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find Author "王群" 28 results
  • 父母及家庭压力因素预测小儿新发癫痫患者的健康相关生活质量

    研究对人口学特征、疾病因素及抗癫痫药物(AEDs)依从性进行校正后,父母及家庭总体和健康相关压力对新发癫痫儿童的纵向通用和癫痫特异性健康相关生活质量(Health-related quality of life, HRQOL)的影响。此项前瞻性纵向研究纳入了124例新发癫痫儿童患者(平均年龄7.2岁, 标准差2.9岁)。患儿父母分别在诊断后1、13、25个月时完成关于父母压力、羞耻感、恐惧和担心以及HRQOL的调查问卷。AEDs的依从性应用电子监测装置进行评估。每次就诊均进行医疗过程回顾以获得发作和药物副作用的数据。高水平的总体及癫痫特异性父母及家庭压力、恐惧和担心以及羞耻感对儿童通用及癫痫特异性HRQOL存在负面影响,大于疾病及人口学因素。总体父母及家庭压力在疾病管理第1年对儿童通用及癫痫特异性HRQOL的影响大于疾病诊断2年后的影响。更大的恐惧和担心对于诊断后13个月更高的癫痫特异性HRQOL有预测作用,而在诊断后2年,更大的恐惧和担心则预示更低的癫痫特异性HRQOL。多个人口学(如年龄)及疾病相关变量(如副作用和AED依从性)影响儿童通用及癫痫特异性HRQOL。尽管一些发现在各项通用及癫痫特异性HRQOL指标中一致,但其它的都是独有的。可改进的父母因素(如总体及疾病特异性父母及家庭压力、羞耻感)对小儿新发癫痫患者诊断后前2年中的HRQOL的影响是不同的。在诊断后第1年内用以改善HRQOL的心理社会干预应当解决父母和家庭压力、总体应对和癫痫管理的预期指导。针对依从性、羞耻感、恐惧和担心的干预措施可改善HRQOL。推动压力、恐惧/担心和羞耻感的父母管理可改善儿童HRQOL结局。

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  • 生酮饮食治疗癫痫作用机制研究进展

    生酮饮食(Ketogenic diet,KD)是一种高脂肪、低碳水化合物,适量蛋白质、维生素和矿物质的饮食。KD用于治疗癫痫已有很长的历史,其疗效明确但作用机制尚不清楚。基于临床观察和研究,最初人们认为KD的作用机制与脱水、酸中毒相关。近几年,基于越来越多的动物实验和临床研究,人们逐渐提出了更多假说。KD减少了葡萄糖的摄入,机体利用葡萄糖受限,而酮体、脂肪酸升高,这可能与其产生抗癫痫作用相关。此外研究发现,KD的抗癫痫机制可能与神经递质、神经元兴奋性及突触传递有关。KD还有神经保护功能,如抗炎、氧化应激等,这与其抗癫痫作用也有关联。但是上述机制并不明确,目前关于KD的抗癫痫机制仍在探索之中。

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  • 单光子计算机断层减影与核磁共振融合成像术在癫痫致痫灶定位中的应用进展

    癫痫是最常见的慢性脑部疾病之一,其中药物难治性癫痫比例为 20%~30%,目前癫痫手术治疗是难治性癫痫的唯一手段,而术前准确定位致痫病灶则是手术成败的关键。发作期单光子计算机断层减影与核磁共振融合成像术(Subtraction ictal single-photon emission computed tomography coregistered to MRI,SISCOM)作为一种全新的技术为癫痫致痫灶的准确定位翻开了新篇章,它克服了传统单光子发射计算机断层成像术(SPECT)空间分辨率不足的缺点,其成像的敏感性与特异性已被证实较单纯的发作期与发作间期 SPECT 成像增加,特别是对于核磁共振(MRI)阴性和颞叶外的癫痫患者,另外 SISCOM 在预测癫痫术后效果方面也具有独特价值。文章就 SISCOM 技术应用介绍、致痫灶定位的准确性、预测术后效果、基于 SISCOM 的新理念以及未来的发展等方面做一综述。

    Release date:2018-03-20 04:09 Export PDF Favorites Scan
  • Application of Gastric Tube in Minimally Invasive Esophagectomy

    Objective To summarize the experiences of applying gastric tube in minimally invasive esophagectomy (MIE), in order to assess its feasibility and safety. [WTHZ]Methods From June 2004 to August 2009, MIE was performed on 102 patients with esophageal carcinoma, including 71 males and 31 females whose age ranged from 37 to 79 years old with an average age of 61.1. Among them, 62 patients underwent thoracoscopic laparotomy 3-incision esophagectomy, 35 patients underwent thoracoscopic and laparoscopic 3-incision esophagectomy and 5 patients underwent thoracotomy and laparoscopic esophagectomy. Prevertebral reconstruction was performed on 58 patients and retrosternal reconstruction was performed on 44 patients. [WTHZ]Results All operations were performed successfully with a perioperative mortality rate of 2.0%(2/102) and a postoperative complication rate of 41.2%(42/102). The complications included anastomotic leakage, anastomotic stricture and lung infection. The complication rate was higher in the retrosternal group than in the prevertebral group (56.8% vs. 29.3%, Plt;0.05). Anastomotic leakage rate in the retrosternal group was also higher than that in the prevertebral group (34.1% vs. 6.9%, Plt;0.05). There was no significant difference in anastomotic stenosis, gastric fistula, dysfunction of gastric emptying, heart and lung complications, chylothorax and injury of recurrent laryngeal nerve between the two groups. [WTHZ]Conclusion Gastric tube is an effective way for reconstruction of the digestive tract after minimally invasive esophagectomy. The choice of prevertebral reconstruction or retrosternal reconstruction should be based on each individual patient.

    Release date:2016-08-30 06:01 Export PDF Favorites Scan
  • The analysis of two Brain-Derived Neurotrophic Factor polymorphisms G196A and C270T in epilepsy

    ObjectiveTo investigate the relationship between the G196A and C270T polymorphism and epilepsy.MethodsDatabase including PubMed, EMbase, the Cochrane Library, CNKI and Wan fang data were retrieved upto September, 2017 to collect the case-control study concerning BDNF two polymorphisms G196A/C270T and epilepsy. Two reviewers independently screened the literature, extracted the data, and assessed the quality of methodology. Then Meta-analysis was performed using RevMan 5.2 software.Results①A total of 9 studies were included in the Meta-analysis between BDNF G196A and epilepsy. The studies included 1841 epilepsy patients and 6467 healthy control subjects. The G allele increase the risk of epilepsy[OR=1.13, 95%CI (1.06–1.21), P=0.0001]. When stratified by Asian and western subgroup, a similar trend of associated was detected with Asian epilepsy patients [OR=1.13, 95%CI (1.05–1.20), P=0.0004]. When stratified by epilepsy type, the G allele increase the risk of temporal lobe epilepsy [OR=1.18, 95%CI (1.04–1.34), P=0.008]. ② The Meta-analysis between BDNF C270T and epilepsy included 4 studies, 594 epilepsy patients and 738 healthy control subjects. The result suggested the frequency of the CT genotype and of the C270T T allele was not associated with epilepsy.ConclusionsBDNF G196A polymorphism is a susceptibility locus for temporal lobe epilepsy and Asian epilepsy patients.

    Release date:2018-03-20 04:09 Export PDF Favorites Scan
  • 刺激诱发出的脑电异常对重症患者脑功能的临床意义

    刺激诱发出的节律性、周期性或者发作期放电(Stimulus-induced rhythmic,periodic,or ictal discharges,SIRPIDs)是Hirsch等在2004年首次命名的一种脑电现象,在意识障碍或者昏迷患者的长程脑电监测中所得。SIRPIDs机制可能与皮层下-皮层功能异常相关,尤其与丘脑皮层回路功能异常相关。但目前研究对于这一现象的病理生理学机制不甚明确。部分研究认为出现这一脑电现象提示患者预后较差,但从现有研究来看,该异常脑电活动能否引起神经损伤,或者这些异常是否仅仅为脑损伤严重的表现,以及是否需要药物干预治疗,临床中尚无法确定。文章目的是综述现有的文献了解SIRPIDs的概念、病理生理学机制、临床相关性,以及其对于神经重症患者脑功能的提示。

    Release date:2017-09-26 05:09 Export PDF Favorites Scan
  • 经颅直流电刺激治疗癫痫研究进展

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  • 癫痫的发病机制研究

    癫痫是神经系统的常见疾病之一,其发病机制十分复杂,目前尚未完全阐明。近年来关于癫痫发病机制的研究表明,癫痫的发生与离子通道、神经递质、突触连接、神经血管单元以及神经胶质细胞等均存在密切联系。为深入理解癫痫发病机制,为癫痫的诊断、预防与治疗提供必要的理论依据,文章将从以上方面对癫痫发生机制的研究作一综述。

    Release date:2017-04-01 08:51 Export PDF Favorites Scan
  • 颞叶癫痫动物模型

    癫痫是一种神经系统常见疾病,绝大多数癫痫患者可以通过药物控制发作,但是仍有约1/3患者为药物难治性癫痫,在难治性癫痫中绝大多数为颞叶癫痫。对颞叶癫痫动物模型的研究有助于了解其发病机制、脑电改变及病理生理特点,为寻找其治疗方法有一定帮助。现就颞叶癫痫动物模型的制作方法、行为学表现、脑电改变及病理特征进行总结。目前常用颞叶癫痫动物模型有海人酸模型和匹罗卡品模型,两种模型均可以通过系统给药和局部给药方式实现,可以诱发急性癫痫持续状态,之后出现反复自发发作从而形成慢性癫痫模型。两种模型均可引发海马起源的痫样放电,造成海马神经元变性、胶质细胞增生及苔藓纤维出芽,与人类颞叶癫痫相似。

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  • 脑电图检查对自身免疫性脑炎的诊断进展

    对近年自身免疫性脑炎病例研究中脑电图(EEG)的特点进行综述。EEG 对于自身免疫性脑炎的诊断有着高于其他检查的敏感性,常见的异常表现为弥漫性或局灶慢波改变,且近年发现极度 δ 刷为抗 N-甲基-D-天门冬氨酸受体脑炎相对特异性 EEG 改变,有助于对自身免疫性脑炎的诊断。但其他自身免疫性脑炎的 EEG 总结资料相对较少,应进一步进行总结研究。

    Release date:2019-07-15 02:48 Export PDF Favorites Scan
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