Objective:To investigate the effects of apolipoprotein E (APOE) ε4 allele on β-amyloid (Aβ) deposition in subcortical structures and functional connectivity (FC) between brain regions in patients with Alzheimer′s disease (AD). Methods:Forty-three patients with probable mild/moderate AD were prospectively enrolled from the First Medical Centre, Chinese PLA General Hospital between January 2023 and October 2023, including 23 APOE ε4+ patients (12 males and 11 females, age (74.8±8.4) years), 20 APOE ε4- patients (14 males and 6 females, age (77.6±8.9) years) and 20 normal cognitive volunteers (NC) (15 males and 5 females, age (75.3±6.2) years). All subjects underwent 11C-Pittsburgh compound B (PIB) PET/MR brain imaging. The differences of gray matter volume (GMV) in subcortical structures (hippocampus, amygdala) among the three groups were analyzed by one-way analysis of variance and least significant difference (LSD) t test. Independent-sample t test and Pearson correlation analysis were used to analyze difference in Aβ deposition between APOE ε4+ patients and APOE ε4- patients, and the correlation between subcortical structure and brain FC. Results:The GMV of bilateral amygdala between NC group and APOE ε4+ gene carrier group, and between APOE ε4+ and APOE ε4- gene carrier groups were significantly different ( F=6.43, P=0.002; P values: 0.002, 0.003). Significant difference of GMV was observed in the bilateral hippocampus among three groups ( F=5.34, P=0.030). Abnormal PIB uptake was detected in both the hippocampus and amygdala of both APOE ε4+ and APOE ε4- gene carrier groups, with a more pronounced effect observed in the APOE ε4+ group ( t values: 3.14, 2.19, P values: 0.032, 0.009). Taking the hippocampus as the seed point, there was no obvious abnormality in the whole brain connectivity map among APOE ε4+, APOE ε4- carriers and NC groups. With the amygdala as the seed point, the whole brain connectivity in the APOE ε4+ gene carrier group was significantly reduced, and the connectivity between the amygdala and the cingulate gyrus, parietal lobe and temporal lobe was significantly reduced in the APOE ε4+ gene carrier group compared with NC group, while the connectivity between the amygdala and the whole brain was not significantly reduced in the APOE ε4- gene carrier group. Aβ deposition in amygdala was positively correlated with FC coefficients of frontal brain regions, gyrus rectus, right middle occipital gyrus and left temporal lobe ( r values: 0.56-0.70, all P<0.05). Conclusion:APOE influences GMV and Aβ deposition of hippocampus and amygdala, and FC of amygdala, and may be involved in the pathological mechanism of cognitive impairment.

Humans ; Asthma/drug therapy* ; Biological Therapy

Objective: To examine the correlation between atmospheric PM2.5 and emergency call for respiratory diseases. Methods: The daily emergency call for respiratory and cardio-cerebrovascular diseases was collected from Hangzhou Emergency Medical Center from 2018 to 2020, and meteorological and atmospheric pollutant data were collected from Hangzhou Municipal Center for Ecological and Environmental Monitoring during the same period, including daily mean air temperature, daily mean relative humidity, PM2.5, PM10 and SO2 levels. The correlation between atmospheric PM2.5 and emergency call for respiratory and cardio-cerebrovascular diseases was examined using a generalized additive model, and the risk of emergency call was predicted using excessive risk (ER) and its 95%CI. Results: The daily mean emergency call was 14 (interquartile range, 12) cases for respiratory diseases and 20 (interquartile range, 7) cases for cardio-cerebrovascular diseases in Hangzhou City from 2018 to 2020, and the daily mean PM2.5 mass concentration was 29.77 (interquartile range, 21.32) μg/m3. Cumulative exposure to PM2.5 for 5 or 6 d caused the largest effect on the emergency call for respiratory diseases, and an increase in PM2.5 by 10 μg/m3 led to a 1.93% (95%CI: 0.76%-3.11%) rise in the emergency call for respiratory diseases. Cumulative exposure to PM2.5 for 4 d caused the largest effect on the emergency call for cardio-cerebrovascular diseases, and an increase in PM2.5 by 10 μg/m3 led to a 1.88% (95%CI: 0.80%-2.97%) rise in the emergency call for cardio-cerebrovascular diseases. Cumulative exposure to PM2.5 for 7 d caused the largest effect on the emergency call for respiratory diseases among residents aged 60 years and older, and an increase in PM2.5 by 10 μg/m3 led to a 4.37% (95%CI: 2.70%-6.06%) rise in the emergency call for respiratory diseases. Cumulative exposure to PM2.5 for 4 d caused the largest effect on the emergency call for cardio-cerebrovascular diseases among residents aged 60 years and older, and an increase in PM2.5 by 10 μg/m3 led to a 2.44% (95%CI: 0.97%-3.52%) rise in the emergency call for cardio-cerebrovascular diseases. However, exposure to PM2.5 had no marked effects on emergency call for respiratory or cardio-cerebrovascular diseases among residents aged <60 years. Conclusions Elevated atmospheric PM2.5 mass concentration may lead to an increase in the daily emergency calls for respiratory and cardio-cerebrovascular diseases, notably among residents aged 60 years and older.

Objective:To explore the effect of tibial nerve vibration on triceps surae spasticity in stroke survivors and its electrophysiological mechanism.Methods:Thirty stroke survivors with upper limb spasticity were randomly divided into a treatment group and a control group, each of 30. Both groups were given routine rehabilitation training while the treatment group was additionally provided with local vibration of the tibial nerve with an amplitude of 0.3mm at 60Hz. Before and after the treatment, the modified Ashworth scale (MAS) and Clonus grading were used to assess muscle tone and spasticity. Electrophysiological functions were evaluated using the tibial nerve motor and sensory conduction test and F wave and H reflex sensing.Results:Before the treatment there were no significant differences between the two groups in their average MAS scores, Clonus grading, maximum H amplitude (Hmax), the ratio of maximum H to maximum M amplitude (H/M) or the intensity of stimulus required to elicit Hmax. After the treatment, however, all of those measurements had improved significantly in both groups with the average improvements in the treatment group significantly greater than those in the control group.Conclusions:Local vibration of the tibial nerve combined with traditional rehabilitation is more effective than traditional rehabilitation alone in relieving triceps surae spasticity and reducing muscle tone after a stroke. The vibration seems to inhibit excitation of the reflex pathway.

Objective To explore the efficiency of 6-18 F-fluoro-L-3,4-dihydroxyphenylalanine (18 F-FDOPA) PET/CT imaging in the diagnosis of pheochromocytoma/paraganglioma (PPGLs). Methods Twenty-six patients (15 males, 11 females;age:13-76 years) who were suspected of PPGLs with adrenal or retro-peritoneal mass were enrolled into this prospective study. All patients underwent 18 F-FDOPA PET/CT ima-ging. The clinical data, laboratory data and imaging results were collected. Region of interest ( ROI) was drawn on the liver and lesions, and the mean standardized uptake value ( SUVmean ) of the liver and the max-imum standardized uptake value ( SUVmax ) of lesions were calculated, as well as the ratio of tumor/lesion ratio ( T/L) . Based on the pathological results considered as the gold standard, the diagnostic efficiency of 18 F-FDOPA PET/CT imaging in PPGLs was calculated and compared with that of CT/MR. Besides, receiv-er operating characteristic ( ROC) curve analysis of T/L was used. Results Twenty-five patients were path-ologically confirmed, including 12 patients with PPGLs and 13 patients with non-PPGLs. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 18 F-FDOPA PET/CT ima-ging was 11/12, 12/13, 92.00％(23/25), 11/12 and 12/13, respectively. The area under the ROC curve of T/L was 0.978, with the cut-off value of 1.55. 18 F-FDOPA PET/CT imaging totally detected 29 positive foci, including 12 of pheochromocytoma (PCC) and 17 of paraganglioma (PGL). Among those 18F-FDOPA positive PGL foci, 11 were detected by CT/MR, while 6 with diameter less than 1 cm were missed. Conclu-sion 18 F-FDOPA PET/CT imaging can detect more small PGL lesions than CT/MR, suggesting that it may be a proper imaging modality of PPGLs.

China's pre - hospital emergency resources are shortage, city traffic is congestion, and the arrival of ambulance takes some time. For this reason, the emergency center designed and manufactured a pre - hospital e-mergency volunteer mobile application software. This paper analyzed some ethical problems encountering in the practical application of the software in the 120 emergency alarm of Hangzhou area, such as volunteer identification, patient information confidentiality, volunteer rescue whether to cause a dispute and other issues, and gave the rele-vant solution countermeasures, including setting access threshold for the emergency volunteer, adopting various technical measures to protect the information of patient and formulating and perfecting the relevant legal regulations.

Childhood obesity and obesity-related metabolic complications are induced by a high-fat postnatal diet.The lack of a suitable animal model,however,remains a considerable challenge in obesity studies.In the current study,we provided high-fat diet (HFD) to dams during lactation and to pups after weaning.We also developed a novel model of C57BL/6J mouse pups with HFD-induced postnatal obesity.Results showed that feeding with HFD induces fat deposition and obesity in pups.Furthermore,HFD more potently increased the body weight (BW) of male than female pups.HFD-fed female pups were obese,underwent precocious puberty,and showed increased kisspeptin expression in the hypothalamus.However,parental obesity and precocious puberty exerted no synergistic effects on the HFD-induced postnatal weight gain and puberty onset of the pups.Interestingly,some HFD-fed litters with normal BW also exhibited precocious puberty.This finding suggested that diet composition but not BW triggers puberty onset.Our model suggests good construction validity of obesity and precocious puberty.Furthermore,our model can also be used to explore the mutual interactions between diet-induced postnatal childhood obesity and puberty.

Objective To synthesize 2-(5-[18 F] fluoro-pentyl)-2-methyl-malonic acid (18 F-ML-10) and to investigate the biodistribution in mice and the primary clinical application.Methods 18F-ML-10 was synthesized by domestic synthesis module MF-2V-IT-1.Quality control of the probe was performed after automated synthesis.The biological characteristics of 18F-ML-10 were assessed by biodistribution assay on male Kunming mice and microPET imaging on a male SD rat.Six patients with brain metastasis (4males,2 females,and age 21-68 years) were enrolled in this study.18F-ML-10 PET images were acquired before and at 48 h after radiotherapy.SUVmean and SUVmax of ROI were calculated.GTV changes were measured by MRI before and 3 months after radiotherapy.Response of brain metastasis to radiotherapy was assessed by PET imaging with 18F-ML-10.Two-sample t test was used.Results The non-corrected radiochemical yield of 18F-ML-10 was (26.5±7.3)％ with acceptable quality.The radiochemical purity exceeded 99％.18F-ML-10 was excreted through the kidneys,and the radiouptake in the blood was declined rapidly.The radiotracer accumulation was low in most of other organs.The testis showed a significant uptake.The SUVmean and SUVmax after radiotherapy (5.54±2.72 and 7.29±3.09) were significantly higher than the baseline values(3.81±1.13 and 4.97±1.05;t=2.670,2.663,both P＜0.05).The GTV after radiotherapy was significantly lower than the baseline value:(13.14±9.39) cm3 vs (23.34± 18.13) cm3;t =3.002,P＜0.05.Conclusions 18F-ML-10 could be synthesized reliably and repeatedly by domestic synthesis module.It has satisfactory properties in vivo and is probably suitable for early assessment of the response to radiotherapy in patients with brain metastasis.

Objective:To explore the association between interleukin(IL)-28B single nucleotide polymorphisms and natural outcome of hepatitis C virus.Methods:The IL-28B rs12979860 locus was genotyped in 266 HCV infected volunteer blood donors(107 spontaneous cleared and 159 chronic infection) and 97 healthy controls using Sanger sequencing assay.The difference in rs12979860 genotypes and allele frequencies between the six groups(107 spontaneous cleared and 159 chronic infection,266 HCV infection and 97 healthy controls,159 chronic infection and 97 healthy controls) were analyzed by statistics.Results:159 HCV chronic infection,107 spontaneous cleared and 97 healthy controls,were shown more CC genotype,accounting for 83.6%,95.3%and 86.6%,respectively, while the CT genotype accounted for 16.4%,4.7%and 13.4%respectively.No TT genotype was found.The CC/CT genotype was not significant difference between HCV infection and healthy controls,chronic infection and healthy controls(χ2=0.204,P=0.652;χ2=0.406,P=0.524),but between chronic infections and spontaneous clearance had statistically significant(χ2=8.474,P=0.004),the frequence of C allele in spontaneous cleared was higher than HCV chronic infection(χ2=7.949,P=0.005).Conclusion: The gene polymorphism of IL-28B rs12979860 is not related to HCV susceptibility,but there are differences in chronic infection and spontaneous cleared,showing the C allelic in favor of HCV spontaneous cleaed.

Objective To evaluate the relationship between the cytokine levels in the serum and cerebrospinal fluid and the brain injury in preterm infants. Methods From August of 2012 to August of 2013,51 preterm infants were included and 46 infants were survived. All of them were born at the Maternal and Child Hospital of Hubei Pro-vince,with GA≤32 weeks and high risk factors of intrauterine infection and suffering from early onset sepsis. Ac-cording to the screening findings of cerebral ultrasound and/or MRI,the infants were divided into normal group(n=28) and abnormal groups(n=18) with intracranial hemorrhage or white matter damage. The levels of interleukin(IL)-6,IL-1β and tumor necrosis factor-α( TNF-α) in the serum within 12 hours after birth and in cerebrospinal fluid within 72 hours after birth were investigated. The differences in cytokines between two groups were compared with t-test and Chi-square test,and high risk factors of brain injury were analyzed by Logistic regression models. Results The ab-normal group had higher incidence of clinical maternal chorioamnionitis[44. 44%(8/18 cases) vs 14. 29%(4/28 ca-ses),χ2=5.168,P=0.038] and higher white blood cell count[(11.51±9.03)×109/L vs(6.95±5.64)×109/L,t=-2. 107,P=0. 041]. In the abnormal group,the levels of serum IL-6 [(44. 83±16. 31) ng/L],and IL-6,IL-1βand TNF-αin cerebrospinal fluid [(51. 85±15. 65) ng/L,(11. 95±2. 58) ng/L and(193. 11±67. 25) ng/L] were higher than those in the normal group[(36.83±8.76) ng/L,(42.56±12.89) ng/L,(10.26±2.91) ng/L and(160.56± 29. 02) ng/L,respectively] with the statistical difference(t=-2. 687,-2. 250,0. 269,-2. 243,P=0. 010,0. 029,0. 044, 0. 030). Maternal chorioamnionitis,higher serum TNF-αand cerebrospinal fluid IL-6 were high risk factors for brain in-jury(P=0. 014,0. 031,0. 047). Conclusion Increased systemic and cerebrospinal fluid cytokine levels are possibly re-lated to the preterm brain injury when intrauterine infection occurred.