2011—2018年某市农村饮用水6项理化指标监测结果分析

目的 了解某市农村饮用水中氟化物、硝酸盐氮、氯化物、硫酸盐、总硬度、溶解性总固体的达标率情况,为加强农村居民饮用水卫生管理提供依据.方法 水样采集、保存和分析均按照 《生活饮用水标准检验方法》(GB/T 5750-2006)进行,检测结果按照《 生活饮用水卫生标准》(GB 5749-2006)进行评价,采用SPSS对检...     

动态血糖监测系统和扫描式血糖监测系统判断2型糖尿病患者黎明现象的一致性研究

目的探讨基于动态血糖监测系统(CGMS)评价扫描式血糖监测系统判断2型糖尿病(T2DM)患者黎明现象的有效性。方法采用便利抽样法,选取2019年6月-2020年6月于新乡市中心医院内分泌科住院的45例T2DM患者为研究对象。患者入院后先佩戴扫描式动态血糖监测系统,48 h后再佩戴CGMS行连续血糖监测,再过72 h后同时取下扫描式动态血糖监测系统和CGMS,核对同时间段的血糖分析报告,判断是否发生黎明现象。采用Kappa检验分析CGMS与扫描式血糖监测系统判断黎明现象的一致性,以CGMS判断结果为标准,绘制扫描式血糖监测系统判断黎明现象的ROC曲线,评定夜间血糖预测黎明现象及次日空腹血糖评估黎明现象的最佳切点值。结果 CGMS判断55.56%(25/45)的患者、扫描式血糖监测系统判断46.67%(21/45)的患者发生黎明现象,两者比较差异无统计学意义(χ2=0.711,P>0.05)。CGMS和扫描式血糖监测系统判断黎明现象的一致性良好(Kappa=0.895,95%CI为1.130~4.883,P<0.01)。夜间血糖预测黎明现象的最佳切点值为8.31 mmol/L,次日空腹血糖评估黎明现象的最佳切点值为7.25 mmol/L,两者的ROC曲线下面积分别为0.729、0.803。结论扫描式血糖监测系统可以准确地判断黎明现象,当夜间血糖值为8.31 mmol/L时提示可能会发生黎明现象,次日空腹血糖值为7.25 mmol/L时提示可能发生了黎明现象。     

阻塞性睡眠呼吸暂停综合征患者血清小而密低密度脂蛋白水平

目的 探讨阻塞性睡眠呼吸暂停综合征(OSAHS)患者血清小而密低密度脂蛋白(sdLDL)水平改变及临床意义。方法 收集该院163例OSAHS患者,分为轻中重3组,选择同期体检健康者66例为对照组。所有受试者采用多导睡眠脑电监测仪(PSG)进行睡眠脑电监测,并测定外周血sdLDL的含量。结果 OSAHS患者sdLDL较对照组明显升高,且不同程度的OSAHS组间比较差异有统计学意义。结论 OSAHS患者sdLDL明显升高,且与OSAHS的程度有关,在OSAHS患者动脉粥样硬化疾病的发生发展中可能起一定作用。     

Taking a Better History for Behavioral Issues Pre‐ and Post‐Deep Brain Stimulation: Issues Missed by Standardized Scales

Objectives: To screen for potentially underreported behavioral changes in patients with idiopathic Parkinson's disease (PD) pre‐ and post‐deep brain stimulation (DBS), a retrospective data base review was performed. Methods: In total, 113 patients who underwent unilateral or bilateral DBS at the University of Florida in either subthalamic nucleus or globus pallidus internus for PD were screened for behavioral issues by asking about the presence or absence of seven neuropsychiatric symptoms (panic, fear, paranoia, anger, suicidal flashes, crying, and laughing). Results: There was a high prevalence of fear (16.3%), panic (14.0%), and anger (11.6%) at baseline in this cohort. In the first six months following DBS implantation, anger (32.6%), fear (26.7%), and uncontrollable crying (26.7%) were the most frequent symptoms reported. Those symptoms also were present following six months of DBS surgery (30.2%, 29.1%, and 19.8%, respectively). New uncontrollable crying occurred more in the acute postoperative stage (less than or equal to six months) (p= 0.033), while new anger occurred more in the chronic postoperative stage (greater than six months) (p= 0.017). The frequency of uncontrollable laughing significantly increased with bilateral DBS (p= 0.033). Conclusions: Many of the neuropsychiatric issues were identified at preoperative baseline and their overall occurrence was more than expected. There was a potential for worsening of these issues post‐DBS. There were subtle differences in time course, and in unilateral vs. bilateral implantations. Clinicians should be aware of these potential behavioral issues that may emerge following DBS therapy, and should consider including screening questions in preoperative and postoperative interviews. Standardized scales may miss the presence or absence of these clinically relevant issues.     

立体定向联合术中皮层电极、神经电生理监测治疗功能区皮层下小肿瘤性癫痫

目的 评价采用立体定向联合术中皮层脑电图(ECoG)、神经电生理监测(IOM)治疗功能区皮层下小肿瘤性癫痫的手术方法及效果、并发症. 方法 解放军第153医院神经外科自2006年6月至2011年6月共收治功能区皮层下小肿瘤引起的癫痫患者15例,均在立体定向仪导向下,开放直视手术准确切除肿瘤,ECoG监测定位致痫灶,IOM判断致痫灶与功能区的重叠程度,分别采取切除术、多处软膜下横切术(MST)或皮层低功率电凝热灼术处理致痫灶.总结分析患者的手术方法及疗效. 结果 本组肿瘤全切13例,次全切2例;瘤周致痫灶切除4例,瘤周致痫灶MST或/和皮层低功率电凝热灼术11例;术毕ECoG监测发现痫样放电消失、基本节律大致恢复正常6例,仍残留少量棘波6例,残存较多棘波且基本节律轻到中度异常3例;无严重永久性并发症;随访1～3年,肿瘤原位复发2例,Engel分级Ⅰ级10例,Ⅱ级3例,Ⅲ级2例,总有效率100％.结论 立体定向联合术中ECoG、IOM治疗功能区皮层下小肿瘤性癫痫,能够精准定位并切除肿瘤及处理致痫灶,避免损伤功能区,是一种微创、安全、有效的手术方法.     

Aqueductal stenosis 9 years after mumps meningoencephalitis: treatment by endoscopic third ventriculostomy

Introduction Hydrocephalus due to aqueductal stenosis following mumps meningoencephalitis is a rare condition, reported only in 16 cases in the literature. The pathogenetic role of the mumps virus in inducing aqueductal stenosis has been demonstrated experimentally in animal models and clinically proven in a few cases. Although obstructive in nature, the post-infectious etiology raises the question as to whether third ventriculostomy is the appropriate treatment.Patient We report a case of hydrocephalus due to pure aqueductal stenosis occurring in an 11-year-old boy who suffered from mumps meningoencephalitis 9 years previously. The boy was successfully treated by endoscopic third ventriculostomy.Conclusions The present case offers further evidence of the purely obstructive nature of the hydrocephalus induced by paramyxovirus meningoencephalitis, even if it did occur several years after the infectious disease. The pathogenesis of mumps-induced hydrocephalus and the rationale of treatment are discussed, and the literature is reviewed.     

Automated classification of neonatal sleep states using EEG

Objective

To develop a method for automated neonatal sleep state classification based on EEG that can be applied over a wide range of age.

术中肌电监测在累及第四脑室底肿瘤手术中的应用

目的探讨术中肌电监测在累及第四脑室底面肿瘤切除术中的应用及影响因素。方法南方医科大学南方医院神经外科自2007年1月至2010年12月在后组颅神经肌电监测下完成累及第四脑室底面肿瘤切除术32例,其中髓母细胞瘤11例,第四脑室室管膜瘤9例,脑干海绵状血管瘤6例,脑干起源外生性胶质瘤4例,脑干背侧血管网状细胞瘤2例。分析术中肌电监测对手术效果的影响及其干扰因素。 结果 本组肿瘤全切除21例,次全切除9例,大部切除2例;无后组脑神经功能障碍9例,轻度后组颅神经损伤18例,中度后组颅神经损伤5例,无严重损伤者。肌电监测结果的干扰因素主要包括双极电凝产生的外泻电流、肌松药物的过多使用、麻醉深度的改变、以及患者体温、冲洗盐水温度、血压急剧变化等。 结论术中肌电监测可以为累及第四脑底面肿瘤切除术中颅神经核团的位置及功能保护提供客观依据。     

同步视频监测侧方扩散反应在面肌痉挛手术中的应用

目的 探讨显微血管减压术(microvascular decompression,MVD)治疗面肌痉挛术中应用同步视频监测侧方扩散反应(lateral spread response,LSR)的意义.方法 回顾性分析105例行MVD且术中实施同步视频LSR监测的面肌痉挛病人的临床资料.分别将依据术中LSR监测及同步视频...