Objective To investigate the changes in cerebral blood flow(CBF)and whole-brain functional connectivity(FC)in patients with neuromyelitis optica spectrum disorder(NMOSD)examined by conventional MRI.Methods Twenty-two patients with NMOSD and 25 matched healthy controls(HC)were included,and all subjects'conventional MRI sequences,arterial spin labeling(ASL),and resting-state functional magnetic resonance imaging(rs-fMRI)image data were acquired,and the brain regions with CBF differences between groups extracted based on ASL were used as seed points for whole-brain FC analysis,the FC differences between the groups were compared,and the correlation between the parameter values and the expanded disability status scale(EDSS)scores were analyzed.Results NMOSD patients exhibited a decrease in CBF value in the right supratemporal gyrus,bilateral calcarine fissure and right supplementary motor area,while the right middle temporal gyrus displayed an increase when compared to HC.Whole-brain FC analysis based on seed points revealed an increase in FC value between bilateral calcarine fissure and olfactory cortex,as well as between right supplementary motor area and left superior frontal gyrus.While FC value between the right supplementary motor area and left precentral gyrus,bilateral thalamus,right supraoccipital gyrus were decreased.The FC value between the right supratemporal gyrus and right inferior parietal lobule,left supratemporal gyrus,right precuneus lobes showed a decrease[Gaussian random field(GRF)-corrected,P＜0.05].There was a correlation between CBF values of bilateral calcarine fissure and EDSS scores in NMOSD patients(rs=-0.456,P=0.033).Conclusion There are CBF and FC abnormalities in multiple brain regions in NMOSD patients,which provide imaging basis and insights for the brain micropathological changes of NMOSD,and help to understand the pathology and neural mechanism of NMOSD.

Background In mainland China, patients with neovascular age-related macular degeneration (nAMD) have approximately an 40% prevalence of polypoidal choroidal vasculopathy (PCV). This disease leads to recurrent retinal pigment epithelium detachment (PED), extensive subretinal or vitreous hemorrhages, and severe vision loss. China has introduced various treatment modalities in the past years and gained comprehensive experience in treating PCV.Methods A total of 14 retinal specialists nationwide with expertise in PCV were empaneled to prioritize six questions and address their corresponding outcomes, regarding opinions on inactive PCV, choices of anti-vascular endothelial growth factor (anti-VEGF) monotherapy, photodynamic therapy (PDT) monotherapy or combined therapy, patients with persistent subretinal fluid (SRF) or intraretinal fluid (IRF) after loading dose anti-VEGF, and patients with massive subretinal hemorrhage. An evidence synthesis team conducted systematic reviews, which informed the recommendations that address these questions. This guideline used the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach to assess the certainty of evidence and grade the strengths of recommendations. Results The panel proposed the following six conditional recommendations regarding treatment choices. (1) For patients with inactive PCV, we suggest observation over treatment. (2) For treatment-na?ve PCV patients, we suggest either anti-VEGF monotherapy or combined anti-VEGF and PDT rather than PDT monotherapy. (3) For patients with PCV who plan to initiate combined anti-VEGF and PDT treatment, we suggest later/rescue PDT over initiate PDT. (4) For PCV patients who plan to initiate anti-VEGF monotherapy, we suggest the treat and extend (T&E) regimen rather than the pro re nata (PRN) regimen following three monthly loading doses. (5) For patients with persistent SRF or IRF on optical coherence tomography (OCT) after three monthly anti-VEGF treatments, we suggest proceeding with anti-VEGF treatment rather than observation. (6) For PCV patients with massive subretinal hemorrhage (equal to or more than four optic disc areas) involving the central macula, we suggest surgery (vitrectomy in combination with tissue-plasminogen activator (tPA) intraocular injection and gas tamponade) rather than anti-VEGF monotherapy. Conclusions Six evidence-based recommendations support optimal care for PCV patients' management.

Selective dorsal neurotomy (SDN) is a surgical treatment for primary premature ejaculation (PE), but there is still no standard surgical procedure for selecting the branches of the dorsal penile nerves to be removed. We performed this study to explore the value of intraoperative neurophysiological monitoring (IONM) of the penile sensory-evoked potential (PSEP) for standard surgical procedures in SDN. One hundred and twenty primary PE patients undergoing SDN were selected as the PE group and 120 non-PE patients were selected as the normal group. The PSEP was monitored and compared between the two groups under both natural and general anesthesia (GA) states. In addition, patients in the PE group were randomly divided into the IONM group and the non-IONM group. During SDN surgery, PSEP parameters of the IONM group were recorded and analyzed. The differences in PE-related outcome measurements between the perioperative period and 3 months' postoperation were compared for the PE patients, and the differences in effectiveness and complications between the IONM group and the non-IONM group were compared. The results showed that the average latency of the PSEP in the PE group was shorter than that in the normal group under both natural and GA states (P < 0.001). Three months after surgery, the significant effective rates in the IONM and non-IONM groups were 63.6% and 34.0%, respectively (P < 0.01), and the difference in complications between the two groups was significant (P < 0.05). IONM might be useful in improving the short-term therapeutic effectiveness and reducing the complications of SDN.
Male ; Humans ; Premature Ejaculation/surgery* ; Intraoperative Neurophysiological Monitoring/methods* ; Prospective Studies ; Neurosurgical Procedures/methods* ; Penis/surgery* ; Retrospective Studies

Objective To investigate the sensitivity of adult worms of filial generations from praziquantel-resistant and -sensitive Schistosoma japonicum mixed infections to praziquantel. Methods Mice were infected with the cercariae of an experimentally generated praziquantel-resistant S. japonicum isolate [median effective dose (ED₅₀) = 277.4 mg/kg] and a laboratory-maintained praziquantel-sensitive S. japonicum isolate (ED₅₀ = 99.6 mg/kg) at a mixture ratio of 1:1 and 2:1, which was maintained in the laboratory via the mouse-snail cycle for 8 generations. Then, mice were infected with the cercariae of the 8th filial-generation parasite, and grouped 35 days post-infection. Mice in the 5 treatment groups were given praziquantel treatment by gavage at a single oral dose of 37.5, 75, 150, 300 mg/kg and 600 mg/kg, while animals in the control group was administered orally with 2.5% cremophor EL. All mice were sacrificed 14 days post-treatment and adult worms were collected by perfusion of the portal vein. The worm burden reductions and praziquantel ED₅₀ values were calculated. The praziquantel-resistant S. japonicum isolate generated from experimental induction with 12 rounds of praziquantel treatment with sub-curative doses was maintained in the laboratory via the mouse-snail cycle, and mice were infected with the cercariae of the 8th filial-generation parasite. The praziquantel ED₅₀ value against the 8th filial-generation adults was measured. Results After mice were infected with the mixture of cercariae of PZQ-resistant and -sensitive S. japonicum isolates at a ratio of 1:1, the praziquantel ED₅₀ was 135.2 mg/kg against the adults of the 8th filial-generation parasite. After mice were infected with the mixture of cercariae of PZQ-resistant and -sensitive S. japonicum isolates at a ratio of 2:1, the praziquantel ED₅₀ was 129.2 mg/kg against the adults of the 8th filial-generation parasite. In addition, the praziquantel ED₅₀ was 208.4 mg/kg against the adults of the 8th filial-generation S. japonicum without the selection pressure of praziquantel. Conclusions Compared with the experimentally induced praziquantel-resistant S. japonicum isolate, the adult worms of the filial-generation S. japonicum show a reduced sensitivity to praziquantel in the same host following infection with the mixture of cercariae of praziquantel-resistant and -sensitive S. japonicum isolates. The adult worms of the filial generation of the praziquantel-resistant S. japonicum isolate without the selection pressure of praziquantel may still maintain the resistance to praziquantel.

Objective:To investigate the effect of strength training of hip muscles on functional ankle instability (FAI), and be evaluated with surface electromyography (sEMG). Methods:From January, 2019 to June, 2020, 60 FAI patients were recruited in Qingdao Municipal Hospital. They were divided into control group (n = 30) and observation group (n = 30) randomly. The control group received conventional therapy, including ankle joint mobilization training, strength training and balance training for six weeks, while the observation group received strength training of hip muscles in addition. Cumberland Ankle Instability Tool (CAIT), Star Excursion Balance Test (SEBT) and sEMG were used to assess the function before and after intervention, and integrated electromyography (iEMG) was measured with sEMG. The correlation of CAIT and SEBT to iEMG was analyzed with Pearson coefficient. Results:No one dropped out. Before intervention, there was no significant difference between CAIT, SEBT and iEMG between two groups (P > 0.05). CAIT and SEBT improved significantly in both groups (t > 3.657, P < 0.001) after six-week intervention; the iEMG increased significantly in the observation group (t > 22.038, P < 0.001), while no significance was found in the control group (t < 1.916, P > 0.05); all the indexes were better in the observation group than in the control group (t > 2.125, P < 0.05). iEMG of gluteus medius and gluteus maximum correlated to CAIT and SEBT in the observation group (r = 0.712 to 0.866, P < 0.05). Conclusion:The strength training of the hip muscles could improve the ankle function of FAI patients. iEMG of gluteus medius and gluteus maximum could be a valid measure to assess the effect of strength training on FAI.

Objective To compare the difference of fertility of Biomphalaria glabrata snails between self-fertilization and cross-fertilization and to observe the circadian rhythm of laying eggs, the effect of light on laying eggs and the tolerance of the snail to water and food deficiency, so as to provide the evidence for control and elimination of B. glabrata snails in the field. Methods Under laboratory conditions, a single B. glabrata egg for self-fertilization was separated and hatched individually, and young snails were raised in different plastic boxes individually. The eggs for cross-fertilization were hatched and the young snails were fed in the same plastic box. The ability of spawn, the development of the eggs, and the number of snails growing from young to adult snails were compared between the self-fertilization and cross-fertilization. The snails were in the water under four environments, all day illumination, all day without illumination, daytime lighting and night without illumination, and daytime without illumination but night lighting. The eggs were collected and counted daily. The circadian rhythm of spawn and the effect of illumination on spawn were observed. The adult snails were divided into 6 groups and exposed to the environments with relative humidity of 0, 65%, 87% and 100%, respectively. The survival rates of the adult snails exposed to the different environments after different time were observed. The adult snails were placed at 25 °C in the oven to remove water content from the soft body of snails. When the dehydration rates of the soft bodies achieved 10%, 20%, 30%, 40%, 50%, 52%, 55%, 57%, 60%, and 70% respectively, the survival rates of the adult snails exposed to the oven were observed. Results In the 25 °C water, the average laying egg number for 15 days per snail was (8.77 ± 16.92) eggs/snail in the self-fertilization snail. The average laying egg number for 15 days per snail was (149.71 ± 142.28) eggs/snail in the cross-fertilization snails. There was a significant difference between the self-fertilization snail and cross-fertilization snail (t = 0.999 999, P < 0.01). The hatching rate and reproductive maturation rate of the self-fertilization snails and cross-fertilization snails were 50.1% and 78.9%, and 19.3% and 3.8%, respectively, There was a significant difference (the hatching rate: χ² = 18.18, P < 0.01, the reproductive maturation rate: χ² = 11.83, P < 0.01) . In the natural environment of daytime with illumination and nighttime with darkness, the amount of laying 20 eggs of B. glabrata snail was (944.07 ± 392.53) eggs/day during a whole day, among them the amount of laying eggs during daytime account for 10.1% and the amount of laying eggs during nighttime account for 89.9%, and the laying egg was given priority to with the night. The above results suggested that the dark environment was conducive to B. glabrata snails to lay eggs. The above results suggested that light can promote the increase of spawning of B. glabrata. When B. glabrata was exposed to the environments with the relative humidity of 0, 65%, 87% and 100% at 25 °C, respectively, and the longest survival times of snails were 7, 70, 150 d and 100 d, respectively. In the 25 °C water, the snails could survive for 50 days without food. The adult snails were placed at 25 °C in the oven to remove water content from the soft body of snails. When the dehydration rates of the soft bodies achieved 10%, 20%, 30%, 40%, 50%, 52%, 55%, 57%, 60%, and 70% respectively, the survival rates of the adult snails exposed to the oven were 100%, 100%, 100%, 100%, 70%, 30%, 0, 0, 0 and 0, respectively. Conclusions B. glabrata can achieve the reproductive process by cross-fertilization or self-fertilization. There is a significant difference in reproductive ability between the cross-fertilization snail and self-fertilization snail, cross-fertilization is stronger than self-fertilization, but the rate of reproduction in the self-fertilization is higher than that in the cross-fertilization. It is indicated that B. glabrata that survive after the dry season plays an important role in the maintenance of local snail populations and transmission of schistosomiasis mansoni.

Objective: To compare the prognosis of intra-aortic balloon pump (IABP) supported primary percutaneous coronary intervention (PPCI) between very elderly (age ≥ 80 years) and elderly (age < 80 years) patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 288 STEMI patients received IABP supported PPCI in our hospital from 2004-01 to 2015-12 were retrospectively studied. Clinical condition, coronary angiography and follow-up data were analyzed; the patients with pre-operative cardiac shock, mechanical complication and non ST-segment elevation acute coronary syndrome were excluded. Eligible patients were divided into 2 groups: Very elderly group, n=51 and Elderly group, n=237. Major adverse cardiac and cerebral events (MACCE) as death, cardiac shock, new or worsen heart failure, re-MI and stroke were studied at 1 month and 1, 2 years after PPCI. Independent predictors for MACCE occurrence were investigated by Cox proportional hazard model analysis.Results: Compared with Elderly group, Very elderly group had increased incidence of MACCE at 1 month after PPCI (41.2% vs 24.5%), P=0.029 and obviously elevated incidence of stroke (9.8% vs 0.8%), P<0.001. Mortalities were similar between 2 groups at 1 month and 1 year after PPCI (17.6% vs 15.2%) and (25.5% vs 16.9%), both P>0.05; mortality was higher in Very elderly group at 2 years after PPCI (35.3% vs 20.7%), Log-rank P=0.037. Cox proportional hazard model analysis indicated that post-operative TIMI flow < 3 was the strong independent predictor for MACCE occurrence (HR=3.41, 95% CI 2.09-5.56, P<0.001), which was also the strongest predictor for death at different time points as at 1 month after PPCI (HR=9.51, 95% CI 5.23-17.29), at 1 year after PPCI (HR=7.24, 95% CI 4.13-12.69) and at 2 years after PPCI (HR=5.85, 95% CI 3.45-9.94), all P<0.001. Patients ≥ 80 years had no obvious predictors for end point event occurrence. Conclusion: Very elderly STEMI patients had the higher mortality at 2 years after IABP supported PPCI and increased incidence of MACCE at 1 month after PPCI. Patients≥80 years had no obvious predictors for end point event occurrence.

Objective To predict the colonization risk and potential geographical distribution of Biomphalaria glabrata in the Mainland China based on the past period temperature data.Methods The survival extreme high temperatures and low tem-peratures of B.glabrata eggs,young and adult B.glabrata snails and the average effective accumulated temperature of genera-tion development were determined in laboratory conditions.The temperature data in January and July from 1955 to 2010 were collected from the national meteorological monitoring sites in the southern part of China,including Chongqing,Zhejiang,Yun-nan,Sichuan,Jiangxi,Hunan,Hainan,Guizhou,Guangdong,Guangxi and Fujian provinces(11 provinces).A database of ambient temperature related to B.glabrata was established based on the Geographic Information System(GIS).The colonization risk and potential geographical distribution of B.glabrata in the southern part of China were analyzed and predicted by ArcGIS 10.1 software.Results The half lethal low temperatures of B.glabrata eggs,young and adult B.glabrata snails were 6.80,6.34℃ and 6.60℃ respectively;the half lethal high temperatures of B.glabrata eggs,young and adult B.glabrata snails were 35.99,33.59℃ and 32.20℃,respectively.The developmental threshold temperature was 7.16℃;the average effective accumu-lated temperature of generation development was(1 970.07 ± 455.10)days-degree.The GIS overlay analysis of the half lethal low and high temperatures of B.glabrata showed that the local temperature conditions in all Hainan and part regions in Yunnan,Guangxi,Guangdong and Fujian were conformed to the survival temperature of B.glabrata snails.The regions,where the aver-age effective accumulated temperature was more than the average effective accumulated temperature of generation development of B.glabrata,were Guangdong and Hainan,and part regions of other 9 provinces.The overlay analysis of GIS maps of the sur-vival extreme high temperatures and low temperatures of B.glabrata with the GIS map of the average effective accumulated tem-perature of generation development in 2010 showed that the whole region of Hainan and part regions of Guangdong,Guangxi,Yunnan and Fujian were potential geographical distribution regions of colonization risk of B.glabrata.The overlay analysis of GIS maps of the survival extreme high temperatures and low temperatures of B.glabrata with the GIS map of the average effective accumulated temperature of generation development from 1955 to 2010 showed that the potential geographical distribution re-gions of B.glabrata was expanding from the whole region of Hainan and part regions of Guangdong in 1955 to the whole region of Hainan and part regions of Guangdong,Guangxi,Yunnan and Fujian in 2010.Conclusions If B.glabrata snails were intro-duced into the Mainland China,the potential geographical distribution regions would be the whole region of Hainan and part re-gions of Guangdong,Guangxi and Yunnan.The changes of risk range and risk intensity present the trends of expanding and in-creasing from the south to the north gradually.

Background Giant idiopathic macular hole (IMH) severely affects visual acuity and increases operative difficulty during the surgery,so modifying or optimizing the operation method is helpful for improving the prognosis.Objective This study aimed to evaluate the efficacy and safty of vitrectomy combined with free internal limiting membrane transplantation for large IMH.Methods A prospective serial cases-observational study was carried out under the informed consent of each patient.Forty-two eyes of consecutive 42 patients with IMH of mean diameter (814.31±112.95)μm were included in the Second Hospital of Hebei Medical University from January 2013 to November 2015.All the eyes received vitrectomy combined with free internal limiting membrane transplantation and 12％ C3F8 filling.The best corrected visual acuity (BCVA) (LogMAR),inner segment/outer segment (IS/OS) defect range,external limiting membrane defect range,retinal thickness at macular fovea were measured with slit lamp microscope,indirect ophthalmoscope and spectral-domain optical coherence tomography (SD-OCT) before surgery and 1,3,6 and 12 months after surgery.Results IMH complete closure in 97.6％ eyes (41/44) at 12 months after surgery.BCVA was improved after operation and showed a significant difference among various time points (F =28.032,P＜0.001).The IS/OS defect range was (1 112.00±45.44),(859.00±84.55),(649.00±52.47),(486.00±46.88) and (320.00±45.13) μm before surgery and 1,3,6 and 12 months after surgery,showing a significant difference among different time points (F=38.761,P＜0.001),and the IS/OS defect range was gradually shrinked after operation compared with that before operation (all at P＜0.05).The mean defect range of external limiting membrane was (1 038.00 ±39.63),(748.00±64.12),(585.00±48.88),(438.00±42.84) and (265.00±28.97)μm before surgery and 1,3,6 and 12 months after surgery,with a significant difference among various time points (F=36.459,P＜0.001),and the mean defect range of external limiting membrane was evidently reduced (all at P＜0.05).The foveal retinal thickness value was increased at 3,6 and 12 months after surgery,which was significantly higher than that 1 month after surgery (all at P＜0.05).The high reflect signal was faded away at 3 months after operation,indicating that implanted internal limiting membrane was decomposed and metabolized.Conclusions Vitrectomy combined with autologous internal limiting membrane transplantation seems to be safe and effective for large IMH.

Objective: To investigate the effect and safety of contrast-enhanced ultrasonography (CEUS) in the diagnosis of venous erectile dysfunction (VED). METHODS: From June 2015 to March 2016, 43 ED patients underwent corpus cavernography, of whom 23 were diagnosed with and the other 20 without corpus cavernosal venous leakage (CCVL). All the patients received intracorporal injection of a vasoactive drug and CEUS. RESULTS: Of the 23 patients with CCVL, 21 were confirmed by CEUS, including 12 cases of double venous leakage, 2 cases of single venous leakage, 5 cases of crural venous leakage, and 2 cases of the mixed type, while the other 2 showed no CCVL on CEUS. Of the 20 patients with CCVL, 2 presented CCVL on CEUS. CONCLUSIONS CEUS has the advantages of accuracy, safety, and less invasiveness in the diagnosis of VED.
Contrast Media ; Humans ; Impotence, Vasculogenic ; diagnostic imaging ; Injections ; Male ; Penis ; blood supply ; diagnostic imaging ; Ultrasonography ; methods ; Veins