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Objective:To explore the difference of brain structure between patients with early-onset depression with and without suicidal ideation and its relationship with the severity of depression.Methods:Totally 37 patients with early-onset depressive disorder with suicidal ideation and 23 patients with early-onset depressive disorder without suicidal ideation were examined by psychological assessment and magnetic resonance imaging(MRI)from 2019 to 2020.Voxel-based morphometry (VBM) technology was used to compare the differences in brain structure between the two groups of subjects, and further analyze the relationship between the gray matter volume of the different brain areas and the severity of depression. The demographic and clinical data were analyzed by SPSS 24.0 statistical software package. The comparison between the two groups was performed by double sample t-test and chi square test. SPM8 software was used for VBM statistical analysis, and double sample t test was used for image analysis and comparison between the two groups. Pearson correlation analysis was performed between the mean gray matter volume of the two groups and the scores of HAMD-17 and Beck scale for suicide ideation(BSI). Results:Compared with the group without suicide ideation, the volume of gray matter in the right middle frontal gyrus(MNI: x, y, z=28.5, 33.0, 43.5, FWE correction for mass level, P<0.05)and left angular gyrus of the suicide idea group increased(MNI: x, y, z=-37.5, -73.5, 48.0, FWE correction for mass level, P<0.05). There was no significant correlation between the gray matter volume of the right middle frontal gyrus and the HAMD-17 scale, BSI scale in patients with early-onset depression ( r=0.073, r=-0.153, both P>0.05). Conclusion:There are structural differences in the right middle frontal gyrus and left angular gyrus between patients with early-onset depression with suicidal ideation and patients with early-onset depression without suicidal ideation, and there was no significant correlation between gray matter volume and depression severity.
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Objective:To evaluate changes in urinary neutrophil gelatinase-associated lipocalin(NGAL)levels in elderly coronary artery disease(CAD)patients after percutaneous coronary intervention(PCI), and to explore the role of NGAL and its value in the early diagnosis of contrast-induced nephropathy(CIN).Methods:This was a retrospective case-control study.A total of 68 patients undergone PCI were consecutively enrolled between October 2012 and October 2013.Serum creatinine(SCr)was measured before and at 24, 48 and 72h after PCI.Urinary NGAL was measured before and at 2, 12 and 24 h after PCI.The value of urinary NGAL for early diagnosis of CIN was analyzed.Results:The overall incidence of CIN was 8.82%.Urinary NGAL levels at 2 h, 12 h and 24 h after PCI were higher than pre-surgery levels(all P<0.05). Compared with the non-CIN group, urinary NGAL levels were increased in the CIN group at 2 h, 12 h and 24 h after PCI(all P<0.05). Pearson correlation analysis showed that urinary NGAL levels at 2 h, 12 h and 24 h after PCI were positively correlated with peak SCr within 72 h after PCI( r=0.625、0.493, and 0.226, all P<0.05), and were negatively correlated with peak eGFR within 72 h after PCI( r=-0.732、-0.603 and -0.449, all P<0.05). The area under the receiver operating characteristic(ROC)curve(AUC)showed that urinary NGAL was 0.740(95% CI: 0.481-0.998, P=0.029)at 2 h post-operation, and the sensitivity and specificity for the diagnosis of CIN were 62.5% and 73.3%, respectively, when the cut-off level was 17.52 ng/ml.The AUC of urinary NGAL was 0.948(95% CI: 0.895-1.001, P<0.001)at 12 h post-operation, and the sensitivity and specificity for the diagnosis of CIN were 87.7% and 88.3%, respectively, when the cut-off level was 44.30 ng/ml.The AUC of urinary NGAL was 0.931(95% CI: 0.869-0.994, P<0.001)at 24 h post-operation, and the sensitivity and specificity for the diagnosis of CIN were 86.2% and 73.3%, respectively, when the cut-off level was 48.65 ng/ml. Conclusions:Urinary NGAL can reflect acute kidney injury within 24 h of administration of contrast agents in coronary interventional therapy, and has a certain predictive value in the early diagnosis of CIN.
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Objective:To explore the correlation between TCM Syndromes of small pulmonary nodules (SPN) and the features of CT imaging and tumor markers in the chest.Methods:With retrospective study, the clinical data of 420 patients with small pulmonary nodules who were included from June 2016 to May 2018 from the East China Hospital Affiliated to Fudan University and Shanghai TCM Integrated Hospital were analized. The correlation between TCM syndromes and clinical high-risk indicators was analyzed by frequency analysis and Pearson correlation analysis.Results:The TCM syndromes were mainly lung qi and spleen qi deficiency syndrome (28.8%), followed by qi and yin deficiency syndrome (27.6%), lung yin deficiency syndrome (22.9%), qi deficiency and blood stasis syndrome (12.4%) and liver depression and spleen deficiency syndrome (8.3%). Compared with the patients with qi deficiency and blood stasis, the patients with liver depression and spleen deficiency had carcino embryonic antigen (CEA) level decreased significantly ( P<0.01); compared with the patients with qi and yin deficiency, CYFRA21-1 level in the patients with lung yin deficiency increased significantly ( P<0.001) and CYFRA21-1 level decreased in the patients with qi deficiency and blood stasis ( P=0.014); compared with the patients with lung yin deficiency, the level of neuron-specific- enolase (NSE) in the patients with lung qi and spleen qi deficiency. The level of NSE decreased ( P=0.044), and the level of NSE increased significantly in patients with liver depression and spleen deficiency ( P=0.005); there was no significant difference in the level of SCC between different syndromes ( F=0.825, P=0.551). The syndrome of deficiency of lung yin was moderately correlated with chronic bronchitis, smooth margin and burr ( r=0.613, -0.628, 0.755). The syndrome of qi and yin deficiency was lowly correlation to the solidity ( r=-0.421). The syndrome of lung qi and spleen qi deficiency was moderately correlation with the solidity ( r=0.540), and were low correlation with the chronic bronchitis history, ground glass, round, quasi round, and smooth edge ( r value was 0.303, -0.495, 0.376, -0.337, 0.319 respectively); liver depression and spleen deficiency syndrome were correlated with smoking history, chronic bronchitis history, left lower lobe of lung, isolated focus, multiple focus, quasi circle, NSE ( r value was -0.099, -0.150, 0.120, 0.113, -0.113, -0.107, 0.133 respectively); qi deficiency and blood stasis syndrome was moderately correlated with lobular shape ( r=0.682), and slightly correlated with irregular edge ( r=0.470). Conclusions:There is a certain correlation between TCM syndrome differentiation and clinical indexes in patients with pulmonary nodules. The level of tumor markers was different in different syndrome types. Among them, the lung yin deficiency syndrome and qi deficiency and blood stasis syndrome are at high risk of developing malignant tumors, but the lung qi and spleen qi deficiency syndrome, qi and yin deficiency syndrome and liver depression and spleen deficiency syndrome are at low risk of developing malignant tumors.
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Objective To investigate the gut microbial characteristics and risk factors in people with mild cognitive impairment. Methods Twenty-eight people with mild cognitive impairment and 65 age-, gender- as well as education-matched controls were recruited. Carotid artery ultrasonography was conducted and fasting anticoagulant blood and fresh fecal samples were collected on all subjects. Total bacterial DNA was extracted from the stool samples and amplified through real-time quantitative polymerase chain reaction (qPCR). Next generation analysis of 16S rRNA was performed to achieve genomic sequences using the Illumina Hiseq 2500 platform. Results Compared with the control group, mild cognitive impairment group exhibited greater microbial diversity (Bray Curtis distance, Adonis test, P<0.05), which were characterized by enrichment of proteobacteria, Synergistetes, lactobacillus, and depletion of Epulopiscium. Age, creatinine, average CCAIMT, Crouse score, and plaque numbers were associated with cognitive impairment. Multiple logistic regression analysis revealed that the number of hyperechoic plaques (OR=11.511, 95%CI:1.406~94.226, P=0.023) and the abundance of lactobacillus (OR=4.894, 95%CI: 1.090~21.966, P=0.038) were the important risk factors for mild cognitive impairment. Conclusion Higher abundance of lactobacillus in the gut holds potential as novel risk factor of people with mild cognitive impairment.
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Objective To evaluate the predictive value of IABP SHOCK Ⅱ risk score in in-hospital mortality of patients with ST segment elevation myocardial infarction complicated with cardiogenic shock (CS). Methods From August 2011 to August 2013, the clinical data of 89 patients with cardiogenic shock after STEMI treated with primary PCI and then supported by using IABP were retrospectively analyzed. The IABP SHOCK Ⅱ risk score were calculated from the data at admission and primary PCI. Comparisons of general information, medication and intervention, pre/post IABP vital life signs and in-hospital death were carried out among patients with different risk stratifications. Results The area under ROC curve of risk stratification was 0.723. The patients were categorized into low risk group (score 0-2, n=71) and intermediate-high risk group (score 3-9, n=18).The patients in intermediate-high risk group were with advanced age, high rate of diabetes mellitus, history of stroke, renal insufficiency, higher serum lactate and glucose at admission compared with low risk group. And more patients in intermediate-high risk group had impaired post-PCI coronary flow (TIMI flow grade<3). Conclusions The IABP SHOCK Ⅱ risk score is a simple and useful risk score for predicting in-hospital mortality of STEMIpatients complicated with CS. Though the patietns are treated with primary PCI and then supported by IABP, the in-hospital mortality of patients with IABP SHOCK Ⅱ risk score ≥ 3 increases significantly.
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Aim To observe the analgesic effect of oxymatrine(OMT)and its mechanism.Methods A peripheral mononeuropathy was produced in adult mice by placing loosely constrictive ligatures around the common sciatic nerve.The antinociceptive effects of the OMT were assessed in mechanical allodynia and cold allodynia tests.The CAMKII inhibitor KN-93 and AIP were adopted to investigate the influence of OMT on the analgesic effect and analyze its analgesic mecha-nisms.Western blot was used to evaluate the expres-sions of tCaMKII and pCaMKII protein.Results The intraperitoneal administration of OMT (1 60,80 mg· kg -1 )increased the paw withdrawal threshold in the mechanical allodynia test (P <0.05 ),OMT (1 60, 80,40 mg·kg -1 ,ip)remarkably decreased the paw lifts in the cold allodynia test (P <0.05).Ith KN-93 (1 .25 μg/site),AIP (0.02 μg/site)significantly en-hanced the analgesic effect of OMT (35 mg·kg -1 ) (P <0.01 ).Protein expression of pCaMKII was de-creased by OMT(1 60 mg·kg -1 ).Conclusion OMT has significant protective effects on chronic constriction injury(CCI)in mice,and the effective mechanism of OMT inhibits the expression of CaMKII receptor.
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Intracranial branch atheromatous disease (BAD) was proposed by Caplan in 1989.It has been widely studied in Japan in recent years.With the application of high-resolution magnetic resonance,BAD has become a hot topic.This article reviews the concept,etiology,pathology,diagnosis and treatment of BAD as well as its relationship with ischemic stroke.
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Objective To investigate the correlation between plasma homocysteine (Hcy) level and cerebral microbleeds (CMBs) band leukoaraiosis (LA) in patients with acute stroke.Methods The clinical and imaging data of patients with acute stroke were analyzed retrospectively.The numbers of CMBs were counted and the severity of LA was graded according to the results of MRI.Fasting venous samples were obtained and the plasma Hey concentration was measured the next day after admission.Results A total of 139 patients with acute stroke were enrolled,67 of them were females and 72 were males (mean age 70.1 ± 10.2 years); 24 had hemorrhagic stroke and 115 had ischemic stroke.The age (76.23 ± 8.74 years vs.64.58 ± 7.42 years;t =4.621,P =0.012) hypertension ratio (89.13％ vs.67.74％ ;x2 =8.324,P =0.0 370) and plasma Hey level (14.53 ± 4.31 mmol/L vs.11.31 ±3.16 mmol/L;t =6.538,P=0.008| in a severe LA group (n=46) were significantly higher than those in a non-severe LA group (n =93).Spearman correlation analysis showed that there was significant correlation between the plasma Hcy level and the severity of LA (rs =0.365,P =0.002).Multivariate logistic regression analysis showed that the increased Hey level (odds ratio [ OR ],1.366,95％confidence interval [ CI] 1.141 - 1.526; P =0.010) and age (OR 1.093,95％ CI 1.031 - 1.162; P =0.016)were the independent risk factors for severe LA.The age (74.37 ± 6.35 years vs.67.56 ± 8.52 years; t =6.628,P =0.038) and hypertension ratio (94.74％ vs.62.20％;x2 =8.773,P =0.002) in a CBM group were significantly higher than those in a non-CMB group (n =82).Spearman correlation analysis showed that there was no significant correlation between the plasma Hcy level and the numbers of CBMs (rs =0.038,P =0.813).Multivariate logistic regression analysis showed that hypertension was an independent risk factor for CBMs.Conclusions The elevated plasma Hcy level was associated with LA,but it was not associated with CBMs.