Theta-Burst Stimulation Combined With Virtual-Reality Reconsolidation Intervention for Methamphetamine Use Disorder: Study Protocol for a Randomized-Controlled Trial.

Background: Craving associated with drug-related memory is one of the key factors that induce the relapse of methamphetamine (MA). Disruption or modulation of the reconsolidation of drug-related memory may serve as an option for clinical treatment of MA addiction. This protocol proposes to use virtual reality (VR) to retrieve drug-associated memory and then use transcranial magnetic stimulation (TMS) at the neural circuit that encodes the reward value of drug cues to provide a non-invasive intervention during reconsolidation. We aim to evaluate the effectiveness of TMS treatment after VR retrieval on the reduction of cue reactivity and craving of MA. Methods: This is a randomized, double-blind, sham-controlled, parallel group trial, targeting participants with MA use disorder aged from 18 to 45 years old. Forty-five eligible volunteers in Shanxi Drug Rehabilitation Center will be recruited and be randomly allocated into three parallel groups, receiving either 1) MA-related cues retrieval in VR combined with active TMS (MA VR scene + TBS) or 2) sham TMS (MA VR scene + sham TBS), or 3) neutral cues retrieval in VR combined with active TMS (neutral VR scene + TBS). Two sessions of post-VR-retrieval TBS will be scheduled on two separate days within 1 week. The primary outcome will detect the memory-related activity by the electroencephalography (EEG) reactivity to drug cues in VR scenes. Secondary outcomes are the self-reported MA craving in VR scene, the physiological parameter (cue-induced heart rate) and the scores of psychological questionnaires including anxiety, depression, and mood. All primary and secondary outcomes will be assessed at baseline, 1-week, and 1-month post-intervention. Assessments will be compared between the groups of 1) MA VR scene + TBS, 2) MA VR scene + sham TBS and 3) neutral VR scene + TBS. Discussion: This will be the first study to examine whether the TMS modulation after VR retrieval can reduce self-reported craving and drug-related cue reactivity. It will promote the understanding of the neural circuit mechanism of the reconsolidation-based intervention and provide an effective treatment for MA use disorder patients. Clinical Trial Registration: [Chinese Clinical Trial Registry], identifier [ChiCTR1900026902]. Registered on 26 October 2019.

Comparison of image quality and lesion diagnosis in abdominopelvic unenhanced CT between reduced-dose CT using deep learning post-processing and standard-dose CT using iterative reconstruction: A prospective study.

PURPOSE: To compare image quality and lesion diagnosis between reduced-dose abdominopelvic unenhanced computed tomography (CT) using deep learning (DL) post-processing and standard-dose CT using iterative reconstruction (IR). METHOD: Totally 251 patients underwent two consecutive abdominopelvic unenhanced CT scans of the same range, including standard and reduced doses, respectively. In group A, standard-dose data were reconstructed by (blend 30 %) IR. In group B, reduced-dose data were reconstructed by filtered back projection reconstruction to obtain group B1 images, and post-processed using the DL algorithm (NeuAI denosing, Neusoft medical, Shenyang, China) with 50 % and 100 % weights to obtain group B2 and B3 images, respectively. Then, CT values of the liver, the second lumbar vertebral centrum, the erector spinae and abdominal subcutaneous fat were measured. CT values, noise levels, signal-to-noise ratios (SNRs), contrast-to-noise ratios (CNRs), radiation doses and subjective scores of image quality were compared. Subjective evaluations of low-density liver lesions were compared by diagnostic results from enhanced CT or Magnetic Resonance Imaging. RESULTS: Groups B3 and B1 showed the lowest and highest noise levels, respectively (P < 0.001). The SNR and CNR in group B3 were highest (P < 0.001). The radiation dose in group B was reduced by 71.5 % on average compared to group A. Subjective scores in groups A and B2 were highest (P < 0.001). Diagnostic sensitivity and confidence for liver metastases in groups A and B2 were highest (P < 0.001). CONCLUSIONS: Reduced-dose abdominopelvic unenhanced CT combined with DL post-processing could ensure image quality and satisfy diagnostic needs.

Large-scale isolation and antitumor mechanism evaluation of compounds from the traditional Chinese medicine Cordyceps Militaris.

We established a large-scale separation and purification platform to obtain kilogram amounts of natural compounds from the extraction of the fruiting bodies of C. militaris. Seven monomeric compounds, N6-(2-hydroxyethyl) adenosine (HEA), ergosterol (E), ergosta-7,22-diene-3,5,6-triol (EI), 5α,8α-epidioxy-(22E,24R)-ergosta-6,22-dien-3ß-ol (ED),ergosta-7,22-dien-3ß,5α-dihydroxy-6-one (EO), (20S,22E,24R)-Eegosta-7,22-dien-3ß,5α,6ß,9α-tetraol (ET), and (24S)-5,22-stigmastadien-3ß-ol (SE), were harvested using different solvents, and the structure of each compound was identified. The activities and functions of the isolated compounds were tested by label-free, real-time cell analysis methods at the cellular level, and their antitumor effects were verified using mouse models of Lewis and H22 tumors. The anti-insomnia effect of HEA was tested in an anti-insomnia mouse model. The interactions between E and 8 A549 cell proteins were determined. The biosynthetic pathways of HEA and E, which possess pharmacologically active monomers, were determined. This platform can provide a theoretical basis for the further development and discovery of novel natural medicines.