Transient global amnesia after epiduroscopy in a failed back surgery syndrome patient: Case report

Epiduroscopy (EDS) allows diagnosis and treatment of spinal nerve root pathology by a fiberoptic device inserted percutaneously in the epidural space. Transient global amnesia syndrome (TGA) is defined by an abrupt onset of an anterograde and retrograde amnesia that lasts up to 24 h, although mild subclinical neuropsychological deficits, with concomitant vegetative symptoms, can last for days after the episode. To our knowledge no cases of TGA in association with EDS have been recognized. We present a case of a 54-year-old man who was admitted for EDS, having experienced two times the failed surgery for spinal and left leg pain. During the EDS, 10 ml of non-ionic contrast media (CM) was injected to confirm the inside lesions. The epidural adhesions were gently broken down and drugs were injected around any inflamed nerve roots. Immediately after EDS, the patient experienced a TGA with loss of memory for the recent procedure and an impaired ability to retain new information. There were no signs of confusion or altered conscious level or seizure activities and neurological examination was normal. At 24 h a cranial computerized tomography (cCT) without CM showed “abnormal contrast enhancement at subarachnoid liquoral spaces levels”, then at 72 h cCT control was normal. The patient was discharged on the seventh day with perioperative lacunar amnesia persisting at this time. Herein, we sought a possible relationship between neurotoxic effect of CM and TGA in a patient emotionally stressed, even if the CM dose was given as a normal clinical range.

Nerve growth factor downregulates c-jun mRNA and Caspase-3 in striate cortex of rats after transient global cerebral ischemia/reperfusion

BACKGROUND： Immediate early gene （lEG） c-jun is a sensitive marker for functional status of nerve cells. Caspase-3 is a cysteine protease, which is a critical regulator of apoptosis. The effect of exogenous nerve growth factor （NGF） on the expression of c-jun mRNA and Caspase-3 protein in striate cortex of rats with transient global cerebral ischemia/reperfusion （IR） is unclear. OBJECTIVE： To study the protective effect of exogenous NGF on the brain of rats with transient globa cerebral IR and its effecting pathway by observing the expression of c-jun mRNA and Caspase-3 protein. DESIGN： Randomized controlled animal trial SETTING： Department of Neural Anatomy, Institute of Brain, China Medical University MATERIALS：Eighteen healthy male SD rats of clean grade, aged 1 to 3 months, with body mass of 250 to 300 g, were involved in this study. NGF was provided by Dalian Svate Pharmaceutical Co.,Ltd. c-jun in situ hybridization detection kit, Caspase-3 antibody and SABC kit were purchased from Boster Biotechnology Co.. Ltd. METHODS： This trial was carried out in the Department of Neural Anatomy, Institute of Brain, China Medical University during September 2003 to April 2005. （1） Experimental animals were randomized into three groups with 6 in each： sham-operation group, IR group and NGF group.（2）After the rats were anesthetized, the bilateral common carotid arteries and right external carotid arteries of rats were bluntly dissected and bilateral common carotid arteries were clamped for 30 minutes with bulldog clamps. Reperfusion began after buldog clamps were removed. Normal saline of lmL and NGF （1×10^6 U/L） of 1 mL was injected into the common carotid artery of rats via right external carotid arteries in the IR group and NGF group respectively. The injection was conducted within 30 minutes, and then the right external carotid arteries were ligated. In the sham-operation group, occlusion of bilateral common carotid arteries and administration of drugs were omitted.GAll the rats were executed by decollation at 3 hours after modeling. The animals were fixed with phosphate buffer solution （PBS, 0.1 mol/L） containing 40 g/L polyformaldehyde, their brains were quickly removed. The coronal section tissue mass containing striate cortex about 3 mm before line between two ears was taken and made into successive frozen sections.（4）The expression of c-jun mRNA and Caspase-3 protein in striate cortex of global cerebral ischemia rats were detected with in situ hybridization, immunohistochemistry and microscope image analysis. （5）t test was used for comparing the difference of the measurement data. MAIN OUTCOME MEASURES：Comparison of the expression of lEG c-jun mRNA and Caspase-3 protein in striate cortex of brain of rats in each group. RESULTS：All the 18 SD rats were involved in the analysis of results. The c-jun mRNA and Caspase-3 protein positive reaction cells were found brown yellow in the striate cortex of rats, and most of them were in lamellas Ⅱ and Ⅲ, mainly presenting round or oval. The expression of c-jun mRNA and Caspase-3 protein in sham-operation group was weak or negative. The average gray value of c-jun mRNA and Caspase-3 protein in the IR group was significantly lower than that in the sham-operation group （49.52±4.13 vs. 95.48± 5.28; 74.73±4.29 vs. 162.38±9.16,P 〈 0.01）. The average gray value of c-jun mRNA and Caspase-3 protein in the NGF group was significantly higher than that in the IR group （63.96±4.25 vs.49.52±4.13; 83.98± 4.13 vs. 74.73±4.29, P〈 0.05）. CONCLUSION： NGF can protect ischemic neurons by down-regulating the expression of c-jun mRNA and Caspase-3 protein in striate cortex of global cerebral ischemia rats.

Pretreated Oenan the Javanica extract increases anti-inflammatory cytokines, attenuates gliosis, and protects hippocampal neurons following transient global cerebral ischemia in gerbils

Recently,we have reported that Oenanthe javanica extract(OJE)displays strong neuroprotective effect against ischemic damage after transient global cerebral ischemia.However,neuroprotective mechanisms of OJE have not been fully identified.Thus,this study investigated the neuroprotection of OJE in the hippocampal CA1 area and its anti-inflammatory activity in gerbils subjected to 5 minutes of transient global cerebral ischemia.We treated the animals by intragastrical injection of OJE(100 and 200 mg/kg)once daily for 1 week prior to transient global cerebral ischemia.Neuroprotection of OJE was observed by immunohistochemistry for neuronal nuclear antigen and histofluorescence staining for Fluoro-Jade B.Immunohistochemistry of glial fibrillary acidic protein and ionized calcium-binding adapter molecule 1 was done for astrocytosis and microgliosis,respectively.To investigate the neuroprotective mechanisms of OJE,we performed immunohistochemistry of tumor necrosis factor-alpha and interleukin-2 for pro-inflammatory function and interleukin-4 and interleukin-13 for anti-inflammatory function.When we treated the animals by intragastrical administration of 200 mg/kg of OJE,hippocampal CA1 pyramidal neurons were protected from transient global cerebral ischemia and cerebral ischemia-induced gliosis was inhibited in the ischemic hippocampal CA1 area.We also found that interleukin-4 and-13 immunoreactivities were significantly increased in pyramidal neurons of the ischemic CA1 area after OJE pretreatment,and the increased immunoreactivities were sustained in the CA1 pyramidal neurons after transient global cerebral ischemia.However,OJE pretreatment did not increase interleukin-2 and tumor necrosis factor-alpha immunoreactivities in the CA1 pyramidal neurons.Our findings suggest that pretreatment with OJE can protect neurons and attenuate gliosis from transient global cerebral ischemia via increasing expressions of interleukin-4 and-13.The experimental plan of this study was reviewed and approved by the Institutional Animal Care and Use Committee(IACUC)in Kangwon National University(approval No.KW-160802-1)on August 10,2016.

Time-course pattern of neuronal loss and gliosis in gerbil hippocampi following mild, severe, or lethal transient global cerebral ischemia

Transient ischemia in the whole brain leads to neuronal loss/death in vulnerable brain regions. The striatum, neocortex and hippocampus selectively loose specific neurons after transient ischemia. Just 5 minutes of transient ischemia can cause pyramidal neuronal death in the hippocampal cornu ammonis (CA) 1 field at 4 days after transient ischemia. In this study, we investigated the effects of 5-minute (mild), 15-minute (severe), and 20-minute (lethal) transient ischemia by bilateral common carotid artery occlusion (BCCAO) on behavioral change and neuronal death and gliosis (astrocytosis and microgliosis) in gerbil hippocampal subregions (CA1-3 region and dentate gyrus). We performed spontaneous motor activity test to evaluate gerbil locomotor activity, cresyl violet staining to detect cellular distribution, neuronal nuclei immunohistochemistry to detect neuronal distribution, and Fluoro-Jade B histofluorescence to evaluate neuronal death. We also conducted immunohistochemical staining for glial fibrillary acidic protein and ionized calcium-binding adapter molecule 1 (Ibal) to evaluate astrocytosis and microgliosis, respectively. Animals subjected to 20-minute BCCAO died in at least 2 days. BCCAO for 15 minutes led to pyramidal cell death in hippocampal CA1-3 region 2 days later and granule cell death in hippocampal de匚tate gyrus 5 days later. Similar results were not found in animals subjected to 5-minute BCCAO. Gliosis was much more rapidly and severely progressed in animals subjected to 15-minute BCCAO than in those subjected to 5- minute BCCAO. Our results indicate that neuronal loss in the hippocampal formation following transient ischemia is significantly different according to regions and severity of transient ischemia. The experimental protocol was approved by Institutional Animal Care and Use Committee (AICUC) of Kangwon National University (approval No. KW-180124-1) on May 22, 2018.

Effect of Chinese Patent Medicine Naodesheng against Repeated Transient Global Cerebral Ischemia in Mice

Objective To investigate the therapeutic effect and possible mechanisms of Chinese ptent medicine Naodesheng（NDS） on repeated transient global cerebral ischemia（GCI） in mice. Methods The repeated transient GCI mice were induced by bilateral carotid arteries ligation, and were randomly divided into model group, Sham group without arteries ligation, NDS groups（1.25 and 2.5 g/kg） and positive control（vinpocetine 3.1 mg/kg, VP） group. After oral administration once daily for successive 7 d, the transient GCI was induced. The degree of neurological deficit, histological changes, and neurons loss in the hippocampus were evaluated. In order to investigate the possible mechanisms, the oxidative stress and inflammatory factor were measured after 24 h of GCI. Comparison among multiple groups was performed with one-way analysis of variance（ANOVA）. Results NDS could significantly alleviate the neurological function impairment, histological injury, and neurons loss, increase the superoxide dismutase（SOD） activity, decrease the content of malondialdehyde（MDA）, and reduce inflammatory factor in the ischemic brain tissue. Conclusion NDS could significantly reduce brain injury induced by global ischemia, and its mechanism is closely associated with anti-oxidation and anti-inflammation.

瞬变电磁法在煤矿老窑采空区积水探测中的应用

以某煤矿6-1采区为研究案例,根据采区地质水文及地球物理电性特征情况,合理在采取内容实施数据采集,对数据实施预处理后,从全域视电阻率断面图和全域视电阻率切面图2个角度实施煤矿老窑采空区积水探测分析。根据分析结果对采取1#和2#煤层采空区积水范围进行综合解释说明,最后采用钻孔探测法进行采取采空区积水情况验证分析,有效确认瞬变电磁法的应用价值。

Full electromagnetic transient simulation for large power systems

For building Global Energy Interconnection(GEI), it is necessary to implement new breakthroughs on largepower system simulation. Key routes for implementing full electromagnetic transient simulation of large-power systems are described in this paper, and a top framework is designed. A combination of the new large time step algorithm and the traditional small-time step algorithm is proposed where both parts A and B are calculated independently. The method for integrating the Norton equivalence of the power electronic system to the entire power grid is proposed. A two-level gird division structure is proposed, which executes a multi-rate parallel calculation among subsystems and element parallel calculation in each subsystem. The initialization method of combining load flow derivation and automatic trial-and-error launching is introduced. The feasibility of the method is demonstrated through a practical power grid example, which lays a foundation for further research.

表现为短暂性全面性遗忘的心脏造影术后碘对比剂脑病1例

报道1例冠心病合并肥厚型心肌病患者行冠状动脉造影及左心室造影术后40 min突发全面性遗忘,无视力丧失、头痛、精神错乱、癫痫发作、偏瘫、失语、昏迷等其他临床表现。神经系统查体未发现明显阳性体征。急查头颅CT及头颅磁共振成像联合磁共振血管成像均未见缺血性或出血性脑卒中特征性影像。考虑碘对比剂脑病,予地塞米松、依达拉奉、甘露醇及水化治疗,约18 h后患者记忆完全恢复。碘对比剂脑病是一种罕见的并发症,表现为短暂性全面性遗忘的病例更为罕见,鲜有报道。临床医师使用碘对比剂时应警惕诱发脑病的可能性,以防误诊为急性脑卒中导致不必要地额外使用对比剂行进一步检查及侵入性或非侵入性干预。

基于局部编码和多头注意力模型的电力系统暂态稳定性评估

针对当前基于神经网络的暂态稳定性评估方法无法对暂态状态量测数据进行全局建模的问题,提出一种基于局部编码和多头注意力模型的暂态稳定性评估框架。利用局部RNN结构提取“三段式”暂态状态量测数据的局部特征;利用多头注意力模型对所有局部特征进行建模,计算各局部特征的长距离依赖关系,挖掘之间显著的关联特征表示。将该特征表示输入到全连接神经网络层和softmax层,输出暂态稳定性评估概率。在新英格兰10机39节点系统模拟仿真环境中的实验结果表明该方法切实可行,相较于次优结果,准确率提高3.05%,F1值提高3.04%,误报率降低39.44%。

非共面瞬变电磁超前预报装置及解释方法研究

瞬变电磁法超前预报主要采用共面同轴装置。共面同轴装置的发射与接收回线距离较近,存在电磁高次互感影响,一定程度上降低了探测效果;同时,由于将发射回线和接收回线紧贴工作面,对施工人员存在一定的安全隐患。提出一种非共面瞬变电磁超前预报装置及解释方法,计算了非共面装置条件下任意测点的电磁场响应,分析了不同测点对探测结果的影响,并利用Bz分量进行全域视电阻率定义。首先通过对电偶极子响应进行矢量叠加得到非共面装置瞬变电磁Bz分量响应;基于反函数原理利用Bz分量进行全域视电阻率定义;最后通过视电阻率曲线图与剖面图分析了工作面前方不同形态含水体对不同测点的视电阻率的影响。非共面瞬变电磁超前预报装置及解释方法能够有效探测工作面前方含水构造,在一定程度上保障施工人员安全。

GNSS接收机射频芯片中LDO的设计

为了降低全球卫星导航系统(GNSS)接收机中射频前端芯片电源噪声对本振信号频率干扰的影响,提出一种快速瞬态响应、高稳定性全片内低压差线性稳压器(LDO):通过动态偏置缓冲器的阻抗衰减技术以及米勒补偿技术,对LDO进行动态的主极点跟踪;在整个负载电流范围内,次极点推离单位增益带宽外,保证系统的稳定性;同时动态偏置缓冲器随负载电流变化为功率管栅极充放电,以实现LDO的快速瞬态响应。该电路用于GNSS接收机中频率综合器(FS),基于中国台湾积体电路制造公司的互补金属氧化物半导体(CMOS)工艺完成电路设计,电路输出电压为2.5 V,最大负载电流为3×10^(-1)A。仿真结果表明:该LDO在输出电容为0到2×10^(-1)0F的范围内均能稳定,最小相位裕度为60.2°;当负载电流以3×10^(-1)A/5×10^(-7)s跳变时,输出电压下冲6.5×10^(-2)V、上冲8.3×10^(-2)V,平均响应时间5.3×10^(-7)s;线性调整率为5×10^(-5)V,负载调整率为9×10^(-6)V,电源抑制比在1×10^(3)Hz下为-77.8 dB。

短暂性全面遗忘症患者的病因及临床探讨

目的 探讨短暂性全面遗忘症患者的病因及临床特点。方法 对10例确诊为短暂性全面遗忘症的患者进行24 h内的脑电图、经颅多普勒超声、单光子发射计算机扫描(SPECT)、脑磁共振成像检查。结果 10例短暂性全面遗忘症患者的脑电图均正常,而经颅多普勒超声检查提示椎基底动脉供血异常,SPECT显示不同脑区有低灌注情况。结论 短暂性全面遗忘症患者均有不同程度脑缺血,提示本病病因与脑关键部位缺血有关。

短暂性全面遗忘症的认知功能和MRI及PET的对比研究

目的 研究短暂性全面遗忘症 (transientglobalamnesia ,TGA)患者认知功能及脑代谢状况。方法 对 3例临床诊断为TGA的患者分别行简易心理测试 (MMSE)、修订的韦氏记忆量表 (WMS R)测定和脑核磁共振成像 (MRI)检查 ,在恢复后不同时间以18氟标记的脱氧葡萄糖 (18F FDG)为示踪剂行脑正电子发射型计算机断层扫描 (positrone missiontomography ,PET)成像 ,并对其图像、量表测试结果与病史作对照研究。结果 3例患者MMSE测试及MRI扫描均未见明显异常 ,而WMS R测试及PET成像显示 :1例正常 ,另外 2例有不同程度认知功能损害 ,与记忆相关结构有不同程度的低代谢。结论 TGA患者认知功能及局部脑代谢与其症状持续时间密切相关 ,尽早终止其发作是必要的。

短暂性全面遗忘症的临床与PET成像研究

目的 研究短暂性全面遗忘症 (transientglobalamnesia ;TGA)患者脑代谢状况 ,并探讨其发病机制。方法 对 3例临床上诊断为TGA的患者 ,分别行简易心理测试 (MMSE)及脑核磁共振成像 (MRI) ,在恢复后不同时间以 18F标记的脱氧葡萄糖 (18F FDG)为示踪剂行脑正电子发射型计算机断层扫描 (positronemissiontomography ;PET)成像 ,并对其图像与病史进行对照研究。结果 3例患者MMSE测试及MRI扫描均未见异常。PET成像显示 :1例正常 ,另外2例发现与记忆相关结构有不同程度的低代谢。结论 TGA的发病机制符合脑缺血的病理生理过程 ,其脑代谢状况与症状持续时间密切相关 ,尽早终止其发作是必要的。

短暂性全面遗忘症20例脑电图分析

目的探讨短暂性全面遗忘症的脑电图表现。方法比较短暂性全面遗忘症患者与正常人的脑电图表现,对其病理机制及治疗进行探讨。结果短暂性全面遗忘症患者的脑电图异常率明显高于对照组,两组比较,差异显著(P<0.05),不同年龄短暂性全面遗忘症患者脑电图异常差异无显著性。结论短暂性全面遗忘症患者的脑电图有明显异常,可根据其异常对患者进行个体化治疗,脑电图表现对探索其病因及病理机制有一定的指导意义。

12例短暂性全面遗忘症临床分析及发病机制探讨

目的分析短暂性全面遗忘症的临床特点,探讨其发病机制。方法对12例经过临床确诊的短暂性全面遗忘症病例,从临床表现、EEG结果、影像学检查等方面进行回顾性分析。结果短暂性全面遗忘症多为急性起病的顺行性遗忘,症状多在24h内缓解,EEG结果未发现异常。1例患者头颅MRI检查可见双侧海马区异常信号。1例患者临床发作两次,预后好。结论短暂性全面遗忘症发病机制不明,诊断主要依据临床表现,影像学检查可用来鉴别其他疾病。

短暂性全面遗忘症患者15例临床资料分析

目的分析短暂性全面遗忘症患者的危险因素、病因、鉴别及治疗。方法收集15例临床确诊的短暂性全面遗忘症患者的临床资料,针对症状学、发病危险因素、辅助检查、鉴别诊断及治疗方案进行分析。结果 15例短暂性全面遗忘症患者辅助检查提示脑血管处于缺血状态,经改善循环、营养神经、抗血小板等治疗,治疗有效且随访半年未见复发。结论短暂性全面遗忘症发病很可能与脑缺血有关,按缺血性脑血管病治疗可取得较好效果,并能有效预防疾病复发。

广域测量系统在电力系统分析及控制中的应用综述

综述了广域测量系统(Wide-Area Measurement System,WAMS)在电力系统稳态分析、全网动态过程记录和事后分析、电力系统动态模型辨识和模型校正、暂态稳定预测及控制、电压和频率稳定监视及控制、低频振荡分析及抑制、全局反馈控制、故障定位及线路参数测量等方面的应用。通过这些应用可以看到,WAMS给电力系统分析与控制提供了新的视角和解决方法,值得深入研究。

静脉回流障碍与短暂性全面遗忘症的相关性

背景颈静脉回流异常被认为是短暂性全面遗忘症(transient global amnesia,TGA)的病因。既往研究报道,Valsalva动作(Valsalva maneuver,VM)期间短暂增高的胸内压或者腹内压主要是通过椎静脉系统上传及通过颈内静脉(internal jugular vein,IJV)下传,所以通畅的颈内静脉对短暂增高的颅内压力的释放及脑静脉的回流非常重要。我们假设颈内静脉受压导致的静脉回流障碍是TGA发病机制中的决定性因素。方法本研究是病例对照研究,研究对象为45例TGA者及性别/年龄相匹配的45例健康对照组。利用磁共振成像(magnetic resonance imaging,MRI),包括应用造影剂的增强轴向T1加权成像(contrastenhanced axial T1-weighted imaging,Contrast T1)与时间分辨对比剂动态成像(time-resolved imaging of contrast kinetics,TRICKS)及未应用造影剂的磁共振静脉血管成像(magnetic resonance venography,MRV),评估双侧颈内静脉与左侧头臂静脉(brachiocephalic vein,BCV)的形态及横窦(transverse sinus,TS)的不对称性,其中颈内静脉被分成上、中及下段。结果相对于对照组,TGA者双侧颈内静脉上段(左侧:37.8%vs 17.8%,P=0.0393;右侧:57.8%vs 15.6%,P<0.0012)及左侧头臂静脉(60%vs 8.9%,P<0.0004)中、重度狭窄/闭塞及横窦发育不良(53.3%vs 31.1%,P=0.0405)的比例显著高。病例组静脉回流的任一部位狭窄/闭塞(包括颈内静脉或者左侧头臂静脉狭窄/闭塞)的比例显著高于对照组(91.1%vs 33.3%,P<0.0004)。MRV显示病例组左侧横窦的管径与对照组相比显著小([0.31±0.21)cm vs(0.41±0.19)cm,P=0.0290],而Contrast T1显示病例组左侧横窦的管径与对照组无显著差异,此结果与回流静脉存在近心端狭窄/闭塞相符。结论头颈静脉回流障碍是TGA的重要发病机制;双侧颈内静脉和(或)左侧头臂静脉狭窄/闭塞及横窦发育不良是导致头颈静脉回流障碍的重要因素。

光伏发电系统的小信号建模及其控制器参数的全局优化设计方法

研究光伏发电系统的暂态稳定性有利于认识太阳能发电与电力系统之间的交互式影响规律。在充分考虑光伏发电系统中各重要环节的详细模型的基础之上,建立了适用于暂态稳定分析的全系统小信号模型,并据此分析了光伏发电系统的小干扰稳定性和低频振荡特性。研究结果表明:光伏逆变器的电压外环以及有功电流内环对系统的特征值影响较显著且较全面,对系统的稳定性影响较大。电压外环的积分系数以及有功电流内环的比例系数过大均可能会对电力系统阻尼产生负面影响,甚至改变光伏发电系统的阻尼性质。最后提出了一种提高系统稳定性的控制器参数全局优化设计方法,为科学合理地设计控制器参数提供了方法支撑。