皮质下缺血性血管认知功能障碍与听觉P300关系的探讨

目的 探讨P300靶刺激中的P3波用于评估皮质下缺血性血管认知功能障碍(VCI)的价值.方法测试皮质下缺血性血管病患者痴呆(SIVD)组43例、非痴呆的认知功能障碍(VCND)组34例与认知正常组38例P3波潜伏期和波幅的变化.结果在Cz和Pz区域,与正常对照组比较,SIVD组的潜伏期[(400.43±3.57)ms、(309.76±3.96)ms]明显延长(P《0.05),波幅[(4.23±0.34)μV、(5.87±1.54)μV]明显降低(P《0.05).在Cz和Pz区域,VCND组的潜伏期[(400.26±5.55)ms、(396.12±5.23)ms]较正常对照组均明显延长(P《0.05);而波幅[(18.22±0.29)μV、(8.85±0.2)μV]较正常对照组在Cz区域明显降低(P《0.05),但在Pz区域无显著性差异.结论 P3波可作为诊断SIVD的重要客观指标:P3波潜伏期作为皮质下缺血性VCND的辅助诊断指标可能更为敏感.     

分类任务与心理旋转任务的事件相关电位P300比较

目的通过比较分类任务与心理旋转任务的事件相关电位(Event Related Potential,ERP)P300平均波幅和脑地形图,探讨心理旋转认知加工的脑机制.方法记录10名男性健康大学生在完成字母和数字分类任务和心理旋转任务时的事件相关电位,比较顶区电极点的P300的平均波幅.结果进行心理旋转任务时,随着刺激图片旋转角度从30.到150.的增加,顶点Pz点P300的平均波幅从[(10.94±2.21)μV]减小为[(8.28±2.83)μV],Cz点P300的平均波幅从[(4.72±2.44)μV]减小为[(2.07±1.23)μV],差异有显著性.分类任务的P300的平均波幅差异无显著性.结论分类任务由于不需要心理旋转加工,其ERP成分不会受到旋转所引起的变化.心理旋转认知加工主要由大脑右半球顶叶完成,旋转角度越大,P300的平均波幅越小.     

海洛因成瘾者冲动行为的事件相关电位P300研究

目的 探讨海洛因成瘾者冲动行为的事件相关电位(ERP)P300的特点.方法 运用神经心理学试验范式,海洛因成瘾组和健康对照组在执行爱荷华赌博任务(IGT)时同步进行ERP脑电描记,数据采集后分析比较2组被试P300的波幅和潜伏期,并与冲动性量表(BIS-11)的测评结果作相关分析.结果 海洛因成瘾组BIS评分、选择“高频损失”纸牌次数[(75.12±12.49)分;(91.14 ±21.35)次]高于正常对照组[(66.54±8.61)分;(73.71 ±18.91)次],均差异有统计学意义(P＜0.05);2组被试在执行IGT时均出现明显的P300的波形,其中海洛因成瘾组P300的波幅、潜伏期[(4.92±1.14) μV;(293.43±36.21)ms]低于对照组[(7.65±1.59) μV;(332.68 ±40.15)ms],且与BIS评分呈负相关(r=-0.76,-0.52),差异及相关性有统计学意义(P＜0.05),而进一步Logistic回归分析显示,BIS评分仅与P300波幅相关(P＜0.05).结论 海洛因成瘾者冲动行为P300的异常可反映成瘾者的冲动行为,海洛因成瘾者的较高冲动性行为可能是成瘾及复吸的原因之一.     

难治性精神分裂症患者认知异常的事件相关电位研究

目的 探讨难治性精神分裂症患者诱发电位P300和失匹配负波(MMN)的特征.方法 对21例难治性精神分裂症患者(病例组)和26名健康被试(对照组)行事件相关电位P300和MMN检测,比较两组被试F3、F4、Fz、Cz点P300和Fz、Cz、Pz点MMN的差异.结果 ①病例组反应时[(408.91±202.24)ms]长于对照组[(361.60±254.32) ms],差异具有统计学意义(P＜0.05).②病例组P300潜伏期在F3、F4、Fz、Cz四点[分别为(385.92±53.14)ms,(400.31±51.32) ms,(386.77±62.68) ms,(374.77±57.61)ms]长于对照组[分别为(341.00±30.42)ms,(335.23±29.71)ms,( 338.65±30.09) ms,( 344.42±30.86) ms],病例组波幅在F4、Fz两点[分别为(4.68±2.90)μV,(5.83±3.73) μV]比对照组[分别为(6.71±2.57) μV,(7.99±2.78)μV]低,均差异具有统计学意义(均P＜0.05).③病例组MMN在Fz点波幅[(2.77±2.25)μV]低于对照组[(5.87±3.28)μV],差异具有统计学意义(P＜0.05).对照组脑中央电极从前向后波幅逐渐降低,而病例组却与此相反.结论 难治性精神分裂症患者认知功能受损,事件相关电位技术可以为其提供生物学基础.     

分类任务与心理旋转任务的事件相关电位P300比较

目的通过比较分类任务与心理旋转任务的事件相关电位(Event Related Potential,ERP)P300平均波幅和脑地形图,探讨心理旋转认知加工的脑机制。方法记录10名男性健康大学生在完成字母和数字分类任务和心理旋转任务时的事件相关电位,比较顶区电极点的P300的平均波幅。结果进行心理旋转任务时,随着刺激图片旋转角度从30o到150o的增加,顶点Pz点P300的平均波幅从[(10.94±2.21)μV]减小为[(8.28±2.83)μV],Cz点P300的平均波幅从[(4.72±2.44)μV]减小为[(2.07±1.23)μV],差异有显著性。分类任务的P300的平均波幅差异无显著性。结论分类任务由于不需要心理旋转加工,其ERP成分不会受到旋转所引起的变化。心理旋转认知加工主要由大脑右半球顶叶完成,旋转角度越大,P300的平均波幅越小。     

惊恐障碍患者听觉诱发电位的动态检测及临床意义

目的探讨惊恐障碍(PD)患者听觉诱发电位(AEP)的特点.方法应用丹麦Keypoint肌电/诱发电位仪,记录29例PD患者(PD组)和29名健康人(NC组)的AEP.PD组患者服用5-羟色胺再摄取抑制剂4周、12周、24周时予以复查.结果 (1)治疗前,PD组AEP-N2潜伏期[(237.88±16.64)ms]长于NC组[(223.48±18.27)ms,P <0.05],N1-P2波幅[(4.29±2.02)μV]低于NC组[(8.39±2.49)μV,P <0.01],P2-N2波幅[(4.05±1.57)μV]低于NC组[(7.65±3.54)μV,P <0.01].(2)治疗后,PD组患者随情绪和行为改善,HAMA分数降低,AEP-N2潜伏期逐渐缩短,至治疗24周时与治疗前差异有显著性[治疗前(237.88±16.64)μV,治疗24周时(210.52±26.58)μV,P <0.05],余各项指标差异无显著性.结论 PD患者AEP变化与临床症状有关,且滞后于临床症状的改善.     

海洛因依赖者的脑干听觉诱发电位和事件相关电位P300研究

目的探讨海洛因依赖者的脑干听觉诱发电位(BAEP)和事件相关电位(ERP)P300的变化特点及其应用.方法使用意大利Galileo Sirius数字化32导脑诱发电位仪对32例海洛因依赖者BAEP和P300检查,并与30例正常人比较.结果 (1)海洛因依赖者BAEP的波Ⅱ-波Ⅶ绝对潜伏期[依次为(2.67±0.12)μV,(3.82±0.16)μV,(4.95±0.17)μV,(5.11±0.12)μV,(6.61±0.17)μV,(7.52±0.14)μV]较正常对照组延长(P＜0.05),绝对波幅[依次为(0.16±0.10)μV,(0.29±0.09)μV,(0.36±0.12)μV,(0.41±0.11)μV,(0.26±0.11)μV,(0.27±0.10)μV]降低(P＜0.05),而波I差异无显著性(P＞0.05).(2)海洛因依赖者P300的潜伏期M[(89.47±15.02)ms]较正常人缩短(P＜0.05),潜伏期P3[(320.23±19.01)ms]较正常人延长(P＜0.05).结论海洛因依赖者存在一定程度的脑功能损害,其BAEP和P300变化特点既可作为辅助诊断依据又可为海洛因的戒断分析时提供神经电生理基础.     

出租车司机驾驶疲劳前后事件相关电位P300比较

目的 探讨和评估驾驶疲劳前后的P300变化.方法 测量20名健康男性白班出租车司机驾驶前后的听觉事件相关电位P300成分,并对被试的主观疲劳感做出评价.以同一批司机在休息日的同时段测量结果作为对照.结果 驾驶疲劳组P300波幅变化在驾驶疲劳前后差异有显著性[(PZ点的P300平均波幅在驾驶前后分别为(8.0±2.8)μV和(6.2±2.1)μV,P＜0.05],而在对照组中差异无显著性[对照组PZ点前后的平均波幅分别为(7.9±2.3)μV和(8.6±3.8)μV].结论 事件相关电位P300的波幅差值能够为驾驶疲劳的评估提供神经电生理证据.     

伴攻击或暴力行为精神分裂症患者事件相关电位P300研究

目的 探讨伴攻击或暴力行为精神分裂症患者的电生理机制.方法 根据诊断标准,对住院及门诊的精神分裂症患者采用修改版外显攻击量表(MOAS)评定其攻击行为,将符合条件的患者分为攻击或暴力行为精神分裂症组(攻击组,n=70)和非攻击或暴力行为精神分裂症组(非攻击组,n＝65),按照年龄、性别等匹配原则收集健康对照组(n=60),使用日本光电公司生产的MEB-9200诱发功能仪对所有受试者进行P300测试.结果 (1)在Cz点上,P3a的潜伏期攻击组[(344.0±33.0)ms]长于非攻击组[(328.3±28.0)ms] (P=0.01),非攻击组又长于健康组[(310.1±24.0)ms],差异均有统计学意义(P＜0.01);在Fz点上,P3a的潜伏期攻击组[(348.2±30.1)ms]长于非攻击组[(333±28.5)ms],非攻击组又长于健康组[(312.3±25.4)ms],差异均有统计学意义(P＜0.01).(2)在Cz点上,N2’的波幅攻击组[(6.96±7.2)μV]均高于非攻击组[(3.85±5.4)μV]及健康组[(3.6±4.2)μV],差异均有统计学意义(P＜0.05),而非攻击组及健康组间差异无统计学意义(P=0.985).结论 伴攻击或暴力行为的精神分裂症患者的事件相关电位P300有其特征性的电生理状态指标改变.     

珠心算训练对儿童形状识别影响的事件相关电位研究

目的 探讨珠心算训练对儿童形状识别的影响.方法 采用事件相关电位(ERP)技术对14名珠心算训练儿童和14名非珠心算训练儿童进行不同形状识别时的ERP记录,分析两组儿童不同脑区ERP波幅和潜伏期的差异.结果 (1)两组儿童枕部P1波幅差异显著,珠心算儿童的P1波幅[(9.59±3.58)μV]高于非珠心算儿童[(7.06 ±2.84)μV],差异具有显著性(P＜0.05);(2)珠心算儿童右侧枕颞区N170波幅[(-9.83 ±2.97)μV]小于非珠心算儿童[(- 12.45 ±2.51)μV],差异具有显著性(P＜0.05);(3)珠心算儿童前额P3波幅[(7.65 ±2.25)μV]大于非珠心算儿童[(4.89±3.35) μV],差异具有显著性(P＜0.05).结论 珠心算训练对儿童形状识别的脑功能有一定影响.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.