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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.
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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.
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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.
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Objective To investigate the efficacy and side effects of carbon dioxide (CO2) fractional laser for the treatment of suborbital wrinkles.Methods Twenty-one female patients with suborbital wrinkles received a single treatment of CO2 fractional laser at fluences of 20-30 mJ with density of 10 ％-15 ％.Patients were photographed standardly and evaluated at baseline,one and six months after the treatment.Wrinkle improvements were graded in 5 levels:1 (no improvement or worse),2 (1％ 25％ improvement),3 (26％-50％ improvement),4 (51％-75％ improvement),and 5 (76％-100％ improvement).Patients rated the pain intensity by a visual analog scale (VAS,0 10).The side effects,such as hyperpigmentation,were observed and recorded.Results After one month follow-up,3-level improvement was observed in 7 patients (33.3％),2-level in 9 patients (42.9％);and after six months,3-level improvement was observed in 9 patients (42.9％),2-level in 8 patients (38.1％),but there was no statistically significant difference between one month and six months (P ＞0.05).The overall patient satisfactory rate was 81.0％.The average pain of VAS was 4.24± 1.73,7 patients (33.3％) had hyperpigmentation which faded within three months,and no patients had scars.Conclusions Single CO2 fractional laser treatment can improve the suborbital wrinkles in a cerrain extent with few side effects.
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Objective The decease of varicose vein and telangiectasis of lower extremity has always been difficult to treat.Regular treatments and medicines are invalid.This research aimed to study the effect of foam sclerotherapy and the long-pulsed 1064 nm Nd∶YAG laser in treatment of reticular veins and telangiectasis of lower extremity.Methods From January 2012 to June 2012,excluding deep and superficial veins valve insufficiency of the lower extremity through duplex uhrasonography,72 patients with simple reticular veins and telangiectasis of the lower extremity were treated with foam sclerosing agent injection combined with Nd∶YAG 1064 nm laser therapy.Results Of the 72 patients,cure was achieved in 38 cases,significantly effective in 32 cases,effective in 2 cases,and total effective rate was 100％.Follow-up showed that after 3 months 1 case was dissatisfied,3 cases were discontent,6 relatively satisfied,32 satisfied,and 30 very satisfied;after 12 months no cases were very dissatisfied,1 cases were discontent,9 relatively satisfied,28 satisfied,and 34 cases very satisfied.There were no severe complications in all cases.Conclusions Foam sclerotherapy and Nd:YAG 1064 nm laser can be used for different stages of the treatment process and different caliber of blood vessels.Treatment with foam sclerotherapy and Nd∶YAG 1064 nm laser for reticular veins and telangiectasia of lower extremity is a safe,simple and effective way.
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[Summary] Neuroischemic diabetic foot ulcer ( NDFU) is characterized by infection, ulceration of deep tissues, neurological abnormalities, and various degrees of peripheral vascular disease in the lower limbs. The patients often have multiple risk factors such as older, longer duration, cardiovascular disease. The treatment is very difficult. The prognosis depends on the severity of complications, tissue range of infections, and the peripheral vascular disease. In this article, the treatment process of an old inpatient with NDFU and severe complications was reviewed and to propose a standard pathway for its management.
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Objective To evaluate the efficacy and safety of Meian granule in the treatment of patients with melasma and to investigate the recurrence rate.Methods The patients,who were diag nosed pathologically as melasma from November 2010 to April 2011 in our department and accorded with the standards that we supposed,were enrolled in this study.They were then divided into three groups:Meian granule group (group A),Meian granule group (group B) and control group (group C).Patients in group A were given a packet of Meian granule each time,once a day,and those in group B were given a packet of Meian granule each time,twice a day for 2 months.Patients in group C were treated by Antixin (3 pills,thrice a day).The efficacy and safety were observed and analyzed by using statistical methods after the treatment.All the cases were followed up for a month at out-patient department or by telephone.Results A total of 158 cases of melasma were treated,including 54 cases in group A,51 cases in group B,and 53 cases in group C. The effective rates were 58 ％,52 ％,and 60 ％ in groups A,B and C,respectively.There was no significantly statistical difference (P＞0.05) of effective rates amoung the three groups.One month after the treatment the recurrence rates were 3.3 ％,15.3 ％,and 10.0 ％ in the groups A,B and C,respectively.The incidence of adverse reactions during the study were 14.8 ％,15.6 ％,and 7.5 ％,respectively.Conclusions It has been proved that Meian granule is an effective and reliable treatment for melasma.
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Objective To evaluate the clinical efficacy of factional multiplex laser (AffirmTM) with combined apex pulse (CAP) technology in treating depressive acne scars,post inflammatory erythema and enlarged pores and other lesions.By following up,the correlative factors were analyzed to guide the further use of the factional laser (AffirmTM) with CAP technology.Methods Patients who received the AffirmTM laser therapy from Sept.2007 to July 2008 were enrolled in this retrospective follow-up study.Pictures were taken before and after each treatment during the therapy.Then the pictures were evaluated by dermatologists to attain object variables.Other subject variables from patients were recorded during survey.The relation between the efficacy and age,sex and treatment frequencies were analyzed statistically.Results The effective rate was 25.34 ％ for post-acne scars,36.84 ％ for post-acne erythema.28.57 ％ for enlarged pores,and 14.29 ％ for rythids.Nonparametric test showed no statistical difference with gender or age.There was correlation between efficacy and treatment frequencies.No severe adverse effect was observed.Conclusions AffirmTM laser with CAP technology has a good effect on treating post-acne depressed scars and erythema,enlarged pores and fine rythids.
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Objective To evaluate the effect of superficial temporal fascia flap for the reconstruction of temporal depression. Methods According to the degree of temporal depression, we applied folded superficial temporal fascia to reconstruct the temporal depression, combined with forehead and orbital subperiosteal facelift. Results Postoperative follow-up for 1~2 years showed that the method used in subperiosteal facelift combined with temporal depression, maintained a satisfactory long-term full contour. And it improved the facial contour.Conclusions Application of superficial temporal fascia flap in reconstructing the temporal depression combined with facelift for one-stage is a good method. It can get the purposes of tightening the skin and improving the facial contour together. Good results are achieved.