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BACKGROUND:Previous studies have shown that puerarin can inhibit the differentiation of osteoclasts,and the expression of Notch signaling pathway-related proteins such as Notch1,HES1,and Jagged1 is decreased.However,the specific mechanism of the Notch1 signaling pathway for the inhibition of osteoclast differentiation by puerarin is not clear. OBJECTIVE:To explore the effect of Notch signaling pathway on puerarin inhibiting the differentiation of mouse macrophage Raw264.7 into osteoclasts. METHODS:Raw264.7 cells were divided into seven groups for intervention culture.Blank control group was cultured in high-sugar DMEM medium;the osteoclast induction group was cultured in osteoclast induction medium;the puerarin intervention group was cultured with 50 μmol/L puerarin at the same time of osteoclast induction;Notch1 siRNA control group,Notch1 siRNA group,Notch1 overexpression control group and Notch1 overexpression group were transfected with Notch1 siRNA control sequence,Notch1 siRNA,Notch1 overexpression control plasmid and Notch1 overexpression plasmid,respectively,and then cultured with osteoclast induction medium and puerarin.The number and size of osteoclasts were observed by tartrate-resistant acid phosphatase staining,the skeleton formation of osteoclasts was observed by F-actin staining,and the gene expression level of osteoclast formation markers was detected by RT-PCR. RESULTS AND CONCLUSION:Tartrate-resistant acid phosphatase staining results showed that puerarin intervention could inhibit the generation of osteoclasts,Notch1 silencing could further reduce the number of osteoclasts,while the number of osteoclasts in the osteoclast-induced group increased significantly after Notch1 overexpression.The results of F-actin showed that Raw264.7 cells could form a well-defined F-actin ring after osteoclast induction.Puerarin intervention would inhibit the formation of cytoskeleton,and Notch1 silencing could aggravate the inhibitory effect of cytoskeleton formation,while Notch1 overexpression could alleviate this inhibitory effect of puerarin.RT-PCR results showed that puerarin could inhibit the mRNA expression levels of tartrate-resistant acid phosphatase,Cathepsin K and c-Fos,the expression of the above-mentioned three factors decreased significantly after Notch1 gene silencing,and Notch1 overexpression could upregulate the expression of these factors.These finding indicate that puerarin inhibits the differentiation of Raw264.7 cells into osteoclasts through the Notch signaling pathway.

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Objective To explore the application effect of enteral nutrition-related diarrhea in postoperative esophageal cancer patients.Methods Based on literature search and expert meeting,a management process for enteral nutrition-associated diarrhea in postoperative esophageal cancer patients was constructed.A convenience sampling method was used to select a total of 68 patients with enteral nutrition-related diarrhea after esophageal cancer surgery admitted to the thoracic surgery department of a tertiary A cancer hospital in Jiangsu Province.Among them,patients admitted from January 2022 to December 2022 were set as an experimental group.The experimental group was implemented the management process for enteral nutrition-associated diarrhea in postoperative esophageal cancer patients.Those admitted from January 2021 to December 2021 were set as a control group with routine nursing.Then,the time of stopping diarrhea,the King's of Stool Chart(KSC-Tr)diarrhea score,and abnormal incidence of nutrition-related indexes,electrolytes abnormalities(low sodium,low potassium,and low calcium)were compared between 2 groups.Results The time of stopping diarrhea,KSC diarrhea score after 3 days of intervention and the time to achieve target feeding volume of the experimental group were lower than those in the control group,and the difference was statistically significant(P＜0.05).There were no significant differences in hemoglobin,albumin,prealbumin after 3 days of intervention,the incidence of electrolyte abnormalities(low sodium,low potassium,and low calcium)after 3 days of intervention,and the BMI index after 7 days of intervention between 2 groups(P＞0.05).Conclusion The management process for enteral nutrition-associated diarrhea in postoperative esophageal cancer patients can reduce the time of diarrhea,improve the severity of diarrhea,and shorten the time to achieve the target feeding,but has no significant change in the incidence of electrolyte abnormalities.

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Objective:To explore the association between the G71R polymorphism of the UGT1A1 gene and neonatal hyperbilirubinemia. Methods:DNA was extracted from blood samples of 61 neonates with severe neonatal hyperbilirubinemia(severe neonatal hyperbilirubinemia group), 60 neonates with hyperbilirubinemia(hyperbilirubinemia group) and 62 healthy neonates(control group), the G71R mutation of UGT1A1 gene was analyzed by direct sequencing. Results:In severe neonatal hyperbilirubinemia group, there were 17 cases of homozygous mutation(A/A), 23 cases of heterozygous mutation(A/G) , and 21 cases of wild type(G/G) , with 28.87% homozygous mutation rate and 37.70% heterozygous mutation rate.In neonatal hyperbilirubinemia group, there were ten cases of homozygous mutation(A/A), 28 cases of heterozygous mutation(A/G) and 22 cases of wild type(G/G), with 16.67% homozygous mutation rate and 46.67% heterozygous mutation rate.In the control group, there were nine cases of homozygous mutation (A/A), 28 cases of heterozygous mutation(A/G) and 25 cases of wild type(G/G), among which the homozygous mutation rate was 14.52% and the heterozygous mutation rate was 45.16%.The genotype frequency( χ2=4.14, P=0.38)and allele frequency( χ2=2.47, P=0.29)of G71R in severe neonatal hyperbilirubinemia group, neonatal hyperbilirubinemia group and control group were not statistically significant. Conclusion:The G71R polymorphism of the UGT1A1 gene may not be significantly correlated with the prevalence of neonatal hyperbilirubinemia.

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Objective To investigate the expression levels of scf and c-kit under the regulation of Dahuang Lingxian prescription and the possible mechanism of its effect on gallbladder dynamics, and to provide a theoretical basis for Dahuang Lingxian prescription in preventing the development and recurrence of cholesterol gallstone. Methods A total of 45 specific pathogen-free healthy male guinea pigs were randomly divided into normal group, model group, and traditional Chinese medicine (TCM) group. The guinea pigs in the normal group were fed with normal diet, and those in the model group and the TCM group were fed with high-fat lithogenic diet. After 8 weeks of feeding, 5 guinea pigs were randomly selected from each group, and successful modeling was determined if gallstone was observed with the naked eye in more than 4 guinea pigs. After successful modeling, the guinea pigs in the TCM group were given Dahuang Lingxian prescription by gavage, and those in the model group were given an equal volume of normal saline by gavage. After 8 consecutive weeks of administration by gavage, gallbladder tissue samples were collected, and HE staining was used to observe the pathological changes of gallbladder tissue; Western blot was used to measure the expression level of tumor necrosis factor-α (TNF-α) in gallbladder tissue; immunohistochemistry was used to measure the protein expression levels of scf and c-kit in gallbladder smooth muscle tissue. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference multiple comparison method was used for further comparison between two groups. Results HE staining showed marked inflammation of gallbladder tissue in the model group, and compared with the model group, the TCM group had a significantly lower degree of inflammation. Western blot showed that the model group had the highest expression level of TNF-α in gallbladder tissue, followed by the TCM group and the normal group ( P < 0.05); immunohistochemistry showed that compared with the model group, the normal group and the TCM group had significantly higher protein expression levels of scf and c-kit in gallbladder smooth muscle tissue ( P < 0.05). Conclusion Dahuang Lingxian prescription can enhance the dynamic function of the gallbladder, possibly by upregulating the scf/c-kit signaling pathway in interstitial cells of Cajal in gallbladder.

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The objective of this research was to study the correlation between PPARγ, Aß1-42, miR-155 and the occurrence and development of diabetes. For this purpose, 52 patients with diabetes who were hospitalized from September 2019 to May 2021 were selected as the research objects. They were grouped according to the severity of the disease, which was pre-diabetes (n=16), mild (n=25), and moderate (n=16). =11), another 20 healthy subjects were taken as the control group, and the levels of PPARγ, Aß1-42, miR-155 in each group were measured, and the correlation between changes in the levels of various indicators and the occurrence and development of diabetes was explored. Results showed that comparison of age, gender, course of disease, BMI, living habits, comorbidities, and high-density lipoprotein among the groups of diabetic patients (P>0.05); the levels of total cholesterol, triglycerides and low-density cholesterol decreased with the development of diabetes (P<0.05) ); Compared with the healthy group, the levels of PPARγ and miR-155 were significantly reduced, and the levels of Aß1-42 were significantly increased (P<0.05); compared with the prediabetes, the levels of mild and moderate PPARγ and miR-155 showed a downward trend, and Aß1 -42 level showed an upward trend (P<0.05); PPARγ and miR-155 levels were negatively correlated with pre-diabetes, mild, and moderate; Aß1-42 was positively correlated with pre-diabetes, mild, and moderate (P<0.05) ; PPARγ, Aß1-42, miR-155 levels can effectively predict the occurrence and development of diabetes, and the sensitivity, specificity and accuracy of the detection of diabetes by various indicators, positive predictive value and negative predictive value are significantly higher. It is concluded that PPARγ, Aß1-42, miR-155 are closely related to the occurrence and development of diabetes, and there are many influencing factors of diabetes. Clinical intervention measures can be taken according to specific conditions.

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Objective:To investigate the drug resistance of patients with acquired immunodeficiency syndrome (AIDS) who failed antiviral therapy.Methods:A total of 156 AIDS patients with antiviral therapy failure at the Sixth People′s Hospital of Zhengzhou from October 2017 to December 2018 were selected. The human immunodeficiency virus (HIV)-1 ViroSeq? genotyping method was used for the detection of HIV resistance, and Stanford University HIV drug resistance database (http: ∥hivdb.stanford.edu/) was used for testing results comparison.Results:Among the 156 AIDS patients with antiviral therapy failure, 122(78.21%) developed drug resistance. One hundred and six (67.95%) cases were multi-resistant to nucleoside reverse transcriptase inhibitor (NRTI), among which, 104 (66.67%) were resistant to lamivudine, emtricitabine and abacavir. One hundred and eighteen (75.64%) were resistant to non-nucleoside reverse transcriptase inhibitor (NNRTI), and 118 (75.64%) were multi-resistant to efavirenz and nevirapine. And seven (4.49%) were resistant to protease inhibitor (PI). There were 16 resistant sites for NRTI, with 87 (71.31%) most frequent M184V/I mutations. There were 13 resistant sites for NNRTI, with 49 (40.16%) K103N/R mutations. There were 11 resistant sites for PI, with 49 (40.16%) A71V/T mutations. The antiviral drugs lamivudine and emtricitabine were moderately and highly resistant in 102 (83.61%) cases, efavirenz and nevirapine were moderately and highly resistant in 117 (95.90%) cases. Once drug resistance developed, these drugs were likely to be moderate or high resistance. There were 29 (23.77%), 48 (39.34%), and five (4.10%) cases were resistant to zidovudine, tenofovir and lopinavir/ritonavir, respectively. The resistance barrier of these drugs was relatively high.Conclusion:The incidence of drug resistance in patients with AIDS treatment failure is high, and multi-drug resistance is serious with various sites of drug resistance.

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Objective:To discuss the quantitative evaluation of left ventricular systolic function in patients with light-chain amyloidosis (AL) by pressure-strain loop (PSL).Methods:Forty-six patients with clinically diagnosed as AL in the Affiliated Tumor Hospital of Zhengzhou University from January 2018 to December 2020 were selected as case group, and they were divided into 2 groups according to whether the thickness of interventricular septum and posterior wall at end-diastole was >12 mm; ①cardiac amyloidosis (CA) group (21 cases, the thickness>12mm); ②non cardiac amyloidosis (NCA) group (25 cases, the thickness≤12 mm). Twenty five healthy volunteers were selected as control group at the same time. Routine echocardiography was performed in all subjects.Two-dimensional dynamic images of the left ventricular apical two-chamber, three-chamber, and four-chamber views were collected for three consecutive cardiac cycles using two-dimensional speckle-tracking. A tracing analysis was conducted and blood pressure was entered on the off-line Echo PAC 203 software, and the left ventricular global longitudinal strain (GLS), peak strain time dispersion(PSD), global myocardial work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE) were obtained. The differences of GLS, PSD and myocardial work (GWI, GCW, GWW, GWE) parameters were compared between groups, and Pearson correlation was used to analyze the correlations.Results:①Routine echocardiography: Compared with the control group and NCA group, inter-ventricular septum thickness (IVST), left ventricle posterior wall thickness (LVPWT), left ventricular mass index (LVMI), left atrial diameter (LAD), and E/e′ in CA group were increased, while left ventricular ejection fraction (LVEF) was decreased; ②Compared with the control group, GLS, GWI, and GCW in NCA group were decreased, while there were no statistically differences in GWE, PSD, and GWW between the two groups (all P>0.05); Compared with the control group and NCA group, GLS, GWI, GCW, and GWE were obviously decreased, while PSD and GWW were obviously increased in CA group.③ Correlation analysis showed that: the absolute value of GLS was positively correlated with GWI, GCW and GWE ( r=0.654, 0.695, 0.788; all P<0.001), and negatively correlated with GWW, and PSD ( r=-0.710, -0.625; all P<0.001). Besides, PSD had negative correlation with GWI, GCW and GWE ( r=-0.754, -0.653, -0.702; all P<0.001), and positive correlation with GWW ( r=0.676, P<0.001). Conclusions:PSL can quantitatively evaluate the left ventricular systolic function of AL patients, while the myocardial work parameters are conducive to evaluate the degree of cardiac involvement in the course of AL patients.

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To determine the neural mechanism underlying the effects of sound therapy on tinnitus, we hypothesize that sound therapy may be effective by modulating both local neural activity and functional connectivity that is associated with auditory perception, auditory information storage or emotional processing. In this prospective observational study, 30 tinnitus patients underwent resting-state functional magnetic resonance imaging scans at baseline and after 12 weeks of sound therapy. Thirty-two age- and gender-matched healthy controls also underwent two scans over a 12-week interval; 30 of these healthy controls were enrolled for data analysis. The amplitude of low-frequency fluctuation was analysed, and seed-based functional connectivity measures were shown to significantly alter spontaneous local brain activity and its connections to other brain regions. Interaction effects between the two groups and the two scans in local neural activity as assessed by the amplitude of low-frequency fluctuation were observed in the left parahippocampal gyrus and the right Heschl's gyrus. Importantly, local functional activity in the left parahippocampal gyrus in the patient group was significantly higher than that in the healthy controls at baseline and was reduced to relatively normal levels after treatment. Conversely, activity in the right Heschl's gyrus was significantly increased and extended beyond a relatively normal range after sound therapy. These changes were found to be positively correlated with tinnitus relief. The functional connectivity between the left parahippocampal gyrus and the cingulate cortex was higher in tinnitus patients after treatment. The alterations of local activity and functional connectivity in the left parahippocampal gyrus and right Heschl's gyrus were associated with tinnitus relief. Resting-state functional magnetic resonance imaging can provide functional information to explain and 'visualize' the mechanism underlying the effect of sound therapy on the brain.

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The aim of this study is to determine the accuracy of RSI and RFS in the diagnosis of hypopharyngeal reflux （LPR）, the scores of RSI and RFS were compared in different age groups. To explore the RSI and RFS scoring thresholds for diagnosis of LPR in different age groups. From January 2017 to March 2019, 258 patients with suspected LPR in our hospital outpatient clinic completed the RSI and RFS scales. According to their age, 258 patients with RSI>13 and RFS>7 were selected. They were divided into group A （18-0.05）, RSI score was significantly different （<0.05）, RSI score of group A and group B was higher than that of group C （<0.05）. According to ROC analysis, the best RSI cutoffs for diagnosing LPR in group C was 11, and the area under the ROC curve was 0.866. The RSI score is a good criterion for the diagnosis of LPR. The diagnostic threshold of RSI in elderly patients is different from that in young patients. For elderly patients, the diagnostic threshold for the recommended RSI score is 11.

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Objective:The blood free carnitine levels of preterm infants with neonatal respiratory distress syndrome (NRDS) were detected within 7 days after birth, and the correlation between blood free carnitine levels and NRDS in preterm infants was explored.Methods:Seventy premature infants with gestational ages from 28 to 36 weeks who were admitted to the NICU of the Affiliated Hospital of Inner Mongolia Medical University from January 1, 2017 to December 31, 2019 were selected as the participants.Among them, 35 cases were in the NRDS group, while 35 cases of premature infants without NRDS were chosen as the control group.Heel blood samples were collected from all subjects within 6 hours, 3 days and 7 days after birth, and the levels of blood free carnitine were detected by tandem mass spectrometry.Results:Within 7 days after birth, the levels of free carnitine in blood of premature infants in the two groups gradually decreased with time, but the decreasing trend was not similar( F=4.096, P=0.021). Compared with 6 hours after birth, the blood free carnitine level in NRDS group decreased significantly with 3 days after birth[(35.24±9.58) μmol/L vs.(23.96±7.12) μmol/L, P<0.05]. The levels of blood free carnitine in NRDS group at 6 hours and 3 days after birth were significantly lower than those in control group[(35.24±9.58) μmol/L vs.(40.85±11.39) μmol/L; (23.96±7.12) μmol/L vs.(29.60±8.05) μmol/L, P<0.05]. There was no significant difference in blood free carnitine levels between the two groups at 7 days after birth ( P>0.05). Conclusion:The blood free carnitine levels of premature infants decreased within 7 days after birth.The decrease of carnitine level in premature infants with NRDS may be related to the occurrence and development of NRDS.

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Objective:To explore the effect of PSD-95 inhibitor ZL006 in neonatal rats with hypoxic-ischemic brain damage(HIBD) and its potential mechanism.Methods:The seven-day-old healthy Wistar rats( n=80) were randomly divided into control group( n=20), sham operation group( n=20) and operation group (HIBD model group, n=40). The operation group was randomly divided into ZL006, treatment group (intraperitoneal injection of ZL006, 10 mg/kg, n=20) and non-treatment group ( n=20). The neonatal rats of each group were randomly selected on the 1st and 7th day after operation, and the degree of cerebral infarction was observed by triphenyl tetrazolium chloride staining.The protein expression level of brain tissue in the injured area was examed by Western blot, and the effects of ZL006 on oxidative stress and antioxidant enzymes in rats with HIBD were evaluated by ELISA. Results:(1) On the first day after operation, the brain injury was the most serious in the non-treatment group, and the cerebral infarction decreased in the ZL006 treatment group.On the 7th day after operation, a little infarction could be seen in the operation group, but there was no significant difference among other three groups.(2)On the first day after operation, the expression of PSD-95 protein in the operation group was significantly higher than that in the control group and sham operation group( P<0.01). There was significant difference in the expression of PSD-95 protein between the ZL006 treatment group and the non-treatment group ( P<0.05). On the 7th day after operation, there was no significant difference in the expression of PSD-95 protein among three groups.(3)On the first day after operation, the expression of 4-hydroxynonenal in the operation group was significantly higher than that in the control group and sham operation group( P<0.01), and that in the non-treatment group was higher than that in the ZL006 treatment group ( P<0.05). On the 7th day after operation, there was no significant difference in the expression of 4-hydroxynonenal among three groups.(4) On the first day after operation, the expression of superoxide dismutase in the operation group was significantly lower than that in the control group and sham operation group( P<0.01), and that in the non-treatment group was lower than that in the ZL006 treatment group ( P<0.05). There was no significant difference in the expression level of superoxide dismutase among three groups on the 7th day after operation. Conclusion:It is suggested that PSD-95 may be involved in the early pathogenesis of HIBD, and ZL006 may have neuroprotective effect on HIBD in newborn rats.

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Objective:To evaluate the left ventricular systolic function and synchronization of patients with early left breast cancer after breast conserving radiotherapy by layer-specific strain technique.Methods:Thirty-six patients with early left breast cancer who underwent breast surgery and radiotheraphy in Affiliated Tumor Hospital of Zhengzhou University from January 2018 to January 2019 were selected for this study. The layered strain technique was respectively applied to collect two-dimensional dynamic ultrasonic cardiograms one week before radiotherapy, one week after radiotherapy, and six months after radiotherapy. The EchoPAC 201 software was applied to analyze and obtain the global longitudinal peak strain(GLPS) and peak stain dispersion(PSD) of the epicardial layer(epi), the middle layer(mid) and endocardial layer(endo) of 17 left ventricular segments. The differences of every parameter before and after radiotherapy were compared, and the correlation of PSD and other parameters was analyzed.Results:Compared with one week before radiotherapy, the absolute values of LPSepi, LPSmid, LPSendo, and GLPS all reduced significantly one week and six months after radiotherapy, and PSD increased significantly ( P<0.05). Compared with one week after radiotherapy, the LPS absolute value of every layer and GLPS obviously reduced after six months, PSD obviously increased, the difference had statistical significance ( P<0.05). PSD and GLPS displayed negative correlation one week after radiotherapy ( r=-0.420, P<0.05), PSD and GLPS displayed negative correlation six months after radiotherapy ( r=-0.641, P<0.05). Conclusions:Layered strain technique can noninvasively and quantitatively evaluate the early changes of global and layered longitudinal peak strain and systolic synchrony of left ventricle in left breast cancer breast-conserving radiotherapy patients, and provides a new noninvasive test method for evaluating radioactive myocardial injury, and it has a certain guiding value to early clinical intervention and treatment of cardiovascular complications.

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Objective:To explore the clinical application value of S-Detect intelligent assistant diagnosis technology in the diagnosis of suspicious thyroid nodules.Methods:A total of 153 patients who were diagnosed as TI-RADS 3-4 according to the ACR TI-RADS standard by ultrasound examination in Henan Provincial Cancer Hospital from September 2019 to December 2019 were included in the study. Differential diagnosis of benign and malignant thyroid nodules were made by senior doctors, junior doctors and S-Dectect technology, respectively. Then using pathological results as the standard, receiver operating charateric curve(ROC) curves were plotted to compare the area under curve (AUC), sensitivity, specificity and accuracy of S-Detect, senior and junior doctor groups, as well as their combinations.Results:Of the 153 patients with thyroid nodules, 108 cases(108 nodules) were comfirmed benign and 45 cases(45 nodules) were malignant afeer operation. The diagnostic sensitivity, specificity and accuracy of S-Detect were 77.78%, 87.04%, 84.31%. They were higher than junior doctors(68.89%, 79.63%, 76.47%), but lower than senior doctors(84.44%, 94.44%, 91.50%). The diagnostic sensitivity, specificity and accuracy in junior doctors combined with S-Detect were significantly improved(77.78%, 85.18%, 83.01%). The area under curve of S-Detect diagnosis was higher in the group of junior doctors combined with S-Detect (0.815) than that in the group of junior doctors (0.743), and the difference was statistically significant (χ 2=8.332, P=0.004). There was no statistically significant difference (χ 2=0.095, P=0.756) in the AUC of diagnosis between the group of senior doctors combined with S-Detect(0.901) and senior doctors(0.894). Using pathological results as the "gold standard" , the highest consistency of diagnosis was found in the senior doctors combined with S-Detect(Kappa=0.797). Conclusions:S-Detect technology has a high accuracy in the differential diagnosis of thyroid nodules. With the aid of this technology, it can improve the specificity and accuracy of diagnosis for the junior doctors.

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Objective@#The aim of this study is to determine the accuracy of RSI and RFS in the diagnosis of hypopharyngeal reflux （LPR）, the scores of RSI and RFS were compared in different age groups. To explore the RSI and RFS scoring thresholds for diagnosis of LPR in different age groups. @*Method@#From January 2017 to March 2019, 258 patients with suspected LPR in our hospital outpatient clinic completed the RSI and RFS scales. According to their age, 258 patients with RSI>13 and RFS>7 were selected. They were divided into group A （18-<40 years, n=86）, group B （40-<60 years, n=107） and group C （≥60 years, n=65）. The diagnosis was confirmed by 24 h pH-metry. The diagnostic rate, RSI and RFS scores were compared among the three groups. ROC curve was used to analyze the optimal thresholds for the diagnosis of LPR by RSI and RFS scores. @*Result@#Among the three groups, group C had the highest diagnostic rate（93.85%）. There was no significant difference in RFS score among the three groups （P>0.05）, RSI score was significantly different （P<0.05）, RSI score of group A and group B was higher than that of group C （P<0.05）. According to ROC analysis, the best RSI cutoffs for diagnosing LPR in group C was 11, and the area under the ROC curve was 0.866. @*Conclusion@#The RSI score is a good criterion for the diagnosis of LPR. The diagnostic threshold of RSI in elderly patients is different from that in young patients. For elderly patients, the diagnostic threshold for the recommended RSI score is 11.

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Previous resting-state functional magnetic resonance imaging (fMRI) studies have shown neural connectivity alterations after the treatment of tinnitus. We aim to study the value of the baseline functional connectivity features of neural network nodes to predict outcomes of sound therapy through adjusted narrow band noise. The fMRI data of 27 untreated tinnitus patients and 27 matched healthy controls were analyzed. We calculated the graph-theoretical metric degree centrality (DC) to characterize the functional connectivity of the neural network nodes. Therapeutic outcomes are determined by the changes in the Tinnitus Handicap Inventory (THI) score after a 12-week intervention. The connectivity of 10 brain nodes in tinnitus patients was significantly increased at baseline. The functional connectivity of right insula, inferior parietal lobule (IPL), bilateral thalami, and left middle temporal gyrus was significantly modified with the sound therapy, and such changes correlated with THI changes in tinnitus patients. Receiver operating characteristic curve analyses revealed that the measurements from the five brain regions were effective at classifying improvement after therapy. After age, gender, and education correction, the adjusted area under the curve (AUC) values for the bilateral thalami were the highest (left, 0.745; right, 0.708). Our study further supported the involvement of the fronto-parietal-cingulate network in tinnitus and found that the connectivity of the thalamus at baseline is an object neuroimaging-based indicator to predict clinical outcome of sound therapy through adjusted narrow band noise.

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BACKGROUND: Tinnitus is considered to be triggered by aberrant neural activity in the brain. Sound therapy is regarded as a reasonable management option for tinnitus treatment and has been applied in the clinical setting for decades. HYPOTHESIS: We hypothesized that sound therapy, a commonly used tinnitus treatment method, would alter the functional connectivity (FC) of brain regions in tinnitus models. STUDY TYPE: Longitudinal. POPULATION: Resting-state functional MRI data were collected from 27 tinnitus patients before and after 12 weeks of sound therapy. Twenty-seven age- and sex-matched healthy controls were also longitudinally scanned at the 12-week timepoint. FIELD STRENGTH: 3.0T MRI system and echo planar imaging (EPI) sequence, 3D brain volume imaging (BRAVO) sequence. ASSESSMENT: Functional connectivity strength (FCS), a graph-theoretical-based analytic method, was applied to analyze the FC features in the whole brain. STATISTICAL TESTS: Student's t-test and chi-square test were used for analyses between two groups. A two-way analysis of covariance (ANCOVA) followed by post-hoc analyses was performed to determine differences of FC. RESULTS: The interaction effect between the two groups and two scans on FCS was observed in the bilateral thalami and left anterior cingulate cortex (ACC). The fitted FCS values in the bilateral thalami were significantly higher in tinnitus patients at baseline and decreased to a relatively normal range after sound therapy compared with healthy controls. Conversely, the fitted FCS values in the left ACC were within the normal range, but increased after treatment (1.08 ± 0.29, P < 0.02); however, there was no change in the control group. Importantly, significant correlations were observed between the FCS changes in the right thalamus (P = 0.028), the FC of the right thalamus-right inferior frontal gyrus (P = 0.015), and symptomatic improvement. DATA CONCLUSION: Sound therapy may modulate the brain network by altering the gating function of the thalamus as well as enhancing the tinnitus-canceling system. LEVEL OF EVIDENCE: 2 Technical Efficacy Stage: 4 J. Magn. Reson. Imaging 2019;50:1731-1741.

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Objective@#To study the predictive value of general movements(GMs) quality assessment technique(writhing movements)on the motor development outcome of high-risk infants, so as to provide a reference basis for clinical diagnosis and treatment.@*Methods@#A retrospective analysis was made on the high-risk infants who were hospitalized in the Neonatal Department of the Affiliated Hospital of Inner Mongolia Medical University from January 1, 2017 to December 31, 2018, and the GMs quality assessment was finished and followed up to 12-month-old among high-risk infants.The clinical diagnostic criteria for patients with cerebral palsy and Peabody Development Motor Scales-2(PDMS-2)were used to evaluate the motor development outcome of 12-month-old high-risk infants.Furthermore, the predictive value of GMs writhing movements on the motor development outcome of high-risk infants were evaluated.@*Results@#The predictive validity of writhing movements phase[cramped synchronized(CS)+ poor repertoire(PR)]for motor retardation and cerebral palsy in high-risk infants who met the inclusion criteria were as follows: the sensitivity, specificity, positive predictive value, negative predictive value were 94.44%, 23.03%, 11.04%, 97.62% and 100%, 21.88%, 2.60%, 100%, respectively.The predictive sensitivity and negative predictive value of writhing movements PR for motor retardation and cerebral palsy were 92.31%, 100%; 98.18%, 100% respectively.The predictive sensitivity, specificity and negative predictive value of writhing movements CS for motor retardation and cerebral palsy were 100%, 95.81%, 100% and 100%, 95.31% and 100%, respectively.@*Conclusion@#GMs quality assessment(writhing movements)has high reliability in predicting the motor development outcome of high-risk infants, especially cramped-synchronized has significant value in early screening of children with motor retardation and cerebral palsy.

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Objective@#To explore the relationship between serum glial fibrillary acidic protein (GFAP) level and neonatal hypoxic-ischemic encephalopathy (HIE), and to verify whether GFAP combined with craniocerebral magnetic resonance imaging (MRI) can more accurately evaluate the prognosis of HIE.@*Methods@#We selected HIE children who hospitalized in the department of neonatology, the affiliated hospital of Inner Mongolia Medical University from January 2017 to December 2017, and full-term newborns without brain injury who were hospitalized in the same period. Serum samples were taken for GFAP detection on the 1st, 3rd, 7th day after birth of HIE and the 3rd day after birth of full-term newborns without brain injury. All the subjects completed craniocerebral MRI examination and followed up. At the same time, the correlation between GFAP level and the severity of brain MRI was evaluated.@*Results@#⑴ The level of serum GFAP in HIE group on the 3rd day after birth [(5.54±1.30)ng/ml] was significantly higher than that in control group [(3.38±0.31)ng/ml] (P<0.01). ⑵ Comparison of serum GFAP levels in HIE children with different degrees: the serum levels of GFAP in the severe group on the 1st, 3rd and 7th day were as follows: (5.56±1.89)ng/ml, (6.42±1.63)ng/ml, (7.22±1.30)ng/ml; the serum levels of GFAP in moderate group on the 1st, 3rd and 7th day were as follows: (5.07±0.62)ng/ml, (6.73±0.772)ng/ml, (6.25±0.812)ng/ml; the serum levels of GFAP in mild group on the 1st, 3rd and 7th day were as follows: (4.20±0.13)ng/ml, (5.34±0.33)ng/ml, (4.52±0.33)ng/ml; the serum GFAP levels in severe group were higher than those in moderate group and mild group on the 1st, 3rd and 7th day, and those in moderate group were higher than those in mild group (P<0.01). ⑶ Comparison of serum GFAP levels between sequelae group and non-sequelae group: there was no significant difference between sequelae group [(5.22±1.52)ng/ml, (6.48±1.17)ng/ml] and non-sequelae group [(4.47±0.50)ng/ml, (5.75±0.88)ng/ml] on the 1st and 3rd day (P>0.05); there was significant difference between sequelae group [(6.93±1.29)ng/ml] and non-sequelae group [(4.91±0.77)ng/ml] on the 7th day (P<0.01). ⑷ Comparison of serum GFAP levels between abnormal group of MRI and normal group of MRI: the levels of serum GFAP on day 1, 3 and 7 in abnormal craniocerebral MRI group were as follows: (5.25±1.28)ng/ml, (6.66±1.10)ng/ml, (6.64±1.08)ng/ml; the levels of serum GFAP on day 1, 3 and 7 in the normal group of MRI were as follows: (4.26±0.25)ng/ml, (5.41±0.40)ng/ml, (4.62±0.48)ng/ml; the serum levels of GFAP on day 1, 3 and 7 in mild abnormal craniocerebral MRI group were as follows: (4.92±0.9)ng/ml, (6.42±0.47)ng/ml, (5.95±0.58)ng/ml; the levels of serum GFAP on day 1, 3 and 7 in moderate abnormal group of craniocerebral MRI were as follows: (4.49±0.58)ng/ml, (6.24±1.87)ng/ml, (6.11±0.08)ng/ml; the levels of serum GFAP on day 1, 3 and 7 in the severe abnormal group of craniocerebral MRI were as follows: (6.17±1.34)ng/ml, (7.22±0.91)ng/ml, (7.73±1.01)ng/ml. Among the three groups of abnormal group of craniocerebral MRI, there were no significant differences in serum GFAP levels on day 1 and 3 (P>0.05), and there were significant differences on day 7 (P<0.05).@*Conclusions@#It is speculated that the increase of serum GFAP level in HIE newborns is related to the severity and prognosis of the disease, and is positively related to the results of craniocerebral MRI examination.Detecting the changes of serum GFAP in HIE newborns is helpful to determine the severity of the disease and evaluate the prognosis of the children. Combining GFAP with craniocerebral MRI may improve the accuracy of the judgment.

RESUMEN

Objective To study the predictive value of general movements( GMs) quality assess-ment technique(writhing movements)on the motor development outcome of high-risk infants,so as to pro-vide a reference basis for clinical diagnosis and treatment. Methods A retrospective analysis was made on the high-risk infants who were hospitalized in the Neonatal Department of the Affiliated Hospital of Inner Mongolia Medical University from January 1,2017 to December 31,2018,and the GMs quality assessment was finished and followed up to 12-month-old among high-risk infants. The clinical diagnostic criteria for patients with cerebral palsy and Peabody Development Motor Scales-2 ( PDMS-2) were used to evaluate the motor development outcome of 12-month-old high-risk infants. Furthermore, the predictive value of GMs writhing movements on the motor development outcome of high-risk infants were evaluated. Results The predictive validity of writhing movements phase[cramped synchronized(CS) +poor repertoire(PR)]for mo-tor retardation and cerebral palsy in high-risk infants who met the inclusion criteria were as follows:the sensi-tivity,specificity, positive predictive value, negative predictive value were 94. 44%, 23. 03%, 11. 04%, 97. 62% and 100%,21. 88%,2. 60%,100%,respectively. The predictive sensitivity and negative predictive value of writhing movements PR for motor retardation and cerebral palsy were 92. 31%,100%;98. 18%, 100% respectively. The predictive sensitivity,specificity and negative predictive value of writhing movements CS for motor retardation and cerebral palsy were 100%,95. 81%,100% and 100%,95. 31% and 100%, respectively. Conclusion GMs quality assessment(writhing movements)has high reliability in predicting the motor development outcome of high-risk infants,especially cramped-synchronized has significant value in ear-ly screening of children with motor retardation and cerebral palsy.

RESUMEN

Objective To explore the relationship between serum glial fibrillary acidic protein (GFAP) level and neonatal hypoxic-ischemic encephalopathy (HIE),and to verify whether GFAP combined with craniocerebral magnetic resonance imaging (MRI) can more accurately evaluate the prognosis of HIE.Methods We selected HIE children who hospitalized in the department of neonatology,the affiliated hospital of Inner Mongolia Medical University from January 2017 to December 2017,and full-term newborns without brain injury who were hospitalized in the same period.Serum samples were taken for GFAP detection on the 1st,3rd,7th day after birth of HIE and the 3rd day after birth of full-term newborns without brain injury.All the subjects completed craniocerebral MRI examination and followed up.At the same time,the correlation between GFAP level and the severity of brain MRI was evaluated.Results (1) The level of serum GFAP in HIE group on the 3rd day after birth [(5.54 ± 1.30)ng/ml] was significantly higher than that in control group [(3.38 ± 0.31) ng/ml] (P ＜ 0.01).(2) Comparison of serum GFAP levels in HIE children with different degrees:the serum levels of GFAP in the severe group on the 1st,3rd and 7th day were as follows:(5.56 ± 1.89) ng/ml,(6.42 ± 1.63) ng/ml,(7.22 ± 1.30) ng/ml;the serum levels of GFAP in moderate group on the 1st,3rd and 7th day were as follows:(5.07 ±0.62)ng/ml,(6.73 ±0.772) ng/ml,(6.25 ±0.812)ng/ml;the serum levels of GFAP in mild group on the 1st,3rd and 7th day were as follows:(4.20 ±-0.13) ng/ml,(5.34 ±0.33) ng/ml,(4.52 ±0.33) ng/ml;the serum GFAP levels in severe group were higher than those in moderate group and mild group on the 1st,3rd and 7th day,and those in moderate group were higher than those in mild group (P ＜ 0.01).(3) Comparison of serum GFAP levels between sequelae group and non-sequelae group:there was no significant difference between sequelae group [(5.22 ± 1.52) ng/ml,(6.48 ± 1.17) ng/ml] and non-sequelae group [(4.47 ± 0.50)ng/ml,(5.75 ±0.88) ng/ml] on the 1st and 3rd day (P ＞0.05);there was significant difference between sequelae group [(6.93 ± 1.29) ng/ml] and non-sequelae group [(4.91 ± 0.77) ng/ml] on the 7th day (P ＜0.01).(4) Comparison of serum GFAP levels between abnormal group of MRI and normal group of MRI:the levels of serum GFAP on day 1,3 and 7 in abnormal craniocerebral MRI group were as follows:(5.25 ± 1.28) ng/ml,(6.66 ± 1.10) ng/ml,(6.64 ± 1.08) ng/ml;the levels of serum GFAP on day 1,3 and7 in the normal group of MRI were as follows:(4.26 ±0.25)ng/ml,(5.41 ±0.40) ng,/ml,(4.62 ±0.48) ng/ml;the serum levels of GFAP on day 1,3 and 7 in mild abnormal craniocerebral MRI group were as follows:(4.92 ±0.9)ng/ml,(6.42 ±0.47)ng/ml,(5.95 ±0.58)ng/ml;the levels of serum GFAP on day 1,3 and 7 in moderate abnormal group of craniocerebral MRI were as follows:(4.49 ± 0.58) ng/ml,(6.24 ± 1.87) ng/ml,(6.11 ± 0.08) ng/ml;the levels of serum GFAP on day 1,3 and 7 in the severe abnormal group of craniocerebral MRI were as follows:(6.17 ± 1.34) ng/ml,(7.22 ± 0.91) ng/ml,(7.73 ± 1.01)ng/ml.Among the three groups of abnormal group of craniocerebral MRI,there were no significant differences in serum GFAP levels on day 1 and 3 (P ＞ 0.05),and there were significant differences on day 7 (P ＜ 0.05).Conclusions It is speculated that the increase of serum GFAP level in HIE newborns is related to the severity and prognosis of the disease,and is positively related to the results of craniocerebral MRI examination.Detecting the changes of serum GFAP in HIE newborns is helpful to determine the severity of the disease and evaluate the prognosis of the children.Combining GFAP with craniocerebral MRI may improve the accuracy of the judgment.