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目的 探讨事件相关电位P300在颅脑损伤患者认知功能障碍评定中的应用价值。方法 选取2021年1月-9月在绵阳市第三人民医院神经外科保守治疗、并符合诊断标准的颅脑损伤患者36例作为研究组,同期在医院其他患者家属和护工中招募健康对照组共36名。采用Oddball范式对受试者进行事件相关电位P300检测,采用蒙特利尔认知评估量表(MoCA)和简易精神状态评价量表(MMSE)评定受试者的认知功能。比较两组P300的潜伏期、波幅以及MoCA和MMSE评分,比较P300潜伏期、MoCA和MMSE对颅脑损伤患者认知功能障碍的检出率。结果 研究组MoCA和MMSE评分均低于对照组[(18.08±4.29)分vs.(27.36±1.20)分,(22.53±3.54)分vs.(28.11±1.09)分,t=-12.510、-9.041,P均<0.05];研究组P300潜伏期高于对照组[(406.08±26.95)ms vs.(367.08±22.50)ms,t=6.665,P<0.05],波幅低于对照组[(7.76±0.90)μV vs.(9.87±0.99)μV,t=-9.459,P<0.05]。在研究组中,P300潜伏期阳性检出率和MoCA对认知功能障碍的检出率均高于MMSE对认知功能障碍的检出率(χ2=5.675、7.604,P均<0.05)。结论 事件相关电位P300或许可作为评估颅脑损伤患者认知功能障碍的客观临床指标。  相似文献   
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肾功能异常指多种原因,包括肾脏疾病或非肾脏疾病引起的血肌酐和尿素氮升高,伴或不伴水肿、电解质紊乱、高血压等多系统、脏器累及症状。儿科临床上很大一部分患者以肾功能异常为首发表现。笔者就儿童肾功能异常的诊断思路进行综述,提出儿童肾功能异常的诊断应该遵循病程和肾功能分期、定位、定因、并发症评估的程序,其中特别建议无论急性或慢性肾功能异常,肾功能分级均采用目前慢性肾脏病的国际分级标准,病因方面儿童肾功能异常仍以遗传性疾病最为常见。先天性肾脏和尿路畸形只是一种形态学诊断,其病因也可能仍以遗传因素为主。  相似文献   
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The coronavirus disease 2019 (COVID-19) pandemic continues to be a global problem with over 438 million cases reported so far. Although it mostly affects the respiratory system, the involvement of extrapulmonary organs, including the liver, is not uncommon. Since the beginning of the pandemic, metabolic com-orbidities, such as obesity, diabetes, hypertension, and dyslipidemia, have been identified as poor prognostic indicators. Subsequent metabolic and lipidomic studies have identified several metabolic dysfunctions in patients with COVID-19. The metabolic alterations appear to be linked to the course of the disease and inflammatory reaction in the body. The liver is an important organ with high metabolic activity, and a significant proportion of COVID-19 patients have metabolic comorbidities; thus, this factor could play a key role in orchestrating systemic metabolic changes during infection. Evidence suggests that metabolic dysregulation in COVID-19 has both short- and long-term metabolic implications. Furthermore, COVID-19 has adverse associations with metabolic-associated fatty liver disease. Due to the ensuing effects on the renin-angiotensin-aldosterone system and ammonia metabolism, COVID-19 can have significant implications in patients with advanced chronic liver disease. A thorough understanding of COVID-19-associated metabolic dysfunction could lead to the identification of important plasma biomarkers and novel treatment targets. In this review, we discuss the current understanding of metabolic dysfunction in COVID-19, focusing on the liver and exploring the underlying mechanistic pathogenesis and clinical implications.  相似文献   
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This systematic review aims to summarize cognitive reserve (CR) evaluation approaches and to examine the role of seven selected modifiable lifestyle factors (diet, smoking, alcohol consumption, physical activity, cognitive leisure activity, sleep, and meditation) in mitigating the impacts of age- or disease-related brain changes on cognition. Eighteen population-based English empirical studies were included. We summarize the study designs and identify three CR models that were broadly used in these studies, including a residual model assessing lifestyle factors in relation to unexplained variance in cognition after accounting for brain markers, a moderation model testing whether lifestyle factors moderate the relationship between brain status and cognition, and a controlling model examining the associations between lifestyle factors and cognition when controlling for brain measures. We also present the findings for the impact of each lifestyle factor. No studies examined diet, sleep, or meditation, and only two studies focused on smoking and alcohol consumption each. Overall, the studies suggest lifestyle activity factors (physical and cognitive leisure activities) may contribute to CR and attenuate the damaging impact of brain changes on cognition. Standardized measurements of lifestyle factors and CR are needed, and mechanisms underlying CR need to be further addressed as well.  相似文献   
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Frailty is a complex condition that emerges from dysregulation in multiple physiological systems. Increasing evidence suggests the potential role of age-related energy dysregulation as a key driver of frailty. Exercise is considered the most efficacious intervention to prevent and even ameliorate frailty as it up-tunes and improves the function of several related systems. However, the mechanisms and molecules responsible for these intersystem benefits are not fully understood. The skeletal muscle is considered a secretory organ with endocrine functions that can produce and secrete exercise-related molecules such as myokines. These molecules are cytokines and other peptides released by muscle fibers in response to acute and/or chronic exercise. The available evidence supports that several myokines can elicit autocrine, paracrine, or endocrine effects, partly mediating inter-organ crosstalk and also having a critical role in improving cardiovascular, metabolic, immune, and neurological health. This review describes the current evidence about the potential link between energy metabolism dysregulation and frailty and provides a theoretical framework for the potential role of myokines (via exercise) in counteracting frailty. It also summarizes the physiological role of selected myokines and their response to different acute and chronic exercise protocols in older adults.  相似文献   
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Alzheimer’s disease (AD) is a multifactorial neurodegenerative disorder. Cardiometabolic and genetic risk factors play an important role in the trajectory of AD. Cardiometabolic risk factors including diabetes, mid-life obesity, mid-life hypertension and elevated cholesterol have been linked with cognitive decline in AD subjects. These potential risk factors associated with cerebral metabolic changes which fuel AD pathogenesis have been suggested to be the reason for the disappointing clinical trial results. In appreciation of the risks involved, using search engines such as PubMed, Scopus, MEDLINE and Google Scholar, a relevant literature search on cardiometabolic and genetic risk factors in AD was conducted. We discuss the role of genetic as well as established cardiovascular risk factors in the neuropathology of AD. Moreover, we show new evidence of genetic interaction between several genes potentially involved in different pathways related to both neurodegenerative process and cardiovascular damage.  相似文献   
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认知康复是教育康复体系中的重要组成部分,实训活动作为实现认知康复实践教学目标的重要手段和形式,可帮助学生逐渐从理论过渡到临床实践,是提升教育康复人才专业素养和技能的关键过程。本文运用ICF理念与应用方法,根据认知康复总体目标与原则,构建ICF框架下认知康复实训体系的规范化流程与内容,主要包括填写患者基本信息、认知功能障碍筛查、认知功能评估、认知康复计划制订、实施认知康复与认知康复效果评价6部分,其对于完善认知康复教学体系、提升认知康复实训教学质量、培养合格的认知康复人才、促进教育康复行业发展新局面具有借鉴意义。  相似文献   
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