个性化脑认知功能护理与训练在成人烟雾病手术患者中的应用研究

目的 探讨个性化脑认知功能护理与训练在成人烟雾病脑血运重建手术患者中的应用效果。 方法 连续前瞻性入组2018年11月-2020年7月首都医科大学附属北京天坛医院行脑血运重建手 术治疗的成人烟雾病患者,随机分为对照组和研究组。对照组住院期间给予常规护理;研究组在 常规护理的基础上进行个性化脑认知功能护理与训练。比较两组术前和随访3个月时的成人韦氏 智力量表（Wechsler adult intelligence scale,WAIS）、中文版剑桥前瞻性记忆测试（Chinese version of the Cambridge prospective memory test,CAMPROMPT）和重复性成套神经心理状态测验（repeatable battery of neuropsychological state,RBANS）中的中的即刻记忆（immediate memory,IM）分项和延迟记 忆（delayed memory,DM）分项得分。比较两组术后3个月缺血性和出血性卒中复发率和预后（mRS 0～1分为神经功能正常,2～3分为轻度残疾,4～5分为重度残疾）。 结果 研究共入组14 0例患者,对照组和研究组各70例,两组基线资料和术前认知功能评 分差异均无统计学意义。3个月随访时,研究组与对照组WAI S差异无统计学意义（98.11±11.16 分 vs 95.27±14.83分,P =0.202）;研究组的CAMPROMPT评分（22.99±4.11分 vs 20.41±5.69分, P =0.003）、RBANS-DM（89.86±18.96分 vs 79.54±16.12分,P =0.001）、RBANS-I M（84.43±12.35 分 vs 79.61±15.93分,P =0.048）评分均高于对照组。 结论 对成人烟雾病脑血运重建手术治疗的患者实施个性化脑认知功能护理与训练,有利于患者 认知功能,特别是记忆力的康复。     

急性缺血性卒中后炎症因子水平与神经功能恢复的关系研究

目的 分析急性大动脉粥样硬化性缺血性卒中后炎症因子水平及其与神经神经功能恢复的相关性。 方法 收集2015年11月-2018年1月中国康复研究中心北京博爱医院神经内科收治的轻中度 （NIHSS≤15分）大动脉粥样硬化性急性缺血性卒中患者。分别在入院时、1周、2周、4周进行白细胞计数 （white blood cell,WBC）、中性粒细胞计数（neutrophils,NEU）及纤维蛋白原（fibrinogen,Fib）、IL-6、TNF-α 等炎症因子的检测,同时进行NIHSS评分;并在发病4周进行mRS评分。根据入组时NIHSS评分,将患者 分为轻型卒中（NIHSS 0～4分）和中型卒中（NIHSS 5～15分）两组,比较两组间发病4周内的炎症因子 水平。分析WBC、NEU和Fib水平与同期NIHSS的相关性,入院时WBC、NEU和Fib水平与后续随访（1周、2 周和4周）时NIHSS以及4周时mRS的相关性。 结果 研究共入组61例患者,轻型卒中组5 0例、中型卒中组11例。入院时中型卒中组W B C [（8.87±2.99）×109/L v s（7.07±2.06）×109/L,P =0.019]、N E U [（6.38±2.77）×109/L v s （4.72±1.66）×109/L,P =0.010]和Fib[3.31（2.74～4.24）g/L vs 2.71（2.36～3.30）g/L,P =0.041] 水平均高于轻型卒中组;发病1周时,中型卒中组WBC（[ 8.80±1.47）×109/L vs（6.99±2.32）×109/L, P=0.032]、NEU（[ 6.16±1.09）×109/L vs（4.72±2.14）×109/L,P =0.049]和Fib[3.73（2.92～4.39）vs 2.65 （2.25～3.11）,P=0.022]水平均高于轻型卒中组;发病2周时,中型卒中组WBC（[ 8.40±1.68）×109/L vs（6.89±1.28）×109/L,P=0.012]、NEU（[ 5.76±1.46）×109/L vs（4.59±1.12）×109/L,P =0.024]仍 高于轻型卒中组,但两组Fib水平差异无统计学意义;发病4周时两组的WBC、NEU和Fib水平差异均无 统计学意义。两组各个时间点IL-6、TNF-α水平差异均无统计学意义。入院时（r =0.225,P =0.048）、 发病1周时（r =0.413,P =0.005）和发病2周（r =0.382,P =0.034）时NIHSS与Fib水平呈正相关;入院 时（r =0.257,P =0.046）和发病2周时（r =0.396,P =0.027）NIHSS与NEU水平呈正相关;发病2周时 （r =0.451,P =0.011）NIHSS与WBC水平呈正相关。入院时WBC水平与发病2周（r =0.442,P =0.007）和 4周（r =0.518,P =0.011）时的NIHSS呈正相关;入院时NEU水平与发病1周（r =0.268,P =0.048）、2周 （r =0.402,P =0.015）和4周（r =0.431,P =0.040）时的NIHSS评分呈正相关;入院时Fib水平与发病1周 （r =0.318,P =0.023）和2周（r =0.378,P =0.025）时NIHSS呈正相关。 结论 对于轻中度大动脉粥样硬化性缺血性卒中,发病2周内神经功能缺损程度与Fib和NEU水平呈 正相关;中型缺血性卒中在发病2周内的WBC、NEU和Fib水平高于轻型缺血性卒中,该差异在发病4周时 逐渐消失。     

骶髂关节半脱位矫正对慢性期卒中后功能障碍恢复的影响

目的 初步探讨矫正骶髂关节半脱位对慢性期卒中偏瘫患者步行能力及平衡功能的影响。方法 选择2018年4月—2021年12月在包头市中心医院神经康复中心住院且符合入组标准的慢性期卒中偏瘫患者,对确定存在骶髂关节半脱位的13例患者进行手法矫正治疗。治疗前、治疗3周后进行Berg平衡量表评估、“起立-行走”计时测试、10米步行计时测试、Holden步行能力分级以及骨盆正位X线片检查,并进行比较。结果 存在骶髂关节半脱位的慢性期卒中偏瘫患者共11例纳入研究。按冈斯德分析系统进行骨盆正位X线片画线测量,其中髂骨ASIn7例,髂骨ASEx2例,髂骨PIIn1例,髂骨In1例。手法矫正治疗3周后,Berg平衡量表评分高于治疗前[（47.00±9.22）分vs.(37.45±11.04)分,P<0.001];“起立-行走”计时测试时间短于治疗前[（18.51±5.29）s vs.(24.94±9.50)s,P=0.003];10米步行计时测试：步行速度较治疗前变快[（53.72±25.71）cm/s vs.(43.49±24.24)cm/s,P<0.001],步长较治疗前增加[（38.37±...     

体外膈肌起搏联合肺康复训练对脑卒中亚急性期患者肺功能和膈肌功能的影响

目的 探讨体外膈肌起搏联合肺康复训练对脑卒中亚急性期患者肺功能和膈肌功能的影响。方法 选取2021-08—2022-10于南京医科大学附属南京医院诊治的脑卒中亚急性期患者80例,采用随机数字表法分为实验组（40例）和对照组（40例）。实验组采用体外膈肌起搏联合肺康复训练治疗,对照组仅采用肺康复训练治疗。所有患者均治疗3周,比较2组治疗前后肺功能、膈肌功能相关指标。结果 治疗3周后,2组第1秒用力呼气容积（FEV1）[(2.07±0.45)L比（2.63±0.41）L,(2.11±0.47)L比（2.42±0.33）L]、用力肺活量（FVC）[(2.31±0.46)L比（2.77±0.38）L,(2.35±0.39)L(2.56±0.31)L]、FEV1/FVC[(81.41±7.55)%比（89.25±6.43）%,(81.29±6.87)%比（85.12±5.32）%]、峰值呼气流量[（1.81±0.23）L/s比（3.15±0.57）L/s,(1.78±0.44)L/s比（2.54±0.41）L/s]、最大自主通气量[（61.78±7.49）L/min比（78.69±5.69）L/...     

卒中急性期患者情绪与记忆状况

目的 探讨急性卒中患者情绪和记忆状况。方法 采用焦虑自评量表、抑郁自评量表、汉密尔顿抑郁量表和临床记忆量表对30例卒中患者（卒中组）和30例健康志愿者（对照组）进行调查研究。结果 卒中组焦虑自评量表分、抑郁自评量表分和汉密顿抑郁量表分均显著高于正常对照组（41.43±10.71 vs 33.40±3.11,P <0.01;45.29±12.76 vs 34.04±5.30,P <0.01;10.80±6.07 vs 2.53±1.43,P <0.01）。卒中组指向记忆、联想学习、无意义词再认、图像自由回忆、人像特点回忆均明显低于国内常模（15.03±6.17 vs 17.33±5.48,P <0.01;16.42±5.17 vs 18.35±4.96,P <0.01;15.13±6.26 vs17.42±5.31,P <0.01;15.83±5.58 vs 18.63±5.60,P <0.01;14.57±3.14 vs 16.41±5.35,P <0.01）,指向记忆、联想学习、图像自由回忆和记忆商低于正常对照组（15.03±6.17 vs 18.33±4.54,P <0.05;16.42±5.17 vs 19.30±4.20,P <0.05;15.83±5.58 vs 19.45±6.41,P <0.05;90.43±17.70 vs101.97±11.44,P <0.01）。结论 卒中对患者的情绪有明显影响,部分患者出现焦虑和抑郁情绪;卒中对患者的记忆力有明显影响,患者记忆力显著下降。     

西安地区伴心房颤动的首发脑梗死患者临床特征及1年预后分析

目的 探讨西安地区伴心房颤动（atrial fibrillation,AF）的首发脑梗死患者临床特征及1年预后情况。 方法 通过西安卒中登记研究,连续纳入2015年1-12月4所三级甲等医院确诊的首发脑梗死患者, 根据是否伴AF分为非AF组和AF组。比较两组基本临床特征和1年不良预后[卒中复发（脑梗死和脑出 血）、预后不良（mRS 2～5分）和全因死亡]发生率的差异。采用多因素logistic回归模型分析AF对首发 脑梗死患者1年预后的影响。 结果 共1564例首发脑梗死患者纳入研究,其中AF组113例（7.2%）,非AF组1451例（92.8%）。AF 组平均年龄[71.18±12.66岁 vs 63.25±12.46岁,P <0.001]、BMI[24.0（22.0～25.5）kg/m2 vs 23.4 （21.1～24.6）kg/m2,P =0.004] 、目前仍吸烟比例（11.5% vs 26.6%,P =0.002）、入院NIHSS评分 [7（3～12）分 vs 4（2～6）分,P <0.001]、继发肺炎比例（17.7% vs 3.7%,P <0.001）、入院48 h 不能行走比例（54.0% vs 32.9%,P <0.001）、吞咽障碍比例（14.2% vs 6.4%,P =0.001）、LDL-C （2.44±0.71 mmol/L vs 2.65±0.86 mmol/L,P =0.016）、INR（1.21±0.52 vs 1.02±0.13,P <0.001）和 血小板计数[（164.91±47.55）×109/L vs（192.58±59.98）×109/L,P <0.001]等指标与非AF组相 比,差异均有统计学意义。多因素logistic回归分析显示,AF组患者的1年预后不良风险（OR 2.25, 95%CI 1.10～5.23,P =0.022）和死亡风险（OR 3.28,95%CI 1.48～7.28,P =0.004）较非AF组升高,两 组卒中复发风险差异无统计学意义（OR 1.14,95%CI 0.34～3.85,P =0.833）。 结论 西安地区伴AF的首发脑梗死患者部分临床特征显著区别于非AF组,1年预后不良风险和死 亡风险均显著升高。建议开展区域内AF患者卒中风险评估,以规范高危患者的抗凝治疗。     

丁苯酞对华法林治疗心源性卒中患者抗凝作用的影响

目的 探讨心源性卒中患者使用丁苯酞对华法林抗凝作用的影响。 方法 前瞻性连续纳入成都医学院第一附属医院神经内科2019年6月—2021年12月期间收治的心源性卒中患者,患者入组后随机分为试验组（华法林+丁苯酞）和对照组（华法林）。监测两组患者的国际标准化比值（international standardized ratio,INR）变化情况并收集两组患者的临床资料,比较分析两组患者的INR达标时间、2周内达标率和90 d mRS评分的差异。 结果 本研究共纳入101例心源性卒中患者,试验组51例,对照组50例。两组基线数据（年龄、性别、用药前INR、收缩压和舒张压）差异无统计学意义,入院时试验组的NIHSS评分[10（3.0～15.0）分 vs. 0（0～6.5）分,P<0.001],溶栓率（27.5% vs. 8.0%,P=0.011）与取栓率（25.5% vs. 2.0%,P=0.001）均高于对照组。试验组INR 2周内达标率与对照组相比差异无统计学意义（43.1% vs. 44.0%,P=0.930）。试验组达标时间较对照组明显缩短[（6.50±2.41）d vs.（9.64±4.40）d,P=0.015]。试验组90 d mRS评分与对照组相比,差异无统计学意义[3（0.5～4.0）分 vs. 2（0～3.0）分,P=0.175]。 结论 丁苯酞联合华法林治疗心源性卒中可能缩短华法林的达标时间,需进一步的研究来验证,但对于INR的达标率和90 d mRS评分无影响。     

脑梗死患者呼吸中枢驱动和呼吸功能的变化

目的 探讨脑梗死患者呼吸功能指标及呼吸中枢驱动力的变化,了解脑梗死对患者呼吸中枢及呼吸功能的影响.方法 对35例脑梗死患者和15名健康对照分别进行血气分析、呼吸中枢驱动(P0.1)和肺功能测定,使用SPSS 10.0 for Windows加以分析处理,两组之间各指标比较采用t检验.两因素之间的相关性分析采用直线相关分析.结果 脑梗死患者血氧分压(mmHg,75.80±4.12,1 mm Hg=0.133 kPa)、血氧饱和度(%,94.97±0.78)和最大口腔吸气压(Pimax,kPa,41076±2.443)明显低于健康对照组(分别为88.68±3.77,96.40±0.48和7.747±0.599,t值分别为-8.310、-5.731、-5.439,均P=0.000).P0.1max和P0.1/每分钟通气量比健康对照组低,差异有统计学意义.P0.1/P0.1max、P0.1/PImax较健康对照组高,且差异有统计学意义.用力肺活量(FVC)、一秒用力呼气容积(FEV1.0)、呼气流速峰值(PEF)亦明显低于健康对照组.经相关分析,最大口腔吸气压与血氧分压、血氧饱和度、肺泡动脉氧压差、P0.1max、P0.1、P0.1/Pimax、P0.1/P0.1max、FVC、FEV1.0、PEF密切相关;最大口腔呼气压与P0.1/Pimax、FVC、FEV1.0、PEF密切相关.结论 脑梗死患者呼吸功能受损,氧合指标降低、吸气及呼气功能均受累、中枢呼吸驱动力降低且中枢呼吸驱动储备下降.     

急性脑梗死患者血管内皮功能损害的临床研究

目的 探讨急性脑梗死患者血管内皮功能改变.方法 39例脑梗死患者,采用欧洲卒中量表（ESS）进行神经功能缺损评分,分为轻度卒中组（13例）、中度卒中组（17例）和重度卒中组（9例）.另选20例健康志愿者为对照组,分别采用高效液相色谱技术和酶标法检测血浆中ADMA水平和eNOS的活性.结果 与健康对照组比较,随着神经功能损害,脑梗死组血浆ADMA水平明显升高（轻、中、重度脑梗死组ADMA分别（1.14±0.09）μmol/L、（3.68±0.21）μmol/L、（5.04±0.29）μmol/L;对照组为（0.62±0.10）μmol/L,P＜0.05）,eNOS活性显著降低（轻、中、重度脑梗死eNOS分别（6.03±1.39）U/ml、（4.17±1.24）U/ml、（3.98±1.06）U/ml;对照组（7.61±1.37）U/ml,P＜0.05）.脑梗死亚组之间相互比较均有明显统计意义（P＜0.05）.血浆ADMA的水平与ESS评分正相关（r=0.367,P=0.007）,血浆eNOS与ESS水平呈负相关（r=-0.336,P=0.024）.ADMA水平与eNOS活性负相关（r=-0.271,P=0.039）.结论 急性脑梗死患者血浆ADMA抑制eNOS活性影响,是血管内皮功能障碍的机制之一.     

西安地区伴心房颤动老年急性缺血性卒中患者临床特征及1年预后分析

目的 探讨西安地区伴心房颤动老年急性缺血性卒中（acute ischemic stroke,AIS）患者临床特征及1 年预后情况。 方法 通过西安卒中数据库平台,收集西安市4所三级甲等医院2015年1-12月连续入院的老年AIS （年龄≥65岁）患者的临床资料,比较分析伴心房颤动老年AIS患者的临床特征;登记随访1年的结局 事件（包括卒中复发、死亡和预后不良）,通过多因素Logi sti c回归分析,探讨西安地区伴心房颤动老 年AIS患者1年不良预后的独立危险因素。 结果 研究最终纳入老年AIS患者1239例,其中伴心房颤动者133例（10.7%）。与不伴心房颤动组相比, 伴心房颤动老年AIS患者的年龄大（[ 77.7±6.3）岁 vs（74.0±6.1）岁,P=0.019]、出院mRS评分高（2.0 分 vs 1.0分,P <0.001）、出院NIHSS评分≥14分比例高（16.5% vs 3.1%,P <0.001）、合并肺炎患者比例 高（21.1% vs 5.8%,P <0.001）、入院48 h不能行走的患者比例高（63.0% vs 36.1%,P <0.001）、空腹 血糖水平高[（6.3±3.0）mmol/L vs（5.8±2.0）mmol/L,P =0.037]、LDL-C水平低[（2.4±0.7）mmol/L vs （2.5±0.8）mmol/L,P =0.031]。伴心房颤动老年AIS患者1年卒中复发率高（15.8% vs 5.9%,P =0.020）、 死亡率高（32.3% vs 9.2%,P <0.001）、预后不良率高（51.9% vs 25.9%,P <0.001）。校正相关混杂 因素后,多因素Logistic回归分析显示,心房颤动是老年AIS患者1年死亡风险的独立影响因素（OR 2.45, 95%CI 1.26～4.78,P =0.008）,但不是1年卒中复发和预后不良的独立影响因素（P >0.05）。 结论 相比不伴心房颤动组,西安地区伴心房颤动老年AIS患者年龄更大、卒中所致残障及神经功 能缺损更重、合并肺炎和入院48 h不能行走的患者比例较高;伴心房颤动老年AIS患者1年死亡风险显 著升高。     

Évolutions biotechnologiques et nanosciences: Une approche de l’épistémologie clinique comparative du vivant

The authors analyse the progress of the construction of knowledge and its effect on social and scientific representations, but also on representations of human relations in the environment and in the world. This evolution marked by the importance of human relations in the infinitesimally small and in the immensely big, modifies the relation between living creatures and the inanimate and between man and matter; this emerging knowledge interferes with processes of exploration, of production and of transformation of living creatures.     

Can risperidone and olanzapine in elderly patients with dementia and other mental disorders be discontinued?

BACKGROUND: In March 2004, the UK Committee of Safety of Medicines (CSM) informed clinicians that risperidone and olanzapine should not be used to treat behavioural and psychological symptoms of dementia (BPSD) because of increased risk of strokes with both drugs and increased risk of mortality with olanzapine. An audit to examine the implications of the implementation of the CSM guidance was undertaken. METHODS: All patients receiving these two drugs, in one psychogeriatric service, at the time of CSM guidance were identified and reviewed. Data on clinical and demographic features, patient and carer involvement in the review and clinical outcome of the efficacy of the overall treatment package at 6 month follow-up was ascertained from the case-notes. RESULTS: The main findings were: (i) all patients receiving risperidone or olanzapine were identified and reviewed at a median interval of 8 days after the CSM guidance; (ii) most patients and carers were involved in the initial review; (iii) risperidone and olanzapine were discontinued in 22 and 12 of the patients respectively, and in 19 of these patients another neuroleptic was substituted; (iv) there was no relationship between discontinuation of these two drugs and presence of cerebrovascular and cardiovascular risk factors; and, (v) there was no relationship between the clinical outcome of efficacy at six months and discontinuation of these two drugs. CONCLUSIONS: This study illustrates that it is possible to identify, review and follow-up patients on these two drugs and involve the patient and carer in the review, and clinical outcome of efficacy of the overall treatment package is not adversely affected by continuation or discontinuation of these two drugs.     

The refugee’s predicament

The experiences of trauma, displacement, and forced migration faced by refugees raise profound questions about the relationship of self and community. This article explores some ways in which the intrapsychic dynamics of refugees' suffering and remembering interact with the larger social dynamics of refugee communities and host societies. The narrative construction of the self constitutes the pivot between the realms of the social and the psychological and rests on cultural meta-narratives. In Euro-American folk psychology two of the meta-narratives or concepts of the self can be compared in terms of their root metaphors: the adamantine self, characterized by its integrity, coherence, autonomy, self-definition, self-determination and self-control; and the transactional self, characterized by its fluidity, sensitivity to context, deference to authority, multivocality, deference and yielding to or accommodating others. These two accounts of the self shape how we view people who have suffered wrenching transformations of their worlds through violence, dislocation and loss. The changes produced through the therapeutic process can be understood as the development of a form of dialogue that is at once, within and without, personal and transcendental, rooted in communal tradition and in the open confrontation of the face of the other. The ethics of storytelling has its necessary counterpart in the ethics of listening, of witnessing and taking part in the creation of community through copresence.     

Considering context, place and culture: the National Latino and Asian American Study

This paper provides a rationale for, and overview of, procedures used to develop the National Latino and Asian American Study (NLAAS). The NLAAS is nationally representative community household survey that estimates the prevalence of mental disorders and rates of mental health service utilization by Latinos and Asian Americans in the US. The central aims of the NLAAS are to: 1) describe the lifetime and 12-month prevalence of psychiatric disorders and the rates of mental health services use for Latino and Asian American populations using nationwide representative samples of Latinos and Asian Americans, 2) assess the associations among social position, environmental context, and psychosocial factors with the prevalence of psychiatric disorders and utilization rates of mental health services, and 3) compare the lifetime and 12-month prevalence of psychiatric disorders, and utilization of mental health services of Latinos and Asian Americans with national representative samples of non-Latino whites (from the National Comorbidity Study-Replication) (NCS-R) and African Americans (from the National Survey of American Life) (NSAL). This paper presents new concepts and methods utilized in the development of the NLAAS to capture and investigate ethnic, cultural and environmental considerations that are often ignored in mental health research.     

Neonatal Seizures: Problems in Diagnosis and Classification

Summary: The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo-graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction.     

Thalamic structures and associated cognitive functions: Relations with age and aging

The thalamus, with its cortical, subcortical, and cerebellar connections, is a critical node in networks supporting cognitive functions known to decline in normal aging, including component processes of memory and executive functions of attention and information processing. The macrostructure, microstructure, and neural connectivity of the thalamus changes across the adult lifespan. Structural and functional magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) have demonstrated, regional thalamic volume shrinkage and microstructural degradation, with anterior regions generally more compromised than posterior regions. The integrity of selective thalamic nuclei and projections decline with advancing age, particularly those in thalamofrontal, thalamoparietal, and thalamolimbic networks. This review presents studies that assess the relations between age and aging and the structure, function, and connectivity of the thalamus and associated neural networks and focuses on their relations with processes of attention, speed of information processing, and working and episodic memory.     

过表达TBX2对胶质瘤细胞增殖和侵袭的影响

目的 探讨TBX2表达对胶质瘤细胞增殖、侵袭的影响。方法 采用RT-qPCR和免疫印迹法检测53例胶质瘤组织和瘤旁组织TBX2mRNA和蛋白表达水平。体外培养胶质瘤细胞（U251、U87和SHG-44）和正常星型胶质细胞（HA1800）,采用RT-qPCR和免疫印迹法检测细胞TBX2 mRNA和蛋白表达水平。构建TBX2过表达或低表达U251细胞株,分别采用WST-1法检测胶质瘤细胞增殖能力,Transwell实验检测细胞侵袭能力。结果 胶质瘤组织TBX2 mRNA和蛋白表达水平明显高于瘤旁组织（P<0.05）,而且,高级别胶质瘤TBX2表达水平显著高于低级别胶质瘤（P<0.05）。相比于人正常星型胶质细胞系HA1800,胶质瘤细胞系U251、U87、SHG-44细胞TBX2 mRNA和蛋白表达水平均明显增高（P<0.05）;而且,U251细胞TBX2表达水平显著高于U87和SHG-44细胞（P<0.05）,因此使用U251细胞进行后续实验。过表达TBX2显著增加U251细胞增殖和侵袭能力（P<0.05）,低表达TBX2显著抑制U251细胞增殖和侵袭能力（P<0.05）。结论 胶质瘤TBX2呈高表达,与胶质瘤增殖、侵袭能力有关。     

Violences, homicides et délires de persécution

Persecution and prejudice are the most common themes of delirium. Psychotic subjects (paranoiacs or schizophrenics) who suffer from delirium are therefore liable to defensive behavioural characteristics and mechanisms. These characteristics include behaviour of avoidance or escape and even aggression towards the persecutor/s. In such cases, violent acts are committed in an effort to control or destroy the source of suffering and persecution. Several examples regularly attest this claim. In complement to classical therapeutic methods, certain new cognitive and behaviourist psychotherapies of chronic psychoses, appear to be promising therapeutic and preventive vectors, which reduce or resolve the different intensity of criminal urges caused by certain delirium of persecution and prejudices. Delirium of prejudice and persecution, whether isolated or associated with other themes of delirium, are a risk factor for emotional changes, which can engender self or heteroaggressive acts (once or multiple), carried out by subjects who suffer from them. The interruption of treatment of these psychotic processes, when they exist, is a possible factor for maintaining or increasing these troubles and sometimes of the dangers associated with them. Therefore, to avoid subjects committing dangerous acts, constant and regular checks of psychotherapeutic and psychotropic treatment, with constrained hospitalisation if necessary, are curative and preventive measures, should be systematic.