Objective To discuss the application of spiral computed tomography and reconstruction technology for patients of depressed nasal bone. Methods The patients of transsection location were backlying on the scan bed and continuously scanning in spiral, and baseline was acou-infraorbital line. The reconstructed image with 2mm layer thickness and 1.5mm overlap can be selected SSD liminal value as bone -wide and surface threshold. Results SSD image can be clearly demonstrated than general nasal bone cross-section profile in the shape, location, size and suitability of filled composite. Conclusion The surface shadow display can be shown nasal bone structure realistically, the three-dimensional anatomic structure images of vessels and the effect of bionics. The bone of volume, distance and angle can be measured exactly by clinical physician, and made the best treatment plan based on the images.

Objective To investigate the association among cerebral lesions, mild cognitive impairment and artery stenosis.Methods In 685 cases which seek medical care in our hospital in recent years, we studied the cortical infarction lesions in this study, analysis of subcortical infarction in patients with cognitive impairment as well as the composition of the artery stenosis conditions were conducted .Results in this study, subcortical infarct patients with mild disturbance of consciousness accounted for 9.20%, while blood supply stenosis cases accounted for 49.34%.Elder than 70 years, long course of subcortical infarction, family history of alcohol consumption and dementia were associated with cortical (P <0.05), the incidence of subcortical infarct and mild cognitive disturbance were 2.138 times for infarct and mild disturbance of consciousness patients.Multivariate regression analysis showed that family history of hypertension and cerebrovascular disease were also risk factors.In addition, mild cognitive impairment can increase the risk of subcortical infarct and the incidence of vascular stenosis, OR was 2.077;elder than 70 years of age, subcortical infarct length, hypertension and family history of cerebrovascular disease were risk factors for subcortical infarction and stenosis of blood supply.In multivariate regression analysis, mild cognitive impairment, long duration of subcortical infarct, overweight and obesity, and hypertension showed to be risk factors of subcortical infarct and blood supply stenosis.Conclusion The artery stenosis and subcortical infarction with mild cognitive impairment show a positive correlation, while the presence of mild cognitive impairment and subcortical infarction and artery stenosis and an increased risk of an association, are related to each while age, duration and associated subcortical infarcts family history and other factors also affect the potential relationship between them .

Objective To investigate the safety and effectiveness of rescue stenting after failure of mechanical thrombectomy in patients with acute ischemic stroke (AIS) caused by large vessel occlusion (LVO). Methods From December 2015 to December 2017, patients with AIS caused by LVO and treated with Solitaire AB stent thrombectomy in the Fifth Central Hospital of Tianjin were enrolled retrospectively. CT scans were performed within 24 h after surgery. Symptomatic intracraninal hemorrhage (sICH) was defined as CT confirmed intracranial hemorrhage and the National Institutes of Health Stroke Scale score increased ≥4. Clinical outcomes were assessed using the modified Rankin Scale at 90 d after onset, and 0 to 2 was defined as good outcome. According to whether to receive rescue stenting or not, the patients were divided into 2 groups. The clinical outcomes and incidence of sICH were compared between the 2 groups. Results A total of 39 patients were enrolled. Among them, 29 (74. 3％) were successfully recanalized by mechanical thrombectomy and 10 (25. 6％) performed stenting after failure of mechanical thrombectomy. Four (40. 0％) in the stenting group and 11 (37. 9％) the non-stenting group had good outcomes respectively at 90 d. There was no significant difference (P = 1. 000). Two patients (20. 0％) and 1 patient (3. 4％) developed sICH within 24 h after operation in the stenting group and the non-stenting group respectively. There was also no significant difference (P = 0. 156). Conclusions Rescue stenting can be used as a safe and effective remedy for patients with failure of mechanical thrombectomy.

Objective To compare the outcomes of Solitaire AB stent mechanical thrombectomy for the treatment of large-artery atherosclerotic stroke (LAA) and cardioembolic stroke (CES).Methods Acute ischemic stroke patients treated with Solitaire stent retriever device were enrolled retrospectively. They were divided into either a LAA group or a CES group according to the etiology. The outcomes in both groups were compared. Multivariate logistic regression analysis was used to determine the independent risk factors for poor outcome (defined as the modified Rankin Scale score > 2) at 90 d after onset. Results A total of 39 patients were enrolled in the study. There were 18 patients in the LAA group (49. 2％), 6 (33. 3％) had good outcome at 90 days; there were 21 patients (50. 8％) in the CES group, 9 (42. 9％) had good outcome at 90 days. There was no significant difference in the the good outcome rate at 90 days in both groups (P = 0. 223). Multivariate logistic regression analysis showed that only age was independently associated with poor outcome (odds ratio 1. 107, 95％ confidence interval 1. 016-1. 206; P = 0. 047), and stroke etiology subtype was not independently associated with poor outcome (odds ratio 0. 671, 95％ confidence interval 0. 078- 5. 743; P = 0. 716). Conclusions There was no significant difference in the clinical outcome between the patents with LAA and CES who received mechanical thrombectomy with Solitaire AB stent.

Objective:To evaluate the clinical diagnostic significance of altered functional connectivity (FC) within the central executive network (CEN) in patients with mild cognitive impairment (MCI) related to end-stage renal disease (ESRD).Methods:A total of 155 patients with ESRD receiving hemodialysis treatment at the department of nephrology, Changzhou Second People's Hospital, from June 2020 to December 2023, were recruited. According to wether the patient had MCI symptoms, 85 patients were classified in the ESRD with MCI group, while 70 patients were in the ESRD without MCI group. Additionally, 76 healthy volunteers matched for age, sex, and years of education were enrolled in the study. All participants underwent resting-state functional magnetic resonance imaging and were evaluated using the Montreal cognitive assessment. With the dorsolateral prefrontal cortex serving the core of CEN, functional attributes of the CEN were calculated using seed-based FC analysis. Based on these imaging features and clinical data, a LASSO + Logistic regression model was constructed to predict MCI in patients with ESRD, and SPSS 20.0 software was used for analysis.Results:There were significant differences in FC in 10 brain regions, including the inferior temporal gyrus, temporal pole, corpus callosum, ventromedial prefrontal cortex, ventral posterior cingulate cortex, inferior parietal lobule, precuneus, dorsomedial prefrontal cortex, dorsal anterior cingulate cortex, and supplementary motor area, among the three groups (all P<0.001). Post hoc analysis revealed that the zFC values of the ventromedial prefrontal cortex and dorsomedial prefrontal cortex in ESRD with MCI group(0.385±0.219, 0.215±0.247) were significantly higher than those in the ESRD without MCI group (0.278±0.184, 0.121±0.221) and the healthy controls (0.206±0.217, 0.078±0.212) (all P<0.05). In addition to the ventromedial prefrontal cortex and dorsomedial prefrontal cortex, zFC values in all brain regions exhibiting significant differences were markedly reduced in both the ESRD with MCI group (temporal pole (0.157±0.221 vs 0.327±0.191), corpus callosum (0.100±0.184 vs 0.327±0.191), ventral posterior cingulate cortex (0.027±0.199 vs 0.128±0.154), inferior parietal lobule (0.218±0.195 vs 0.387±0.213), precuneus (0.193±0.184 vs 0.358±0.142), supplementary motor area (0.182±0.163 vs 0.231±0.163)) and the ESRD without MCI group (inferior temporal gyrus (0.055±0.125 vs 0.250±0.146), temporal pole (0.048±0.223 vs 0.335±0.195), corpus callosum (0.192±0.161 vs 0.327±0.191), inferior parietal lobule (0.234±0.197 vs 0.387±0.213), dorsal anterior cingulate cortex (0.383±0.242 vs 0.585±0.195), supplementary motor area (0.076±0.162 vs 0.231±0.163)), compared to healthy controls ( P<0.01). The zFC values of 4 brain regions in ESRD with MCI group were significantly higher than those in the ESRD without MCI group (inferior temporal gyrus (0.226±0.205 vs 0.055±0.125), temporal pole (0.157±0.221 vs 0.048±0.223), dorsal anterior cingulate cortex (0.498±0.254 vs 0.383±0.242), supplementary motor area (0.182±0.163 vs 0.076±0.162)) ( P<0.05). The diagnostic model developed from these results demonstrated excellent discrimination(the area under the curve=0.94, the sensitivity=0.89, the specificity=0.86, and the accuracy=0.88). Additionally, it exhibited strong calibration ( R2=0.908) and clinical applicability(patients benefited when the predicted probability exceeded 0.12). Conclusion:The enhancement of FC in CEN and its attenuation with other networks provide relevant evidence for the neuropathological mechanisms underlying MCI in patients with ESRD.The diagnostic model based on FC changes in the CEN, as presented in this study, is valuable for detecting early cognitive impairment in patients with ESRD.