Objective To explore the levels of serum alkaline phosphatase ( ALP) as well as its impact on the cognitive impairment in patients with subcortical ischemic vascular disease ( SIVD).Methods One hundred and fifty-eight SIVD patients were divided into two subgroups which included 86 patients with mild cognitive impairment ( SVMCI ) and 72 patients with vascular dementia ( SVaD ) according to the severity of cognitive impairment.Sixty-seven old people with normal cognitive function were selected as control qruop.Multiple lacunar infarction ( LI) or leukoaraiosis ( LA) was detected according to their MRI scan appearances and graded LA according to the severity.Serum ALP was measured by an enzymatic method as well as the Mini-Mental State Examination ( MMSE) and the Cambridge Cognitive Examination-Chinese Version (CAMCOG-C) were used in assessments.Serum ALP was divided into 3 groups and the occurrence rate of LI , LA and cognitive impairment were compared with each other.The levels of ALP were compared in different cognitive impairment and Logistic regression was used to explore the relation between ALP and cognitive impairment.Results Both SVaD and SVMCI groups (17.00 (13.00, 20.00), 59.50 (49.00, 68.75);25.00 (25.00, 26.00), 82.50 (76.75, 89.00)) showed significantly lower scores in MMSE and CAMCOG-C than control group (28.00 (28.00, 29.00), 93.00 (89.00, 96.00); Z=187.337, P=0.000; Z=150.480, P=0.000).A positive relationship between the elevated ALP level and the severity of cognitive impairment was found after adjusting for sex , age and other confunding factors ((68.60 ±15.52), (78.76 ±13.39), (86.75 ±18.85) U/L, F=22.587, P=0.000).The occurrence rate of LI, LA and SVaD among the three groups were significantly different (χ2 =8.008, P=0.018;χ2 =17.998, P=0.000;χ2 =12.255, P=0.002).The ALP level was negatively correlated with MMSE and CAMCOG-C scores ( r=-0.350, P=0.000; r=-0.286, P=0.000 ).Logistic regression analysis revealed the relation between ALP and cognitive impairment was positive when we controlled all the vascular risk factors.However , the relation had gone when futher adjusting for the grade of LA.Conclusions The level of ALP is significantly higher in SIVD patients and positively relates with cognitive impairment especially in those whose grade of LA is severe.

Objective:To investigate the alterations of resting-state functional connectivity (RSFC) in ventral tegmental area (VTA) and substantia nigra (SN) among male smokers, and its correlation with clinical characteristics of smoking.Methods:The resting-state functional magnetic resonance data of 131 subjects recruited from January 2014 to December 2018 were analyzed retrospectively, including 76 smokers (smoking group) and 55 non-smokers (control group). VTA/SN was selected as regions of interest (ROI), and then calculated RSFC between VTA/SN and the whole brain.Based on SPM12 software, independent sample t-test was conducted to compare the differences in RSFC between smoking group and control group.Based on SPSS 22.0 software, Pearson correlation analysis was used to investigate the relationships between the RSFC of brain regions with significant differences and Fagerstr?m test for nicotine dependence (FTND) score, pack-year of smokers. Results:Compared with control group, the results showed decreased RSFC between VTA and the brain regions related default mode network (DMN)(including posterior cingulate cortex, right anterior cuneiform lobe, bilateral superior temporal gyrus, right middle temporal gyrus and right inferior parietal lobule), and regions of limbic system(including right marginal lobe and right angular gyrus), right calcarine (MNI: x, y, z=24, -55, -14) and left insula(MNI: x, y, z=-35, -11, 9) in smoking group(GRF corrected, voxel level P<0.005, cluster level P<0.05). Taking SN as the seed, there was no significant difference between smoking group and control group ( P>0.05). RSFC of VTA-left superior temporal gyrus was positively correlated with pack-year( r=0.243, P=0.034) and FTND ( r=0.282, P=0.014). VTA-left insula RSFC was positively correlated with FTND ( r=0.316, P=0.006). Conclusion:The RSFC in the mesolimbic system and the VTA-DMN circuit exist abnormal changes in smokers.To some extent, it may explain the reward deficits and dysfunction of emotion regulation in smokers, which may provide clues for further understanding the mechanism of tobacco addiction.

Objective:To investigate the changes in dynamic functional connectivity density (dFCD) and its relationship with Fagerstr?m test for nicotine dependence (FTND) scores in individuals with smoking addiction based on functional MR.Methods:The clinical and imaging data of 176 volunteers recruited through wechat and other online platforms from September 2019 to December 2020 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. The 176 volunteers were male, aged 20 to 55 years old, and were divided into light smoking addiction group (59 cases), heavy smoking addiction group (61 cases) and control group (56 cases). All subjects underwent resting state functional MR scanning and dFCD was calculated. The dFCD values of three groups were analyzed by ANOVA analysis (GRF corrected, voxel level P<0.005, cluster level P<0.01). Bonferroni correction was used for pairwise comparison. Pearson partial correlation analysis was used to analyze the correlation between dFCD values of brain regions with statistically significant differences and FTND scores. Results:Differences in dFCD among light smoking addiction group, heavy smoking addiction group and control group were mainly distributed in the right orbitofrontal cortex, left caudate nucleus, right putamen, bilateral calcarine sulcus cortex, right cuneus, left parahippocampal gyrus, left precuneus, left middle temporal gyrus and bilateral thalamus (GRF corrected, voxel level P<0.005, cluster level P<0.01). Compared with the control group, both the light and heavy smoking addiction groups showed decreased dFCD in the bilateral calcarine sulcus cortex, right cuneus and left precuneus, as well as increased dFCD in the right orbitofrontal cortex, right putamen, left caudate nucleus and left thalamus (Bonferroni corrected, P<0.05). Compared with the control group, the heavy smoking addiction group showed increased dFCD in the right thalamus, and the light smoking addiction group showed decreased dFCD in the left middle temporal gyrus (Bonferroni corrected, P<0.001). Compared with the light smoking addiction group, the heavy smoking addiction group showed increased dFCD in the left middle temporal gyrus and right thalamus, and decreased dFCD in the left parahippocampal gyrus (Bonferroni corrected, P<0.05). The mean value of dFCD in the right thalamus was positively correlated with FTND scores in smoking addiction patients ( r=0.227, P=0.014), and the mean value of dFCD in the right thalamus of the heavy smoking addiction subgroup was positively correlated with FTND scores ( r=0.323, P=0.013). There was no correlation between FTND scores and dFCD in the right thalamus of the light smoking addiction group ( P>0.05). Conclusion:There are changes of neural activity in brain regions related to smoking behaviors among people with different severity of smoking addiction, and smoking behaviors of people with heavy smoking addiction tend to be habitual compared with those with light smoking addiction.

Objective:To explore the value of machine learning models based on MRI predict the brain age of smokers and healthy controls, and further to explore the relationship between smoking and brain aging.Methods:This was a retrospective study. Dataset 1 consisted of 95 male smokers [20-50 (34±7) years old] and 49 healthy controls [20-50 (33±7) years old] recruited from August 2014 to October 2017 in First Affiliated Hospital of Zhengzhou University. Dataset 2 contained 114 healthy male volunteers [20-50 (34±11) years old] from the Southwestern University Adult Imaging Database from 2010 to 2015. All subjects underwent high-resolution 3D T 1WI scan. Gaussian process regression (GPR) model and support vector machine model were constructed to predict brain age based on structural MR images of healthy controls in dataset 1 and dataset 2. After the performance of the model was verified by the cross-validation method, the mean absolute error (MAE) between the predicted brain age and the actual age and the correlation ( r-value) between the actual age and the predicted brain age were calculated, and the best model was finally selected. The best models were applied to smokers and healthy controls to predict brain age. Finally, a general linear model was used to compare the differences in brain-predicted age difference (PAD) between smokers and healthy controls with age, taking years of education and total intracranial volume as covariates. Result:The performance of GPR model (MAE=5.334, r=0.747) in predicting brain age was better than support vector machine model (MAE=6.040, r=0.679). The GPR model predicted that PAD value of smokers in dataset 1 (2.19±6.64) was higher than that of healthy controls in dataset 1 (-0.80±8.94), and the difference was statistically significant ( F=8.52, P=0.004). Conclusion:GPR model based MRI has better performance in predicting brain age in smokers and healthy controls, and smokers show increased PAD values, further indicating that smoking accelerates brain aging.

Objective:To explore the differences of static and dynamic spontaneous brain activity between male smoking addicts and healthy controls, and analyze the mechanism of smoking addiction.Methods:Based on static amplitude of low-frequency fluctuation (sALFF) and dynamic amplitude of low frequency fluctuation (dALFF), the differences of static and dynamic spontaneous brain activity were compared between male smoking addicts ( n=63) and healthy controls ( n=30) by independent sample t-test. Pearson correlation analysis was used to investigate the relationships between the altered dALFF values and score of Fagerstr?m test for nicotine dependence(FTND) and pack-years of smoking addicted males. Results:Compared with healthy controls, the values of sALFF in the left superior/middle/inferior orbitofrontal gyrus ( t=5.17, clusters≥108) were increased and the variation of dALFF in the right superior temporal/middle gyrus, left orbitofrontal region, left orbital superior/middle/inferior frontal gyrus, right orbitofrontal gyrus/middle/inferior frontal gyrus and right putamen ( t=4.90, 4.37, 4.91, 4.62, 4.59, clusters≥96) were also increased in the smoking addicted group. It was noteworthy that the dALFF values of the right superior temporal/middle gyrus( r=0.252, P=0.047), left orbital region superior frontal gyrus( r=0.281, P=0.026) and right putamen( r=0.313, P=0.012) were positively correlated with pack-years of male smoking addicts. Conclusion:Male smoking addicts may have abnormal static and dynamics spontaneous neural activity in prefrontal cortex (including orbital frontal lobe), putamen and superior temporal/middle gyrus, which are correlated with pack-years.

Accessory spleen refers to the spleen tissue that exists outside of the normal spleen， with a similar structure to the main spleen and certain functions. Intrapancreatic accessory spleen （IPAS） completely enveloped by the pancreas has an incidence rate of only 2%， and it is easily misdiagnosed in clinical practice due to its atypical clinical symptoms and similar radiological features to pancreatic neuroendocrine tumor， pancreatic solid pseudopapillary tumor， and other pancreatic space-occupying lesions. This article reports the clinical data of two patients with IPAS who were misdiagnosed as pancreatic neuroendocrine tumor and pancreatic solid pseudopapillary tumor， respectively， analyzes the reasons for misdiagnosis， and summarizes the experience in diagnosis and treatment， in order to improve the ability for the differential diagnosis of IPAS in clinical practice.

Objective:To explore the interaction effects on brain activity between the smoking addiction and weight status by resting-state functional magnetic resonance imaging.Methods:Retrospective analysis of clinical data and resting-state functional magnetic resonance imaging data were analyzed from 99 recruited subjects from January 2019 to December 2021. All participants were divided into four groups: overweight smokers ( n=24), normal-weight smokers ( n=28), overweight non-smokers ( n=19), and normal weight non-smokers ( n=28). Calculate regional homogeneity (ReHo) to reflect the internal brain activity of the subjects. Two-way ANOVA was used to detect the interaction effects between smoking addiction and overweight on ReHo by SPM12 software, correcting for age, years of education and head motion. Results:The interaction effect between smoking addiction and overweight on ReHo was significant in right superior frontal gyrus(x, y, z=15, 9, 60)(GRF corrected, Pvoxel<0.005, Pcluster<0.05). The ReHo value in the right superior frontal gyrus of overweight smokers was significantly higher than that of normal weight smokers ( t=3.768, P<0.001, Bonferroni corrected). The ReHo values in the right superior frontal gyrus of overweight non-smokers were significantly lower than those of normal weight non-smokers ( t=-3.242, P=0.002, Bonferroni corrected). The ReHo values in the right superior frontal gyurs of normal-weight smokers were significantly lower than those of normal weight non-smokers( t=-3.540, P=0.001, Bonferroni corrected). The ReHo values in the right superior frontal gyrus of overweight smokers were significantly higher than those of overweight non-smokers ( t=3.392, P=0.002, Bonferroni corrected). Correlation analyses showed that the strengthen ReHo value in right superior frontal gyrus was positively associated with pack-year in smoking addicts( r=0.387, P=0.007, Bonferroni corrected). Conclusion:Smoking addiction and overweight have an antagonistic effect on brain activity in the right superior frontal gyrus, which may provide potential therapeutic targets for individuals with comorbidity of smoking addiction and overweight.

Objective:To explore the dynamic temporal variability of brain functional networks in individuals with internet gaming disorder(IGD)using dynamic functional connectivity density(dFCD).Methods:From January 2019 to December 2021, resting-state functional magnetic resonance imaging data were recruited from 55 patients with IGD and demographically matched 50 healthy controls.Data analysis was performed by IBM SPSS 21.0 software. The functional connectivity density(FCD) combined with sliding window analysis was employed to calculate the temporal variability of global functional connectivity.FCD in whole brain was further devided into ipsilateral and cotralateral parts.The temporal variability of dFCD was further quantified utilizing the standard deviations of whole brain, intra-, and inter-hemispheric FCD. Finally, Pearson correlation analysis was performed between dFCD variance in differential brain regions and clinical behaviors.Results:The inter-hemispheric dFCD in the left posterior cingulate cortex(-0.16±0.24) and the left precuneus(-0.08±0.23) in patients with IGD were lower that those in healthy controls(0.002±0.260, 0.12±0.36)( t=-3.502, -4.160, both P<0.05).And the intra-hemispheric dFCD in the left calcarine, the left precuneus, and the left posterior cingulate cortex in patients with IGD were lower that those in healthy controls( t=-3.809, -4.360, -3.561, all P<0.05).Moreover, abnormal global dFCD variability of the calcarine and ipsilateral dFCD variability of the PCC negatively correlated with the severity of IGD( r=-0.380, -0.413, both P<0.05). Conclusion:Patients with IGD show intra-and inter-hemispheric dFCD differences in the visual attention network and default mode network, which may respond to the underlying neurobiological basis for the presence of cognitive dysfunction and impaired concentration.

Objective To observe whether there was difference of inferior glenohumeral joint capsule thickness(ICT)measured on coronal and transverse axillary section with high-frequency ultrasound.Methods ICT of 56 patients with frozen shoulder(FS group)and 115 healthy controls(HC group)were measured on coronal and transverse axillary sections with high-frequency ultrasound.The ultrasonic findings were compared between groups,while ICT measured on different sections were compared within groups.Results In FS group,ICT thickened,presented as low echo with poor boundary clarity,with reduced and uneven internal echo.No echo areas could be detected when there was fluid accumulation,and concomitant blood flow signal could be observed.In HC group,the inferior glenohumeral joint capsule presented as moderate echo with clear boundary,with uniform low or equal echo.No significant difference of ICT values measured on coronal or transverse section was found within both groups(both P＞0.05).Conclusion ICT measured on coronal and transverse axillary section with high-frequency ultrasound were not significantly different.

Objective To explore the mechanism by which soybean isoflavone(SI)reduces calcium overload induced by cerebral ischemia-reperfusion(I/R).Methods Forty-eight SD rats were randomized into 4 groups to receive sham operation,cerebral middle artery occlusion for 2 h followed by 24 h of reperfusion(I/R model group),or injection of adeno-associated virus carrying Frizzled-2 siRNA or empty viral vector into the lateral cerebral ventricle after modeling.Western blotting was used to examine Frizzled-2 knockdown efficiency and changes in protein expressions in the Wnt/Ca2+signaling pathway.Calcium levels and pathological changes in the ischemic penumbra(IP)were measured using calcium chromogenic assay and HE staining,respectively.Another 72 SD randomly allocated for sham operation,I/R modeling,or soy isoflavones pretreatment before modeling were examined for regional cerebral blood flow using a Doppler flowmeter,and the cerebral infarct volume was assessed using TTC staining.Pathologies in the IP area were evaluated using HE and Nissl staining,and ROS level,Ca2+level,cell apoptosis,and intracellular calcium concentration were analyzed using immunofluorescence assay or flow cytometry;the protein expressions of Wnt5a,Frizzled-2,and P-CaMK II in the IP were detected with Western blotting and immunohistochemistry.Results In rats with cerebral I/R,Frizzled-2 knockdown significantly lowered calcium concentration(P<0.001)and the expression levels of Wnt5a,Frizzled-2,and P-CaMK II in the IP area.In soy isoflavones-pretreated rats,calcium concentration,ROS and MDA levels,cell apoptosis rate,cerebral infarct volume,and expression levels of Wnt/Ca2+signaling pathway-related proteins were all significantly lower while SOD level was higher than those in rats in I/R model group.Conclusion Soy isoflavones can mitigate calcium overload in rats with cerebral I/R by inhibiting the Wnt/Ca2+signaling pathway.