Is ecstasy-induced protracted symptom of motion perception associated with altered regional homogeneity of brain？

The synthetic hallucinogen 3,4-methylenedioxymet hamphetamine （MDMA） is the main psychoactive constituent of the popular recreational drug ＂ecstasy.＂ Whether its neurotoxic effects are fully reversible is unknown. Here we report a patient with protracted syndrome induced by ecstasy.     

A randomized double-blinded sham-controlled trial of α electroencephalogram-guided transcranial magnetic stimulation for obsessive-compulsive disorder

Background Obsessive-compulsive disorder （OCD） is a highly prevalent and devastating psychiatric condition.Repetitive transcranial magnetic stimulation （rTMS） is a potential and non-invasive treatment for OCD.Diverse efficacies of rTMS have been reported in different locations or frequencies of the stimulation.The main objective of this study was to assess the treatment effect for OCD with alpha electroencephalogram （αEEG）-guided TMS over dorsal Iateral prefrontal cortex bilaterally.Methods There were 25 OCD patients in the αTMS treatment group and 21 OCD patients in the sham control group.Each subject received 10 daily treatment sessions （5 days a week）.The αTMS group had significant reduction in scores of Yale-Brown Obsessive Compulsive Scale and Hamilton Rating Scale for Anxiety （HAMA） compared with the control group at the end of 2-week treatment and 1-week follow-up.Analysis of variance with repeated measures was used to test the effects between the two groups.Results Significant difference in scores of obsession and HAMA were found between the two groups after treatment.No significant difference in scores of Hamilton Rating Scale for Depression was found between the two groups after the treatment,but statistical significance was shown at the end of 1-week follow-up.Conclusions αEEG-guided TMS may be an effective treatment for OCD and related anxiety.Delayed response to αTMS in depression suggests that it might be secondary to the improvement of primary response in OCD and anxiety.     

Effects of Bu-Shen-An-Tai recipe and its two components on endometrial morphology during peri-implantation in superovulated mice

The aim of this study was to investigate the effect of Bu-Shen-An-Tai recipe （BSATR） and its two components （Bushen recipe, and Huoxue recipe） on endometrial morphology during peri-implantation in superovulated mice. Mice were randomly divided into five groups, including the normal （N）, model （M）, Bushen （BS）, Huoxue （HX） and Bu-Shen-An-Tai （BH） groups. The uteri were collected on day 4 of pregnancy, and the endometrium thickness, microvessel density （MVD） and number of pinopodes observed. Compared with the M group, the endometrial thickness in the BS, HX and BH groups was significantly increased and there was a significant difference in endometrial thickness between the BS and the BH groups. The mean MVD was significantly lower in the M group than in the N group, and there was a significant increase in MVD in the BS, HX and BH groups as compared with the M group. Compared with the M group, the pinopode scores in the en- dometrium were significantly increased in the HX and BH groups; and the BS group had significantly higher pinipode scores than the HX and BH groups. In conclusion, the results of the present study demonstrated that the recipes （Bushen, Huoxue and BSATR） could improve the endometrial envi- ronment by regulating the endometrial thickness, MVD and the number of pinopodes at the window of implantation. Moreover, the Huoxue recipe and the BSATR were more efficient than the Bushen recipe, with the BSATR tending to have the most beneficial effects.     

Brain stimulation for treatment of refractory epilepsy

Objective We review the targets of the deep brain and the responsive neurostimulation system (RNS) to identify the best optimal stimulation parameters and the best mode of stimulation,whether cyclical,...     

Comparison of the Effects and Safety of Mild Ovarian Stimulation and Conventional Ovarian Stimulation with A Long GnRH Agonist Protocol on IVF Outcomes

Objective To conduct a Meta-analysis of studies that compared the efficacies of mild ovarian stimulation and conventional long GnRH agonist protocol in patients under- going IVF or intracytoplasmic sperm injection （ICSI）. Methods Meta-analysis was performed. All studies were published by July 2012 with data related to outcomes following mild ovarian stimulation compared with the conventional protocol. Odds ratios （ORs） and weighted/standardized mean difference （WMD/SMD） from individual study were pooled in fixed and random effect models. Main outcome measure was the efficacy of mild ovarian stimulation. Results Six articles were included in this Meta-analysis. The number of oocytes retrieved was lower, the cycle cancellation rate was higher and the incidence of ovarian hyperstimulation syndrome （OHSS） was lower in the mild stimulation group than in conventional ovarian stimulation group. Clinical pregnancy rates were similar in both mild and conventional stimulation groups. Conclusions The level of evidence supporting the use of mild stimulation protocols in IVF is low, considering the fewer oocytes retrieved and the higher rates of cycle cancellation.     

Microarray analysis of gene expression after electrical stimulation of the dura mater surrounding the superior sagittal sinus in conscious adult rats

Background The molecular and cellular origins of migraine headache are among the most complex problems in contemporary neurology.Up to now the pathogenesis of migraine still remains unclearly defined.The objective of this study was to explore new factors that may be related to the mechanism of migraine.Methods The present study performed a comprehensive analysis of gene expression in the trigeminal nucleus caudalis induced by electrical stimulation of dura mater surrounding the superior sagittal sinus in conscious rats using microarray analysis followed by quantitative real-time reverse-transcribed polymerase chain reaction （qRT-PCR） verification.Student＆#39;s two sample t-test was employed when two groups were compared.A P value 〈0.05 was considered to be statistically significant.Results Comparing the placebo and the electrical stimulation groups,40 genes were determined to be significantly differentially expressed.These significantly differentially expressed genes were involved in many pathways,including transporter activity,tryptophan metabolism,G protein signaling,kinase activity,actin binding,signal transducer activity,anion transport,protein folding,enzyme inhibitor activity,coenzyme metabolism,binding,ion transport,cell adhesion,metal ion transport,oxidoreductase activity,mitochondrion function,and others.Most of the genes were involved in more than 2 pathways.Of particular interest is the up-regulation of Phactr3 and Akap5 and the down-regulation of Kdr.Conclusion These findings may provide important clues for a better understanding of the molecular mechanism of migraine.     

High-frequency stimulation of anterior nucleus thalamus improves impaired cognitive function induced by intra-hippocampal injection of Aβ1-40 in rats

Background The advent of brain stimulation techniques to treat movement disorders and psychiatric diseases has shown potential to decode the neural mechanism that underlies the cognitive process by modulating the interrupted circuit.Here,the present investigation aimed at evaluating the influence of deep brain stimulation of the anterior nucleus thalamus （ANT-DBS） on memory.Methods Thirty-two rats were randomized into phosphate buffer saline （PBS） group （n=8,rats received PBS injections without implantation of electrodes into the ANT）,Alzheimer＇s dementia （AD） group （n=8,rats received Aβ1-40 injections without implantation of electrodes into the ANT）,ANT sham stimulation group （n=8,rats received Aβ1-40 injections with implantation of electrodes into the ANT but without stimulation） and ANT stimulation group （n=8,rats received Aβ1-40 injections with implantation of electrodes into the ANT and stimulation）.A Morris maze test was used for determining the effect of electrical stimulation on cognitive function in rats.The data were assessed statistically with one-way analysis of variance （ANOVA） followed by Tukey＇s tests for multiple post hoc comparisons.Results The data showed that in the training test,PBS group and AD group managed to learn the hidden-platform faster and faster while AD group needed a significantly longer time to reach the platform than PBS group （P ＜0.05）.Meanwhile,ANT stimulation group demonstrated a significantly shorter time to reach the platform （P ＜0.05） compared to the AD group,while there was no significant difference between the ANT sham stimulation group and the AD group （P ＞0.05）.On the probe test,the AD group spent less time （（10.15±2.34） seconds） in the target quadrant than the PBS group （（28.20±2.75） seconds） （P ＜0.05）.And the times of platform-traversing of the AD group （3.35±1.12） significantly decreased compared with the PBS group （8.69±2.87） （P ＜0.05）.However,the times of platform-traversing and the time spent in the target quadrant of the ANT stimulation group significantly increased compared to the AD group （P ＜0.05）,while times of platformtraversing or the time spent in the target quadrant was not significantly different between the ANT sham stimulation group and the AD group （P ＞0.05）.Conclusion Bilateral high-frequency stimulation of the ANT may be useful as a potential therapeutic modality for cognitive dysfunction in AD.     

Associations among cerebral microbleeds, cerebral large-artery diseases and endothelial function

Background Endothelial dysfunction is not only an early stage of atherosclerosis,but also involved in the pathogenesis of cerebral small-vessel diseases.Patients with cerebral microbleeds （CMBs） may have arteriolosclerosis as well as systemic atherosclerosis.However,little is known about the associations among CMBs,atherosclerosis of cerebral large arteries,and endothelial function.Our study aimed to investigate the relationships among them.Methods This was a cross-sectional study.Ninety patients hospitalized in Peking University First Hospital with acute ischemic stroke were enrolled consecutively between November 1,2007 and January 31,2008.All subjects underwent transcranial Doppler and carotid color duplex ultrasonography to record the intima-media thickness （IMT） of common carotid artery,carotid plaque,and cerebral artery stenosis.Brain magnetic resonance imaging （MRI） routine sequences and gradient recall-echo T2＊-weighted imaging were performed to count CMBs with clinical data blindness.Endothelial function was evaluated using flow-mediated dilation （FMD） and nitroglycerin-mediated dilation （NMD） of the brachial artery.FMD and NMD were examined by an experienced vascular sonographer using a high-resolution ultrasound.Results Thirty cases （33.3%） had CMBs with counts ranging from 1 to 30.Both FMD （（9.9＆#177;4.8）% vs.（15.2＆#177;7.4）%,P=0.001） and NMD （（13.7＆#177;6.1）% vs.（19.0＆#177;7.4）%,P=0.001） were significantly decreased in CMB-positive patients than in CMB-negative patients.No significant relationships were demonstrated between CMBs and intracranial and/or extracranial artery stenosis.The frequencies of CMBs in patients with IMT≥1.0 mm,carotid plaque,and extracranial artery stenosis were 37.5%,39.4%,and 47.6% respectively,with no significant difference,but much higher than in patients with IMT 〈1.0 mm （5%,P 〈0.05）.In Logistic regression analysis,impaired FMD （OR=5.783,95% CI 1.652-6.718,P=0.007） and high pulse pressure （OR=6.228,95     

Diagnosis of brain death: confirmatory tests after clinical test

Background The brain death confirmation tests occupy a different position in each country＇s diagnostic criteria （or guideline）; the choices of tests are also different.China brain death criteria include clinical judgment and confirmation tests.This study aimed to confirm the preferred confirmatory test and complementary confirmatory tests.Methods We did a clinical brain death determination on deep coma patients,and then divided them into brain death group and non-brain death group.According to the Chinese standards for determining brain death,both the groups accepted confirmatory tests including electroencephalograph （EEG）,somatosensory evoked potentials （SEP）,and transcranial Doppler （TCD）.The sensitivity,specificity,false positive rate,and false negative rate were calculated to evaluate the accuracy of the confirmatory tests.Results Among the 131 cases of patients,103 patients met the clinical criteria of brain death.Respiratory arrest provocation test was performed on 44 cases and 32 cases （73％） successfully completed and confirmed that they have no spontaneous breathing.Of the three confirmation tests,EEG had the highest completion rate （98％） and good sensitivity （83％） and specificity （97％）; TCD had followed completion rate （54％） and not good sensitivity （73％） and specificity （75％）; SEP had the lowest completion rate （49％）,good sensitivity （100％）,and not good specificity （78％）.After the combination of SEP or TCD with EEG,the specificity can increase to 100％.Conclusions The completion rate of respiratory arrest provocation test remains a problem in the clinical diagnosis of brain death.If the test cannot be completed,whether to increase a confirmatory test is debatable.SEP had an ideal sensitivity,and the specificity will reach 100％ after combining with TCD or EEG.When a confirmed test was uncertain,we suggest increasing another confirmatory test.     

Pathological characteristics of liver allografts from donation after brain death followed by cardiac death in pigs

Donation after brain death followed by circulatory death （DBCD） is a unique practice in China. The aim of this study was to define the pathologic characteristics of DBCD liver allografts in a porcine model. Fifteen male pigs （25-30 kg） were allocated randomly into donation after brain death （DBD）, donation after circulatory death （DCD） and DBCD groups. Brain death was induced by aug- menting intracranial pressure. Circulatory death was induced by withdrawal of life support in DBCD group and by venous injection of 40 mL 10% potassium chloride in DCD group. The donor livers were perfused in situ and kept in cold storage for 4 h. Liver tissue and common bile duct samples were col- lected for hematoxylin and eosin staining, TUNEL testing and electron microscopic examination. Spot necrosis was found in hepatic parenchyma of DBD and DBCD groups, while a large area of necrosis was shown in DCD group. The apoptosis rate of hepatocytes in DBD [（0.56±0.30）%] and DBCD [（0.50 ±0.11）%] groups was much lower than that in DCD group [（3.78±0.33）%] （P〈0.05）. And there was no significant difference between DBD group and DBCD group （P〉0.05））. The structures of bile duct were intact in both DBD and DBCD groups, while the biliary epithelium was totally damaged in DCD group. Under electron microscope, the DBD hepatocytes were characterized by intact cell membrane, well-organized endoplasmic reticulum, mild mitochondria edema and abundant glycogens. Broken cell membrane, mild inflammatory cell infiltration and sinusoidal epithelium edema, as well as reduced glycogen volume, were found in the DBCD hepatocytes. The DCD hepatocytes had more profound cell organelle injury and much less glycogen storage. In conclusion, the preservation injury of DBCD liver allografts is much less severe than that of un-controlled DCD, but more severe than that of DBD liver allografts under electron microscope, which might reflect post-transplant liver function to some extent.     

Effect of sub-hypothermia therapy on coagulopathy after severe head injury

Sub-hypothermia therapy is one of the treatments for patients with severe head injury. The objective of the therapy is to treat traumatic brain injury （TBI） by alleviating brain edema, protecting blood brain barrier （BBB）, and preventing subsequent damage to neurons. It can protect brain function by depressing metabolism, reducing the release of excitatory amino acids and free radicals, reducing the level of lactic acid, and lowering the damage of cytoskeletal structure However,     

Value of diffusion-weighted imaging in distinguishing pancreatic carcinoma from mass-forming chronic pancreatitis: a meta-analysis

Background Several previous studies have shown that diffusion-weighted imaging （DWl） can provide additional information for focal pancreatic lesions by demonstrating more restricted diffusion in solid malignant tumors than in chronic pancreatitis, which can be indicated by a decreased apparent diffusion coefficient （ADC）. However, these studies have a modest sample size and convey inconclusive results. The aim of this study was to determine, in a meta-analysis, the diagnostic performance of quantitative diffusion-weighted magnetic resonance imaging in distinguishing pancreatic carcinoma from mass-forming chronic pancreatitis. Methods We determined the sensitivities and specificities across studies. A summary receiver operator characteristic （sROC） curve was constructed to calculate the area under the curve （AUC）. Results The pooled sensitivity of DWI was 0.86 （95% Cl： 0.80-0.91） and the pooled specificity was 0.82 （95% CI： 0.72- 0.89）. The AUC of the sROC was 0.91 （95% CI： 0.88-0.93）. Conclusions DWl may be a potentially technically feasible tool for differentiating pancreatic carcinoma from mass- forming chronic pancreatitis. However, large-scale randomized control trials are necessary to assess its clinical value.     

Preparation of Magnetic Molecularly Imprinted Polymers for Selective Isolation and Determination of Kaempferol and Protoapigenone in Macrothelypteris torresiana

Novel uniform-sized magnetic molecularly imprinted polymers （MMIPs） were synthe- sized for selective recognition of active antitumor ingredients of kaempferol （KMF） and protoapi- genone （PA） in Macrothelypteris torresiana （M. torresiana） by surface molecular imprinting tech- nique in this study. Super paramagnetic core-sheU nanoparticles （γ-MPS-SiO2@Fe3O4） were used as seeds, KMF as template molecule, acrylamide （AM） as functional monomer, and N, N＇-methylene bisacrylamide （BisAM） as cross-linker. The prepared MMIPs were characterized by X-ray diffraction （XRD）, Fourier transform infrared spectrum fiT/R）, transmission electron microscopy （TEM） and thermo-gravimetric analysis （TGA）, respectively. The recognition capacity of MMIPs was 2.436 times of non-imprinted polymers. The adsorption results based on kinetics and isotherm analysis were in accordance with the pseudo-second-order model （R2=0.9980） and the Langmuir adsorption model （R2=0.9944）. The value of E （6.742 kJ/mol） calculated from the Dubinin-Radushkevich isotherm model suggested that the physical adsorption via hydrogen-bonding might be predominant. The Scatchard plot showed a single line （R2=0.9172） and demonstrated the homogeneous recognition sites on MMIPs for KMF. The magnetic solid phase extraction （MSPE） based on MMIPs as sorbent was established for fast and selective enrichment of KMF and its structural analogue PA from the crude extract of M. torresiana and then KMF and PA were detected by HPLC-UV. The established method showed good performance and satisfactory results for real sample analysis. It also showed the feasi- bility of MMIPs for selective recognition of active structural analogues from complex herbal extracts.     

扶正抗移方联合放、化疗治疗肺癌脑转移的临床观察

目的探讨扶正抗移方联合放、化疗治疗肺癌脑转移的临床疗效。方法将64例肺癌脑转移患者随机分为治疗组（中西医结合组,43例）和对照组（西医常规治疗组,21例）。治疗组在西医常规放、化疗同时,加服扶正抗移方治疗。对照组采用西医常规放、化疗治疗。结果治疗组近期疗效有效率48．8％优于对照组（19．0％）,差异有统计学意义（P〈0．05）;治疗组半年生存率及头痛、偏瘫、抽搐症状改善率明显高于对照组（P〈0．05）;治疗组临床受益率、1年生存率及头晕、恶心呕吐症状改善率均高于对照组,但差异无统计学意义（P〉0．05）。结论中西医结合治疗肺癌脑转移疗效优于西医常规治疗,能改善患者临床症状,提高生活质量。     

Meta-analysis of Quantitative Diffusion-weighted MR Imaging in Differentiating Benign and Malignant Pancreatic Masses

There have been numerous studies done to explore the diagnostic performance of quanti- tative diffusion-weighted （DW） MR imaging to differentiate between benign and malignant pancre- atic masses. However, the results have been inconsistent. We performed a meta-analysis to investigate whether DW-MR imaging can differentiate between these two diseases. Databases including MEDLINE, EMBASE and Cochrane Library were utilized to find relevant articles published between January 2001 and January 2014. A Stata version 12.0 and a Meta-Disc version 1.4 were used to de- scribe primary results. Twelve studies with 594 patients, which fulfilled the inclusion criteria, were enrolled for the analysis. The pooled sensitivity and specificity of DW imaging was 0.91 （95% CI： 0.84, 0.95） and 0.86 （95% CI： 0.76, 0.93） respectively. The area under the curve of the summary re- ceiver operating characteristic was 0.95 （95% CI： 0.93, 0.96）. The results indicated that DW imaging might be a valuable tool for differentiating benign and malignant pancreatic masses.     

Application of immunosuppressant facilitates the therapy of optic neuritis combined with Sj（o）gren＇s syndrome

Background Optic neuritis （ON） is often the first symptom of multiple sclerosis （MS） and neuromyelitis optica （NMO） while there has been very little research reported on ON combined with Sj（o）gren＇s syndrome （SS）.The aim of this study is to provide different treatments and services for and NMO patients combined with SS.Methods Twenty-seven patients with ON combined SS were divided into two groups：corticosteroid group （C group,methylprednisolone sodium succinate,14 patients） and corticosteroid＋ immunosuppressant group （C＋I group,leflunomide,13 patients）.ON relapse times in 1 year after treatment,number of patients who relapsed to NMO/MS in 1 years,visual acuity and retina nerve fiber layer （RNFL） thickness were measured.Mann Whitney-Wilcoxon test was used to compare continuous variables and Chi-square test or Fisher＇s exact test was to compare proportions.Results ON combined with SS patients had higher incidence rates in middle-aged women who have binocular damage and heavier visual function damage or when there is an easy relapse,and the patients are often hormone dependent.The patients are more likely anti-aquaporin-4 IgG seropositive （70.4％）.They are liable to form a centrocecal scotoma and tubular vision.The times of relapse decreased in patients who used immunosuppressant,and a significant difference was found between immunosuppressant and non-immunosuppressant groups in visual acuity recovery during 6-month followup period （P ＜0.05）; however,the RNFL thickness at the four quadrants was not significantly different.Conclusions The effect of immunosuppressant plus corticosteroid on the early onset of ON combined with SS was to provide ON remedy and to prevent recurrence in clinics.This study provides a significant reference for the prevention and treatment of ON on the basis of immunosuppressant and corticosteroid.     

乳腺癌保乳手术MRI影像学证据的多中心前瞻性研究

Background This multicenter prospective study aimed to assess the utility of dynamic enhanced magnetic resonance imaging （MRI） prior to breast-conserving surgery for breast cancer.Methods The research subjects were drawn from patients with primary early resectable breast cancer treated in the breast disease centers of six three-level hospitals in Beijing from 1 January 2010 to 31 December 2012.The participants were allocated to a breast-conserving surgery group （breast-conserving group） or a total mastectomy group （total mastectomy group）.Enhanced MRI was used to measure breast volume,longest diameter of tumor and tumor volume.The correlations between these measurements and those derived from histopathologic findings were assessed.The relationships between the success rate of breast-conserving surgery and MRI-and pathology-based measurement results were statistically analyzed in the breast-conserving group.Results The study included 461 cases in the total mastectomy group and 195 in the breast-conserving group.Allocation to these groups was based on clinical indications and patient preferences.The cut-off for concurrence between MRI-and pathology-based measurements of the longest diameter of tumor was set at 0.3 cm.In the total mastectomy group,the confidence interval for 95％ concurrence of these measurements was 35.41％-44.63％.Correlation coefficients for MRI and histopathology-based measurements of breast volume,tumor volume and tumor volume/breast volume ratio were r=0.861,0.569,and 0.600,respectively （all P ＜0.001）.In the breast-conserving group,with 0.30 cm taken as the cut-off for concurrence,the 95％ confidence interval for MRI and pathology-based measurements of the longest diameter of tumor was 29.98％-44.01％.The subjective and objective success rates for breast-conserving surgery were 100％ and 88.54％,respectively.Conclusions There were significant correlations between dynamic enhanced MRI-and histopathology-based measurements of the longest diameter of breast lesions,breas     

Cardiovascular magnetic resonance imaging findings in children with myocarditis

Background Myocarditis is a common,potentially life-threatening disease that presents a wide rang of symptoms in children,as an important underlying etiology of other myocardial diseases such as dilated and arrhythmogenic right ventricular cardiomyopathy.The incidence of nonfatal myocarditis is probably greater than that of the one actually diagnosed,which is the result of the challenges of establishing the diagnosis in standard clinical settings.Currently,no single clinical or imaging finding confirms the diagnosis of myocarditis with absolute certainty.Historically,clinical exam,electrocardiogram （ECG）,serology and echocardiography had an unsatisfactory diagnostic accuracy in myocarditis.Endomyocardial biopsy remains as a widely accepted standard,but may not be suitable for every patient,especially for those with less severe disease.Our aim was to find the changes in cardiovascular magnetic resonance （CMR） imaging of children with myocarditis diagnosed by clinical criteria.Methods We studied 25 children （18 male,7 female; aged from 5-17 years） with diagnosed myocarditis by clinical criteria.CMR included function analyses,T2-weighted imaging,T1-weighted imaging before and after i.v.gadolinium injection （early gadolinium enhancement （EGE） and late gadolinium enhancement （LGE））.Results The T2 ratio was elevated in 21 children （84％,11 in anterolateral （44％）,5 in inferolateral （20％）,and 5 in septum （20％））,EGE was present in 9 children （36％,3 in anterolateral （12％）,4 in inferolateral （20％）,and 2 in septum （8％））,and LGE was present in 5 children （20％,2 in anterolateral （8％）,1 in inferolateral （4％）,1 in septum （4％）,and 1 in midwall of left ventricular （LV） wall）.In 9 children （36％）,two （or more） out of three sequences （T2,EGE,LGE） were abnormal.Conclusions The CMR findings in children with clinically diagnosed myocarditis vary within the groups,including regional or global myocardial signal increase in T2-w     

Hyperperfusion of Multiple Sclerosis Plaques Characterized by 3D FSE Arterial Spin Labelling

MULTIPLE sclerosis （MS） is a common inflammatory demyelinating disorder of central nervous system, and the disease burder could be well evaluated by conven-tional magnetic resonance imaging （MRI）,1 including T2-weighted, fluid-attenuatd inversion recovery, and postcontrast Tl-weighted sequences. 2 We investigated the perfusion state of MS plaques using brain perfusion imaging in a 12-year-old boy with MS.