Value of predictive liver metastasis in pancreatic neuroendocrine neoplasms based on ultrasonographic radiomics / 中华超声影像学杂志

Objective:To explore the predictive value of ultrasound-based radiomics for liver metastasis in pancreatic neuroendocrine tumors (pNEN).Methods:A retrospective analysis was conducted on clinical, pathological, and ultrasound data of 269 pNEN patients confirmed by pathology at Tianjin Medical University Cancer Institute and Hospital from January 2012 to June 2022, including 94 patients with liver metastasis and 175 without liver metastasis. The regions of interest (ROI) were delineated on the maximum diameter section of the tumor using ITKSNAP software, and radiomics features were extracted using Pyradiomics. Radiomics features with an intra-group correlation coefficient greater than 0.90 were retained, and the optimal features were selected using the maximum relevance minimum redundancy (MRMR) algorithm. The dataset was randomly divided into a training set and a validation set in a ratio of 7∶3, and the random forest algorithm (Rfs) was used to predict pNEN liver metastasis. Three models were constructed, including the clinical ultrasound model, the radiomics model, and the comprehensive model that combined clinical ultrasound and radiomics features. The predictive performance of different models for pNEN liver metastasis was analyzed using the ROC curve, and the predictive performance of different models was compared using the Delong test.Results:A total of 874 features were extracted from the ROI, and 12 highly robust radiomics features were retained for model construction based on inter- and intra-observer correlation grading and feature selection. The area under curve(AUC), sensitivity, specificity, and accuracy of the radiomics model, the clinical ultrasound model, and the comprehensive model for predicting liver metastasis in pNEN patients were 0.800, 0.574, 0.789, 0.714; 0.780, 0.596, 0.874, 0.777; and 0.890, 0.694, 0.874, 0.810, respectively. The Delong test showed that the comprehensive model had the best predictive performance, with an AUC superior to that of radiomics model ( Z=3.845, P=0.000 12) and clinical ultrasound model ( Z=3.506, P=0.000 45). Conclusions:The radiomics model based on ultrasound has good performance in predicting liver metastasis in pNEN, and the comprehensive model that combines clinical ultrasound and radiomics features can further improve the predictive performance of the model.

RhoGEF Trio Regulates Radial Migration of Projection Neurons via Its Distinct Domains / 神经科学通报·英文版

The radial migration of cortical pyramidal neurons (PNs) during corticogenesis is necessary for establishing a multilayered cerebral cortex. Neuronal migration defects are considered a critical etiology of neurodevelopmental disorders, including autism spectrum disorders (ASDs), schizophrenia, epilepsy, and intellectual disability (ID). TRIO is a high-risk candidate gene for ASDs and ID. However, its role in embryonic radial migration and the etiology of ASDs and ID are not fully understood. In this study, we found that the in vivo conditional knockout or in utero knockout of Trio in excitatory precursors in the neocortex caused aberrant polarity and halted the migration of late-born PNs. Further investigation of the underlying mechanism revealed that the interaction of the Trio N-terminal SH3 domain with Myosin X mediated the adherence of migrating neurons to radial glial fibers through regulating the membrane location of neuronal cadherin (N-cadherin). Also, independent or synergistic overexpression of RAC1 and RHOA showed different phenotypic recoveries of the abnormal neuronal migration by affecting the morphological transition and/or the glial fiber-dependent locomotion. Taken together, our findings clarify a novel mechanism of Trio in regulating N-cadherin cell surface expression via the interaction of Myosin X with its N-terminal SH3 domain. These results suggest the vital roles of the guanine nucleotide exchange factor 1 (GEF1) and GEF2 domains in regulating radial migration by activating their Rho GTPase effectors in both distinct and cooperative manners, which might be associated with the abnormal phenotypes in neurodevelopmental disorders.

Distinct Effects of Social Stress on Working Memory in Obsessive-Compulsive Disorder / 神经科学通报·英文版

Stress might exaggerate the compulsion and impair the working memory of patients with obsessive-compulsive disorder (OCD). This study evaluated the effect of stress on the cognitive neural processing of working memory in OCD and its clinical significance using a “number calculation working memory” task. Thirty-eight patients and 55 gender- and education-matched healthy controls were examined. Stress impaired the performance of the manipulation task in patients. Healthy controls showed less engagement of the medial prefrontal cortex and striatum during the task under stress versus less stress, which was absent in the patients with OCD. The diagnosis × stress interaction effect was significant in the right fusiform, supplementary motor area, precentral cortex and caudate. The failure of suppression of the medial prefrontal cortex and striatum and stress-related hyperactivation in the right fusiform, supplementary motor area, precentral cortex, and caudate might be an OCD-related psychopathological and neural response to stress.

Molecular mechanism of resistance to VRC01 neutralization in HIV-1 subtype B′ strains / 中华微生物学和免疫学杂志

Objective:To investigate the molecular mechanism of VRC01 resistance in HIV-1 subtype B′ strains isolated from a patient (DRVI01) with broadly neutralizing antibody (bNAb).Methods:Sequences of the HIV-1 subtype B′ strains isolated from patient DRVI01 were compared with those of HIV-1 subtype B′ strains that were isolated at the same time but sensitive to VRC01 antibody. Key amino acids that might affect the neutralization of VRC01 were selected according to literature reports. Effects of the selected amino acids on VRC01 neutralization were verified by site-directed mutation and sequence exchange of membrane proteins from different patients.Results:Single-point mutations of E279D and R282K in LoopD region and N460A and N463Q in V5 region reversed the viral sensitivity to VRC01 neutralization. Combined mutations in two or three above-mentioned sites significantly increased the viral sensitivity to VRC01 antibody compared with single-point mutations. Contrary to literature reports, the glycosylation site mutation of N276 had no influence on the viral sensitivity to VRC01.Conclusions:HIV-1 subtype B′ strains isolated from patient DRV01 with bNAb carried the mutations of D279 and K282 in LoopD region and N460 and N463 in V5 region, resulting in resistance to VRC01 antibody.

Effect of Usnea diffracta Against Atherosclerosis in Rats and on Microbial Flora of Ileum： An Investigation Based on Interior-exterior Relationship Between Heart and Small Intestine / 中国实验方剂学杂志

Objective:To explore the correlation between the efficacy of <italic>Usnea diffracta</italic> in treating atherosclerosis （AS） and the altered microbial flora in rat ileum based on the interior-exterior relationship between heart and small intestine in traditional Chinese medicine （TCM）. Method:Forty-eight SD rats were randomized into a normal group （<italic>n</italic>=8） and a modeling group （<italic>n</italic>=40）. The AS model was established with high-fat diet combined with intraperitoneal injection of vitamin D₃. The successfully modeled rats were further randomly divided into the model group， positive control （simvastatin， 4 mg·kg^-1） group， and low- （0.7 g·kg^-1）， medium- （1.4 g·kg^-1）， and high-dose （2.8 g·kg^-1） <italic>U. diffracta</italic> ethanol extract groups， with eight rats in each group. After four weeks of intervention， the blood， aorta， ileum， and ileum content of rats in each group were collected. The levels of serum lipopolysaccharide （LPS）， tumor necrosis factor-<italic>α </italic>（TNF-<italic>α</italic>） and interleukin 6 （IL-6） were measured by enzyme-linked immunosorbent assay （ELISA）， and the pathological changes in rat thoracic aorta was detected by hematoxylin-eosin （HE） staining. Western blot was conducted to determine the protein expression levels of tight junction protein zonula occluden （ZO-1） and Occludin in rat ileum， and the high-throughput 16S rRNA sequencing technology was employed to detect changes in microbial diversity and abundance in rat ileum of each group. Result:Compared with the normal group， the model group exhibited obvious aortic plaque deposition， increased LPS， TNF-<italic>α</italic>， and IL-6 levels （<italic>P</italic><0.01）， but decreased ZO-1 and Occludin protein expression （<italic>P</italic><0.01）. The comparison with the model group revealed that <italic>U. diffracta</italic> significantly ameliorated the aortic plaque deposition of model rats， lowered serum LPS， TNF-<italic>α</italic>， and IL-6 levels （<italic>P</italic><0.05， <italic>P</italic><0.01）， and up-regulated ZO-1 and Occludin protein expression （<italic>P</italic><0.05， <italic>P</italic><0.01）. The abundance of Proteobacteria and Bacteroidetes in the model group changed significantly in contrast to that in the normal group， and the Bacteroidetes/Firmicutes（B/F） value declined （<italic>P</italic><0.05）. Alpha and Beta diversity analysis indicated higher total number of intestinal flora species in the model group， but lower richness and uneven distribution （<italic>P</italic><0.05， <italic>P</italic><0.01）， with a large number of pathogenic bacteria enriched. The ethanol extract of <italic>U. diffracta</italic> significantly increased the B/F value， corrected the structural disorder of microbial flora in ileum， reduced pathogenic bacteria， and increased the relative abundance of probiotics. Conclusion:<italic>U. diffracta</italic> exerts the therapeutic effect against AS possibly by improving the intestinal microbial communities， strengthening the intestinal mucosal barrier function， and reducing the serum LPS and inflammatory factors.

A multicenter, randomized, open and positive parallel controlled clinical study of clotrimazole vaginal expansion suppository and vaginal tablet in the treatment of mild and moderate vulvovaginal candidiasis / 中华妇产科杂志

Objective:Using clotrimazole vaginal tablet as a positive control, to evaluate the results of clotrimazole vaginal expansion suppository in the treatment of mild and moderate vulvovaginal candidiasis in terms of efficacy, patient satisfaction, side effects, and recurrence rate.Methods:This study was jointly conducted by 5 hospitals from August 2017 to October 2018, patients with mild and moderate vulvovaginal candidiasis confirmed by fungal culture and symptoms scores were selected. They were randomized to experimental group and control group as 1∶1 ratio. In the experimental group ( n=105), the subjects applied clotrimazole vaginal expansion suppository (150 mg) daily at night for 7 days. In the control group ( n=106), the subjects used a single dose of clotrimazole vaginal tablet (500 mg). Follow-ups were performed at (8±3) and (30±5) days after the discontinuation of the drugs, respectively. The difference in clinical symptoms and signs scores was used to evaluate the improvement of clinical symptoms, and the patient′s satisfaction and side effects were recorded. Results:At the first follow-up, the experimental group and control group were followed up by fungal culture on the cure rate [66.7% (70/105) versus 63.2% (67/106), P>0.05] and total effective rate [98.1% (103/105) versus 99.1% (105/106), P>0.05], the differences were not statistically significant. At the second follow-up, the recurrence rates of the experimental group and the control group were 5.7% (4/70) and 14.9% (10/67), respectively, with no significant difference ( P>0.05). In the evaluation of patient satisfaction, the leakage of the drug in the experimental group was significantly better than that in the control group ( P<0.01). The side effects mainly included vaginal stimulation, itching and burning sensation, and there was no statistical difference between the two groups ( χ2=1.070, P=0.586). Conclusions:In the treatment of mild and moderate vulvovaginal candidiasis, clotrimazole vaginal expansion suppository is no less effective than clotrimazole vaginal tablet, and there is no significant difference in the recurrence rate between the two. In terms of patient satisfaction, clotrimazole vaginal expansion suppository is superior to clotrimazole vaginal tablet.

Binding epitopes of HIV-1 broad neutralization antibodies / 中华微生物学和免疫学杂志

Objective:To analyze the potential specificity of broad neutralizing antibodies (bNAbs) in one patient (DRVI01) with chronic HIV-1 infection.Methods:Sequences of the envelope glycoprotein (Env) obtained from DRVI01 at different time points were analyzed by comparing with the key amino acids of reported HIV-1 bNAbs in HIV Database. After reverse mutation of key amino acids that had frequently mutated to wild type, the neutralizing sensitivity of autologous plasma against wild-type and mutated Env-pesudoviruses was compared and the potential bNAbs in DRVI01 were speculated.Results:Reported key amino acids of 10 bNAbs classes were detected in 155 Env sequences derived from DRVI01. Frequent mutations were found in key amino acids of two bNAbs classes of gp41 fusion domain and gp120/gp41 interface. Neutralizing sensitivity of the contemporaneous autologous plasma and the plasma collected at the next time point against the mutated pesudoviruses was significantly increased as compared with wild-type pesudoviruses.Conclusions:Potential NAbs with similar key amino acids to those of gp41 fusion domain and gp120/gp41 interface might present in the HIV-1 infected patient with broad neutralizing antibodies.

Kidney tumor segmentation in ultrasound images using adaptive sub-regional evolution level set models / 生物医学工程学杂志

Kidney tumor is one of the diseases threatening human health. Ultrasound is widely applied in kidney tumor diagnosis due to its high popularization, low price and no radiation. Accurate segmentation of kidney tumor is the basis of precise treatment. Kidney tumors often grow in the middle of cortex, so that segmentation is easy disturbed by nearby organs. Besides, ultrasound images own low contrast and large speckle, leading to difficult segmentation. This paper proposed a novel kidney tumor segmentation method in ultrasound images using adaptive sub-regional evolution level set models (ASLSM). Regions of interest are firstly divided into subareas. Secondly, object function is designed by integrating inside and outside energy and gradient, in which the ratio of these two parts are adjusted adaptively. Thirdly, ASLSM adapts convolution radius and curvature according to centroid principle and similarity inside and outside zero level set. Hausdorff distance (HD) of (8.75 ± 4.21) mm, mean absolute distance (MAD) of (3.26 ± 1.69) mm, dice-coefficient (DICE) of 0.93 ± 0.03 were obtained in the experiment. Compared with traditional ultrasound segmentation method, ASLSM is more accurate in kidney tumor segmentation. ASLSM may offer convenience for doctor to locate and diagnose kidney tumor in the future.

P-Rex1 Overexpression Results in Aberrant Neuronal Polarity and Psychosis-Related Behaviors / 神经科学通报·英文版

Neuronal polarity is involved in multiple developmental stages, including cortical neuron migration, multipolar-to-bipolar transition, axon initiation, apical/basal dendrite differentiation, and spine formation. All of these processes are associated with the cytoskeleton and are regulated by precise timing and by controlling gene expression. The P-Rex1 (phosphatidylinositol-3,4,5-trisphosphate dependent Rac exchange factor 1) gene for example, is known to be important for cytoskeletal reorganization, cell motility, and migration. Deficiency of P-Rex1 protein leads to abnormal neuronal migration and synaptic plasticity, as well as autism-related behaviors. Nonetheless, the effects of P-Rex1 overexpression on neuronal development and higher brain functions remain unclear. In the present study, we explored the effect of P-Rex1 overexpression on cerebral development and psychosis-related behaviors in mice. In utero electroporation at embryonic day 14.5 was used to assess the influence of P-Rex1 overexpression on cell polarity and migration. Primary neuron culture was used to explore the effects of P-Rex1 overexpression on neuritogenesis and spine morphology. In addition, P-Rex1 overexpression in the medial prefrontal cortex (mPFC) of mice was used to assess psychosis-related behaviors. We found that P-Rex1 overexpression led to aberrant polarity and inhibited the multipolar-to-bipolar transition, leading to abnormal neuronal migration. In addition, P-Rex1 overexpression affected the early development of neurons, manifested as abnormal neurite initiation with cytoskeleton change, reduced the axon length and dendritic complexity, and caused excessive lamellipodia in primary neuronal culture. Moreover, P-Rex1 overexpression decreased the density of spines with increased height, width, and head area in vitro and in vivo. Behavioral tests showed that P-Rex1 overexpression in the mouse mPFC caused anxiety-like behaviors and a sensorimotor gating deficit. The appropriate P-Rex1 level plays a critical role in the developing cerebral cortex and excessive P-Rex1 might be related to psychosis-related behaviors.

Primary study on the relationship between high-risk HPV infection and vaginal cervical microbiota / 中华妇产科杂志

Objective@#To understand characteristics of vaginal cervical microbiota in high-risk HPV (hrHPV) infected women and to uncover the relationship between hrHPV infection and vaginal cervical microbiota.@*Methods@#All participants were randomly selected from Peking University First Hospital from September to October of 2017, including 5 subjects of control group, 5 cases of HPV16/18 group, 5 cases of other hrHPV infected group and 3 cases of cervical squamous carcinoma group. All subjects were required to fill in a questionnaire, and cervical and vaginal discharges were separately collected for microscopic examination and new generation sequencing targeting the variable region (V3-V4) of bacterial 16S rRNA gene.@*Results@#Vaginal microbiota analysis: (1) 6 major phylum were found in vaginal microbiota:Firmicutes, Bacteroidetes, Fusobacteria, Actinobacteria, Tenericutes and Proteobacteria. Firmicutes contributed to the majority of normal vaginal flora, Bacteroidetes and Fusobacteria increased in hrHPV infected ones, while Fusobacteria showed significant difference in cervical carcinoma group. (2) Lactobacillus occupied most of normal vaginal flora while genus like Gardnella, Prevotella, Atopobium, Megasphaera and Sneathia increased in hrHPV infected subjects, Sneathia showed significant difference in cervical carcinoma group. (3) No significant difference had been calculated in Alpha diversity of four groups (P=0.073) . Cervical microbiota analysis: (1) Microbial diversity of cervical microbiota was higher than that of vaginal microbiota. (2) Significant difference had been found in Alpha diversity of four groups (P=0.046) . (3) Proteobacteria in normal cervical flora was much more than that in vagina, and Proteobacteria increased significantly in hrHPV infected cervical discharge. (3) Chlamydia increased significantly in cervical carcinoma group.@*Conclusions@#The diversity of cervical microbiota is higher than that of vaginal microbiota. Change in cervical microbiota is more obvious than that of vagina in hrHPV infected subjects. Fusobacteria-Sneathia and Chlamydia significantly increase in cervical carcinoma group. Proteobacteria might relate to hrHPV infection.

The vaginal microecology in gynecological outpatients: a report from China / 中华检验医学杂志

Objective To study the vaginal microecology of the patients in the outpatient department of Obstetrics and gynecology in China.Methods A multicenter cross-sectional study was conducted in gynecologic clinic of 9 collaborative hospitals in China.200 consecutive patients were collected in each hospital and their vaginal microecology combined with related factors were analyzed.Results A total of 2 093 specimens were collected in this study.The detection rate of Trichomonas was 5.5%(115/2 093). The detection rate of Candida mycelia was 15.9%(333/2 093), with germinal spores was 4.1%(86/2093).The detection rate of bacterial vaginosis was 18.8%(394/2 093).The distribution results of vaginal flora in patients showed that the normal flora accounted for only 27.3%(571/2 093).The normal flora with the insufficiency of H2O2 accounted for 23%(480/2 093).The bacteria inhibiting flora accounted for 3.8%(79/2 093).The abnormal microflora(non BV type)accounted for 14.9%(312/2 093).The abnormal microflora(BV intermediate type)accounted for 13.4%(280/2 093).The abnormal microflora(BV type)accounted for 17.6%(369/2 093).The average pH of vaginal discharge was 4.58 ±0.495.There was no significant difference of the incidence of trichomonas and bacterial vaginosis between north and south of the Yangtze river, while the detection rate of fungal hyphae and the fungal spores is significantly higher in the south than that in the north.The analysis results of factors affecting the microecology showed that age and contraception methods were two important factors.The patients′age from bacteria inhibition group was 49.64 +16.68 which was significantly higher than that of the other microecology groups.The proportion of abnormal microflora of patients from the oral contraceptive group was 40%(20/50).The proportion of abnormal microflora of patients from IUD group was 36.6%(63/172).Compared with these two contraception methods, the proportion of abnormal microflora of patients from condoms usage group was 27.8%(91/327)which was significantly lower.The incidence of abnormal leucorrhea in the normal group was 37.7%, which was significantly lower than that of other abnormal groups.Conclusion This study showed the vaginal microecology status of the Chinese outpatient ′s clinic and found that the vagina microecology was related to age, region and contraceptive methods.The typical manifestation of microecological abnormality is the increase of leucorrhea.(Chin J Lab Med,2018, 41:287-291)

Association of AKT1 gene polymorphisms with therapeutic effects of 8-week treatment with risperidone / 中国心理卫生杂志

Objective:To investigate the association of AKT1 gene polymorphism with risperidone in the treatment of first-episode and untreated schizophrenia for 8 weeks.Methods:A total of 150 patients with Chinese schizophrenia who met DSM-Ⅳ,including 128 cases of risperidone (treatment dose 4-6 mg/d) for 8 weeks were treated with risperidone (treatment dose 4-6 mg/d).The Positive and Negative Symptom Scale (PANSS) reduction rate was used to evaluate the curative effect of drugs after 8 weeks.Using DNA sequencing,four single nucleotide polymorphisms (SNP) loci (rs1130214,rs10149779,rs1130233,rs2494732) genotype were detected in 128 Han patients with schizophrenia,and quantitative trait locus analysis (QTL) was used to explore the association between AKT1 gene polymorphisms and the efficacy of risperidone in the treatment of schizophrenia.Results:AKT1 gene rs1130233 (G ＞ A) and rs2494732(C ＞ T) were significantly associated with the increase in PANSS after 8-week risperidone treatment of schizophrenia (P ＜ 0.05).After repeated testing Bonferroni correction was still statistically significant.The correlation between rs1130214and rs10149779 in this sample was not statistically significant (P ＞0.05).Conclusion:This study suggests that polymorphisms of the AKT1 gene may be associated with the efficacy of risperidone in the treatment of schizophrenia in the Chinese Han population and is expected to provide a basis for the prediction of individual drug efficacy.

Association study of gamma-aminobutyric acid type A receptor genes cluster with autism in Chinese Han population / 中国心理卫生杂志

Objective:To investigate the genetic association of single nucleotide polymorphisms (SNPs) in gamma-aminobutyric acid type A (GABAA) receptor genes cluster on chromosome 15q12 with autism in Chinese Han population.Methods:Totally 502 autism trios of Chinese Han ethnicity (including 502 autism individuals and 1004 healthy biological parents) were selected.All children met the autism diagnosis of Diagnostic and Statistical Manual of Mental Disorders,Fourth edition (DSM-Ⅳ).Genotyping for 15 selected tag SNPs in three GABAA receptor genes (GABRB3,GABRA5,and GABRG3) was performed using Agena Bioscience MassARRAY platform.The family-based association test for 15 tag SNPs was performed to compare the transmitted frequency of al leles of heterozygous genotypes from parents to offspring in autism trios.Results:The C allele of rs7180500 in GABRG3 and the A allele of rs4906902 in GABRB3 exhibited the preferential transmission from parents to affected offspring (Z =3.573,P ＜0.001;Z =3.141,P =0.002),and the association was significant after Bonferroni correction.Conclusion:It suggests that GABRG3 and GABRB3 which located in chromosome 15q12 might be susceptibility genes in Chinese Han population.

Sleep problem and related factors in children with autism / 中国心理卫生杂志

Objective:The aim of the current study is to understand the sleep disorders in children with autism and related factors.Methods:A case-control study method was conducted in this study which included 198 children autism who met the criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ) and 233 cases of gender-and age-matched normal children.Their general demographic and sleep data were collected and the children with autism were assessed with Autism Behavior Checklist,Child Behavior Checklist and Autism Spectrum Screening Questionnaire.Correlation analysis and regression analysis were performed to compare sleep quality,sleep problems and the related factors of the two groups.Results:The scores of difficulty falling asleep,sleep restlessness,taking hold or shaking,restless sleep,interrupted sleep,nightmares,sleepwalking,night terrors,sleep snoring,nocturnal enuresis,sleep apnea,mouth breathing,sweating and sleep scores were higher in the autism group compared to the normal control group before falling asleep (P ＜ 0.05),while the proportion of daytime sleep time in the autism group was lower than the normal control group (P ＜0.05).With sleep status as dependent variable,linear regression analysis was conducted with children's birth weight,walking month age,speaking month age,father age,and autism spectrum as independent variables.The multiple linear regression analysis showed the scores of,sensory behaviors,body and object use behaviors,and self-help behaviors in Autism Behavior Checklist for autistic children were positively associated with their sleep (β =0.21,0.21,0.29,P ＜ 0.05).However,paternal age at birth in the autism group had negative associatin with the sleep of autistic children (β =-0.16,P ＜0.05).In the autism group,their total scores of Autism Behavior Checklist and the scores of language and social behavior in Autism Behavior Checklist were not associated with their sleep status score (P ＞ 0.05).Conclusion:It suggests that children with autism may have more sleep problems,and their sleep problems are related to autism symptoms including the scores of,sensory behaviors,body and object use behaviors,and self-help behaviors in Autism Behavior Checklist for autistic and their paternal age at birth.

Effect of aripiprazole combined with risperidone on serum prolactin and glucose lipid metabolism in male patients with schizophrenia / 新乡医学院学报

Objective To explore the effect of aripiprazole combined with risperidone on serum prolactin and glucolipid metabolism in male patients with schizophrenia. Methods A total of 113 male patients with schizophrenia who were treated with risperidone in the Second Affiliated Hospital of Xinxiang Medical University from October 2016 to May 2017 were select-ed. The patients were randomly divided into observation group and control group. Fifty-nine patients in the control group were given risperidone 4 - 6 mg·d - 1 orally,while fifty-four patients in the observation group were given risperidone 4 - 6 mg·d - 1 combined with aripiprazole 10 mg·d - 1 orally,the course of treatment was 8 weeks. The serum prolactin(PRL)levels were measured before treatment and at 2,4,8 weeks after treatment. Positive and negative syndrome scale(PANSS)was used to eval-uated the psychiatric symptoms in the two groups before treatment and at 4,8 weeks after treatment. The levels of fasting plas-ma glucose(FPG),total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),high density lipoprotein(HDL), body mass index(BMI)were measured in the two groups before treatment and at 4,8 weeks after treatment. Results A total of 113 patients completed the experiment,with 53 cases in the observation group and 59 cases in the control group. There was no significant difference in the level of PRL,FPG,TC,TG,HDL,LDL and the total score,positive symptom score,negative symptom score,general pathologic score of PANSS and BMI between the two groups before treatment(P > 0. 05). At 2,4,8 weeks after treatment,the level of PRL in the control group was higher than that before treatment(P < 0. 05),and in the obser-vation group it was lower than that before treatment(P < 0. 05). Compared between any two time points,there was significant difference in the PRL level at 2,4,8 weeks after treatment in the two groups(P < 0. 05). Compared with the control group,the level of PRL in the treatment group was significantly lower at 2,4,8 weeks after treatment (P < 0. 01). The total score,positive symptom score,negative symptom score,general pathologic score of PANSS in the two groups at 4,8 weeks after treatment were lower than those before treatment and at 4 weeks after treatment (P < 0. 05). The total score,positive symptom score,negative symptom score,general pathologic score of PANSS in the two groups at 8 weeks after treatment were lower than those at 4 weeks after treatment(P < 0. 05). The total score,negative symptom score,general pathologic score of PANSS in the observation group at 4,8 weeks after treatment were lower than those in the control group(P < 0. 05),but there was no significant difference in the positive symptom score of PANSS between the two groups at 4,8 weeks after treatment(P > 0. 05). There was no significant difference in the level of FPG,TC,TG,HDL,LDL and BMI in the control group at 4,8 weeks after treatment compared with that before treatment(P > 0. 05). There was no significant difference in the level of FPG,TC,TG,HDL,LDL and BMI in the observation group at 4 weeks after treatment compared with that before treatment(P > 0. 05). There was no significant differ-ence in the level of FPG,TC,TG,HDL in the observation group at 8 weeks after treatment compared with that before treatment and at 4 weeks after treatment(P > 0. 05). But the level of LDL and BMI in the observation group at 8 weeks after treatment were lower than those before treatment and at 4 weeks after treatment(P < 0. 05). There was no significant difference in the level of FPG,TC,TG,HDL,LDL and BMI between the observation group and the control group at 4 weeks after treatment(P >0. 05). There was no significant difference in the level of FPG,TC,TG,HDL between the observation group and the control group at 8 weeks after treatment (P > 0. 05). But the level of LDL and BMI in the observation group at 8 weeks after treatment were lower than those in the control group(P < 0. 05). At 8 weeks after treatment,the incidence rate of akathisia,thirst,somno-lence,tremor,nausea and salivation in the control group was 5. 08％,10. 16％,10. 16％,15. 25％,6. 77％,11. 86％,respec-tively;the incidence rate of akathisia,thirst,somnolence,tremor,nausea and salivation in the observation group was 3. 70％, 14. 81％,9. 25％,16. 67％,11. 11％,9. 26％,respectively. There was no significant difference in the incidence rate of akathi-sia,thirst,somnolence,tremor,nausea and salivation between the two groups(χ2 = 0. 207,0. 106,0. 159,0. 326,0. 091,0. 162;P > 0. 05). Conclusion Risperidone combined with aripiprazole in the treatment of male schizophrenia patients is beneficial to reduce the level of serum high PRL induced by risperidone and to improve lipid metabolism.

ZNF804A Variation May Affect Hippocampal-Prefrontal Resting-State Functional Connectivity in Schizophrenic and Healthy Individuals / 神经科学通报·英文版

The ZNF804A variant rs1344706 has consistently been associated with schizophrenia and plays a role in hippocampal-prefrontal functional connectivity during working memory. Whether the effect exists in the resting state and in patients with schizophrenia remains unclear. In this study, we investigated the ZNF804A polymorphism at rs1344706 in 92 schizophrenic patients and 99 healthy controls of Han Chinese descent, and used resting-state functional magnetic resonance imaging to explore the functional connectivity in the participants. We found a significant main effect of genotype on the resting-state functional connectivity (RSFC) between the hippocampus and the dorsolateral prefrontal cortex (DLPFC) in both schizophrenic patients and healthy controls. The homozygous ZNF804A rs1344706 genotype (AA) conferred a high risk of schizophrenia, and also exhibited significantly decreased resting functional coupling between the left hippocampus and right DLPFC (F(2,165) = 13.43, P < 0.001). The RSFC strength was also correlated with cognitive performance and the severity of psychosis in schizophrenia. The current findings identified the neural impact of the ZNF804A rs1344706 on hippocampal-prefrontal RSFC associated with schizophrenia.

Progressive Grey Matter Volume Changes in Patients with Schizophrenia over 6 Weeks of Antipsychotic Treatment and Their Relationship to Clinical Improvement / 神经科学通报·英文版

Cross-sectional and longitudinal studies have identified widespread and progressive grey matter volume (GMV) reductions in schizophrenia, especially in the frontal lobe. In this study, we found a progressive GMV decrease in the rostral medial frontal cortex (rMFC, including the anterior cingulate cortex) in the patient group during a 6-week follow-up of 40 patients with schizophrenia and 31 healthy controls well-matched for age, gender, and education. The higher baseline GMV in the rMFC predicted better improvement in the positive score on the Positive and Negative Syndrome Scale (PANSS), and this might be related to the improved reality-monitoring. Besides, a higher baseline GMV in the posterior rMFC predicted better remission of general symptoms, and a lesser GMV reduction in this region was correlated with better remission of negative symptoms, probably associated with ameliorated self-referential processing and social cognition. Besides, a shorter disease course and higher educational level contributed to better improvement in the general psychopathological PANSS score, and a family history was negatively associated with improvement of the negative and total PANSS scores. These phenomena might be important for understanding the neuropathological mechanisms underlying the symptoms of schizophrenia and for making clinical decisions.

Application of Blink Reflex and Brainstem Auditory Evoked Potential in Brain Stem Function Evaluation of Patients with Consciousness Disorder / 中国康复理论与实践

@#Objective To explore the characteristics of blink reflex (BR) and brainstem auditory evoked potential (BAEP) in patients with consciousness disorder and the role of BR and BAEP in the evaluation of brain stem function. Methods From January to December, 2015, 31 patients with consciousness disorder were examined with BAEP, BR and Glasgow Coma Scale (GCS), and the outcome was record-ed one month after examination. Results BAEP and BR were positively related with GCS score (r≥0.562, P<0.05) and outcome (χ2=9.644, P<0.01). Conclusion Both BR and BAEP can reflect the brain stem function and respective pathway. Their combination could provide ob-jective basis for prognosis evaluation.

The application value of contrast-enhanced ultrasound in focal liver lesions / 中国中西医结合急救杂志

Objective To compare the difference in diagnostic value between conventional ultrasound and contrast-enhanced ultrasound (CEUS) for focal liver lesions and observe the application value of CEUS in the diagnosis and differential diagnosis of focal liver lesions. Methods Eighty-three patients who carried out conventional examination were diagnosed as focal liver lesions admitted to the Department of Ultrasound in Tianjin Medical University Cancer Hospital from May 2012 to July 2016, and totally 93 lesions were found. The types of lesions were determined by conventional ultrasonography, CEUS and pathology, and the effectiveness of conventional ultrasound and CEUS in the diagnosis of focal lesion types was compared, the time-intensity curve was used to record the beginning time of enhancement, peak time of enhancement, washout time and peak strength in different types of focal liver lesion, that may provide certain characteristics for differentiation of benign from malignant lesions, and the patterns of CEUS in different types of liver focal lesion were observed. Results Pathological examination confirmed the types of lesions:there were 57 malignant focal lesions in 93 lesions (including 34 hepatocellular carcinoma, 11 cholangiocarcinoma, 11 metastatic tumors and 1 lymphoma in liver), there were 36 benign lesions in 93 lesions [including 16 liver abscesses, 5 liver focal nodular hyperplasia (FNH), 5 hepatic adenomas, 4 hemangiomas, 3 uneven fatty liver, 2 hepatic cysts, and 1 hepatic perivascular cytoma]. By conventional ultrasound 51 focal liver lesions and by CEUS 80 focal liver lesions were correctly diagnosed. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CEUS in diagnosing focal liver lesions were significantly higher than those of conventional ultrasound: 91.23% vs. 68.42%, 77.78% vs. 33.33%, 86.67% vs. 61.90%, 84.85% vs. 40%, 86.02% vs. 54.84%, respectively, the differences being statistically significant (all P < 0.01). All of malignant lesions including the arrival time (seconds: 11.17±2.15 vs. 15.92±2.90), the enhancement peak time (seconds: 21.13±3.06 vs. 40.93±11.71), the washout time (seconds:37.16±6.84 vs. 73.51±11.80) were earlier than those of benign lesions, and peak strength of malignant lesion was higher than that of benign lesions (dB: -46.64±3.60 vs. -63.36±15.38), the difference being statistically significant (all P < 0.01). Under CEUS pattern, different liver focal lesions revealed different types of enhancement, but in part of the focal lesions the types of enhancement had manifestations crossed. Conclusions CEUS improves the diagnostic efficacy for focal liver lesions which has great value for differential diagnosis of benign from malignant liver lesions.

Multi-modality imaging in the diagnosis and differential diagnosis of small renal mass / 天津医药

Objective To compare contrast-enhanced ultrasonography (CEUS), contrast-enhanced CT (CECT) and combined detection of two methods in the diagnosis of small renal masses, and differential diagnosis of different types of small renal masses by CEUS. Methods In 95 cases of small renal masses, there were 79 patients with small renal cell carcinoma and 16 patients with benign tumor. The diagnostic results of the three methods were compared based on the pathological results, which were used as thegold standardfor the diagnostic efficacy. The ROC curve was drawn, and the area under the curve (AUC) was compared. The characteristics of the two groups were analyzed and compared by Q-Lab software in CEUS. The angiographic parameters included arrival time (AT), time to peak (TTP) and peak intensity (PI). CEUS patterns for several pathologic types of renal tumors with larger sample sizes were compared. The characteristic manifestations of small renal masses under CEUS were analyzed. Results The accuracy, sensitivity, specificity, positive predictive value, negative predictive value and AUC of CEUS were 87.37%, 93.67%, 56.25%, 91.36%, 64.29%and 0.750, the values for CECT were 88.42%, 93.67%, 62.50%, 92.50%, 66.67%and 0.775, and the values for combined detection of two methods were 95.79%, 98.73%, 81.25%, 96.30%, 92.86%and 0.869 respectively. The sensitivities of the three methods were high, but the specificities were the same. The combined detection showed better diagnostic efficacy than that of single diagnostic method. The AT and TTP of CEUS were earlier in small renal carcinoma group than those of benign nephrotic group, and PI was higher than that of benign nephrotic group (P<0.05). There were significant differences in the contrasts ofcontrast enhancement methods between clear cell carcinoma, papillary cell carcinoma, chromophobe cell carcinoma, and angiomyolipoma (P<0.01). There was little difference in contrast enhancement between the other types of carcinoma. False envelope can be observed by CEUS.'Cystic area'of the detection rate was increased significantly by CEUS than that of conventional ultrasound. Conclusion Combined detection of CEUS and CECT can improve the diagnostic accuracy of small renal tumors. CEUS has great clinical value in the differential diagnosis of small renal masses, which is worthy of clinical promoting.