The Relationship Between Cerebral Blood Flow Velocities and the Amount of Blood Clots in Computed Tomography After Subarachnoid Haemorrhage

127 patients with aneurysmal subarachnoid haemorrhage (SAH) were analyzed for the relationship between the amount of blood clots as detected by initial computed tomography (CT) up to 48 hours after SAH and changes of blood flow velocities as measured using transcranial Doppler ultrasonography (TCD). All patients were operated on within 72 hours after SAH. Patients who presented with remarkable brain oedema or with pathological intracranial pressure (ICP) due to mass effects of a haematoma, and who were in a poor neurological condition classified according to Hunt-Hess as grade V were excluded from this study. Serial TCD examination of the middle cerebral arteries (MCA) and anterior cerebral arteries (ACA) started within 48 hours after SAH and were performed daily up to three weeks. A statistically significant correlation between blood load designated according to Fisher's grading as group CT I-CT IV and mean flow velocities (MFV) was found in groups CT I, II, and III. High values of MFV in MCA examinations were noted in patients with severe SAH (group CT III)--161 cm/s, and low values in patients without SAH (group CT I)--119 cm/s. Patients with haematocephalus and/or haematoma without a mass effect (group CT IV) had lower blood flow velocities than patients with severe SAH (group CT III) but values were higher than in patients without SAH (group CT I). The number of days for which MFV in the MCA was > 120 cm/s and was statistically (p < 0.05) correlated with the amount of blood clots as observed in the respective CT (in group CT I, II, and III). MFV values in the anterior cerebral artery (ACA) were lower than those obtained in the middle cerebral artery (MCA) in all groups. Statistically significant (p < 0.05) differences were noted between groups CT I and CT III (first and third week) and between groups CT I and CT IV (third week). If the SAH was extensive in the CT scan, pathological values of MFV > 90 cm/s were observed in ACA, and this was more pronounced in group CT III than in group CT IV. Blood flow velocities obtained via TCD were registered to compare side-to-side differences and particularly high differences were observed in patients with severe SAH. It is concluded that the amount of blood clots in the initial computed tomography after SAH is significantly correlated with cerebral blood flow velocity measurements by TCD.     

热性惊厥对大鼠情感行为及学习记忆的影响

【目的】　探讨热性惊厥对大鼠情感行为及学习记忆能力的影响。　【方法】　 3 6只雄性SD (Spraque Dawley)大鼠随机分为热性惊厥组 (febrileseizuresgroup ,FS) ,发热对照组 (febrilecontrolgroup ,FG)及正常对照组 (nor malcontrolgroup ,NG)。观察各组大鼠在旷场试验 (openfieldtest ,OFT)、避暗试验 (passiveavoidancetest,PAT)以及在Morris水迷宫 (Morriswatermaze ,MWM )试验中情感行为及学习记忆能力的改变。　【结果】　FS组大鼠与NG、FG组相比 :在OFT中穿格得分分值 ( 3 7.48± 7.0 9)降低 ,后肢性站立的次数 ( 12 .11± 4.41)减少 ,排出粪便粒数 ( 10 .62±2 .3 2 )增多 ,差异有非常显著性 (P <0 .0 1) ;在PAT中 ,FS组大鼠犯错次数 ( 4 .0 2± 1.2 9)增加 ,且记忆潜伏期 [( 169.71± 10 3 .2 2 )秒 ]缩短 ,差异有非常显著性 (P <0 .0 1) ;在Morris水迷宫试验中 ,FS组大鼠搜寻站台的逃逸潜伏期明显延长 ,差异有非常显著性 (P <0 .0 1)。　【结论】　多次热性惊厥发作可使大鼠的情感行为和学习记忆能力受损     

抗脑抗体对精神分裂症自身免疫反应的探讨

目的探讨精神分裂症患者脑脊液中抗脑抗体(ABAb)的致病作用。方法应用ELISA法检测患者脑脊液抗脑抗体，并对患者尸解脑组织进行免疫组化染色和病理学检验。结果患者脑脊液中有73．9％(34／46)检出抗脑抗体；在脑右侧扣带回、海马及胼胝体等脑组织神经元细胞胞浆中发现IgG和补体C3沉着；脑组织呈现明显的多种退行性改变，伴胶质细胞增生。结论抗脑抗体可能参与精神分裂症自身免疫反应，使患者脑内某些部位出现自身抗体沉着并引起补体活化，而导致脑组织病理性改变。     

Stress and hippocampal abnormalities in psychiatric disorders.

The hippocampus plays a main role in regulating stress response in humans, but is itself highly sensitive to neurotoxic effects of repeated stressful episodes. Hippocampal atrophy related to experimental stress has been reported in laboratory studies in animals. Several controlled brain imaging studies have also shown hippocampal abnormalities in psychiatric disorders, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and borderline personality disorder (BPD). This paper reviews the physiological role of the hippocampus in stress circuitry and the effects of stress on cognitive functions mediated by the hippocampus. We also review brain imaging studies investigating hippocampus in PTSD, MDD, and BPD. This literature suggests that individuals with PTSD, MDD, and BPD may suffer hippocampal atrophy as a result of stressors associated with these disorders. Prospective, longitudinal studies will be needed in high-risk offspring and first-episode subjects to explore the relationship between stress and hippocampal atrophy in these neuropsychiatric illnesses.     

德清县农村人群戊型肝炎感染状况调查

目的调查德清县农村人群戊型肝炎的感染情况.方法用ELISA法检测人群中抗-HEV lgG、抗-HEV IgM水平,同时调查相关的危险因素.结果在调查的850名7岁以上健康人群中,抗-HEV IgG,抗-HEV IgM阳性率分别为46.35%和3.06%.男女抗-HEV IgG阳性率分别为53.62%和39.45%(P＜0.001),抗-HEVIgM阳性者中女性较多(P＜0.01).戊型感染可见于各个年龄段,但感染率不平衡,差异有显著性(P＜0.001),随着年龄的增长感染率有上升的趋势,到45～55岁年龄组感染率保持在一个稳定水平.结论德清县农村人群戊型肝炎病毒感染率明显高于国内其他地区报道.感染与性别年龄显著相关,男性感染率高于女性,随着年龄的增长感染率上升,到一定年龄达到稳定水平.     

种植体直径和长度在Ⅰ类骨质中的优化选择

目的:应用Ansys DesignXplorer模块,研究圆柱形种植体直径和长度同时连续变化对Ⅰ类骨质的颌骨应力影响,为临床选择和设计种植体提供理论依据。方法:建立包含圆柱状种植体的下颌骨Ⅰ类骨质骨块的三维有限元模型,设定种植体直径(D)变化范围为3.0~5.0mm,种植体长度(L)变化范围为6.0~16.0mm,观察D和L变化对颌骨Von Mises应力峰值的影响。同时进行颌骨Von Mises应力峰值对变量的敏感度分析。结果:随着D和L的增加,垂直向加载时,皮、松质骨的EQV应力峰值分别降低了54.5%和70.2%,颊舌向加载时,皮、松质骨的EQV应力峰值分别降低了73.5%和75.1%;当D大于3.8mm同时L大于9.0mm时,应力峰值的响应曲线的切斜率位于-1和0之间;在垂直向加载和颊舌向加载时,变量D比L更易影响皮质骨的EQV应力峰值。结论:种植体的直径比长度更易影响皮质骨的应力大小。从生物力学角度而言,对于Ⅰ类骨质,在临床上选择种植体时,种植体的直径应不小于3.8mm,种植体的长度应不小于9.0mm。     

Rapid diagnosis of glucocorticoid suppressible hyperaldosteronism in infants and adolescents

Glucocorticoid suppressible hyperaldosteronism (GSH) is an uncommon form of dominantly inherited hypertension. Presentation with hypertension and complications such as stroke in early life are well recognised. The use of a simple genetic test carried out on blood or placenta facilitates the detection of infants and children with GSH before the development of hypertension, allowing prompt treatment of hypertension if it occurs, and an opportunity to study the effects of growth and environmental influences on the progression of the condition.