Objective:Using T2-weighted imaging(T2WI),diffusion-weighted imaging(DWI),pulsed gradient spin echo(PGSE)multiparametric magnetic resonance imaging combined with various histopathological techniques to observe the effects of reperfusion after different times of cerebral ischemia(CIRI)on the cytotoxic edema of brain tis-sues in rats.This provides a solid foundation for the establishment of ischemic stroke models and clinical diagnosis and treatment.Methods:Healthy adult male Sprague Dawley rats were randomly allocated to four groups:the sham-opera-ted(Sham)group,the ischaemia 60 min reperfusion(IR-60 min)group,the IR-120 min group,and the IR-180 min group.CIRI rat model was prepared by modified Zea Longa method.Laser doppler flowmetry combined with hematoxy-lin-eosin(HE)staining was employed to identify the model.Multiparametric magnetic resonance imaging,combined with water content of brain,immunofluorescence staining of aquaporin-4(AQP4),and Western Blot were performed to observe cytotoxic edema of brain tissues and tumour necrosis factor alpha(TNF-α),interleukin 1β(IL-1β)in brain tissue of rats in each group.Results:HE staining and determination of brain tissue water content prove that as ischemia time prolongs,the degree of cerebral cortex edema on the ischemic side increases.The T2WI results showed that the injury in the IR-60 min group began to affect the cerebral cortex,the injury in the IR-120 min group had completely affected the cerebral cortex,and the injury in the IR-180 min group was the most severe(P＜0.05),with a significant shift of the midline of the brain towards the opposite side.The relative apparent diffusion coefficient and water exchange time of the cerebral cortex on the ischemic side of the rats were found to be significantly lower than those of the sham group,with an declining trend(P＜0.05).Additionally,the values of cell membrane permeability of the cerebral cor-tex on the ischemic side of the rats were observed to be significantly higher than those of the sham group in all groups(P＜0.05).The expression of AQP4,IL-1 β and TNF-α in the cerebral cortex of ischemic side was significantly higher than that in the sham group,and showed an upward trend(P＜0.05).Conclusion:Reperfusion following 60,120 and,180 minutes of middle cerebral artery ischemia in rats can result in brain damage.Prolongation of ischemia time has been shown to exacerbate the toxic edema of brain cells and brain damage.Ischemia of 120 minutes reperfusion has been identified as the optimal modeling time for ischemic stroke.Multiparametric MRI can be utilized to monitor the mi-crostructural changes of brain tissue in rats following CIRI in vivo,providing a foundation for the visualization of early clinical diagnosis and treatment.

Objective:To explore the association between cognitive function and the level of gamma-amino-butyric acid(GABA)in anterior cingulate cortex(ACC)before and after treatment in patients with major depres-sion disorder.Methods:Totally 31 medication-naive patients with major depression disorder meeting the criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)and 33 normal controls were col-lected.Each eligible patient received treatment with selective serotonin reuptake inhibitor agents for 8 weeks.The MATRICS Consensus Cognitive Battery(MCCB)was used to evaluate the cognitive function.By means of 1H magnetic resonance spectroscopy,anterior cingulate cortex GABA concentrations were measured.Results:At base-line,the concentration of ACC GABA relative to water(GABA+/W)was lower in the patient group than in the control group(P＜0.05)and increased after treatment(P＜0.05).ACC GABA+/W was negatively associated with verbal learning and visual memory score in patient group at baseline(correlation coefficient and P value were r=-0.40,P＜0.05;r=-0.42,P＜0.05,respectively).The ACC GABA+/W difference resulted of treatment in patient group was positively associated with the difference of working memory score and the difference of reasoning and problem-solving score(correlation coefficient and P value were r=0.58,P＜0.05;r=0.66,P＜0.05,respec-tively).Conclusion:The cognitive dysfunction of patients with major depression disorder may not be related to the degree of depression and anxiety.And improvement of cognitive function may be associated with increase of ACC GABA concentrations.

Objective To explore the clinical efficacy of prone position ventilation(PPV)in improving hypoxemia in patients with severe brain damage.Methods A retrospective research method was conducted,140 patients with severe brain damage who were admitted to the department of critical care medicine of the First Affiliated Hospital,Zhejiang University School of Medicine from August 2020 to August 2021 were selected as subject objected.According to the inclusion and exclusion criteria,20 patients with oxygenation index≤200 mmHg(1 mmHg≈0.133 kPa)who were treated with PPV were statistically analyzed.The patients'blood gas analysis related indicators[including arterial partial pressure of oxygen(PaO2),fractional of inspired oxygen(FiO2),oxygenation index,arterial oxygen saturation(SaO2),arterial partial pressure of carbon dioxide(PaCO2),pH value],ventilator-related parameters[including peak inspiratory pressure(PIP),positive end-expiratory pressure(PEEP),tidal volume(VT),lung dynamic compliance(Cdyn),etc.],and mean arterial pressure(MAP),heart rate(HR)were compared before PPV,12 hours after PPV,and 12 hours after reverting to supine position.At the same time,the related complications of patients during PPV were recorded.Results There were 15 males and 5 females,the mean age of the patients was(46.10±17.22)years old,the average PPV time was(22.20±5.94)hours.Compared with before PPV,patients showed significant increases in PaO2,oxygenation index,SaO2,VT,and Cdyn at 12 hours after PPV and 12 hours after recovery from supine position[PaO2(mmHg):98.35±21.85,98.45±17.90 vs.72.15±10.14,oxygenation index(mmHg):198.82±40.51,202.27±46.39 vs.133.20±33.95,SaO2:0.97±0.02,0.97±0.01 vs.0.94±0.03,VT(mL):558.42±111.23,580.29±119.44 vs.484.82±123.77,Cdyn(mL/cmH2O):26.11±5.42,27.90±5.80 vs.24.15±6.13,all P<0.05];Compared with 12 hours after PPV,the Cdyn of the patient still showed a significant increase after 12 hours of recovery from supine position(P<0.05).There were no statistical differences in the FiO2,PaCO2,pH value,PIP,PEEP,HR,and MAP of patients at various time points before and after PPV(all P>0.05).Five patients developed redness and swelling at the skin compression site mainly on the face after PPV,which gradually improved after returning to a supine position.During this period,there was no occurrence of catheter detachment,malignant arrhythmia,or significant hemodynamic instability.Conclusion PPV has a certain clinical effect on improving hypoxemia in patients with severe brain damage.

Objective:Using T2-weighted imaging(T2WI),diffusion-weighted imaging(DWI),pulsed gradient spin echo(PGSE)multiparametric magnetic resonance imaging combined with various histopathological techniques to observe the effects of reperfusion after different times of cerebral ischemia(CIRI)on the cytotoxic edema of brain tis-sues in rats.This provides a solid foundation for the establishment of ischemic stroke models and clinical diagnosis and treatment.Methods:Healthy adult male Sprague Dawley rats were randomly allocated to four groups:the sham-opera-ted(Sham)group,the ischaemia 60 min reperfusion(IR-60 min)group,the IR-120 min group,and the IR-180 min group.CIRI rat model was prepared by modified Zea Longa method.Laser doppler flowmetry combined with hematoxy-lin-eosin(HE)staining was employed to identify the model.Multiparametric magnetic resonance imaging,combined with water content of brain,immunofluorescence staining of aquaporin-4(AQP4),and Western Blot were performed to observe cytotoxic edema of brain tissues and tumour necrosis factor alpha(TNF-α),interleukin 1β(IL-1β)in brain tissue of rats in each group.Results:HE staining and determination of brain tissue water content prove that as ischemia time prolongs,the degree of cerebral cortex edema on the ischemic side increases.The T2WI results showed that the injury in the IR-60 min group began to affect the cerebral cortex,the injury in the IR-120 min group had completely affected the cerebral cortex,and the injury in the IR-180 min group was the most severe(P＜0.05),with a significant shift of the midline of the brain towards the opposite side.The relative apparent diffusion coefficient and water exchange time of the cerebral cortex on the ischemic side of the rats were found to be significantly lower than those of the sham group,with an declining trend(P＜0.05).Additionally,the values of cell membrane permeability of the cerebral cor-tex on the ischemic side of the rats were observed to be significantly higher than those of the sham group in all groups(P＜0.05).The expression of AQP4,IL-1 β and TNF-α in the cerebral cortex of ischemic side was significantly higher than that in the sham group,and showed an upward trend(P＜0.05).Conclusion:Reperfusion following 60,120 and,180 minutes of middle cerebral artery ischemia in rats can result in brain damage.Prolongation of ischemia time has been shown to exacerbate the toxic edema of brain cells and brain damage.Ischemia of 120 minutes reperfusion has been identified as the optimal modeling time for ischemic stroke.Multiparametric MRI can be utilized to monitor the mi-crostructural changes of brain tissue in rats following CIRI in vivo,providing a foundation for the visualization of early clinical diagnosis and treatment.

Bladder cancer is one of the common tumors of urinary system. Early detection and treatment can reduce the recurrence rate and mortality. Currently, it is difficult to balance the diagnostic specificity and sensitivity of traditional diagnostic methods. However, Raman spectroscopy, as a molecular diagnostic technology, can reveal the difference between normal urinary tract epithelial tissue and urinary tract epithelial cell carcinoma of the bladder at the molecular level, which has the characteristics of faster and more accurate diagnosis compared with traditional diagnostic techniques. This paper reviews the research progress of Raman spectroscopy in the diagnosis of bladder cancer.

Background: Recent studies showed that the clinical outcome of moderately severe acute pancreatitis (MSAP) are different among different subgroups. Aims: To further subdivide MSAP, and explore the heterogeneity of MSAP subgroups. Methods: A retrospective analysis was performed on patients with acute pancreatitis (AP) from January 2016 to December 2020 at Northern Jiangsu People’s Hospital, including 538 patients with mild acute pancreatitis (MAP) and 461 patients with MSAP. MSAP patients were divided into four groups according to local complication and transient organ failure (TOF), including single acute peripancreatic fluid collection (APFC) without TOF group (group A), multiple APFC without TOF group (group B), other local complication without TOF group (group C) and TOF group (group D). The baseline data and the severity of AP among the four subgroups were compared. Meanwhile, the severity of disease between group A and MAP patients was also compared. Logistic regression analysis was used to evaluate the risk factors of MSAP. Results: Patients in group D were older than those in group A (P<0.05). There were statistically significant differences in different scoring systems among the four subgroups (P<0.05). The proportions of APACHE Ⅱ≥8, Glasgow≥3 and BISAP≥3 in group D were significantly higher than those in the other three groups (P<0.05). There were significant differences in levels of Ca

Objective:To investigate the relationship between preoperative serum thyroglobulin (Tg) and clinical data with the risk of cervical lymph node metastasis in patients with papillary thyroid carcinoma (PTC) .Methods:Data of 395 PTC patients who underwent surgery from Feb. 2016 to Jun. 2019 at the Second Affiliated Hospital of Soochow University were retrospectively analyzed. Based on whether cervical lymph nodes had metastasis, patients were classified into central lymph node metastasis positive group ( n=195 cases) , central lymph node metastasis negative group ( n=200 cases) , lateral lymph node metastasis positive group ( n=72 cases) , and lateral lymph node metastasis negative group ( n=323 cases) .Then the relationship between age, sex, multifocality, tumor diameter, capsular invasion, preoperative TSH and preoperative Tg with lymph node metastasis were analyzed by SPSS. Comparisons between groups were performed by χ2 test and rank sum test. Prediction efficiency of the preoperative Tg and Logistic regression model was estimated by receiver operating characteristic (ROC) curve. A total of 100 PTC patients confirmed by pathological results in the Second Affiliated Hospital of Soochow University from Jul. 2019 to Apr. 2020 were selected as the validation data. Results:Multi-factor Logistic regression showed that age, tumor diameter, capsular invasion and preoperative Tg were independent risk factors of central cervical lymphatic metastasis ( P<0.05) ; Tumor diameter, capsular invasion, central cervical lymphatic metastasis and preoperative Tg were independent risk factors of lateral cervical lymphatic metastasis ( P<0.05) . The area under the ROC curve (AUC) for diagnosing central lymph node metastasis by preoperative Tg was 0.710, with a sensitivity of 49.2%, and specificity of 88.5%. The AUC for diagnosing lateral lymph node metastasis by preoperative Tg was 0.728, with a sensitivity of 59.7%, and specificity of 89.5%. The AUC for diagnosing central lymph node metastasis by the prediction model was 0.773, with a sensitivity of 78.5%, and specificity of 64.5%.The AUC for diagnosing lateral lymph node metastasis by the prediction model was 0.869, with a sensitivity of 84.7%, and specificity of 70.3%. Conclusions:The preoperative serum Tg level is correlated with cervical lymph node metastasis in PTC patients. But the Logistic regression model based on preoperative Tg and other independent risk factors shows a better predictive value.

Brucellosis is a common global zoonotic disease caused by Brucella, which has a variety of clinical manifestations. Fever, sweating and musculoskeletal pains appear in partial brucellosis patients. The most common complication of brucellosis is osteoarthritis, including spondylitis, sacroiliitis, and peripheral arthritis such as osteomyelitis, bursitis, and tenosynovitis. The spine and sacroiliac are the most frequent affected sites of brucellosis osteoarthritis; however, the reports of peripheral arthritis such as osteomyelitis, bursitis, and tenosynovitis are low. Early and proper treatment is vital for patients with brucellosis osteoarthritis. The therapy of drugs and surgery are two current options for treatment of brucellosis osteoarthritis. In this review, clinical manifestations and treatments of brucellosis osteoarthritis are discussed in detail, which are helpful to deepen clinicians' knowledge in brucellosis.

Brucellosis is a common bacterial zoonotic disease that affects a variety of organs and tissues and causes a variety of clinical manifestations. Bone and joint are the most frequently involved parts, among which sacroiliac arthritis, spondylitis and peripheral arthritis are the most common osteoarticular disease. Brucella induces bone damage by affecting various cells of the skeletal system and the immune system, Brucella increases the expression of nuclear factor kappa B receptor activating factor ligand (RANKL), tumor necrosis factor (TNF)-α and interleukin (IL)-17 in osteoclasts and osteocytes, enhances the activity of osteoclasts. Brucella can proliferate in osteoblasts and osteocytes, induce apoptosis of osteoblasts and osteocytes, and inhibit the deposition of mineral and organic matrix in osteoblasts. After Brucella infection, inflammatory cells such as monocyte macrophages, neutrophils, T cells and B cells also participate in the inflammatory response, these inflammatory cells and bone system secrete more pro-inflammatory cytokines, chemokines and matrix metalloproteinases (MMPs), which enhance the inflammatory response and promote the degradation of extracellular matrix. Finally, the bone homeostasis is broken and the bone injury is aggravated. With the development of research on the molecular mechanism of Brucella osteoarthropathy, more and more people will understand the pathogenesis of chronic osteoarthropathy caused by Brucella.

Objective]To discuss the effect of sciatic nerve injury on the expressions of tumor necrosis factor-alpha(TNF-α), interleukin-1β(IL-1β)and interleukin-10(IL-10)in anterior cingulate cortex(ACC),and further to explain their roles resided in the development of neuropathic pain.[Method]With use of the methods of behavioral test,western blot and immunohistochemistry, we examine the effects of spared sciatic nerve injury(SNI)on the expressions of TNF-α,IL-1β,and IL-10 in ACC,and observe the effect of the neutralizing antibody of TNF-α,IL-1β on the rat mechanical allodynia.[Result]In present experiment ,SNI increased the protein levels of TNF-α,IL-10,but not IL-1β in ACC. Increased TNF-α-IR and IL-10-IR in ACC is located in neurons ,but not astrocytes and microglia at 7 d following L5-VRT. Pre-treatment with anti-TNFα antibody but not anti-IL-1βantibody into ACC significantly increased the rat paw withdrawal threshold to von Frey hairs.[Conclusion]These data suggested that the increased TNF-αin ACC neurons might be responsible for the development of neuropathic pain.