Objective To investigate the effect of 100 kVp low tube voltage combined with adaptive statistical iterative reconstruc-tion-Veo(ASIR-V)on the imaging display,image quality and radiation dose of Adamkiewicz artery(AKA).Methods Ninety patients with computed tomography angiography(CTA)of aorta were randomly divided into two groups.In group A,the tube voltage was 100 kVp,and ASIR-V was 80%reconstructed.The tube voltage in group B was 120 kVp,and adaptive statistical iterative recon-struction(ASIR)was 40%reconstructed.The CT value and the standard deviation(SD)value of descending aorta were measured at the 12th thoracic vertebra level,and the CT value and the SD value of the spinal cord were measured at the same level to calculate the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of AKA.According to the continuity between AKA and intercostal artery or lumbar artery,the visualization of AKA was evaluated by two doctors with a double-blinded method and a five-point method,and the radiation doses of group A and group B were compared.Results Compared with group B,the CT value of aorta in group A was sig-nificantly increased by about 22.83%(P<0.001).The background noise of AKA in group A was significantly lower than that in group B(P<0.001),and the SNR and CNR were significantly higher than those in group B(P<0.001).The visualization score of AKA in group A was higher than that in group B(P<0.05).The effective dose(ED)in group A was significantly lower than that in group B by about 41.28%(P<0.001).Conclusion 100 kVp combined with ASIR-V technique for spinal cord AKA imaging can obtain better image quality,improve the sensitivity of AKA display and reduce the radiation dose.

Objective To identify early Klebsiella pneumoniae(KP)infection after liver transplantation and its impact on prognosis.Methods Clinical data of 171 liver transplant recipients were retrospectively analyzed,and they were divided into the non-infection(n=52)and infection groups(n=119)according to the bacterial culture results at postoperative 2 weeks.In the infection group,KP was not detected in 86 cases(non-KP infection group),and KP was cultured in 33 cases(KP infection group).Preoperative,intraoperative and postoperative data were statistically compared between the non-infection and infection groups,and between the non-KP infection and KP infection groups.The risk factors of early KP infection after liver transplantation and the influencing factors of long-term survival of the recipients were analyzed.Results Compared with the non-infection group,model for end-stage liver disease(MELD)score and total bilirubin level were higher,the operation time was longer,the length of postoperative intensive care unit(ICU)stay and the length of hospital stay were longer,the amount of intraoperative red blood cell transfusion was higher,the hospitalization expense was higher,the incidence of severe complications was higher,white blood cell count,absolute neutrophil cell count and neutrophil-to-lymphocyte ratio at postoperative 14 and 30 d were higher,absolute lymphocyte count at postoperative 14 d was lower and hemoglobin level at postoperative 30 d was lower in the infection group.The differences were statistically significant(all P＜0.05).Compared with the non-KP infection group,MELD score,total bilirubin level and aspartate aminotransferase(AST)level were higher,the operation time and the length of postoperative ICU stay were longer,the hospitalization expense was higher,the 90-d fatality was higher,the albumin level at postoperative 14 d was lower,and total bilirubin level at postoperative 30 d was higher in the KP infection group.The differences were statistically significant(all P＜0.05).Among 33 recipients with KP infection,16 cases were resistant to carbapenem antibiotics,and 7 of them died within postoperative 90 d.Seventeen cases were intermediate or sensitive to carbapenem antibiotics,and 4 of them died within postoperative 90 d.Preoperative MELD score ≥17 and operation time≥415 min were the independent risk factors for KP infection after liver transplantation(both P＜0.05).The length of postoperative ICU stay ≥44 h and KP infection were the independent risk factors for long-term prognosis of liver transplantation(both P＜0.05).Conclusions KP infection is an independent risk factor for death after liver transplantation.High preoperative MELD score and long operation time are the independent risk factors for early KP infection after liver transplantation.

Objective To compare the discrepancies among results of three commonly used laboratory direct test methods for maximal oxygen uptake(VO2max),explore their linear regression relationships,mutual predictability and comparability.Methods Using a quasi-experimental design of cluster sampling and within-group interaction design,20 male cross-country skiers were tested for VO2max using the Bruce protocol(Method 1),90-second incremental load exercise on power bicycle(Method 2),and 1-minute incremental load exercise on treadmill(Method 3),with an interval of one week.The indepen-dent and dependent variable were the three VO2max test methods and the VO2max,respectively.Results Significant differences were found in the average VO2max of the three test results,with the value mea-sured by Method 1 ranking the first,followed by that assessed by Method 3 and Method 2(P<0.05).Moreover,the frequency of individual differences in the results of the three methods showed that the VO2max of Method 1 was about 6 and 3 ml/min·kg higher than that measured by Method 2 and 3.However,at the same treadmill speed,the average blood lactate evaluated using Method 3 was higher than Method 1,and the speed reached aerobic and anaerobic thresholds about one speed unit(1 km/h)lower than Method 1.Meanwhile,linear regression analyses of the test results between Method 1 and 2,as well as Method 1 and 3 showed that both the regression models and coefficients were statis-tically significant(P<0.001),with the R-squared values of 9.25 and 9.05,respectively.Conclusion The Bruce protocol performs best in assessing the maximum value of the athlete's VO2max phase,whose results have linear regression relationships with the other two methods,and can be used for pre-dicting their results.Moreover,athletes of different events and levels can choose different VO2max test methods accordingly.Lastly,the speed and heart rate ranges corresponding to the aerobic and anaero-bic thresholds can serve as an effective and convenient method to control the training intensity.

Objective:A genome-wide molecular characterization of FJ21351116, a strain of G3P[8]-E2 2021 collected in Fujian, China, was performed.Methods:Whole genome sequencing of FJ21351116 was performed using a high-sensitivity group A rotavirus whole genome sequencing method. Genomic characteriza-tion of the virus was assessed by nucleic acid sequence analysis using MEGA 11.0, Geneious 9.0.2 and DNASTAR software. Neutralization epitopes of VP7 and VP4 (VP8*) were analyzed using BioEdit v. 7.0.9.0 and PyMOL v. 2.5.2.Results:In this study, FJ21351116 was shown to be a G3-P[8]-I2-R2-C2-M2-A2-N2-T2-E2-H2 genotype, and the result of phylogenetic tree showed that the VP7, VP4, VP3, and NSP2-NSP5 genes of the FJ21351116 strain were related to the equine-like DS-1-like G3P[8] genes that have been detected in Japan in recent years. VP6, VP1, VP2, and NSP1 genes are closely related to G2P[4] in most countries, especially in Singapore, suggesting that this strain was formed by genetic reassortment during the evolution of equine-like G3P[8] and G2P[4]. Evolutionary relationships between the VP7/VP4 genes of FJ21351116 and Rotarix and RotaTeq vaccines suggest that the multiple mutations in both VP7 and VP4 (VP8*) neutralizing antigenic epitopes and vaccine amino acid sites. It is hypothesized that the Rotarix and RotaTeq vaccines may be less effective against equine DS-1-like G3P[8] RVA, and the sequence differences with Rotarix are higher than those with RotaTeq.Conclusions:In this study, we found a rare case of DS-1-like G3P [8] RVA strain in China. Currently, horse-like DS-1-like G3P [8] RVA is relatively rare in China and may be poorly protected by vaccine strains, emphasizing the importance of continuous monitoring of RVA strains and the development of efficient and full-coverage RVA vaccines.

Objective To analyze the clinical efficacy of transcatheter tricuspid valve replacement (TTVR) in cardiac implantable electronic lead-related tricuspid regurgitation (TR). Methods The patients with severe TR who underwent LuX-Valve TTVR in 9 Chinese medical centers from June 2020 to August 2021 were retrospectively enrolled. They were divided into a cardiac implantable electronic device (CIED) group and a non-CIED group based on whether they had pre-existing CIED implantation. Success of the procedure was defined as safe implantation of the LuX-Valve and complete withdrawal of the delivery system. Prognostic improvement was defined as a decrease of TR grade to≤2+ and an improvement of cardiac function by≥2 grades. Surgical success and postoperative prognosis were compared between the two groups. Results A total of 190 patients were collected, including 50 males and 140 females with a mean age of 66.2±7.8 years. There were 29 patients in the CIED group, and 161 patients in the non-CIED group. In the CIED group, 28 patients were implanted with a permanent pacemaker and 1 patient with a cardioverter-defibrillator. Preoperative New York Heart Association (NYHA) cardiac function class, TR degree, left ventricular ejection fraction, tricuspid annular plane systolic excusion, and cardiac risk scores were comparable between the two groups (P>0.05). Postoperative TR was reduced to≤2+ in all patients, and there was no statistical difference in the incidence of perivalvular leakage between the two groups (P=0.270). Postoperative CT of CIED patients showed the valve was in place, and the lead was not extruded, twisted, or deflected. The in-hospital mortality of the two groups were 10.3% and 1.9%, respectively, and the difference was statistically significant (P=0.047). In addition, there was no statistical difference between the two groups in terms of postoperative improvement of cardiac function and mortality in the 1- and 2-year follow-up. Conclusion TTVR is feasible, safe, and effective in patients with CIED implantation, and the pre-existing lead has no significant effect on the clinical efficacy.

Objective To propose a method for correcting the attenuation of positron emission tomography (PET) data in PET/magnetic resonance (MR) based on transmission scan, and to improve image quality, diagnostic accuracy, and lesion location accuracy. Methods In this study, the head phantom in the national standard GB/T 18988.1—2013 was used as the experimental model. The head phantom contained three 50 mm diameter cylindrical inserts filled with air, water, and solid teflon. The attenuation correction coefficients were calculated and analyzed based on transmission scan. Results With slice = 33 and theta = 0, the attenuation correction coefficient was the largest (about 7.5) when the coincidence line passed through the axis of the phantom. The spatial distribution of the attenuation correction coefficients clearly showed the positions of air insert and teflon insert, indicating that the attenuation correction coefficients calculated from transmission scan data were accurate. In the clinical verification experiment, the attenuation correction method based on transmission scan significantly improved the image quality and showed efficient attenuation correction. Conclusion This paper studied the attenuation correction method for PET data in PET/MR based on transmission scan. This method can improve the image quality. In the future work, the attenuation correction method of PET/MR will be further studied and optimized to facilitate clinical applications.

Objective To propose a method for correcting the attenuation of positron emission tomography (PET) data in PET/magnetic resonance (MR) based on transmission scan, and to improve image quality, diagnostic accuracy, and lesion location accuracy. Methods In this study, the head phantom in the national standard GB/T 18988.1—2013 was used as the experimental model. The head phantom contained three 50 mm diameter cylindrical inserts filled with air, water, and solid teflon. The attenuation correction coefficients were calculated and analyzed based on transmission scan. Results With slice = 33 and theta = 0, the attenuation correction coefficient was the largest (about 7.5) when the coincidence line passed through the axis of the phantom. The spatial distribution of the attenuation correction coefficients clearly showed the positions of air insert and teflon insert, indicating that the attenuation correction coefficients calculated from transmission scan data were accurate. In the clinical verification experiment, the attenuation correction method based on transmission scan significantly improved the image quality and showed efficient attenuation correction. Conclusion This paper studied the attenuation correction method for PET data in PET/MR based on transmission scan. This method can improve the image quality. In the future work, the attenuation correction method of PET/MR will be further studied and optimized to facilitate clinical applications.

Objective:To document any correlation between eye-tracking test results and cognitive impairment after a stroke.Methods:Forty stroke survivors made up the stroke group, while 20 healthy subjects without a history of stroke formed the normal group. Everyone was given an eye-tracking test, the mini-mental state examination (MMSE), and the Montreal Cognitive Assessment (MoCA). The eye-tracking test results were then tested for any correlation with age, level of education, and the MMSE and MoCA scores.Results:In the static image test and the prosaccade test, the total number of fixations was significantly higher in the stroke group than in the normal group. In the dynamic path test, the ocular motor test and the anti-saccade test, significant differences were observed between the two groups in terms of the duration of total fixation, the fixation duration ratio, and the total number of fixations. In the static image test, the total number of fixations was weakly negatively correlated with the MMSE scores. Total fixation duration and fixation duration ratio were weakly positively correlated with the MoCA scores, while total number of fixations, total saccade distance and average saccade velocity were weakly negatively correlated with the MoCA scores. In the dynamic path test, total fixation duration was weakly positively correlated with the MMSE and MoCA scores. Fixation duration ratio was weakly positively correlated with the MMSE scores and weakly negatively correlated with the MoCA scores. First fixation duration was weakly positively correlated with the MoCA scores. The total number of fixations was weakly positively correlated with age and weakly negatively correlated with the MoCA scores. Total saccade distance was weakly negatively correlated with age and the MoCA scores, and average saccade velocity was weakly negatively correlated with the MMSE and MoCA scores. In the ocular motor test, total fixation duration and fixation duration ratio were weakly positively correlated with the MoCA scores. Total number of fixations, total saccade distance, and average saccade velocity were weakly negatively correlated with the MoCA scores. In the prosaccade test, total fixation duration and fixation duration ratio were weakly positively correlated with the MoCA scores. Total number of fixations was weakly positively correlated with age and weakly negatively correlated with the MoCA scores. Total saccade distance and average saccade velocity were weakly negatively correlated with both the MMSE and MoCA scores. In the anti-saccade test, total fixation duration was weakly and positively correlated with age and the MoCA scores. Fixation duration ratio was weakly and positively correlated with age and the MoCA scores. The total number of fixations was weakly positively correlated with age and weakly negatively correlated with the MoCA scores, and total saccade distance and average saccade velocity were weakly negatively correlated with the MoCA scores.Conclusions:Eye-tracking test results are significantly correlated with post-stroke cognitive impairment, suggesting that such tests can be used in the assessment of post-stroke cognitive dysfunction.

Objective:To explore the sequential chemotherapy efficacy of different chemotherapeutic regimens in ovarian epithelial carcinoma, fallopian tube carcinoma, and primary peritoneal carcinoma.Methods:A retrospective analysis was conducted on clinical and pathological data of 100 patients with platinum-sensitive ovarian epithelial carcinoma, fallopian tube carcinoma, and primary peritoneal carcinoma treated at Peking University Peopel′s Hospital from January 1992 to January 2019. All patients underwent staging surgery or cytoreductive surgery followed by adjuvant chemotherapy. Based on different postoperative adjuvant chemotherapy regimens, patients were divided into the sequential chemotherapy group (70 cases) and the conventional chemotherapy group (30 cases). Clinical and pathological characteristics, chemotherapy efficacy, adverse reactions, and prognosis were compared between the two groups.Results:(1) Clinical and pathological characteristics: the age, tumor types (including ovarian epithelial carcinoma, fallopian tube carcinoma, and primary peritoneal carcinoma), pathological types, International Federation of Gynecology and Obstetrics (FIGO) stage, postoperative residual disease size, presence of neoadjuvant chemotherapy, and total number of chemotherapy cycles were compared between the sequential chemotherapy group and the conventional chemotherapy group. There were no statistically significant differences observed in these characteristics between the two groups (all P>0.05). (2) Chemotherapy efficacy: the median sum of complete response (CR)+partial response (PR) duration in the sequential chemotherapy group was 80.0 months (range: 39 to 369 months), whereas in the conventional chemotherapy group, it was 28.0 months (range: 13 to 52 months). A statistically significant difference was observed between the two groups ( Z=-7.82, P<0.001). (3) Chemotherapy adverse reactions: in the sequential chemotherapy group, 55 cases (79%, 55/70) experienced bone marrow suppression and 20 cases (29%, 20/70) had neurological symptoms. In the conventional chemotherapy group, these adverse reactions occurred in 11 cases (37%, 11/30) and 2 cases (7%, 2/30), respectively. Statistically significant differences were observed between the two groups for both bone marrow suppression and neurological symptoms (all P<0.05). For the other chemotherapy adverse reactions compared between the two groups, no statistically significant differences were observed (all P>0.05). (4) Prognosis: during the follow-up period, the recurrence rate in the sequential chemotherapy group was 73% (51/70) and in the conventional chemotherapy group was 100% (30/30). The median sum of recurrence-free interval was 70.5 months (range: 19 to 330 months) in the sequential chemotherapy group and 15.0 months (range: 6 to 40 months) in the conventional chemotherapy group. Statistically significant differences were observed between the two groups for both recurrence rate and median recurrence-free interval (all P<0.01).In the sequential chemotherapy group, the median progression-free survival (PFS) time was 84.0 months (range: 34 to 373 months), and the median overall survival (OS) time was 87.0 months (range: 45 to 377 months). In contrast, in the conventional chemotherapy group, the median PFS time was 30.5 months (range: 14 to 60 months), and the median OS time was 37.5 months (range: 18 to 67 months). Statistically significant differences were observed between the two groups for both PFS and OS (all P<0.001). In the sequential chemotherapy group, the 3-year, 5-year, and 10-year OS rates were 100% (70/70), 93% (65/70), and 21% (15/70), respectively. In contrast, in the conventional chemotherapy group, the OS rates were 50% (15/30) at 3 years, 3% (1/30) at 5 years, and 0 at 10 years, respectively. The two groups were compared respectively, and the differences were statistically significant (all P<0.05). Conclusions:Sequential chemotherapy significantly prolongs PFS and OS in patients with ovarian epithelial carcinoma, fallopian tube carcinoma, and primary peritoneal carcinoma. The efficacy is superior to that of the conventional chemotherapy, with manageable adverse reactions. The use of sequential chemotherapy as first-line treatment for patients with ovarian epithelial carcinoma, fallopian tube carcinoma, and primary peritoneal carcinoma is recommended.

Objective:To examine the factors that contribute to memory impairment in elderly stroke patients and develop a predictive model.Methods:One hundred stroke patients from the First People's Hospital of Changzhou were selected to assess the incidence of memory impairment using the Montreal cognitive assessment memory index score(MoCA-MIS).Univariate analysis and multivariate Logistic regression were performed to determine the factors influencing memory impairment in these patients.Additionally, the correlation among relevant scale scores was examined, and a prediction model was developed.Results:In the study, 49 patients(49.0%)did not exhibit memory impairment.Patients with memory impairment were found to have higher proportions of individuals over 75 years old, elevated levels of triglyceride(TG), total cholesterol(TC), low-density lipoproteins cholesterol(LDL-C), and National Institute of Health Stroke Scale(NIHSS)scores compared to those without memory impairment.Conversely, patients without memory impairment had higher proportions of individuals with more than 9 years of education, higher levels of high-density lipoprotein cholesterol(HDL-C), mini-mental state examination(MMSE)scores, Rivermead behavioural memory test-Ⅱ(RBMT-Ⅱ)scores, and picture-based memory impairment screen(PMIS)scores(all P<0.05).Furthermore, Montreal cognitive assessment-memory index(MoCA-MIS)scores in stroke patients with memory impairment showed negative correlations with NIHSS scores, TG, and LDL-C, while showing positive correlations with HDL-C, MMSE scores, RBMT-Ⅱ scores, and PMIS scores(all P<0.05).Multifactorial Logistic regression analysis indicated that years of education, TG, HDL-C, NIHSS score, MMSE score, RBMT-Ⅱ score, PMIS score, and the location of the lesion in the cortex or temporal lobe were significant factors influencing memory impairment in stroke patients(all P<0.05).The receiver operating characteristic curve(ROC)analysis revealed an area under curve(AUC)of 0.955(95% CI: 0.921-0.977)for the prediction model of memory impairment in stroke patients, with a Yoden index of 0.841. Conclusions:The risk of memory impairment in stroke patients is associated with education years and blood lipid levels.Factors such as high education level, active cognitive function, and memory training serve as protective factors against memory impairment.The prediction model developed using these influencing factors demonstrates high predictive accuracy for post-stroke memory impairment.