Objective: Here in we assessed the cortical basis for olfactory dysfunction in Chinese Parkinson’s disease (PD) patients through functional magnetic imaging (fMRI)-based analyses.Methods: A block design and a 3.0 T scanner were utilized to assess 19 PD patients (average age: 56.69 ± 6.97 years) and 20 age-matched controls (average age: 61.33 ± 6.83 years) while they were passively exposed to a positively-valenced (rose-like or lavender) odorant.Result: Activated brain regions associated with olfactory processing in both PD patients and healthy controls included the left inferior parietal lobule, angular gyrus, medial frontal cortex, orbitofrontal gyrus, posterior central gyrus, cingulate gyrus, inferior temporal gyrus, piriform cortex left insula, cerebellum. Control patients exhibited more robust left inferior temporal gyrus, bilateral hippocampus, and left thalamus activation in response to olfactory stimulation, while PD patients exhibited more robust paracentral lobule, thalamus, and hippocampal gyrus activation.Conclusions: Olfactory processing is a complex process in which several brain regions are involved. The results of this study highlight the mechanistic basis for compensatory olfactory processes in PD patients. Observed differences between the PD and healthy control groups may be linked to the reorganization of olfactory function, resulting in olfactory network reorganization. By combining objective olfactory assessment and fMRI imaging approaches, it may be possible to detect PD at an earlier stage and thereby provide patients with more timely interventions aimed at slowing disease progression.

Epilepsy is a high incidence neurological disease, and its repeated attacks cause serious physical and psychological damage to the patient. Differentially expressed in normal and neoplastic cells (DENN) domain containing 5B (DENND5B) is a lipoprotein binding protein that mediates synaptic vesicle transport and regulates neuroplasticity and lipid metabolism. Nevertheless, the effect of DENND5B on seizures remains unclear. We aimed to investigate the association of DENND5B with epilepsy, detect its expression and distribution in the nervous system, and explore its role in epileptogenesis through western blot, immunofluorescence staining, and behavioral studies. In this experiment, two C57BL/6 mice models, which induced seizures by pentylenetetrazole and kainic acid, were established. We observed that the expression of DENND5B was reduced in the brains of patients with temporal lobe epilepsy, and its expression was also similarly decreased in both chronic epileptic mice. The findings strongly suggest that DENND5B may be associated with epileptic seizures. Results of immunofluorescence showed that DENND5B was mainly expressed in the hippocampal region and co-located with neurons but not with astrocytes. Next, we used lentivirus to induce both lentiviral vector-mediated overexpression and knockdown of DENND5B in mice to test the change of susceptibility and severity of seizures in the two chronic seizure models. Knockdown of DENND5B was found to promote epileptic seizures, increase chronic spontaneous recurrent epileptic seizures and epileptic discharge, and reduce the incubation period. However, overexpression of DENND5B showed the opposite effect. These results suggest that DENND5B overexpression decreased the behavioral phenotype of epileptic seizures, but DENND5B downregulation had the opposite effect. In summary, our findings suggest that DENND5B can regulate epileptic seizures and may provide a new target for antiepileptic therapy.

Studies have indicated that the dorsal attention network (DAN) and the ventral attention network (VAN) functionally interact via several fronto-parietal connector hubs. However, the anatomical connectivity profiles of these connector hubs, and the coupling between the anatomical and functional connectivities of them, are still unknown. In the present study, we found that functional connector hubs anatomically bridged the DAN and VAN based on multimodal magnetic resonance imaging data from the Human Connectome Project (HCP) Consortium and an independent Chinese cohort. The three hubs had unique anatomical connectivity patterns with the attention sub-networks. For each connector hub, the pattern of anatomical connectivity resembled the functional one. Finally, the strength of the anatomical connectivity of these connector hubs was positively associated with the functional connectivity at the group- and individual-levels. Our findings help to better understand the anatomical mechanisms underlying the functional interactions between the DAN and the VAN.

目的:研究功能性消化不良(FD)患者血浆降钙素基因相关肽(CGRP)、神经肽S受体-1(NPSR1)、白介素-6(IL-6)的水平变化及临床意义.方法:选取136例FD患者,其中餐后不适综合征(PDS)组77例,上腹痛综合征(EPS)组59例,健康对照组40例,采用酶联免疫吸附法检测血浆中NPSR1、IL-6、CGRP的浓度.结果:FD组、PDS组和EPS组NPSR1水平较对照组明显减低(P<0.01),PDS组NPSR1水平低于EPS组(P<0.01);FD组、PDS组和EPS组CGRP水平较对照组明显减低(P<0.01),PDS组CGRP浓度明显低于EPS组(P<0.01);FD组、PDS组和EPS组中IL-6水平明显高于对照组(P<0.01),但PDS组IL-6水平明显低于EPS组(P<0.01).FD组中,NPSR1水平与IL-6水平正相关(P<0.01);PDS组中,NPSR1水平与CGRP水平正相关(P<0.01),与IL-6水平存在正相关(P<0.01);CGRP水平与IL-6水平正相关(P<0.01).结论:NPSR1、CGRP、IL-6参与FD的发生,在FD的发病中起重要作用;NPSR1、CGRP与PDS关系更密切,IL-6与EPS更密切;炎性反应激活自身免疫在FD的发生中起重要作用;NPSR1、CGRP和IL-6为判定FD患者不同亚型提供客观依据,作为FD患者病情评估的指标之一,有利于FD的分型和指导治疗.

目的:观察活性维生素D3对咳嗽变异性哮喘(cough variant asthma,CVA)气道炎症及肺组织骨桥蛋白(osteopontin,OPN)表达的干预效应.方法:SD大鼠随机分为空白组、模型组、治疗组,每组各10只.采用腹腔注射联合雾化吸入卵清蛋白(OVA)诱导CVA模型,治疗组激发前30 min予活性维生素D3100 ng/mL灌胃.大鼠肺功能仪检测吸入乙酰胆碱(Ach)后气道阻力值,瑞氏-吉姆萨染色观察支气管肺泡灌洗液(BALF)中炎症细胞分类计数,HE染色、PAS染色观察肺组织形态学改变,免疫组化检测肺组织OPN表达.结果:(1)气道高反应:模型组和治疗组吸入Ach后气道阻力明显高于空白组(P<0.01),治疗组的气道阻力低于模型组(P<0.01).(2)炎症细胞分类计数:模型组及治疗组BALF中巨噬细胞百分率、淋巴细胞百分率、中性粒细胞百分率及嗜酸性粒细胞百分率均较空白组增加(P<0.01),治疗组炎症细胞计数低于模型组(P<0.05).(3)肺组织形态学改变:模型组肺组织可见大量炎症细胞浸润,杯状细胞增生,治疗组上述改变较模型组减轻.⑷肺组织OPN表达:模型及治疗组OPN表达较空白组增加(P<0.05),治疗组较模型组降低(P<0.05),OPN含量与BALF中炎症细胞所占百分率正相关(P<0.05).结论:活性维生素D3可降低CVA大鼠气道高反应,减轻气道炎症,其机制可能与干预肺组织OPN表达相关.

The salience network (SN) is mainly involved in detecting and filtering multimodal salient stimuli, and mediating the switch between the default mode network and central executive network. Early studies have indicated a right-sided dominance in the functional organization of the SN; however, the anatomical basis of the functional lateralization remains unclear. Here, we hypothesized that the structural connectivity profile between the frontoinsular cortex (FIC) and dorsal anterior cingulate cortex (dACC), which are two core hubs of the SN, is also dominant in the right hemisphere. Based on diffusion and resting-state functional magnetic resonance imaging (rfMRI) of adult healthy volunteers in independent datasets, we found a stable right-sided laterality of both the FIC-dACC structural and functional connectivity in both the human connectome project cohort and a local Chinese cohort. Furthermore, a significant effect of aging on the integrity of the right FIC-dACC structural connectivity was also identified. The right-sided laterality of the structural organization of the SN may help us to better understand the functional roles of the SN in the normal human brain.

Benign epilepsy with centrotemporal spikes (BECT) is the most common childhood idiopathic focal epilepsy syndrome, which characterized with white-matter abnormalities in the rolandic cortex. Although diffusion tensor imaging research could characterize white-matter structural architecture, it cannot detect neural activity or white-matter functions. Recent studies demonstrated the functional organization of white-matter by using functional magnetic resonance imaging (fMRI), suggesting that it is feasible to investigate white-matter dysfunctions in BECT. Resting-state fMRI data were collected from 24 new-onset drug-naive (unmedicated [NMED]), 21 medicated (MED) BECT patients, and 27 healthy controls (HC). Several white-matter functional networks were obtained using a clustering analysis on voxel-by-voxel correlation profiles. Subsequently, conventional functional connectivity (FC) was calculated in four frequency sub-bands (Slow-5:0.01-0.027, Slow-4:0.027-0.073, Slow-3:0.073-0.198, and Slow-2:0.198-0.25 Hz). We also employed a functional covariance connectivity (FCC) to estimate the covariant relationship between two white-matter networks based on their correlations with multiple gray-matter regions. Compared with HC, the NMED showed increased FC and/or FCC in rolandic network (RN) and precentral/postcentral network, and decreased FC and/or FCC in dorsal frontal network, while these alterations were not observed in the MED group. Moreover, the changes exhibited frequency-specific properties. Specifically, only two alterations were shared in at least two frequency bands. Most of these alterations were observed in the frequency bands of Slow-3 and Slow-4. This study provided further support on the existence of white-matter functional networks which exhibited frequency-specific properties, and extended abnormalities of rolandic area from the perspective of white-matter dysfunction in BECT.

目的 探讨功能性消化不良(FD)患者外周血浆神经肽S受体-1(NPSR1)、降钙素基因相关肽(CGRP)、白介素6(IL-6)的水平变化与精神心理因素的关系.方法 选取136例FD患者,其中餐后不适综合征(PDS)组77例,上腹痛综合征(EPS)组59例,以同期40名健康人作为对照组,采用抑郁自评量表(SDS)、焦虑自评量表(SAS)对FD患者的焦虑、抑郁情况进行评估,采用ELISA法检测血浆中NPSR1、IL-6、CGRP的浓度,分析FD不同亚型NPSR1、IL-6、CGRP及其与焦虑、抑郁之间的相关性.结果 PDS组、EPS组的焦虑、抑郁评分均高于对照组(P＜0.01),PDS组焦虑评分高于EPS组(P＜0.01).PDS组中,SAS评分与SDS评分呈正相关(P＜0.05).FD组中,NPSR1水平与焦虑评分呈负相关(P＜0.01);PDS组中,NPSR1水平与焦虑评分呈负相关(P＜0.05).结论 FD患者存在明显焦虑、抑郁,精神心理因素与FD的发生密切相关,在PDS组患者中更明显,焦虑、抑郁对FD的发生起促进作用,它在FD不同亚型的发病中所起的作用存在差异.NPSR1参与调节FD患者的焦虑情绪,PDS组患者的焦虑情绪影响NPSR1的分泌,对焦虑或抑郁的FD患者进行药物治疗及心理治疗等综合治疗措施,能提高疗效,改善患者的生活质量.

Benign epilepsy with centrotemporal spikes (BECTS) is the most common idiopathic focal childhood epilepsy associated with either unilateral or bilateral epileptic discharge. Asymmetry as an important characteristic of the human brain is beneficial for brain functions. However, little is known about on asymmetry of BECTS patients with different epileptic spikes pattern. In the present study, we investigated functional and structural asymmetries in unilateral spikes BECTS (U_BECTS) patients and bilateral spikes BECTS (B_BECTS) patients using resting state functional magnetic resonance images and diffusion tensor imaging. Compared with the controls, we observed a decreased voxel-mirrored interhemispheric functional connectivity (FC) in primary sensorimotor cortex (SM1) in U_BECTS and B_BECTS groups, and reduced fractional anisotropy (FA) values of the corpus callosum (CC) connecting bilateral SM1 were also observed in B_BECTS group. Further region-based FC map analysis of SM1 demonstrated increased functional asymmetry with ipsilateral hemisphere, contralateral hemisphere and the whole brain in U_BECTS and increased functional asymmetry with the contralateral hemisphere and the whole brain in B_BECTS groups. The correlation between functional asymmetry of SM1 and intelligence quotient scores was found in the U_BECTS group. The altered asymmetries of the SM1 further indicated the important role of SM1 in the pathophysiology of the BECTS. Furthermore, the B_BECTS group also showed abnormal voxel-mirrored interhemispheric FC in the temporal pole, the lobule IX of the cerebellum, the caudate and the occipital cortex relative to the controls. Altogether, our findings provide additional insight into the neuronal mechanism of BECTS with different epileptic spikes pattern and cognitive impairments with BECTS patients.

Objective To explore the features of activation mapping induced by olfactory stimulation with functional magnetic imaging (fMRI), which will help to reveal the neural mechanism of olfactory dysfunction and contribute to the earlier diagnosis and treatment of neural degenerative disorders.Methods In this prospective study, 21 healthy volunteers were recruited in the Affiliated Hospital of North Sichuan Medical College from March to October 2015.Olfactory function was evaluated by using Visual Analogue Scale (VAS).During the fMRI scanning, all subjects received olfactory stimulation of rose and lavender odor.The brain activation was obtained by using softwares matlab2008a and SPM8.Results All subjects had normal olfactory function evaluated by VAS score (4.86±0.07).The activated brain areas included: bilateral inferior parietal lobule, bilateral inferior frontal gyrus-orbitofrontal gyrus, left insula, bilateral inferior temporal gyrus, left putamen, bilateral hippocampus, bilateral cingulate cortex, bilateral piriform cortex, bilateral amygdale, left lingual gyrus, bilateral cerebellum (t=2.62, P<0.01).Conclusions Olfactory is associated with multiple brain regions.The combination of olfactory event-related design and fMRI, as an objective measurement of olfactory, can be applied to investigate the olfactory cortical brain mapping.

目的 探讨原发性十二指肠癌(PDC)的临床特点及诊治措施,以减少误诊.方法 对1例诊断为肠系膜上动脉压迫综合征的原发性十二指肠癌患者的临床资料进行回顾性分析.结果 患者临床表现为上腹胀、恶心、呕吐、呕吐后腹痛缓解等较为典型的肠系膜上动脉压迫综合征表现,上腹部增强CT提示腹主动脉各主要分支结构正常,肠系膜上动脉及腹主动脉间夹角较小,约26°左右,考虑肠系膜上动脉压迫综合征.腹部MRI提示考虑小肠肿瘤伴肠系膜扭转或腹内疝.精做胃镜提示十二指肠环下方环腔黏膜见深凹溃疡,病检提示腺癌.结论 提高对PDC的警惕性,积累与其他消化道疾病鉴别的经验,避免PDC的误诊,早发现、早诊断、早手术是治疗的关键.

There are 2 intrinsic networks in the human brain: the task positive network (TPN) and task negative network (alternately termed the default mode network, DMN) in which inverse correlations have been observed during resting state and event-related functional magnetic resonance imaging (fMRI). The antagonism between the 2 networks might indicate a dynamic interaction in the brain that is associated with development. To evaluate the alterations in the relations of the 2 networks in children with benign childhood epilepsy with centrotemporal spikes (BECTS), resting state fMRI was performed in 17 patients with BECTS and 17 healthy controls. The functional and effective connectivities of 29 nodes in the TPN and DMN were analyzed. Positive functional connectivity (FC) within the networks and negative FC between the 2 networks were observed in both groups. The patients exhibited increased FC within both networks, particularly in the frontoparietal nodes such as the left superior frontal cortex, and enhanced antagonism between the 2 networks, suggesting abnormal functional integration of the nodes of the 2 networks in the patients. Granger causality analysis revealed a significant difference in the degree of outflow to inflow in the left superior frontal cortex and the left ventral occipital lobe. The alterations observed in the combined functional and effective connectivity analyses might indicate an association of an abnormal ability to integrate information between the DMN and TPN and the epileptic neuropathology of BECTS and provide preliminary evidence supporting the occurrence of abnormal development in children with BECTS.

目的:探讨功能性消化不良(FD)的临床特点及躯体化症状,为临床提供依据.方法:分析1088例FD患者的临床资料,采用焦虑/抑郁量表(SAS/SDS)、消化不良症状量表、躯体化量表评分,研究性别、年龄、体重指数(BMI)、文化程度、病程、病情严重程度、临床特点、躯体化、焦虑抑郁情况.结果:性别:FD患者中,女性明显多于男性(72.1％ vs27.9％)(p＜0.05);年龄:40～49岁和50～60岁(45.6％、41.2％),(p＜0.05);BMI:18～24之间(78.7％)(p＜0 05);学历:小学和初中为主(552例、328例)(50.7％、30.2％) (p＜0.05);SAS:PDS组50～60分408例(66.2％),EPS组SAS＜50分200例,50～60分248例(42.4％、52.5％)(p＜0.05);SDS:PDS组SDS＜50分136例,50～59分440例(22.1％、71.4％),EPS组SDS＜50分176例,50～59分272例(37.3％、57.6％)(p＜0.05);症状比较:消化不良864例(79.4％),疲乏848例(77.9％),腹痛816例(75.0％),餐后饱胀768例(70.6％),口干768例(70.6％),麻木688例(63.2％),健忘656例(60.3％),咽痛640例(58.8％).结论:FD发病年龄在40-60岁之间,以女性多见,小学或初中学历为主,与年龄、性别、文化程度、焦虑抑郁状况关系密切,以轻中度焦虑、抑郁为主,以消化不良、乏力、腹痛、餐后饱胀、口干、麻木、咽痛等症状为主,早诊断、早治疗有利于改善患者预后.

Objective To study the changes of cognitive function and brain microstructure of patients with benign epilepsy of childhood with centrotemporal spikes (BECTS) from neuropsychological test and voxel-based morphometry.Methods Sixteen patients with BECTS and 16 healthy volunteers,who were matched in gender,age and education,were enrolled in this study from May 2014 to May 2015 in the Affiliated Hospital of North Sichuan Medical College.The cognitive function and morphometry of the subjects were evaluated by neuropsychological test (full scale intelligence quotient (FSIQ),verbal intelligence quotient (VIQ) and performance intelligence quotient (PIQ)) and high-resolution T1-weighted imaging scanning.Thereafter,these data were analyzed with Student's t test,Chi-squared test and correlation analysis.Results (1) FSIQ(79.3±13.3),VIQ(82.3±12.1) andPIQ(81.3±10.3)ofBECTS group were significantly lower than the control group (107.0 ± 6.4,101.6 ± 6.5,114.8 ± 6.2;t =9.511,7.521,16.360,all P ＜0.01).(2) Patients with BECTS showed significantly increased gray matter volume in the bilateral putamen,paracentral lobule and right supplementary motor area (P ＜ 0.05,FDR-corrected).(3) A significant negative correlation was found between the gray matter volume of the left putamen and age of epilepsy onset (r=-0.586,P=0.017).Conclusions (1) There is a certain degree of cognitive impairment in patients with BECTS.(2) Patients with BECTS have some changes in brain microstructure.Genetic factors could indirectly influence the children's brain developmental trajectory,and the age of onset may be associated with the changes on the brain microstructure.

Benign epilepsy with centrotemporal spikes (BECT) is the most common form of childhood idiopathic focal epilepsy syndrome. We investigated quantitative evidence regarding brain morphology and functional connectivity features to provide insight into the neuroanatomical foundation of this disorder, using high resolution T1-weighted magnetic resonance imaging (MRI) and resting state functional MRI in 21 patients with BECT and in 20 healthy children. The functional connectivity analysis, seeded at the regions with altered gray-matter (GM) volume in voxel-based morphometry (VBM) analysis, was further performed. Then, the observed structural and functional alteration were investigated for their association with the clinical and behavior manifestations. The increased GM volume in the striatum and fronto-temporo-parietal cortex (striato-cortical circuit) was observed in BECT. The decreased connections were found among the motor network and frontostriatal loop, and between the default mode network (DMN) and language regions. Additionally, the GM of striatum was negatively correlated with age at epilepsy onset. The current observations may contribute to the understanding of the altered structural and functional feature of striato-cortical circuit in patients with BECT. The findings also implied alterations of the motor network and DMN, which were associated with the epileptic activity in patients with BECT. This further suggested that the onset of BECT might have enduring structural and functional effects on brain maturation.

Objective Aδ and C fiber nociceptors can be excited when people received contact heat stimulation(CHS) and this excitation may be reflected by functional magnetic resonance imaging(fMRI).The aim of this study was to observe the different fMRI characteristics in CHS with distinct temperatures in healthy people and to explore the pain related functional network.Depending on the fMRI results,we can evaluate the values of CHS-fMRI during the research of brain functional connectivity.Methods Twenty-two healthy volunteers were recruited to this study.During the acquisition of fMRI,the right dorsal forearm received two different CHS in 41 and 51 degree respectively(41 ℃ CHS-fMRI group and 51 ℃ CHS-fMRI group),and two series of fMRI data were obtained for each subject.The brain activation was obtained by using one sample t test for the 41 ℃CHS-fMRI group and 51 ℃CHS-fMRI group separately.The difference between 41 ℃ CHS-fMRI group and 51 ℃ CHS-fMRI group was analyzed by paired-sample t-test.Result These activated brain areas in 41 ℃ CHS-fMRI group included bilateral superior temporal gyrus (STG),contralateral transverse temporal gyrus,contralateral amygdala,bilateral insula,bilateral inferior frontal gyrus (IFG),contralateral hippocampus,bilateral putamen,contralateral supramarginal,ipsilateral postcentral,ipsilateral inferior parietal lobule,ipsilateral middle temporal gyrus (MTG),bilateral cerebelum,bilateral middle cingulate cortex and bilateral posterior cingulate cortex.These activated brain areas in 51 ℃ CHS-fMRI group included bilateral STG,bilateral amygdala,contralateral hippocampus,bilateral thalamus,contralateral putamen,bilateral insula,bilateral IFG,bilateral cerebellum,contralateral postcentral,contralateral superior parietal lobule,bilateral MTG,bilateral precuneus,and contralateral cuneus.Compared with 41 ℃ CHS-fMRI group,the 51 ℃ CHS-fMRI group showed higher brain activation in bilateral cerebellum (right:4.455,left:3.891),ipsilateral precuneus (4.150),contralateral insula (3.530),contralateral IFG (3.530),and contralateral postcentral (3.530; t =2.83,P ＜ 0.01).Conclusions There are common brain activated areas and specific areas for each group,which suggested that existence of two central pathways activated by Aδ and C fiber which have different effects in perception of pain and have their brain network responsively.It may become one of the ideal pain stimulation methods with CHS-fMRI,which warrant worth further research.

胆囊癌(Gallbladder carcinoma,GBC)是胆道系统常见的恶性肿瘤之一,约占全部道系统肿瘤的2/3,发病年龄大多为50岁以上中老年人,男女发病率比例大约为1∶3,其发病率随着年龄的增长而呈上升趋势[1]. 1 病历摘要 患者女,69岁,因腹痛半月入院.患者入院前半月无明显诱因出现腹痛、位置不固定,脐周明显,稍感腹胀,伴食欲减退、恶心、呕吐,伴腹泻,3～4次/d,无黏液及脓血,无腹鸣、腹块,无呕血、黑便,无明显消瘦,院外治疗,腹泻、呕吐缓解,但仍感腹痛,既往有肺结核病史,6个月前患者院外行B超提示"胆囊结石",曾在当地基层医院治疗,效果不佳.

Peripheral nerve injury repairing technology has been developed from single microsurgical approach to neural transplantation,tissue engineering,gene therapy,etc,which greatly enriches and developes the repairing technology of peripheral nerve injury. However,all kinds of repairing technique have certain limitations,needing further research. This article will present more details of the research progress of peripheral nerve injury repairing technology.