癫痫与抑郁

抑郁是癫痫最常见的共患精神障碍疾病之一,发病率大约在30%~35%之间。抑郁严重影响癫痫患者的生活质量、增加患者自杀风险,明显增加医疗负担。很多癫痫合并抑郁患者因为担心抗抑郁药物可增加癫痫恶化的风险,或者不知道选择哪种抗抑郁药物,而没有得到及时、正确的治疗。同样,有些抗癫痫药物同时具有治疗抑郁的作用,临床选择抗癫痫药物时,应该考虑到共患病抑郁的情况。本文对以上情况进行介绍供临床参考。     

Only-child and non-only-child exhibit differences in creativity and agreeableness: evidence from behavioral and anatomical structural studies

Different family composition and size inevitably make only-children different from non-only-children. Previous studies have focused on the differences in behaviors, such as cognitive function and personality traits, between the only-child and the non-only-child. However, there are few studies that have focused on the topic of whether different family environments influence children’s brain structural development and whether behavior differentially has its neural basis between only-child and non-only-child status. Thus, in the present study, we investigated the differences in cognition (e.g., intelligence and creativity) and personality and the anatomical structural differences of gray matter volume (GMV) using voxel-based morphometry (VBM) between only-children and non-only-children. The behavioral results revealed that only-children exhibited higher flexibility scores (a dimension of creativity) and lower agreeableness scores (a dimension of personality traits) than non-only-children. Most importantly, the GMV results revealed that there were significant differences in the GMV between only-children and non-only-children that occurred mainly in the brain regions of the supramarginal gyrus, which was positively correlated with flexibility scores; the medial prefrontal cortex (mPFC), which was positively correlated with agreeableness scores; and the parahippocampal gyrus. These findings may suggest that family environment (i.e., only-child vs. non-only-child), may play important roles in the development of the behavior and brain structure of individuals.     

腹腔镜对腹腔肿瘤的诊断价值

目的:探讨腹腔镜对腹腔肿瘤的临床诊断价值。方法:对2006年12月至2010年12月76例有腹痛腹胀、发热或腹部肿块怀疑腹腔肿瘤的患者进行腹腔镜探查。结果:腹腔镜手术探查76例均得到明确诊断。结论:腹腔镜探查是一种安全有效的诊断方法,通过镜下观察及活检组织病理检查可基本明确病因,有效指导手术治疗。     

原发性头颈部非霍奇金淋巴瘤62例临床分析

目的 :探讨原发性头颈部非霍奇金淋巴瘤 (NHL)的临床特征。方法 :分析 6 2例头颈部NHL的临床资料。结果 :腭扁桃体 (2 5 .8% )、颈淋巴结 (19.4 % )、鼻腔及鼻窦 (12 .9% )为NHL的好发部位 ;临床分期ⅠE期和ⅡE期分别为 38.7%、2 4 .2 %。病理分型高度恶性为 75 .8%。CR率 75 .8% ,PR率 14 .5 % ,有效率 90 .3% ;部分患者无瘤长期生存。结论 :头颈部NHL一般恶性度高 ,多发于结外组织且易发生淋巴结转移 ,准确的取材活检结合免疫组化有利于早期确诊 ,治疗上应采用化疗、放疗或结合手术的综合治疗方案。     

Bone marrow contributes to epithelial cancers in mice and humans as developmental mimicry

Bone marrow cells have the capacity to contribute to distant organs. We show that marrow also contributes to epithelial neoplasias of the small bowel, colon, and lung, but not the skin. In particular, epithelial neoplasias found in patients after hematopoietic cell transplantations demonstrate that human marrow incorporates into neoplasias by adopting the phenotype of the surrounding neoplastic environment. To more rigorously evaluate marrow contribution to epithelial cancer, we employed mouse models of intestinal and lung neoplasias, which revealed specifically that the hematopoietic stem cell and its progeny incorporate within cancer. Furthermore, this marrow involvement in epithelial cancer does not appear to occur by induction of stable fusion. Whereas previous claims have been made that marrow can serve as a direct source of epithelial neoplasia, our results indicate a more cautionary note, that marrow contributes to cancer as a means of developmental mimicry. Disclosure of Potential Conflicts of Interest is found at the end of this article.     

The bright side and dark side of daydreaming predict creativity together through brain functional connectivity

Daydreaming and creativity have similar cognitive processes and neural basis. However, few empirical studies have examined the relationship between daydreaming and creativity using cognitive neuroscience methods. The present study explored the relationship between different types of daydreaming and creativity and their common neural basis. The behavioral results revealed that positive constructive daydreaming is positively related to creativity, while poor attentional control is negatively related to it. Machine learning framework was adopted to examine the predictive effect of daydreaming‐related brain functional connectivity (FC) on creativity. The results demonstrated that task FCs related to positive constructive daydreaming and task FCs related to poor attentional control both predicted an individual''s creativity score successfully. In addition, task FCs combining the positive constructive daydreaming and poor attentional control also had significant predictive effect on creativity score. Furthermore, predictive analysis based on resting‐state FCs showed similar patterns. Both of the subscale‐related FCs and combined FCs had significant predictive effect on creativity score. Further analysis showed the task and the resting‐state FCs both mainly located in the default mode network, central executive network, salience network, and attention network. These results showed that daydreaming was closely related to creativity, as they shared common FC basis.     

益气活血软坚解毒法治疗中晚期原发性肝癌临床疗效观察

目的:观察益气活血软坚解毒法治疗中晚期原发性肝癌的临床疗效.方法:近期疗效观察中晚期肝癌患者80例,根据治疗方式分为中药组(20例)、介入化疗组(30例)、中药 介入化疗组(30例),3组全部疗程均为3个月;远期疗效观察肝癌患者45例,分为中药组(14例)与中西医结合组(31例).结果:近期疗效研究表明,中药有改善肝癌患者临床症状作用,与介入化疗结合能明显提高肝癌患者癌灶稳定率及生存质量稳定率.远期疗效生存期Kaplan-Meier分析结果显示,远期效果中药组与中西医结合组无明显差异,近期效果中西医结合组优于中药组.结论:益气活血软坚解毒法有改善肝癌患者临床症状作用,与介入化疗结合能明显提高肝癌患者癌灶稳定率及生存质量稳定率,并能提高肝癌近期疗效.     

颈部旋转在超声诊断椎动脉型颈椎病中的价值

目的 :探讨颈部旋转对在超声常规体位检查中血流动力学无异常改变的椎动脉型颈椎病的诊断价值。材料和方法 :对 90例临床症状典型 ,CT、X线诊断为椎动脉型颈椎病而超声检查血流动力学无明显改变的患者 ,进行了颈部向检查对侧旋转约 70°后的超声检查 ,并对其结果进行了统计学检验。结果 :( 1)二维图像 :椎动脉均匀狭窄并可伴有内膜毛糙及斑块形成 ,内径 <3mm ;椎动脉骨段走形扭曲 ;( 2 )频谱多谱勒 :椎动脉供血不足时PI、RI增高 ,血流速度明显降低 ,椎动脉频谱形态异常 ;( 3)彩色多谱勒 :供血不足时椎动脉血流速变细、扭曲、中断。结论 :颈部旋转在超声诊断椎动脉型颈椎病鉴别诊断中具有实用价值。     

成人危重呼吸道阻塞的临床诊断和治疗

目的:探讨成人危重呼吸道阻塞的临床诊断及治疗方案。方法:1995年1月~2006年12月我科收治86例成人危重呼吸道阻塞,采用快速诊断和及时解除呼吸困难的临床处理方法,分析应用该方法的效果。结果:86例危重患者中,炎症性疾病34例,占39.5%;肿瘤性疾病32例,占37.2%;外伤性疾病9例,占10.5%。其他还有喉痉挛3例,喉狭窄6例,双侧声带麻痹2例,鼻咽癌放疗后大出血误吸窒息1例。喉和气管阻塞分别为60例和13例,占69.8%和15.1%。采用气管切开和气管插管分别为46例和4例,占53.5%和4.7%。只采用内科治疗缓解呼吸困难26例。86例患者均于2h内确诊并解除重度呼吸道阻塞。发生严重并发症者14例,发生率为16.3%;手术并发症6例,发生率为6.9%。死亡1例。结论:成人危重呼吸道阻塞的病因复杂,阻塞部位和性质多变,采取快速诊断、及时解除呼吸道阻塞的诊疗方案,是确保疗效的关键。     

Spatiotemporal cortical activation underlying self-referencial processing evoked by self-hand

Event-related potentials (ERPs) were recorded to explore the electrophysiological correlates of self-referencial processing when subjects were asked to judge whether the stimuli (their hands) were their own or not. ERP results showed that: first, own hand elicited a greater positive component (P350-500) than did other hand in the time window of 350-500 ms, and the generator of P350-500 was localized in the anterior cingulate cortex (ACC), which might be related to retrieval and identification of self-referencial information due to their sensitivity to self-hand. Second, own hand elicited a more positive component (LPC) than did other hand in the later time window. Dipole analysis revealed that the generators were localized in the parahippocampal gyrus and the medial frontal gyrus, which might be involved in making a self-referencial decision based on retrieval of self-hand information.