帕金森病痴呆患者的脑电活动研究

目的:通过比较帕金森病(PD)患者痴呆组与非痴呆组的脑电图特点,探讨PD患者痴呆与脑电活动的关系。方法:将经临床确诊的PD患者分为痴呆组和非痴呆组,分别作脑电图(EEG)描记。结果:痴呆组EEG异常率明显高于非痴呆组(P<0.01);痴呆程度与EEG异常程度有关,痴呆组EEGα波低波幅者、低波率者、低指数者及有泛化者均显著高于对照组(P<0.05或P<0.01);痴呆组异常EEG快波(β)与慢波(θ,δ)出现率均高于对照组,但以θ,δ波为著(P<0.01或P<0.05)。结论:EEG可用以帮助判断PD痴呆的严重程度,并可作为评价PD智能状况的一个参考指标。     

帕金森病痴呆患者的脑电活动研究

目的：通过比较帕金森病（PD）患痴呆组与非痴呆组的脑电图特点，探讨PD患痴呆与脑电活动的关系。方法：将经临床确诊的PD患分为痴呆组和非痴呆组，分别作脑电图（EEG）描记，结果：痴呆组EEG异常率明显高于非痴呆组（P＜0．01）；痴呆程度与EEG异常程度有关，痴呆组EEGα波低波幅，低波率，低指数及有泛化均显高于对照组（P＜0．05或P＜0．01），痴呆组异常EEG快波（β）与慢波（θ，δ）出现率均高于对照组，但以θ，δ波为（P＜0．01或P＜0．05）。结论：EEG可用以帮助判断PD痴呆的严重程度，并可作为评价PD智能状况的一个参考指标。     

高原地区阿尔次海默病患者的脑电图和CT变化

目的　探讨高原地区Alzheimer病 (AD)脑电图及脑CT变化的特征。方法　对 2 4例AD患者及 2 0例正常老年人进行脑电图 (EEG)的检测和 9个参数进行测量分析。结果　AD患者EEG异常率 83.3% ,α节律变慢出现弥慢性θ和δ波增多 ,波幅降低。CT表现为皮质及皮质下脑萎缩 ,脑室系统普遍性扩大。结论　高原地区AD患者的脑电图及CT与正常老年人不同 ,采用EEG和CT相结合的方法有可能作为AD辅助的诊断方法     

脑电图对急性一氧化碳中毒后迟发性脑病的动态观察

目的:了解急性一氧化碳中毒及中毒后迟发性脑病(delayed enceph-alopathy after acute CO poisoning,DRACMP)的脑电图(EEG)变化,探讨EEG对判断病情和预后的作用。方法:对96例急性一氧化碳中毒中出现DRACMP的45例患者进行EEG动态检查。结果:EEG的异常率为100%,主要表现为!波慢化或消失,弥漫性中高幅θ、δ波,以额或额颞部最明显,持续或较长程出现,昏迷时间越长其EEG异常率越高,病情越重,其改变越明显,并随病情好转逐渐恢复。结论:EEG对DRACMP早期诊断和预后评估有重要的意义。     

24小时动态脑电图在精神运动性癫痫患者诊断中的作用

目的:探讨动态脑电图(AEEG)对精神运动性癫痫的诊断及鉴别诊断价值.方法:分别采取常规脑电图(EEG)和AEEG对60例精神运动性癫痫患者行脑电监测,并进行比较.结果:与EEG相比,AEEG的总异常率和中度异常率有显著性差异 (P<0.01 ).结论:精神运动性癫痫患者在发作间期进行AEEG检查,可提高痫样波的检出率...     

一氧化碳中毒迟发脑病脑电图60例诊断分析

选取2012年1月~2015年12月60例一氧化碳中毒伴迟发性脑病患者与60例未伴发迟发性脑病的一氧化碳中毒患者进行研究,设置为观察组、对照组。对患者进行脑电图检查,统计两组患者的脑电图异常例数及脑电波所占比例。结果与对照组相比,观察组的脑电图中度异常率、重度异常率均明显更高(P0.05),界限性异常率、轻度异常率均明显更低(P0.05)。与对照组相比,观察组的β波、α波所占比例均明显更低(P0.05),θ波、δ波所占比例均明显更高(P0.05)。在一氧化碳中毒伴发迟发性脑病的临床诊断中,应用脑电图具有较高的诊断价值。     

20例阿尔茨海默病患者的脑电图观察

目的：观察正常老人与阿尔茨海默病(AD)患者脑电图(EEG)变化特点。方法：选择正常老人20名，阿尔茨海默病患者20例，进行EEG，对所获资料进行分析。结果：正常组EEG示：α节律变慢，调节变差，α指数减少；δ、θ波随着年龄增大，有明显增加趋势。AD组EEG示：α节律变但和α指数减少；弥漫性δ、θ波进一步增加。两组间比较，呈显著性差异(P＜0．001)。AD组EEG改变，特别是侵波较正常组明显增加。结论：EEG检查，对于AD早期诊断、客观评价老年人健康状况，都有重要实用价值。     

阿尔茨海默病和血管性痴呆的定量脑电图研究

目的探讨阿尔茨海默病(AD)和血管性痴呆(VD)的定量脑电图(QEEG)特征及其与AD、VD患者认知功能的相关性。方法对50例AD患者、50例VD患者及50例健康老年人行脑电图(EEG)功率谱分析。功率谱按频率分为δ波(0.5~3.9Hz)、θ波(4.0~7.9Hz)、α波(8.0~13.9Hz)、β波(14.0~30.0Hz),以(δ+θ)/(α+β)值作为观察评估指标进行比较。对3组EEG异常程度、全脑及FP1、FP2、F3、F4、C3、C4、P3、P4、O1、O2、F7、F8、T3、T4、T5、T6的(δ+θ)/(α+β)值进行比较,并分析其与简明智力状态检查量表(MMSE)评分的相关性。结果AD组中、重度异常EEG发生率明显高于VD组(χ~2=4.11,P0.05)。AD组全脑及FP1、FP2、F3、F4、C3、C4、P3、P4、O1、O2、F7、F8、T3、T4、T5、T6的(δ+θ)/(α+β)值高于对照组,差异均有统计学意义(P0.05)。VD组全脑、FP1、FP2、F4、C3、C4、P4、O1、O2、F7、F8、T3、T4、T5的(δ+θ)/(α+β)值高于对照组,差异均有统计学意义(P0.05)。AD组与VD组各区域(δ+θ)/(α+β)值比较,差异无统计学意义(P0.05)。VD组FP1、F3、C3、F7、T3、T5及全脑左侧的(δ+θ)/(α+β)值均高于右侧对称区域,差异有统计学意义(P0.05)。AD组仅全脑左侧的(δ+θ)/(α+β)值与右侧比较,差异有统计学意义(P0.05);对照组全脑左右侧及各区域左右对称部位的(δ+θ)/(α+β)值比较,差异无统计学意义(P0.05)。AD组、VD组的MMSE评分与各区域(δ+θ)/(α+β)值均呈负相关(P0.05)。结论 QEEG是一种客观、量化的脑功能检测方法,对AD、VD的诊断、鉴别诊断及认知功能评估有重要价值。     

帕金森病患者事件相关电位和抑郁的相关因素

目的:探讨帕金森病(Parkinson'sdisease,PD)患者抑郁的发生和事件相关电位(eventrelatedpotential,ERP)的变化,并对其相关因素进行分析。方法:采用汉密顿抑郁量表(HAMD)及Zung抑郁自评量表(SDS)对45例PD患者(PD组)和30例对照组进行测试,检测事件相关电位的潜伏期及P3的波幅,并与年龄、病程、受教育年限、运动功能障碍、脑萎缩等因素进行相关性分析。结果:PD组抑郁发生率49%,对照组抑郁发生率17%,两者差异有显著性意义(χ2=11.01,P<0.01)。病程>5年的PD患者抑郁的发生明显高于病程≤5年的患者(χ2=28.96,P<0.01);运动功能障碍越重的患者越易发生抑郁(χ2=5.17,P<0.05);有脑萎缩的PD患者中抑郁的发生高于无脑萎缩的PD患者(χ2=13.55,P<0.01)。PD患者中有27例(60%)N2,P3的潜伏期异常率,显著高于对照组(χ2=9.80,P<0.01);PD组N2,P3的潜伏期较对照组明显延长(t=7.78,P<0.001),PD组P3的波幅较对照组降低(t=10.69,P<0.05)。脑萎缩、长时间应用抗胆碱药与N2,P3的潜伏期成正相关(r=0.2839～0.2879,P<0.05),与P3的波幅成负相关(r=-0.321,P<0.05),年龄、病程、运动功能障碍、受教育年限与P3的潜伏期及P3的波幅无相关性。结论:PD患者事件相关电位的异常主要表现N2,P3的潜伏期延长和P3波幅降低,脑萎缩和长时间应用抗     

帕金森病患者睡眠障碍92例临床护理

目的:分析帕金森病(PD)患者睡眠障碍的临床特征,探讨临床护理方法。方法:应用帕金森睡眠量表(PDSS)及爱泼沃斯嗜睡量表(ESS)对93例PD患者(研究组)及60例与PD患者相匹配的健康体检者(对照组)进行测定,PD睡眠障碍患者给予药物及护理治疗,包括睡眠卫生教育、心理护理、药物知识指导等,1个月后复查。结果:研究组患者PDSS评分明显低于对照组(P<0.05,P<0.01),治疗后较治疗前有明显改善(P<0.05,P<0.01);研究组ESS评分较对照组高(P<0.05),治疗后有明显改善(P<0.05)。结论:PD患者睡眠障碍嗜睡常见,药物及护理能明显改善总体睡眠质量、入睡困难、夜尿、夜间精神状况,提高患者生活质量。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.