RÉSUMÉ
Objective:To investigate the alterations of brain resting-state functional connectivity in patients with leukoaraiosis(LA), and to explore its neuropathological mechanism of cognitive dysfunction.Methods:From August 2022 to February 2023, 28 patients with LA(LA group) and 30 gender, age and education level matched normal controls(NC group) in Jiangsu Shengze Hospital affiliated to Nanjing Medical University were prospectively recruited.Mini mental state examination, trail-making test, and Stroop color-word test were used to evaluate the cognitive function of participants, rs-fMRI images were processed by DPABI V6.1 based on MATLAB R2022a.Voxel-mirrored homotopic connectivity(VMHC) values were calculated and two-sample t test were performed to compare the differences in local brain activity between the two groups.The brain regions with significant differences were selected as the seeds to calculate the functional connectivity(FC) values of the whole brain, and Pearson correlation analyses were performed to evaluate the correlation between the FC values and neuropsychological scores. Results:The VMHC values of the calcarine fissure and surrounding cortex(CAL) (x=±18, y=-63, z=15), postcentral gyrus(PoCG) (x=±39, y=-27, z=48), lingual gyrus(LING) (x=±12, y=-51, z=-6), middle occipital gyrus(x=±27, y=-75, z=24) and insula(x=±36, y=6, z=3) in the LA group were lower than those in the NC group( P<0.05). The seed points FC results showed, FC values between right CAL(CAL.R) and bilateral precuneus(PCUN), right dorsolateral prefrontal cortex(DLPFC.R) and right temporal_mid were reduced in the LA group( P<0.05); FC values between PoCG.R and left CAL, left temporal_mid and right LING were reduced too( P<0.05). Additionally, the FC value in the LA group between CAL.R and DLPFC.R was negatively correlated with the Stroop C score( r=-0.39, P<0.05). The FC value in LA group and NC group between CAL.R and DLPFC.R was negatively correlated with the Stroop C score( r=-0.48, P<0.001)and also negatively correlated with the trail making test B(TMT-B) score( r=-0.40, P<0.01), and the FC value between CAL.R and PCUN.L was negatively correlated with the TMT-B score( r=-0.45, P<0.001). Conclusion:Desynchronized interhemispheric functional connectivity and abnormal cortical circuit functional connectivity were probably associated with the underlying neural mechanisms of cognitive impairment in LA.
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Objective: To explore the operation method and clinical effect of treatment for bilateral cleft lip with improved straight line closure. Methods: On the basis of straight line closure, the vermilion and anterior lip pear were repaired with the muscle-vermilion labial flap of lateral lip. In order to close nasal floor, flap-C from lateral wall of anterior lip and flap-G from nasal wing base were designed, meanwhile, nasal mucosa flap-D and flap-H from two sides of nasal base fissure were designed. The function of the orbicularis oris was repaired by cutting off the anomaly adhesion of the orbicularis oris. Results: The post-operational upper lip was thickened together with good shape and vermilion color, there was no obvious dynamic abnormality, nasal floor was closed well. Conclusion: The improved straight line closure can obtain good shape of lip, reduce the whistling deformities, oronasal fistula and dynamic abnormality.
RÉSUMÉ
Objective To further explore the mechanism by which bone morphogenetic protein 4(BMP-4)might be involved in hematopoietic differentiation of the yolk sac.We observed the expression of BMP-4,CD34,CD133 and tyrosine kinase receptors(KDR) in the blood island of the yolk sac at embryonic 3 to 8 weeks.Methods Gene expression was analyzed by RT-PCR and the presence of BMP-4,CD34,CD133 and KDR proteins was confirmed by immunohistochemistry in 57 human embryos.Results In the human yolk sac,we found that BMP-4 was expressed at high levels from the 16th day to the 7th week,and decreased quickly after week 7.The results showed that KDR,CD133 and CD34 largely appeared on the 21st and 30th day,then increased at the 6th week,and decreased quickly after week 7.Furthermore,Ihh,SCl,GATA-1,GATA-2 and PU.1 mRNAs showed that PU.1 was not expressed on the 16th day;however,other factors were expressed all the time.Conclusion The distribution of BMP-4,KDR,CD34,CD133 and transcription factors expression highly suggested that BMP-4 was secreted from the yolk sac which might exert its effects on the specification of human hemangioblast and hematopoietic stem cells from the embryonic mesoderm in vivo through transcription factors.