BACKGROUND:To assist doctors in making better treatment decisions and improve patient prognosis, it is important to determine which therapy modalities are suitable for various forms of idiopathic hypertrophic cranial pachymeningitis (IHCP). METHODS:All cases were received from the hospital medical record system, and some follow-up information was gathered through telephone follow-up. RESULTS:A total of 26 patients, 14 men and 12 women, with ages ranging from 20 to 73 years and a mean of 47.42 years, were included in the research. Regular types were less likely to recur than irregular and nodular types, focal types were less likely to recur than diffuse types, and corticosteroid-refractory types were more likely to recur than corticosteroid-sensitive types. CONCLUSIONS:The extent and shape of the lesion and susceptibility to corticosteroids are potential factors that could influence recurrence. Futhermore, this paper also proposes the fibroblasts as a new therapeutic target which may improve the quality of prognostic survival of patients.
Background The reemergence of the monkeypox epidemic has aroused great concern internationally. Concurrently, the COVID-19 epidemic is still ongoing. It is essential to understand the temporal dynamics of the monkeypox epidemic in 2022 and its relationship with the dynamics of the COVID-19 epidemic. In this study, we aimed to explore the temporal dynamic characteristics of the human monkeypox epidemic in 2022 and its relationship with those of the COVID-19 epidemic. Methods We used publicly available data of cumulative monkeypox cases and COVID-19 in 2022 and COVID-19 at the beginning of 2020 for model validation and further analyses. The time series data were fitted with a descriptive model using the sigmoid function. Two important indices (logistic growth rate and semi-saturation period) could be obtained from the model to evaluate the temporal characteristics of the epidemic. Results As for the monkeypox epidemic, the growth rate of infection and semi-saturation period showed a negative correlation ( r = 0.47, p = 0.034). The growth rate also showed a significant relationship with the locations of the country in which it occurs [latitude ( r = –0.45, p = 0.038)]. The development of the monkeypox epidemic did not show significant correlation compared with the that of COVID-19 in 2020 and 2022. When comparing the COVID-19 epidemic with that of monkeypox, a significantly longer semi-saturation period was observed for monkeypox, while a significant larger growth rate was found in COVID-19 in 2020. Conclusions This novel study investigates the temporal dynamics of the human monkeypox epidemic and its relationship with the ongoing COVID-19 epidemic, which could provide more appropriate guidance for local governments to plan and implement further fit-for-purpose epidemic prevention policies.
BACKGROUND:COVID-19 was first reported in 2019, and the Chinese government immediately carried out stringent and effective control measures in response to the epidemic.OBJECTIVE:Nonpharmaceutical interventions (NPIs) may have impacted incidences of other infectious diseases as well. Potential explanations underlying this reduction, however, are not clear. Hence, in this study, we aim to study the influence of the COVID-19 prevention policies on other infectious diseases (mainly class B infectious diseases) in China.METHODS:Time series data sets between 2017 and 2021 for 23 notifiable infectious diseases were extracted from public data sets from the National Health Commission of the People's Republic of China. Several indices (peak and trough amplitudes, infection selectivity, preferred time to outbreak, oscillatory strength) of each infectious disease were calculated before and after the COVID-19 outbreak.RESULTS:We found that the prevention and control policies for COVID-19 had a strong, significant reduction effect on outbreaks of other infectious diseases. A clear event-related trough (ERT) was observed after the outbreak of COVID-19 under the strict control policies, and its decreasing amplitude is related to the infection selectivity and preferred outbreak time of the disease before COVID-19. We also calculated the oscillatory strength before and after the COVID-19 outbreak and found that it was significantly stronger before the COVID-19 outbreak and does not correlate with the trough amplitude.CONCLUSIONS:Our results directly demonstrate that prevention policies for COVID-19 have immediate additional benefits for controlling most class B infectious diseases, and several factors (infection selectivity, preferred outbreak time) may have contributed to the reduction in outbreaks. This study may guide the implementation of nonpharmaceutical interventions to control a wider range of infectious diseases.
BackgroundEpidemics of infectious diseases have a great negative impact on people's daily life. How it changes over time and what kind of laws it obeys are important questions that researchers are always interested in. Among the characteristics of infectious diseases, the phenomenon of recrudescence is undoubtedly of great concern. Understanding the mechanisms of the outbreak cycle of infectious diseases could be conducive for public health policies to the government.MethodIn this study, we collected time-series data for nine class C notifiable infectious diseases from 2009 to 2021 using public datasets from the National Health Commission of China. Oscillatory power of each infectious disease was captured using the method of the power spectrum analysis.ResultsWe found that all the nine class C diseases have strong oscillations, which could be divided into three categories according to their oscillatory frequencies each year. Then, we calculated the oscillation power and the average number of infected cases of all nine diseases in the first 6 years (2009–2015) and the next 6 years (2015–2021) since the update of the surveillance system. The change of oscillation power is positively correlated to the change in the number of infected cases. Moreover, the diseases that break out in summer are more selective than those in winter.ConclusionOur results enable us to better understand the oscillation characteristics of class C infectious diseases and provide guidance and suggestions for the government's prevention and control policies.
ObjectiveSchizophrenia is a mental disorder that is characterized by progressive cognitive impairment. Objective measures of cognitive function may provide reliable neurobiomarkers for patients with schizophrenia. The goal of the current work is to explore the correlation between resting theta power and cognitive performance in patients with schizophrenia.MethodsTwenty-two patients with schizophrenia and 23 age-, sex-, and education-matched healthy controls were included in this study. The MATRICS Consensus Cognitive Battery (MCCB) was used for cognitive evaluation and the Positive and Negative Syndrome Scale (PANSS) for evaluation of clinical symptoms. EEGs were acquired in the resting state with closed and opened eyes. Between the two groups, we compared the relative theta power and examined their relationship with cognitive performance.ResultsCompared to healthy controls, patients with schizophrenia showed significantly higher theta power, both with eyes closed and open (P < 0.05). When the eyes were open, negative correlations were found in patients with schizophrenia between theta power in the central and parietal regions with processing speed scores, and between the theta power of the Pz electrode and verbal learning and reasoning and problem-solving scores (r ≥ −0.446). In the control group, theta power over the Fz electrode was negatively correlated with processing speed (r = −0.435).ConclusionsOur findings showed that theta activity increased in certain brain regions during resting state in schizophrenia. Negative associations between resting theta power (increased) over the parietal-occipital regions with MCCB domains scores (decreased) suggest that altered theta activity can be used as a neurobiological indicator to predict cognitive performance.
目的 探讨个体认知行为干预对老年情绪障碍患者的社会功能和照料者负担的影响.方法 选择2018年2月—2020年8月本院收治的80例老年情绪障碍患者作为研究对象,分为个体认知行为干预组(40例)和常规治疗组(38例)两组.个体认知行为干预组在12周时间内进行8次干预,于基线时期记录患者的基本情况、临床症状评分、社会功能情况及照料者负担水平,并在治疗结束、治疗后3个月和治疗后9个月两组对社会功能情况和照料者负担水平进行评估比较.结果 与常规治疗组相比,在治疗结束后、随访3个月、随访9个月等随访点,个体认知行为干预组的社会功能得分显著高于常规治疗组,而照料者负担得分显著低于常规治疗组.结论 个体认知行为干预可以显著改善老年情绪障碍患者的社会功能,减低照料者的负担,可以进行推广.
目的 评价静息态功能MRI(rs-fMRI)全脑信号对左侧基底节区脑梗死患者低频振幅(ALFF)及分数ALFF(fALFF)的影响.方法 纳入21例左侧基底节区脑梗死患者(梗死组)及26名健康志愿者(对照组),于去除和未去除全脑信号2种预处理条件下,根据rs-fMRI数据计算ALFF及fALFF,分析梗死组发病7天内(急性期)与3个月(恢复期)之间、后者与对照组之间ALFF及fALFF存在差异的脑区.结果 未去除全脑信号条件下,梗死组恢复期大脑双侧额上回、后扣带回(PCC)和健侧壳核ALFF均明显低于对照组(P均<0.05),健侧额下回眶部及颞上回颞极ALFF均明显高于对照组(P均<0.05);梗死组患者恢复期健侧楔叶、颞下回、枕中回ALFF明显高于急性期(P均<0.05).去除全脑信号条件下,梗死组恢复期健侧额上回、PCC及壳核ALFF均明显低于对照组(P均<0.05),健侧额下回眶部及颞上回ALFF均明显高于对照组(P均<0.05);梗死组恢复期健侧颞下回ALFF明显高于急性期(P<0.05).梗死组恢复期与对照组、梗死组内不同时期之间各脑区fALFF未见显著差异(P均>0.05).结论 左侧基底节区脑梗死患者随运动恢复而发生脑皮质功能代偿;未去除全脑信号条件下可显示更多ALFF存在差异的脑区.
Purpose. We investigated the disparate influence of lesion location on functional damage and reorganization of the sensorimotor brain network in patients with thalamic infarction and pontine infarction. Methods. Fourteen patients with unilateral infarction of the thalamus and 14 patients with unilateral infarction of the pons underwent longitudinal fMRI measurements and motor functional assessment five times during a 6-month period (<7 days, at 2 weeks, 1 month, 3 months, and 6 months after stroke onset). Twenty-five age- and sex-matched controls underwent MRI examination across five consecutive time points in 6 months. Functional images from patients with left hemisphere lesions were first flipped from the left to the right side. The voxel-wise connectivity analyses between the reference time course of each ROI (the contralateral dorsal lateral putamen (dl-putamen), pons, ventral anterior (VA), and ventral lateral (VL) nuclei of the thalamus) and the time course of each voxel in the sensorimotor area were performed for all five measurements. One-way ANOVA was used to identify between-group differences in functional connectivity (FC) at baseline stage (<7 days after stroke onset), with infarction volume included as a nuisance variable. The family-wise error (FWE) method was used to account for multiple comparison issues using SPM software. Post hoc repeated-measure ANOVA was applied to examine longitudinal FC reorganization. Results. At baseline stage, significant differences were detected between the contralateral VA and ipsilateral postcentral gyrus (cl_VA-ip_postcentral), contralateral VL and ipsilateral precentral gyrus (cl_VL-ip_precentral). Repeated measures ANOVA revealed that the FC change of cl_VA-ip_postcentral differ significantly among the three groups over time. The significant changes of FC between cl_VA and ip_postcentral at different time points in the thalamic infarction group showed that compared with 7 days after stroke onset, there was significantly increased FC of cl_VA-ip_postcentral at 1 month, 3 months, and 6 months after stroke onset. Conclusions. The different patterns of sensorimotor functional damage and reorganization in patients with pontine infarction and thalamic infarction may provide insights into the neural mechanisms underlying functional recovery after stroke.
To the Editor: Polycythemia vera (PV) is a chronic progressive myeloproliferative neoplasm (MPN) characterized by clonal proliferation of myeloid cells. This condition presents with a high number of abnormal erythrocytosis, leukocytosis, and thrombocytosis, which may lead to venous thromboembolism. Cerebral venous sinus thrombosis (CVST) is a rare presentation of PV in clinical practice. Symptoms of PV are often insidious during the onset, and a lack of specific clinical manifestations of CVST may lead to delayed diagnosis. To date, diagnosis and management of CVST in PV remain a challenge due to the low incidence and limited evidence. In this study, we presented five cases of PV with JAK2V617F mutation, and CVSTwas the first manifestation of PV. The detailed characteristics are summarized in Table 1. The Institute Ethics Committee of Xuanwu Hospital, Capital Medical University approved this study (approval number 2019119). The authors certify that they have obtained all appropriate patient consent forms.
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目的 利用三维对比增强磁共振静脉成像(3D CE-MRV)分析耳鸣与脑鸣患者头颈静脉系统的形态特征,探究3D CE-MRV技术对耳鸣及脑鸣病因诊断的应用价值.方法 回顾性分析224例耳鸣或脑鸣患者的临床资料及3DCE-MRV检查.对126例耳鸣患者与98例脑鸣患者的临床特点及图像特征进行分析比较.结果 耳鸣组与脑鸣组流行病学特点及头颈静脉异常表现差异均无统计学意义(P >0.05);224例患者的3D CE-MRV结果显示178例(79.5%)患者均有不同类型的静脉异常表现:包括111例(49.5%)静脉引流通路局部狭窄、77例(34.3%)静脉引流通路发育不良、12例(5.3%)镰状窦开放、5例(2.2%)颅内静脉窦血栓形成.结论 3D CE-MRV对头颈静脉系统的形态学异常有良好的显示效果,为耳鸣或脑鸣患者的病因诊断和治疗提供了思路和依据.
目的 探讨左侧基底核区梗死患者在特定频段(slow-4:0.027~0.073 Hz,slow-5:0.010~0.027 Hz)下低频振幅(ALFF)改变,追踪其大脑自发活动纵向变化.方法 对25例左侧基底核区脑梗死患者(梗死组)和26名正常志愿者(对照组)采集静息态fMRI数据;采用混合效应分析,针对梗死组慢性期与梗死组急性期、梗死组慢性期与对照组,分别计算其ALFF值频率间、组间主效应脑区差异;于2个频段下进行事后检验,获得组间有差异脑区.结果 ALFF结果显示,两个频段间存在差异性脑区,slow-4频段激活脑区位于皮层下脑区,slow-5频段激活脑区多位于默认网络.在slow-4频段上,梗死组慢性期与急性期对比,慢性期患者双侧顶上小叶、楔前叶、枕叶及健侧颞叶ALFF值升高,扣带回和辅助运动区ALFF值降低;梗死组慢性期与对照组对比,慢性期患者健侧后扣带回和患侧中央前回ALFF值降低,健侧侧部额叶脑回和额极ALFF值升高.在slow-5频段未见差异脑区.结论 slow-4频段显示左侧基底核区脑梗死患者脑自发活动更为敏感;患者恢复过程中存在脑皮质功能重构.
Purpose We aimed to investigate the possible factors associated with the occurrence of crossed cerebellar diaschisis (CCD) at the hyperacute stage of ischemic stroke using whole-brain volume perfusion CT (VPCT) combined with magnetic resonance imaging (MRI). Materials and methods We retrospectively analyzed 108 patients with ischemic stroke within 6 h of onset. The VPCT findings of the patients showed a unilateral perfusion deficit in the supratentorial territory. Follow-up MRI examinations were performed within 24 h after onset. The effects of the supratentorial cerebral ischemia, the location distribution, the final infarct volume and the apparent diffusion coefficient (ADC) value on the occurrence and severity of CCD were analyzed. Results Among 108 patients with hyperacute cerebral ischemia, 62 (57.4%) demonstrated a contralateral cerebellar perfusion deficit on the VPCT maps. The occurrence of CCD was related to a reduction in cerebral blood volume (CBV) and prolongation of the mean transit time (MTT). Notably, the decrease in the ADC value in the infarct based on follow-up MRI was closely related to the occurrence and severity of CCD. Conclusion The occurrence and severity of CCD are related to the degree of low supratentorial perfusion and the decrease in the ADC value of infarct focus.
Connectivity-based methods are essential to explore brain reorganization after a stroke and to provide meaningful predictors for late motor recovery. We aim to investigate the homotopic connectivity alterations during a 180-day follow-up of patients with pontine infarction to find an early biomarker for late motor recovery prediction. In our study, resting-state functional MRI was performed in 15 patients (11 males, 4 females, age: 57.87 ± 6.50) with unilateral pontine infarction and impaired motor function during a period of 6 months (7, 14, 30, 90, and 180 days after stroke onset). Clinical neurological assessments were performed using the Fugl–Meyer scale (FM).15 matched healthy volunteers were also recruited. Whole-brain functional homotopy in each individual scan was measured by voxel-mirrored homotopic connectivity (VMHC) values. Group-level analysis was performed between stroke patients and normal controls. A Pearson correlation was performed to evaluate correlations between early VMHC and the subsequent 4 visits for behavioral measures during day 14 to day 180. We found in early stroke (within 7 days after onset), decreased VMHC was detected in the bilateral precentral and postcentral gyrus and precuneus/posterior cingulate cortex (PCC), while increased VMHC was found in the hippocampus/amygdala and frontal pole (P < 0.01). During follow-up, VMHC in the precentral and postcentral gyrus increased to the normal level from day 90, while VMHC in the precuneus/PCC presented decreased intensity during all time points (P < 0.05). The hippocampus/amygdala and frontal pole presented a higher level of VMHC during all time points (P < 0.05). Negative correlation was found between early VMHC in the hippocampus/amygdala with FM on day 14 (r = −0.59, p = 0.021), day 30 (r = −0.643, p = 0.01), day 90 (r = −0.693, p = 0.004), and day 180 (r = −0.668, p = 0.007). Furthermore, early VMHC in the frontal pole was negatively correlated with FM scores on day 30 (r = −0.662, p = 0.013), day 90 (r = −0.606, p = 0.017), and day 180 (r = −0.552, p = 0.033). Our study demonstrated the potential utility of early homotopic connectivity for prediction of late motor recovery in pontine infarction.
The mechanisms of motor functional recovery after pontine infarction (PI) remain unclear. Here, we assessed longitudinal changes in gray matter volume (GMV) and examined the relationship between GMV and clinical outcome. Fifteen patients with unilateral PI underwent magnetic resonance imaging and neurological exams five times during a period of 6 months. Another 15 healthy participants were enrolled as the normal control (NC) group and were examined with the same protocol. The MR exam included routine protocol and a 3D T1-weighted magnetization-prepared rapid acquisition gradient echo scan. Changes in GMV were assessed using voxel-based morphometry. Furthermore, the correlations between GMV changes in regions of interest and clinical scores were assessed. Compared with NCs, the decreased GMVs in the contralateral uvula of cerebellum and the ipsilateral tuber of cerebellum were detected at third month after stroke onset. At the sixth month after stroke onset, the decreased GMVs were detected in the contralateral culmen of cerebellum, putamen, as well as in the ipsilateral tuber/tonsil of cerebellum. Compared with NC, the PI group exhibited significant increases in GMV at each follow-up time point relative to stroke onset. Specifically, the significant GMV increase was found in the ipsilateral middle frontal gyrus and ventral anterior nucleus of thalamus at second week after stroke onset. At first month after stroke onset, the increased GMVs in the ipsilateral middle temporal gyrus were detected. The significant GMV increase in the ipsilateral mediodorsal thalamus was noted at third month after stroke onset. At the end of sixth month after stroke onset, the GMV increase was found in the ipsilateral mediodorsal thalamus, superior frontal gyrus, and the contralateral precuneus. Across five times during a period of 6-month, a negative correlation was observed between mean GMV in the contralateral uvula, culmen, putamen, and ipsilateral tuber/tonsil and mean Fugl-Meyer (FM) score. However, mean GMV in the ipsilateral mediodorsal thalamus was positively correlated with mean FM score. Our findings suggest that structural reorganization of the ipsilateral mediodorsal thalamus might contribute to motor functional recovery after PI.
目的 通过应用单光子发射断层扫描(single-photon emission tomography,SPECT)脑血流灌注显像及动脉自旋标记(arterial spin labeling,ASL)脑血流灌注成像技术对海马硬化(hippocampal sclerosis,HS)所致颞叶癫痫(intractable temporal lobe epilepsy,TLE)患者脑血流灌注,特别是海马区血流灌注进行定性及半定量测量,并比较其相关性.方法 搜集经手术及病理证实为HS的18例TLE患者.选择性别、年龄匹配的21例健康志愿者作为对照组.18例患者及3例健康志愿者行SPECT脑血流灌注显像,全部患者及志愿者行ASL脑血流灌注成像.对HS所致TLE患者脑内,特别是海马区的血流灌注进行定性及定量分析,分别比较应用两种血流灌注方法(SPECT、ASL)测得的HS患者病变侧、对侧及与对照组海马区rCBF的差异.结果 应用SPECT及ASL两种脑血流灌注显像技术测得HS所致TLE患者病变侧海马区rCBF均较对侧减低,病变侧与对侧海马区rCBF有显著性差异(P<0.01);病变侧海马区rCBF较对照组明显减低,病变侧与对照组海马区rCBF有非常显著性差异(P<0.01);对侧与对照组海马区rCBF有无显著性差异(P>0.05).结论 SPECT脑血流灌注显像和ASL脑血流灌注成像技术定性分析HS所致TLE脑血流灌注改变一致性较好,均证实HS所致TLE病变侧海马区血流灌注减低.
Objective To explore the changes of cerebral perfusion and glucose metabolism in patients with crossed cerebellar diaschisis (CCD) after supratentorial unilateral cerebral infarction using single photon emission tomography(SPECT). Methods Thirty CCD patients after cerebral infarction underwent SPECT 99mTc-ECD cerebral blood perfusion and glucose metabolism ima-ging. SPECT images were performed qualitative and quantitative analysis. The correlation of cerebral blood perfusion and glucose metabolism asymmetry index(AI) between supratentorial cerebral region and contralateral cerebellum were analyzed. The correla-tion between the infarction volume and cerebral blood perfusion and glucose metabolism AI of contralateral cerebellum was also an-alyzed. Results SPECT demonstrated cerebral blood perfusion and glucose metabolism decreased of multiple cerebral regions in patients with CCD. The most involved cerebral region was the frontal lobe. The AI of cerebral blood perfusion between supratento-rial cerebral region and contralateral cerebellum had positive correlation ( P <0.01). However,there had no correlation of glu-cose metabolism AI between supratentorial cerebral region and contralateral cerebellum ( P >0.05). There also had no correla-tion of infarction volume(25.87 ± 16.43) cm3and cerebral blood perfusion and glucose metabolism AI of contralateral cerebellum ( P >0.05). Conclusion SPECT could demonstrate the changes of cerebral blood flow and glucose metabolism, and evaluate the relationship between cerebral blood flow and abnormal glucose metabolism and CCD.
目的 利用功能核磁共振成像(functional magnetic resonance imaging,fMRI)技术探讨抗抑郁治疗对抑郁症患者识别动态面部表情神经基础改变的影响.方法 选取自愿参加试验的35例重性抑郁症患者,在治疗前后进行fMRI扫描同时进行悲伤、喜悦及中性的面部表情视频分辨测试.fMRI原始图像数据转化格式后经SPM2软件处理.采用治疗前后自身对照研究,行配对t检验统计分析.结果 识别喜悦表情时治疗后较治疗前激活增加的脑区包括右颞中回(BA37)、左颞下回(BA37)、左颞上回(BA39)、左梭状回(BA20)、右海马、左海马、右额中回(BA10)、右后扣带回(BA30)、右海马回(BA36)及左海马回(BA30);而治疗前较治疗后激活增加的脑区包括右梭状回(BA19)、左颞中回(BA21)及左楔前叶(BA19).识别悲伤表情时治疗后较治疗前激活增加的脑区包括左梭状回(BA19)和右颞中回(BA21),而治疗前较治疗后激活增加的脑区包括右梭状回(BA19)及右海马回(BA35),差异有显著性(P<0.05).结论 有效的抗抑郁治疗后抑郁症患者情绪相关脑区有所改变,主要表现在喜悦表情的识别中,患者情绪相关皮质区域激活较治疗前增加,但短期的抗抑郁治疗对悲伤表情的识别改善甚微.
OBJECTIVE To analyze disease-related clinical features and therapeutic effects of basal cell adenoma in head and neck. METHODS Clinical data of 9 patients with pathologically diagnosed basal cell adenoma in head and neck between Mar 2007 and Jan 2016 in our department were analyzed retrospectively. The ratio of male 3 to female 6 was 1:2. The median age of the patients was 48.9 years old(22 to 65 years). 5 cases affected parotid gland, 1 occurred in left maxillary sinus and infratemporal fossa, 1 involved nasopharyngeal and pterygopalatine fossa, 1 originated from nasal vestibule and 1 derived from nasal septum. RESULTS 8 of the patients underwent surgical treatment, while one patient with tumor involving the left maxillary sinus and infratemporal fossa was given a transnasal surgery for concurrent rhinosinusitis and subsequently confirmed by pathology. The postoperative follow-up period was between 1 and 10 years. One patient with tumor affecting infratemporal fossa recurred 1.5 years after surgery, while the rest shown no signs of recurrence and complication. CONCLUSION Basal cell adenoma in head and neck is a rare kind of disease. Clinical features and imaging helped to differenced basal cell adenoma in head and neck from other diagnoses, but definite diagnosis relies on the pathological tests.Surgery may provide good effects and prognosis on patients with basal cell adenoma.
围产期抑郁症是一种复杂的疾病,包括生理、心理和社会等多种病因,虽然目前尚不能确定围产期抑郁症的根本原因,但科学研究已经在相当程度上了解了影响围产期抑郁症的危险因素.即使不能改变一些诸如遗传等方面的危险因素,但有些相关的危险因素在很大程度上是可以控制的.因此,了解引发围产期抑郁症的危险因素,采取一些针对性的措施,能够降低患上该病的概率.