Improving our understanding,and detection,of glaucomatous damage: An approach based upon optical coherence tomography (OCT)

Although ophthalmologists are becoming increasingly reliant upon optical coherence tomography (OCT), clinicians who care for glaucoma patients are not taking full advantage of the potential of this powerful technology. First, we ask, how would one describe the nature of glaucomatous damage if only OCT scans were available? In particular, a schematic model of glaucomatous damage is developed in section 2, and the nature of glaucomatous damage seen on OCT scans described in the context of this model in section 3. In particular, we illustrate that local thinning of the circumpapillary retinal nerve fiber layer (cpRNFL) around the optic disc can vary in location, depth, and/or width, as well as homogeneity of damage. Second, we seek to better understand the relationship between the thinning of the cpRNFL and the various patterns of sensitivity loss seen on visual fields obtained with standard automated perimetry. In sections 4 and 5, we illustrate why one should expect a wide range of visual field patterns, and iilustrate why they should not be placed into discrete categories. Finally, section 6 describes how the clinician can take better advantage of the information in OCT scans. The approach is summarized in a single-page report, which can be generated from a single wide-field scan. The superiority of this approach, as opposed to the typical reliance on summary metrics, is described.     

Pallidal deep brain stimulation modulates excessive cortical high β phase amplitude coupling in Parkinson disease

Objective

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) and globus pallidus internus (GPi) are equally efficacious in the management of Parkinson disease (PD). Studies of STN-DBS have revealed a therapeutic reduction in excessive cortical β-γ phase-amplitude coupling (PAC). It is unclear whether this is specific to STN-DBS and potentially mediated by modulation of the hyperdirect pathway or if it is a generalizable mechanism seen with DBS of other targets. Moreover, it remains unclear how cortical signals are differentially modulated by movement versus therapy. To clarify, the effects of GPi-DBS and movement on cortical β power and β-γ PAC were examined.

海坤失眠治疗仪配合心理疏导治疗卒中后失眠疗效观察

目的 观察海坤失眠治疗仪联合心理疏导治疗卒中后失眠的效果。方法 110例纳入患者随机分为两组,常规中西医对症基础治疗,对照组54例采用海坤失眠治疗仪治疗,观察组56例再联合心理疏导干预,每日1次,每周6次,连续治疗2周。结果 观察组总有效54例(96.43%),对照组总有效47例(87.04%)。两组具有显著性差异(P＜0.05)。结论 海坤失眠治疗仪联合心理疏导治疗卒中后失眠效果肯定,提示心理干预有良好的改善睡眠作用。     

基于偏定向相干性(PDC)的脑卒中后抑郁症患者脑网络研究

探究脑卒中后抑郁症（PSD）患者脑网络异常。采集PSD患者及其对照组（卒中后无抑郁症（PSND）患者及健康人（CONT））各10例16导联静息态脑电信号进行偏定向相干性（PDC）分析,利用单尾单样本t检验构建这3类人群的平均脑网络图,并对所得脑网络进行基于图论的拓扑参数比较分析。结果表明,经统计学检验（P<0.05）,当PDC阈值取0.2时,三类人群平均脑网络节点度、平均集群系数及中介中心度参数差异最明显。具体表现为脑卒中患者相对健康人出现了优势半球（左半球）信息流入的减弱,PSD患者相对PSND患者在与“情绪”相关的左额叶及左颞叶信息流出减弱。PSD患者相对CONT及PSND人群平均集群系数分别下降2.4%及1.8%,脑网络集团化程度减弱;网络核心节点个数分别增大2.2倍及1.6倍,且核心节点有所转移,枢纽节点核心地位下降。受脑卒中和抑郁情绪的影响,PSD患者的脑网络发生了异常改变。     

Notch1 signaling,hippocampal neurogenesis and behavioral responses to chronic unpredicted mild stress in adult ischemic rats

Accumulating evidence indicates that the Notch signaling pathway fulfills important roles in ischemia-stimulated neurogenesis, which may be regarded as an etiological factor in post-stroke depression. Here we explored Notch₁ signaling, hippocampal neurogenesis and behavioral responses to chronic unpredicted mild stress (CUMS) in adult ischemic rats. Animals were treated with permanent middle cerebral artery occlusion followed by an 18 day CUMS procedure. Proliferating cells in the hippocampus and their cell fate were investigated on days 19 and 28 after ischemic surgery. Additionally, expression of the Notch₁ intracellular domain (NICD) and its downstream targets Hes1 and Hes5 was examined. A sucrose preference test and forced swim test were used to assess behavioral responses. CUMS produced depressive-like behaviors and decreased the number of proliferating cells on day 19 (both p < 0.001), accompanied by a decreased expression of both Hes1 and Hes5 in the hippocampus of ischemic animals (p < 0.001). On day 28, CUMS resulted in a decreased number of neurogenically-differentiating cells in the subgranular zone (p < 0.001) while permitting differentiation into astrocytes in the hilus (p < 0.05). Hes1 and Hes5 protein expression levels were increased. The expression of the NICD was significantly decreased at both time-points. CUMS led to expression changes in the Notch₁ signaling cascade in ischemic rats, most of which concerned hippocampal neurogenesis. This suggests that variation in Notch₁ activity and subsequent expression of its downstream targets, including Hes1 and Hes5, may, at least in part, contribute to modulation of ischemia-related hippocampal neurogenesis by CUMS.     

突触后密度家族蛋白与疼痛研究进展

PSD是最早在电镜下发现的位于突触后膜的"致密物蛋白质".这种"致密物"是由一系列细胞骨架蛋白结合了多种与突触信号传递相关的分子(包括受体和各种激酶等)构成的特殊结构.其中一些成员,包括NMDA受体、CaMKII、PSD-93及PSD-95,与疼痛的发生、维持及治疗密切相关,并且彼此之间有着"微妙"的相互调节作用.     

Plasma and cerebrospinal fluid substance P in post-stroke patients with depression

Aims: To investigate the correlation between the incidence of post‐stroke depression (PSD) and the levels of substance P (SP) in the plasma and cerebrospinal fluid (CSF). Methods: Ninety‐one stroke patients were divided into PSD (n = 46) and post‐stroke (without depression) groups (n = 45). PSD must have occurred 2–4 weeks after the onset of the stroke and was determined by the Hamilton Rating Scale for Depression (HAMD). In addition, the subjects were divided into anterior (n = 67) and posterior circulation stroke groups (n = 24) based on the location of the focus as determined by computed tomography. All recruited patients were graded by the National Institutes of Health Stroke Scale (NIHSS). Results: The results included the following findings: (i) the level of plasma SP in the PSD group (58.47 ± 14.39) was higher than that of the PS group (36.98 ± 9.49; P = 0.000), while the level of CSF SP in the PSD group (72.13 ± 13.06) was higher than that of the post‐stroke group (37.30 ± 12.57; P = 0.03); (ii) the level of plasma SP was positively correlated with the HAMD and NIHSS score; (iii) the level of plasma SP (38.45 ± 12.23), the HAMD score (9.08 ± 8.72), and the NIHSS score (3.25 ± 1.90) of the anterior stroke group (51.21 ± 16.27, 17.46 ± 15.96, and 6.91 ± 3.30, respectively) were higher than those of the posterior stroke group (38.45 ± 12.23, 9.08 ± 8.7, and 3.25 ± 1.90, respectively; P = 0.017, P = 0.001, and P = 0.000, respectively). Conclusions: SP in the plasma and CSF of patients exhibited a close correlation with neural damage and the incidence of PSD. This study also suggested that anterior hemispheric strokes may play a significant role in development of PSD.     

理性情绪疗法对精神分裂症后抑郁患者心理状态的影响

目的：探讨理性情绪疗法对精神分裂症后抑郁患者心理状态的影响。方法将84例精神分裂症后抑郁患者分为两组,每组42例。两组均予以精神科常规治疗及健康宣教,研究组在此基础上联合理性情绪疗法治疗。观察6周。于治疗前后采用自尊量表、自我接纳问卷、汉密顿抑郁量表评定干预效果。结果治疗后两组汉密顿抑郁量表评分均较治疗前显著降低（P＜0．05或0．01）,研究组显著低于对照组（ P＜0．05）;自尊量表、自我接纳问卷评分均较治疗前显著升高（P＜0．05或0．01）,研究组显著高于对照组（P＜0．05）。结论理性情绪疗法能显著改善精神分裂症后抑郁患者的抑郁情绪,提高其自尊水平及自我接纳程度。     

电针治疗中风后抑郁145例

目的验证电针治疗中风后抑郁的有效性及安全性,探究其作用机制。方法 300例PSD患者随机分为电针组150例给予电针治疗,1次/d,15 d为1个疗程;药物组给予氟西汀口服治疗;两组均连续治疗5 W。治疗前后进行汉密顿抑郁量表（HAMD）积分判定和血清白细胞介素-6（IL-6）、肿瘤坏死因子α（TNFα）和可溶性白细胞介素-2受体（SL-2R）的含量测定。结果电针组HAMD积分显著低于药物组（p〈0.05）,疗效优于药物组（p〈0.05）,血IL-6（p〈0.05）和SL-2R（p〈0.05）含量显著低于药物组,副反应低于药物组（p〈0.01）。结论电针治疗有助于减轻PSD病情,疗效显著、安全,能降低PSD患者血清IL-6、SL-2R含量。降低PSD患者血清中部分细胞因子水平,纠正紊乱的免疫功能可能是电针治疗PSD的作用机制之一。     

Detailed Inspection of γ-ray,Fast and Thermal Neutrons Shielding Competence of Calcium Oxide or Strontium Oxide Comprising Bismuth Borate Glasses

For both the B₂O₃-Bi₂O₃-CaO and B₂O₃-Bi₂O₃-SrO glass systems, γ-ray and neutron attenuation qualities were evaluated. Utilizing the Phy-X/PSD program, within the 0.015–15 MeV energy range, linear attenuation coefficients (µ) and mass attenuation coefficients (μ/ρ) were calculated, and the attained μ/ρ quantities match well with respective simulation results computed by MCNPX, Geant4, and Penelope codes. Instead of B₂O₃/CaO or B₂O₃/SrO, the Bi₂O₃ addition causes improved γ-ray shielding competence, i.e., rise in effective atomic number (Z_eff) and a fall in half-value layer (HVL), tenth-value layer (TVL), and mean free path (MFP). Exposure buildup factors (EBFs) and energy absorption buildup factors (EABFs) were derived using a geometric progression (G–P) fitting approach at 1–40 mfp penetration depths (PDs), within the 0.015–15 MeV range. Computed radiation protection efficiency (RPE) values confirm their excellent capacity for lower energy photons shielding. Comparably greater density (7.59 g/cm³), larger μ, μ/ρ, Z_eff, equivalent atomic number (Z_eq), and RPE, with the lowest HVL, TVL, MFP, EBFs, and EABFs derived for 30B₂O₃-60Bi₂O₃-10SrO (mol%) glass suggest it as an excellent γ-ray attenuator. Additionally, 30B₂O₃-60Bi₂O₃-10SrO (mol%) glass holds a commensurably bigger macroscopic removal cross-section for fast neutrons (Σ_R) (=0.1199 cm⁻¹), obtained by applying Phy-X/PSD for fast neutrons shielding, owing to the presence of larger wt% of ‘Bi’ (80.6813 wt%) and moderate ‘B’ (2.0869 wt%) elements in it. 70B₂O₃-5Bi₂O₃-25CaO (mol%) sample (B: 17.5887 wt%, Bi: 24.2855 wt%, Ca: 11.6436 wt%, and O: 46.4821 wt%) shows high potentiality for thermal or slow neutrons and intermediate energy neutrons capture or absorption due to comprised high wt% of ‘B’ element in it.