The Performances of SNAQ, GLIM, mNICE, and ASPEN for Identification of Neurocritically Ill Patients at High Risk of Developing Refeeding Syndrome.

We previously found that neurocritically ill patients are prone to refeeding syndrome (RFS), a potentially life-threatening complication. However, there is no unified or validated consensus on the screening tool for RFS so far. We aimed to validate and compare the performance of four screening tools for RFS in neurocritically ill patients. We conducted a single-center, observational, retrospective cohort study among neurocritically ill adult patients who were admitted to the neurocritical care unit (NCU), and who received enteral nutrition for 72 h or longer. They were scored on the Short Nutritional Assessment Questionnaire (SNAQ), the Global Leadership Initiative on Malnutrition (GLIM), the modified criteria of the Britain's National Institute for Health and Care Excellence (mNICE), and ASPEN Consensus Recommendations for Refeeding Syndrome (ASPEN) scales to predict RFS risk via admission data. The performance of each scale in predicting RFS was evaluated. Logistic regression analysis was used to identify the independent risk factors for RFS, and they were added to the above scales to strengthen the identification of RFS. Of the 478 patients included, 84 (17.57%) developed RFS. The sensitivity of the SNAQ and GLIM was only 20.2% (12.6-30.7%), although they had excellent specificities of 84.8% (80.8-88.1%) and 86.0% (82.1-89.2%), respectively; mNICE predicted RFS with a sensitivity of 48.8% (37.8-59.9%) and a specificity of 65.0% (60.0-69.9%); ASPEN had the highest Youden index, with a sensitivity and specificity of 53.6% (42.4-64.4%) and 64.7% (59.8-69.4%), respectively. The Area Under the receiver operating characteristic Curves (AUC) of SNAQ, GLIM, mNICE, and ASPEN to predict RFS were 0.516 (0.470-0.561), 0.533 (0.487-0.579), 0.568 (0.522-0.613), and 0.597 (0.551-0.641), respectively. We identified age, Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), and Glasgow Coma Scale (GCS) score as independent risk factors of RFS, and the combination of GCS and age can improve the AUC of ASPEN to 0.664 (0.620-0.706) for predicting RFS. SNAQ, GLIM, mNICE, and ASPEN do not perform well in identifying neurocritically ill patients at high risk of RFS, although ASPEN appears to have relatively a good validity among them. Combining GCS and age with ASPEN slightly improves RFS recognition, but it still leaves a lot of room for improvement.

[Povidone-iodine versus the benzethonium chloride wipe for penile skin disinfection before semen collection from sperm donors].

Objective: To study the influence of povidone-iodine (PI) versus that of the benzethonium chloride wipe (BCW) on semen collection and semen quality of sperm donors undergoing penile skin disinfection and provide some evidence for the selection of disinfection methods for semen collection. METHODS: We used PI from August to December 2015 and BCWs from January to July 2016 for penile skin disinfection before semen collection, with two samples from each donor, one collected with and the other without penis skin disinfection (the blank control group). After semen collection, we conducted a questionnaire investigation on the influence of the two disinfection methods on semen collection and compared the semen parameters between the two groups of sperm donors. RESULTS: Totally, 185 sperm donors were included in this study, of whom 63 underwent penile skin disinfection with PI and the other 122 with BCWs before semen collection. Statistically significant differences were found between the PI and BCW groups in the adaptability to the disinfectant and rigid disinfection procedures (P <0.05), but not in the other items of the questionnaire (P >0.05). Compared with the sperm donors of the blank control group, those of the PI group showed statistically significant difference in the percentage of progressively motile sperm (PMS) (ï¼»63.02 ± 3.18ï¼½% vs ï¼»61.45 ± 4.78ï¼½%, P<0.05), but not in the abstinence time (ï¼»4.97 ± 1.79ï¼½ vs ï¼»4.7 ± 0.94ï¼½ d, P >0.05), semen volume (ï¼»4.11 ± 1.54ï¼½ vs ï¼»4.15 ± 1.61ï¼½ ml, P >0.05), sperm concentration (ï¼»110 ± 29.6ï¼½ vs ï¼»107.5 ± 31.79ï¼½ ×106/ml, P >0.05), or total sperm count (ï¼»439.10 ± 170.13ï¼½ vs ï¼»434.02 ± 186.91ï¼½ ×106/ejaculate, P >0.05), while those of the BCW group exhibited no remarkable difference in any of the above parameters (P >0.05). Among the samples with abnormal semen quality, significantly fewer were found with abnormal PMS in the BCW than in the PI group (1.64% ï¼»2/122ï¼½ vs 9.68% ï¼»6/62ï¼½, P <0.05). However, there were no significant differences between the PI and BCW groups in the abnormal semen volume, abnormal sperm concentration, or the rate of semen bacterial contamination (P >0.05). CONCLUSIONS: Before semen collection from donors, penile skin disinfection with povidone-iodine may affect both the semen collection process and the quality of donor sperm, while the benzethonium chloride wipe can reduce the influence on the semen collection process and does not affect the semen parameters.

TFP5 peptide, derived from CDK5-activating cofactor p35, provides neuroprotection in early-stage of adult ischemic stroke.

Cyclin-dependent kinase 5 (CDK5) is a multifaceted protein shown to play important roles in the central nervous system. Abundant evidence indicates that CDK5 hyperactivities associated with neuronal apoptosis and death following ischemic stroke. CDK5 activity increases when its cofactor p35 cleaves into p25 during ischemia. Theoretically, inhibition of CDK5/p25 activity or reduction of p25 would be neuroprotective. TFP5, a modified 24-aa peptide (Lys254-Ala277) derived from p35, was found to effectively inhibit CDK5 hyperactivity and improve the outcomes of Alzheimer's disease and Parkinson's disease in vivo. Here, we showed that intraperitoneal injection of TFP5 significantly decreased the size of ischemia in early-stage of adult ischemic stroke rats. Relative to controls, rats treated with TFP5 displayed reduced excitotoxicity, neuroinflammation, apoptosis, astrocytes damage, and blood-brain barrier disruption. Our findings suggested that TFP5 might serve as a potential therapeutic candidate for acute adult ischemic stroke.

TFP5 is comparable to mild hypothermia in improving neurological outcomes in early-stage ischemic stroke of adult rats.

AIM: We compared the efficacy of a modified truncated 24-aa peptide (TFP5), derived from the cyclin-dependent kinase 5 (CDK5)-activating cofactor p35, with mild hypothermia (MH), and determined whether the efficacy of TFP5 is affected by MH. METHODS: Ischemic stroke was induced in adult male Sprague-Dawley rats for 2h. Immediately after initiating reperfusion, TFP5, MH, or the combination of the two were administrated. 48h after reperfusion, neurological outcomes were evaluated. RESULTS: Rats that received either MH, TFP5, or the combined treatment showed smaller brain infarct size than normothermia control (NT), and there was no apparent difference among these three treatment groups. The neurological deficit was significantly improved only by the combined treatment. MH or TFP5 ameliorated the blood-brain barrier (BBB) disruption in ischemic regions with similar efficacy, whereas the combination of them had a trend toward better effect. Besides, the cleavage of p35 into p25 and apoptosis in ischemic regions was inhibited by TFP5 or the combination, but not by MH alone. CONCLUSIONS: TFP5 is comparable to MH in improving neurological outcomes in early-stage adult ischemic stroke. When TFP5 is given along with MH, less neurological deficit tends to be achieved.

[Study on the Determination of the Maturity Level of Tobacco Leaf Based on In-Situ Spectral Measurement].

Discriminating the maturity levels of tobacco leaf with in-situ measurement can effectively reduce loss rate and quality decline due to misjudgment of the maturity levels of tobacco leaf. In the meantime, the regular way we use to determine the maturity levels of tobacco, which is depend on tobacco leaf age and judgment of tobacco grower, lacks of objectivity. So this paper proposed a method to identify maturity levels of tobacco leaf by using spectral feature parameters combined with the method of support vector machine (SVM). In this paper, a total of 351 tobacco leaf samples collected in 5 maturity levels including immature (M1), unripe (M2), mature (M3), ripe (M4), and mellow (M5) determined by experts were scanned by field spectroscope(ASD FieldSpec3) with in-situ measurement for getting their reflectance spectrum. Through spectral analysis we found that the spectrum of tobacco leaf with different levels of maturity can be distinguished in visible band but not easily be distinguished in near-infrared band, so we use the tobacco leaf spectrum in visible band as the sensitive bands to analyze and model. To find the most suitable input variables for modeling, we use continuous spectrum (350~780 nm), feature band (496~719 nm) and spectral feature parameters (the reflectance of green peak, location of green peak, first order differential value of red-edge and blue-edge, red-edge and blue-edge area, location of red-edge and blue-edge) in visible region as the input variables, and using these three kinds of input variables in the method of SVM to establish a discriminant model for identifying maturity levels of tobacco leaf. The result shows that, the model using spectral feature parameters gains the accuracy rate of 98.85%. While the accuracy rates of other two models were 90.80% and 93.10%, respectively. The conclusion was drawn that using spectral feature parameters in visible spectrum as the input variables in SVM can improve the model performance. It is feasible to use this method to identify maturity level of tobacco leaf with in-situ measurement.

Intermittent hypothermia is neuroprotective in an in vitro model of ischemic stroke.

OBJECTIVE: To investigate whether the intermittent hypothermia (IH) protects neurons against ischemic insult and the potential molecular targets using an in vitro ischemic model of oxygen glucose deprivation (OGD). METHODS: Fetal rat cortical neurons isolated from Day E18 rat embryos were subjected to 90-min OGD and hypothermia treatments during reoxygenation before examining the changes in microscopic morphology, cell viability, microtubule- associated protein 2 (MAP-2) release, intracellular pH value and calcium, reactive oxygen species (ROS) generation, mitochondrial membrane potential (△Ψm) and neuronal death using cell counting kit (CCK-8), enzyme-linked immunosorbent assay (ELISA), BCECF AM, Fluo-3 AM, DCFH-DA and dihydroethidium (DHE), JC-1 staining and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL), respectively. RESULTS: 90-min OGD induced morphologic abnormalities, cell viability decline, MAP-2 release, intracellular acidosis, calcium overload, increased ROS generation, △Ψm decrease and cell death in primary neurons, which was partially inhibited by continuous hypothermia (CH) and intermittent hypothermia (IH). Interestingly, 6-h CH was insufficient to reduce intracellular calcium overload and stabilize mitochondrial membrane potential (△Ψm), while 12-h CH was effective in reversing the above changes. All IH treatments (6×1 h, 4×1.5 h or 3×2 h) effectively attenuated intracellular free calcium overload, inhibited ROS production, stabilized mitochondrial membrane potential (△Ψm) and reduced delayed cell death in OGD-treated cells. However, only IH intervals longer than 1.5 h appeared to be effective in preventing cell viability loss and intracellular pH decline. CONCLUSION: Both CH and IH were neuroprotective in an in vitro model of ischemic stroke, and in spite of shorter hypothermia duration, IH could provide a comparable neuroprotection to CH.

[Body mass index correlates with the level of serum prostate-specific antigen in men in Fangcheng area of Guangxi].

OBJECTIVE: To investigate the influence of body mass index (BMI) on the serum prostate-specific antigen (PSA) level in males in the Fangcheng area of Guangxi. METHODS: We reviewed the health examination data of males collected from September 2009 to December 2011, including their height, weight, BMI, and serum PSA level. The subjects were categorized as underweight (BMI <18.5 kg/m2), normal (BMI 18.5-22.9 kg/m2), overweight (BMI 23.0-27.4 kg/m2), and obese (BMI > or = 27.5 kg/m2), and divided into four age groups: 20-29, 30-39, 40-49, and > or = 50 years old. The PSA levels were stratified by the BMI category for statistical analysis. RESULTS: A total of 2,397 men were included in this study, with a mean age of (37.4 +/- 11.0) yr, BMI of (23.3 +/- 3.4) kg/m2, and PSA level of (0.98 +/- 0.93) microg/L. There were significant differences in the age-associated PSA levels in the groups with BMI < 23 (0.81 microg/L) and > or = 23 kg/m2 (0.78 microg/L) (P < 0.05), as well as in those with BMI < 27.5 (0.81 microg/L) and > or = 27. 5 kg/m2 (0.70 microg/L) (P < 0.05). In the 30-39 and 40-49 age groups, the PSA levels were significantly decreased with the increase of BMI (P < 0.05). CONCLUSION: Increased BMI is associated with decreased PSA in men <50 years old in the Fangcheng area of Guangxi, which should be taken into consideration while determining whether to carry out prostate biopsy as part of early prostate cancer detection in young men with marginal PSA levels.

Intra-carotid cold magnesium sulfate infusion induces selective cerebral hypothermia and neuroprotection in rats with transient middle cerebral artery occlusion.

Local hypothermia induced by intra-arterial infusion of cold saline reduces brain injury in ischemic stroke. Administration of magnesium sulfate through the internal carotid artery is also known to reduce ischemic brain damage. The neuroprotective effects of combination therapy with local endovascular hypothermia and intra-carotid magnesium sulfate infusion has not been evaluated. The aim of the study was to determine whether infusion of intra-carotid cold magnesium offers neuroprotective efficacy superior to cold saline infusion alone. Sixty-eight Sprague-Dawley rats were subjected to 3 h of middle cerebral artery occlusion and were randomly divided into six groups: sham-operated group; stroke control group; local cold magnesium infusion group; local cold saline infusion group; local normothermic magnesium infusion group; and local normothermic saline infusion group. Before reperfusion, ischemic rats received local infusion or no treatment. Infarct volume, neurological deficit, and brain water content were evaluated at 48 h after reperfusion. Selective brain hypothermia (33-34 °C) was successfully induced by intra-carotid cold infusion. Local cold saline infusion and local cold magnesium infusion reduced the infarct volumes by 48 % (p < 0.001) and 65 % (p < 0.001), respectively, compared with stroke controls. Brain water content was decreased significantly in animals treated with local cold magnesium infusion. Furthermore, the rats given a local cold magnesium infusion had the best neurological outcome. Local normothermic infusion failed to improve ischemic brain damage. These data suggest that local hypothermia induced by intra-carotid administration of cold magnesium is more effective in reducing acute ischemic damage than infusion of cold saline alone.

Interrupted intracarotid artery cold saline infusion as an alternative method for neuroprotection after ischemic stroke.

OBJECT: Intracarotid artery cold saline infusion (ICSI) is an effective method for protecting brain tissue, but its use is limited because of undesirable secondary effects, such as severe decreases in hematocrit levels, as well as its relatively brief duration. In this study, the authors describe and investigate the effects of a novel ICSI pattern (interrupted ICSI) relative to the traditional method (uninterrupted ICSI). METHODS: Ischemic strokes were induced in 85 male Sprague-Dawley rats by occluding the middle cerebral artery for 3 hours using an intraluminal filament. Uninterrupted infusion groups received an infusion at 15 ml/hour for 30 minutes continuously. The same infusion speed was used in the interrupted infusion groups, but the whole duration was divided into trisections, and there was a 20-minute interval without infusion between sections. Forty-eight hours after reperfusion, H & E and silver nitrate staining were utilized for morphological assessment. Infarct sizes and brain water contents were determined using H & E staining and the dry-wet weight method, respectively. Levels of neuron-specific enolase (NSE), S100ß protein, and matrix metalloproteinase 9 (MMP-9) in the serum were determined using enzyme-linked immunosorbent assay. Neurological deficits were also evaluated. RESULTS: Histology showed that interrupted ICSI did not affect neurons or fibers in rat brains, which suggests that this method is safe for brain tissues with ischemia. The duration of hypothermia induced by interrupted ICSI was longer than that induced via the traditional method, and the decrease in hematocrit levels was less pronounced. There were no differences in infarct size or brain water content between uninterrupted and interrupted ICSI groups, but neuron-specific enolase and matrix metalloproteinase 9 serum levels were more reduced after interrupted ICSI than after the traditional method. CONCLUSIONS: Interrupted ICSI is a safe method. Compared with traditional ICSI, the interrupted method has a longer duration of hypothermia and less effect on hematocrit and offers more potentially improved neuroprotection, thereby making it more attractive as an infusion technique in the clinic.

[Risk factors analysis of outcomes for patients with primary pontine hemorrhage].

OBJECTIVE: To evaluate the risk factors of prognosis in patients with primary pontine hemorrhage. METHODS: A retrospective analysis was conducted using data from 60 patients admitted with a diagnosis of primary pontine hemorrhage to the Department of Neurology of Nanfang Hospital in Guangzhou City. Patients were classified as survivors (n=34) and non-survivors (n=26) according to their outcomes on 30 days from the onset of symptoms. Univariate analysis and multivariate logistic regression analysis were performed on clinical data and imaging features of patients. Receiver operating characteristic curve (ROC curve) analysis was used on continuous parameters verified by multivariate logistic regression analysis to determine their cut-off value. RESULTS: The 30-day mortality was 43.3% for 60 patients with primary pontine hemorrhage. Univariate analysis showed Glasgow coma scale (GCS) at admission, temperature, heart rate, hemorrhage volume, mechanical ventilation, involvement of ventricles and location of hematoma were statistically related to 30-day mortality in patients with primary pontine hemorrhage. Multivariate logistic regression analysis demonstrated that the GCS at admission [odds ratio (OR)=0.745, 95% confidence interval (95%CI) 0.585 to 0.949], hemorrhage volume (OR=1.438, 95%CI 1.077 to 1.919) and location of hematoma (basal-tegmental hemorrhage, OR=0.120, 95%CI 0.016 to 0.904) were independent risk factors of poor prognosis in patients with primary pontine hemorrhage (all P<0.05). ROC curve analysis showed the cut-off value for GCS score at admission and hemorrhage volume was 7.5 and 5.5 ml, respectively. CONCLUSION: Patients suffering from primary pontine hemorrhage in the basal-tegmental region, GCS<7.5 at admission and hemorrhage volume≥5.5 ml would lead to a poor outcome in 30 days.

Guillain-Barré syndrome following sepsis after stereotactic aspiration for spontaneous pontine hemorrhage.

A 52-year-old female was treated with CT-guided stereotactic aspiration for acute spontaneous pontine hemorrhage. On postoperative day 7, the patient was complicated by Acinetobacter baumannii sepsis. As sepsis was stabilized, she developed flaccid weakness and autonomic dysfunction on postoperative day 21. Investigations including neurophysiological studies and cerebral spinal fluid analysis prompted the diagnosis of acute motor axonal neuropathy, a variant of Guillain-Barré syndrome. Intravenous administration of immunoglobulin resolved her potentially life-threatening autonomic instability. At 1-year follow-up, she was able to stand with significant assistance. Although Guillain-Barré syndrome rarely occurs, clinicians should be alert to the possibility of this potentially life-threatening consequence after cranial surgery with severe respiratory infection.

Outcome prediction by amplitude-integrated EEG in adults with hypoxic ischemic encephalopathy.

INTRODUCTION: Amplitude-integrated electroencephalography (aEEG) had been widely used in predicting outcome in infants with hypoxic ischemic encephalopathy (HIE). We aimed to evaluate the use of aEEG as a quantitative predictor of outcome in adult patients with HIE. METHODS: aEEG and Glasgow coma scale (GCS) were recorded for patients with HIE within 72 h of onset. aEEG traces were categorized as Grade I (normal amplitude): upper margin of aEEG activity >10 µV, lower margin >5 µV; Grade II (moderately abnormal amplitude): upper margin of aEEG activity >10 µV, lower margin ≤5 µV, or with suppressed amplitude, upper margin ≤10 µV, lower margin >5µV; Grade III (mild abnormality): either upper margin <10 µV, lower margin <5 µV. GCS was graded as I (9-14), grade II (4-8), or grade III (3). Cerebral performance category scores (CPCs) were determined 1 and 3 month after clinical evolution. CPC 1,2 were defined as favorable outcome; CPC 3,4,5 were considered as poor outcome. RESULTS: 30 cases met inclusion criteria. Both the aEEG grade and GCS scores correlated significantly with short-term outcome, and cases with a worse aEEG grade were more likely to have an unfavorable short-term outcome. Since the number of patients is really too small for long-term outcome analysis, we did not perform the analysis of aEEG, GCS and longer-term outcome. There was significant difference of clinical findings among aEEG classifications, while no statistical difference was found of causes of HIE. CONCLUSIONS: aEEG is a reliable predictor of short-term outcome in HIE, and aEEG results within 72h after onset were associated with neurodevelopmental outcome at 1 mo following clinical evolution.

[A study on the neuronal mechanism of retrieval of long-term digital memory in human by functional magnetic resonance imaging].

To investigate the neuronal mechanism of retrieval of long-term digital memory in healthy volunteers, functional magnetic resonance imaging (fMRI) technique was used in the study. Twenty-two right-handed volunteers were subjected to a long-term digital memory test with block-design. The memory task and control task were adopted in the experiment alternatively. The fMRI data were recorded by a Siemens 1.5T MR machine and analyzed by SPM99. The activated brain regions were shown in the Talairach coordinate. The results showed that the Brodmann's area (BA) 9 region in left middle frontal gyrus was the most activated cortex during the long-term digital memory task. The left medial frontal gyrus, left inferior frontal gyrus, right inferior frontal gyrus, cingulate gyrus, left inferior parietal lobule, left superior parietal lobule, right superior parietal lobule, right middle temporal gyrus, left lingual gyrus, left middle occipital gyrus, right middle brain, cerebellum and right caudate nucleus tail were also involved. The activation in cortices showed obvious left predominance. It is suggested that a series of brain regions with left predominance are involved in long-term digital memory. Left lateral frontal cortex would be the most important structure for information extraction, while the other cortices and their connections may be important for processing and long-term storage of digital information.

[Evaluation of sperm mitochondrial membrane potential in varicocele patients using JC-1 fluorescent staining].

OBJECTIVE: To detect sperm mitochondrial membrane potential (MMP) of varicocele patients and investigate its clinical significance. METHODS: Sixty-seven varicocele patients were divided into a VC1 (grade 1, n = 26), a VC2 (grade 2, n = 21) and a VC3 group (grade 3, n = 20). And 29 normal fertile volunteers were included in a control group ( m = 29). Conventional semen analyses were performed by computer-assisted semen analysis (CASA). Semen samples were washed, followed by JC-1 staining to evaluate the sperm MMP (JC-1+ %) by flow cytometry. RESULTS: The sperm MMPs of the VC1, VC2 and VC3 groups were siginificantly lower ([56.29 +/- 16.32]%, P < 0.05; [45.04 +/- 13.21]%, P < 0.01; [31.63 +/- 12.91]%, P < 0.01) than that of the control ([76.21 +/- 13. 96]%). There was a significant positive correlation between the percentage of JC-1+ and that of grade (a + b) sperm (r =0.693, P=0.000). CONCLUSION: The decreased MMP in the sperm of varicocele men might be one of the important causes of male infertility.

[Value of lower-limb short latency somatosensory evoked potentials in predicting early death in patients with massive cerebral infarction].

OBJECTIVE: To explore the value of lower-limb short latency somatosensory evoked potentials (SLSEP) in predicting early death in patients with massive cerebral infarction. METHODS: Forty-eight patients of massive cerebral infarction were admitted in the Neurological Intensive Care Unit (NICU) between March 2008 and March 2009, and Glasgow-Pittsburgh coma scale (GPCS) and SLSEP were recorded and graded within 24 h after admission. The patients were divided into survival and death groups (including brain death) according to their short-term prognosis. The correlations of SLSEP and GPCS to the mortality were assessed. RESULTS: A significant correlation was found between SLSEP and the mortality in patients with massive cerebral infarction (r=0.484, P<0.001). The positive predictive value of the SLSEP grade 3 to death was 100%, and the patients with malignant middle cerebral artery infarction (mMCAI) appeared to have a 100% mortality. CONCLUSION: SLSEP grade 3 can be a highly specificity in predicting early death in patients with massive cerebral infarction, and it is also of value in determining the timing of surgical intervention of mMCAI.

[Activated brain areas during simple and complex mental calculation--a functional MRI study].

Functional magnetic resonance imaging (fMRI) was used to study the activated brain areas of human during simple and complex digital calculation, and to investigate the role of cortical and subcortical structures involved in the mental calculation. Sixteen right-handed healthy volunteers performed mental calculation of simple and complex addition/subtraction respectively, while the fMRI data were recorded by a Seimens 1.5 T MR machine. Block-design was used in the tasks. Two calculation tasks and one base-line tasks were performed for the block-design. Simple calculation task was single-digit addition and subtraction, while the complex was multi-digit addition and subtraction. The base-line task was to tell whether the two numbers were the same in every trial. Statistical parametric mapping (SPM99) was employed to process data and localize functional areas. We compared the average activation intensity of each activated brain regions in the same calculation task and the activation intensity of the same regions in both tasks respectively. Both the cortex and the subcortical structures including basal ganglia and thalamus were activated during simple and complex mental calculations. Similar brain regions in subjects including frontal lobe, parietal lobe, occipital lobe, cingulate gyrus, thalamus and cerebellum were engaged in simple and complex addition/subtraction. In the same task, activation intensity of all activated brain areas differed insignificantly. Compared with the complex task, the right parietal lobe was not activated in the simple one. The subcortical structures such as the caudate nucleus and the left marginal division of the striatum (MrD) were activated in both two calculation tasks. The cortical regions involved in both simple and complex addition/subtraction were similar. In conclusion, both the cortex and the subcortical structures were activated during the mental calculation. The cortex including the frontal cortex, parietal cortex, and cingulate gyrus were activated during mental calculation, while the subcortical structures such as the caudate nucleus, the globus pallidum and the left marginal division of the striatum also played a critical role in the neural networks of the calculation at the same time. Right parietal lobe (supramarginal gyrus) was engaged only in the complex task, which suggested that this region might be involved in the visuospatial memory and processing.

[Evaluation of sperm mitochondrial membrane potential by JC-1 fluorescent staining and flow cytometry].

OBJECTIVE: To investigate the feasibility and clinical significance of detecting sperm mitochondrial membrane potential (MMP) by JC-1 fluorescent staining and flow cytometry, and to explore the relationship between the results of JC-1 staining and seminal parameters. METHODS: Sixty-three semen samples were divided into a fertile (n = 31) and an infertile group (n = 32) and underwent computer-assisted semen analysis (CASA). All the samples were washed, followed by JC-1 staining and evaluation of sperm MMP by flow cytometry. The percentage of normal sperm MMP was indicated as the percentage of sperm emitting orange-red fluorescence (JC-1 + %). RESULTS: The JC-1 + % was significantly higher in the fertile group than in the infertile one ([75.89 +/- 15.69]% vs [54.04 +/- 22.21] %, P = 0.000), correlated positively with sperm motility (r = 0.610, P = 0.000) and the percentage of grade a + b sperm (r = 0.614, P = 0.000) and negatively with grade d sperm (r = -0.504, P = 0.000). There was a significant positive correlation between the results of JC-1 staining (JC-1 + %) and that of Rh123 /PI dual fluorescent staining (Rh123 + / PI (-)%) (r = 0.938, P = 0.000). CONCLUSION: JC-1 staining and flow cytometry could readily and quickly detect sperm MMP and the sperm JC-1 + % could be an auxiliary marker for the diagnosis of male infertility.