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Objective To investigate the characteristics of gray matter volume in Obsessive Compulsive Disorder (OCD) patients compared with healthy controls, and to explore the correlation between brain regions with altered gray matter volume and the patients'cognitive function and clinical symptoms. Method Thirty-six patients with first-episode OCD and 35 healthy controls who were matched by age, gender and education level were selected and examined by MATRICS Consensus Cognitive Battery (MCCB) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The head MRI and the Voxel-based morphometry was used to test the volume of gray matter. The correlation analysis was conducted to analyze the correlation between brain areas with altered gray matter volume and patients'cognitive function and Y-BOCS results. Results Compared with the control group, the OCD group had increased gray matter volume in frontal parietal lobe (postcentral gyrus-L, precentral gyrus-L) (t=4.299, P<0.0005, voxels>100) and temporal-limbic system (fusiform gyrus-L, superior temporal gyrus-L, medial temporal lobe-L, parahippocampal gyrus-L) (t=4.841, P<0.0005, voxels> 100). Meanwhile, the volume of gray matter decreased in bilateral anterior cingulate gyrus (t=-4.181, P<0.0005, voxels>100). In the case group, there were a positive correlation between the volume of gray matter in the temporal lobo-limbic system and social cognition score (r=0.347,P=0.038) and a positive correlation between the volume of gray matter in the anterior cingulate gyrus and obsessions score (r=0.416,P=0.012). Conclusion Patients with OCD have abnormal gray matter volume in a wide range of brain regions, including the frontal parietal lobe, the temporal-limbic system, and bilateral anterior cingulate gyrus, among which the volume of gray matter in the temporal-limbic system is correlated with social cognition, and gray matter volume in the anterior cingulate gyrus is correlated with obsessions.
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Objective To analyze the brain structure changes of the first-episode obsessive compulsive disorder (OCD) patients who were scanned by three-dimensional structure magnetic resonance imaging.Methods According to the diagnostic criteria of OCD in American Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-Ⅳ),the fist-episode obsessive compulsive disorder patients as case group(OCD,n=26) and the adult healthy volunteers as control group (control group,n=25) were selected.All subjects were assessed with Yale-Brown obsessive-compulsive scale(Y-BOCS),Hamilton Anxiety rating Scale (HAMA) and Hamilton Depression Rating Scale(HAMD),and then,they received 3D-MRI scanning runs.All the data was processed with freesurfer software and analyzed about cerebral cortical volume,cortical thickness,cortical surface area,the local gyrification index and subcortical nuclei volume.Results Compared with control group,the cerebral cortical thickness of OCD group increased at the left postcentral gyrus ((2.223±0.118)mm),left supramarginal gyrus ((2.486 ± 0.027) mm) and left parahippocampal gyrus ((2.399±0.164)mm).The cerebral cortical surface area larged at the right inferior frontal gyrus((1.036±0.079) mm2),right paracentral lobule ((0.827 ± 0.048) mm2) and medial orbitofrontal ((0.990 ± 0.083)mm2),and decreased at right superior parietal lobule ((0.779 ± 0.040) mm2),right inferior parietal lobule ((0.767±0.093) mm2) and right inferior temporal gyrus ((0.888±0.070) mm2).The cerebral cortical volume increased at the right inferior frontal gyrus((2.330±0.223) mm3).The cerebral cortical local gyrification index decreased at right middle temporal gyrus(2.893±0.288)and left inferior temporal gyrus(2.589±0.100).Conclusion The first-episode OCD patients have multiple changes of brain structures,and this changes were priority for the frontal lobes,orbital frontal,parietal lobe,temporal lobe and hippocampus.The changes in these regions maybe have close relationship with symptoms of OCD.
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Objective To explore the influence of ozone therapy on high-sensitivity C-reactive protein (hs-CRP) and matrix metalloproteinases-3 (MMP-3) in synovial fluid of patients with knee osteoarthritis,and to investigate the possible mechanism.Methods Sixty-two patients with knee osteoarthritis were divided into observation group and control group by random digits table method with 31 cases each.The patients of observation group were treated with ozone,while the patients of control group were treated with hyaluronic acid once a week for 5 weeks.The efficacy was evaluated and the level of hs-CRP and MMP-3 in synovial fluid were detected before and after treatment.Results The total effective rate in observation group was 100.00％ (31/31),significantly higher than that in control group [87.10％ (27/31)],and there was significant difference (x2 =4.28,P ＜ 0.05).After treatment,the level of hs-CRP and MMP-3 in observation group was (6.68 ±2.15) mg/L,(69.84 ± 16.97) μ g/L,significantly lower than that in control group [(8.72 ± 2.39) mg/L,(85.43 ± 19.52) tμ g/L],and there was significant difference (t =3.53,3.36,P ＜ 0.01).Conclusion There is significant effect of ozone therapy of patients with knee osteoarthritis,its mechanism may be reducing the level of MMP-3 and inhibiting inflammatory reaction.
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Objective To investigate the correlation between the level of serum cortisol and alexithymia in depressive patients with somatic symptoms.Methods The morning level of serum cortisol was measured with radioimmunoassay in 30 depressive patients with somatic symptoms (somatization group) and 30 depressive patients without somatic symptoms (non-somatization group).The severity of alexithymia was evaluated with Toronto alexithymia Scale(TAS-20).Results (1) The level of serum cortisol in somatization group was significantly higher than that in non-somatization group((533.88±144.10) μmol/L vs (458.27±82.87) μmol/L,P＜0.01).(2) The total TAS score and the factor score of Difficulty in identifying feelings and Difficulty in describing feelings in somatization group were obviously higher than those in non-somatization group,respectively ((67.13 ± 6.96) vs (62.03±7.14),(24.50±3.78) vs (21.63±3.63),(15.30±2.69) vs (13.57±2.03),all P＜0.01).(3) The level of serum cortisol in somatization group was positively correlated with the total score of alexithymia (r=0.596,P＜0.01) and the factor score of Difficulty in identifying feelings, Difficulty in describing feelings, externally oriented thinking,respectively (r=0.391,0.435,0.452,all P＜0.05).(4) The level of serum cortisol in non-somatization group was positively related to the total TAS score (r=0.418,P＜0.05) and the factor score of externally oriented thinking(r=0.489,P＜0.01).Conclusions Compared with depressive patients without somatic symptoms,depressive patients with somatic symptoms had more severe alexithymia,especially in Difficulty in identifying feelings and Difficulty in describing feelings.The severity of alexithymia was positively correlated with the level of serum cortisol.
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OBJECTIVE To analyze the correlation factors and preventive measures of lower respiratory tract infection after general anesthesia with laryngeal mask airway.METHODS In surgery 158 cases of general anesthesia with laryngeal mask ventilation in gynecology and orthopedic wards were analyzed retrospectively.RESULTS Forty-three cases were found in hospitals with lower respiratory tract infection,accounting for 83% of the total lower respiratory tract infection in the wards at the same period.CONCLUSIONS The anesthesia way,the age,the operation time,whether gastric tube,the abuse of antibiotics and whether the anesthesia equipments strictly disinfected and managed may be the important factors which can cause the lower respiratory tract infection.