Objective To explore the value of diffusion tensor imaging (DTI) and diffusion tensor tracography (DTT) in assessment of Corticospinal tract (CST) and medial lemniscus (ML) in tumors involving brainstem.Methods A total of 35 cases with pathologically confirmed tumors involving brainstem were collected,and 35 volunteers matched with genders and ages were recruited as the normal group.DTI scanning was performed on all the patients and controls.The damage degrees of CST and ML were evaluated and graded by DTT,and the dysfunction degrees were evaluated for the patients.Spearman correlation was used to statistically analyze the relationships of limb movement,sensory dysfunction and CST and ML damage.Results According to the rating results,normal findings,shifting,edema or infiltration and damage of CST was found in 9,9,11,and 6 cases respectively.They were 8,9,15,3 cases for ML.Motor function was normal in 20 cases,slightly defective in 11 cases,and moderate defective in 4 cases.Sensory function was normal in 21 cases,slightly defective in 6 cases,and moderate defective in 8 cases.The patients' dyskinesia and CST damage degree,sensory dysfunction and ML damage degree were positively correlated (r was 0.786 and 0.686 respectively,P ＜ 0.01).The position relationship among tumor and CST and ML could be well displayed on images.None of the patients showed new symptoms of dysneuria after surgery.Conclusions DTI and DTT technology can be used to evaluate CST and ML damage degree in tumors involving brainstem.They can display the position relationship between tumor and the brainstem CST and ML,which is important in protecting the brainstem fiber tract during operation and evaluating the recovery after the operation.

Objective To understand the impairment and compensation mechanism of brain function in pa-tients with non-fluent aphasia after ischemic stroke. The fractional amplitude of low frequency fluctuation (fALFF) method was used to analyze the functional magnetic resonance imaging (fMRI) data in the resting state between the aphasia patients and the normal controls. Methods The scans of the resting state of fMRI were performed in 17 aphasia patients and 19 age-, education-, and sex-matched healthy control subjects. The scan sequence was single-shot echo planar image,DPARSF software was used to analyze fALFF data of the aphasia patients and the healthy controls. Results Compared to the control group, the value in right superior temporal gurus, inferior parietal lob-ule, frontal lobe cortex, and postcentral gurus were significantly increased in the aphasia group. The fALFF in bilat-eral cerebellum and right thalamus were also decreased in the aphasia group. Conclusions The fALFF values in some brain region in the aphasia group were abnormal in the resting state , indicating a few pathological change of brain function in patients with non-fluent aphasia after ischemic stroke.

Objective To investigate the effect of thyroxine replacement therapy with residual subclinical hypothyroidism on the success rate of catheter ablation in elderly patients with atrial fibrillation(AF).Methods Among the consecutive patients with AF who underwent a first AF ablation in our center between 2009 and 2012,we identified 56 patients(41 paroxysmal AF,15 persistent AF)with subclinical clinical hypothyroidism after receiving thyroid hormone replacement therapy as study group.The control group consisted of 56 patients with euthyroidism and no history of thyroid dysfunction.All patients underwent catheter ablation.Results At the end of follow up,37.5%(21/56)patients were AF free after the first procedure in the study group,in comparison to 64.3%(36/56)in control group(χ2=8.655,P=0.003).Last procedure was performed in 27 patients of study group and in 15 patients of control group.After the last performed ablation,62.5%(35/56)study group patients and 80.4%(45/56)controls group patients had no recurrence(χ2=4.653,P=0.031).The major complications rate did not differ between two groups(P=0.642).Conclusions Thyroid hormone replacement therapy with residual subclinical hypothyroidism reduces catheter ablation success rate in elderly patients with atrial fibrillation.

Objective: To evaluate the efficacy and safety of three-dimensional electroanatomical mapping system for catheter ablation of paroxysmal supraventricular tachycardiain (PSVT) children. Methods: Clinical data from 187 children with paroxysmal supraventricular tachycardia undergoing radiofrequency catheter ablation in our department between January 2012 and April 2016 were analyzed. Among the patients, 91 cases were treated with traditional two-dimensional X-ray radiofrequency ablation, 96 cases were treated with radiofrequency ablation guided by three-dimensional electroanatomical mapping system. Postoperative electrocardiogram and echocardiography follow-up was performed at 1, 3, 6, 12, and 24 months. The success rate, recurrence rate, complication rate, operation time and amount of X-ray exposure were compared between the two groups. Kaplan-Meier survival curve was used to analyze the PSVT-free survival rate of the patients between the 2 groups. Results: The mean follow-up time was (739±92) days. The success rate (95.8%(92/96) vs. 94.5%(86/91), P=0.912), recurrence rate (5.4%(5/92) vs. 4.7%(4/86), P=0.807), complication rate (4.2%(4/96) vs. 5.5%(5/91), P=0.379), operation time ((73±31)min vs. (79±36)min, P=0.124) were similar between the two groups. However, X-ray exposure time ((8.1±2.9)min vs. (21.3±8.4)min, P=0.026), amount of X-ray ((23±11)mGy vs. (58±23)mGy, P=0.013) were significantly lower in the three-dimensional electroanatomical mapping system group than in the traditional two-dimensional X-ray radio frequency ablation group. PSVT-free survival rate was similar between the two groups (χ²=0.060, P=0.807) . Conclusion Three-dimensional electroanatomical mapping system is safe and effective for radiofrequency ablation of paroxysmal supraventricular tachycardia in children, and can significantly reduce the amount of radiation as compared to the traditional two-dimensional X-ray radiofrequency ablation.

Objective:To explore the disease-related impairment of functional and structural connectivity network and their relationship with psychometric hepatic encephalopathy score (PHES) in patients with chronic hepatitis B virus-related cirrhosis (HBV-RC) by combining resting-state functional MRI (rs-fMRI) and diffusion tensor imaging (DTI).Methods:Data of 30 HBV-RC patients [including 13 HBV-RC patients with minimal hepatic encephalopathy (MHE) and 17 HBV-RC patients without MHE (NMHE)] from April 2011 to October 2011 in Guangdong No.2 People′s Hospital were analyzed prospectively, and 38 healthy individuals matched for age, sex, and education with HBV-RC patients (HC group) were included during the same period. Rs-fMR and DTI data as well as PHES data of all participants were collected. Gretna and PANDA software package were used to preprocess the imaging data and construct the functional and structural network respectively. The network-based statistic (NBS) approach was used to compare the differences of the functional and structural connections among three groups. Spearman′s correlation analysis was used to identify the relationship between functional or structural connectivity and PHES. The structural equation modeling (SEM) was used to explore the relationships among functional connectivity, structural connectivity, and PHES.Results:Compared to HC group, both functional and structural connectivity in the whole brain progressively destroyed from NMHE to MHE, mainly involving cognitive control network, default mode network, and limbic network (NBS corrected, all P<0.01). There were significantly negative relationships between functional or structural connectivity and PHES in HBV-RC patients (false discovery rate corrected, all P<0.05). The SEM results showed the influence of structural connectivity on neurocognitive impairment was mediated by functional connectivity ( P<0.05). Conclusion:Both functional and structural networks progressively destroy in HBV-RC patients as the disease advanced and these alterations significantly correlate with PHES. Besides, the influence of structural connectivity on neurocognitive impairment is mediated by functional connectivity.

Objective To understand the pathological mechanism of brain function in irritable bowel syndrome (IBS) patients by analyzing the fraction amplitude of low-frequency fluctuation (fALFF) of functional magnetic resonance imaging (fMRI) raw data in resting state.Methods The fMRI at resting state was performed in 21 IBS patients and 21 age-,education-and sex-matched normal healthy subjects,collected in our hospital from August 2010 to April 2012.The scan sequence in this study was single-shot echo planar image.The DPARSF software was used to preprocess the fMRI data,and then,the fALFF was compared between the IBS and normal control groups.Results As compared with the control group,the IBS group showed significantly increased fALFF values in the primary somatosensory cortex region and secondary somatosensory cortex region such as right temporal pole,middle temporal gyrus,precentral gyrus,postcentral gyrus and right superior frontal gyrus,and decreased fALFF values in the cerebellum.Conclusion Some somatosensory cortex regions in the IBS group are abnormal in the resting state in IBS patients,which can reflex a few pathological changes of brain dysfunction,and it also helps to understand IBS from the perspective of the brain neural activity for clinic diagnosis.

Objective To observe the value of self-supervised deep learning artificial intelligence(AI)noise reduction technology based on the nearest adjacent layer applicated in ultra-low dose CT(ULDCT)for urinary calculi.Methods Eighty-eight urinary calculi patients were prospectively enrolled.Low dose CT(LDCT)and ULDCT scanning were performed,and the effective dose(ED)of each scanning protocol were calculated.The patients were then randomly divided into training set(n=75)and test set(n=13),and a self-supervised deep learning AI noise reduction system based on the nearest adjacent layer constructed with ULDCT images in training set was used for reducing noise of ULDCT images in test set.In test set,the quality of ULDCT images before and after AI noise reduction were compared with LDCT images,i.e.Blind/Referenceless Image Spatial Quality Evaluator(BRISQUE)scores,image noise(SDROI)and signal-to-noise ratio(SNR).Results The tube current,the volume CT dose index and the dose length product of abdominal ULDCT scanning protocol were all lower compared with those of LDCT scanning protocol(all P＜0.05),with a decrease of ED for approximately 82.66％.For 13 patients with urinary calculi in test set,BRISQUE score showed that the quality level of ULDCT images before AI noise reduction reached 54.42％level but raised to 95.76％level of LDCT images after AI noise reduction.Both ULDCT images after AI noise reduction and LDCT images had lower SDROI and higher SNR than ULDCT images before AI noise reduction(all adjusted P＜0.05),whereas no significant difference was found between the former two(both adjusted P＞0.05).Conclusion Self-supervised learning AI noise reduction technology based on the nearest adjacent layer could effectively reduce noise and improve image quality of urinary calculi ULDCT images,being conducive for clinical application of ULDCT.

OBJECTIVETo investigate the changes in orbitofrontal cortex (OFC) functional connectivity and its association with decision-making deficits in chronic heroin-dependent individuals (HDIs) and explore the neural mechanisms of heroin addiction and relapse.

METHODSFourteen male chronic HDIs and 14 healthy subjects matched for age, education, and nicotine consumption participated in this study. Resting state functional magnetic resonance imaging (fMRI) was performed using a 1.5 T MR scanner. Functional connectivity of the OFC and the rest of the brain were calculated using REST software. Voxel-based analysis of the functional connectivity maps between the control and HDI groups was performed with two-sample t test. The Iowa gambling task (IGT) was used to assess the participants' decision making during uncertainty.

RESULTSCompared with the control group, the HDIs showed significantly decreased functional connectivity of the OFC and the right inferior parietal lobule (rIPL) (t=3.5, P<0.05). A significant negative correlation was noted between the functional connectivity of the OFC-rIPL and performance level at the IGT.

CONCLUSIONThe OFC-rIPL functional connectivity is significantly disrupted in HDIs, which may be the neural basis for decision-making deficits.

Adult ; Case-Control Studies ; Decision Making ; Frontal Lobe ; physiopathology ; Heroin Dependence ; physiopathology ; psychology ; Humans ; Magnetic Resonance Imaging ; Male

OBJECTIVETo explore the possible mechanism and protective effect of BMSCs (bone mesenchymal stem cells) carrying superoxide dismutase (SOD) gene on mice with paraquat-induced acute lung injury.

METHODSTo establish the cell line of BMSCs bringing SOD gene, lentiviral vector bringing SOD gene was built and co-cultured with BMSCs. A total of 100 BALB/c mice were randomly divided into five groups, namely Control group, poisoning group (PQ group) , BMSCs therapy group (BMSC group) , BMSCs-Cherry therapy group (BMSC-Cherry group) , BMSCs-SOD therapy group (BMSC-SOD group) . PQ poisoning model was produced by stomach lavaged once with 1 ml of 25 mg/kg PQ solution, and the equal volume of normal saline (NS) was given to Control group mice instead of PQ. The corresponding BMSCs therapy cell lines were delivered to mice through the tail vein of mice 4h after PQ treatment.Five mice of each group were sacrificed 3 d, 7 d, 14 d and 21 days after corresponding BMSCs therapy cell lines administration, and lung tissues of mice were taken to make sections for histological analysis. The serum levels of glutathione (GSH) , malondialdehyde (MDA) , SOD, and the levels of transforming growth factor-β (TGF-β) and tumor necrosis factor-α (TNF-α) in lung tissue were determined. The level of SOD was assayed by Westen-blot.

RESULTSCompared with Control group, the early (3 days) levels of SOD protein in lung tissue of PQ group obviously decreased, and the late (21 days) levels of SOD obviously increased, while in therapy groups, that was higher than that in PQ group, and the BMSCs-SOD group showed most obvious (all P<0.05) . Compared with Control group, the levels of plasma GSH and SOD of PQ group and each therapy group wae significantly lower than those in Control group, while in therapy groups, those were higher than those of PQ group, and the BMSCs-SOD group showed most obvious (all P<0.05) .Compared with Control group, the level of plasma MDA, TNF-α and TGF-β in PQ group and therapy groups were significantly higher, while in therapy groups, that was lower than that in PQ group, and the BMSCs-SOD group showed most obvious (all P<0.05) . Lung biopsy showed that, the degree of lung tissue damage in each therapy group obviously reduced.

CONCLUSIONSOD is the key factor of the removal of reactive oxygen species (ROS) in cells, that can obviously inhibit the oxidative stress damage and the apoptosis induced by PQ, thus significantly increasing alveolar epithelial cell ability to fight outside harmful environment.

Acute Lung Injury ; chemically induced ; therapy ; Animals ; Antioxidants ; metabolism ; Cell Line ; Glutathione ; blood ; Lung ; pathology ; Malondialdehyde ; blood ; Mesenchymal Stem Cell Transplantation ; Mice ; Mice, Inbred BALB C ; Oxidative Stress ; Paraquat ; poisoning ; Superoxide Dismutase ; blood ; genetics ; Transforming Growth Factor beta ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

Objective To assess the influence of metabolic syndrome(MS)on the success rate of catheter ablation for the treatment of atrial fibrillation (AF)in the elderly. Methods A retrospective study included a total of 221 aged patients with AF who underwent AF ablation for the first time. The patients were divided into two groups :an MS group(n＝72)and a control group(without MS)(n＝149) . The MS group had a mean age of (67.1 ± 5.2) years ;the control group had a mean age of (68.3 ± 5.7) years. Forty-six patients in the MS group and 105 patients in the control group experienced paroxysmal atrial fibrillation. Prognoses in two groups were compared at the end of the follow-up. Results At the end of the follow-up ,the success rates of the procedure in the MS group and the control group were 37.5%(n ＝ 27)and 51.7%(n ＝ 77) ,respectively (χ2＝ 3.917 ,P ＝ 0.049) .Recurrence happened in 19 patients of the MS group and 28 patients of the control group ,and they underwent a repeat ablation. The overall success rates after the last ablation in the two groups were 51.4%(n＝37)and 65.8%(n＝98) ,respectively (χ2＝4.224 ,P＝0.034).In the multivariable model adjusted for risk factors ,MS(HR＝1.42 ,95% CI :1.11-1.64 ,P＝0.033)and left atrial diameter(HR＝ 1.83 ,95% CI :1.27-3.19 , P ＝ 0.017 ) were independent predictors for recurrence. Conclusions MS can affect the success rate of catheter ablation for AF in elderly patients and the effect remains even after the procedures are repeated