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Obsessive-compulsive disorder (OCD) mainly manifests as obsessions and compulsions with the characteristics of early age of onset, long illness duration, and low diagnosis and treatment rate.The development of OCD involves mutations in genes associated with the 5-hydroxytryptamine, glutamate, and dopamine systems, as well as changes in the brain structure and function.However, how the potentially pathogenic genes affect brain structure and function and lead to different clinical manifestations remains unknown.Imaging genetics has been used to study the etiological mechanisms of OCD by combining genetics and imaging to analyze the relationship between genetic variation, neurologic and clinical manifestations.As a complex polygenic disease, imaging genetics that combines polygenic association analysis with epigenetic inheritance may become a new trend and perspective to explore the mechanism of the environment-gene-brain-behavior model in OCD.Therefore, this paper reviewed the related imaging genetics studies of OCD, and provided a theoretical basis for the etiological mechanism and precise intervention for OCD.
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Major depressive disorder (MDD) is one of the most common psychiatric disorders.It is characterized by emotional, cognitive, and physical symptoms which can also cause severe disability and disease burden. The current study found that patients with MDD have cognitive impairment in both acute and remission phases, which seriously affect the prognosis of patients. The impairment of visual cognitive function greatly affects the social function of MDD patients and the current researches showed that visual cognitive impairment of MDD patients is closely related to the functional connection in the brain, which can be reflected by different degrees of neuroimaging changes in the frontal, occipital, temporal, and parietal regions.The change of visual cognitive function in patients with MDD is mainly influenced by the frontal lobe and the occipital lobe, which may be related to the large number of visual cortex in the anatomy of the two brain regions. The activation of the frontal lobe may be positively related to the patient's visual cognitive impairment; the reduction of the occipital lobe activity may have an impact on the visual process and may be the starting factor for cognitive impairment. The active enhancement of the parietal region plays an important role in the visual short-term memory. In addition, the temporo-parietal junction is also found to be involved in the processing of visual and working memory, and the activation of temporal lobe and parietal lobe can be observed.This review summarizes recent researches at home and abroad and reveals the visual perception of MDD patients in different ways in each different brain regions.
ABSTRACT
Major depressive disorder (MDD) is one of the most common psychiatric disorders. It is characterized by emotional,cognitive,and physical symptoms which can also cause severe disability and dis-ease burden. The current study found that patients with MDD have cognitive impairment in both acute and remission phases,which seriously affect the prognosis of patients. The impairment of visual cognitive function greatly affects the social function of MDD patients and the current researches showed that visual cognitive im-pairment of MDD patients is closely related to the functional connection in the brain,which can be reflected by different degrees of neuroimaging changes in the frontal, occipital, temporal, and parietal regions. The change of visual cognitive function in patients with MDD is mainly influenced by the frontal lobe and the oc-cipital lobe,which may be related to the large number of visual cortex in the anatomy of the two brain re-gions. The activation of the frontal lobe may be positively related to the patient's visual cognitive impairment;the reduction of the occipital lobe activity may have an impact on the visual process and may be the starting factor for cognitive impairment. The active enhancement of the parietal region plays an important role in the visual short-term memory. In addition,the temporo-parietal junction is also found to be involved in the pro-cessing of visual and working memory,and the activation of temporal lobe and parietal lobe can be observed. This review summarizes recent researches at home and abroad and reveals the visual perception of MDD pa-tients in different ways in each different brain regions.
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Background and purpose:As one of the most fatal malignant tumors in China, the morbidity and mortality of lung cancer remain high. Early diagnosis and normative treatment is the key to improve the prognosis of lung cancer. The aim of this study was to explore the practice of early lung cancer screening with low-dose spiral computed tomography (CT) based on the current situation in community health service, with integration of superior resources of med-ical institutions at all levels in Shanghai.Methods:From Aug. 2013 to Aug. 2014, we screened high-risk population in selected communities of Minhang District, Shanghai, for early diagnosis of lung cancer with low-dose spiral CT combined with multidisciplinary comprehensive treatment models including minimally invasive surgery, exploring the medical service network covering prevention, diagnosis, treatment, rehabilitation and follow-up.Results:Screening population is 11 332 (male 7 144, female 4 188); Twenty-nine cases with pathological diagnosis of malignant tumor, including 27 cases of pri-mary lung cancer, 1 case of lung metastasis, 1 case of breast cancer. The morbidity of primary lung cancer is 238.26×10-5. There were 22 cases of Stage 0-Ⅰ lung cancer accounting for 81.48% of all diagnosed primary lung cancer.Conclusion:Based on community health service, screening with low-dose spiral CT could improve the early diagnosis rate of lung can-cer with feasibility and validity, which could be applicable in qualified eligible medical center and community in China.
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Objective:To evaluate the feasibility and safety of laparoscopic jejunostomy with central venous catheterization set (CVC, Arrow International Inc., USA) during the operation of totally minimally invasive Ivor-Lewis esophagectomy (MIIE). Methods:The clinical data of 88 patients with esophageal squamous cell carcinoma who were admitted to the Fudan University Cancer Hospital from February 2013 to April 2014 were retrospectively analyzed. Among them, 48 patients with early mid-lower esophageal cancer un-derwent laparoscopic jejunostomy with CVC, and 40 patients accepted nasogastric tube nutrition. Short-term clinical outcomes were collected. Results:No significant difference in nutrition index was found between the two groups, but the rate of unplanned extubation in the laparoscopic jejunostomy with CVC group was less than that in the nasogastric tube nutrition group. Conclusion:Laparoscopic jejunostomy with CVC set is a safe and feasible technique. It is potentially accepted as an optional approach in MIIE for post-operative nutrition support.
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Background and purpose:Endoscopic treatment is a promising therapeutic option for superifcial lesions throughout the gastrointestinal tract, this study was aimed to evaluate the efficacy of endoscopic resection (ER) using the new Duette multiband mucosectomy kit (DT-6) on treating esophageal disease. Methods:Since Jun. 2011, ER using DT-6 has been performed on 100 patients in a tertiary medical center. Data from those who have been followed up for over 6 months was analyzed. ER and esophagectomy were compared on treating high grade dysplasia (HGD) lesions and early esophageal cancer. Results:From Jun. 2011 to Jan. 2012, a total of 32 patients with esophageal lesions underwent 34 ER using DT-6 (22 male and 10 female, mean age 59.0 years, range 25 to 83 years). There were (3.4±1.0) specimen resected per operation, and the average greatest diameter was (11.8±2.7)mm. Intraoperative blood loss was (5.45±1.47)mL. The median follow-up period was 8.2 months with a 100%half-year-follow-up rate. Except one pneumothorax occurred during one endoscopic submucosal dissection (ESD), no other complications happened. When Comparing ER and esophagectomy on treating HGD and early esophageal cancer, ER showed advantages in terms of operation time, intraoperative blood loss, hospital stay and complications. Conclusion:ER using DT-6 is safe, simple, minimally invasive and effective for esophageal disease. Prospective study and long follow-up are needed to compare endoscopic resection and esophagectomy for HGD and early esophagus cancer.
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Objective Totally MIIE with per-oral placement of anvil has been reported elsewhere,but MIIE with manual pursestring and per-thoracic port placement of anvil has been seldomly reported.The feasibility of the latter technique was proved in this study.Methods Patients with mid-lower thoracic esophageal cancer were prospectively treated with totally MIIE at Shanghai Cancer Center of Fudan University from Feberay 28,2013 to August 31,2013.Laproscopic intracorporeal construction of the gastric conduit and needle catheter J-tube were performed in the first stage of MIIE.In the second stage a hand sewn pursestring was made with endostitch system and the anvil of EEA stapler was inserted via the tenth inter costal port prior to the intrathoracic anastamosis.Short-term clinicopathologic outcomes were collected.Results 39 cases were treated with totally MIIE,media age 61 years,ranged 48-69 years,10 females and 29 males.There was 1 conversion to open surgery.The median duration of operation was 245 minutes.The median intraoperative blood loss was 210 ml.All the patients were margin negative and staged from pT1N0M0 to pT3N2M0.The average lymph node yields were 16.5 per patient.The median postoperative hospital stay was 7 days.There was no mortality.Perioperative morbidity occurred in 4 patients (10％).2 patients were complicated with late stage gastric paralysis which began 2 or 3 days after oral feeding and both recovered in 1 month.1 patient was with minor anastamotic leakage which was endoscopically demonstrated on the 14th day postoperatively and the patient recovered in 1 month post leakage.1 patient was complicated with severe pneumonitus and ARDS; the ICU stay of that case was 19 days and the recovered patient was discharged 27 days postoperatively.Conclusion MIIE with regular EEA stapler and intrathoracic anastamosis is feasible in patients with thoracic esophageal cancer.Prospective randomized clinical trials could be conducted to compare the open procedure and totally MIIE with regular EEA stapler.
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Objective To study liver function, hepatic energy metabolism, regeneration and apoptosis in obstructive jaundiced or normal liver after 70% partial hepatectomy (PH) with hepatic artery resection (HAR) in rats. Methods In this study, 133 male SD rats were enrolled, 6 rats were in sham operation group, 20 rats underwent choledochoduodenostomy after 70% PH and 20 rats did 70%- PH, choledochoduodenostomy plus HAR. The remaining 87 rats 5 days after common bile duct ligation (CBDL) were randomized into two groups: 70% PH with choledochoduodenostomy, and 70% PH with choledochoduodenustomy plus HAR. Serum TB, ALT, ALB and ALP; tissue of hepatic HGF, bcl-2 mRNA and protein expression; ATP, ADP and AMP in hepatic tissues; hepatocyte proliferation/ apoptosis index were observed postoperatively (24 h, 72 h and 7 d). MortaLity was calculated. Results Rats without obstructive jaundice could tolerate 70% PH plus HAR with good liver regeneration. Compared with other groups, the serum liver function index; ATP content and EC value; HGF,bcl-2 mRNA content of liver tissue and the hepatocyte proliferation/apoptosis index in 70% PH with HAR group significantly aggravated and the mortality signiticanfly increased in obstructive jaundice rats ( P < 0. 05). Conclusions (1) The liver regeneration and apoptosis were not significantly influenced in normal mrs undergoing 70% PH and 70% PH with HAR, moreover hepatoeyte energy metabolism and liver function recovered rapidly in both groups. (2) With the existence of severe bilirubinemia, 70% PH with HAR caused an increased mortality suggesting a rationale for a preoperative bilirubin reducing procedures before a major surgery in malignant obstructive jaundice.
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[Objective] Scoliosis with wedging of vertebra and open-up disc space over convex side can be reversed when PRSS(plate-rod system for scoliosis)was applied.In order to study the mechanical properties of the remedy for the scoliosis by PRSS,the photoelastic test was performed.[Method] The model that consists of five vertebra bodies and four intervertebral discs was built with aluminum and polycarbonate,thus the situation of low-grade scoliosis was simulated.The axial stress was loaded 0 kg,5kg,10 kg,15 kg,20 kg respectively,and the lateral side load was 0 kg,3 kg,6 kg,9 kg,and 12 kg respectively over the spinal column.According to the factual situation,the in-situ stress was measured by using photoelastic and strain gage method.ANSYS9.0 method was also applied to simulate the experiment process and evaluate the reliability of measurement.[Result]When PRSS was placed in,compressive stress was found to exert on the convex side whereas tensile stress was found on the concave side of the curvature,thus modulating bony growth of spinal vertebra,resulted in spinal column realignment.[Conclusion]The PRSS is an effective device to treat the scoliosis of the patients,especially in young children,because it not only can correct the deformity but also allows extension along with the children's growth.