Dear Editor,In recent years,there has been an increasing focus on the non-motor functions of the cerebellum[1,2].Clinical observations have demonstrated that individuals with cerebellar damage exhibit affective insens...Dear Editor,In recent years,there has been an increasing focus on the non-motor functions of the cerebellum[1,2].Clinical observations have demonstrated that individuals with cerebellar damage exhibit affective insensitivity,executive dysfunction,spatial cognitive impairment,personality changes,and speech difficulties,collectively known as cerebellar cognitive affective syndrome[3].Furthermore,cerebellar dysfunction has been implicated in various neurological disorders such as autism spectrum disorder,obsessive-compulsive disorder,and attention-deficit/hyperactivity disorder[4].展开更多
Objective： The aim of our meta-analysis was to assess the effects of antiepileptic drugs on bone mineral density and bone metabolism in epileptic children. Methods： Searches of Pub Med and Web of Science were undert...Objective： The aim of our meta-analysis was to assess the effects of antiepileptic drugs on bone mineral density and bone metabolism in epileptic children. Methods： Searches of Pub Med and Web of Science were undertaken to identify studies evaluating the association between antiepileptic drugs and bone mineral density and bone metabolism. Results： A total of 22 studies with 1492 subjects were included in our research. We identified：（1） a reduction in bone mineral density at lumbar spine（standardized mean difference（SMD）=-0.30, 95% confidence interval（CI） [-0.61,-0.05]）, trochanter（mean difference（MD）=-0.07, 95% CI [-0.10,-0.05]）, femoral neck（MD=-0.05, 95% CI [-0.09,-0.02]）, and total body bone mineral density（MD=-0.33, 95% CI [-0.51,-0.15]）;（2） a reduction in 25-hydroxyvitamin D（MD=-3.37, 95% CI [-5.94,-0.80]） and an increase in serum alkaline phosphatase（SMD=0.71, 95% CI [0.38, 1.05]）;（3） no significant changes in serum parathyroid hormone, calcium, or phosphorus. Conclusions： Our meta-analysis suggests that treatment with antiepileptic drugs may be associated with decreased bone mineral density in epileptic children.展开更多
Group 1 metabotropic glutamate receptors(Gp1 mGluRs),comprising mGluR1 and mGluR5,are predominantly located at postsynaptic terminals.Gp1 mGluRs induce the activation of phospholipase C-γ.
Dear editor,Pupillary abnormalities, i.e., mydriasis, pupillary arefl exia, and/or anisocoria, may indicate the occurrence of acute clinical events in intensive care units (ICUs),which are particularly seen in severe ...Dear editor,Pupillary abnormalities, i.e., mydriasis, pupillary arefl exia, and/or anisocoria, may indicate the occurrence of acute clinical events in intensive care units (ICUs),which are particularly seen in severe patients with brain and/or cervical spinal cord injury. The pathophysiology of benign episodic mydriasis is still not completely clear. We present a patient with severe burns presented with temporary alternating bilateral pupil enlargement accompanied by paroxysmal increases in respiration,heart rate, and blood pressure.展开更多
脓毒症是一种由感染引起的异质性疾病,感染触发了一系列复杂的局部或者全身的免疫炎症反应,引起多器官功能衰竭,发病率和病死率显著升高。由于至今仍然没有诊断脓毒症的金标准,所以脓毒症的临床诊断仍是一个难题。因此,脓毒症的临床诊...脓毒症是一种由感染引起的异质性疾病,感染触发了一系列复杂的局部或者全身的免疫炎症反应,引起多器官功能衰竭,发病率和病死率显著升高。由于至今仍然没有诊断脓毒症的金标准,所以脓毒症的临床诊断仍是一个难题。因此,脓毒症的临床诊断需要不断改变来满足临床和研究的要求。然而,尽管有许多新型的生物标记和筛选工具去预测脓毒症发生的风险,但是这些措施的诊断价值和有效性不足以让人满意,并且没有充分的证据去建议临床使用这些新技术。因此,脓毒症的临床诊断标准需要定期更新去适应不断产生的新证据。这篇综述旨在呈现当前脓毒症的诊断和早期识别方面的最新研究证据。临床运用不同的诊断方法的推荐意见依赖于推荐、评价、发展和评估分级体系(Grades of Recommendation Assessment,Development and Evaluation,GRADE),因为大部分的研究是观察性研究,并没有对这些方法进行可靠评估,采用的是两步推理方法。未来需要更多研究来确认或者反驳某一特殊的指标检测,同时应该直接采用相关病人的结果数据。展开更多
Background Improvement of clinical symptoms following hyperbaric oxygen （HBO） treatment of neuropsychiatric disorders arising from traumatic brain injury was proved by our previous study. This study was aim to obtai...Background Improvement of clinical symptoms following hyperbaric oxygen （HBO） treatment of neuropsychiatric disorders arising from traumatic brain injury was proved by our previous study. This study was aim to obtain the evidence of other changes. Methods Three hundred and ten patients with neuropsychiatric disorders arising from traumatic brain injury were treated twice with hyperbaric oxygen. Cerebral single photon emissions computed tomography （SPECT） images and computed tomography scans （CT） before and after hyperbaric oxygen treatment, were compared. Results Before treatment, the proportion of abnormal cerebral changes detected by SPECT was 81.3% but only 15.2% by CT. After HBO treatment, 70.3% of SPECT scans showed no abnormalities and these patients were clinically improved. Treatment improved regional cerebral blood flow. Conclusion SPECT was much more sensitive than CT in the diagnosis of neuropsychiatric disorders following hyperbaric oxygen treatment of neuropsychiatric disorders arising from traumatic brain injury.展开更多
基金supported by grants from the STI2030-Major Projects(2021ZD0204000)the Key Strategic Science and Technology Cooperation Project(2023YFE0206800)+1 种基金the Ministry of Science and Technology of China,the National Natural Science Foundation of China(31820103005,32170976,32100791,and 81971874),Zhejiang Province Natural Science Foundation of China(LZ24C090003 and LY21C090003)the Peak Discipline Cultivation Program of Zhejiang University School of Basic Medicine.
文摘Dear Editor,In recent years,there has been an increasing focus on the non-motor functions of the cerebellum[1,2].Clinical observations have demonstrated that individuals with cerebellar damage exhibit affective insensitivity,executive dysfunction,spatial cognitive impairment,personality changes,and speech difficulties,collectively known as cerebellar cognitive affective syndrome[3].Furthermore,cerebellar dysfunction has been implicated in various neurological disorders such as autism spectrum disorder,obsessive-compulsive disorder,and attention-deficit/hyperactivity disorder[4].
基金Project supported by the National High-Tech R&D Program(863)of China(No.2012AA020408)the Medical and Health General Research Plan of Zhejiang Province(No.2014KYA103),China
文摘Objective： The aim of our meta-analysis was to assess the effects of antiepileptic drugs on bone mineral density and bone metabolism in epileptic children. Methods： Searches of Pub Med and Web of Science were undertaken to identify studies evaluating the association between antiepileptic drugs and bone mineral density and bone metabolism. Results： A total of 22 studies with 1492 subjects were included in our research. We identified：（1） a reduction in bone mineral density at lumbar spine（standardized mean difference（SMD）=-0.30, 95% confidence interval（CI） [-0.61,-0.05]）, trochanter（mean difference（MD）=-0.07, 95% CI [-0.10,-0.05]）, femoral neck（MD=-0.05, 95% CI [-0.09,-0.02]）, and total body bone mineral density（MD=-0.33, 95% CI [-0.51,-0.15]）;（2） a reduction in 25-hydroxyvitamin D（MD=-3.37, 95% CI [-5.94,-0.80]） and an increase in serum alkaline phosphatase（SMD=0.71, 95% CI [0.38, 1.05]）;（3） no significant changes in serum parathyroid hormone, calcium, or phosphorus. Conclusions： Our meta-analysis suggests that treatment with antiepileptic drugs may be associated with decreased bone mineral density in epileptic children.
文摘Group 1 metabotropic glutamate receptors(Gp1 mGluRs),comprising mGluR1 and mGluR5,are predominantly located at postsynaptic terminals.Gp1 mGluRs induce the activation of phospholipase C-γ.
文摘Dear editor,Pupillary abnormalities, i.e., mydriasis, pupillary arefl exia, and/or anisocoria, may indicate the occurrence of acute clinical events in intensive care units (ICUs),which are particularly seen in severe patients with brain and/or cervical spinal cord injury. The pathophysiology of benign episodic mydriasis is still not completely clear. We present a patient with severe burns presented with temporary alternating bilateral pupil enlargement accompanied by paroxysmal increases in respiration,heart rate, and blood pressure.
文摘脓毒症是一种由感染引起的异质性疾病,感染触发了一系列复杂的局部或者全身的免疫炎症反应,引起多器官功能衰竭,发病率和病死率显著升高。由于至今仍然没有诊断脓毒症的金标准,所以脓毒症的临床诊断仍是一个难题。因此,脓毒症的临床诊断需要不断改变来满足临床和研究的要求。然而,尽管有许多新型的生物标记和筛选工具去预测脓毒症发生的风险,但是这些措施的诊断价值和有效性不足以让人满意,并且没有充分的证据去建议临床使用这些新技术。因此,脓毒症的临床诊断标准需要定期更新去适应不断产生的新证据。这篇综述旨在呈现当前脓毒症的诊断和早期识别方面的最新研究证据。临床运用不同的诊断方法的推荐意见依赖于推荐、评价、发展和评估分级体系(Grades of Recommendation Assessment,Development and Evaluation,GRADE),因为大部分的研究是观察性研究,并没有对这些方法进行可靠评估,采用的是两步推理方法。未来需要更多研究来确认或者反驳某一特殊的指标检测,同时应该直接采用相关病人的结果数据。
文摘Background Improvement of clinical symptoms following hyperbaric oxygen （HBO） treatment of neuropsychiatric disorders arising from traumatic brain injury was proved by our previous study. This study was aim to obtain the evidence of other changes. Methods Three hundred and ten patients with neuropsychiatric disorders arising from traumatic brain injury were treated twice with hyperbaric oxygen. Cerebral single photon emissions computed tomography （SPECT） images and computed tomography scans （CT） before and after hyperbaric oxygen treatment, were compared. Results Before treatment, the proportion of abnormal cerebral changes detected by SPECT was 81.3% but only 15.2% by CT. After HBO treatment, 70.3% of SPECT scans showed no abnormalities and these patients were clinically improved. Treatment improved regional cerebral blood flow. Conclusion SPECT was much more sensitive than CT in the diagnosis of neuropsychiatric disorders following hyperbaric oxygen treatment of neuropsychiatric disorders arising from traumatic brain injury.
