Objective Soft and hard channel minimally invasive interventions for patients with hypertensive intracerebral hemorrhage have been used for many years. A retrospective study was performed to evaluate the superiority of these two methods. Methods 122 patients with hypertensive intracerebral hemorrhage were included in this retrospective study, 64 cases in soft channel group and 58 cases in hard channel group. The clinical effects were compared; catheter retention time and complications of the minimally invasive surgery were also observed in these two groups. Results In soft channel group, NIHSS before the treatment was 18.05±7.77, and NIHSS after the treatment was 7.57±4.68. The mortality was 17.19%. The catheter retention time in hematoma puncture was (4.35±1.56)days, and the catheter retention time in ventricle puncture was (7.67±2.37)days. There were 4 cases of rebleeding and 3 cases of intracranial infection. In hard channel group, NIHSS before the treatment was 18.38±9.02, and NIHSS after the treatment was 8.02±4.84. The mortality was 20.69%. The catheter retention time in hematoma puncture was (4.07±1.49)days, and the catheter retention time in ventricle puncture was (8.17±2.55)days. There were 9 cases of rebleeding and 2 cases of intracranial infection. The differences were not statistically significant (P＞0.05). Conclusions Soft and hard channel minimally invasive interventions of hypertensive cerebral hemorrhage have the same clinical value.

Objective To explore changes of brain function among patients with partial epilepsy in resting state by using the blood oxygenation level dependent functional magnetic resonance imaging (fMRI) techniques.Methods fMRI scanning was performed in resting state among 60 patients with partial epilepsy and 60 gender,age and educational levels matched normal controls.The functional connectivity analysis was applied to calculate the default mode network ( DMN ) functional connectivity in resting-state fMRI.SPM5 was used to analyze differences in functional connectivity between the two groups( P ＜0.001,cluster ＞50).Results Left precuneus and adjacent posterior cingulate cortex ( Pcu/PCC),angular gyrus,and cingulate gyrus were involved in the DMN of epileptic patients.By contrast,the DMN of controls included left Pcu/PCC,right angular gyrus,bilateral medial frontal lobe and temporal lobe.Compared with normal controls,patients with partial epilepsy showed a significantly decrease in functional connectivity of DMN region such as left inferior parietal lobule,supramarginal gyrus,parahippocampa gyrus and superior temporal gyrus,and bilateral uncus,while no regions were found increased functional connectivity in patients group.Conclusions Patients with partial epilepsy show abnormal changes in functional connectivity of DMN in resting state by fMR],which may associate with the potential pathophysiological mechanisms of epilepsy.The findings demonstrate that the resting-state fMRI might detect the extensive changes of brain function in partial epilepsy with negative results of conventional MRI,suggestive of fMRI as an effective and non-invasive method to explore brain function in epilepsy.

Objective:To explore the risk factors of acute exacerbation (AE) of chronic obstructive pulmonary disease (COPD) and whether Eosinophil (EOS) in peripheral blood can guide the treatment of inhaled corticosteroids (ICS).Methods:This study was a single center, Prospective cohort study. The subjects of this study were from stable COPD patients who were treated in the Department of Respiratory Medicine of the Xiangya Second Hospital of Central South University from January 2020 to December 2021. Patient general information, past year AE status, exposure risk factors, modified version of the British Medical Research Council Respiratory Difficulty Questionnaire (mMRC) score, Chronic Obstructive Pulmonary Disease Assessment Questionnaire (CAT) score, ICS usage, lung function, blood routine, etc. were collected. We followed up the patient for one year. During the follow-up period, the clinical characteristics of patients with and without AE were compared to analyze the correlation between blood EOS and ICS use.Results:The median blood EOS of 617 stable COPD patients was 0.13×10 9/L, 289 patients (46.8%) with chronic obstructive pulmonary disease had a history of AE, and 207 patients (33.5%) experienced AE during 1-year follow-up. The results of univariate analysis showed that the future occurrence of AE in COPD was correlated with body mass index (BMI), AE history, Global Initiative for Chronic Obstructive Lung Disease (GOLD) grading, GOLD grouping, mMRC score, and CAT score (all P<0.05). The results of logistic multiple factor regression analysis showed that patients with BMI<24 kg/m 2, AE in the past year, severe AE in the past year, smoking history and other exposure factors, GOLD level 2 or above, GOLD C and D groups, and mMRC score≥ 2 had a higher risk of future AE (all P<0.05). There was no statistically significant difference in the incidence of AE between patients with COPD with different levels of EOS and those without ICS during a 1-year follow-up period (all P>0.05). Conclusions:The past 1-year AE history, BMI, exposure risk factors, degree of airflow restriction, and respiratory symptoms of patients with chronic obstructive pulmonary disease can predict future AE risk. There is no significant difference in future AE risk among patients with different levels of EOS, and EOS cannot guide ICS treatment to reduce AE risk.

Objective:To understand the use of inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD) in the real world and analyze its compliance with the guidelines.Methods:This study is a multicenter, cross-sectional study. 1 051 COPD patients who were treated in the Second Xiangya Hospital of Central South University, the First Affiliated Hospital of Shaoyang College and Zhuzhou Central Hospital from January 2020 to March 2022 were collected. The general information, drug use, types of exposure risk factors, acute exacerbation (AE) in the past year, the scores of the modified British Medical Research Council Dyspnea Questionnaire (mMRC), COPD Assessment Test (CAT), pulmonary function, blood routine of patients were collected. The status of ICS use in COPD patients, the clinical characteristics and guideline compliance of non-ICS users and ICS users were analyzed.Results:Among 1 051 patients with COPD, ICS was used in 490 cases (46.6%) and was not used in 561 cases (53.4%). ICS use was associated with relapse, frequent AE, severe AE, Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) grade 2 or above, GOLD D group, mMRC score, bronchial asthma, and blood eosinophils (EOS) (all P<0.05). Among 1 051 patients, 583(55.5%) were newly treated, 222(38.1%) were newly treated with ICS, and 361(61.9%) were not treated with ICS. ICS use in newly treated patients was associated with frequent AE, severe AE in the past year, GOLD grade 2 to 3, GOLD B and D group, mMRC score, bronchial asthma, and blood EOS (all P<0.05). Conclusions:Nearly half of patients with COPD are treated with ICS, and patients with ICS use had a higher risk of AE, more severe symptoms, higher blood EOS, and higher rates of asthma. However, there still exists the phenomenon of overuse of ICS.