经颅多普勒检测脑微栓子

应用经颅多普勒检测脑循环中的微栓子是国外目前开展的一项新的无创性检测方法。它能直接检测脑循环中微栓子的数量和性质。对不同类型的缺血性卒中的发病机制、鉴别诊断、病情监测和药物疗效的评价,以及发现高危卒中患者都有较大的价值。     

经颅多普勒检测脑微栓子

应用经颅多普勒检测脑循环中的微栓子是国外目前开展的一项新的无创性检测方法。它能直接检测脑循环中微栓子的数量和性质。对不同类型的缺血性卒中的发病机制、鉴别诊断、病情监测和药物疗效的评价，以及发现高危卒中患者都有较大的价值。     

脑循环中栓子的经颅超声多普勒检测

应用经颅超声多普勒检测脑循环中的无症状性栓子对脑卒中的防治有重要的临床意义。文章就这一技术的基本原理、动物实验和临床研究及发展方向作一综述。     

脑循环中栓子的经颅超声多普勒检测

应用经颅超声多普勒检测脑循环中的无症状性栓对脑座中的防治有重要的临床意义。文章就这一技术的基本原理、动物实验和临床研究及发展方向作一综述。     

经颅多普勒微栓子监测

文章回顾了经颅多普勒超声实时监测脑动脉血流中微栓子的基本原理，详细介绍了这一新技术的使用方法和临床应用研究进展。     

经颅多普勒微栓子监测

文章回顾了经颅多普勒超声实时监测脑动脉血流中微栓子的基本原理，详细介绍了这一新技术的使用方法和临床应用研究进展。     

微拴的经颅超声多普勒检测

综述经颅超声多普勒检测微栓信号的特征,检测标准以及与栓子的性质、大小之间的关系;并对经颅超声多普勒微栓检测相关的几个问题作一简要分析。     

短暂性脑缺血发作的经颅多普勒微栓子监测

目的探讨短暂性脑缺血发作的经颅多普勒微栓子监测,了解其发病机制,确定缺血性卒中的高危人群。方法应用经颅多普勒超声检测仪对65例短暂性脑缺血发作患者进行微栓子监测,常规测定颅内外各血管的血流狭窄、频谱形态及声频,以确定有无血管狭窄及狭窄部位,每次监测30min～60min。结果颅内动脉狭窄54例,其中单发动脉狭窄例15例,狭窄动脉以大脑中动脉狭窄为主;微栓子信号(MES)阳性14例,MES共56个,MES强度5.1dB～24.9dB;颈内动脉轻度狭窄出现MES阳性3例,中度狭窄7例,重度狭窄4例。结论对短暂性脑缺血发作经颅多普勒微栓子监测,使脑动脉内栓子的直接检测或实时监测成为可能。     

经颅多普勒检测脑循环中的反常栓子

反常脑栓塞是缺血性卒中病因之一。经颅多普勒技术能检测脑循环中的反常栓子，提高了卵圆孔未闭的检出率，对卒中的防治有重要意义。文章着重讨论了这一技术的原理、检测方法及临床研究进展。     

微栓的经颅超声多普勒检测

综述经颅超声多普勒检测微栓信号的特征，检测标准以及与栓子的性质、大小之间的关系；并对经颅超声多普勒微栓检测相关的几个问题作一简要分析。     

Inadequacies of absolute threshold levels for diagnosing prediabetes

Prediabetes comprising Impaired Fasting Glucose (IFG) and Impaired Glucose Tolerance (IGT) represents an intermediate stage of altered glucose metabolism between normal glucose levels and type 2 diabetes mellitus and is associated with an increased risk for the development of diabetes and cardiovascular disease. There is considerable evidence that glucose levels lower than those meeting the current definition of prediabetes may also be associated with similar risks particularly in high‐risk individuals. Prediabetes is often unrecognized and therefore constitutes a major public health concern suggesting the need for earlier intervention than is currently recommended. Copyright © 2010 John Wiley & Sons, Ltd.     

闭塞性脑血管病的TCD与MRA对照研究

对５２例闭塞性脑血管病患者进行穿颅多普勒（ＴＣＤ）及磁共振血管造影（ＭＲＡ）检查。结果ＭＲＡ显示２２例大血管闭塞，３０例正常；ＴＣＤ显示４５例异常，７例正常。认为ＭＲＡ诊断大血管闭塞有较肯定的价值。而ＴＣＤ不但对大血管闭塞有诊断价值，对小血管闭塞亦能反映相应血管的功能状态及脑血流灌注情况。     

Power Doppler sonography for hepatocellular carcinoma: factors affecting the power Doppler signals of the tumors

Abstract: Aims/Background: A recent advancement in Doppler ultrasonography (US) is power Doppler for detecting low-velocity blood flow at the microvascular level with angle independence. The present study was performed to characterize the factors contributing to the power Doppler signals of hepatocellular carcinoma (HCC). Method: Correlation of Doppler signals of HCC in 114 patients with 178 HCC nodules was analyzed in relation to the findings of CT and angiography, tumor characteristics (size, echo pattern, and histological differentiation of tumor), viral markers and severity of liver disease. Results: The sensitivity of power Doppler US was superior to that of CT and angiography (each p<0.05; McNemar's test). The detection rate of power Doppler signal was significantly higher in tumors with diameter ≥2 cm (vs <2 cm in diameter), and with low/mixed echo pattern (vs high echo appearance), and with moderately/poorly differentiated HCC (vs well-differentiated HCC). Univariate analysis revealed that echo pattern, tumor size and histological differentiation of HCC in addition to CT and angiographic findings were significant. Multivariate analysis showed that tumor size and differentiation were significant. Conclusion: These results indicate that tumor characteristics play an important role in power Doppler signals and that these could be assessed by the presence or absence of power Doppler signals.     

Assessment of pain threshold in haemophilic patients

Many patients with haemophilia (PWH) live with persistent end‐stage arthritis, as a result of multiple joint haemarthrosis, and experience daily pain. For these people, pain becomes a central aspect of life. The aim of this study was to use mechanical pain thresholds (MPT) to characterize pain perception in different PWH groups. The groups tested were characterized by age, previous bleeding into joints, Hemophilia Joint Health Score (HJHS) and PAIN perception score in the HJHS scoring. A total of 23 PWH (haemophilia A) were included in this study (10 children, 13 adults). A total of 12 PWH suffered from repeated bleeding into some of the tested joints. Data were compared to those collected from 15 age‐matched control subjects. The most significant differences in MPTs were found when the PWH were compared to the controls, based on the differences in PAIN score (PAIN score 1 and 2) in all the tested joints, except for the right knee. Similarly, the difference in MPT in ankle joints was confirmed when PWH with and without bleeding were compared to controls. Summarizing the outcomes, we can emphasize the potential usefulness of MPT as an objective tool in evaluating the pain of PWH.     

实验性血压变化对基础痛阈的影响

目的 :观察左侧肾动脉结扎大鼠血压变化对热痛阈和机械痛阈影响的时程。方法 :将 16只动物分为 3组 :假手术组、肾动脉结扎组和肾动脉结扎 +肌注利血平组 ,每天在一定时间检测动脉收缩压 （BP）、热刺激缩足反应潜伏期 （PWTL ）和机械刺激缩足反应阈值 （PWMT） ,并作定量分析。结果 :1假手术组 BP,PWTL和 PWMT均未发生明显变化 （P>0 .0 5 ）。 2肾动脉结扎组大鼠血压在术后第 1天开始升高 ,第 3天达峰值 ,并维持在高血压水平 （112± 6 vs 16 0± 8m m Hg） ,平行观察显示 PWTL和 PWMT均随动脉收缩压升高而降低 ,提示发生了热和机械痛敏现象。 3利血平降压治疗后动脉收缩压虽然降至正常范围 ,但热痛敏和机械痛敏却未被翻转。结论 :持续实验性高血压可能对伤害性反射的神经通路具有不可逆的调节作用     

5种不规则抗体筛查方法的检测阈值比较

目的:了解各种不规则抗体筛查方法的检测阈值,以避免不规则抗体漏检而引起输血不良反应。方法:选取献血者不规则抗体筛查阳性样本3例和配血不合疑难样本9例,采用盐水法、酶介质法、凝聚胺法、抗人球蛋白法、微柱凝胶法平行检测,比较5种方法的检测阈值。结果:盐水法只能检出IgM类的不规则抗体;木瓜酶法在检测IgG抗体效价时敏感性略低,而且有漏检的可能;凝聚胺法检测结果不易判断;抗人球蛋白法操作较繁琐;微柱凝胶法对IgG类抗体检测效价较高,高于凝聚胺法和抗人球蛋白法。结论:微柱凝胶法操作简单,检出率较高,是值得推广的不规则抗体筛查方法。     

Safe and effective use of conscious sedation for defibrillation threshold testing during ICD implantation

Background

Over a period of years general anesthesia has been a standard anesthetic technique for defibrillation threshold (DFT) testing at the time of implant. DFT testing without general anesthesia cover has gained limited acceptance. Use of local anesthesia combined with deep sedation for DFT testing might facilitate and simplify these procedures by reducing the procedural time, staff time, avoiding inefficient service in organizing anesthetic cover; thereby improving patient compliance.

Objective

The objective of this study was to evaluate feasibility, safety and efficacy of conscious sedation for DFT testing during Implantable cardioverter defibrillators (ICD) implantation.

Method

Data of 87 non-selected patients who achieved adequate sedation with titrated doses of midazolam and pethidine were analyzed retrospectively. These medications were administered by a circulating nurse under the supervision of the implanting physicians. All hemodynamic measures, treatment and complications were monitored and recorded throughout the procedure.

Results

A retrospective analysis of data from 87 patients who underwent ICD implantation and DFT testing under conscious sedation at our center was reported. The mean dose of midazolam and pethidine administered was 4.9 ± 1.8 and 47.7 ± 20 mg, respectively. During the period of conscious sedation, no patient depicted episode of sustained apnea. No major complication or mortality was reported.

Conclusion

Use of conscious sedation as an alternative to the use of general anesthesia for DFT testing during ICD implantation is found to be feasible, safe and effective, with an added advantage of reduced procedural time and improved patient compliance.     

Evidence for a memory threshold in second-choice recognition memory responses

A fundamental question in the study of cognition is whether memory strength varies continuously or whether memories sometimes fall below a threshold and fail completely. Previous studies examining this question have relied exclusively on 1 method—receiver operating characteristics—so in the current study, we addressed this issue by using a completely different approach. We tested memory for single items and for arbitrary associations (e.g., memory for random word pairs) by using a 4-alternative forced-choice test in which subjects either made a single choice or a first and a second choice. In item recognition, single- and second-choice scores were directly related, as expected if a continuous strength signal supported performance. In contrast, in associative recognition, single- and second-choice scores were found to be unrelated, as predicted by high-threshold theories. However, when the word pairs were encoded as single compound words rather than arbitrary associations, associative recognition appeared to rely more on a continuous strength process. The results support memory models that include both a continuous familiarity process and a threshold recollection process.