Loss is a permanent theme in Elizabeth Bishop’s poems.Bishop owned an unhappy childhood and frustrated life experience.In her early phase,Bishop describes her early struggle with traumas and pains brought by loss.Sen...Loss is a permanent theme in Elizabeth Bishop’s poems.Bishop owned an unhappy childhood and frustrated life experience.In her early phase,Bishop describes her early struggle with traumas and pains brought by loss.Senses of sadness and isolation of loss consciousness are evident.This thesis tries to analyze her mental world and feelings in her poems through conceptual metaphor which is a part of cognitive poetics.A final goal is being pursued for several years,which builds a foundation for her later conception of harmony in her poems.展开更多
Vasospastic angina is caused by sudden occlusive vasoconstriction of a segment of an epicardial artery, which can present with a wide spectrum of clinical scenario. We report the cases of two patients diagnosed with v...Vasospastic angina is caused by sudden occlusive vasoconstriction of a segment of an epicardial artery, which can present with a wide spectrum of clinical scenario. We report the cases of two patients diagnosed with vasospastic angina, with one of which presenting with sudden cardiac arrest, while the other presenting with a relatively benign syncope. But both of them have J waves formation on ECG during active ischemia. The diagnosis and management of vasospastic angina, as well as the proposed clinical significance of J waves during coro- nary soasm are discussed.展开更多
General anesthesia is widely applied in clinical practice.However,the precise mechanism of loss of consciousness induced by general anesthetics remains unknown.Here,we measured the dynamics of five neurotransmitters,i...General anesthesia is widely applied in clinical practice.However,the precise mechanism of loss of consciousness induced by general anesthetics remains unknown.Here,we measured the dynamics of five neurotransmitters,includingγ-aminobutyric acid,glutamate,norepinephrine,acetylcholine,and dopamine,in the medial prefrontal cortex and primary visual cortex of C57BL/6 mice through in vivo fiber photometry and genetically encoded neurotransmitter sensors under anesthesia to reveal the mechanism of general anesthesia from a neurotransmitter perspective.Results revealed that the concentrations of γ-aminobutyric acid,glutamate,norepinephrine,and acetylcholine increased in the cortex during propofol-induced loss of consciousness.Dopamine levels did not change following the hypnotic dose of propofol but increased significantly following surgical doses of propofol anesthesia.Notably,the concentrations of the five neurotransmitters generally decreased during sevoflurane-induced loss of consciousness.Furthermore,the neurotransmitter dynamic networks were not synchronized in the non-anesthesia groups but were highly synchronized in the anesthetic groups.These findings suggest that neurotransmitter dynamic network synchronization may cause anesthetic-induced loss of consciousness.展开更多
Objective： To explore the effect of hepatic function on loss of consciousness （LOC） and bispectral index （BIS） during sedation with midazolam （MDZ）. Methods： Forty-five patients were assigned to three groups a...Objective： To explore the effect of hepatic function on loss of consciousness （LOC） and bispectral index （BIS） during sedation with midazolam （MDZ）. Methods： Forty-five patients were assigned to three groups according to their liver function. Thirty of these patients with diagnoses of cholelithiasis were scheduled laparoscopic cholecys- tectomy, including 15 patients with normal liver function （normal group）, and 15 patients with moderately abnormal liver function based on the results of ultrasonic diagnosis of a moderately fatty liver and elevated alanine transaminase levels of less than three times normal （moderate group）. The other 15 patients with end-stage liver disease （severe group） underwent liver transplantation. Each patient was administered MDZ by way of target-controlled infusion to increase the concentration gradually. At the time of LOC, the BIS was recorded and a blood sample was withdrawn for measurement of the concentration of MDZ. The concentration of MDZ （EC50） and the BIS value （BIS50） at which 50% of patients lose consciousness were calculated using logistic regression. Results： At the time of LOC, the EC50 of MDZ and the BIS50 were similar in the normal and moderate groups （P〉0.05）. LOC occurred at a lower EC50 of MDZ and at a higher BIS50 in the severe group, compared with the normal and moderate groups （P〈0.01）. Conclusions： Patients with end-stage liver disease were more sensitive to MDZ and this affected the prediction of their time of LOC following MDZ administration. There were no changes in response in patients with moderately abnormal hepatic function.展开更多
目的探讨小儿一过性意识丧失(transient loss of consciousness,TLOC)的病因、临床特征及鉴别诊断。方法收集2013年1月至2014年3月在重庆医科大学附属儿童医院门诊就诊或住院的106例TLOC患儿的临床资料,对其病因及临床特征进行分析总结...目的探讨小儿一过性意识丧失(transient loss of consciousness,TLOC)的病因、临床特征及鉴别诊断。方法收集2013年1月至2014年3月在重庆医科大学附属儿童医院门诊就诊或住院的106例TLOC患儿的临床资料,对其病因及临床特征进行分析总结。结果 106例患儿中,晕厥型89例(84.0%),非晕厥型17例(16.0%)。在晕厥型中,直立不耐受(orthostatic intolerance,OI)42例(39.6%),心源性晕厥(cardiac syncope,CS)16例(15.1%),境遇性晕厥1例(0.9%),不明原因晕厥30例(28.3%);在非晕厥型中,神经源性疾病5例(4.7%),心因性疾病10例(9.4%),代谢性疾病2例(1.9%)。92.9%(39/42)的OI有诱因及先兆,59.5%(25/42)意识丧失<1 min,26.2%(11/42)存在晕厥家族史。CS起病急剧,56.3%(9/16)CS在劳累时诱发,100%(16/16)心电图异常,住院期间死亡3例。10例心因性疾病中8例有明确的诱因,7例意识丧失>10 min。结论 OI是儿童TLOC最常见病因,具有明显临床特征,诊断过程中首先需排除CS,其次应注意与心因性假性晕厥及癫痫相鉴别。展开更多
文摘Loss is a permanent theme in Elizabeth Bishop’s poems.Bishop owned an unhappy childhood and frustrated life experience.In her early phase,Bishop describes her early struggle with traumas and pains brought by loss.Senses of sadness and isolation of loss consciousness are evident.This thesis tries to analyze her mental world and feelings in her poems through conceptual metaphor which is a part of cognitive poetics.A final goal is being pursued for several years,which builds a foundation for her later conception of harmony in her poems.
基金grants from the National Nat-ural Science Foundation of China，the PhD Programs Foundation of Ministry of Education of China (20120001120131). The authors of this article do not have potential conflicts of interest
文摘Vasospastic angina is caused by sudden occlusive vasoconstriction of a segment of an epicardial artery, which can present with a wide spectrum of clinical scenario. We report the cases of two patients diagnosed with vasospastic angina, with one of which presenting with sudden cardiac arrest, while the other presenting with a relatively benign syncope. But both of them have J waves formation on ECG during active ischemia. The diagnosis and management of vasospastic angina, as well as the proposed clinical significance of J waves during coro- nary soasm are discussed.
基金supported by the National Natural Science Foundation of China(81870841 and 82171192 to X.S.L.,82101349 to G.L.Q.)。
文摘General anesthesia is widely applied in clinical practice.However,the precise mechanism of loss of consciousness induced by general anesthetics remains unknown.Here,we measured the dynamics of five neurotransmitters,includingγ-aminobutyric acid,glutamate,norepinephrine,acetylcholine,and dopamine,in the medial prefrontal cortex and primary visual cortex of C57BL/6 mice through in vivo fiber photometry and genetically encoded neurotransmitter sensors under anesthesia to reveal the mechanism of general anesthesia from a neurotransmitter perspective.Results revealed that the concentrations of γ-aminobutyric acid,glutamate,norepinephrine,and acetylcholine increased in the cortex during propofol-induced loss of consciousness.Dopamine levels did not change following the hypnotic dose of propofol but increased significantly following surgical doses of propofol anesthesia.Notably,the concentrations of the five neurotransmitters generally decreased during sevoflurane-induced loss of consciousness.Furthermore,the neurotransmitter dynamic networks were not synchronized in the non-anesthesia groups but were highly synchronized in the anesthetic groups.These findings suggest that neurotransmitter dynamic network synchronization may cause anesthetic-induced loss of consciousness.
基金supported by the Qianjiang Talents Project of the Technology Office in Zhejiang Province(No.2012R10033)the Clinical Scientific Research Funds of Zhejiang Provincial Medical Association(No.2012ZYC-A72),China
文摘Objective： To explore the effect of hepatic function on loss of consciousness （LOC） and bispectral index （BIS） during sedation with midazolam （MDZ）. Methods： Forty-five patients were assigned to three groups according to their liver function. Thirty of these patients with diagnoses of cholelithiasis were scheduled laparoscopic cholecys- tectomy, including 15 patients with normal liver function （normal group）, and 15 patients with moderately abnormal liver function based on the results of ultrasonic diagnosis of a moderately fatty liver and elevated alanine transaminase levels of less than three times normal （moderate group）. The other 15 patients with end-stage liver disease （severe group） underwent liver transplantation. Each patient was administered MDZ by way of target-controlled infusion to increase the concentration gradually. At the time of LOC, the BIS was recorded and a blood sample was withdrawn for measurement of the concentration of MDZ. The concentration of MDZ （EC50） and the BIS value （BIS50） at which 50% of patients lose consciousness were calculated using logistic regression. Results： At the time of LOC, the EC50 of MDZ and the BIS50 were similar in the normal and moderate groups （P〉0.05）. LOC occurred at a lower EC50 of MDZ and at a higher BIS50 in the severe group, compared with the normal and moderate groups （P〈0.01）. Conclusions： Patients with end-stage liver disease were more sensitive to MDZ and this affected the prediction of their time of LOC following MDZ administration. There were no changes in response in patients with moderately abnormal hepatic function.
文摘目的探讨小儿一过性意识丧失(transient loss of consciousness,TLOC)的病因、临床特征及鉴别诊断。方法收集2013年1月至2014年3月在重庆医科大学附属儿童医院门诊就诊或住院的106例TLOC患儿的临床资料,对其病因及临床特征进行分析总结。结果 106例患儿中,晕厥型89例(84.0%),非晕厥型17例(16.0%)。在晕厥型中,直立不耐受(orthostatic intolerance,OI)42例(39.6%),心源性晕厥(cardiac syncope,CS)16例(15.1%),境遇性晕厥1例(0.9%),不明原因晕厥30例(28.3%);在非晕厥型中,神经源性疾病5例(4.7%),心因性疾病10例(9.4%),代谢性疾病2例(1.9%)。92.9%(39/42)的OI有诱因及先兆,59.5%(25/42)意识丧失<1 min,26.2%(11/42)存在晕厥家族史。CS起病急剧,56.3%(9/16)CS在劳累时诱发,100%(16/16)心电图异常,住院期间死亡3例。10例心因性疾病中8例有明确的诱因,7例意识丧失>10 min。结论 OI是儿童TLOC最常见病因,具有明显临床特征,诊断过程中首先需排除CS,其次应注意与心因性假性晕厥及癫痫相鉴别。
