Quantitative analysis and developmental observations on the planum temporale of 157 fetus and infantal brains have been made. The results are as follows: 1) left planum temporale of 82％ of the fetal brains and 76％ of the infantal brains are larger than the right. 2) Average area values of the left planum temporale are signifcantly larger than the right. 3) The earliest appearance of the planum temporale is in the sixth gestational month. 4) Rate of appearance of the left planum tempo-rale in fetuses is higher than that of the right. 5) Right/left ratio of planum temporale increases with the development of the embryo. These findings indicate that the asymmetry of the left and right planum temporale is present since the appearance of the planum temporale, and changes as the fetus develops.

Objective To explore the value of susceptibility weighted imaging (SWI) in the quantitative analysis of ischemia-reperfusion injury (IRI) of the rabbit kidneys . Methods Thirty New Zealand white rabbits were randomly assigned to IRI group (n=24, operation with clamping) and Sham group (n=6, operation without clamping). Left renal ischemia-reperfusion was performed by occlusion (calmping) of the left renal arterial for 60 minutes, followed by reperfusion. All the rabbits underwent MRI including T2WI and SWI before and 0.5 h, 12 h, 24 h and 48 h after the establishments of models . Three rabbits in IRI group were randomly sacrificed 0.5 h, 12 h, and 24 h after the establishment of model. The rest of the rabbits in IRI group and 6 rabbits in sham group were sacrificed for pathological examination 48 h after the establishment of model All specimen were cut into slices and stained with hematoxylin-eosin (HE). Region of interest ( ROI) was manually created by outlining the inner medulla, inner stripe of outer medulla, outer stripe of outer medulla, and cortex, then relative signal-to-noise ratio of the kidney (rSNR) to muscle in SWI sequence was recorded. and compared with histopathologic features. One-way ANOVA was performed to compare difference of rSNR to muscle in respective location at 5 time-points between Sham group and IRI group, and the differences between groups were tested using repetitive measure analysis of variance, repetitive measure analysis of variance was performed to compare difference of rSNR to muscle in respective location at respective time-points between Sham group and IRI group. Results rSNR value in the inner medulla 0.5 h, 12 h, 24 h and 48 h after the establishments of models were 0.28 ± 0.04, 0.98 ± 0.14, 0.69 ± 0.07, 0.57±0.06, 0.43±0.03, respectively (F=69.82,P<0.01), the inner stripe of outer medulla at the five time-points 0.08 ± 0.03, 0.57 ± 0.05, 0.32 ± 0.07, 0.16 ± 0.02, 0.04 ± 0.01, respectively(F=16.59,P<0.01), the outer stripe of outer medulla were 0.31 ± 0.04, 0.86 ± 0.09, 0.65 ± 0.07, 0.55 ± 0.06 0.43 ± 0.04(F=67.52,P<0.01), respectively,the cortex 0.05±0.01, 0.80±0.04, 0.68±0.07, 0.47±0.07, 0.36±0.08, respectively(F=118.96,P<0.01). The difference of the rSNR was statistically significant in the inner medulla, inner stripe of outer medulla, outer stripe of outer medulla, and cortex at the five different time-points. The differences between two groups were significant (F=206.29, 14.25, 42.8, 39.12, P all<0.05). The pathological findings in Sham group included normalglomerular structure l, clear cavity of tubular, no interstitial hyperemia and edema. The pathological findings in IRI group demonstated, at 0.5 h after IRI, Bowman's capsule cavity expansion, glomerular shrinkage, swelling of renal tubular epithelial cells, vacuoles degeneration, the tube cavity expansion, interstitial edema and congestion ecta became slender, andat 12 h after IR, Bowman's capsule expansion became more obvious, foam degeneration of renal tubular epithelial cells, apoptosis, partial loss of the brush border of the proximal convoluted tubule, formation of protein cast, and a small amount of inflammatory cells appeared in the renal interstitium, swelling of endothelial cells of the vasa recta, congestion of small vessels, and at 24 and 48 h after IRI, more serious injury of renal tubular in the outer stripe of outer medulla , massive necrosis of renal tubular epithelial cells, apoptosis, parts of the renal tubular had the contour lines, and renal tubular outline, increment in inflammatory cells, red cell and protein cast. Conclusion rSNR of SWI in the inner medulla, inner stripe of outer medulla, outer stripe of outer medulla, and cortex of the kidney varies with the degree of IRI over time, and is consistent with corresponding pathological feature, suggesting SWI is useful imaging tool to detect early damage of renal IRI quantitatively.

OBJECTIVE: To assess the feasibility of susceptibility-weighted imaging (SWI) while monitoring changes in renal oxygenation level after water loading. MATERIALS AND METHODS: Thirty-two volunteers (age, 28.0 +/- 2.2 years) were enrolled in this study. SWI and multi-echo gradient echo sequence-based T2* mapping were used to cover the kidney before and after water loading. Cortical and medullary parameters were measured using small regions of interest, and their relative changes due to water loading were calculated based on baseline and post-water loading data. An intraclass correlation coefficient analysis was used to assess inter-observer reliability of each parameter. A receiver operating characteristic curve analysis was conducted to compare the performance of the two methods for detecting renal oxygenation changes due to water loading. RESULTS: Both medullary phase and medullary T2* values increased after water loading (p < 0.001), although poor correlations were found between the phase changes and the T2* changes (p > 0.05). Interobserver reliability was excellent for the T2* values, good for SWI cortical phase values, and moderate for the SWI medullary phase values. The area under receiver operating characteristic curve of the SWI medullary phase values was 0.85 and was not different from the medullary T2* value (0.84). CONCLUSION: Susceptibility-weighted imaging enabled monitoring changes in the oxygenation level in the medulla after water loading, and may allow comparable feasibility to detect renal oxygenation level changes due to water loading compared with that of T2* mapping.
Adult ; Female ; Humans ; Kidney/*metabolism ; Magnetic Resonance Imaging/*methods ; Male ; Oxygen/blood/*metabolism ; ROC Curve ; Reproducibility of Results ; Water/*administration & dosage ; Young Adult

Objective:To compare proximal humerus internal locking system (PHILOS) and Multiloc intramedullary nail in the treatment of proximal humerus fracture-anterior dislocation.Methods:A retrospective study was performed to analyze the data of 33 patients with proximal humerus fracture-anterior dislocation who had been treated by open reduction and internal fixation from June 2015 to April 2021 at Department of Upper Limbs, Zhengzhou Orthopaedic Hospital. According to methods of internal fixation, the patients were divided into an extramedullary group and an intramedullary group. In the extramedullary group of 18 cases subjected to internal fixation with PHILOS, there were 8 males and 10 females with an age of (53.3 ± 10.6) years, and 1 2-part fracture, 15 3-part fractures and 2 4-part fractures by the Neer classification. In the intramedullary group of 15 cases subjected to internal fixation with Multiloc intramedullary nail, there were 8 males and 7 females with an age of (51.5 ± 11.2) years, and 14 3-part fractures and 1 4-part fracture by the Neer classification. The 2 groups were compared in terms of incision length, operation time, intraoperative blood loss, postoperative complications, and visual analog scale (VAS), range of shoulder motion, and Constant-Murley score at postoperative 12 months.Results:The 2 groups were comparable due to insignificant differences in their preoperative general data ( P>0.05). All patients were followed up for (20.8 ± 4.7) months. The incision length in the intramedullary group [(11.6 ± 1.7) cm] was significantly shorter than that in the extramedullary group [(17.6 ± 2.0) cm], and the intraoperative blood loss in the former [(106.7 ± 34.4) mL] was significantly lower than that in the latter [(151.7 ± 45.7) mL] ( P<0.05). The VAS scores at 1 week and 1 month after surgery [2.0 (2.0, 3.0) and 0.0 (0.0, 1.0) respectively] in the intramedullary group were significantly lower than those in the extramedullary group [3.0 (3.0, 3.3) and 1.0 (0.0, 1.3) respectively] ( P<0.05). The external rotation of the shoulder at the last follow-up in the intramedullary group (65.3° ± 15.5°) was significantly larger than that in the extramedullary group (50.6° ± 13.9°) ( P<0.05). There were no significant differences in operation time, incidence of postoperative complications, VAS score at 12 months after operation, Constant-Murley score or range of shoulder motion at the last follow-up between the 2 groups ( P>0.05). Conclusions:In the treatment of proximal humerus fracture-anterior dislocation, open reduction and internal fixation with both PHILOS and Multiloc intramedullary nail can result in a favorable prognosis when the fracture-dislocation is well reduced and fixated. However, the Multiloc intramedullary nail may lead to better early pain relief, less surgical invasion, and better functional recovery of the external rotation of the shoulder.

Objective : To observe the changes of soft tissue in patients with Angle class Ⅱ division Ⅰ malocclusion during mixed dentition treated with MRC functional appliance. Methods : Twenty patients with Class Ⅱ division Ⅰ malocclusion of Angle were treated with functional MRC. The facial features before and after treatment were measured by software and the results were analyzed statistically. Results: The patients′soft tissue profiles were improved significantly before and after treatment, The OE-Prn-Pos angle, OE-N′-B′ angle, OE-N′-Pos angle, OE-Prn-N′angle, Cm-Sn-UL angle, and N′-Sn-Pos angle increased significantly (P < 0.05). The OE-Sn-UL angle, and Sn-N′-B′ angle decreased significantly (P < 0.05); the distance between the lateral soft tissue line and the middle Sn-H line, UL-E line and LL-E line were significantly different (P < 0.05). The distances were all reduced, and the difference was statistically significant (P < 0.05). Conclusion The application of an MRC functional appliance can improve the relationship among nasolabial soft tissue, upper and lower lip soft tissue, and chin-lip soft tissue, thus improving the protrusion profile of patients.

Objective To evaluate the clinical effect of dextromethorphan and its effect on daily living of patients with poststroke pseudobulbar affect. Methods Sixty patients with poststroke pseudobulbar affect admitted in our hospital from May 2013 to October 2016 were enrolled. Then they were randomly divided into the control group and the treatment group,with 30 patients in each group.Patients in the control group were treated with fluox-etine therapy and patients in the treatment group were treated with dextromethorphan therapy.The center for neuro-logic study lability scale(CNS-LS)and activity of daily living(Barthel index,BI)before and 30 days after the treat-ments in the two groups had been accessed. Results Thirty days after the treatment,CNS-LS of the treatment group had obvious improvement compared with that before treatment(P < 0.01),but CNS-LS of the control group had no obvious improvement compared with that before treatment(P > 0.05). And significant improvement has been found 30 days after the treatment between the two groups(P<0.01).Furthermore,significant difference was found on BI between these two groups(P<0.05).Conclusions Dextromethorphan is effective in treatment of pa-tients with poststroke pseudobulbar affect and it can improve the activity of daily living of these patients.

Objective To observe the clinical effects of breaking blood expelling stasis method of traditional Chinese medicine (TCM) combined with edaravone on patients with acute hypertensive intra-cerebral hemorrhage and preliminarily discuss its protection mechanism on this disease. Methods Ninety-two patients with hypertensive intra-cerebral hemorrhage within 72 hours after occurrence admitted to Zengcheng District People's Hosipital of Guangzhou from May 2013 to December 2017 were enrolled, they were divided into conventional therapy group and combined treatment of TCM and western medicine group by random numbers produced by a computer, 46 cases in each group. The conventional therapy group was treated with conventional therapy, and the combined treatment of TCM and western medicine group was treated with conventional therapy, additionally the treatment of Poxue Zhuyu decoction (the ingredients of the decoction: leech 10 g, gradfly 10 g, rhubarb 15 g, cattail pollen 5 g, trichosanthes fruit 10 g, radix notoginseng 5 g, colla plastri testudinis 10 g, grassleaf sweetflag rhizome 10 g, ground beetle 3 g, dried lacquer 3 g, peach seed 10 g) and edaravone for 10 days. The levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in serum were tested by enzyme-linked immunosorbent assay (ELISA) before and 7 days after treatment in the two groups; and the differences in National Institutes of Health stroke scale score (NIHSS) before and 14 days, 90 days after treatment as well as the changes of brain edema around the hematoma 14 days after treatment were compared between the two groups, and the incidence of adverse reaction was observed. Results After treatment, the levels of TNF-α, IL-6 and intra-cerebral hemorrhage quantities in the two groups were all decreased compared with those before treatment, and the degrees of decrease of TNF-α and cerebral hemorrhage volume in combined treatment of TCM and western medicine group were more significant than those in the conventional treatment group [TNF-α (ng/L): 21.00±6.10 vs. 29.40±11.33, cerebral hemorrhage volume (mL): 5.23±0.60 vs. 8.50±0.64, both P <0.05]. The IL-6 in the two groups were recovered to approximately normal levels after the treatment (ng/L: 13.60±5.36 vs. 15.40±6.13, P > 0.05). With the prolongation of therapeutic time, the scores of NIHSS of the two groups were significantly lowered than those before treatment, and the degree of reduction in the combined TCM and western medicine group on 90 days after treatment was more obvious than that of the conventional treatment group (4.34±0.67 vs. 7.73±0.61, P < 0.05). The volumes of edema around hematomas were increased after treatment in the two groups, but the degree of increase in combined treatment of TCM and western medicine group was slower than that of the conventional group (cm3: 7.57±0.64 vs. 10.16±0.60, P < 0.05). There was no statistical significant difference in the incidence of adverse reactions in comparison between the combined treatment of TCM and western medicine group and conventional therapy group [18.2% (8/44) vs. 20.5% (9/44), P > 0.05]. Conclusions Using breaking blood expelling stasis and edaravone for treatment of acute hypertensive intra-cerebral hemorrhage can accelerate the absorption of brain hematoma and improve the neurological function, and its mechanism may be relevant to the inhibition of some inflammatory factors.

Objective: To explore the effects of Shenqi Yizhi Granule on the cognitive function and the expression of MMP-2 and VEGF in serum of APP/PS1 transgenic mice. Methods: Taking APP/PS1 double transgenic mice as the research carrier, Shenqi Yizi granule was used to interven for 180 days. The learning and remembering ability was tested by Morris water maze, passive avoidance test, and open field. The pathomorphism of the hippocampus CA1 region of mice was tested by HE staining and electron microscopy. The concentration of MMP-2 and VEGF in serum was tested by ELISA. Results: Compared with the blank group, the escape latency of the model group was significantly increased (P ＜ 0.05), and the frequency of the entering medium ring was obviously decreased (P ＜ 0.05). The number of nerve cells in the hippocampal CA1 area was reduced, and the arrangement was disordered. The nuclear pyknosis was deeply stained, and the ultrastructure of nerve cells was abnormal. The concentration of MMP-2 and VEGF in serum was significantly increased (P ＜ 0.05). Compared with the model group, the escape latency of treatment group was decreased (P ＜ 0.05) and the frequency of the entering middle ring was increased (P ＜ 0.05). The concentration of MMP-2 and VEGF in serum was decreased (P ＜ 0.05). Conclusion: Shenqi Yizhi Granule could improve the ability of learning and memory of APP/ PS1 double transgenic mice, and decrease the concentration of MMP-2 and VEGF in serum.

Objective: To investigate the clinical effect and safety of long-acting pegylated interferon-α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 μg/week) in the treatment of HBeAg-positive chronic hepatitis B (CHB) patients, with standard-dose Peg-IFN-α-2a as positive control. Methods: This study was a multicenter, randomized, open-label, and positive-controlled phase III clinical trial. Eligible HBeAg-positive CHB patients were screened out and randomized to Peg-IFN-α-2b (Y shape, 40 kD) trial group and Peg-IFN-α-2a control group at a ratio of 2:1. The course of treatment was 48 weeks and the patients were followed up for 24 weeks after drug withdrawal. Plasma samples were collected at screening, baseline, and 12, 24, 36, 48, 60, and 72 weeks for centralized detection. COBAS® Ampliprep/COBAS® TaqMan® HBV Test was used to measure HBV DNA level by quantitative real-time PCR. Electrochemiluminescence immunoassay with Elecsys kit was used to measure HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe). Adverse events were recorded in detail. The primary outcome measure was HBeAg seroconversion rate after the 24-week follow-up, and non-inferiority was also tested. The difference in HBeAg seroconversion rate after treatment between the trial group and the control group and two-sided confidence interval (CI) were calculated, and non-inferiority was demonstrated if the lower limit of 95% CI was > -10%. The t-test, chi-square test, or rank sum test was used according to the types and features of data. Results: A total of 855 HBeAg-positive CHB patients were enrolled and 820 of them received treatment (538 in the trial group and 282 in the control group). The data of the full analysis set showed that HBeAg seroconversion rate at week 72 was 27.32% in the trial group and 22.70% in the control group with a rate difference of 4.63% (95% CI -1.54% to 10.80%, P = 0.1493). The data of the per-protocol set showed that HBeAg seroconversion rate at week 72 was 30.75% in the trial group and 27.14% in the control group with a rate difference of 3.61% (95% CI -3.87% to 11.09%, P = 0.3436). 95% CI met the non-inferiority criteria, and the trial group was non-inferior to the control group. The two groups had similar incidence rates of adverse events, serious adverse events, and common adverse events. Conclusion In Peg-IFN-α regimen for HBeAg-positive CHB patients, the new drug Peg-IFN-α-2b (Y shape, 40 kD) has comparable effect and safety to the control drug Peg-IFN-α-2a.

Objective: To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control. Methods: A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed. Results: A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group. Conclusion In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.