Objective To investigate the application values of thymosin α1 in severe sepsis.Methods Selected 94 patients with severe sepsis in our hospital from September 2014 to October 2016,were randomly divided into observation group(n=45)and control group(n=49),the control group was given routine treatment,the observation group was given thymosin α1 on the basis of conventional treatment,observed two groups before and after treatment T cell subsets and CD14+monocyte human leukocyte antigen(HLA-DR)and so on.Results The observation group the duration of ventilator use and ICU treatment were(12.51±3.82)d and(15.81±3.18)d,significantly shorter than the control group(P< 0.05).There was no significant difference in 28d mortality between the observation group and the control group; After treatment,the CD14+monocytes HLA-DR,CD3+and CD4+T cells in the observation group were significantly improved than before treatment(P<0.05);The HLA-DR,CD3+and CD4+T cells in the observation group after treatment were(36.04± 8.90)％,(58.93±8.74)％and(43.20±9.90)％,significantly higher than those in the control group(P<0.05);The observation group after treatment TNF-α,endotoxin and CRP respectively(56.40±11.78)ng/L,(27.83±9.98)ng/L and(53.20±9.73)g/mL,significantly lower than the control group(P< 0.05).Conclusion Application of thymosin α1 in the treatment of severe sepsis,which can improve the cellular immune function,adjust the state of inflammatory response,shorten the duration of mechanical ventilation and ICU stay.

Objective To analyze the role of dysphagia during the course of sleep apnea in patients who experienced a first-ever ischemic stroke.Methods According to the video-fluoroscopy,50 patients were divided into two groups:dysphagia and non-dysphagia groups.The effect of different sites and severity of infarction on the breathing disturbance was analyzed,and the possible role of dysphagia was discussed.Results Patients with dysphagia showed more number of OAIs at the acute phase(AHI,20.9;OAI,19.1)than that of non-dysphagic patients(AHI,9.5;OAI,8.6).Multiple correlation analysis found the extent of dysphagia had relationship with the AHI,especially OAI(AHI,P=0.018;OAI,P=0.024).Conclusion The number and type of obstructive apneic events may occur at the acute phase of a first-ever cerebral infarction in patients with pharyngeal muscle alterations secondary to the neurological lesion.

Objective To explore abnormalities in functional connectivity of the affective network (AN) in relapse of major depressive disorder (MDD) after antidepressant treatment combined with resting state functional connectivity analysis.Methods Eleven recurrent MDD subjects after treatment,seventeen non recurrent MDD subjects after treatment and seventy-two healthy controls underwent fMRI scan.The amygdala,the pallidum,the insular cortex and the anterior cingulate cortex of the AN were selected as the template.Group independent component analysis (ICA) was performed to decompose the fMRI images into spatially independent components and the independent component which fit this template best was selected as AN.Two-sample t-tests were performed to investigate the changes in functional connectivity of the AN.Finally,the right amygdala and the medial prefrontal cortex were defined as seed regions.Results Compared with healthy control subjects and non-recurrent MDD group,recurrent MDD group showed significantly increased functional connectivity in the right amygdala in AN(P＜0.001).Meanwhile,the functional connectivity between the right amygdala and the medial prefrontal cortex was significantly decreased in recurrent MDD group(P ＜0.05).Conclusion Abnormal resting-state functional connectivity of the right amygdala after antidepressant treatment in MDD was found,suggesting that altered amygdala functional connectivity may serve as a predicator of relapse of the MDD.

Subcortical vascular mild cognitive impairment (svMCI) is a common prodromal stage of vascular dementia. Although mounting evidence has suggested abnormalities in several single brain network metrics, few studies have explored the consistency between functional and structural connectivity networks in svMCI. Here, we constructed such networks using resting-state fMRI for functional connectivity and diffusion tensor imaging for structural connectivity in 30 patients with svMCI and 30 normal controls. The functional networks were then parcellated into topological modules, corresponding to several well-defined functional domains. The coupling between the functional and structural networks was finally estimated and compared at the multiscale network level (whole brain and modular level). We found no significant intergroup differences in the functional–structural coupling within the whole brain; however, there was significantly increased functional–structural coupling within the dorsal attention module and decreased functional–structural coupling within the ventral attention module in the svMCI group. In addition, the svMCI patients demonstrated decreased intramodular connectivity strength in the visual, somatomotor, and dorsal attention modules as well as decreased intermodular connectivity strength between several modules in the functional network, mainly linking the visual, somatomotor, dorsal attention, ventral attention, and frontoparietal control modules. There was no significant correlation between the altered module-level functional–structural coupling and cognitive performance in patients with svMCI. These findings demonstrate for the first time that svMCI is reflected in a selective aberrant topological organization in multiscale brain networks and may improve our understanding of the pathophysiological mechanisms underlying svMCI.