Objective To study the clinical, imaging and pathological features of primary angiitis of central nervous system (PACNS). Methods The clinical data of 8 patients with PACNS (4 suspected and 4 definite) were retrospectively analysed.Results There were 5 males and 3 females in 8 patients with PACNS. Average age was 32 years old and average disease course was 11 months. The initial symptoms were headache in 5, extremital weakness in 2, and speech disorder in 1 patients. The major clinical manifestations were headache in all patients, extremital weakness and numbness in 5, speech disorder in 1, and seizure disorder in 2 patients. 7 patients were with slow-progressive disease courses, and 1 patients with a relapsing-remitting one. MRI showed abnormality in all patients. 6 cases had unilateral lesions and 2 had bilateral lesions. MRI showed ill-defined, irregular or atypical wedge-shaped foci in cortical and subcortical areas in 7 patients and strip-shaped foci with surrounding finger-like cerebral edema in the left frontal and parietal lobe and gyrus cinguli in 1 patient. All lesions enhanced with different degree on contrast-enhanced scan. Enhanced lesions along sulcus and gyrus were seen in 7 patients and mass-like irregular linear enhancement lesion in 1 patient. Diffusion-weighted imaging(DWI) showed hyper-signal and apparent diffusion coefficient(ADC) showed hypo-signal in 5 patients. MRA showed stiffness and lack of smooth in one or more cerebral arteries with multiple segmental narrowing and expanding, and rarity of arterial distal branches in 8 patients. Digital subtraction angiography (DSA) also showed multiple segmental narrowing and expanding in cerebral arteries, and rarity of arterial distal branches in 4 patients. Brain biopsy in 4 cases revealed angiitis with lymphocytic infiltration. 5 patients received treatment with single corticoid, and 3 with cyclophosphamide. All cases had good outcome. Conclusions The clinical manifestations of PACNS are various. The changes of imaging are obvious, MRI, MRA and DSA are helpful in the diagnosis of PACNS. The definite diagnosis relies on brain biopsy.

Objective To observe the effect of electro-acupuncture therapy (ET) on the expression of sodium channel Na(v) 1.1 in rats after acute cerebral ischemia and the mechanism of any protective function of ET.Methods A model of focal acute cerebral ischemia was established by occluding the right middle cerebral artery.One hundred and eighty healthy SD rats were randomly divided into a sham operation control (SC) group, an ischemia control (IC) group, a real ET group and a false ET group, with 45 in each group. Immunohistochemistry and real-time polymerase chain reaction (PGR) methods were used to detect Na(v)1. 1 expression. 2,3,5-triphenyl tetrazolium chloride (TTC) staining was used to detect infarct volume. Neurological examination and grading was carried out at 6 hours and then 1, 2, 3 and 7 days after inducing ischemia. Results The gradings and infarction volume ratios of the rats in the IC group were the most serious, while in the real ET group the severity was much less at each time point. Compared with the SC group, the expression of Na(v) 1.1 was significantly up-regulated in the IC group. The expression of Na(v) 1.1 was increased at the 6th hour, then down-regulated to the lowest level at day 1,then from the 2nd to the 7th day was up-regulated again. The expression of Na(v) 1.1 in the real ET group was significantly lower than in the IC group. Although the expression of Na(v)1.1 in the false ET group was low compared with the IC group, the difference was not significant. The difference between the real ET group and the false ET group was significant, however. Conclusions ET can reduce damage from cerebral ischemia and benefit the recovery of neural function. ET can also could regulate the expression of Na(v)1.1 after acute cerebral ischemia, which may be an important mechanism for neural function recovery.

Objective To develop a mammogram microcalcification detection model(DL model)based on Attention U-Net for realizing the efficient detection of microcalcifications,and to investigate the effects of breast density and microcalcification type on the microcalcification detection performance of the DL model.Methods A retrospective analysis was performed on 694 images from 347 patients undergoing mammography.Through the independent image diagnosis by junior physicians and review by senior physicians,the reference standard for microcalcification detection was established.Neural network training was performed to establish a DL model.The performance of the model for microcalcification detection was evaluated using precision rate,recall rate,intersection over union(IoU)and F1-score which were calculated based on calcification area or quantity;and the effects of microcalcification type(benignvsmalignant)and breast density(a+bvsc+d)on the model performance were also analyzed.Results For detecting microcalcifications by the DL model,the precision rate,recall rate,IoU and F1-score were 85.12%±18.39%,78.18%±19.25%,68.29%±21.39%and 78.96%±17.70%when the calculation was based on calcification area,and those were 76.72%±19.85%,85.12%±18.39%,67.13%±23.84%and 77.65%±9.37%when the calculation was based on calcification quantity.The differences in precision rate,recall rate,IoU,F1-score of DL model in different microcalcification types(benignvsmalignant)and breast densities(a+bvsc+d)were insignificant.Conclusion The developed mammogram microcalcification detection model based on Attention U-Net can effectively detect breast microcalcifications and is conducive to the quantitative research on breast microcalcifications.Meanwhile,the model exhibits high stability,and the breast density and microcalcification type have trivial effects on the microcalcification detection performance of the model.

AIM: To investigate the efficacy and safety of intense pulsed light(IPL)combined with meibomian gland massage and tobramycin and dexamethasone ophthalmic ointment in treating dry eye(DE)with meibomian gland dysfunction after phacoemulsification(PHACO).METHODS: A total of 100 cases(100 eyes)of DE patients with meibomian gland dysfunction after receiving PHACO in our hospital from January 2022 to December 2023 were selected and divided into control group(receiving meibomian gland massage + eye ointment)and observation group(receiving IPL + meibomian gland massage + eye cream treatment)according to different treatment methods, with 50 cases(50 eyes)in each group. The score of meibomian gland secretion, tear film break-up time(BUT), clinical efficacy and safety were compared between the two groups.RESULTS: After treatment, the scores of the meibomian gland secretion status decreased in both groups, and the observation group had lower scores(all P<0.05). After treatment, the BUT increased in both groups, and the observation group had higher BUT(P<0.05). The clinical efficacy of the observation group(98%)was higher than that of the control group(84%; P<0.05). In addition, the incidence of adverse reactions in the observation group(6%)was lower than that in the control group(20%; P<0.05).CONCLUSION: IPL combined with meibomian gland massage and tobramycin and dexamethasone ophthalmic ointment can effectively improve the clinical efficacy of DE patients after PHACO surgery, reduce adverse reactions, and have high safety.

Objective: To understand the consciousness of the cancer early treatment and its demographic and socioeconomic factors. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China (CanSPUC) from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The questionnaire collected personal information, the consciousness of the cancer early treatment and relevant factors. The Chi square test was used to compare the difference between the consciousness of the cancer early treatment and relevant factors among the four groups. The logistic regression model was used to analyze the influencing factors related to the consciousness of the cancer early treatment. Results: With the assumption of being diagnosed as precancer or cancer, 89.97% of community residents, 91.84% of cancer risk assessment/screening population, 93.00% of cancer patients and 91.52% of occupational population would accept active treatments (P<0.001). If the immediate family members were diagnosed as precancer or cancer, people who would encourage their family members to receive early treatment in the four groups accounted for 91.96%, 91.94%, 92.44% and 91.55%, respectively (P<0.001). The company employees, annual household income with 40 000 yuan and more and other three groups had a relatively better consciousness of the cancer early treatment (P<0.05). Male, widowed, unemployed and from the central and western regions had a relatively worse consciousness of the cancer early treatment (P<0.05). Conclusion Residents in urban China participants had a good consciousness of the cancer early treatment. The marital status, occupation, annual household income and residential regions were major factors related to the consciousness of the cancer early treatment.