光学相干断层成像技术诊断深Ⅱ度烧伤创面实验研究

目的 评估光学相干断层成像技术(OCT)在诊断烧伤创面深度方面的应用价值.方法 应用自制的小鼠蒸气烫伤装置,制作Skh-1小鼠深Ⅱ度烫伤模型,分别于伤后3 h、3 d和8 d以OCT扫描创面行动态检测,同步采集创面组织行组织病理学检查;同时扫描小鼠正常部位皮肤并行组织病理学检查. 结果蒸气烫伤小鼠皮肤真皮胶原降解,与其正常部位皮肤相比,在OCT扫描检测中表现为双折射光信号的丢失或减弱,其变化强度与创面病变过程相关,且与组织病理学切片结果一致. 结论 OCT作为无创的创面检测技术,可用于烧伤创面动态检测.     

The gut microbiome in intravenous immunoglobulin-treated chronic inflammatory demyelinating polyneuropathy

Background and purpose

The gut microbiome is involved in autoimmunity. Data on its composition in chronic inflammatory demyelinating polyneuropathy (CIDP), the most common chronic autoimmune disorder of peripheral nerves, are currently lacking.

Methods

In this monocentric exploratory pilot study, stool samples were prospectively collected from 16 CIDP patients (mean age 58 ± 10 years, 25% female) before and 1 week after administration of intravenous immunoglobulin (IVIg). Gut microbiota were analyzed via bacterial 16S rRNA gene sequencing and compared to 15 age-matched healthy subjects (mean age 59 ± 15 years, 66% female).

Results

The gut microbiota of CIDP patients showed an increased alpha-diversity (p = 0.005) and enrichment of Firmicutes, such as Blautia (p = 0.0004), Eubacterium hallii (p = 0.0004), or Ruminococcus torques (p = 0.03), and of Actinobacteriota (p = 0.03) compared to healthy subjects. IVIg administration did not alter the gut microbiome composition in CIDP in this short-term observation (p = 0.95).

Conclusions

The gut microbiome in IVIg-treated CIDP shows distinct features, with increased bacterial diversity and enrichment of short-chain fatty acid producing Firmicutes. IVIg had no short-term impact on the gut microbiome in CIDP patients. As the main limitation of this exploratory pilot study was small cohort size, future studies also including therapy-naïve patients are warranted to verify our findings and to explore the impact of long-term IVIg treatment on the gut microbiome in CIDP.     

Helicobacter pylori antibody responses and evolution of precancerous gastric lesions in a Chinese population

Helicobacter pylori‐specific proteins are involved in gastric carcinogenesis. To investigate the seroprevalence of six H. pylori‐specific antibodies in patients with different gastric histology, and the impact of seropositivities on the evolution of precancerous gastric lesions, a follow‐up study was conducted in Linqu County, China. The seropositivities for CagA, VacA, GroEL, UreA, HcpC and gGT were assessed by recomLine analysis in 573 H. pylori‐positive subjects and correlated with evolution of precancerous gastric lesions. We found that the score of H. pylori recomLine test was significantly increased in subjects with chronic atrophic gastritis (CAG, p < 0.0001) or intestinal metaplasia (IM, p = 0.0125), and CagA was an independent predictor of advanced gastric lesions, adjusted odds ratios (ORs) were 2.54 (95% CI = 1.42–4.55) for IM and 2.38 (95% CI = 1.05–5.37) for dysplasia (DYS). Moreover, seropositivities for CagA and GroEL were identified as independent predictors for progression of gastric lesions in a longitudinal study, and ORs were 2.89 (95% CI = 1.27–6.59) and 2.20 (95% CI = 1.33–3.64), respectively. Furthermore, the risk of progression was more pronounced in subjects with more than three positive antigens (p_{for trend} = 0.0003). This population‐based study revealed that seropositivities for CagA and GroEL might be potential markers to identify patients infected with high‐risk H. pylori strains, which are related to the development of GC in a Chinese high‐risk population, and recomLine test might serve as a tool for risk stratification.     

Neuropsychological outcome after selective amygdalohippocampectomy: subtemporal versus transsylvian approach

Objective In the context of discussions on the optimal cognitive outcome of temporal lobe epilepsy surgery, and stimulated by recent reports on the beneficial effects of a selective subtemporal approach to memory function, this study evaluated the cognitive consequences of subtemporal versus transsylvian selective amygdalohippocampectomy (SAH) in patients with mesial temporal lobe epilepsy, taking verbal/figural memory and language functions into account. Methods We contrasted cognitive outcomes of 26 subtemporal SAH patients with those observed in a transsylvian SAH control group. The surgical groups were pairwise matched with regard to clinical and demographic characteristics. Preoperative and 1 year postoperative memory and language evaluations served as within group factors, and surgical approach (transsylvian vs subtemporal) and side of surgery (right vs left) as between group factors. Results Both surgical approaches caused decline in verbal memory to a similar degree. Differential effects were seen with regard to decline in verbal recognition memory (more affected by left transsylvian SAH) as well as in figural memory and verbal fluency (more affected by subtemporal SAH). Interpretation Different from previous optimistic reports, this study demonstrates that subtemporal surgery, such as transsylvian surgery, poses similar risks for verbal memory. Differences between the approaches appear to reflect the effect of different collateral temporal lobe lesions due to the approach. Different cognitive outcomes across studies on the subtemporal approach are discussed as being in part due to study design and the chosen dependent functional measures.     

Imagined tool-use in near and far space modulates the extra-striate body area

Active tool-use can result in the incorporation of the tool into the body schema, e.g., the representation of the arm is enlarged according to tool length. This modification even influences the processing of space: using a long tool leads to a remapping of far space as near space. We here further investigate the interaction of the neural representations of the human body, tool use, and spatial domain. Functional magnetic resonance imaging (fMRI) was performed in twelve right-handed healthy individuals while they imagined moving a cylinder towards a target position in far or near space by mentally using either pliers or a joystick. The fMRI data revealed that already the imagined use of preferred tools in near and far space (i.e., pliers in far space, joystick in near space) modulated the neural activity in the extra-striate body area (EBA) located in the occipito-temporal cortex. Moreover, psycho-physical interaction analysis showed that during imagined tool-use the functional connectivity of left EBA to a network representing the near-personal space around the hand was strengthened. This increased functional connectivity is likely to reflect the neural processes underlying the incorporation of the tool into the body schema. Thus, the current data suggest that simulating tool-use modulates the representation of the human body in extra-striate cortex.