Objective To evaluate the microstructural integrity of white matter (WM) in patients with amnestic mild cognitive impairment (aMCI) and mild Alzheimer's disease (AD) using voxel-based analysis (VBA), and investigate the relationship between WM abnormalities and gray matter(GM) atrophy.Methods Thirty-three cases with aMCI, 32 cases with mild AD and 31 normal aging volunteers as control subjects were scanned on a 3.0 T MR system using diffusion tensor imaging (DTI) and three-dimensional spoiled gradient-recalled(3DSPGR) sequences. Fractional anisotropy (FA) maps and morphological images were preprocessed by SPM5 and voxel-based comparisons between the 2 patient groups and the control group were performed by t test. Results Relative to the control group, patients with aMCI showed significantly reduced FA value in bilateral frontal, temporal and left occipital WM, left anterior part of cingulum, left inferior parietal lobule, and the W M adjacent to the triangular part of the right lateral ventricle(k≥20 voxels).In mild AD,significantly reduced FA value was found in bilateral hippocampal,inferior parietal lobular,frontal,temporal,and occipital WM,bilateral corpus callosum,anterior part of cingulums,the WM adjacent to the triaangular part of the bilateral lateral ventricles,left temporal stem,left thalamus,right precuneus(k≥20 voxels).Significantly reduced GM volume was found in left hippocampus,parahippocampal gyrus,lingual gyrus and superior temporal gyrus,bilateral insulae and middle temporal gyri in aMCl group whencompared with control group(k≥50 voxels).In mild AD,significantly reduced GM volume was found in bilateral hippoeampi,parahippocampal gyri,amygdalae,thalami,temporal,parietal,frontal,occipital cortex(k≥50 voxels).The pattern of areas with reduced FA differs;from that of the GM volumetric reduction.No areas with significantlv reduced FA was detected in aMCl compared with mild AD. There was no significant correlation between FA value of WM in patient groups and Mini-Mental State Examination(MMSE)scores.Conclusions Voxel-based MRI DTI analysis of whole brain white matter can objectively reveal widespread white matter abnormalities in early-stage AD.The difierence between WM FA reduction pattern and GM volumetric reduction pattern indicates that the pathological WM changes in earlyslage AD were caused by multiple mechanisms. FA did not vary significantly in patients pr0gressing from aMCI to mild AD and can hardly reflect the severitv of cognitive function damage in these patients.

Objective To observe the effect of new vomit-receiving device in department of neurosurgery. Methods A total of 44 patients with vomiting symptoms in our department in May 2015 were randomly divided into the observation group (n=23) and the control group (n=21). The observation group used a new type of vomit-receiving device to carry out vomiting nursing, while the control group was treated with conventional vomiting nursing. The number of cases of vomiting and the number of occurrence times were observed. Results Observation group of 23 cases with no vomit leaks occur, and the control group 21 patients vomit leaked out in 16 cases, the incidence of vomit were leaked by 72.73% (χ2=27.53, P < 0.01), vomiting leaked rate was 40.74% (22/54) (χ2 = 32.49, P < 0.01), including who prepared to receive tools but not timely for 16 times, receive tools leakage for 5 times, no enough capacity of receive tool for 1 times. The total score of patients′ satisfaction in the observation group was 78, while the total score of patients in the control group was 57. The difference was statistically significant (t=2.80, P＜0.01). The total nursing time of the observation group was 68 min, and that of the control group was 347 min,the difference was statistically significant (t=-5.73, P＜0.01). Conclusions The new vomit-receiving device can effectively reduce the incidence of vomit substance leakage, and the installation is easy to install, easy to operate and conducive to the management of vomit. It greatly improves the efficiency of nursing, and effectively improves the satisfaction of patients and their families to nursing.

Objective·To assess the effect of veno-arterial extracorporeal membrane oxygenation(VA-ECMO)treatment on the mortality rate of patients suffering from cardiogenic shock and cardiac arrest in hospital.Methods·A total of 19 patients with cardiogenic shock or cardiac arrest who were treated with VA-ECMO treatment in Suzhou Kowloon Hospital,Shanghai Jiao Tong University School of Medicine from September 2017 to March 2022 were included in the retrospective study.Patients were divided into extracorporeal cardiopulmonary resuscitation(ECPR)group(n=9)and VA-ECMO for cardiogenic shock(E-CS)group(n=10)according to whether cardiac arrest had occurred.The general demographic data,clinical data,Sequential Organ Failure Assessment(SOFA)scores,postoperative complications and prognostic indicators of the two groups of patients were collected.Univariate and multivariate Cox proportional hazard regression analyses were used to evaluate the correlation between each covariate and hospital mortality.Results·Among the included patients,there were 15 males(78.9％),with an average age of 46.5(34.5,61.6)years.The incidence of postoperative complications was as follows:bleeding(47.4％),AKI(36.8％),infection(31.6％),limb ischemia(15.8％)and cerebrovascular accident(5.3％).The duration of VA-ECMO was 4.0(2.0,6.8)days,and the intensive care duration was 11.5(5.8,26.2)days;the ECMO withdrawal success rate was 63.2％,and the hospital mortality was 63.2％.The results of univariate Cox proportional hazard regression analysis showed that AKI(prior to VA-ECMO initiation),postoperative complications of infection and limb ischemia were correlated with the hospital mortality of patients(all P＜0.05).The results of multivariate Cox proportional hazard regression analysis showed that AKI(prior to VA-ECMO initiation),postoperative complications of infection and limb ischemia were also independent risk factors for the hospital mortality of patients(all P＜0.05).Conclusion·For patients with cardiogenic shock and cardiac arrest treated with VA-ECMO,AKI(prior to VA-ECMO initiation),postoperative infection and limb ischemia are independently associated with higher hospital mortality.

Objective To analyze the effects of change water sources on population iodine nutrition and goiter status in historical high water-iodine area in Yufa Town of Daxing District,Beijing,and evaluate the control effects.Methods A retrospective analysis method was used to collect epidemiological survey data such as water iodine content,urinary iodine content and goiter rate before and after iodine reduction in Yufa Town of Daxing District,Beijing,2005-2016,and the data were compared and analyzed.Results Yufa Town had implemented water reform since 2005.As of 2015,8 change water source projects had been built,and all historical high-water iodine villages had completed drinking water transformation.Totally 64,12,26,26,and 37 water samples were collected and tested in 2005,2009,2010,2011,and 2014,the medians of water iodine were 185.2,20.9,14.1,16.8,and 21.6 μg/L,respectively,and the medians of water iodine decreased significantly through changing water source.Totally 148,153,150,and 40 urine samples of children aged 8 to 10 years old were collected and tested in 2005,2009,2011,and 2016,the medians of urinary iodine were 520.1,201.6,143.0,and 135.0 μg/L,respectively,and the medians of urinary iodine decreased to a suitable range (100-199 μg/L) through changing water source.Totally 154,292,40,and 40 school-age children were tested for thyroid volume in 2005,2009,2011,and 2016,and 10,6,0,and 1 thyroid enlargements were detected,respectively.The thyroid enlargement rates were 6.49％.2.05％,0,and 2.50％,and the rates of goiter were reduced to less than 5％ through changing water source.Conclusion The high water-iodine in water-borne high iodine area in Yufa Town,Daxing District,Beijing is basically eliminated after change water sources,water improvement to reduce iodine is a basic measure to control high iodine damage in high water-iodine areas.

Objective:To analyze the characteristics of cardio-metabolic risk factors coronary artery disease(CAD)patients with in-stent restenosis(ISR)after percutaneous coronary intervention(PCI).Methods:A total of 169 patients undergone primary(T1)PCI and followed up and rechecked by coronary angiography(T2)in our hospital from 2010 to 2017 were enrolled.According to the results of coronary angiography during follow-up, patients were divided into the ISR group(n=66)and the control group(non-ISR or NISR, n=103). Patients were sub-grouped into the elderly ISR group(the E-ISR group, n=17), the elderly non-ISR group(the E-NISR group, n=19), the young ISR group(the Y-ISR group, n=49)and the young non-ISR group(the Y-NISR group, n=84). Clinical data including medical history, laboratory results, and coronary angiography records during the two hospital stays were collected.Cardio-metabolic risk factors and clinical features of coronary artery disease were analyzed for the groups.Results:The levels of systolic blood pressure, glycated hemoglobin A1c(HbA1c), fasting blood glucose(FBG), the percentage of patients with diabetes or myocardial infarction(MI)history, the coronary Gensini score and the percentage of patients with triple vessel disease were higher in the ISR group than in the NISR group(128.6±16.4) mmHg vs.(123.4±10.7) mmHg, P=0.023; (7.0±1.6)% vs.(6.2±0.9)%, P<0.001; 6.6 mmol/L vs.5.7 mmol/L, P<0.001; 53.0% vs.31.1%, P=0.004; 36.4% vs.20.4%, P=0.022; 40 vs.29, P=0.01; 57.6% vs.40.8%, P=0.033). The E-ISR group had higher systolic blood pressure and a lower glomerular filtration rate than the E-NISR group(135.9±27.2) mmHg vs.(124.1±10.8) mmHg, P=0.013; 77.5±14.4 ml·min -1·1.73 m -2vs.(84.8±9.4) ml·min -1·1.73 m -2, P=0.033), but the Y-ISR group had longer hypertension history, higher levels of low-density lipoprotein and HbA1c, and higher Gensini scores than the Y-NISR group[129.7 months vs.83.1 months, P=0.008; (2.78±1.08) mmol/L vs.(2.31±0.65) mmol/L, P=0.002; (7.2±1.7)% vs.(6.1±0.9)%, P<0.001; 41 vs.29, P=0.009]. Conclusions:Clinical features are different between elderly CAD patients and young and middle-aged CAD patients with ISR after PCI, and metabolic risk factors such as blood pressure, blood lipid and blood glucose levels should be proactively controlled