ABSTRACT
Objective To investigate the influence of collateral circulation recruitment on cognitive functions in patients with severe unilateral stenosis or unilateral occlusion of the internal carotid artery by using TCD.Methods A total of 176 patients with severe unilateral stenosis or unilateral occlusion of the internal carotid artery were enrolled and were divided into a single vessel collateral group(n=80,45.5 ％),a multiple vessel collateral group(n=74,42.1％) and a no collateral group(n=22,12.5 ％).In order to study the influence of single vessel collateral circulation on cognitive functions,the single vessel collateral group was further divided into an anterior communicating subgroup(AcoA),a posterior communicating subgroup(PcoA),an ocular artery subgroup(OA),and a normal control subgroup.All patients and 34 normal controls(NC) received MoCA,and scores for the overall assessment and individual domains were analyzed.Results Compared with the control group (26.3± 1.1,4.7 ± 0.5,2.0 ± 0.0,3.6 ± 1.0),the multiple vessel collateral group,the single vessel collateral group and the no collateral group had lower overall scores (24.2 ± 1.7,21.9 ± 2.3,19.0 ± 2.4),lower executive/visuospatial function(3.9 ± 0.7,3.2 ± 0.8,2.4 ± 0.6),lower abstraction (1.7 ± 0.5,1.6±0.5,1.3±0.5),and lower delayed recall(2.9±0.8,1.9±0.8,1.6±0.5)(F=80.52,63.21,12,48.99,all P＜0.05);both collateral groups had lower scores in subtraction and attention (4.6±0.6 vs.5.2±0.7,4.3±0.7 vs.5.2±0.7);the no collateral group had lower scores in orientation(4.7±0.7 vs.5.7±0.5)(P＜0.05).Compared with the multiple vessel collateral group,both the single vessel collateral group and the no collateral group had lower overall scores(21.9±2.3 vs.24.2 ± 1.7,19.0± 2.4 vs.24.2 ± 1.7),executive/visuospatial function (3.2 ± 0.8 vs.3.9 ± 0.7,2.4±0.6 vs.3.9±0.7),subtraction and attention(4.6±0.6 vs.5.1±0.5,4.3±0.7 vs.5.1±0.5) (all P＜ 0.05);the no collateral group had lower scores in abstraction (1.3 ± 0.5 vs.1.7 ± 0.5),delayed recall(1.6 ± 0.5 vs.2.9 ± 0.8) and orientation (4.7 ± 0.7 vs.5.7 ± 0.5) (all P ＜ 0.05).Compared with the single vessel collateral group,the no collateral group had lower overall scores(19.0 ±2.4 vs.21.9±2.3),executive/visuospatial function(2.4±0.6 vs.3.2±0.8)and orientation(4.7± 0.7 vs.5.7 ± 0.6) (all P ＜0.05).In single vessel collateral patients,the AcoA subgroup had higher MoCAscores than the PcoA subgroup(22.9± 1.7 vs.21.2±2.7) (P＜0.05),and the AcoA subgroup had higher scores in delayed recall than the OA subgroup(2.2±0.8 vs.1.7±0.6) (P＜ 0.05).Conclusions Severe unilateral stenosis or unilateral occlusion in the internal carotid artery can result in cognitive impairment,especially in executive/visuospatial function,abstraction,delayed recall,subtraction and attention.However,collateral circulation can protect cognitive function in patients with unilateral internal carotid artery stenosis or occlusion and multiple vessel collateral circulation is more effective than single vessel collateral circulation,and AcoA is more effective than either PcoA or OA,but the difference between PcoA and OA is not significant.
ABSTRACT
Objective@#To investigate the changes of 31P-MRS in denervated skeletal muscle at 7.0 T MR system.@*Methods@#In the experiment group, a total of 18 male Sprague-Dawley rats aged 6-8 weeks old and weighing 200-250 g were obtained. The right posterior femoral nerve were transected, and the proximal stumps were ligated by using 5-0 nylon stitches to preclude spontaneous repair. A sham surgery (incision and exploration of the nerve) was performed at the same time (n=6). Before rat model established and at varying times after initial surgery (3 d, and 1, 2, 4, 6, and 8 weeks). 31P-MR spectra of rat quadriceps femoris were acquired on 7.0 T Agilent small animal MR imaging system. We quantified the phosphocreatine (PCr), adenosine triphosphate(β-ATP), and inorganic phosphate (Pi) using Creatine phosphate disodium salt(10 mmol/L) as an external standard. The ratios, include PCr/Pi, Pi/β-ATP, PCr/β-ATP, PCr/(PCr+Pi) and Pi/(PCr+Pi) were quantified in jMRUI. All data were analyzed by one way analysis of variance (ANOVA) with posttest inter-group comparisons using Bonferroni test. Comparative analysis methods between the experimental and control group were performed via independent samples t test. P<0.05 was considered as statistically significance.@*Results@#The average measured concentrations of β-ATP, PCr, and Pi in control groups were (6.654±0.178) μmol/g, (25.656±0.738) μmol/g, and (1.594±0.096) μmol/g, respectively. There were significant statistically differences in β-ATP, PCr, Pi, PCr/Pi, PCr/PCr+Pi,Pi/PCr+Pi between the study and control group(P<0.05) at any measurement time point after denervation. Pi/β-ATP,PCr/β-ATP and pHi in the experimental group significantly statistically differed from those of the control group (all P<0.05)at each time point except on day 3 after operation. The total concentrations of β-ATP and PCr were reduced by 11.5% and 19.7% respectively on day 3. Thereafter, β-ATP and PCr declined rapidly by 63.1% and 68.8% at week 4 respectively, then decreased slowely by 74.0%和82.3% till week 10. The change of PCr/Pi is similar to β-ATP and PCr, but more remarkable. Pi, Pi/PCr+Pi, Pi/ATP showed a progressively increase till week 10. The intra-cellular pH (pHi) of normal rat muscles was 7.033±0.017, While the pHi gently in experiment rat muscles decreased during the entire experiment.@*Conclusion@#31P-MRS with 7.0 T can quantify the temporal changes of energy metabolism and pHi in normal and denervated rat muscles. It shows that the dysfunction of energy metabolism are progressive with time and that they begin within a short period following the nerve section, the change of β-ATP, PCr, PCr/Pi take place primarily within 4 weeks after denervation. β-ATP, PCr, and PCr/Pi may be potential biomarkers of energy metabolism in the evaluation of denervated muscle atrophy.
ABSTRACT
Objective To investigate the metabolite changes in systemic lupus erythematosus (SLE) patients with and without neuropsychiatric symptoms using magnetic resonance spectroscopy (MRS) and explore the associations between image findings and clinical variables. Methods Twenty-two SLE patients with neuropsychiatric symptoms (NPSLE), twenty-one SLE patients without neuropsychiatric symptoms (non-NPSLE) and twenty healthy controls (HCs) underwent routine MRI scan and multivoxel magnetic reson-ance spectroscopy (MVS). The absolute metabolite concentrations were measured bilaterally in the posterior cingulate gyrus (PCG), dorsal thalamus (DT), lentiform nucleus (LN) and posterior paratrigonal white matter (PWM) using LCModel and SAGE software. The relationships between metabolite con-centrations and cognitive function scores were analyzed by Spearman rank correlation. Single-factor Chi-square analysis and t-test were used for analysis. Results ① Compared to control subjects, NPSLE patients had significantly lower N-acetylaspartate (NAA) values in bilateral PCG and DT, with the mean differences of -1.504 [95% confidence interval ( CI) (-2.335, -0.672), P=0.001], -1.460 [95%CI (-2.349, -0.570), P=0.002], -1.259 [95%CI (-1.894, -0.625), P=0.000] and -1.022[95%CI (-1.688, -0.356), P=0.003] for RPCG, LPCG, RDT and LDT, respectively. The concentration of total creatinine were observed to decline in RPCG and RDT, with the mean differences of-1.094 [95%CI (-1.845, -0.342), P=0.003], -0.955 [95%CI (-1.630, -0.280), P=0.006], -1.259 [95%CI (-1.894,-0.625), P=0.006] respectively. Glutamine and glutamate-values decreased significantly in RDT [mean difference=-2.586, 95%CI (-4.139, -1.033), P=0.002]. ② Compared to non-NPSLE patients, NPSLE patients had a lower NAA level in LPCG [mean difference=-1.256, 95%CI (-2.146, -0.367), P=0.006]. Positive correlations between mini-mental state examination scores [RPCG: rs=0.312, P<0.05; LPCG: rs=0.355, P<0.01], Montreal cognitive assessment scores (RPCG: rs=0.362, P<0.01; LPCG: rs=0.285, P<0.05) and NAA values in bilateral PCG were detected. Conclusion Both NPSLE and non-NPSLE patients may have metabolite dysfun-ctions in different brain regions. The cognitive disorder in SLE patients may be interpreted by neuronic damage of PCG.
ABSTRACT
Objective To investigate the alteration of energy metabolism and oxidative injury in the myocardia suffering from lethal ventricular tachyarrhythmia (LVTA). Methods Two LVTA-SCD SD rat models, induced by aconitine injection or coronary artery ligation (CAL), respectively, were developed. Rats that died from over-anaesthesia or CAL-induced heart failure were served as their controls, respectively. Mitochondrial membrane potential (MMP), reactive oxygen species (ROS), malonaldehyde (MDA), phosphocreatine (PCr) in the ventricular myocardia, and serum troponin I (cTnI) were detected, and compared between LVTA rats and their controls. Results Fourteen ACO-LVTA and six CAL-LVTA rats were successfully developed. As compared to their controls, ACO-LVTA and CAL-LVTA rats had higher ROS and MDA content, and lower concentration of PCr in the ventricular myocardia. MDA content in ACO-LVTA group is signiifcantly higher than that of its control (P<0.05). MMP in myocardia of ACO-LVTA is lower than that of its control, but is higher than those of two CAL groups. Serum cTnI in rats of both LVTA models is higher than those of their controls and pre-treated control. Specially, serum cTnI in CAL-LVTA was signiifcantly higher than that of ACO-LVTA and its control (P<0.01). The myocardial ROS content is correlated with the duration of VT and VF (P<0.05), with correlation coefifcients being 0.44 and 0.46, respectively. Conclusions After LVTA, the ventricular myocardia had lower MMP and PCr content, higher concentration of ROS, MDA, as well as higher serum cTnI than their controls, indicative of oxidative injury and alteration of energy metabolism under LVTA-SCD.
ABSTRACT
Objective To analyze the articles and citation published in the Chinese Journal of Internal Medicine from 2008 to 2010,in order to investigate the influence factors of impact factor (IF).Methods All articles published in the Chinese Journal of Internal Medicine covered by Chinese Medical Citation Index(CMCI) from 2008 to 2010 were searched and downloaded.Some article related attributions were manual added and their influences to IF were analyzed.Results A total of 1164 academic papers were published in the journal in 3 years,with 9.95 references per paper.The total citation was 1029 times,with 0.93 time per paper and 0.31 time per page.Among them,736 articles were not cited,accounting for 63.2％.Original articles,pure clinical articles had good citation output.For fund supporting,the citation of articles without fund was higher than those with fund.The articles on hematology,cardiology and gastroenterology accounted the most,while ICU,emergency and nephrology were the least internal medicine reported specialties.Although there exists citation difference among different subjects,for considering the absolute values,neurology/psychiatry (0.73 time per paper),cardiology (0.65 time per paper) and gastroenterology (0.54 time per paper) had better citation output,while hematology,basic research and rheumatology had no good performance to IF.Conclusion We should further strengthen acquisition and dissemination of excellent articles,reduce the number of non-cited paper,expand periodical visibility,and provide a quick and convenient way of literature reading.
ABSTRACT
Objective To evaluate the academic level of Chinese Journal of Internal Medicine by analyzing its citation status by using bibliometrics method.Methods The distribution of articles published in Chinese Journal of Internal Medicine from January,2005 to December,2011 indexed by Chinese Science Citation Database (CSCD) was analyzed.Results A total of 2809 articles were published in Chinese Journal of Internal Medicine between January,2005 and December,2011.Among them,832 (29.62％) articles were cited for totally 1993 times.There were 14 authors whose total citation number in 2005-2011 was ≥ 10 times.Authors of the cited articles came from 25 provinces,autonomous regions and municipalities.The regions from where the articles had the highest citation were Beijing (341 articles),Shanghai (87 articles),Guangdong (64 articles),Jiangsu (45 articles) and Zhejiang (43 articles).The medical institutions with the highest citation were Peking Union Medical College Hospital of Peking Union Medical College and Chinese Academy of Medical Sciences (205 times),Peking University People's Hospital (77 times),and Chinese PLA General Hospital (76 times).Conclusions Quite a few high level academic papers had been published in Chinese Journal of Internal Medicine in recent years.Chinese Journal of Internal Medicine plays a good role in enhancing academic exchange.
ABSTRACT
The technology of Magnetic Resonance Spectroscopy(MRS) is a newly-developed mean for analyzing some specific nucleus and their compounds making use of the principles of magnetic resonance and the effects of chemical shift. Currently, among MRS applications, proton magnetic resonance spectroscopy (1HMRS) is the most widely applied one developed from single voxel to three-dimensional multi-voxel scanning technique. It provides a lot of important information for clinical studies. This article mainly reviews the methods for absolute quantification measurement of brain metabolites using multi-voxel MRS.
ABSTRACT
Objective To evaluate the absolute quantification of brain metabolites concentrations using external standard MRS in acute hypoxia ischemia encephalopathy (HIE) piglet model. Method Eight 7-day-old healthy piglets were subjected to insult of hypoxia ischemia (HI). The animals and an external standard phantom containing detectable metabolites of known concentrations were studied on a 1.5 T GE Signa scanner. The single-voxel proton magnetic resonance spectroscopy (1H-MRS) data were processed using LCModel software, and the quantification of N-acetylaspartate ( NAA), creatine (Cr) and lactate (Lac) were accomplished. Multivariate analysis of variance was performed to compare the NAA, Cr, Lac concentration differences in the brains of piglets pre- and post-HI (0h). In addition, the dynamic changes of brain metabolites concentrations of 2 HIE piglets were observed at the time points of 0 h and 2 h. Results One piglet was excluded because it was over anesthetized to death. Seven piglets' data were analyzed. The concentrations of NAA pre- and post-HI were ( 6. 86 ± 0. 49 ) mmol/kg and ( 5.73 ± 0. 88 ) mmol/kg respectively, they were ( 4. 65 ± 0. 73 ) mmol/kg and ( 4. 40 ± 0. 80 ) mmol/kg for Cr; and were 0. 00 mmol/kg and (0. 43 ± 0. 39) mmol/kg for Lac. After HI, decreased NAA concentration immediately was observed, and it was of statistical significance ( F = 8. 608, P = 0. 013 ). The concentration of Cr was insignificantly decreased ( F = 0. 379, P = 0. 550). The concentration of Lac was increased, and the difference was of statistical significance ( F = 8. 600 ,P = 0. 013 ). Dynamic observation showed a Lac peak immediately after HI and it decreased after 2 h post-HI. Conclusions External standard MRS using LCModel has great value in the quantitative analysis of brain metabolites. The changes of NAA and Lac concentrations are sensitive to reflect the early metabolic change of acute HIE.
ABSTRACT
Objective To investigate the accuracy for absolute quantification of brain creatine (Cr) concentration using long time echo (TE) point resolved spectroscopy (PRESS) sequence performed with an external standard and postprocessed with the linear combination of model spectra (LCModel).Methods Ten swine (3.1±0.6 kg) and an external standard phantom containing detectable compounds of known concentration were investigated in this study by using 1.5 T GE Signa scanner and a standard head coil. The single-voxel proton magnetic resonance spectroscopy (1H-MRS) data were acquired from the two ROIs (2 cm×2 cm×2 cm) placed in swine brain and external standard solution using PRESS sequence with TE 135 ms,TR 1500 ms,and 128 scan averages.The in vivo quantification of Cr was accomplished by LCModel.After 1H-MRS examination,each animal was sacrificed immediately.In vitro Cr concentration was analyzed by high performance liquid chromatography (HPLC).Results In the 1H-MRS group,the Cr concentration was (9.37±0.14)mmol/kg.In the HPLC group,the Cr concentration was (8.91±0.13)mmol/kg.Good agreement was obtained between these two methods (t=9.038,P=0.491).Conclusion The long echo time PRESS sequence performed with an external standard and processed with LCModel iS proven to be an accurate technique to detect the in vivo brain Cr concentration.
ABSTRACT
Objective To design and optimize the MRS pulse sequence which used to measure gamma-aminobutyric acid(GABA) in vivo. Methods In-depth research for the MRS sequence was carried out and a theoretical analysis and simulation by software using product-operator algebra for the design and optimization of pulse sequence was discussed. Results Through the simulation of MRUI software, Cr signal at ?3.0 was seen to be suppressed and the weak GABA signal was displayed clearly. Conclusion The sequence was designed and optimized. Method to increase the efficiency and the stability of the measurement was studied. Our research gives theoretical preparation for the coming programming work.