Three-dimensional(3D)cell spheroid models combined with mass spectrometry imaging(MSI)enables innovative investigation of in vivo-like biological processes under different physiological and patho-logical conditions.Herein,airflow-assisted desorption electrospray ionization-MSI(AFADESI-MSI)was coupled with 3D HepG2 spheroids to assess the metabolism and hepatotoxicity of amiodarone(AMI).High-coverage imaging of＞1100 endogenous metabolites in hepatocyte spheroids was achieved using AFADESI-MSI.Following AMI treatment at different times,15 metabolites of AMI involved in N-desethylation,hydroxylation,deiodination,and desaturation metabolic reactions were identified,and according to their spatiotemporal dynamics features,the metabolic pathways of AMI were proposed.Subsequently,the temporal and spatial changes in metabolic disturbance within spheroids caused by drug exposure were obtained via metabolomic analysis.The main dysregulated metabolic pathways included arachidonic acid and glycerophospholipid metabolism,providing considerable evidence for the mechanism of AMI hepatotoxicity.In addition,a biomarker group of eight fatty acids was selected that provided improved indication of cell viability and could characterize the hepatotoxicity of AMI.The combination of AFADESI-MSI and HepG2 spheroids can simultaneously obtain spatiotemporal infor-mation for drugs,drug metabolites,and endogenous metabolites after AMI treatment,providing an effective tool for in vitro drug hepatotoxicity evaluation.

Objective:To investigate any change in the effective connectivity between the bilateral anterior central gyruses after transcranial magnetic stimulation (TMS).Methods:Twenty-one healthy subjects were examined using resting state functional magnetic resonance imaging (rs-fMRI) before and after receiving continuous theta burst stimulation (cTBS). The brain atlas of the Institute of Automation of the Chinese Academy of Sciences was used for fine partitioning of the bilateral anterior central gyruses. Granger causality analysis was used to compare any changes in the effective connectivity between them.Results:After the cTBS inhibited the right M1 area, significant changes in effective connectivity among the sub-regions of the bilateral M1 area were observed. The effective connectivity of the right upper limb to the left upper limb and the left head to face were weakened, while that of the left upper limb to the right head, as well as of the face to the right upper limb was enhanced.Conclusion:For people whose right M1 area has been inhibited by cTBS, the effective connectivity changes in both upper limb functional areas of the M1 region reflect inter-hemispheric inhibition. Opposite changes were found in the trunk and upper limbs.

Objective:To explore the effectiveness of evaluating voice disorders in dysarthria patients after brain injury using speech production measurements and analyze their phonics characteristics.Methods:Twenty-nine patients were divided into a severe dysarthria group ( n=19) and a mild dysarthria group ( n=10) through the subjective evaluation of their speech, and then evaluated using a computer speech monitor. The maximum phonation time (MPT), maximum counting ability (MCA), basic frequency (F0), standard deviation of F0 (F0SD), F0 range, intensity, formant, and the distance of jaw and tongue movements were recorded. Results:All of the patients displayed abnormal MPTs and MCAs, with the average MPT and MCA of the severe dysarthria group significantly lower than the mild group′s averages. In the severe dysarthria group, the abnormal F0s, F0SDs, F2(i)s and tongue movement distances were significantly greater than in the mild group.Conclusions:Speech production measurements can be applied to evaluate the speech dysarthria patients after brain injury. It is very common for such patients to have impaired speech and respiratory function, so this is worthy of attention.

Objective: To investigate the current status and real performance of the detection of RUNX1-RUNX1T1 fusion transcript levels and WT1 transcript levels in China through interlaboratory comparison. Methods: Peking University People’s Hospital (PKUPH) prepared the samples for comparison. That is, the fresh RUNX1-RUNX1T1 positive (+) bone morrow nucleated cells were serially diluted with RUNX1-RUNX1T1 negative (-) nucleated cells from different patients. Totally 23 sets with 14 different samples per set were prepared. TRIzol reagent was added in each tube and thoroughly mixed with cells for homogenization. Each laboratory simultaneously tested RUNX1-RUNX1T1 and WT1 transcript levels of one set of samples by real-time quantitative PCR method. All transcript levels were reported as the percentage of RUNX1-RUNX1T1 or WT1 transcript copies/ABL copies. Spearman correlation coefficient between the reported transcript levels of each participated laboratory and those of PKUPH was calculated. Results: ①RUNX1-RUNX1T1 comparison: 9 samples were (+) and 5 were (-) , the false negative and positive rates of the 20 participated laboratories were 0 (0/180) and 5% (5/100) , respectively. The reported transcript levels of all 9 positive samples were different among laboratories. The median reported transcript levels of 9 positive samples were from 0.060% to 176.7%, which covered 3.5-log. The ratios of each sample’s highest to the lowest reported transcript levels were from 5.5 to 12.3 (one result which obviously deviated from other laboratories’ results was not included) , 85% (17/20) of the laboratories had correlation coefficient ≥0.98. ②WT1 comparison: The median reported transcript levels of all 14 samples were from 0.17% to 67.6%, which covered 2.6-log. The ratios of each sample’s highest to the lowest reported transcript levels were from 5.3-13.7, 62% (13/21) of the laboratories had correlation coefficient ≥0.98. ③ The relative relationship of the reported RUNX1-RUNX1T1 transcript levels between the participants and PKUPH was not always consistent with that of WT1 transcript levels. Both RUNX1-RUNX1T1 and WT1 transcript levels from 2 and 7 laboratories were individually lower than and higher than those of PKUPH, whereas for the rest 11 laboratories, one transcript level was higher than and the other was lower than that of PKUPH. Conclusion The reported RUNX1-RUNX1T1 and WT1 transcript levels were different among laboratories for the same sample. Most of the participated laboratories reported highly consistent result with that of PKUPH. The relationship between laboratories of the different transcript levels may not be the same.

Objective To explore the CT features and pathology of intrapulmonary lymph nodes (IPLNs), so as to improve the understanding and diagnosis of IPLNs. Methods A total of 38 patients (49 IPLNs) who were confirmed by the surgery and pathology were retrospectively analyzed, including 21 males and 17 females with a mean age of (56±8) years. All the patients underwent MSCT scan and 1.0 mm thin layer reconstruction before surgery. Double-blind method was used to analyze CT signs and the corresponding histopathological changes were compared. Results (1) Location: all IPLNs were located below the level of tracheal carina with 17 were on the left lung, and 32 were on the right lung. (2) Shape: 34 IPLNs were round, 15 were triangular or prism and so on. (3) Size: the maximum diameter of IPLNs ranged from 0.26 to 1.28 cm (0.66±0.23 cm), of which 45 cases were≤1.0 cm. (4) Quantity: 28 IPLNs were solitary and 10 were multiple. (5) Density: All 48 IPLNs were solid nodules with a median CT value of 43 HU (range from 19 to 106 HU), and there were no calcification, vacuoles and air bronchial signs were showed. (6) Margin and pleura: all the 48 IPLNs boundaries were clear and smooth, and 45 pieces were less than 1.0 cm from the pleura, of which 20 were close to the pleura or inter-lobar fissure. (7) Other: no"satellite focal", pleural depression syndrome, and vascular bundle sign were showed;22 peripheral fine lines of IPLNs were visible. (8) Pathology: IPLNs were dark brown or gray-black nodules with well-defined borders, coated, tough, hard, and carbon deposition could be seen in most cases. Conclusion IPLNs are benign nodules in the lung, which have certain CT features and typical pathological changes. Based on the CT performance and characteristics, it is helpful to make correct diagnosis of IPLNs before operation.

Objective To study the value of whole tumors volume based apparent diffusion coefficient histogram analysis in grading diagnosis of ependymoma. Methods Seventy?one patients with ependymal tumors were retrospectively analyzed, including 13 cases of WHOⅠ, 28 cases of WHOⅡ, 30 cases of WHO Ⅲ. Regions of interest (ROI) in the apparent diffusion coefficient maps of three groups on each layer of tumor level were drawn by using MaZda software and were analyzed using the whole tumors gray histogram. The histogram parameters of the three groups all fitted the normal distribution and homogeneity test of variance. The ANOVA analysis was used to compare the three groups. LSD-t test was used to compare the two groups to find out statistical significance of each parameter. Results Through histogram analysis of 9 parameters, three parameters were statistically significant (P<0.05), including variance, perc. 01％ and perc. 10％. The remaining 6 parameters had no significant difference between the three groups (P>0.05). Between the WHOⅠand the WHOⅡ, the sensitivity of perc.10％was 85.7％, the specificity was 87.7％, the area under the curve was 0.835, and the best cut-off value was 131.33. Between the WHOⅠand the WHOⅢ, the sensitivity of perc.10％was 85.7％, the specificity was 100.0％, the area under the curve was 0.872, and the cut-off was 126.5.Between the WHOⅡand the WHOⅢ, the sensitivity of variance was 68.4％, the specificity was 79.6％, the area under the curve was 0.794, and the cut-off was 2645.7. They had a high identification efficiency. Conclusion Whole-tumor histogram analysis of apparent diffusion coefficient maps could provide ancillary diagnostic value in grading diagnosis of ependymoma. Perc.10％and variance had a high diagnostic efficiency.

Objective To explore the MRI features of cavernous hemangioma in the thoracic spinal epidural space,to improve the recognition of the disease.Methods The clinical,pathological and MRI data of 7 cases with cavernous hemangioma in the thoracic spinal epidural space confirmed by surgery and pathology were analyzed retrospectively.Results 7 cases of cavernous hemangioma in the thoracic spinal epidural space were included in our study,all cases underwent MRI contrast enhancement examination and 6 of them underwent conventional MRI examination.On T1WI,4 cases showed hypointensity,2 cases showed slightly hypointensity and 1 case showed mixed slightly hypointensity.On T2WI,5 cases showed slightly hyperintensity,1 case showed slightly hypointensity. On fat suppression sequence,5 cases showed hyperintensity,1 case showed heterogeneous hyperintensity.On diffusion-weighted imaging (DWI),7 cases showed obviously hyperintensity.On contrast-enhanced images,the lesions enhanced homogeneously in 5,enhanced heterogeneously in 2.Conclusion MRI can display the location,appearance and enhancement pattern of thoracic spinal epidural cavernous hemangioma distinctly,while definite diagnosis of which still depends on pathology.

Cardiovascular surgery is a type of high-risk surgery for pressure ulcers. This review summarizes the risk factors of pressure ulcers in patients undergoing cardiovascular surgery, including preoperative, intraoperative and postoperative risk factors. At the same time, it points out that in the present study, there is a dispute about whether the pressure sore is associated with the time of cardiopulmonary bypass and the change of body temperature in patients undergoing cardiovascular surgery. In addition, here is a lack of related research on whether the anticoagulant of protamine has an effect on pressure sores during the operation. This article aims to provide a basis for the clinical observation of the risk factors of pressure sores in cardiovascular surgery.

Objective To explore the value of MRI histogram analysis in the risk assessment of medulloblastoma recur rence.Methods The data of 28 patients pathologically confirmed of medulloblastoma was analyzed retrospectively.All patients were divided into recurrent group and the non recurrent group (each n=14).The ROIs were drawn on the maximum level of enhanced MR sagittal images,and the histogram analysis were performed using the software named Mazda.The statistical analysis was performed on the histogram parameters to find out the different characteristics between the two groups,and the ROC curve was drawn to evaluate its diagnostic efficacy for recurrence of medulloblastoma.Results In all of the 9 parameters which are extracted from histogram,kurtosis had statistical significance between the 2 groups (P=0.018).The area under the ROC curve was 0.776 (P=0.018),and the sensitivity and specificity of kurtosis in the risk assessment of medulloblastoma recurrence were 64.3％ and 71.4％,respectively.Conclusion MRI histogram analysis can be an important method to assess the risk of medulloblastoma recurrence.

Objective To explore the effect of action verb processing on the excitability of the motor cortex and any effect on the upper limb motor function of stroke survivors.Methods Experiment 1:The motor evoked potential by transcranial magnetic stimulation (TMS-MEP) was measured while 18 healthy subjects were processing concrete action verbs or abstract verbs.Experiment 2:Eight hemiplegic stroke survivors were asked to read silently text describing concrete hand actions,and then repeat and explain the meaning of the action verbs used in the text.This was repeated for 30 minutes per day,5 days per week for 3 weeks.In the 2nd week the same training was conducted except that the text was about abstract verbs.The modified Ashworth scale (MAS),Fugl-Meyer assessment (FMA),the Hong Kong version of the functional test for a hemiplegic upper extremity (FTHUE-HK) and a simple test for evaluating hand function (STEF) were used to assess upper limb motor function before and after the training each week.Results Experiment 1:Processing the concrete action verbs induced significantly greater MEP than processing the abstract verbs.Experiment 2:The average FMA and STEF ratings improved significantly after the training each week.Training with the concrete action verbs resulted in significantly better FMA and STEF scores than with the abstract verbs.The average MAS score increased significantly week by week.There was significantly more improvement in the average FTHUE-HK rating after the 1st and 3rd week of training than after the 2nd week.Conclusion Action verb processing induces greater motor cortex excitation than abstract verb processing among healthy subjects and better improves the upper limb motor function of stroke survivors.