老年人脑电图与认知功能的关系研究

目的:探讨老年人脑电图(EEG)与认知功能的关系。方法:对569名老年人进行EEG 检查及认知功能测验,用选自韦氏成人智力量表(WAIS-R)的算术、数字广度、填图、木块图以及简易智能状态检查表(MMSE)等五项测验逐个测量老年人的认知水平。在第一次测查一年后,对其中373 名老年人重复进行认知功能测查。结果:MMSE及数字广度测验的得分变化与各位点EEG θ、δ波功率值有关,MMSE:得分下降组基线θ、δ波功率值高于MMSE得分不变组,差异有统计学意义,主要以头后部各区(T3、T5,P3、O1,O2,T4、T6)为明显。T6处θ波功率为9．25μV2,对MMSE得分下降诊断的灵敏度为0．73,特异度为0．64。T3处θ波功率的增加为8．75μV2,对数字广度得分下降诊断的灵敏度为 0．75,特异度为0．56。结论:EEG θ波功率的增加对了解认知功能下降有重要的参考价值。     

动脉瘤性蛛网膜下腔出血后认知功能检查及损害特点

目的：检测动脉瘤性蛛网膜下腔出血后认知功能损害的发生率及损害程度。分析SAH对认知功能的影响。方法：对37例动脉瘤性蛛网膜下腔出血病人手术前进行了认知功能检查。检查内容包括算术、数字广度、数字符号、图画填充、视觉再生、词语流畅性测验、连线测验、简易精神状态检查等内容。结果：表现有认知功能损害者26人，总的发生率为70．3％。有一项损害者14人(37．8％)，二项损害及以上者12人(32．4％)。在所测验项目中．算术发生损害率为2．7％、数字广度为5．4％、数字符号为2．7％、填图项目为2．7％、视觉再生为48．6％、词语流畅性测验为(食品名称)27％和(日用品)18．9％、连线测验为(A)18．9％和(B)21．6％、MMSE为18．9％。结论：动脉瘤性蛛网膜下腔出血本身可引起认知功能损害，以图形记忆力、注意力、额叶功能损害为主。     

奎的平和氯丙嗪对精神分裂症认知功能影响的双盲对照研究

目的 :探讨奎的平和氯丙嗪对精神分裂症患者认知功能的影响。方法 :40例精神分裂症患者随机均分为奎的平组和氯丙嗪组 ,在治疗前、治疗后 4、 6周作知识、算术、数字符号、数字广度 (顺、逆 )、木块拼图、瞬时逻辑记忆、视觉再生即刻和延迟、STROOPC测验、词汇流畅、TOH总分 ,计划时间、延迟逻辑记忆、WCST等神经心理测验 ,整个研究过程采用双盲双模拟法。为观察学习效应 ,12例健康者在相同间隔时间作神经心理测验。所得数据用SPSS10 0进行统计分析。结果 :治疗后 ,奎的平组大部分患者神经心理测验成绩提高而氯丙嗪组的测验结果变化不大 ,尤其在注意、执行功能方面。奎的平对精神分裂症患者认知功能的改善作用优于氯丙嗪 (P <0 0 5 )。结论 :奎的平对精神分裂症患者的注意和执行功能有改善作用而氯丙嗪不明显。     

阿立哌唑和奋乃静对首发精神分裂症患者认知功能的影响

目的探讨阿立哌唑和奋乃静对首发精神分裂症患者认知功能的影响。方法 86例首发精神分裂症患者随机均分为阿立哌唑组和奋乃静组,在治疗前和治疗3月后作数字广度(顺、逆)、即刻逻辑记忆、延迟逻辑记忆、即刻视觉记忆、延迟视觉记忆、连线测验A和B、字色混淆测验(Stroop)以及威斯康星卡片分类测验(W CST)等神经心理测验。结果治疗3个月后同组间相比较:阿立哌唑组除视觉记忆外其他各项认知功能指标均有所好转(即刻视觉记忆t=0.029,延迟视觉记忆t=0.032,P均0.05;其余项目t=2.562～4.658,P0.05或P0.01),而奋乃静组在13项认知功能指标中有5项恶化,主要在逻辑记忆(t=2.747和3.290,P均0.01)和执行功能方面(S troopC-W评分t=2.819,P0.01);两组间相比较:阿立哌唑组除视觉记忆外各项认知功能测查结果均明显好于奋乃静组(即刻视觉记忆t=0.093,延迟视觉记忆t=0.048,P均0.05;其余项目t=2.635～5.748,P0.05或P0.01)。结论阿立哌唑对首发精神分裂症患者的认知功能有改善作用,而奋乃静对认知功能的某些领域有损害。     

城市老年人认知功能的相关因素分析

目的探讨影响城市老年人认知功能的相关危险因素.方法对来自同一调查样本的2485名65岁及以上城市老人,以简明精神状态检查(MMSE)、韦氏成人智力量表(WAIS)中的数字广度测验(DST)得分的"均数-标准差”(M-SD)值划界,将认知功能分为下降/正常,"认知功能”可转变为二项分类变量,作为因变量,同时将作为自变量的相关因素也转变为二项分类变量,进行非条件Logistic回归分析.结果MMSE得分,男性高于女性(25.6±5.2/22.0±6.4,t=15.4,P<0.01).高龄、文盲、农民或无正式职业、日常生活能力障碍、社会支持不佳、离婚丧偶等后独居是影响老年认知功能的危险因素.结论城市老年人认知功能的与生物、心理、社会等多种因素的影响有关.     

重症肌无力的认知功能研究

目的：研究重症肌无力（MG）的认知功能，方法：采用听觉词语记忆测验、数字符号转换、连线测验、逻辑记忆测验、Stroop色词测验（A，B，C）、言语流畅性、Boston命名测验等对36例MG全身划病例及33例眼肌型病例和36例健康对照组进行检查。结果：病例组与对照组比较，多项认知成绩下降，结论：MG存存认知功能障碍，提示MG可能存在CNS受累。     

慢性精神分裂症事件相关电位P300与认知功能成套测验的研究

目的探讨慢性精神分裂症P300的波幅、潜伏期的变化,及其与认知功能成套测验的关系。方法检测41例慢性精神分裂症患者（患者组）及40名正常人（对照组）Cz、Fz、Pz 3点的P300,并用认知功能成套测验（MCCB）评定其认知功能。结果与正常对照相比,在Cz、Fz、Pz 3点,患者组P300波幅降低,潜伏期延长 患者组女性波幅明显比男性高。P300与MCCB相关分析显示,Fz潜伏期与连线、符号编码及持续操作呈负相关 Cz潜伏期与连线、符号编码、言语记忆及迷宫呈负相关 Pz潜伏期与符号编码、迷宫及视觉记忆呈负相关 Pz波幅与符号编码、空间广度、迷宫及视觉记忆呈正相关。结论P300及MCCB可以反映出额叶、顶叶及枕叶的情况,将神经生理学与神经心理学结合起来,说明他们可以从两方面共同对大脑认知功能做出评定。     

老年糖尿病患者某些认知功能的临床探讨（二）

本文对 81例 型老年糖尿病患者及其 3 0名健康老年人进行了认知功能的评定。在 81例糖尿病患者中 ,18例接受胰岛素注射治疗、3 5例口服药物治疗及 2 8例饮食控制治疗。结果 :胰岛素注射治疗组的患者在数字广度、数学符号及 Stroop测验的成绩明显低于正常对照组 ,口服药物组在 Stroop测验的成绩也明显低于正常对照 ,而饮食控制组具有良好的认知功能。研究提示 :胰岛素注射和口服药物治疗的患者存在有一定的认知功能障碍。     

癫痫不同发作类型的患者的智能研究

目的：探讨不同发作类型癫痫患者智能损害特征。方法：对30例全面性癫痫患者（A组）和20例复杂部分性癫痫患者（B组）,用韦氏智力量表测其智商并进行某些分测验,以听觉“oddball”序列刺激,从Cz处引出P3,测其潜伏期和波幅。结果：A组P3潜伏期明显长于B组,两组的总智商、言语智商及操作智商无明显差异。但A组分测验算术、数字广度、词汇、填图以及数字符号得分明显偏低。结论：尽管两组病人总智商无明显差异,但事件相关电位（ERP）检查及韦氏智力量表的某些分测验显示A组病人智能损害重于B组病人;ERP在癫痫病人认知功能检测方面是一项有价值的客观指标。     

老年认知功能缺损者二项必选数字记忆测验结果分析

目的：探讨认知功能缺损程度对二项必选数字记忆测验(简称二项测验)成绩的影响。方法：用简易智力状态量表和韦氏成人智力量表简式调查出38例认知功能缺损者(研究组)和19例无认知功能缺损者(对照组)，同时实施二项数字测验。结果：(1)研究组与对照组二项测验容易条目、困难条目、总分的得分差异均无显著性。(2)智商70-89者困难条目分及总分显著高于智商50-69及34-49者；各组间容易条目分的差异均无显著性。(3)二项测验的假阳性率随着认知功能缺损的加重而有增加趋势。结论：二项测验成绩在一定程度上受认知功能缺损的影响，尤其是严重认知功能减退者，应注意假阳性率的问题。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

HLA genes in Amerindians from Mexico San Vicente Tancuayalab Teenek/Huastecos

Huastecos or Teenek Amerindians are presently living at North East Mexico (San Luis Potosi State). They have probably one of the most ancient culture of Mexico and Central America together with Mayas and Olmec groups with which also show close relationships. Proximity to Atlantic Ocean/Mexican Gulf originated that Spaniards had very early contact with them at about 1519 CE or before. In the present paper we have aimed to study HLA gene profile which may be useful for HLA and disease epidemiology and transplant programs in Teeneks. HLA-DRB1*04:07, -DRB1*14:06 and -DRB1*04:11 have been found in high frequency like in other Amerindian groups. High frequency typical Amerindians HLA extended haplotypes have been found, such as A*02-B*35-DRB1*04:07-DQB1*03:02; A*68-B*39-DRB1*04:07-DQB1*03:02 and A*02-B*39-DRB1*04:07-DQB1*03:02; also new haplotypes have been described, like A*02-B*52-DRB1*04:11-DQB1*03:02, A*68-B*35-DRB1*14:02-DQB1*03:01 and A*68-B*40-DRB1*16:02-DQB1*03:01. Genetic proximity is observed not only to linguistically close Mayans, but also to Mazatecans, Mixtecans and Zapotecans, who speak an altogether different languages; it shows once more that genes and languages do not correlate. This population was greatly diminished after European contact between 1500 and 1600 years CE; in fact, North and South America First Inhabitants population was brought from 80 down to 8 million people because of diseases (i.e.: measles, smallpox or influenza), slavery and war.     

État de l’art : nouveaux anticoagulants et transfusion

Direct oral anticoagulants (DOAC) are indicated for stroke prevention in atrial fibrillation and for the prevention and treatment of venous thromboembolism. As any anticoagulant, they are associated with a bleeding risk. Management of DOAC-induced bleeding is challenging. Idarucizumab, antidote for dabigatran, is currently available and is part of the therapeutic strategy, whereas antidotes for anti-Xa agents are under development. Activated or non-activated prothrombin concentrates are proposed, although their efficacy to reverse DOAC is uncertain. We propose an update on DOAC-associated bleeding management, integrating the availability of idarucizumab and the critical place of DOAC concentration measurements.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.