Objective To investigate the correlation between serum retinol-binding protein 4 (RBP4) level and stroke severity and short-term outcome in patients with acute ischemic stroke.Methods From January 2017 to December 2017,patients with acute ischemic stroke admitted to the Department of Neurobgy,the Third Affiliated Hospital of Anhui Medical University and who did not receive thrombolytic or endovascular treatment were enrolled retrospectively within 2 weeks of onset.The serum RBP4 levels were measured within 24 h of admission and the demographics and baseline clinical data of the patients were documented.On the day of admission,the National Institutes of Health Stroke Scale (NIHSS) was used to assess the degree of neurological deficit;≤8 was defined as mild stroke and ＞8 was defined as moderate to severe stroke.The modified Rankin scale was used to assess the short-term outcomes at the time of discharge or 14 days after onset;0 to 2 were defined as good outcomes,and ＞ 2 was defined as poor outcome.Results A total of 235 patients were enrolled,including 101 females (43％) and 134 males (57％);aged (66.8 ± 1.7) years (range 28-93 years).There were 200 mild strokes (85.1％) and 35 moderate to severe strokes (14.9％);171 (72.8％) had good outcomes and 64 (27.2％) had poor outcomes.Univariate analysis showed that the serum RBP4 level in the moderate to severe stroke group was significantly lower than that in the mild stroke group (29.28 ± 10.43 mg/L vs.36.88 ± 10.61 mg/L;t =3.920,P ＜ 0.001),and the RBP4 level in the poor outcome group was significantly lower than that in the good outcome group (32.03 ± 11.33 mg/L vs.37.14± 10.44 mg/L;t=3.264,P=0.001).Multivariate logistic regression analysis showed that the high serum RBP4 level was independently correlated with the milder stroke severity (odds ratio 0.917,95％ confidence interval 0.874-0.962;P ＜0.001) and short-term poor outcome (odds ratio 0.955,95％ confidence interval 0.927-0.983;P =0.002).Conclusion In patients with high serum RBP4 levels,acute ischemic stroke is less severe and better in short-term outcomes.

Objective To investigate the risk factors and MRA manifests in the patients with cortical wa-tershed infarcts(CWSI)or internal watershed infarcts(IWSI).Methods We collected the patients with acute wa-tershed infarcts in our hospital from January 2013 to April 2016.According to the Bogousslavsky classification stan-dard,the patients were divided into two groups:CWSI and IWSI. The two groups were compared in terms of risk factors and MRA manifests. Results We included 36 CWSI and 11 IWSI patients in the study.There were signifi-cant differences in smoke,diabetes mellitus,fasting blood glucose levels and carotid atherosclerotic plaque be-tween the two groups,and so it was with the stenosis of ICA,MCA,ACA,PCA,VA and BA:The stenosis of ICA in the CWSI group was more serious than in the IWSI group,but the stenosis of MCA,ACA,PCA,VA and BA in the IWSI group was more serious than in the CWSI group. Conclusions The pathogenesis of CWSI may be related to the formation of carotid atherosclerotic plaques,carotid stenosis and arterial artery embolism,or plaque shedding and micro emboli removal.The pathogenesis of IWSI may be related to the decrease of the perfusion pres-sure at the end of the intracranial artery.The ratio of IWSI to diabetes mellitus is higher than that of CWSI,suggest-ing that the damage of diabetes to intracranial arteriole is earlier than that of intracranial and extracranial arteries.

Objective To assess the cerebrovascular reserve (CVR)and the relationship of CVR with the short-term prognosis in patients with acute atherosclerotic cerebral infarction.Methods A total of 106 patients with unilateral acute (within 72 h) atherosclerotic cerebral infarction (trial group) were selected from December 2016 to December 2017 in the Department of Neurology of the First People's Hospital of Hefei,which were divided into two groups including the lesion group (106 cases) and the nonlesion group (106 cases).The median score of NIHSS in patients was 4(2,5).The control group included 40 healthy controls.The cerebral blood flow reserve and pulsatility index were measured by transcranial Doppler combined with CO2 inhalation test in both the trial group and the control group.According to the rate of change of cerebral blood flow velocity (CBFV),all subjects were divided into two groups including the normal group and the impaired cerebral blood flow reserve group.The changes of CBFV were compared in the control group and the trial group,which was divided into two groups including the group with lesion side and the group with non-lesion side.To evaluate the brain structure reserve the circle of Willis in the trial group was assessed by MRA.According to the integrity of the circle of Willis anterior and posterior circulation all subjects were divided into four groups (type Ⅰ,type Ⅱ,type Ⅲ and type Ⅳ).The effect of the factors,such as diabetes,hypertension,low density lipoprotein (LDL),high density lipoprotein (HDL),smoking,and drinking history,on cerebral blood flow reserve was measured by single-factor analysis.The correlation of NIHSS scores,infarct size and volume with CVR was also measured.All patients in the trial group were treated with drugs and were followed-up for three months.The modified Rankin Scale (Mrs) was used to evaluate the prognosis of the patients.It means poor prognosis if the value of Mrs was more than three.The effects of factors,such as sex,HDL,LDL,diabetes,hypertension,smoking history,drinking history,cerebral blood flow reserve,NIHSS scores,brain structure reserve,infarct location,age,on the prognosis were measured by multivariate Logistic regression.Results The increase rate of CBFV in the lesion-side of patients with atherosclerotic cerebral infarction was 5.94％ (2.18％,10.49％),and the increase rate of pulsatility index was 10.77％ (2.21％,22.62％),which were both lower than the control group (CBFV:11.54％ (5.01％,17.96％),Z =2.547,P＜0.05);pulsatility index:48.36％ (33.93％,64.51％),Z =6.604,P ＜ 0.01).There was significant difference (x2 =4.328,P ＜ 0.05) in the distribution of diabetes,which was 2/14 in the normal group and 43.48％ (40/92) in the impaired cerebral blood flow reserve group.And in the trial group the brain structural reserve was positively correlated to the infarct volume and the NIHSS score,and the rank correlation coefficient was 0.219 and 0.238 respectively (P ＜ 0.05).The prognosis of cerebral blood flow reserve in the normal group was better than the impaired group (x2 =4.155,P ＜ 0.05),for example,the proportion of patients with good prognosis and normal CBFV was 18.84％ (13/69),the proportion of patients with good prognosis but decreased CBFV was 81.16％ (56/69),the proportion of patients with poor prognosis but normal CBFV was 2.70％ (1/37),the proportion of patients with poor prognosis and decreased CBFV was 97.30％ (36/37).The proportion of patients with type Ⅰ and type Ⅲ of the brain structure reserve was 37.68％ (26/69) and 5.80％ (4/69) respectively,whose prognosis was better (x2 =8.456,P ＜ 0.05) than patients with type Ⅱ and type Ⅳ,whose proportion was 43.48％ (30/69) and 13.04％ (9/69).Multivariate Logistic regression analysis showed that NIHSS score,age,and brain structural reserve were risk factors for poor prognosis in the trial group.Normal cerebral blood flow reserve was a protective factor for good prognosis.Conclusions CVR in patients with acute atherosclerotic cerebral infarction is significantly reduced.CVR can be used as an index to evaluate the prognosis of patients who were followed-up for three months.

Objective To compare the clinical value of uterine submucosal myoma classification by two dimensional and three-dimensional contrast-enhanced ultrasonography and surgical pathologic results.Methods The imaging data of ultrasonographic hysterography including 2D and 3D of 124 patients with uterine submucosal myoma were retrospectively analyzed,and the results were compared with the surgical pathologic results.The diagnostic accuracy of uterine submucosal myoma classification and the operation success rate of uterine submucosal myoma for Ⅰ grade by ultrasonographic hysterography including 2D and 3D were compared.Results The patients were diagnosed pathologically with 0,Ⅰ and Ⅱ grade of uterine submucosal myoma in 26 cases,52 cases,68 cases,respectively.The patients were diagnosed by 2D ultrasonic sonohysterography with 0 grade,Ⅰ grade and Ⅱ grade of uterine submucosal myoma in 26 cases,62 cases,58 cases,respectively.The patients were diagnosed by 3D ultrasonic sonohysterography with 0,Ⅰ and Ⅱ grade of uterine submucous myoma in 26 cases,52 cases,68 cases,respectively.For pathological results as thegold standard,the diagnostic sensitivity,specificity and accuracy of uterine submucosal myoma for 0 grade by 2D and 3D ultrasonic sonohysterography were all 100.00％.The diagnostic sensitivity,specificity and accuracy of uterine submucosal myoma for Ⅰ and Ⅱ grade by 2D ultrasonic sonohysterography were 92.32％,79.46％,85.00％,respectively.The diagnostic sensitivity,specificity and accuracy of uterine submucosal myoma for Ⅰ and Ⅱ grade by 3D ultrasonic sonohysterography were 96.24％,88.24％,91.76％,respectively.There were significant differences in the diagnostic sensitivity,specificity and accuracy of submucosal myoma of uterus for Ⅰ and Ⅱ grade by 2 D and 3 D ultrasonic sonohysterography (x2 =3.21,2.78,2.17,2.33,all P ＜ 0.05).The patients diagnosed as uterine submucous myoma for 0 grade all underwent the hysteroscopic surgery for successful resection,while the patients with uterine submucous myoma for Ⅱ grade underwent laparoscopic surgery or open surgery.The operation success rates of uterine submucous myoma for Ⅰ grade by hysteroscopic surgery diagnosed by 2D and 3D ultrasonic sonohysterography were 75.81％,98.07％,respectively.The operation success rate of uterine submucous myoma for Ⅰ grade by hysteroscopic surgery diagnosed by 3D ultrasonic sonohysterography was significantly higher than that diagnosed by 2D ultrasonic sonohysterography (x2 =7.15,P ＜ 0.05).Conclusion The accuracy of uterine submucosal myoma classification by 3D ultrasonographic hysterography is better than 2D ultrasonographic hysterography.

The atherosclerotic plaque and stenosis in the carotid artery are the important causes of ischemic stroke. Evaluation of cerebrovascular reserve capacity in patients with carotid stenosis is beneficial to screening high-risk stroke patients. This article reviews the evaluation methodology of cerebrovascular reserve and its application in patients with carotid stenosis.

Objective To analyze the influence of human papilloma virus (HPV) infection on puerperas and fetus in pregnant women.Methods A total of 116 pregnant women with infection of human papilloma virus were selected as experimental group,while 116 healthy pregnant women were selected as control group.Parturient in amniotic fluid,placenta and fetal umbilical venous blood,oropharyngeal secretion and vulva secretion of HPV were detected,and maternal HPV infection type was analyzed.After one year of follow up,the effect of HPV infection on maternal and fetal were observed.Results In the experimental group,single HPV infection and high-risk HPV infection were the main types,and the proportions were 66.38％ and 76.72％ respectively.The risk factors of HPV infection were cervical abnormality and cytology examination.There were no significant differences in the mode of delivery,postpartum hemorrhage and fetal growth restriction (P ＞ 0.05).There were no significant differences in the HPV positive rates in the amniotic fluid,placenta and umbilical venous blood,oropharynx,vulva secretion or wrapping secretion between fetus with normal vaginal delivery and cesarean delivery (P ＞ 0.05).The infection rate of fetal HPV was 24.14％.Conclusion Single type HPV infection and high risk type HPV infection are the main types in pregnant women with HPV infection.

Objective To analyze the influence of human papilloma virus (HPV) infection on puerperas and fetus in pregnant women.Methods A total of 116 pregnant women with infection of human papilloma virus were selected as experimental group,while 116 healthy pregnant women were selected as control group.Parturient in amniotic fluid,placenta and fetal umbilical venous blood,oropharyngeal secretion and vulva secretion of HPV were detected,and maternal HPV infection type was analyzed.After one year of follow up,the effect of HPV infection on maternal and fetal were observed.Results In the experimental group,single HPV infection and high-risk HPV infection were the main types,and the proportions were 66.38％ and 76.72％ respectively.The risk factors of HPV infection were cervical abnormality and cytology examination.There were no significant differences in the mode of delivery,postpartum hemorrhage and fetal growth restriction (P ＞ 0.05).There were no significant differences in the HPV positive rates in the amniotic fluid,placenta and umbilical venous blood,oropharynx,vulva secretion or wrapping secretion between fetus with normal vaginal delivery and cesarean delivery (P ＞ 0.05).The infection rate of fetal HPV was 24.14％.Conclusion Single type HPV infection and high risk type HPV infection are the main types in pregnant women with HPV infection.

Objective To investigate the emotional memory characteristic in patients with leuloaraiosis(LA) and explore the neurobiological mechanisms through observing the changes of emotional memory.Methods Different valence images (including positive,neutral and negative pictures) were used to test twenty-four patients with Leuloaraiosis(LA group)and twenty-four healthy colltrols(HC group) at the same time.The emotional memory was evaluated by the recognition of emotional pictures.Results In appraisal of the emotional pictures,there was no significant difference between patients with LA (positive (10.42±2.30) and neulral (12.87±2.29),respectively) and healthy controls (positive (11.38 ± 3.25) and neutral (12.75 ± 2.86),respectively) in positive and negative appraisal (all P＞0.05).But the negative appraisal decreased between LA group (11.63 ± 1.81) and HC group (12.75 ± 2.02) (P＞ 0.05).Compared with healthy controls (38.08+±5.45),patients with LA(33.67±7.10) showed sharply decline in the emotional images memorizing task(P＜0.05).And the accuracy in recognizing positive and netural valence pictures in patients with LA ((Positive(11.04±2.40) and neulral (10.42±2.93)) was significantly lower than that in healthy controls ((positive(12.79±2.17) and neutral(12.08±2.59))(P＜0.05).But in negative stimulus,there was no significant difference between LA group(13.20± 1.86)and HC group(12.20±2.65) (P＞0.05).In addition the total correct recognition,positive and neutral valence in pictures recognition were negativly correlated with the se verity of white matter lesions in the LA patients group(r=-0.308,P=0.033;r=-0.462,P=0.003;r=-0.352,P=0.014).Conclusion The emotional memory is impaired in patients with LA,and the degree of damage is accompornied with the severity degree of LA.The emotional memory for positive and neutral vanlence pictures is impaired but the emotional memory for neutral is relatively reserved in patients with LA in pictures recognition phase.It suggests that impaired emotional memory with different valences may be related to different neuromechanisms.

Objective To investigate the emotional memory impairment in patients with primary insomnia (PI) and explore the neurobiological mechanisms underlying primary insomnia through emotional memory tasks involving different valance of emotional pictures.Methods Thirty patients with primary insomnia(PI group) and twenty healthy controls(HC group) were given emotional memory tasks using positive,neutral and negative valence images.The emotional memory was evaluated by the recognition of emotional pictures.Results Compared with healthy controls (positive (11.60±4.00) , neutral (11.05± 3.73) and negative (12.60± 2.06) , respectively), patients with PI (positive (11.30±3.75),neutral (11.47±3.21) and negative (11.43±4.12) ,respectively) showed no significant difference in appraisal of the emotional pictures (P＞0.05).Compared with healthy controls (43.40± 4.88) for the emotional images memorizing task,patients with PI (39.40±6.43) exhibited evident deficit of all emotional images (P＜0.05).Furthermore, the accuracy in recognizing both positive (12.60± 2.42) and neutral (12.87±3.18) valence pictures were significantly lower in patients with P1 than those in healthy controls(positive (14.05±2.19) and neutral (14.75± 1.80)) (P＜0.05).There was no significant difference in negative stimulus between PI group(13.93±1.76) and HC group(14.70±1.59) (P＞0.05).Conclusion The results suggest thant emotional memory is impaired in patients with PI.Moreover,the emotional memory for positive and neutral vanlence pictures is impaired but the emotional memory for negative is relatively spared in patients with primary insomnia.The results also indicate that impaired emotional memory with different valences may relate with distinct neuromechanisms.

Objectives To compare the migrating motor complex (MMC) in irritable bowel syndrome (IBS) patients with that in healthy controls. To explore whether discrete clustered contractions (DCC) are connected with abdominal pain in IBS patients. To improve the method of measuring gastroenteric motility (esp. jejunum). Methods By using 16-channel water-perfused catheter and manometry instruments, MMC in 16 cases of IBS with constipation (IBS-C), 18 cases of IBS with diarrhea (IBS-D) and 18 cases of healthy controls were monitored. Results The MMC durations of IBS-C and IBS-D patients were (127.5±25.5) min and (74.5±18.7) min, respectively. Comparision with those in the control group [(87.5±24.2) min]showed significant differences (P<0. 001). The contraction amplitudes of stage Ⅲ in different sites of IBS-C patients decreased significantly as compared with those in the controls [jejunum, (39.8±11.7) mm Hg vs. (61.1±14.1) mm Hg,P<0.001,1 mm Hg=0.133 kPa]. The propagation velocities of stage Ⅲ in different sites of IBS-C patients also decreased significantly as compared with those in the controls [jejunum, (1.8±0.9) cm/min vs. (2.6±0.8) cm/min,P<0.01].The contraction amplitudes of stage Ⅲ in different sites of IBS-D patients increased significantly as compared with those in the controls [jejunum, (69.7±20.5) mm Hg vs. (61.1±14.1) mm Hg, P<0.01]. The propagation velocities of stage Ⅲ in different sites of IBS-D patients also increased significantly as compared with those in the controls [jejunum, (4.1±2.5) cm/min vs. (2.6±0.8) cm/min, P < 0. 01]. DCC incidences of IBS-C and IBS-D were 87.5% and 88. 8%, respectively. Comperision with those in the normal group (83.3%) did not show significant difference (P>0.05). The prevalences of abnormal stage Ⅲ contractions (include disturbances and interferences of stage Ⅲ contractions) in IBS-C and IBS-D patients were 68.8% and 66. 7%, respectively; there were no significant differences between the two groups (P > 0. 05). However abnormal stage Ⅲ contractions did not exist in healthy controls. Conclusions (1) The MMC of IBS-C and IBS-D patients are changed, as compared with that in healthy people; this implies that small intestinal motility dysfunction is one of the pathogenetic factors of IBS. The abnormal stage Ⅲ contractions in jejunum may be a predominant change in IBS gastroenteric motility. (2) No apparent connection is found between DCC and pain in IBS. (3) By using 16-channel water-perfused catheter, we first carried out the method of monitoring jejunum contractions in China. Parameters of MMC in Chinese healthy people were investigated, esp. those of jejunum.