Objective Depression is a mood disorder that causes a persistent feeling of sadness,with high morbidity rates and great social impairment.Increasingly studies show the abnormalities of brain networks.We summarized the results of resting state functional magnetic resonance imaging study of depression,and demonstrated the neural loops mechanism from neuroimaing perspective.Methods The key words depression, resting state and network were searched in PubMed,CNKI and Wan Fang databases from January 2000 to December 2014.The nodes of depression related network and the alterations of cortex resting-state networks were summarized.Results 24 studies focusing on resting state network of depression were identified.40 studies based on ROI (region of interest) analysis,which included amygdala,frontal lobe,pregenual anterior cingulate cortex and cerebellum.The functional connectivity of ROIs were calculated and compared between groups.8 studies based on ICA (independent component analysis),the resting state networks were extracted and compared between groups.Two based on graph theory,the functional connectivity of whole brain were analyzed and compared.Conclusion There are abnormalities of functional connectivity among limbic system-thalamus-frontal cortex,and the changes of functional connectivity were associated with clinical symptom and drug efficacy of depression.

OBJECTIVE:To investigate the occurrence of ADR induced by Shuxuening injection in Beijing area,and to pro-vide reference for rational drug use in clinic. METHODS:ADR induced by Shuxuening injection in Beijing area during 2003-2013 was classified statistically in respects of population,organs/systems involved in ADR,clinical manifestations,occurrence time, drug combination and prognosis. RESULTS:Of 1648 ADR cases,the incidence of ADR in the elderly patients was higher than young patients,and that of female patients (60.92％) was higher than that of male patients (39.14％). Multiple organs/systems were involved in Shuxuening injection-induced ADR,and top 3 were nervous system (422 cases,21.33％),skin and its appen-dants (411 cases,20.78％) and others (305 cases,15.42％). Clinical manifestations were skin rash,itching,dizziness and ner-vousness,palpitation,arrhythmia,etc. ADR mostly occurred within 5-30 min after medication. In ADR reports,there were a vari-ety of drugs combined with Shuxuening injection. Shuxuening injection combined with Alprostadil injection was most common(61 cases,accounting for 23.46％ of drug combination). Among 1648 ADR cases,there were 622 cured cases and 1039 cases im-proved,4 cases were not improved,3 cases had sequelae and 1 case died. CONCLUSIONS:Clinical application of Shuxuening in-jection should strictly follow the indications of drug package inserts;differentiation of symptoms and signs is based on specific dos-age,solvent,route of administration,etc. It is necessary to strengthen the prescription check,and strengthen the observation after medication especially for the elderly and other special groups so as to reduce and avoid ADR.

Objective To discuss the effects of acupuncture therapy on resting state functional magnetic resonance imaging (fMRI) in patients with ischemic stroke; To explore the central mechanism of acupuncture therapy.Methods Ten is chemic stroke patients with hemiplegia limbs and ten matched control subjects were included. Treatment group was given anti-platelet aggregation, anticoagulation, and nutrition brain cell therapy. At the same time, acupuncture therapy was given, taking Jianyu, Quchi, Shousanli, Waiguan, Hegu, Zusanli, Fenglong, Yanglingquan, Sanyinjiao, and Taichong, with even reinforcing-reducing method, and retaining the needle 30 min, manipulating needle every 10 min, once a day, 5 times a week, needle stopping for 2 d, for continuous 30 d. The health group did not undergo any treatment. BOLD-fMRI imaging technique was used, and based on RSET1.8 software, the parameters of brain activity before and after treatment were observed by amplitude of low frequency fluctuation (ALFF) method. The Results were compared with healthy group. Results Before treatment, the ALFF value of left caudate nucleus, putamen and globus pallidus in the treatment group was lower than that in the health group, and the ALFF value of bilateral precentral and postcentral gyrus, left grus frontalis superior, gyrus frontalis medius, gyrus temporalis medius and precuneus was higher than the health group (P<0.05). After treatment, the ALFF value in left caudate nucleus, putamen and globus pallidus in the treatment group was higher than that before treatment, and the ALFF value in left gyrus frontalis superior, gyrus frontalis medius and precuneus decreased than before group (P<0.05).Conclusion In the resting state of the ischemic stroke patients with hemiplegia limbs, the principal injured brain regions are caudate nucleus, putamen and globus pallidus. Acupuncture has a regulatory role for these brain areas, presumably may be the central mechanism of efficacy.

Objective:To investigate the correlation between serum procalcitonin (PCT) level and intracranial atherosclerotic burden (ICASB) in patients with ischemic stroke.Methods:From January 2019 to December 2020, consecutive patients with acute ischemic stroke admitted to the Department of Neurology, Jiangsu Provincial Second Chinese Medicine Hospital were enrolled. Chemiluminescence immunoassay was used to detect serum PCT levels, and ICASB was evaluated based on the results of cranial magnetic resonance angiography. Univariate analysis was used to determine the baseline data among the different ICASB score groups. Then the independent correlation between serum PCT level and ICASB was determined by the ordinal logistic regression analysis. At the same time, the correlation between serum PCT level and ICASB was determined by the linear regression analysis. Results:A total of 291 patients with acute ischemic stroke were enrolled, including 161 male (55.3%), aged 64.5±8.4 years; median serum PCT level was 0.053 μg/L. According to the ICASB score, the patients were divided into 0 group ( n=155, 53.3%), 1-3 group ( n=95, 32.6%) and >3 group ( n=41, 14.1%). Univariate analysis showed that the age, serum homocysteine and PCT level, as well as the proportion of diabetes were significantly higher in the higher ICASB score group, while the proportion of the patients with atrial fibrillation was significantly lower (all P<0.05). Ordinal multivariable logistic regression analysis showed that higher serum PCT level was an independent factor for higher ICASB score (the 4 th quartile vs. the 1 st quartile: odds ratio, 2.015, 95% confidence interval 1.052-3.927; P=0.043). Multiple linear regression analysis showed that the serum PCT level was positively correlated with the ICASB score ( r=0.253, P=0.001). Conclusion:The serum PCT level is correlated with ICASB.

Background and purpose:Tumor budding is a poor prognostic factor in colorectal cancer. In this study, we studied the tumor budding by counting the actual number in 10 high power fields and evaluated itsclinical application in predicting lymph node metastasis of T1 colorectal cancer.Methods:Tissue specimens from 307 patients with histologically conifrmed T1 colorectal cancer were enrolled. The clinicopathological characteristics including tumor budding were evaluated for their predictive value in lymph node metastasis. A formula was created to calculate the risk score for prediction of lymph node metastasis which was validated by 14 new cases.Results:In the multivariate analysis, it showed that tumor grade, lymphovascular invasion and the number of tumor budding were signiifcantly associated with lymph node metastasis. The probability of lymph node metastasis was calculated using the following equations:Z=1.571×(lymphovascular state: invasion, 1; no invasion, 0)+2.661×(tumor grade: high grade, 1; low grade, 0)+0.024×(budding counts)-3.885; Probability=1/1+e-Z. The high scores were correlated with the lymph node metastasis in the validations.Conclusion:We can accurately assess the risk of lymph node metastasis by counting the number of tumor budding in 10 high power fields. Therefore tumor budding could potentially assist treatment decision making in T1 colorectal cancer patients with high-risk lymph node metastasis.

Mild encephalopathy/encephalitis with a reversible spleniat (MERS) lesion is a clinic-radiological entity.The clinical features of MERS in neonates are still not systemically reported.This paper presents five cases of MERS,and the up-to-date reviews of previously reported cases were collected and analyzed in the literature.Here we describe five cases clinically diagnosed with MERS.All of them were neonates and the average age was about 4 days.They were admitted for the common neurological symptoms such as hyperspasmia,poor reactivity and delirium.Auxiliary examinations during hospitalization also exhibited features in common.In this report,we reached following conclusions.Firstly,magnetic resonance imaging revealed solitary or comprehensive lesions in the splenium of corpus callosum,some of them extending to almost the whole corpus callosum.The lesions showed low intensity signal on Tl-weighted images,homogeneously hyperintense signal on T2-weighted images,fluid-attenuated inversion recovery and diffusion-weighted images,and exhibited an obvious reduced diffusion on apparent diffusion coefficient map.Moreover,the lesions in the magnetic resonance imaging disappeared very quickly even prior to the clinical recovery.Secondly,all the cases depicted here suffered electrolyte disturbances especially hyponatremia which could be easily corrected.Lastly,all of the cases recovered quickly over one week to one month and majority of them exhibited signs of infections and normal electroencephalography.

Objective The abnormal ankle-brachial index ( ABI) is associated with the incidence of cardiocerebral vascular diseases, but little is known about its relationship with cerebral microbleeds (CMB).This study aimed to investigate the correlation be-tween ABI≤0.9 and different distribution patterns of CMB . Methods We enrolled 187 patients with acute lacunar infarction , inclu-ding 115 non-CMB cases and 72 CMB cases (20 strictly lobar, 24 strictly deep, and 28 lobar and deep).We analyzed the differences between the two groups and the association of abnormal ABI with the occurrence and distribution of CMB by logistic regression analysis . Results ABI≤0.9 was found in 57 (30.5%) of the patients, with a significantly higher incidence rate in the CMB group than in the non-CMB group (43.1%vs 22.6%, P=0.003).The level of ABI was negatively correlated with the number of CMBs (r=-0.211, P=0.006).Multivariate logistic regression analysis after adjusted for confounders indicated that ABI ≤0.9 was significantly associated with the presence of CMB (OR=2.363;95%CI:1.181-4.729), deep CMB (OR=3.434;95%CI:1.283-9.187), and lobar and deep CMB ( OR=2.837;95%CI:1.098-7.333) in patients with ischemic cerebrovascular disease . Conclusion Decreased ABI is a risk factor of CMB, particularly deep CMB, in patients with ischemic stroke.

INTRODUCTIONProximal femoral nail antirotation (PFNA) and third-generation Gamma nail (Gamma 3) are widely used in the treatment of intertrochanteric fractures. However, it remains unclear which device achieves better clinical and radiographic outcomes when treating intertrochanteric fractures.

METHODSThis study comprised 239 patients with intertrochanteric fractures treated with either PFNA or Gamma 3 for a minimum of 12 months. During surgery, the operative time, image intensifier time and amount of blood loss were recorded. Following surgery, we assessed reduction quality and implant position. At the final follow-up, postoperative complications, including femoral shaft fracture, cutout, reoperation, pneumonia, urinary tract infection, cerebral infarction, cardiac infarction and decubital ulcer, were recorded. In addition, walking ability was assessed using the Parker-Palmer mobility score.

RESULTSNo difference was found in the operative time, image intensifier time and amount of blood loss between patients treated with PFNA and those treated with Gamma 3. The reduction quality of fractures treated with Gamma 3 was better than those treated with PFNA. However, there were no significant differences in implant position, walking ability and postoperative complications between the two groups. Although Gamma 3 resulted in better reduction quality, it did not provide any advantages in walking ability and postoperative complications when compared with PFNA.

CONCLUSIONTherefore, we conclude that both PFNA and Gamma 3 are safe and reliable devices for the treatment of intertrochanteric fractures.

Aged ; Aged, 80 and over ; Bone Nails ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Internal ; instrumentation ; Fracture Healing ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Recovery of Function ; Rotation

Objective To investigate the risk factors for reduced renal function in patients with ischemic stroke.Methods The medical records of patients with ischemic stroke were analyzed retrospectively.They were divided into normal renal function group and reduced renalfunction group.Reduced renal function was defined as estimated glomerular filtration rate (eGFR) ＜60 ml/(min·1.73 m2).Multivariate logistic regression analysis was used to identify the risk factors for reduced renal function in patients with ischemic stroke.Results A total of 805 patients with ischemic stroke were enrolled in the study.8.8％ of patients had a reduced renal function.There was no significant differences in the proportion of patients with mild and moderate neurological deficit between the reduced renal function group and the normal renal function group (all P ＞ 0.05),however,the proportion of patients with severe neurological deficit was significantly higher than that in the normal renal function group (8.4％vs.2.6％,x2 =5.573,P =0.017).The proportion of small artery occlusion in the reduced renal function group was sigaificantly higher than that in the normal renal function group (66.2％ vs.46.5％,x2 =9.962,P =0.002),and the proportion of large artery atherosclerosis was significantly lower than that in the normal renal function group (19.7％ vs.43.5％,x2 =15.045,P =0.000).Multivariate logistic regression analysis indicated that old age (odds ratio [ OR] 3.301,95％ confidence interval [ CI],1.575 to 6.918; P=0.002) was the most important independent risk factor for reduced renal function,then was female (OR,2.291,95％ CI 1.355to 3.872; P=0.002) and hyperlipidemia (OR,2.527,95％ CI 1.095 to 5.831; P=0.030).Conclusions Reduced renal function in patients with ischemic stroke is strongly associated with old age,female,and hyperlipidemia.

OBJECTIVETo explore the clinical significance of cytokeratin 19 fragments test in the diagnosis of nasopharyngeal carcinoma.

METHODSThe study included 102 cases of nasopharyngeal carcinoma, 90 cases of nasal polyp/nasopharyngitis, and 150 healthy individuals. RT-PCR was used to detect CK19 mRNA expression and Western blot to detect CK19 fragment protein expression in tissues of nasopharyngeal carcinoma. Expression of CK19-2G2 was examined by immunohistochemistry. Chemiluminescence analysis was used to detect the serum levels of CK19-2G2, and ELISA to detect that of EB-VCA IgA.

RESULTSAmong 102 cases of nasophryngeal carcinoma, 64 showed CK19 mRNA expression by RT-PCR, 60 showed CK19 protein fragments in tumor tissues by Western blot, and 66 showed expression of CK19-2G2 by immunohistochemistry in nasopharyngeal carcinoma, including strong positivity in 20 cases, moderate in 34 cases and weak in 12 cases. The sensitivity and specificity of CK19-2G2 in the diagnosis of nasopharyngeal carcinoma were 49.0% and 89.2%, and those of EB-VCA IgA were 52.9% and 85.4%, respectively. The combined detection of CK19-2G2 and EB-VCA IgA increased the sensitivity to 73.5% while the specificity remained at 80.0%.

CONCLUSIONSHigh levels of CK19-2G2 fragment expressed in tissue and serum are present in patients with nasopharyngeal carcinoma. The serum level of CK19-2G2 is helpful in the diagnosis of nasopharyngeal carcinoma. Furthermore, the combination of serum CK19-2G2 and EB-VCA IgA improves the detection sensitivity.

Adult ; Aged ; Antigens, Viral ; blood ; Blotting, Western ; Capsid Proteins ; blood ; Carcinoma, Squamous Cell ; diagnosis ; metabolism ; pathology ; Herpesvirus 4, Human ; immunology ; Humans ; Immunoglobulin A ; blood ; Immunohistochemistry ; Keratin-19 ; blood ; metabolism ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; metabolism ; pathology ; Neoplasm Staging ; Peptide Fragments ; blood ; metabolism ; RNA, Messenger ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity