Objective To investigate the differences of brain imaging changes in patients with mesial temporal lobe epilepsy(mTLE)based on individual structural covariance networks of gray matter volume.Methods A total of 74 mTLE patients,including 39 patients in the left mTLE group and 35 patients in the right mTLE group,along with 46 healthy controls(control group),had completed 3D T1WI structural imaging scans.The network template perturbation approach was used to analyze the individualized structural covariance networks in patients with mTLE.Results Compared with the control group,the left and right mTLE groups showed decreased structural covariance connections for the ipsilateral hippocampus to the contralateral hippocampus and parahippocampal gyrus,orbitofrontal gyrus,middle frontal gyrus,superior parietal gyrus,amygdala and fusiform gyrus.In addition,increased structural covariation connections was mainly distributed in the bilateral frontal lobe,parietal lobe,temporal lobe,occipital lobe and paralimbic system in the right mTLE group,whereas increased structural covariation connections was mainly located within the left frontal lobe,parietal lobe and occipital lobe in the left mTLE group(P＜0.05).Compared with the left mTLE group,the right mTLE group showed decreased structural covariance connections with the ipsilateral hippocampus as a core node(P＜0.05).Conclusion Compared with the left mTLE group,the right mTLE group showed more pronounced decreased structural covariance connections centered around the ipsilateral hippocampus,as well as a more intricate compensatory mechanism.The pattern of the individual structural covariance networks in mTLE patients not only contribute to understanding of its pathogenesis but also served as a potential biomarker for clinical diagnosis.

This study explored how the human cortical folding pattern composed of convex gyri and concave sulci affected single-subject morphological brain networks, which are becoming an important method for studying the human brain connectome. We found that gyri-gyri networks exhibited higher morphological similarity, lower small-world parameters, and lower long-term test-retest reliability than sulci-sulci networks for cortical thickness- and gyrification index-based networks, while opposite patterns were observed for fractal dimension-based networks. Further behavioral association analysis revealed that gyri-gyri networks and connections between gyral and sulcal regions significantly explained inter-individual variance in Cognition and Motor domains for fractal dimension- and sulcal depth-based networks. Finally, the clinical application showed that only sulci-sulci networks exhibited morphological similarity reductions in major depressive disorder for cortical thickness-, fractal dimension-, and gyrification index-based networks. Taken together, these findings provide novel insights into the constraint of the cortical folding pattern to the network organization of the human brain.
Humans ; Cerebral Cortex/anatomy & histology* ; Male ; Female ; Magnetic Resonance Imaging ; Adult ; Connectome/methods* ; Young Adult ; Nerve Net/anatomy & histology* ; Neural Pathways ; Depressive Disorder, Major/diagnostic imaging*

Objective:To evaluate immunotherapy combined with neoadjuvant chemotherapy before radical total gastrectomy in microsatellite stable locally advanced gastric cancer in two cases.Methods:Two male patients with clinical stage cT3N 1M0 and microsatellite-stable locally advanced gastric cancer were treated with neoadjuvant chemotherapy with PD-1 inhibitor (Nivolumab) combined with SOX (Oxaliplatin+S-1) for 4 cycles before surgery. Standard laparoscopic assisted total gastrectomy with D 2 lymphadenectomy was performed on Feb 2023 and Oct 2023 respectively after the neoadjuvant treatment. Pathological tumor regression grade(TRG) was observed to assess the degree of tumor regression, and follow-up was conducted to monitor tumor markers and abdominal enhanced CT to detect recurrence. Results:Two patients achieved pathological complete response(TRG0). They were followed up until May 2024 and no recurrence was observed.Conclusion:Preoperative combination of chemotherapy and immunotherapy may provide survival benefit for microsatellite stable locally advanced gastric cancer patients.

Objective:To investigate cerebral blood flow (CBF) changes in type 2 diabetes mellitus (T2DM) and its relationship with cognitive function by arterial spin labeling (ASL).Methods:This study was a cross-sectional study. Clinical data (age, sex, years of education, body mass index) and imaging data of 46 patients with T2DM (T2DM group) and 57 healthy controls (HC group), who visited the First Affiliated Hospital of Guangzhou University of Chinese Medicine from September 2017 to March 2019 were analyzed retrospectively. All subjects underwent clinical cognitive function assessments, including the auditory verbal learning test (AVLT), trail making test (TMT), and montreal cognitive assessment (MoCA) scale. All subjects underwent routine axial 3D-ASL imaging, and CBF pseudocolor images were automatically generated from the 3D-ASL raw images. CBF values in the differential brain regions were extracted. The differences in clinical data, cognitive function scores, and CBF values between T2DM group and HC group were evaluated using independent sample t-tests, Mann-Whitney U tests, and χ 2 tests. The correlation between the differential brain region CBF values and cognitive function scores was analyzed using partial correlation analysis, controlling for age, gender, and years of education. Results:There were no significant differences in age, gender, years of education, AVLT scores, and TMT scores between T2DM group and HC group ( P>0.05). But there were significant differences in body mass index and MoCA scores ( Z=-2.16, P=0.031; Z=-3.18, P=0.001). Compared with HC group, T2DM group showed significantly increased CBF in the left insula ( P<0.001), but significantly decreased CBF in the right fusiform gyrus, right cuneus, and right prefrontal gyrus ( P<0.001). The partial correlation analysis showed that the CBF value in the right prefrontal gyrus of T2DM group was positively correlated with MoCA scores ( r=0.330, P=0.001), while the CBF value in the right fusiform gyrus was positively correlated with MoCA scores ( r=0.210, P=0.034). Conclusions:Patients with T2DM show changes in CBF in the left insula, right fusiform gyrus, right cingulate anterior, and right prefrontal cortex. Reduced CBF in the right prefrontal cortex and right fusiform gyrus is associated with cognitive function decline.

Objective:To analyze the predictive effects of the Big Five personality traits and emotions on self-management behaviors in patients with type 2 diabetes mellitus (T2DM).Methods:This study was a cross-sectional research. From 2016 to 2020, community interventions for self-management among patients with chronic diseases were conducted in Hangzhou, targeting patients with type 2 diabetes recruited from 69 community health service centers across the city. The data for this study were derived from the baseline information collected during the community intervention. The Chinese Big Five Personality Inventory (CBF-PI-15), the Type 2 Diabetes Self-Management Scale (2-DSCS), the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS) were employed for questionnaire assessments. Biochemical indicators, including postprandial 2-hour blood glucose, glycated hemoglobin (HbA 1c), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were measured. Spearman correlation analysis was used to examine the relationship between personality traits, relevant biochemical indicators, and self-management behaviors. Hierarchical regression analysis was employed to assess the predictive effects of the Big Five personality traits and emotions on self-management behaviors after controlling for demographic characteristics and factors related to health status. Results:A total of 839 patients were included in this study, comprising 518 females (61.75%) and 321 males (38.25%), with an average age of (66.92±8.67) years and an average disease duration of (8.87±6.91) years. There were significant differences in self-management behavior scores among patients with varying disease durations, educational levels, treatment methods, and levels of anxiety and depression ( t/F=6.172, 3.340, 4.699, 16.007, 27.127, all P<0.05). Neuroticism showed a negative correlation with various dimensions of self-management behaviors ( r=-0.130--0.073), while conscientiousness and agreeableness were positively correlated with various dimensions of self-management behaviors ( r=0.072-0.215). Dietary control score was negatively correlated with HbA 1c and LDL-C ( r=-0.106, -0.077), and regular exercise score was negatively correlated with postprandial 2-hour blood glucose, HbA 1c, TG, TC, HDL-C, and LDL-C ( r=-0.115--0.071). The total score of the 2-DSCS was negatively correlated with HbA 1c, TG, and TC ( r=-0.104--0.071). Patients with a disease duration exceeding 15 years and those receiving insulin injections or a combination of oral medication and insulin injections had higher total 2-DSCS score ( β=0.085, 0.146, 0.118, all P<0.05). Conversely, patients with higher HbA 1c and SDS standard scores had lower total 2-DSCS score ( β=-0.151, -0.328, both P<0.05), while those with higher agreeableness scores had higher total 2-DSCS score ( β=0.143, P<0.05). Conclusion:The traits of neuroticism, conscientiousness, and agreeableness within the Big Five Personality Traits, as well as anxiety and depressive emotions, are correlated with self-management behaviors. Specifically, agreeableness has a positive predictive effect on self-management behaviors, whereas depressive emotions have a negative predictive effect.

Objective To investigate the differences of brain imaging changes in patients with mesial temporal lobe epilepsy(mTLE)based on individual structural covariance networks of gray matter volume.Methods A total of 74 mTLE patients,including 39 patients in the left mTLE group and 35 patients in the right mTLE group,along with 46 healthy controls(control group),had completed 3D T1WI structural imaging scans.The network template perturbation approach was used to analyze the individualized structural covariance networks in patients with mTLE.Results Compared with the control group,the left and right mTLE groups showed decreased structural covariance connections for the ipsilateral hippocampus to the contralateral hippocampus and parahippocampal gyrus,orbitofrontal gyrus,middle frontal gyrus,superior parietal gyrus,amygdala and fusiform gyrus.In addition,increased structural covariation connections was mainly distributed in the bilateral frontal lobe,parietal lobe,temporal lobe,occipital lobe and paralimbic system in the right mTLE group,whereas increased structural covariation connections was mainly located within the left frontal lobe,parietal lobe and occipital lobe in the left mTLE group(P＜0.05).Compared with the left mTLE group,the right mTLE group showed decreased structural covariance connections with the ipsilateral hippocampus as a core node(P＜0.05).Conclusion Compared with the left mTLE group,the right mTLE group showed more pronounced decreased structural covariance connections centered around the ipsilateral hippocampus,as well as a more intricate compensatory mechanism.The pattern of the individual structural covariance networks in mTLE patients not only contribute to understanding of its pathogenesis but also served as a potential biomarker for clinical diagnosis.

Objective:To analyze the predictive effects of the Big Five personality traits and emotions on self-management behaviors in patients with type 2 diabetes mellitus (T2DM).Methods:This study was a cross-sectional research. From 2016 to 2020, community interventions for self-management among patients with chronic diseases were conducted in Hangzhou, targeting patients with type 2 diabetes recruited from 69 community health service centers across the city. The data for this study were derived from the baseline information collected during the community intervention. The Chinese Big Five Personality Inventory (CBF-PI-15), the Type 2 Diabetes Self-Management Scale (2-DSCS), the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS) were employed for questionnaire assessments. Biochemical indicators, including postprandial 2-hour blood glucose, glycated hemoglobin (HbA 1c), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were measured. Spearman correlation analysis was used to examine the relationship between personality traits, relevant biochemical indicators, and self-management behaviors. Hierarchical regression analysis was employed to assess the predictive effects of the Big Five personality traits and emotions on self-management behaviors after controlling for demographic characteristics and factors related to health status. Results:A total of 839 patients were included in this study, comprising 518 females (61.75%) and 321 males (38.25%), with an average age of (66.92±8.67) years and an average disease duration of (8.87±6.91) years. There were significant differences in self-management behavior scores among patients with varying disease durations, educational levels, treatment methods, and levels of anxiety and depression ( t/F=6.172, 3.340, 4.699, 16.007, 27.127, all P<0.05). Neuroticism showed a negative correlation with various dimensions of self-management behaviors ( r=-0.130--0.073), while conscientiousness and agreeableness were positively correlated with various dimensions of self-management behaviors ( r=0.072-0.215). Dietary control score was negatively correlated with HbA 1c and LDL-C ( r=-0.106, -0.077), and regular exercise score was negatively correlated with postprandial 2-hour blood glucose, HbA 1c, TG, TC, HDL-C, and LDL-C ( r=-0.115--0.071). The total score of the 2-DSCS was negatively correlated with HbA 1c, TG, and TC ( r=-0.104--0.071). Patients with a disease duration exceeding 15 years and those receiving insulin injections or a combination of oral medication and insulin injections had higher total 2-DSCS score ( β=0.085, 0.146, 0.118, all P<0.05). Conversely, patients with higher HbA 1c and SDS standard scores had lower total 2-DSCS score ( β=-0.151, -0.328, both P<0.05), while those with higher agreeableness scores had higher total 2-DSCS score ( β=0.143, P<0.05). Conclusion:The traits of neuroticism, conscientiousness, and agreeableness within the Big Five Personality Traits, as well as anxiety and depressive emotions, are correlated with self-management behaviors. Specifically, agreeableness has a positive predictive effect on self-management behaviors, whereas depressive emotions have a negative predictive effect.

Objective:To evaluate immunotherapy combined with neoadjuvant chemotherapy before radical total gastrectomy in microsatellite stable locally advanced gastric cancer in two cases.Methods:Two male patients with clinical stage cT3N 1M0 and microsatellite-stable locally advanced gastric cancer were treated with neoadjuvant chemotherapy with PD-1 inhibitor (Nivolumab) combined with SOX (Oxaliplatin+S-1) for 4 cycles before surgery. Standard laparoscopic assisted total gastrectomy with D 2 lymphadenectomy was performed on Feb 2023 and Oct 2023 respectively after the neoadjuvant treatment. Pathological tumor regression grade(TRG) was observed to assess the degree of tumor regression, and follow-up was conducted to monitor tumor markers and abdominal enhanced CT to detect recurrence. Results:Two patients achieved pathological complete response(TRG0). They were followed up until May 2024 and no recurrence was observed.Conclusion:Preoperative combination of chemotherapy and immunotherapy may provide survival benefit for microsatellite stable locally advanced gastric cancer patients.

Objective:To investigate cerebral blood flow (CBF) changes in type 2 diabetes mellitus (T2DM) and its relationship with cognitive function by arterial spin labeling (ASL).Methods:This study was a cross-sectional study. Clinical data (age, sex, years of education, body mass index) and imaging data of 46 patients with T2DM (T2DM group) and 57 healthy controls (HC group), who visited the First Affiliated Hospital of Guangzhou University of Chinese Medicine from September 2017 to March 2019 were analyzed retrospectively. All subjects underwent clinical cognitive function assessments, including the auditory verbal learning test (AVLT), trail making test (TMT), and montreal cognitive assessment (MoCA) scale. All subjects underwent routine axial 3D-ASL imaging, and CBF pseudocolor images were automatically generated from the 3D-ASL raw images. CBF values in the differential brain regions were extracted. The differences in clinical data, cognitive function scores, and CBF values between T2DM group and HC group were evaluated using independent sample t-tests, Mann-Whitney U tests, and χ 2 tests. The correlation between the differential brain region CBF values and cognitive function scores was analyzed using partial correlation analysis, controlling for age, gender, and years of education. Results:There were no significant differences in age, gender, years of education, AVLT scores, and TMT scores between T2DM group and HC group ( P>0.05). But there were significant differences in body mass index and MoCA scores ( Z=-2.16, P=0.031; Z=-3.18, P=0.001). Compared with HC group, T2DM group showed significantly increased CBF in the left insula ( P<0.001), but significantly decreased CBF in the right fusiform gyrus, right cuneus, and right prefrontal gyrus ( P<0.001). The partial correlation analysis showed that the CBF value in the right prefrontal gyrus of T2DM group was positively correlated with MoCA scores ( r=0.330, P=0.001), while the CBF value in the right fusiform gyrus was positively correlated with MoCA scores ( r=0.210, P=0.034). Conclusions:Patients with T2DM show changes in CBF in the left insula, right fusiform gyrus, right cingulate anterior, and right prefrontal cortex. Reduced CBF in the right prefrontal cortex and right fusiform gyrus is associated with cognitive function decline.

Objective To investigate the influence of type 2 diabetes mellitus(T2DM)on cognitive function and the effective connectivity with in the default mode network(DMN)in the brain.Methods A total of 93 hospitalized patients diagnosed with T2DM were enrolled in this study as T2DM group from The First Affiliated Hospital of Guangzhou University of Chinese Medicine during September 2021 to December 2022.Simultaneously,108 healthy individuals were recruited from the community as normal control(NC)group.The cognitive functions were evaluated in the two groups.A random dynamic causal modeling approach was employed to analyze the effective connectivity within DMN in both groups.Additionally,Pearson correlation analysis was performed to examine the association between differential connectivity,clinical indicators,and cognitive scores in both groups.Results In comparison to the NC group,T2DM individuals exhibited statistically significant reductions in scores in the auditory verbal learning test(AVLT)for immediate recall and the digit symbol substitution test(DSST)(P＜0.05).Additionally,they displayed a notable decrease in effective connectivity from the left lateral parietal cortex(LLPC)to the posterior cingulate cortex(PCC),as well as from the LLPC to the right lateral parietal cortex(RLPC)within the DMN(P＜0.05).Pearson correlation analysis unveiled a negative association between HbA1c levels and the strength of effective connectivity from LLPC to PCC.Conversely,a positive correlation was observed between AVLT(immediate)scores and the strength of effective connectivity from LLPC to PCC and LLPC to RLPC.Additionally,DSST scores displayed a positive correlation with the strength of effective connectivity from LLPC to PCC(P＜0.05).Conclusion Patients with T2DM display compromised effective connectivity from LLPC to PCC and LLPC to RLPC within the DMN network,and this alteration may associated with cognitive impairment.