Predictive value of deep learning-based coronary artery calcification score for coronary artery disease in type 2 diabetes mellitus / 中华放射学杂志

Objective:To explore the predictive value of deep learning (DL)-based coronary artery calcification score (CACS) for obstructive coronary artery disease (CAD) and noncalcified plaque/mixed plaque in type 2 diabetes mellitus (T2DM).Methods:Forty hundred and twenty-four consecutive T2DM patients who accepted CACS scan and coronary CT angiography (CCTA) from December 2012 to December 2019 were included retrospectively, with clinical risk factors and plaque features collected. Plaque composition was classified as calcified, non-calcified or mixed plaque. Obstructive CAD was defined as maximum diameter stenosis≥50%. CACS was calculated with a fully automated method based on DL. Univariate and multivariate logistic regressions were applied to select statistically significant factors and the odds ratios(ORs) were measured. Receiver operating characteristic (ROC) curve was evaluated to assess the predictive performance.Results:Increased CACS was associated with a significantly higher odds of obstructive CAD in CCTA (adjusted ORs were 2.22, 6.18 and 16.98 for CACS=1-99, 100-299, 300-999 vs. CACS=0, and P values were 0.009,<0.001,<0.001 respectively). The area under ROC curve (AUC) of CACS to predict obstructive CAD was 0.764. Compared with 0, increased CACS was associated with increased risk of non-calcified/mixed plaque (adjusted ORs were 2.75, 4.76, 5.29 for CACS=1-99, 100-299, 300-999 respectively and P values were 0.001,<0.001,<0.001 respectively). The AUC of CACS to predict non-calcified/mixed plaque was 0.688. It took 1.17 min to perform automated measurement of CACS based on DL in total, which was significantly less than manual measurement of 1.73 min ( P<0.001). Conclusion:DL-based CACS can predict obstructive CAD and non-calcified plaque/mixed plaque in T2DM, which is economical and efficient, and has important value for clinical diagnosis and treatment.

Transcranial Doppler ultrasound for assessment of dynamic cerebral autoregulation in patients with acute ischemic stroke / 国际脑血管病杂志

Transcranial Doppler (TCD) is a method for measuring cerebral artery blood flow velocity, which has the advantages of low cost, non-invasive, high temporal resolution. Dynamic cerebral autoregulation (dCA) is to study the instantaneous change of cerebral blood flow (CBF) at the moment of arterial blood pressure or intracranial pressure change, that is, the ability to recover CBF in the face of sudden change of perfusion pressure. After the onset of acute ischemic stroke (AIS), effective dCA can maintain the stability of cerebral hemodynamics and avoid excessive or insufficient perfusion at the injured site. Therefore, it is of great significance to evaluate dCA in patients with AIS. However, at present, there is no recognized optimal evaluation method for dCA. This article mainly summarizes the advantages of TCD in evaluating dCA compared with other methods and the application of TCD combined with transfer function analysis (TFA) in evaluating dCA in AIS.

Clinical features and therapeutic efficacy analysis of Epstein-Barr virus-positive T-cell lymphoma patients with hemophagocytic syndrome / 白血病·淋巴瘤

Objective:To investigate the effects of hemophagocytic syndrome also known as hemophagocytic lymphohistiocytosis (HLH) on the clinical features and therapeutic efficacy of patients with Epstein-Barr virus-positive T-cell lymphoma (EBV-TCL).Methods:The clinical data of patients with EBV-TCL diagnosed by pathological examination in the First Affiliated Hospital of Guangzhou Medical University from November 2015 to August 2020 were retrospectively analyzed. According to whether they were accompanied with HLH at the time of onset, patients were divided into HLH group (10 cases) and non-HLH group (13 cases), and the clinical features and prognosis of the two groups were compared. The curative effects of different treatment methods and patients with different plasma EBV-DNA titers were compared.Results:Among 23 patients, 3 cases (13.0%) were in Ann Arbor stage Ⅰ-Ⅱ, 20 cases (87.0%) were in stage Ⅲ-Ⅳ; the International Prognostic Index (IPI) score was 1 point in 3 cases (13.0%), 2 points in 4 cases (17.4%), 3 points in 8 cases (34.8%), 4 points in 8 cases (34.8%). In the HLH group, there were 2 cases of aggressive NK-cell leukemia and 3 cases of childhood systemic EBV-TCL. There were no cases of above two pathological types in the non-HLH group. In the HLH group, the proportions of patients with fever, bone marrow invasion, IPI score > 2 points, and EBV-DNA > 10 4 copies/ml were higher than those in the non-HLH group (all P < 0.05). The objective response rate (complete remission plus partial remission) of all patients after chemotherapy was 47.8% (11/23); there were 3 cases undergoing hematopoietic stem cell transplantation in both the HLH group and the non-HLH group, and all achieved objective remission. The objective remission of 7 patients and 10 patients who did not undergo hematopoietic stem cell transplantation in the HLH group and non-HLH group after lymphoma chemotherapy had 0 case and 5 cases, respectively, and the difference was statistically significant ( P = 0.044). In the chemotherapy alone group, 5 of 17 patients had objective remission, 6 patients in the chemotherapy plus transplantation group had objective remission, and the difference was statistically significant ( P = 0.039). Among 16 patients whose plasma EBV-DNA titers turned negative, 11 patients had objective remission, and 7 patients whose plasma EBV-DNA titers were continuously positive had no objective remission, and the difference was statistically significant ( P = 0.001). The 1-year overall survival rate of all patients was 69.3%, and the 2-year overall survival rate was 52.0%. In the HLH group, the 1-year and 2-year overall survival rates of 7 patients receiving chemotherapy alone and 3 patients receiving chemotherapy plus transplantation were 42.9% and 66.7%, respectively. In the non-HLH group, the 1-year overall survival rates of 10 patients receiving chemotherapy alone and 3 patients receiving chemotherapy plus transplantation were 80.0% and 100.0%, respectively; the 2-year overall survival rates were 26.7% and 100.0%,respectively. The overall survival of patients receiving chemotherapy plus transplantation was better than that of those receiving chemotherapy alone in both the HLH group and the non-HLH group, and differences were statistically significant (all P < 0.05). Conclusions:The general clinical stage of patients with EBV-TCL is later, and the prognosis of EBV-TCL patients with HLH is worse. The therapeutic efficacy may be related to plasma EBV-DNA titers. Hematopoietic stem cell transplantation can improve the remission rate.

Polycythemia vera and essential thrombocytosis and cerebral thrombosis / 国际脑血管病杂志

Polycythemia vera (PV) and essential thrombocythemia (ET) are the two most common subtypes of myeloproliferative diseases. Recent studies have shown that cerebral thrombosis is one of the major complications of PV and ET, which is closely related to the poor outcomes of patients. Meanwhile, PV and ET also increase the risk of recurrent cerebrovascular events in patients with cerebral thrombosis. This article reviews the research progress on the correlation between PV and ET and cerebral thrombosis, in order to provide the basis for clinical prevention and treatment of PV and ET.

Population analysis of clinical Vibrio parahaemolyticus strains from Asia based on multilocus sequence typing and AA-multilocus sequence typing / 军事医学

Objective To find out more about the population structure and clonal complex of clinical Vibrio parahaemolyticus strains in Asia.Methods Clinical Vibrio parahaemolyticus strains data were screened in Asia with complete ST and pST types from PubMLST public database,their subgroup and complex were analyzed,and the minimum spanning tree based on ST and pST types respectively was completed.Results From the database,341 items of ST and pST types of Asian clinical Vibrio parahaemolyticus strains were screened,including 157 ST,most of which were of ST3 type.Totally 214 items of data came from China (including Hong Kong and Taiwan),and covered 133 ST,most of which were of ST3 type.eBURST software was used and 17 groups and 94 singletons were found.Software STRUCTURE analysis showed that the appropriate subset number of clinical V.parahaemolyticus strains in Asia was 7,and that the average distance between samples in each subgroup was 0.9113.Conclusion Clinical V.parahaemolyticus strains in Asia show high diversity and can be subdivided into seven subgroups.ST3 type is dominating when multilocus sequence typing(MLST)is used and pST2 type is the majority by AA-MLST typing.

Typing of Vibrio parahaemolyticus strains from aquatic products in East-China coastal areas based on multilocus sequence typing and AA-multilocus sequence typing / 军事医学

Objective To learn more about virulence genes and clonal complex group structure of Vibrio parahaemolyticus (VPH)strains separated from aquatic products in East China coastal areas between 2007 and 2012.Methods Seventy-nine strains separated from aquatic products in eastern coastal areas(Guandong,Fujian,Shanghai,Shandong,Jiangsu and Beijing)of China between 2007 and 2012 were identified as VPH by real-time-PCR with gene tlh.Gene tdh,trh and orf8 were also detected.Subgroup analysis and complex analysis were conducted of the VPH strains to build the minimum spanning tree respectively based on ST and pST types.Results In 79 VPH strains,gene tlh was positive while 8.86%(7 /79)of the isolates of gene tdh were positive.The carrying rate of gene orf8 was 8.86%.These 79 strains were of 69 ST types,involving 3 clonal complex and 62 singleton.By amino acid(AA)-multilocus sequence typing(MLST),79 strains covered the 23 pST types,2 clonal complexes and 1 singleton.The 363 single nucleotide polymorphisms(SNPs)were divided into 68 patterns.Conclusion VPH strains from aquatic products in eastern coastal areas of China are characterized by high polymorphisms and a low carrying rate of virulence genes.ST3 type is dominating when MLST typing is used while pST1 type is the majority by AA-MLST typing.

Associations of interleukin 6-572G/C gene polymorphism with migraine in a Chinese northeastern Han population / 中华神经科杂志

Objective To investigate the associations of a single-nucleotide polymorphisms (SNPs) in the interleukin (IL)-6 gene with the migraine of a Han Chinese northeastern population.Methods We collected 252 patients of the migraine attack,who were diagnosed at People' s Hospital of Liaoning Province from March 2012 to June 2013,all being Han nationality in the northeast of China.At the same time,we collected 270 healthy people over the same period who had health examination or were healthy workers of People' s Hospital of Liaoning Province.We used polymerase chain reaction and gene sequencing to analyze the genotype and allele frequencies of the-572G/C (rs1800796) IL-6 polymorphisms between migraine cases (n =252;including migraine without aura (MO) group (n =168) and migraine with aura group (n =84);the male group (n =109) and the female group (n =143)) and control group (n =270;the male group (n =116) and the female group (n =152)),as well as analyzed the genotype and allele frequencies distribution between the subgroups.Results We found higher frequencies of the distribution of the C/C genotype and the C allele of the-572G/C polymorphism in migraine cases than in control group (32.54％ (82/252) vs 19.63％ (53/270),x2 =12.061,P =0.002;55.56％ (280/504) vs 45.37％ (245/540),x2 =10.818,P =0.001),higher distribution frequencies of the C/C genotype and the C allele in female group (21.83％ (55/252) vs 12.59％ (34/270),x2 =10.187,P =0.006;33.73％ (170/504) vs 26.48％ (143/540),x2 =10.073,P =0.002).Between MO group and controls,these distribution frequencies had statistically significant difference (24.60％ (62/252) vs 19.63％ (53/270),x2 =18.172,P=0.000;39.88％ (201/504) vs 45.37％ (245/540),x2 =17.307,P=0.000).After correction by conditional Logistic regression,the frequency distribution difference of the C/C genotype between the migraine cases and controls remained statistically significant (OR =22.861,95％ CI 5.218-27.098,P =0.023).Conclusion Our data indicate that the SNPs of the IL-6 are associated with migaine and the C/C genotype increases the migraine susceptibility in a Han Chinese northeastern population.

Astrocytic gap junction protein and cerebral ischemia / 国际脑血管病杂志

Studies have shown that gap junction (GJ) of astrocytes plays an important role in ischemic brain injury.Therefore,GJ may become a new target for the treatment of ischemic brain injury.In recent years,although the relationship between GJ of astrocytes and ischemic brain injury has been extensively studied,the conclusions are not consistent.This article reviews the structure,distribution,function of GJ,and its research progress related ischemic brain injury.

Epidemiology advances in researches on prehypertension / 中华疾病控制杂志

The present paper introduces the definition of prehypertension,summarizes the advances in prehypertensive epidemiology and focus of debate and suggests the outlook of prehypertension.