Objective To investigate the correlation between serum S100B, IL-6 and intracranial pressure in patients with severe craniocerebral injury.Methods 81 cases of patients with severe brain injury in our hospital from August 2012 to April 2016 were selected,intracranial pressure was monitored immediately after admission to calculate the average daily ICP level ,and venous blood were collected after craniocerebral injury 6,12,24,48, 72 hours.Detection of serum S100B protein and IL-6 levels,and the correlation analysis with the level of intracranial pressure.Results Patients with severe craniocerebral injury S100B levels increased gradually after injury, reached the peak at 24 hours, then decreased gradually; while patients with IL-6 and intracranial pressure after injury gradually increased, the difference was statistically significant in different time points among the S100B,IL-6 and intracranial pressure levels (P<0.05).Conclusion The changes of intracranial pressure after severe craniocerebral injury were proportional to the levels of serum S100B and IL-6,S100B and IL-6 can reflect the changes of intracranial pressure,intracranial pressure changes predicted by S100B plasma concentration in 48 hours were more sensitive than those in the same concentration of IL-6.

Objective To analyze the effect of long-term wearing of hard corneal contact lens and its effect on the stability of tear film.Methods From April 2016 to April 2017,150 patients of myopia in Yongkang Hospital were selected in this study and randomly divided into study group and control group,with 75 cases in each group.The patients in the study group wore hard corneal contact lens for a long time before operation,the patients in the control group had no hard corneal contact lens before operation.The basal tear secretion amount,tear film break-up time(TBUT) and the incidence of postoperative complications were compared between the two groups.Results One year after operation,the basal tear secretion amount of the study group [(11.1 ± 1.5) mL] was significantly lower than that of control group[(18.5 ± 3.2) mL] (t =12.235,P ＜ 0.05).The TBUT of the study group [(15.8 ± 1.5) min] was significantly shorter than that of the control group [(25.1 ± 4.8) min] (t =11.935,P ＜ 0.05).The incidence rates of dry eye,corneal staining in the study group were 22.7％,18.7％,respectively,which were significantly lower thanthose in the control group (33.3％,34.7％),there were statistically significant differences between the two groups (x2 =5.931,6.425,all P ＜ 0.05).Conclusion Long-term wearing hard contact lens seriously affects the tear secretion and TBUT,and reduces the stability of tear film.Although the incidence of postoperative complications islow,tear film damage can not be avoided.In order to protect the stability of the tear film,the patients with myopia should try to avoid the wear of the hard corneal contact lens and choose to wear frame glasses.

Objective To investigate the effects of rTMS stimulation in different brain regions combined with paroxetine on treating patients with obsessive -compulsive disorders. Methods Outpatients and inpatients with obsessive-compulsive disorder(OCD) treated at Kangning Hospital of Ningbo province from March 2015 to December 2016 were collected. Patients were randomly divided into control group(29 cases), treatment group 1(30 cases) and treatment group 2(30 cases). Patients in control group were treated with paroxetine only. Patients in treatment group 1 received rTMS stimulation of right prefrontal lobe combined with paroxetine systemic treatment. Patients in treatment group 2 received rTMS stimulation of bilateral supplementary motor area with paroxetine treatment. Obsessive -compulsive idea and behavior were assessed using Y-BOCS before treatment and 1, 2, 4, 6, 8 weeks after treatment. Adverse reaction was assessed after treatment with TESS. Results The Y-BOCS score of the control group decreased significantly at the 6th and the 8th week of treatment compared with before (P＜0. 05). The Y-BOCS score of the treatment group 1 and group 2 were significantly lower at 4, 6 and 8 weeks of treatment than that of the control group (P＜0. 05). The Y-BOCS scores of treatment group 1 and group 2 were significantly lower after 4 weeks of treatment than those before treatment (P＜0. 05). Conclusion rTMS stimulation of the right prefrontal lobe and bilateral supplementary motor area combined with paroxetine in the treatment of obsessive -compulsive disorder has consistent efficacy and take effect rapidly with minor adverse reactions.

Objective To confirm whether or not let-7b and miR-199a were significantly associated with malignant melanoma growth and proliferation. Methods An over -expression plasmid and an inhibitor, which targeted on let-7b and miR-199a, was constructed. B16F10 cells were divided into seven groups: control group, let-7b plasmid group, miR-199a plasmid group, empty plasmid group, let-7b inhibitor group, miR-199a inhibitor group, inhibitor control group. Foreign gene was transfected into B16F10 cells, let-7b and miR-199a expression were validated from RNA level, protein level and cell level. Results The relative let-7b or miR-199a gene expression of the let-7b plasmid group (3.8776±0.1372)and miR-199a plasmid group (2.8660±0.2821)were significantly higher than control group (P＜0.05), the relative let-7b or miR-199a gene expression of the let-7b inhibitor group (0.2057±0.0263) and miR-199a inhibitor group(0.2656±0.0253) were significantly lower than control group(P＜0.05). The cyclinD1 expression of the let-7b plasmid group(2.023±0.315) and let-7b inhibitor group (1.857±0.377) were significantly higher than control group (0.997±0.041) (P＜0.05), whereas, the Met expression of themiR-199a plasmid group (5.19±0.309) and miR-199a inhibitor group (4.87±0.044) were significantly higher than control group (2.2±0.198) (P＜0.05). The let-7b plasmid group and miR-199a plasmid group B16F10 cell growth rate were slower than control group, especially on the third day after transfection, the growth rate gradually dropped to the lowest value (P＜0.05). In addition, the apoptosis rates of the let-7b plasmid group and miR-199a plasmid group reach to (11.8±1.19)% and (11.3±1.59)%,which were significantly higher than control group (P＜0.05). Conclusions let-7b and miR-199a may be a negative regulator on the B16F10 cell growth and proliferation.

Objective To study the influence of let-7b on cell proliferation and aerobic glycolysis of human melanoma cell A375.Methods Transfect A375 cell line with hsa-let-7b oligonucleotide or antisense.Glucose and lactate in medium were determined by spectrophotometry at 24 h and 48 h time point after transfection.The cell proliferation was determined by methylthiazol tetrazolium (MTT) assay.Results Over expression of let-7b in melanoma cell reduced cell proliferation notably,compared to the other groups by MTT(P ＜0.05).However,the glucose consumption and lactate production differences were not observed during 24 h or 48 h ( P ＞ 0.05 ),the blank control group transformed about 57％ and 43％ glucose to lactate during 24 h and 48 h.Conclusions Melanoma cell line A375 has notably aerobic glycolysis hallmark,let-7b could inhibit proliferation of melanoma cell line A375,but it may has no influence on glucose metabolism.

Objective To analyze the correlation between the concentration of serum and cerebrospinal fluid clusterin(CLU)and the severity of acute traumatic brain injury(TBI).Methods A total of 102 patients with acute moderate and severe TBI admitted to the Second Hospital of Jiaxing from September 2019 to October 2020 were included in the study,and were divided into two batches in chronological order.The first batch of 20 cases were tested for serum CLU content and its time expression map for 4 consecutive days after injury by Western blot;The second batch of 82 cases were divided into groups according to Glasgow coma score(GCS),Rotterdam-CT score and brain contusion and laceration volume,the CLU concentration in serum and cerebrospinal fluid was detected by enzyme linked immunosorbent assay(ELISA)at peak time according to the serum CLU time expression map,and the differences of CLU concentrations between the groups were compared;The correlation between CLU concentration and patients'general data,GCS score,Rotterdam CT score and brain contusion and laceration volume was analyzed by Spearman correlation coefficient;The factors affecting CLU concentration were analyzed by multiple linear regression.Results The serum CLU concentration gradually increases in patients after TBI,and reached the peak at 3 days after injury;There was no statistical difference in serum CLU concentration in two GCS groups,three Rotterdam-CT score groups and two brain contusion and laceration volume groups(P>0.05),but there was a statistical difference in cerebrospinal fluid CLU concentration(P<0.05);Cerebrospinal fluid CLU concentration was negatively correlated with GCS score(r=-0.542,P<0.05),and positively correlated with Rotterdam-CT score and brain contusion and laceration volume(r=0.414,0.738,P<0.05);There was statistical difference in the influence of brain contusion and laceration volume on cerebrospinal fluid CLU concentration(β=8.074,P<0.001).Conclusion The concentration of CLU in cerebrospinal fluid can reflect the severity of TBI,which is mainly related to the volume of brain contusion and laceration.

Objective To explore the effect of hypertonic saline combined with magnesium sulfate on severe craniocerebral injury.Methods Patients with severe craniocerebral injury admitted to our hospital from September 2017 to February 2019 were selected prospectively.With the informed consent of the patients' families,the patients were divided into control group and experimental group according to the random number table.Patients in the two groups accepted intracranial pressure monitoring;patients in the experimental group additionally accepted magnesium sulfate combined with hypertonic saline for a continuous use of 7 d.Incidences of high intracranial pressure,epilepsy,low intracranial perfusion,cerebral vasospasm,cerebral infarction,and intracranial pressure rebound,total mannitol dosages one week after injury,serum neuron specific enolase (NSE) level,and Glasgow outcome scale (GOS) scores and mortality rate 3 months after injury were analyzed and compared between the two groups.Results A total of 93 patients were enrolled;47 were into the control group and 46 into the experimental group.There were no significant differences in age,gender,Glasgow coma scale (GCS) scores and NSE levels at admission,and percentages of patients accepted craniotomy evacuation of hematoma or bone flap decompression between the two groups (P＞0.05).As compared with those in the control group,the total mannitol dosage one week after injury and serum NSE concentration were significantly lower,and GOS scores 3 months after injury in the experimental group were significantly higher(P＜0.05).Patients in the experimental group had significantly lower incidences of high intracranial pressure,cerebral vasospasm and intracranial pressure rebound as compared with patients in the control group (P＜0.05).Conclusion Hypertonic saline combined with magnesium sulfate can improve the prognoses of severe craniocerebral injury;it has few side effects and is cheap;it might be an effective cerebral protective agent.

Objective:Glioblastoma(GBM)and brain metastases(BMs)are the two most common malignant brain tumors in adults.Magnetic resonance imaging(MRI)is a commonly used method for screening and evaluating the prognosis of brain tumors,but the specificity and sensitivity of conventional MRI sequences in differential diagnosis of GBM and BMs are limited.In recent years,deep neural network has shown great potential in the realization of diagnostic classification and the establishment of clinical decision support system.This study aims to apply the radiomics features extracted by deep learning techniques to explore the feasibility of accurate preoperative classification for newly diagnosed GBM and solitary brain metastases(SBMs),and to further explore the impact of multimodality data fusion on classification tasks. Methods:Standard protocol cranial MRI sequence data from 135 newly diagnosed GBM patients and 73 patients with SBMs confirmed by histopathologic or clinical diagnosis were retrospectively analyzed.First,structural T1-weight,T1C-weight,and T2-weight were selected as 3 inputs to the entire model,regions of interest(ROIs)were manually delineated on the registered three modal MR images,and multimodality radiomics features were obtained,dimensions were reduced using a random forest(RF)-based feature selection method,and the importance of each feature was further analyzed.Secondly,we used the method of contrast disentangled to find the shared features and complementary features between different modal features.Finally,the response of each sample to GBM and SBMs was predicted by fusing 2 features from different modalities. Results:The radiomics features using machine learning and the multi-modal fusion method had a good discriminatory ability for GBM and SBMs.Furthermore,compared with single-modal data,the multimodal fusion models using machine learning algorithms such as support vector machine(SVM),Logistic regression,RF,adaptive boosting(AdaBoost),and gradient boosting decision tree(GBDT)achieved significant improvements,with area under the curve(AUC)values of 0.974,0.978,0.943,0.938,and 0.947,respectively;our comparative disentangled multi-modal MR fusion method performs well,and the results of AUC,accuracy(ACC),sensitivity(SEN)and specificity(SPE)in the test set were 0.985,0.984,0.900,and 0.990,respectively.Compared with other multi-modal fusion methods,AUC,ACC,and SEN in this study all achieved the best performance.In the ablation experiment to verify the effects of each module component in this study,AUC,ACC,and SEN increased by 1.6%,10.9%and 15.0%,respectively after 3 loss functions were used simultaneously. Conclusion:A deep learning-based contrast disentangled multi-modal MR radiomics feature fusion technique helps to improve GBM and SBMs classification accuracy.