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Objective:To systematically evaluate the safety of family integrated care (FICare) model in neonatal intensive care unit (NICU).Methods:Multiple medical databases were searched for clinical studies on FICare in NICU published from January 1, 2010 to May 28, 2022. The quality of the literature was evaluated using Risk?of?Bias?2 tool?and cohort evaluation criteria from the Cochrane Systematic Evaluation Manual depending on the types of studies included. Meta-analysis was performed using Review Manager 5.3 software.Results:Six randomized controlled trials and four cohort studies were included for meta-analysis. The results of meta-analysis showed that compared with the traditional care model, FICare model did not increase the risk of nosocomial infection ( RR=0.75, 95% CI 0.46-1.24, P=0.27) and unstable medical conditions ( RR=0.86, 95% CI 0.61-1.22, P=0.40). No significant difference existed in the all-cause mortality between FICare and traditional care ( RR=2.74, 95% CI 0.88-8.57, P=0.08). Conclusions:FICare does not increase the risk of nosocomial infection, unstable medical conditions and adverse events compared with traditional care. It is safe and feasible to implement FICare in NICU.
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Objective:To study the genetic profiles and clinical characteristics of neonatal-onset genetic epilepsy.Methods:From July 2016 to May 2021, patients with neonatal-onset genetic epilepsy admitted to our hospital and received second-generation genetic sequencing were enrolled in this study. According to the types of genetic variations, the patients were assigned into ion channel group and non-ion channel group. Clinical characteristics, treatments and prognosis of the two groups were compared.Results:A total of 36 patients with identified genetic variations were enrolled, involving 15 epilepsy-related genes. KCNQ2, SCN2A and STXBP1 were the most common pathogenic genes. 20 cases (55.6%) were in the ion channel group and 16 cases (44.4%) in the non-ion channel group. No significant differences existed in their general status, seizure types, EEG characteristics, treatments and outcomes between the two groups ( P>0.05). Among all 36 cases, the age of onset ranged from 10 min to 24 d after birth and 28 cases (78.8%) developed epilepsy within 1 week after birth. Developmental and epileptic encephalopathies were diagnosed in 20 patients. 7 patients were diagnosed with self-limited neonatal epilepsy, 2 were pyridoxine dependence, 2 were Zellweger syndrome and 1 case of self-limited familial neonatal-infantile epilepsy, Turner type mental retardation with epilepsy, PURA syndrome, Rett syndrome and 22q11.2 deletion syndrome, each. The patients received antiepileptic drugs including phenobarbital, levetiracetam, oxcarbazepine, topiramate, valproic acid, benzodiazepines (nizepam/clonazepam /clobazam/midazolam), lacosamide and lamotrigine. 5 patients died after giving up treatment. 31 patients were followed up for 6 to 50 months. 22 cases (71.0%) were controlled at 1- to 35-month-old including 21 cases (56.7%) with developmental delay. 6 cases (19.4%) had ineffective seizure control and 3 cases (9.7%) showed reduced seizures, all with varying degrees of developmental delay. Conclusions:Neonatal-onset epilepsy is correlated with multiple genes. KCNQ2, SCN2A, STXBP1 are the common pathogenic genes with multiple variants of KCNQ2 gene. Most patients have seizures within 1 week after birth. More than half of patients have ion channel related gene variations. Sodium channel blockers have certain effects as treatment.
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The typical manifestations of primary aldosteronism (PA) are hypertension with or without hypokalemia, high aldosterone, and low renal level. However, PA with normal blood pressure is rare in clinical practice. This article reported the diagnosis and treatment of a patient with subclinical PA, admitted for "adrenal accidental tumor" with normal blood pressure and serum potassium. We summarized and analyzed the clinical characteristics and treatment strategies, in order to provide some reference for clinicians.
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Objective:The aim of the present study was to re-evaluate the diagnostic value and optimal cutoff point of captopril challenge test (CCT) in diagnosis of primary aldosteronism (PA).Methods:This is a retrospective study. All patients with a high risk for PA underwent screening test, and then proceeded to CCT and fludrocortisone suppression test (FST) on different days. The FST was used as a reference standard for PA. The plasma renin concentration (PRC) and plasma aldosterone concentration (PAC) were measured with an automated chemiluminescence immunoassay. Random number method was performed in the patients with unilateral primary aldosteronism (UPA), in order to make the proportion of the analyzed UPA in PA was 35%. Receiver operating characteristic (ROC) analyses were performed to compare diagnostic accuracy.Results:A total of 543 patients with 400 PA patients and 143 essential hypertension (EH) patients were enrolled. The diagnostic value of post-CCT PAC was significantly higher than that of the post-CCT plasma aldosterone-renin ratio (ARR), and that of the PAC suppression percentage, respectively. The area under the ROC curve (AUC ROC) was 0.86 (0.83, 0.89) for PAC, 0.78 (0.74, 0.82) for ARR, and 0.62 (0.56, 0.67) for the PAC suppression percentage (all P<0.01), respectively. The optimal cutoff point of post-CCT PAC for PA was 110 ng/L, in which the sensitivity and specificity were 73.25% and 79.02%, respectively. The diagnostic efficiency of post-CCT PAC was not improved either in combination with PAC suppression percentage or in combination with post-CCT ARR. Conclusions:CCT is a useful test for the confirmation of PA. PAC level of 110 ng/L at 2 h after 50 mg of captopril is recommended as an optimal cutoff point for the diagnosis of PA.
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Spontaneous intestinal perforation(SIP) is one of the causes of digestive tract perforation in premature infants and requires surgical intervention.Except for preterm delivery, the etiology and pathogenesis of SIP remain unclear.The studies have shown that it may be related to the application of magnesium sulfate, nonsteroidal anti-inflammatory drugs, hormones, vasoactive drugs and low perfusion status, infection, congenital intestinal dysplasia, non-invasive respiratory support, delayed nutrition initiation and other factors.In the management of premature infants, it is particularly important to improve the understanding of SIP, early diagnosis and treatment.
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Objective:To observe any effect of body-weight-supported treadmill training (BWSTT) combined with functional electrical stimulation (FES) on lower limb motor function and the walking ability of hemiplegic stroke survivors.Methods:Fifty-eight stroke survivors with hemiplegia were randomly divided into an FES group of 19, a BWSTT group of 19 and a combination group of 20. In addition to their early routine rehabilitation therapy, the FES and BWSTT groups were provided with the respective therapies, while the combination group received both. The three groups received 30 minutes of treatment a day, 5 days a week for 8 weeks. The Berg Balance Scale (BBS), the simplified version of the Fugl-Meyer assessment scale for the lower extremities (FMA-LE), the 10-metre walk test (10MWT) and functional ambulation classification (FAC) were used to evaluate the subjects′ balance, lower-limb motor function, walking speed and walking function before and after the 8 weeks of treatment.Results:After the treatment, the average BBS, FMA-LE, 10MWT and FAC scores of all three groups had improved significantly, but the combination group′s averages were then significantly better than those of the other two groups.Conclusions:BWSTT combined with FES can best improve the balance, lower-limb motor functioning and walking of hemiplegic stroke survivors.
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Objective:Aimed to investigate the value of adrenocorticotropic hormone (ACTH) stimulation in adrenal venous blood sampling (AVS).Methods:Patients who diagnosed as primary aldosteronism (PA) and completed successful bilateral cannulation judged by selection index (SI) for routine and(or) ACTH stimulation AVS were enrolled. The lateralization index(LI) was calculated to compare the effect of ACTH stimulation on AVS cannulation success rate and lateralization judgment.Results:A total of 73 patients with PA were enrolled in the study, of whom 28 were confirmed as aldosterone producing adenoma (APA) after unilateral adrenalectomy. Cortisol and aldosterone in peripheral and adrenal veins were significantly increased after ACTH stimulation. The left SI was increased from 6.5(3.0-13.6) to 26.8 (16.9-40.3) ( P<0.01) and the right SI from 20.8(4.8-34.8) to 57.6(35.7-80.9) ( P<0.01) after ACTH stimulation. There was no significant difference on LI before and after ACTH stimulation [7.7(2.3-19.6) vs 5.6(1.9-14.6), P=0.14]. The success rates of left and right adrenal cannulation were increased by 15% and 10% respectively after ACTH stimulation. For 57 patients who were determined in successful cannulation by both routine and ACTH stimulation AVS, 27 patients were determined to have lateralization by both AVS methods, 21 patients were determined to have bilateralization, and the consistency of lateralization by both AVS methods was 84%(48/57). Among the 28 patients who were confirmed to be APA after unilateral adrenalectomy, the correct rate of lateralization by both AVS methods was 89% (25/28). Conclusion:ACTH stimulation is able to improve the success rate of bilateral adrenal vein cannulation, and is helpful to judge AVS results. For patients with successful cannulation, there is no significant difference in lateralization judgment for routine and ACTH stimulation AVS.
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Objective:To investigated the clinical, biochemical, and immunohistological characteristics of patients with aldosterone producing adenoma(APA)and different gene mutations.Methods:The clinical and biochemical data of 206 patients with APA who received unilateral adrenalectomy were collected. Sanger sequencing was used to identify the mutation in the hot-point of KCNJ5 and other genes. The tumor samples were stained by 11β-hydroxylase(CYP11B1)and aldosterone synthase(CYP11B2), which was quantified by McCarty′s H-score system.Results:The gene mutations were identified in 166 out of 206(80.6%)patients with APA, of which 158 cases were KCNJ5 mutation, 2 ATP1A1 mutation, 5 ATP2B3 mutation, and 1 CTNNB1 mutation. Age, duration of hypertension, and serum potassium in APA patients with genetic mutant were significantly lower than those without genetic mutation( P<0.05) while the proportion of female, systolic blood pressure, diastolic blood pressure, aldosterone/renin ratio(ARR), and plasma aldosterone concentration(PAC)post saline infusion test(SIT)were significantly higher( P<0.05). Subgroup analysis showed that age, duration of hypertension, systolic blood pressure, and proportion of left ventricular hypertrophy in APA patients with ATP1A1 and ATP2B3 mutations were significantly higher than those with KCNJ5 mutation( P<0.05)while the PAC post SIT and tumor diameter were significantly lower( P<0.05). The positive rates of CYP11B2 in APA with different mutations were not significantly different. The H-score of CYP11B1 was significantly higher [160.0(127.5, 193.5) vs 80.0(27.5, 152.3), P=0.020] and the H-score of CYP11B2 was significantly lower [155.0(123.0, 190.0) vs 240.0(140.0, 270.0), P<0.01] in APA with KCNJ5 mutation compared with those with ATPase mutation. Conclusion:The types of genetic mutation are closely correlated with the clinical, biochemical, and immunohistological phenotypes in patients with APA.
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Objective:To analyze the diagnosis, treatment, and outcomes of neonates with deep venous thrombosis (DVT) of the extremities and torso.Methods:The clinical diagnosis, treatment and outcomes of seven neonates with DVT of the extremities and torso admitted to Beijing Children's Hospital, Capital Medical University from March 2016 to March 2020 were retrospectively analyzed. Paired t test and paired rank sum test were used to compare the difference of coagulation indexes before and after the anticoagulant therapy. Results:Among the seven neonates with DVT of the extremities and torso, six were male and five were term infants, with the gestational age of (37.9±2.5) weeks and birth weight of (2 989±619) g. The median age at admission was 2.0 d and the age at diagnosis was 3.0 d. Except for one case of left common femoral vein thrombosis with limb swelling on the affected side, the other cases were all found with DVT by routine abdominal ultrasound examination after admission. Six cases received heparin treatment with the median duration of 8.5 d (1.8-28.8 d), including four cases of thrombosis in the portal venous, one in the postcava and renal venous, and one in the left common femoral vein. Among the six cases, the thrombus disappeared in five cases, which were confirmed by vascular ultrasound examination during follow-up, and in another case, the thrombus was shrinked significantly but remained. After the treatment, the platelet count [(464.5±128.9)×10 9/L vs (142.5±104.2)×10 9/L, t=－5.019, P=0.004] and antithrombin-Ⅲ level [(67.08±28.87)% vs (46.05±12.60)%, Z=－2.201, P=0.028] were increased and the D-dimers was decreased [0.392 mg/L(0.250-0.884 mg/L) vs 2.511 mg/L(0.755-14.033 mg/L), Z=－2.201, P=0.028] with no reports of heparin-related side-effect. One case with advanced postcaval thrombosis did not receive heparin anticoagulant therapy, but the thrombosis disappeared 270 d after diagnosis during follow-up. Conclusions:DVT of the extremities and torso may have no specific symptoms during the neonatal period and the overall prognosis is good. Heparin anticoagulant therapy is recommended until thrombosis disappears for patients with large thrombosis or significantly high level of D-dimer. The course of heparin treatment varies greatly among individuals, and close monitoring is required.
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To investigate the renal venous and spermatic venous sampling in assisting the diagnosis of reninoma. The case of reninoma was retrospectively reviewed together with the literature review of reninoma diagnosed with renal venous and spermatic venous sampling. A young patient with hypertension and headache was admitted to our hospital. Laboratory test showed high plasma renin concentration (>500 mIU/L), and enhanced computed tomography(CT) in the upper abdomen showed a mass in left inferior renal pole. The concentration of renin in the left spermatic vein was significantly higher than that in renal veins and branches, and peripheral vein, which was considered the left reninoma possibility. The left renal mass was resected surgically and pathologic exam revealed reninoma. The renin level and the blood pressure recoveried normal after operation.The literature reported that the positive rate of renal vein segmental blood collection for locating renin tumor was only 8.3%-64%. The possible reason was that reninoma usually located in the renal cortex, and the tumor blood might be collected by renal capsule vein instead of renal vein. In fact, the renal capsule vein intersects with the lateral division of the spermatic vein, but there have been no reports about the localization of reninoma by spermatic vein sampling. Since renin secreted by reninoma may go into the spermatic vein through renal capsule vein, it should be noted that spermatic venous blood should be collected simultaneously in renal vein sampling when locating reninoma.
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Objective:To explore the proportion of obstructive sleep apnea (OSA) in primary aldosteronism (PA) in Chinese population and compare the clinical characteristics between PA patients with OSA and those without.Methods:A total of 96 patients diagnosed with PA from September 2015 to November 2018 were recruited in this study. OSA was screened by cardio-respiratory polygraphy. According to the apnea hypopnea index (AHI), the patients were divided into PA with OSA group (AHI ≥5 times) and PA without OSA group (AHI<5 times).Results:Among all patients (96), 69 (71.9%) were with OSA, among them 22 patients (22.9%) were with mild OSA, 17 patients (17.7%) were with moderate OSA and 30 patients (31.3%) were with severe OSA. Compared with the patients without OSA, the patients with OSA were elder, and had higher levels of body mass index (BMI), waist circumference (WC), hip circumference (HC), creatinine (CR) and glycosylated haemoglobin (HbA1c) ( P<0.05), but lower concentrations of plasma aldosterone (PAC), supine aldosterone renin concentration ratio(ARR) and the PAC after the diagnosis test ( P<0.05). Spearman correlation analyses showed that BMI, WC, HC, CR and HbA1c were positively correlated with AHI ( P<0.05), while high-density lipoproteincholesterol (HDL-C), supine-PAC and saline infusion test(SIT)-post PAC were negatively correlated with AHI ( P<0.05). Conclusions:The proportion of OSA in PA patients is relatively high (71.9%). Metabolic abnormalities are more common in PA patients with OSA, indicating that screening for OSA should be carried out routinely in PA patients.
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Objective@#To evaluate the consistency of different methods for detecting aldosterone concentration in blood and to establish a reference interval of serum aldosterone concentration by liquid chromatography-tandem mass spectrometry(LC-MS/MS).@*Methods@#Concentrations of blood aldosterone were measured by LC-MS/MS, chemiluminescent assays (Diasorin, Domestic A and B systems) and radioimmunoassay (RIA) in 138 healthy adults, 67 patients with essential hypertension and 23 patients with primary aldosteronism.@*Results@#Aldosterone concentrations measured by various methods were quiet different(P<0.01). Spearman correlation analysis showed that the correlation coefficient were 0.776(P<0.01) between CLIA (Diasorin) and LC-MS/MS, 0.805(P<0.01) between CLIA (Domestic A) and LC-MS/MS, 0.058(P>0.05) between CLIA(Domestic B) and LC-MS/MS, 0.338(P<0.01) as well as between RIA and LC-MS/MS. Bland-Altman analysis for the measurements showed poor consistency among methods for aldosterone concentrations. The reference interval was 15.2-222.2 pg/ml for serum aldosterone concentrations by LC-MS/MS.@*Conclusions@#There are significant differences of blood aldosterone concentrations determined by different methods. Clinically, a specified reference interval might be needed while using different methods.
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Objective To compare the imported (Diasorin,Italy) and domestic (Mindray,Shenzhen) chemiluminescent systems used in the measurement of plasma aldosterone and renin concentrations;To establish the reference interval of plasma aldosterone and renin concentrations in healthy adults.Methods With the assay instrument and its kits from Italy Diasorin as the reference system,the concentrations of plasma aldosterone and renin were measured by the two systems,in 143 healthy adults,72 patients with hypertension (16 patients with primary aldosteronism) and to establish the medical reference range (P2.5-P97.5) of them.Results The plasma aldosterone (r=0.914,P＜0.01) and renin(r=0.977,P＜0.01)concentrations detected by the two systems were positively correlated.Distribution of plasma aldosterone and renin was skewed in healthy adults.The reference interval was 30.8-344.6 pg/ml for aldosterone and 2.4-90.0 μIU/ml for renin by the imported chemiluminescent system.The reference interval was 29.4-473.3 pg/ml for aldosterone and 3.6-98.3 μIU/ml for renin by the domestic chemiluminescent detection system.Conclusion The two systems are closely correlated in measuring plasma aldosterone and renin concentrations.
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More and more cases of aldosterone-and cortisol-producing adenoma (A/CPA) have been reported in recent years.In order to further understand the clinical characteristics of patients with A/CPA,we report 2 cases of A/CPA treated in our hospital,and analyzes them in combination with domestic reports.We recommend that clinicians routinely perform Low Dose Dexamethasone Suppression Test on every primary aldosteronism patient prior to adrenal vein sampling (AVS) or adrenal adenoma surgery to rule out the possibility of Cushing's syndrome so as to avoid the wrong judgment of AVS results and avoid adrenal hypofunction or adrenal crisis after operation.
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Objective To explore the effect of progressive strength training with TheraBand on lower limb motor function and gait after stroke.Methods Forty-eight hemiplegic stroke survivors were randomly divided into a treatment group and a control group,each of 24.The patients of both groups were provided with the routine rehabilitation training,while the treatment group additionally trained the muscles of the paretic side progressively using Thera-Band elastic belts.Before and after 8 weeks of treatment,both groups were evaluated using the Fugl-Meyer movement assessment (FMA),the Berg balance scale (BBS),and the walking and stair negotiation components of the functional independence measure (FIM).GaitWatch gait analysis was also performed.Results After the treatment,significant improvement was observed with both groups' average FMA scores,BBS ratings,FIM scores,stride frequency,stride length and walking speed,but the treatment group showed significantly greater improvement than the control group,on average.Conclusion Using Thera-Band elastic belts to provide resistance can supplement routine rehabilitation training in improving motor function and walking ability after a stroke.
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Objective To assess the diagnostic value of saline infusion test ( SIT) and its optimal cutoff in the diagnosis of primary aldosteronism ( PA ), and to analyze whether the dietary salt intake affects the SIT accuracy. Methods This is a prospective study. All 236 patients with a high risk for PA underwent the screening test, SIT and the fludrocortisone suppression test (FST) in separate days. The diagnosis of PA was established according to the FST criteria. According to the 24 h urinary sodium level, the patients were divided into low salt, normal salt, and high salt groups respectively, and the effect of salt intake on SIT was analyzed. Receiver operating characteristic (ROC) analysis was performed to compare the diagnostic accuracies. Results Finally, in 236 patients with high risk for PA, 134 patients with PA and 102 patients with essential hypertension ( EH) were diagnosed. Using post-test plasma aldosterone concentration (PAC) for diagnosis, the area under the ROC curve (AUCROC) of the SIT was 0.974 (0.957, 0.991), which was significantly higher than that of the post-test plasma aldosterone to renin ratio (ARR) [0.900 ( 0. 862, 0. 938)] and that of the PAC suppression percentage [ 0. 752 ( 0. 690, 0. 813)] ( both P<0.01). Considering both sensitivity and specificity, an optimal cutoff of PAC post-SIT was set at 8 ng/dl, resulting in a sensitivity of 88. 1% and a specificity of 95. 1%. The PAC post-SIT, whether in PA or EH patients, had no statistically significant differences among low salt, normal salt, and high salt groups (P>0.05). Conclusion SIT is reliable for the diagnosis of PA. PAC post-SIT more than 8.0 ng/dl is recommended to confirm PA.
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Objective To study and analyze the effect of amlodipine besylate and amlodipine besylate in the treatment of hypertension. Methods 100 patients with hypertension treated in our hospital from January 2015 to December 2016 were selected and randomly divided into two groups, the control group and the experimental group, with 50 patients in each group. The control group was treated with amlodipine besylate, and the patients in the experimental group were treated with amlodipine besylate and amlodipine besylate. The therapeutic effects of the experimental group and the control group were compared and analyzed. Results After the corresponding treatment, the experimental group of 50 cases, the total effective number of 44 cases, 6 patients invalid, the total effective rate was 88%. In the control group of 50 cases, the total effective number was 37 cases, 13 cases were invalid, the total effective rate was 74%. The treatment effect of the experimental group was significantly higher than that of the control group, with statistical difference (P<0.05). There were 5 cases of adverse reactions in the experimental group, 3 patients had facial flushing, and 2 patients suffered from pain. The incidence was 10%. The number of adverse reactions in the control group was 12 cases, ankle edema occurred in 5 patients, and headache occurred in 7 patients, with a rate of 24%. The rate of adverse reactions in the control group was significantly higher than that in the experimental group, with statistical difference (P<0.05). Conclusion Amlodipine and Levamlodipine besylate in treatment of hypertension can improve the treatment efficiency to a great extent, high safety, low probability of adverse reactions, with further clinical promotion and application significance.
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Objective To analyze crossed cerebellar diaschisis(CCD) after subacute phase of spontaneous cerebral hemorrhage(SPSCH)and it's relevant factors with whole-brain CT perfusion(CTP) imaging. Methods Eighty-six patients diagnosed with unilateral SPSCH by CT were prospectively enrolled in our study from July 2015 to October 2016. Whole-brain CTP was performed in each patient.Cerebral blood flow(CBF), cerebral blood volume(CBV), mean transit time(MTT)and time-to-peak(TTP) inipsilateral and contralateral cerebellum were manually measured.The asymmetric indexs(AIs) were also calculated. Moreover, the volume of hematoma, the maximumarea of peri-hematomahypoperfusionin CBF and clinical factors(age, gender, time intervals from symptom onset)were analyzed,and NIHSS scores were used to evaluate the neurological status before patient admission, inspection, and discharge.CCD was rated positive when a unilateral supratentorial hematomawas appeared and an accompanying perfusion decrease was showed in the contralateral cerebellum on at least two sequential slices of CTP maps.All the individuals were divided into two groups including CCD-positive groupand CCD-negative group. The perfusion parameters (CBF, CBV, MTT, and TTP)between the contralateral and ipsilateral cerebellum were analyzed by the two-tailed paired t-test in CCD-positive group. The differences in the perfusion and clinical variables between the two groups were analyzed by the independent sample t-test and the Chi-squared test. Therelationships between the AI values and clinical or radiologic variables were assessed with Pearson correlation test. Results We found 35 CCD positive cases and 51 negative cases in the 86 patients.In CCD-positive groups, the perfusion values of cerebellumipsilateral and contralateral to the hematomawere as follows:CBF were (40.88±11.23) vs. (33.91±9.96) ml·100 g-1·min-1, CBV were (3.30±1.18) vs. (2.75±1.13) ml/100 g and TTP were (22.09±3.98) vs. (22.88±4.15) s, respectively, and there was statistical significance (t=10.231,8.223,-2.883,P0.05)was found in hematoma location,hematoma volume, supratentorialhypoperfusion area and NIHSS scores(at admission, inspection)between CCD-positive and negative groups.The AICBF and AITTP showed linear correlation with time intervals in CCD-positive patients(P<0.05). Conclusions CCD is a common phenomenon in patients with SPSCH.Of all the perfusion parameters,CBF abnormalities are more common.The severity of CCD has a certain correlation with time intervals.There is no significant correlation between CCD and the clinical or radiological data(age, NIHSS scores,hematoma volume, and supratentorial hypoperfusion area).
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Objective Visceral pain in patients with inflammatory bowel disease (IBD) may be associated with the abnormal processing of pain in the central nervous system.The aim of the study is to investigate the characteristic changes of brain functions in the IBD patients using resting-state functional magnetic resonance imaging (rs-fMRI) with the amplitude of low-frequency fluctuation (ALFF) algorithm.Methods This study included 27 cases of IBD treated in our hospital from December 2015 to August of 2016 and 21 healthy volunteers as normal controls.We recorded the high-resolution structure imaging and rs-fMRI data, compared the brain activities of the two groups patients by ALFF analysis, and evaluated the correlation of the ALFF values with the clinical parameters of the IBD patients.Results Compared with the normal control group, the IBD patients showed significantly decreased ALFF values in the medial frontal gyrus, right putamen, right insula, left middle cingulate gyrus (MCC), and bilateral supplementary motor region (P<0.05), increased ALFF values in the middle frontal gyrus, left superior frontal gyrus, and medial prefrontal lobe region (P<0.05).The ALFF values in the inferior parietal lobule, precuneus and MCC of the IBD patients were correlated negatively with the blood sedimentation rate (r=-0.537,-0.588, and-0.588, P<0.05), disease course (P<0.05), and C-reactive protein (CRP) level (P<0.05), while that in the medial frontal gyrus positively with the CRP level (r=-0.623, P<0.001).Conclusion IBD patients have abnormal ALFF values in various brain regions, mainly in those involved in the processing of visceral pain and emotion.
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Objective To assess the activity of Crohn’s disease (CD)by using the quantitative parameter of dynamic contrast-enhanced MRI (DCE-MRI).Methods 50 CD patients with ileocecal solitary lesion were recruited in this study.All of patients underwent con-ventional and DCE-MRI.The quantitative parameter of volume transfer constant (Ktrans )and the clinical data including Harvey-Brad-show index (HBI)and C-reactive protein (CRP)were recorded.(1)the reliability and repeatability of Ktrans measurement were analyzed. (2)the correlation between Ktrans value and clinical data was analyzed by using Pearson analysis.(3)according to HBI,all of the CD patients were divided into severe group,mild-moderate group,and static group.The differences of Ktrans values among the three groups were compared by using Mann-Whitney U test.Results (1)the reliability of Ktrans measurement was high (Cronbach’s Alpha=0.993).(2)there was positive correlation between HBI and Ktrans(r=0.635,P<0.001),and between CRP and Ktrans(r= 0.764,P<0.001).(3)there was significant difference of Ktrans value between the static group and the mild-moderate group (P<0.001),be-tween the static group and the severe group (P<0.001),and.between the mild-moderate group and the severe group (P<0.001). Conclusion Quantitative parameter of DCE-MRI (Ktrans )had a high reliability and can be used to assess the inflammation activity of CD.