Objective To investigate the predictive value of serum homocysteine(HCY)and lipoprotein(a)[Lp(a)]in autologous arteriovenous fistula(AVF)failure in patients undergoing maintenance hemodialy-sis(MHD).Methods A total of 175 patients with MHD admitted to the hospital from January to December 2022 were selected as the observation group,among them,103 patients without AVF failure were selected as observation group 1,and 72 patients with AVF failure were selected as observation group 2.175 healthy indi-viduals who underwent physical examinations at the outpatient examination center of the hospital during the same period were selected as the control group.Enzyme-linked immunosorbent assay was used to detect the levels of HCY and Lp(a).Pearson method was used to analyze the correlation between HCY,Lp(a)with clin-ical indicators.Multivariate Logistic regression analysis was performed to analyze the influencing factors of AVF failure in MHD patients.Receiver operating characteristic(ROC)curve was plotted to analyze the pre-dictive value of serum HCY and Lp(a)for AVF failure in MHD patients.Results Compared with the control group,the serum levels of HCY and Lp(a)in observation group 1 were increased(P<0.05).Compared with the control group and observation group 1,the serum levels of HCY and Lp(a)in observation group 2 were in-creased(P<0.05).The serum levels of HCY and Lp(a)in observation group 2 were negatively correlated with ultrafiltration amount(P<0.05),and HCY and Lp(a)were positively correlated with parathyroid hor-mone(PTH),blood phosphorus(P),uric acid(UA)(P<0.05).Multivariate Logistic regression analysis showed that HCY,Lp(a),PTH,P,UA,diabetic nephropathy,duration of endovascular fistula use≥12 months,duration of puncture point compression≥30 min,and arteriovenous internal diameter<2 mm and vascular stenosis were the risk factors for AVF failure in MHD patients(P<0.05),and ultrafiltration a-mount was a protective factor for AVF failure in MHD patients(P<0.05).ROC curve results showed that the area under the curve of HCY and Lp(a)alone and in combination in the prediction of AVF failure in MHD patients were 0.822,0.820 and 0.908,respectively(Zcombination vs.HCY=3.144,Zcombination vs.Lp(a)=2.925,P<0.05).Conclusion The serum levels of HCY and Lp(a)in MHD patients with AVF failure are increased.They are the influencing factors of AVF failure in MHD patients,and the value of the combination of the two for pre-dicting AVF failure in MHD patients is relatively high.

Objective To explore the efficacy of moderate dose bromocriptine by one-off oral administration in treatment of patients with non-acute prolactin (PRL) type pituitary adenoma.Methods Forty-three patients with definite diagnosis of non-acute prolactin type pituitary adenoma,admitted to our hospital from January 2016 to December 2017,were chosen in our study.All patients were administrated with 5 mg bromocriptine at 18 pm;the serum PRL levels were examined at 2,3 and 12 h after bromocriptine administration.The curative effects of these patients were judged by decline rate of PRL,and the curative effects of patients with different genders,different initial PRL levels and different ages were compared.Results In these 43 patients,bromocriptine showed excellent effect in 20 patients,obvious effect in 18 and invalid effect in 5.There were statistically significant differences in the efficacy of bromocriptine between different genders (P＜0.05).There were statistically significant differences in efficacy of patients with different genders after taking bromocriptine (P＜0.05).The female patients had obviously higher rate of obvious effect than the male patients.Patients with different initial PRL values had statistically significant differences in efficacy after taking bromocriptine (P＜0.05).Patients with PRL initial value of 40-200 ng/mL had significantly higher rate of obvious effect than patients with PRL initial value of ＞200 ng/mL.There was no significant difference in efficacy between patients ＜ 45 years old and patients＞45 years old (P＞0.05).Conclusion The treatment ofhyperprolactin caused by prolactin type pituitary adenoma with moderate dose bromocriptine by one-off oral administration is effective;female patients have obviously better effect than male patients;and for patients with initial prolactin＞200 ng/mL,the effect is better.

Objective Transient brain function inhibition is a common symptom after mild brain injury,but some patients show persistent post-concussional syndrome (PCS).The aims of this study are to assess functional and causal connectivity of attention and default mode network using resting-state functional MR imaging (fMRI) to investigate the abnormal connectivity and its significance in PCS patients.Methods Resting-state fMRI data were collected from 23 PCS patients with attention disorders,admitted to our hospital from November 2015 to October 2016 and 21 age-,gender,and education-matched healthy controls recruited at the same period.The fMRI data were analyzed by group independent component analysis (ICA) toolbox to attention networks and default mode network (DMN).The components of the selected networks were compared in PCS and healthy controls to explore the changes of functional connectivity (FC).Granger causality analysis (GCA) was performed by taking the above significant brain areas as regions of interest (ROIs) to calculate bivariate coefficient of each pair of ROIs.Comparisons were performed to find the significant different causal connectivity of the two groups.Results In attention networks,the FC value of left frontal eye field (FEF),bilateral intraparietal sulcus (IPS),bilateral ventral prefrontal cortex (vPFC) and bilateral temporo-parietal junction (TPJ) was decreased.In DMN,the FC value of bilateral medial prefrontal cortex (mPFC) was reduced and bilateral precuneus (PCUN) was enhanced.Correlating GCA value,it was increased significantly from left FEF to left PCUN and IPS,while it was reduced from left PCUN and IPS to left FEF;and it was decreased from left IPS to left vPFC and increased from left TPJ to left PCUN.Conclusion The attention networks are restrained in resting state,which may influence the attention function in PCS patients;and the causal connection is altered in the above ROIs,and these changes may be related to inhibition of activation of default network to compensate for the loss of attention function by antagonistic effects in PCS patients.

Objective To explore the functional imaging alteration of dorsal attention network (DAN) between heroin addicts and heroin abstainers and probe into its influence on attentional function.Methods Attention-related neuropsychological assessments were applied to evaluate the difference of attentional function between heroin addicts and heroin abstainers.With the functional magnetic resonance imaging (fMRI) data obtained from 17 heroin addicts and 15 heroin abstainers at resting state,we extracted the DANs of heroin withdrawal group and heroin dependence group respectively by using independent component analysis (ICA) and analysed the differences of intra-group and inter-group,then correlation analysis was performed among brain areas which have significant difference between groups and Stroop interference effect test.Results Compared with the heroin dependence group,there was a better result of attentional function in the heroin withdrawal group (P＜0.05),especially at the digit span test(backward) (P=0.0363),digit symbol test (writing) (P =0.0195),Stroop test C (reaction) (P =0.0379),Stroop test C (error) (P=0.0014) and Stroop interference effect test (P=0.0002).Neuroimaging findings demonstrated that there was a similar DAN in the heroin withdrawal group and heroin dependence group which mainly included the bilateral intraparietal suleus,postcentral gyrus and frontal eye field.Compared with the DAN of heroin addicts,significantly enhanced functional connectivity within the DAN of heroin abstainers was observed in the left superior parietal lobule (MIN:-24,-75,48),right inferior parietal lobule (MIN:39,-54,45) and left inferior parietal lobule (MIN:-33,-51,57).Significant negative correlations were observed between these brain areas and Stroop interference effect test in the heroin dependence group (r=-0.79,-0.69,-0.64,P＜0.01),but not in the heroin withdrawal group.Conclusions Heroin addiction can impair attentional function,compared with the DAN of heroin addicts,significantly enhanced functional connectivity in the left superior parietal lobule as well as bilateral inferior parietal lobule are observed in the heroin abstainers at resting state,which may be one of the neural mechanisms of attentional function improvement.

Objective To investigate the relationship between impulsive behaviors and the errorrelated negativity (ERN) component of event-related potentials of error processing in heroin addicts.Methods Using the paradigms for psychological experiment,the Iowa gambling task (IGT) was performed both in heroin addiction group (HA group,20 cases) and healthy control group (HC group,20 cases),and the inspection of electroencephalography was underwent in all subjects concurrently.Following the collection of data,the amplitude and latency of ERN were compared between the two groups,and then the relationship between the amplitude of ERN and the scores of Barratt Impulsiveness Scale (BIS-11) was analyzed separately.Results Decision-making course had no effect on the net score remarkably in HA group (F =1.21,P ＞0.05).Compared with HC group(64.3 ±8.4,73.8 ± 16.4),BIS score as well as the numbers of high frequency loss cards were significantly higher in HA group(75.2 ±7.6,105.5 ±22.2; t =-5.39,-9.24 ; P ＜ 0.05),while both the two groups had visible waveforms of ERN,and the amplitude was markedly lower in HA group(HA:(4.23 ±0.87) μV,HC:(6.11 ± 1.09) μV; t =5.96,P ＜0.05),but no statistical difference was found in latency of these two groups(HC:(102.1 ±28.2) ms,HA:(107.8 ±24.2) ms;t =-0.62,P =0.54),and the amplitude of the two groups was negatively associated with BIS score respectively in both two groups (HC:r =-0.66,HA:r =-0.78 ; both P ＜ 0.05).Conclusion The reduced capability of error processing maybe partly contribute to both addiction and relapse to heroin addict,and the ERN event-related potential could be regarded as an indicator of impulsive behaviors and the capability error processing.

Objective To investigate the characteristic of P30o event-related potentials(ERP) of impulsive behavior in heroin addicts.Methods The Iowa gambling task (IGT) were performed by using the paradigm for psychological experiment both in heroin addiction group (HA group) and health control group (HC group),the inspection of electroencephalography were underwent in all the subjects concurrently.Following the collection of data of ERP,amplitude and latency of P300 were compared between the two groups,and then the relationship betweenamplitude or latency of P300 and the results of Barratt impulsiveness scale were analyzed separately.Results Compared to HC group,BIS score as well as the numbers of high frequency loss cards were significantly higher in HA group ( HA:75.12 ± 12.49,91.14 ± 21.35 ; HC:66.54 ± 8.61,73.71 ± 18.91 ; P ＜ 0.05 ),while the both two groups had visible waveforms of P30o,and the amplitude and latency were markedly lower ( HA:4.92 ± 1.14,293.43 ± 36.21 ; HC:7.65 ± 1.59,332.68 ± 40.15 ; P ＜ 0.05 ) and were negatively associated with BIS score in HA group( r =-0.76,-0.52,P＜ 0.05).Logistic regression results showed that the scores of BIS-11 were related to amplitude of P30o merely( P ＜ 0.05 ).Conclusion Impulsive behavior can be observed from the abnormal characteristic of the P300 event-related potential of impulsive behavior in heroin addicts,which may partly contribute to both addiction and relapse of heroin addict.

Objective To explore surgical techniques and curative effects of microsurgical treatment for neurilemmoma in upper cervical spinal canal. Methods From Jan. 2004 to Nov. 2007, 59 cases of schwannoma was resected through microoperation, the operation was conducted through a posteromedial approach, using German Laika microscope resection of the tumor, large tumors cannot complete resection,block or sac, resection postoperative neck activity conventional neck restrictions, with following observation of 6 months-2 years. Results A complete recovery was achieved in 54 cases, an improvement of symptoms was achieved in 5 cases, no death was encountered. Follow-up observations were carried out in 55 cases from 3 months-2 years (6.5 ± 1.5 months). MRI examinations 3-12 months after operation in 35 cases found no residual or recurrent tumor. X-ray radiography under anteroposterior, lateral, and open-mouth view 6 months after operation in 42 cases showed no spinal deformation and good vertebral stability. Conclusions As long as neurilemmoma in upper cervical spinal canal are diagnosed, a microsurgical treatment should be given as early as possible. Appropriate selection of surgical approach, skillful microsurgical techniques in accordance with pathological types of lesions, and principles of minimal invasion are critical for the operation safety.

Objective To explore the reaction patterns of impulsiveness and risk-taking decision-making in heroin addicts and their significance.Methods Seventeen heroin addicts(HA group)admitted to Detoxification and Rehabilitation Center of Anhui Province from July 2010 to December 2010 and 18 healthy controls(HC group)recruited at the same period were performed Iowa gambling task(IGT)and Risky-Gains task(RGT),respectively; the different capacities of impulsiveness control and risk-taking decision-making between HA group and HC group were compared.Results As for IGT,decision-making course affected the net scores remarkably in HC group,whereas contrary result was observed in HA group(P＜0.05); no statistical difference between the numbers of low-frequency punishment cards and high-frequency punishment cards which subjects selected was noted in HA group,while statistical difference was observed in HC group(P＜0.05).Furthermore,the difference between the number of low-frequency punishment cards and high-frequency punishment cards in HC group was higher than that in HA group(P＜0.05).In RGT,as compared with risky response rate before punishment,risky response rate after punishment declined notably in HC group,while no significant changes were seen in HA group; risky response rate after reward and after punishment in HA group were significantly higher than those in HC group(P＜0.05).Conclusion As evidence of chronic heroin addicts' behavior,heroin addict exsits impulsiveness and deficit in risk-taking decision-making,which may be one of the causes of generation and maintenance of heroin addiction.

According to the three-parameter expression of blood , the dual-frequency complex impedance information is selected as the known quantity. In this paper , the particular solution process of three-parameter is introduced. A calculational method to obtain basic quantity and pulsatile quantity of three-parameter of blood electrical impedance is established.