重复性急性应激对攻击行为的影响及调控机制

关于急性应激对攻击行为的影响, 现有研究多集中于单次急性应激情境下。然而, 相比单次急性应激, 对重复暴露于同一应激源的研究更能反映人们在现实生活中经历的应激事件。与单次应激不同, 重复性急性应激与应激适应有关, 能够节省资源, 具有很强的进化和适应意义, 但目前关于重复性急性应激对攻击行为的影响却知之甚少。鉴于此, 研究运用事件电位相关技术、鼻喷催产素和催产素受体基因型分析方法, 探讨重复性急性应激对攻击行为的影响及内部机制, 并进一步探讨通过内部和外部调控重复性急性应激反应后攻击行为的变化。     

Post-stroke depression as a predictor of caregivers burden of acute ischemic stroke patients in China

Our aim was to explore the independent attribution of Post-stroke depression (PSD) to caregiver burden of acute ischemic stroke patients. A cross-sectional survey was performed with 271 acute ischemic stroke patients in the Huai-He Hospital and First People’s Hospital of Kaifeng City in China. PSD was assessed by Self-rating Depressive Scale, and caregiver burden was assessed by Zarit Caregiver Burden Interview. Clustered logistic regression was applied to identify the impact of PSD on caregiver burden. As results, female patients, normal muscle strength and PSD were associated with caregiver burden. PSD correlated with an independent influence of 17.2% on the risk of caregiver burden, The independent influence of PSD on caregiver burden was smaller than that of social-demographics of caregivers and clinical factors of stroke patients This study suggests that PSD may have a modest influence on caregiver burden.     

Brain-derived neurotrophic factor Val66met polymorphism and plasma levels in road traffic accident survivors

Background: Alterations in brain-derived neurotrophic factor (BDNF) expression and release may play a role in the pathogenesis of post-traumatic stress disorder (PTSD). Design: This study evaluated road traffic accident (RTA) survivors to determine whether PTSD and trauma-related factors were associated with plasma BDNF levels and BDNF Val66Met carrier status following RTA exposure. Methods: One hundred and twenty-three RTA survivors (mean age 33.2 years, SD?=?10.6 years; 56.9% male) were assessed 10 (SD?=?4.9) days after RTA exposure. Acute stress disorder (ASD), as assessed with the Acute Stress Disorder Scale, was present in 50 (42.0%) of the participants. Plasma BDNF levels were measured with enzyme-linked immunosorbent assay and BDNF Val66Met genotyping was performed. PTSD, as assessed with the Clinician-Administered PTSD Scale, was present in 10 (10.8%) participants at 6 months follow-up. Results: Neither BDNF Val66Met genotype nor plasma BDNF was significantly associated with the presence or severity of ASD or PTSD. Plasma BDNF levels were, however, significantly correlated with the lifetime number of trauma exposures. Conclusions: In RTA survivors, plasma BDNF levels increased with increasing number of prior trauma exposures. Plasma BDNF may, therefore, be a marker of trauma load.     

急性疼痛与慢性疼痛对奖赏加工的影响及神经机制

疼痛和奖赏能够为个体提供不同的行为动机和主观价值体验,寻求奖赏和避免疼痛对于生存都很重要。疼痛可划分为急性疼痛和慢性疼痛,奖赏可区分为预期阶段的动机成分和体验阶段的享乐成分。奖赏对疼痛的抑制作用已经被广泛证实,但关于疼痛对奖赏的影响,目前的研究结果并不一致。因此需要进一步区分并探究急性疼痛与慢性疼痛对奖赏加工不同阶段的影响,分析两种疼痛对奖赏加工产生不一致影响的现象。这种现象出现的原因可能与急性疼痛向慢性疼痛转变过程中出现的奖赏加工能力缺陷有关。未来可以考虑从改善奖赏加工能力缺陷的角度进行检测和治疗,提前预防急性疼痛向慢性疼痛转变。     

Fluency disorders in genetic syndromes

The characteristics of various genetic syndromes have included “stuttering” as a primary symptom associated with that syndrome. Specifically, Down syndrome, fragile X syndrome, Prader-Willi syndrome, Tourette syndrome, Neurofibromatosis type I, and Turner syndrome all list “stuttering” as a characteristic of that syndrome. An extensive review of these syndromes indicated clients diagnosed with these syndromes do show evidence of nonfluency patterns, but not all would be considered stuttering. Many of the syndromes are marked by degrees of mental retardation that probably contribute to a higher than average prevalence of stuttering, as well as a higher than average prevalence of other fluency disorders (when compared to the population at large).

An in-depth analysis of the available data indicates that some of these genetic syndromes show patterns of stuttering that may be indicative of only that syndrome (or similar syndromes) that can be differentially diagnosed from developmental stuttering. Among these patterns are the word-final nonfluencies noted in Prader-Willi syndrome; the presence of stuttering in the absence of secondary behaviors noted in Prader-Willi syndrome and; the presence of palilalia, word-final and word-medial nonfluencies, and word-medial and word-final nonfluencies in Tourette syndrome. Implications for future research are discussed in light of these findings.

Educational objectives: The reader will be able to: (1) describe the various different genetic syndromes that are associated with fluency disorders; (2) describe the types of nonfluencies that are associated with the major types of genetic syndromes that have fluency disorders; (3) describe the behaviors that may assist in differentially diagnosing different types of speech characteristics associated with various genetic syndromes.     

急性呼吸窘迫综合征肺泡塌陷与肺复张的意义

大量肺泡塌陷是急性呼吸窘迫综合征(ARDS)病理生理改变的基础,可导致顽固性低氧血症、肺泡表面活性物质丢失、呼气气流受限、去复张性肺损伤、肺部感染和生物性肺损伤。积极的实施肺开放策略,实现塌陷肺泡的复张具有重要的临床意义。肺复张导致肺泡过度膨胀、循环干扰,以及肺泡难以复张因素的存在,使肺泡完全复张可能并不必要。在避免肺泡塌陷危害与肺复张的局限性之间寻求平衡,才能使肺复张确立其在ARDS治疗中的恰当地位。     

急性心肌梗死中医治疗的两点策略——附临床资料回顾性分析

急性心肌梗死(AMI)是临床常见的急重症,现代医学已在循证医学基础上建立了诊疗指南,为临床诊治决策提供依据。相比而言,以辨证论治为特色的中医药缺乏循证依据。对AMI诊治过程中如何发挥中医药治疗的价值,认为不能停留在传统的概念上,应选择正确治疗策略,提高疗效。     

防治血管剩留风险的决策探讨

针对冠心病和（或）2型糖尿病患者,已有许多有效的防治措施。然而,尽管接受了当前的标准治疗,这类患者仍会反复发生许多大血管和微血管事件,这种现象称之为血管剩留风险。有许多因素影响血管剩留风险的存在,其中最为重要的是致动脉粥样硬化性血脂异常。因此,采取积极的全面干预措施如改善生活方式、联合降脂以改善所有的脂质异常指标,是最大程度降低血管剩留风险的动向。     

从现代系统科学角度看冠状动脉支架置入术后再狭窄

随着介入治疗技术在临床的广泛应用,目前已成为治疗冠心病（CAD）的主要方法之一。目前国内外指南一致推荐对于CAD的大多数de novo病变常规置入支架,可有效减少单纯球囊扩张的并发症和再狭窄的发生率,但支架内再狭窄的形成又日益突出,成为严重影响介入治疗远期疗效的主要问题。对再狭窄发生机制的研究近十年来取得诸多新进展,对其发生机制的研究和探索为解决这个世纪难题提供了理论基础和依据。本文应用现代系统科学的自组织理论,从哲学角度深入认识和理解这一病理过程。