支气管哮喘气道炎症无创检测技术的应用与评价

对支气管哮喘气道炎症进行评估和监测对于评价病情、治疗反应以及预测急性发作和预后具有重要的意义.目前相关的检测技术包括无创技术和有创技术,无创检测技术主要有气道反应性测定、诱导痰检测、呼出一氧化氮(NO)测定、呼出气冷凝物检测以及血液、尿液当中炎性介质的检测,常用的测定指标包括NO以及代谢产物、H2O2、嗜酸粒细胞计数及其颗粒蛋白、白三烯等等.在应用于临床时还需要解决标本采集的标准化问题.     

无创产前DNA检测的文献分析:易忽略的伦理和社会问题

无创产前DNA检测技术(NIPT)作为一种产前筛查与诊断的新技术,在临床中的推广应用必然会遇到伦理、社会、道德、政策、法律等多方面的问题。本文分析近5年报道NIPT技术相关的医学学术文献,发现多数文献报道该技术的敏感性、特异性、准确性及无创、安全、快速等优势,却容易忽略伦理和社会相关问题。本文探讨这些问题并提出几点思考。     

孕妇对无创产前DNA检测的认知水平与社会因素分析

了解孕妇对无创产前DNA检测的认知及在选择该技术时的影响因素。采用单中心随机问卷调查的方法,共发放问卷500份,收回有效问卷456份(91.2%)。结果显示对无创产前DNA检测真正熟悉的孕妇只有9.2%,不了解该技术孕妇占55.9%。选择该技术的孕妇与地区、受教育水平、经济条件有关。孕妇对该技术的认知水平较低,收到高风险检测报告时存在一定的困扰,甚至不接受诊断而直接终止妊娠。医务人员应加大检测前咨询,特别对农村、文化程度较低、家庭经济收入不高的孕妇,要告知NIPT技术应用、局限性、高风险处理等,减少孕妇心理压力,降低对社会的后续影响。     

在发展中求善：动脉粥样硬化影像诊断技术不断演进的思索

动脉粥样硬化疾病是严重危害人类健康的一大类疾病,涉及人体全身各个部位,影响多个器官。动脉粥样硬化的影像诊断经历了从有创到无创、从局部到全身、从单一技术到整体化优势一系列过程,充分体现了影像技术在动脉粥样硬化诊断中的动态发展观、整体原则及个体化原则。     

三种药物对糖尿病患者血清诱导内皮损伤的保护效应比较

利用银杏叶提取物(GBE)、银杏内酯B(GB)以及阿托伐他汀(AT)分别对糖尿病患者血清(DS)损伤的人脐静脉内皮细胞(HUVECs)进行干预,干预30min、3h以及3d后,测定细胞存活率,上清液中测定乳酸脱氢酶(LDH)、丙二醛(MDA)以及一氧化氮(NO)的含量.三种药物均能增加细胞存活率;MDA和LDH水平,组别与干预时间有交互作用(P＜0.05);药物干预组NO水平较DS组显著升高(P＜0.05),以GBE为著.可见,DS可通过氧化应激损伤内皮细胞;三种药物均能减轻这种损伤,GBE的效果优于GB和AT.     

经颅直流电刺激技术在增强健康个体认知功能中的应用及其影响因素

经颅直流电刺激作为一种无创脑刺激技术,已在临床治疗及康复领域有广泛应用。随着研究的深入和人类对于自身认知需求的提高,近年来也有研究者开始尝试使用该技术增强健康个体的认知功能。本文从感知觉、注意、记忆、学习和复杂任务五个方面对目前经颅直流电刺激技术在健康个体认知增强领域的研究现状进行梳理和总结,讨论了机制和影响因素,以及未来面临的问题和挑战。     

导言：辅助细胞脂肪移植（CAL）技术

医学发展是随着社会、人文、自然科学的发展而发展的,是社会、人文、自然科学的发展成果不断向医学渗透的结果,这种渗透表现在物理（诊疗设备）、化学（药物为主）、生物学（再生医学）等方面。所有这些的总特征是向着微创／无创技术的方向发展。由此,出现了美容医学发展的三个原则和四个方向：三个原则是安全有效、微创／无创、综合疗法;四个方向是常规技术、微创／无创技术、再生医学、抗衰老医学发展。微创／无创技术既是原则也是方向,这是高端科学技术发展的必然结果和规律。再生医学和抗衰老医学均涉及生命科学领域的高端科学技术。〈br〉 再生是大自然普遍存在的现象,有生命就有再生,没有再生就没有生命,因此再生与生命息息相关。生命的再生能力主要体现在细胞的再生能力,尤其是干细胞／祖细胞的再生能力。干细胞（stem cells）又称祖细胞（progeni-tor cell）,是再生医学的核心。许多细胞组成组织,多个组织组成器官,多种器官组成系统,多个系统组成生命体。因此活细胞是生命体最小的基本单位。     

高低创造性思维水平者的认知抑制能力：行为和生理的证据

本研究采用2个实验, 考察创造性思维测验得分高低者在Stroop任务干扰条件上的差异, 从行为和生理指标探讨认知抑制与创造性思维的关系, 以及时间压力对认知抑制与创造性思维关系的调节作用。实验1采用Stroop颜色命名任务。结果发现, 相比低创者, 高创者的反应时干扰效应量和正确率干扰效应量均更小。实验2采用更灵活的Stroop字义-颜色命名转换任务, 操纵不同的时间压力条件, 并记录被试完成任务时的皮肤电活动。结果发现, 高创者在有时间压力条件下的干扰效应量显著小于无时间压力条件下, 而低创者在有和无时间压力条件下的干扰效应量无显著差异; 高创者在颜色命名任务的不一致条件下的皮肤电活动变化显著高于一致条件, 而低创者在颜色命名任务的一致和不一致条件下无显著差异。研究表明：总体而言, 相比低创者, 高创者的认知抑制能力更高, 能够有效抑制优势的但不相关的反应倾向。时间压力在认知抑制与创造性思维的关系中起调节作用, 高创者面对不同任务要求能够灵活调整自身的认知抑制水平, 并表现出变化的生理唤醒水平。结果支持创造性思维的适应性认知抑制假说。     

幽门螺杆菌诊断方法评价

诊断幽门螺杆菌（Hp）感染有侵入性和非侵入性两类方法。前者需通过胃镜取胃粘膜活检,包括快速尿素酶试验（RUT）、病理组织学检查、细菌培养及基因检测等;非侵入性方法包括尿素呼气试验（UBT）、血清Hp抗体测定及Hp粪便抗原检测等。各种检测方法的敏感性及特异性不一,适用范围也不同,选择合适的检测方法需结合Hp感染特点、检测条件及费用情况等。     

幽门螺杆菌诊断方法评价

诊断幽门螺杆菌(Hp)感染有侵入性和非侵入性两类方法.前者需通过胃镜取胃粘膜活检,包括快速尿素酶试验(RUT)、病理组织学检查、细菌培养及基因检测等;非侵入性方法包括尿素呼气试验(UBT)、血清Hp抗体测定及Hp粪便抗原检测等.各种检测方法的敏感性及特异性不一,适用范围也不同,选择合适的检测方法需结合Hp感染特点、检测条件及费用情况等.     

Blood pressure response during verbal interaction: Review and prospect

Blood pressure changes during verbal interaction have typically been measured by noninvasive devices, at regular intervals of 1 to 5 minutes, in hypertensive as well as in normotensive subjects. In early studies the role of content variables was emphasized together with that of the emotions of anger and anxiety. Later the focus was on transactional involvement as one of the main causes of blood pressure changes. Two categories of independent variables that have received recent attention are the act of speaking itself and individual difference variables such as the Type A behavior pattern, which is characterized by a competitive, aggressive and impatient style of living. The discontinuous and momentary nature of most measurement techniques poses serious limitations to the study of fast fluctuating physiological changes during verbal episodes. In this regard, the recent advent of a noninvasive device for the continuous measurement of blood pressure could give a new impetus to the experimental clinical investigation of blood pressure changes during verbal communication.     

Using individual functional channels of interest to study cortical development with fNIRS

Functional near‐infrared spectroscopy (fNIRS) is a noninvasive neuroimaging technique that could be uniquely effective for investigating cortical function in human infants. However, prior efforts have been hampered by the difficulty of aligning arrays of fNIRS optodes placed on the scalp to anatomical or functional regions of underlying cortex. This challenge can be addressed by identifying channels of interest in individual participants, and then testing the reliability of those channels' response profiles in independent data. Using this approach, cortical regions with preferential responses to faces versus scenes, and to scenes versus faces, were observed reliably in both adults and infants. By contrast, standard analysis techniques did not reliably identify significant responses to both categories in either age group. These results reveal scene‐responsive regions, and confirm face‐responsive regions, in preverbal infants. More generally, the analysis approach will be a robust and sensitive tool for future characterization of the early functional development of the human brain.     

ICU患者呼吸道念珠菌是否需要去定植

ICU机械通气患者肺部念珠菌定植较为常见。研究显示呼吸道念珠菌定植可促进机械通气患者呼吸机相关性肺炎（VAP）进展,是VAP患者死亡和多重耐药菌（MDR）产生的独立预测因素,对念珠菌呼吸道定植的VAP患者经验性采用抗真菌治疗可产生有益作用。本文就呼吸道念珠菌是否需要去定植这一热点话题做一聚焦以供临床参考。     

Self-reports, spouse ratings, and psychophysiological assessment in a behavioral medicine program: an application of the five-factor model.

This article describes the integration of the five-factor model into assessment procedures used with 109 patients in an outpatient behavioral medicine program. The population, program, assessment techniques, and general findings are explored. A case history involving a psychophysiological disorder is utilized to demonstrate the utility of a taxonomy of personality traits. The NEO-PI, a five-factor instrument, is integrated with other assessment techniques to assist in diagnosis, rapport building with the patient, tailoring treatment techniques and goals to the individual's intrapersonal and interpersonal dynamics, and predicting relative success and compliance with noninvasive self-regulation procedures and psychotherapy.     

MONITORING CONSCIOUS RECOLLECTION VIA THE ELECTRICAL ACTIVITY OF THE BRAIN

Abstract— Although another person's experience of recollection cannot be observed directly, we have found that the underlying operations can be monitored using noninvasive electrophysiological techniques. Results from two experiments showed that brain potentials elicited 500 to 900 ms after the onset of visually presented words vary systematically in amplitude with manipulations that influence the extent to which subjects engage in recollective processing. These brain potentials can thus be construed as correlates of the subjective experience of recollection     

脑成像技术及其在决策研究中的应用

先进的无创神经影像技术(如EEG和fMRI)允许研究者直接观察被试在完成多种知觉、运动和认知任务时的大脑活动。将脑功能成像与严密的实验设计和数据分析方法结合起来, 我们可以考察大脑不同脑区的功能以及它们之间的交互作用。随着脑功能成像技术在研究人类决策行为中的日益成功运用, 一个被称为神经经济学的新兴领域正在逐渐形成和发展起来。本文中首先对脑成像技术进行一个总体介绍, 重点在于探讨近年来在多体素分析和多模态数据整合的最新进展。接下来, 我们以风险决策、跨时间选择以及社会决策领域的几个研究为例, 阐述神经影像技术如何能加深和拓展我们对人类决策的认识。最后, 我们讨论了神经经济学中研究中面临的一些挑战以及未来的研究方向。     

Usefulness of simultaneous EEG-NIRS recording in language studies

One of the most challenging tasks in neuroscience in language studies, is investigation of the brain’s ability to integrate and process information. This task can only be successfully addressed by applying various assessment techniques integrated into a multimodal approach. Each of these techniques has its advantages and disadvantages, but help to elucidate certain aspects of the capacity of neural networks to process information. These methods provide information about changes in electrical, hemodynamic and metabolic activities. Ideally, they should be noninvasive in order to facilitate their use particularly in children. In the present review, we describe the advantages of simultaneous electroencephalographic (EEG) acquisition with near infrared spectroscopy (NIRS) to provide a better understanding of the mechanisms involved in cerebral activation. This coregistration is also useful to avoid misleading interpretation of NIRS, notably during the various phases of sleep. Development and implementation of the various tools required and assessment strategies are also discussed.     

Fiber tracking using magnetic resonance diffusion tensor imaging and its applications to human brain development

Diffusion tensor imaging is unique in its ability to noninvasively visualize white matter fiber tracts in the human brain in vivo. Diffusion is the incoherent motion of water molecules on a microscopic scale. This motion is itself dependent on the micro-structural environment that restricts the movement of the water molecules. In white matter fibers there is a pronounced directional dependence on diffusion. With white matter fiber tracking or tractography, projections among brain regions can be detected in the three-dimensional diffusion tensor dataset according to the directionality of the fibers. Examples of developmental changes in diffusion, tracking of major fiber tracts, and examples of how diffusion tensor tractography and functional magnetic resonance imaging can be combined are provided. These techniques are complimentary and allow both the identification of the eloquent areas of the brain involved in specific functional tasks, and the connections between them. The noninvasive nature of magnetic resonance imaging will allow these techniques to be used in both longitudinal developmental and diagnostic studies. An overview of the technique and preliminary applications are presented, along with its current limitations.     

长期机械通气患者的气道管理方法初探

探讨ICU长期机械通气患者人工气道的管理方法及其对预后的影响。回顾性分析我院中心ICU2006年1月至今4例连续机械通气时间大于3个月患者的临床资料,总结人工气道管理经验。通过加强气道管理,可以明显减少抗菌药物的应用,有效改善预后。4例患者中1例成功撤机封管出院,2例至今仍生存,1例死亡。提示具体有效的呼吸道管理措施是减少呼吸机相关性肺炎、延长患者生命及提高治愈率的保证。     

Movement-Based Priming: Clinical Applications and Neural Mechanisms

Priming can be described as behavior change generated by preceding stimuli. Although various types of priming have been long studied in the field of psychology, priming that targets motor cortex is a relatively new topic of research in the fields of motor control and rehabilitation. In reference to a rehabilitation intervention, priming is categorized as a restorative approach. There are a myriad of possible priming approaches including noninvasive brain stimulation, motor imagery, and sensory-based priming, to name a few. The authors report on movement-based priming which, compared to other priming types, is less frequently examined and under reported. Movement-based priming includes, but is not limited to, bilateral motor priming, unilateral priming, and aerobic exercise. Clinical and neural mechanistic aspects of movement-based priming techniques are explored.