Objective To study the activated status of insula during the performance of word generation task, and to explore the function of different part of insula with functional MRI (fMRI). Methods Twenty-eight subjects were recruited in this study (male 15, female 13), all of them underwent block-designed fMRI with word generation tasks and resting-state scan. SPM 5 and REST 1.3 were used to process the data. Bilateral anterior insula and posterior insula were selected as seeds to calculate the connectivity coefficiency with other voxels, and differences between the anterior and the posterior insula were compared. Results Bilateral anterior insula was significantly activated, while bilateral posterior insula was significantly deactivated. The functional connectivity areas with left anterior insula included right anterior insula, right posterior insula, supplementary motor area (SMA), left superior temporal gyrus, left middle frontal gyrus, left superior frontal gyrus, left inferior parietal lobe, middle cingulate gyrus, right striatum and right inferior frontal gyrus. The functional connectivity areas with left posterior insula included right posterior insula, left anterior insula, right superior temporal gyrus, middle cingulate gyrus, right precentral gyrus and right striatum. The functional connectivity areas with right anterior insula included SMA, left inferior frontal gyrus, right inferior parietal lobe, left inferior parietal lobe, left superior temporal gyrus, right precentral gyrus, right striatum, middle cingulate gyrus, left middle frontal gyrus, left striatum, right middle frontal gyrus, right inferior frontal gyrus and left transverse temporal gyrus. The functional connectivity areas with right posterior insula included right precentral gyrus, left superior temporal gyrus, left anterior insula, left posterior insula, right supramarginal gyrus and middle cingulate gyrus. Conclusion Anterior insula and posterior insula are functionally connected with different areas, and concerned with the language function in different manners. Left lateral anterior insula may play an important role in the language function.

Objectives To measure the microstructural differences in the brains of participants with amnestic mild cognitive impairment ( aMCI) and compare with a control group using a magnetic resonance diffusion tensor imaging ( DTI) technique with fully automated image analysis tools. Methods A standardized clinical and neuropsychological evaluation was conducted on each subject 31 participants (15 participants with aMCI, 16 healthy elderly adults) underwent magnetic resonance imaging (MRI)-based DTI. To control the effects of anatomical variation, the diffusion images of all participants were registered to standard anatomical space. Voxel-by-voxel comparisons showed significant regional reductions in white matter regions of fractional anisotropy (FA) in the participants with aMCI as compared with the controls. Results Significantly decreased FA value measurements (P<0. 001) were observed in the right frontal white matter in participants with aMCI. Moreover, there was a statistically significant difference between the patients with aMCI and controls in considering the small regions of bilateral superior frontal gyrus white matter (P < 0.001). Conclusions White matter damage of frontal lobe may play an important role in histopathologic changes associated with amnestic mild cognitive impairment

Objective To compare three different anti-hypertension therapeutic projects by pharmacoeconomic evaluation and to find out the best therapeutic project.Methods Retrospective study was used.120 patients with hypertension were ran-domly assigned to group A(fosinopril sodium),group B(valsartan),group C(amlodipine besylate tablet),the therapeutic effects were observed and were evaluated by cost minimization analysis.Results The total efficiency of A,B,C group were 90·7%, 92·3%,92.1%(P>0.05)respectively.The incidence of adverse reaction were 16.7%,7.7%,13.2%(P>0.05)respective-ly.The costs were 287.3 yuan,378.7 yuan and 320.4 yuan respectively.Conclution The effectiveness of the three groups was similar.In terms of pharmacoeconomics,group A was the best therapeutic project.

Objective To investigate the status of depression/anxiety in obese patients seeking metabolic surgery and analyze the effects of depression/anxiety on different aspects of quality of life. Methods Convenient sampling was used and 117 metabolic surgery were recruited from the Department of Bariatric and Metabolic Surgery in the First Affiliated Hospital of Nanjing Medical University from March to July,2017. Patient Health Questionnaire(PHQ-9),Generalized Anxiety Disorder 7-item scale (GAD-7),12 item Short-Form Health Survey(SF-12)and the general information and disease characteristics questionnaire were used to collect data. Results Nearly 25.6%(30/117) of the patients suffered from moderate, moderately severe and severe depression symptoms and the median and interquartile range of PHQ-9 was 6 and 7 points.16.2%(19/117)of the patients had moderate and severe anxiety symptoms and the median and interquartile range of GAD-7 was 3 and 6 points. Multiple linear regression analysis showed that scores in the physical component of the SF-12 were associated with the body mass index,the presence of comorbidities and depression,which could explain 20.0% of the total variance;the symptoms of depression and anxiety were negatively related to the mental component summary of SF-12,which could explain 49.6% of the total variance. Conclusions The present findings suggests that there is a high occurrence of depression and anxiety in metabolic surgery patients, which severely impair the patients′quality of life. As for the obese patients seeking metabolic surgery for treatment, routine screening of depression and anxiety incorporating the diagnosis of the problems are warranted.Then intervention based on the assessment can be exerted to maximize the benefit of patients undergoing the surgery in the long term.

Objective: To evaluate the value of computed tomography (CT) multi-planner reconstruction (MPR)in the treatment of lung cancer with percutaneous argon-helium cryoablation.Method:A total of 66 patients with stage T2 or T3 non-small cell lung can-cer who had complete follow-up data were treated with percutaneous argon-helium cryoablation with conventional axial CT(conven-tional group)or MPR guidance(MPR group)between January 2013 and 2016.There were 31 patients in the conventional group and 35 in the MPR group.The total number of punctures,the total time of operation,and the incidence of complications,tumor residual rates,and local control rates were compared between the two groups.Results:When the number of needles was the same,the aver-age number of punctures and puncture errors in the two groups were significantly lower in the MPR group than in the conventional group(P<0.05).Comparing the average operation time,there was no statistical difference between the MPR group and the conven-tional scan group(P>0.05).The incidence of postoperative complications was significantly lower in the MPR group than in the conven-tional scan group.Among them,the incidence of puncture combined hemorrhage was 1.52% vs.13.64%,and pneumothorax second-ary to puncture was 3.03% vs.19.70%(P<0.05).During the follow-up period to 12 months after surgery,the therapeutic benefit indica-tors such as local residual rate and total effective rate in the MPR group were also significantly better than those in the conventional group,which were 1.52% vs.10.61 and 51.52% vs.36.36%(P<0.05),respectively.Conclusions:Using MPR technology to guide percuta-neous argon-helium cryoablation treatment for lung cancer confers a small puncture error,low incidence of complications,and signifi-cant treatment benefits.This method is worthy of clinical promotion.

Metabolic surgery is a gastrointestinal surgical procedure to treat obesity and its related co-morbidities with rapid development in recent years. Patients undergoing metabolic surgery have preoperative nutritional disorders, and the nutrition management for these patients is the key point of perioperative management. During the perioperative period, current research has preliminarily confirmed that perioperative managements including supplementation of micronutrients, preoperative evaluation of the weight loss, preoperative fasting and carbohydrate oral intake based on the full application of ERAS and characteristics of the patients undergoing metabolic surgery, are safe and effective in clinical practice. As for the postoperative diet strategy, current literature remains non-unified to identify the duration and the content of the nutrition managements. Domestic clinical reports about the postoperative nutrition managements after metabolic surgery are rare and lack of unified and good reference standard. Meanwhile, divergence still existed in current literature regarding to the content of the postoperative nutrition managements. Therefore, it is necessary to develop the standardized protocol for nutrition managements which is offering basis and reference for the clinical application of perioperative nutrition managements after metabolic surgery.
Bariatric Surgery ; Digestive System Surgical Procedures ; Humans ; Nutrition Therapy ; methods ; standards ; Perioperative Care ; methods ; standards

Humans ; Artificial Intelligence ; Algorithms ; Brain ; Head

Connectome/methods* ; Magnetic Resonance Imaging/methods* ; Brain/diagnostic imaging* ; Head ; Brain Mapping/methods* ; Nerve Net

Cross-modal selective attention enhances the processing of sensory inputs that are most relevant to the task at hand. Such differential processing could be mediated by a swift network reconfiguration on the macroscopic level, but this remains a poorly understood process. To tackle this issue, we used a behavioral paradigm to introduce a shift of selective attention between the visual and auditory domains, and recorded scalp electroencephalographic signals from eight healthy participants. The changes in effective connectivity caused by the cross-modal attentional shift were delineated by analyzing spectral Granger Causality (GC), a metric of frequency-specific effective connectivity. Using data-driven methods of pattern-classification and feature-analysis, we found that a change in the α band (12 Hz-15 Hz) of GC is a stable feature across different individuals that can be used to decode the attentional shift. Specifically, auditory attention induces more pronounced information flow in the α band, especially from the parietal-occipital areas to the temporal-parietal areas, compared to the case of visual attention, reflecting a reconfiguration of interaction in the macroscopic brain network accompanying different processing. Our results support the role of α oscillation in organizing the information flow across spatially-separated brain areas and, thereby, mediating cross-modal selective attention.

Neuroimaging has opened new opportunities to study the neural correlates of consciousness, and provided additional information concerning diagnosis, prognosis, and therapeutic interventions in patients with disorders of consciousness. Here, we aim to review neuroimaging studies in chronic disorders of consciousness from the viewpoint of the brain network, focusing on positron emission tomography, functional MRI, functional near-infrared spectroscopy, electrophysiology, and diffusion MRI. To accelerate basic research on disorders of consciousness and provide a panoramic view of unconsciousness, we propose that it is urgent to integrate different techniques at various spatiotemporal scales, and to merge fragmented findings into a uniform "Brainnetome" (Brain-net-ome) research framework.
Animals ; Brain ; physiology ; Chronic Disease ; Consciousness ; physiology ; Consciousness Disorders ; physiopathology ; Humans ; Neuroimaging ; methods ; Persistent Vegetative State