Spleen volume is associated with overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with portal hypertension.

BACKGROUND: Portal shunt and immune status related to the spleen are related to the occurrence of hepatic encephalopathy (HE). It is unknown whether spleen volume before transjugular intrahepatic portosystemic shunt (TIPS) is related to postoperative HE. AIM: To investigate the relationship between spleen volume and the occurrence of HE. METHODS: This study included 135 patients with liver cirrhosis who underwent TIPS, and liver and spleen volumes were elevated upon computed tomography imaging. The Kaplan-Meier curve was used to compare the difference in the incidence rate of HE among patients with different spleen volumes. Univariate and multivariate Cox regression analyses were performed to identify the factors affecting overt HE (OHE). Restricted cubic spline was used to examine the shapes of the dose-response association between spleen volumes and OHE risk. RESULTS: The results showed that 37 (27.2%) of 135 patients experienced OHE during a 1-year follow-up period. Compared with preoperative spleen volume (901.30 ± 471.90 cm3), there was a significant decrease in spleen volume after TIPS (697.60 ± 281.0 cm3) in OHE patients. As the severity of OHE increased, the spleen volume significantly decreased (P < 0.05). Compared with patients with a spleen volume ≥ 782.4 cm3, those with a spleen volume < 782.4 cm3 had a higher incidence of HE (P < 0.05). Cox regression analysis showed that spleen volume was an independent risk factor for post-TIPS OHE (hazard ratio = 0.494, P < 0.05). Restricted cubic spline model showed that with an increasing spleen volume, OHE risk showed an initial increase and then decrease (P < 0.05). CONCLUSION: Spleen volume is related to the occurrence of OHE after TIPS. Preoperative spleen volume is an independent risk factor for post-TIPS OHE.

Environmentally Relevant Levels of Antiepileptic Carbamazepine Altered Intestinal Microbial Composition and Metabolites in Amphibian Larvae.

There is growing concern about the potential ecological risks posed by pharmaceutical residues in the aquatic environment. However, our understanding of the toxic effects of antiepileptic pharmaceuticals, such as carbamazepine (CBZ), on aquatic animal larvae is still limited. In this study, the tadpoles of the black-spotted pond frog (Pelophylax nigromaculatus) were exposed to environmentally relevant concentrations of CBZ (0.3 and 3.0 µg/L) for 30 days, and their growth, intestinal microbial composition, and metabolites were investigated to assess the potential toxic effects of CBZ in non-targeted aquatic organisms. Some tadpoles died during exposure, but there was no significant among-group difference in the survival and growth rates. CBZ exposure significantly altered the composition of tadpole intestinal microbiota. Relative abundances of some bacterial genera (e.g., Blautia, Prevotella, Bacillus, Microbacterium, etc.) decreased, while others (e.g., Paucibacter, etc.) increased in CBZ-exposed tadpoles. Interestingly, CBZ-induced alterations in some bacteria might not necessarily lead to adverse outcomes for animals. Meanwhile, small molecular intestinal metabolites related to energy metabolism, and antioxidant and anti-inflammatory activities were also altered after exposure. Taken together, environmentally relevant levels of CBZ might alter the metabolic and immune performances of amphibian larvae by modifying the abundance of some specific bacteria and the level of metabolites in their intestines, thereby potentially causing a long-term effect on their fitness.

Activation of the NLRP3-CASP-1 inflammasome is restrained by controlling autophagy during Glaesserella parasuis infection.

Infection with Glaesserella parasuis, the primary pathogen behind Glässer's disease, is often associated with diverse clinical symptoms, including serofibrinous polyserositis, arthritis, and meningitis. Autophagy plays a dual role in bacterial infections, exerting either antagonistic or synergistic effects depending on the nature of the pathogen. Our previous studies have demonstrated that autophagy serves as a defense mechanism, combating inflammation and invasion caused by infection of highly virulent G. parasuis. However, the precise mechanisms remain to be elucidated. Pathogens exhibit distinct interactions with inflammasomes and autophagy processes. Herein, we explored the effect of autophagy on inflammasomes during G. parasuis infection. We found that G. parasuis infection triggers NLRP3-dependent pro-CASP-1-IL-18/IL-1ß processing and maturation pathway, resulting in increased release of IL-1ß and IL-18. Inhibition of autophagy enhances NLRP3 inflammasome activity, whereas stimulation of autophagy restricts it during G. parasuis infection. Furthermore, assembled NLRP3 inflammasomes undergo ubiquitination and recruit the autophagic adaptor, p62, facilitating their sequestration into autophagosomes during G. parasuis infection. These results suggest that the induction of autophagy mitigates inflammation by eliminating overactive NLRP3 inflammasomes during G. parasuis infection. Our research uncovers a mechanism whereby G. parasuis infection initiates inflammatory responses by promoting the assembly of the NLRP3 inflammasomes and activating NLRP3-CASP-1, both of which processes are downregulated by autophagy. This suggests that pharmacological manipulation of autophagy could be a promising approach to modulate G. parasuis-induced inflammatory responses.

Interventions involving nudge theory for COVID-19 vaccination: A systematic review and meta-analysis.

OBJECTIVE: New approaches to mitigate vaccine hesitancy and improve vaccine uptake are urgently needed. Nudging has shown effective results in several health areas. However, the effectiveness of interventions involving nudge theory in increasing COVID-19 vaccination remains unclear. METHOD: We searched PubMed, Web of Science, and Scopus for randomized controlled trials published before December 31, 2022, to determine whether interventions involving nudge theory improved COVID-19 vaccination behavior and intent. Risk ratio (RR) and a 95% confidence interval (CI) were used as pooled measures to assess vaccination behavior. Intention to vaccinate was reported in a narrative synthesis. RESULTS: Sixteen randomized controlled trials involving 176,125 participants were included. Interventions involving nudge theory weakly boosted the COVID-19 vaccine uptake rate (RR = 1.21, 95% CI [1.07, 1.36], p < .01). Subgroup analysis showed a weak positive effect of social norms (RR = 2.04, 95% CI [1.61, 2.57]), defaults (RR = 1.32, 95% CI [1.03, 1.69]), and salient reminders (RR = 1.19, 95% CI [1.04, 1.36]). Nudge interventions integrating multiple components were more efficacious in increasing vaccination rates compared to nudge alone. The effect of nudging interventions weakened over time (p < .001). Most studies (10 of 11) involving vaccination intention outcomes showed positive or partially positive results. CONCLUSIONS: Interventions involving nudge theory can promote COVID-19 vaccination behavior and intentions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Hydroxyl-functionalized Microporous Polymer Membranes with Tunable Para Position Substituent Benzaldehydes for Gas Separation.

We report hydroxyl-functionalized microporous polymers with tunable benzaldehyde groups for gas separation membranes. These polymers were synthesized via acid-catalyzed Friedel-Crafts polycondensation. The tunability in d-spacing and fractional free volume of these polymers depends on the para position substituents (-H, -F, -Cl, and -Br) of the benzaldehyde. Specifically, the size and polarity of the para position substituent influence the polymer chain-packing structure. Consequently, the hydroxyl-functionalized microporous polymer membrane with a larger para position substituent in the benzaldehyde group exhibited improved gas permeability. This improvement is due to enhanced gas diffusivity resulting from the inefficient polymer chain-packing structure. Furthermore, these membranes demonstrated enhanced CO2 plasticization resistance, attributable to the rigid, contorted polymer structure and the hydrogen bonding interactions between hydroxyl groups. This study provides insights into the relationship between the polymer chain-packing structure, tunable para position substituents, and molecular transport.

Isolation and characterization of a novel Bacillus cereus bacteriophage vBce-DP7.

Foodborne pathogens have become a major concern for public health. Bacillus cereus, a representative foodborne pathogen, is particularly challenging due to its ability to cause food poisoning and its resilient spores that are difficult to completely eradicate. Therefore, it is crucial to develop measures to prevent and control B. cereus. Bacteriophages, which are high specific towards their host strains and cannot infect eukaryotes, have proven to be effective in combating foodborne pathogens and are safe for human use. In this study, we isolated and characterized a novel bacteriophage named vBce-DP7 that specifically targets B. cereus strains belonging to three different sequence types (STs). Phage vBce-DP7 is a lytic one and has a short latent time of only 15 min. Moreover, it exhibites a good temperature tolerance, retaining high activity across a broad range of 4-55 ℃. Additionally, its activity remains unaffected within a wide pH range spanning from 2 to 10. Interestingly, with only 4 % genetic similarity with known bacteriophages, vBce-DP7 shows a possible classification on a family level though it shares many similar functional proteins with Salasmaviridae bacteriophages. Taken together, vBce-DP7 demonstrates its significant potential for further exploration in terms of phage diversity and its application in controlling B. cereus.

High levels of mitochondrial dynamics, autophagy, and apoptosis contribute to stable testicular status in hibernating Daurian ground squirrels.

Daurian ground squirrels (Spermophilus dauricus) experience various stress states during winter hibernation, but the impact on testicular function remains unclear. This study focused on the effects of changes in testicular autophagy, apoptosis, and mitochondrial homeostasis signaling pathways at various stages on the testes of Daurian ground squirrels. Results indicated that: (1) During winter hibernation, there was a significant increase in seminiferous tubule diameter and seminiferous epithelium thickness compared to summer. Spermatogonia number and testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) levels were higher during inter-bout arousal, suggesting that the testes remained stable during hibernation. (2) An increased number of mitochondria with intact morphology were observed during hibernation, indicating that mitochondrial homeostasis may contribute to testicular stability. (3) DNA fragmentation was evident in the testes during the hibernation and inter-bout arousal stages, with the highest level of caspase3 enzyme activity detected during inter-bout arousal, together with elevated levels of Bax/Bcl-2 and Lc3 II/Lc3 I, indicating an up-regulation of apoptosis and autophagy signaling pathways during hibernation. (4) The abundance of DRP1, MFF, OPA1, and MFN2 proteins was increased, suggesting an up-regulation of mitochondrial dynamics-related pathways. Overall, testicular autophagy, apoptosis, and mitochondrial homeostasis-related signaling pathways were notably active in the extreme winter environment. The well-maintained mitochondrial morphology may favor the production of reproductive hormones and support stable testicular morphology.

Natural Affinity Driven Modification by Silicene to Construct a "Thermal Switch" for Tumorous Bone Loss.

Tumorous bone defects present significant challenges for surgical bio-reconstruction due to the dual pathological conditions of residual tumor presence and extensive bone loss following excision surgery. To address this challenge, a "thermal switch" smart bone scaffold based on the silicene nanosheet-modified decalcified bone matrix (SNS@DBM) is developed by leveraging the natural affinity between collagen and silicene, which is elucidated by molecular dynamics simulations. Benefitting from its exceptional photothermal ability, biodegradability, and bioactivity, the SNS@DBM "thermal switch" provides an integrated postoperative sequential thermotherapy for tumorous bone loss by exerting three levels of photothermal stimulation (i.e., strong, moderate, and nonstimulation). During the different phases of postoperative bioconstruction, the SNS@DBM scaffold realizes simultaneous residual tumor ablation, tumor recurrence prevention, and bone tissue regeneration. These biological effects are verified in the tumor-bearing nude mice of patient-derived tissue xenografts and critical cranium defect rats. Mechanism research prompts moderate heat stimulus generated by and coordinating with SNSs can upregulate osteogenic genes, promote macrophages M2 polarization, and intensify angiogenesis of H-type vessels. This study introduces a versatile approach to the management of tumorous bone defects.

Current and future trends of acupuncture as an adjuvant therapy in cancer: A bibliometric and visual analysis.

BACKGROUND: Acupuncture, as one of the representatives of complementary therapies, is often used as an adjunctive therapy in the treatment of cancer and related complications with beneficial results. METHODS: We selected the Web of Science Core Collection (WOSCC) database as the data source and searched to obtain relevant literatures on the application of acupuncture in cancer treatment. The relevant literature was analyzed using CiteSpace (version 6.1.R6) and VOSviewer (version 1.6.20). RESULTS: A total of 592 publications were included, with an overall upward trend in the number of publications. There were 135 countries or institutions involved, with China as the most published country. There were 1888 related institutions, and Memorial Sloan Kettering Cancer Center was the institution with the most publications. A total of 3067 authors were involved, and there were obvious collaborations between authors. There were 190 related journals, and J Clin Oncol was the most cited journal. The most frequently occurring keywords were breast cancer and management, but also other related topics such as quality of life, chemotherapy, and complementary. CONCLUSION: Acupuncture is gaining increasing attention as an adjunctive therapy in cancer treatment programs. Currently, relevant research focuses on acupuncture to alleviate cancer-induced comorbid symptoms, such as pain and insomnia. Future research is gradually shifting toward spiritual care, Colorectal Cancer Surgery, and systematic review.

Arthroscopic M-shaped suture fixation for tibia avulsion fracture of posterior cruciate ligament: A modified technique and case series.

BACKGROUND: Tibial avulsion fractures of the posterior cruciate ligament (PCL) are challenging to treat and compromise knee stability and function. Traditional open surgery often requires extensive soft tissue dissection, which may increase the risk of morbidity. In response to these concerns, arthroscopic techniques have been evolving. The aim of this study was to introduce a modified arthroscopic technique utilizing an M-shaped suture fixation method for the treatment of tibial avulsion fractures of the PCL and to evaluate its outcomes through a case series. AIM: To evaluate the effects of arthroscopic M-shaped suture fixation on treating tibia avulsion fractures of the PCL. METHODS: We developed a modified arthroscopic M-shaped suture fixation technique for tibia avulsion fractures of the PCL. This case series included 18 patients who underwent the procedure between January 2021 and December 2022. The patients were assessed for range of motion (ROM), Lysholm score and International knee documentation committee (IKDC) score. Postoperative complications were also recorded. RESULTS: The patients were followed for a mean of 13.83 ± 2.33 months. All patients showed radiographic union. At the final follow-up, all patients had full ROM and a negative posterior drawer test. The mean Lysholm score significantly improved from 45.28 ± 8.92 preoperatively to 91.83 ± 4.18 at the final follow-up (P < 0.001), and the mean IKDC score improved from 41.98 ± 6.06 preoperatively to 90.89 ± 5.32 at the final follow-up (P < 0.001). CONCLUSION: The modified arthroscopic M-shaped suture fixation technique is a reliable and effective treatment for tibia avulsion fractures of the PCL, with excellent fracture healing and functional recovery.

The dual effects of Benzo(a)pyrene/Benzo(a)pyrene-7,8-dihydrodiol-9,10-epoxide on DNA Methylation.

Benzo[a]pyrene (BaP) is one of the most thoroughly studied polycyclic aromatic hydrocarbons(PAHs) and a widespread organic pollutant in various areas of human life. Its teratogenic, immunotoxic and carcinogenic effects on organisms are well documented and widely recognized by researchers. In the body, BaP is enzymatically converted to form a more active benzo(a)pyrene-7,8-dihydrodiol-9,10-epoxide (BPDE). BaP/BPDE has the potential to trigger gene mutations, influence epigenetic modifications and cause damage to cellular structures, ultimately contributing to disease onset and progression. However, there are different points of view when studying epigenetics using BaP/BPDE. On the one hand, it is claimed in cancer research that BaP/BPDE contributes to gene hypermethylation and, in particular, induces the hypermethylation of tumor's suppressor gene promoters, leading to gene silencing and subsequent cancer development. Conversely, studies in human and animal populations suggest that exposure to BaP results in genome-wide DNA hypomethylation, potentially leading to adverse outcomes in inflammatory diseases. This apparent contradiction has not been summarized in research for almost four decades. This article presents a comprehensive review of the current literature on the influence of BaP/BPDE on DNA methylation regulation. It demonstrates that BaP/BPDE exerts a dual-phase regulatory effect on methylation, which is influenced by factors such as the concentration and duration of BaP/BPDE exposure, experimental models and detection methods used in various studies. Acute/high concentration exposure to BaP/BPDE often results in global demethylation of DNA, which is associated with inhibition of DNA methyltransferase 1 (DNMT1) after exposure. At certain specific gene loci (e.g., RAR-ß), BPDE can form DNA adducts, recruiting DNMT3 and leading to hypermethylation at specific sites. By integrating these different mechanisms, our goal is to unravel the patterns and regulations of BaP/BPDE-induced DNA methylation changes and provide insights into future precision therapies targeting epigenetics.

Exploration of the application of augmented reality technology for teaching spinal tumor's anatomy and surgical techniques.

Background: Augmented reality (AR) technology is gradually being applied in surgical teaching as an innovative teaching method. Developing innovative teaching methods to replicate clinical theory and practical teaching scenarios, simulate preoperative planning and training for bone tumor surgery, and offer enhanced training opportunities for young physicians to acquire and apply clinical knowledge is a crucial concern that impacts the advancement of the discipline and the educational standards for young orthopedic physicians. Objective: This study explores the application effect of augmented reality technology in anatomy teaching and surgical clinical teaching for spinal tumor. Methods: The method utilizes virtual reality and augmented reality technology to present a spinal tumor model and the surgical process of percutaneous vertebroplasty. We conducted a random selection of 12 students forming into the augmented reality teaching group and 13 students forming into the traditional teaching group among the 8-year medical students from Peking Union Medical College and Tsinghua University, ensuring that the age and learning stage of the students in both groups were similar. Two groups of students were taught using traditional teaching methods and augmented reality technology-assisted teaching methods, respectively. A questionnaire survey was conducted after class to assess the quality of course instruction, student motivation in learning, their proficiency in anatomical structures, their comprehension of spinal tumor growth and metastasis, and their understanding and proficiency in percutaneous vertebroplasty. Results: This study was the first to apply augmented reality technology in teaching, using spinal tumors and percutaneous vertebroplasty as examples, a head-mounted augmented reality device was used to create learning scenarios, presenting the complex three-dimensional spatial structure intuitively. The two groups of students differ significantly in their rating of teaching quality, enthusiasm for learning, knowledge of anatomical features, understanding of spinal trabecular structure, and understanding of steps in percutaneous vertebroplasty. The augmented reality technology-assisted teaching system demonstrates outstanding advantages. Conclusion: Augmented reality technology has great potential and broad prospects in teaching bone tumors, which can help improve the visualization, interactivity, and three-dimensional spatial sense of medical teaching in spinal tumor. The application and development prospects of using augmented reality technology for anatomy instruction, surgical teaching, and simulation training are extensive.

How and when does proactive personality predict career adaptability? A study of the moderated mediation model.

In the present study, we explored the relationship between proactive personality and career adaptability to construct a cross-level moderated mediation model based on the conservation of resources (COR) theory. By conducting a time-lagged study involving three data collection points from 587 employees across 104 teams in China, we examined how and when proactive personality predicts employees' career adaptability using strengths use as a mediator and managerial coaching as boundary conditions. The results revealed that proactive personality predicted strengths use, which, in turn, influenced career adaptability, with managerial coaching moderating the indirect relationship between proactive personality and career adaptability. Consequently, our findings suggest that, in contexts where managerial coaching lacks guidance, facilitation, and inspiration, a proactive personality encourages employees to leverage their strengths, subsequently enhancing their career adaptability. Finally, we discuss the theoretical and practical implications of our findings, address limitations, and propose directions for future research.

Spatial proximity and gene function: a new dimension in prokaryotic gene association network analysis with 3D-GeneNet.

Understanding the biological functions and processes of genes, particularly those not yet characterized, is crucial for advancing molecular biology and identifying therapeutic targets. The hypothesis guiding this study is that the 3D proximity of genes correlates with their functional interactions and relevance in prokaryotes. We introduced 3D-GeneNet, an innovative software tool that utilizes high-throughput sequencing data from chromosome conformation capture techniques and integrates topological metrics to construct gene association networks. Through a series of comparative analyses focused on spatial versus linear distances, we explored various dimensions such as topological structure, functional enrichment levels, distribution patterns of linear distances among gene pairs, and the area under the receiver operating characteristic curve by utilizing model organism Escherichia coli K-12. Furthermore, 3D-GeneNet was shown to maintain good accuracy compared to multiple algorithms (neighbourhood, co-occurrence, coexpression, and fusion) across multiple bacteria, including E. coli, Brucella abortus, and Vibrio cholerae. In addition, the accuracy of 3D-GeneNet's prediction of long-distance gene interactions was identified by bacterial two-hybrid assays on E. coli K-12 MG1655, where 3D-GeneNet not only increased the accuracy of linear genomic distance tripled but also achieved 60% accuracy by running alone. Finally, it can be concluded that the applicability of 3D-GeneNet will extend to various bacterial forms, including Gram-negative, Gram-positive, single-, and multi-chromosomal bacteria through Hi-C sequencing and analysis. Such findings highlight the broad applicability and significant promise of this method in the realm of gene association network. 3D-GeneNet is freely accessible at https://github.com/gaoyuanccc/3D-GeneNet.

Tailoring whispering-gallery fields in optical black hole cavities.

The ability to confine light has great significance in both fundamental science and practical applications. Optical black hole (OBH) cavities show intriguing zero radiation loss and strong field confinement. In this work, we systematically explore the whispering gallery mode (WGM) in a group of generalized OBH cavities, featuring bound states and strong field confinement. The field confinement in generalized OBH cavities is revealed to be enhanced with the increase of index-modulation factors, resulting from the increase of a potential barrier. Furthermore, we reveal the anomalous external resonant modes, exhibiting fascinating field enhancement in the low-index region far beyond the cavity boundary. These anomalous WGMs are attributed to the potential bending effect and above-barrier resonance. Our work may shed light on tailoring WGM fields in gradient-index cavities and find potential applications in light coupling and optical sensing.

Research on the Asymmetric Phenomenon of Voltage Polarity Based on Dielectric Wetting.

The present research investigated the voltage polarity asymmetry phenomenon based on dielectric wetting. In an ITO-hydrophobic layer-droplet setup, three reagents with different pH values (3.96, 7.0, and 10.18), two types of hydrophobic materials (AF1601 and 6%T6), and two different thicknesses (340 nm and 2.5 µm) of each material were systematically investigated. The results show that the thickness of the hydrophobic dielectric layer and the pH of the droplets had a significant impact on the droplet contact angle variation with the voltage. The contact angle on the thick hydrophobic dielectric layer followed the Lippmann-Young equation as the voltage changed. The angle of the thin hydrophobic dielectric layer was affected by its own properties and the type of droplet, which led to the occurrence of voltage polarity asymmetry of the electrowetting phenomenon. After further investigation of this phenomenon, it was found that it mainly accounted for the decrease in electric field strength at both ends of the droplet, which was caused by electrochemical reactions and changes in circuit resistance. The leakage current is an important indicator, and this phenomenon can be prevented by increasing the thickness of the hydrophobic dielectric layer.

Feasibility of low contrast volume and low injection flow rate in CT pulmonary angiography.

BACKGROUND: Computed Tomography Pulmonary Angiography (CTPA) is currently the gold standard for diagnosing Pulmonary Embolism (PE), with a high flowrate (>4.5ml/s) for contrast media (CM) administration recommended for sufficient pulmonary artery opacification. However, this may not be achievable for patients with challenging IV access. AIM: To determine if a low volume CM, low flowrate (LVLF) CTPA protocol produces images of similar image quality compared to a standard protocol in two aspects, in terms of peak arterial enhancement through the quantitative measurement of Hounsfield unit (HU) and based on subjective overall image quality. METHODS: Retrospective collection of 151 patients who underwent CTPA via 320 slice multi-detector CT due to clinical suspicion of PE. 80 patients underwent the standard protocol, with a fixed flowrate of 4.5ml/s and 50ml of CM, while 71 patients underwent the LVLF protocol with up to a 37% and 30% reduction in flowrate and CM administered, respectively. Two independent radiographers measured the attenuation of multiple pulmonary arteries in HU, with ≥200HU being considered diagnostic. Overall image quality was also reviewed using a 5-point close-ended questionnaire by two independent radiologists. RESULTS: There was no significant difference in terms of attenuation measured in HU for the seven regions of interest (main pulmonary trunk, right and left pulmonary arteries, right and left lobar arteries, and right and left subsegmental arteries (RSA and LSA)) between the LVLF and standard CTPA protocol. Similarly, there were no significant differences in the overall image quality score obtained from standard and LVLF protocols reported by both radiologists. CONCLUSION: The LVLF protocol can achieve similar enhancement and subjective image quality as the standard CTPA protocol, potentially allowing for further optimisation in the CM dosage.

White Matter Microstructure Changes Revealed by Diffusion Kurtosis and Diffusion Tensor Imaging in Mutant Huntingtin Gene Carriers.

Background: Diffusion magnetic resonance imaging (dMRI) has revealed microstructural changes in white matter (WM) in Huntington's disease (HD). Objective: To compare the validities of different dMRI, i.e., diffusion kurtosis imaging (DKI) and diffusion tensor imaging (DTI) in HD. Methods: 22 mutant huntingtin (mHTT) carriers and 14 controls were enrolled. Clinical assessments and dMRI were conducted. Based on CAG-Age Product (CAP) score, mHTT carriers were categorized into high CAP (hCAP) and medium and low CAP (m& lCAP) groups. Spearman analyses were used to explore correlations between imaging parameters in brain regions and clinical assessments. Receiver operating characteristic (ROC) was used to distinguish mHTT carriers from control, and define the HD patients at advanced stage. Results: Compared to controls, mHTT carriers exhibited WM changes in DKI and DTI. There were 22 more regions showing significant differences in HD detected by MK than FA. Only MK in five brain regions showed significantly difference between any two group, and negatively correlated with the disease burden (r = -0.80 to -0.71). ROC analysis revealed that MK was more sensitive and FA was more specific, while Youden index showed that the integration of FA and MK gave rise to higher authenticities, in distinguishing m& lCAP from controls (Youden Index = 0.786), and discerning different phase of HD (Youden Index = 0.804). Conclusions: Microstructural changes in WM occur at early stage of HD and deteriorate over the disease progression. Integrating DKI and DTI would provide the best accuracies for differentiating early HD from control and identifying advanced HD.