Increased functional connectivity of amygdala subregions in patients with drug-naïve panic disorder and without comorbidities / 中华医学杂志(英文版)

BACKGROUND@#Amygdala plays an important role in the neurobiological basis of panic disorder (PD), and the amygdala contains different subregions, which may play different roles in PD. The aim of the present study was to examine whether there are common or distinct patterns of functional connectivity of the amygdala subregions in PD using resting-state functional magnetic resonance imaging and to explore the relationship between the abnormal spontaneous functional connectivity patterns of the regions of interest (ROIs) and the clinical symptoms of PD patients.@*METHODS@#Fifty-three drug-naïve, non-comorbid PD patients and 70 healthy controls (HCs) were recruited. Seed-based resting-state functional connectivity (rsFC) analyses were conducted using the bilateral amygdalae and its subregions as the ROI seed. Two samples t test was performed for the seed-based Fisher's z -transformed correlation maps. The relationship between the abnormal spontaneous functional connectivity patterns of the ROIs and the clinical symptoms of PD patients was investigated by Pearson correlation analysis.@*RESULTS@#PD patients showed increased rsFC of the bilateral amygdalae and almost all the amygdala subregions with the precuneus/posterior cingulate gyrus compared with the HC group (left amygdala [lAMY]: t  = 4.84, P  <0.001; right amygdala [rAMY]: t  = 4.55, P  <0.001; left centromedial amygdala [lCMA]: t  = 3.87, P  <0.001; right centromedial amygdala [rCMA]: t  = 3.82, P  = 0.002; left laterobasal amygdala [lBLA]: t  = 4.33, P  <0.001; right laterobasal amygdala [rBLA]: t  = 4.97, P  <0.001; left superficial amygdala [lSFA]: t  = 3.26, P  = 0.006). The rsFC of the lBLA with the left angular gyrus/inferior parietal lobule remarkably increased in the PD group ( t  = 3.70, P  = 0.003). And most of the altered rsFCs were located in the default mode network (DMN). A significant positive correlation was observed between the severity of anxiety and the rsFC between the lSFA and the left precuneus in PD patients ( r  = 0.285, P  = 0.039).@*CONCLUSIONS@#Our research suggested that the increased rsFC of amygdala subregions with DMN plays an important role in the pathogenesis of PD. Future studies may further explore whether the rsFC of amygdala subregions, especially with the regions in DMN, can be used as a biological marker of PD.

The comparison of the value of mono-exponential mode and diffusion kurtosis imaging mode in predicting the response to neoadjuvant chemotherapy for locally advanced breast carcinoma using diffusion-weighted imaging / 中华放射学杂志

Objective To compare the value of diffusion kurtosis imaging (DKI) mode and mono-exponential mode in predicting the response to neoadjuvant chemotherapy (NAC) for locally advanced breast carcinoma using DWI.Methods From January 1,2013 to December 31,2016,eighty patients with locally advanced breast carcinoma were enrolled into this prospective clinical study.The diagnosis was confirmed on the basis of histopathological results.The clinical stage stayed at Ⅱ or Ⅲ.The patients would receive breast-conserving surgery after NAC.All the patients underwent DWI examination by using both mono-exponential mode and DKI mode before chemotherapy was initiated.The parameters included ADC,mean diffusivity (MD) and mean kurtosis (MK).Within 1 to 3 days before or after MRI examination,the patients underwent aspiration biopsy,received 4 to 8 cycles of NAC and followed by surgery.According to histologic grading before NAC,the patients were classified into well-differentiated and poor-differentiated group.According to the comparison between pathological results acquired from biopsy before NAC and specimen acquired after surgery,the patients were classified into pathologic complete response (pCR) and pathologic non-complete response (non-pCR) according to treatment effect.The imaging parameters were compared between the pCR and the non-pCR group using t test.The predicting ability of two imaging modes was compared and analyzed with ROC analysis.The relationships between multiple imaging parameters,pathologic,clinical characteristics of tumor and treatment effect were analyzed using logistic multi-variate regression analysis,and further analyzed using Wald test.Results There were 30 cases of pCR and 50 cases of non-pCR.The ADC and MD values were lower in the pCR group than in the non-pCR group (P＜0.05).MK value was higher in the pCR group than in the non-pCR group (P＜0.05).ROC analysis showed that the area under ROC curve of ADC,MD and MK in predicting treatment effect were 0.732,0.866 and 0.683 respectively.Logistic regression analysis showed that,according to predicting ability,MD,ADC and MK successively were the independent predictors for the early response to chemotherapy.Conclusion Compared with mono-exponential mode,DKI mode can reflect the real micro-environment and water diffusion restriction within the tumor area more reliably and accurately,and is more suitable to serve as an imaging technique for predicting the response to NAC for locally advanced breast carcinoma.

Effect of rhBNP on serum chemerin and IL-37 levels in acute myocardial infarction patients undergoing emergency PCI / 中华老年心脑血管病杂志

Objective To study the effect of rhBNP on serum chemerin and IL-37 levels in acute myocardial infarction (AMI) patients undergoing emergency PCI.Methods Eighty AMI patients who underwent emergency PCI were randomly divided into cortrol group (n =40) and rhBNP treatment group (n=40).The patients in control group were treated with conventional drugs and those in rhBNP treatment group were treated with intravenous rhBNP.Their serum chemerin and IL-37 levels were measured by ELISA.Their LVEDD and LVEF were compared.Results The serum level of chemerin was significantly lower while that of IL-37 was significantly higher in two groups at 72 h and on day 7 after PCI than before PCI (P＜0.05).The serum level of chemerin was significantly lower while that of IL-37 was significantly higher in rhBNP group than in control group at 72 h and on day 7 after PCI (P＜0.05).The LVEDD was significantly shorter while the LVEF was significantly higher in two groups on day 7 and month 1 after PCI than before PCI (P＜0.05).The LVEDD was significantly shorter in rhBNP group than in control group on day 7 and month 1 after PCI (P＜0.05).Conclusion rhBNP can effectively reduce the serum chemerin level,increase the serum IL-37 level,and improve the cardiac function in AMI patients following emergency PCI.The effect of rhBNP is better than that of conventional drugs in AMI patients after emergency PCI.

Investigation on Current Situation of Workplace Violence the Intern Experienced and Their Professional Identity / 中国医学伦理学

Objective:To understand the current situation of hospital violence medical students experienced during the internship period and their professional identity.Method:With the method of cluster sampling,a questionnaire survey was conducted among 500 medical students from a medical college in Ganzhou,to understand the characteristics of hospital violence and compare the difference between the medical students who experienced violence and those not.Results:The effective recovery rate of questionnaire was 90.8％,of which 61.4％ of medical students had witnessed hospital violence,8.1％ of students had experienced hospital violence;the hospital violence that medical students experienced were characterized by low frequency and emotional violence.The overall score of personal identity was (117.05 ± 19.65),was in a medium level.Among the comparison of personal identity between the medical students who had experienced violence and those not,there was a significant difference in occupational cognition dimension (P ＜ 0.01),but there was no significant difference in the total score and other four dimensions (P ＞ 0.05).Conclusion:We should pay attention to the current situation of hospital violence that students experienced and their professional attitude,carry out targeted training and psychological counseling to improve their ability to respond to hospital violence and enhance their professional identity.

Preoperative dynamic contrast-enhanced MRI can reduce the rate of tumor-positive resection margins after breast conserving surgery in patients with early non-mass breast carcinoma / 中华肿瘤杂志

Objective@#To investigate the value of preoperative dynamic contrast-enhanced MRI in reducing the rate of tumor-positive resection margins after breast conserving surgery in patients with early non-mass breast carcinoma.@*Methods@#Seventy-two patients with early non-mass breast carcinoma received ultrasonographic and mammographic examination and subsequently underwent dynamic contrast-enhanced MRI examination before breast conserving surgery. The control group consisted of 74 patients who had early non-mass breast carcinoma. They only received ultrasonographic and mammographic examination and didn′t undergo contrast-enhanced MRI examination. The comparison of the rate of tumor-positive resection margins between two groups was performed. The MRI findings that had the significant influence on the rate of tumor-positive resection margins were analyzed using Logistic regression model.@*Results@#In 28 patients (28/72, 38.9%), dynamic contrast-enhanced MRI could correct or supplement the ultrasonographic and mammographic findings and resulted in the reasonable change of surgical program. The preoperative MRI examination group (n=30) had lower rate of tumor-positive resection margins than control group for invasive ductal carcinoma (23.3% vs 40.0%, P=0.02), but there was no significant difference (21.4% vs 26.9%, P=0.10) between two groups for ductal carcinoma in situ (n=28). The preoperative MRI examination group (n=14) had lower rate of tumor-positive resection margins than control group for the other pathologic types of breast carcinoma (14.3% vs 38.9%, P=0.02). The statistical analysis on the basis of Logistic regression model showed that some main MRI findings, including change surrounding the tumor, distance between tumor and nipple and tumor size, had the significant influence on the rate of tumor-positive resection margins.@*Conclusion@#Preoperative dynamic contrast-enhanced MRI significantly increased the accuracy of resection margins evaluation, and greatly reduced the rate of tumor-positive resection margins after breast conserving surgery in patients with early non-mass breast carcinoma.

Expression of plasma miR-106a in colorectal cancer and its clinical significance / 南方医科大学学报

<p><b>OBJECTIVE</b>To detect plasma miR-106a level in patients with colorectal cancer (CRC) and analyze its correlation to the clinicopathological features and disease diagnosis.</p><p><b>METHODS</b>miRNA expression profiling was performed using miRNA microarray chip for 3 colorectal adenocarcinoma samples and matched normal tissues. Plasma samples was collected from 50 colorectal cancer patients for quantitative analysis of miR-106a using real-time RT-PCR using 47 plasma samples from healthy volunteer as the control. Forty plasma samples were collected from these patients 7 days after operation to examine the changes in miR-106a expression.</p><p><b>RESULTS</b>miR-106a was differentially expressed in colorectal adenocarcinoma compared to normal tissues. The plasma levels of miR-106a expression were significantly higher in the cancer patients than in the healthy control group (P=0.012). miR-106a expression significantly decreased after the operation compared with its preoperative level (P<0.01), and no correlation was found between preoperative plasma miR-106a and the clinicopathological features including lymph node metastasis and TNM stage (P>0.05). miR-106a showed a receiver operating characteristic (ROC) curve area of 66.1%, a sensitivity of 62.3%, and a specificity of 68.2% in discriminating colorectal cancer patients from the control subjects.</p><p><b>CONCLUSION</b>plasma miR-106a is up-regulated in CRC patients, suggesting its potential value for the diagnosis of CRC.</p>

Effects of percutaneous coronary interventional procedures on plasma levels of high sensitive C-reactive protein and interlekin-6 in patients with coronary artery disease / 中国综合临床

Objective To investigate the impact of percutaneous coronary interventional (PCI) on the inflammatory indices and postoperative vascular restenosis.Methods This study involved 90 patients undergoing PCI procedures for Coronary artery disease (CAD) compromising a single coronary artery.Fourty healthy individuals with normal findings by coronary angiography were selected as the control group.Before and after PCI or coronary angiography,plasma hs-CRP and IL-6 were measured in all the subjects by immunonephelometry and enzyme-linked immunosorbant assay (ELISA),respectively.Results (1) In the CAD patients,the plasma hs-CRP level was significantly elevated after PCI as compared with the preoperative level((18.69 ±5.14) mg/L vs (14.45 ± 4.32) mg/L,t =1.42,P ＜ 0.01),whereas in the control group,the hs-CRP level underwent no significant changes after coronary angiography((13.59 ±5.99) mg/L vs(12.46 ±5.35) mg/L,t =1.25,P ＞ 0.05).(2) PCI procedures also resulted in significant elevation of plasma IL-6 level in the CAD patients((1.87±0.45) pg/L vs (1.35 ±0.39) pg/L,t =1.33,P＜0.01),but in the control group,IL-6 showed no significant variation after coronary angiography ((1.32 ± 0.41) pg/L vs (1.21 ± 0.38)pg/L,t =1.16,P ＞ 0.05).We observed significant difference of hs-CRP and IL-6 levels between the CAD patient group and the control group (t =4.96,6.61 respectively,P ＜ 0.01).Conclusion Plasma hs-CRP and IL-6 are elevated in CAD patients following PCI procedures.But the roles of elevated hs-CRP and IL-6 in the vascular restenosis following the procedures need further investigation.

Dual-source dual-energy CT for the differentiation of urinary stone composition: preliminary study / 中华放射学杂志

Objective To evaluate dual-source dual-energy CT(DSCT) for the differentiation of urinary stone composition in vitro. Methods Ninety-seven urinary stones were obtained by endoscopic lithotripsy and scanned using dual-source dual-energy CT. The stones were divided into six groups according to infrared spectroscopy stone analysis: uric acid ( UA ) stones ( n = 10 ), cystine stones ( n = 5 ), struvite stones( n = 6), calcium oxalate ( CaOx ) stones ( n = 22 ), mixed UA stones ( n=7 ) and mixed calcium stones(n=47). Hounsfield units (HU) of each stone were recorded for the 80 kV and the 140 kV datasets by hand-drawing method. HU difference, HU ratio and dual energy index ( DEI ) were calculated and compared among the stone groups with one-way ANOVA. Using dual energy software to determine the composition of all stones, results were compared to infrared spectroscopy analysis. Results There were statistical differences in HU difference [(-17±13), (229±34),(309 ±45), (512 ±97), (201±64)and (530±71) HU respectively], in HU ratio (0.96±0.03, 1.34 ±0.04, 1.41 ±0.03, 1.47 ±0.03,1.30±0.07, and 1.49 ±0.03 respectively), and DEI( -0.006 ±0.004, 0.064 ±0.007, 0.080 ±0. 007, 0. 108±0.011 ,0. 055 ±0.014 and 0. 112 ±0.008 respectively ) among different stone groups(F=124. 894,407.028, 322. 864 respectively, P ＜0. 01 ). There were statistical differences in HU difference,HU ratio and DE1 between UA stones and the other groups( P ＜ 0. 01 ). There were statistical differences in HU difference, HU ratio and DEI between CaOx or mixed calcium stones and the other four groups (P＜0. 01 ). There was statistical difference in HU ratio between cystine and struvite stones ( P ＜ 0. 01 ). There were statistical differences in HU difference, HU ratio and DEI between struvite and mixed UA stones (P＜0. 05 ). Dual energy software correctly characterized 10 UA stones, 4 cystine stones, 22 CaOx stones and 6 mixed UA stones. Two struvite stones were considered to contain cystine. One cystine stone, 1 mixed UA stone, 4 struvite stones and 47 mixed calcium stones were considered to contain oxalate. Conclusions DSCT has the ability to differentiate urinary stone composition in vitro. With dual energy software, the UA, cystine and mixed UA stones can be differentiated from other types of stones.

On the Continuing Training of Nursing Ethics for Clinical Nurses / 中国医学伦理学

In this paper,the importance and the necessity of the continuing training of nursing ethics for clinical nurses were analyzed.Then,based on the needs and characteristics of current clinical nursing work in China,a preliminary study on the implementation of the continuing training was conducted in terms of the training objectives,process,content,form,and the evaluation approaches.