Topological disruption of high-order functional networks in cognitively preserved Parkinson's disease

Aims

This study aimed to characterize the topological alterations and classification performance of high-order functional connectivity (HOFC) networks in cognitively preserved patients with Parkinson's disease (PD), relative to low-order FC (LOFC) networks.

Methods

The topological metrics of the constructed networks (LOFC and HOFC) obtained from fifty-one cognitively normal patients with PD and 60 matched healthy control subjects were analyzed. The discriminative abilities were evaluated using machine learning approach.

Results

The HOFC networks in the PD group showed decreased segregation and integration. The normalized clustering coefficient and small-worldness in the HOFC networks were correlated to motor performance. The altered nodal centralities (distributed in the precuneus, putamen, lingual gyrus, supramarginal gyrus, motor area, postcentral gyrus and inferior occipital gyrus) and intermodular FC (frontoparietal and visual networks, sensorimotor and subcortical networks) were specific to HOFC networks. Several highly connected nodes (thalamus, paracentral lobule, calcarine fissure and precuneus) and improved classification performance were found based on HOFC profiles.

Conclusion

This study identified disrupted topology of functional interactions at a high level with extensive alterations in topological properties and improved differentiation ability in patients with PD prior to clinical symptoms of cognitive impairment, providing complementary insights into complex neurodegeneration in PD.     

皮肤T细胞淋巴瘤继发噬血细胞性淋巴组织细胞增多症7例临床分析

目的探讨皮肤T细胞淋巴瘤(CTCL)合并继发性噬血细胞性淋巴组织细胞增多症(sHLH)的临床及实验室特征。方法回顾性分析2016年6月至2021年10月武汉市第一医院血液内科收治的CTCL并拟诊sHLH患者, 按照HLH-2004标准和HScore评分对患者进行评估。结果 7例CTCL患者确诊合并sHLH, 分别为2例原发性皮肤γδT细胞淋巴瘤(PC-GDTCL), 3例皮肤结外NK/T细胞淋巴瘤(C-ENKTCL), 2例原发皮肤间变大细胞淋巴瘤(PC-ALCL)。7例患者均接受化疗, 6例死亡, 确诊CTCL合并sHLH后生存期14 ～ 60 d (中位生存期26.5 d)。2例检出HLH相关基因突变(PRF1、LYST突变), 2例PC-GDTCL患者分别检出淋巴瘤相关基因突变(KRAS、KMT2D和JAK3 、SAMHD1突变)。结论 CTCL合并sHLH临床进展迅速, 需早期诊断及干预, 初诊及病情进展时行骨穿检查及淋巴瘤、HLH相关基因突变检测有助于早期诊断。     

稳定型心绞痛的中医证候分布及用药规律研究

目的：通过数据挖掘总结稳定型心绞痛的证候分布特点及组方用药规律。方法：搜索国家知识基础设施数据库（CNKI）、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、PubMed、Web of Science数据库从建库至2022年2月收录的有关中医药治疗稳定型心绞痛的相关文献，建立方药数据库，并对高频药物进行关联规则及系统聚类分析。结果：共纳入文献105篇，处方111首，涉及患者9 786例，涵盖中医证型21种，频次最高证型为气虚血瘀，共提取出7个病性证素和2个病位证素。涉及中药123味，共计使用频次1 162次，使用频次前5位的中药分别是丹参70次、川芎69次、甘草54次、黄芪53次、当归50次。前30味高频药物关联规则分析显示，支持度最高的前3位药对为川芎-当归、川芎-赤芍、川芎-红花，聚类分析得到4个药物核心组合。结论：稳定型心绞痛常见气虚血瘀、痰瘀互结、气滞血瘀证；病性证素以实性居多，常见血瘀、痰浊，虚性证素主要为气虚；用药主要以活血化瘀、理气通滞、化痰降浊、益气通脉为法，是现代中医治疗稳定型心绞痛的主导思想。