter, SNR deep white matter, SNR superficial gray matter, SNR superficial white matter, CNR deep gray white matter, and CNR superficial gray white matter were statistically significant( F =98.23, 72.95, 68.43, 58.24, 241.13, 289.91, P < 0.05). Among them, DLIR-H images had the lowest noise in deep gray matter, deep white matter, superficial gray matter, and superficial white matter, and had statistically significant differences compared to other image groups ( t = 167.43, 275.46, 182.32, 361.54, P < 0.05). The subjective score of DLIR-H image quality was superior to ASIR-V-30%, DLIR-L, and DLIR-M, with the statistically significant difference ( t = 7.25, 8.32, 9.63, P < 0.05). Conclusions:Compared with ASIR-V, DLIR algorithm can effectively reduce image noise and artifacts in low-dose brain CT, and improve SNR and CNR. The subjective and objective image quality evaluation of DLIR-H is the best.

Objective:To observe any effect of magnetic stimulation of the primary motor cortex and sacral nerve roots on urinary retention after spinal cord injury.Methods:Forty patients experiencing urine retention after a spinal cord injury were randomly divided into an experimental group and a control group, each of 20. Both groups received conventional treatment and repeated magnetic stimulation of the roots of the sacral nerve. The experimental group also received repeated magnetic stimulation of the bilateral primary motor cortices (M1 region). Bladder capacity and pressure indices, residual urine volume and life quality were evaluated in both groups before and after 8 weeks of treatment.Results:After the treatment, the average maximum bladder pressure, first sensation capacity, residual urine volume and life quality score of both groups had improved significantly, but the improvements in average first sensation capacity, residual urine volume and life quality score of the experimental group were significantly greater than those of the control group. There was, however, no significant difference in the groups′ average maximum bladder pressure after the treatment.Conclusion:Magnetic stimulation of the primary motor cortex and sacral nerve roots can significantly improve the sensory function of the bladder, reduce residual urine volume and improve the life quality of persons experiencing urinary retention after a spinal cord injury.

Objective:To investigate multimodality imaging characteristics and clinical features of lymphomatosis cerebri (LC) and reasons for misdiagnosis,with the goal of potentially facilitating an early and accurate diagnosis for this often-missed disease.Methods:Clinical data and cerebral multimodality imaging findings from 11 patients with LC proven basing on pathology in the Affiliated Hospital of Guizhou Medical University from November 30, 2011 to December 28, 2020 were retrospectively extracted, analyzed, and reviewed in combination with the literatures.Results:The common presenting symptoms with subacute onset included cognitive decline (8/11), gait disturbance (9/11), and behavioral disturbance (5/11). Test of cerebrospinal fluid showed that the number of cells and the level of protein increased (8/10), the sugar content (2/10) and chloride (4/10) decreased. The imaging manifestations of 11 patients with LC were diffuse lesions of bilateral cerebral white matter in the both deep and lobar lesion distribution, involving the cerebral cortex and subcortical white matter in eight cases (8/11), basal ganglia in seven cases (7/11), thalamus in five cases (5/11), cerebellum in six cases and brain stem in six cases (6/11). All 11 patients showed equal or slightly low-density shadows on CT plain scan and slightly longer T 1WI and T 2WI signals on magnetic resonance imaging. Six cases (6/11) had no obvious enhancement in the early stage, and five cases and six follow-up cases showed heterogenous spots, patches, nodules or clusters of distinct enhancement. Diffusion-weighted imaging showed non restricted diffusion in nine (9/11) cases initially diagnosed, and restricted diffusion in two cases (2/11) and nine follow-up cases, which were hyperintense on diffusion-weighted imaging and hypointense on apparent diffusion coefficient maps. Five patients (5/5) presented a marked decrease in N-acetyl aspartic acid (NAA)/creatine (Cr) and increase in choline (Cho)/Cr on hydrogen proton magnetic resonance spectrum, including an increase in lipid/Cr in three cases. One case (1/3) showed no abnormal increase in lesion metabolism, and two cases (2/3) showed slightly increased uptake on positron emission tomography/CT. Conclusions:Diffuse bilateral cerebral lesions especially in deep and lobar region, without enhancement or with patchy enhancement, marked decrease in NAA/Cr and increase in Cho/Cr and Lip/Cr are suggestive of LC. Misdiagnosis may be mainly due to insufficient understanding and improper brain biopsy.

A 26-year female was admitted to hospital with fever and cough. Blood routine test showed leukopenia and thrombocytopenia. CT scan indicated pneumonia-like disease. Antibiotics therapy was ineffective, and primary pulmonary extranodal NK/T-cell lymphoma (ENKTL), nasal type was confirmed by percutaneous lung biopsy. Twenty cases of ENKTL were collected from 14 reports through literature retrieval. Patients aged 19-80 years with a male to female ratio of 3∶1. Main clinical symptoms included fever (85%), cough (65%), and shortness of breath (55%). CT findings of primary pulmonary ENKTL varied widely and might occur in all lobes of both lungs; the lesions were nodular or mass-like (60%) and pneumonia-like (20%). Few cases showed pleural effusion (25%) and/or mediastinal lymphadenopathy (25%). ENKTL presented NK/T cell phenotype, cytotoxic granule protein, and evidence of EB virus infection. The pulmonary ENKTL progressed rapidly, the hemophagocytic syndrome presenting with high fevers, hepatosplenomegaly or cytopenias usually indicated a late stage of the disease. The survival time ranged from 8 days to 12 months. The primary pulmonary ENKTL is a rare disease. The clinical course tends to be rapidly progressive, with life-threatening complications occurring less than a year after the disorder becomes apparent. When a non-responding pneumonia is associated with hemophagocytic syndrome (fever, leukopenia, splenomegaly), lung biopsy should be considered for the diagnosis of ENKTL.

Objective:To investigate the current status of dietary behaviors of children with inflammatory bowel disease (IBD) , explore the types of exclusion diet, screen out unreasonable dietary behaviors, and analyze the reasons leading to their behaviors, so as to provide a basis for developing individualized dietary health education plan.Methods:From January 2018 to December 2019, convenience sampling was used to select 60 IBD children who were treated and hospitalized in the Gastroenterology Department and their main caregivers of the Children's Hospital of Nanjing Medical University as research subjects. All subjects were investigated with the self-designed IBD Patients Dietary Behaviors Questionnaire. Single factor analysis and multiple linear regression analysis were performed on the influencing factors of the dietary behavior of IBD children. A total of 60 questionnaires were issued and 50 were validly recovered with a valid recovery rate of 83.3%.Results:The score of dietary behaviors of IBD children was (34.68±2.77) , and the standard score was (86.70±6.91) . Education level and residence were the effects of the dietary behavior scores of the main caregivers of children with IBD. In terms of the attitude of the main caregivers to the exclusion diet, there were unreasonable exclusion behaviors such as lack of crude fiber food, and dairy products.Conclusions:The overall dietary behaviors of IBD children are relatively good, but there are still some unreasonable dietary behaviors and excessive reliance on the exclusion diet, and the main influencing factors include the education level and residence of their caregivers. It is recommended that medical staff emphasize individualization when formulating dietary health education plan to achieve the goal of standardizing the dietary behavior of IBD children, promoting growth and development, and reducing symptom deterioration and recurrence.

Objective To compare the growth of three different cancer cell lines on chick chorioallantoic membrane (CAM), to select the best transplanted cancer cell line for establishing a transplanted tumor model and to observe the biological characteristics.Methods The human lung cancer cell line A549, human tongue cancer cell line TCA8113 and human liver cancer cell line QGY7703 were respectively inoculated into CAM at the 7th day of age.The chick embryo survival rate, tumor survival rate, tumor formation rate and induced angiogenesis were detected and the growth characteristics of the transplanted tumor model were observed.Results Compared with the groups inoculated with A549 cells and QGY7703 cells, the tumor formation rate of TCA8113 cells was the highest (P < 0.05), to be the best cancer cell line for transplanted tumor.The optimal inoculated number of cells was 8.0×106/chick embryo, the optimal growth period of the tumor was 4~8 d, and the best experiment time was 7 d after inoculation.Conclusion The TCA-CAM transplanted tumor model of tongue squamous cell cancer is successfully established for further study of the biological characteristics and mechanisms of tumor growth, angiogenesis, invasion and metastasis, and provide a good experimental animal model for anti-tumor drug screening.