Objective: To investigate the effects of carotid arteriosclerosis on cognitive functions and current prognosis in patients with cerebral infarction. Methods: Extracranial carotid arteries were assessed using dopple ultrasongraphy in 112 patients with cerebral infarction. Cognitive functions were evaluated with the Mini-Mental state Examination (MMSE) and five neuropsychological tests assessing memory, attention, calculation psychomotor rapidity and visuospatial perception. Deficits in neurological functions were assessed on admission and 3 to 4 weeks. Results:All neuropsychological measures were found to be poorer in patients with carotid arteriosclerosis than those with no carotid arteriosclerosis, especially in cases with severe carotid arteriosclerosis and severe carotid stenosis. There was a positive relationship between severity of carotid arteriosclerosis and change in cognitive functions. The scores of SSS were higher on admission in cerebral infarction patients with carotid arteriosclerosis. Recent prognosis was also poorer in patients with carotid arteriosclerosis.Conclusions: Significant effect of carotid arteriosclerosis was shown on cognitive functions of patients with cerebral infarction. As cerebral ischemic injury is severe, prognosis in cerebral infarction patients with carotid arteriosclerosis is poor.

Objective To study the clinical significance of carotid atherosclerosis and the relationship between carotid atherosclerosis and cerebral infarction recurrence.Methods Carotid atherosclerosis was assessed using doppler ultrasongraphy in 312 patients with cerebral infarction, the duration of following up was 12 to 18 months,and the characteristics of carotid atherosclersis was compared to patients with or without recurrence cerebral infarction.Results Of the 312 patients with cerebral infarction, 61 patients suffered from new cerebral infarction during following up period, the recurrence rate in patients with atherothrombotic brain infarction was higher than those with lacunar infarction, and the cerebral infarction recurrence usually occurred in the same side of initial stroke of the 57 patients with severe carotid atherosclerosis, 26 patients had a sufference of new infarction, of the 48 patients with high grade stenosis, 25 had a sufference of new cerebral infarction, of the 42 patients with ulcerated plaque, 23 had sufference of new cerebral infarction,showing a recurrence rate significantly higher than those patients with non carotid atherosclerosis or those with mild carotid atherosclerosis. The logistic regression analysis showed that the levels of carotid atheroslerosis , stenosis and ulcerated plaque were positively related to the cerebral infarction recurrence.Conclusions There is a positively relationship between carotid atherosclerosis and cerebral infarction recuurrence, and the level of carotid atherosclerosis is a risk factor of cerebral infarction recurrence.It serves as a risk marker of cerebral infarction recurrence.

Objective To investigate the relationships between the parameters of intravoxel incoherent motion (IVIM)DWI at 3.0 Tesla and T staging of moderately differentiated adenocarcinoma of rectum.Methods Clinical data and MRI findings including con-ventional imaging and IVIM-DWI were collected in a total of 37 patients with moderately differentiated adenocarcinoma of rectum proven by pathology.The patients were divided into two groups without (staging T1 and T2)or with myometrial invasion (T3 and T4).The D,D? ,f and ADC values of rectal cancer and normal rectal wall were measured and were compared between the lesion and normal rectal wall,between both groups and among different T stages.The relationships of the parameters of IVIM-DWI and ADC values with the T staging of moderately differentiated adenocarcinoma of rectum were analyzed.Results The D,D? ,f and ADC val-ues of rectal cancer were lower than those of normal rectal wall with statistical differences in D,f and ADC values (P <0.05).The differences in D and D? values among different T stages were statistically significant,and LSD Duncan test showed that the differ-ence in D? value between T1 and T4 (P =0.01 7)and between T3 and T4 (P =0.003)and in D value between T2 and T3 (P =0.005) were statistically significant.The D,f,D? and ADC values of noninvasion group and invasion one were (0.93±0.1 6)×10 -3 mm2/s versus (0.77±0.1 9)×10 -3 mm2/s,(27.1±2.94)% versus (24.6 ±4.13)%,(12.6±2.44)×10 -3 mm2/s versus (12.3±3.49)× 10 -3 mm2/s,and (0.95±0.09)×10 -3 mm2/s versus (0.87 ±0.12)×10 -3 mm2/s respectively,and the difference in D value was statistically significant (t=2.5 12,P =0.01 7).Conclusion The parameters of IVIM-DWI and the ADC values are different in rectal cancer and normal rectal wall,and the D value may help to identify the tumor invasion into the muscularis propria.

Objective To investigate the effects of lipopolysaccharide(LPS) on myelin phagocytosis during Wallerian degeneration after early peripheral nerve injury in rats.Methods Fifty male Wistar rats were recruited and randomly divided into LPS group(n=20),model group(n=20) and sham group(n=10).The right sciatic nerves of rats in the LPS and model groups were cut and sutured end-to-end,while the sciatic nerve of sham group rats were only exposed.Immediately after surgery,the rats in LPS group were given microinjections of LPS(2 g/L) into the surgical site in a final volume of 1 μL,and the rats in other two groups were injected with the same volume of saline.The sciatic nerves were taken at 1.5 h,24 h and 7d after surgery.Real-time quantitative PCR(qRT-PCR) was applied to detect the dynamic expressions of IL-1β mRNA and MCP-1 mRNA.Immunofluorescence staining was used to test the expression of CD68+ macrophages in sciatic nerves.HE staining was used to observe the pathological alterations of sciatic nerves tissue.ORO staining was used to observe sciatic nerves demyelination.LFB staining was used to detect the sciatic nerves myelin.Sciatic function index was used to evaluate the recovery of motor function in rats.Results Compared with the model group,qRT-PCR indicated that the expression of IL-1β and MCP-1 from LPS group were increased at 1.5 h and 24 h after surgery(P<0.001, P<0.001),respectively.Compared with the model group,the expression of CD68+ cells was increased significantly at 7th day after surgery(P<0.05).Histological examination showed that compared with the model group,a lot of inflammatory cells and Schwann cells were found at sciatic nerve stump in the LPS group at 7th day after operation.ORO staining showed that the degree of demyelination in the LPS group was higher than that in the model group.LFB staining showed that the sciatic nerve stump demyelination appeared in both model group and the LPS group at 7th day after operation,but compared with the model group,myelin debris clearance in the LPS group was significantly accelerated(P<0.05).Finally,compared with the model group,the SFI in the LPS group was increased significantly at 20 d after surgery(P<0.05).Conclusions The results confirm that LPS is possible to manipulate the innate immune response to accelerate myelin clearance during Wallerian degeneration after early peripheral nerve injury in rats.

Dongting Lake area is one of the major marshland schistosomiasis endemic areas in China. In recent years spatial epidemiology is widely used in the research of schistosomiasis which is a new opportunity to break through the current wander-ing situation of schistosomiasis control. In this article both the generalized and Dongting-Lake-specific epidemic indicators of schistosomiasis are reviewed to provide the basis to construct the schistosomiasis Geographic Information System GIS database of Hunan Province.

BACKGROUND:The mechanism underlying Wal erian degeneration fol owing peripheral nerve injury is complex. Immune regulation on Wal erian degeneration is beneficial for early repair of perpheral nerve injury.
OBJECTIVE:To investigate the effects of Tol-like receptor 4 (TLR4) antagonist on Wal erian degeneration and axonal regeneration after early peripheral nerve injury in rats.
METHODS:Fifty male Wistar rats were recruited and randomly divided into treatment group (n=20), model group (n=20) and sham group (n=10). The right sciatic nerves of rats in treatment and model groups were cut and sutured end-to-end, while the sciatic nerves of rats in sham group were only exposed. In the treatment group rats were intravenously injected with 0.15 mg/kg TAK-242 via tail vein 1 hour preoperatively and 7 days postoperatively, and the rats in the other two groups were given intravenous injection of the same volume of normal saline. The sciatic nerves were removed at 24 hours, 3, 4 and 7 days after surgery.
RESULTS AND CONCLUSION:Real-time PCR indicated that the mRNA expressions of interleukin-1βand monocyte chemoattractant-1 were significantly increased in the model group compared with the sham group at 24 hours after surgery (both P<0.001), while the expressions were significantly decreased after TAK-242 injection (both P<0.001). Immunofluorescence showed that compared with the model group, down-regulated expression of CD68+and iba1+cel s appeared in the treatment group at 3 days after surgery (P<0.01, P<0.05). Luxol fast blue staining revealed that demyelination at the sciatic nerve stump appeared in both model and treatment groups at postoperative 7 days, but myelin debris clearance in the treatment group was significantly reduced compared with the model group (P<0.05). Hematoxylin-eosin staining showed that a lot of inflammatory cel s, Schwann cells and regenerated nerve fibers at the sciatic nerve stump were found in the model group, while there were few inflammatory cells, Schwann cel s and regenerated nerve fibers in the treatment group at 7 days after surgery. Immunohistochemistry found that the expression of growth-associated protein-43 in the treatment group was significantly lower than that in the model group at 4 days postoperatively (P<0.05). Besides, compared with the model group, a significantly decreased sciatic functional index was found in the treatment group at 20, 30 and 40 days after surgery (P<0.05). These results show that TLR4 antagonists delay early nerve regeneration in rats after sciatic nerve injury probably by inhibiting the TLR4 signaling pathway.

OBJECTIVETo observe the difference of clinical effects of acupoints selected based on meridian differen-tiation and conventional method for cervical spondylosis radiculopathy(CSR) treated with acupuncture and moxibustion.

METHODSSixty patients with CSR were randomly divided into an observation group and a control group,30 cases in each one.points of the injured meridians in the neck,namely six-points,were selected in the observation group,matched with-connecting points of the injured meridians on the same side and the interiorly-exteriorly correlated meridians on the opposite side. Conventional acupuncture was used on Fengchi(GB 20),Jiaji(EX-B 2) of the neck,Tianzhu(BL 10),Jianjing(GB 21),Houxi(SI 3),Hegu(LI 4) and Waiguan(TE 5) on the affected side in the control group. Treatment was given once every other day,three times a week and total 12 times in the two groups. Twenty subscales for CSR and visual analogue scale(VAS) were observed before and after treatment,and total effects were evaluated after treatment.

RESULTSThe effective rate of the observation group was 93.3%(28/30),which was better than 66.7%(20/30) of the control group(<0.05). The scores of 20 subscales and VAS after treatment were all improved compared with those before treatment in the two groups(all<0.01),with more apparent change in the observation group(both<0.05).

CONCLUSIONSThe effect of acupuncture and moxibustion based on meridian differentiation is obvious,and superior to that of conventional acupoints selection.

Objective: To establish a CT image radiomics-based prediction model for the differential diagnosis of silicosis and tuberculosis nodules. Methods: A total of 53 patients with silicosis and 89 patients with tuberculosis who underwent routine CT scans in Suzhou Fifth People's Hospital from January to August, 2018 were enrolled in this study. AK/ITK software was used to segment the images to obtain 139 silicosis lesions and 119 tuberculosis lesions. For each lesion image, 396 features were extracted, and feature dimension reduction was applied to select the most characteristic feature subset. Support vector machine (SVM) , feedforward back propagation neural network (FNN-BP) , and random forest (RF) were implemented using R software (Rstudio V1.1.463) , and the algorithm that achieved the largest area under of the receiver operating characteristic (ROC) curve (AUC) was selected as the final prediction model. Results: RF was the best prediction model for the differential diagnosis of silicosis and tuberculosis nodules, with an accuracy of 83.1%, a sensitivity of 0.76, a specificity of 0.9, and an AUC of 0.917 (95% confidence interval: 0.8431-0.9758) . RF had a significantly larger AUC than SVM and FNN-BP (P<0.05) . Conclusion CT image-based RF prediction model can be used to differentially diagnose silicosis and tuberculosis nodules.