Modified electroconvulsive therapy(MECT)has a good therapeutic effect on major depressive disorder(MDD),but its mechanism of action is still unclear.In recent years,accumulated studies have confirmed the effects of MECT on brain structure and function using neuroimaging techniques and large datasets obtained through global collaborations and the conclusions are becoming increasingly consistent.For example,there is an increase in gray matter volume in specific brain regions such as the hippocampus and amygdala,an increase in white matter microstructural integrity and normalization of brain functional connections associated with MDD,such as the hippocampus-amygdala-subgenual anterior cingulate cortex-prefrontal cortex network,hippocampus-thalamus-temporal cortex-parietal cortex network,etc.However,the relationship between these changes and the mechanism of MECT action still needs further investigation.This review provides an overview of the research progress on the structural and functional changes of the brain by MECT to provide methodological support and theoretical basis for its better application in clinical diagnosis and treatment.

Objective:To explore the value of machine-learning models based on magnetic resonance imaging(MRI)radiomics features for the preoperative prediction of the blood supply in pituitary neuroendocrine tumors.Methods:A retrospective analysis was performed on the clinical and imaging data of 136 patients with pathologically confirmed pituitary neuroendocrine tumors(diameter>10 mm)from April 2013 to April 2023 at Yi Jishan Hospital of Wannan Medical College.Based on the intraoperative findings,the patients were assigned into richly vascularized(n=50)and normally vascularized(n=86)groups.All patients were allocated randomly in a 7:3 ratio into a training(n=96)or a validation group(n=40).Three machine-learning algorithms,multivariate Logistic regression(LR),random forest(RF),and support vec-tor machine(SVM),were used to establish radiomics prediction models.Receiver operating characteristic(ROC)curves were plotted to eval-uate the diagnostic performance of the models;decision curve analysis(DCA)was used to assess the net clinical benefit of the models.Res-ults:The clinical model achieved areas under the ROC curve(AUC)of 0.74 and 0.82 in the training and validation groups,respectively.The radiomics models using T1-weighted imaging(WI),T2WI,T1WI-enhanced,and combined sequences achieved AUCs of 0.80,0.84,0.82,and 0.84 in the training group and 0.82,0.80,0.85,and 0.83 in the validation group,respectively.The LR,RF,and SVM models had AUCs of 0.85,0.87,and 0.84 in the training group and 0.85,0.85,and 0.83 in the validation group,respectively.All radiomics models demonstrated great-er diagnostic efficacy than the clinical model.DCA indicated that the LR,SVM,and combined-sequence models achieved good net clinical be-nefits;the LR model showed the best results.Conclusions:Machine-learning models based on MRI radiomics exhibit high predictive value,surpassing the clinical judgment of radiologists based on MRI images alone,and offer a favorable net clinical benefit.

Objective To observe the clinical efficacy of Jiangshabanxia nano-paste on nausea and vomiting in end-stage patients and its effect on the quality-of-life (QOL) in cancer patients. Methods 120 end-stage patients with nausea and vomiting symptoms above grade III were randomly divided into observation group and control group. They were treated with Jiangshabanxia nano-paste and placebo paste respectively. The paste patch was changed every 24 hours and used continuously for 7 days. The nausea and vomiting symptom score, the quality-of-life measurement score and KPS score of cancer patients in the two groups were observed to evaluate the curative effect. Results After 7 days of treatment, the symptom scores of nausea and vomiting in the observation group decreased significantly, the KPS score of the observation group increased, and the effective rate was higher than that in the control group. The score of QOL measurement showed that after treatment, the score of main symptom areas and other symptom areas (except external dyspnea, diarrhea and economic difficulties) in the observation group decreased, and the score of overall health area increased. After treatment, the score of main symptom areas and other symptom areas (except external dyspnea, diarrhea and economic difficulties) in the observation group was lower than that in the control group, and the scores of overall health area in the observation group were higher than those in the control group. Conclusion Jiangshabanxia nano-paste has a good clinical efficacy nausea and vomiting in end-stage patients, it also can improve the quality of life end-stage cancer patients.

Objective To investigate the influence of different fractions of inspired oxygen used in non-invasive mechanical ventilation on blood gas parameters and serum high mobility group box-1(HMGB1)and interleukin-27(IL-27)levels in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and type Ⅱ respiratory failure.Methods A total of 152 patients with AECOPD and type Ⅱ respiratory failure were selected as the subjects of the study and divided into group A(n=76)and group B(n=76)using a random number table method.The fraction of in-spired oxygen used in non-invasive mechanical ventilation in the group A was 45％,while was 60％in the group B.The changes in blood gas parameters,serum HMGB1 and IL-27 levels at different time points were compared between the groups;the occurrence of complications during treatment was recor-ded.Results After 7 days of treatment,the arterial oxygen partial pressure[pa(O2)]and pH levels in the group A were significantly higher than those in the group B,while the arterial carbon dioxide partial pressure[pa(CO2)]level was significantly lower than that in the group B(P＜0.05).After 1 day and 7 days of treatment,the serum HMGB1 and IL-27 levels in the group A were significantly lower than those in the group B(P＜0.05).During the treatment period,there was no significant difference in the overall incidence of complications between the two groups(P＞0.05).Conclusion Compared with 60％inhaled oxygen concentration,AECOPD patients with type Ⅱ respiratory failure receiving non-invasive mechanical ventilation with an inhaled oxygen concentration of 45％have better clinical outcomes.The patients'blood gas indicators,serum HMGB1 and IL-27 levels are significantly im-proved,and the treatment is relatively safe.

Objective To investigate the influence of different fractions of inspired oxygen used in non-invasive mechanical ventilation on blood gas parameters and serum high mobility group box-1(HMGB1)and interleukin-27(IL-27)levels in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and type Ⅱ respiratory failure.Methods A total of 152 patients with AECOPD and type Ⅱ respiratory failure were selected as the subjects of the study and divided into group A(n=76)and group B(n=76)using a random number table method.The fraction of in-spired oxygen used in non-invasive mechanical ventilation in the group A was 45％,while was 60％in the group B.The changes in blood gas parameters,serum HMGB1 and IL-27 levels at different time points were compared between the groups;the occurrence of complications during treatment was recor-ded.Results After 7 days of treatment,the arterial oxygen partial pressure[pa(O2)]and pH levels in the group A were significantly higher than those in the group B,while the arterial carbon dioxide partial pressure[pa(CO2)]level was significantly lower than that in the group B(P＜0.05).After 1 day and 7 days of treatment,the serum HMGB1 and IL-27 levels in the group A were significantly lower than those in the group B(P＜0.05).During the treatment period,there was no significant difference in the overall incidence of complications between the two groups(P＞0.05).Conclusion Compared with 60％inhaled oxygen concentration,AECOPD patients with type Ⅱ respiratory failure receiving non-invasive mechanical ventilation with an inhaled oxygen concentration of 45％have better clinical outcomes.The patients'blood gas indicators,serum HMGB1 and IL-27 levels are significantly im-proved,and the treatment is relatively safe.

Objective To analyze the biological characteristics of clinical isolates of coxsackievir-us A6 (CVA6), a pathogen of hand,foot and mouth disease (HFMD), and to provide reference for vaccine development. Methods CVA6 strains were isolated from 21 stool and throat swab specimens of patients with HFMD in Yunnan Province and then identified. Their growth characteristics, plaque morphology and virulence to suckling mice were analyzed. Results Five CVA6 strains, named CVA6-129, CVA6-113, CVA6-57, CVA6-94 and CVA6-162, were isolated and all belonged to D3 subtype. Only the CVA6-129 strain could proliferate rapidly in Vero and KMB17 cells and the proliferation peaked 30 h after inoculation. The infectious titer of the CVA6-129 strain was 7. 54 lgCCID50 (50％ cell culture infective dose) / ml in KMB17 cells. Different morphologies of plaques were formed by the CVA6-129 strain in Vero and KMB17 cells at the same time points, which were small and round with clear edges in Vero cells, and large and irregular with blurry edges in KMB17 cells. Suckling mice were susceptible to CVA6 via intramuscular and intraperito-neal injection. The most common symptoms in infected suckling mice were reduced mobility, hind limb pa-ralysis and quadriplegia. CVA6 infection could result in death in severe cases. Conclusions This study isolated five CVA6 strains from a number of clinical samples of suspected HFMD cases, of which the CVA6-129 strain showed potential as a vaccine candidate.

Objective To investigate the changes aad possible role of estrogen and its receptor ERα、ERβ、GPR30 in the pathogenesis of asymptomatic hyperuricemia.Methods The peripheral blood of 62 asymptomatic hyperuricemia patients (AH) and 68 healthy controls (HC) were collected.The expression of estradial (E2) in serum was detected by the chemilluminescent microparticle immunoassay (CMIA).The expression of ERα,ERβ,GPR30 mRNA in peripheral blood mononuclear cells (PBMCs) was measured using Real time quantitative polymerase chain reaction (RT-qPCR).Statistical Package form Soci-science (SPSS) 17.0 statistical software was used for data analysis.The measurement data were compared by t test,rank sum test or one factor analysis of variance test.The correlation between variables was used by Spearman correlation analysis.Results ① The expression of E2 in serum of the HC group was higher than that in the AH group [(38.7±10.2) pg/ml vs (33.7±8.6) pg/ml,Z=-0.356,P＜0.05].② The expression of ERα,GPR30 mRNA in PBMCs of HC group was increased,compared with that in the AH group (0.000 17±0.000 23 vs 0.000 12± 0.000 12,0.002 0±0.002 1 vs 0.001 5±0.000 8,Z=-2.112,-2.147,P＜0.05,respectively).No significant difference in PBMCs ERβ mRNA levels was found between HC group and AH group,while a slight but not significant increase was observed in HC group.③ The Spearman correlation analysis found that the expression of ERα and ERβ mRNA,E2 and GR,ERβ and GLU in the AH group were positively related (r=0.259,0.251,0.260,P＜0.05,respectively).Conclusion The expression of E2,ERα,ERβ,GPR30 mRNA in the peripheral blood of patients with AH is decreased,suggesting that the estrogen and its receptor may be involved in the patho-genesis of hyperuricemia.

Objective To investigate the characteristics of auditory P300 amplitude and latency and cognition in patients with clinical high-risk of psychosis (CHR). Method Thirty six CHR (study group) and thirty five healthy con?trols (control group) were included. Oddball paradigm and MATRICS Consensus Cognitive Battery (MCCB) were used to record auditory P300 and to evaluate the cognition, respectively. The structured interview for psychosis-risk syndromes (SIPS) was used to evaluate the clinic symptoms of patients. Result The cognition of CHR was significantly lower than healthy controls in information processing, attention/vigilance, working memory, verbal learning, visual learning, reason?ing and problem solving and social cognition (P<0.01). The study group showed decreased amplitude in Fz, Cz and Pz and delayed latency in Pz (P<0.05). P300 latency of CHR in Fz positively correlated with positive score of SOPS (r=0.544, P=0.001), while P300 amplitude positively correlated with verbal fluency (r=0.339,P=0.043). Conclusion Cogni?tion and P300 is abnormal in CHR. The correlation between P300 and clinical symptoms, cognitive dysfunction reminds that we should put more attention on the role of P300 in CHR subjects.

Objective To study the expression of aquaporin-4 (AQP-4) in core and marginal region of the contusion brain tissues from patients with severe traffic brain injuries. Methods Thirty patients with severe traffic brain injuries (frontal-temporal brain contusion) admitted into our department from January 2007 to July 2009 were enrolled in the study and divided into three groups according to the period from injury to operation, ie, 0-4 hours (Group A), 5-8 hours (Group B) and 9-12 hours (Group C). The tissue was collected from core and marginal regions of brain contusion in each group. Ten parts of normal brain tissues obtained from the cerebellum to gain good exposure of CPA region tumors were used as control. The expression of AQP-4 in the normal brain tissues and in the tissues from core and marginal region of brain contusion, with GAPDH used as a control. Results The expression of AQP-4 in the marginal region was distinctly higher than that in normal tissues and in the tissues from core region. The AQP-4 expression in the tissues of the core region was lower than that in normal tissues. Conclusions AQP-4 is highly expressed in the tissues from the marginal region early after injury in a time-dependent fashion. Low expression level of AQP-4 in the core region is possibly correlated with early damage of blood brain barrier and peripheral structures.

Objective To investigate the polymorphism of human cytomegalovius UL143 gene of low passage clinical isolates in Guangzhou,China.Method PCR was performed to amplify the entire HCMV ULl43 gene region of 3 clinical isolates,which had been proven by multiplex PCR.The amplification products were cloned into pMD18-T-Vector and subjected to sequencing.The result of DNA sequences were analyzed together with the one of published homologous sequences in GenBank from 14 clinical isolates.Result There were several stop codons in UL143 gene due to a base deletion in open reading frame (ORF) of D3 isolate,which could lead to produce non-functional protein.UL143 ORF of Toledo isolate consisted of 279 nueleotides,encoding a protein with 92 amino acids.UL143 ORFs of other isolates consisted of 252 nueleotides,encoding a protein with 83 amino acids.The DNA sequences were quite conserved and all the variations were base substitution.The amino acid sequences of different isolates were highly conserved.with variation of 1.2%-2.4%.There were no additional or deleted sites of post translational modification of UL143 protein in all clinical isolates except Toledo isolate.There were some differences in the secondary structure among different isolates.The isoelectric point of UL143 protein of all clinical isolates except Toledo isolate was 8.75.Conclusion All DNA and deduced amino acid sequences of UL143 gene shared great similarity among HCMV clinical strains regardless of their polymorphism.