Objective To explore the role of the brief visuospatial memory test-revised(BVMT-R)in predicting the clinical conversion to psychosis in subjects with clinical high-risk for psychosis(CHR-P).Methods A total of 217 CHR subjects were recruited and assessed using BVMT-R at baseline.Participants were followed up for three years to determine whether they converted to psychosis.The relationship between BVMT-R total score and CHR-P conversion probability was analyzed using generalized additive model,and the cutoff values of BVMT-R total score for predicting CHR-P conversion were calculated by maximally selected rank statistics.Then,the total BVMT-R score was stratified into different intervals based on the cutoff values obtained as previously described.Finally,the positive likelihood ratios and the conversion rates at different time points were calculated for each interval.Results A total of 168 subjects with CHR-P completed the 3-year follow-up assessment.According to the results of the generalized additive model,the relationship between the BVMT-R total score and CHR-P conversion probability exhibited the characteristics of a piecewise function model.The cutoff values identified using the maximally selected rank statistics method were 18 and 29,which divided the BVMT-R total scores into three intervals:0-18,19-29,and 30-36.The positive likelihood ratios of the three intervals for predicting CHR-P psychosis conversion were significantly different(all P<0.01).All three intervals had significantly different rates of psychosis conversion at different follow-up time points(all P<0.01).Conclusion The total BVMT-R score can be divided into three intervals,each associated with a distinct positive likelihood ratio for predicting psychosis conversion in CHR-P individuals.Accordingly,the BVMT-R total score may serve as a preliminary indicator for estimating the probability of psychosis conversion in the CHR-P population.

Objective To explore the role of the brief visuospatial memory test-revised(BVMT-R)in predicting the clinical conversion to psychosis in subjects with clinical high-risk for psychosis(CHR-P).Methods A total of 217 CHR subjects were recruited and assessed using BVMT-R at baseline.Participants were followed up for three years to determine whether they converted to psychosis.The relationship between BVMT-R total score and CHR-P conversion probability was analyzed using generalized additive model,and the cutoff values of BVMT-R total score for predicting CHR-P conversion were calculated by maximally selected rank statistics.Then,the total BVMT-R score was stratified into different intervals based on the cutoff values obtained as previously described.Finally,the positive likelihood ratios and the conversion rates at different time points were calculated for each interval.Results A total of 168 subjects with CHR-P completed the 3-year follow-up assessment.According to the results of the generalized additive model,the relationship between the BVMT-R total score and CHR-P conversion probability exhibited the characteristics of a piecewise function model.The cutoff values identified using the maximally selected rank statistics method were 18 and 29,which divided the BVMT-R total scores into three intervals:0-18,19-29,and 30-36.The positive likelihood ratios of the three intervals for predicting CHR-P psychosis conversion were significantly different(all P<0.01).All three intervals had significantly different rates of psychosis conversion at different follow-up time points(all P<0.01).Conclusion The total BVMT-R score can be divided into three intervals,each associated with a distinct positive likelihood ratio for predicting psychosis conversion in CHR-P individuals.Accordingly,the BVMT-R total score may serve as a preliminary indicator for estimating the probability of psychosis conversion in the CHR-P population.

Objective To compare the efficacy of tibial tuberosity osteotomy (TTO) combined with medial patellofemoral ligament reconstruction (MPFLR) with simple TTO in treatment of recurrent patella dislocation associated with patella alta.Methods From July 2010 to December 2015,50 patients with recurrent patella dislocation and patella alta were included in this study.There were 15 males and 35 females with an average age of 20.6 years.These patients received surgical treatment and their clinical data were collected and retrospectively analyzed by case-control study.According to surgical methods,patients were divided into TTO group (32 cases) and MPFLR + TTO group (18 cases).The differences between preoperative status and postoperative status were evaluated by knee function scores including Tegner,international knee documentation committee (IKDC),Kujala scores,knee injury and osteoarthritis outcome score (KOOS).Patellar stability was checked at the last follow-up visit.Results The TTO group and MPFLR + TTO group were followed up for (50.9 ± 17.8) months and (22.3± 10.1)months,respectively.Two patients occurred recurrent dislocation in TTO group,who showed positive in both extrapolation test and extrapolation apprehension test at 0°flexions of knee.All patients in MPFLR + TTO group did not occur recurrent dislocation,who showed negative in both extrapolation test and extrapolation apprehension test at 0° flexions of knee.There was no significant difference between preoperative and postoperative results in TTO group in Tegner score (P ＞ 0.05),KOOS scores in pain and daily life activities subdomains (P ＞ 0.05),while differences in the rest of scores were statistically significant (P ＜ 0.05).Compared with TFO group,the differences of all scores were statistically significant (P ＜ 0.05) and KOOS scores in the pain and daily life activities subdomains were significantly improved postoperatively in MPFLR + TTO group P ＜0.05).Conclusions For patients with recurrent patellar dislocation associated with patella alta,both surgical methods are found to be effective.Postoperative improvements in pain and daily life activities are less obvious in TTO.While postoperative improvements in pain and daily life activities in MPFLR + TTO are superior to those of TTO.

Objective To investigate the brain gray matter atrophy in behavioral variant of frontotemporal dementia (bvFTD) in order to provide an objective basis for early diagnosis. Methods High-resolution 3D structural brain images of 39 probable bvFTD and 46 controls were acquired by 3.0 Tesla MRI scanner. Neuropsychiatric Inventory (NPI), MMSE, Logical Memory Subtest of the Wechsler Memory Scale-Chinese Revision, Consortium to Establish a Registry for Alzheimer''s Disease drawing and WCST were administered to assess cognitive function and psychological and behavioral symptoms. Then voxel-based morphometry and diffeomorphic anatomical registration through exponentiated lie algebra (VBM-DARTEL)was used to compare the structural difference between bvFTD and control groups. Partial correlation analysis was deployed to examine the relationship between the whole brain volume and the total score of the NPI. Results Compared with the control group, bvFTD patients showed abnormalities in most of the neuropsycological tests (all P<0.01), including the higher scores in NPI(Z=-6.545), and the poor performance in global cognitive function(t=-8.621), execution function(t=4.776), episodic memory (t=-7.990)and visuospatial skills(Z=-4.909). In addition, the volume of specific regions, including notably bilateral prefrontal and pre-temporal cortex, insula and subcortical structures, were significantly reduced in bvFTD group (t=4.89-10.95,P<0.05,FWE-corrected). Most prominent atrophy was observed in bilateral caudate nucleus, amygdala, pallidum, putamen, insula, and rectus gyrus. Moreover, the atrophy of left precuneus (cluster size=193 voxels, peak MNI coordinates x=-7.5, y=-66.0, z=67.5) was significantly associated with the total score of NPI (ρ=-0.515,P<0.05,AlphaSim corrected). Conclusions It indicates that the structure of cortico-striatal-thalamic circuits is compromised in bvFTD. The atrophy of bilateral striatum may be most prominent. Besides, the volume of left precuneus may be associated with the severity of psychological and behavioral symptoms. These findings suggest the atrophy of bilateral striatum and left precuneus might be considered as potential imaging markers of bvFTD.

Objective To investigate the brain gray matter atrophy in behavioral variant of frontotemporal dementia (bvFTD) in order to provide an objective basis for early diagnosis. Methods High-resolution 3D structural brain images of 39 probable bvFTD and 46 controls were acquired by 3.0 Tesla MRI scanner. Neuropsychiatric Inventory (NPI), MMSE, Logical Memory Subtest of the Wechsler Memory Scale-Chinese Revision, Consortium to Establish a Registry for Alzheimer''s Disease drawing and WCST were administered to assess cognitive function and psychological and behavioral symptoms. Then voxel-based morphometry and diffeomorphic anatomical registration through exponentiated lie algebra (VBM-DARTEL)was used to compare the structural difference between bvFTD and control groups. Partial correlation analysis was deployed to examine the relationship between the whole brain volume and the total score of the NPI. Results Compared with the control group, bvFTD patients showed abnormalities in most of the neuropsycological tests (all P<0.01), including the higher scores in NPI(Z=-6.545), and the poor performance in global cognitive function(t=-8.621), execution function(t=4.776), episodic memory (t=-7.990)and visuospatial skills(Z=-4.909). In addition, the volume of specific regions, including notably bilateral prefrontal and pre-temporal cortex, insula and subcortical structures, were significantly reduced in bvFTD group (t=4.89-10.95,P<0.05,FWE-corrected). Most prominent atrophy was observed in bilateral caudate nucleus, amygdala, pallidum, putamen, insula, and rectus gyrus. Moreover, the atrophy of left precuneus (cluster size=193 voxels, peak MNI coordinates x=-7.5, y=-66.0, z=67.5) was significantly associated with the total score of NPI (ρ=-0.515,P<0.05,AlphaSim corrected). Conclusions It indicates that the structure of cortico-striatal-thalamic circuits is compromised in bvFTD. The atrophy of bilateral striatum may be most prominent. Besides, the volume of left precuneus may be associated with the severity of psychological and behavioral symptoms. These findings suggest the atrophy of bilateral striatum and left precuneus might be considered as potential imaging markers of bvFTD.