Objective:To analyze the patterns of dynamic functional connectivity(dFC) at rest in different obsessive-compulsive disorder(OCD) subtypes based on gray matter volume, and explore the relationship between abnormal gray matter volume and dFC patterns and clinical symptoms in different OCD subtypes.Methods:Clinical data were prospectively collected from a total of 48 patients with OCD from inpatient and outpatient departments of the Fourth Affiliated Hospital of Qiqihar Medical College(20 cases) and Qiqihar Mental Health Center(28 cases) from September 2013 to March 2020. There were 33 males and 15 females, aged 18 to 42(27.1±6.7) years. During the same period, 39 age-matched healthy controls were also recruited, including 31 males and 8 females, aged 18 to 43(28.5±8.6) years. Structural and resting-state functional magnetic resonance imaging scans were performed on 48 OCD patients(OCD group) who met the ICD-10 diagnostic criteria and 39 healthy controls(control group). Using voxel-based morphometry(VBM) and semi-supervised machine learning methods, the patient group was characterized by gray matter volume to perform subtype analysis, and brain regions with abnormal gray matter volume were selected as regions of interest for whole-brain voxel-wise dFC analysis. Correlations between abnormal gray matter volume and dFC and clinical symptoms in OCD patients were analyzed.Results:Based on gray matter volume, OCD patients were computed into two subtypes, of which subtype 1 increased gray matter volume in the right central posterior gyrus(809 voxels; t=4.31; GRF corrected voxel P<0.001, cluster P<0.05 two-tailed), and subtype 2 showed reduced gray matter volume in the left superior temporal gyrus(1 118 voxels; t=-4.37; GRF corrected voxel P<0.001, cluster P<0.05 two-tailed). In subtype 1, the dFC between the right central posterior gyrus and left medial superior frontal gyrus was significantly reduced(187 voxels; t=-4.42; GRF corrected voxel P<0.001, cluster P<0.05 two-tailed); in subtype 2, dFC between the left superior temporal gyrus and left hippocampus, and left central opercular cortex was significantly reduced(272 voxels、99 voxels; t=-4.69, -5.01; GRF corrected voxel P<0.001, cluster P<0.05 two-tailed). In subtype 1, dFC between the right central posterior gyrus and left medial superior frontal gyrus was negatively correlated with illness duration( r=-0.579; P=0.002, uncorrected). In subtype 2, dFC between the left superior temporal gyrus and left hippocampus was positively correlated with illness duration( r=0.578; P=0.003, uncorrected). Conclusions:In the resting state, patients with different subtypes of OCD may have different patterns of dFC abnormalities based on gray matter volume.

Objective:To analyze the patterns of dynamic functional connectivity(dFC) at rest in different obsessive-compulsive disorder(OCD) subtypes based on gray matter volume, and explore the relationship between abnormal gray matter volume and dFC patterns and clinical symptoms in different OCD subtypes.Methods:Clinical data were prospectively collected from a total of 48 patients with OCD from inpatient and outpatient departments of the Fourth Affiliated Hospital of Qiqihar Medical College(20 cases) and Qiqihar Mental Health Center(28 cases) from September 2013 to March 2020. There were 33 males and 15 females, aged 18 to 42(27.1±6.7) years. During the same period, 39 age-matched healthy controls were also recruited, including 31 males and 8 females, aged 18 to 43(28.5±8.6) years. Structural and resting-state functional magnetic resonance imaging scans were performed on 48 OCD patients(OCD group) who met the ICD-10 diagnostic criteria and 39 healthy controls(control group). Using voxel-based morphometry(VBM) and semi-supervised machine learning methods, the patient group was characterized by gray matter volume to perform subtype analysis, and brain regions with abnormal gray matter volume were selected as regions of interest for whole-brain voxel-wise dFC analysis. Correlations between abnormal gray matter volume and dFC and clinical symptoms in OCD patients were analyzed.Results:Based on gray matter volume, OCD patients were computed into two subtypes, of which subtype 1 increased gray matter volume in the right central posterior gyrus(809 voxels; t=4.31; GRF corrected voxel P<0.001, cluster P<0.05 two-tailed), and subtype 2 showed reduced gray matter volume in the left superior temporal gyrus(1 118 voxels; t=-4.37; GRF corrected voxel P<0.001, cluster P<0.05 two-tailed). In subtype 1, the dFC between the right central posterior gyrus and left medial superior frontal gyrus was significantly reduced(187 voxels; t=-4.42; GRF corrected voxel P<0.001, cluster P<0.05 two-tailed); in subtype 2, dFC between the left superior temporal gyrus and left hippocampus, and left central opercular cortex was significantly reduced(272 voxels、99 voxels; t=-4.69, -5.01; GRF corrected voxel P<0.001, cluster P<0.05 two-tailed). In subtype 1, dFC between the right central posterior gyrus and left medial superior frontal gyrus was negatively correlated with illness duration( r=-0.579; P=0.002, uncorrected). In subtype 2, dFC between the left superior temporal gyrus and left hippocampus was positively correlated with illness duration( r=0.578; P=0.003, uncorrected). Conclusions:In the resting state, patients with different subtypes of OCD may have different patterns of dFC abnormalities based on gray matter volume.

Objective:To investigate the dynamic functional connectivity (dFC) of bilateral precuneus at resting-state in obsessive-compulsive disorder (OCD).Methods:Fifty patients with OCD who matched the criteria of ICD-10 and 50 healthy controls (HCs) were examined by the resting-state functional magnetic resonance imaging scanning. Voxel-based whole-brain dFC method was used to analyze the dFC of bilateral precuneus at resting-state in OCD; Pearson correlation analyses was used to analyze the relationship between the abnormal dFC values and clinical symptoms in OCD; support vector machine analyses was used to explore whether abnormal dFC could be used to identify OCD.Results:Compared with HCs, patients with OCD showed decreased dFC values between left precuneus and left medial prefrontal cortex (MPFC) (0.23±0.02 vs. 0.26±0.03, t=-6.23, P<0.05, GRF corrected), left cuneus (0.24±0.03 vs. 0.28±0.04, t=-5.30, P<0.05, GRF corrected), and left paracentral lobule (0.23±0.03 vs. 0.27±0.04, t=-5.36, P<0.05, GRF corrected); and decreased dFC values between right precuneus and left postcentral gyrus (0.23±0.04 vs. 0.27±0.04, t=-5.12, P<0.05, GRF corrected). The decreased dFC values between left precuneus and left MPFC was positively correlated with the total score of Yale-Brown obsessive compulsive scale (Y-BOCS)( r=0.289, P<0.05, uncorrected); the decreased dFC values between right precuneus and left posterior central gyrus was positively correlated with Y-BOCS total scores ( r=0.292, P<0.05, uncorrected) and obsessive subscale scores ( r=0.304, P<0.05, uncorrected). The area under the curve value of the decreased dFC values between right precuneus and left posterior central gyrus was 0.856; the Youden Index was 0.52; the sensitivity was 100%, and the specificity was 52%. Conclusions:The dFC of bilateral precuneus decreases at resting-state in patients with OCD. The abnormal dFC value between the right precuneus and the left posterior central gyrus may have implications to identify OCD.

Objective:To investigate the dynamic functional connectivity (dFC) of bilateral precuneus at resting-state in obsessive-compulsive disorder (OCD).Methods:Fifty patients with OCD who matched the criteria of ICD-10 and 50 healthy controls (HCs) were examined by the resting-state functional magnetic resonance imaging scanning. Voxel-based whole-brain dFC method was used to analyze the dFC of bilateral precuneus at resting-state in OCD; Pearson correlation analyses was used to analyze the relationship between the abnormal dFC values and clinical symptoms in OCD; support vector machine analyses was used to explore whether abnormal dFC could be used to identify OCD.Results:Compared with HCs, patients with OCD showed decreased dFC values between left precuneus and left medial prefrontal cortex (MPFC) (0.23±0.02 vs. 0.26±0.03, t=-6.23, P<0.05, GRF corrected), left cuneus (0.24±0.03 vs. 0.28±0.04, t=-5.30, P<0.05, GRF corrected), and left paracentral lobule (0.23±0.03 vs. 0.27±0.04, t=-5.36, P<0.05, GRF corrected); and decreased dFC values between right precuneus and left postcentral gyrus (0.23±0.04 vs. 0.27±0.04, t=-5.12, P<0.05, GRF corrected). The decreased dFC values between left precuneus and left MPFC was positively correlated with the total score of Yale-Brown obsessive compulsive scale (Y-BOCS)( r=0.289, P<0.05, uncorrected); the decreased dFC values between right precuneus and left posterior central gyrus was positively correlated with Y-BOCS total scores ( r=0.292, P<0.05, uncorrected) and obsessive subscale scores ( r=0.304, P<0.05, uncorrected). The area under the curve value of the decreased dFC values between right precuneus and left posterior central gyrus was 0.856; the Youden Index was 0.52; the sensitivity was 100%, and the specificity was 52%. Conclusions:The dFC of bilateral precuneus decreases at resting-state in patients with OCD. The abnormal dFC value between the right precuneus and the left posterior central gyrus may have implications to identify OCD.

Objective:To investigate the spontaneous neural activities and the whole-brain functional connectivity(FC) patterns at rest in patients with obsessive-compulsive disorder (OCD).Methods:40 drug-naive patients with OCD matched the diagnostic criteria of ICD-10 (OCD group), and 38 genders, age, education-matched healthy controls (controls group) underwent resting-state functional magnetic resonance imaging scan. The fractional amplitude of low-frequency fluctuations (fALFF) approach was used to explore spontaneous neural activities. The brain region with abnormal fALFF value (right orbitofrontal cortex (OFC)) was used as the interested region to carry out the whole-brain FC analysis. We analyzed the correlation of clinical symptoms with the abnormal fALFF and FC values by partial correlation analysis in patients with OCD.Results:Compared with controls group, increased fALFF were found in the right OFC and right dorsolateral prefrontal gyrus ( t=4.45, 5.25; P<0.05, GRF corrected), and increased FC were observed between the right OFC and left OFC, and left cerebellum crus Ⅱ ( t=5.39, 4.94; P<0.05, GRF corrected) in OCD group. The increased FC between right OFC and left cerebellum crus Ⅱ positively correlated with 17-Items Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale scores ( r=0.401, P=0.015; r=0.389, P=0.019; uncorrected). Conclusions:The local spontaneous neural activities and FC in the cortical-striatal-thalamic-cortical and OFC-cerebellar circuits were abnormal at rest in patients with OCD.

Objective:To investigate the spontaneous neural activities and the whole-brain functional connectivity(FC) patterns at rest in patients with obsessive-compulsive disorder (OCD).Methods:40 drug-naive patients with OCD matched the diagnostic criteria of ICD-10 (OCD group), and 38 genders, age, education-matched healthy controls (controls group) underwent resting-state functional magnetic resonance imaging scan. The fractional amplitude of low-frequency fluctuations (fALFF) approach was used to explore spontaneous neural activities. The brain region with abnormal fALFF value (right orbitofrontal cortex (OFC)) was used as the interested region to carry out the whole-brain FC analysis. We analyzed the correlation of clinical symptoms with the abnormal fALFF and FC values by partial correlation analysis in patients with OCD.Results:Compared with controls group, increased fALFF were found in the right OFC and right dorsolateral prefrontal gyrus ( t=4.45, 5.25; P<0.05, GRF corrected), and increased FC were observed between the right OFC and left OFC, and left cerebellum crus Ⅱ ( t=5.39, 4.94; P<0.05, GRF corrected) in OCD group. The increased FC between right OFC and left cerebellum crus Ⅱ positively correlated with 17-Items Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale scores ( r=0.401, P=0.015; r=0.389, P=0.019; uncorrected). Conclusions:The local spontaneous neural activities and FC in the cortical-striatal-thalamic-cortical and OFC-cerebellar circuits were abnormal at rest in patients with OCD.

Objective To understand the clinical characteristics of traumatic brain injury (TBI) patients and provide fundamental data for reducing the incidence of TBI and improving its treatment efficacy.Methods Medical histories of TBI inpatients from January 2011 to December 2016 were collected from the TBI database of Neurosurgical Department at Tianjin Medical University General Hospital.Information including gender,age,causes of TBI,injury severity,sources of the inpatients,interval from injury to treatment,diagnosis,and treatment were analyzed retrospectively.Results A total of 2 368 TBI patients were enrolled,aged mainly 30-60 years.There were more male patients (n =1 741) than female patients (n =627) (2.78 ∶ 1),while the gender ratio was reversed among patients above 60 years old (2.09 ∶ 1) (P ＜ 0.05).Traffic accident (60.14％) remained the major cause of TBI,while the proportion of electric motorcycle accident was 17.35％,followed by fall from height (13.64％).The proportion of mild TBI patients from suburb counties was lower than that of patients from the six urban areas (P ＜ 0.05),while the proportion of heavy TBI patients from other provinces was higher than those of both urban and suburb counties (P ＜ 0.05).The average interval from injury to specialist treatment was 7.53 hours.Patients who received treatment within 3 hours had better improvement than those who were treated 3 hours after TBI (P ＜ 0.05).The main injuries were skull fracture (33.07％) and brain contusion (30.32％).A total of 783 patients (33.07％) underwent surgery,among which 693 patients received the most common procedure of craniotomy hematoma evacuation (including decompressive craniectomy).The improvement rate of patients with intracranial pressure monitoring was higher than those without intracranial pressure monitoring (P ＜ 0.05).The improvement rate of the surgery group was significantly higher than that of the non surgery group (P ＜0.05).Conclusions The ratio of elderly female TBI patients is on the rise;TBI presents an increase in traffic accidents;mild TBI patients choose to receive treatment in close hospitals while those with severe TBI choose comprehensive hospitals;and the interval from injury to treatment is long.The following strategies including improving the traffic facilities,strengthening the education of traffic safety on elderly females and pedestrians,and optimizing the TBI medical treatment process would reduce the incidence of TBI and improve the efficiency of treatment.

Objective To compare the diagnostic reliability of AO classification and Evans-Jensen classifications in X ray film and three-dimensional CT reconstruction images intertochanteric fractures, and explore advantage of the three-di?mensional CT. Methods A retrospective study was performed to evaluate 54 patients with intertochanteric fractures. Three orthopaedic surgeons were asked to make assessment of fracture classifications using X ray film and the three-dimen?sional CT images. Agreement test was performed to evaluate interobserver and intraobserver reliability for fracture classifica?tion. Results When X ray film was used, mean Kappa values of interobserver reliability for AO and Evans-Jensen classifi?cations between three surgeons were 0.597 and 0.571, that was medium consistency. While using three-dimensional CT to AO classification, lower Kappa value was 0.411, medium consistency. Evans-Jensen classification, Kappa value was 0.704, highly consistency. Each surgeon respectively using X ray film and three-dimensional CT, the mean Kappa values of AO and Evans-Jensen classification were 0.464, medium consistency and 0.191 (0.160-0.233), weak consistency. Conclusion Both classifications based on X ray film show moderate consistency, using three-dimensional CT does not improve the consis?tency of AO classification. The three-dimensional CT is not applicable in Evans-Jensen classification.