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Objective To explore specific magnetic resonance imaging(MRI)features of somatic symptoms in depression by comparing the differences of brain gray matter volume in depression patients with and without somatic symptoms using voxel-based morphometry(VBM).Methods A total of 52 depression patients were recruited and divided into somatic and no somatic symptoms group according to the patient health questionnaire-15 score(＞9 and≤9,respectively).Forty gender-age-matched healthy volunteers were recruited as the control group.All subjects underwent MRI scanning.Imaging data were analyzed to explore the differences in brain gray matter between groups using VBM.Results Compared with control group,gray matter volume increased in the right superior temporal gyrus,and decreased in the right inferior orbitofrontal gyrus,right inferior temporal gyrus,left inferior orbitofrontal gyrus,and left superior temporal gyrus for depressive patients with somatic symptoms(P＜0.001);gray matter volume increased in the right middle temporal gyrus,and decreased in the right superior temporal gyrus and right inferior temporal gyrus for depressive patients without somatic symptoms(P＜0.001).Only the volume in the right tongue and left cingulate gyrus increased in depressive patients with somatic symptoms compared with that in patients without somatic symptoms(P＜0.01).Conclusion VBM-MRI has demonstrated increased volume in the tongue and cingulate gyrus in the somatic symptoms of depression.
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It is the main method to save the ischemic penumbra and improve the nerve function for the patients with ischemic stroke to realize the vascular recanalization within the time window. However, the possible hyperperfusion after successful recanalization will result in neurological deterioration and poor outcome. This article reviews the risk factors for cerebral hyperperfusion after vascular recanalization.
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Objective:To explore the risk factors for poor prognosis in patients with tuberculous meningitis (TBM), and establish their nomogram predictive models.Methods:Three hundred and fifty-eight patients with TBM, admitted to Department of Neurology, 940 th Hospital of Chinese People's Liberation Army Joint Logistic Support Force from January 2010 to February 2022, were chosen and divided into model group ( n=287) and validation group ( n=71) according to the simple random sampling at a ratio of 8:2. Their clinical data were retrospectively analyzed. Independent risk factors for poor prognosis of TBM were analyzed by least absolute shrinkage and selection operator (LASSO) and Logistic regression, and the risk factors were visualized by nomogram. Bootstrap method was used for 1 000 repeated samples for internal verification, and data from validation group were used for external verification. The discrimination and calibration of the models were evaluated by area under receiver operating characteristic (ROC) curve, calibration curve and Hosmer-Lemeshow goodness of fit test. Results:Multivariate Logistic regression analysis showed that mental symptoms ( OR=3.593, 95% CI: 1.790-7.211, P<0.001), limb weakness ( OR=3.087, 95% CI: 1.551-6.144, P=0.001), pulmonary infection ( OR=5.162, 95% CI: 2.373-11.227, P<0.001), improved British Medical Research Council (mBMRC) staging II ( OR=4.291, 95% CI: 2.037-9.039, P<0.001), mBMRC staging III ( OR=13.073, 95% CI: 3.352-50.975, P<0.001) were independent risk factors for poor prognosis in TBM patients. Consistency indexes indicated by area under ROC curves by internal verification and external verification were 0.880 and 0.823, respectively; the calibration curve coincided with the ideal curve, enjoying good Hosmer-Lemeshow fit ( P=0.546, P=0.401). Conclusion:Based on these 4 prognostic factors (mental symptoms, limb weakness, lung infection and mBMRC stages), the nomogram is helpful in predicting the risk of poor prognosis in TBM patients.
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AMP-activated protein kinase (AMPK) is an energy sensor, which can regulate the energy metabolism of cells by regulating mitochondrial oxidation capacity and substrate utilization, affecting various pathways such as glucose and fatty acid transport. Recent studies have shown that energy metabolism disturbance is a "blasting fuse" leading to a series of secondary injuries after cerebral ischemia-reperfusion, including oxidative stress, acidosis, apoptosis, and excitotoxicity. AMPK participates in most pathophysiological processes of cerebral ischemia-reperfusion injury by regulating cellular energy metabolism. This article reviews the mechanism of action of AMPK signaling pathway in cerebral ischemia-reperfusion injury.
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A pedigree with familial acanthosis nigricans presenting with atypical clinical symptoms was reported. The 4-year-old female proband began to develop black patches on the neck and abdomen since the age of 1 year, which had gradually spread to the lips and front of the trunk in recent years. Reflectance confocal microscopy of the abdominal skin showed downward extension and twisting of dermal papillary rings with formation of gully-like structures, and moderately to highly refractive particles in the dermal papillary rings. The proband′s father and grandmother had similar medical history, but the pigmentation spontaneously subsided with age, leaving only local thickened skin lines. Peripheral blood samples were collected from the proband, her parents and grandmother, and panel-based targeted sequencing of peripheral blood DNA was performed for the proband. Sequencing showed a missense mutation c.1949A>C (p.Lys650Thr) in exon 14 of the FGFR3 gene in the proband, and Sanger sequencing confirmed the presence of this mutation in the proband and her father and grandmother. A diagnosis of familial acanthosis nigricans was made.
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The data of 1 case diagnosed with hyperphenylalaninemia (HPA) combined with Cornelia de Lange syndrome (CdLS) by neonatal screening in Newborn Disease Screening Center, Liaocheng Maternal and Child Health Hospital in February 2018 were analyzed retrospectively.The patient was a girl, 22 months old, with clinical features of specific facial appearance, excessive body hair (especially on the forehead and face), dark and thick hair on the head, a low hairline, a heavy and straight brow, lower ear positions, a small nose, a shallow philtrum, a simian line, strong and rhythmic heart sounds, no murmur in the precordial area, clear respiratory sounds of both lungs, purple marbling patterns on the whole body skin, a soft abdomen, and high muscle tension of limbs.The gene mutation c. 1256A>G(p.Q419R) of the polyclonal antibody( PAH) originated from the patient′s mother, while the mutation c. 4421G>A(splicing) derived from the patient′s father. SMC1A gene was X-linked dominant inheritance, and c. 1979_1980insTGAA was a spontaneous mutation.In this paper, the diagnosis and treatment of HPA and clinical and genetic variation characteristics of 23 CdLS cases in China were reviewed, so as to improve the knowledge of doctors about HPA combined with CdLS.
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Objective:To investigate the attention deficit/hyperactivity disorder(ADHD) like behavior of offspring mice induced by stress during pregnancy and its mechanism.Methods:Chronic unpredictable stress was applied to ICR pregnant mice in different gestational periods. The offspring mice were randomly selected and the behavior changes of each group were observed in open field experiment (CG: control group; SG1: cums stress stimulation from 8 to 14 days of gestation; SG2: cums stress stimulation from 15 days of gestation to childbirth). The plasma concentrations of GABA, its metabolic enzymes and dopamine were detected by ELISA.Results:The results of open field experiment showed that the total distance, the time of stay in central area, the speed in central area, and the speed in surrounding area in SG1 group, SG2 group and CG group were statistically significant ( F=8.30, 5.01, 8.05, 7.15, all P<0.05). The total distances of SG1 group and SG2 group were significantly longer than that of CG group ((5 221.07±469.95)mm, (4 825.63±545.49)mm, (3 781.17±111.34)mm, both P<0.05).The times of stay in central area of SG1 and SG2 groups were shorter than that in CG group ((5.95±3.32)s, (8.59±3.42)s, (11.10±3.61)s, all P<0.05). The speeds in central area of SG1 and SG2 groups were faster than that of CG group ((30.93±5.79)mm/s, (32.48±9.06)mm/s, (20.57±5.07)mm/s, all P<0.05).The speed in surrounding area in SG1 group was faster than that in CG group ((16.91±1.64)mm/s), (12.42±3.77)mm/s, P<0.05). ELISA results showed that there were significant differences in mice plasma GABA, GAD65, GAD67 and DA among CG group, SG1 group and SG2 group ( F=16.52, 6.42, 11.04, 7.26, all P<0.05).The plasma concentrations of GABA in SG1 group and SG2 group were lower than that in CG group ((3.70±0.80)μmol/L, (4.40±0.80)μmol/L, (6.06±1.01)μmol/L, all P<0.05).The plasma concentrations of GAD65 ((5.36±0.75)μg/L, (6.99±1.01)μg/L, P<0.05)and GAD67((10.52±1.09)μg/L, (9.84±1.35)μg/L, (12.83±1.67)μg/L, P<0.05)in SG1 group were lower than those in CG group. The plasma DA concentration in SG1 group ((82.81±8.59)ng/L) was higher than that in CG group ((69.43±9.42)ng/L, P<0.05) and SG2 group ((66.36±10.77)ng/L, P<0.05). Conclusion:Prenatal stress can induce ADHD-like behavioural phenotypes in offspring mice, which may be related to the influence of plasma GABA metabolism and DA concentration.
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Objective:To observe the change of the left ventricular(LV) wall shear stress (WSS) using vector flow mapping (VFM) in different segments at each phase of diastolic period among normal subjects.Methods:From August 2018 to March 2019, 200 healthy volunteers selected from the Physical Examination Center of the Second Affiliated Hospital of Harbin Medical University were recruited. The WSS values of LV segments at the same and at different phases[isovolumic relaxation period(D1), rapid filling period(D2), slow filling period(D3), atrial contraction period(D4)] in diastole were measured and analyzed.Results:①The relationships of the WSS of LV different segments at the same phase of diastolic period: The WSS values of anterior septum, posterior septum and posterior wall during D1, and the WSS values of posterior septum, posterior wall and inferior wall during D2 showed basal>middle>apical segments, the differences were statistically significant (all P<0.05). ②The changes of the WSS values of LV different segments during diastolic period: During D1-D2-D3-D4 period, the absolute values of WSS in anterior septum, posterior septum, anterior wall, lateral wall and inferior wall showed an increasing-decreasing-increasing trend. During D2-D3-D4 period, the absolute values of WSS in the posterior wall showed a decreasing-increasing trend. During D1-D2-D3-D4 period, the absolute values of WSS in the apical segment of anterior septum, basal and middle segments of posterior septum, basal, middle and apical segments of anterior wall, basal segment of lateral wall, the middle and apical segments of posterior wall, basal and middle segments of inferior wall all showed an increasing-decreasing-increasing trend, the difference was statistically significant (all P<0.05). Conclusions:The LV WSS in different segments at the same phase or in the same segment at the different phases in diastole exhibit a regular change and is consistent with the LV hemodynamic changes, which indicates that WSS can quantitatively reflect the hemodynamic changes of the LV in normal subjects.
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Objective To evaluate the efficacy of Xiaopi-Zhitong-Poyu decoction combined with gosserin sustained-release implant for the treatment of endometriosis after laparoscopy. Methods A total of 204 patients with endometriosis who met the inclusion criteria were divided into 2 groups by random number table methods, with 102 cases in each group. On the 5th day after the operation, the control group was subcutaneously injected with Gosserin sustained-release implant in the anterior abdominal wall on the basis of routine treatment, the observation group was added with Xiaopi-Zhitong-Poyu soup on the basis of the control group. Both groups were treated for 24 weeks and followed up for 3 years. The World Health Organization Quality of Life Scale-Brief Form Questionnaire (WHOQOL-BREF) was used to evaluate the quality of life of patients. The TCM symptom scores were used to evaluate the menstrual pain, waist sour bloated, thin stool, dizziness and abnormal menstruation. The FSH, E2 and LH was detected by full automatic serum analyzer, and the endomethal antibody (EMAb), matrix metalloproteinase-3 (mmp-3) and carbohydrate antigen 125(ca-125) were detected by enzyme labeling instrument. Clinical efficacy was evaluated and adverse reactions during treatment were recorded. Results The total effective rate was 93.1% (95/102) in the observation group and 80.4% (82/102) in the control group, with statistically significant differences (χ2=3.871, P=0.039). After treatment, scores in environmental field, life field, physiological field and social relation field in the observation group were all significantly higher than those in the control group (t values were 4.725, 4.930, 4.259, 4.571, all Ps<0.05). Scores of menstrual pain, waist sour bloated, thin stool, dizziness and abnormal menstruation in the observation group were all significantly lower than those of the control group (t values were 3.561, 3.457, 3.421, 3.652, 3.529, all Ps<0.05). After treatment, the serum FSH (1.48 ± 0.15 U/L vs. 2.98 ± 0.29) U/L, t=3.174), E2 (52.17 ± 5.25 pg/ml vs. 88.04 ± 8.23 pg/ml, t=3.141), LH (1.82 ± 0.18 U/L vs. 2.45 ± 0.25 U/L, t=3.372) levels in the observation group were significantly lower ( P<0.05); Serum EMAb (0.23 ± 0.02 vs. 0.32 ± 0.03, t=3.763), MMP-3 (69.69 ± 6.68 μg/L vs. 82.57 ± 8.89 μg/L, t=3.890], the CA-125 (25.89 ± 2.78 U/ml vs. 61.43 ± 6.78 U/ml, t=3.652) levels in the observation group were significantly lower (P<0.05). The recurrence rates of the observation group were 4.2% (4/95), 7.4% (7/95), 12.6% (12/95) at 1, 2, and 3 years respectively, while those of the control group were 13.4% (11/82), 18.3% (15/82), 25.6% (21/82), respectively. The differences were statistically significant ( χ 2 values were 3.309, 3.911, 4.102, all Ps<0.05). Conclusions The Xiaopi-Zhitong-Poyu decoction combined with gosserin sustained-release implant can reduce the hormone level of patients with endometriosis after laparoscopic surgery, improve the content of markers of endometriosis, improve the quality of life and clinical efficacy of patients, and reduce adverse reactions.
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Objective@#To evaluate the efficacy of Xiaopi-Zhitong-Poyu decoction combined with gosserin sustained-release implant for the treatment of endometriosis after laparoscopy.@*Methods@#A total of 204 patients with endometriosis who met the inclusion criteria were divided into 2 groups by random number table methods, with 102 cases in each group. On the 5th day after the operation, the control group was subcutaneously injected with Gosserin sustained-release implant in the anterior abdominal wall on the basis of routine treatment, the observation group was added with Xiaopi-Zhitong-Poyu soup on the basis of the control group. Both groups were treated for 24 weeks and followed up for 3 years. The World Health Organization Quality of Life Scale-Brief Form Questionnaire (WHOQOL-BREF) was used to evaluate the quality of life of patients. The TCM symptom scores were used to evaluate the menstrual pain, waist sour bloated, thin stool, dizziness and abnormal menstruation. The FSH, E2 and LH was detected by full automatic serum analyzer, and the endomethal antibody (EMAb), matrix metalloproteinase-3 (mmp-3) and carbohydrate antigen 125(ca-125) were detected by enzyme labeling instrument. Clinical efficacy was evaluated and adverse reactions during treatment were recorded.@*Results@#The total effective rate was 93.1% (95/102) in the observation group and 80.4% (82/102) in the control group, with statistically significant differences (χ2=3.871, P=0.039). After treatment, scores in environmental field, life field, physiological field and social relation field in the observation group were all significantly higher than those in the control group (t values were 4.725, 4.930, 4.259, 4.571, all Ps<0.05). Scores of menstrual pain, waist sour bloated, thin stool, dizziness and abnormal menstruation in the observation group were all significantly lower than those of the control group (t values were 3.561, 3.457, 3.421, 3.652, 3.529, all Ps<0.05). After treatment, the serum FSH (1.48 ± 0.15 U/L vs. 2.98 ± 0.29) U/L, t=3.174), E2 (52.17 ± 5.25 pg/ml vs. 88.04 ± 8.23 pg/ml, t=3.141), LH (1.82 ± 0.18 U/L vs. 2.45 ± 0.25 U/L, t=3.372) levels in the observation group were significantly lower (P<0.05); Serum EMAb (0.23 ± 0.02 vs. 0.32 ± 0.03, t=3.763), MMP-3 (69.69 ± 6.68 μg/L vs. 82.57 ± 8.89 μg/L, t=3.890], the CA-125 (25.89 ± 2.78 U/ml vs. 61.43 ± 6.78 U/ml, t=3.652) levels in the observation group were significantly lower (P<0.05). The recurrence rates of the observation group were 4.2% (4/95), 7.4% (7/95), 12.6% (12/95) at 1, 2, and 3 years respectively, while those of the control group were 13.4% (11/82), 18.3% (15/82), 25.6% (21/82), respectively. The differences were statistically significant (χ2 values were 3.309, 3.911, 4.102, all Ps<0.05).@*Conclusions@#The Xiaopi-Zhitong-Poyu decoction combined with gosserin sustained-release implant can reduce the hormone level of patients with endometriosis after laparoscopic surgery, improve the content of markers of endometriosis, improve the quality of life and clinical efficacy of patients, and reduce adverse reactions.