2018年·第98卷第31期

Magnetic resonance imaging (MRI) technology has the advantages of good tissue and spatial resolution and no radiation, and its value in clinical and scientific research of the central nervous system (CNS) has been unanimously recognized by the industry. MRI research of central nervous system covers many fields such as tumors, cerebrovascular diseases, neurodegenerative diseases and aging, demyelinating diseases, epilepsy, cognitive and mental diseases, etc. At the same time, new technologies and methods of MRI, whether in scientific research or clinical application, are often the first to be tried in the nervous system, developed and matured in all systems of the whole body. Therefore, being familiar with and understanding the progress and existing problems of MRI of nervous system will help us to better use various new MRI technologies.

Studies show that the prevalence rate of Parkinson's disease among people over 65 years old in China is 1,700/100,000, and the incidence rate gradually increases with the increase of the overall age of the population^[1]。 Depression is common in Parkinson's disease^[2,3]The incidence rate of non-motor symptoms is 40% ~50%, which seriously affects the daily function, emotional state and disease prognosis of patients, reduces the quality of life of patients and increases the burden of caregivers. However, because the clinical symptoms of Parkinson's depression are relatively hidden and difficult to identify and diagnose, they have not received enough attention from researchers; In addition, most current studies focus on its causes and pathogenesis^[4]Rare studies on interventable influencing factors of depression in Parkinson's disease. In view of this, the purpose of this study is to understand the depression level of patients with Parkinson's disease in Dalian, analyze its influencing factors, and reduce their depression and improve their prognosis by adjusting the intervening factors.

TCS as a non-invasive, radiation-free and easy-to-operate inspection method^[1]It has gradually become one of the important tools to assist in the diagnosis of PD. Previous studies have evaluated the relationship between SN strong echoes and clinical features. Most studies support that SN strong echoes can maintain a relatively stable state for a long time, independent of disease course and disease progression^[2]； There is also a combination of cranial MRI and PET imaging tests, which confirms the correlation between strong echo and disease severity^[3]However, the current research evidence is insufficient, and there are few related studies using TCS for follow-up. Therefore, in order to clarify the relationship between SN strong echo and disease progression, we performed TCS examination and clinical characteristics evaluation in PD patients, and performed dynamic follow-up observation to analyze the correlation between SN strong echo changes with S/M as the main reference index and clinical symptom progression.

A 61-year-old female developed right upper abdominal pain for 10 days without obvious trigger. Ultrasound in a local hospital showed multiple liver occupation. She was admitted to Sino-Japanese Friendship Hospital of Jilin University for further treatment. After admission, all indexes of liver function and tumor markers such as alpha-fetoprotein (AFP) were normal in the laboratory. Conventional ultrasound showed that the left and right lobes of the liver were enlarged, the caudate lobe was not large, full in shape, rounded and blunt in edge, and the parenchyma echoed was uneven. The patchy echoic areas were diffusely distributed in the liver, without obvious boundaries, showing map-like changes, and no definite localized mass was found. The portal vein and intrahepatic branches are not wide, the blood flow is full, the flow rate is 12 cm/s, the three hepatic veins are not wide, compressed and slightly narrow, the flow rate is not fast (excluding Budd-Chiari syndrome), the gallbladder wall is not thick, the spleen is not large, and there is no ascites. It was suggested that the liver was enlarged and showed diffuse damaging changes (Figure 1，Figure 2)。 CT and enhanced scans showed uneven density of liver parenchyma, diffuse patchy low density shadows, patchy abnormal enhancement shadows in portal and delayed phases, and no obvious enhancement in arterial phases. It suggests heterogeneous fatty liver and diffuse intrahepatic changes. After that, the patient came to the ultrasound department for contrast enhancement, which showed that the hepatic parenchyma showed uneven enhancement in the arterial phase, portal phase and delayed phase, and multiple low-enhancement areas were visible. Combined with the changes of conventional ultrasound, the possibility of hepatic sinusoidal obstruction sydrome (HSOS) was considered (Figure 3，Figure 4)。 Ultrasound-guided liver tissue biopsy was performed. Under microscope, the hepatic sinus was highly dilated, some sinus endothelial cells were degenerated, and hepatocytes were atrophied. No definite malignant tumor was found in histology, and the pathology considered hepatic sinus obstruction syndrome. After effective treatment, the clinical symptoms disappeared and the patient was allowed to be discharged.

Rheumatoid arthritis (RA) is a systemic chronic inflammation characterized by synovial inflammation and progressive destruction of articular cartilage and bone. Immune imbalance of helper T cells 17 (Th17 cells) and regulatory T cells (Treg cells) is involved in the pathogenesis of RA: Th17 cells can produce inflammatory factors such as interleukin (IL) -17, which lead to synovial inflammation, articular cartilage and bone destruction; The function of Treg cells mainly lies in maintaining autoimmune tolerance and negatively regulating inflammatory factors to prevent the occurrence of chronic inflammation^[1]。 The study found a decrease in the number or dysfunction of Treg cells and a relative increase in Th17 cells in peripheral blood and target organs (synovium) in RA patients. In the field of oncology, in addition to IL-2 as an earlier anti-tumor drug, IL-15 as a member of the IL-2 family has also begun to become a new anti-tumor drug^[2,3]。 Similarly, in the field of autoimmune diseases, IL-15 and-2 have previously been considered to be pro-inflammatory factors^[4,5]Recent studies have found that low-dose IL-2 can promote Treg cell proliferation in RA patients^[6], inhibiting the proliferation and differentiation of Th17 cells, which is beneficial to controlling inflammation-mediated joint destruction^[7]。 Moreover, various regulatory pathways of IL-15 on Th17 cells and Treg cells have been gradually explored. When IL-2 is deficient, IL-15 can also increase the number of Treg, and may inhibit Th17 cell proliferation and IL-17 secretion, thereby alleviating the inflammatory response. In this article, the recent research progress on the effect of IL-15 on Th17 and Treg cells in RA is reviewed below.

Epilepsy is a common neurological disorder, which is characterized by repeated hypersynchronous firing activity of neurons without obvious trigger^[1]。 Drug therapy is still the first choice, but more than one third of epilepsy patients cannot effectively control seizures with existing antiepileptic drugs, thus developing drug-refractory epilepsy^[2]。 focal cortical dysplasia (FCD) is the most important pathological type of epileptogenic tissue in patients with drug-refractory epilepsy^[3]It is also considered to be one of the main causes of drug-refractory epilepsy^[4,5,6,7]。 Therefore, exploring the neuroelectrophysiological mechanism of FCD-induced epilepsy is extremely important for developing novel therapeutic strategies for refractory epilepsy caused by FCD.

Metastasis-associated in colon cancer 1 (MACC1) is a gene of Stein et al.^[1]Differentially expressed genes discovered in 2009 through a genome-wide search of primary and metastatic colon cancer, which can promote colorectal cancer metastasis, hence the name. Compared with normal tissues (colon mucosa, liver) or adenomas, the expression of MACC1 was significantly upregulated in malignant tissues (colon cancer at all stages and liver and lung metastases). In recent years, many literatures have reported about the abnormally high expression of MACC1 in various cancers and its potential application value in cancer occurrence, development and prognosis. This article reviews the results of the current research progress of MACC1 in cancer.