Objective The influence of antiplatelet medications on prognosis after non -aneurysmal subarachnoid hemorrhage(SAH)is unknown.This study aimed to evaluate the risk of antiplatelet mdications in devel-oping SAH.Methods 420 patients who underwent catheter cerebral angiography after presenting with nontraumatic SAH were included.Outcomes were assessed by using the modified Rankin scale.Results A total of 420 patients underwent catheter angiography for evaluation of SAH.Of these,63 cases (15%)were angiogram -negative.The fraction of patients presenting with angiogram -negative SAH as well as the frequency of antiplatelet use among these patients significantly increased during the study period.Antiplatelet use was more commonly associated with angiogram-negative SAH(18 /63,28.6%)than with angiogram -positive SAH(39 /357,11%;P =0.001).At 14 days after presentation,poor outcome was significantly more frequent among patients who took antiplatelet agents (20 /63, 31.7%)than among those who did not(12 /63,20%;P =0.017).Conclusion Antiplatelet medication use is asso-ciated with poor early,but not late,outcomes after angiogram -negative SAH.More studies are needed to confirm this association.

Objective To investigate the features of variation of sympathetic skin response(SSR)in depression patients and to clarify the correlation between SSR and the effect of antidepressant therapy in first episode depression.Methods The sample comprised 50 first visit patients,who fulfilled the ICD-10 criteria in a structured interview for depressive disorder.These 50 patients received antidepressant therapy for 6 weeks.Clinical response was defined as ≥50%reduction in total 17-item Hamilton depression rating scale(HAMD).Remission was defined as HAMD score ≤7 at week 6.SSR waveforms were classified into three patterns based on the amplitudes of positive and negative components:P pattern,N pattern and M pattern.Another 50 healthy subjects were involved in this study as controls.Results (1)SSR could be obtained in all normal subjects but couldn't be recorded in 5 of 50 patients whose HAMD scores>28.SSR waveforul patterns were analyzed in these 45 patients P pattern in 7 cases,N pattern 21,M pattern 17.(2)Depression patients had longer latency and lower amplitude than the controls(P<0.01).P pattern had shorter latency and higher amplitude than N pattern.There were no difference in age,course and HAMD scores among the patients with 3 different SSR patterns.(3)Nine of 21 patients of N pattern treated with fluoxetine were remitters.6 patients were clinical responders.These 15 patients had shorter latency and higher amplitude after treatment than that at the initial stage,but there were still differences in latency and amplitude compared with the controls.Conclusion There were significant damages on sympathetic function of depression patients.N pattern was the most SSR pattern among 45 patients recorded SSR.P pattern had shorter latency and higher amplitude than N pattern.SSR is a sensitive and feasible measure inder for neurocardiac electrophysiologic autonomic regulation examination,which could be used to measure clinical therapeutic efficacy for antideppressant in depression patients.

Objective To evaluate the ability of contrast-enhanced ultrasonography (CEUS)in differentiate reactive lymph node,metastatic lymph node and lymphoma.Methods In a prospective study CEUS was performed in 129 patients with cervical lymph node enlargement.The entire process were recorded and preserved in DICOM format.The results were registered with Sonoliver.The receiver operating characteristic curve (ROC curve)analysis was performed to find the corresponding cutoff values. The selected node was removed surgically and submitted for histology.Results Of all the nodes,26 were reactive nodes,85 were metastases and 1 8 were lymphoma.Enhancement pattern was the most accurate way to characterize lymph nodes.The enhancement pattern of reactive lymph nodes was homogeneous and most of them were enhanced by lymphatic type while the metastatic lymph nodes were inhomogeneously enhanced or weakly enhanced by peripheral type.Lymph node lymphoma usually had no fixed enhancement pattern. Arrive time (AT),rise time (RT),time to peak (TTP),mean transit time (mTT),maximum intensity (IMAX),under the curve (AUC),rising slope(Kup),semi descending slope(Kdown)and perfusion index (PI)were significantly different in the three groups(P <0.05).RT,TTP and mTT of reactive lymph nodes were the shortest,which had significant difference compared with those of metastatic lymph nodes and lymphoma (P < 0.05 ).Kup,Kdown,IMAX%,AUC,PI in the reactive lymph nodes were significantly decreased compared with the metastatic group (P <0.05),but there was no significant difference compared with those in lymphoma (P >0.05 ).When TTP≥ 7.74 s,mTT≥26.54 s,metastatic lymph nodes were considered.When RT≥4.62 s,TTP ≥ 7.74 s,mTT ≥ 28.32 s,reactive lymph nodes were not considered. Conclusions Dynamic contrast-enhanced ultrasound image and enhancement pattern can distinguish neck lymph nodes while the optimal cut-off point time of the time-intensity curve parameters can further contribute to the identification of lymph nodes.

Objective To provide a reference for differential diagnosis of thyroid microcarcinoma classified as TI-RADS 3-4 grade using contrast-enhanced ultrasound.Methods SonoLiver software was used to analyze the process of contrast-enhanced ultrasound of 112 thyroid small nodules classified as TI-RADS 3-4 grade.The dynamic vascular pattern curve(DVPC)and the time-intensity curve(TIC)were automatically acquired for summarization of the types and characteristics of the two curves.The relevant parameters such as the rise time(RT),time to peak(TTP),maximum intensity(IMAX%),mean transit time(mTT),area under curve(AUC)and perfusion index(PI)were acquired and calculated using the software.Receiver operating curve (ROC) analysis was used to achieve the cut-off value of these parameters for differential diagnosis.Results For thyroid microcarcinoma which TI-RADS assessment of grade 3-4,TIC showed as slow rise and slow drop wave or slow rise and fast drop wave,DVPC showed negative waveform or negative-positive bi-directional waveform.ROC analysis demonstrated that IMAX of 96.5%,AUC of 443.08 and PI of 47.64 were the best cut-off values for the differential diagnosis of benign and malignant nodules.When IMAX<96.5%,AUC<443.08,PI<47.64,the nodules were highly likely to be thyroid microcarcinoma.Conclusions The contrast-enhanced ultrasound parameters can provide effective reference for the differential diagnosis of thyroid carcinoma with grade 3-4 in TI-RADS classification.

Objective: To provide a reference for differential diagnosis of orbit tumors in extraconal compartment by analyzing the parameters of contrast-enhanced ultrasonography (CEUS). Methods: A total of 76 patients with orbit tumors in extraconal compartment who underwent CEUS examination were retrospectively analyzed. These patients were divided into two groups depending on histological diagnosis including 27 cases with malignant tumor and 49 cases with benign tumor. CEUS images were analyzed using Sonoliver software. The time-intensity curve (TIC) and dynamic vascular pattern curve (DVPC) were acquired and the characteristics of the arterial flow infusion of these were analyzed. The related parameters such as time of arrival time(AT), rise time (RT), time to peak(TTP), mean transit time(mTT), slope of rise(K₁), the absolute value for slope of down (K₂) were also obtained. The differences of DVPC, TIC and quantitative parameters between the two groups were compared. Receiver operating curve analysis was used to acquire the cut-off values of these parameters for differential diagnosis. Results: ①TICs of the benign tumors were mainly fast rise and slow drop and DVPCs were mainly positive biphasic, while TICs of the malignant tumors were mainly fast rise and fast drop and DVPCs were mainly biphasic. ②The differences of quantitative parameters IMAX, K₁, K₂, mTT and RT of TICs were statistically significant between the two groups (P<0.05), while those of AT and TTP were not (P>0.05). ③IMAX=456.2%, K₁=109.6, K₂=35.2, RT=7.9 s, mTT=28.1 s were the best cut-off values for differential diagnosis. Among these parameters, mTT with 28.1 s had the highest diagnostic value(sensitivity: 81%, specificity: 77%). Conclusions The quantitative CEUS parameters can provide effective reference for differential diagnosis of orbit tumors in extraconal compartment.

Objective:To provide objective basis for the diagnosis on liver metastasis from lung cancer by analysing contrast-enhanced ultrasonography(CEUS) characteristics.Methods:In a reprospective study, CEUS was performed in 78 cases with liver metastasis from lung cancer in Renmin Hospital of Wuhan University from January 2014 to March 2019. Patients were divided into three groups: the adenocarcinoma group( n=30), squamous cell carcinoma group ( n=20), and neuroendocrine neoplasm group( n=28). Conventional ultrasound and CEUS features were analyzed and the distinctions among the three groups were compared. Results:CEUS showed that 85.9%(67/78) of the liver metastasis from lung cancer with pattern of rapid wash-in and 89.7%(70/78) of rapid wash-out, so there was no statistical difference among the three groups( P>0.05). In the adenocarcinoma and squamous cell carcinoma group, 53.3%(16/30) and 55.0%(11/20) of cases were rim-like enhancement. And 71.4%(20/28) of the neuroendocrine neoplasm group with global enhancement that was different from the other groups(all P<0.05). At the peak of enhancement, most cases were hyperenhancement among the three groups, and the difference was not statistically significant( P>0.05). During the lesions of hyperenhancement, 73.7%(14/19) was global enhancement in the neuroendocrine neoplasm, compared to 75.0% (12/16) of the adenocarcinoma group and 72.7%(8/11) of the squamous cancer group with rim-like enhancement, which the differences was statistically significant(all P<0.05). At the peak of enhancement, 67.9%(19/28) lesions of the neuroendocrine neoplasm group were homogeneous enhancement, and only 21.4%(6/28) of the lesions was observed non-enhanced area, which was different from the other groups(all P<0.05). The times to iso-echogenity and hypo-echogenity were (33.2±7.6)s and (45.1±10.8)s respectively in the neuroendocrine neoplasm group, which were more than the other groups(all P<0.05). Capsule enhancement appeared in 32.1%(9/28) of the neuroendocrine neoplasm group in the delay phase, which was higher than 13.3%(4/30) of the adenocarcinoma group and 10.0%(2/20) of squamous cell carcinoma group (all P<0.05). Conclusions:CEUS can provide more diagnostic information for liver metastasis from lung cancer and may be a beneficial technique for differential diagnosis.

Objective:To investigate the correlation between serum lipoprotein (a) [LP(a)] and the severity of white matter hyperintensities (WMHs) in the middle-aged and elderly people in the community.Methods:Consecutive middle-aged and elderly residents residing in the community underwent physical examinations in the Affiliated Jiangning Hospital of Nanjing Medical University from June 2016 to August 2021 were retrospectively collected. Fasting venous blood was collected on the next day of admission to detect the level of Lp(a). During hospitalization, cranial MRI examination was performed and the severity of WMHs was graded using the Fazekas visual scoring method. Ordinal multivariate logistic regression analysis was used to determine independent related factors for the severity of WMHs.Results:A total of 1 752 patients were included in the analysis. There were 969 males (55.31%) and 783 females (44.69%). Their age was 66.18±10.32 years old. There were 1 167 patients (66.61%) in the mild WMHs group, 407 (23.23%) in the moderate WMHs group, and 178 (10.16%) in the severe WMHs group. Ordinal multivariable logistic regression analysis showed that after adjusting for confounding factors, a higher serum Lp(a) level was independently related to the severity of WMHs (with the first quartile as a reference, the third quartile: odds ratio 1.441, 95% confidence interval 1.050-1.976, P=0.023; the fourth quartile: odds ratio 1.717, 95% confidence interval 1.252-2.354, P=0.001). Conclusion:Serum Lp(a) is independently correlated with the severity of WMHs.

Objective To provide a reference for differential diagnosis of orbit tumors in extraconal compartment by analyzing the parameters of contrast‐enhanced ultrasonography ( CEUS) . Methods A total of 76 patients with orbit tumors in extraconal compartment w ho underwent CEUS examination were retrospectively analyzed . T hese patients were divided into two groups depending on histological diagnosis including 27 cases with malignant tumor and 49 cases with benign tumor . CEUS images were analyzed using Sonoliver software . T he time‐intensity curve ( T IC ) and dynamic vascular pattern curve ( DVPC ) were acquired and the characteristics of the arterial flow infusion of these were analyzed . T he related parameters such as time of arrival time( AT ) ,rise time ( RT ) ,time to peak( T T P) ,mean transit time( mT T ) ,slope of rise( K1 ) ,the absolute value for slope of down ( K 2 ) were also obtained . T he differences of DVPC ,TIC and quantitative parameters between the two groups were compared . Receiver operating curve analysis was used to acquire the cut‐off values of these parameters for differential diagnosis . Results ① T ICs of the benign tumors were mainly fast rise and slow drop and DVPCs were mainly positive biphasic ,w hile T ICs of the malignant tumors were mainly fast rise and fast drop and DVPCs were mainly biphasic . ② T he differences of quantitative parameters IM AX ,K 1 ,K2 ,mT T and RT of T ICs were statistically significant between the two groups ( P ＜0 .05) ,w hile those of A T and T T P were not ( P ＞ 0 .05 ) . ③ IM AX＝ 456 .2% ,K1 ＝109 .6 ,K2 ＝35 .2 ,RT＝7 .9 s ,mT T＝28 .1 s were the best cut‐off values for differential diagnosis . Among these parameters ,mT T with 28 .1 s had the highest diagnostic value ( sensitivity :81% ,specificity :77% ) . Conclusions The quantitative CEUS parameters can provide effective reference for differential diagnosis of orbit tumors in extraconal compartment .

In recent years, due to the emergence of ultrafast ultrasound imaging technology, the sensitivity of detecting slow and micro blood flow with ultrasound has been dramatically improved, and functional ultrasound imaging (fUSI) has been developed. fUSI is a novel technology for neurological imaging that utilizes neurovascular coupling to detect the functional activity of the central nervous system (CNS) with high spatiotemporal resolution and high sensitivity, which is dynamic, non-invasive or minimally invasive. fUSI fills the gap between functional magnetic resonance imaging (fMRI) and optical imaging with its high accessibility and portability. Moreover, it is compatible with electrophysiological recording and optogenetics. In this paper, we review the developments of fUSI and its applications in neuroimaging. To date, fUSI has been used in various animals ranging from mice to non-human primates, as well as in clinical surgeries and bedside functional brain imaging of neonates. In conclusion, fUSI has great potential in neuroscience research and is expected to become an important tool for neuroscientists, pathologists and pharmacologists.
Animals ; Mice ; Ultrasonography/methods* ; Brain/physiology* ; Magnetic Resonance Imaging ; Optogenetics ; Hemodynamics

Objective:To analyze the site of vestibular nerve damaged in patients with acute vestibular neuritis. Methods:Fifty-seven patients with acute vestibular neuritis were recruited, and each patient underwent caloric irrigation test, video head impulse test（vHIT） and vestibular evoked myogenic potentials（VEMPs）. The results were further analyzed. Results:Analysis of abnormal rates of different vestibular function tests: the abnormal rate of caloric irrigation test, horizontal semicircular canal vHIT, anterior semicircular canal vHIT, and posterior semicircular canal vHIT were 92.98%, 92.98%, 92.98%, and 52.63%, respectively. The abnormal rate of cervical vestibular evoked myogenic potentials（cVEMP） and ocular vestibular evoked myogenic potentials（oVEMP） were 52.63% and 89.47%. The abnormal rate of caloric irrigation test, horizontal semicircular canal vHIT, anterior semicircular canal vHIT, and oVEMP were significantly higher than posterior semicircular canal vHIT and cVEMP（P<0.01）. Combination analysis of different vestibular function tests: there are twenty-six patients（45.61%, superior and inferior vestibular nerve） with abnormal caloric irrigation test, video head impulse test, and VEMPs. There are twenty-five patients（43.86%, superior vestibular nerve） with abnormal caloric irrigation test, horizontal semicircular canal vHIT, anterior semicircular canal vHIT, and oVEMP. There are 4 patients（7.02%, inferior vestibular nerve） with abnormal posterior semicircular canal vHIT and cVEMP. There are two patients（3.51%, ampullary vestibular nerve） with abnormal caloric irrigation test, horizontal semicircular canal vHIT, and anterior semicircular canal vHIT. The rate of superior and inferior vestibular neuritis and superior vestibular neuritis were significantly higher than inferior vestibular neuritis and ampullary vestibular neuritis（P<0.01）. Conclusion:Acute vestibular neuritis subtypes can be divided into four categories: superior and inferior vestibular neuritis, superior vestibular neuritis, inferior vestibular neuritis, and ampullary vestibular neuritis. Video head impulse test can accurately assess the site of vestibular nerve damage in patients with acute vestibular neuritis. In addition, vHIT combined with VEMPs can provide objective evidence for the diagnosis of ampullary vestibular neuritis.
Humans ; Vestibular Neuronitis/diagnosis* ; Vestibule, Labyrinth ; Vestibular Nerve ; Semicircular Canals ; Head Impulse Test/methods*