近似熵和复杂度应用于睡眠脑电研究的比较

介绍了两种度量序列复杂性的方法,一种是Ｋａｓｐａｒ和Ｓｃｈｕｓｔｅｒ定义的复杂度算法,一种是最近新发展起来的度量序列复杂性的统计方法－近似熵。应用这两种方法对睡眠脑电各睡眠期提取复杂性的特征,并通过对比研究表明,近似熵是值得重视的,很有前景的复杂度度量方法。     

Effects of chronic treatment with methadone and naltrexone on sleep in addicts

Previous studies have described sleep disturbance secondary to chronic opiate use and abuse. Drug-dependency insomnia is of interest because chronic sleep disturbances can promote depressive symptoms which could lead to a drug relapse. For the first time we compared the polysomnographic parameters of 10 methadone-substituted outpatients and 10 naltrexone-treated outpatients. Methadone (-opioid agonist) produced a marked fragmentation of the sleep architecture with frequent awakenings and a decrease in EEG arousals. In comparison with methadone and controls, the naltrexone (-opioid antagonist) group showed the shortest sleep latency and the longest total sleep time. These data indicate that -agonists and -antagonists have different effects on sleep. The implications, especially the involvement of opioid-dopamine interactions on sleep and movements during sleep, are discussed.     

The 24-Hour Sleep Propensity Function: Experimental Bases for Somnotypology

The present study investigated the temporal structure of sleep propensity during 48 hours using an ultrashort 7-min sleep/13-min wake cycle. Eight subjects were tested under two experimental conditions of either attempting sleep, or resisting sleep after a monitored night in the laboratory. Electrophysiological recordings were carried out during the 7-min trials. The temporal structure and the overall level of sleepiness of the 48-hour sleep propensity functions calculated from the amount of total sleep in each trial revealed a high within-subjects stability. This was found both across the two days of the study within conditions, and across conditions. Also, diurnal levels of sleepiness were systematically related to nocturnal sleep parameters. Subjects having short nocturnal sleep latencies and higher sleep efficiencies slept more during the day. It is proposed that the structure and level of the sleep propensity function can be used to characterize individuals along two dimensions of somnotypology: "morningness-eveningness" and "sleepy-alert."     

Effects of theβ-adrenoceptor antagonists acebutolol and metoprolol on sleep pattern in normal subjects

Summary The effects of acute introduction and withdrawal of 2 new -adrenergic blockers, acebutolol and metoprolol, on sleep in normal subjects were investigated. Both the subjective effects of the drug and EEG sleep variables were determined during a baseline period with placebo and in relation to the drug. The results showed that neither drug had a significant effect on sleep pattern in normal subjects. However, a transient effect on certain sleep parameters was seen on the first night of drug administration, with complete return to baseline, on the following night without any evidence of rebound. Possible mechanisms to explain the central actions of -adrenergic blockers are briefly discussed.     

Effects of hypnotics on the sleep EEG of healthy young adults: new data and psychopharmacologic implications

Benzodiazepine hypnotics increase NREM sleep and alter its EEG by reducing delta (0.3–3 Hz) and increasing sigma (12–15 Hz) and beta (15–23 Hz) activity. We tested whether the nonbenzodiazepine hypnotic, zolpidem (10 mg), produced the same pattern of sleep and EEG changes as two “classical” benzodiazepines, triazolam (0.25 mg) and temazepam (30 mg). Sleep EEG of 16 subjects was analyzed with period amplitude analysis for 3 nights during drug administration or placebo. The effects of zolpidem were in the same direction but generally of smaller magnitude than those of the classical benzodiazepines. These differences are more likely the result of non-equivalent dosages than different pharmacologic actions. Period amplitude analysis showed that the decreased delta activity resulted mainly from a decrease in wave amplitude. In contrast, the increased sigma and beta activity were produced by increased wave incidence. Delta suppression increased with repeated drug administration but sigma and beta stimulation did not. While these findings have little relevance for the clinical choice of hypnotics they may hold important implications for the brain mechanisms involved in hypnotic tolerance and withdrawal delirium.     

Is sleep-disordered breathing an independent risk factor for hypertension in the general population (13,057 subjects)?

Objective: Sleep-disordered breathing has been hypothesized to have a close relationship with hypertension but previous studies have reported mixed results. This is an important health issue that requires further clarification because of the potential impact on the prevention and control of hypertension.Methods: The relationship between hypertension and three forms of sleep-disordered breathing (chronic snoring, breathing pauses and obstructive sleep apnea syndrome (OSAS)) was assessed using representative samples of the non-institutionalized population of the UK, Germany and Italy (159 million inhabitants). The samples were comprised of 13,057 individuals aged 15–100 years who were interviewed about their sleeping habits and their sleep symptoms over the telephone using the Sleep-EVAL system.Results: OSAS was found in 1.9% (95% CI: 1.2% to 2.3%) of the UK sample, 1.8% (95% CI: 1.4% to 2.2%) of the German sample and 1.1% (95% CI: 0.8% to 1.4%) of the Italian sample. OSAS was an independent risk factor (odds ratio (OR): 9.7) for hypertension after controlling for possible confounding effects of age, gender, obesity, smoking, alcohol consumption, life stress, and, heart and renal disease.Conclusions: Results from three of the most populated countries in Western Europe indicate that OSAS is an independent risk factor for hypertension. Snoring and breathing pauses during sleep appeared to be non-significant predictive factors.     

Esophageal pressure and apnea hypopnea index in sleep-disordered breathing

Severity of negative esophageal pressure (Pes) and apnea hypopnea index (AHI) were investigated in six cases of upper airway resistance syndrome (UARS) and 11 cases of obstructive sleep apnea syndrome (OSAS). The severity of negative Pes was represented by the highest peak (Pes Max) and the number of increased episodes (more than 13.5 cmH2O) per h (NPesI13.5). There was no significant correlation between Pes indices and AHI. Pes Max and NPesI13.5 were not different among severe OSAS (AHI > 30), mild OSAS (AHI < 30) and UARS. Apnea hypopnea index failed to represent the severity of negative Pes, which is an important aspect of the pathophysiology of sleep-disordered breathing.     

《时病论》与脏腑辨证

简要介绍了清末温病学派医家雷丰的生平、著述及影响。重点论述其代表作《时病论》的辨证方法，总结了《时病论》运用脏腑辨证的规律和特点，进而阐明其在整个中医“辨证”历史上的位置和特色。主要从三个方面阐述《时病论》对“脏腑辨证”的运用，1)在温病领域的运用情况。雷氏治温病虽也采用三焦辨证卫气营血辨证，但所占比例较小，而广泛地使用脏腑辨证，且能明确反映温病的传变及分期特点。2)治泄痢的脏腑辨证特色，3)创新辨证脏腑证型。     

Snoreguard矫治器治疗阻塞性呼吸暂停综合征疗效分析

目的 :探讨 Snoreguard矫治器对阻塞性呼吸暂停综合征 ( OSAS)患者气道、睡眠结构的影响。方法 :选择 2 6岁～ 5 9岁患有 OSAS的患者 8例 ,在睡眠时分别配戴 Snoreguard矫治器 ,同时结合应用头颅侧位片、夜间多导睡眠图监测来测定分析配戴 Snoreguard矫治器的测量指标 ,进行统计分析。结果 :配戴 Snoreguard矫治器后 ,8例患者的AI值、平均呼吸暂停时间、AHI值均有显著性的降低 ( P<0 .0 1) ,Sa O2 显著增加 ( P<0 .0 1) ,HI值降低显著 ( P<0 .0 5 )。鼾声指数大幅度减轻甚至消失 ( P<0 .0 1)。配戴矫治器后下颌在水平向和垂直向的位移平均为 2 .0 3 mm和 8.74m m,IAS无显著变化 ,MAS变化明显 ( P<0 .0 5 ) ,最显著性改变的是上气道后间隙 ( SPAS) ( P<0 .0 1) ,SPL 减少 3 .64m m。结论 :Snoreguard矫治器是通过将下颌限制在一个前伸位 ,从而改变口咽部的结构影响上气道大小来达到治疗效果