Brain Perfusion Alterations on 3D Pseudocontinuous Arterial Spin-Labeling MR Imaging in Patients with Autoimmune Encephalitis: A Case Series and Literature Review.

Autoimmune encephalitis is a heterogeneous group of newly identified disorders that are being diagnosed with increasing frequency. Early recognition and treatment of autoimmune encephalitis are crucial for patients, but diagnosis remains challenging and time-consuming. In this retrospective case series, we describe the findings of conventional MR imaging and 3D pseudocontinuous arterial spin-labeling in patients with autoimmune encephalitis confirmed by antibody testing. All patients with autoimmune encephalitis showed increased CBF in the affected area, even when some of them presented with normal or slightly abnormal findings on conventional MR imaging. Additionally, serial 3D pseudocontinuous arterial spin-labeling showed perfusion reduction in 1 patient after therapy. For patients with highly suspected autoimmune encephalitis, 3D pseudocontinuous arterial spin-labeling may be added to the clinical work-up. Further studies and longitudinal data are needed to corroborate whether and to what extent 3D pseudocontinuous arterial spin-labeling improves the diagnostic work-up in patients with autoimmune encephalitis compared with conventional MR imaging.

[Population's acceptance and attitude toward a novel fecal immunochemical test for colorectal cancer screening: a multi-center survey in China].

Objective: To investigate the acceptance and attitude toward a novel fecal immunochemical test (FIT) in colorectal cancer screening among populations in China. Methods: From May 2018 to May 2019, 2 474 people aged 50-74 years were recruited from five provinces of China (Zhejiang, Anhui, Jiangsu, Hunan and Yunnan). The general demographic characteristics, acceptance of the new FIT technology and operational difficulties through the whole screening process were obtained through questionnaire survey. Multivariate logistic regression model was used to analyze the factors related to difficulties encountered in sampling stool, reading and uploading results. Results: The subjects were (60.0±6.4) years old, and female, high school of above educated, unemployed/retired/other, married and with medical insurance status of "new rural cooperative medical care (NRCMC)" accounted for 61.7% (1 526), 29.0%(718), 34.3% (849), 92.7% (2 293) and 31.3%(775), respectively. The population's acceptance of the FIT technology was 94.8%. In the process of FIT screening, the percentage of occurred difficulties in sampling stool, reading and uploading results were 33.1% (819), 46.4% (1 147) and 62.9% (1 557), respectively. The main difficulties were the uncertainty about whether the sampling operation was standard (28.0%), the inability to accurately judge the result displayed (32.5%) and the need for help without using a smartphone (44.2%). The results of multivariate logistic regression model analysis showed that people aged 65-74 years old and with medical insurance status of "NRCMC" were more likely to encounter difficulties in sampling, and those who were unemployed/retired/other and living with 3 or more family members were less likely to encounter difficulties in sampling. Those aged 65-74 years old, farmers or migrant workers, and those with "NRCMC" were more likely to encounter difficulties in readingresults, and those with 3 or more family members were less likely to encounter difficulties in reading result. Those with "NRCMC" were more likely to encounter difficulties in uploading results, and those with education level of high school or above, living with more than 3 family members were less likely to encounter difficulties in uploading results. Conclusion: The acceptance of the new FIT technology is relatively high among the subjects. Age, education level, occupation, number of family members living together and medical insurance status might be related to difficulties encountered in sampling stool, reading and uploading results, and it can be further strengthened in terms of the technology and characteristics of sub-populations.

Role of 3D Pseudocontinuous Arterial Spin-Labeling Perfusion in the Diagnosis and Follow-Up in Patients with Herpes Simplex Encephalitis.

BACKGROUND AND PURPOSE: Early diagnosis and treatment of herpes simplex encephalitis are crucial to reduce morbidity and mortality. Our aim was to investigate the role of 3D pseudocontinuous arterial spin-labeling in herpes simplex encephalitis. MATERIALS AND METHODS: From 2014 to 2019, seventeen consecutive patients with herpes simplex encephalitis and 15 healthy volunteers were recruited in the study. Conventional MR imaging and 3D pseudocontinuous arterial spin-labeling were performed in all subjects. According to the disease duration, the lesions were classified into 3 groups, including acute, subacute, and chronic stages, respectively. Clinical, neuroradiologic, and follow-up features were studied. The normalized lesion/normal tissue CBF values of lesions at different stages were measured and compared with those in the control group, respectively. RESULTS: Compared with the control group, herpes simplex encephalitis demonstrated hyperperfusion in 11 acute cases and 6 subacute cases and hypoperfusion in 6 chronic cases. The mean normalized lesion/normal tissue CBF values of the lesions were 2.68 ± 0.54 in the acute stage, 2.42 ± 0.52 in the subacute stage, and 0.87 ± 0.30 in the chronic stage, respectively. The mean normalized lesion/normal tissue CBF values of acute and subacute lesions were significantly higher than those of the control group (1.33 ± 0.08; P < .001, respectively), while the mean normalized lesion/normal tissue CBF values of chronic lesions were lower than those of the control group (P < .05). Gradual perfusion reduction on serial 3D pseudocontinuous arterial spin-labeling was observed in herpes simplex encephalitis after effective therapy. CONCLUSIONS: Conventional MR imaging remains most helpful in the diagnosis of herpes simplex encephalitis, while 3D pseudocontinuous arterial spin-labeling could be an adjunctive technique by providing dynamic CBF features at different stages in herpes simplex encephalitis.

Pharmacokinetics of febuxostat in healthy Chinese volunteers.

BACKGROUND: Febuxostat is a novel non-purine selective inhibitor of xanthine oxidase developed for the management of hyperuricemia in patients with gout. OBJECTIVE: To investigate the pharmacokinetics and also evaluate the effects of gender and food on the pharmacokinetics of febuxostat in healthy Chinese volunteers. METHODS: A phase I, 3-period study was performed in healthy Chinese male and female subjects. Subjects either received single 40 mg, multiple 40 mg and single 80 mg doses of febuxostat under fasted conditions, or received single 80 mg doses under fed condition. Plasma concentrations of febuxostat were collected and determined at 14 time points over 48 h. RESULTS: After 40 mg and 80 mg single dose administration of febuxostat, the C max were 2.308±0.812 and 4.559±1.246 µg/mL, the T max were 1.6±0.6 and 2.1±1.0 h, the t 1/2 were 6.8±1.7 and 6.7±1.9 h, and the AUC0-∞ were 7.704±1.723 and 16.34±3.87 µg∙h/mL, respectively. In the multiple-dose study at 40 mg dose for 6 consecutive days, the mean (SD) steady-state pharmacokinetic parameters on day 8 were similar to those following a single dose of febuxostat on day 1. In addition, food caused a decrease of 33% for C max and a delay of 0.3 h for T max. Gender had no significant effect on the pharmacokinetics of febuxostat. Febuxostat was well tolerated over the investigated dose range. CONCLUSION: Compared with the previous study, the pharmacokinetics of febuxostat appeared to be different between Chinese and other races.