多导睡眠监测与睡眠质量指数对脑卒中后睡眠-觉醒障碍的检测分析

目的分析多导睡眠监测与睡眠质量指数对脑卒中后睡眠-觉醒障碍治疗中的应用效果。方法选取2017年11月-2018年11月收治的108例脑卒中后睡眠-觉醒障碍患者为研究对象,均分为常规组和研究组,各54例。常规组单独使用睡眠质量指数进行检测,研究组在常规组检测方法的基础上联合使用多导睡眠监测,对比分析两组患者的相关睡眠指标。结果研究组患者PSQI评分为(8.42±2.55)分,显著低于常规组的(12.52±1.25)分,差异有统计学意义(P<0.05);研究组患者睡眠潜伏期较常规组短,两组比较,差异存在统计学意义(P<0.05),且快速眼动睡眠潜伏期、睡眠总时长显著高于常规组,差异均存在统计学意义(P<0.05);研究组睡眠效率明显高于常规组,而觉醒次数明显低于常规组,两组间比较,差异均存在统计学意义(P<0.05)。结论多导睡眠监测联合睡眠质量指数能有效了解脑卒中后睡眠-觉醒障碍患者的睡眠情况,能真实反应患者病情,有利于医生诊断、治疗。

以容积黏度吞咽试验为基础的喂养策略在脑出血吞咽障碍管理中的应用价值

目的探讨以容积黏度吞咽试验(V-VST)为基础的喂养策略在脑出血吞咽障碍管理中的应用价值。方法选取广州市第一人民医院2017年10月-2020年1月收治的脑出血吞咽障碍患者150例,纳入2017年10月-2018年9月实施常规喂养的患者为对照组(n=70),纳人2018年10月-2020年1月实施V-VST为基础的喂养策略的患者为观察组(n=80)。比较两组患者干预后吞咽障碍相关并发症发生率、管饲时间、住院时间和洼田饮水试验分级。结果观察组吞咽障碍误吸、吸入性肺炎和营养不良的发生率均显著低于对照组(P值均<0.05)。观察组的管饲时间和住院时间均显著短于对照组(P值均<0.05)。观察组洼田饮水试验1级+2级患者人数所占百分比显著高于对照组(P<0.05)。结论以V-VST为基础的喂养策略用于脑出血吞咽障碍管理能够降低并发症发生率,缩短住院时间,改善吞咽功能。

醒脑开窍针刺法联合还少丹治疗脑卒中后认知障碍的临床研究

目的:观察醒脑开窍针刺法联合还少丹治疗脑卒中后认知障碍的临床疗效。方法:将58例脑卒中后认知障碍患者按随机数表法随机分为对照组和治疗组各29例,两组均采用脑卒中后常规治疗,对照组在常规治疗的基础上予以还少丹口服,治疗组在对照组治疗基础上予以醒脑开窍针刺法,4周为一个疗程,治疗2个疗程后观察比较两组患者简易精神状态检查量表(MMSE)、日常生活能力(ADL)、蒙特利尔认知评估量表(MoCA)的评分情况。结果:治疗组MMSE评分、ADL评分、MoCA评分改善程度均显著优于对照组(P<0.05)。结论:醒脑开窍针刺法联合还少丹对于脑卒中后认知障碍患者有着明显的治疗效果。

减轻变革伤痛的艺术之一 突破视而不见的脑障

要进行变革首先需要改变认知。改变认知有双重的使命:让人们意识到某些旧的观念、旧的办事方法由于环境的改变已经变得不正确了;让人们认清为了组织的生存和发展需要接受新的观念和办事方法。

一阶导数分光光度法测定硫樟脑洗剂中樟脑含量

目的建立硫樟脑洗剂中樟脑的含量测定方法。方法采用一阶导数分光光度法,测定波长为305nm,Δλ为1nm。结果样品浓度线性范围是1～20mg/mL,r=0.9991,平均回收率为100.28%,RSD为1.08%。结论方法简便、准确,可用于测定硫樟脑洗剂中樟脑的含量。

脑胶质瘤靶向递药系统研究现状

由于血脑屏障的存在,严重影响了化疗药物进入脑组织发挥疗效治疗脑胶质瘤,进年来随着对脑胶质瘤的不断认知以及科学技术手段的不断发展,越来越多的脑胶质瘤递送系统已经逐步建立起来,并可以达到有效治疗脑胶质瘤的目的。本文将主要综述治疗脑胶质瘤的纳米载体递送系统及脑靶向及肿瘤靶向纳米递释系统,并简单介绍血脑屏障的特点,并对脑胶质瘤的研究进展做出展望。

实验性脑损伤早期血脑屏障通透性定量研究

本实验选用家兔,定量研究脑损伤早期血-脑屏障(BBB)通透性变化。并检测脑组织水含量变化。结果表明:BBB通透性在伤后0.5h已开始增高,伤后6h,通透性增高达高峰,并伴有脑组织水含量明显增加,导致血管源性脑水肿。山莨菪碱可显著降低BBB通透性,并有利于脑水肿的防治。

Inter- and intra-hemispheric EEG coherence in patients with mild cognitive impairment at rest and during working memory task

Objective： To assess functional relationship by calculating inter- and intra-hemispheric electroencephalography （EEG） coherence at rest and during a working memory task of patients with mild cognitive impairment （MCI）. Methods： The sample consisted of 69 subjects： 35 patients （n = 17 males, n = 18 females; 52-71 years old） and 34 normal controls （n = 17 males, n = 17 females; 51 -63 years old）. Mini-mental state examination （MMSE） of two groups revealed that the scores of MCI patients did not differ significantly from those of normal controls （P〉0.05）. In EEG recording, subjects were performed at rest and during working memory task. EEG signals from F3-F4, C3-C4, P3-P4, T5-T6 and O1-O2 electrode pairs are resulted from the inter-hemispheric action, and EEG signals from F3-C3, F4-C4, C3-P3, C4-P4, P3-O1, P4-O2, T5-C3, T6-C4, T5-P3 and T6-P4 electrode pairs are resulted from the intra-hemispheric action for delta （1.0-3.5 Hz）, theta （4.0-7.5 Hz）, alpha-1 （8.0-10.0 Hz）, alpha-2 （10.5-13.0 Hz）, beta-1 （13.5-18.0 Hz） and beta-2 （18.5-30.0 Hz） frequency bands. The influence of inter- and intra-hemispheric coherence on EEG activity with eyes closed was examined using fast Fourier transformation from the 16 sampled channels. Results： During working memory tasks, the inter- and intra-hemispheric EEG coherences in all bands were significantly higher in the MCI group in comparison with those in the control group （P〈0.05）. However, there was no significant difference in inter- and intra-hemispheric EEG coherences between two groups at rest. Conclusion： Experimental results comprise evidence that MCI patients have higher degree of functional connectivity between hemispheres and in hemispheres during working condition, It suggests that MCI may be associated with compensatory processes during working memory tasks between hemispheres and in hemispheres. Moreover, failure of normal cortical connections may exist in MCI patients.

Altered blood-brain barrier permeability in rats with prehepatic portal hypertension turns to normal when portal pressure is lowered

AIM： To study the blood-brain barrier integrity in prehepatic portal hypertensive rats induced by partial portal vein ligation, at 14 and 40 dafer ligation when portal pressure is spontaneously normalized. METHODS： Adult male Wistar rats were divided into four groups： Group Ⅰ： Sham14d, sham operated; Group Ⅱ： PHil, portal vein stenosis, （both groups were used 14 days after surgery）; Group Ⅲ： Sham4od, Sham operated and Group Ⅳ： PH4od Portal vein stenosis （Groups Ⅱ and Ⅳ used 40 d afer surgery）. Plasma ammonia, plasma and cerebrospinal fluid protein and liver enzymes concentrations were determined. Trypan and Evans blue dyes, systemically injected, were investigated in hippocampus to study blood-brain barrier integrity. Portal pressure was periodically recorded. RESULTS： Forty days afer stricture, portal pressure was normalized, plasma ammonia was moderately high, and both dyes were absent in central nervous system parenchyma. All other parameters were reestablished. When portal pressure was normalized and ammonia level was lowered, but not normal, the altered integrity of blood-brain barrier becomes reestablished. CONCLUSION： The impairment of blood-brain barrier and subsequent normalization could be a mechanism involved in hepatic encephalopathy reversibility. Hemodynamic changes and ammonia could trigger blood-brain barrier alterations and its reestablishment.

Obesity promotes oxidative stress and exacerbates blood-brain barrier disruption after high-intensity exercise

Purpose: The purpose of this study was to investigate the effects of obesity and high-intensity acute exercise on oxidant-antioxidant status,neurotrophic factor expression, and blood-brain barrier(BBB) disruption.Methods: Twenty-four healthy, untrained men(12 non-obese(mean 14.9% body fat) and 12 obese subjects(mean 29.8% body fat)) performed20 min of continuous submaximal aerobic exercise at 85% maximal oxygen consumption. Blood sampling was performed to examine the oxidant-antioxidant status(reactive oxygen species(ROS) and superoxide dismutase(SOD)), neurotrophic factors(brain-derived neurotrophic factor(BDNF) and nerve growth factor(NGF)), and BBB disruption(S100β and neuron-specific enolase) before and after acute exercise.Results: The obese group showed significantly higher pre-exercise serum ROS levels and significantly lower pre-exercise serum SOD levels than the non-obese group(p < 0.05). Serum ROS, SOD, BDNF, NGF, and S100β levels were significantly increased post-exercise compared with pre-exercise levels in both the non-obese and the obese groups(p < 0.05). The obese group showed significantly higher serum ROS, BDNF, NGF,and S100β levels post-exercise compared to the non-obese group(p < 0.05).Conclusion: Our study suggests that episodic vigorous exercise can increase oxidative stress and blood neurotrophic factor levels and induce disruption of the BBB. Moreover, high levels of neurotrophic factor in the blood after exercise in the obese group may be due to BBB disruption,and it is assumed that oxidative stress was the main cause of this BBB disruption.

Hyperammonemia,brain edema and blood-brain barrier alterations in prehepatic portal hypertensive rats and paracetamol intoxication

AIM:To study the blood-brain barrier integrity,brain edema, animal behavior and ammonia plasma levels in prehepatic portal hypertensive rats with and without acute liver intoxication. METHODS:Adults male Wistar rats were divided into four groups.Group Ⅰ:sham operation;Ⅱ:Prehepatic portal hypertension,produced by partial portal vein ligation;Ⅲ: Acetaminophen intoxication and Ⅳ:Prehepatic portal hypertension plus acetaminophen.Acetaminophen was administered to produce acute hepatic injury.Portal pressure,liver serum enzymes and ammonia plasma levels were determined.Brain cortex water content was registered and trypan blue was utilized to study blood brain barrier integrity.Reflexes and behavioral tests were recorded. RESULTS:Portal hypertension was significantly elevated in groups Ⅱ and Ⅳ.Uver enzymes and ammonia plasma levels were increased in groups Ⅱ,Ⅲ and Ⅳ.Prehepatic portal hypertension (group Ⅱ),acetaminophen intoxication (group Ⅲ) and both (group Ⅳ) had changes in the blood brain-barrier integrity (trypan blue) and hyperammonemia.Cortical edema was present in rats with acute hepatic injury in groups Ⅲ and Ⅳ.Behavioral test (rota rod) was altered in group Ⅳ. CONCLUSION:These results suggest the possibility of another pathway for cortical edema production because blood brain barrier was altered (vasogenic) and hyperammonemia was registered (oltotoxic).Group Ⅳ,with behavioral altered test,can be considered as a model for study at an early stage of portal-systemic encephalopathy.

EFFECTS OF MUSICAL MEDITATION TRAINING ON AUDITORY MISMATCH NEGATIVITY AND P300 IN NORMAL CHILDREN

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EFFECT OF ACUPUNCTURE STIMULATION AT SANYINJIAO (SP 6) ON CEREBRAL GLUCOSE METABOLISM IN DYSMENORRHEA PATIENTS

To study the central mechanism of acupuncture stimulation of Sanyinjiao （三阴交 SP 6） in relieving dysmenorrhea. Methods： A total of 6 dysmenorrhea volunteer patients were subjected into this study. On the first positron emission tomography （PET） scan examination, they were assigned to pseudoacupuncture group by using the acupuncture needle just to prick the skin of Sanyinjiao （SP 6） ; while on the second PET scans, they were assigned to acupuncture group by inserting the needle into the same acupoint. 18F fluorodeoxyglucose （;SF-FDG） PET of the whole brain was performed during pseudo-acupuncture and real acupuncture of Sanyinjiao （SP 6）. The acquired PET data were analyzed by using statistical parametric mapping （SPM） software to determine changes of glucose metabolism in different cerebral regions. The patient＇s pain intensity was rated by using 0-10 numerical pain intensity scale. Results： After pseudo-acupuncture stimulation of Sanyinjiao （SP 6）, no significant changes were found in the pain intensity （ P 〉0.05）, while after real-acupuncture stimulation, the pain intensity declined significantly （ P〈0.01 ）. Following acupuncture of the right Sanyinjiao （SP 6）, multiple cerebral regions involving pain were activated （increase of glucose metabolism）, including ipsilateral lenticular nucleus （globus palliclus, putamen）, ipsilateral cerebellum and insular lobe, bilateral dorsal thalamus, ipsilateral paracentral Iobule, bilateral amygdaloid bodies, contralateral substantia nigra of the midbrain, bilateral second somatosensory （S Ⅱ ） areas, ispsilateral hippocampal gyms, frontal part of the ipsilateral cingulated gyrus, and bilateral mammary bodies of the hypothalamus. In addition, fewer regions of the cerebral cortex responded with decrease of the glucose metabolism after real acupuncture.

EAE （Experimental Autoimmune Encephalomyelitis）, Corticotropin-Releasing Factor and the Blood Brain Barrier

EAE （experimental autoimmune encephalomyelitis） is an established, inducible animal model employed in the study of MS （multiple sclerosis） characterized by inflammation, BBB （blood brain barrier） malfunction, demyelination and neuronal disruption. CRF （corticotropin releasing factor） is a neuropeptide critically associated with immune function, BBB permeability, and the hypothalamic-pituitary-adrenal axis. Potential CRF targets in the brain include astrocytes, as well as endothelial cells of cerebral microvessels, since they have been reported to express CRFR （CRF receptors）. Further, both of these cell types function critically in regulating BBB permeability. CRF-BP （CRF binding protein） is also expressed in both neurons and glial cells. Changes in the cortical CRF system could be a contributing factor to the BBB disruption associated with MS/EAE and has been suggested to play a protective role against cytokine-induced inflammation. The current study assessed alterations associated with the C57BL/6 mouse model of EAE in the cortical CRF system and correlated these events with changes to the microvascular unit. Immunohistochemical confocal microscopy was used to analyze the distribution of CRF, CRF-BP, and CRFR in the mouse cerebral cortex. The authors observed a reduction in detectable CRF immunofluorescence in the EAE motor cortex, an increase in CRFBP immunoreactivity in EAE astrocytes and a concurrent reduction in astrocytic CRFR immunofluorescence. Staining techniques were used to visualize astrocytes/microvessels to document alterations in BBB integrity. Changes in the CRF system were associated with a modification of the blood brain barrier as manifested by a poorly defined astrocytic barrier in EAE microvessels. Evidence suggests that manipulation of CRF signaling pathways offers an intriguing target for interventional therapies designed to modify BBB permeability that may be beneficial for treating disease states such as MS.

Preventive administration of cromakalim reduces aquaporin-4 expression and blood-brain barrier permeability in a rat model of cerebral ischemia/reperfusion injury

Cromakalim,an adenosine triphosphate-sensitive potassium channel opener,exhibits protective effects on cerebral ischemia/reperfusion injury.However,there is controversy as to whether this effect is associated with aquaporin-4 and blood-brain barrier permeability.Immunohistochemistry results show that preventive administration of cromakalim decreased aquaporin-4 and IgG protein expression in rats with ischemia/reperfusion injury;it also reduced blood-brain barrier permeability,and alleviated brain edema,ultimately providing neuroprotection.

Progress in the expression of P-glycoprotein in brain metastases of lung cancer andrelated TCM research

Brain metastases are common intracranial tumors, and their occurrence not only represents a high degree of malignancy, but also often is the major factor in treatment failure and poor prognosis. Primary site of brain metastases often occur in lung. P-glycoprotein is a member of the （ATP binding cassette） transporter superfamily,which is closely related to the development of lung metastases. It is the main reason for influencing the drug through the blood_brain barrier into the brain tissue, and it also is an important factor affecting the treatment of brain metastases. According to the theory of traditional chinese mddicine, the pathogenesis of brain metastases is due to phlegm, poison, stasis, virtual and so on. The principle of treatment is to promote blood circulation, remove phlegm turbidity. In recent years, the impact of Chinese herbal medicine on P-glycoprotein is increasing. This paper analyzes the mechanism and components of the relevant Chinese medicine on P-glycoprotein. It provides a reference for clinical rational drug use.

Whitehead＇s Categoreal Scheme as a Social-Psychiatric Game Autism and Metaphysics

The lack of emotional relations is not replaced by the ＂savant＂ characteristics （see Asperger syndrome） but by their immersing into stereotypic instincts. In other words, they compensate their divergent intrinsic emotions with imitated convergences （eg., the monotonous ＂convergence obsessed＂ logic of hammering, wringing hands etc.） Today＇s science cannot declare this to be convergent, especially for the fact that psychotic autist patients prove to be weak at convergence, but the male/female proportion reflects on notable facts （with Kanner syndrome it is 3：1 or 4：1, while Rett syndrome only affects females）. Can we declare Kanner and Rett syndromes to be basically female brain disorders？ Asperger-autism has been scientifically considered as a type of ＂male-brain disorder＂ since 199l （Baron-Cohen theory）. The proportion of male-female is approximately 6：1 with this disease. The author would like to demonstrate a very special case, the Asperger-autism as a ＂cognitive autism.＂ It is common to address autistic disorder as ＂pervasive＂ or ＂comprehensive＂ ontogenetic disorders because they affect all areas of adolescent psychological development negatively. But as the expression itself suggests, we are not aware of the specific disorders directly. As it will turn out we cannot deal with autism as on complex disorder, we should rather use the term in plural, i.e., autisms and autistic disorders.

Mortality Prognostics during First 24 Hours Due to Cerebral Stroke among Adult Population of Rostov-on-Don

In the present research, the model of mortality prognostics during the first 24 hours due to ACA （acute cerebrovascular accident） was developed. Eleven characteristics, developed by logistic regression method, were offered. The present model allows to predict the result ＂died/survived＂ for every adult patient with cerebral stroke, who was delivered to hospital to choose individual approach. And in such way, it raised the effectiveness of treatment and lowered the frequency of fatal case. External causes among solar, geomagnetic and meteorological were defined, which reflected the varied impact of environment and raised of fatal case probability during the first 24 hours.

Dixy： A Connection Between the “Typographic Appearance” and the Brain of Children

This study presents a comparison between three different fonts in order to know the possible influence they may have when used in educational materials for children with readers difficulties resulting from dyslexia. Two of the three selected fonts （Arial and MeMimas） are frequently used in textbooks in Spain. The third type of letter （Dixy） was specially developed for typographic research purposes, following graphic features that according to literature and previous studies on reading patterns favor the dyslexic, and could improve reading skills in these individuals. To examine the quality of reading （speed and accuracy） between fonts, a small--but significant--sample was used. Ten children in Madrid, from eight to 10 years old were examined while reading words and pseudowords with three different fonts （Arial, MeMimas, and Dixy）. The result of the study shows the influence of the shapes of the letters in the legibility of texts with familiar and unfamiliar words （pseudowords） in children with dyslexia. The study showed that using the font Dixy, despite not being known by the children, reading is more accurate than using fonts known to them, such as Arial and MeMimas. As to the reading speed, the results indicate that, although the Dixy is a font never seen before by the children, reading speed is similar to a known font for them, as is the Arial, and greater than a hand writing font such as MeMimas.