Objective:To evaluate the hemodynamic situation of the patients with moyamoya disease using MR perfusion imaging,and to explore the relationship between compensatory collateral circulation and perfusion. Methods:Seventy-two hospitalized patients with moyamoya disease were selected as typical moyamoya disease group,including 37 males and 35 females,aged 10 - 62 years old,all patients underwent cerebral angiography (DSA)and MR perfusion imaging.And 20 patients with out neurological history were used as control group.With mean transit time (MTT)image as a standard,the abnormal perfusion ranges were classified as region of interest (ROI),and the corresponding perfusion parameter values,including cerebral blood flow (CBF),cerebral blood volume (CBV),MTT and time to peak (TTP)were recorded,respectively.The cerebellum was used as a reference in this study,the perfusion parameters were standardized,and the relative ratios of the perfusion parameters (rMTT,rTTP,rCBF,rCBV)were obtained.Results:Compared with control group,the rMTT and rTTP of the patients in typical moyamoya disease group were prolonged and the rCBF was reduced (P <0.05 or P < 0.01), but the rCBV had no obvious difference (P >0.05).②Compared with the contralateral side,the rMTT and rTTP of the suffered side were prolonged,and the rCBF and rCBV were reduced (P < 0.05 or P < 0.01).Compared with chronic onset group,the rCBV and rCBF of the patients in acute onset group were reduced (P <0.05 or P <0.01),but the rMTT and rTTP had no statistically significant difference (P > 0.05).There were no significant differences in all parameters between hemorrhagic moyamoya disease group and ischemia group (P > 0.05 ). Conclusion:MR perfusion imaging can accurately evaluate the hemodynamic condition of moyamoya disease;MTT and TTP hve higher sensitivities than CBF and CBV.MR perfusion imaging can evaluate the compensation of collateral circulation of moyamoya disease and provide the objective basis for the clinician to select the proper surgical timing and the best operation methods.

Objective To explore the effect of amisulpride and risperidone in the treatment of patients with first-episode schizophrenia and its influence on social function.Methods 70 patients of schizophrenia conformed to the International classification of diseases tenth edition(ICD-10) were randomly divided into amisulpride group(observation group,35 cases) and risperidone group(control group,35 cases) by using the random number table method.The Positive and Negative Scale(PANSS) was used to evaluate the efficacy,the Scale of Social Function in Psychosis Inpatients(SSPI) was used to evaluate social function before and after 8 weeks of treatment.Results After 8 weeks treatment,the negative symptom factor score of the PANSS in the observation group was (15.04±3.55)points,which was improved significantly compared with (17.82±3.87)points in the control group,the difference was statistically significant(t=3.132,P<0.05).The scores of the field in movement and interaction,social activities and skills factor score and the total score of SSPI in the observation group were (15.49±3.54)points,(14.53±4.25)points,(39.25±8.27)points,respectively,which in the control group were (12.78±3.29)points,(10.01±3.78)points,(33.72±7.83)points,respectively,the differences between the two groups were statistically significant (t=3.317,4.701,2.873,all P<0.05).Conclusion Amisulpride is effective in improving the negative symptoms,social function in patients with schizophrenia,and the effect is better than risperidone.

ObjectiveTo investigate the effect of arsenic trioxide-loaded CalliSpheres beads (CBATO) in transarterial chemoembolization (TACE) in the treatment of rabbits with VX2 liver tumor. MethodsA total of 120 tumor-bearing rabbits were divided into control group, CalliSpheres beads (CB) group (blank beads for TACE), CBATO group, and conventional TACE (cTACE) group (arsenic trioxide lipiodol for TACE) using a random number table, with 30 rabbits in each group. Five rabbits in each group were sacrificed at 12 hours and on days 3, 7, and 14 after TACE, and immunohistochemistry was used to measure the proliferation index and apoptosis percentage of tumor cells in the residual tumor area. The tumor necrotic volume was measure on day 7 after TACE, and the growth rate and necrosis rate of tumor cells were calculated. Ten rabbits were randomly selected from each group for the observation of survival time. An analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups; the Kaplan-Meier survival analysis was used to evaluate survival time, and the log-rank test was used for comparison. ResultsOn day 7 after TACE, the CBATO group had a significantly lower growth rate and a significantly higher necrosis rate of tumor cells than the cTACE group, the CB group, and the control group (all P＜0.05). At each time point after TACE, there were significant differences in the proliferation index and apoptosis percentage of tumor cells between the CBATO group and the other three groups (all P＜0.05). The median survival time was 26 days in the CBATO group, 18.5 days in the CB group, 22 days in the cTACE group, and 15.5 days in the control group, and the CBATO group had a significantly longer survival time than the other three groups (χ2=3.95, 8.99, and 13.47, P=0.049, P=0.003, and P＜0.01). ConclusionCBATO has a better effect than cTACE and CB in the treatment of rabbits with VX2 liver tumor and can significantly improve tumor necrosis rate, promote the apoptosis of tumor cells, and prolong the survival time of experimental animals.

Objective:To compare the clinical value of early and deferred empirical antifungal strategies in febrile neutropenic children with acute leukemia.Methods:A total of 101 cases of febrile neutropenic children with acute leukemia hospitalized in Qilu Hospital of Shandong University from January 2019 to June 2021 were divided into two groups according to different empirical antifungal strategies.There were 41 cases in early group in which antifungal therapy was given within 4 days of fever, and 60 cases in deferred group in which antifungal therapy was not given within 4 days of fever.Outcomes such as time to stable defervescence, positive diagnosis rate of invasive fungal disease, incidence of severe pneumonia, rate of transference to PICU, exposure time and costs of antifungal agents, and infection-related hospitalization days were compared between two groups.Results:There were no significant differences in time to stable defervescence[5 (4, 7) days vs.5 (3, 7) days, P=0.986], positive diagnosis rate of invasive fungal disease[9.8%(4/41) vs.8.3%(5/60), P=1.000], incidence of severe pneumonia[19.5%(8/41) vs.10.0%(6/60), P=0.174], and rate of transference to PICU[2.4%(1/41)vs.0(0/60), P=0.406] between two groups.Exposure time of antifungal agents was longer in early group than that in deferred group[10 (6, 12)days vs.0 (0, 6)days, P<0.001]. Costs of antifungal agents were higher in early group than those in deferred group[0.78(0.51, 0.95)ten thousand yuan vs.0(0, 0.44)ten thousand yuan, P<0.001]. Infection-related hospitalization days were longer in early group than those in deferred group[16 (10, 21) days vs.9(6, 13)days, P<0.001]. Conclusion:For febrile neutropenic children with acute leukemia, clinical effect of early empirical antifungal strategy is not superior to that of deferred empirical antifungal strategy.Pediatricians should make reasonable antifungal decisions according to overall situation of patients.

The number of white blood cells in the leucorrhea microscopic image can indicate the severity of vaginal inflammation. At present, the detection of white blood cells in leucorrhea mainly relies on manual microscopy by medical experts, which is time-consuming, expensive and error-prone. In recent years, some studies have proposed to implement intelligent detection of leucorrhea white blood cells based on deep learning technology. However, such methods usually require manual labeling of a large number of samples as training sets, and the labeling cost is high. Therefore, this study proposes the use of deep active learning algorithms to achieve intelligent detection of white blood cells in leucorrhea microscopic images. In the active learning framework, a small number of labeled samples were firstly used as the basic training set, and a faster region convolutional neural network (Faster R-CNN) training detection model was performed. Then the most valuable samples were automatically selected for manual annotation, and the training set and the corresponding detection model were iteratively updated, which made the performance of the model continue to increase. The experimental results show that the deep active learning technology can obtain higher detection accuracy under less manual labeling samples, and the average precision of white blood cell detection could reach 90.6%, which meets the requirements of clinical routine examination.

Objective:To investigate the morphological feature and clinical significance of MRI around tumor after drug-eluting bead transcatheter arterial chemoembolization (DEB-TACE) of primary hepatocellular carcinoma.Methods:We reviewed and analyzed the data of hepatocellular carcinoma patients admitted from January 2017 to December 2018 in the Department of Radiological Intervention of the First Affiliated Hospital of Zhengzhou University. A total of 42 patients were enrolled, including 35 males and 7 females, aged (57.0±11.9) years. For the first time after operation, MRI enhancement showed peri-tumor margin enhancement as the starting point of follow-up. Follow-up and measure enhanced edge thickness, delayed enhancement, progression or remission data.Results:A total of 49 tumors and 84 peritumoral enhancement margins were included in 42 patients, with 30 sharp type , 40 rough type and 14 nodular type. The thickness of sharp type is less than that of rough type and nsodular type, and the differences were statistically significant (all P<0.05). The sharp type is the majority of the tumors with maximum diameter <5 cm, rough type and nodule type are the majority of tumors with maximum diameter ≥5 cm. Most of the sharp type are continuously enhanced, while the rough type and nodular type are not. Most sharp type relief (93.3%, 28/30), while rough type (80.0%, 32/40) and nodular type ( n=12) are mostly of deterioration, the differences are statistically significant (all P<0.05). Conclusion:Compared with the rough type and nodular type, the sharp type usually occurs in smaller tumors and more prone to local mitigation in the enhanced morphology around MRI after DEB-TACE in primary hepatocellular carcinoma.

Objective To investigate the cost-effect of transarterial chemoembolization (TACE) with CalliSpheres beads loaded with arsenic trioxide (ATO) (CBATO) versus ATO iodized oil emulsion (conventional TACE, cTACE) in the treatment of unresectable liver cancer. Methods A total of 100 patients with advanced liver cancer who attended The First Affiliated Hospital of Zhengzhou University from May 2017 to December 2018 were enrolled and divided into CBATO group( n =45) and cTACE group( n =55) according to the treatment regimen. Progression-free survival (PFS) was used to evaluate the efficacy of quality-adjusted life year (QALY), and European Quality of Life-5 Dimensions (EQ-5D) index was used to evaluate quality of life. The t -test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups; the number of surgeries, length of hospital stay, treatment cost, and incremental cost-effectiveness ratio (ICER) were calculated for the two groups, and then a cost-effect analysis was performed. Results Within the PFS time, the per capita hospital cost was 96 446 yuan in the CBATO group and 91 230.43 yuan in the cTACE group. There were significant differences between the two groups in the mean number of surgeries (2.5±0.7 vs 3.4±0.8, t =16.911, P < 0.01) and mean hospital stay (5.8±1.2 days vs 7.5±1.8 days, t =12.459, P < 0.01). The CBATO group had a significantly higher QALY than the cTACE group (0.804 vs 0.512). Compared with the cTACE group, the CBATO group had an ICER of 17 861.53 yuan/QALY for unresectable liver cancer. Conclusion Although CBATO has a higher surgery cost than cTACE, CBATO has a better clinical effect than cTACE and can reduce the number of surgeries and length of hospital stay, with a better postoperative quality of life than cTACE, suggesting that CBATO has marked cost-effect advantages.