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Since the first plasma realized in 2020, a series of key systems on HL-3 (known as HL-2M before) tokamak have been equipped/upgraded, including in-vessel components (the first wall, lower divertor, and toroidal cryogenic/water-cooling/baking/glow discharge systems, etc.), auxiliary heating system of 11 MW, and 28 diagnostic systems (to measure the plasma density electron temperature, radiation, magnetic field, etc.). Magnet field systems were commissioned firstly for divertor plasma discharges. During the 2nd experimental campaign of HL-3 tokamak, several great progresses have been achieved. Firstly, the successful operation with plasma current larger than 1 MA was achieved under a divertor configuration. Secondly, the advanced divertor concept with two distinct snowflake configurations was realized. It is found that the distribution of ion saturation current and heat flux on bottom plate becomes wide due to magnetic surface expansion, demonstrating the advantage of such configuration in the heat flux mitigation. In addition, using the combination of NBI, ECRH and LHCD, the standard sawtoothing high confinement mode of megampere plasma was firstly accessed on the HL-3. The successful commissioning of HL-3 is beneficial for the initial operation of ITER.

Chen Qu,1,&ast; Fei Xia,2,&ast; Ling Chen,1 Hong-Jian Li,2 Wei-Min Li1 1Department of Ultrasonography, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China; 2Department of Ultrasonography, Huai’an Cancer Hospital, Huai’an, Jiangsu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hong-Jian Li, Department of Ultrasonography, Huai’an Cancer Hospital, Huai’an, Jiangsu, 223232, People’s Republic of China, Tel +8613511507565, Email 492938595@qq.com Wei-Min Li, Department of Ultrasonography, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, 214000, People’s Republic of China, Tel +8613912362309, Email 1005342597@qq.comPurpose: : To explore the diagnostic value of artificial intelligence (AI)-based on real-time dynamic ultrasound imaging system for minimal breast lesions.Patients and Methods: Minimal breast lesions with a maximum diameter of ≤ 10mm were selected in this prospective study. The ultrasound equipment and AI system were activated Simultaneously. The ultrasound imaging video is connected to the server of AI system to achieve simultaneous output of AI and ultrasound scanning. Dynamic observation of breast lesions was conducted via ultrasound. And these lesions were evaluated and graded according to the Breast Imaging Reporting and Data System (BI-RADS) classification system through deep learning (DL) algorithms in AI. Surgical pathology was taken as the gold standard, and ROC curves were drawn to determine the area under the curve (AUC) and the optimal threshold values of BI-RADS. The diagnostic efficacy was compared with the use of a BI-RADS category > 3 as the threshold for clinically intervening in diagnosing minimal breast cancers.Results: 291 minimal breast lesions were enrolled in the study, of which 228 were benign (78.35%) and 63 were malignant (21.65%). The AUC of the ROC curve was 0.833, with the best threshold value > 4A. When using >BI-RADS 3 and >BI-RADS 4A as threshold values, the sensitivity and negative predictive value for minimal breast cancers were higher for >BI-RADS 3 than >BI-RADS 4A (100% vs 65.08%, 100% vs 89.91%, P values < 0.001). However, the corresponding specificity, positive predictive value, and accuracy were lower than those for >BI-RADS 4A (42.11% vs 85.96%, 32.31% vs 56.16%, and 54.64% vs 81.44%, P values < 0.001).Conclusion: The AI-based real-time dynamic ultrasound imaging system shows good capacity in diagnosing minimal breast lesions, which is helpful for early diagnosis and treatment of breast cancer, and improves the prognosis of patients. However, it still results in some missed diagnoses and misdiagnoses of minimal breast cancers.Keywords: Breast cancer, ultrasound, artificial intelligence, diagnostic

Hu Huang,1,&ast; Hong-Jian Li,2,&ast; Qi Gao,3 Ming-Jie Zhu,1 Wei-Min Li4 1Department of Thyroid and Breast Surgery, Affiliated Hospital of Jiangnan University, Wuxi, People’s Republic of China; 2Department of Ultrasonography, Huai’an Cancer Hospital, Huai’an, People’s Republic of China; 3Department of Ultrasonography, Zhongda Hospital Southeast University, Nanjing, People’s Republic of China; 4Department of Ultrasonography, Affiliated Hospital of Jiangnan University, Wuxi, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wei-Min Li, Department of Ultrasonography, Affiliated Hospital of Jiangnan University, No. 1000 Hefeng Road, Wuxi, 214000, People’s Republic of China, Email 1005342597@qq.comObjective: As a positive features in C-TIRADS (Chinese Thyroid Imaging Reporting and Data System) guidelines, solid features represent the latest positive indicator, which differs from those in other guidelines. This study was to explore the diagnostic value of the solid features for thyroid nodules of different sizes.Methods: Between January 2022 and October 2023, a total of 1561 patients with 1790 thyroid nodules confirmed by surgical pathology were prospectively included in this study. These nodules were divided into three groups based on their maximum diameter: Group A1 (≤ 10mm), Group A2 (> 10mm, < 20mm), and Group A3 (≥ 20mm). The component characteristics of thyroid nodules in each group were analyzed. Based on the surgical pathology results, Receiver Operating Characteristic (ROC) curves were constructed to evaluate the diagnostic efficiency of C-TIRADS solid features for thyroid nodules of different sizes.Results: As the size of thyroid nodules increased, the incidence of cystic changes in both benign and malignant nodules showed a linear increasing trend (Z-values of 46.251 and 156.586, respectively; P values < 0.001 for both). The occurrence rate of solid malignant nodules was higher than that of benign nodules in all groups, with Area Under Curve (AUC) values of 0.620, 0.723, and 0.767, respectively.Conclusion: With the increase in the size of thyroid nodules, the diagnostic value of solid features for thyroid cancer progressively increases. The specificity of thyroid nodule diagnosis also increases progressively. Which may have certain value in the evaluation process using C-TIRADS, particularly in the management of thyroid nodules in clinical settings.Keywords: C-TIRADS, ultrasound, thyroid nodule

Chen Qu,1,&ast; Hong-jian Li,2,&ast; Qi Gao,3 Jun-chao Zhang,1 Wei-min Li1 1Department of Ultrasonography, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China; 2Department of Ultrasonography, Huai’an Cancer Hospital, Huai’an, Jiangsu, People’s Republic of China; 3Department of Ultrasonography, Zhongda Hospital Southeast University, Nanjing, Jiangsu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wei-min Li, Department of Ultrasonography, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, 214000, People’s Republic of China, Tel +8613912362309, Email 1005342597@qq.comPurpose: This study aimed to investigate the alteration trends and overlaps of positive features in benign and malignant thyroid nodules of different sizes based on the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS).Patients and Methods: 1337 patients with 1558 thyroid nodules were retrospectively recruited from November 2021 to December 2023. These nodules were divided into three groups according to maximum diameter: A (≤ 10 mm), B (10– 20 mm), and C (≥ 20 mm). C-TIRADS positive features were compared between benign and malignant thyroid nodules of different sizes. In addition, the trends of positive features with changes in nodule size among malignant thyroid nodules were analyzed.Results: The incidence of positive features in malignant thyroid nodules was higher than that in benign. As benign nodules grow, the incidence of all positive features showed a linear decreasing trend (Z values were 72.103, 101.081, 17.344, 33.909, and 129.304, P values < 0.001). With the size of malignant thyroid nodules increased, vertical orientation, solid, marked hypoechogenicity, and ill-defined/irregular margins/extrathyroidal extension showed a linear decreasing trend (Z = 148.854, 135.378, 8.590, and 69.239, respectively; P values < 0.05), while suspicious microcalcifications showed a linear increasing trend (Z = 34.699, P< 0.001). In terms of overlapping characteristics, group A had a significantly higher overlapping rate than the other two groups, and the overlapping rate of solid indicators remained the highest among all three groups (P < 0.05).Conclusion: Differences in positive features were observed between thyroid nodules of different sizes. Except for suspicious microcalcifications, the incidence of other four positive features decreased with increasing nodule size. In addition, a negative correlation was observed between the overlap rate and nodule size. These results may provide a basis for sonographers to upgrade or downgrade thyroid nodules based on their own experience.Keywords: size, thyroid, C-TIRADS, ultrasound

Shuang-Jiang Zhou,1,&ast; Rui Yang,2,&ast; Lei-Lei Wang,1 Meng Qi,1 Xiao-Fei Yuan,2 Ting-Ting Wang,3 Tian-He Song,4 Yun-Yue Zhuang,4 Hong-Juan Li,1 Yun-Long Tan,1 Xue Wang,2 Jing-Xu Chen1 1Sleep Medicine Center, Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, People’s Republic of China; 2Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China; 3School of Mental Health, Bengbu Medical College, Bengbu, People’s Republic of China; 4Department of Psychology, Chengde Medical University, Chengde, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xue Wang, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, People’s Republic of China, Tel +86-10-58303034, Email xuew37@ccmu.edu.cn Jing-Xu Chen, Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, 100096, People’s Republic of China, Tel +86-10-83024278, Email chenjx1110@163.comObjective: To assess the performance of a wearable multi-sensor system (SensEcho) in comparison to polysomnography (PSG) in measuring sleep stages and searching for obstructive sleep apnea (OSA).Methods: Participants underwent overnight simultaneous monitoring using SensEcho and PSG in a sleep laboratory. SensEcho analyzed the recordings spontaneously, and PSG was assessed as per standard guidelines. The degree of snoring was evaluated according to the guidelines for the diagnosis and treatment of OSA hypopnea syndrome (2011 revision). The Epworth Sleepiness Scale (ESS) was used to assess general daytime sleepiness.Results: This study included 103 Han Chinese, 91 of whom (age 39.02 ± 13.84 years, body mass index 27.28 ± 5.12 kg/m2, 61.54% male) completed the assessments. The measures of total sleep time (P = 0.198); total wake time (P = 0.182); shallow sleep (P = 0.297), deep sleep (P = 0.422), rapid eye movement sleep (P = 0.570), and awake (P = 0.336) proportions were similar between SensEcho and PSG. Using an apnea-hypopnea index (AHI) cutoff of ≥ 5 events/h, the SensEcho had 82.69% sensitivity and 89.74% specificity. Almost the same results were obtained at an AHI threshold of ≥ 15 events/h. Although the specificity increased to 94.67%, it decreased to 43.75% at an AHI cutoff of ≥ 30 events/h.Conclusion: This study demonstrated that SensEcho can be used to evaluate sleep status and screen for OSA. Nevertheless, improving the accuracy of its assessment of severe OSA and further testing its effectiveness in community and home environments is necessary.Keywords: wearable multi-sensor system, polysomnography, sleep stages, obstructive sleep apnea

Sui-Yi Xu,1,&ast; Hui-Juan Li,2,&ast; Shun Li,2 Qian-Qian Ren,1 Jian-Lin Liang,1 Chang-Xin Li1 1Department of Neurology, Headache Center, The First Hospital of Shanxi Medical University, Taiyuan, People’s Republic of China; 2Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Chang-Xin Li, Department of Neurology, The First Hospital of Shanxi Medical University, Jiefangnan 85 Road, Taiyuan, Shanxi Province, 030001, People’s Republic of China, Tel +86 15103513579, Email lichangxin0351@sina.comAbstract: High temperature requirement serine peptidase A1 (HTRA1) related cerebral small vessel disease (CSVD) includes both symptomatic heterozygous HTRA1 variant carrier and cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) patients. Presently, most reported symptomatic heterozygous HTRA1 variant carrier cases are sporadic family reports with a lack of specific characteristics. Additionally, the molecular mechanism of heterozygous HTRA1 gene variants is unclear. We conducted this review to collect symptomatic carriers of heterozygous HTRA1 gene variants reported as of 2022, analyzed all pathogenicity according to American College of Medical Genetics and Genomics (ACMG) variant classification, and summarized the cases with pathogenic and likely pathogenic HTRA1 variants gender characteristics, age of onset, geographical distribution, initial symptoms, clinical manifestations, imaging signs, HTRA1 gene variant information and to speculate its underlying pathogenic mechanisms. In this review, we summarized the following characteristics of pathogenic and likely pathogenic symptomatic HTRA1 variant carriers: to date, the majority of reported symptomatic HTRA1 carriers are in European and Asian countries, particularly in China which was found to have the highest number of reported cases. The age of first onset is mostly concentrated in the fourth and fifth decades. The heterozygous HTRA1 gene variants were mostly missense variants. The two variant sites, 166– 182 aa and 274– 302 aa, were the most concentrated. Clinicians need to pay attention to de novo data and functional data, which may affect the pathogenicity analysis. The decrease in HtrA1 protease activity is currently the most important explanation for the genetic pathogenesis.Keywords: stroke, HTRA1 gene, ACMG criteria, heterozygous variant, symptomatic carrier

Background: The Z=50 shell closure, near N=82, is unique in the sense that it is the only shell closure with the spin-orbit partner orbitals, πg9/2 and πg7/2, enclosing the magic gap. The interaction of the proton hole/particle in the above-mentioned orbitals with neutrons in the νh11/2 orbital is an important prerequisite to the understanding of the nuclear structure near N=82 and the νπ interaction. Purpose: To explore the structural similarity between the high-spin isomeric states in In (Z=49), Sn (Z=50), and Sb (Z=51) isotopes from a microscopic point of view. In addition, to understand the role of a proton hole or particle in the spin-orbit partner orbitals, πg9/2 and πg7/2, respectively, with neutron holes in the νh11/2 orbital on these aforementioned isomers. Methods: The fusion and transfer induced fission reaction Be9(U238, f) with 6.2 MeV/u beam energy, using a unique setup consisting of AGATA, VAMOS++, and EXOGAM detectors, was used to populate through the fission process and study the neutron-rich In119,121 isotopes. This setup enabled the prompt-delayed γ-ray spectroscopy of isotopes in the time range of 100ns-200μs. Results: In the odd-AIn119,121 isotopes, indications of a short half-life 19/2- isomeric state, in addition to the previously known 25/2+ isomeric state, were observed from the present data. Further, new prompt transitions above the 25/2+ isomer in In121 were identified along with reevaluation of its half-life. Conclusions: The experimental data were compared with the theoretical results obtained in the framework of large-scale shell-model calculations in a restricted model space. The (πg9/2νh11/2;I|Ĥ|πg9/2νh11/2;I) two-body matrix elements of residual interaction were modified to explain the excitation energies and the B(E2) transition probabilities in the neutron-rich In isotopes. The (i) decreasing trend of E(29/2+)-E(25/2+) in odd-In (with dominant configuration πg9/2-1νh11/2-2 and maximum aligned spin of 29/2+) and (ii) increasing trend of E(27/2+)-E(23/2+) in odd-Sb (with dominant configuration πg7/2+1νh11/2-2 and maximum aligned spin of 27/2+) with increasing neutron number could be understood as a consequence of hole-hole and particle-hole interactions, respectively.

Background: The Z=50 shell closure, near N=82, is unique in the sense that it is the only shell closure with the spin-orbit partner orbitals, πg9/2 and πg7/2, enclosing the magic gap. The interaction of the proton hole/particle in the above-mentioned orbitals with neutrons in the νh11/2 orbital is an important prerequisite to the understanding of the nuclear structure near N=82 and the νπ interaction. Purpose: To explore the structural similarity between the high-spin isomeric states in In (Z=49), Sn (Z=50), and Sb (Z=51) isotopes from a microscopic point of view. In addition, to understand the role of a proton hole or particle in the spin-orbit partner orbitals, πg9/2 and πg7/2, respectively, with neutron holes in the νh11/2 orbital on these aforementioned isomers. Methods: The fusion and transfer induced fission reaction Be9(U238, f) with 6.2 MeV/u beam energy, using a unique setup consisting of AGATA, VAMOS++, and EXOGAM detectors, was used to populate through the fission process and study the neutron-rich In119,121 isotopes. This setup enabled the prompt-delayed γ-ray spectroscopy of isotopes in the time range of 100ns-200μs. Results: In the odd-AIn119,121 isotopes, indications of a short half-life 19/2- isomeric state, in addition to the previously known 25/2+ isomeric state, were observed from the present data. Further, new prompt transitions above the 25/2+ isomer in In121 were identified along with reevaluation of its half-life. Conclusions: The experimental data were compared with the theoretical results obtained in the framework of large-scale shell-model calculations in a restricted model space. The (πg9/2νh11/2;I|Ĥ|πg9/2νh11/2;I) two-body matrix elements of residual interaction were modified to explain the excitation energies and the B(E2) transition probabilities in the neutron-rich In isotopes. The (i) decreasing trend of E(29/2+)-E(25/2+) in odd-In (with dominant configuration πg9/2-1νh11/2-2 and maximum aligned spin of 29/2+) and (ii) increasing trend of E(27/2+)-E(23/2+) in odd-Sb (with dominant configuration πg7/2+1νh11/2-2 and maximum aligned spin of 27/2+) with increasing neutron number could be understood as a consequence of hole-hole and particle-hole interactions, respectively.

The mission of HL-2A is to explore the key physical topics relevant to ITER and to the advanced tokamak operation (e.g. the operation of future HL-2M), such as the access of H-mode, energetic particle physics, edge-localized mode (ELM) mitigation/suppression and disruption mitigation. Since the 2016 Fusion Energy Conference, the HL-2A team has focused on the investigations on the following areas: (i) pedestal dynamics and L-H transition, (ii) techniques of ELM control, (iii) turbulence and transport, (iv) energetic particle physics. The HL-2A results demonstrated that the increase of mean shear flow plays a key role in triggering L-I and I-H transitions, while the change of flow is mainly induced by the ion pressure gradient. Both mitigation and suppression of ELMs were realized by laser blow-off seeded impurity (Al, Fe, W). The 30% Ne mixture supersonic molecular beam injection seeding also robustly induced ELM mitigation. The ELMs were mitigated by low-hybrid current drive. The stabilization of m/n = 1/1 ion fishbone activities by electron cyclotron resonance heating was found on the HL-2A. A new m/n = 2/1 ion fishbone activity was observed recently, and the modelling indicated that passing fast ions dominantly contribute to the driving of 2/1 fishbone. The non-linear coupling between the toroidal Alfven eigenmode and tearing mode (TM) led to the generation of a high frequency mode with the toroidal mode number n = 0. The turbulence was modulated by TM when the island width exceeds a threshold and the modulation is localized merely in the inner area of the islands. Meanwhile, turbulence radial spread took place across the island region.

Fei-Ran Yang,1,&ast; Si-Yi Li,1,&ast; Xi-Wen Hu,1 Xiu-Rong Li,2 Hui-Jie Li2 1College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People’s Republic of China; 2Department of Oncology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hui-Jie Li; Xiu-Rong Li, Department of Oncology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jingshi Road, Jinan, Shandong, 250014, People’s Republic of China, Email 2008lihuijie@163.com; szylxr2012@126.comBackground: As the main component of turmeric (Curcuma longa L.), curcumin is widely used in the treatment of various diseases. Previous studies have demonstrated that curcumin has great potential as a therapeutic agent, but the lack of understanding of the functional mechanism of the drug has hindered the widespread use of the natural product. In the present study, we used comprehensive bioinformatics analysis and in vitro experiments to explore the anti-tumor mechanism of curcumin.Materials and Methods: LUAD mRNA expression data were obtained from TCGA database and differentially expressed genes (DEGs) were identified using R software. Functional enrichment analysis was conducted to further clarify its biological properties and hub genes were identified by a protein–protein interaction (PPI) network analysis. Survival analysis and molecular docking were used to analyze the effectiveness of the hub genes. By an in vitro study, we evaluated whether curcumin could influence the proliferation, migration, and invasion activities of LUAD cells.Results: In this study, 1783 DEGs from LUAD tissue samples compared to normal samples were evaluated. Functional enrichment analysis and the PPI network revealed the characteristics of the DEGs. We performed a topological analysis and identified 10 hub genes. Of these, six genes (INS, GCG, SST, F2, AHSG, and NPY) were identified as potentially effective biomarkers of LUAD. The molecular docking results indicated that curcumin targets in regulating lung cancer may be INS and GCG. We found that curcumin significantly inhibited the proliferation, migration, and invasion of LUAD cells and significantly decreased the expression of the INS and GCG genes.Conclusion: The results of this study suggest that the therapeutic effects of curcumin on LUAD may be achieved through the intervention of INS and GCG, which may act as potential biomarkers for LUAD prevention and treatment.Graphical Abstract: Keywords: lung adenocarcinoma, curcumin, antitumor effect, bioinformatics analysis, TCGA

Rong Fu,1 Chuan-Qing Jing,1 Xiu-Rong Li,2 Zhao-Feng Tan,2 Hui-Jie Li2 1Clinical Department of Integrated Traditional Chinese and Western Medicine, The First Clinical Medical College of Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of China; 2Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, People’s Republic of ChinaCorrespondence: Hui-Jie Li Email 2008lihuijie@163.comBackground: There are no useful biomarkers for the clinical outcome of advanced esophageal squamous cell carcinoma (ESCC). In this study, we aimed to investigate the prognostic value of soluble PD-L1 (sPD-L1) in serum of patients with locally advanced or metastatic ESCC who received cytotoxic chemotherapy as first-line treatment.Materials and Methods: This study evaluated the expression pattern of PD-L1 by immunohistochemistry and sPD-L1 concentration, and correlation with clinicopathological factors and overall survival (OS) in 190 patients with ESCC.Results: sPD-L1 concentration was highly expressed in ESCC, especially in female patients. Patients with a high sPD-L1 level (≥ 0.63 ng/mL) had a shorter OS than those with a low sPD-L1 level (< 0.63 ng/mL). In a multivariate analysis, high sPD-L1 concentration remained an independent prognostic factor of OS after adjustment for possible confounders. However, tissue PD-L1 expression level was non-prognostic in this study.Conclusion: There was no significant correlation between serum sPD-L1 concentration and tissue PD-L1 expression level. sPD-L1 concentration before treatment could be an effective and convenient biomarker of prognosis in patients with locally advanced or metastatic ESCC treated with combination cytotoxic chemotherapy.Keywords: esophageal squamous cell carcinoma, PD-L1, soluble PD-L1, prognosis, clinical outcome, chemotherapy

A new experimental setup to measure prompt-delayed γ-ray coincidences from isotopically identified fission fragments, over a wide time range of 100ns-200μ s, is presented. The fission fragments were isotopically identified, on an event-by-event basis, using the VAMOS++ large acceptance spectrometer. The prompt γ rays emitted at the target position and corresponding delayed γ rays emitted at the focal plane of the spectrometer were detected using, respectively, thirty two crystals of the AGATA γ-ray tracking array and seven EXOGAM HPGe Clover detectors. Fission fragments produced in fusion and transfer-induced fission reactions, using a 238U beam at an energy of 6.2 MeV/u impinging on a 9Be target, were used to characterize and qualify the performance of the detection system.

Sui-yi Xu,* Hui-juan Li,* Jing Huang, Xiu-ping Li, Chang-xin Li Department of Neurology, The First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chang-xin LiDepartment of Neurology, The First Hospital of Shanxi Medical University, Jiefangnan Road 85, Taiyuan, 030001, Shanxi Province, People’s Republic of ChinaTel +86-15103513579Email lichangxin0351@sina.comAbstract: Migraine with brainstem aura (MBA) accompanied by disorders of consciousness (DOC) is a rare subtype of migraine. The pathophysiology of MBA with DOC has not been elucidated yet. Some patients have a family history of migraine, and women are more affected than men. The aura symptoms are diverse; however, when MBA is combined with DOC, the clinical manifestations are more complicated. Coma is the most common clinical manifestation. The overall duration of the patient’s DOC is short and can often return to normal within half an hour. Headache often occurs after regaining consciousness and can also occur at the same time as DOC. The most common headache is located at the occipital region. Although DOC is reversible, considering the current small number of cases, we still need to improve our understanding of the disease to avoid misdiagnosis. The MBA patient’s electroencephalogram and cerebral blood flow perfusion may have transient changes and may return to normal in the interictal period or after the DOC. Although triptans have traditionally been contraindicated in MBA under drug instructions, the evidence of basilar artery constriction, as postulated in MBA, is lacking. Lasmiditan is currently the first and only 5-HT 1F receptor agonist approved by the Food and Drug Administration. The calcitonin gene-related peptide receptor antagonists and monoclonal antibody therapies may be the most promising for future consideration. Here, the pathophysiology, clinical manifestations, diagnostic tools, and treatment progress for MBA with DOC are reviewed.Keywords: migraine, brainstem aura, coma, calcitonin gene-related peptide

Jing-Xu Chen,1,* Lu Yin,1,* Hai-Ting Xu,1 Suo-Yuan Zhang,1 Wen-Qian Huang,1 Hong-Juan Li,1 Bin-Bin Li,1 Ke-Bing Yang,1 Qian Li,2 Michael Berk,3 Yun-Ai Su2 1Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, 100096, People’s Republic of China; 2Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100083, People’s Republic of China; 3Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Vic., Australia*These authors contributed equally to this workCorrespondence: Yun-Ai Su Email suyunai@163.comIntroduction: Unlike unipolar depression, depressive episode of bipolar disorder is often associated with clinical characteristics, such as atypical and mixed symptoms. However, there are currently no valid and reliable specific tools available to assess the specific psychiatric symptomatology of depressive episode of bipolar disorder in China. Therefore, we aimed to evaluate the psychometric properties of the Chinese version of the Bipolar Depression Rating Scale (BDRS) in Chinese patients with bipolar disorder.Methods: The sample of this study included 111 patients with bipolar disorder (30 male, 81 female). All participants were interviewed with the Chinese version of the BDRS (BDRS-C), the 17-item Hamilton Depression Rating Scale (HAMD-17), the Montgomery-Asberg Depression Rating Scale (MADRS) and the Young Mania Rating Scale (YMRS). A psychometric analysis of the BDRS was conducted.Results: The Cronbach’s alpha coefficient of the BDRS-C reached a value of 0.869. The BDRS-C score and scores for the HAMD-17 (r = 0.819, p < 0.01), the MADRS (r = 0.882, p < 0.01) and the YMRS (r = 0.355, p < 0.01) exhibited significant positive correlations. Close correlations were observed between the mixed subscale score of the BDRS-C and the YMRS score (r = 0.784, p < 0.01). Exploratory factor analysis resulted in three factors: a primary depressive symptoms cluster, a secondary depressive symptoms cluster, and a mixed symptoms cluster.Conclusion: The Chinese version of the BDRS has satisfactory psychometric properties. This is a valid and reliable instrument to assess depressive symptomatology in patients with bipolar disorder.Keywords: bipolar disorder, mania, depression, psychometrics, depressive episode, rating scale, psychiatry

Xiao-Dong Zhang,1,2 Guang-Xue Liu,3 Xiao-Yue Wang,2 Xiao-Jie Huang,4 Jing-Li Li,1 Rui-Li Li,2 Hong-Jun Li2 1Department of Radiology, Tianjin First Central Hospital, Tianjin 300192, People’s Republic of China; 2Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, People’s Republic of China; 3Department of Natural Medicines, School of Pharmaceutical Sciences, Peking University Health Science Center, Beijing 100191, People’s Republic of China; 4Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, People’s Republic of ChinaCorrespondence: Rui-Li Li; Hong-Jun LiDepartment of Radiology, Beijing Youan Hospital, Capital Medical University, No. 8, Xi Tou Tiao, Youanmen Wai, Fengtai District, Beijing 100069, People’s Republic of ChinaTel +86 010 83997337Fax +86 010 63051182Email 1985lrli@sina.com; lihongjun00113@sina.comObjective: This study assessed the possible effect of syphilis co-infection in the brain function in young HIV patients by using voxel-wise degree centrality (DC) analysis.Methods: Forty-four syphilis-co-infected HIV patients (HIV+/syphilis+), 45 HIV patients without syphilis history (HIV+/syphilis-) and 43 matched healthy controls (HC) underwent resting-state fMRI examinations. Laboratory tests and a battery of neuropsychological tests were performed before each MRI examination. One-way ANOVA was used to compare the differences of DC among the three groups. The correlations between MRI metrics and laboratory/neuropsychological tests in each patient’s group were performed by Pearson correlation analysis.Results: Compared with HIV+/syphilis-, worse performance in complex motor skills was found in HIV+/syphilis+. Compared with HC, HIV+/syphilis+ and HIV+/syphilis- groups showed attenuated DC in the right orbital frontal cortex and increased DC in the left parietal/temporal cortex. Besides, we also found increased DC in the left inferior frontal cortex and bilateral posterior cingulated cortex/precuneus in HIV+/syphilis+ compared with HC. Moreover, compared with HIV+/syphilis-, HIV+/syphilis+ displayed decreased DC in the left middle occipital cortex. Additionally, in HIV+/syphilis+ group, the mean z value of DC was correlated to the CD4+ cell counts and the learning and delayed recall score.Conclusion: Syphilis co-infection might be related to more brain functional reorganization in young HIV patients which could be reflected by DC value.Keywords: syphilis, HIV, functional connectivity, fMRI, brain

For the first time supersonic molecular beam injection (SMBI) and cluster jet injection (CJI) were applied to mitigate edge-localized modes (ELMs) in HL-2A successfully. The ELM frequency increased by a factor of 2-3 and the heat flux on the divertor target plates decreased by 50% on average after SMBI or CJI. Energetic particle induced modes were observed in different frequency ranges with high-power electron cyclotron resonance heating (ECRH). The high frequency (200-350 kHz) of the modes with a relatively small amplitude was close to the gap frequency of the toroidicity-induced Alfvén eigenmode. The coexistent multi-mode magnetic structures in the high-temperature and low-collision plasma could affect the plasma transport dramatically. Long-lived saturated ideal magnetohydrodynamic instabilities during strong neutral beam injection heating could be suppressed by high-power ECRH. The absolute rate of nonlinear energy transfer between turbulence and zonal flows was measured and the secondary mode competition between low-frequency (LF) zonal flows (ZFs) and geodesic acoustic modes (GAMs) was identified, which demonstrated that ZFs played an important role in the L-H transition. The spontaneously generated E × B shear flow was identified to be responsible for the generation of a large-scale coherent structure (LSCS), which provided unambiguous experimental evidence for the LSCS generation mechanism. New meso-scale electric potential fluctuations (MSEFs) at frequency f ∼ 10.5 kHz with two components of n = 0 and m/n = 6/2 were also identified in the edge plasmas for the first time. The MSEFs coexisted and interacted with magnetic islands of m/n = 6/2, turbulence and LF ZFs. © 2013 IAEA, Vienna.

Bao-Liang Zhong,1,2 Yan-Min Xu,2 Jun-Hong Zhu,2 Hong-Jie Li2 1Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, Hubei Province, China; 2Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, China Purpose: Pain is potentially associated with sexual dysfunction. Both sexual dysfunction and pain are common in methadone-maintained patients, but the association of pain with sexual dysfunction in methadone-maintained patients is rarely studied. This study examined the association between pain and sexual life satisfaction (SLS) in Chinese patients receiving methadone maintenance treatment (MMT). Patients and methods: A total of 477 methadone-maintained patients who recently had sex with their sex partners were recruited from three MMT clinics in Wuhan, China. SLS was assessed with a single question, and the sociodemographic, psychological, and clinical data were collected with standardized questionnaires. Pain intensity was assessed with the 5-point verbal rating scale. Multiple ordinary logistic regression was used to control for potential confounders that may bias the pain–SLS relationship. Results: The prevalence of self-reported dissatisfaction with one’s sexual life was significantly higher in patients with clinically significant pain (CSP) than those without CSP (41.5% vs 19.4%, χ2 =23.567, P

Zhi-Bi Zhang,1 Tian-Yong Xu,2 Ding-Yun You,3 Shuai Yi,4 Qing Liu,4 Huifang-Jie Li,4 Jin-Yun Gu5 1Biomedical Engineering Center, Kunming Medical University, Kunming, People’s Republic of China; 2Experiment Center for Medical Science Research, Kunming, People’s Republic of China; 3Department of Science and Technology, Kunming Medical University, Kunming, People’s Republic of China; 4School of Forensic Medicine, Kunming Medical University, Kunming, People’s Republic of China; 5Zhanyi Branch of Qujing Public Security Bureau, Qujing, People’s Republic of China Background: A number of studies have demonstrated the significant and rapid antidepressant effects of ketamine, which is also known as a neurotoxic and illicit drug. Ketamine and alcohol are increasingly used together in clubs by teenagers and young adults. Previous studies have proven that chronic ketamine consumption induces a delayed and persistent activation of the dopamine (DA) system. However, the rewarding properties of recreational ketamine abuse remain unclear, and the underlying mechanisms of the effects on the DA system after administration of ketamine with ethanol are yet to be explored. Methods: Here, we evaluated the effects of two different doses of ketamine (30 mg/kg and 60 mg/kg) with and without ethanol (0.3156 g/kg) on DA concentration in the rat’s ventral tegmental area (VTA), a vital region in the reward and motivation system. We explored the effects of the combined drug treatment on the expression profiling of the DA metabolism genes, tyrosine hydroxylase, dopa decarboxylase, vesicular monoamine transporter 2, and synaptosomal-associated protein 25, as well as protein expression level of brain-derived neurotrophic factor in the rat’s VTA. Results: We found that administration of ketamine with ethanol led to a significant increase of DA in the VTA associated with differential regulation of mRNA levels of the four DA metabolism genes and protein levels of brain-derived neurotrophic factor. Moreover, the rewarding properties of coadministration of ketamine and ethanol were related to dopaminergic neuron activation in the VTA. Conclusion: These results indicated the possibility that combined drug treatment might positively affect the mesencephalic DA reward system. Keywords: ketamine, ethanol, TH, DDC, dopamine, ventral tegmental area

Rui Wang,1,* Yang Li,2,* Xu-Dong Huai,3 Qing-Xuan Zheng,1 Wei Wang,1 Hui-Jing Li,4 Qi-Yong Huai1 1Marine College, Shandong University, Weihai, China; 2Zhong Yuan Academy of Biological Medicine, Liaocheng People’s Hospital/Affiliated Liaocheng Hospital, Taishan Medical University, Liaocheng, China; 3School of Chemistry and Molecular Engineering, Qingdao University of Science and Technology, Qingdao, China; 4School of Marine Science and Technology, Harbin Institute of Technology at Weihai, Weihai, China *These authors contributed equally to this work Background: The structural modification of natural products with the aim to improve the anticancer activity is a popular current research direction. The pentacyclic triterpenoid compounds oleanolic acid (OA) and glycyrrhetinic acid (GA) are distributed widely in nature. Methods: In this study, various oleanolic acids and glycyrrhetinic acids were designed and synthesized by using the combination principle. The in vitro anticancer activities of new OA and GA derivatives were tested by the 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) method with SGC-7901 (gastric cancer), MCF-7 (breast cancer), Eca-109 (esophageal cancer), HeLa (cervical cancer), Hep-G2 (hepatoma cancer) and HSF (normal human skin fibroblast) cells. Results and conclusion: The screening results showed that the compound 3m presented the highest inhibitory activities against SGC-7901, MCF-7 and Eca-109 cell lines with IC50 values of 7.57±0.64 µM, 5.51±0.41 µM and 5.03±0.56 µM, respectively. In addition, this compound also showed effective inhibition of Hep-G2 cells with an IC50 value of 4.11±0.73 µM. Moreover, compound 5b showed the strongest inhibitory activity against Hep-G2 cells with an IC50 value of 3.74±0.18 µM and compound 3l showed strong selective inhibition of the HeLa cells with the lowest IC50 value of 4.32±0.89 µM. A series of pharmacology experiments indicated that compound 5b could induce Hep-G2 cells autophagy and apoptosis. These compounds will expand the structural diversity of anti-cancer targets and confirm the prospects for further research. Keywords: oleanolic acid, glycyrrhetinic acid, cytotoxic properties, synthesis, apoptosis

Li-Yuan Tang,1,* Hai-Jun Li,2,* Xin Huang,1 Jing Bao,1 Zubin Sethi,3 Lei Ye,1 Qing Yuan,1 Pei-Wen Zhu,1 Nan Jiang,1 Gui-Ping Gao,1 Yi Shao1 1Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; 2Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China; 3The Department of Medicine, University of Miami, Coral Gables, FL, USA *These authors contributed equally to this work Objective: Previous neuroimaging studies have demonstrated that pain-related diseases are associated with brain function and anatomical abnormalities, whereas altered synchronous neural activity in acute eye pain (EP) patients has not been investigated. The purpose of this study was to explore whether or not synchronous neural activity changes were measured with the regional homogeneity (ReHo) method in acute EP patients.Methods: A total of 20 patients (15 males and 5 females) with EP and 20 healthy controls (HCs) consisting of 15 and 5 age-, sex-, and education-matched males and females, respectively, underwent resting-state functional magnetic resonance imaging. The ReHo method was applied to assess synchronous neural activity changes.Results: Compared with HCs, acute EP patients had significantly lower ReHo values in the left precentral/postcentral gyrus (Brodmann area [BA]3/4), right precentral/postcentral gyrus (BA3/4), and left middle frontal gyrus (BA6). In contrast, higher ReHo values in acute EP patients were observed in the left superior frontal gyrus (BA11), right inferior parietal lobule (BA39/40), and left precuneus (BA7). However, no relationship was found between the mean ReHo signal values of the different areas and clinical manifestations, which included both the duration and degree of pain in EP patients.Conclusion: Our study highlighted that acute EP patients showed altered synchronous neural activities in many brain regions, including somatosensory regions. These findings might provide useful information for exploration of the neural mechanisms underlying acute EP. Keywords: acute eye pain, corneal pain, regional homogeneity, resting state, functional magnetic resonance imaging

Shengnan Huang,1,* Chunming Li,2,* Weiping Wang,1 Huanjie Li,1 Zhi Sun,3 Chengzhi Song,4 Benyi Li,5 Shaofeng Duan,6,7 Yurong Hu1,8,9 1Key Laboratory of Targeting Therapy and Diagnosis for Critical Diseases, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, People’s Republic of China; 2Department of Pharmacy, Chongqing Cancer Institute & Hospital & Cancer Center, Chongqing, People’s Republic of China; 3Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China; 4School of Physical Sciences, University of Science and Technology of China, Hefei, People’s Republic of China; 5Department of Urology and Cancer Center, the University of Kansas Medical Center, Kansas City, KS, USA; 6College of Pharmacy, Henan University, Kaifeng, People’s Republic of China; 7Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China; 8Key Laboratory of Key Technology of Drug Preparation, Ministry of Education, Institute of Drug Discovery & Development, Zhengzhou University, Zhengzhou, People’s Republic of China; 9Collaborative Innovation Center of New Drug Research and Safety Evaluation, Zhengzhou, People’s Republic of China *These authors contributed equally to this work Abstract: The combination of photothermal therapy and chemotherapy (photothermal–­chemotherapy) is a promising strategy for cancer therapy. Gold nanocages (AuNCs), with hollow and porous structures and unique optical properties, have become a rising star in the field of drug delivery. Here, we designed a novel targeted drug delivery system based on functionalized AuNCs and evaluated their therapeutic effects in vitro and in vivo. We then loaded doxorubicin into this promising system, designated as DHTPAuNCs consisting of hyaluronic acid-grafted and A54 peptide-targeted PEGylated AuNCs. Its formation was corroborated by ultraviolet–visible spectroscopy, transmission electron microscopy and dynamic light scattering. This delivery platform needed hyaluronidase to release encapsulated drugs, meanwhile the acidic pH and near-infrared irradiation could accelerate the release. In addition, the results of cellular uptake demonstrate that this system could bind specifically with BEL-7402 cells. In vitro, we evaluated therapeutic effects of the DHTPAuNCs in BEL-7402 cells by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl-tetrazolium bromide assay. Moreover, in BEL-7402 tumor-bearing nude mice, its therapy effect in vivo was also evaluated. As expected, DHTPAuNCs exhibited excellent therapeutic effect by photothermal–chemotherapy, both in vitro and in vivo. In short, DHTPAuNCs with low toxicity showed great potential as a drug delivery system for cancer therapy. Keywords: hepatocellular carcinoma, nanocarriers, targeted delivery, chemotherapy, photothermal therapy

Yao-Li Cui,1,2 Bing Wang,2 Hong-Mei Gao,2 Ying-Hong Xing,2 Jian Li,2 Hong-Jie Li,2 Zhu Lin,2 Yong-Qiang Wang2 1Department of Lymphoma and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, 2Department of Intensive Care Unit and Key Lab for Critical Care Medicine of the Ministry of Health, Emergency Medicine Research Institute, Tianjin First Center Hospital, Tianjin, People’s Republic of China Background: Thrombocytopenia is one of the most common laboratory abnormalities encountered in patients with severe sepsis. It has been reported that thrombocytopenia is linked to mortality in patients with severe sepsis. However, the mechanism of thrombocytopenia in sepsis is unknown. We hypothesized that inflammatory cytokines and microRNAs (miRNAs) are not only involved in the pathogenesis of sepsis, but also are correlated with thrombocytopenia.Patients and methods: Eligible patients with severe sepsis were prospectively recruited and treated at our hospital between June 2012 and May 2014. The miRNA and protein expression of interleukin (IL)-18 and IL-27 were detected by real-time polymerase chain reaction and enzyme-linked immunosorbent assay, respectively. The expression of miR-130a and miR-150 was detected by TaqMan real-time polymerase chain reaction.Results: Sixty eligible patients were divided into two groups: 28 severe sepsis patients with thrombocytopenia and 32 severe sepsis patients without thrombocytopenia. The results demonstrated that the miRNA expression and plasma concentration of IL-18 in severe sepsis patients with thrombocytopenia were higher than those in severe sepsis patients without thrombocytopenia (P=0.015 and P=0.034, respectively), and miR-130a expression was significantly lower in severe sepsis patients with thrombocytopenia (P

Xiao Nie,1,* Yi Shao,2,* Si-yu Liu,3 Hai-jun Li,1 Ai-lan Wan,4 Si Nie,1 De-chang Peng,1 Xi-jian Dai1,5 1Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People’s Republic of China; 2Department of Ophthalmology,The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People’s Republic of China; 3Medical College of Nanchang University, Nangchang, Jiangxi, People’s Republic of China; 4Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People’s Republic of China; 5Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, People’s Republic of China *These authors contributed equally to this work Objective: The aim of this study is to explore the resting-state functional connectivity (FC) differences between the paired default mode network (DMN) subregions in patients with primary insomnia (PIs).Methods: Forty-two PIs and forty-two age- and sex-matched good sleepers (GSs) were recruited. All subjects underwent the resting-state functional magnetic resonance imaging scans. The seed-based region-to-region FC method was used to evaluate the abnormal connectivity within the DMN subregions between the PIs and the GSs. Pearson correlation analysis was used to investigate the relationships between the abnormal FC strength within the paired DMN subregions and the clinical features in PIs.Results: Compared with the GSs, the PIs showed higher Pittsburgh Sleep Quality Index score, Hamilton Anxiety Rating Scale score, Hamilton Depression Rating Scale score, Self-Rating Depression Scale score, Self Rating Anxiety Scale score, Self-Rating Scale of Sleep score, and Profile of Mood States score (P

TianHong Zhang,1 HuiJun Li,2,3 Kristen A Woodberry,3 Larry J Seidman,3 Annabelle Chow,4 ZePing Xiao,1 JiJun Wang1 1Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Department of Psychology, Florida A&M University, Tallahassee, FL, USA; 3Department of Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA; 4Department of Psychological Medicine, Changi General Hospital, Singapore Abstract: Clinical high risk of psychosis is defined as the period in which the first signs of psychotic symptoms begin to appear. During this period, there is an increased probability of developing frank psychosis. It is crucial to investigate the interaction between psychotic symptoms and the individual’s personality and life experiences in order to effectively prevent, or delay the development of psychosis. This paper presents case reports of three Chinese female subjects with attenuated positive symptoms, attending their initial outpatient assessment in a mental health service, and their longitudinal clinical outcomes. Information regarding each subject’s symptoms and life stressors was collected at 2-month intervals over a 6-month period. The assessments indicated that these women were suffering from the recent onset of symptoms in different ways. However, all three hid their symptoms from others in their school or workplace, and experienced a decline in performance related to their social roles and in their daily functioning. They were often excluded from the social groups to which they had previously belonged. A decline in social activities may be a risk factor in the development of psychosis and a mediator of functional sequelae in psychosis. Effective treatment strategies may include those that teach individuals to gain insights related to their symptoms and a service that provides a context in which individuals can discuss their psychotic symptoms. Keywords: prodromal psychosis, ultra high risk, follow-up, functional sequelae, transition

Hai-Jun Li,1,* Xi-Jian Dai,1,2,* Hong-Han Gong,1 Xiao Nie,1 Wei Zhang,3 De-Chang Peng1 1Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China; 2Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administrative Region, People’s Republic of China; 3Department of Pneumology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China *These authors contributed equally to this work Background: The majority of previous neuroimaging studies have demonstrated both structural and functional abnormalities in obstructive sleep apnea (OSA). However, few studies have focused on the regional intensity of spontaneous fluctuations during the resting state and the relationship between the abnormal properties and the behavioral performances. In the present study, we employed the amplitude of low-frequency fluctuation (ALFF) method to explore the local features of spontaneous brain activity in OSA patients (OSAs).Methods: Twenty-five untreated male severe OSAs and 25 age-matched and years-of-education-matched male good sleepers (GSs) were included in this study. The ALFF method was used to assess the local features of spontaneous brain activity. The mean signal values of the altered ALFF areas were analyzed with receiver operating characteristic curve. Partial correlation analysis was used to explore the relationship between the observed mean ALFF values of the different areas and the behavioral performances.Results: Compared with GSs, OSAs had significantly higher scores for body mass index, apnea–hypopnea index, arterial oxygen saturation

Xi-Jian Dai,1,2 De-Chang Peng,1 Hong-Han Gong,1 Ai-Lan Wan,3 Xiao Nie,1 Hai-Jun Li,1 Yi-Xiang J Wang2 1Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People’s Republic of China; 2Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong; 3Department of Psychosomatic Medicine, the First Affiliated Hospital of Nangchang University, Nangchang, Jiangxi, People’s Republic of China Study objective: To prospectively explore the underlying regional homogeneity (ReHo) brain-activity deficit in patients with chronic primary insomnia (PCPIs) and its relationship with clinical features.Design: The ReHo method and Statistical Parametric Mapping 8 software were used to evaluate whether resting-state localized brain activity was modulated between PCPIs and good sleepers (GSs), and correlation analysis between altered regional brain areas and clinical features was calculated. Patients and participants: Twenty-four PCPIs (17 females, seven males) and 24 (12 females, 12 males) age-, sex-, and education-matched GSs.Measurements and results: PCPIs disturbed subjective sleep quality, split positive mood, and exacerbated negative moods. Compared with GSs, PCPIs showed higher ReHo in left fusiform gyrus, and lower ReHo in bilateral cingulate gyrus and right cerebellum anterior lobe. Compared with female GSs, female PCPIs showed higher ReHo in the left fusiform gyrus and right posterior cingulate, and lower ReHo in the left cerebellum anterior lobe and left superior frontal gyrus. Compared with male GSs, male PCPIs showed higher ReHo in the right temporal lobe and lower ReHo in the bilateral frontal lobe. The fusiform gyrus showed strong positive correlations and the frontal lobe showed negative correlations with the clinical measurements.Conclusion: The ReHo analysis is a useful noninvasive imaging tool for the detection of cerebral changes and the indexing of clinical features. The abnormal spontaneous activity areas provided important information on the neural mechanisms underlying emotion and sleep-quality impairment in PCPIs. Keywords: insomnia, regional homogeneity, functional magnetic resonance imaging, sex difference, sleep disorder, blood oxygen level-dependent, mood disorder

De-Chang Peng,1 Xi-Jian Dai,1,2 Hong-Han Gong,1 Hai-Jun Li,1 Xiao Nie,1 Wei Zhang3 1Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi, 2Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region, 3Department of Pneumology, The First Affiliated Hospital of Nanchang University, Jiangxi, People’s Republic of China Background: Previous studies have demonstrated that obstructive sleep apnea (OSA) is associated with abnormal brain structural deficits. However, little is known about the changes in local synchronization of spontaneous activity in patients with OSA. The primary aim of the present study was to investigate spontaneous brain activity in patients with OSA compared with good sleepers (GSs) using regional homogeneity (ReHo) analysis based on resting-state ­functional magnetic resonance imaging (MRI). Methods: Twenty-five untreated male patients with severe OSA and 25 male GSs matched for age and years of education were included in this study. The ReHo method was calculated to assess the strength of local signal synchrony and was compared between the two groups. The observed mean ReHo values were entered into Statistical Package for the Social Sciences software to assess their correlation with behavioral performance. Results: Compared with GSs, patients with OSA showed significantly lower ReHo in the right medial frontal gyrus (BA11), right superior frontal gyrus (BA10), right cluster of the precuneus and angular gyrus (BA39), and left superior parietal lobule (BA7), and higher ReHo in the right posterior lobe of the cerebellum, right cingulate gyrus (BA23), and bilateral cluster covering the lentiform nucleus, putamen, and insula (BA13). The lower mean ReHo value in the right cluster of the precuneus and angular gyrus had a significant negative correlation with sleep time (r=-0.430, P=0.032), and higher ReHo in the right posterior lobe of the cerebellum showed a significant positive correlation with stage 3 sleep (r=0.458, P=0.021) and in the right cingulate gyrus showed a significant positive correlation with percent rapid eye movement sleep (r=0.405, P=0.045). Conclusion: Patients with OSA showed significant regional spontaneous activity deficits in default mode network areas. The ReHo method is a useful noninvasive imaging tool for detection of early changes in cerebral ReHo in patients with OSA. Keywords: obstructive sleep apnea, regional homogeneity, intermittent hypoxia, functional magnetic resonance imaging, resting state, spontaneous activity

Abstract In this article, SnO2nanowires (NWs) have been prepared and their microwave absorption properties have been investigated in detail. Complex permittivity and permeability of the SnO2NWs/paraffin composites have been measured in a frequency range of 0.1–18 GHz, and the measured results are compared with that calculated from effective medium theory. The value of maximum reflection loss for the composites with 20 vol.% SnO2NWs is approximately −32.5 dB at 14 GHz with a thickness of 5.0 mm.