Objective To explore the pathological and imaging characteristics of focal nodular hyperplasia(FNH) of liver.Methods 17 cases of FNH proven pathologically underwent triphase spiral CT scan,of them,10 cases underwent fast MR imaging.The pathological andimaging features were comparatively analysed.Results All lesions were a solitary globular or lobulated mass,the majority of cases wasapproximately 2~5 cm in diameter.On plain CT and MRI,FNH was classically seen as a solitary,homogeneous and slightly hypoattenuating or isoattenuating area in comparison with normal liver,slightly hyper-or isointense on T_2WI,intense homogeneous enhancement during the arterial phase of enhanced imaging,and hyperattenuating in 12 cases,hypoattenuating or isoattenuating in 6 cases in comparison with normal liver during venous and delayed phase.The central scar was showed in 11 cases during delayed phase and 8 cases showed delayed enhancement,4 cases had pseudocapsular like enhancement in delayed images.In histology,17 cases of FNH were well limited but nonencapsulated,the hyperplastic parenchyma of the liver was subdivided into small nodules surrounded by the fibrous septa,there was a central scar composedof fibrous connective tissue and malformed vessels of various caliber.Conclusion The typical FNH can be easily diagnosed,while theatypical cases should be differentiated from hepatocelluar adenoma,hepatocellular carcinoma and hemangiomas.

Objective To investigate the effects of hyperbaric Oxygen (HBO)exposure on Caspase-3 and Bcl-2 mRNA ex-pressions in both internal carotid artery (ICA)and basal artery (BA)in rabbits.Methods Twenty-four healthy adult New Zealand rabbits were randomly divided into 2 groups:HBO group and the control group,with each group consisted of 12 animals.The rab-bits in the HBO group were exposed to HBO at 2.2 ATA for 60 minutes each day for 3 successive days.The rabbits in the control group were normally fed without any treatment.Real-time PCR was used to detect Caspase-3 and Bcl-2 mRNA expressions in both ICA and BA in 2 groups.Results HBO significantly decreased the Caspase-3 mRNA expression [(0.038 ±0.006 )vs .(1.000 ± 0.225)]and increased the Bcl-2 mRNA expression [(1.877 ±0.1 69)vs .(1.000 ±0.364)].In ICA,HBO similarly decreased the Caspase-3 mRNA expression [(0.41 9±0.091)vs .(1.000 ±0.1 75)]and increased the Bcl-2 mRNA expression [(1.269 ±0.270) vs .(1.000±0.1 1 7)]in BA.All the differences mentioned above were of statistical significance (P <0.01).Conclusion HBO ex-erts an inhibition effect on apoptosis in cerebral vascular endothelial cells.The mechanism may be related to inhibiting the expres-sion of Caspase-3 mRNA and promoting the expression of Bcl-2 mRNA.

Objective To identify the association of thyroid stimulating hormone receptor ( TSHR ) gene intron 1 susceptible loci and 4p14 susceptible locus rs6832151 polymorphisms with Graves’ disease ( GD) in Han Chinese population in Bengbu, Anhui, China. The gene-gene interaction among TSHR intron 1 susceptible loci and 4p14 susceptible locus rs6832151 was also investigated. Methods The genotypes of the single-nucleotide polymorphisms ( SNPs) were analyzed by Taqman probe technique on Fluidigm EP1 platform in 611 patients with GD and 555 control subjects, and linkage analysis, correlation analysis, haplotype analysis, and epistasis analysis with them were performed. Results Six SNPs in two candidate genes(rs12101261, rs4903964,rs179247, rs2284722 and rs17111394 in TSHR, rs6832151 in 4p14) were associated with GD (all P<0. 05). The frequency distributions of haplotypes of SNPs in TSHR intron 1 ( AGTA, GGCG, AATA, and CC) were significantly different between GD and control groups(all P<0. 01). There existed the interactions between rs179247 and rs12101261 in TSHR(P=0. 001) and among rs179247(TSHR),rs4903964(TSHR) and rs6832151(4p14) (P=0. 001). Conclusions rs683215 in 14p14 and rs12101261, rs4903964, rs179247, rs2284722 and rs17111394 in TSHR intron 1 were susceptible loci of GD in the Chinese Han population from Bengbu. The haplotypes in TSHR intron 1 were associated with GD. There exists the interaction between the SNPs in TSHR and 4p14,which may change the risk of GD.

Objective: To study the effect of hyperbaric oxygen (HBO) treatment of severe brain injury.Methods: Fifty-five patients were divided into a treatment group (n = 35 receiving HBO therapy ) and a control group (n = 20 receiving dehydrating, cortical steroid and antibiotic therapy) to observe the alteration of clinic GCS (Glasgow Coma Scale), brain electric activity mapping (BEAM), prognosis and GOS (Glasgow Outcome Scale) before and after hyperbaric oxygen treatment.Results: In the treatment group GCS, BEAM and GOS were improved obviously after 3 courses of treatment,GCS increased from 5.1 to 14.6 ( P ＜ 0.01-0.001 ), the BEAM abnormal rate reduced from 94.3％ to 38％ (P ＜0.01-0.001 ), the GOS good-mild disability rate was 83.7％, and the middle-severe disability rate was 26.3％compared with the control group. There was a statistic significant difference between the two groups (P ＜ 0.01-0.001).Conclusions: Hyperbaric oxygen treatment could improve obviously GCS, BEAM and GOS of severe brain injury patients, and effectively reduce the mortality and morbidity. It is an effective method to treat severe brain injury.

Cerebral venous sinus thrombosis(CVST)is a special type of cerebrovascular disease,and the common autoimmune diseases that can cause CVST are systemic lupus erythematosus and antiphospholipid syndrome,and the combination of CVST with Sj?gren's syndrome is not common in clinical practice.The authors reported the case data of a patient with Sj?gren's syndrome combined with CVST and discussed the possible pathogenesis,treatment and prognosis,with the aim of providing some guidance for the diagnosis and treatment of this type of patient.

Objective To investigate the establishment of focal cerebral ischemia model in rabbits with the improved suture method.Methods A total of 45 healthy and clean adult New Zealand rabbits were divided into either a sham operation group (n =5) or a model group (n =40) using random number table method before modeling,and the sex was not limited.The self-made head ends of 2-0 fishing lines dipped in paraffin were used as the sutures.The external carotid artery was cut and inserted into a intracranial artery through the internal carotid artery and blocked the origin of middle cerebral artery.The neurological function score was performed after 6 h.The neurological deficit scores &ge;2 was successful modeling.The rabbits were killed by anesthesia.The brain slices were stained with 2％ 2,3,5-triphenyl tetrazolium chloride solution.The infarct foci were observed.The diameters of suture head and the depth of suture insertion were compared in the model rabbits with successful modeling,failure,and death in the model group.Results There were 40 rabbits in the model group,six of them died,including 4 died of subarachnoid hemorrhage within 4 h after operation,and 2 died from anesthetic accident.The mortality rate was 15.0％.Seven rabbits failed,mainly because of cerebral vasospasm and the insertion depth of suture was insufficient.Twenty-seven had successful modeling,and the success rate was 67.5％.All the rabbits in the sham operation group survived.The diameter of the suture head and insertion depth in the successful modeling rabbits were compared with the death and failure outcome in rabbits.The difference was statistically significant (diameter:0.52 ± 0.14 mm vs.0.45 ±0.40 mm and 0.58 ±0.17 mm;depth:5.49 ±0.17 cm vs.6.04 ± 0.11 cm and 4.26 ±0.30 cm;all P ＜ 0.05).Conclusions The improved suture method can successfully prepare the focal cerebral ischemia model of middle cerebral artery in rabbits.The method is simple.Its repeatability and practicability are better.

Ferroptosis is a novel type of oxidatively regulated cell death driven by iron-dependent lipid peroxidation.As the main site of iron utilization and oxidative metabolism,mitochondria are the main source of intracellular reactive oxy-gen species.Ferroptosis is associated with the severe impairment of mitochondrial structure and function,bioenergetics,and metabolism.Alzheimer disease(AD)is a devastating progressive neurodegenerative disease with the main clinical manifestation of decline in memory and cognitive function.Emerging evidence suggests that mitochondrial dysfunction plays a significant role in the process of ferroptosis in AD.This article elaborates on the mechanism of ferroptosis,mito-chondrial dysfunction and its role in ferroptosis in AD,and the treatment of AD,in order to provide a new perspective for exploring new strategies for the prevention and treatment of AD.

ObjectiveTo explore the diagnoses of diseases and functioning of speech fluency disorder, analyze the main assessment content, and construct framework of intervention solution based on International Classification of Diseases 11th Revision (ICD-11), International Classification of Functioning, Disability and Health (ICF) and International Classification of Health Interventions (ICHIβ-3). MethodsThe diagnoses of diseases and functioning was discussed with ICD-11 and ICF. The assessment tools were analyzed with ICF. A holistic intervention solution was constructed with ICF and ICHIβ-3. ResultsSpeech fluency disorder is classified as 6A01.1 developmental speech fluency disorder for ICD-11. The related diseases include 6A01.0 developmental speech sound disorder, 6A01.2 developmental language disorder, cerebral palsy, MA80.0 aphasia, MA80.1 dysphasia and MA80.2 dysarthria, etc. For ICF, the categories related to speech fluency disorder might be s3 structures invovled in voice and speech; b3 voice and speech functions, especially b330 fluency and rhythm of speech functions; d1 learning and applying knowledge, d3 communication, especially d330 speaking and d355 discussion, d7 interpersonal interactions and relationships, and d9 community, social and civic life. A holistic intervention solution for speech fluency disorder was developed, involving in body structure, body function, activities and participation, and environmental factors, including assessment, training and treatment, educational counseling, and psychological and social support, etc. ConclusionA framework of diagnosis, assessment and rehabilitation has been constructed for speech fluency disorder.

Compared with conventional cardiopulmonary resuscitation (CCPR), extracorporeal cardiopulmonary resuscitation (ECPR) can improve the survival rate of patients with cardiac arrest, and reduce the risk of reperfusion injury. However, it is still difficult to avoid the risk of secondary brain damage. Low temperature management has good neuroprotective potential for ECPR patients, which minimizes brain damage. However, unlike CCPR, ECPR has no clear prognostic indicator. The relationship between ECPR combined with hypothermia management-related treatment measure and neurological prognosis is not clear. This article reviews the effect of ECPR combined with different therapeutic hypothermia on brain protection and provides a reference for the prevention and treatment of neurological injury in patients with ECPR.
Humans ; Brain ; Cardiopulmonary Resuscitation ; Brain Injuries ; Hypothermia, Induced ; Heart Arrest

ObjectiveTo discuss the diagnosis, assessment and rehabilitation for children with cerebral palsy complicated with speech disorder based on the tools of World Health Organization Family of International Classifications (WHO-FICs). MethodsThe diagnosis of speech disorder after cerebral palsy was classified using International Classification of Diseases, 11th Revision (ICD-11). The disorders of speech function were classified using International Classification of Functioning, Disability and Health (ICF). A structured speech function rehabilitation solution was developed based on the International Classification of Health Interventions (ICHIβ-3). ResultsAccording to ICD-11, cerebral palsy was classified as 08 Neurological Disorder, which was further classified as 8D20.0 Spastic Unilateral Cerebral Palsy and 8D20.1 Spastic Bilateral Cerebral Palsy (8D20.10 Spastic Quadriplegic Cerebral Palsy and 8D20.11 Spastic Bilateral Cerebral Palsy), with the speech disorders involving 6A00 Disorders of Intellectual Development, 6A01 Developmental Speech or Language Disorders, MA80 Speech Disturbances, MA81 Speech Dysfluency and MA82 Voice Disturbances. For ICF, the speech disorders mainly involved s1 structures of the nervous system, s3 structures invoved in voice and speech, b3 voice and speech functions, d1 learning and applying knowledge, and environment and individual factors; and could be further classified as b310 voice functions, b320 articulation functions, and b330 fluency and rhythm of speech functions. Based on ICHIβ-3, a rehabilitation solution was developed, involving the areas of body structure and function, activity and participation, and environmental factors. ConclusionBased on ICD-11, ICF and ICHIβ-3, a methodological system of assessment and interventions for speech disorders after cerebral palsy has been systematically constructed, including diagnosis of disease, assessment, intervention and coding of speech disorder.