Depression is a common psychiatric disorder, and approximately 30% patients with depression do not respond effectively to standard antidepressant medication; this condition is termed treatment resistant depression (TRD) and its neurobiological mechanism remains unclear. Neuroimaging techniques can non-invasively explore changes in brain structure, function and metabolism. These techniques have been applied in neurobiological research of TRD and revealed critical abnormalities in brain structure, function and metabolism in fronto-limbic system. In this paper, we reviewed the latest progress in neuroimaging researches on TRD, providing new insight and imaging evidence for further neurobiological studies of TRD.
Based on the scientific research management experience for many years and the characteristics and advantages of the hospital, West China Hospital of Sichuan University develops an innovative scientific research management model relying on deepening the top-level design of scientific research management, strengthening the information management means, establishing the assessment and evaluation system of full-time scientific research personnel, and creating the benchmark of scientific research technician training industry. The “West China Model” of innovative scientific research management has achieved remarkable results. The comprehensive strength of scientific research has been strong, the management strength of scientific research has been greatly improved, and the scientific and technological research on the epidemic situation has been accurately deployed. The “West China Model” of innovative scientific research management not only provides a working path for research hospitals, but also lays a theoretical foundation for the exploration and establishment of the “scientific research management-scientific research team-scientific research project” trinity innovative hospital scientific research management system, which plays a positive role in effectively stimulating the vitality of scientific research and improving the core medical technology.
Amblyopia is a visual development deficit caused by abnormal visual experience in early life, mainly manifesting as defected visual acuity and binocular visual impairment, which is considered to reflect abnormal development of the brain rather than organic lesions of the eye. Previous studies have reported abnormal spontaneous brain activity in patients with amblyopia. However, the location of abnormal spontaneous activity in patients with amblyopia and the association between abnormal brain function activity and clinical deficits remain unclear. The purpose of this study is to analyze spontaneous brain functional activity abnormalities in patients with amblyopia and their associations with clinical defects using resting-state functional magnetic resonance imaging (fMRI) data. In this study, 31 patients with amblyopia and 31 healthy controls were enrolled for resting-state fMRI scanning. The results showed that spontaneous activity in the right angular gyrus, left posterior cerebellum, and left cingulate gyrus were significantly lower in patients with amblyopia than in controls, and spontaneous activity in the right middle temporal gyrus was significantly higher in patients with amblyopia. In addition, the spontaneous activity of the left cerebellum in patients with amblyopia was negatively associated with the best-corrected visual acuity of the amblyopic eye, and the spontaneous activity of the right middle temporal gyrus was positively associated with the stereoacuity. This study found that adult patients with amblyopia showed abnormal spontaneous activity in the angular gyrus, cerebellum, middle temporal gyrus, and cingulate gyrus. Furthermore, the functional abnormalities in the cerebellum and middle temporal gyrus may be associated with visual acuity defects and stereopsis deficiency in patients with amblyopia. These findings help explain the neural mechanism of amblyopia, thus promoting the improvement of the treatment strategy for amblyopia.
ObjectiveTo integrate person imagery from drawing tests in screening for mental disorders through meta-analysis to identify indicators that can effectively predict mental disorders. MethodsA computerized search of CNKI, WanFang Data, VIP, PubMed, Web of Science, and EBSCO databases was conducted to collect studies related to mental disorders and drawing tests, with a search timeframe of the period from the creation of the database to May 8, 2023. Meta-analysis was performed using CMA 3.0 after two researchers independently screened the literature, extracted information, and assessed the risk of bias. ResultsA total of 43 studies were included, with 791 independent effect sizes and 8 444 subjects. Meta-analysis revealed that a total of 29 person imagery traits significantly predicted mental disorders, which could be categorized into 7 types according to the features: absent, bizarre, blackened, simplified, static, detailed, and holistic. The subgroup analysis revealed that the specific indicators of affective disorders included "excessive separation among items", "oversimplified person", "rigid and static person" and "hands behind the back". The specific indicators of thought disorders were "absence of limbs", "absence of facial features" and "disproportionate body proportions". Moreover, there were seven common indicators of mental disorders, including "oversimplified drawing", "very small drawing", "very small person", "weak or intermittent lines", "single line limb", "absence of hands or feet" and "no expression or dullness''. ConclusionThe findings could provide a reference standard for selection and interpretation of drawing indicators, promote standardization of the drawing test, and enhance the accuracy of results in screening for mental disorders.
Since January 2020, due to the epidemic of coronavirus disease 2019, all universities in China have postponed their studies or even suspend their studies. In response to the teaching policy of “suspending class, but keeping teaching and learning” , college teachers have rapidly changed into online teaching mode. However, how to ensure the quality and effect of online teaching still needs further exploration. Through analyzing the course characteristics of medical imaging diagnostics and students’ learning situations, this study discusses how to design detailed online teaching projects and improve the teaching quality and how to select online software suitable for the course. A questionnaire survey was conducted to evaluate the effect of online teaching during the spring course in 2020, selecting a total of 297 clinical and other undergraduate students of grade 2017 from West China School of Medicine of Sichuan University. The results showed that the detailed online teaching programs including “video learning” “distance teaching” “periodic examination” “weakness tutorial” were helpful to the learning process agreed by the majority of students. During the epidemic period, online teaching method can help students master the content of medical imaging diagnosis. In the era of Internet, the “online+offline” teaching mode is expected to be popularized in the future.
Objective To identify the most consistent and replicable characteristics of altered spontaneous brain activity in mesial temporal lobe epilepsy patients with unilateral hippocampal sclerosis (MTLE-HS). Methods A systematic literature search was performed in PubMed, Embase, The Cochrane Library, China National Knowledge Infrastructure, Wanfang, and CQVIP databases, to identify eligible whole-brain resting state functional magnetic resonance imaging studies that had measured differences in amplitude of low-frequency fluctuations or fractional amplitude of low-frequency fluctuations between patients with MTLE-HS and healthy controls from January 2000 to January 2019. After literature screening and data extraction, Anisotropic Effect-Size Signed Differential Mapping software was used for voxel based pooled meta-analysis. Results Nine datasets from six studies were finally included, which contained 207 MTLE-HS patients and 239 healthy controls. The results demonstrated that, compared with the healthy controls, the MTLE-HS patients showed increased spontaneous brain activity in right hippocampus and parahippocampal gyrus, right superior temporal gyrus, left cingulate gyrus, right fusiform gyrus, and right inferior temporal gyrus; while decreased spontaneous brain activity in left superior frontal gyrus, right angular gyrus, right middle frontal gyrus, left inferior parietal lobule, left precuneus, and right cerebellum (P<0.005, cluster extent≥10). Conclusion The current meta-analysis demonstrates that patients with MTLE-HS show increased spontaneous brain activity in lateral and mesial temporal regions and decreased spontaneous brain activity in default mode network, which preliminarily clarifies the characteristics of altered spontaneous brain activity in patients with MTLE-HS.
In the current study, we aim to investigate whether post-traumatic stress disorder (PTSD) is associated with structural alterations in specific subfields of hippocampus comparing with trauma-exposed control (TC) in a relatively large sample. We included 67 PTSD patients who were diagnosed under Diagnostic and Statistical Manual of Mental Disorders (4th Edition) (DSM-Ⅳ) criteria and 78 age- and sex-matched non-PTSD adult survivors who experienced similar stressors. High resolution T1 weighted images were obtained via a GE 3.0 T scanner. The structural data was automatically segmented using FreeSurfer software, and volume of whole hippocampus and subfield including CA1, CA2-3, CA4-DG, fimbria, presubiculum, subiculum and fissure were extracted. Volume differences between the two groups were statistically compared with age, years of education, duration from the events and intracranial volume (ICV) as covariates. Hemisphere, sex and diagnosis were entered as fixed factors. Relationship between morphometric measurements with Clinician-Administered PTSD Scale (CAPS) score and illness duration were performed using Pearson’s correlation with SPSS. Comparing to TC, PTSD patients showed no statistically significant alteration in volumes of the whole hippocampus and all the subfields (P > 0.05). In male patients, there were significant correlations between CAPS score and volume of right CA2-3 ( R2 = 0.197, P = 0.034), right subiculum (R2 = 0.245, P = 0.016), and duration statistically correlated with right fissure (R2 = 0.247, P = 0.016). In female patients, CAPS scores significant correlated with volume of left presubiculum (R2 = 0.095, P = 0.042), left subiculum (R2 = 0.090, P = 0.048), and left CA4-DG (R2 = 0.099, P = 0.037). The main findings of the current study suggest that stress event causes non-selective damage to hippocampus in both PTSD patients and TC, and gender-specific lateralization may underlie PTSD pathology.
目的 利用局部一致性（ReHo）方法探測創傷后應激障礙（PTSD）患者在靜息狀態下是否存在著大腦功能異常。 方法 2010年5月－7月對18例未經治療的地震PTSD患者和19例同樣經歷地震但未患PTSD的對照者進行了靜息態功能磁共振成像（Rs-fMRI） 掃描。應用ReHo方法處理Rs-fMRI數據，得出PTSD患者的異常腦區，并將患者存在組間差異的腦區ReHo值與臨床用PTSD診斷量表（CAPS）、漢密爾頓抑郁量表（HAMD）和漢密爾頓焦慮量表（HAMA）分別進行相關分析。 結果 ① PTSD組ReHo顯著增加的腦區包括右側顳下回、楔前葉、頂下葉、中扣帶回，左側枕中回以及左/右側后扣帶回；ReHo顯著降低的腦區包括左側海馬和左/右側腹側前扣帶回。② 異常腦區中后扣帶回和右側中扣帶回ReHo與HAMD呈負相關（中扣帶回r=?0.575，P=0.012；右側后扣帶回：r=?0.507，P=0.032），其余腦區ReHo與臨床指標無明顯相關性（P＞0.05），左側海馬與CAPS的相關性相對其他腦區較大（r=?0.430，P=0.075）。 結論 PTSD患者在靜息狀態下即存在著局部腦功能活動的降低和增加，ReHo方法可能有助于研究PTSD患者靜息狀態腦活動。
Health poverty alleviation is an important practice in implementing the basic strategy of precision poverty alleviation. It is also an important measure to win the battle against poverty in rural areas. Through the investigation of local medical and health conditions, West China Hospital of Sichuan University built a demand-oriented framework for medical poverty alleviation in Ganzi Prefecture, and gradually carried out precision top-level design, discipline construction, technical training, talent training, endemic disease prevention and control; through establishinga regional medical cooperation network, built featured specialies, built the backbone of medical and health forces, achieved the prevention of endemic diseases throughout life cycle, and improved the overall medical and health service capacity of Ganzi Prefecture. This article introduces the exploration and practice of the demand-oriented model in Ganzi Prefecture by West China Hospital of Sichuan University, aiming at providing a guide for the precision health poverty alleviation in China.
目的 利用磁共振彌散張量成像技術（DTI）對右側難治性顳葉癲癇（TLE）患者術前及術后腦白質各向異性分數（FA）進行縱向隨訪研究，并對其與病程等臨床癥狀之間的相關性進行分析，探討右側TLE患者的腦白質FA變化模式。 方法 2008年7月－2009年8月納入10例右側難治性TLE患者。對每個受試者采用GE 3.0 T磁共振及8通道頭線圈掃描，所有DTI圖像通過單次回波平面成像序列采集。采用基于體素分析的SPM8軟件對受試患者術前術后FA圖進行配對t檢驗，觀察難治性TLE患者腦白質變化模式。采用Pearson相關計算FA變化幅度與病程等臨床癥狀之間的相關性，經比較校正后P值＜0.05的區域為有統計學意義的區域。 結果 右側TLE患者FA值降低的區域包括左側顳下回、雙側額中回及左側殼核、右側楔葉。FA升高的區域包括左側海馬旁回、左側顳葉、右側額下回和左側中央旁小葉。相關分析發現，右側TLE患者右側額下回FA變化值與發病年齡呈負相關，左側顳下回FA變化值與術后隨訪間隔時間呈負相關。 結論 右側難治性TLE患者手術治療后大腦白質變化不僅局限于顳葉，還涉及顳葉外結構。