Leukoaraiosis (LA) has important clinical significance;however, the neurobiological mechanism was still unclear. In this pa-per, we reviewed literatures about the clinical symptoms, pathology and imaging of LA in order to improve the understanding of the patho-logic mechanism, recognize the reversible pathological change in the earliest stage, which can help to prevent dementia.

Objective: To investigate the protective effect of rhubarb (大黄) combined with scopolamine on gastric and gut mucosal barrier in patients with severe trauma. Methods: Forty patients with severe trauma, injury severity score (ISS)≥25, were randomly divided into two groups (each n=20), namely common therapy group (CM group) and rhubarb (infused into stomach) combined with scopolamine group (RS group). In RS group, rhubarb combined with scopolamine were given just after the first time measuring gastrointramucosal pH (pHi), the other treatment was the same as CM group.The mean arterial pressure (MAP) and heart rate (HR) were recorded, and pHi, lactic acid, interleukin-6 (IL-6) and tumor necrosis factor-? (TNF-?) were measured on admission and at 24, 48 and 72 hours after admission. Results: The MAP, HR and pHi were uptrend in both groups. There were significant increase in MAP and pHi of RS group at 72 hours compared with those of CM group (both P

Aim To provide references for clinical trials dose and rational drug use by evaluating mitochondrial toxicity of bentysrepinine on HepG2 cells.Methods Mitochondrial toxicity of bentysrepinine on HepG2 cells was cmomprehensively evaluated by measuring proliferation inhibition rate, lactic acid content in culture supernatant, reactive oxygen species(ROS) content, mitochondrial membrane potential (MMP) variation and the activity of mitochondrial respiratory chain complex enzymes Ⅰ to Ⅳ.Results The half inhibitory concentration of bentysrepinine of HepG2 cells was 359 μmol·L-1.Compared with the control group, bentysrepinine could reduce the MMP, raise the level of lactic acid, increase the content of ROS and lower the activity of mitochondrial respiratory chain complex enzymes Ⅰ to Ⅲ with the concentration of 400 μmol·L-1(196 mg·L-1), showing an obvious mitochondrial toxicity.Compared with lamivudine and adefovir dipivoxil, bentysrepinine exerted no influence on indexes above with the same concentration 100 μmol·L-1.Conclusions Bentysrepinine shows an obvious mitochondrial toxicity on HepG2 cells with the concentration of 400 μmol·L-1.This mitochondrial toxicity is not presented with the concentration of 200 μmol·L-1.It shows that the safety range of bentysrepinine about mitochondrial toxicity is relatively wide.The test plays a guiding role in clinical trial dose design as well as clinical treatment.

Objective To explore the clinical features of congenital hepatic fibrosis (CHF) in children.MethodsA total of 111 patients diagnosed with CHF during January 2002 to June 2015 were included and divided into children group and adult group according to the age at diagnosis. The clinical data including gender, age, clinical symptoms, signs, laboratory examinations, and imaging characteristics were retrospectively analyzed and compared between two groups.ResultsThere were high incidences of splenomegaly and liver cirrhosis in both children and adult groups, and no difference was found between two groups (P>?0.05). The fatigue, jaundice, and hepatosplenomegaly were more common in children group while the renal cyst and liver cyst were more common in adult group, and the differences were statistically signiifcant (P all?

Background and purpose: Thyroid carcinoma cells spread mainly through lymph node metastasis, and lymphangiogenesis plays an important role during the lymph node metastasis, but it is not very clear to understand the formation mechanism. This study was to investigate the correlative expressions of HPSE, VEGF-C, D2-40 and lymphangiogenesis in thyroid carcinoma. Methods: Immunohistochemistry SP method was used to detect the expressions of HPSE, VEGF-C and D2-40 in 77 patients with thyroid carcinoma including papillary thyroid carcinoma (PTC), follicular thyroid carcinoma (FTC),medullary thyroid carcinoma (MTC), 32 of them with lymph node metastasis was enrolled into the study, D2-40 stained the lymphatic vessels, and lymphatic vessel density (LVD) was scanned under the light-microscope, and the correlation among the above indexes in different thyroid carcinoma types were analyzed respectively. Results: The expressions of HPSE, VEGF-C and D2-40 were observed to have a different degree in thyroid carcinoma, and the highest expression of the protein could be seen in the patients with papillary carcinoma (P<0.05),The expression ratios of HPSE,VEGF-C and D2-40 in different carcinoma types were 54.9%, 68.6%, 12.8±5.7 for PTC, 37.5%, 50%, 8.6±1.7 for FTC, 20% and 20%, 4.9±0.8 for MTC, respectively. There were significant different expressions of HPSE, VEGF-C and D2-40 between the patients with lymph node-positive group and node-negative group (P=0.014, P=0.048, respectively). In addition, the expressions of them were positively correlated (P<0.001, r=0.616). Conclusion: HPSE, VEGF-C and D2-40 have a close relationship with lymph node metastasis, HPSE and VEGF-C are related to the lymphangiogenesis.

40 patients,20 males and 20 females,with 52 miniscrews were included.The concentration of IL-1β,IL-6 and IL-8 in the gingival crevicular fluid around the miniscrews were measured.The results showed that the concentrations of IL-1β,IL-6 and IL-8 increased during orthodintic tooth movement(P ＜0.05),indicating that orthodontic force had an effect on the cytokines around the miniscrews,which may be related to orthodontic bone resorption.

Objective:To analyze the characteristic of nerve tracts in different stages of cognitive impairment caused by white matter hypertensities, applying diffusion tensor imaging-peak width of skeletonized mean diffusivity as evaluation indicator.Methods:Demographic characteristics and vascular risk factors of all subjects were recorded.Screened out 50 subjects without WMH and whose MoCA scale was more than or equal 26 points as normal control group.Then, we assessed 85 patients with WMH using the MoCA scale and clinical dementia assessment. Of 85 patients, 45 cases were divided into the normal cognition group, 23 cases were assigned into non-dementia vascular cognitive impairment group, and 17 cases into the vascular dementia group.The diffusion tensor imaging-peak width of skeletonized mean diffusivity marking method was used to compare the integrity of white matter fibers in WMH patients with varying degrees of cognitive impairment and normal control group.Results:The difference of PSMD among the four groups was statistically significant(CN group: 3.558±0.157, VCIND group: 4.128±0.222, VaD group: 5.469±0.000, NC group: 2.612±0.105, F=42.479, P<0.05). PSMD in WMH groups were higher than that in NC group (all P<0.05). There was no significant difference between WMH-VCIND group and WMH-CN group ( P=0.067). The PSMD of WMH-VAD group was higher than that of WMH-CN group and WMH-VCIND group (both P<0.05). Conclusion:PSMD can accurately detect white matter fiber damage caused by WMH.The degree of WMH combined cognitive decline was not completely consistent with the degree of PSMD increase.Compared with the cases with normal WMH cognition, PSMD was not significantly increased when WMH was combined with VCIND, while PSMD was significantly increased when WMH was combined with VaD.DTI-PSMD value as imaging marker can provide objective basis for clinical diagnosis of WMH-VaD.

Objective To explore the clinical characteristics of cognitive impairment in different age groups with the same severity of white matter lesions.Methods This study involved 110 consecutively recruited patients with white matter lesions(WMLs)from the Department of Neurology at Beijing Tiantan Hospital from August 2014 to March 2017.Patients were aged from 50 to 85 with a mean age of 63.1±9.7,and they were divided into an elderly group with a mean age of 71.6±5.2 (range:65-85 years)and a middle aged group with a mean age of 54.8 ± 3.4 (range:50-60 years).The severity of white matter lesions was evaluated with the Fazekas scale.MoCA was used to evaluate the cognitive function of patients.Results For Fazekas 1,the MoCA score was 25.5 ± 2.2 in the elderly group and 28.1 ± 1.4 in the middle aged group(t =6.946,P =0.000);the score for visuospatial and execution abilities was 3.8 ± 0.9 in the elderly group and 4.5 ± 0.6 in the middle aged group(t =3.7 2 6,P =0.0 2 3);the score for delayed memory was 2.7 ± 1.5 in the elderly group and 4.0 ± 1.0 in the middle aged group(t =4.365,P =0.018).For Fazekas 2,the MoCA score was 22.5±2.5 in the elderly group and 24.1 ± 1.5 in the middle aged group(t =3.361,P =0.034);the score for visuospatial and execution abilities was 2.8 ± 1.2 in the elderly group and 3.8 ± 0.8 in the middle aged group(t=6.473,P=0.007);the score for concentration was 4.6± 1.3 in the elderly group and 5.6±0.5 in the middle aged group(t=0.491,P=0.721).For Fazekas 3:the MoCA score was 15.2 ± 3.4 in the elderly group and 19.4 ± 2.8 in the middle aged group(t =4.709,P =0.001);the score for visuospatial and execution abilities was 1.8 ± 1.1 in the elderly group and 2.8± 1.4 in the middle aged group(t =1.563,P =0.043);the score for concentration was 3.3± 1.1 in the elderly group and 4.4± 1.4 in the middle aged group(t=2.231,P=0.026);the score for orientation was 4.2 ± 1.3 in the elderly group and 5.7 ± 0.5 in the middle aged group (t=3.255,P =0.000).Conclusions WMLs can increase the risk of vascular cognitive impairment and cause decline in multiple cognitive functions in both middle aged and elderly people.Cognitive dysfunction in age-related WMLs is mainly characterized by impairment in visuospatial and execution abilities.

Objective:To develop a mesenteric creeping fat index (MCFI) based on CT enterography (CTE) to characterize the degree of creeping fat wrapping around the inflamed gut in Crohn disease (CD), and to assess the relationship between MCFI and the inflammatory intestinal stricture.Methods:From December 2018 to July 2019, the patients with CD who underwent surgery in the First Affiliated Hospital of Sun Yat-Sen University were prospectively collected. The extent of perienteric mesenteric vessels wrapping around the gut was reconstructed to develop MCFI based on CTE images. The intestinal stricture index was obtained by calculating the ratio of the maximal upstream luminal diameter divided by the minimum luminal diameter apparent within the stricturing region. Using region-by-region correlation between CTE and surgical specimen, creeping fat score in intestinal specimen was obtained by assessing the extent of creeping fat wrapping around the resected bowel segment, and HE staining was performed on the bowel specimen corresponding to creeping fat to obtain the pathological inflammatory score. The Spearman correlation analysis was used to evaluate the correlation between MCFI, creeping fat score in intestinal specimen, and inflammatory score, intestinal stricture index. The ROC curve analysis was used to assess the accuracy of MCFI in distinguishing moderate-severe and mild inflammatory bowel walls.Results:Totally 30 CD patients were enrolled. The creeping fat score in intestinal specimen positively correlated with pathological inflammatory score ( r s=0.403, P=0.027) and with intestinal stricture index ( r s=0.642, P<0.001). MCFI positively correlated with creeping fat score in intestinal specimen ( r s=0.840, P<0.001), with pathological inflammatory score ( r s=0.497, P=0.005), and with intestinal stricture index ( r s=0.599, P<0.001). ROC analysis showed that the area under the curve of MCFI for differentiating moderate-severely from mildly inflammatory bowel walls was 0.718 (95%CI 0.522-0.913). Using MCFI≥4 as a cutoff value, the sensitivity and specificity were 81.8% and 47.4%, respectively. Conclusions:There was a correlation between creeping fat and inflammatory intestinal strictures in CD. MCFI can non-invasively depict the degree of creeping fat wrapping around the gut and assess the inflammatory intestinal stricture.

Objective:To explore the diagnostic efficacy of nomogram based on multi-parameter MRI for assessment of bowel fibrosis in patients with Crohn disease（CD).Methods:The clinical and imaging data of CD patients diagnosed by surgical histopathology in the First Affiliated Hospital of Sun Yat-sen University from June 2015 to March 2018 were prospectively collected. All the patients underwent conventional MRI and diffusion kurtosis imaging（DKI) within 2 weeks before surgery. Patients who underwent surgery between June 2015 and September 2017 were included in the model building group, and those who underwent surgery between October 2017 and March 2018 were included in the model validation group. We measured the apparent diffusion coefficient（ADC) from monoexponential model of diffusion-weighted imaging（DWI), apparent diffusional kurtosis（K app), and apparent diffusion for non-Gaussian distribution（D app) from non-Gaussian DKI model, and observed T 2WI signal intensity and enhancement pattern of the same segment. One to three intestinal specimens per patient were stained with Masson′s trichrome for the histological grading of fibrosis. Correlations between qualitative/quantitative MRI indexes and histological grades were evaluated using the Spearman rank test. Multivariate logistic regression analysis was performed to identify independent factors to be included into the nomogram for predicting the degree of bowel fibrosis and its diagnostic performance was assessed by internal and external validation. Results:A total of 40 CD patients were included, including 31 in the model construction group and 9 in the model verification group. A total of 81 intestinal specimens from 31 patients were graded as none-to-mild bowel fibrosis（ n=32) and moderate-to-severe bowel fibrosis（ n=49) according to a scoring system of fibrosis. In the training cohort, the K app value of moderate-to-severely fibrotic bowel walls was significantly higher than that of none-to-mildly fibrotic bowel walls, and the D appand ADC values of moderate-to-severely fibrotic bowel walls were significantly lower than those of none-to-mildly fibrotic bowel walls（ Z=-5.999, -4.521 and -3.893; P<0.001). There was no significant difference in T 2WI signal intensity or enhancement pattern between these two groups（χ2=1.571 and 0.103; P>0.05). Moderate and mild correlations of histological fibrosis grades with K appand D app( r=0.721 and -0.483; P<0.001), and a mild correlation with ADC（ r=-0.445, P<0.001) were found. Independent factors derived from multivariate logistic regression analysis to predict the degree of bowel fibrosis were K app and D app. Internal and external validation revealed good performance of the nomogram with concordance index of 0.901（95% confidence interval, 0.824-0.978) and 1.000, respectively, for differentiating none-to-mild from moderate-to-severe fibrosis. Conclusion:The DKI-based nomogram can be used to evaluate the bowel fibrosis in CD patients and provides a visual and simple prediction method for clinic.