Objective:To analyze the patterns of change of brain function among civil pilots in prospective memory tasks by using task-state functional magnetic resonance imaging (fMRI) and a cue-based repetitive search task.Methods:A total of 85 subjects were enrolled, including 47 civil pilots (pilot group) and 38 ordinary workers (control group). The task-state fMRI data during the execution of the prospective memory task was analyzed using a general linear model to find out about the activation patterns of brain functions in the 2 groups in the 3 phases of encoding, maintenance, and retrieval of the prospective memory task. The differences in activation patterns between the 2 groups and correlations between regions of interest and the rate of accuracy, reaction time and flying hours were analyzed.Results:The repeated measurement analysis of variance showed that there were no interactions of reaction time or of the rate of accuracy between the task and grouping ( P>0.05), and that the difference in the main effect of grouping was significant ( F=5.67, 15.46, P=0.020, <0.001). The difference in the main effect of grouping on the rate of accuracy was significant ( F=5.42, P=0.022), and the rate of accuracy in the pilot group was higher than in the control group ( P=0.048). In the phase of encoding, the activation in the bilateral cerebellum, bilateral superior frontal gyrus, bilateral fusiform gyrus, and temporal lobe regions decreased in the pilot group compared with the control group ( t=2.68-4.13, all P<0.05), while the activation in the fusiform gyrus and the right parietal superior gyrus increased, and the differences were statistically significant ( t=3.28, 3.35, 3.02, P=0.038, 0.024, 0.042). During the phase of maintenance, the pilot group showed significantly reduced activation in the bilateral cerebellum, bilateral medial superior frontal gyrus, bilateral middle occipital gyri, and the right middle temporal gyrus compared with the control group ( t=2.24-3.36, P<0.05 or 0.01). In the retrieval phase, activation in the right peri-calcarine cortex, bilateral caudate nuclei, and bilateral precentral and postcentral gyri was enhanced in the pilot group compared with the control group ( t=2.57-3.35, all P<0.05), especially in the right middle frontal gyrus ( t=3.12, P=0.007). In the encoding phase, activation was increased in the left fusiform gyrus and right parietal superior gyrus of the pilot group, which was positively correlated with flying hours in the last 3 months ( r=0.347, 0.418, P=0.020, 0.005). Conclusions:Due to long-term flights, the way in which such regions as the frontal lobe, cerebellum, and default mode network are activated in civil pilots is likely to undergo some changes during prospective memory activities, which is why they have higher processing efficiency when performing prospective memory tasks.

Objective:To analyze the patterns of change of brain function among civil pilots in prospective memory tasks by using task-state functional magnetic resonance imaging (fMRI) and a cue-based repetitive search task.Methods:A total of 85 subjects were enrolled, including 47 civil pilots (pilot group) and 38 ordinary workers (control group). The task-state fMRI data during the execution of the prospective memory task was analyzed using a general linear model to find out about the activation patterns of brain functions in the 2 groups in the 3 phases of encoding, maintenance, and retrieval of the prospective memory task. The differences in activation patterns between the 2 groups and correlations between regions of interest and the rate of accuracy, reaction time and flying hours were analyzed.Results:The repeated measurement analysis of variance showed that there were no interactions of reaction time or of the rate of accuracy between the task and grouping ( P>0.05), and that the difference in the main effect of grouping was significant ( F=5.67, 15.46, P=0.020, <0.001). The difference in the main effect of grouping on the rate of accuracy was significant ( F=5.42, P=0.022), and the rate of accuracy in the pilot group was higher than in the control group ( P=0.048). In the phase of encoding, the activation in the bilateral cerebellum, bilateral superior frontal gyrus, bilateral fusiform gyrus, and temporal lobe regions decreased in the pilot group compared with the control group ( t=2.68-4.13, all P<0.05), while the activation in the fusiform gyrus and the right parietal superior gyrus increased, and the differences were statistically significant ( t=3.28, 3.35, 3.02, P=0.038, 0.024, 0.042). During the phase of maintenance, the pilot group showed significantly reduced activation in the bilateral cerebellum, bilateral medial superior frontal gyrus, bilateral middle occipital gyri, and the right middle temporal gyrus compared with the control group ( t=2.24-3.36, P<0.05 or 0.01). In the retrieval phase, activation in the right peri-calcarine cortex, bilateral caudate nuclei, and bilateral precentral and postcentral gyri was enhanced in the pilot group compared with the control group ( t=2.57-3.35, all P<0.05), especially in the right middle frontal gyrus ( t=3.12, P=0.007). In the encoding phase, activation was increased in the left fusiform gyrus and right parietal superior gyrus of the pilot group, which was positively correlated with flying hours in the last 3 months ( r=0.347, 0.418, P=0.020, 0.005). Conclusions:Due to long-term flights, the way in which such regions as the frontal lobe, cerebellum, and default mode network are activated in civil pilots is likely to undergo some changes during prospective memory activities, which is why they have higher processing efficiency when performing prospective memory tasks.

Objective The study aimed to investigate the prevalence of various Traditional Chinese Medicine(TCM)syndromes during the acute phase of ischemic stroke and identify the key symptoms associated with each syndrome.Methods A total of 1011 patients in the acute phase of ischemic stroke were assessed for TCM syndromes using the"Diagnostic criteria for stroke in Traditional Chinese Medicine"within 72 h of symptom onset,on the 7th day post onset,and on the 14th day.R4.2.3 software was utilized to analyze the TCM syndromes and symptoms,as well as to conduct network analysis.Results The incidence of phlegm syndrome was the highest(54.10％,51.18％,49.39％)at 72 h,7th and 14th day of disease onset,respectively,followed by wind syndrome,fire-heat syndrome,blood stasis syndrome,qi deficiency syndrome and excessive yang due to yin deficiency syndrome.The incidence of wind syndrome gradually decreased over time(x2=15.619,P＜0.001).In the network of 44 TCM syndrome entries,TZ-5(pulse)had the highest centrality index(strength=2.4)and was located at the most central position of the network.In the network analysis of different TCM syndrome,TZ-5(pulse)(strength=1.91)was located in the center of the phlegm syndrome network,FZ-1(onset)(strength=1.61)was located in the center of the wind syndrome network,HRZ-2(tongue coating)(strength=1.37)was located in the center of the network in the fire-heat syndrome,XYZ-1(tongue texture)(strength=1.18)was located at the center of the network for the blood stasis syndrome.Conclusion The phlegm syndrome is the most important syndrome in the acute phase of ischemic stroke.Employing network analysis can elucidate the central symptoms of different syndromes and the interconnections between the symptoms,providing new ideas for the identification of ischemic stroke.

Objective To evaluate the intraoperative identification of ectopic parathyroid tissue in the central neck region using autofluorescence point-spectral analysis(AFPSA)combined with immune colloidal gold technique(ICGT),for guiding total parathyroidectomy(TPTX)or clean parathyroidectomy(CPTX)in the management of secondary hyperparathyroidism(SHPT).Methods Retrospectively collected and compared the clinical data of 64 patients with SHPT from October 2019 to June 2023.In the observation group,TPTX was performed as the initial procedure in 36 cases,followed by sampling of suspicious targets using AFPSA in the central neck area and subsequent detection through ICGT.CPTX was then conducted if a positive result was obtained.On the other hand,the control group consisted of 28 cases where only TPTX was performed without any additional tests during surgery.The surgical data,parathyroid hormone(PTH)levels,blood calcium levels,blood phosphorus levels,alkaline phosphatase(ALP)levels,regression of clinical symptoms,changes in parathyroid function and occurrence of hypocalcemia were compared between these two groups.Results In the observation group,there were 9 cases of AFPSA-ICGT positivity,including 2 left-sided cases,4 right-sided cases,and 3 thymic cases;among these posi-tive cases,there were a total of 10 locations with mildly hyperplastic or nonhyperplastic microscopic parathyroid tissue.The difference in the number of total parathyroid glands removed(including ectopic)between the two groups was statistically significant(P<0.05).At both 3 and 6 months postoperatively,ALP levels in the observation group were significantly lower than those in the control group(P<0.01 and P<0.001 respectively);at 6 months postoperatively,differences in PTH and blood phosphorus levels between the two groups were also statistically significant(P<0.05 and P<0.001 respectively).Joint bone pain and skin itching recurred in some patients within the control group at six months after surgery(P<0.05),whereas recurrence of SHPT was less frequent within the observation group compared to controls(P<0.05);however,no statistically significant differences were observed regarding postoperative hypoparathyroidism or hyperparathyroidism as well as hypocalcemia between either groups.Conclusion The AFPSA-ICGT intraoperative test can be utilized to guide surgery for SHPT,enabling accurate and efficient identification as well as safe targeting of parathyroid tissues that may not exhibit obvious hyperplasia in the central cervical region.

Objective The study aimed to investigate the prevalence of various Traditional Chinese Medicine(TCM)syndromes during the acute phase of ischemic stroke and identify the key symptoms associated with each syndrome.Methods A total of 1011 patients in the acute phase of ischemic stroke were assessed for TCM syndromes using the"Diagnostic criteria for stroke in Traditional Chinese Medicine"within 72 h of symptom onset,on the 7th day post onset,and on the 14th day.R4.2.3 software was utilized to analyze the TCM syndromes and symptoms,as well as to conduct network analysis.Results The incidence of phlegm syndrome was the highest(54.10％,51.18％,49.39％)at 72 h,7th and 14th day of disease onset,respectively,followed by wind syndrome,fire-heat syndrome,blood stasis syndrome,qi deficiency syndrome and excessive yang due to yin deficiency syndrome.The incidence of wind syndrome gradually decreased over time(x2=15.619,P＜0.001).In the network of 44 TCM syndrome entries,TZ-5(pulse)had the highest centrality index(strength=2.4)and was located at the most central position of the network.In the network analysis of different TCM syndrome,TZ-5(pulse)(strength=1.91)was located in the center of the phlegm syndrome network,FZ-1(onset)(strength=1.61)was located in the center of the wind syndrome network,HRZ-2(tongue coating)(strength=1.37)was located in the center of the network in the fire-heat syndrome,XYZ-1(tongue texture)(strength=1.18)was located at the center of the network for the blood stasis syndrome.Conclusion The phlegm syndrome is the most important syndrome in the acute phase of ischemic stroke.Employing network analysis can elucidate the central symptoms of different syndromes and the interconnections between the symptoms,providing new ideas for the identification of ischemic stroke.

Objective:To evaluate the effect of the improved team-based learning (TBL) teaching method in the undergraduate probation course of ophthalmology based on the goal of cultivating excellent doctors.Methods:The undergraduates of clinical medicine were randomly divided into experimental group and control group. The control group ( n=50) was given conventional ophthalmology probation teaching, while the experimental group ( n=50) was given ophthalmology probation teaching of improved TBL teaching method. The theoretical examination performance and skill assessment results of students in the two groups were compared, and the subjective evaluation of the students on the teaching was also compared. SPSS 23.0 was used to conduct t-test and Wilcoxon's rank sum test. Results:The theoretical examination performance of experimental group (29.68±4.52) was better than that of control group (27.84±4.33), with significant differences ( P<0.05); the skill assessment results of experimental group (32.88±5.05) were also better than those of the control group (30.88±6.99), with significant differences ( P<0.05); the subjective evaluation of teaching effect in each item of experimental group was better than that of control group ( P<0.05). Conclusion:The improved TBL teaching method can not only improve students' theoretical knowledge and experimental skills, but also improve students' self-study and teamwork ability, which will provide a feasible educational reform plan for achieving the goal of cultivating excellent doctors.

Objective:To explore surgical treatment for persistent pupillary membrane (PPM) and its effect.Methods:The medical records and postoperative follow-up data for 12 consecutive patients (16 eyes),who were submitted to PPM resection in Xiangya Hospital,Central South University from March 2011 to August 2016,were retrospectively reviewed.Results:Among 12 consecutive patients (16 eyes),8 patients (12 eyes) with PPM and clear lens were submitted to simply PPM resection,and 4 patients (4 eyes) with PPM and cataract were submitted to PPM resection combined with cataract surgery.In the patients who received the combined operation,phacoaspiration with or without intraocular lens implantation was performed in 3 eyes or in 1 eye.In the early stage after surgery,1 eye was complicated with a transient high intraocular pressure.In the patients who were submitted to PPM resection,the final follow-up visual acuity in 7 patients (11 eyes) were improved except 1 patient (1 eye).After the PPM resection combined with cataract surgery,the follow-up visual acuity was improved in 2 patients (2 eyes) but not in the other 2 patients (2 eyes).Conclusion:The surgical treatment is effect on congenital pupil residual membrane.Serious membrane pupil residual membrane should be surgically treated at early stage,and amblyopia treatment after the surgery is important.

To study the change of the dominant eye in the age-related cataract patients before and after surgery, to analyze the correlation between the orientation of the dominant eye and the visual quality, and to observe whether the patients with the change in dominant eye were converted to dizziness.
 Methods: A total of 44 patients, with age-related cataract between 60 and 80 years old were enrolled. Group A: the non-dominant (secondary) eye served as the surgical eye (n=35); Group B: the dominant eye served as the surgical eye (n=9); Group C: the operation was performed on the contralateral eye after a month (n=28). Measurement of the dominant eye was performed before operation, 1 week after operation and 1 month after the operation. The changes in the uncorrected distance visual acuity (UCDVA), contrast sensitivity (CS), best corrected visual acuity (BCVA) and spherical equivalent (SE) between the dominant and non-dominant eye were compared.
 Results: The UCDVA, CS, BCVA and SE were significantly improved at 1 day after the operation. There was significant difference between the 2 groups (P<0.05). Preoperative: in group A, the UCDVA, CS, BCVA of ocular dominance were better than the non-dominant eye with significant difference (P<0.05), while there was no significant difference between the SE (P>0.05); in group B, the UCDVA, CS, BCVA in the dominant eye were better than the non-dominant eye's, but the difference was not statistically significant (P>0.05). After operation: the UCDVA, CS and BCVA in the dominant eye in group A and group B were higher than those of the non-dominant eye with statistical difference (P<0.05), but there was no statistical difference between SE (P>0.05). The dominant eye's transformation occurred in group A when the non-dominant eye's postoperative visual quality improved over the leading eye. The transformation rate was 60% in 1 week, and the conversion rate was 80% in 1 month. In group C, the dominant eye reduction rate was 100%, and the visual quality was not significant difference between the two eyes (P>0.05). After the operation, the patients with the dominant eye's transformation felt discomfort, which could be relieved within 1 week.
 Conclusion: The location of the dominant eye was correlated with uncorrected visual acuity, contrast sensitivity, and the best corrected visual acuity. The dominant eye's transformation occurred when the non-dominant eye's postoperative visual quality improved over the leading eye after the surgery. If the contralateral eye's surgery was performed in a short term, the dominant eye can be returned to the initial state.
Aged ; Aged, 80 and over ; Cataract ; therapy ; Cataract Extraction ; Humans ; Middle Aged ; Phacoemulsification ; Treatment Outcome ; Visual Acuity

Objective To investigate the effects of maxillary protraction combined with repetitive rapid palatal expansions and constrictions(RPE/C) vs.rapid palatal expansion(RPE) alone using cone-beam computed tomography(CBCT).Methods Twenty four subjects with maxillary retrusion were recruited and block randomized into either the control group(n=12) or the RPE/C(n=12) group.Control group:facemask protraction after RPE.RPE/C group:facemask protraction after RPE/C.3D reconstruction,landmarks identifying,superimposition and cephalometric analysis were performed to compare the pre-treatment and post-treatment CBCT images.Results One subject in the RPE/C group was lost to follow up during the treatment.Maxilla moved forward[(2.5 ± 1.0) mm] after maxillary protraction with RPE/C,which was significantly greater than that in the control group[(1.6±0.8) mm](P＜0.05).The distance of basion to subspinale (Ba-A) increased[(3.1 ± 1.0) mm] in the RPE/C group,which was significantly greater than that in the control group[(2.2 ± 0.9) mm] (P＜0.05).The amount of forward movement of upper first molars was significantly greater in the RPE/C group(P＜0.05).Conclusions Maxillary protraction with RPE/C might positively affect the forward movement of maxilla compared with the RPE alone protocol with the early treatment of maxillary retrusion patients.

Objective To investigate the value of three-dimensional speckle tracking imaging(3D-STI) in assessment of left ventricular regional systolic function in acute myocardial infarction model of dogs.Methods Left anterior descending (LAD) coronary artery was ligated in 24 adult beagle dogs.Longitudinal strain(LS) of every left ventricular segment before ligation and 180 min after ligation,and the time for acquisition and analysis were obtained using two-dimensional speckle tracking imaging (2D-STI) and 3D-STI.After the experiment,left ventricular myocardium were determined by TTC staining and divided into two groups:infarcted myocardial segments and non-infarcted myocardial segments.Results Experimental model of acute myocardial infarction was established successfully in 20 dogs.After ligation,both LS of 2D-STI and 3D-STI in infarcted myocardial segments were significantly lower (P ＜ 0.01).The time for acquisition and analysis of the images by 3D-STI were significantly shorter than that by 2D-STI (P ＜0.01).The area under the ROC curve of 3D-STI was larger than that of 2D-STI.A cut-off value of-12.56％ for LS of the 3D-STI had 77.9％ sensitivity and 88.2％ specificity in predicting acute myocardial infarction.Conclusions 3D-STI is a convenient,accurate method for evaluating left ventricular regional systolic function.