The space-time profiles of sleep spindles and their coordination with slow oscillations on the electrode manifold

Sleep spindles are important for sleep quality and cognitive functions, with their coordination with slow oscillations (SOs) potentially organizing cross-region reactivation of memory traces. Here, we describe the organization of spindles on the electrode manifold and their relation to SOs. We analyzed the sleep night EEG of 34 subjects and detected spindles and SOs separately at each electrode. We compared spindle properties (frequency, duration, and amplitude) in slow wave sleep (SWS) and Stage 2 sleep (S2); and in spindles that coordinate with SOs or are uncoupled. We identified different topographical spindle types using clustering analysis that grouped together spindles co-detected across electrodes within a short delay (±300 ms). We then analyzed the properties of spindles of each type, and coordination to SOs. We found that SWS spindles are shorter than S2 spindles, and spindles at frontal electrodes have higher frequencies in S2 compared to SWS. Furthermore, S2 spindles closely following an SO (about 10% of all spindles) show faster frequency, shorter duration, and larger amplitude than uncoupled ones. Clustering identified Global, Local, Posterior, Frontal-Right and Left spindle types. At centro-parietal locations, Posterior spindles show faster frequencies compared to other types. Furthermore, the infrequent SO-spindle complexes are preferentially recruiting Global SO waves coupled with fast Posterior spindles. Our results suggest a non-uniform participation of spindles to complexes, especially evident in S2. This suggests the possibility that different mechanisms could initiate an SO-spindle complex compared to SOs and spindles separately. This has implications for understanding the role of SOs-spindle complexes in memory reactivation.     

蓝-黄视野计与标准的白-白视野计对早期原发性开角型青光眼视野的对比研究

目的　评价蓝 -黄视野计 (blue- on- yellow perim etry,B/ Y)又称短波长视野计 (short- wavelength auto-mated perim etry,SWAP)与标准的白色视野计 (white- on- white perimetry,W/ W)在早期青光眼视野损害诊断中的意义。方法　利用 Hum phrey- - 75 0型全自动视野计 C- 30 - 2全阈值检测程序对 2 0例 (4 0只眼 )正常人、2 0例 (36只眼 )可疑青光眼、18例 (32只眼 )确诊的早期原发性开角型青光眼 (primary open- angle glaucoma,POAG)分别进行 W/ W与 B/ Y的视野检查。结果　正常人、可疑青光眼、早期青光眼 B/ Y检测的全视网膜光敏感度均值 (MS)低于 W/ W检测的结果 ,两者有显著性意义 (t=11.6 8,P <0 .0 1;t=14 .0 1,P <0 .0 1;t=14 .6 8,P <0 .0 1)。B/ Y检测光敏感度缺损均值 (MD)与 W/ W检测的结果 ,正常人组无显著性意义 (t=1.0 4 ,P <0 .0 1) ,其它两组有显著性意义 (t=4 .88,P <0 .0 1;t=3.378,P <0 .0 1)。W/ W检查正常人组与可疑性青光眼的 MS差别无显著意义 (t=2 .5 4 ,P >0 .0 1) ,B/ Y有显著意义 (t=5 .5 7,P <0 .0 1)。两组的 MD差别均有显著意义 (t=3.16 ,P <0 .0 1,t=6 .2 6 ,P <0 .0 1) ;W/ W与 B/ Y检查正常人组与早期青光眼组的 MS差别有显著意义 (t=6 .4 7,P <0 .0 ;t=10 .19,P     

哈萨克族牧民慢性闭角型青光眼前房角组织病理研究及临床意义

目的:观察研究新疆哈萨克族慢性闭角型青光眼患者前房角组织的病理改变及临床意义。方法:对手术切除的小梁和虹膜组织常规脱水石蜡包埋,作矢状连续切片,苏木素-伊红染色,光镜下观察。结果:镜下见小梁网眼变窄或消失,内皮细胞减少,小梁网中有色素沉积,部分小梁网完全被色素斑块遮盖,看不清小梁结构,部分可见小梁虹膜并置,小梁纤维化伴玻璃样变性。Schlemm腔内壁内皮细胞不同程度增生,致管腔呈不规则狭窄甚至管腔闭塞,部分管腔内可见色素沉积。虹膜变薄,基质疏松,有的虹膜间质血管壁增厚并呈玻璃样变,部分可见虹膜间质薄壁血管形成。结论:慢性闭角型青光眼前房角组织的病理损伤是一个渐进的过程,早期诊断,早期治疗,既可以有效地防止视功能的损害,又能有效地预防因高眼压而造成的前房角组织的损害。     

白内障术中后囊撕囊术的临床分析

目的探讨白内障术中后囊撕囊术的技巧及并发症。方法白内障310例（356只眼）行后囊中央部撕囊术。结果术后一过性高眼压51只眼,瞳孔轻度上移4只眼,瞳孔散大7只眼,虹膜萎缩伴色素沉着7只眼;3个月后眼压〈10mmHg4只眼,人工晶状体偏位7只眼,人工晶状体脱人玻璃体2只眼。结论后囊撕囊术是预防后囊浑浊的较好方法,增加了术后视力,但也存在较难处理的并发症,需掌握好手术适应证。     

Comparison of posterior capsule folds following intracapsular implantation of three types of intraocular lenses with different haptic design

AIM: To compare the incidence of posterior capsule folds among different types of intraocular lens (IOL) to determine risk factors of posterior capsule folds. METHODS: It was a retrospective study. We collected the cases in which the patients underwent phacoemulsification (PHACO) and IOL implantation and at least one of the three types of IOL was implanted, including 2-haptic 3-piece IOLs (HOYA PY60AD), 4-haptic 1-piece IOLs (Bausch&Lomb AO), 2-haptic 1-piece IOLs (AMO Tecnis ZCB00). The posterior capsule folds were measured using slit lamp microscope 2d after the surgery. Information of patient’s age, gender, length of ocular axis, intraocular pressure, types of IOL were recorded. Posterior capsule fold risk indicators were identified by using logistic regression analysis. RESULTS: One hundred eighty-seven patients (242 eyes) had been collected, including 80 eyes implanted with HOYA PY60AD IOLs, 81 eyes implanted with Bausch&Lomb AO IOLs, 81 eyes implanted with AMO Tecnis ZCB00 IOLs. The incidence of posterior capsule folds of patients implanted with HOYA PY60AD IOLs was significantly higher than those of patients implanted with AMO Tecnis ZCB00 IOLs. While the incidence of patients implanted with Bausch&Lomb AO IOLs was significantly lower than those of patients implanted with AMO Tecnis ZCB00 IOLs. Multi-factor logistics regression analysis demonstrated that independent risk factors were type of IOLs and length of ocular axis. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs increased the risk of posterior capsule folds [P=0.020, OR (95%CI)=2.145 (1.129, 4.073)], while using Bausch&Lomb AO IOLs reduced the risk [P=0.001, OR (95%CI)=0.274 (0.127, 0.591)]. Shorter ocular axis might increase the risk of posterior capsule folds [P=0.012, OR (95%CI)=0.669 (0.489, 0.915)]. CONCLUSION: Haptic design should be an important consideration in IOL design. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs is more likely to lead to posterior capsule folds formation, while using Bausch&Lomb AO IOLs is less likely to lead the formation. The posterior capsule folds are more engendered in eyes with shorter ocular axis.     

可逆性后部白质脑病综合征患者临床表现与磁共振影像学特点分析

目的分析可逆性后部白质脑病综合征(RPLS)患者的临床表现及磁共振(MRI)影像学特点。方法回顾性分析115例RPLS患者的临床及影像学资料。结果 115例RPLS患者表现为血压升高(89.56%)、痫性发作(74.78%)、头痛(59.13%)、视觉障碍(32.17%)、神经系统体征(20.00%)和意识改变(15.65%),其中101例(87.83%)患者头颅MRI异常,累及枕叶(71.29%)、顶叶(59.40%)、额叶(49.50%)、颞叶(38.26%)、侧室脑旁(1.98%)、脑干(3.96%)、小脑(3.96%)、皮质(3.96%)、丘脑(0.99%)、基底节区(0.99%),病灶为等或低T1WI信号,高T2WI信号,等或低DWI信号,高ADC及FLAIR信号。治疗后随访3～60月,81例预后良好,21例预后不良,5例死亡。预后不良组头痛发生率、住院期间m RS评分≥3分及并发症比例高于预后良好组(P<0.05)。结论 RPLS的MRI表现具有特征性,结合临床表现可作出正确判断,及时治疗,改善预后。     

Role of pilocarpine use following laser peripheral iridotomy in eyes with refractory acute angle closure glaucoma: A case report and literature review

Rationale:Angle closure glaucoma (ACG) is one of the most emergent types of glaucoma in clinical practice. Laser peripheral iridotomy (LPI) could minimize pupillary block and prevent ACG from an acute attack. However, recurrent increase in intraocular pressure (IOP) may still occur despite successful LPI. The aim of this study is to highlight the importance of postLPI pilocarpine use and larger LPI size as well as to share some experiences of cataract surgery in patients with ACG.Patient concerns:A 63-year-old female was referred to our hospital for headache, and poor control of IOP in the right eye for 3 hours.Diagnoses:The patient was diagnosed ACG in the right eye. Recurrence of ACG in the right eye and new-onset and recurrent ACG in the left eye were noted during follow-up, despite successful LPI. The diagnosis was confirmed through slit lamp and gonioscope examination.Interventions:The LPI size was enlarged and pilocarpine use was maintained at 2% (1 drop 4 times a day) in both the eyes. Finally, cataract surgery was performed in both the eyes.Outcomes:No recurrence of ACG was noted during postLPI pilocarpine use in both the eyes. The postoperative IOP was stable for >6 months after cataract surgery without any surgical intervention or antiglaucoma medication use. No discomfort or major complication was observed.Conclusion:This report highlights the importance of postLPI pilocarpine use and larger LPI size in patients with refractory ACG.     

Prognostic factors for acute posterior circulation cerebral infarction patients after endovascular mechanical thrombectomy: A retrospective study

This article was to analyze the factors influencing the prognosis of posterior circulation cerebral infarction (PCCI) patients, retrospectively.One hundred forty five patients diagnosed with PCCI in Nanyang Central Hospital between June 25, 2016 and October 14, 2019 were included and underwent cerebral vascular mechanical thrombectomy. The clinical data of those patients were collected. The patients were followed up for 3 months to observe the prognostic efficacy and explore the influencing factors for poor prognosis. The potential prognostic factors for PCCI patients after emergency endovascular mechanical thrombectomy were analyzed by univariate and multivariable logistic regression. The thermodynamic diagram was drawn to explore the associations between the prognostic factors.The risk of poor prognosis in PCCI patients receiving emergency endovascular mechanical thrombectomy was reduced by 0.552 time with every 1-point increase of the Alberta Stroke Program Early CT in posterior circulation score (odds ratio [OR] = 0.448, 95% confidence interval [CI]: 0.276–0.727). The risk of poor prognosis was increased by 0.827 time for each additional grade in the digital subtraction angiography-American Society of Intervention and Therapeutic Neuroradiology grading (OR = 1.827, 95% CI: 1.221–2.733, P = .003) and increased by 0.288 time for every 1-point increase in National Institutes of Health Stroke scale at 24 hours (OR = 1.288, 95% CI: 1.161–1.429). All P < .05.Alberta Stroke Program Early CT in posterior circulation score, digital subtraction angiography-American Society of Intervention and Therapeutic Neuroradiology grading, National Institutes of Health Stroke scale score at 24 hours were factors affecting the prognosis of PCCI patients undergoing emergency endovascular mechanical thrombectomy, which might provide evidence for endovascular treatment of PCCI.     

Oblique Low-Velocity Impact Response and Damage Behavior of Carbon-Epoxy Composite Laminates

The low-velocity impact behavior of carbon-epoxy cross-ply composites was numerically investigated, examining the effect of impact angle. A plastic continuum damage model, introducing the cohesive interface to describe delamination damage, was established and was validated by available experimental data. Impact histories, progressive deformation, stress transfer, and impact damage are respectively discussed. The results show that an increase in impact angle intensifies the action of tangential force, and gradually transfers energy absorption from normal plastic deformation to tangential deformation and friction, which dissipates more energy through relatively longer contact duration and larger impactor displacement. The delamination damage to upper layers is more affected by tangential loads, intensifying with the increase of the impact angle, and the damage area to the top interface is increased by 132.1% from 0° impact to 60° impact. Meanwhile, the delamination damage to lower layers is mainly determined by normal loads, weakening with the increasing impact angle overall, and the damage area of the lowest interface decreases by 36.6% from 0° impact to 60° impact.