A Study on Brain Functional Connectivity in Patients With Disorders of Consciousness Based on Auditory Stimulation / 生物化学与生物物理进展

Objective At present, the grading evaluation of patients with disorders of consciousness (DOC) is still a focus and difficulty in related fields. Electroencephalogram (EEG) can directly read and continuously reflect scalp electrical activity generated by brain tissue structure, with high temporal resolution. Auditory stimulation is easy to operate and has broad application prospects in clinical detection of DOC. The causal network can intuitively reflect the direction of information transmission through the causal relationship between time series, helping us better understand the information interaction between different regions of the brain of patients. This paper combines EEG and causal networks to explore the differences in brain functional connectivity between patients with unresponsive arousal syndrome (VS) and those with minimum state of consciousness (MCS) under auditory stimulation. MethodsA total of 23 DOC patients were included, including 11 MCS patients and 12 VS patients. Based on the Oddball paradigm, auditory naming stimulation was performed on DOC patients and EEG signals of DOC patients were synchronously collected. The brain functional networks were constructed using multivariate Granger causality method, and the differences in node degree, clustering coefficient, global efficiency, and causal flow of the brain networks between MCS patients and VS patients were calculated. The differences in network characteristics of patients with different levels of consciousness under auditory stimulation were compared from the perspective of cooperation between brain regions. ResultsThe causal connectivity between most brain regions in MCS patients was stronger than that in VS patients, and MCS patients had more brain network connectivity edges than VS patients. The average degree (P<0.05), average clustering coefficient, and global efficiency (P<0.05) of MCS patients under naming stimulation were higher than those of VS patients. The difference in out-degree between each node of VS patients was larger, and the difference in in-degree between each node of MCS patients was smaller. The difference in in-degree of MCS patients was more significant than that of VS patients, and the inflow and outflow of information in the brain functional network of MCS patients were stronger than those of VS patients. MCS and VS patients had differences of causal flow in the frontal and temporal lobes, the direction of information transmission in the parietal lobe and central region was not the same, and MCS patients had more electrodes as causal sources than VS patients. ConclusionThe information transmission ability of MCS patients is stronger than that of VS patients under auditory naming stimulation. Compared with VS patients, MCS patients have an increase in the number of electrode channels as the causal source, an increase in information output to other brain regions, and also an increase in the information output within brain regions, which may indicate a better state of consciousness in patients. MCS patients have more electrode channels for information output in the frontal lobe than VS patients, and the number of electrode channels for changing the direction of information transmission in the frontal lobe is the highest. The frontal lobe is closely related to the level of consciousness in patients with consciousness disorders. This study can provide a theoretical basis for the grading evaluation of consciousness levels in DOC patients.

Risk factors for early disseminated intravascular coagulation in neonates with sepsis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the risk factors for early disseminated intravascular coagulation (DIC) in neonates with sepsis.</p><p><b>METHODS</b>A retrospective clinical study was performed on 100 neonates with a confirmed diagnosis of sepsis between 2012 and 2013. The children were classified into normal coagulation group, non-overt DIC group (early DIC group), and overt DIC group (late DIC group) based on the ISTH overt DIC scoring system. The clinical manifestations and risk factors were analyzed statistically.</p><p><b>RESULTS</b>Early DIC occurred in 44 (44%) cases in the 100 neonates with sepsis. The incidence of sclerema showed significant differences between the three groups (P<0.05). Asphyxia, bleeding, and Gram-negative bacterial infection were independent risk factors for early DIC.</p><p><b>CONCLUSIONS</b>Coagulation function should be actively monitored and early intervention measures should be taken for neonates with asphyxia, bleeding, and Gram-negative bacterial infection to prevent early DIC from progressing to late DIC.</p>

Short-term efficacy comparison of complete mesocolic excision and traditional colon cancer resection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the short-term efficacy of complete mesocolic excision (CME).</p><p><b>METHODS</b>Clinical data of 62 cases of colon cancer (I-III phase) with radical resection including CME surgery group of 31 cases and traditional surgery group of 31 cases from January 2011 to October 2011 in Peking University People's Hospital were retrospective analyzed.</p><p><b>RESULTS</b>The number of removed lymph node in CME and traditional resection group was 22.5±1.8 and 17.6±1.3 respectively (P<0.05) and the positive rate of lymph node in mesentery root was 9.7% (3/31) in CME surgery group. Operative blood loss was (123.5±17.6) ml and (143.5±15.3) ml in CME and traditional resection group without significant difference (P>0.05). Except for more abdominal drainage volume of 3 days post-operation in CME group (P<0.05), the postoperative recovery indicators of postoperative drainage tube removed time, exhaust time, eating time, and the socioeconomic effects indicators of postoperative hospitalization, hospitalization costs were not significantly different between two groups (all P>0.05). Postoperative intestinal obstruction occurred in 3 cases and 4 cases, lymph fistula in 2 cases and 0 case, wound dehiscence in 1 case and 1 case in CME group and traditional resection group respectively. Postoperative complication rate was not significantly different (19.4% vs. 16.1%, P>0.05).</p><p><b>CONCLUSION</b>Compared with traditional radical surgery, CME sweeps lymph nodes more thoroughly, including lymph nodes of mesocolic roots, and does not affect postoperative recovery and increase the risk of postoperative complications.</p>