The hippocampus and its circuits play crucial roles in human learning, memory, and emotional regulation. Whether it is vascular cognitive impairment (VCI) or Alzheimer's disease (AD), damage to the hippocampus is a prominent pathological feature. This review summarizes the recent advance in multimodal magnetic resonance imaging in anatomy, blood supply, structure and function of the hippocampus and the circuits related to VCI and AD in recent years, aiming to provide help in early recognizing and differentially diagnosing VCI and AD.

Cerebral small vascular disease (CSVD) is an important risk factor for stroke, cognitive impairment, and death, but its exact pathogenesis is not yet fully understood. Recent studies have shown that as an important part of pathophysiological mechanisms of CSVD, immunoinflammation may affect the progression and prognosis of CSVD. This article reviews the role of immunoinflammation in CSVD.

Objective:To establish an automated labeling method of 18F-AlF-1, 4, 7-triazocyclohexane-1, 4, 7-triacetic acid- D-Phe1-Tyr3-Thr8-octreotide (NOTATATE) and perform neuroendocrine tumor (NET) imaging. Methods:Based on the GE-FASTLab2 synthesis module, 18F-AlF-NOTATATE was automatically prepared by one-step chelation labeling with aluminum fluoride, and its labeling conditions were optimized. The product quality was analyzed. One patient (male, 47 years old) with lower rectal segment NET and one patient (female, 52 years old) with pancreatic NET underwent 18F-AlF-NOTATATE PET/CT imaging. Results:18F-AlF-NOTATATE was successfully prepared with a total synthesis time of 35 min. The optimized radiochemical yield was (23.8±3.1)% (without decay correction, n=3), the radioactivity was (4.63±0.68) GBq, and the radiochemical purity was >95%. The stability was good, and the product quality met the requirements. 18F-AlF-NOTATATE showed clear imaging in the patient with rectal segment NET, with SUV max of 13.3 and tumor/liver ratio of 3.3. Metastatic lesions in the liver, lymph nodes, and ribs showed high SUV max and tumor/liver ratios. The imaging of the pancreatic NET patient showed an abnormal increase in local radioactive uptake at the uncinate process of the pancreatic head, with SUV max of 5.6 and SUV max of 6.3 and the tumor/liver ratio of 2.3 after 2-hours imaging. Conclusions:Using the GE-FASTLab2 synthesis module, 18F-AlF-NOTATATE can be prepared with high activity. The preparation is simple, the method is stable, and the product has high radiochemical purity. 18F-AlF-NOTATATE exhibits good imaging performance in NET patients, providing valuable information for diagnosis, treatment, and prognosis evaluation.

Preeclampsia is a unique complication in the second and third trimesters of pregnancy, but its pathogenesis remains unclear and the early diagnosis and treatment methods are yet to be perfect. Termination of pregnancy at the right time is the only way to prevent its deterioration and avoid adverse pregnancy outcomes. In recent years, with the in-depth research, non-coding RNAs has been found to be involved in many important physiological and pathological processes such as proliferation and apoptosis of trophoblast cells and these non-coding RNAs can regulate each other to form an intricate and competitive endogenous RNA regulatory network. This article will introduce the biological roles of non-coding RNAs in regulating the invasion and proliferation of trophoblast cells in patients with preeclampsia and possible regulatory relationship between non-coding RNAs. Furthermore, the potential clinical value of non-coding RNAs as diagnostic biomarkers for preeclampsia and therapeutic targets are also elaborated.

ObjectiveTo evaluate the current situation of human resource allocation in district and county centers for disease control and prevention （CDCs） in Kashgar ， identify existing problems and influencing factors， and to provide scientific evidence for optimizing the human resource allocation. MethodsA survey was conducted among all CDCs in Kashgar in February 2022. The questionnaire included the institutional and individual questions. ResultsThe overall staff size approved for the CDCs in Kashgar was 604， with a staffing rate of 76.17%， among which the staffing rates in 5 county CDCs were less than 60%. Currently， there were a total of 524 approved staff members in all CDCs， resulting in a vacancy rate of 13.25%. In the district CDC， 85 staff members were on duty， while the median of staff on duty was 34 in each county CDC. The staff in the district CDC was ageing， of which those aged over 45 accounted for 67.06%. The staff in the county CDCs was generally young， of which those aged less than 35 accounted for 54.22%. Moreover， the proportion of staff with bachelor’s degree or above in the district and county CDCs was 31.76% and 24.95%， respectively. The proportion of staff without professional title was 32.94% and 48.03%， respectively. In contrast， the proportion of those with middle and senior professional title was 57.89% and 22.02%， respectively. In addition， in recent 3 years， 24 staff members resigned in the CDCs， all of whom had professional titles. ConclusionHuman resources are insufficient in CDCs in Kashgar. Furthermore， staff structure is unreasonable， with a serious loss of human resources. In particular， the district CDC needs to optimize the allocation of human resources.

Objective:To investigate the relationship between the changes of inflammatory cytokine levels and prognosis of patients with critical coronavirus disease 2019 (COVID-19) undergoing invasive mechanical ventilation (IMV).Methods:A retrospective study was conducted. The clinical date of critical COVID-19 patients undergoing IMV who were hospitalized in Wuhan Union Hospital, Tongji Medical College of Huazhong University of Science and Technology from February 4th to March 25th in 2020 were collected. At the same time, the inflammatory cytokine levels including interleukins (IL-2, IL-4, IL-6, IL-10) and tumor necrosis factor-α (TNF-α) at 48 hours before IMV and 48 hours after IMV of all the patients, as well as the 48 hours after weaning or right before death were recorded. Multivariate unconditional Logistic regression analysis was used to screen the independent risk factors of death during hospitalization.Results:Among the 43 patients, 13 patients improved and 30 died. Compared with the survival group, the patients in the non-survival group were older (years old: 67.6±7.3 vs. 58.5±11.9, P < 0.05), with higher rates of hypertension, diabetes and coronary heart disease (53.3% vs. 15.4%, 63.3% vs. 23.1%, 26.7% vs. 0%, all P < 0.05), and the time from onset to admission to hospital, admission to ICU and IMV were longer (days: it was 9.17±5.00 vs. 5.07±2.49, 17.10±7.11 vs. 12.23±5.05, and 17.90±7.46 vs. 12.61±5.60, respectively, all P < 0.05). The IL-6 and TNF-α levels on 48 hours after IMV in the non-survival patients increased significantly as compared with those before 48 hours and the surviving patients. Especially, the IL-6 levels increased significantly as compared with those at 48 hours after IMV and 48 hours after weaning in the surviving patients [ng/L: 800.00 (194.25, 2 000.00) vs. 22.03 (6.66, 28.21), 3 204.00 (1 264.88, 5 000.00) vs. 5.00 (3.98, 12.27), both P < 0.01]. The IL-10 level before death in the non-survival patients increased significantly as compared with that at 48 hours after weaning in the surviving patients [ng/L: 55.89 (26.07, 100.14) vs. 3.53 (2.76, 12.36), P < 0.05]. There were no significant differences in the levels of IL-2 and IL-4 between the two groups at every time point. The variables of age, basic diseases, the IL-6 level after IMV were included in the multivariate unconditional Logistic regression analysis, which showed that age [odds ratio ( OR) = 0.821, 95% confidence interval (95% CI) was 0.695-0.968], hypertension ( OR = 0.027, 95% CI was 0.002-0.378), diabetes mellitus ( OR = 0.054, 95% CI was 0.005-0.611), coronary heart disease ( OR = 0.042, 95% CI was 0.002-0.968) and the IL-6 level after IMV ( OR = 0.902, 95% CI was 0.819-0.994) were independent risk factors for death during hospitalization in patients with critical COVID-19 undergoing IMV (all P < 0.05). Conclusions:The levels of inflammatory cytokine including IL-6, IL-10, and TNF-α increased significantly with aggravation in critical COVID-19 patients undergoing IMV, especially IL-6. IL-6 was an independent risk factor for death of critical COVID-19 patients undergoing IMV.

Objective To investigate the effectiveness of evoked potential in monitoring cerebral perfusion during carotid endarterectomy by a retrospective cohort study.Methods A retrospective cohort survey of clinical data of 59 patients,who underwent carotid endarterectomy in our hospital from September 2013 to December 2016,was performed.All patients were monitored by transcranial doppler ultrasonography (TCD) and somatosensory evoked potential (SEP),motor evoked potential (MEP) for changes of cerebral blood flow;the monitoring of TCD was defaulted as "gold standard",recording monitoring results at different time points.By drawing the four table,the sensitivity,specificity,positive predictive value,negative predictive value of SEP and MEP during cerebral hypoperfusion were calculated,and correlation analyses between SEP and TCD,and between MEP and TCD were performed.Through receiver operating characteristic (ROC) curve,SEP monitoring threshold of cerebral hypoperfusion was predicted.Results The sensitivity,specificity,positive predictive value,and negative predictive value of SEP in predicting intra-operative cerebral hypoperfusion were 60.00％,91.84％,60.00％,and 91.84％ when SEP amplitude declined beyond 50％;the sensitivity,specificity,positive predictive value and negative predictive value of SEP in predicting intra-operative cerebral hypoperfusion were 70.00％,93.88％,70.00％ and 93.88％ when SEP latency extended beyond 10％.The sensitivity,specificity,positive predictive value,and negative predictive value of MEP in predicting intra-operative cerebral hypoperfusion were 30.00％,97.96％,75.00％,and 87.27％ when MEP amplitude declined beyond 50％.Decline of SEP and MEP amplitudes and extension of SEP latency have positive correlations with TCD.ROC indicated that the amplitude of somatosensory evoked potentials could predict intraoperative hypoperfusion when it decreased by 51.0％ than the baseline monitoring value after carotid artery occlusion,with sensitivity of 100.0％,specificity of 89.8％ and area under the curve of 0.918 (95％CI:0.846～0.990,P=0.024).ROC also showed that the latent phase of somatosensory evoked potentials could predict intraoperative hypoperfusion when it was prolonged ＞9.8％ compared to the baseline monitoring value after carotid artery occlusion,with sensitivity of 100.0％,specificity of 92.9％and area under the curve of 0.941 (95％CI 0.878～0.995,P=0.014).Conclusion Evoked potentials can real-time monitor intra-operative cerebral hypoperfusion continuously in carotid endarterectomy,enjoying high sensitivity and specificity;in addition,decline of SEP amplitude and extension of SEP latency have higher sensitivity than MEP.

Objective To explore the association,consistency and complications prognostic value of thromboelastography and conventional coagulation tests in detecting coagulation function of antiplatelet after endovascular treatments in patients with acute ischemic stroke.Methods A retrospective cohort survey of 240 patients,admitted to our hospital from September 2012 to December 2017,was performed.All acute ischemic stroke patients accepted coagulation function monitoring 5 d after aspirin and clopidogrel and endovascular treatments by thromboelastography (R time,K time,α angle,maximum amplitude [MA]) and routine coagulation tests (prothrombin time [PT],activated partial thromboplastin time [APTT],fibrinogen [FIB],international normalized ratio [INR],blood platelet count).The association,consistency,and sensitivity,specificity,positive predictive value,negative predictive value of complications prognostic value of thromboelastography and conventional coagulation tests were analyzed.Results (1) R time and APTT,K time and APTT,α angle and FIB,and α angle and PLT were positively correlated;K time and FIB,R time and PLT,and α angle and APTT were negatively correlated.(2) R time and APTT (κ=0.266,P=0.000),K time and APTT (κ=0.134,P=0.024),and α angle and FIB (κ=0.162,P=0.007) had agreement in identifying hypercoagulability;R time and APTT (κ=0.211,P=0.001),K time and APTT (κ=0.198,P=0.002),and blood platelet count and K (κ=0.388,P=0.000),and α angle and PLT (κ=0.099,P=0.041) had agreement in identifying hypocoagulability.(3) The sensitivity of thromboelastography and routine coagulation tests in identifying early neurological deterioration was 17.65％ and 58.82％,and the sensitivity in identifying symptomatic hemorrhages by thromboelastography and routine coagulation tests was 73.68％ and 47.39％.Conclusions Some parameters has correlations in peroperative period,and has agreement in identifying hypercoagulability and hypocoagulability.Accordingly,routine coagulation tests might be superior in evaluating early neurological deterioration,and thromboelastography might be superior in evaluating symptomatic hemorrhages in patients with acute ischemic stroke.

Objective To determine the spectrum of conjunctival flora and the antibiotic susceptibility profiles of patients scheduled for penetrating intraocular surgeries.Methods A prospective case control study was performed.A total of 192 patients (192 eyes) scheduled for penetrating intraocular surgeries at the Fourth People's Hospital of Shenyang from February to August 2015 were enrolled.Samples from the conjunctival sac were collected before instillation of any ophthalmic solutions for both aerobic and anaerobic culture.The positive rate and bacterial spectrum were observed.Bacterial isolates were tested for antibiotic susceptibility to 7 commonly used ophthalmic antibiotics using automated drug resistance analyzing system.The research was approved by the Ethics Committee of the Fourth People's Hospital of Shenyang.Results Totally 91 strains were collected from 81 conjunctival samples during aerobic culture,the positive rate was 42.19％.Staphylococcus epidermidis was the most common microorganism (64.84％),followed by Staphylococcus lentus (7.69％) and Staphylococcus aureus (3.30％).Coagulatase negtive Staphylococcus (CNS) accounted for 80.22％ of the positively cultured aerobes.For anaerobic culture,a total of 28 strains were isolated from 28 conjunctival samples,the positive rate was 14.58％ Propionibacterium acnes was the predominant species (71.43％),followed by Finegoldia magna (10.71％).Majority of the CNS were sensitive to gentamycin and vancomycin,with resistance rates lower than 10％,but their resistance rate to erythromycin and ceftazidime was 87.67％ and 63.01％,respectively.Resistance rate of these CNS to levofloxacin,ciprofloxacin,and moxifloxacin was 42.47％,39.73％ and 17.81％,respectively.Multidrug resistance to at least 3 antibiotic classes was present in 38.36％ of the CNS.Conclusions Bacteria in the conjunctiva sac of preoperative patients are resistant to various ophthalmic antibiotics.To follow-up the bacterial distribution and antibiotic resistance is great meaningful in the prophylactic and treatment in ocular surgery-related infections.

Objective To establish HPLC determination method and impurity profile of the related substances in metronidazole.Methods A Welch Ultimate(R)XB-C1s (4.6 mm× 250 mm,5 μm)was used with a mobile phase consisting of methanol-1.36 g· L-1 solution of potassium dihydrogen phosphate (20∶ 80).The detection wavelength was 315 nm and the flow rate was 1 mL· min-1.Its related substances were determined by principal component self-contrast method.Results Good separation of metronidazole and the impurities could be achieved.Twenty batches of samples in the past six years were determined which meet quality standards.The study of impurity profiles could effectively monitor the synthetic process and the change of impurities in metronidazole.Conclusion The method is simple,quick and sensitive,which can be used to control the related substances in metronidazole.Meanwhile,the impurity profiles ensure the quality stability of metronidazole.