3.0T MRI诊断高血压性脑微出血的价值

目的比较MRI不同扫描序列检出高血压性脑微出血（CMBs）的能力。方法对215例高血压患者行颅脑常规MRI和梯度回波T2^＊加权（GRE T2^＊-WI）扫描，并对其中的21例行磁敏感加权成像（SWI）扫描，比较不同扫描序列检出CMBs的差异，以及分析CMBs在GRE T2^＊-WI上的分布。结果215例患者中，GRE T2^＊-WI检出的CMBs最多（112例，961个CMBs），其次为T2WI、DWI、T2 Flair和T1WI。在GRE T2^＊-WI上，脑不同部位CMBs的分布不同，以皮质-皮质下区最多，小脑最少。21例行SWI的患者中，SWI检出267个CMBs。结论在MRI检出高血压患者CMBs方面，GRE T2^＊-WI序列应作为首选，SWI是检出CMBs的辅助检查方法。     

三维时间飞跃法磁共振血管成像原始图像评估脑微出血病灶的应用价值

目的 研究三维时间飞跃法磁共振血管成像（three dimensional time-of-flight magnetic resonance angiography，3D-TOF MRA）原始图像评估脑内微出血病灶的应用价值。方法 收集269例高血压、缺血性卒中、短暂性脑缺血或既往原发性脑出血病患者。分别进行T2*加权梯度回波（T2* weighted gradient echo，T2*GRE）序列及3D-TOF MRA序列扫描，评估T2*GRE图像及3D-TOF MRA原始轴位图像显示的微出血病灶数量、部位及分级。结果 75例患者脑实质内存在微出血病灶，排除9例不符合标准者，剩余66例。T2*GRE成像共发现微出血病灶338个，1级50例，2级10例，3级6例；3D-TOF MRA序列原始图像显示微出血病灶242个，0级11例，1级40例，2级12例，3级3例。两种序列发现微出血病灶的比较差异有显著性（皮质和皮质下P=0.000、丘脑P=0.001、小脑P=0.039）；对基底节（P=0.581）和脑干（P=0.211）发现的微出血病灶之间的差异无显著性。结论 3D-TOF MRA原始图像可显示脑微出血灶。在无T2*GRE图像的情况下，观察3D-TOF MRA原始图像有助于了解及初步观察脑微出血情况     

脑微出血的影像学与脑卒中临床研究

目的：探讨脑微出血（CMBs）与脑卒中发生和发展之间的关系。方法：对脑出血50例（脑出血组）、腩梗死50例（脑梗死组）和非腩血管病患者30例（对照组）行常规磁共振序列加梯度回波T2^＊加权（GRE—T2^＊）检查，分别记录CMBs的发生例数、部位、数日，脑卒中部位，脑白质疏松情况和患者高血压、高血脂、糖尿病等资料。结果：CMBs发生率在腩出血组为76％，脑梗死组为36％，对照组为10％。CMBs的发生与高血压、脑卒中病史、年龄和脑白质疏松有关；与血脂和血糖无关。结论：CMBs在脑卒中患者中有较高的发生率，加强对CMBs的充分认识，对于提高脑卒中的防治有重要意义。     

3.0T磁共振磁敏感成像在脑出血性病变中的应用探讨

目的 探讨3.0T磁共振磁敏感加权成像(susceptibility weighted imaging,SWI)在颅脑出血性病变中的应用价值.方法 对临床疑有颅脑出血的56例患者进行检查.其中男32例,女24例.受检者年龄14～72岁,平均45.9岁.设备:飞利浦Achieva3.0T X-series 磁共振扫描仪.全部采用常规T1WI、T2WI、FLAIR、DWI及SWI扫描,有8例患者追加MRA检查.对各扫描序列显示的异常信号,尤其是出血灶的显示及出血灶大小、多少及病灶分布进行分析.同时对脑静脉分支显示进行后处理,以提高脑静脉的显示质量.结果 56例患者脑静脉分支均显示清楚.SWI显示22例有出血灶(22/56),T1WI显示8例有出血灶(8/56),T2WI显示11例有出血灶(11/56),FLAIR显示10例有出血灶(10/56),DWI显示7例有出血灶(7/56).13例脑梗死患者,4例提示治疗后梗死区有低信号出血灶.3例脑血管瘤合并出血者,SWI显示出血灶明显大于和多于常规T1WI及T2WI序列显示.1例CT扫描阴性,SWI显示大脑前动脉畸形并少量蛛网膜下腔出血.结论 3.0T磁共振扫描仪磁敏感序列(SWI)对脑出血的敏感性明显高于其他常规序列,是一种显示少量脑出血及提高出血灶检出率的有效检查方法,值得在临床疑有脑出血性病变的患者检查中运用.     

磁敏感加权成像在脑微出血诊断中的应用价值

目的探讨磁敏感加权成像在脑微出血诊断中的应用价值。方法选取我院收治的120例疑似脑微出血患者为研究对象,对120例疑似脑微出血患者分别行MRI常规序列扫描以及SWI序列扫描,对检出CMBs阳性例数、脑微出血灶位置分布情况、脑微出血灶数量的显示情况进行比较。结果 90例患者通过SWI检测均显示出磁敏感效应,SWI主要表现为条状、点状以及类圆形等,检出率为100%;86例常规序列检出CMBs阳性,检出率为76.5%,二者具有显著性差异(P0.05)。90例患者中通过T1WI序列扫描表示病灶显示不明显,通过T2WI序列扫描共检出232个低信号灶。SWI序列共检出1 392个低信号灶。结论磁敏感加权成像技术具有高度的敏感性,在现阶段的临床应用中可检出脑微出血的最佳序列,从而更好的为临床治疗提供参考。     

磁敏感加权成像检查对自发性脑出血急性期的诊断价值

目的探讨磁敏感加权成像检查(SWI)对自发性脑出血急性期的诊断价值。方法142例自发性脑出血急性期患者,分析其临床资料,常规行头颅CT扫描。统计头颅CT的出血灶,MR各序列的出血灶显示率。结果近一半的自发性脑出血患者有高血压史,最常见的出血部位位于基底节及丘脑。SWI对出血灶的检出率100%,T1检出率16.32%,T2检出率18.40%,FLAIR检出率19.0%。统计发现SWI对自发性脑出血急性期出血灶显示最高,与T1WI、T2WI及FLAIR序列间差异有统计学意义(P0.05),而T1WI、T2WI及FLAIR序列间差异无统计学意义(P0.05)。结论 SWI对自发性脑出血急性期出血灶的显示明显高于其他序列,为脑出血早期出血灶的有效检查方法,对脑内出血有极高的诊断价值。     

磁共振成像T2~* WI检测在临床自发性脑出血含铁病灶演变过程中的应用

目的:旨在研究用磁共振成像(MRI)T2*WI检测临床自发性脑出血患者脑内含铁病灶的演变过程。方法:收集临床自发性脑出血患者10例,于发病后第1、7和14天行头颅MRIT1WI、T2WI、DWI和T2*WI系列扫描,记录图像特征,由Image J软件进行图像分析。结果:患者脑出血后MRI T2*WI序列显示的含铁病灶图像与其他MRI序列比较明显清晰;发病后第7和14天含铁病灶范围测量显示T2*WI序列比T2WI序列所测得的体积更大(P<0.05)。结论:住自发性脑出血脑内含铁病灶的检测中,MRI T2*WI序列较其他MRI序列图像更为清晰,与MRI T2WI相比也更为敏感。     

磁敏感加权成像在脑出血中的应用价值

目的 探讨MRI磁敏感加权成像(SWI)在脑出血中的应用价值.方法 对12例经CT确诊的脑出血患者于发病2 d内及2周后分别进行MRI常规序列及SWI扫描,并进行血肿分期及对各序列的病灶显示率、微出血灶的分布和出血量评估.结果 在12例脑出血患者中,共发现33处出血灶.SWI、T,WI、T<,2>WI、Flair序列对...     

专题综述:脑微出血

<正>编者按脑微出血(cerebral microbleed,CMB)是脑小血管病的一种,指T*2梯度回波序列(T2 star gradient-recalled echo,GRE T*2)和磁敏感加权(susceptibilityweighted imaging,SWI)序列影像上的小圆形或椭圆形低信号病变。病理和影像对照研究证实其病理改变为陈旧出血和含铁血黄素沉积,小动脉的脂质玻璃样变和淀粉样血管病是导致CMB的主要血管病变基础。CMB的出现及数量与潜在的小血管病严重程度有关,反映在影像上即与腔隙性脑梗死的数     

脑微出血:共识、困惑与研究方向

<正>对脑微出血(cerebral microbleed,CMB)的认识是影像技术发展牵引疾病研究的典型代表。随着磁共振T*2梯度回波序列(T2 star gradient-recalled echo,T*2GRE)和磁敏感加权(susceptibility-weighted imaging,SWI)序列的广泛应用,1.5T、3.0T场强的磁共振仪的逐渐普及,CMB成为影像和神经内、外科医师经常遇到一种影像发现,对其关注度也迅速     

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     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

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.     

Release of endogenous catecholamines from slices of hypothalamus of rats

The release of endogenous catecholamines from superfused slices of rat hypothalamus was studied under basal conditions and during release evoked by 40 mM K⁺. Catecholamines in superfusates, and in extracts of the tissue after stimulation, were isolated by column chromatography and quantitated by liquid chromatography with electrochemical detection. Norepinephrine (NE) was not consistently demonstrable in superfusate collected under basal conditions, but 40 mM K⁺ caused the release of from 2 to 4 ng/g of tissue per min. The addition of cocaine to the superfusate caused increases in basal and evoked release of NE. Epinephrine (E) could be measured in superfusates of slices from male but not female rats and then only when cocaine was added to the superfusate. Accordingly, the concentration of E in hypothalamus was greater in male rats than in female rats. Dopamine (DA) was not consistently measurable in the spontaneous overflow from slices either in the presence or absence of cocaine. K⁺-evoked release of DA could be demonstrated in slices from female rats. The addition of cocaine increased the evoked release of DA from slices from both sexes. Corticosterone, added to cocaine, had no effects on the efflux of any of the catecholamines. The experiments suggest that neuronal reuptake of all catecholamines is very efficient in the hypothalamus both under basal conditions and during evoked release.     

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.     

《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。     

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.     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。