Cognitive disorders in patients with occlusive disease of the carotid artery: a systematic review of the literature

We present a systematic review of the literature on the prevalence, nature, severity, course, and causes of cognitive deficits in patients with occlusive disease of the carotid artery prior to surgery (if surgery was under discussion). Searches were carried out on Medline and Psychlit from 1980 to 1999 using neurovascular and psychological index terms, and papers and books were checked for further references. Studies describing neuropsychological assessment of groups of patients with carotid obstruction were included. Eighteen studies were found. We extracted from the papers data on study design, demographic characteristics of patients, clinical diagnosis, carotid obstruction, cerebral imaging, time interval between ischemic episode and neuropsychological assessment, neuropsychological asessment procedures, integration and interpretation of test performances, and conclusions of authors. Fourteen studies concluded that there are cognitive deficits both in patients with symptomatic and in those with asymptomatic carotid obstruction; four studies denied cognitive impairment. There were no differences in patient characteristics, study design, or neuropsychological assessment procedures between the 14 studies that found deficits and the 4 that did not. There are indications for a mild, diffuse, detrimental effect of carotid occlusive disease on cognitive functioning. However, methodological problems prevent a definitive conclusion. Further research is needed to confirm these findings and to ascertain the neurovascular risk factors for and the natural course of cognitive impairment in patients with carotid occlusive disease. Received: 12 July 1999/Received in revised form: 10 November 1999/Accepted: 26 January 2000     

Pericyte and microvascular diseases

Pericytes are perivascular cells of microcirculation, which construct the barrier between the microcircula-tion and interstitial fluid with endothelial cell and basement membrane. Contractility and other multifunctional activities of pericytes are now being elucidated. Pericytes are pluripotential cells (i. e. as a source of other cell types)and take part in many biological and pathological procedures, such as vascularization, vascular remodeling , microvessel permeability and wound healing, etc. The functional interaction of pericytes with endothelial cells (EC) is now being established. The disfunction and population alteration of pericytes are characterized in many microvascular diseases, such as diabetic retinopa-thy, vascularization of tumors, hypertension,etc.     

伊朗传统医学治疗牙周疾病

目的:牙周疾病非常普遍,尽管有各种特定的治疗方法,但我们始终面临治疗方法有限的问题。考虑到世界组织十分关注传统医学在医疗服务中的发展和应用,我们在一直考察研究伊朗传统医学中药物对牙周疾病的治疗作用。方法:此项研究是一个对有关方面书籍的综合论述,伊朗传统医学内容是经过对重量级作者如Avicenna和Alzahrawy所著的有价值的书籍修订,收集了各医学院校馆藏图书和医药公司的有关信息编辑而成,因为在伊朗传统医学中牙周疾病分成不同目类,对有关药物的研究也被分成8个大组63个题目。(1)缓解牙龈肿胀药物(2)治疗牙龈恶化药物(3)治疗口疮腐烂药物(4)治疗牙龈肥大药物(5)利于伤口康复药物(6)利于牙龈加固的药物(7)阻止牙龈出血的药物(8)防止牙齿松动药物。结果结论:伊朗传统医学在准确的观察和实践的基础上来描述和治疗牙周疾病的。在制药学、有效治疗方面、科学研究手段等领域,伊朗传统医学在以下几个方面可作为现代制药研究的重要资源:(1)纯天然资源(2)容易获得(3)相对比较安全。     

中医学发展有赖于对病证关系的再认识

提出就中医学辨证与辨病的关系,应该是方法与结果的关系.辨证必须以辨病为前提,证只有因病的存在才有自己的特殊性可言.而这时的病不能是传统意义上的以症状命名的"病",而必须是具有发展规律、表现出特定症状与相应阶段证候的"新"病.     

颈动脉与冠状动脉粥样硬化的病理对比分析

目的探讨颈动脉粥样硬化与冠状动脉粥样硬化病变之间的关系。方法应用图象分析对17例尸检患者的272段颈动脉和冠状动脉血管进行测量,比较内容包括动脉壁厚比值腔面积/截面积比值和狭窄血管支数比值。结果颈动脉和冠状动脉粥样硬化病变血管支数的比值呈正相关(r=0.79,P<0.01),其余比值无相关性。结论颈动脉粥样硬化病变的存在可以预示冠状动脉有病变,但二者病变的严重程度无明确的相关性。     

甲状腺功能亢进性心脏病的围术期处理

目的探讨甲状腺功能亢进（甲亢）性心脏病的围术期处理的方法与效果。方法对98例甲亢性心脏病围手术期的处理措施和效果结合文献进行分析总结。结果98例经充分术前准备和精确的心功能评估达手术要求,再配合术中恰当的麻醉、轻柔快捷的手术、合理的术后处理,本组除1例中止手术外,其余均顺利完成手术,围术期无心血管并发症出现。结论甲亢性心脏病并非甲亢手术的禁忌证,A-B级心功能下进行手术是安全的。     

老年人心力衰竭91例临床分析

目的探讨老年人心力衰竭的临床特点。方法回顾性分析91例老年人心力衰竭临床资料,与21例中青年人心力衰竭进行对比分析。结果(1)随着年龄的增加,NYHA心功能Ⅲ、Ⅳ的比例显著增加;(2)引起心力衰竭前3位病因分别为冠心病(67.9%)、高血压病(32.1%)、肺心病(26.8%),老年组及高龄组常为2-3种疾病并存;(3)各年龄组心力衰竭最常见的诱因是感染(59.8%),高龄组心律失常(51.4%)也是重要的诱因;(4)老年及高龄组症状、体征常不典型,易致漏诊误诊;(5)高龄组并发脑梗死(25.7%)、心律失常-房颤(34.3%)及死亡(17.4%)的比例增加。结论年龄越大,临床表现越不典型,病情越危重,并发症越多,预后不良。     

动脉疾病的微创治疗32例分析

目的探讨介入技术在动脉疾病中的应用及与手术联合使用的意义。方法对32例不同的动脉疾病采用介入技术或介入联合手术的方法进行治疗,对临床治疗效果及介入技术的应用进行分析。结果31例患者治疗成功,1例失败。平均随访9个月,1例降主动脉瘤破裂形成食道瘘患者,出院后1个月因支架感染而死亡。其余症状均消失或改善。结论动脉疾病的介入治疗可以减轻患者痛苦,减少手术风险,缩短住院时间。与手术联合使用可以减少手术的创伤或扩大介入技术的运用范围。     

皮肤分枝杆菌感染的研究进展

皮肤分枝杆菌感染是一类复杂的皮肤疾病,临床和病理无特异表现,易漏诊误诊。临床上大致分为3类,皮肤结核、麻风、非结核分枝杆菌感染性皮肤病。本文就各类分枝杆菌感染相关的皮肤疾病进行流行病学特征、临床表现、诊断及治疗进展进行综述。     

Genomic and In Vitro Phenotypic Comparisons of Epidemic and Non-Epidemic Getah Virus Strains

Getah virus is an emerging mosquito-borne animal pathogen. Four phylogenetic groups of GETV, Group I (GI), GII, GIII and GIV, were identified. However, only the GETV GIII was associated with disease epidemics suggesting possible virulence difference in this virus group. Here, we compared the genetic and in vitro phenotypic characteristics between the epidemic and non-epidemic GETV. Our complete coding genome sequence analyses revealed several amino acid substitutions unique to the GETV GIII and GIV groups, which were found mainly in the hypervariable domain of nsP3 and E2 proteins. Replication kinetics of the epidemic (GIII MI-110 and GIII 14-I-605) and non-epidemic GETV strains (prototype GI MM2021 and GIV B254) were compared in mammalian Vero cells and mosquito C6/36 and U4.4 cells. In all cells used, both epidemic GETV GIII MI-110 and GIII 14-I-605 strains showed replication rates and mean maximum titers at least 2.7-fold and 2.3-fold higher than those of GIV B254, respectively (Bonferroni posttest, p < 0.01). In Vero cells, the epidemic GETV strains caused more pronounced cytopathic effects in comparison to the GIV B254. Our findings suggest that higher virus replication competency that produces higher virus titers during infection may be the main determinant of virulence and epidemic potential of GETV.