Military psychiatry, a new subcategory of psychiatry, has become an invaluable, intangible effect of the war. In this review, we begin by examining related military research, summarizing the related epidemiological da...Military psychiatry, a new subcategory of psychiatry, has become an invaluable, intangible effect of the war. In this review, we begin by examining related military research, summarizing the related epidemiological data, neuropathology, and the research achievements of diagnosis and treatment technology, and discussing its comorbidity and sequelae. To date, advances in neuroimaging and molecular biology have greatly boosted the studies on military traumatic brain injury(TBI). In particular, in terms of pathophysiological mechanisms, several preclinical studies have identified abnormal protein accumulation, blood–brain barrier damage, and brain metabolism abnormalities involved in the development of TBI. As an important concept in the field of psychiatry, TBI is based on organic injury, which is largely different from many other mental disorders. Therefore, military TBI is both neuropathic and psychopathic, and is an emerging challenge at the intersection of neurology and psychiatry.展开更多
Research scientists and clinicians should be aware that missed diagnoses of mild-moderate traumatic brain injuries in post-acute patients having spinal cord injuries may approach 60-74% with certain risk factors, pote...Research scientists and clinicians should be aware that missed diagnoses of mild-moderate traumatic brain injuries in post-acute patients having spinal cord injuries may approach 60-74% with certain risk factors, potentially causing clinical consequences for patients, and confounding the results of clinical research studies. Factors leading to a missed diagnosis may include acute trauma-related life-threatening issues, sedation/intubation, subtle neuropathology on neuroimaging, failure to collect Glasgow Coma Scale scores or duration of posttraumatic amnesia, or lack of validity of this information, and overlap in neuro-cognitive symptoms with emotional responses to spinal cord injuries. Strategies for avoiding a missed diagnosis of mild-moderate traumatic brain injuries in patients having a spinal cord injuries are highlighted in this perspective.展开更多
目的探讨血清IL-11在急性脑梗死诊断和预后评估中的价值及其与血清脑源性神经营养因子(BDNF)的相关性。方法收集102例急性脑梗死患者(脑梗死组)和64名正常对照者(正常对照组)的一般临床资料。根据90 d mRS评分将脑梗死组分为预后良好亚...目的探讨血清IL-11在急性脑梗死诊断和预后评估中的价值及其与血清脑源性神经营养因子(BDNF)的相关性。方法收集102例急性脑梗死患者(脑梗死组)和64名正常对照者(正常对照组)的一般临床资料。根据90 d mRS评分将脑梗死组分为预后良好亚组和预后不良亚组。采用Pearson相关性分析血清IL-11和NIHSS评分、脑梗死体积、血清BDNF的相关性,Logistics回归分析脑梗死预后的影响因素,并绘制IL-11在脑梗死诊断和预后预测中的ROC曲线。结果脑梗死组高血压比率及糖化血红蛋白、低密度脂蛋白水平显著高于正常对照组(均P<0.05)。预后不良亚组的年龄、糖尿病比率、糖化血红蛋白水平、入院时NIHSS评分、脑梗死体积显著高于预后良好亚组(均P<0.05)。脑梗死组血清IL-11水平显著低于正常对照组(t=10.123,P<0.001)。脑梗死预后不良亚组血清IL-11水平显著低于预后良好亚组(t=7.438,P<0.001)。脑梗死患者血清IL-11表达与NIHSS评分(r=-0.603,P<0.001)及脑梗死体积(r=-0.681,P<0.001)呈负相关关系。Logistics回归分析显示,IL-11为影响脑梗死患者预后的保护性因素(OR=0.814,P=0.009),脑梗死体积(OR=2.262,P<0.001)和NIHSS评分(OR=2.107,P=0.006)为影响脑梗死预后的危险因素。当IL-11应用于脑梗死的诊断时,ROC曲线下面积为0.841,灵敏性为91.18%,特异性为72.42%,截断值为378.47;当IL-11应用于脑梗死预后预测时,ROC曲线下面积为0.786,灵敏性为67.09%,特异性为87.93%,截断值为310.94。脑梗死患者血清IL-11水平与血清BDNF水平的相关系数为r=0.711、P<0.01。结论脑梗死患者血清IL-11水平显著降低,且预后不良患者的IL-11水平显著低于预后良好亚组。同时,IL-11水平与血清BDNF水平呈负相关,可能可以用于脑梗死的辅助诊断和预后评估。展开更多
基金supported by the Zhejiang Provincial Key Research and Development Program (2021C03107)。
文摘Military psychiatry, a new subcategory of psychiatry, has become an invaluable, intangible effect of the war. In this review, we begin by examining related military research, summarizing the related epidemiological data, neuropathology, and the research achievements of diagnosis and treatment technology, and discussing its comorbidity and sequelae. To date, advances in neuroimaging and molecular biology have greatly boosted the studies on military traumatic brain injury(TBI). In particular, in terms of pathophysiological mechanisms, several preclinical studies have identified abnormal protein accumulation, blood–brain barrier damage, and brain metabolism abnormalities involved in the development of TBI. As an important concept in the field of psychiatry, TBI is based on organic injury, which is largely different from many other mental disorders. Therefore, military TBI is both neuropathic and psychopathic, and is an emerging challenge at the intersection of neurology and psychiatry.
基金Department of Physical Medicine&Rehabilitation funding by the United States Department of Education,National Institute of Disability Research and Rehabilitation#H133A120099(TBI Model Systems grant)
文摘Research scientists and clinicians should be aware that missed diagnoses of mild-moderate traumatic brain injuries in post-acute patients having spinal cord injuries may approach 60-74% with certain risk factors, potentially causing clinical consequences for patients, and confounding the results of clinical research studies. Factors leading to a missed diagnosis may include acute trauma-related life-threatening issues, sedation/intubation, subtle neuropathology on neuroimaging, failure to collect Glasgow Coma Scale scores or duration of posttraumatic amnesia, or lack of validity of this information, and overlap in neuro-cognitive symptoms with emotional responses to spinal cord injuries. Strategies for avoiding a missed diagnosis of mild-moderate traumatic brain injuries in patients having a spinal cord injuries are highlighted in this perspective.
文摘目的探讨血清IL-11在急性脑梗死诊断和预后评估中的价值及其与血清脑源性神经营养因子(BDNF)的相关性。方法收集102例急性脑梗死患者(脑梗死组)和64名正常对照者(正常对照组)的一般临床资料。根据90 d mRS评分将脑梗死组分为预后良好亚组和预后不良亚组。采用Pearson相关性分析血清IL-11和NIHSS评分、脑梗死体积、血清BDNF的相关性,Logistics回归分析脑梗死预后的影响因素,并绘制IL-11在脑梗死诊断和预后预测中的ROC曲线。结果脑梗死组高血压比率及糖化血红蛋白、低密度脂蛋白水平显著高于正常对照组(均P<0.05)。预后不良亚组的年龄、糖尿病比率、糖化血红蛋白水平、入院时NIHSS评分、脑梗死体积显著高于预后良好亚组(均P<0.05)。脑梗死组血清IL-11水平显著低于正常对照组(t=10.123,P<0.001)。脑梗死预后不良亚组血清IL-11水平显著低于预后良好亚组(t=7.438,P<0.001)。脑梗死患者血清IL-11表达与NIHSS评分(r=-0.603,P<0.001)及脑梗死体积(r=-0.681,P<0.001)呈负相关关系。Logistics回归分析显示,IL-11为影响脑梗死患者预后的保护性因素(OR=0.814,P=0.009),脑梗死体积(OR=2.262,P<0.001)和NIHSS评分(OR=2.107,P=0.006)为影响脑梗死预后的危险因素。当IL-11应用于脑梗死的诊断时,ROC曲线下面积为0.841,灵敏性为91.18%,特异性为72.42%,截断值为378.47;当IL-11应用于脑梗死预后预测时,ROC曲线下面积为0.786,灵敏性为67.09%,特异性为87.93%,截断值为310.94。脑梗死患者血清IL-11水平与血清BDNF水平的相关系数为r=0.711、P<0.01。结论脑梗死患者血清IL-11水平显著降低,且预后不良患者的IL-11水平显著低于预后良好亚组。同时,IL-11水平与血清BDNF水平呈负相关,可能可以用于脑梗死的辅助诊断和预后评估。
