急性冠脉综合征患者血液Rho激酶活性分析

探讨 Rho 激酶（ROCK）活性与急性冠脉综合征（ACS）患者冠状动脉狭窄程度及预后的关系。选取2012年6月至2013年3月住院的129例患者,其中急性心肌梗死（AMI）组68例、不稳定型心绞痛（UA）组30例、对照（CON ）组31例。Western Blot 检测血液白细胞中 ROCK 、ROCK1、ROCK2活性,同时根据冠状动脉的狭窄程度及是否发生心血管意外分组再次比较。 AMI 组和 UA 组 ROCK 、ROCK1、ROCK2活性均增高;且 AMI 组高于 UA 组;三支、双支、单支病变组活性依次减低,Gensini 评分≥20分组及发生心血管意外组均高于 Gensini 评分＜20分组及未发生心血管意外组,差异均有统计学意义（P＜0．05）。 ROCK 活性可能对 ACS 患者预后观察、评估有重要意义。     

Transcranial parenchymal sonography in patients with Chronic Disorders of Consciousness: Association with neuroimaging data,and beyond

Differential diagnosis of patients with Chronic Disorders of Consciousness (DoC) is rather challenging, owing to the lack of objective approaches highlighting residual awareness. Sophisticated functional neuroimaging have provided high diagnostic value, but their application in the clinical setting is limited due to their relative complexity, cost, availability and poor collaboration of persons with DoC. By using a specific ultrasound-based methodology, namely Transcranial B-mode Parenchymal Sonography (TCS), it is possible to obtain images of the main parenchymal brain structures. We assessed the TCS abnormalities in three patients with DoC, demonstrating widespread alterations of brain parenchyma morphology that matched to MRI findings and were associated with the degree of consciousness disorders. Thus, TCS might represent a valuable tool for routine assessment and follow-up of brain structures functioning of patients with DoC, potentially helping in differential diagnosis and prognosis.     

莫比乌斯综合征的社交障碍：互动主义解释

莫比乌斯综合征患者的面无表情会带来严重的社交障碍。以当代心灵哲学与认知科学视角讨论莫比乌斯综合征所面临的社交障碍及原因。从互动主义两种类型假设给予解释：强互动主义和温和互动主义。强互动主义强调身体的动作耦合是与他人连接的关键,患者由于表情和动作障碍导致社会互动障碍。温和互动主义则认为高层次认知过程可能会通过其他方式来弥补表情和动作障碍的缺失,即通过不同的感官通道（听觉、触觉等）从另一种非视觉的身体耦合处理中受益。建议为患者寻找多元化的社交互动模式,有助于莫比乌斯综合征患者更好地完成社会适应。

     

代谢综合征致病的诊疗思考

如果将心血管疾病喻为冰山一角,潜在水中的冰山是危险因素的话,那么代谢综合征(MetS)就是深藏于水中冰山的最底层,这一形象的比喻是人类长期与疾病作斗争中运用科学思维的总结。目前,MetS已被公认是心血管疾病的危险因素,是与糖尿病和心血管疾病密切相关的一种疾病,其发病率居心血管疾病危险因素之首。     

Spatial breakdown in spatial construction: evidence from eye fixations in children with Williams syndrome

We investigated the role of executive and spatial representational processes in impaired performance of block construction tasks by children with Williams syndrome (WS), a rare genetic defect that results in severely impaired spatial cognition. In Experiment 1, we examined performance in two kinds of block construction tasks, Simple Puzzles, in which block faces contained a single color, and Complex, in which some block faces contained an arrangement of two colors. WS and control children were comparable in their ability to solve simple puzzles, and showed similar eye-fixation patterns, suggesting that basic executive processes were intact. However, WS children were severely impaired in their ability to solve complex puzzles. In these puzzles, WS children fixated the complex puzzle models and checked their partial solutions less often than normal children, but they were comparable in their ability to detect errors in their copies and almost exclusively made repairs to copies that were, in fact, incorrect. We conjecture that the abnormal fixation patterns were a consequence of impoverished spatial representations, rather than a cause of it. This conjecture was tested in Experiment 2, where we examined children's capacity to match and place individual blocks without engaging the complex executive processes required to carry out a complete puzzle solution. We found serious deficiency among WS children in both aspects of spatial representation. Moreover, estimates of the errors in representing the identity and location of model blocks derived from Experiment 2 provided a good account of the observed errors in the block construction task of Experiment 1.     

DS14 is more likely to measure depression rather than a personality disposition in patients with acute coronary syndrome

It has been suggested that Type D Personality is a risk factor for acute coronary syndrome (ACS) and the DS14 has been developed for its assessment. However, some of the items on the DS14 seem to evaluate depressive symptoms rather than personality features. Therefore, the present study aims to verify whether an overlap exists between the constructs of Type D Personality and depression. Three‐hundred‐and‐four consecutive patients who were both presenting their first ACS and had no history of major depression completed the Hospital Anxiety and Depression Scale (HADS) and the DS14 to assess Type D personality at baseline and have been re‐evaluated at 1, 2, 4, 6, 9 and 12‐month follow‐ups. Out of 304 subjects (80.6% males), 40 were diagnosed as depressed. An exploratory factor analysis of HADS and the DS14 in the second month revealed that four out of seven items on the depressive subscale of HADS (HADS‐D) and six out of seven items on the Negative Affectivity (NA) subscale of the DS14 segregated on the same factor. Results were verified by a Partial Confirmatory Factor Analysis performed at the twelfth month when most of the patients achieved complete remission from the depressive episode. Temporal stability was poor for NA and Type D Personality and these construct co‐vary with HADS‐D over time. Our data suggests that NA and depression are overlapping constructs, supporting the idea that the DS14 measures depressed features, rather than a personality disposition.     

Motor excitability during movement preparation in Tourette syndrome

Tourette syndrome (TS) is a neurodevelopmental disorder characterized by the occurrence of motor and vocal tics. TS has been linked to the impaired operation of cortical‐striatal‐thalamic‐cortical circuits that give rise to hyper‐excitability of cortical motor areas, which may be exacerbated by dysfunctional intra‐cortical inhibitory mechanisms. That said, many individuals gain control over their tics during adolescence and it has been suggested that this increased control arises as a result of the development of mechanisms that operate to suppress corticospinal excitability (CSE) ahead of volitional movements. Here we used single‐pulse transcranial magnetic stimulation (TMS) in conjunction with a manual Go/NoGo task to investigate alterations in CSE ahead of volitional movements in a group of adolescents with TS (N = 10). Our study demonstrated that CSE, as measured by TMS‐induced motor‐evoked potentials (MEPs), was significantly reduced in the TS group in the period immediately preceding a finger movement. More specifically, we show that individuals with TS, unlike their age‐matched controls, do not exhibit the predicted increase in mean MEP amplitude and decrease in MEP variability that immediately precede the execution of volitional movements in typically developing young adults. Finally, we report that the magnitude of the rise in MEP amplitude across the movement preparation period in TS is significantly negatively correlated with clinical measures of motor tic severity, suggesting that individuals with severe motor tics are least able to modulate motor cortical excitability.     

Evaluation of upper limb movements in children with Down’s syndrome: A systematic review

The aim of the present study was to perform a review of the literature on current quantitative clinical methods for the evaluation of upper limb movements in children and adolescents with Down syndrome, with a focus on describing the variables, protocols, motor function and motor control.MethodsA survey of PubMed, Scielo, BVS Bireme and PEDro databases using the following key words: upper limb and EMG and Down syndrome; upper limb and kinematics and Down syndrome; upper limb and motion analysis and Down syndrome; movement and upper limb and Down syndrome; upper limb and Down syndrome; reach and Down syndrome.ResultsIn all, 344 articles and five were selected to compose the present systematic review. No standardization was found among the studies analyzed with regard to data collection, data processing or procedures for the evaluation of the variables.ConclusionA kinematic evaluation is effective for the discussion of the results, but methodological differences among the studies and inconsistent results exert a negative influence on clinical interpretations and the possibility of reproducibility. The standardization of an upper limb movement evaluation protocol using kinematic analysis is important, as it would provide the basis for comparable, reproducible results and facilitate the planning of treatment interventions.