257例癫痫与发作性疾病的24h动态脑电图监测

目的：探讨动态脑电图(AEEG，即脑Holter)对癫痫的诊断及鉴别诊断价值。方法：257例常规EEG无痼样放电患者分为临床癫痫组和可疑癫痫组进行24hAEEG监测并分析结果。结果：临床癫痫组痫样放电总发生率为59．4％，可疑癫痴组总发生率为19．9％。痴样放电最多出现于非快速眼动睡眠期。各种发作类型痫样放电阳性率差别无显著性。结论：AEEG可提高痫样放电的检出率，对癫痫的诊断有重要意义。     

动态脑电图加心脏导联监测对晕厥与癫痫的鉴别诊断价值

目的：探讨24小时动态脑电图（AEEG）加心脏导联监测对晕厥与癫痫的鉴别诊断价值。方法：对92例以昏倒就诊，但常规脑电图（REEG）和心电图（ECG）均阴性的患者做24小时AEEG加心脏导联监测，并结合临床进行观察。结果：46例AEEG检测到多次阵发性棘波、尖波、棘慢波综合、尖慢波综合等痫样放电而诊断为癫痫，24例诊断为晕厥（心源性晕厥占58．3％，脑源性晕厥占25％，反射性晕厥占16．7％），6例不能定性，16例正常，总阳性率为82．6％。结论：24小时AEEG加心脏导联监测能帮助鉴别临床以昏倒发作的晕厥与癫痫，并能区分晕厥的类型。     

24h动态脑电图对癫痫的诊断意义

目的：了解动态脑电图对癫痫诊断的应用价值。方法：对１１２名诊断癫痫，可疑癫痫及发作性晕厥病人行２４ｈ动态脑电图检查，并在一周内做脑电图或脑电地形图检查作为自身对照。结果：发现全部病人组ＡＥＥＧ痫样放电检出率明显高于ＥＥＧ／ＢＥＡＭ组；在癫痫发作类型中，以复杂部分性发作ＡＥＥＧ痫样放电阳性率明显高于ＥＥＧ／ＢＥＡＭ组；睡眠期痫样放电检出占有痫样放电患者５６／６７（８４％），主要出现在ＮＲＥＭⅠ－Ⅱ期（７５％）。结论：动态脑电图对癫痫的诊断有重要的意义     

动态脑电图对癫痈与晕厥的鉴别诊断意义

癫痫是由多种病因引起的慢性脑部病变,以脑部神经元异常过度放电而出现的一过性体征和（或）症状。晕厥是一种起病突然、意识短暂丧失的临床现象,伴有晕倒,能自行恢复。二者在临床都极为常见。但是,对于意识短暂丧失伴有可疑或轻微肢体抽搐的患者,经过常规脑电图EEG检查仍然不能明确诊断为癫痫的一类患者,24h动态EEG检查可以提供重要依据,对癫痫与晕厥的鉴别诊断有较大价值。现将60例意识短暂丧失伴有可疑或轻微肢体抽搐的患者的动态EEG结果报告如下,以探讨其意义。     

可疑癫痫患者的24h动态脑电图分析

目的：探讨24h动态脑电图（AEEG）对可疑癫痫的诊断价值。方法：对98例多次常规脑电图（REEG）检查未见异常,临床怀疑癫痫的患者进行24hAEEG监测,并观察觉醒期和睡眠期脑电图异常情况。结果：24hAEEG痫样放电发生率为44．9％,痢样放电多见于NREMⅠ-Ⅱ期,非特异性异常24．5％,多见于清醒期。结论：对多次REEG检查未见异常,临床怀疑癫痫的患者行24hAEEG检查,可提高痫样放电的检出率;对可疑癫痫的诊断有重要意义。     

反射性癫痫的24h脑电图监测

目的探讨反射性癫痫的ＥＥＧ变化。方法对３４例不同类型反射性癫痫在特定刺激下作动态ＥＥＧ监测，以常规ＥＥＧ作比较。结果动态ＥＥＧ异常率（６２％）与痫样放电检出率（５３％）均高于常规ＥＥＧ的３５％与２６％。痫样放电的部位主要涉及到额、前颞。诱发异常占所有动态ＥＥＧ异常的７６％。结论ＡＥＥＧ对提示反射性癫痫是原发还是继发及对预后判断有帮助。     

动态脑电图对晕厥患者的诊断意义

目的:探讨动态脑电图(AEEG)在晕厥患者中的诊断价值。方法:采用十六导联动态脑电图分析仪连续监测24小时的脑电活动。结果:242例晕厥发作患者中AEEG结果示:28例为正常脑电图,95例为轻度异常脑电图,97例为中度异常脑电图,22例为重度异常脑电图,中、重度异常脑电图的异常率为49.2%。而REEG结果示:191例为正常脑电图,38例为轻度异常脑电图,13例为轻-中度异常脑电图,有异常表现者51例,异常率为21.1%。结论:AEEG较REEG在对脑源性晕厥患者的中有明显的优势,对临床诊疗有很大的价值。     

脑电与心电同步检测对癫痫性与心律失常性晕厥的鉴别诊断价值

目的 :探讨 2 4小时脑电 /心电同步监测对癫性晕厥和心律失常性晕厥的诊断和鉴别诊断价值。方法 :对 72例临床怀疑癫性晕厥和心律失常性晕厥患者进行 2 4小时动态脑电图 (AEEG) /心电图 (ECG)同步监测。结果 :①癫性晕厥 42例中 ,EEG总异常率 83 91%。样放电出现率71 2 4% ;心电图显著异常率 19% ;②心律失常性晕厥 2 1例中 ,EEG总异常率 2 4% ,样放电出现率 5 % ,心电图显著异常 91% ;③可疑癫性晕厥 4例中 ,AEEG样放电 1例 ;④可疑心律失常性晕厥 3例 ,ECG均为非显著异常 ;⑤晕厥原因不明 (癫与心律失常两种疾病并存 ) 2例 ,均检出样放电及显著心律失常。结论 :2 4小时EEG/ECG同步监测对癫性晕厥和心律失常性晕厥有重要的诊断和鉴别诊断的价值。     

癫痫病人24小时动态脑电图分析

目的：分析动态脑电图对癫的应用价值。方法：对121例常规脑电图未见痫样放电的癫痫病人，在一周内行24小时动态脑电图检查，观察痫样放电的检出率，结果：24小时动态脑电图痫样放电检出率72．73％（88／121）明显高于常规脑电图，涉及额颞区占73．86％（65／88），自然睡眠中痫样放电81例占92．05％（81／88），NREMⅠ，Ⅱ期出现痫样放电59例，占72．84％（59／81），结论：24小时动态脑电图对癫痫的诊断有重要意义。     

Microcomputer-based system for 24-hour recording of oesophageal motility and pH profile with automated analysis

A system developed for long-term simultaneous recording of eosophageal motility and pH in the ambulant patient is described. The system consists of a microprocessor based data-acquisition and preprocessing device, a personal computer for postprocessing, report generation and data storage, a miniature two-sensor pressure catheter and a pH electrode. Identification and classification of oesophageal contractions are performed in separate steps, using online preprocessing software for identification and offline postprocessing software for categorisation, classification and report generation. Contractions are categorised as peristaltic, simultaneous or nontransmitted and classified according to their amplitude, duration and propagation velocity. The method described reduces the amount of data from 870 kbyte to approximately 40kbyte per 24 hours in a multiparameter recording device, and offers the opportunity for offline postprocessing with different sets of criteria. The system has been found to be accurate and reliable in 24-hour studies in both healthy volunteers and patients with non-cardiac chest pain.     

不同条件保存24小时尿液对生化检测的影响

目的探讨24h尿在不同的保存条件下对生化项目检测结果的影响,探寻一种不影响尿液生化检测结果且留取安全简便的保存方式。方法在同一时间收集20份患者尿液,将每份尿液分装四份,使用不同方法分别处理:冷藏(2~8℃)未添加防腐剂、常温(18~25℃)未添加防腐剂、常温添加浓盐酸以及常温添加硼酸。尿液按上述方法保存24h后进行生化项目检测,包含:总蛋白、钾、钠、氯、钙、磷、尿素、尿酸及肌酐。采用单因素方差分析或Wilcoxon检验比较其他三种与冷藏保存方式间的差异。结果尿液各项生化检测结果在常温保存与冷藏保存相比差异均无统计学意义(P>0.05);使用浓盐酸保存与冷藏保存相比在总蛋白、钾、氯、尿素、尿酸及肌酐检测差异存在统计学意义(P<0.05);使用硼酸保存与冷藏保存相比在钾、尿酸、尿素及肌酐检测差异存在统计学意义(P<0.05)。结论24h尿液在留取过程中,使用常温与冷藏保存方式相比,生化检测结果无明显差异,而添加浓盐酸和硼酸保存尿液会对生化检测结果产生不同程度的影响。     

24h动态脑电图在儿童癫痫和非癫痫疾病的应用价值

目的探讨24h动态脑电图在儿童癫痫的诊断与鉴别诊断中的应用价值.方法 2002年2月至2004年10月在我院儿科病房和门诊就诊的具有发作性症状病例149例,其中拟诊癫痫52例,非癫痫性发作性疾病97例,全部病例作常规脑电图(EEG)和24h动态脑电图(AEEG)检查.结果拟诊癫痫52例,经24h动态脑电图监测,结合其临床表现,确诊为癫痫40例;而非癫痫性发作性疾病97例,经24h动态脑电图监测,并结合其临床表现,90例被除外癫痫.结论 24h动态脑电图对儿童发作性疾病,尤其是癫痫与非癫痫性发作性疾病的诊断与鉴别诊断具有重要价值,同时24h动态脑电图还可揭示癫痫灶的起源,有助于癫痫和癫痫综合征的分类,为正确治疗提供依据.     

Successful Treatment of Syncope with Chemotherapy Irresponsive to Cardiac Pacemaker in Head and Neck Cancer

Recurrent syncope as a complication of recurrent neck malignancy is an uncommon but well documented association. The syncope is presumed to occur when a tumor mass invades the baroreceptor within the carotid sinus or when it disrupts the afferent nerve fibers of the glossopharyngeal nerve. A 59-year-old man presented with recurrent syncope and headache. He had a wide local excision including tonsillectomy and modified left radical neck dissection for tonsilar cancer 4 years ago. A computed tomography scan revealed ill-defined lesions in left parapharyngeal, carotid space and right upper jugular region. After clinical evaluation, cardiac pacemaker was placed, but he still suffered from the syncope. Then, he received the chemotherapy with docetaxel and cisplatin. The last hypotension event occurred on day 10 of the chemotherapy. Six months after 3 cycles of chemotherapy, he remained in complete remission and resolution of syncope. We report a case in which syncope was associated with a recurrence of tonsilar cancer and successfully treated with chemotherapy.     

睡眠视频脑电监测对癫癎诊断及疗效评估的价值

目的：探讨睡眠视频脑电监测（Sleep—VEEG）对癫痫（epilepsy,EP）诊断及疗效评估的价值。方法：对98例拟诊为EP和60例EP治疗后复查的病例均进行5—10小时的Sleep—VEEG监测,并与常规脑电图（REEG）检查结果对比分析。结果：REEG正常的98例疑诊病例中Sleep—VEEG检查结果正常12例,异常86例,异常率87．75％,其中25例捕捉到同步发作并能明确发作性质及类型;48例EP治疗2年后REEG检查正常者复查Sleep—VEEG,异常31例,异常阳性率为64．58％,与REEG检查结果比较差异有显著性。结论：睡眠VEEG监测可提高EP诊断阳性率和准确率,对EP诊断及分型和临床随访疗效评估具有重要价值。     

The Association of Sleep Duration with Adolescents' Fat and Carbohydrate Consumption

Study Objectives:

To investigate the relation between sleep duration and energy consumption in an adolescent cohort.

Design:

Cross-sectional.

Setting:

Free-living environment.

Participants:

Two hundred forty adolescents (mean age 17.7 ± 0.4 years).

Measurements and Results:

Daily 24-hour food-recall questionnaires and wrist-actigraphy measurements of sleep duration were employed to test the hypothesis that shorter weekday sleep duration (< 8 h) is associated with altered nutrient intake. Nutrition parameters included total calories, calories from meals and snacks, and proportions of caloric intake from fat and carbohydrates. Compared with adolescents sleeping 8 or more hours on average on weekdays, those sleeping less than 8 hours consumed a higher proportion of calories from fats (35.9% ± 6.7% vs 33.2% ± 6.9%; mean ± SD; P = 0.004) and a lower proportion of calories from carbohydrates (49.6% ± 8.2% vs 53.3% ± 8.3%; P = 0.001). After adjusting for potential confounders, shorter sleep duration was significantly associated with an average daily increase of calories consumed from fat of 2.2 percentage points and an average daily decrease in percentage of calories from carbohydrates of 3.0 percentage points. In unadjusted analyses, shorter sleep duration was also associated with a 2.1-fold increased odds (95% confidence interval: 1.03, 4.44) of daily consuming 475 or more kcal from snacks.

Conclusion:

Quantitative measures of macronutrient intake in adolescents were associated with objectively measured sleep duration. Short sleep duration may increase obesity risk by causing small changes in eating patterns that cumulatively alter energy balance.

Citation:

Weiss A; Xu F; Storfer-Isser A; Thomas A; Ievers-Landis CE; Redline S. The association of sleep duration with adolescents'' fat and carbohydrate consumption. SLEEP 2010;33(9):1201-1209.     

IL-24基因修饰增强CIK细胞对HL-60细胞的细胞毒作用

目的:研究IL-24基因修饰的CIK细胞与同源树突状细胞共培养后对白血病细胞的杀伤作用及其机制.方法:从健康人外周血单个核细胞中常规诱导DC和CIK 细胞,电穿孔法将IL-24基因导入CIK细胞中(获得细胞为CIK-IL24),RT-PCR 和ELISA法检测CIK细胞中IL-24基因的表达,FCM和ELISA法检测转基因前后CIK表型及分泌细胞因子能力的变化,将CIK 细胞和同源DC共培养,FCM法检测共培养的DC-CIK细胞对HL-60细胞细胞毒活性的变化.结果:通过电穿孔法成功将IL-24基因导入CIK细胞,与对照组相比,转IL-24基因后CIK细胞中CD3~+、CD3~+CD56~+细胞的比例无明显改变,CD4~+CD25~+细胞比例显著下降.IL-24可上调CD3+CD56+细胞表面粘附分子CD54、CXCR4的表达,转染IL-24基因后CIK分泌TNF-α和IFN-γ的能力显著增强,与DC共同作用HL-60细胞时转染IL-24基因后的CIK细胞细胞毒活性明显增强.结论:通过IL-24基因修饰,明显增强了CIK细胞对HL-60细胞的杀伤能力,其机制与IL-24促进CIK分泌TNF-α、IFN-γ,上调CIK细胞表面粘附分子的表达,减少CD4~+CD25~+调节性T细胞比例等密切相关.     

Dynamic regulation of CD24 expression and release of CD24‐containing microvesicles in immature B cells in response to CD24 engagement

The glycophosphatidylinositol‐anchored cell surface receptor CD24 (also called heat‐stable antigen) promotes the apoptosis of progenitor and precursor B‐lymphocytes. However, the immediate proximal events that occur after engagement of CD24 in B cells are not precisely understood. Using a bioinformatics analysis of mouse (Mus musculus) gene expression data from the Immunological Genome Project, we found that known vesicle trafficking and cellular organization genes have similar expression patterns to CD24 during B‐cell development in the bone marrow. We therefore hypothesized that CD24 regulates vesicle trafficking. We first validated that antibody‐mediated engagement of CD24 induces apoptosis in the mouse WEHI‐231 cell line and mouse primary bone marrow‐derived B cells. We next found that CD24 surface protein expression is rapidly and dynamically regulated in both WEHI‐231 cells and primary immature B cells in response to engagement of CD24. The change in surface expression was not mediated by classical endocytosis or exocytosis. However, we found that CD24‐bearing plasma membrane‐derived extracellular microvesicles were released in response to CD24 engagement. Furthermore, in response to CD24 engagement we observed a clear exchange of CD24 between different populations of B cells. Hence, we show that engagement of CD24 in immature B cells results in a dynamic regulation of surface CD24 protein and a redistribution of CD24 within the population.     

某三甲医院消毒灭菌连续三年主动监测效果分析

目的 分析我院连续三年消毒灭菌的环境卫生学监测结果,查找薄弱环节,确保消毒灭菌质量,预防控制医院内感染的发生。方法 回顾性分析我院2016~2018年消毒灭菌及环境卫生学监测资料,分析检测样本合格率及比合格标准分布情况。结果三年共监测物体表面、空气、手指表面、内镜、透析液及透析用水等标本3458份,监测合格标本3419份,合格率为98.87%。不合格标本分别为:医务人员手19份,物体表面10份,内镜8 份,消毒液2份。三年合格率分别为98.93%,98.75% 和98.93%,差异无统计学意义（P＞0.05）。结论 我院消毒灭菌质量总体情况良好,通过监测,反馈,培训,整改,再监测的良性循环,有效的预防控制了院内感染的发生。