A pilot study of brain activation in children with trichotillomania during a visual-tactile symptom provocation task: A functional magnetic resonance imaging study

Objectives

In order to reveal the etiology and pathophysiology of trichotillomania (TTM), it is necessary to investigate which brain regions are involved in TTM, but limited knowledge exists regarding the neurobiology of TTM and the available functional neuroimaging studies of TTM are little. The purpose of the present study was to investigate the specific brain regions involved in the pathophysiology of TTM with symptom provocation task using functional magnetic resonance imaging (fMRI) for children and adolescents with TTM.

Methods

Pediatric subjects who met the DSM-IV TR criteria for TTM (n = 9) and age-, sex-, handedness-, IQ matched healthy controls(HC) (n = 10), ages 9 to 17 years, were recruited for two fMRI experiments; symptom provocation of Visual Only (VO) and Visual and Tactile (VT). They were scanned while viewing two alternating blocks of symptom provocation (S) and neutral (N) movies.

Results

Random effects between-group analysis revealed significant activation in left temporal cortex(including middle and superior temporal gyrus), dorsal posterior cingulate gyrus, and putamen for the contrast S > N in TTM subjects versus HC subjects during the VO session. And TTM subjects demonstrated higher activity in the precuneus and dorsal posterior cingulate gyrus to the contrast S > N during the VT session.

Conclusions

This study provided an objective whole-brain-based analysis that directed researchers to areas that were abnormal in TTM. Using the symptom provocation tasks, we found significant differences in regional brain function between pediatric TTM and HC subjects. However, in the face of modest statistical power, our preliminary findings in TTM need to be replicated in a larger sample. As the functional neuroanatomic circuits involved in TTM remain largely unexplored, future functional neuroimaging studies using other various paradigms may help investigate the neuroanatomic abnormalities of TTM.     

Relationship of parental bonding styles with gray matter volume of dorsolateral prefrontal cortex in young adults

Previous epidemiologic studies using the parental bonding instrument (PBI), a self-report scale to rate attitudes of parents during the first 16 years, have suggested that a lower parental care score or higher parental overprotection score could lead to an increased risk of several psychiatric disorders, including schizophrenia and mood disorder. However, neuroimaging studies of an association between PBI scores and brain developmental abnormalities are still limited. In this region-of-interest analysis study using a cross-sectional design, we examined 50 normal young adults, in terms of relationships of parental bonding styles during the first 16 years measured by PBI with regional gray matter (GM) volume in the dorsolateral prefrontal cortex (DLPFC). Our study showed that paternal care score positively correlated with the GM volume in the left DLPFC, and paternal and maternal overprotection score negatively correlated with the GM volume in the left DLPFC. In conclusion, our results suggest that in normal young adults, lower paternal care and higher parental overprotection scores correlated with the GM volume reduction in the DLPFC     

妊娠期高血压疾病孕产妇脑电生理学研究

目的分析妊娠期高血压疾病（HDP）孕产妇脑电生理的特点。方法对2009年9月至2010年3月在我院产科住院分娩的HDP孕产妇进行脑电图（EEG）和脑电地形图（BEAM）检查,分析其特点并与正常孕产妇EEG和BEAM进行比较。结果 30例正常分娩孕产妇,EEG均为正常EEG。32例HDP孕产妇（轻度HDP20例,重度HDP12例）,其中13例为正常EEG,19例为异常EEG（界限性EEG7例,异常EEG12例）。异常EEG中,15例（79%）表现为癫痫样放电,2例以慢波活动为主,2例以快波活动为主。HDP与正常孕产妇EEG结果经卡方检验,P〈0.01,两者有非常显著性差异;30例正常孕产妇BEAM均正常;32例HDP孕产妇,4例BEAM异常,经Fisher精确检验,P=0.11,两者无显著性差异。结论非子痫性HDP孕产妇EEG改变以癫痫样放电为主。与正常孕产妇相比,HDP孕产妇EEG变化显著,而BEAM变化不大。     

Prevalence of Trachoma in Northern Benin: Results from 11 Population-Based Prevalence Surveys Covering 26 Districts

Aims: We sought to evaluate trachoma prevalence in all suspected-endemic areas of Benin.

Methods: We conducted population-based surveys covering 26 districts grouped into 11 evaluation units (EUs), using a two-stage, systematic and random, cluster sampling design powered at EU level. In each EU, 23 villages were systematically selected with population proportional to size; 30 households were selected from each village using compact segment sampling. In selected households, we examined all consenting residents aged one year or above for trichiasis, trachomatous inflammation – follicular (TF), and trachomatous inflammation – intense. We calculated the EU-level backlog of trichiasis and delineated the ophthalmic workforce in each EU using local interviews and telephone surveys.

Results: At EU-level, the TF prevalence in 1–9-year-olds ranged from 1.9 to 24.0%, with four EUs (incorporating eight districts) demonstrating prevalences ≥5%. The prevalence of trichiasis in adults aged 15+ years ranged from 0.1 to 1.9%. In nine EUs (incorporating 19 districts), the trichiasis prevalence in adults was ≥0.2%. An estimated 11,457 people have trichiasis in an area served by eight ophthalmic clinical officers.

Conclusion: In northern Benin, over 8000 people need surgery or other interventions for trichiasis to reach the trichiasis elimination threshold prevalence in each EU, and just over one million people need a combination of antibiotics, facial cleanliness and environmental improvement for the purposes of trachoma’s elimination as a public health problem. The current distribution of ophthalmic clinical officers does not match surgical needs.     

人工耳蜗术后编程中神经反应遥测阈值及行为T值的比较分析

目的 了解人工耳蜗术后神经反应遥测(NRT)阈值的变化,NRT与行为T值之间的相关性,以及长期行为T值的变化,为人工耳蜗植入术后的患儿编程提供帮助。 方法 20例接受Nucleus CI24R型多导人工耳蜗植入的患儿,在开机时及6个月调试时对1、11、20号电极进行NRT阈值测试,通过NRT值进行电子耳蜗程序设置;开机后1年和2年对患儿进行行为T值测试,并设置程序;收集开机时及6个月的NRT值分别与1年及2年的行为T值比较。 结果 1号电极开机时和6个月时NRT相互比较差异无统计学意义,11号和22号电极开机时和6个月时NRT差异有统计学意义,三对电极1年与2年行为T值差异都无统计学意义;开机时NRT阈值与行为T值的相关关系中:开机时NRT阈值与行为T值只有22号电极呈正相关,其余两电极中无相关关系。6个月NRT阈值与行为T值的相关关系中:1号电极6个月NRT阈值与行为T值均为正相关;22号电极开机6个月NRT值与1年行为T值为正相关,其他无相关关系。 结论 各电极NRT阈值自开机时基本保持稳定,NRT阈值与行为T值部分电极具有相关性,开机时和最初几次调机时患儿不能配合进行行为测试可以选择NRT阈值来参考调试耳蜗;1年和2年的行为T值也基本稳定,说明患儿术后1年能较好配合行为T值测试,对于配合较好者的患儿可以适当延长调试时间。     

T2* Mapping对正常青年人骶髂关节骨髓的初步评估

目的探讨T2*Mapping成像技术量化评估骶髂关节软骨下骨髓含水量的可行性。方法对30例青年志愿者骶髂关节行MR 16回波GRE序列的T2*Mapping成像,分别测量骶侧上下区域和髂侧上下区域及L5椎体下终板区域的骨髓T2*值,对比各区域间、髂侧和骶侧及L5椎体下终板区域间的骨髓T2*值差异,分析骶髂关节软骨下骨髓含水量的细微差异。结果骶髂关节的髂侧T2*值均值为23.08±2.9ms,骶侧为21.09±3.43ms,髂侧骨髓平均T2*值大于骶侧(P0.05);L 5椎体下终板骨髓T 2*值均值为18.55±5.5ms,分别小于髂侧和骶侧骨髓平均T2*值(P0.05);而左右髂骨上下区域间(RI1/RS1,LI4/LS4,RI1/LI4,RS1/LS4)T2*值对比无差异(P0.05),左右骶骨上下区域间(RI2/RS2,LI3/LI3,LI3/RI2,LS3/RS2)T2*值对比也无统计学意义(P0.05)。结论正常青年人骶髂关节软骨下骨髓含水量髂侧多于骶侧,髂侧和骶侧均多于L5椎体下终板区域,T2*mapping成像技术对骶髂关节软骨下骨髓的核磁共振含水量进行细微量化评估是可行的。     

采用3.0T MRI T2和T2* mapping评价下腰痛患者腰椎间盘退变

目的探讨下腰痛患者腰椎间盘的T2和T2*值与退变Pfirrmann分级的相关性,明确T2和T2*值是否可以作为影像学生物标记定量评价IVD退变。方法 2015年3月-2015年6月间,对66例下腰痛患者采用3.0T MRI行腰椎常规结构成像和定量成像(T2和T2*mapping)。Pfirrmann分级由两位放射诊断医生依据矢状位T2WI通过协商进行。在正中矢状位的T2 map和T2*map上由一位放射诊断医生手工绘制感兴趣区尽可能包括髓核和内层纤维环测量IVD的T2和T2*值。采用Pearson相关比较IVD的T2和T2*值与Pfirrmann分级相关性,并对相邻的Pfirrmann分级的T2和T2*值比较。结果 IVD的T2和T2*值与Pfirrmann分级呈负相关,相关系数分别为-0.612和-0.354,P值均小于0.001。PfirrmannⅠ级到Ⅲ级T2和T2*值显著降低,Ⅲ级到Ⅴ级下降变缓。除Ⅳ级与Ⅴ级IVD的T2和T2*值差别没有统计学意义外,其他相邻的Pfirrmann分级IVD的T2和T2*值差别均有统计学意义。结论 IVD的T2和T2*值具有作为影像学生物标记定量评价IVD的退变潜在可能性,有助于IVD退变的早期诊断和客观评价退变程度。晚期IVD退变T2和T2*值下降变缓,以形态学改变为主。     

SSCI收录医学信息科学期刊文献分析

以SSCI收录的3种医学信息科学期刊近10年发表的文献为研究对象,利用CiteSpace工具对文献作者、机构、国家、被引期刊、高被引论文、关键词等指标进行统计分析,以揭示医学信息科学领域高频作者、核心团队、重要研究机构及研究热点演进等,为该领域研究提供参考。     

CMR对急性心肌炎诊断价值的Meta分析

目的 通过Meta 分析评价心脏磁共振（CMR）各参数对急性心肌炎（AM）的诊断效能。方法 检索Embase、PubMed、Cochrane、中国知网、万方、维普数据库的CMR诊断AM的中英文文献,按照纳入排除标准筛选CMR对AM的诊断价值的研究,检索时间从建库至2020年7月31日。根据QUADAS-2条目评价纳入文献的质量,采用RevMan5.4评价偏倚风险及临床适用性,采用Meta-disc 1.4软件对纳入研究的合并敏感度、合并特异度、合并阳性似然比、合并阴性似然比和合并诊断比值比进行分析。绘制森林图和综合受试者操作特征（SROC）曲线,并计算相应曲线下面积（AUC）。采用不一致指数（I²）和Chochrane Q指数评价异质性,采用阈值效应、Meta回归、敏感性分析探讨异质性来源。采用Stata 15.1绘制漏斗图,评估是否存在发表偏倚,并进行Begg和Egger检验。结果 最终纳入21篇中英文文献,包括1 678例病人。路易斯湖标准（LLC）和native T₁ mapping的合并敏感度、合并特异度分别为77%、88%和85%、85%,两参数的合并敏感度、合并特异度相当;native T₁ mapping的AUC（0.941 9）大于LLC的（0.868 1）。T₂r、EGE、LGE、LLC、native T₁ mapping、T₂ mapping和ECV参数均存在中度以上异质性,阈值效应是EGE异质性的重要来源,Meta回归分析显示设备、场强、研究方法和确诊标准均不是异质性来源（均P>0.05）。Begg和Egger检验结果显示纳入研究的以上参数均不存在明显的发表偏倚（均P>0.05）。结论 native T₁ mapping具有良好的诊断效能,且只需评估单一参数,可优化检查流程。