Objective:To explore the distribution and clearance of 99mTc labeled diethylenetriamine pentaacetic acid(99mTc-DTPA)in different brain regions of adult rats after administration through brain extracellular space(ECS)pathway.Methods:After the injection of a volume of 2 μL and radioactive activity of about 3.7 MBq(100 μCi)of 99mTc-DTPA into the caudate nucleus and thalamus of SD rats through stereotactic positioning of rat brain,the single photon emission computed tomography/computed tomography(SPECT/CT)for small animals was used for imaging at different time points,and the dyna-mic distribution and clearance of the tracer in the whole body were observed continuously.The SD rats were injected with 99mTc-DTPA into thalamus and caudate nucleus respectively for biological distribution in vivo.They were put to death 4 h later.Their blood and urine were collected.The brain,cerebellum,heart,liver,spleen,lung,and kidney were taken and weighed by γ counter to measure its radioactivity.Results:SPECT/CT imaging results showed that after 99mTc-DTPA was administered through brain ECS,the radioactivity was concentrated in the brain,kidney and bladder.The tracer administered to the left caudate nucleus was preferentially drained to the right cerebellum,while the tracer administered to the right caudate nucleus was preferentially drained to the left cerebellum.There was a phenomenon of"con-tralateral cerebellar dominant drainage"in the caudate nucleus.The thalamic area preferentially drained to the ipsilateral cerebellum after administration.Four hours after administration via ECS,high radioac-tive uptake appeared in urine,cerebellum and brain,followed by blood and kidney.The radioactive up-take values of heart,liver,spleen and lung were low,which were mainly excreted through urinary sys-tem.Conclusion:Intracerebral ECS administration is a promising method of administration,but there are significant differences in distribution and clearance in different brain regions.This study further ex-pands the content and significance of"ECS regions",and also provides an important theoretical founda-tion for the treatment of encephalopathy and the research of new drugs through brain ECS in the future.

Objective:To explore the distribution and clearance of 99mTc labeled diethylenetriamine pentaacetic acid(99mTc-DTPA)in different brain regions of adult rats after administration through brain extracellular space(ECS)pathway.Methods:After the injection of a volume of 2 μL and radioactive activity of about 3.7 MBq(100 μCi)of 99mTc-DTPA into the caudate nucleus and thalamus of SD rats through stereotactic positioning of rat brain,the single photon emission computed tomography/computed tomography(SPECT/CT)for small animals was used for imaging at different time points,and the dyna-mic distribution and clearance of the tracer in the whole body were observed continuously.The SD rats were injected with 99mTc-DTPA into thalamus and caudate nucleus respectively for biological distribution in vivo.They were put to death 4 h later.Their blood and urine were collected.The brain,cerebellum,heart,liver,spleen,lung,and kidney were taken and weighed by γ counter to measure its radioactivity.Results:SPECT/CT imaging results showed that after 99mTc-DTPA was administered through brain ECS,the radioactivity was concentrated in the brain,kidney and bladder.The tracer administered to the left caudate nucleus was preferentially drained to the right cerebellum,while the tracer administered to the right caudate nucleus was preferentially drained to the left cerebellum.There was a phenomenon of"con-tralateral cerebellar dominant drainage"in the caudate nucleus.The thalamic area preferentially drained to the ipsilateral cerebellum after administration.Four hours after administration via ECS,high radioac-tive uptake appeared in urine,cerebellum and brain,followed by blood and kidney.The radioactive up-take values of heart,liver,spleen and lung were low,which were mainly excreted through urinary sys-tem.Conclusion:Intracerebral ECS administration is a promising method of administration,but there are significant differences in distribution and clearance in different brain regions.This study further ex-pands the content and significance of"ECS regions",and also provides an important theoretical founda-tion for the treatment of encephalopathy and the research of new drugs through brain ECS in the future.

ObjectiveTo investigate the effect of combination with repetitive transcranial magnetic stimulation (rTMS) and median nerve electrical stimulation (MNS) on patients with prolonged disorders of consciousness (pDOC) in different age. MethodsFrom January, 2021 to May, 2023, 93 patients with pDOC in the First Affiliated Hospital of Nanchang University were divided into young group (≤ 45 years old), middle-aged group (46 to 60 years old) and elderly group (> 60 years old). All the groups were treated with rTMS and MNS for four weeks. The Coma Recovery Scale-Revised (CRS-R), Glasgow Coma Scale (GCS), and Full Outline of Unresponsiveness Scale (FOUR) were used to evaluate the efficiency of awakening after treatment and the awakening ratios were compared among three groups weekly. Four weeks after treatment, regional cerebral blood flow (rCBF) was measured with CT perfusion imaging. The score of Glasgow Outcome Scale Extended (GOS-E) was compared six months after treatment. ResultsFrom three weeks after treatment, the scores of CRS-R, GCS and FOUR increased in all groups (P < 0.05). After weekly treatment, there was no significant difference in the composition ratio of consciousness level and the awakening ratio among three groups (χ² < 11.057, P > 0.05). After four weeks of treatment, rCBF improved in three groups (|t| > 2.495, P < 0.05), however, there was no difference among three groups (F < 1.887, P > 0.05). There was no difference in the score of GOS-E at six months after treatment (F = 3.083, P = 0.055). ConclusionrTMS combined with MNS is effective on pDOC patients in different ages, and elderly patients could also benefit from it.

Objective To explore ways to improve effect of antiretroviral therapy in acquired immune defi-ciency syndrome patients with comorbid malnutrition, in an effort to enhance quality of life and reduce cost. Methods 126 AIDS patients with comorbid malnutrition were randomly divided into treatment group ( n=63) and control group (n=63). Patients in the treatment group were given nutrition support besides antiretroviral ther-apy (ART), while those in the control group only received ART. After 3 months, the two groups were compared in terms of body mass index, skinfold thickness, CD4+T cell count and human immunodeficiency virus load. Re-sults The two groups were comparable before treatment in BMI, skinfold thickness, CD4+T cell count and HIV load (P>0. 05). After treatment, the treatment group, compared with the controls, had higher BMI [ (23. 23± 3. 15) kg/m2vs. (17. 25±1. 83) kg/m2], thicker skinfold [ (42. 9±6. 8) mm vs. (34. 5±5. 2) mm in males;(97. 6±17. 4) mm vs. (92. 3±14. 7) mm in females], higher CD4+T cell count (χ2=12. 573, P<0. 01), and lower HIV load (χ2=8. 683, P<0. 01). Conclusion Nutrition support may improve treatment of AIDS patients with comorbid malnutrition, as manifested in better BMI, skinfold thickness, CD4+T cell count and HIV load.