OBJECTIVE: To observe the dynamic changes of microvascular injury and repair in the penumbra of traumatic brain injury (TBI) rats with effective cerebral perfusion microvascular imaging using optical coherence tomography angiography (OCTA). METHODS: Transparent closed cranial windows were placed in craniotomy rats after TBI caused by weight drop. All the rats in TBI group and control group underwent head MRI examination on the first postoperative day, and the changes of cerebral cortical microvessel density were measured by OCTA through cranial windows on d0, d2, d4, d6, and d8. On the second day after the operation, the same number of rats in the two groups were selected to complete the immunohistochemical staining of brain tissue with pimonidazole, an indicator of hypoxia. RESULTS: MRI T2W1 and immunohistochemical staining demonstrated that edema and hypoxia in the traumatic brain tissue extended deeply throughout the entire cortex. OCTA showed that the cortical surface veins of the rats in both groups were significantly dilated and tortuous after operation, and recovered to the postoperative day level on d8. The effective perfusion microvessel density of the rats in both groups gradually recovered after a temporary decrease, and the TBI group decreased from 39.38%±4.48% on d0 to 27.84%±6.01% on d2, which was significantly lower than that on d0, d6, and d8 (P < 0.05). The highest value was 61.71%±7.69% on d8, which was significantly higher than that on d0, d2, and d4 (P < 0.05). The control group decreased from 44.59%±7.78% on d0 to 36.69%±5.49% on d2, which was significantly lower than that on d0, d6, and d8 (P < 0.05). The highest value was 51.92%±5.96% on d8, which was significantly higher than that on d2, and d4 (P < 0.05). Comparing the two groups, the effective perfusion microvessel density in the TBI group was significantly lower than that in the control group on d2 (P=0.021), and significantly higher than that in the control group on d8 (P=0.030). CONCLUSION OCTA can be used as a method of imaging and measurement of effective perfusion microvessels in the injured cerebral cortex of TBI rats. After TBI, the effective perfusion microvessel density in the wound penumbra gradually recovered after decreasing, and increased significantly on d8.
Animals ; Brain Injuries, Traumatic/physiopathology* ; Rats ; Tomography, Optical Coherence/methods* ; Male ; Rats, Sprague-Dawley ; Microvessels/pathology* ; Microvascular Density ; Cerebral Cortex/blood supply* ; Cerebrovascular Circulation

Objective:To investigate the relationship between the Palatopharyngeal Arch Staging System（PASS） and the severity of Obstructive Sleep Apnea（OSA）, as well as the patterns of airway collapse, while further assessing its clinical applicability. Methods:A total of 98 patients diagnosed with OSA at the Department of Otorhinolaryngology Head and Neck Surgery, Shenzhen University Affiliated Shenzhen Hospital, were recruited for this study. Data collected included basic demographic information, oropharyngeal laryngoscopy videos, results from awake laryngoscopy Muller tests, and indicators from sleep respiratory monitoring. The distribution of each PASS stage among patients with varying severities of OSA was compared. Additionally, both objective and subjective sleep indicators along with occurrences of airway collapse in OSA patients across different PASS stages were analyzed. Results:In total, 98 patients participated in this study. Statistically significant differences were observed in neck circumference, weight, Body Mass Index（BMI）, tongue position, and PASS stage when comparing mild-to-moderate OSA patients to those with severe OSA（P<0.05）. Furthermore, there were statistically significant variations in Apnea-Hypopnea Index（AHI）, minimum blood oxygen saturation levels, average blood oxygen saturation levels, oxygen desaturation index values, and total oxygen desaturation indices among OSA patients categorized by different PASS stages. Multiple comparisons revealed statistically significant differences in AHI as well as minimum and average blood oxygen saturation levels between patients at PASS 1 versus those at PASS 3（P<0.05）. Additionally, notable differences regarding oropharyngeal collapse rates among OSA patients across various PASS stages were identified; specifically between those at PASS stage 1 and those at PASS stage 3. Conclusion:The proportion of PASS stages for OSA varies across different severity levels. The severity of OSA and the degree of airway collapse in patients with varying PASS stages also exhibit significant differences. Patients classified as PASS 3 demonstrate a more severe form of OSA compared to those at PASS 1, with stage 3 being more susceptible to oropharyngeal collapse than its stage 1 counterpart. This assessment system is anticipated to address the current limitations in evaluating the lateral pharyngeal wall within the oropharynx.
Humans ; Sleep Apnea, Obstructive/pathology* ; Male ; Severity of Illness Index ; Female ; Middle Aged ; Polysomnography ; Adult ; Pharynx/physiopathology* ; Aged

Objective To detect the levels of anti-soluble liver antigen(anti-SLA)antibodies in the serum of patients with autoim-mune hepatitis(AIH)and analyze their value in liver injury.Methods A retrospective analysis was conducted on 33 AIH patients with anti-SLA antibody-positive and 33 age-and sex-matched anti-SLA antibody-negative AIH cases diagnosed at Nanjing Second Hos-pital from January 2017 to April 2024.The general and clinical data of the patients were collected along with the detection of anti-SLA antibody(by protein immunoblotting),anti-nuclear antibodies(by indirect immunofluorescence)and other autoimmune liver disease-related autoantibodies,the biochemical parameters,e.g.,total bilirubin(T-Bil),alanine aminotransferase(ALT),aspartate amin-otransferase(AST),gamma-glutamyl transferase(GGT),alkaline phosphatase(ALP),and the level of immunoglobulin IgG.The clinical characteristics,laboratory parameters,and liver histopathological features of the patients were analyzed and compared.Results There were no statistically significant differences were observed in gender,age,autoimmune liver disease-related antibodies(such as antinuclear antibody,anti-smooth muscle antibody,etc.)and liver function parameters(AST,ALT,GGT and ALP),between the two groups of patients(P＞0.05).However,in the patients with positive anti-SLA antibodies,the levels of T-Bil and IgG in serum were significantly higher than those of the negative group with both P value less than 0.05(P values of 0.017 and 0.048,respectively).The pathological examination for liver tissue revealed that the proportion of the patients with lymphocyte-plasma cell infiltration in anti-SLA-positive group was significantly higher than that in anti-SLA-negative group(χ2=4.243,P＜0.05),suggesting more active immune re-sponse.Conclusion The detection of anti-SLA antibodies levels in the serum of AIH patients may reflect the extent of liver injury,and should have the potential for assisting diagnosis and monitoring the disease condition.

Objective To explore the relationship between health literacy of chronic diseases and the effect of blood glucose control in newly diagnosed and prediabetes patients. Methods A total of 180 newly diagnosed and prediabetes patients treated in the Western Theater Command General Hospital from January 2021 to January 2023 were selected, including 94 newly diagnosed and 86 prediabetes patients. The health literacy of chronic diseases in these patients was evaluated by using the health literacy management scale (HeLMS) developed by Jordan et al. The differences of clinical general information and blood glucose control between patients with adequate and insufficient health literacy were analyzed. Results Among the 180 patients, the total score of information acquisition ability, communication and interaction ability, willingness to improve health, willingness for financial support, total score of health literacy, and adequate proportion of health literacy assessed by HeLMS were (35.54 ± 7.21), (33.02 ± 8.15), (15.54 ± 3.92), (7.10 ± 0.98), (91.87 ± 7.28), and 51.67%, respectively. The age of patients with adequate health literacy in the newly diagnosed diabetes group was (52.23 ± 7.15) years old, which was significantly lower than that of patients with insufficient health literacy (P<0.05). The proportions of patients with high school education and above, monthly income ≥ 3000 yuan, and relatives engaged in medical work were 68.09%, 68.09%, and 34.04%, respectively, which were significantly higher than those of patients with insufficient health literacy (P<0.05). The age of patients with adequate health literacy in prediabetes group was (82.23 ± 4.15) years old, which was significantly lower than that of patients with insufficient health literacy (P<0.05). The proportions of patients with high school education and above, monthly income ≥ 3000 yuan, number of children ≥ 2, and relatives engaged in medical work were 65.22%, 67.39%, 34.78%, and 41.30%, respectively, which were significantly higher than those of patients with insufficient health literacy (P<0.05). The fasting blood glucose, glycosylated hemoglobin and 2h postprandial blood glucose of patients with adequate health literacy in the newly diagnosed diabetes group after treatment were (6.43 ± 0.93) mmol/L, (6.02 ± 0.91)% and (7.71 ± 1.01) mmol/L, respectively, which were significantly lower than those of patients with insufficient health literacy (P<0.05). The fasting blood glucose, glycosylated hemoglobin and 2h postprandial blood glucose in patients with adequate health literacy in prediabetes group after treatment were (5.21 ± 0.37) mmol/L, (5.20 ± 0.40)% and (6.20 ± 0.92) mmol/L, respectively, which were significantly lower than those in patients with insufficient health literacy (P<0.05). Conclusion The chronic disease health literacy of prediabetes and new-onset patients is related to the age, education and monthly income level, number of children, relatives engaged in medical work of patients, and the level of health literacy is helpful to the control of blood glucose.

Obsessive-compulsive disorder (OCD) mainly manifests as obsessions and compulsions with the characteristics of early age of onset, long illness duration, and low diagnosis and treatment rate.The development of OCD involves mutations in genes associated with the 5-hydroxytryptamine, glutamate, and dopamine systems, as well as changes in the brain structure and function.However, how the potentially pathogenic genes affect brain structure and function and lead to different clinical manifestations remains unknown.Imaging genetics has been used to study the etiological mechanisms of OCD by combining genetics and imaging to analyze the relationship between genetic variation, neurologic and clinical manifestations.As a complex polygenic disease, imaging genetics that combines polygenic association analysis with epigenetic inheritance may become a new trend and perspective to explore the mechanism of the environment-gene-brain-behavior model in OCD.Therefore, this paper reviewed the related imaging genetics studies of OCD, and provided a theoretical basis for the etiological mechanism and precise intervention for OCD.

Objective:To construct a teaching model of pathology of oral mucosal disease through team-based learning (TBL) based on digital slices combined with mind mapping, and to explore its teaching effect.Methods:A total of 64 oral medical five-year undergraduates from Batch 2017 who took oral histology and pathology were randomized into 2 groups in average, experimental group and control group. Both groups were asked to do self-study on line before class. Students in the experimental group were taught by TBL method. While students in the control group were taught by the traditional methods. Effects of the different teaching methods were evaluated by comparing the scores of two groups. Besides, questionnaires on teaching effect were distributed to evaluate students' satisfaction with TBL method, with Likert 5 as the guideline for scoring. SPSS 2016 was used to analyze the data.Results:The experimental group achieved better teaching results than the control group did, and the students were more satisfied with TBL method.Conclusion:It can be concluded from the study that, the teaching mode of TBL method combined with mind mapping can cause better teaching effects and improve the students' clinical thinking ability and teamwork ability, which is worthy of wide application.

Objective:To investigate the clinical characteristics and risk factors of alcoholic liver disease (ALD) combined with type 2 diabetes mellitus (T2DM).Methods:The clinical data of 70 patients with ALD combined with T2DM (ALD + T2DM group) who received treatment from March 2015 to March 2020 in the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed. The clinical data of 69 patients with ALD (ALD group) and 69 patients with T2DM (T2DM group) who concurrently received treatment were also analyzed. Sex, age, body mass index, drinking habits and other basic information in the three groups were collected. The risk factors of ALD combined with T2DM were evaluated by logistic regression analysis.Results:The daily alcohol intake and years of drinking in the ALD + T2DM group were (110.97 ± 79.78) g/d and (25.17 ± 10.05) years, respectively, which were significantly higher than (91.48 ± 64.26) g/d and (21.78 ± 8.91) years respectively in the ALD group ( t = 1.699, 2.102, both P < 0.05). The incidence of metabolic syndrome in the ALD + T2DM group was 34.3% (24/70), which was significantly higher than 15.9% (11/69) in the ALD group ( χ2 = 6.210, P < 0.05). The activity ratio of aspartate aminotransferase/alanine aminotransferase, total bilirubin level, gamma glutamyl transpeptidase activity in the ALD + T2DM group were 1.59 ± 0.93, (64.73 ± 39.90) μmol/L, (522.93 ± 353.66) U/L, respectively, which were significantly higher than (1.04 ± 0.53), (10.37 ± 4.51) μmol/L, (35.73 ± 23.99) U/L, respectively in the T2DM group ( t = 4.280, 3.780, 5.045, all P < 0.05). Triacylglycerol level in the ALD + T2DM group was significantly higher than that in the ALD group [(1.69 ± 1.04) mmol/L vs. (1.28 ± 0.87) mmol/L, t = 2.523, P < 0.05). Prothrombin time and lactate dehydrogenase activity in the ALD + T2DM group were (13.13 ± 2.79) s and (226.17 ± 79.93) U/L, respectively, which were significantly higher than (10.41 ± 0.84) s, (172.63 ± 39.34) U/L, respectively in the T2DM group ( t = 7.715, 4.969, both P < 0.05). Multivariate Logistic regression analysis showed that prothrombin time, triacylglycerol level, years of drinking, gamma glutamyl transpeptidase activity, and amount of drinking were the main risk factors for ALD combined with T2DM ( OR = 2.010, 3.270, 1.230, 1.060, 1.006, all P < 0.05). Conclusion:Patients with ALD combined with T2DM are prone to metabolic syndrome and lipid disorders, which may aggravate the disease. Prothrombin time, triacylglycerol level, years of drinking play an important role in the development of ALD combined with T2DM.

Objective:To describe the composition of fecal microbiota in patients with inflammatory bowel disease, identify the bacteria related to inflammatory bowel disease, and to provide new ideas for the treatment and diagnosis of the disease.Methods:Fecal samples were obtained from patients with Crohn’s disease (CD, n=20), ulcerative colitis (UC, n=10) and healthy controls ( n=30). A 16S rRNA sequencing approach was applied to determine the compositions of microbial communities in fecal samples. Results:The microbial structure of patients with inflammatory bowel disease was significantly different from that of the control group. Abundance of Proteobacteria, Epsilonbacteraeota, Acidobacteria, Escherichia-Shigella were significantly higher in IBD patients relative to healthy controls, whereas significantly lower abundances were observed for Prevotella_9, Megamonas and Lachnoclostridium. The abundance of Lachnoclostridium in Crohn′s disease was significantly higher than that in ulcerative colitis, while Acidobacteria and Prevotella _9 was significantly lower than that in ulcerative colitis. The abundance of Firmicutes and Bacteroidetes were decreased in disease cohorts, but the difference was not statistically significant ( P>0.05). Conclusions:Intestinal microbial disorders in patients with IBD, and increased pathogenic bacteria (mainly proteobacteria and shigella Escherichia coli) in the intestinal microflora of IBD patients. The difference in microbiota between Crohn′s disease and ulcerative colitis may be related to the disease.

Objective To observe the bone marrow signals of acetabulum and proximal femur of asymptomatic non?professional marathoners by 3.0 T magnetic resonance imaging (MRI) T1WI, and evaluate the bone marrow transformation, so as to obtain the effect of Marathon exercise on bone marrow composition and function. Methods The study group was randomly selected to participate in and complete the whole marathon at least once a year in the past two years. The training mileage of long?distance running was not less than 1 600 kilometers per year. There were no symptoms such as hip pain. There were no abnormalities in hip joint physical examination. The age of 22?53 years old. A total of 31 and 62 hips were evaluated. The control group was randomly selected 29 healthy persons (58 hip joints), aged 23?53 years, without hip pain and regular exercise. All subjects underwent hip joint MRI scan, and the hip joint MRI showed normal. At least 12 hours before MR scan, he did not engage in long?distance running or other sports. The bone marrow signal intensity of acetabulum and proximal femur in T1WI was compared with that of surrounding muscles and fat. The signal intensity was graded from low to high and evaluated by grade. The research group was divided into two groups according to the training years of marathon (running age). The running age of group A was more than 4 years and group B was less than 4 years. The distribution of bone marrow signal in proximal femur was also evaluated by a more intuitive 3?4 classification method. Mann?Whitney U test was used for statistical analysis. Results Bone marrow signal grading evaluation showed that there were significant differences in bone marrow signal grade distribution between the two groups (Z=-6.828, -4.779, -3.046,-5.266,-3.490,-5.053, P<0.05). In the study group, there were 14, 28 hips and 168 parts in group A, 17, 34 hips and 204 parts in group B, bone marrow signals were graded. There were significant differences in acetabulum, femoral neck and upper femoral shaft bone (Z=-2.202, -2.214, -2.730, P<0.05), but no significant differences in femoral head, trochanter and trochanter bone (Z=-0.886,-1.642,-0.711, P>0.05). To evaluate the classification of bone marrow signals in proximal femur, 62 cases of bone marrow signals in the study group were classified as follows: 10 cases with type 1a, 24 cases with type 1b, 17 cases with type 2 and 11 cases with type 3. In the control group, 58 cases of bone marrow signals in proximal femur were classified as follows: 2 cases with type 1a, 13 cases with type 1b, 26 cases with type 2 and 17 cases with type 3. There were significant differences between the two groups (Z=-4.003, P<0.05). Conclusion The T1WI signal intensity of asymptomatic non?professional marathoners′acetabulum and proximal femur bone marrow is lower than that of non?marathoners; the T1WI signal intensity of acetabulum, femoral neck and upper femoral shaft bone marrow of the elderly runners is lower; that is, marathon exercise has certain influence on the bone marrow signal of acetabulum and proximal femur, that is, the change of bone marrow signal in weight?bearing area has a certain phase with the amount of exercise.

Objective: To observe the bone marrow signals of acetabulum and proximal femur of asymptomatic non-professional marathoners by 3.0 T magnetic resonance imaging (MRI) T₁WI, and evaluate the bone marrow transformation, so as to obtain the effect of Marathon exercise on bone marrow composition and function. Methods: The study group was randomly selected to participate in and complete the whole marathon at least once a year in the past two years. The training mileage of long-distance running was not less than 1 600 kilometers per year. There were no symptoms such as hip pain. There were no abnormalities in hip joint physical examination. The age of 22-53 years old. A total of 31 and 62 hips were evaluated. The control group was randomly selected 29 healthy persons (58 hip joints), aged 23-53 years, without hip pain and regular exercise. All subjects underwent hip joint MRI scan, and the hip joint MRI showed normal. At least 12 hours before MR scan, he did not engage in long-distance running or other sports. The bone marrow signal intensity of acetabulum and proximal femur in T₁WI was compared with that of surrounding muscles and fat. The signal intensity was graded from low to high and evaluated by grade. The research group was divided into two groups according to the training years of marathon (running age). The running age of group A was more than 4 years and group B was less than 4 years. The distribution of bone marrow signal in proximal femur was also evaluated by a more intuitive 3-4 classification method. Mann-Whitney U test was used for statistical analysis. Results: Bone marrow signal grading evaluation showed that there were significant differences in bone marrow signal grade distribution between the two groups (Z=-6.828, -4.779, -3.046, -5.266, -3.490, - 5.053, P<0.05). In the study group, there were 14, 28 hips and 168 parts in group A, 17, 34 hips and 204 parts in group B, bone marrow signals were graded. There were significant differences in acetabulum, femoral neck and upper femoral shaft bone (Z=-2.202, -2.214, -2.730, P<0.05), but no significant differences in femoral head, trochanter and trochanter bone (Z=-0.886, -1.642, -0.711, P>0.05). To evaluate the classification of bone marrow signals in proximal femur, 62 cases of bone marrow signals in the study group were classified as follows: 10 cases with type 1a, 24 cases with type 1b, 17 cases with type 2 and 11 cases with type 3. In the control group, 58 cases of bone marrow signals in proximal femur were classified as follows: 2 cases with type 1a, 13 cases with type 1b, 26 cases with type 2 and 17 cases with type 3. There were significant differences between the two groups (Z=-4.003, P<0.05). Conclusion The T₁WI signal intensity of asymptomatic non-professional marathoners′ acetabulum and proximal femur bone marrow is lower than that of non-marathoners; the T₁WI signal intensity of acetabulum, femoral neck and upper femoral shaft bone marrow of the elderly runners is lower; that is, marathon exercise has certain influence on the bone marrow signal of acetabulum and proximal femur, that is, the change of bone marrow signal in weight-bearing area has a certain phase with the amount of exercise.