N20-P25、N18消失在深昏迷预后判断中的价值

目的评价短潜伏期体感诱发电位(shortlatencysomatosensoryevokedpotentials,SLSEP)N20P25、N18消失在深昏迷患者预后判断中的作用。方法运用便携式诱发电位仪,对95例深昏迷患者进行SLSEP检测,记录脑皮质电位N20P25和周围电位N13,44例患者同时记录脑皮质下电位N18。结果95例患者N20P25均消失(100%),8例患者因有周围神经损伤未记录到周围电位N13;44例患者中脑皮质下电位N18消失者38例(86.4%)。结论95例患者SLSEP检查结果与临床判断完全吻合。在脑功能判断中,N20P25敏感性较高,N18特异性较高,二者均消失高度提示脑功能预后不良。     

P300包括N 1、P2、N 2、P3吗？

有关诱发电位中认知电位 P300的研究，虽然我们以往曾强调过，但是在相当部分稿件中，仍存在P300概念不清的问题，认为P300包括 N1、P2、N2、P3。例如在“P300 PL测定结果比较”这样的表题下，表头列出各组 P300的内容有N1、P2、N2、P3各波的潜伏期、波幅等项目，显然是错误地把P300当成经典的事件相关电位（ERP），把N1、P2、N2、P3作为P300的各种成分了。这种逻辑上以点代面，以偏概全的错误应予纠正。     

事件相关电位N400与精神分裂症

作者对２３例服药精神分裂症和２０例未服药精神分裂症及２０例正常受试者，记录事件相关电位Ｎ４００。受试者均接受视觉词意分类作业。结果显示，精神分裂症组Ｎ４００波幅较对照组低，潜伏期延长３０～１００ｍｓ。随病情好转，精神分裂症Ｎ４００波幅逐渐增大，其潜伏期缩短，而未服药组Ｎ４００波波幅更小且形状不规则，潜伏期延长５０～１００ｍｓ，精神分裂症组Ｎ４００潜伏期与阴性症状评定量表得分呈正相关。精神分裂症组Ｎ     

Management iatrogener N.-accessorius-Läsionen

Lesions of the spinal accessory nerve are usually iatrogenic, especially after lymph node extirpation on the neck. Between 1994 and 2003, 31 patients were operated on in the Neurosurgical Department of the University of Ulm for iatrogenic lesions of the XIth cranial nerve. Of 31 patients, 22 had undergone a previous lymph node extirpation, 2 had been injured during a selective peripheral denervation for spasmodic torticollis, and the other 7 patients by different causes. The neurosurgical intervention was performed 0-19 months after trauma (mean 7.2 months). All patients showed paresis/atrophy of the trapezius muscle, and the abduction of the shoulder was markedly reduced. Additional neck and/or shoulder pain was present in 29 of 31 cases. In seven cases, the nerve was compressed by scar tissue and subsequently treated by external neurolysis. Ten patients underwent an end-to-end anastomosis; autologous sural nerve grafting was necessary in 13 cases. After a mean follow-up of 12.6 months, 7of 31 patients completely recovered. Of 31 patients, 19 experienced partial relief of pain and weakness. Only five patients remained unchanged. The clinical findings after autologous nerve grafting, end-to-end reconstruction, or external neurolysis did not show any significant differences. Microsurgical reconstruction of iatrogenic injury of the spinal accessory nerve is very promising if the interval between trauma and surgical revision is less than 6 months. Up to 12 months, partial recovery can be achieved. Outcome after longer delay is unsatisfactory.     

汉字单字词识别的N400

目的　探讨单词识别过程中事件相关电位N40 0成分的心理学意义。方法　在长 ( 60 0ms)与短 ( 2 0 0ms)两种刺激呈现间隔 (SOA)、3种语境 (相关、中性和无关 )条件下 ,进行词汇抉择作业 ,通过对反应时间 (RT)和事件相关电位 (ERP)的检测 ,观察目标词词汇抉择的语义启动效应 (RT效应和N40 0波幅效应 )。结果　长SOA时 ,RT实验有语义促进效应 (相关语境RT较中性语境短 )和抑制效应 (无关语境RT较中性语境长 ) ,而ERP实验只有N40 0波幅抑制效应 ;短SOA时 ,RT实验只有语义促进效应 ,而ERP实验无任何N40 0波幅效应。结论　结果表明 ,N40 0反映了词汇后水平的整合加工 ,而不反映词汇水平的词汇提取加工。     

苯甲酰胺阻止N—甲基—N‘—亚硝基氮亚硝基胍引起的神经胶质瘤 …

研究ＤＮＡ损伤所造成的神经胶质瘤细胞ＴＪ９０５凋亡过程中聚ＡＤＰ核糖基聚合酶［ｐｏｌｙ（ＡＤＰ－ｒｉｂｏｓｅ）ｐｏｌｙｍｅｒａｓｅ,ＰＡＲＰ］的作用。用Ｎ－甲基－Ｎ’－亚硝基氮来硝基胍（ＭＮＮＧ）和ＰＡＲＰ的ＮＡＤ位点特异性抑制剂苯甲酰胺（ｂｅｎｚｍｉｄｅ,ＢＡ）,分别或同时处理神经胶质瘤细胞ＴＪ９０５。结果发现在ＭＮＮＧ的作用下,细胞的增殖活性受到明显的抑制,细胞凋亡显著;单独用ＢＡ处理细胞时,     

Några reflexioner over kotfrakturerna vid elektrochock

Depression and other neuropsychiatric symptoms are frequently reported in patients with dementia. These symptoms may seriously compromise the function and quality of life of demented patients. Both biologic and behavioral strategies are necessary in dealing with these problems. This article documents the efficacy of electroconvulsive therapy (ECT) in a 67-year-old woman with early-onset Alzheimer's disease. She developed severe depression that did not respond to drug therapy. Unilateral ECT was immediately effective, and she was given maintenance therapy with paroxetine. Two post-ECT relapses were effectively treated with further ECT series, and maintenance ECT was the most efficient prophylactic treatment. It is recommended that ECT is prescribed for demented patients with treatment refractory, severe depression.

Alzheimer's disease, Dementia, Depression, Electroconvulsive therapy.     

事件相关电位N400神经发生源研究

目的事件相关电位(event-related potentials,ERPs)N400是与语境歧义处理相关的高级认知电位,研究应用于精神分裂症的认知功能障碍。有关N400神经发生源,国内外均少有研究报道。本研究应用“低分辩率电磁断层扫描术(low resolution electromagnetic tomography,LORETA)”技术研究 N400的神经发生源。方法ERPs应用汉词语词对(S1-S2)诱发。S1-S2的关系为:语义关联对、语义非关联对和汉词-人造词对。脑电信号应用17导电极记录。被试为18例正常健康者,男9,女9,平均年龄25．2±4．4岁。应用LORETA软件中内含的“统计学非参数地形图(statistical non-parametric mapping,SnPM)”程序分析被试处理不同类语词时所激活的脑功能区差异。结果与语义关联词对中S2诱发ERPs相比,语义非关联词对中S2诱发出潜伏期在300-500 ms左右的负向偏转成分N400。分别比较S2开始后300-350 ms、350-400 ms、400-450 ms和450-500 ms时间窗内两类刺激语词激活的脑功能区,发现具有显著性差异的脑功能区集中在左半球的颞上回、颞中回、岛回、梭状回、后扣带回和海马旁回等区域。结论事件相关电位N400的神经发生源位于优势半球的颞叶及扣带回-海马结构。     

数字散斑法测量加载100 N与400 N肱骨干骨折钢板固定下的位移

背景：将光学测量技术数字散斑相关方法应用到生物医学领域中,能更精确地分析螺钉断裂的特点。 目的：以数字散斑法测量肱骨钢板螺钉的位移。 方法：取4根肱骨制造肱骨中段骨折模型。将骨折标本进行复位,用8孔钢板固定,骨折线两端各使用4枚螺钉固定。分别在100及400 N拉力下,将模型设计成骨折前后的5种状态,即状态a是未骨折加压钢板坚强内固定组(模拟骨折愈合,未锯断);状态b是骨折后近端去1枚螺钉;状态c是在状态b的基础上远端去1枚螺钉;状态d是在状态c的基础上近端去1枚螺钉;状态e是在状态d的基础上远端去1枚螺钉。分别测量骨折线两端两枚螺钉的位移,通过相关软件计算位移。 结果与结论：在100 N及400 N拉力下,骨折线旁对称分布的两枚螺钉随着其他螺钉的减少,所产生的位移差异存在显著性意义(P < 0.01);骨折线旁成对称分布的两枚螺钉所承受的应力差异无显著性意义(P > 0.05)。提示骨折线两端的2枚螺钉是承受较多应力的部位(应力集中),易于发生断裂,应选用比现有螺钉的直径增大1.0~2.5 mm的螺钉,增加骨折线旁的固定螺钉稳定性以避免断钉等后遗症。     

数字散斑法测量加载100 N与400 N股骨干骨折钢板固定下的位移**◆

摘要 背景：钢板内固定是治疗长骨骨折常用的固定物之一,易发生螺钉断裂致骨畸形。将光学测量技术应用到生物医学领域中,能更精确的分析螺钉断裂的特点。 目的：以数字散斑法测量股骨钢板螺钉的位移。 方法：取6根股骨,于股骨干中点横行锯断,制造股骨中段骨折模型。将骨折标本进行复位,用10孔钢板固定,骨折线两端各使用5枚螺钉固定。将实验模型设计成骨折前后2种状态,进行对比测量锁钉位移。分别在100,400 N拉力下,通过相关软件计算位移。 结果与结论：在100 N及400 N状态下,螺钉1~10所承受的应力均存在显著差异(F =108.326,P < 0.01;F =151.258,P < 0.01)。进一步行两两比较,成对称分布的螺钉所承受的应力差异无显著性意义(P > 0.05),其余两两比较所承受的应力差异均有显著性意义(P < 0.05)。提示骨折线两端的2枚螺钉是承受较多应力的部位,易发生断裂,所有螺钉的固定应尽量在一条直线上,使负荷平衡。 关键词：股骨干;骨折;钢板;螺钉;内固定;生物力学     

认知事件相关电位N400与精神分裂症

本文介绍认知事件相关电位N400成分和精神分裂症的N400研究。     

数字散斑法加载100 N与500 N测量胫骨干骨折内固定下的位移

背景：以往研究多以传感器研究钢板置入内固定治疗骨折生物力学特点,存在直接接触、精度低等缺点。 目的：以数字散斑法测试成人胫骨加压钢板内固定中骨折断端第4颗和第5颗螺钉在不同拉力条件下的平均位移。 方法：测试之前在所有成人胫骨标本表面喷涂银漆粉,用于数字散斑测量。横行截断胫骨中点,制造胫骨干中段骨折模型。将加压钢板置入胫骨后外侧骨膜下,骨折端两侧各4枚螺钉穿透4层骨皮质。标本分6个状态：A,8枚螺钉加压胫骨内固定(未锯断,模拟骨愈合状态);B,在A组的基础上胫骨中点锯断;C,在B组的基础上去掉上面第1颗螺钉;D,在C组的基础上去掉下面第1颗螺钉;E,在D组的基础上去掉上面第2颗螺钉;F,在E组的基础上去掉下面第2颗螺钉,按A~F组测量顺序进行测量。在100,500 N拉力下,用CSS-44100型电子万能试验机进行加载拉力测量骨折断端近侧第4颗与第5螺钉的位移。 结果与结论：方差分析显示在100 N拉力下(F=3.107),A组与F组比较方差的P < 0.05;在500 N拉力下(F=4.719),A组与F组比较方差的P值< 0.05。说明靠近骨折线的螺钉承受较大的应力,容易断裂,在加压钢板内固定治疗胫骨骨折时,经过推断假定其螺钉直径建议增加1.0~2.0 mm。     

N5,N10-亚甲基四氢叶酸还原酶基因多态性和吸烟与缺血性卒中的关系

目的 探讨N5,N10-亚甲基四氢叶酸还原酶(MTHFR)基因多态性和吸烟与缺血性卒中患病的关系。 方法 应用聚合酶链反应(PCR)和变性高效液相色谱(DHPLC)技术筛查454例缺血性卒中患者（患者组）和334例非缺血性卒中患者(对照组)MTHFR基因的多态分布,依据TOAST分型及神经功能缺损评分分型分别进行MTHFR基因多态性的亚组分析,采用非条件Logistic回归模型分析MTTH FR基因多态性、吸烟情况与缺血性卒中患病的关系。 结果 TT基因型和T等位基因与中、重型缺血性卒中,大动脉粥样硬化型和心源性栓塞型缺血性卒中相关。携带TT基因型和T等位基因的吸烟群体患缺血性卒中的相对危险度分别为4.393和2.359,而携带CC基因型的吸烟群体患缺血性卒中的相对危险度则为0.353。非吸烟群体MTH FR基因的各基因型和等位基因频率的分布与对照组相比差异均无统计学意义（P＞0.05）。 结论 携带T等位基因的吸烟群体容易患缺血性卒中,而携带C等位基因的吸烟群体不容易患缺血性卒中;MTHFR基因与吸烟在缺血性卒中的发病过程中存在协同作用。     

儿童抽动障碍事件相关电位N400的研究

目的探讨儿童抽动障碍患者事件相关电位N400的变化及其意义。方法用诱发电位检测仪测定35例抽动障碍患儿(病例组)的N400,并与20名正常儿童(正常对照组)进行比较。结果病例组N400的潜伏期为(706.87±198.99)ms,波幅为(26.12±13.64)μV,对照组为(485.75±85.76)ms和(22.35±19.76)μV。两组潜伏期比较,差异有非常显著性(P<0.001);波幅比较,差异无显著性(P>0.05)。结论抽动障碍患者的事件相关电位N400潜伏期明显延长,显示其存在认知功能障碍。     

颅内压监测中闪光视觉诱发电位N2波特点分析及N2波潜伏期最佳测量方式的选择

目的 分析闪光视觉诱发电位(fVEP)的N2波的波形特点，探讨N2波潜伏期在颅内压监测中最佳测量方式。方法 观察40例患者，10min内连续3次fVEP记录．分析所得240幅fVEP波，总结N2波的波形特点，比较在同一测试者10min内连续3次fVEP记录后．4种N2波潜伏期测量方法中N2波潜伏期在同一测试者中稳定性。结果 fVEP的N2波变异性较大．可以为单一波，也可以为复合波．在同一测试者，10min内连续3次测量也可得出不同的波形，N2波的波幅与颅内压无关，N2波较宽，其波形的一个主要特点是前后均有较深的P波。颅内压越高N2波潜伏期越长。N2波潜伏期的4种测量方法在同一患者10min内3次连续测量中，中点潜伏期在变化差值最小。结论 fVEP的N2波波形变异较大。建议在颅内压监测中选用N2波的中点潜伏期作为颅内压监测的指标。     

Névrite optique. Diagnostics différentiels

Optic neuritis is clinically suspected when painful, rapidly progressive central visual loss occurs in a young patient who has a relative afferent pupillary defect. Ophthalmoscopy is normal in the majority of cases but papillitis or optic disc palor can occur. Several other diseases can mimic optic neuritis, such as ophthalmological conditions or other diseases affecting the visual pathways. Their appropriate clinical diagnosis is of paramount importance in order to avoid unnecessary or invasive procedures or treatments.     

Mononeuritis des N. oculomotorius bei infektiöser Mononukleose

A 19-year-old immune-competent patient developed right-sided headache and, subsequently, subacute diplopia. On clinical examination he had incomplete right oculomotor palsy. Cranial MRI showed pathologic contrast enhancement of the right oculomotor nerve at its exit point from the mesencephalon, and the CSF displayed slight pleocytosis. The following relevant differential diagnoses were not supported by additional examinations: neurosarcoidosis, Lyme neuroborreliosis, neurosyphilis, tuberculous meningitis, viral meningitis (HIV, VZV, CMV), CNS lymphoma, vasculitis associated with rheumatic disease, Tolosa-Hunt syndrome, and diabetic neuropathy. However, on the basis of blood lymphocytosis, positive heterophile antibody test (Paul-Bunnell test), the presence of IgM antibodies against Epstein-Barr virus capsid antigen, and elevated transaminases, infectious mononucleosis was diagnosed. Isolated neuritis of the oculomotor nerve is a rare parainfectious manifestation of infectious mononucleosis.     

Effects of 3,N,N′-trimethyl-2-phenyl-1,4-piperazine diastereomers on monoamine uptake and monoamine oxidase in rat brain

Summary The diastereomers of 3,N,N-trimethyl-2-phenyl-1,4-piperazine dihydrochloride (TPP) were tested for their effects on NA, DA and 5-HT uptake in synaptosomes prepared from hypothalamus, corpus striatum, and frontal cortex, respectively. The diastereomers differed with respect to their inhibitory properties. (2R, 3R)-TPP was more potent than the other diastereomers on NA and DA uptake, whereas (2S, 3S)-TPP was least potent. In contrast, the (2S, 3S)- and (2 S, 3R)-diastereomers of TPP were more potent than (2R, 3R)- and (2R, 3S)-TPP as inhibitors of 5-HT uptake. None of the diastereomers affected monoamine oxidase activity. The findings show that the diastereomers of TPP interact stereoselectively with neuronal mechanisms for monoamine uptake, and that the (S)-configuration at the 2 carbon is important for inhibitory actions of TPP on 5-HT uptake.