ABSTRACT
Objective:To explore the differences of resting-state spontaneous neural activity between migraine without aura (MwoA) patients with response or nonresponse to non-steroidal anti-inflammatory drugs (NSAIDs), and its correlation with migraine-related features.Methods:From February 2021 to April 2022, thirty MwoA patients with response to NSAIDs, 30 MwoA patients with nonresponse to NSAIDs, and 30 healthy controls were recruited in the Affiliated Jiangning Hospital of Nanjing Medical University.All subjects were scanned with a 3.0 T resting-state functional magnetic resonance imaging scanner.The percent amplitude of fluctuation (perAF) approach was used to calculate the differences of the resting state brain functional activities among the three groups (Bonferroni multiple comparison correction). SPSS 24.0 software and RESTplus software were used for statistical analysis.Analysis of variance was used for the perAF values of three groups.Correlation analysis was performed between perAF values of brain regions with significant differences and migraine-related features.Results:The brain areas showing significant differences of perAF among the three groups located in the left anterior cingulate cortex (ACC)( x, y, z = -6, 9, -3), left middle frontal gyrus (MFG)( x, y, z =-39, 48, 9) and left middle temporal gyrus (MTG)( x, y, z = -57, -30, -15)(all P<0.05, Bonferroni correction). Compared with nonresponse group, the perAF in response group showed significant decreased in the left ACC, MFG and MTG.There was positive correlation between the perAF of left ACC and disease duration ( r=0.506, P=0.007). Compared with healthy controls, the perAF of nonresponse group showed increased in the left ACC, which was negatively correlated with frequency ( r=-0.414, P=0.032). Conclusion:The neural activity of prefrontal cortex and ACC may be the neuropathological basis underlying response to NSAIDs in MwoA treatment.Moreover, the ACC has certain correlations with migraine-related characteristics, which may serve as a potential neuroimaging biomarker to evaluate the efficacy of NSAIDs.
ABSTRACT
Objective:To investigate the changed functional connectivity (FC) of the visual network in patients with migraine without aura (MwoA).Methods:Clinical data of thirty-three patients with MwoA(MwoA group) who visited neurology department from July 2019 to July 2020 were collected, and twenty-two healthy volunteers were recruited as healthy controls (HCs group). All subjects underwent resting-state functional magnetic resonance imaging scans, and the RESTplus software package was used to analyze the resting state function data.The visual network was extracted based on independent component analysis to compare the differences in visual cortex.Subsequently, seed-base FC analysis was used to investigate the changed FC between the visual network and rest of whole brain.Results:Compared with the HCs group, the FC of left fusiform gyrus, right lingual gyrus and right superior occipital gyrus (SOG) within the visual network in MwoA group were significantly increased.MowA group showed increased FC between the left fusiform gyrus and the right superior frontal gyrus (SFG) and left anterior cingulum cortex (ACC), between the right lingual gyrus and left thalamus, left middle frontal gyrus (MFG) and right SFG, and between the right SOG and the SFG, as well as the decreased FC between the left fusiform gyrus and the left inferior occipital gyrus (IOG). Moreover, the changed FC between the left fusiform gyrus and left ACC was positively correlated with disease duration ( r=0.365, P=0.047), and the changed FC between the left fusiform with right SFG was negatively correlated with headache severity ( r=-0.424, P=0.020). Conclusion:The FC of inter- and intra-visual network in MwoA patients is changed, with parts of brain regions are associated with some neural circuits.Additionally, the compensatory period translates to the worse period along with disease progression in MwoA.
ABSTRACT
Objective:To investigate the predicting effect of the disrupted functional connectivity of the anterior cingulate cortex (ACC) on the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with migraineurs without aura (MwoA).Methods:From January 2019 to January 2021, seventy patients with migraine and thirty-three healthy people in the same period were selected.The functional connectivity analysis based on the ACC was used in MwoA patients with NSAIDS-effective ( n=35), MwoA patients with NSAIDS-ineffective ( n=35), and healthy controls (HCs) ( n=33). The abnormal resting-state functional connectivity patterns among the three groups were analyzed to reveal potential correlations with clinical characteristics in migraine. Then the receiver operating characteristic (ROC) curve was used to analyze the predictive ability of the abnormal ACC functional connectivity on the efficacy of NSAIDs in patients with MwoA. Results:(1)Compared with the MwoA patients with NSAIDs-ineffective, the MwoA patients with NSAIDs-effective showed higher functional connectivity between bilateral ACC and left middle cingulate cortex (MCC) (MNI: x, y, z=0, -24, 48, cluster=14, t=3.380) and postcentral gyrus (PoCG)( MNI: x, y, z=-21, -45, 69, cluster=12, t=3.016) (all P<0.005, Bonferroni correction). Compared with the HCs, patients with MwoA showed increased functional connectivity between left ACC and ipsilateral inferior parietal lobule, middle frontal gyrus (MFG) and angular gyrus (AG), and between right ACC and right precuneus, bilateral MFG and left AG (all P<0.005, Bonferroni correction). (2)There was a positive correlation between the functional connectivity of right ACC to right precuneus and MIDAS scores ( r=0.375, P=0.035) in MwoA patients with NSAIDs-effective. In MwoA patients with NSAIDs-ineffective, there were also significant correlations between the functional connectivity of left ACC to ipsilateral AG and MFG and headache onset duration ( r=0.357, P=0.045) and disease duration ( r=-0.367, P=0.039). (3)ROC curve analysis showed that the area under the curve (AUC) for the functional connectivity between the right ACC and left MCC and between the left ACC and left PoCG to predict the efficacy of NSAIDs were 0.728 and 0.736, respectively. Conclusions:Resting-state functional connectivity of the ACC is involved in the evaluation and prediction for analgesic efficacy of NSAIDs in migraine patients, which provides neuroimaging evidence for further investigations on the neurophysiological mechanism of migraine and assistance in clinical individualized precise treatment.
ABSTRACT
Objective:To survey bone age, vitamin A, vitamin D and IGF-1 levels among stunted children, and to explore the clinical values.Methods:The experimental group was composed of 200 stunted children who visited the growth retardation clinic of Jiangning Hospital Affiliated to Nanjing Medical University between October 2017 and October 2019.The control group consisted of 200 children of normal height during the same period.The differences of developmental level, the qualified rates of serum vitamin A and vitamin D, and the number of the children whose serum IGF-1 at or above the median and their corresponding measurements were compared between the two groups.Results:Totally, 26% of the experimental group fell behind normal children by two years in their bone ages, as compared with 12% of control group.The differences in developmental levels of bone ages between the two groups were statistically significant( χ2=12.74, t=5.42、7.92, P<0.01). Compared with the control group, the experimental group had obviously lower rates of vitamin A and vitamin D levels( χ2=26.85、13.65, t=8.45、12.47, P<0.01). A total of 88 children (44%) of the experimental group had serum IGF-1 levels at or above the median, as compared with 138 children (69%) of the control group( χ2=25.43, t=32.31, P<0.01). Conclusion:This finding supports the potential use of the bone age, vitamin A and D status and IGF-1 levels in growth retardation screening among children.
ABSTRACT
Objective To investigate the continuous ambulatory peritoneal dialysis ( CAPD) and daytime ambulatory perito-neal dialysis ( DAPD) on sleep quality. Methods This is a multi-center cross-sectional survey, we used the Pittsburgh Sleep Index Scale ( PSQI) ,the unified investigating time, the organized trained peritoneal dialysis nurses qualified to conduct research full-time. Survey content includes general information, sleep index, laboratory tests, dialysis adequacy and other indicators, and the results were pooled analysis. Results A total of eight hospitals of 325 patients undergoing peritoneal dialysis were included in this study,which CAPD patients and DAPD Pittsburgh Sleep Quality Index Scale scores were 6.88 ±2.43,6.71 ±2.69, the difference was not statisti-cally significant (P>0.01).DAPD patients had a lower sleep efficiency than CAPD patients, but it had no difference between subjec-tive feeling, CAPD patients were more likely to have more nocturnal cough, snoring and other symptoms and lower quality of life in mental status scores than DAPD patients(P<0.01). Conclusion Sleep quality of peritoneal dialysis patients scored lower than the norm.Dialysis modes have an impact on sleep quality of patients, health care workers should fully assess the physical and mental state of the patients in order to select the appropriate mode of dialysis.
ABSTRACT
Objective We evaluated the role of a quality improvement initiative in improving clinical outcomes in peritoneal di-alysis ( PD) . Methods In a retrospective analysis of 6 years of data from a hospital registry, the period between 1 July 2005 and 30 June 2008 ( control group) provided baseline data from before implementation of systemic outcomes monitoring, and the period between 1 July 2008 and 30 June 2011 [continuous quality improvement (CQI) group] represented the time when a CQI program was in place.Per-itonitis incidence, patient and technique survival, cardiovascular status, causes of death, and drop-out were compared between the groups. Results In the 370 patients of the CQI group and the 249 patients of the control group, the predominant underlying kidney diseases were chronic glomerulonephritis and diabetic nephropathy.After implementation of the CQI initiative, the peritonitis rate de-clined to 1 episode in 77.3 patient-months from 1 episode in 22.6 patient-months.In the CQI group, the complicance of blood pressure was more significantly improved than the control group ( 67.8% vs 47.4%,P<0.05).During the 3 years of follow-up,cardiothoracic ratio and IVST were significantly increased in the control group [0.55 ± 0.08 vs 0.51 ±0.05,P<0.05,11.07 ±1.66 mm vs 10.25 ±1.38 mm, P<0.05〗.The difference of LVID between the two groups was signifi-cant at the 2nd and 3rd year of follow-up(P<0.05).Patient survival at 1, 2, and 3 years was significantly higher in the CQI group (97.3%, 96.3%, and 96.3%respectively) than in the control group (92.6%, 82.4%, and 67.3%respectively, P<0.001).Imple-mentation of the CQI initiative also appeared to significantly improve technique survival rates:95.6%, 92.6%, and 92.6%in the CQI group compared with 89.6%, 79.2%, and 76.8%in the control group (P<0.001) after 1, 2, and 3 years respectively. Conclusion Integration of a CQI process into a PD program can significantly improve the quality of therapy and its outcomes.
ABSTRACT
Objective To analyze the diagnostic value of CT and MRI in spinal trauma.Methods 41 cases of spinal trauma in patients with spinal CT scan and MRI image data were retrospectively analyzed and compared.Results MRI examination revealed 41 cases of spinal fractures,CT showed 38 cases of fracture; MRI examination revealed 10 cases of bone contusion,CT scan found 1 case of bone contusion;MRI examination revealed 15 cases of anterior longitudinal ligament injury,12 cases occurred posterior longitudinal ligament injury,CT scan found that the anterior longitudinal ligament and posterior longitudinal ligament injury of 2 cases of MRI detection rate was significantly higher than CT(P ＜ 0.05).120 bone chips CT findings,MRI examination revealed 83 cases of bone chips,the difference was statistically significant(P ＜ 0.05).Conclusion CT and MRI of spinal trauma are two commonlyways of imaging examination.There are advantages and disadvantages of CT examination of the bone chips shift and so can be clearly shown MRI for ligament injury.Bone contusion can be clearly demonstrated for the general compression fractures in MRI examination.Commimcted fracture should be added to do a CT scan.
ABSTRACT
Objective To explore a new surgical procedure for phallic reconstruction. Methods Since Dec 2003 to Nov 2006,4 patients with penile loss were reconstructed by transferring a deep in-ferior epigastric perforator(DIEP)flap with implanting the 12th costal cartilage. Results All of the flaDs survived successfully.With the follow-up from 5 months to 3 years,the appearance oi the neope-nis and donor-site scar was satisfactory. No one developed fistula or urethral stenosls, All patients were reported the return of erogenous sensibility of the neopenis leading to orgasm and achmving Pene-tration during sexual intercourse. Conclusions This new procedure may provide an esthetlcaIlY ac-ceDtable and functional neophallus.It might be a new alternative in penile reconstruction.
ABSTRACT
Apolipoprotein E is an important regulation factor in lipids metabolism. It has been accepted that apolipoprotein E is relevant to many diseases such as Alzheimer′s disease and coronary heart diseases. And increasing study has revealed that apoE gene polymorphism is associated with some kidney diseases. We reviewed the progress of influences of apoE gene polymorphism on renal diseases.
ABSTRACT
Continuous ambulatory peritoneal dialysis (CAPD) is an important form in integrated renal replace treatment.Malnutrition is still a problem to be resolved in CAPD. A number of investigations showed the effects of amino aicd peritoneal dialysate in malnutrition CAPD patients had benefit effects on improving nutrition status.The results of clinical progress of amino acid peritoneal dialysate used in peritoneal dialysis were reviewed.
ABSTRACT
Diabetes mellitus(DM) is a leading cause of chronic kidney disease(CKD) worldwide,and its rising prevalence may explain much of the increase in the incidence of kidney failure.Even when DM is not the cause of kidney disease,the coexistence of CKD and DM presents unique problems that need to be recognized and managed appropriately to optimize the outcomes.The objective of this article is to outline the management of glycemia in patients with DM of stage Ⅳ-Ⅴ and CKD ≥ stage Ⅲ,followed by a review of the appropriate use of available hypoglycemic agents for such patients,with an emphasis on the newer classes of the agents.
ABSTRACT
Objective This study is to summarize the experience of microsurgical reconstruction for donor liver anatomical variations of hepatic arteries in orthotopic liver transplantation. Methods During the bench surgery, the anatomy of donors′ hepatic arteries was carefully examined and microsurgical techniques were used for the anomalous arteries. The graft arterial flow was checked by Doppler ultrasound daily in the first week in postoperative period and periodically thereafter. Results The arterial anatomy was anomalousin 20 out of 141 (14%) donor livers. Nine cases (6.3%) needed arterial reconstruction. In these cases, 7(4.9%) aberrant right hepatic arteries originating from superior mesenteric artery were anastomosed to gastro-duodenal arteries and another two aberrant hepatic left or right arteries were anastomosed to the stump of the donor splenic arteries. Conclusions The variations of hepatic arteries in donors are common. To obtain the ideal arterial supply of liver graft, both careful checking on the origin of donor's artery and appropriate plastic performance with refined microsurgical techniques are necessary.