三叉神经痛患者半月节射频热凝术前后静息态fMRI的变化

目的 利用功能MR研究三叉神经痛患者半月节射频热凝术(PRT)前后脑功能局部一致性(ReHo)变化。方法 对31例接受PRT手术的三叉神经痛患者在术前1周及术后6个月分别进行MR扫描,采集其大脑结构及静息态功能图像;同时记录患者的疼痛视觉模拟量表(VAS)评分、面部麻木程度及患病时间。比较患者手术前后全脑ReHo值出现显著变化的脑区,再将这些脑区的平均ReHo值与临床观察指标进行相关分析。结果 与术前相比,患者术后右侧梭状回(FG)和双侧前扣带回(ACC)的ReHo值显著增高(P均0.05),而左侧顶下小叶(IPL)、右侧距状回、右侧颞中回(MTG)、左侧中央后回(PoCG)以及左侧岛叶的ReHo值显著降低(P均0.05)。左侧PoCG的ReHo值与手术前后VAS评分呈正相关,术前右侧MTG的ReHo值与手术前后VAS的变化值呈负相关。结论 PRT术后多个脑区的Re-Ho出现显著变化,这些区域与痛觉感知、情感表达及情绪体验密切相关,其中左侧PoCG具有作为靶点判断疼痛部位及评估疼痛强度的潜在价值。     

药品标准物质基本特性与规范生产有关质量管理要求

目的：为规范药品标准物质的研制生产提供参考。方法：结合ISO导则34,根据药品标准物质的基本特性,探讨在全面质量管理新形势下,药品标准物质在均匀性、稳定性、准确性和程序合规性等几方面应遵循的有关要求。结果与讨论：规范和完善药品标准物质生产技术要求和质量管理,是标准物质量值准确、稳定、可靠的保障。     

采用多条溶出曲线评价异烟肼片的质量

目的：研究国内外异烟肼片在4种溶出介质中的溶出曲线,以评价该制剂质量。方法：浆法,50 r·min^-1,分别在pH1.2盐酸溶液、pH4.5醋酸盐缓冲液、pH6.8磷酸盐缓冲液和水中测定溶出曲线,比较了各企业样品的溶出均一性,并用单点法或f₂因子法进行了比较分析。结果：美国山德士样品批内批间溶出均一性均较好,国内企业溶出均一性参差不齐。以山德士样品作为参比制剂,A、B、C、F、G企业样品在4种溶出介质中均与参比制剂溶出过程相似;D、E、H企业样品在部分介质中与参比制剂溶出过程相似。结论：国内部分厂家异烟肼片生产工艺不稳定,各企业产品质量存在差异,亟待提高。     

慢性腰痛(cLBP)针刺“同病异治”效应的脑网络影像学的客观评价

目的 本研究旨在诊断病(慢性腰痛)基础上进行中医辨证(肾虚和非肾虚慢性腰痛),并观察不同证型针刺治疗前后脑活动间的差异性,用以研究“同病异治”理论。方法 采用静息态功能性磁共振技术经不同针刺方案对由16例肾虚腰痛患者和16例非肾虚腰痛患者组成的32例慢性腰痛组进行治疗,对25例年龄和性别匹配的健康对照组进行扫描,并用局部一致性(regional homogeneity,ReHo)分析法对健康对照组和慢性腰痛组(包括肾虚和非肾虚)分别进行分析,采用视觉模拟评分表评估患者临床症状。结果 相对健康对照组,慢性腰痛患者ReHo值增加的区域主要在于双侧颞下回、左侧颞上回、左顶上叶等;ReHo值下降的区域主要在双侧中央后回、双侧额上回、右侧辅助运动区等。相比非肾虚腰痛组,肾虚腰痛组患者ReHo值增加的区域主要位于左侧颞上回、右侧颞下回、右侧颞中回、右侧楔叶、右侧顶上回等,无ReHo值显著下降的脑区。经过分型治疗后,非肾虚腰痛组和肾虚腰痛组的脑ReHo图均与健康对照组相接近,3组间差异无统计学意义。结论 不同的中医证型慢性腰痛会引起脑区不同的活动变化,脑网络能够反映“同病异证”之间的差异。不同取穴方案均能改善疼痛症状,且改善程度间无明显差异。     

胃俞募配穴针刺对功能性消化不良患者静息态脑功能局部一致性和胃电图的影响

目的 观察胃俞募配穴与非经非穴针刺对功能性消化不良(FD)患者静息态脑功能局部一致性(ReHo)和胃电图(EGG)的影响,探讨胃俞募配穴针刺调节FD患者胃运动效应的中枢作用机制。方法 将37例FD患者随机分为配穴组（19例）和非穴组（18例）,分别予以双侧胃俞+中脘、同节段非经非穴针刺治疗,同时选取19名健康人作为对照组。治疗前后分别对2组患者进行静息态脑功能磁共振成像( rs-fMRI)扫描和EGG检测,观察2组患者针刺治疗前后各脑区ReHo及EGG变化情况,并对差异脑区ReHo变化与胃运动变化进行相关性分析。结果 治疗后,①配穴组EGG振幅、频次均增高（P＜0.05~0.01）。非穴组EGG振幅增高（P＜0.01）,频次较治疗前未见明显差异（P>0.05）。②与对照组相比,FD患者小脑、额叶、扣带回、脑岛、颞叶等脑区内不同区域ReHo值异常。配穴组针刺后FD患者梭状回、后扣带回等脑区ReHo值增高（P＜0.05）,海马、额中回等脑区ReHo值降低（P＜0.05）。非穴组针刺后FD患者小脑、额上回、额中回、楔前叶、角回等脑区ReHo值发生变化。③相关性分析可见:配穴组颞上回、颞极颞中回、后扣带回、额中回、海马与EGG变化相关。非穴组各差异脑区ReHo值变化与EGG变化无显著相关。结论 胃俞募配穴针刺可引起FD患者多个脑区ReHo值变化且其对胃运动调节效应优于非穴,海马、后扣带回等脑区可能参与了针刺对胃运动的调节。胃俞募配穴针刺可能通过对边缘系统、胃肠感觉矩阵相关脑区的良性调控而发挥对FD患者胃运动功能的调节作用。      

Altered regional homogeneity and connectivity in cerebellum and visual-motor relevant cortex in Parkinson's disease with rapid eye movement sleep behavior disorder

ObjectiveRapid eye movement sleep behavior disorder (RBD) frequently occurs in Parkinson's disease (PD), however, the exact pathophysiological mechanism underlying its occurrence is not clear. In this study, we explored whether there is abnormal spontaneous neuronal activities and connectivity maps in some brain areas under resting-state in PD patients with RBD.MethodsWe recruited 38 PD patients (19 PD with RBD and 19 PD without RBD), and 20 age- and gender-matched normal controls. We used resting-state functional magnetic resonance imaging (RS-fMRI) to analyze regional homogeneity (ReHo) and functional connectivity (FC), and further to reveal the neuronal activity in all subjects.ResultsCompared with the PD without RBD patients, the PD with RBD patients showed a significant increase in regional homogeneity in the left cerebellum, the right middle occipital region and the left middle temporal region, and decreased regional homogeneity in the left middle frontal region. The REM sleep behavioral disorders questionnaire scores were significantly positively correlated with the ReHo values of the left cerebellum. The functional connectivity analysis in which the four regions described above were used as regions of interest revealed increased functional activity between the left cerebellum and bilateral occipital regions, bilateral temporal regions and bilateral supplementary motor area.ConclusionThe pathophysiological mechanism of PD with RBD may be related to abnormal spontaneous neuronal activity patterns with strong synchronization of cerebellar and visual-motor relevant cortex, and the increased connectivity of the cerebellum with the occipital and motor regions.     

同质化管理在降低新生儿红臀发生率中的应用

目的探讨同质化护理服务在降低住院新生儿红臀发生率中的应用。方法选取本科住院新生儿921名作为研究对象,2017年12月—2018年2月的住院新生儿实施常规护理,2018年3月—2018年5月的住院新生儿实施同质化管理,比较实施前和实施后新生儿红臀的发生率及红臀严重程度均明显降低,护士发现红臀原因的能力及家属满意度提升。结果实施后比实施前红臀的发生率及严重程度明显降低,家属满意度以及护理人员及时发现红臀原因较实施前得到了提高,前后差异均存在统计学意义,P<0.05。结论同质化管理能降低红臀发生率及减轻红臀严重程度,提高护理质量。     

Brain Activity of Benzoate,a D-Amino Acid Oxidase Inhibitor,in Patients With Mild Cognitive Impairment in a Randomized,Double-Blind,Placebo Controlled Clinical Trial

BackgroundCurrent anti-dementia drugs cannot benefit mild cognitive impairment (MCI). Sodium benzoate (a D-amino acid oxidase [DAO] inhibitor) has been found to improve the cognitive function of patients with early-phase Alzheimer’s disease (mild Alzheimer’s disease or MCI). However, its effect on brain function remains unknown. This study aimed to evaluate the influence of benzoate on functional magnetic resonance imaging in patients with amnestic MCI.MethodsThis was a 24-week, randomized, double-blind, placebo-controlled trial that enrolled 21 patients with amnestic MCI and allocated them randomly to either of 2 treatment groups: (1) benzoate group (250–1500 mg/d), or (2) placebo group. We assessed the patients’ working memory, verbal learning and memory, and resting-state functional magnetic resonance imaging and regional homogeneity (ReHo) maps at baseline and endpoint.ResultsResting-state ReHo decreased in right orbitofrontal cortex after benzoate treatment but did not change after placebo. Moreover, after benzoate treatment, the change in working memory was positively correlated with the change in ReHo in right precentral gyrus and right middle occipital gyrus; and the change in verbal learning and memory was positively correlated with the change in ReHo in left precuneus. In contrast, after placebo treatment, the change in working memory or in verbal learning and memory was not correlated with the change in ReHo in any brain region.ConclusionThe current study is the first to our knowledge to demonstrate that a DAO inhibitor, sodium benzoate herein, can alter brain activity as well as cognitive functions in individuals with MCI. The preliminary finding lends supports for DAO inhibition as a novel approach for early dementing processes.