RESUMEN
Brain biological age, which measures the aging process in the brain using neuroimaging data, has been used to assess advanced brain aging in neurodegenerative diseases, including Parkinson disease (PD). However, assuming that whole brain degeneration is uniform may not be sufficient for assessing the complex neurodegenerative processes in PD. In this study we constructed a multiscale brain age prediction models based on structural MRI of 1240 healthy participants. To assess the brain aging patterns using the brain age prediction model, 93 PD patients and 91 healthy controls matching for sex and age were included. We found increased global and regional brain age in PD patients. The advanced aging regions were predominantly noted in the frontal and temporal cortices, limbic system, basal ganglia, thalamus, and cerebellum. Furthermore, region-level rather than global brain age in PD patients was associated with disease severity. Our multiscale brain age prediction model could aid in the development of objective image-based biomarkers to detect advanced brain aging in neurodegenerative diseases.
Asunto(s)
Envejecimiento , Encéfalo , Imagen por Resonancia Magnética , Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/diagnóstico por imagen , Enfermedad de Parkinson/patología , Enfermedad de Parkinson/fisiopatología , Masculino , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Femenino , Envejecimiento/patología , Persona de Mediana Edad , AncianoRESUMEN
In global term, as of November 30, 2020, over 30 million people has been infected by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and more than 10,000,000 of them died of acute organ failure. Our reviews have shown that coronavirus disease 2019 (COVID-19) patients with pneumonia and acute respiratory distress syndrome (ARDS) have life-threatening acute brain dysfunction (ABD), ranging from altered mental status/delirium to stupor/coma. Altered mental status/delirium was the most common manifestation of ABD caused by severe COVID-19. The prevalence of altered mental status and/or delirium was up to 66-79.5%, and prevalence of coma was 10%. The most common clinical type of COVID-19-associated ABD was COVID-19-associated acute stroke including ischemic and hemorrhagic stroke (n > 350 cases), followed by COVID-19-associated encephalopathy (n > 200 cases), and COVID-19-associated central nervous system (CNS) infection (n > 70 cases). According to the Sepsis-3 criteria, we confess that severe COVID-19-associated ABD with ARDS and altered mental status is related to sepsis. Moreover, we also review the diagnosis and treatment of COVID-19-associated ABD with sepsis. In view of the fact that COVID-19 is at the peak of epidemic worldwide, we hope that this review will provide evidence of COVID-19 sepsis threating to the brain dysunction. Thus, recognizing the COVID-19-associated ABD related to sepsis is very important for early empirical combination therapy to survive severe COVID-19.
RESUMEN
We were to investigate the time course of lesions for awakening in acute Percheron artery ischemic coma (PAIC), which was previously unknown. Patients who had newly identified acute PAIC events in 2012-2015 and had not received thrombolytic therapy were enrolled retrospectively. The time course of lesions in PAIC was investigated by diffusion-weighted imaging (DWI). Ninety-three patients met the inclusion criteria, of whom 63 and 30 had transient PAIC and persistent PAIC, respectively. The time course of awakening events in persistent PAIC decreased over time, with large lesions in the bilateral paramedian thalamus/ rostral midbrain on DWI almost in all patients who was either plus or minus a "top of basilar artery" strokes. Whereas awakening events in transient PAIC increased over time, with small or lacunar lesions in the unilateral or bilateral thalamus/rostral midbrain about in 30.2 % cases, and the rest in naturally recanalization of infarcts or TIA. Lesion volumes were larger for persistent PAIC than for transient PAIC (median, 2.4 cm3 vs. 0.03 cm3, P < 0.0001). In Cox hazards ratio (HR) analysis, a lower GCS score was associated with mortality (HR, 5.5; 95 % confidence interval [CI],1.427-21.45). Multivaliate analysis shown that the predictors of higher risk of persistent PAIC were only increased NIHSS scores (HR,1.3; 95 % CI,1.109-1.640) and large lesions in bilateral thalamus/rostral midbrain (HR,15.0; 95 % CI,1.440-58.13). The time course of acute PAIC included transient and persistent. Most persistent PAIC was associated with large lesions in bilateral paramedian thalamus/ rostral midbrain, and with high mortality.
Asunto(s)
Isquemia Encefálica/diagnóstico por imagen , Coma/diagnóstico por imagen , Mesencéfalo/diagnóstico por imagen , Tálamo/diagnóstico por imagen , Anciano , Anciano de 80 o más Años , Isquemia Encefálica/complicaciones , Isquemia Encefálica/mortalidad , Coma/etiología , Coma/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia , Factores de TiempoRESUMEN
BACKGROUND The aim of this study was to investigate the incidence and related risk factors of new silent cerebral infarction in patients with acute non-cerebral amyloid angiopathy (non-CAA) intracerebral hemorrhage (ICH) and to explore clinical cerebrovascular event recurrence within 1 year. MATERIAL AND METHODS This prospective study observed 152 patients with non-CAA ICH diagnosed by computed tomography within 3 days after onset. All patients underwent magnetic resonance imaging on day 14 to identify silent cerebral infarction, and their subsequent clinical cerebrovascular events were followed up regularly within 1 year. RESULTS Of the 152 patients, 46 (30.26%) had silent cerebral infarctions. Multiple logistic regression analysis revealed that the white blood cell (WBC) count, cerebral microbleeds (CMBs), and leukoaraiosis were silent cerebral infarction risk factors. At 1-year follow-up, 34 (22.37%) had clinical cerebrovascular events, with 8 (23.53%) having vascular-related deaths. Multiple logistic regression analysis showed that silent cerebral infarction was the only independent predictor of future clinical cerebrovascular events. CONCLUSIONS Silent cerebral infarction is common during acute non-CAA ICH and is independently related to WBC counts, CMBs, and leukoaraiosis. The risk of clinical cerebrovascular events in non-CAA ICH patients with silent cerebral infarction increases in the following year; thus, silent cerebral infarction may be a useful predictor of recurrent cerebrovascular events.
Asunto(s)
Angiopatía Amiloide Cerebral/patología , Hemorragia Cerebral/patología , Infarto Cerebral/patología , Anciano , Anciano de 80 o más Años , Encéfalo/patología , China , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Recurrencia , Factores de Riesgo , Accidente Cerebrovascular , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: To explore clinical outcomes of buttress plating in treating posterior Pilon fracture by amodified posteromedial approach. METHODS: From July 2014 to January 2015, 10 patients with posterior Pilon fracture were respectively analyzed, including 7 females and 3 males, aged from 31 to 54 years old. One patient were type , 3 patients were type IIand 6 patients were type III according to classification of Pilon fracture by YU Guang-rong. All patients were treated by buttress plating through amodified posteromedial approach. Postoperative complications, fracture healing and reduction were observed, AOFAS score were used to evaluate function recovery at 1 year after operation. RESULTS: All patients were followed up for 12 to 18 months with an average of(14.1±3.2) months. All incisions were primarily healed at stage I without wound complication, neurovascular injuries or musculus flexor contracture. According to Burwell-Charnley imaging scoring, 8 patients got anatomical reduction and 2 patients got moderate reduction. All fracture got healing from 12 to 16 weeks with an average of(13.2±1.8) weeks. According to AOFAS score at 1 year after operation, 8 got excellent results and 2 moderate. All patients returned to work at about(4.7±1.4) months (ranged from 3 to 6 months) after operation. CONCLUSIONS: Buttress plating using a modified posteromedial approach in treating posterior Pilon fractures is an effective method, has less complications, and could recovery early weight-bearing functional exercise.
Asunto(s)
Fracturas de Tobillo , Fracturas de la Tibia , Adulto , Femenino , Fijación Interna de Fracturas , Curación de Fractura , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
OBJECTIVE: To develop a bionic animal skin and evaluate its detective effect of Schistosoma japonicum cercariae so as to provide a new technique for the monitoring of the schistosome susceptibility water body. METHODS: A bionic animal skin was made with pigskin and the experiments were carried out for evaluating its detective effects of S. japonicum cercariae in laboratory and simulate fields, and at the same time, the sentinel mouse method was used as the control. RESULTS: In the laboratory, the cercariae were found in 10-, 30-, 60-cercaria subgroups in the bionic animal skin group after 1 and 2 hours, but the cercariae were found only in the 60-cercaria subgroup in the sentinel mouse group. In the simulate fields, in the water body with 5 schistosome-infected Oncomelania hupensis snails, the cercariae were found in 2 bionic animal skin devices (2/4) and 3 bionic animal skin devices (3/4) after 2 hours and 4 hours respectively, and in the water body with 10 schistosome-infected O. hupensis snails, the cercariae were found in 4 bionic animal skin devices (4/4) and 3 bionic animal skin devices (3/4) after 2 hours and 4 hours respectively in the bionic animal skin group. In the the sentinel mouse group, in the above-mentioned water bodies (with 5 or 10 schistosome-infected O. hupensis snails), the cercariae were found in 2 sentinel mice (2/4) and 1 sentinel mice (1/4) after 2 hours and 4 hours respectively; and the cercariae were found in 2 sentinel mice (2/4) and 3 sentinel mice (3/4) after 2 hours and 4 hours respectively. CONCLUSIONS: The bionic animal skin device can be used to detect the S. japonicum cercariae, and its sensibility and efficiency are superior to the traditional sentinel mouse method.
Asunto(s)
Monitoreo del Ambiente/instrumentación , Schistosoma japonicum/aislamiento & purificación , Piel Artificial/parasitología , Agua/parasitología , Animales , Cercarias/aislamiento & purificación , Ratones , Caracoles/parasitologíaRESUMEN
OBJECTIVE: To explore clinical outcome of locked fibular nail in treating lateral malleolus fractures in elderly patients with diabetes. METHODS: From July 2012 to July 2014, clinical data of 22 diabetic patients with lateral malleolus fractures were respectively analyzed, including 15 females and 7 males, aged from 62 to 84 years old with an average of (69.3±13.7) years old. According to Danis-Weber classification, 2 cases were type A, 13 cases were type B, 5 cases were type C, and 2 cases were other type. All patients were reduced and fixed with Acumed locked fibular nail through a minimally invasive approach. Complication and fracture healing was recorded after operation. Clinical function was evaluated according to AOFAS. RESULTS: All patients were followed up from 12 to 24 months with an average of (17.3±5.9) months. All incisions were healed at stage I. No wound complication, neurovascular or tendon injuries occurred. No fixation loss or discomfort of nail was reported. All patients achieved primary bone union, and healing time ranged from 8 to 14 weeks with an average of (10.3±3.9) weeks. AOFAS score was 87.4±5.2 at 1 year after operation 9 cases got excellent results and 12 cases good. CONCLUSIONS: For elderly diabetic patients with lateral malleolus fractures, locked fibular nail has advantages of effective and stable fixation, high rate of bone healing, short healing time, less complication, and could obtain satisfied clinical effect.
Asunto(s)
Fracturas de Tobillo/cirugía , Diabetes Mellitus , Peroné/cirugía , Fijación Interna de Fracturas , Anciano , Anciano de 80 o más Años , Clavos Ortopédicos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
OBJECTIVE: To evaluate the effects of the project of ditching for drain on Oncomelania hupensis snail control and flood prevention security and explore the optimal engineering design plan in Dongting Lake region. METHODS: A retrospective study was performed on the previous studies about the project of ditching for drain. The reference values of project indices were determined. The outside levee of Nanhu New Distinct of Yueyang City in Dongting Lake region was selected as the study area, and the cross section of marshland perpendicular to the center line of the levee was extracted to research. According to the situations of various water levels, a dynamic simulation was performed on the effect and security of the project of ditching for drain through the software FLAC3D. RESULTS: The retrospective study showed that the project would be effective when the relatively subsoil water level decreased by 0.35 m, and the soil water content decreased correspondingly. The dynamic simulation by FLAC3D showed that the minimum safe distances between transverse ditch 1, vertical ditch and levee toe should be 25 m and 13 m respectively. The digging depth of transverse ditch and vertical ditch should be 1.2 m and 1.0 m respectively. If the width of marshland in drought period was less than 500 m, one transverse ditch was efficient. Otherwise, more transverse ditches should be set with the intervals of 300 m. CONCLUSIONS: The project of ditching for drain is an effective ecological snail elimination method. Optimizing the digging depth of ditches and distances between transverse ditches, vertical ditch and levee toe will ensure the effects and security of the project.
Asunto(s)
Drenaje de Agua , Inundaciones , Caracoles , Animales , China , Ciudades , Simulación por Computador , Lagos , Estudios RetrospectivosRESUMEN
OBJECTIVE: To analyze clinical outcomes of osseous-bridge resection for the treatment of adult symptomatic talocalcaneal coalitions without arthritis. METHODS: The clinical data of 12 patients (15 feet) with symptomatic talocalcaneal coalitions without arthtitis from January 2013 to June 2016 were respectively analyzed. All cases were secondary talocalcaneal coalition. There were 9 males (11 feet) and 3 females (4 feet) with a mean (26.6±3.3) years old (ranged, 18 to 33 years old). According to the Rozansky classification, there were 4 (6 feet) type I, 3 (3 feet) type II, 2 (2 feet) type III, 1 (1 feet) type IV, and 2 (3 feet) type V. All patients received coalition resection and interposition of fat graft. Complication, recurrence and range of motion was regularly recorded after operation. Clinical efficacy was evaluated according to the visual analogue scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) ankle hindfoot scale. RESULTS: All patients were followed up for an average duration of (28.7±18.3) months (ranged, 12 to 48 months). All the incisions were primarily healed. There were no wound necrosis, infection, neurovascular or tendon injuries. Range of motion was improved in 13 feet. All patients returned back to work. Recurrence happened in 1 case 2 years after surgery, the patient received a secondary coalition resection. At the latest follow-up, VAS was 2.1±0.8 and AOFAS score was 82.7±7.2, were siginificantly improved when compared with the preoperative scores(8.2±0.7, t=6.233, P<0.01; 48.4±6.8, t=5.747, P<0.01). CONCLUSIONS: For adult patients with symptomatic talocalcaneal coalitions without arthritis, simple coalition resection could provide good clinical outcomes with minimal complications.
Asunto(s)
Artrodesis/métodos , Calcáneo/cirugía , Sinostosis/cirugía , Huesos Tarsianos/cirugía , Adolescente , Adulto , Artritis , Femenino , Humanos , Masculino , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Although there have been sporadic reports of patients with hemorrhagic pure sensory strokes (HPSS) in the thalamus and striatocapsular areas, the causes, clinical featuring and long-term outcome have not been adequately investigated. METHODS: We recruited 7 consecutive patients without hemiparetic stroke who had HPSS in the thalamic and striatocapsular areas. A CT scan was performed to verify brain imaging patterns, and their causes, clinical featuring and long-term outcome were observed. RESULTS: We studied 7 patients who had HPSS in the thalamic and striatocapsular areas as seen in CT scans. The 7 patients had hypertension, and small hemorrhages were found in the thalamus of 2 patients and in the posterior quarter of the posterior limb of the internal capsule in 4 patients; only 1 patient had a microhemorrhage in the thalamus. The volume of the hemorrhages ranged from 0.3 to 6.3 ml, with a mean of 2.3 ± 1.9 ml. Three patients showed a decreased sense of spinothalamic modality, and position and vibration senses were spared. Four patients showed a sensory deficit of both spinothalamic and medial lemniscal type. The outcomes were excellent and without post-stroke pain in all patients. CONCLUSION: HPSS in the thalamus and striatocapsular area are usually small hemorrhages or microhemorrhages from rupturing of the microvessels or the branches of small vessels. HPSS only have an impact on the adjacent sensory nucleus or pathway, and have a good outcome without post-stroke pain.
Asunto(s)
Corteza Cerebral/fisiopatología , Cuerpo Estriado/fisiopatología , Hemorragias Intracraneales/patología , Trastornos de la Sensación/patología , Accidente Cerebrovascular/patología , Tálamo/fisiopatología , Anciano , Corteza Cerebral/diagnóstico por imagen , Corteza Cerebral/patología , Cuerpo Estriado/diagnóstico por imagen , Cuerpo Estriado/patología , Femenino , Estudios de Seguimiento , Humanos , Hemorragias Intracraneales/complicaciones , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Trastornos de la Sensación/etiología , Accidente Cerebrovascular/complicaciones , Tálamo/diagnóstico por imagen , Tálamo/patología , Tomografía Computarizada por Rayos X/métodosRESUMEN
OBJECTIVE: To investigate the long-term effects of TCV116 (candesartan cilexetil) on cardiac function changes after myocardial infarction. METHODS: Myocardial infarction (MI) was induced by ligation of the left anterior descending coronary artery in rats. One week after the surgical performance,the surviving rats were randomly assigned to the following treatment groups: (1) MI rats with no therapy; (2) MI rats treated with TCV116 2 mg/kg per day; (3) Sham-operated control and (4) Sham-operated rats treated with TCV116 2 mg/kg per day. At 22 weeks, left ventricular function and cardiac histomorphometric parameters were measured, mRNA expression of cardiac genes such as beta myosin heavy chain, B-type natriuretic peptide, transforming growth factor beta1, collagen I and III quantified, and survival rates calculated. RESULTS: Treatment with TCV116 significantly improved LV function, suppressed mRNA expression of cardiac genes,and extended the survival period compared with MI rats with no therapy (P<0.05). CONCLUSION: Treatment with long-term angiotensin II type 1 receptor blocker may improve LV function and prolong the survival of rats after MI.