Obstructive sleep apnea hypopnea syndrome (OSAHS) is a sleep breathing disorder caused by obstruction of the upper airway during sleep from various causes. At present, the diagnosis and treatment of OSAHS are insufficient. OSAHS causes cognitive decline due to excessive oxidative stress and inflammatory response caused by sleep breathing disorder, and its alteration of the brain gray matter area may be related to cognitive dysfunction. This review investigates the correlation between cognitive dysfunction and brain gray matter areas changes in OSAHS, and elucidates the underlying mechanisms, which provide a theoretical basis for early clinical diagnosis and treatment.

Deep transcranial magnetic stimulation (DTMS) is a novel non-invasive neural regulation technology developed on the basis of repetitive transcranial magnetic stimulation; it adopts the Hesed coil (H-coil), which can stimulate wider range of cerebral cortex and deeper brain regions without increasing the stimulation intensity; Currently, it has been applied to the treatment of depression and other mental diseases. In this paper, we review the research status of DTMS in Parkinson's disease, Alzheimer's disease, motor dysfunction after stroke, and aphasia.

White matter lesions in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) are common brain microstructural changes, the mechanism of which is still not clear, including decreased cerebral perfusion, oxidative stress, inflammatory damage, etc. At present, white matter lesions are mainly evaluated by magnetic resonance imaging. White matter lesions in patients with OSAHS are often manifested as cognitive dysfunction such as inattention, decreased executive ability and memory loss. Continuous positive airway pressure can relieve the white matter lesions and improve the cognitive function of some patients with OSAHS. Further study on the pathogenesis and early imaging characteristics of OSAHS white matter lesions is expected to provide targets and evidence for early intervention.

Neuromyelitis optica spectrum disorder (NMOSD) is a central nervous system inflammatory disease characterized by aquaporin-4 immunoglobulin G (AQP4-IgG). The core clinical manifestations include acute myelitis, optic neuritis and area postrema syndrome. AQP4-IgG-positive NMOSD patients have severe symptoms, frequent relapses, less complete recovery and early disability. In recent years, AQP4-IgG-positive NMOSD has gradually been recognized, but its exact mechanism is still unclear. This paper reviews the recent advance in pathogenesis of AQP4-IgG positive NMOSD.

Objective:To observe the clinical efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with eszopiclone in the treatment of chronic insomnia disorder and its influence on brain electrical activity.Methods:Ninety patients with chronic insomnia were randomly divided into rTMS group, drug group and combination group, with 30 cases each group. The rTMS group was treated with bilateral dorsolateral prefrontal lobe (left 5 Hz 400 pulse, right 1 Hz 1 200 pulse), the drug group was treated with eszopiclone (3mg/d) and the combination group was treated with rTMS + eszopiclone. Continuous treatment for 2 weeks, Pittsburgh sleep quality index (PSQI), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and changes in brain electricity activity (α, β, θ, δ) and sleep parameters were evaluated before treatment, after treatment and during follow-up. The SPSS generalized linear model statistical method was used to analyze the changes of each evaluation index.Results:Compared with before treatment, the PSQI score of the combination group decreased (7.2±1.7 vs 13.2±2.9), and the improvement was better than that of the rTMS group (9.2±2.5 vs 12.1±2.8) and the drug group (7.5±2.8 vs 11.4±2.9) ( P<0.05). Multiple comparisons results showed that combination group > drug group > rTMS group; and combination group > rTMS group > drug group during follow-up. After treatment and during follow-up, the HAMA and HAMD scores of the rTMS group and the combination group decreased. There was no statistical difference in the improvement rate between the two groups, but they were all higher than the drug group ( P<0.05). After treatment and during follow-up, the β power of the rTMS group and the combination group decreased, and the α power increased, but there was no statistical difference in the δ and θ power. The β, δ and θ power in the drug group increased ( P<0.05), but the α power had no statistical difference. Multiple comparisons results showed that the power of β, δ and θ bands in the rTMS group and the combination group were lower than the drug group, α power was higher than that in the drug group ( P<0.05). Compared with before treatment During follow-up, the sleep latency of the combination group and rTMS group was shorten, and the total sleep time, sleep efficiency, deep sleep (N3) and rapid eye movement (REM) increased( P<0.05), but there was no statistical difference in the changes of sleep parameters in the drug group. Conclusions:rTMS combined with Eszopiclone can significantly improve the sleep quality of patients with chronic insomnia, which is better than that of rTMS and Eszopiclone alone, and it can reduce cortical excitability by regulating brain electrical activity. It can be an ideal treatment for patients with chronic insomnia disorder.

Objective To provide more reference base for the prevention and treatment of acute cerebral infarction through the correlation study between the onset of acute cerebral infarction and meteorological factors during the same period in Dalian area.Methods From January 1,2015 to December 31,2015,the data of hospitalized medical records and meteorological data during the same period in 3 5 7 8 consecutive patients with acute cerebral infarction admitted to three tertiary hospitals in Dalian were analyzed retrospectively.The seasonal regularity of acute cerebral infarction in Dalian area was analyzed descriptively.A single retrospective 1 ∶ 1 matched case-crossover study design was used to analyze the effect of mean air temperature lag 0-3 days on the onset of acute cerebral infarction.Pearson correlation analysis was used to analyze the influence of meteorological factors of the day on the onset of acute cerebral infarction,at the same time,the relationship between stroke subtypes and meteorological factors was investigated.Results (1) The incidence of acute cerebral infarction was higher in winter (December,January,and February) and it was lower in summer (from June to August).(2) Hysteresis analysis:when the temperature was reduced by 1 ℃each time,the OR values of acute cerebral infarction lagging behind 0 and 1 d were 1.034 (95％ CI 1.012-1.056) and 1.025 (95％ CI 1.008-1.042) respectively.There was significant difference (all P ＜ 0.05).The correlation between the temperature of the day of onset and the onset of acute cerebral infarction was the highest.(3) The onset of cerebral infarction was negatively correlated with the average temperature of the day and hours of sunshine (r =-0.392,-0.260,all P ＜ 0.01),and it was positively correlated with the daily average air pressure (r =0.403,P ＜ 0.01).Among them,the correlation of the type of cardiogenic embolism and each meteorological factor was the highest.The correlation coefficients of daily average temperature,daily air pressure,and hours of sunshine were-0.836,0.733,and-0.629,respectively (all P ＜ 0.01).Conclusion A cold and high air pressure may trigger the onset of acute cerebral infarction,especially cardiogenic cerebral infarction.

Objective To study the role ofTAK-242,a Toll-like receptor 4 (TLR4) specific inhibitor,in β-amyloid peptide (Aβ)25-35 inducing PC12 cytotoxicity and its potential mechanism.Methods PC12 cells were cultured with different concentrations of Aβ25-35 (0,10,20 and 30 μmol/L) for 24 h,and then,the cell survival rate was detected by CCK-8 kit to choose the specific concentration of Aβ25-35 to establish cell AD models.The survival rate of Aβ25-35 inducing PC12 cells was further detected one h after TAK-242 intervention.The PC12 cells were divided into four groups:control group,Aβ treatment group,Aβ+TAK-242 pretreatment group and TAK-242 group.The apoptosis of cells was observed with Hoechst 33258 kit.The secretions of interleukin (IL)-1β and tumor necrosis factor-α (TNF-α) were detected with ELISA.The protein expression levels of TLR4,myeloid differentiation factor 88 (MyD88),IκB kinase complexus α/β (IKKα/β) and nuclear factor (NF)-κB were detected by Western blotting.Results The cell survival rate decreased gradually with the increase of Aβ25-35 concentrations after PC12 cells cultured with Aβ25-35 for 1 h.Twentyμmol/L Aβ25-35 was used to establish the AD models,with which the cell survival rate was closely half of the control group.As compared with Aβ treatment group,Aβ+TAK-242 pretreatment group had significantly increased cell survival rate and significantly decreased apoptosis (P＜0.05).The secretions of IL-1β and TNF-α in Aβ treatment group were significantly increased than those in the control group (P＜0.05),and Aβ+TAK-242 pretreatment group had significantly decreased secretions of IL-1β and TNF-α (P＜0.05).As compared with those in the control group,the protein expressions of TLR4,MyD88,IKKα/β and NF-κB in the Aβ treatment group were significantly increased (P＜0.05);as compared with Aβ treatment group,the protein expressions of TLR4,MyD88,IKKα/β and NF-κB in the Aβ+TAK-242 pretreatment group were degraded obviously,with significant differences (P＜0.05).Conclusions Aβ25-35 could reduce the cell survival rate and apoptosis in PC12 cells by up-regulating the expressions of TLR4/MyD88 signal pathway related proteins and increasing the secretions of IL-1β and TNF-α,and the phenomenon is concentration-dependent.TAK-242 could resist Aβ25-35-induced PC12 cytotoxicity through down-regulating the TLR4/MyD88 signal pathway related proteins levels and decreasing the secretions of TNF-α and IL-1β.

Objective To explore the application of 18F-FDG PET/CT combined with high-resolution CT (HRCT) in the same scanner on diagnosis of lung cancer, and its influencing factors. Methods 50 patients, in which some cannot supply HRCT raw date and under highly suspicion of being lung cancer, some were postoperative lung cancer and metastasis of lung cancer, were examined by 18F-FDG PET/CT combined with HRCT in the same scanner. Results 50 patients were all successful (100%) on PET/CT scans after preparation, injection, rest and breathing exercises;46 cases (92%) were successful on PET/CT combined with HRCT scans;4 cases (8%) failed on HRCT scans. Ma-lignant lesions were found in 35 cases, with the metastasis of 21 cases;4 in 6 cases of postoperative lung cancer were found metastasis;9 cases of benign pulmonary nodules need to be observed sequentially. Conclusion 18F-FDG PET/CT combined with HRCT in the same scan-ner is valuable on diagnosis of lung cancer. The diagnostic accuracy and sensitivity significantly increase. It is a non-invasive new imaging technology and systemic metastasis can be observed.

BACKGROUND:Arthroscopic treatment of tibial eminence fracture requires tiny wire,induces less epiphyseal plate damage during operations,obtains strong fixations,alows early movement postoperatively,obviously attenuate the injuries,facilitate wound healing,and reduce complications.OBJECTIVE:To investigate the biocompatibility of arthroscopic reduction and wire fixation in treatment of fresh and old tibial eminence fractures.METHODS:Twenty-five patients with fresh and old tibial eminence fractures were treated with arthroscopic reduction and wire fixation from January 2010 to April 2012 in the Second People's Hospital of Yichang City.The postoperative fracture healing time and knee function improvement in the two groups were observed.RESULTS AND CONCLUSION: Compared with the fresh fracture patients,the fracture healing time was longer,Lachman test positive rate was higher in the old fracture patients than (P＜0.05),knee flexion and extension activity and Lysholm score were lower (P＜0.05).Experimental findings indicate that,arthroscopic reduction and wire fixation is a feasible clinical treatment of fresh and old tibial intercondylar eminence fractures.

For the near-infrared (NIR) spectral analysis of the concentration of blood glucose, the calibration accuracy can be affected because of the existing of outlier samples. In this research, a Monte-Carlo cross validation (MCCV) method is constructed for eliminating outlier samples. The human blood plasma experiment in vitro and the human body experiment in vivo were introduced to evaluate the MCCV method for its application effect in NIR spectral analysis of blood glucose. And the uninformative sample elimination method based on modified uninformative variable elimination (MUVE-USE) was employed in this study for the comparison with MCCV. The results indicated that, like the MUVE-USE method, the outlier samples elimination method based on MCCV could be used to eliminate the outlier samples which came from gross errors (such as bad sample) or system errors (such as baseline drift). In addition, the outlier samples from the random errors of uncertain causes which affect model accuracy can be eliminated simultaneously by MCCV. The elimination of multiple outlier samples is beneficial to the improvement of prediction accuracy of calibration model.
Blood Glucose ; analysis ; Calibration ; Humans ; Models, Theoretical ; Monte Carlo Method ; Spectroscopy, Near-Infrared ; methods