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Dysfunction of the cingulo-frontal-parietal (CFP) cognitive attention network has been associated with the pathophysiology of chronic low back pain (cLBP). However, the direction of information processing within this network remains largely unknown. We aimed to study the effective connectivity among the CFP regions in 36 cLBP patients and 36 healthy controls by dynamic causal modeling (DCM). Both the resting-state and task-related (Multi-Source Interference Task, MSIT) functional magnetic resonance imaging (fMRI) data were collected and analyzed. The relationship between the effective connectivity of the CFP regions and clinical measures was also examined. Our results suggested that cLBP had significantly altered resting-state effective connectivity of the prefrontal cortex (PFC)-to-mid-cingulate cortex (MCC) (increased) and MCC-to-left superior parietal cortex (LPC) (decreased) pathways as compared with healthy controls. MSIT-related DCM suggested that the interference task could significantly increase the effective connectivity of the right superior parietal cortex (RPC)-to-PFC and RPC-to-MCC pathways in cLBP than that in healthy controls. The control task could significantly decrease the effective connectivity of the MCC-to-LPC and MCC-to-RPC pathways in cLBP than that in healthy controls. The endogenous connectivity of the PFC-to-RPC pathway in cLBP was significantly lower than that in healthy controls. No significant correlations were found between the effective connectivity within CFP networks and pain/depression scores in patients with cLBP. In summary, our findings suggested altered effective connectivity in multiple pathways within the CFP network in both resting-state and performing attention-demanding tasks in patients with cLBP, which extends our understanding of attention dysfunction in patients with cLBP.

Chronic nonspecific low back pain (cNLBP) is a leading contributor to disease burden worldwide that is difficult to treat due to its nonspecific aetiology and complexity. The amygdala is a complex of structurally and functionally heterogeneous nuclei that serve as a key neural substrate for the interactions between pain and negative affective states. However, whether the functions of amygdalar subcomponents are differentially altered in cNLBP remains unknown. Little attention has focused on effective connectivity of the amygdala with the cortex in cNLBP. In this study, thirty-three patients with cNLBP and 33 healthy controls (HCs) were included. Resting-state functional connectivity (rsFC) and effective connectivity of the amygdala and its subregions were examined. Our results showed that the patient group exhibited significantly greater rsFC between the left amygdala and left dorsal medial prefrontal cortex (mPFC), which was negatively correlated with pain intensity ratings. Subregional analyses suggested a difference located at the superficial nuclei of the amygdala. Dynamic causal modelling revealed significantly lower effective connectivity from the left amygdala to the dorsal mPFC in patients with cNLBP than in HCs. Both groups exhibited stronger effective connectivity from the left amygdala to the right amygdala. In summary, these findings not only suggested altered rsFC of the amygdala-mPFC pathway in cNLBP but also implicated an abnormal direction of information processing between the amygdala and mPFC in these patients. Our results further highlight the involvement of the amygdala in the neuropathology of cNLBP.

Pituitary tumors, the most common intracranial tumors, lead to serious morbidity through the inappropriate secretion of pituitary hormones. The anomalous expression of microRNAs (miRNAs), which have a crucial status in the development and function of pituitary gland, promotes the tumorigenesis of hypothalamic-pituitary axis-related pituitary tumors. This mainly leads to alterations in the function of the hypothalamic-pituitary-adrenal axis, hypothalamic-pituitary-gonadal axis and hypothalamic-pituitary-growth hormone. In the tumorigenesis of pituitary tumors, miRNAs have complex roles. They can induce cell cycle arrest, inhibiting cell proliferation and inducing apoptosis via different pathways; however, they also promote the occurrence of pituitary tumors through direct interactions with transcription factors. This review summarizes recent progress in the study of miRNAs on the pathogenesis of pituitary tumors.

Due to the rarity of hemolymphangioma, a limited number of cases of the disease have been reported in the literature thus far. The present case report describes the cases of 4 patients with hemolymphangioma that were diagnosed and treated at the Second Affiliated Hospital of Xi'an Jiaotong University (Xi'an, China). All patients were female, with a mean age of 44.7 years and a mean duration of symptoms prior to diagnosis of 2.7 years. The diagnosis of hemolymphangioma was determined by postoperative histopathology in all patients. A total of 2 patients were diagnosed with tumors that exhibited cystic characteristics (one in the mediastinum and the other in the neck), which was determined by computed tomography and magnetic resonance imaging. Another of the patients' tumors was located in the left forearm, and 1 patient had multifocal hemolymphangioma in the mediastinum and spleen. All patients underwent surgery and were asymptomatic during the follow-up periods (range, 8-15 months). In the present case report, the radiographic findings of the 4 cases are presented, including the unusual imaging characteristics that were observed, and relevant reports in the literature are discussed.

Objective To observe the change of ceramide galactosyltransferase (CGT) expression in sciatic nerve of experimental diabetic rats after electroacupuncture (EA) treatment.

AIM To investigate wall shear stress (WSS) magnitude and distribution in cirrhotic patients with portal hypertension using computational fluid dynamics. METHODS Idealized portal vein (PV) system models were reconstructed with different angles of the PV-splenic vein (SV) and superior mesenteric vein (SMV)-SV. Patient-specific models were created according to enhanced computed tomography images. WSS was simulated by using a finite-element analyzer, regarding the blood as a Newtonian fluid and the vessel as a rigid wall. Analysis was carried out to compare the WSS in the portal hypertension group with that in healthy controls. RESULTS For the idealized models, WSS in the portal hypertension group (0-10 dyn/cm2) was significantly lower than that in the healthy controls (10-20 dyn/cm2), and low WSS area (0-1 dyn/cm2) only occurred in the left wall of the PV in the portal hypertension group. Different angles of PV-SV and SMV-SV had different effects on the magnitude and distribution of WSS, and low WSS area often occurred in smaller PV-SV angle and larger SMV-SV angle. In the patient-specific models, WSS in the cirrhotic patients with portal hypertension (10.13 ± 1.34 dyn/cm2) was also significantly lower than that in the healthy controls (P < 0.05). Low WSS area often occurred in the junction area of SV and SMV into the PV, in the area of the division of PV into left and right PV, and in the outer wall of the curving SV in the control group. In the cirrhotic patients with portal hypertension, the low WSS area extended to wider levels and the magnitude of WSS reached lower levels, thereby being more prone to disturbed flow occurrence. CONCLUSION Cirrhotic patients with portal hypertension show dramatic hemodynamic changes with lower WSS and greater potential for disturbed flow, representing a possible causative factor of PV thrombosis.

To explore the morphometric abnormalities of brain gray matter (GM) in patients with chronic low back pain (CLBP).Thirty patients with CLBP and 30 healthy individuals were enrolled and examined with a 3.0 T magnetic resonance (MR) scanner. High-resolution T1 structural MR data were acquired and data analysis was performed using voxel-based morphometry (VBM) in FMRIB Software Library. The morphological differences were compared between the two groups.s Compared with the healthy control subjects, patients with CLBP showed decreased GM volumes in several brain cortical areas including the bilateral superior frontal gyrus, right frontal pole, left insular cortex, left middle and left inferior temporal gyrus (P0.05, after TFCE correction). Increased GM volumes were found in the patients in the subcortical structures including the left thalamus, bilateral putamen, bilateral nucleus accumben and right caudate nucleus (P0.05, after TFCE correction).Patients with CLBP have different patterns of GM abnormalities in different brain regions, characterized by reduced GM volume in cerebral cortical regions and increased GM volume in the subcortical nuclei. Such changes might be associated with the maladaptation of the brain in chronic pain state.

Despite the involvement of subcortical brain structures in the pathogenesis of chronic pain and persistent pain as the defining symptom of knee osteoarthritis (KOA), little attention has been paid to the morphometric measurements of these subcortical nuclei in patients with KOA. The purpose of this study is to explore the potential morphological abnormalities of subcortical brain structures in patients with KOA as compared to healthy control subjects by using high resolution MRI. Structural MRI data were acquired from 26 patients with KOA and 31 demographically similar healthy individuals. The MR data were analyzed by using FMRIB's integrated registration and segmentation tool (FIRST). Both volumetric analysis and surface-based shape analysis were performed to characterize the subcortical morphology. The normalized volumes of bilateral caudate nucleus were significantly smaller in the KOA group than in the control group (P = 0.004). There was also a trend toward smaller volume of the hippocampus in KOA as compared to the control group (P = 0.027). Detailed surface analyses further localized these differences with a greater involvement of the left hemisphere (P < 0.05, corrected) for the caudate nucleus. Hemispheric asymmetry (right larger than left) of the caudate nucleus was found in both KOA and control groups. Besides, no significant correlation was found between the structural data and pain intensities. Our results indicated that patients with KOA had statistically significant smaller normalized volumes of bilateral caudate nucleus and a trend toward smaller volume of the hippocampus as compared to the control subjects. Further investigations are necessary to characterize the role of caudate nucleus in the course of chronicity of pain associated with KOA.

Objective: We aimed to do a meta-analysis of the existing literature to assess the accuracy of prostate cancer studies which use magnetic resonance spectroscopy (MRS) as a diagnostic tool. Materials and Methods: Prospectively, independent, blind studies were selected from the Cochrane library, Pubmed, and other network databases. The criteria for inclusion and exclusion in this study referenced the criteria of diagnostic research published by the Cochrane center. The statistical analysis was adopted by using Meta-Test version 6.0. Using the homogeneity test, a statistical effect model was chosen to calculate different pooled weighted values of sensitivity, specificity, and the corresponding 95% confidence intervals (95% CI). The summary receiver operating characteristic (SROC) curves method was used to assess the results. Results: We chose two cut-off values (0.75 and 0.86) as the diagnostic criteria for discriminating between benign and malignant. In the first diagnostic criterion, the pooled weighted sensitivity, specificity, and corresponding 95% CI (expressed as area under curve [AUC]) were 0.82 (0.73, 0.89), 0.68 (0.58, 0.76), and 83.4% (74.97, 91.83). In the second criterion, the pooled weighted sensitivity, specificity, and corresponding 95% CI were 0.64 (0.55, 0.72), 0.86 (0.79, 0.91) and 82.7% (68.73, 96.68). Conclusion: As a new method in the diagnostic of prostate cancer, MRS has a better applied value compared to other common modalities. Ultimately, large scale RCT randomized controlled trial studies are necessary to assess its clinical value.

Parkinson's disease is a commonly encountered central nervous retrograde affection in elder persons. According to the theories of traditional Chinese medicine, Parkinson's disease is characterized by deficiency in the Ben (root) and excess in the Biao (branch). The Ben (root) is insufficiency of liver and kidney and deficiency of qi and blood; and the Biao (branch) is wind, fire, phlegm and stasis. Good therapeutic effects have been obtained by treatment based on syndrome differentiation, treatment with specific prescriptions and acupuncture. The further study on literatures, standardized criterion of symptoms differentiation and therapeutic effect determination as well as the screening and further research on the effective prescriptions and herbs should be paid more attention, meanwhile, the integration of herbs and acupuncture will be conducive to raise the therapeutic effect.

To explore the diffusion-tensor imaging (DTI) characteristics of normal-appearing white matter (NAWM) and normal-appearing gray matter (NAGM) on conventional magnetic resonance imaging (MRI) in patients with subcortical ischemic vascular disease (SIVD) and examine the relation of such features with the general cognitive function of the patients.DTI was performed in 46 SIVD patients and 34 age-matched control subjects with normal MRI findings. The apprarent diffusion coeeficient (ADC) and fractional anisotropy (FA) were measured within the regions of white matter lesions (WMLs), NAWM and NAGM. All the subjects were examined by neurologists with MMSE and clinical neurologic examination.Compared with normal controls, SIVD subjects showed increased ADC values in the subcortical NAGM and NAWM in anterior periventricular and centrum semiovale, with decreased FA values in the caudate nucleus, thalamus and centrum semiovale. An increased severity of the WMLs was associated with increased ADC and decreased FA in the NAWM of SIVD patients. After controlling for age, the ADC in the NAWM of the posterior periventricular, NAWM and WMLs in the centrum semiovale, caudate nucleus and thalamus showed significant inverse correlations to MMSE; FA values in NAWM of the anterior periventricular and WMLs of the centrum semiovale were positively correlated to MMSE.In SIVD patients, the NAWM and NAGM regions shown by MRI contain diffusion abnormalities, and these abnormalities shown by DTI are significantly correlated to the general cognitive function of the patients.