抑郁性失眠与心理生理性失眠多导睡眠图特征比较

目的:探讨抑郁性失眠与心理生理性失眠多导睡眠图参数变化特征。 方法:对27例快动眼潜伏期明确缩短的抑郁性失眠(depression or dysthymia insomnia,DDI)和39例心理生理性失眠(psychophysiologic insomnia,PPI)患者的多导睡眠图结果进行回顾性统计分析,并进行两组间睡眠多导图各参数的比较。 结果:①快动跟测量值:快动眼潜伏期(min):DDI组(65.6±11.9)较PPI组(156.7±67.0)明显缩短(t=8.295,P=0.000);快动眼周期数(次):DDI组(4.2±1.1)较PPI组(3.3±1.0)明显增多(f=3.110.P=0.003)。但快动眼时间(min)两组差异无显著性意义(t=1.862.JD=0.067)。②睡眠结构:非快动眼时间占总睡眠时间百分数(％)DDI组较PPI明显减少(t=3.145,P=0.003);但其组分S_1％,S_2％,S_(3-4)％两组分别比较却无明显差别。快动眼时间占TST百分数(快动眼％)DDI组较PPI组明显增多(t=3.164,P=0.002)。但在所有66例失眠患者中S_1％:男21.6±0.09,女15.7±0.08,有显著差异(t=3.145.P=0.006)。③睡眠进程及连续性:在睡眠潜伏期,醒起时间,觉醒时间,醒觉次数,总睡眠时间,觉睡比,睡眠效率,两组分别比较差异均无显著性意义(P>0.05)。 结论:抑郁性失眠的快动眼测量值及睡眠结构较心理生理性失眠患者具有特征性的变化,非快动眼减少而快动眼增加;但     

抑郁症患者睡眠生理的特征改变

目的:探讨抑郁症患者睡眠生理结构的变化,并与正常人比较。方法:抑郁症组为2002-01/2004-12广州市精神病医院门诊抑郁症患者42例,正常对照组为广州市精神病医院部分职工和广州医学院部分学生,共选择30人。使用英国Oxford工厂生产的Medilog多导睡眠图记录仪进行多导睡眠图检查,记录整夜的脑电图信号。主要观察①睡眠进程:包括总记录时间,睡眠总时间,睡眠潜伏期,快速眼动睡眠潜伏等。②睡眠结构:包括各阶段(非快速眼动S1、S2、S3、S4、快速眼动)睡眠的时间和百分比,快速眼动活动度、密度和强度,睡后觉醒的次数、时间和百分比。③睡眠片断的平均时程。对此项检查获患者及家属全面知情同意。结果:抑郁症组及正常对照组均完成多导睡眠图的检查,全部进入结果分析。①睡眠进程分析:总记录时间两组无差异,抑郁症组睡眠总时间比正常对照组少,睡眠潜伏期比正常对照组长,快速眼动睡眠潜伏期比正常对照组短,差异均有显著性(P<0.05),抑郁症组睡眠效率和维持率低。②睡眠结构分析:抑郁症组非快速眼动S1时间比正常对照组长,但无统计学意义;非快速眼动S2时间比正常对照组短,[(212.72±22.9),(224.63±8.1)min,F=9.388,P=0.004];而非快速眼动(S3+S4)时间比正常组短,但无统计学意义,不少患者的整个慢波睡眠(S3+S4)缺失。抑郁症组快速眼动活动度、密度和强度均显著高于正常对照组,睡后觉醒时间长。③抑郁症组睡眠片断的平均时程低于正常对照组(81.90±7.2),(96.73±8.6)min,P=0.818。结论:抑郁症组睡眠潜伏期长、睡后觉醒时间长,睡眠效率和维持率低,快速眼动潜伏期缩短,S1睡眠延长,S3,S4睡眠缩短,部分患者的整个慢波睡眠(S3+S4)缺失。提示抑郁症患者与正常人有不同的睡眠模式,其睡眠障碍模式以快速眼动睡眠过度活跃为特征。     

抑郁性失眠与心理生理性失眠多导睡眠图特征比较

目的：探讨抑郁性失眠与心理生理性失眠多导睡眠图参数变化特征。方法：对27例快动眼潜伏期明确缩短的抑郁性失眠(depression or dysthymia insomnia，DDI)和39例心理生理性失眠(psychophysiologic insomnia，PPI)患者的多导睡眠图结果进行回顾性统计分析，并进行两组间睡眠多导图各参数的比较。结果：①快动眼测量值：快动眼潜伏期(min)：DDI组(65．6&;#177;11．9)较PPI组(156．7&;#177;67．0)明显缩短(t=8．295，P=0．000)；快动眼周期数(次)：DDI组(4．2&;#177;1．1)较PPI组(3．3&;#177;1．0)明显增多(t=3．110，P=0．003)。但快动眼时间(min)两组差异无显著性意义(t=1．862，P=0．067)。②睡眠结构：非快动眼时间占总睡眠时间百分数(％)DDI组较PPI明显减少(t=3．145，P=0．003)；但其组分S1％，S2％，S3-4％两组分别比较却无明显差别。快动眼时间占TST百分数(快动眼％)DDI组较PPI组明显增多(t=3．164，P=0．002)。但在所有66例失眠患者中S1％：男21．6&;#177;0．09，女15．7&;#177;0．08，有显著差异(t=3.145，P=0．006)。③睡眠进程及连续性：在睡眠潜伏期，醒起时间，觉醒时间，醒觉次数，总睡眠时间，觉睡比，睡眠效率，两组分别比较差异均无显著性意义(P&;gt;0．05)。结论：抑郁性失眠的快动眼测量值及睡眠结构较心理生理性失眠患者具有特征性的变化，非快动眼减少而快动眼增加；但两类失眠的睡眠进程和连续性却无差别；另外，在所有失眠病例中男性较女性具有更多的I期浅睡眠。     

抑郁症患者睡眠生理的特征改变

目的：探讨抑郁症患者睡眠生理结构的变化，并与正常人比较。方法：抑郁症组为2002—01／2004—12广州市精神病医院门诊抑郁症患者42例，正常对照组为广州市精神病医院部分职工和广州医学院部分学生，共选择30人。使用英国Oxford工厂生产的Medilog多导睡眠图记录仪进行多导睡眠图检查．记录整夜的脑电图信号。主要观察①睡眠进程：包括总记录时间，睡眠总时间．睡眠潜伏期，快速眼动睡眠潜伏等。②睡眠结构：包括各阶段（非快速眼动S1、S2、S3、S4、快速眼动）睡眠的时间和百分比，快速眼动活动度、密度和强度，睡后觉醒的次数、时间和百分比。③睡眠片断的平均时程。对此项检查获患者及家属全面知情同意。结果：抑郁症组及正常对照组均完成多导睡眠图的检查，全部进入结果分析。①睡眠进程分析：总记录时间两组无差异，抑郁症组睡眠总时间比正常对照组少，睡眠潜伏期比正常对照组长，快速眼动睡眠潜伏期比正常对照组短，差异均有显著性（P〈0．05），抑郁症组睡眠效率和维持率低。②睡眠结构分析：抑郁症组非快速眼动S1时间比正常对照组长，但无统计学意义；非快速眼动S2时间比正常对照组短，[（212．72&;#177;92．9），（224．63&;#177;8．1）min，F=9．388，P=-0．004]；而非快速眼动（S3＋S4）时间比正常组短，但无统计学意义，不少患者的整个慢波睡眠（S3＋S4）缺失。抑郁症组快速眼动活动度、密度和强度均显著高于正常对照组，睡后觉醒时间长。（爹抑郁症组睡眠片断的平均时程低于正常对照组[（81.90&;#177;7．2），（96.73&;#177;8．6）min，P=0．818]。结论：抑郁症组睡眠潜伏期长、睡后觉醒时间长，睡眠效率和维持率低，快速眼动潜伏期缩短，S1睡眠延长，S3，S4睡眠缩短，部分患者的整个慢波睡眠（S3＋S4）缺失。提示抑郁症患者与正常人有不同的睡眠模式，其睡眠障碍模式以快速眼动睡眠过度活跃为特征。     

精神分裂症患者的记忆与睡眠的特点及二者间的关系研究核心探究

目的：分析精神分裂症患者的记忆和睡眠的特点,并对二者之间的关系进行深入性的研究。方法：选取2019年8月至2020年8月临沂市精神卫生中心收治的精神分裂症患者80例作为观察组研究对象,选取同期体检的健康者80名作为对照组研究对象,对2组人员采用多维记忆评估量表(MMAS)评估其记忆状况,采用多导睡眠监测其睡眠状况,对其特点展开分析,并研究记忆和睡眠之间的关系。结果：对比2组睡眠潜伏期、总睡眠时间、快动眼睡眠、非快动眼睡眠N₂、非快动眼睡眠N₁,数据显示2组之间无明显的区别,差异无统计学意义(P>0.05);但在慢波睡眠、睡眠效率数据方面比较,观察组低于对照组,差异有统计学意义(P<0.05),在微觉醒次数、快动眼睡眠潜伏期数据方面比较,观察组高于对照组,差异有统计学意义(P<0.05)。结论：精神分裂症患者存在相应的记忆和睡眠障碍情况,睡眠和记忆之间有一定的关系,睡眠质量的好坏直接对其记忆能力造成影响。     

可乐定对麻醉下大鼠皮质体感诱发电位N20波的影响

目的:探讨大鼠异丙酚麻醉中α2-NA受体激动剂可乐定对皮质体感诱发电位(SEP)N20波的影响。方法:将SD雄性大鼠20只按抽签法随机分为2组,单纯异丙酚A组:微量泵以10mg/(kg·h),60mg/(kg·h)的速度依次各静注45min,停止静注异丙酚直至动物清醒。B组除在输注异丙酚的同时腹腔内注射可乐定0.5mg/kg外,余和A组相同。分别监测麻醉前、中及苏醒期的皮层SEPN20波的潜伏期和波幅。结果:与基础值相比,两组药物对SEPN20波潜伏期均无显著影响;A组对SEPN20波的波幅无影响,B组降低SEPN20波的波幅。结论:异丙酚麻醉下α2-NA受体激动剂所引起SEPN20波波幅变化可能与镇痛机制有关。     

不宁腿综合征多导睡眠图监测情况分析

目的探讨不宁腿综合征（restless legs syndrome,RLS）夜间视频多导睡眠图与患者睡眠质量主观感受的差异,分析RLS患者伴发焦虑-抑郁状态。方法 26例RLS患者为RLS组,24例体检健康者为对照组,分析2组视频多导睡眠图结果,应用汉密尔顿焦虑抑郁量表及匹兹堡睡眠质量问卷评价RLS患者的焦虑-抑郁状态及主观睡眠情况。结果与对照组比较,RLS组总睡眠时间、睡眠效率、睡眠维持率、快速眼动睡眠次数降低（P〈0.05）,睡眠潜伏期、快速眼动睡眠潜伏期、醒起时间、≥5min的醒觉次数、非快速眼动睡眠Ⅰ期和Ⅱ期所占睡眠比例延长或增高（P〈0.05）。结论多导睡眠监测可客观评定患者睡眠质量,对RLS诊断有一定价值。     

睡眠呼吸障碍对儿童睡眠结构的影响分析

分析睡眠呼吸障碍对儿童睡眠结构的影响,以对临床治疗提供参考。将60例睡眠呼吸障碍患儿(A组)及40例健康儿童(B组)作为观察对象。对比两组间睡眠时间(TST)、睡眠潜伏期(SL)及快眼动睡眠潜伏期(RL)等睡眠相关时间及睡眠效率(s E)、非快眼动睡眠期第1、2、3+4期睡眠时间比例(s1、s2、s3+4),快眼动睡眠时间比例(RT)等睡眠质量相关指标差异。A组TST为(361.35±72.31)min明显短于B组的(459.36±67.23)min(P0.05),而A组的SL及RL分别为(33.25±12.67)min及(109.61±22.16)min较B组的(15.22±11.26)min及(88.23±12.32)min明显缩短(P0.05);同时A组s E明显低于B组(P0.05),且A组s1高于B组,而s2、s3+4及RT则明显低于B组(P0.05)。睡眠呼吸障碍可严重影响儿童的睡眠结构,对儿童的睡眠质量可造成严重的影响。     

发作性睡病的临床监测与特征分析

目的探讨多导睡眠图(ploysomnography;PSG)、多次睡眠潜伏期试验(multiplesleeplatencytest;MSLT)在发作性睡病(Narcolepsy;NC)和嗜睡症(lethargy;IH)患者诊断、鉴别诊断中的价值。方法对35例发作性睡病(NC)和30例嗜睡症(IH)进行整夜多导睡眠图(PSG)描记和多次睡眠潜伏期试验(MSLT),分析其睡眠参数异同。结果MSLT结果显示:NC组睡眠潜伏期和快动眼睡眠(REM)潜伏期显著缩短,入睡次数和REM睡眠出现次数明显多于IH组和对照组(P<0.01),睡眠潜伏期<5分钟和ROREMPs≥2次30例(85.7%),与IH组比较差异有统计学意义(P<0.01);整夜PSG结果显示:NC组总睡眠时间和深睡眠(SWS)百分比及REM潜伏期显著低于IH组和对照组,而S1阶段睡眠显著高于IH组,两组比较,差异具有统计学决心义(P<0.01)。结论NC患者具有明显的睡眠潜伏期缩短和反常的REM睡眠特征,MSLT、PSG对NC和IH的诊断和鉴别诊断具有重要参考价值。     

老年性痴呆患者事件相关电位P300和多导睡眠图对照研究

目的：探讨老年性痴呆患者事件相关电位（ERP）和多导睡眠图（PSG）之间的关系。方法：对36例临床诊断的老年性痴呆患者及35例年龄匹配的健康人进行对照研究,所有受试者均进行ERP和PSG测试。结果：研究组中ERP测定的异常率为94．4％（34／36）,ERP中N2、P3波潜伏期较对照组延长,P3波幅降低,其差异具有显著性意义（P〈0．01）,PSG测定睡眠潜伏期延长、觉醒次数和S1阶段增多、总睡眠时间、深睡眠（S3＋S4）、快眼动睡眠时间和睡眠纺锤波指数减少、睡眠效率降低与对照组比较差异有显著性意义（P〈0．01）。ERP成分中P3波潜伏期P3波幅与PSG测定中睡眠潜伏期、觉醒次数、总睡眠时间、深睡眠、快眼动睡眠时间、睡眠效率及纺锤波指数等指标存在显著的相关性（P〈0．01）。结论：老年性痴呆患者存在明显的认知功能减退和睡眠质量下降。ERP和PSG可以作为老年性痴呆患者早期诊断的辅助指标。     

Sleep quality of mechanically ventilated patients sedated with dexmedetomidine

Purpose

Dexmedetomidine is thought to activate an endogenous pathway that naturally promotes non-rapid eye movement (NREM) sleep. Dexmedetomidine may induce restorative sleep, that is, NREM stage 3 and 4 (slow wave sleep; SWS) or sleep continuity in mechanically ventilated patients. Few data have been published, however, on the sleep characteristics of mechanically ventilated patients during dexmedetomidine infusion.

Methods

We recorded polysomnography (PSG) for 24?h in mechanically ventilated patients sedated with dexmedetomidine. Dexmedetomidine (0.2–0.7 μg/kg/h) was administered intravenously to maintain the Richmond Agitation–Sedation Scale between ?1 and ?4 only during the nighttime (9:00 p.m. to 6:00 a.m.). During the daytime, we interrupted the sedatives and analgesics unless the patient complained of discomfort. When this occurred midazolam or opioids were administered intermittently. Sleep stages and the frequency of arousal/awakening during the nighttime were analyzed using Rechtschaffen and Kales criteria.

Results

For the ten mechanically ventilated adult patients recruited into the study, the median total sleep time (TST) during the night was 4.7?h (IQR, 4.2–8.1?h), and 78?% of sleep occurred during the night (median 78?%, IQR: 69–88?%). Sleep architecture was exclusively NREM sleep stage 1 (median 28.9?% of TST) and stage 2 (median 71.2?% of TST). Neither SWS (median 0?% of TST) nor rapid eye movement (REM) sleep (median 0?% of TST) was observed. Median frequency of arousals/awakenings was 9.3/h (IQR, 3–19.5/h).

Conclusions

In mechanically ventilated patients, nighttime infusion of dexmedetomidine preserved the day-night cycle of sleep but induced severely disturbed sleep architecture without evidence of SWS or REM sleep.     

COMBINED EFFECTS OF MIDAZOLAM AND ETHANOL ON SLEEP AND ON PSYCHOMOTOR PERFORMANCE IN NORMAL SUBJECTS

A study was carried out on the effects of midazolam 15 mg in conjunction with ethanol 0.5 g/kg on objective and subjective sleep parameters and psychomotor performance in normal subjects. Midazolam significantly decreased total wake time. Total sleep time (TST) increase was related to larger amounts of stage 2 NREM sleep. Ethanol showed similar effects on sleep, although TST increase was associated with nonsignificant increments of NREM sleep and REM sleep. Ethanol slightly potentiated midazolam effects on sleep. Accordingly, total wake time, REM sleep time and number of wakes showed further depression than with midazolam alone. Subjective evaluations showed relatively good correlation with sleep laboratory findings. In addition, the different treatments did not impair subject's psychomotor performance the morning after their administration.     

成人部分性癫痫患者的睡眠结构与听觉事件相关电位的特征及相关性研究

目的探讨成人部分性癫痫患者的睡眠结构与听觉事件相关电位(AERPS)的特征及相关性。方法选取2012年5月至2014年8月本院收治的54例成人部分性癫痫患者作为研究组,另选取54例同期健康体检者作为对照组,均行AERPS和睡眠脑电图监测,分析两组对象睡眠参数和AERPS参数,并探讨其相关性。结果研究组总睡眠时间、睡眠效率和非快速眼动睡眠(NREM3)+4期占总睡眠时间百分比较对照组低,而NREM1期、NREM2期和清醒期占总睡眠时间百分比较对照组高,差异均有统计学意义(P0.05)。研究组潜伏期P300高于对照组,差异有统计学意义(P0.05)。研究组患者P300潜伏期与NREM3+4期占总睡眠时间百分比(r=-0.452,P0.05)、睡眠效率(r=-0.413,P0.05)呈负相关,与其余睡眠参数间无明显相关性。结论成人部分性癫痫患者睡眠结构和AERPS均发生异常,其中睡眠参数的变化与P300潜伏期有负相关性。     

Propofol (Diprivan-EDTA) counteracts oxidative injury and deterioration of the arterial oxygen tension during experimental septic shock

PURPOSE: Human septic shock can be replicated in the endotoxaemic pig. Endotoxaemia causes a multitude of events, including reduced PaO(2) and increased lipid peroxidation. This study was designed to evaluate the possible effects of a commonly used anaesthetic drug with known antioxidant properties (propofol) during porcine endotoxaemia. METHODS: Ten pigs were anaesthetised and given a 6 h E. coli endotoxin infusion. The animals received, randomly, a supplementary continuous infusion of propofol emulsion (containing 0.005% EDTA) or the corresponding volume of vehicle (controls). Pathophysiologic responses were determined. Non-enzymatic (by measuring plasma 8-iso-PGF(2 alpha) and enzymatic (by measuring plasma 15-keto-dihydro-PGF(2 alpha)) lipid peroxidations were evaluated. Plasma levels of the endogenous antioxidants alpha- and gamma-tocopherols, were also analysed. RESULTS: Endotoxaemia increased plasma levels of 8-iso-PGF(2 alpha) (1st-4th h) and 15-keto-dihydro-PGF(2 alpha) (1st-4th h) significantly more in controls than in the propofol+endotoxin group. PaO(2) was significantly less affected by endotoxin in the propofol treated animals (2nd-4th h). Mean arterial pressure (4th-6th h) and systemic vascular resistance (6th h) were reduced significantly more by endotoxin among the propofol-treated animals. Vitamin E (alpha-tocopherol) increased in all animals, significantly more in the propofol+endotoxin group (1/2-6th h) than in the control group. CONCLUSIONS: Propofol reduced endotoxin-induced free radical mediated and cyclooxygenase catalysed lipid peroxidation significantly. The implication is that propofol counteracts endotoxin-induced deterioration of PaO(2).     

Changes in the first postoperative night bispectral index of patients after thyroidectomy with different types of primary anesthetic management: a randomized controlled trial

Despite major advances in anesthesia management and developments in anesthetic agents, postoperative sleep disturbances remain dissatisfactory for many patients. We hypothesized that propofol might have a subtle influence on sleep after thyroidectomy compared to sevoflurane. A randomized, single-blinded, controlled trial was conducted at the First Hospital of China Medical University from October 2014 to October 2015. One hundred and twenty-four patients undergoing thyroidectomy were enrolled and received sevoflurane (sevoflurane group) or propofol (propofol group) as anesthesia maintenance. Major assessments were made during the operation (different types of anesthetic management) and on the first postoperative night (sleep status). The primary outcome was postoperative sleep status, measured by the BIS-Vista monitor on the first night after surgery between propofol and sevoflurane groups. A total of 105 patients (79 women, 26 men; mean age 49 years; range 18–65 years) were included in the final study sample. All patients in both groups showed one of the five sleep patterns classified by this trial. The BIS-area under the curve was decreased, the sleep efficiency index was significantly increased, and the durations of postoperative sleep and sleep stage N3 were increased by 110.5 and 36.5 min per patient, respectively, in the propofol compared to the sevoflurane group. Propofol might preserve sleep time immediately after thyroidectomy. Clinical Trials.gov identifier: NCT 02146976.     

Relative preservation of the renin-angiotensin-aldosterone system response to active orthostatism in type 2 diabetic patients with autonomic neuropathy and postural hypotension

OBJECTIVE: The pathophysiological mechanisms involved in the progression of autonomic neuropathy (AN) and development of postural hypotension (PH) in type 2 diabetes (T2D) are largely unknown. The aim of this study was to address this issue by investigating the neurohormonal responses during active orthostatism (O) in T2D patients with and without PH. METHODS: Plasma noradrenaline (NA, pmol/L), adrenaline (A, pmol/L), plasma renin activity (PRA, angiotensin I, nmol/L/h) and aldosterone (ALD, pmol/L) were measured in the supine position (baseline) and after 2, 5, and 20 min O in 10 healthy subjects (C), 9 T2D patients without AN (D), 14 T2D patients with AN and without PH (DAN), and 7 T2D patients with AN and PH (DAN-PH). RESULTS: NA concentrations were significantly increased in the C. D and DAN groups during O. In the DAN-PH group, NA increased less markedly with no significant changes at 20 min O (+ 354 +/- 89 pmol/L at 2 min, p < 0.05; + 756 +/- 171 at 5 min, p < 0.05; + 656 +/- 295 at 20 min, p = NS). Absolute NA increments in the DAN-PH group were significantly lower than those in the C, D and DAN groups at 2 and 20 min. Concentrations of A increased significantly in the C and D groups whereas no significant changes were observed in the DAN (+ 27 +/- 27 pmol/L at 2 min, p = NS: + 22 +/- 22 at 5 min, p = NS; + 76 +/- 33 at 20 min, p = NS) and DAN-PH group (+ 16 +/- 11 pmol/L at 2 min, p = NS: + 71 +/- 27 at 5 min, p = NS; + 76 +/- 22 at 20 min, p = NS). Absolute A increments in the DAN and DAN-PH groups were significantly lower than those in controls at 2 and 20 min. By contrast, PRA and ALD increased significantly in all four groups. Absolute PRA increments were similar across the four groups, whereas ALD increments in the D, DAN and DAN-PH groups were significantly lower than those in the C group. CONCLUSIONS: In the DAN-PH group, the renin-angiotensin-aldosterone system response to O was relatively preserved compared with A and NA responses. The impairment of NA response was limited to the DAN-PH group, whereas the reduced A response was a feature of DAN regardless of PH.     

Plasticity in excitatory amino acid receptor-mediated descending pain modulation after inflammation.

The role for excitatory amino acids (EAAs) in the rostral ventromedial medulla (RVM) in descending pain modulation after persistent noxious input is unclear. In an animal model of inflammatory hyperalgesia, we examined the effects of intra-RVM microinjection of EAA receptor agonists and antagonists on paw withdrawal and tail-flick responses in lightly anesthetized rats. N-Methyl-D-aspartate (NMDA) produced effects that depended upon the postinflammatory time period. At 3 h postinflammation, NMDA induced facilitation at a lower dose (10 pmol) and inhibition at a higher dose (1000 pmol). At 24 h postinflammation, NMDA (0.1-1000 pmol) produced a dose-dependent inhibition. The facilitation and inhibition, respectively, were attenuated significantly by the preadministration of an NMDA receptor antagonist, DL-2-amino-5-phosphonovaleric acid (APV) (10 pmol, P < 0.05), to the same site. Intra-RVM microinjection of alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) (0.1-100 pmol) produced dose-dependent inhibition at both 3 and 24 h postinflammation that was blocked by the preadministration of an AMPA/kainate receptor antagonist, 2,3-dihydroxy-6-nitro-7-sulfamoylbenzo(f)quinoxaline (100 pmol, P < 0.05). Unexpectedly, AMPA-produced inhibition was also significantly attenuated by preadministration of APV (10 pmol, P < 0.05). Compared with 3 h postinflammation, both NMDA and AMPA showed a leftward shift in their dose-response curves at 24 h postinflammation. These results demonstrate that NMDA and AMPA receptors in the RVM are involved in the descending modulation after inflammatory hyperalgesia. There is a time-dependent increase in EAA neurotransmission in the RVM after inflammation and NMDA receptors play an important role in AMPA-produced inhibition.     

The accuracy of simple,feasible alternatives to polysomnography for assessing sleep in intensive care: An observational study

BackgroundSleep disturbance is common in intensive care patients. Understanding the accuracy of simple, feasible sleep measurement techniques is essential to informing their possible role in usual clinical care.ObjectiveThe aim of the study was to investigate whether sleep monitoring techniques such as actigraphy (ACTG), behavioural assessments, and patient surveys are comparable with polysomnography (PSG) in accurately reporting sleep quantity and quality among conscious, intensive care patients.MethodsAn observational study was conducted in 20 patients admitted to the intensive care unit (ICU) for a minimum duration of 24 h, who underwent concurrent sleep monitoring via PSG, ACTG, nursing-based observations, and self-reported assessment using the Richards–Campbell Sleep Questionnaire.ResultsThe reported total sleep time (TST) for the 20 participants measured by PSG was 328.2 min (±106 min) compared with ACTG (362.4 min [±62.1 min]; mean difference = 34.22 min [±129 min]). Bland–Altman analysis indicated that PSG and ACTG demonstrated clinical agreement and did not perform differently across a number of sleep variables including TST, awakening, sleep-onset latency, and sleep efficiency. Nursing observations overestimated sleep duration compared to PSG TST (mean difference = 9.95 ± 136.3 min, p > 0.05), and patient-reported TST was underestimated compared to PSG TST (mean difference = −51.81 ± 144.1 7, p > 0.05).ConclusionsAmongst conscious patients treated in the ICU, sleep characteristics measured by ACTG were similar to those measured by PSG. ACTG may provide a clinically feasible and acceptable proxy approach to sleep monitoring in conscious ICU patients.     

松郁安神方对PCPA致失眠大鼠睡眠时相的影响

目的:观察松郁安神方对失眠大鼠睡眠时相的影响.方法:采用腹腔注射对氯苯丙氨酸(Para-chlorophenylalanine,PCPA)建立失眠大鼠模型,用松郁安神方进行干预,通过动物睡眠生物解析系统,记录脑电(Electroencephalogram,EEG)和肌电(Electromyogram,EMG),分析睡眠...