左乙拉西坦治疗小儿癫痫的影响分析

目的研究左乙拉西坦治疗小儿癫痫的疗效以及对智力的影响。方法在本院2017年4月-2019年5月收治的小儿癫痫患儿中选取74例开展研究,按照随机数表法分两组观察组和对照组,观察组37例,对照组37例,对照组采用奥卡西平进行治疗,观察组采用左乙拉西坦进行治疗,对比观察组与对照组组的治疗总有效率和智力评分变化。结果观察组与对照组比较,观察组的治疗总有效率较高,智力评分明显较高,两项对比差异有统计学意义(P <0.05)。结论左乙拉西坦治疗小儿癫痫有较好的治疗效果,治疗总有效率较高,且对患儿的智力有明显的改善作用,在实际临床小儿癫痫的治疗中具有较高的运用价值。     

Neuronal plasticity in memory and learning abilities: Theoretical position and selective review

Neural plasticity of modality-nonspecific and modality-specific memory and learning abilities pertains to fluid intelligence and crystallized intelligence, respectively. The limbic system with the novelty neurons of the hippocampus interacts with the prefrontal cortex optimization of the orienting reflex and voluntary attention. Brain-derived neurotrophic factor produced by novelty neurons of the hippocampus contributes to long-term memory formation and improves learning abilities in a wide range of disciplines. Synergistic combination of stimulation with “analytical-specific visual perceptual patterns” and “optimally high” physiological activation of the bilateral electrodermal system optimizes the limbic system and prefrontal cortex activity as demonstrated by enhanced prefrontal N450 ERPs to a memory workload paradigm. This is accompanied by improvements in auditory retention tasks, word memorization, higher school achievement and marks, and an amelioration of “analytical-specific perceptual skills” as measured by the Mangina-Test. Intracerebral ERPs to a memory workload paradigm contributed to the elucidation of limbic structures and neocortical sites involved in memory workload processes. The progressive degeneration of these same structures causes the gradual decline of memory functions observed in early Alzheimer's disease. Research findings indicate that ERPs elicited by a memory workload paradigm are sensitive markers for diagnosis, treatment and clinical follow-up of early Alzheimer's patients. In addition, ERPs provide objective measurement of cholinergic medication effects on cerebral functions involved in memory processes through neuropsychophysiological parameters.     

Intelligent dialogue based on statistical models of clinical decision-making

The independence Bayesian model has been used widely in computer programs designed to support clinical decision-making. A reasoning strategy has been developed to enable these programs to conduct clinically pertinent dialogue and explain their reasoning. It has been implemented in a program for the diagnosis of acute abdominal pain based on the Bayesian model of de Dombal et al. Several features of the dialogue design have been adopted from artificial intelligence research, including shared initiative and critiquing. The program adopts a flexible goal-driven strategy, attempting to confirm the clinician's diagnosis or rule out the likeliest alternative. Symptoms and signs are selected in order of their expected weights of evidence in favour of the hypothesized disease.     

补碘对7～12岁轻度碘缺乏病儿童脑功能及生长、发育的影响

通过半年对３５名７～１２岁轻度碘缺乏病儿童进行补碘，并与同龄、同地的正常儿童和缺碘未补碘儿童进行比较，以观察补碘对儿童脑功能及生长发育的影响。结果发现：①补碘可使儿童碘营养状况恢复正常，尿碘值由（８３．２±３．５）μｇ／Ｌ上升到（１６２．２±１．６）μｇ／Ｌ，血清Ｔ４、ＦＴ４Ｉ和ｒＴ３：也与正常儿童一致而与未补碘儿童有显著性差异（Ｐ＜０．０５）．②轻度碘缺乏病儿童智商低于正常儿童（Ｐ＜０．０１），补碘在一定程度上改善其智商水平。③轻度碘缺乏病及补碘未能明显影响儿童的生长发育，可能与儿童总营养水平较差有关。     

儿童羟基磷灰石义眼台植入的临床分析

目的:观察儿童羟基磷灰石义眼台植入的临床效果。方法:回顾性分析不同原因造成眼球摘除的31例患儿,其中男性 21例,女性 10例,年龄 3岁～14岁,平均 8.2岁,采用义眼台一期植入 20例,义眼台二期植入 11例,植入直径 18mm义眼台者 17例,植入 20mm义眼台者 14例。结果:31例患儿术后 1例结膜裂开,5例出现轻度上睑沟凹陷,随访 1年～8年,所有患者无感染、无排斥、无义眼台暴露,运动好,外观满意。结论:儿童患者应尽可能一期植入义眼台,采用巩膜包裹义眼台植入的 3岁～6岁患儿选择 18mm直径的义眼台,而 7岁～14岁患儿尽量接近成人选用 20mm直径的义眼台。注意手术操作、术后用药及护理可减少术后并发症。     

Does operational diagnosis of schizophrenia significantly impact intellectual deficits in psychotic disorders?

Background Evidence suggests that, as a group, patients with schizophrenia have intellectual deficits that may precede the manifestation of psychotic symptoms; however, how successfully intelligence tests are able to discriminate schizophrenia from other psychotic disorders has yet to be investigated in detail. Methods Using Wechsler Adult Intelligence Scale – Revised (WAIS‐R) data for 55 inpatients with schizophrenia and 28 inpatients with non‐schizophrenic psychotic disorders (NSPD) (schizophreniform disorder, brief psychotic disorder, delusional disorder, psychotic disorder due to a general medical condition, and psychotic disorders not otherwise specified), intelligence performance was compared between schizophrenia and NSPD and among different subtypes of schizophrenia. Results There were no significant differences in intelligence quotient (IQ), verbal IQ (VIQ) and performance IQ (PIQ) discrepancy, and subtest scores of WAIS‐R between the patients with schizophrenia and those with NSPD. These diagnostic groups were not discriminated well by any WAIS‐R variables. Schizophrenia patients with prominent negative symptoms, on the other hand, had a significantly larger IQ discrepancy (VIQ > PIQ) than those without prominent negative symptoms and NSPD patients. Intelligence performance in schizophrenia did not differ with respect to diagnostic subtypes and longitudinal courses. Conclusions The current study failed to show diagnostic usefulness of WAIS‐R in discriminating schizophrenia and other psychoses. A diagnosis of schizophrenia does not significantly impact intellectual deficits in psychotic disorders.     

A Biomechanical Double Sac (Pericardium-Pebax) for Specially Shaped Artificial Ventricles: A Computerized Study to Evaluate Its Mechanical and Volumetric Properties

Abstract: For original ovoid shaped artificial ventricles. a biomechanical double sac consisting of a biological sac (porcine pericardium) as the blood contact interface and a synthetic sac (Pebax 3533) as the mechanical support to assume systolic-diastolic dynamic constraints was conceived. The volumetric and mechanical properties were assessed with a three-dimensional modeling of Pebax sacs and computerized simulations of their systolic distortions for both right and left ventricular configurations. The stresses and strains of these sacs were represented as quantitative mappings for a maximum end-systolic state and were below the respective threshold values above which the Pebax material is jeopardized for permanent structure impairment. After fatigue tests applied on Pebax strips under the alleged working conditions of Pebax sacs, the material structure was unchanged and maintained its intrinsic mechanical properties. The theoretical maximum stroke volumes were 74.4 cm³ and 62.4 cm for the left and right ventricular configurations, respectively. With these mechanical and volumetric features, the biomechanical double sac concept was considered valid and could be provided for a consequent specific total artificial heart.     

不同类型高危儿早期干预的临床研究

目的 探索早期干预对窒息、高胆、早产三类高危儿智力发育改善的效果，寻找更合适的早期干预措施。方法 将三类高危儿分为干预组及对照组，同时随机选取正常对照组进行随访。干预组采用鲍秀兰教授“0～3岁”早期干预方案训练，各组均在6个月、1岁时分别采用婴幼儿智能发育量表(CDCC)进行智力发育测评，结果用MDI、PDI表示。结果 (1)6个月龄时MDI各干预组与对照组间有显著性差异，窒息组、早产组与正常组间亦有显著性差异；高胆组与正常组间无差异；PDI窒息组中干预组与对照组之间有显著差异(P＜0．01)，高胆组、早产组均无差异(P＞0．05)。(2)1岁时MDI和PDI结果一致，干预组与对照组间比较窒息组、高胆组有显著差异，早产组无差异；窒息组、高胆组干预组与正常组比较无差异，对照组和早产组与正常组比较均有显著差异(P＜0．01)。(3)所有干预组测评分值均高于对照组，6个月与1岁之间比较有显著差异，各观察组间比较有显著性差异(P＜0．01)。结论 三类高危儿早期干预效果差异较大，干预组均较对照组分值高，早期干预有改善智力发育的作用；三类高危儿中，窒息组、高胆组效果最好，均达到或超过正常水平。所有未干预组均不及正常水平；早期干预对足月高危儿效果显著，对早产儿欠佳，远期效果尚需进一步随访观察。