Objective To compare the clinical efficacy of intralesional betamethasone versus triamcinolone acetonide acetate in the treatment of active alopecia areata. Methods A total of 160 patients with active alopecia areata were divided into two groups, test group (n = 100) treated with intralesional betamethasone, and control group (n = 60) treated with intralesional triamcinolone acetonide. Both injections were given once every 3 weeks for 12 consecutive weeks. Results After 12-week treatment, the cure rate, response rate, and total response rate were 60.0%, 32.0% and 92.0% in the test group, respectively, compared to 41.7%, 31.67% and 73.3% in the control group, respectively. A significant increase was observed in the cure rate and response rate in the test group compared with the control group (χ2 = 10.25, 5.06, P < 0.01 and 0.05). During the treatment course, 8 (8%) patients in the test group and 9 (15%) patients in the control group developed localized atrophy of the scalp; 8 (8%) patients in the test group and 3 (5%) patients in the control group developed localized folliculitis; no significant difference was observed between the two groups in the occurrence of adverse reactions (P> 0.05). Conclusion Intralesional use of compound betamethasone injection has a notable therapeutic effect on alopecia areata.

Objective To investigate the predictive value of neutrophil and lymphocyte ratios (NLR)for the prognosis in patients with acute cerebral infarction. Methods From January 2014 to December 2015,307 consecutive patients with acute cerebral infarction admitted to the Department of Neurology,the Fifth Affiliated Hospital of Zhengzhou University were enrolled retrospectively,including 80 females and 227 males. They were divided into ether a good prognosis group (n = 195)or a poor prognosis group (n = 112)according to the scoring criteria of the modified Rankin scale (mRS). The age,gender, past medical history,National Institutes of Health stroke scale (NIHSS)score were documented on admission. The NLR values were calculated according to the neutrophil and lymphocyte counts on admission. Logistic regression analysis was used to analyze the influencing factors of poor prognosis of acute cerebral infarction. The receiver operating characteristic curve (ROC)was used to evaluate the predictive effect of the NLR level on patients with acute cerebral infarction on admission. Results (1)Compared with the good prognosis group,the age,incidence of recurrent cerebral infarction,NIHSS score on admission, NLR levels on admission in the poor prognosis group were higher. There were significant differences between groups (69 ± 12 years vs. 62 ± 14 years,25. 0% [28 / 112]vs. 14. 4% [28 / 195],5. 00 [3. 00, 9. 00]vs. 3. 00 [1. 75,5. 00],and 3. 66 [2. 62,7. 91]vs. 2. 47 [1. 94,3. 40];all P < 0. 05). There were no significant differences in other baseline data and clinical characteristics between the groups (all P >0. 05). (2)Multivariate logistic regression analysis showed that the increase of the age,NLR level on admission,and increased NIHSS score on admission,were independent risk factor for poor prognosis (OR 1. 030,1. 148,and 1. 427,respectively,95% CI were 1. 007 -1. 053,1. 059 -1. 246,and 1. 247 -1. 634, respectively;all P < 0. 05). (3)The diagnostic cut-off value of the NLR level on admission for the poor prognosis in patients with acute cerebral infarction was 2. 84. Its sensitivity was 69. 6% and specificity was 64. 6% . Conclusion The increase of the NLR level on admission had certain reference function on the poor prognosis in patients with acute ischemic stroke.

Objective To establish a GC method for simultaneous determine of camphor, borneol and bornyl acetate in Shenling Baizhu Powder. Methods Capillary column was used with 100% methyl polysiloxane as stationary phase. The temperature-programmed was as follows:starting temperature of 60 ℃, 5 ℃/min, rose to 130 ℃, kept for 5 minutes, followed by 20 ℃/min up to 230 ℃, and kept for 5 minutes. Results The average recovery rate of camphor was 99.87%, RSD was 1.3%, and good linear relationship was showed in the range of 0.003 77-0.150 8 μg (r=0.999 9). The average recovery of borneol was 100.71%, RSD was 2.1%, and good linear relationship was showed in the range of 0.002 411-0.096 4 μg (r=0.999 9). The average recovery rate of bornyl acetate was 101.95%, RSD was 1.3%, and good linear relationship was showed in the range of 0.003 02-0.121 1 μg (r=0.999 9). Conclusion The method is simple, reliable, accurate, and can effectively control the quality of Amomi Fructus in Shenling Baizhu Powder.

Objective To observe non-displaceable binding potential (BPND) changes of striatal dopamine D2 receptors(SDDR) in patients with first-episode major depressive disorder (MDD) using 11C-Raclopride PET/CT,and to analyze the relationship between BPND and Hamilton rating scale for depression (HAM-D).Methods From December 2014 to December 2015,patients with first-episode MDD and age/gender-matched healthy controls underwent brain MRI and 11C-Raclopride PET/CT in this prospective study.BPND of bilateral SDDR was calculated by molecular imaging and kinetic analysis toolbox (MIAKAT).BPND changes of bilateral SDDR and their relationship with HAM-D score were analyzed.Paired t test,two-sample t test and Pearson correlation analysis were used.Results A total of 20 MDD patients (8 males,12 females,average age: (32.80±9.76) years) and 20 healthy controls (9 males,11 females,average age:(29.25±6.93) years) were enrolled in this study.The 11C-Raclopride uptake in brain tissue of the MDD group and control group were mainly distributed in bilateral striatum,and very few 11C-Raclopride was distributed in bilateral cerebral cortex and cerebellum.In MDD group,the BPND level of bilateral SDDR had no statistical differences(t values: 0.69,0.35,both P>0.05),and similar results were found in the control group(t values: 0.28,0.24,both P>0.05).Compared with the control group,however,the MDD group had lower BPND level of bilateral SDDR(t values: 3.13-4.41,all P<0.05).The BPND of bilateral caudate nucleus and/or putamen D2 receptors was correlated with HAM-D total score,anxiety/somatization factor score,cognitive impairment factor score,retardation factor score and sleep disturbance factor score(r values: from-0.688 to-0.453,all P<0.05).Conclusions The binding potential of SDDR in patients with first-episode MDD is declined,and the BPND level of SDDR is correlated with symptoms of depression.The abnormality of SDDR may be an important molecular mechanism of the abnormality of midbrain-striatal dopamine reward circuits in MDD patients.

Objective: To understand the research status of occupational asthma and provide information for related research on occupational asthma in the future. Methods: Papers on occupational asthma published from January 1998 to December 2017 had been retrieved in Web of Science core collection database on 9 October 2018. The data retrieval strategies were set as follows: #1 TS=(occupational AND asthma), #2 TS=(occupational AND asthmas), #3 TS=(occupational asthma OR occupational asthmas), #1 OR #2 OR #3. Three thousand two hundred and twelve publications were analyzed by bibliometric and visualizer. Results: Yearly output of articles in this field had been at a stable high level and annual total citations had been increasing. A significant positive correlation was found between the year and annual total citations (r=0.97, P<0.05). The most productive countries were European countries except the United States and Canada. Our country had few literatures accounting for 1.21 percent of the total and the research on occupational asthma in our country started relatively late which were published mainly from 2013 to 2017. The most studied category and journal were public environmental occupational health and Am J Ind Med respectively. "occupational exposure", "allergy" and "rhinitis" were key words with high frequency. Conclusion Yearly output of publications of occupational asthma has been at a stable high level. Our country should do more research to provide a scientific basis for further prevention and management of occupational asthma.

Objective To explore the correlation between changes of striatal dopamine D2receptors non-displaceable binding potential (BPND) in 11C-Raclopride PET-CT and brain regional homogeneity (ReHo) derived from resting state functional MRI (fMRI) in patients with first-episode major depressive disorder (MDD) . Methods Patients with first-episode MDD and age and sex matched healthy volunteers accepted brain 11C-Raclopride PET-CT and resting state fMRI. MIAKAT based on MATLAB and Rest 1.8 were used to calculate BPNDof brain dopamine D2receptors and brain ReHo, respectively. Changes of striatal dopamine D2receptors BPNDand brain ReHo values were analyzed by paired-sample t test and two independent sample t-test, and Pearson correlation analysis was used to analyze the correlation between BPNDand ReHo. Results Twenty patients with first-episode MDD were enrolled as MDD group, and 20 healthy volunteers as the control group. The two groups were all right-handed, and there were no statistical differences for age (t =1.33,P=0.19)and gender(χ2=0.10,P=0.75). Compared with the control group, the ReHo in MDD patients increased in the bilateral striatum (caudate nucleus and putamen), bilateral medial prefrontal lobes, and right thalamic (27 to 56 voxels, P＜0.05) and decreased in the left middle frontal gyrus, the left anterior cingulate, the left hippocampal and the right amygdala (21 to 35 voxels, P＜0.05). In addition, compared with the control group, BPNDof bilateral caudate nucleus and putamen dopamine D2receptors in the MDD group were decreased (t=－4.41 to －3.13, P＜0.05). Furthermore, there was a negative correlation between D2 receptors BPNDand ReHo of bilateral caudate nucleus and putamen (r=－0.81 to－0.62, P＜0.05). And there was a negative correlation between ReHo of the bilateral medial prefrontal lobes and BPNDof the same lateral caudate nucleus and putamen D2receptors in the MDD group (r=－0.86 to－0.52, P＜0.05). Besides, ReHo of the left middle frontal gyrus, right thalamic, left anterior cingulate, left hippocampal and right amygdala had no correlation with the D2receptors BPNDof the striatum in the MDD group (－0.27 to 0.39, P＞0.05). Conclusion There were abnormal levels of dopamine neurotransmitter in the cerebral striatum regions and abnormal brain activities in the brain region associated with dopamine reward circuit in the first-episode MDD patients, and there was a correlation between the two abnormalities.

Objective To investigate the correlation between the location of ruptured intracranial vertebral artery dissecting aneurysm (VADA)and the outcome after endovascular treatment. Methods Thirty-six patients with ruptured intracranial VADA undergoing endovascular treatment were enrolled retrospectively. According to the relationship between VADA and the location of the opening of posterior inferior cerebellar artery(PICA),they were divided into 3 groups:proximal to PICA group (n=13), distal to PICA group (n=13),and PICA involvement group (n=10). The demographic data, vascular risk factors, clinical features, imaging features, endovascular treatment mode, postoperative complications, and differece of the good outcome rate(defined as the modified Rankin scale 0-2)after 6 months of treatment were compared.Results Seven patients in the proximal to PICA group received reconstructive endovascular treatment (RET), and 6 received endovascular internal trapping(EIT);the good outcome rate was 100%(13/13).Seven patients in the distal to PICA group received RET,6 were treated with EIT;the good outcome rate was 84.6%(11/13).Four patients in the PICA involvement group received RET,and 6 received EIT,and 2 of them received contralateral vertebral artery retrograde PICA stenting combined with VADA segment and proximal vertebral artery coil embolization;the good outcome rate was 60.0%(6/10). There were significant differences in the overall outcome good rate among the 3 groups (P<0.05). The good outcome rate in the PICA involvement group was significant lower than that in the proximal to PICA group,and significantly lower than that in the proximal to PICA combined with distal to PICA group(P<0.05).Multivariate logistic regression analysis showed that only Fisher grade 3-4 was the independent risk factor for poor outcome (odds ratio 28.0, 95% confidence interval 1.71-458.82; P=0.020). Conclusions The surgical options of endovascular treatment for ruptured intracranial VADA needs to evaluate the relationship between the location of dissecting aneurysms and the PICA origin. The risk of endovascular treatment in patients with intracranial VADA involving the origin of PICA is higher and it may affect the outcome.

An "exosome" is a nano-grade biological membrane structure with a diameter of 40 nm-130 nm from cell endocytosis.Exosomes,which are enriched with a subset of proteins,nucleic acid and lipids,represent an important manner for the intercellular communication and exchanging of substances.Exosomes play a critical role at the pathological state such as tumor metastasis as well as in normal physiological state.Metastasis is the main characteristics of malignant tumors.It is the leading cause of tumor recurrence,treatment failure and death.This paper reviewed the current understanding of relationship between exosomes,tumor metastasis and their potential applications as antimetastasis strategy from biosynthesis inhibition,drug delivery system construction and metastasis related signal pathway blocking based on targeting exosomes,especially introduced the future prospects of exosome as drug vehicles for metastasis treatment.With further progress in research,this kind of strategy will be beneficial to anti-tumor metastasis treatment.

Objective To explore the changes of dopamine D2 receptor in dopamine pathway in in-somnia patients and discuss its clinical significance. Methods From January 2016 to December 2016, 15 patients with insomnia (1 male, 14 females, age:(44.3±8.6) years) and 15 gender-/age-matched-healthy volunteers (control group;3 males, 12 females, age:(40.5±9.0) years) were included to undergo resting brain 11C-Raclopride PET/CT imaging. The D2 receptor binding potential (BPND) of the dopamine pathway was calculated by molecular imaging and kinetic analysis toolbox ( MIAKAT) software. The BP ND , Hamilton depression scale ( HAMD) , transient and graphics memory scale results were compared with two-sample t test and Mann-Whitney u test between the two groups. Pearson correlation analysis was used to evaluate the correlation between BPND(nucleus accumbens, caudate nucleus, putamen) and Pittsburgh sleep quality in-dex ( PSQI) , HAMD, course of disease, transient memory and graphical memory scale scores in the patient group. Results The BP ND in bilateral putamen, nucleus accumbens and left caudate nucleus of patients was lower than that of controls( left putamen:z=-2.717, right putamen:z=-2.883, both P<0.01;left nu-cleus accumbens:t=-2.269, right nucleus accumbens:t=-2.410, both P<0.05;left caudate nucleus:t=-2.632,P<0. 05), but the BPND level of right caudate nucleus was not significantly different(z=-0.850, P>0.05) . The scores of HAMD in the patient group were higher than those in control group ( t=10. 273, P<0. 01), while the scores of instantaneous memory (t=-4.888, P<0.01) and graphical memory scale (t=-2.624, P<0.05) were lower. There were significant negative correlations between the BP ND of bilateral nucleus ac-cumbens, caudate nucleus and putamen and the course of insomnia in the patient group ( r range:-0.761 to-0.682, all P<0.01) . Conclusion Patients with insomnia have abnormal neurotransmitter system of dopa-mine D2 and it may play a role in the pathogenesis of insomnia.

Objective:To reveal the specific region location of brain function injury after sleep deprivation by exploring cerebral glucose metabolism and blood perfusion changes and the correlation between them in healthy volunteers of sleep deprivation.Methods:From January 2019 to December 2019, a total of 17 healthy volunteers (8 males, 9 females; age (22.5±1.7) years) from People′s Hospital of Zhengzhou University were enrolled prospectively. All patients accepted MRI three-dimensional (3D) arterial spin labeling (ASL) and 18F-FDG PET/CT scanning at 2 h after normal sleep and after sleep deprivation of 24 h. Statistical parametric mapping (SPM) software was used for image processing, and brain metabolism and perfusion differences activation graphs before and after sleep deprivation were obtained respectively. Then the common activated brain regions were obtained as ROI. The cerebral blood flow (CBF) and the SUV ratio (SUVR; the cerebellum was the reference area) were calculated. Pearson correlation analysis and paired t test were used for data analysis. Results:The cerebral metabolism and perfusion of the subjects after sleep deprivation were reduced, and the abnormal brain areas were similar. Brain areas with reduced metabolism were more than those with reduced perfusion. The brain areas with reduced metabolism and perfusion after sleep deprivation were commonly in the frontal lobe, temporal lobe, parietal lobe, etc. The CBF and SUVR value of left dorsolateral frontal gyrus after sleep deprivation were correlated ( r=0.58, P=0.014). The mean CBF value ((46.32±7.39) ml·100 g -1·min -1) and SUVR value (1.46±0.04) of whole brain after sleep deprivation were lower than those before sleep deprivation ((54.91±6.51) ml·100 g -1·min -1, 1.53±0.06; t values: -2.67, -3.72, P values: 0.012, 0.001). Conclusions:The specific region′s location of brain function injury after sleep deprivation is preliminarily revealed. 18F-FDG PET/CT was more sensitive than 3D-ASL for brain function research of sleep deprivation and left dorsolateral frontal gyrus may be a key responsible functional region in subjects of sleep deprivation.