Connectivity differences between adult male and female patients with attention deficit hyperactivity disorder according to resting-state functional MRI

Attention deficit hyperactivity disorder（ADHD） is a pervasive psychiatric disorder that affects both children and adults. Adult male and female patients with ADHD are differentially affected, but few studies have explored the differences. The purpose of this study was to quantify differences between adult male and female patients with ADHD based on neuroimaging and connectivity analysis. Resting-state functional magnetic resonance imaging scans were obtained and preprocessed in 82 patients. Group-wise differences between male and female patients were quantified using degree centrality for different brain regions. The medial-, middle-, and inferior-frontal gyrus, superior parietal lobule, precuneus, supramarginal gyrus, superior- and middle-temporal gyrus, middle occipital gyrus, and cuneus were identified as regions with significant group-wise differences. The identified regions were correlated with clinical scores reflecting depression and anxiety and significant correlations were found. Adult ADHD patients exhibit different levels of depression and anxiety depending on sex, and our study provides insight into how changes in brain circuitry might differentially impact male and female ADHD patients.

Effects of Yinxingdamo Injection Combined with Oxiracetam Capsule on Cognitive Function and Neurological Deficit in Patients with Acute Cerebral Infarction

OBJETTIVE: To observe the effects of Yinxingdamo Injection combined with oxiracetam capsule on cognitive function and neurological deficit in patients with acute cerebral infarction. METHODS: A total of 76 patients with acute cerebral infarction were randomly divided into observation group and control group, with 38 patients in each group. Patients in the control group were treated with conventional western medicine and oxiracetam capsules while patients in the observation group were given Yinxingdamo injection intravenous drip treatment on the basis of the same treatment. After 4 weeks of treatment, the cognitive function of the two groups before and after treatment was observed [Simple Intelligence Scale(MMSE Score), Montreal Cognitive Assessment Scale(MoCA Score)], Neurological Deficit [Chinese Stroke Scale(CSS Score), Daily Life Activity ability(ADL score)], free radical biochemical indicators [malondialdehyde(MDA), oxide dismutase(SOD)] changes, and statistical effects of two groups. RESULTS: After treatment, the total effective rate of the observation group was 92.1%, which was significantly higher than 73.7% of the control group(P < 0.05). The MMSE score and MoCA score of the two groups were significantly increased after treatment(P < 0.05), and the MMSE score and MoCA score inobservation group were significantly increased after treatment than the control group(P < 0.05). The CSS scores of the two groups were significantly decreased after treatment(P < 0.05), and the ADL scores were significantly increased(P < 0.05). The improvement of CSS score and ADL score in the observation group were significantly better than those in the control group(P < 0.05), and serum MDA levels were significantly decreased in both groups after treatment(P < 0.05), and SOD levels were significantly increased(P < 0.05), and the improvement of MDA and SOD levels in the observation group was significantly better than that in the control group group(P < 0.05). CONCLUSION: Yinxingdamo injection combined with oxiracetam capsule can effectively inhibit the oxygen free radical reaction injury in patients with acute cerebral infarction, and significantly improve the symptoms of cognitive dysfunction and neurological deficit in patients. Its curative effect is exact and worthy of clinical application.

Age-related connectivity differences between attention deficit and hyperactivity disorder patients and typically developing subjects：a resting-state functional MRI study

Attention deficit and hyperactivity disorder（ADHD） is a disorder characterized by behavioral symptoms including hyperactivity/impulsivity among children,adolescents,and adults.These ADHD related symptoms are influenced by the complex interaction of brain networks which were under explored.We explored age-related brain network differences between ADHD patients and typically developing（TD） subjects using resting state f MRI（rs-f MRI） for three age groups of children,adolescents,and adults.We collected rs-f MRI data from 184 individuals（27 ADHD children and 31 TD children;32 ADHD adolescents and 32 TD adolescents;and 31 ADHD adults and 31 TD adults）.The Brainnetome Atlas was used to define nodes in the network analysis.We compared three age groups of ADHD and TD subjects to identify the distinct regions that could explain age-related brain network differences based on degree centrality,a well-known measure of nodal centrality.The left middle temporal gyrus showed significant interaction effects between disease status（i.e.,ADHD or TD） and age（i.e.,child,adolescent,or adult）（P 0.001）.Additional regions were identified at a relaxed threshold（P 0.05）.Many of the identified regions（the left inferior frontal gyrus,the left middle temporal gyrus,and the left insular gyrus） were related to cognitive function.The results of our study suggest that aberrant development in cognitive brain regions might be associated with age-related brain network changes in ADHD patients.These findings contribute to better understand how brain function influences the symptoms of ADHD.

Attention-Deficit/Hyperactivity Disorder in Adults with High-Functioning Pervasive Developmental Disorders in Japan

Aims: This study was designed to verify the proportion of Japanese adults with pervasive developmental disorder (PDD) who met the diagnostic criteria (other than E) for attention-deficit/hyperactivity disorder (ADHD) in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Furthermore, we examined to what extent adults with PDD think that they exhibit ADHD symptoms. Methods: We developed an original Japanese self-report questionnaire to determine the presence or absence of 18 symptoms from the diagnostic criteria for ADHD in the DSM-IV-TR. We administered the questionnaire to 64 adults with high-functioning PDD (45 men and 19 women) and 21 adults with ADHD (10 men and 11 women), aged 18 to 59 years, with a full-scale intelligence quotient ≥75. Target patients were evaluated for ADHD by their psychiatrists. Results: Twenty-nine (45.3%) adults with PDD also had ADHD. The percentage of these adults who had over six perceived inattention symptoms from the DSM-IV-TR was 96.6%. The percentage of these adults who had over six perceived hyperactivity-impulsivity symptoms was 65.5%. Thirty-five (55.6%) adults with PDD responded that they were aware of having ADHD symptoms at the level of the relevant diagnostic criteria. Conclusions: The present study is the first to examine the frequency of objective and perceived ADHD symptoms in adults with PDD in Japan. Our results show that both objective and perceived ADHD symptoms frequently appear in a large number of adults with PDD. This suggests that it is necessary to attend to concomitant ADHD symptoms in the medical care of adults with PDD.

Deficits in Magnocellular Pathway in Developmental Dyslexia: A Functional Magnetic Resonance Imaging-Electroencephalography Study

Background: Magnocellular deficit theory is among the different hypotheses that have been proposed to explain the pathophysiology of developmental dyslexia (DD). Dysfunction of the magnocellular system in DD has been investigated using mainly visual evoked potentials (VEPs), particularly transient VEPs, although recently abnormal steady-state VEPs have also been reported. The brain regions responsible for the abnormal VEPs in DD have yet to be elucidated, however. In this study, we performed functional magnetic resonance imaging and electroencephalography (fMRI-EEG) simultaneously to elucidate the brain areas that were found in a previous study to be activated through stimulation of the magnocellular system, and then investigated the mechanism involved in the dysfunction seen in DD.Methods: Subjects were 20 healthy individuals (TYP group;13 men, 7 women;mean ± standard deviation age, 26.3 ± 5.53 years) and 2 men with DD (aged 42 and 30 years). Images of brain activity were acquired with 3-Tesla MRI while the viewing the reversal of low-spatial frequency and low-contrast black-and-white sinusoidal gratings. EEG was recorded concurrently to obtain steady-state VEPs.Results: Stimulus frequency-dependent VEPs were observed in the posterior region of the brain in the TYP group;however, VEP amplitudes in both DD patients were clearly smaller than those in TYP. fMRI images revealed that both the primary and secondary visual cortices were activated by black-and- white sinusoidal gratings in the TYP group, whereas activity in the visual cortex overall was reduced in both DD patients.Conclusions: Present low spatial and high reversal frequency visual stimuli activated the primary visual cortex presumably through predominant activation of the magnocellular pathway. This finding indicates that some cases of adult patients of DD involve impairment of the visual magnocellular system.

THE RISK MODEL OF THE EXPECTED DISCOUNTED PENALTY FUNCTION WITH CONSTANT INTEREST FORCE

In this article, the expected discounted penalty function Фδ,α （u） with constant interest δ and ＂discounted factor＂ exp（-αTδ） is considered. As a result, the integral equation of Фδ,α （u） is derived and an exact solution for Фδ,α （0） is found. The relation between the joint density of the surplus immediately prior to ruin, and the deficit at ruin and the density of the surplus immediately prior to ruin is then obtained based on analytical methods.

高等教育筛选功能缺失的表征、归因与重塑

高等教育不仅具有传播知识、技能、思想与文化的社会化功能,还具有将不适合接受高等教育或某一专业的人才筛选出来的社会筛选功能。高等教育筛选机制的前提是获取教育文凭的学生要经历严格的筛选过程,教育文凭能够有效区分不同能力的学生。目前,我国高等教育在过程阶段和出口阶段并没有对学生的能力进行严格筛选和区分,最终导致不同能力的学生却获取了相同的文凭,劳动力市场出现了混同均衡现象。不仅如此,担负筛选功能任务的阶段还发生了“前移”和“后移”的状况:“前移”至基础教育阶段,导致教育竞争的不断提前,并且对优质教育资源的需求增加;“后移”至毕业生就业阶段,导致就业招聘“学历论”导向加剧,且产生了高校毕业生过度的教育现象,极大地浪费了高等教育资源。造成高等教育筛选功能缺失现象形成的原因是多方面的:传统思想的积淀与延续是价值前提,利益主体的理性选择是重要推力,制度安排与环境的不兼容是现实基础。破解此问题需要从以下几个方面入手:一是要革新认知观念,由“宽出”到“严出”;二是要转变价值取向,由“利益取向”到“责任取向”;三是要深化学分制改革,由“刻板教条”到“自由灵活”。

A Preliminary Near-Infrared Spectroscopy Study in Adolescent and Adult Patients with Attention-Deficit/Hyperactivity Disorder Symptoms

Prefrontal dysfunction in patients with attention-deficit/hyperactivity disorder (AD/HD) has been repeatedly detected on a behavioral level, and various brain-imaging studies have elucidated the pathophysiology of AD/HD. Recent advances in near-infrared spectroscopy (NIRS) have enabled noninvasive investigations of brain function in various mental disorders, especially major depression, schizophrenia, and bipolar disorder. The objective of this preliminary study was to use NIRS to evaluate changes in frontal lobe blood flow in post childhood or adult patients with AD/HD symptoms. The subjects included five patients with a range of mental disorders and AD/HD symptoms, and a matched (age, sex, and dominant hand) control group of five healthy subjects. We compared the changes in cerebral blood flow during verbal fluency tasks between the two groups. The duration of the elevated oxygenated hemoglobin was notably shorter in the AD/HD group than that in the healthy control group. We suggest that the shorter elevation durations of oxygenated hemoglobin concentrations might be a biological indicator for post childhood or adult AD/HD or of impaired executive functioning.

精神分裂症在语义言语流畅性任务下近红外光谱成像特征探究

目的通过近红外光成像技术,探索在语义言语流畅性任务下,精神分裂症患者和健康人群额叶脑区激活的差异,寻找识别精神分裂症的客观指标。方法共纳入60例精神分裂症患者(研究组)、39名性别、年龄与之匹配的健康对照者(对照组)进行测试,采用阳性与阴性症状量表(PANSS)对患者症状严重程度进行评估,采用蒙特利尔认知评估量表(MoCA)进行认知评估,利用52通道ETG-4100近红外光谱仪采集两组人群前额叶的氧合血红蛋白(Oxy-Hb)的相对浓度值。结果研究组组词正确总数及每一个类别的组词正确数均低于对照组(P<0.001)。研究组执行语义流畅性任务时,脑区激活通道数小于对照组(通道激活数:28 vs.51),差异主要位于背侧额极皮层区,其次是双侧颞上回(FDR矫正P<0.05)。受教育年限、发病次数和言语流畅性任务的正确组词个数对认知功能有一定影响。结论精神分裂症患者有明显的语义言语流畅性缺陷,可能与背侧额极皮层区及双侧颞上回激活功能下降有关。发病次数越多,认知下降越明显。

复方脑肽节苷脂注射液联合亚低温治疗重症颅脑损伤患者的效果

目的:观察复方脑肽节苷脂注射液联合亚低温治疗重症颅脑损伤患者的效果。方法:选取2020年1月至2022年12月该院收治的80例重症颅脑损伤患者进行前瞻性研究,按随机数字表法将其分为对照组与研究组各40例。对照组采用亚低温治疗,研究组在对照组基础上联合复方脑肽节苷脂注射液治疗,比较两组治疗前后认知状态[改良蒙特利尔量表(MoCA)、简易智能精神状态检查表(MMSE)]评分、神经功能缺损程度[美国国立卫生研究院卒中量表(NIHSS)]评分、肢体功能[Fugl-Meyer运动功能量表(FMA)]评分、神经损伤相关指标[降钙素基因相关肽(CGRP)、神经肽Y(NPY)、胶质纤维酸性蛋白(GFAP)]水平,以及不良反应发生率。结果:治疗后,两组MoCA、MMSE评分均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);两组NIHSS评分均低于治疗前,且研究组低于对照组,两组FMA评分均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);两组CGRP水平均高于治疗前,且研究组高于对照组,两组NPY、GFAP水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:复方脑肽节苷脂联合亚低温治疗重症颅脑损伤患者可提高认知状态和肢体功能评分,改善神经损伤相关指标水平,降低神经功能缺损程度评分,其效果优于单纯亚低温治疗。

成人注意缺陷多动障碍患者执行功能的4周正念和白噪音联合干预试验

目的:探讨正念和白噪音联合干预对成人注意缺陷多动障碍(ADHD)患者执行功能的改善效果。方法:选取成人ADHD患者45例,将其随机分为联合干预组、正念干预组和无干预组,联合干预组、正念干预组均进行正念干预,联合干预组同时加入白噪音,无干预组不施加任何干预措施。在基线及4周干预后使用N-back任务、Flanker任务、大小-奇偶转换任务、爱荷华博弈任务、ADHD评定量表测量工作记忆、抑制控制、认知灵活性、情感决策及ADHD症状。结果:4周干预后,联合干预组的抑制控制和认知灵活性任务的正确率均高于正念干预组,而反应时均低于正念干预组(均P<0.05)。联合干预组、正念干预组工作记忆、抑制控制、认知灵活性任务的正确率均高于无干预组,反应时及情感决策得分、ADHD总分及各维度得分均低于无干预组(均P<0.05)。结论:本研究提示,正念和白噪音联合干预在提高成人ADHD患者执行功能、减轻ADHD症状方面具有优势。

基于人机协同决策的运输调度优化研究

为求解带柔性约束的运输调度问题,本文提出一个基于逆差函数的人机协同决策方法。该方法主要包括两个阶段,第1阶段,借助数学规划模型,利用计算机的强大计算能力,快速求解得到问题的一个可行解;第2阶段,借助逆差函数模型,利用人类自身的知识与经验,在考虑柔性约束的情形下,进一步优化第1阶段的可行解。两个阶段通过逆差函数图像构成的图形用户界面进行实时交互,实现人机协同决策。通过网约定制公交车辆调度和民航飞机调度两个案例问题的求解,验证基于逆差函数的人机协同决策方法的有效性。计算结果表明:该方法可实现车次链/航班链的自动化构建和空驶车次的自动化插入,有助于求解带有复杂柔性约束的运输调度问题。

6~10岁注意缺陷多动障碍男童的执行功能发展特点

目的:探讨不同年龄段、不同亚型注意缺陷多动障碍(ADHD)男童的核心执行功能(抑制控制、工作记忆、认知灵活性)发展特点。方法:从北京市某三甲医院招募17名ADHD男童、北京市某公立小学1~4年级学生中筛查出48名ADHD男童。其中6~8岁41人,9~10岁24人,ADHD-PI型48人,ADHD-C型17人,募集年龄相差不超过半岁的正常发育男童65名为正常对照,分别采用Stroop色词测验(SCWT)、Rey复杂图形测验(ROCFT)、连线测验(TMT)评估被试儿童的抑制控制、工作记忆和认知灵活性。结果:整体分析显示,6~10岁ADHD男童的SCWT、ROCFT、TMT测试结果均显著差于正常男童(P<0.05);不同年龄段分析显示,6~8岁ADHD男童在核心执行功能任务中的测试结果均差于正常男童(P<0.05);9~10岁ADHD男童仅SCWT和ROCFT的测试结果差于正常男童(P<0.05);不同亚型分析显示,ADHD-PI和ADHD-C型在核心执行功能任务中的测试结果均显著差于正常男童(P<0.05);且与ADHD-PI型相比,ADHD-C型的SCWT测试结果更差(P<0.05)。结论:6~10岁ADHD男童存在核心执行功能缺陷,且低年龄段ADHD男童的核心执行功能损害范围更广;ADHD-C型的抑制控制缺陷重于ADHD-PI型。

A Joint Density Function in Phase-type(2) Risk Model

In this paper, we consider a Gerber-Shiu discounted penalty function in Sparre Andersen risk process in which claim inter-arrival times have a phase-type （2） distribution, a distribution with a density satisfying a second order linear differential equation. By conditioning on the time and the amount of the first claim, we derive a Laplace transform of the Gerber-Shiu discounted penalty function, and then we consider the joint density function of the surplus prior to ruin and the deficit at ruin and some ruin related problems. Finally, we give a numerical example to illustrate the application of the results.

立体定向微创手术治疗对老年脑胶质瘤患者免疫水平及日常生活能力的影响

目的 探究立体定向微创手术治疗对老年脑胶质瘤患者免疫水平及日常生活能力的影响。方法 选取哈尔滨医科大学附属第一医院2020年3月—2022年2月收治的老年胶质瘤患者90例作为研究对象,按照随机数字表法分为两组,各45例。对照组采取常规开颅术瘤切除治疗,观察组采取立体定向微创手术治疗。比较两组的临床疗效、日常生活活动能力量表(ADL)评分、美国国立卫生研究院卒中量表(NIHSS)评分、外周血免疫指标辅助性T细胞(Th)1、Th2以及Th17水平。结果 观察组临床总有效率高于对照组,术后1年复发率低于对照组,治疗后观察组ADL评分高于对照组,NIHSS评分低于对照组,Th1水平高于对照组,Th2及Th17水平低于对照组,差异均有统计学意义(P<0.05)。结论 立体定向微创手术治疗老年脑胶质瘤疗效确切,不仅改善了免疫功能指标及神经功能缺损情况,还有助于提高日常生活能力,降低短期复发率。

注意缺陷多动障碍儿童粗大动作技能与执行功能发展的特点及关系

目的探讨学龄期注意缺陷多动障碍(ADHD)儿童的粗大动作技能和执行功能的发展特点及其相关关系。方法2020年11月至2021年5月于北京大学第六医院和北京市海淀区万泉小学招募90例ADHD儿童,从该小学另募集年龄和性别匹配的正常发育儿童90例。采用儿童粗大动作发展测试量表第三版(TGMD-3)评估儿童的粗大动作技能,采用Stroop色词测验(SCWT)、Rey-Osterrich复杂图形测验(ROCFT)、连线测验(TMT)分别评估儿童的抑制控制、工作记忆和认知灵活性。结果ADHD儿童TGMD-3得分显著低于正常儿童(t=-6.275,P<0.001),SCWT、ROCFT、TMT测试结果均差于正常儿童(|t|≥1.986,P≤0.05)。ADHD儿童的TGMD-3得分与字义反应时(r=-0.261)、字义错误数(r=-0.404)、颜色错误数(r=-0.326)呈负相关(P<0.05),与延时结构记忆得分(r=0.228)呈正相关(P<0.05),与TMT-A反应时(r=-0.255)、TMT-A错误数(r=-0.329)、TMT-B反应时(r=-0.214)、TMT-B错误数(r=-0.474)呈负相关(P<0.05)。分层线性回归分析显示,ADHD儿童的TGMD-3得分仅对抑制控制和认知灵活性的测试结果具有预测作用(P<0.05),解释率分别为8.7%和22.5%。结论ADHD儿童的粗大动作技能和执行功能均存在发育滞后,且两者之间有一定关联,其中,粗大动作技能水平可在一定程度上影响抑制控制和认知灵活性的发展。

不同剂量盐酸替罗非班治疗急性非心源性脑梗死患者的疗效及对凝血功能的影响

目的分析不同剂量盐酸替罗非班治疗急性非心源性脑梗死患者的疗效及对凝血功能的影响。方法以2021-04—2022-04河北燕达医院的240例急性非心源性脑梗死患者为研究对象,利用计算机生成的随机数列分为对照组、观察一组、观察二组、观察三组,每组60例。对照组采用常规对症治疗,观察一组、观察二组、观察三组在对照组基础上分别给予0.06μg(/kg·min)、0.08μg(/kg·min)和0.1μg(/kg·min)盐酸替罗非班。比较4组血常规指标[血小板计数(PC)、血小板聚集率、平均血小板体积(MPV)、淋巴细胞(LYM)及平均血小板体积/淋巴细胞比值(MPVLR)]及凝血四项指标[凝血酶原时间(PT)、纤维蛋白原(FIB)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)],分析4组美国国立卫生研究院卒中量表(NIHSS)、改良Rankin量表(mRS)评分。结果治疗3个月后,观察三组PC、血小板聚集率、LYM、MPV、MPVLR均低于对照组、观察一组、观察二组(P<0.05),观察三组PT、TT和APTT均高于对照组、观察一组和观察二组(P<0.05),观察三组FIB、NIHSS、mRS评分均低于对照组、观察一组、观察二组(P<0.05)。结论0.10μg(/kg·min)盐酸替罗非班治疗急性非心源性脑梗死患者的疗效较好,抗凝血作用较强,有利于抑制和预防血栓形成。

单次运动对注意缺陷多动障碍患者执行功能作用的meta分析

目的:探讨单次运动对ADHD患者执行功能的作用,为ADHD的运动干预提供理论依据。方法:检索PubMed、Web of Science、Cochrane Library、Embase、中国知网、万方等数据平台中截至2023年4月21日发表的有关单次运动对ADHD患者执行功能作用的实验研究。结果:共纳入15篇文献,ADHD患者515例。Meta分析结果显示,单次运动可提高ADHD患者抑制控制(SMD=0.36,95%CI=0.17~0.55,P<0.05)、认知灵活性(SMD=0.40,95%CI=0.10~0.69,P<0.05)。亚组分析结果显示,单次运动仅能改善儿童青少年ADHD患者的抑制控制、认知灵活性(SMD=0.36、0.43,均P<0.05),而对成年ADHD患者无效(SMD=0.34、0.14,均P>0.05);仅有中高强度、≤20 min、开式运动技能为主的单次运动可同时提高ADHD患者的抑制控制(SMD=0.47、0.51、0.47,均P<0.05)与认知灵活性(SMD=0.86、0.65、0.86,均P<0.05)。结论:单次运动可改善ADHD儿童青少年的抑制控制和认知灵活性,对其工作记忆以及成年患者的执行功能均无显著作用。

扩大的血管周围间隙和中性粒细胞/淋巴细胞比值与视神经脊髓炎谱系疾病患者严重程度的关系

目的探讨扩大的血管周围间隙(enlarged perivascular space,EPVS)和中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)与视神经脊髓炎谱系疾病(neuromyelitis optica spectrum disorders,NMOSD)患者疾病严重程度的关系及其在NMOSD患者发生重度神经功能缺损中的诊断价值。方法回顾性收集2019年11月至2023年4月郑州大学第一附属医院收治的NMOSD患者164例,根据扩展残疾状况量表评分(EDSS),将患者分为轻度组(EDSS<5分,独立行走不受限)和重度组(EDSS≥5分,独立行走受限),比较两组患者的临床资料差异。采用Spearman秩相关性分析EPVS、NLR与NMOSD患者EDSS评分的相关性,采用多因素Logistics回归分析NMOSD患者发生重度神经功能缺损的影响因素,采用受试者工作曲线(ROC)评价EPVS、NLR在识别NMOSD患者发生重度神经功能缺损中的诊断价值。结果重度组总EPVS个数及NLR水平均高于轻度组(P<0.05)。Spearman秩相关结果显示,总EPVS个数(r_(s)=0.374,P<0.01)、NLR(r_(s)=0.329,P<0.01)与NMOSD患者的EDSS评分呈正相关。多因素Logistic回归分析结果显示,年龄(OR=1.082,95%CI:1.046~1.120;P<0.01)、总EPVS个数(OR=1.083,95%CI:1.008~1.663;P<0.05)、NLR(OR=1.334,95%CI:1.077~1.653;P<0.01)、脊髓受累节段数(OR=1.168,95%CI:1.073~1.272;P<0.01)是NMOSD患者发生重度神经功能缺损的影响因素。EPVS联合NLR识别NMOSD患者发生重度神经功能缺损的ROC曲线下面积(AUC)为0.775(95%CI:0.696~0.854,P<0.01),其灵敏度和特异度分别为80.00%和71.43%。结论EPVS和NLR与NMOSD患者疾病严重程度呈正相关,两者在识别NMOSD患者发生重度神经功能缺损中具有一定临床价值,两者联合时其综合诊断效能更高。

规范化护理在急性脑梗死患者支架取栓术后护理干预对于患者生活质量的影响

目的分析以规范化护理形式对急性脑梗死患者开展支架取栓术后护理干预对患者生活质量的影响。方法纳入研究的120例患者均为接受支架取栓术治疗的急性脑梗死患者,研究起止时间为2021年6月—2023年6月,利用信封抽签法随机分为两组,分别采用规范化护理模式(试验组,n=60)及常规护理(对照组,n=60)开展临床护理,比较不同护理方法对患者生活质量带来的影响。结果与对照组比较,试验组患者的生理机能、情感职能、社会功能、精神健康等生活质量评分以及护理满意度均更高,焦虑和抑郁评分以及美国国立卫生院卒中量表(NIHSS)评分更低,均P<0.05。结论针对急性脑梗死支架取栓术患者采用规范化护理可有效提高患者的生活质量,加快患者脑功能缺损状态恢复,提高患者满意度。