Objective: Some pharmacological treatments are ineffective in parts of patients with major depressive disorder (MDD), hence this needs prediction of effective treatment responses. The study aims to examine the relationship between dynamic functional connectivity (dFC) of the hippocampal subregion and antidepressant improvement of MDD patients and to estimate the capability of dFC to predict antidepressant efficacy. Methods: The data were from 70 MDD patients and 43 healthy controls (HC); the dFC of hippocampal subregions was estimated by sliding-window approach based on resting-state functional magnetic resonance imaging (R-fMRI). After 3 months treatment, 36 patients underwent second R-fMRI scan and were then divided into the response group and non-response group according to clinical responses. Results: The result manifested that MDD patients exhibited lower mean dFC of the left rostral hippocampus (rHipp.l) compared with HC. After 3 months therapy, the response group showed lower dFC of rHipp.l compared with the non-response group. The dFC of rHipp.l was also negatively correlated with the reduction rate of Hamilton Depression Rating Scale. Conclusion These findings highlighted the importance of rHipp in MDD from the dFC perspective. Detection and estimation of these changes might demonstrate helpful for comprehending the pathophysiological mechanism and for assessment of treatment reaction of MDD.

Receptor activity-modulating proteins (RAMPs) are accessory molecules that form complexes with specific G protein-coupled receptors (GPCRs) and modulate their functions. It is established that RAMP interacts with the glucagon receptor family of GPCRs but the underlying mechanism is poorly understood. In this study, we used a bioluminescence resonance energy transfer (BRET) approach to comprehensively investigate such interactions. In conjunction with cAMP accumulation, Gα _q activation and β-arrestin1/2 recruitment assays, we not only verified the GPCR-RAMP pairs previously reported, but also identified new patterns of GPCR-RAMP interaction. While RAMP1 was able to modify the three signaling events elicited by both glucagon receptor (GCGR) and glucagon-like peptide-1 receptor (GLP-1R), and RAMP2 mainly affected β-arrestin1/2 recruitment by GCGR, GLP-1R and glucagon-like peptide-2 receptor, RAMP3 showed a widespread negative impact on all the family members except for growth hormone-releasing hormone receptor covering the three pathways. Our results suggest that RAMP modulates both G protein dependent and independent signal transduction among the glucagon receptor family members in a receptor-specific manner. Mapping such interactions provides new insights into the role of RAMP in ligand recognition and receptor activation.

Objective:To discuss the surgical strategies of atlantoaxial dislocation in children with mucopolysaccharidosis IVA.Methods:8 cases of atlantoaxial dislocation in children with mucopolysaccharidosis IVA treated with posterior atlantoaxial reduction, decompression, bone graft and internal fixation from April, 2019 to October, 2020 were retrospectively analyzed, including 6 males and 2 females, aged 6.2±3.1 years (range, 2-10 years). All the 8 children had lower limb weakness and walking instability, and some of them could not even stand and walk, and all of them had odontoid hypoplasia, atlantoaxial dislocation and systemic skeletal dysplasia. Measures, including American Spinal injury Association (ASIA) grade, modified atlanto-dental interval (mADI) and reduction rate, screw placement type and fusion of bone graft, were recorded and analyzed.Results:The follow-up time was 17.8±7.4 months (range, 8-27 months). The total operation time was 144.0±43.1 mins (range, 90-220 min) and the blood loss during the surgery was 89.1±55.1 ml (range, 15-180 ml). The ASIA grade were 3 cases of "C" level, 4 cases of "D" level and 1 case of "E" level before the operation, and 1 case of "C" level, 1 case of "D" level and 6 cases of "E" level at the latest follow-up. The mADI reduced from 7.38±2.62 mm pre-surgery to 2.50±1.60 mm ( t=5.71, P=0.001). The reduction rate of the latest follow-up mADI was 65.0%±26.3%. 31 pedicle screws were inserted, including 26 Type I screws (83.9%), 4 Type II screws (12.9%) and 1 Type III screw (3.2%), and no injury of spinal cord or blood vessels were observed associated with the Type III screw. One unilateral axial lamina screw was used in 1 case. 5 patients showed fusion (autogenous bone) 6 months after the surgery, 2 patients got fusion (allogeneic bone) 1 year after the surgery, and other patients showed bone graft resorption (allogeneic bone) at the latest follow-up. One patient developed type II respiratory failure on the night of operation and recovered after rescue. Other patients had no complications such as vascular and nerve injury, screw loosening and so on. Conclusion:The majority of children with type IVa mucopolysaccharidosis are accompanied by absence of odontoid process. If such children are complicated with atlantoaxial dislocation and cervical spinal canal stenosis resulting in cervical spinal cord injury, timely surgical intervention should be carried out. Posterior atlantoaxial fusion is a safe and effective surgical method. As children have the characteristics of multi-system involvement, multi-disciplinary cooperation may be needed to ensure perioperative safety.

Objective: The connectivity alterations in the putamen were found in revealing the neural correlates of attention-deficit/hyperactivity disorder (ADHD), but whether the effective connectivity of the putamen is atypical in ADHD remains unclear. Investigating this abnormality contributes to describing the neural circuit of ADHD at the level of macrostructural organization. Methods: Data were acquired from thirty-two boys with ADHD and fifty-two matched typically developing controls (TDC) from Peking University (Peking) dataset deposited at the Neuroimaging Informatics Tools and Resources Clearinghouse (NITRC) platform. We examined the effective connectivity of the putamen using Granger causality analysis (GCA) and then determined whether these connections could differentiate ADHD from TDC. Results: Compared with TDC, the ADHD group showed decreased effective connectivity from the left ventral rostral putamen (VRP) to left calcarine (CAL), right medial part of the superior frontal gyrus, left orbital part of superior frontal gyrus and left middle occipital gyrus (MOG). Increased effective connectivity from the left inferior occipital gyrus and right lingual gyrus to left VRP was also found in ADHD. The result of the classification accuracy showed that 72.3% of participants were correctly classified using support vector machine. Moreover, GCA values from the left VRP to left CAL and left MOG were significantly correlated with hyper/impulsive scores of patients with ADHD. Conclusion The findings may help extend our understanding of the ADHD-related neural loops.

Objective: The connectivity alterations in the putamen were found in revealing the neural correlates of attention-deficit/hyperactivity disorder (ADHD), but whether the effective connectivity of the putamen is atypical in ADHD remains unclear. Investigating this abnormality contributes to describing the neural circuit of ADHD at the level of macrostructural organization. Methods: Data were acquired from thirty-two boys with ADHD and fifty-two matched typically developing controls (TDC) from Peking University (Peking) dataset deposited at the Neuroimaging Informatics Tools and Resources Clearinghouse (NITRC) platform. We examined the effective connectivity of the putamen using Granger causality analysis (GCA) and then determined whether these connections could differentiate ADHD from TDC. Results: Compared with TDC, the ADHD group showed decreased effective connectivity from the left ventral rostral putamen (VRP) to left calcarine (CAL), right medial part of the superior frontal gyrus, left orbital part of superior frontal gyrus and left middle occipital gyrus (MOG). Increased effective connectivity from the left inferior occipital gyrus and right lingual gyrus to left VRP was also found in ADHD. The result of the classification accuracy showed that 72.3% of participants were correctly classified using support vector machine. Moreover, GCA values from the left VRP to left CAL and left MOG were significantly correlated with hyper/impulsive scores of patients with ADHD. Conclusion The findings may help extend our understanding of the ADHD-related neural loops.

Objective To investigate the effects of different early enteral nutrient (EN) emulsions of TPF-T and TP on nutritional status and intestinal mucosal barrier in patients with septic shock. Methods From May 2017 to May 2018, 112 patients with septic shock were continuously enrolled in the Department of Intensive Care Unit of the First People's Hospital of Taizhou, and they were randomly divided into a TPF-T group and TP group, each group with 56 cases. After admission, the patients in both groups were all treated according to the 2016 Saving Sepsis Campaign (SSC) Guidelines for septic shock. Both groups were supported with EN, TPT-T group was given TPF-T EN emulsion rich in fish oil, while TP group was supported with standard TP EN emulsion, and the therapeutic course was consecutive 7 days in both groups. The differences in nutritional status, inflammatory response, immune function, intestinal mucosal barrier, gastrointestinal symptoms and prognosis were compared between the two groups. Results After EN, the nutrition indicators such as albumin (Alb), prealbumin (PA), transferrin (TRF) and immune indexes (IgA, IgG), human leukocyte DR antigens (HLA-DR) and D-lactic acid were increased in both groups, reaching the peaks on the 7th day after EN application, Alb, PA, TRF, IgA, IgG, HLA-DR in the TPF-T group were significantly higher than those in the TP group [Alb (g/L): 34.43±5.81 vs. 33.59±5.34, PA (mg/L): 269.83±47.56 vs. 252.67±41.92, TRF (g/L): 3.43±0.64 vs. 3.32±0.81, IgA (mg/L): 159.45±34.56 vs. 143.31±33.81, IgG (mg/L): 4 947.68±871.66 vs. 4 583.75±841.54, HLA-DR: (68.22±9.11)% vs. (62.21±9.69)%], and after EN, the D-lactic acid in the TPF-T group was significantly lower than that in the TP group (mg/L: 30.42±6.79 vs. 33.34±7.31). The inflammatory indicators of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), procalcitonin (PCT), endotoxin and diamine oxidase (DAO) were all gradually reduced in two groups, reached the lowest levels on the 7th day after EN application, and all the above-mentioned indicators in the TPF-T group were significantly lower than those in the TP group [TNF-α (ng/L):95.43±20.69 vs. 109.59±23.45, CRP (mg/L): 21.33±16.35 vs. 32.36±17.83, PCT (μg/L): 1.24±1.21 vs. 4.18±1.32, endotoxin (U/L): 10.32±2.31 vs. 11.54±2.69, DAO (g/L): 19.45±8.49 vs. 25.47±9.41]. The incidences of gastric retention, diarrhea and paralysis of lower digestive tract in TPF-T group were significantly lower than those in TP group [gastric retention: 14.29% (8/56) vs. 32.14% (18/56), diarrhea: 12.50% (7/56) vs. 35.71% (20/56), paralysis of lower digestive tract: 7.14% (4/56) vs. 23.21% (13/56)], the length of hospital stay was significantly shorter in the TPF-T group than that in the TP group (days: 18.77±5.08 vs. 21.71±6.67, P < 0.05); however, there was no significant difference in mortality between the two groups [14.29% (8/56) vs. 21.43% (12/56), P > 0.05]. Conclusion TPF-T could more effectively maintain nutritional status, reduce inflammatory reaction, improve immunity, protect intestinal mucosal barrier function, and has fewer adverse reactions, which was helpful to improve the prognosis of septic shock patients.

Patients in acute myocardial infarction (AMI) with serious complications such as malignant ventricular arrhythmia and cardiogenic shock couldn't receive emergency percutaneous coronary intervention (PCI) procedures and had high perioperative mortality. A case of AMI patients who suffered cardiac arrest and long-term cardiopulmonary resuscitation (CPR) was admitted to the department of critical care medicine of the First People's Hospital of Foshan. With the assistance of extracorporeal membrane oxygenation (ECMO), PCI and intra-aortic balloon counterpulsation (IABP) were performed. ECMO and ventilator were successfully weaned after anti-shock, mechanical ventilation, organ support treatment. The patient was successfully treated and discharged. After 6 months of follow-up, the patient recovered well in heart function.

Objective: To observe the expression of retinal proteins in experimental autoimmune uveitis (EAU) mice and to explore the possible molecular mechanism of autoimmune uveitis. Methods: Twelve female C57BL/6J mice were randomly divided into model group and normal control group, 6 mice in each group.In the model group, the EAU model was established by subcutaneous injection of human interphotoreceptor retinoid-binding protein (IRBP) 651-670.The fundal change of EAV mice was assessed by direct ophthalmoscope, OCT and histopathological staining.At 18 days after immunization, the retinas of the two groups were taken for retinal protein extraction, protein restriction enzyme digestion, mass spectrometry detection, data analysis, and bioinformatics analysis.This study was approved by the experimental animal Ethics Committee of Tianjin Medical University Eye Hospital (TJYY2018070113). The feeding and use of experimental animals follow the ARVO statement. Results: The EAU mouse model was successfully established.At 10 days after immunitation, the retina of EAV mouse was damaged.At 18 days after immunization, retinal edema and infiltration of inflammatory cells into vitreous were observed.Proteomic results showed that a total of 4 458 proteins were identified in this study, of which 522 were differentially-expressed proteins (fold change>1.5, P<0.05). Among these differentially-expressed proteins, 147 proteins including Stat1 and Stat3 were up-regulated and 375 proteins including Gucy2f and Rho were down-regulated.These differentially-expressed proteins were closely related to platelet activation, integrin signaling, T cell activation, the phototransduction cascade, Toll-like receptor and so on. Conclusions EAU is related to the abnormal expression of Stat1, Stat3 and other proteins, as well as the abnormal regulation of platelet activation and integrin signal pathway.

Objective To establish a set of operational status assessment indicators to meet the needs of informationized hospital management.Methods Assessment indicators were selected and weights were set respectively through literature review,field interview,and questionnaire survey.Six target dimensions were key performance indicators medical business,operational performance,cost control,medical insurance,balance and risk management,and development capability.Thus a set of operational status evaluation indicators was established in IT means,and based on the informationization level of a tertiary A general hospital in Zhejiang province.Results In the principle of public welfare,objectivity,effectiveness and prospectiveness,we analyzed and sorted out relevant data in the current hospital informationization,identifying six quantitative indicators,15 level-1 indicators,and 86 level-2 indicators.Conclusions It is feasible to build a set of assessment indicators for hospital operation and management in view of both technology and methodology.

Patients in acute myocardial infarction (AMI) with serious complications such as malignant ventricular arrhythmia and cardiogenic shock couldn't receive emergency percutaneous coronary intervention (PCI) procedures and had high perioperative mortality. A case of AMI patients who suffered cardiac arrest and long-term cardiopulmonary resuscitation (CPR) was admitted to the department of critical care medicine of the First People's Hospital of Foshan. With the assistance of extracorporeal membrane oxygenation (ECMO), PCI and intra-aortic balloon counterpulsation (IABP) were performed. ECMO and ventilator were successfully weaned after anti-shock, mechanical ventilation, organ support treatment. The patient was successfully treated and discharged. After 6 months of follow-up, the patient recovered well in heart function.
Extracorporeal Membrane Oxygenation ; Heart Arrest ; Humans ; Intra-Aortic Balloon Pumping ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Shock, Cardiogenic ; Treatment Outcome