Objective:To investigate alterations in static regional homogeneity(ReHo) and dynamic regional homogeneity (dReHo) and glucose metabolism in MRI-negative refractory temporal lobe epilepsy (TLE) patients using resting-state PET-MRI, and to evaluate their efficacy in predicting surgical outcomes.Methods:This study was a cross-sectional design. A retrospective analysis was conducted on the clinical and imaging data of 30 patients with MRI-negative refractory TLE (patient group) treated at Xuanwu Hospital, Capital Medical University, between 2016 and 2020, and data from 30 healthy controls (control group). All MRI-negative refractory TLE patients underwent surgical treatment and were further divided into a good prognosis subgroup (Engel Class I, 16 cases) and a poor prognosis subgroup (Engel Class Ⅱ-Ⅳ, 14 cases) based on postoperative Engel classification. Analysis of variance was used to compare differences in static ReHo, dReHo, and glucose metabolism(SUVR) among the three groups. The correlation of static ReHo, dReHo, and SUVR values of differential brain regions with Engel grading was analyzed using Spearman. A support vector machine (SVM) model was constructed using the static ReHo, dReHo, and SUVR values from these differential regions to classify and predict patient prognosis. The predictive performance was evaluated using receiver operating characteristic curves and the area under the curve (AUC).Results:Differential dReHo regions among the good prognosis subgroup, poor prognosis subgroup, and control group were located in the right lateral middle temporal gyrus temporal pole, the right fusiform gyrus, the right insula subfrontal gyrus, the left cuneate lobe, the right medial and paracortical cingulate gyrus, and the right supraparietal gyrus; the differential static ReHo regions were primarily found in the bilateral inferior temporal gyrus, the supraparietal gyrus, and the right subfrontal gyrus, the left medial supraparietal gyrus, the left median frontal gyrus, and the right marginal supraparietal gyrus; SUVR differences were in the affected superior, middle and inferior temporal lobes, the internal olfactory cortex and the temporal pole region. dReHo of right middle temporal gyrus temporal pole in patients with MRI-negative TLE showed a positive correlation with Engel classification ( r=0.421, P=0.020). The SVM model based on dReHo combined with SUVR values classified patients with good and poor prognosis with an AUC of 0.825 and an accuracy of 73.3%. Conclusions:In MRI-negative refractory TLE patients, abnormal dReHo regions are predominantly located in the contralateral default mode network areas and are associated with Engel classification. Combined with glucose metabolism values, dReHo can predict postoperative outcomes in MRI-negative TLE patients.

Objective:To analyze the clinical value of translocator protein (TSPO, 18kDa) radiotracer 18F- N, N-diethyl-2-(2-(4-(2-fluoroethoxy)-phenyl)-5, 7-dimethyl-pyrazolo[1, 5-a]pyrimidin-3-yl)-acetamide (DPA-714) PET/MR imaging for precise localization of epileptogenic zone in patients with drug-resistant epilepsy. Methods:From December 2022 to October 2023, 24 refractory epilepsy patients (12 males and 12 females, age (27.5±8.1) years) who underwent surgery in Xuanwu Hospital, Capital Medical University were retrospectively enrolled. All patients received hybrid 18F-DPA-714 PET/MR before surgery, with the surgical resection site and stereoelectroencephalography recordings of the seizure focus serving as the gold standard. Initial qualitative analysis of the images was performed, followed by semi-quantitative analysis using the ROI method to calculate the asymmetry index (AI) of the proposed epileptogenic zone, assessing the degree of increased abnormal uptake (area with AI>10% was considered as the epileptogenic zone). Follow-up assessment using the Engel classification was conducted at least one year postoperatively. Differences of lesion detection efficiency of conventional MRI and PET/MR were evaluated using McNemar test. Results:Among 24 enrolled patients, 13 cases (54.2%) showed positive findings on conventional MRI, while 21 cases (87.5%) exhibited single or multiple foci of abnormally increased tracer uptake on PET/MR imaging, indicating an improved lesion detection rate ( χ2=4.90, P=0.021). Of the MRI-positive patients, 12/13 also had positive findings on PET/MR, with a localization accuracy of 10/13. Among the MRI-negative patients, 9/11 showed positive PET/MR findings, with a localization accuracy of 6/11. At one year post-surgery, 75.0%(18/24) of patients had a favorable outcome (Engel Ⅰ). Conclusion:18F-DPA-714 PET/MR imaging can accurately locate epileptogenic foci, especially for MRI-negative lesions, providing reliable information for surgical planning to improve postoperative outcomes.

Objective To explore the application value of MR MAGiC sequence reconstructed based on deep learning reconstruction(DLR)for localizing epileptogenic focus of intractable epilepsy.Methods Fifty intractable epilepsy patients(epilepsy group)and 20 healthy controls(control group)were retrospectively collected.Brain MR MAGiC sequence was scanned,then traditional reconstruction(inverse Fourier transform)and DLR algorithm were performed to obtain MAGiC and MAGiC DLR images,respectively.The corresponding quantitative parameter maps were generated after post-processing,including T1 mapping,T2 mapping and proton density(PD)mapping.The subjective scores of noise,artifacts,structural clarity and overall quality were compared between two kinds of quantitative parameter images.The asymmetry index(AI)of quantitative parameters(T1,T2 and PD values)between the affected side and the contralateral side in epilepsy group,the contralateral side or the suspected epileptogenic focus in epilepsy group and HC group were calculated.Then epileptogenic focus were localized based on performance of MAGiC and MAGiC DLR corresponding quantitative parameter maps combining obtained AI of quantitative parameter values.According to surgical results,follow-up review,electroencephalogram or PET results,the accuracy of MAGiC and MAGiC DLR images for localizing epileptogenic focus was calculated.Results Compared with MAGiC quantitative parametric maps,noise of MAGiC DLR quantitative parametric maps reduced,while subjective scores of structure clarity and overall quality improved(all P＜0.05).The accuracy of MAGiC and MAGiC DLR images for localizing epileptogenic focus was 82.00％(41/50)and 88.00％(44/50),respectively.Conclusion MR MAGiC sequence based on DLR was beneficial for improving accuracy of localizing epileptogenic focus in intractable epilepsy.

Objective:To analyze the clinical value of translocator protein (TSPO, 18kDa) radiotracer 18F- N, N-diethyl-2-(2-(4-(2-fluoroethoxy)-phenyl)-5, 7-dimethyl-pyrazolo[1, 5-a]pyrimidin-3-yl)-acetamide (DPA-714) PET/MR imaging for precise localization of epileptogenic zone in patients with drug-resistant epilepsy. Methods:From December 2022 to October 2023, 24 refractory epilepsy patients (12 males and 12 females, age (27.5±8.1) years) who underwent surgery in Xuanwu Hospital, Capital Medical University were retrospectively enrolled. All patients received hybrid 18F-DPA-714 PET/MR before surgery, with the surgical resection site and stereoelectroencephalography recordings of the seizure focus serving as the gold standard. Initial qualitative analysis of the images was performed, followed by semi-quantitative analysis using the ROI method to calculate the asymmetry index (AI) of the proposed epileptogenic zone, assessing the degree of increased abnormal uptake (area with AI>10% was considered as the epileptogenic zone). Follow-up assessment using the Engel classification was conducted at least one year postoperatively. Differences of lesion detection efficiency of conventional MRI and PET/MR were evaluated using McNemar test. Results:Among 24 enrolled patients, 13 cases (54.2%) showed positive findings on conventional MRI, while 21 cases (87.5%) exhibited single or multiple foci of abnormally increased tracer uptake on PET/MR imaging, indicating an improved lesion detection rate ( χ2=4.90, P=0.021). Of the MRI-positive patients, 12/13 also had positive findings on PET/MR, with a localization accuracy of 10/13. Among the MRI-negative patients, 9/11 showed positive PET/MR findings, with a localization accuracy of 6/11. At one year post-surgery, 75.0%(18/24) of patients had a favorable outcome (Engel Ⅰ). Conclusion:18F-DPA-714 PET/MR imaging can accurately locate epileptogenic foci, especially for MRI-negative lesions, providing reliable information for surgical planning to improve postoperative outcomes.

Objective To explore the application value of MR MAGiC sequence reconstructed based on deep learning reconstruction(DLR)for localizing epileptogenic focus of intractable epilepsy.Methods Fifty intractable epilepsy patients(epilepsy group)and 20 healthy controls(control group)were retrospectively collected.Brain MR MAGiC sequence was scanned,then traditional reconstruction(inverse Fourier transform)and DLR algorithm were performed to obtain MAGiC and MAGiC DLR images,respectively.The corresponding quantitative parameter maps were generated after post-processing,including T1 mapping,T2 mapping and proton density(PD)mapping.The subjective scores of noise,artifacts,structural clarity and overall quality were compared between two kinds of quantitative parameter images.The asymmetry index(AI)of quantitative parameters(T1,T2 and PD values)between the affected side and the contralateral side in epilepsy group,the contralateral side or the suspected epileptogenic focus in epilepsy group and HC group were calculated.Then epileptogenic focus were localized based on performance of MAGiC and MAGiC DLR corresponding quantitative parameter maps combining obtained AI of quantitative parameter values.According to surgical results,follow-up review,electroencephalogram or PET results,the accuracy of MAGiC and MAGiC DLR images for localizing epileptogenic focus was calculated.Results Compared with MAGiC quantitative parametric maps,noise of MAGiC DLR quantitative parametric maps reduced,while subjective scores of structure clarity and overall quality improved(all P＜0.05).The accuracy of MAGiC and MAGiC DLR images for localizing epileptogenic focus was 82.00％(41/50)and 88.00％(44/50),respectively.Conclusion MR MAGiC sequence based on DLR was beneficial for improving accuracy of localizing epileptogenic focus in intractable epilepsy.

Objective:To investigate alterations in static regional homogeneity(ReHo) and dynamic regional homogeneity (dReHo) and glucose metabolism in MRI-negative refractory temporal lobe epilepsy (TLE) patients using resting-state PET-MRI, and to evaluate their efficacy in predicting surgical outcomes.Methods:This study was a cross-sectional design. A retrospective analysis was conducted on the clinical and imaging data of 30 patients with MRI-negative refractory TLE (patient group) treated at Xuanwu Hospital, Capital Medical University, between 2016 and 2020, and data from 30 healthy controls (control group). All MRI-negative refractory TLE patients underwent surgical treatment and were further divided into a good prognosis subgroup (Engel Class I, 16 cases) and a poor prognosis subgroup (Engel Class Ⅱ-Ⅳ, 14 cases) based on postoperative Engel classification. Analysis of variance was used to compare differences in static ReHo, dReHo, and glucose metabolism(SUVR) among the three groups. The correlation of static ReHo, dReHo, and SUVR values of differential brain regions with Engel grading was analyzed using Spearman. A support vector machine (SVM) model was constructed using the static ReHo, dReHo, and SUVR values from these differential regions to classify and predict patient prognosis. The predictive performance was evaluated using receiver operating characteristic curves and the area under the curve (AUC).Results:Differential dReHo regions among the good prognosis subgroup, poor prognosis subgroup, and control group were located in the right lateral middle temporal gyrus temporal pole, the right fusiform gyrus, the right insula subfrontal gyrus, the left cuneate lobe, the right medial and paracortical cingulate gyrus, and the right supraparietal gyrus; the differential static ReHo regions were primarily found in the bilateral inferior temporal gyrus, the supraparietal gyrus, and the right subfrontal gyrus, the left medial supraparietal gyrus, the left median frontal gyrus, and the right marginal supraparietal gyrus; SUVR differences were in the affected superior, middle and inferior temporal lobes, the internal olfactory cortex and the temporal pole region. dReHo of right middle temporal gyrus temporal pole in patients with MRI-negative TLE showed a positive correlation with Engel classification ( r=0.421, P=0.020). The SVM model based on dReHo combined with SUVR values classified patients with good and poor prognosis with an AUC of 0.825 and an accuracy of 73.3%. Conclusions:In MRI-negative refractory TLE patients, abnormal dReHo regions are predominantly located in the contralateral default mode network areas and are associated with Engel classification. Combined with glucose metabolism values, dReHo can predict postoperative outcomes in MRI-negative TLE patients.

Background An association between atmospheric fine particulate matter (PM_2.5) exposure and Parkinson's disease (PD) has been suggested by previous studies, but the results of current epidemiological studies are still inconclusive. Objective To systematically evaluate the relationship between exposure to ambient PM_2.5 and the risk of PD, as well as to explore potential influencing factors, aiming to provide scientific evidence for formulating early prevention strategies for PD. Methods Cochrane Library, PubMed, Web of Science, Medline, Embase, China National Know-ledge Infrastructure (CNKI), Wanfang Database, and VIP Chinese Science and Technology Journal Database were queried. The search terms included Parkinson's disease, particulate matter 2.5, and PM_2.5 in both Chinese and English. Cohort studies examining the association between atmospheric PM_2.5 exposure and the risk of PD were collected and searched from the inception of each database to June 26, 2023. The identified literature was screened, and the basic information of the included studies and their research subjects, outcome indicators, quantitative results of each study, as well as the information required by bias risk assessment were extracted. The Newcastle-Ottawa Scale was employed to assess the risk of literature bias. Meta-analysis, subgroup analysis, sensitivity analysis, and publication bias analysis were conducted in Stata 15.0 software. Results Twelve cohort studies were identified. A total of 17443136 participants with follow-up periods ranging from 3.5 to 22 years were included in the analysis. The meta-analysis, utilizing a random-effects model, revealed that PD risk was elevated by 6% after exposure to PM_2.5 [HR=1.06 (95%CI: 1.02, 1.11), P=0.006]. The subgroup analysis demonstrated that exposure to PM_2.5 increased PD risk by 6% in North America [HR=1.06 (95%CI: 1.00, 1.12), P=0.033] and by 17% in East Asia [HR=1.17 (95%CI: 1.02, 1.33), P=0.020]. However, the effect was not statistically significant in Europe. PD risk exhibited a 7% rise [HR=1.07 (95%CI: 1.02, 1.14), P=0.011] in individuals aged 60 years and older, which was different from that in individuals younger than 60 years. Exposure to various concentrations of PM_2.5 was observed to associate with an elevated risk of PD. The inclusion of adjustments for PD-related comorbidities did not alter the conclusion that ambient PM_2.5 exposure might elevate the risk of PD. The studies with a follow-up duration exceeding 5 years and reporting more than 1000 PD cases suggested a significant increase in the risk of PD due to ambient PM_2.5 exposure [HR=1.06 (95%CI: 1.01, 1.12), P=0.012; HR=1.06 (95%CI: 1.01, 1.11), P=0.027, respectively]. Conversely, no significant association was identified between ambient PM_2.5 exposure and the risk of PD within the cohorts with a follow-up duration of less than 5 years and reporting fewer than 1000 PD cases [HR=1.09 (95%CI: 0.95, 1.26), P=0.214; HR=1.12 (95%CI: 0.98, 1.02), P=0.092, respectively]. The sensitivity analysis showed that the results were stable. The publication bias analysis and the combined trim-and-fill method showed that the results were robust. Conclusion The risk of PD could be increased by ambient PM_2.5 exposure and influenced by age and area. The research results might be affected by the duration of follow-up and the quantity of PD cases reported.

Objective:To evaluate the value of time-of-flight (TOF) combined with point spread function (PSF) reconstruction for the improvement of brain PET images and lesion localization in patients with temporal lobe epilepsy (TLE).Methods:A retrospective collection of brain 18F-FDG PET imaging data of 52 hospitalized patients with TLE (30 males, 22 females, age: (26.7±7.1) years) and 26 healthy volunteers (14 males, 12 females, age: ( 31.7±6.8) years) from Xuanwu Hospital between 2017 and 2019 was conducted. Images were reconstructed and divided into 4 groups based on different algorithms: ordered subset expectation maximization (OSEM), OSEM+ TOF, OSEM+ PSF, and OSEM+ TOF+ PSF. The image quality, clarity, noise, and the clarity of lesion display of all subjects were visually analyzed using a four-point scale. The signal-to-noise ratio (SNR), contrast, and asymmetry index (AI) of the lesions were calculated. Differences in visual scores, SNR, contrast, and AI among the 4 groups were analyzed using one-way analysis of variance. The ROC curve was used to analyze the efficiency of PET images in localization of epileptogenic foci. Results:The visual score of OSEM+ TOF+ PSF group was the highest (4.0±0.0) among healthy volunteers; compared with OSEM group, OSEM+ TOF+ PSF group showed lower SNR (decreased by 46.6%; the lower the SNR value, the better the image quality) and contrast (increased by 29.8%). Visual assessment of PET images of patients with TLE showed that the scores of OSEM+ TOF+ PSF group , OSEM+ PSF group , OSEM+ TOF group and OSEM group were decreased in order (4.0±0.0 vs 3.4±0.5 vs 2.3±0.4 vs 1.0±0.0; F=884.0, P<0.001); SNRs of those 4 groups were increased in order ((5.2±2.4)% vs (6.2±2.4)% vs (7.9±2.6)% vs (8.9±3.5)%; F=18.82, P<0.001). The contrast and AI of the lesions in 4 groups were as follows: OSEM+ TOF+ PSF (contrast: 0.81±0.03; AI: 0.28±0.05) > OSEM+ TOF (0.74±0.05; 0.23±0.06) > OSEM+ PSF (0.72±0.06; 0.22±0.07) > OSEM (0.64±0.05; 0.19±0.06) ( F values: 107.10, 19.94, both P<0.001). MRI found unilateral hippocampal sclerosis in 32 patients, and the rest 20 patients with TLE were MRI-negative. ROC curve analysis showed that visual analysis and SUV ratio (SUVR) of lesion/contralateral ROI based on OSEM+ TOF+ PSF PET image could localize epileptogenic foci efficiently, with AUC of 0.874 in MRI-positive patients, and AUC of 0.932 in MRI-negative patients. Conclusions:The application of TOF and PSF significantly improves the quality of PET images. The combined use of both techniques yields the best results and aids in the localization of epileptogenic foci in patients with TLE.

Chronic high-salt diet-associated renal injury is a key risk factor for the development of hypertension. However, the mechanism by which salt triggers kidney damage is poorly understood. Our study investigated how high salt (HS) intake triggers early renal injury by considering the ‘gut-kidney axis’. We fed mice 2% NaCl in drinking water continuously for 8 weeks to induce early renal injury. We found that the ‘quantitative’ and ‘qualitative’ levels of the intestinal microflora were significantly altered after chronic HS feeding, which indicated the occurrence of enteric dysbiosis. In addition, intestinal immunological gene expression was impaired in mice with HS intake. Gut permeability elevation and enteric bacterial translocation into the kidney were detected after chronic HS feeding. Gut bacteria depletion by non-absorbable antibiotic administration restored HS loading-induced gut leakiness, renal injury and systolic blood pressure elevation. The fecal microbiota from mice fed chronic HS could independently cause gut leakiness and renal injury. Our current work provides a novel insight into the mechanism of HS-induced renal injury by investigating the role of the intestine with enteric bacteria and gut permeability and clearly illustrates that chronic HS loading elicited renal injury and dysfunction that was dependent on the intestine.
Animals ; Bacteria ; Bacterial Translocation ; Blood Pressure ; Drinking Water ; Dysbiosis ; Enterobacteriaceae ; Gastrointestinal Microbiome ; Gene Expression ; Hypertension ; Intestines ; Kidney ; Mice* ; Microbiota ; Permeability ; Risk Factors

Objective To investigate the effects of chronic hepatitis B virus (HBV) infection on human hepatic cytochrome P450 2C9 (CYP2C9).Methods Liver tissue samples and blood samples were obtained from 10 patients with chronic HBV infeetion and 10 healthy controls.CYP2C9 genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.The activity of CYP2C9 was detected utilizing high performance liquid chromatography (HPLC).The expressions of CYP2C9 mRNA and protein were determined by reverse transcriptase-polymerase chain reaction (RT-PCR) and Western-blotting.The data were analyzed by t test.Results All the liver samples showed CYP2C9 wild-type (*1*1),while CYP2C9 (*2) and CYP2C9 (*3) were not detected.The maximum velocity (Vmax) of CYP2C9 in patients chronic HBV infection and healthy controls were (263.5±66.4) μmol/L and(284.6±85.9) μmol/L,respectively (t=0.614,P=0.5471).The expression of CYP2C9 mRNA in patients with chronic HBV infection (0.39±0.28) was significantly lower than that of healthy controls (0.65±0.13) (t=2.628,P=0.0171).Accordingly,the protein expression in patients with chronic HBV infection (0.26±0.13) was lower than that of healthy controls (0.60±0.19) (t=4.688,P=0.000 2).Conclusion The expressions of CYP2C9 mRNA and protein are decreased in chronic HBV infection which may down-regulate the enzyme activity.