BackgroundCurrent studies on the relationship between depressive symptoms and the risks of stroke and all-cause mortality mostly focus on the elderly population or high-risk groups with chronic diseases. The long-term impact of depressive symptoms in young and middle-aged people on the risks of stroke and all-cause mortality still lacks systematic assessment， and the relevant evidence is insufficient. ObjectiveTo explore the association between depressive symptoms and the risks of stroke and all-cause mortality in young and middle-aged adults， thereby expanding the risk evidence in this age group and providing epidemiological basis for early identification of high-risk individuals and the development of targeted intervention strategies. MethodsBased on data from the National Health and Nutrition Examination Survey （NHANES） database （2009–2018）， a total of 14 947 young and middle-aged respondents aged 18 to 64 were included as the research subjects. Logistic regression and restricted cubic spline （RCS） models were employed to examine the association between depressive symptoms and stroke. Cox proportional hazards model， RCS model， and Kaplan-Meier （K-M） survival curves were used to clarify the relationship between depressive symptoms and all-cause mortality risk. To verify the robustness of main findings， sensitivity analysis was conducted stratified by gender， hypertension， diabetes， hyperlipidemia， body mass index （BMI）， and age. ResultsLogistic regression analysis revealed that compared with the non-depressed group， the risk of stroke in the mild depression group increased by 53.50% （OR=1.535， 95% CI： 1.147–2.053）， while the moderate-to-severe depression group showed the highest risk with a 132.90% increase （OR=2.329， 95% CI： 1.733–3.129）. RCS analysis indicated an approximately linear dose-response relationship between PHQ-9 score and the risk of stroke （P_{for non-linearity}=0.089）， with stroke risk increasing as PHQ-9 scores rose. As the PHQ-9 score increased， the risk of stroke also showed an upward trend. Cox regression analysis demonstrated that compared with the non-depressed group， the risk of all-cause mortality in the mild depression group increased by 48.80% （HR=1.488， 95% CI： 1.164–1.902）， and the moderate-to-severe depression group had a 70.60% increased risk （HR=1.706， 95% CI： 1.310–2.221）. RCS analysis showed a linear dose-response relationship between PHQ-9 scores and all-cause mortality risk （P_{for non-linearity}=0.440）. K-M curves indicated that as the severity of depressive symptoms increases， the risk of all-cause mortality gradually rises （P<0.05）. Sensitivity analysis confirmed that the associations between depression symptoms and risks of stroke and all-cause mortality were not modified by gender， hypertension， diabetes， hyperlipidemia， BMI， or age， demonstrating robust findings. ConclusionAmong the young and middle-aged population， both mild and moderate-to-severe depression were associated with increased risks of stroke and all-cause mortality， with the moderate-to-severe depression group showed more pronounced risk elevations. A positive dose-response relationship was observed between depressive symptoms and these risks.

BACKGROUND:Carboxylesterase 1 and inflammatory factors play a crucial role in regulating lipid metabolism and glucose homeostasis.However,the effects of different exercise intensity interventions on carboxylesterase 1 and inflammatory factors in skeletal muscle of type 2 diabetic rats remain to be revealed. OBJECTIVE:To investigate the effects of different exercise intensity interventions on carboxylesterase 1 and inflammatory factors in skeletal muscle of type 2 diabetic rats. METHODS:Thirty-two 8-week-old male Sprague-Dawley rats were randomly divided into normal control group(n=12)and modeling group(n=20)after 1 week of adaptive feeding.Rat models of type 2 diabetes mellitus were prepared by high-fat diet and single injection of streptozotocin.After successful modeling,the rats were randomly divided into diabetic control group(n=6),moderate-intensity exercise group(n=6)and high-intensity intermittent exercise group(n=6).The latter two groups were subjected to treadmill training at corresponding intensities,once a day,50 minutes each,and 5 days per week.Exercise intervention in each group was carried out for 6 weeks.After the intervention,ELISA was used to detect blood glucose and blood lipids of rats.The morphological changes of skeletal muscle were observed by hematoxylin-eosin staining.The mRNA expression levels of carboxylesterase 1 and inflammatory cytokines were detected by real-time quantitative PCR.The protein expression levels of carboxylesterase 1 and inflammatory cytokines were detected by western blot and immunofluorescence. RESULTS AND CONCLUSION:Compared with the normal control group,fasting blood glucose,triglyceride,low-density lipoprotein cholesterol,insulin resistance index in the diabetic control group were significantly increased(P<0.01),insulin activity was decreased(P<0.05),and the mRNA and protein levels of carboxylesterase 1,never in mitosis gene A related kinase 7(NEK7)and interleukin 18 in skeletal muscle tissue were upregulated(P<0.05).Compared with the diabetic control group,fasting blood glucose,triglyceride,low-density lipoprotein cholesterol,and insulin resistance index in the moderate-intensity exercise group and high-intensity intermittent exercise group were down-regulated(P<0.05),and insulin activity was increased(P<0.05).Moreover,compared with the diabetic control group,the mRNA level of NEK7 and the protein levels of carboxylesterase 1,NEK7 and interleukin 18 in skeletal muscle were decreased in the moderate-intensity exercise group(P<0.05),while the mRNA levels of carboxylesterase 1,NEK7,NOD-like receptor heat protein domain associated protein 3 and interleukin 18 and the protein levels of carboxylesterase 1 and interleukin 18 in skeletal muscle were downregulated in the high-intensity intermittent exercise group(P<0.05).Hematoxylin-eosin staining showed that compared with the diabetic control group,the cavities of myofibers in the moderate-intensity exercise group became smaller,the number of internal cavities was reduced,and the cellular structure tended to be more intact;the myocytes of rats in the high-intensity intermittent exercise group were loosely arranged,with irregular tissue shape and increased cavities in myofibers.To conclude,both moderate-intensity exercise and high-intensity intermittent exercise can reduce blood glucose,lipid,insulin resistance and carboxylesterase 1 levels in type 2 diabetic rats.Moderate-intensity exercise can significantly reduce the expression level of NEK7 protein in skeletal muscle,while high-intensity intermittent exercise can significantly reduce the expression level of interleukin 18 protein in skeletal muscle.In addition,the level of carboxylesterase 1 is closely related to the levels of NEK7 and interleukin 18.

BACKGROUND:Activation of nuclear factor-κB/NOD-like receptor thermal protein domain associated protein 3(NLRP3)signaling leads to endothelial dysfunction,oxidative stress,and plays a key role in the initiation of lipid metabolism disorders and arteriosclerosis.However,currenty,the effect of walnut oil and peanut oil on skeletal muscle inflammatory factors in arteriosclerotic rats remains unclear.OBJECTIVE:To discuss the effect and mechanism of walnut oil and peanut oil on atherosclerosis.METHODS:Forty 8-week-old SD male rats were randomly divided into normal control group(n=10)and high fat group(n=30)after 1 week of adaptive feeding.The atherosclerosis model was established by high-fat diet combined with vitamin D3 injection.The rats with successful modeling were randomly divided into model group(n=10),peanut oil group(n=8)and walnut oil group(n=8).The latter two groups were gavaged with peanut oil or walnut oil for 4 weeks(5 days/week,1.2 g/kg per day).After the intervention,ELISA was used to detect the related indexes of blood lipids in rats.The morphological changes of aorta were observed by hematoxylin-eosin staining.The RT-qPCR and western blot assay were used to detect nuclear factor-κB,NLRP3,Caspase-1,interleukin-1β,interleukin-18 mRNA and nuclear factor-κB,NLRP3,interleukin-1β protein expression levels in skeletal muscle.The protein expressions of nuclear factor-κB and NLRP3 were detected by immunofluorescence immunohistochemical staining.RESULTS AND CONCLUSION:(1)Compared with the normal control group,the aortic wall of rats in the model group was thickened,the damage and lipid precipitation were more serious,the blood lipid levels and arteriosclerosis index were significantly increased(P＜0.01).The mRNA levels of nuclear factor-κB,NLRP3,Caspase-1,interleukin-1β,and interleukin-18,and the protein expressions of nuclear factor-κB,NLRP3,and interleukin-1β in skeletal muscle were significantly increased(P＜0.01).(2)Compared with model group,the vulnerable area of aortic tissue in peanut oil group and walnut oil group was significantly reduced,the levels of total cholesterol,triglyceride,low density lipoprotein cholesterol in serum,and atherosclerosis index were decreased(P＜0.01),and the mRNA expressions of nuclear factor-κB,NLRP3,Caspase-1,interleukin-1β,and interleukin-18 and the protein expressions of nuclear factor-κB,NLRP3,and interleukin-1β in skeletal muscle were significantly decreased(P＜0.01 or P＜0.05).(3)Compared with peanut oil group,the serum total cholesterol,triglyceride,and low density lipoprotein cholesterol levels in walnut oil group were significantly decreased(P＜0.01 or P＜0.05),and the mRNA levels of nuclear factor-κB,NLRP3,Caspase-1,interleukin-18,and the protein levels of nuclear factor-κB,NLRP3,interleukin-1β decreased significantly in skeletal muscle(P＜0.01 or P＜0.05).It is concluded that both peanut oil and walnut oil have ameliorative effect on atherosclerotic damage,which may be related to nuclear factor-κB/NLRP3 signaling pathway,and walnut oil has better ameliorative effect than peanut oil.

Objective:To investigate the influening factors for postoperative paroxysmal sympathetic hyperactivity (PSH) and prolonged disorders of consciousness (pDoC) in patients with severe traumatic brain injury (sTBI).Methods:A retrospective cross-sectional study was performed; 204 patients with sTBI accepted surgery in Department of Neurosurgery, Second Affiliated Hospital of Fuyang Normal University from January 2018 to April 2024 were enrolled. These patients were divided into PSH group and non-PSH group based on postoperative PSH occurrence. These patients were also divided into pDoC group and non-pDoC group depending on whether duration of postoperative pDoC exceeded 28 days. Differences in clinical data between the PSH group and non-PSH group, as well as between the pDoC group and non-pDoC group, were compared respectively. Multivariate Logistic regression analysis was used to determine the independent influencing factors for PSH or pDoC. Receiver operating characteristic curve was used to investigate the predictive value of these influencing factors in PSH or pDoC in patients with sTBI.Results:(1) Of these 204 patients with sTBI, 28 patients (13.7 %) experienced PSH and 176 patients (86.3 %) were without PSH; compared with the non-PSH group, the PSH group had younger age, lower Glasgow Coma Scale (GCS) score on admission, higher proportions of patients with brain herniation, basilar skull fracture and traumatic intraventricular hemorrhage, higher proportion of patients accepted decompressive craniectomy, higher blood glucose level and neutrophil-to-lymphocyte ratio (NLR), and higher proportion of patients with postoperative hydrocephalus, with significant differences ( P<0.05). Of these 204 patients with sTBI, 77 patients (37.7 %) suffered from pDoC, and 127 (62.3 %) were without pDoC; compared with the non-pDoC group, the pDoC group had older age, lower GCS score on admission, higher proportions of patients with brain herniation, basilar skull fracture and traumatic intraventricular hemorrhage, higher proportion of patients accepted decompressive craniectomy, and higher proportions of patients with postoperative hydrocephalus or postoperative PSH, with significant differences ( P<0.05). (2) Multivariate Logistic regression analysis showed that age, skull base fracture, traumatic intraventricular hemorrhage, blood glucose level, NLR, and postoperative hydrocephalus were independent influencing factors for PSH ( P<0.05); PSH, age, GCS score on admission, and postoperative hydrocephalus were independent influencing factors for pDoC ( P<0.05). (3) Areas under the curve (AUC) of age, skull base fracture, traumatic intraventricular hemorrhage, blood glucose level, NLR and postoperative hydrocephalus in predicting PSH were 0.750, 0.718, 0.760, 0.756, 0.790 and 0.679, respectively; AUC of age, GCS score on admission, postoperative hydrocephalus, postoperative PSH and their combinations in predicting pDoC were 0.598, 0.833, 0.691, 0.630 and 0.925, respectively. Conclusion:The sTBI patients with younger age, skull base fracture, traumatic intraventricular hemorrhage, high blood glucose level and NLR, or hydrocephalus are prone to have postoperative PSH; the sTBI patients with older age, low GCS score on admission, postoperative hydrocephalus or postoperative PSH are prone to have postoperative pDoC.

BACKGROUND:Exercise interventions play a key role in disease prevention and treatment,which can effectively activate the nuclear factor erythroid2-related factor 2(Nrf2)signaling pathway to prevent the occurrence and development of insulin resistance.However,the potential mechanism of Nrf2-targeting exercise therapy strategies in alleviating insulin resistance remains unclear.OBJECTIVE:Based on the relationship between Nrf2,insulin resistance and exercise,to analyze the mechanism and influence of different exercise modes on the activation of Nrf2,thereby elucidating the potential mechanism of Nrf2-targeting exercise therapy strategies in the process of alleviating insulin resistance.METHODS:"Diabetes mellitus,insulin,insulin resistance,nuclear factor E2 related factor 2,oxidative stress,ferroptosis,autophagy,inflammatory response,exercise"were used as search terms in Chinese and English.WanFang Database,CNKI,Google Scholar and PubMed database were searched for relevant literature from inception to October 2024,and a total of 127 core related articles were obtained according to the inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1)Keap1/Nrf2 signaling pathway,as an important endogenous antioxidant stress pathway,plays an important role in insulin resistance.Activation of Keap1/Nrf2 signaling pathway can enhance the antioxidant capacity of cells,reduce oxidative stress and inflammation,improve insulin signaling,and thus protect insulin resistance.(2)A variety of exercise methods(including aerobic exercise,resistance exercise and high-intensity intermittent exercise)can effectively activate Nrf2 signal,improve the activity of antioxidant kinase and enhance the antioxidant capacity of cells,so as to alleviate oxidative stress damage to a certain extent.(3)By activating Nrf2 signaling pathway,exercise can up-regulate the activity of antioxidant enzymes such as Heme oxygenase 1,superoxide dismutase,catalase,glutathione peroxidase,glutathione,and enhance the antioxidant capacity of cells.In addition,it can also regulate the key enzymes and proteins in the ferroptosis pathway,such as glutathione peroxidase 4,membrane iron transport protein 1,and ferritin heavy chain 1,inhibit the ferroptosis pathway and promote the balance of iron metabolism.In autophagy,the expression of autophagy related genes p62 and ATG5/7 can be enhanced,and the level of microtubule-associated protein 1 light chain 3 is increased,thus regulating autophagy process.At the same time,the activity of tumor necrosis factor-α,nuclear factor-κB,interleukin-6,interleukin-1β and other pro-inflammatory cytokines is decreased,and the inflammatory response can be effectively inhibited.These combined effects can reduce oxidative stress damage,increase insulin sensitivity and improve insulin signaling,and thus have a positive effect on improving insulin resistance.(4)Given that the Keap1/Nrf2 signaling pathway plays an important role in the pathogenesis and treatment of insulin resistance,exercise therapy strategies targeting the Keap1/Nrf2 signaling pathway will help promote the development of"exercise+drug"precision medicine for insulin resistance.

BACKGROUND:Exercise interventions play a key role in disease prevention and treatment,which can effectively activate the nuclear factor erythroid2-related factor 2(Nrf2)signaling pathway to prevent the occurrence and development of insulin resistance.However,the potential mechanism of Nrf2-targeting exercise therapy strategies in alleviating insulin resistance remains unclear.OBJECTIVE:Based on the relationship between Nrf2,insulin resistance and exercise,to analyze the mechanism and influence of different exercise modes on the activation of Nrf2,thereby elucidating the potential mechanism of Nrf2-targeting exercise therapy strategies in the process of alleviating insulin resistance.METHODS:"Diabetes mellitus,insulin,insulin resistance,nuclear factor E2 related factor 2,oxidative stress,ferroptosis,autophagy,inflammatory response,exercise"were used as search terms in Chinese and English.WanFang Database,CNKI,Google Scholar and PubMed database were searched for relevant literature from inception to October 2024,and a total of 127 core related articles were obtained according to the inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1)Keap1/Nrf2 signaling pathway,as an important endogenous antioxidant stress pathway,plays an important role in insulin resistance.Activation of Keap1/Nrf2 signaling pathway can enhance the antioxidant capacity of cells,reduce oxidative stress and inflammation,improve insulin signaling,and thus protect insulin resistance.(2)A variety of exercise methods(including aerobic exercise,resistance exercise and high-intensity intermittent exercise)can effectively activate Nrf2 signal,improve the activity of antioxidant kinase and enhance the antioxidant capacity of cells,so as to alleviate oxidative stress damage to a certain extent.(3)By activating Nrf2 signaling pathway,exercise can up-regulate the activity of antioxidant enzymes such as Heme oxygenase 1,superoxide dismutase,catalase,glutathione peroxidase,glutathione,and enhance the antioxidant capacity of cells.In addition,it can also regulate the key enzymes and proteins in the ferroptosis pathway,such as glutathione peroxidase 4,membrane iron transport protein 1,and ferritin heavy chain 1,inhibit the ferroptosis pathway and promote the balance of iron metabolism.In autophagy,the expression of autophagy related genes p62 and ATG5/7 can be enhanced,and the level of microtubule-associated protein 1 light chain 3 is increased,thus regulating autophagy process.At the same time,the activity of tumor necrosis factor-α,nuclear factor-κB,interleukin-6,interleukin-1β and other pro-inflammatory cytokines is decreased,and the inflammatory response can be effectively inhibited.These combined effects can reduce oxidative stress damage,increase insulin sensitivity and improve insulin signaling,and thus have a positive effect on improving insulin resistance.(4)Given that the Keap1/Nrf2 signaling pathway plays an important role in the pathogenesis and treatment of insulin resistance,exercise therapy strategies targeting the Keap1/Nrf2 signaling pathway will help promote the development of"exercise+drug"precision medicine for insulin resistance.

Objective:To investigate the influening factors for postoperative paroxysmal sympathetic hyperactivity (PSH) and prolonged disorders of consciousness (pDoC) in patients with severe traumatic brain injury (sTBI).Methods:A retrospective cross-sectional study was performed; 204 patients with sTBI accepted surgery in Department of Neurosurgery, Second Affiliated Hospital of Fuyang Normal University from January 2018 to April 2024 were enrolled. These patients were divided into PSH group and non-PSH group based on postoperative PSH occurrence. These patients were also divided into pDoC group and non-pDoC group depending on whether duration of postoperative pDoC exceeded 28 days. Differences in clinical data between the PSH group and non-PSH group, as well as between the pDoC group and non-pDoC group, were compared respectively. Multivariate Logistic regression analysis was used to determine the independent influencing factors for PSH or pDoC. Receiver operating characteristic curve was used to investigate the predictive value of these influencing factors in PSH or pDoC in patients with sTBI.Results:(1) Of these 204 patients with sTBI, 28 patients (13.7 %) experienced PSH and 176 patients (86.3 %) were without PSH; compared with the non-PSH group, the PSH group had younger age, lower Glasgow Coma Scale (GCS) score on admission, higher proportions of patients with brain herniation, basilar skull fracture and traumatic intraventricular hemorrhage, higher proportion of patients accepted decompressive craniectomy, higher blood glucose level and neutrophil-to-lymphocyte ratio (NLR), and higher proportion of patients with postoperative hydrocephalus, with significant differences ( P<0.05). Of these 204 patients with sTBI, 77 patients (37.7 %) suffered from pDoC, and 127 (62.3 %) were without pDoC; compared with the non-pDoC group, the pDoC group had older age, lower GCS score on admission, higher proportions of patients with brain herniation, basilar skull fracture and traumatic intraventricular hemorrhage, higher proportion of patients accepted decompressive craniectomy, and higher proportions of patients with postoperative hydrocephalus or postoperative PSH, with significant differences ( P<0.05). (2) Multivariate Logistic regression analysis showed that age, skull base fracture, traumatic intraventricular hemorrhage, blood glucose level, NLR, and postoperative hydrocephalus were independent influencing factors for PSH ( P<0.05); PSH, age, GCS score on admission, and postoperative hydrocephalus were independent influencing factors for pDoC ( P<0.05). (3) Areas under the curve (AUC) of age, skull base fracture, traumatic intraventricular hemorrhage, blood glucose level, NLR and postoperative hydrocephalus in predicting PSH were 0.750, 0.718, 0.760, 0.756, 0.790 and 0.679, respectively; AUC of age, GCS score on admission, postoperative hydrocephalus, postoperative PSH and their combinations in predicting pDoC were 0.598, 0.833, 0.691, 0.630 and 0.925, respectively. Conclusion:The sTBI patients with younger age, skull base fracture, traumatic intraventricular hemorrhage, high blood glucose level and NLR, or hydrocephalus are prone to have postoperative PSH; the sTBI patients with older age, low GCS score on admission, postoperative hydrocephalus or postoperative PSH are prone to have postoperative pDoC.

BACKGROUND:Activation of nuclear factor-κB/NOD-like receptor thermal protein domain associated protein 3(NLRP3)signaling leads to endothelial dysfunction,oxidative stress,and plays a key role in the initiation of lipid metabolism disorders and arteriosclerosis.However,currenty,the effect of walnut oil and peanut oil on skeletal muscle inflammatory factors in arteriosclerotic rats remains unclear.OBJECTIVE:To discuss the effect and mechanism of walnut oil and peanut oil on atherosclerosis.METHODS:Forty 8-week-old SD male rats were randomly divided into normal control group(n=10)and high fat group(n=30)after 1 week of adaptive feeding.The atherosclerosis model was established by high-fat diet combined with vitamin D3 injection.The rats with successful modeling were randomly divided into model group(n=10),peanut oil group(n=8)and walnut oil group(n=8).The latter two groups were gavaged with peanut oil or walnut oil for 4 weeks(5 days/week,1.2 g/kg per day).After the intervention,ELISA was used to detect the related indexes of blood lipids in rats.The morphological changes of aorta were observed by hematoxylin-eosin staining.The RT-qPCR and western blot assay were used to detect nuclear factor-κB,NLRP3,Caspase-1,interleukin-1β,interleukin-18 mRNA and nuclear factor-κB,NLRP3,interleukin-1β protein expression levels in skeletal muscle.The protein expressions of nuclear factor-κB and NLRP3 were detected by immunofluorescence immunohistochemical staining.RESULTS AND CONCLUSION:(1)Compared with the normal control group,the aortic wall of rats in the model group was thickened,the damage and lipid precipitation were more serious,the blood lipid levels and arteriosclerosis index were significantly increased(P＜0.01).The mRNA levels of nuclear factor-κB,NLRP3,Caspase-1,interleukin-1β,and interleukin-18,and the protein expressions of nuclear factor-κB,NLRP3,and interleukin-1β in skeletal muscle were significantly increased(P＜0.01).(2)Compared with model group,the vulnerable area of aortic tissue in peanut oil group and walnut oil group was significantly reduced,the levels of total cholesterol,triglyceride,low density lipoprotein cholesterol in serum,and atherosclerosis index were decreased(P＜0.01),and the mRNA expressions of nuclear factor-κB,NLRP3,Caspase-1,interleukin-1β,and interleukin-18 and the protein expressions of nuclear factor-κB,NLRP3,and interleukin-1β in skeletal muscle were significantly decreased(P＜0.01 or P＜0.05).(3)Compared with peanut oil group,the serum total cholesterol,triglyceride,and low density lipoprotein cholesterol levels in walnut oil group were significantly decreased(P＜0.01 or P＜0.05),and the mRNA levels of nuclear factor-κB,NLRP3,Caspase-1,interleukin-18,and the protein levels of nuclear factor-κB,NLRP3,interleukin-1β decreased significantly in skeletal muscle(P＜0.01 or P＜0.05).It is concluded that both peanut oil and walnut oil have ameliorative effect on atherosclerotic damage,which may be related to nuclear factor-κB/NLRP3 signaling pathway,and walnut oil has better ameliorative effect than peanut oil.

Objective To observe the value of grey-level histogram analysis based on T2WI for differentiating consistency of meningioma.Methods Data of 109 patients with meningioma were retrospectively analyzed.The patients were divided into hard group(n=71)and soft group(n=38)according to the consistency of tumors.Tumor ROI was outlined on axial T2WI showing the largest tumor section,gray levels were extracted and histogram analysis was performed.The value of each histogram parameter were compared between groups.Then receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficiency for differentiating soft and hard meningioma.Results P1,P10,P50,P90,P99 and the mean grey levels on T2WI in soft group were all higher than those in hard group(all P＜0.05),while the variance,the kurtosis and the skewness were not significantly different between groups(all P＞0.05).The differentiating efficiency of P1,P10,P50,P90,P99 and the mean grey levels on T2WI were all fine,with AUC of 0.774 to 0.833,and no significant difference was found(all P＞0.05).Conclusion Parameters of grey-level histogram analysis such as P1,P10,Ps0,P90,P99 and the mean values based on T2WI were all valuable for differentiating soft and hard meningioma.

Objective To investigate the effects of controlled low central venous pressure (CLCVP) on cerebral oxygen metabolism during orthotopic liver transplantation (OLT),and study the safety of CLCVP in OLT.Method Forty-six patients subject to OLT were randomly divided into CLCVP group (CL group) and CVP group (C group).Blood samples were taken from radial artery and jugular simultaneously for blood gas analysis before operation (T1,baseline),immediately blocking inferior vena and portal vein (T2),30 min after anhepatic phase (T3),30 min after graft reperfusion (T4),2 h after graft reperfusion (T5),and 24 h after graft reperfusion (T6).Cerebral arterial oxygen content (CaO2),jugular oxygen content (CjvO2),cerebral arterial-venous oxygen content difference (Ca-jvO2),cerebral oxygen extraction rate (CERO2),and cerebral blood flow/ cerebral metabolic rate of oxygen (CBF/CMRO2) were calculated by the Fick formulae.Meanwhile,blood samples were taken from jugular simultaneously for serum creatinine (Cr) and urea nitrogen (BUN) a different time points.We also recorded the whole operation time,anhepatic phase time,volume of blood loss and transfusion,and urine volume.Results As compared with C group,CaO2,CjvO2,Ca-jvO2,SjvO2,CERO2 and CBF/CMRO2 in CL group were nearly not changed at different time pioints (P＞0.05),but in the same group,as compared with T1 and T2,the CaO2,CjvO2,Ca-jvO2 and CERO2 in T3,T4 and T5 were decreased significantly (P＜0.05),and the SjvO2 in T3,T4 and T5 was increased remarkably.The operation time and anhepatic phase time had no significant difference in both groups.As compared with C group,the volume of blood loss and transfusion in CL group were decreased (P＜0.05),and the urine volume in CL group CL was increased significantly (P＜0.05).Cr and BUN showed no significant difference in both groups and at the same time points of C group and CL group.Conclusion CLCVP can decrease volume of blood loss and transfusion,increase urine volume during OLT,and it does not change the cerebral oxygen metabolism during OLT.