Objective To explore the white matter microstructural abnormalities in patients with different subtypes of attention-deficit/hyperactivity disorder (ADHD) and establish a diagnostic classification model. Methods Patients with ADHD admitted to West China Hospital of Sichuan University between January 2019 and September 2021 and healthy controls recruited through advertisement were prospectively selected. All participants underwent diffusion tensor imaging scanning. The whole brain voxel-based analysis was used to compare the diffusion parameter maps of fractional anisotropy (FA) among patients with combined subtype of ADHD (ADHD-C), patients with inattentive subtype of ADHD (ADHD-I) and healthy controls. The support vector machine classifier and feature selection method were used to construct the individual ADHD diagnostic classification model and efficiency was evaluated between each two groups of the ADHD patients and healthy controls. Results A total of 26 ADHD-C patients, 24 ADHD-I patients and 26 healthy controls were included. The three groups showed significant differences in FA values in the bilateral sagittal stratum of temporal lobe (ADHD-C<ADHD-I<healthy controls) and the isthmus of corpus callosum (ADHD-C>ADHD-I>healthy controls) (P<0.005). The direct comparison between the two subtypes of ADHD showed that ADHD-C had higher FA than ADHD-I in the right middle frontal gyrus. The classification model differentiating ADHD-C and ADHD-I showed the highest efficiency, with a total accuracy of 76.0%, sensitivity of 88.5%, and specificity of 70.8%. Conclusions There is both commonality and heterogeneity in white matter microstructural alterations in the two subtypes of patients with ADHD. The white matter damage of the sagittal stratum of temporal lobe and the corpus callosum may be the intrinsic pathophysiological basis of ADHD, while the anomalies of frontal brain region may be the differential point between different subtypes of patients.
Objective To evaluate the effectiveness of microplate fixation in open-door cervical expansive laminoplasty (ELP) by comparing with anchor fixation. Methods Between January 2005 and October 2008, 35 patients with multi-segment cervical spondylotic myelopathy were treated. Of them, 15 patients underwent ELP by microplate fixation (microplate group) and 20 patients underwent ELP by anchor fixation (anchor group). In microplate group, there were 10 malesand 5 females with the age of (51.2 ± 11.5) years; the disease duration ranged from 6 to 60 months (mean, 14 months); and the preoperative Japanese Orthopoaedic Association (JOA) score was 7.7 ± 2.5. In anchor group, there were 13 males and 7 females with the age of (50.7 ± 10.8) years; the disease duration ranged from 3 to 58 months (mean, 17 months); and the preoperative JOA score was 7.8 ± 2.9. There was no significant difference in the general data, such as gender, age, and JOA score between 2 groups (P gt; 0.05). Results All incisions healed by first intention. Thirty-five cases were followed up 24-68 months (mean, 32 months). The operation time was (113 ± 24) minutes in anchor group and (111 ± 27) minutes in microplate group, showing no significant difference (t=0.231 3, P=0.818 5). The rate of spinal canal expansion in microplate group (60% ± 24%) was significantly higher than that in anchor group (40% ± 18%) (t=2.820, P=0.008). The JOA scores of 2 groups at 3 months and 24 months after operation were significantly higher than the preoperative scores (P lt; 0.01). There was no significant difference in JOA score between 2 groups at 3 months after operation (t=1.620 5, P=0.114 6), but the JOA score of microplate group was significantly higher than that of anchor group at 24 months after operation (t=3.454 3, P=0.001 5). X-ray film, MRI, and CT scan at 3-6 months after operation displayed that door spindle reached bony fusion. There was no occurrence of ‘‘re-close of door’’ in 2 groups. The rate of compl ication in microplate group (13.3%, 2/15) was significantly lower than that in anchor group (25.0%, 5/20) (χ2=7.160 0, P=0.008 6). Conclusion ELP by microplate fixation can achieve the stabil ity quickly after operation, which can help patients to do functional exercises early, and has satisfactory effectiveness and less complications.
Objective To investigate the effect of methylprednisolone sodium succinate (MP) and mouse nerve growth factor (mNGF) for injection in treating acute spinal cord injury (ASCI) and cauda equina injury. Methods Between December 2004 and December 2007, 43 patients with ASCI and cauda equina injury were treated, including 33 males and 10 females with an average age of 43 years (range, 32-66 years). Injured vertebral columns were C2 in 1 case, C4 in 5 cases, C5 in 7cases, C6 in 3 cases, T8 in 1 case, T10 in 1 case, T11 in 2 cases, T12 in 3 cases, L1 in 9 cases, L2 in 5 cases, L3 in 3 cases, L4 in 1 case, and L5 in 2 cases. All the patients had sensory disturbance and motor dysfunction at admission. The Frankel scale was used for assessment of nerve function, 5 cases were rated as Grade A, 12 as Grade B, 22 as Grade C, and 4 as Grade D before operation. In 43 patients, 23 cases were treated with MP and mNGF (group A), 20 cases with MP only (group B). There was no significant difference in general data between 2 groups (P gt; 0.05). All the patients were admitted, received drug treatment within 8 hours of injury, and were given spinal canal decompression, bone transplantation, and internal fixation within 48 hours. The neurological function score systems of American Spinal Injury Association (ASIA) were used for neurological scores before treament, at 1 week and 2 years after treatment. The scores of the activity of daily l iving (ADL) were evaluated and compared. Results All the patients achieved heal ing of incision by first intention. Forty-three cases were followed up 24-61 months with an average of 30 months. Bone graft fusion was achieved after 6-17 months, 11 months on average with stable fixation. No death and compl ications of osteonecrosis and central obesity occurred. There was no significant difference in neurological function scores and ADL scores between 2 groups before treatment (P gt; 0.05); however, the neurological function scores and ADL scores at 1 week and 2 years after treatment were higher than those before treatment (P lt; 0.01) in 2 groups. Group A had higher neurological function scores and ADL scores than group B (P lt; 0.01). At 1 week and 2 years after treatment, the improvement rates of neurological function of group A (47.8%, 11/23 and 91.3%, 21/23) were significantly higher (P lt; 0.01) than those of group B (30.0%, 6/20 and 70.0%, 14/20). Conclusion MP and mNGF play an important role in improving the neurological function in patients with ASCI and cauda equina injury.
ObjectiveTo investigate the estimated prevalence of depression and its associated factors among inpatients in the Department of Oncology in general hospitals. MethodsOn October 29th, 2013, we surveyed all hospitalized patients from the Department of Oncology in West China Hospital, Sichuan University. The questionnaire on patients’ demographic characteristics and the Patient Health Questionnaire-9 (PHQ-9) were combined to form one questionnaire to investigate the incidence of depression in hospitalized patients in general hospitals and its influencing factors. ResultsWe gave out 546 questionnaires and retrieved 528 with a retrieval rate of 96.6%. Seven questionnaires had 15 or more empty items and were deleted. The final number of valid questionnaires was 521, with a validity rate of 95.4%. The estimated prevalence of depression among inpatients from the Department of Oncology was 32.8% (171/521). Risk factors for depression in patients in the Department of Oncology included female gender [OR=1.550, 95%CI (1.034, 2.325), P=0.034] illiterate and primary school education [OR=2.534, 95%CI (1.329, 4.832), P=0.005] and annual household income lower than 10 000 RMB [OR=1.850, 95%CI (1.056, 3.243), P=0.032]. A total of 135 patients had suicidal risks, among whom 90 (52.6%) had depression, and Spearman correlation analysis showed that suicidal risk was moderately and positively correlated with PHQ-9 scores (r=0.558, P<0.001). ConclusionsThe estimated total prevalence of depression is high in hospitalized patients in the Department of Oncology, especially in female, low educational level and low family income patients. We must pay more attention to the mental health of cancer patients, evaluate depression and suicidal tendency carefully and provide psychological service timely.