老年高血压患者静息心率与肾功能的相关性研究

[目的]探讨分析520例老年高血压患者静息心率与肾功能的相关性.[方法]随机选取2009年11月份-2011年12月份因高血压就诊于我院进行治疗的患者520例,检测患者的静息心率(resting heart rate,RHR)与肾功能指标,并对结果进行统计,分析静息心率与肾功能损害的相关性.[结果]RHR3组SBP为(167.8±10.7) mmHg,DBP为(97.6±12.4) mmHg,PP为(77.2±6.3) mmHg,Cr(62.5±4.8)μmol/L,MAU为(180.4±2.5)mg/L,明显高于其他组(P＜0.05).[结论]老年高血压患者静息心率与血压以及肾功能损害成正相关,静息心率越快,血压越高越不稳定,肾功能损害进程越快.     

Is there a linkage between metabolism and personality in small mammals? The root vole (Microtus oeconomus) example

Significant inter-individual variation in the rate of animal metabolism is a widespread phenomenon that has started to accumulate general interest. Here we follow recent calls to focus on linkage between the variation in energy metabolism and animal personality. By using wild caught root voles as a study species, we examined the relationship between the behavioral patterns (assessed in open field test) and resting metabolic rate (RMR), both of which are known to show large individual differences and intra-individual consistency in voles. Our results showed only a weak relationship between personality traits and metabolism, since the most parsimonious model (according to AICc) explaining RMR included only body mass and season as factors (explaining 84.8% of variation in RMR). However, the next two alternative models (within ΔAICc = 2) also included the personality trait reflecting proactive behaviors (PC1) in addition to body mass, sex and season (85.2 and 85.8% of RMR variance explained, respectively). In all, our study does not provide compelling support for recent ideas of close linkage between behavior and metabolism. Still, our study highlights that even in the case of wild caught individuals, when behavior and metabolism often carry effects of both intrinsic and extrinsic conditions, the potential metabolic effects of varying energetically costly behaviors cannot be neglected.     

HIV reservoirs and latency models

The main impediment to a cure for HIV is the existence of long-lasting treatment resistant viral reservoirs. In this review, we discuss what is currently known about reservoirs, including their formation and maintenance, while focusing on latently infected CD4+ T cells. In addition, we compare several different in vivo and in vitro models of latency. We comment on how each model may reflect the properties of reservoirs in vivo, especially with regard to cell phenotype, since recent studies demonstrate that multiple CD4+ T cell subsets contribute to HIV reservoirs and that with HAART and disease progression the relative contribution of different subsets may change. Finally, we focus on the direct infection of resting CD4+ T cells as a source of reservoir formation and as a model of latency, since recent results help explain the misconception that resting CD4+ T cells appeared to be resistant to HIV in vitro.     

Dysfunctional connectivity patterns in chronic heroin users: An fMRI study

Recent functional neuroimaging studies have examined cognitive inhibitory control, decision-making and stress regulation in heroin addiction using a cue-reactivity paradigm. Few studies have considered impairments in heroin users from an integrated perspective for evaluation of their brain functions. We hypothesized that the brain regions that are dysregulated in the chronic heroin users during cue-reactivity studies may also show dysfunctional connectivity in memory, inhibition and motivation-related dysfunctions during a resting state free of cues. The present study used resting functional magnetic resonance imaging (fMRI) to compare the interaction of brain regions between 12 chronic heroin users and 12 controls by employing a novel graph theory analysis (GTA) method. As a data-driven approach, GTA has the advantage of evaluating the strength as well as the temporal and spatial patterns of interactions among the brain regions. Abnormal topological properties were explored in the brain of chronic heroin users, such as the dysfunctional connectivity in the prefrontal cortex, ACC, SMA, ventral striatum, insula, amygdala and hippocampus. Our results suggest that GTA is a useful tool in defining dysregulated neural networks even during rest. This dysfunctional brain connectivity may contribute to decrease self-control, impaired inhibitory function as well deficits in stress regulation in chronic heroin users.     

Inter-hemispheric functional coupling of eyes-closed resting EEG rhythms in adolescents with Down syndrome

ObjectiveWe tested the hypothesis that inter-hemispheric directional functional coupling of eyes-closed resting EEG rhythms is abnormal in adolescents with Down syndrome (DS).MethodsEyes-closed resting EEG data were recorded in 38 DS adolescents (18.7 years ±0.67 SE, IQ = 49 ± 1.9 SE) and in 17 matched normal control subjects (NYoung = 19.1 years ±0.39 SE). The EEG data were recorded from 8 electrodes (Fp1, Fp2, C3, C4, T3, T4, O1, O2) referenced to vertex. EEG rhythms of interest were delta (2–4 Hz), theta (4–8 Hz), alpha 1 (8–10.5 Hz), alpha 2 (10.5–13 Hz), beta 1 (13–20 Hz), and beta 2 (20–30 Hz). Power of EEG rhythms was evaluated by FFT for control purposes, whereas inter-hemispheric directional EEG functional coupling was computed by directed transfer function (DTF).ResultsAs expected, alpha, beta, and gamma power was widely higher in NYoung than DS subjects, whereas the opposite was true for delta power. As a novelty, DTF (directionality) values globally prevailed from right to left occipital areas in NYoung subjects and in the opposite direction in DS patients. A control experiment showed that this DTF difference could not be observed in the comparison between DS adults with mild cognitive impairment and normal age-matched adults.ConclusionsThese results indicate a peculiar abnormal directional inter-hemispheric interplay in visual occipital areas of DS adolescents.SignificanceDirection of inter-hemispheric EEG functional coupling unveils a new abnormal brain network feature in DS adolescents.     

Sex differences in resting state functional connectivity across the first two years of life

Sex differences in behavior have been reported from infancy through adulthood, but little is known about sex effects on functional circuitry in early infancy. Moreover, the relationship between early sex effects on the functional architecture of the brain and later behavioral performance remains to be elucidated. In this study, we used resting-state fMRI and a novel heatmap analysis to examine sex differences in functional connectivity with cross-sectional and longitudinal mixed models in a large cohort of infants (n = 319 neonates, 1-, and 2-year-olds). An adult dataset (n = 92) was also included for comparison. We investigated the relationship between sex differences in functional circuitry and later measures of language (collected in 1- and 2-year-olds) as well as indices of anxiety, executive function, and intelligence (collected in 4-year-olds). Brain areas showing the most significant sex differences were age-specific across infancy, with two temporal regions demonstrating consistent differences. Measures of functional connectivity showing sex differences in infancy were significantly associated with subsequent behavioral scores of language, executive function, and intelligence. Our findings provide insights into the effects of sex on dynamic neurodevelopmental trajectories during infancy and lay an important foundation for understanding the mechanisms underlying sex differences in health and disease.     

冠心病患者左房扩大的临床研究

21世纪 ,冠心病 (CHD)仍是全球关注的疾病 ,我国CHD的发病率及死亡率呈逐年上升趋势。近年来研究表明静息心率 (RHR)是CHD、高血压病的发病率及死亡率的独立预报因子[1 ] ,左室肥厚(LVH)与CHD及高血压病的预后密切相关[2 ] 。笔者对 2 86例CHD患者进行左房内径 (LAD)、左室后壁厚度 (LVPWT)、室间隔厚度 (IVST)、RHR及心功能的测定 ,分析LAD与LVH、RHR及心功能的相关性 ,以探讨CHD患者LAD扩大的临床意义及其可能机制。对象与方法一、对象　冠心病组 (CHD) :自 1 998年 9月至 2 0 0 3年 2月住我院并行冠脉造影的CHD患…     

Resting heart rate and mortality in the very old

Abstract

The number of very old individuals in the population is rapidly increasing. Previous studies have indicated that many factors known to be strongly associated with survival among middle-aged and elderly show no association among the oldest old. Resting heart rate (RHR) is associated with increased risk of death in the general population as well as in patients with various types of heart disease. The association between RHR and mortality in the very old is the subject of this report. The study population was identified in The Nationwide Danish 1905 Cohort Study (n?=?1086) and comprised 854 subjects with a median age of 95.2 years (range 94.7–95.9), in whom RHR was measured by radial pulse palpation. Participants were followed until death through the civil registration system, and remaining lifespan after RHR measure was used as outcome. Participants were divided into six groups according to RHR (≤50, 51–60, 61–70, 71–80, 81–90 and ≥91) with the largest group used as the reference group (61–70 beats per minute (bpm)). Survival analyses using Cox’ proportional hazards models were performed to study the association between RHR and mortality. Median RHR was 68 bpm in males (IQR 62–76) and 70 bpm (IQR 64–78) in females. After stratifying both sexes into six groups according to RHR, we found no significant difference in remaining lifespan between groups in either males or females. No significantly increased risk was demonstrated in groups with higher RHR. In very old people, elevated RHR is not associated with increased mortality.     

Day-to-day variability in motor threshold during rTMS treatment for depression: Clinical implications

BackgroundWhen repetitive transcranial magnetic stimulation (rTMS) is used to treat medication refractory depression, the treatment pulse intensity is individualized according to motor threshold (MT). This measure is often acquired only on the first day of treatment, as per the protocol currently approved by Food and Drug Administration.ObjectiveHere, we aimed to assess daily MT variability across an rTMS treatment course and simulate the effects of different schedules of MT assessment on treatment intensity.MethodsWe conducted a naturalistic retrospective study with 374 patients from a therapeutic rTMS program for depression that measures MT daily.ResultsFor each patient, in almost half the TMS sessions, MT varied on average more than 5% as compared to the baseline MT acquired in the first treatment day. Such variability was only minimally impacted by having different TMS technicians acquiring MT in different days. In a smaller cohort of healthy individuals, we confirmed that the motor hotspot localization method, a critical step for accurate MT assessment, was stable in different days, arguing that daily MT variability reflects physiological variability, rather than an artifact of measurement error. Finally, in simulations of the effect of one-time MT measurement, we found that half of sessions would have been 5% or more above or below target intensity, with almost 5% of sessions 25% above target intensity. The simulated effects of weekly MT measurements were significantly improved.ConclusionsIn conclusion, MT varies significantly across days, not fully dependent on methods of MT acquisition. This finding may have important implications for therapeutic rTMS practice regarding safety and suggests that regular MT assessments, daily or at least weekly, would ameliorate the effect.