多巴胺转运体SPECT显像评估帕金森病严重程度的研究

目的本研究探讨显像评估帕金森病严重程度的意义.方法对15例对照者和30例帕金森病患者(根据Hoehn-Yahr分级分为早期组18例,中晚期组12例)行99mTc-TRODAT-1 DAT SPECT断层显像,注射示踪剂2～3 h后采集图像,勾画出感兴趣区(双侧纹状体和枕叶),计算机自动计算感兴趣区的放射性计数,最后测算出纹状体与枕叶部位的放射性计数比值和非对称性指数,并进行比较分析.结果对照组特异性放射性计数比值是0.58±0.16(左侧)、0.56±0.32(右侧),早期帕金森病组特异性放射性计数比值为0.40±0.33(症状对侧或症状严重肢体对侧)、0.51±0.12(症状同侧),中晚期帕金森病组特异性放射性计数比值为0.23±0.18(症状严重肢体对侧)、0.40±0.17(症状同侧);对照组非对称性指数是5.12±0.48,早期帕金森病组为9.05±14.61,中晚期组为20.67±14.2,3组间比较均有显著性差异(P＜0.05).结论多巴胺转运体99mTc-TRODAT-1 SPECT显像有助于帕金森病严重程度的判断.     

99Tcm-TRODAT-1 SPECT与131I-epideprideSPECT显像对早期帕金森病人的临床应用价值

目的探讨脑多巴胺转运体（DAT）^99Tc^m-TRODAT-1 SPECT显像与多巴胺D2受体（D2R）^131I-epidepride SPECT显像在早期帕金森病（PD）中的临床应用价值。方法10例正常对照者及46例早期未经替代治疗的PD患者分别接受脑DAT ^99Tc^m-TRODAT-1 SPECT与多巴胺D2R ^131I-epidepride SPECT断层显像，利用感兴趣区技术计算纹状体与枕叶、额叶的放射性比值（ST-OC／OC和ST-FC／FC）。结果PD患者起病肢体对侧脑DAT比值ST-OC／OC和ST-FC／FC比同侧均降低，双侧ST-OC／OC较对照组均降低。PD患者起病肢体对侧脑D2R比值ST-OC／OC和ST-FC／FC比同侧均增高。PD患者起病肢体对侧脑DAT比值ST-OC／OC与患者病程呈负相关，起病肢体对侧脑D2R比值ST-OC／OC与患者年龄及UPDRS运动评分呈负相关。结论人脑DAT ^99Tc^m-TRODAT-1 SPECT显像与D2R ^131I-epidepride SPECT显像均有助于PD的早期诊断及病情监测。     

^99mTc-TRODAT-1 SPECT多巴胺转运体显像在诊断早期帕金森病中的意义

目的探讨99mTc-TRODAT-1 SPECT多巴胺转运体(DAT)显像在诊断早期帕金森病(PD)中的意义.方法对62例早期PD、12例晚期PD及10名正常人进行99mTc-TRODAT-1 SPECT 基底节DAT显像,选取纹状体区和小脑为感兴趣区,计算两者的放射性比值,比较3组间该比值的差异,并分析早期PD患者DAT放射性结合率与H&Y分级及UPDRS评分之间的相关性.结果PD患者基底节99m Tc-TRODAT-1摄取率显著降低,早期PD患者病变较重肢体对侧纹状体放射性摄取率较同侧纹状体显著下降.PD患者纹状体区放射性摄取率与PD患者的H&Y分级呈负相关,而与UPDRS Ⅱ、Ⅲ评分无相关性.结论99mTc-TRODAT-1 SPECT基底节 DAT显像可用于临床早期PD的诊断.     

多巴胺转运体显像对特发性震颤与早期帕金森病的鉴别诊断价值

目的探讨多巴胺转运体(DAT)显像对特发性震颤(ET)、早期帕金森病(PD)鉴别诊断的价值.方法以99mTc-2β-[N,N'-双(2-巯乙基)乙撑二胺基]甲基-3β-(4-氯苯基)托烷(99mTc-TRODAT-1)为显像剂,用单光子发射计算机断层扫描(SPECT)对8例姿势性震颤(PT)患者,5例姿势性震颤伴静止性震颤(PT+RT)患者、12例早期PD(H-Y I级)患者进行DAT显像.结果与PT组相比,PT+RT组两侧纹状体(ST)与枕叶(OC)的ST/OC均值略高,但无显著性差异;早期PD组ST/OC均值显著性降低.PT+RT组两侧ST/OC均值明显高于早期PD组患肢对侧,但与其同侧无显著性差异.结论PT伴RT的ET患者存在轻度多巴胺神经元的缺失,99mTc-TRODAT-1 SPECT DAT显像对ET和早期PD有鉴别诊断的价值.     

~(99m)Tc-TRODAT-1 SPECT多巴胺转运体显像对帕金森病早期诊断的价值

目的　探讨99mTc TRODAT 1SPECT多巴胺转运体 (dopaminetransporter,DAT)显像对帕金森病 (PD)早期诊断的价值。方法　对 9例PD患者 ,2例可疑的PD患者 ,18例健康自愿者行99mTc -TRODAT-1SPECTDAT断层显像 ,利用感兴趣区技术测定纹状体与小脑部位DAT比值。结果　单侧症状的PD患者起病肢体对侧纹状体DAT特异性摄取为 (1 32± 0 0 3) ,同侧纹状体DAT特异性摄取为 (1 36± 0 0 4) ,两者相比有显著性差异。单侧症状的PD患者与年龄、性别相匹配的正常人相比有显著性的降低。结论　99mTc TRODAT 1SPECTDAT显像有助于PD的早期诊断     

多巴胺转运体显像对老年人帕金森病早期诊断价值的研究

目的 :探讨99mTc TRODAT 1SPECT多巴胺转运体 (DAT)显像对老年帕金森病 (PD)早期诊断的价值。方法 :对 2 9例老年PD患者 ,12例老年健康志愿者行99mTc TRODAT 1SPECTDAT断层显像 ,利用感兴趣区技术测定纹状体与小脑部位DAT比值。结果 :老年早期PD患者 (Hoehn Yahr分级Ⅰ级 )起病肢体对侧纹状体DAT特异性摄取 (左侧 :1 2 5± 0 10 ,右侧 :1 3 2± 0 0 6) ,与正常老年人 (左侧 :1 74± 0 13 ,右侧 :1 69± 0 0 8)相比 ,有显著性的降低 (P <0 0 1)。结论 :99mTc TRODAT 1SPECTDAT显像有助于老年PD的早期诊断。     

99mTc-TRODAT-1脑SPECT显像对帕金森病诊断

目的 :探讨99mTc TRODAT 1SPECT多巴胺转运体 (dopaminetransporter,DAT)显像对帕金森病 (Parkinson’sdisease ,PD)早期诊断的价值。方法 :对 7例早期PD患者、3例中晚期PD患者和 2例正常对照者行99mTc TRODAT 1SPECT脑断层显像 ,利用感兴趣区技术测定纹状体 /额叶 (striuatum/frontalcortex ,ST/FC)和纹状体 /枕叶 (striuatum/occipitalcortex ,ST/OC)的比值 ,表示纹状体的DAT活性。结果 :早期PD患者起病肢体对侧的ST/FC(1 10 6± 0 0 41)和ST/OC(1 12 3± 0 0 45 )比起病肢体同侧的ST/FC(1 2 47± 0 0 63 )和ST/OC(1 2 46± 0 0 3 4)明显降低 (两者P值均 <0 0 1)。早期PD患者起病肢体同侧的ST/FC和ST/OC比正常对照者显著降低 ,比中晚期PD患者起病肢体同侧的ST/FC和ST/OC显著增高。结论 :99mTc TRODAT 1脑SPECT显像有助于PD的早期诊断     

脑多巴胺转运体SPECT鉴别帕金森病与血管性帕金森综合征

目的:多巴胺转运体(Dopamine transporter,DAT)99mTc-TRODAT-1SPECT显像有利于客观评价中枢多巴胺神经元的数量及其功能,本研究探讨DAT显像评估鉴别帕金-森病(PD)与血管性帕金森综合征(VP)的意义。方法:对临床确诊的51例PD患者和12例VP患者进行99mTc-TRODAT-1DATSPECT断层显像。注射示踪剂2-3h后采集图像,勾画出感兴趣区(双侧纹状体和枕叶),计算机自动计算感兴趣区的放射性计数,最后测算出纹状体与枕叶部位的放射性计数比值和非对称性指数并进行比较分析。结果:PD组特异性放射性比值是症状对侧0.38±0.18.症状同侧0.46±0.22,两侧差异有显著性(P<0.05)。VP组特异性放射性比值是左侧0.58±0.16.右侧0.56±0.32,两侧无显著性差异。VP组非对称性指数是6.72±10.53,PD组19.31±16.15,特异性放射性比值和非对称性指数组间比较均有显著性差异(P<0.05)。结论:多巴胺转运体99mTc-TRODAT-1SPECT显像有助于PD与VP的鉴别。     

^99Tc^m-TRODAT-1 SPECT脑显像在早期帕金森病患者显像研究

目的探讨99Tcm-2β-[N,N′-双(2-巯乙基)乙撑二胺基]甲基-3β-(4-氯苯基)托烷(TRODAT-1) 多巴胺转运蛋白(transporter,DAT)显像在帕金森病(PD)早期诊断中的应用价值.方法对50例早期PD患者和12例健康对照者行脑DAT 99Tcm-TRODAT-1 SPECT断层显像.利用感兴趣区技术测定纹状体与小脑部位DAT比值.结果健康对照组双侧纹状体摄取差异无显著性.早期PD 患者双侧纹状体与小脑部位比值分别较健康对照组明显降低(P均＜0.001).起病肢体对侧纹状体与小脑部位比值比起病肢体同侧纹状体与小脑部位比值明显降低(P均＜0.001).结论脑99Tcm-TRODAT-1 SPECT显像有助于PD的早期诊断.     

4000/丘脑底核脑深部电刺激治疗帕金森病的功能显像实验研究

目的：通过PET、SPECT功能显像研究探讨丘脑底核(subthalamic nucleus ,STN) 脑深部电刺激（deep brain stimulation,DBS）对猴偏侧帕金森病（Parkinson’s disease, PD）模型纹状体区代谢的影响。方法：采用单侧颈内动脉注入1-甲基-4-苯基-1,2,3,6四氢吡啶(1-methy-4-phenyl-1,2,3,6-tetrahydropy-rindine, MPTP)建立猴偏侧PD模型,行右侧STN脑深部电极植入术,给予慢性高频电刺激。在刺激前及刺激后1、3个月分别行SPECT、PET功能显像测定。结果：PD模型猴在慢性高频电刺激下对侧肢体僵硬明显缓解,活动增多,步态稳定。SPECT检查显示注药侧纹状体区的多巴胺转运体（DAT）特异摄取率在给予有效刺激后较术前增高,多巴胺D2受体（D2R）的特异摄取率逐渐下降至接近正常侧水平。PET检查提示在电极植入术前右侧基底节区放射性摄取浓度较左侧偏低,给予慢性高频电刺激1个月后复查提示右侧放射性摄取浓度稍高于左侧,但双侧均较低, 3个月时复查右侧放射性摄取浓度明显高于左侧。结论：STN DBS可有效的改善偏侧猴PD模型症状。通过刺激后纹状体区DAT的升高, D2R逐渐下降以及糖代谢的提高提示在给予STN核有效慢性高频电刺激可能提高了纹状体区的代谢活性。     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

Modelling of movement of the lamprey: Control of oscillators

This article discusses the control methods of the central pattern generator (CPG). First a control model of the CPG is presented using 2 oscillators, and we suggest that phasic modulation to the CPG by means of phasic information is effective for controlling the phase difference between oscillators. Next, two models for controlling the CPG of a lamprey are proposed. One model describes a control system from the brain stem, in which the reticulospinal neurons control the CPG by receiving feedback signals and sending control signals to the neck region of the CPG. The other is a model for learning an localized control system to generate a desired motor pattern. By means of these models, a role of the efference copy is suggested.     

广西农村壮族妇女精神分裂症患者生活质量状况调查

目的研究农村壮族妇女精神分裂症患者的生活质量及影响因素。方法前瞻性的队列研究。采用随机分层抽样法分为农村壮族妇女精神分裂症组、农村汉族妇女精神分裂症组、农村正常妇女对照组,应用“世界卫生组织生存质量测定报告”(WHOQOL-100)及PANSS量表调查其生活质量和疾病的严重程度。结果农村壮族妇女精神分裂症患者生活质量明显低于农村汉族妇女精神分裂症患者,影响其生活质量的相关因素是生活环境及精神支柱/个人信仰。结论经济贫困、环境条件、缺乏有效的医疗服务和社会保障是农村壮族妇女精神分裂症患者生活质量低的关键。因此,建立农村壮族社区精神卫生服务网络势在必行。     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

利培酮对精神分裂症患者生活质量的影响

目的：比较利培酮与氟哌啶醇对精神分裂症患者生活质量的影响。方法：对门诊72例服用氟哌啶醇及74例服用利培酮的精神分裂症患者用生活质量综合评定问卷（GQOLI）、阳性与阴性症状量表（PANSS）、副反应量表（TESS）进行评定。结果：利培酮组患者治疗后生活质量有所提高，而氟哌啶醇组患者生活质量有所下降。结论：利培酮治疗有利于患者提高生活质量。