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Connecting brain and body:Transdiagnostic relevance of connective tissue variants to neuropsychiatric symptom expression

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World Journal of Psychiatry 2021年第10期11卷 805-820页

作者： Harriet Emma Clare Sharp hugo d critchley Jessica A Eccles department of Medical Neuroscience Brighton and Sussex Medical SchoolUniversity of SussexBrighton BN19PXEast SussexUnited Kingdom department of Psychiatry Sussex Partnership NHS Foundation TrustWorthingBN133EPWest SussexUnited Kingdom

The mind is embodied;thoughts and feelings interact with states of physiological arousal and physical integrity of the *** this context,there is mounting evidence for an association between psychiatric presentations and the expression variant connective tissue,commonly recognised as joint *** hypermobility is common,frequently under-recognised,significantly impacts quality of life,and can exist in isolation or as the hallmark of hypermobility spectrum disorders(encompassing joint hypermobility syndrome and hypermobile Ehlers-danlos syndrome).In this narrative review,we appraise the current evidence linking psychiatric disorders across the lifespan,beginning with the relatively well-established connection with anxiety,to *** next consider emerging associations with affective illnesses,eating disorders,alongside less well researched links with personality disorders,substance misuse and *** then review related findings relevant to neurodevelopmental disorders and stress-sensitive medical *** growing understanding of mind-body interactions,we discuss potential aetiopathogenetic contributions of dysautonomia,aberrant interoceptive processing,immune dysregulation and proprioceptive impairments in the context of psychosocial stressors and genetic *** examine clinical implications of these evolving findings,calling for increased awareness amongst healthcare professionals of the transdiagnostic nature of hypermobility and related disorders.A role for early screening and detection of hypermobility in those presenting with mental health and somatic symptoms is further highlighted,with a view to facilitate preventative approaches alongside longer-term holistic management ***,suggestions are offered for directions of future scientific exploration which may be key to further delineating fundamental mind-body-brain interactions.

关键词： Joint hypermobility Hypermobile Ehlers-danlos syndrome Psychopathology Psychiatric disorders Neurodevelopmental disorders Mind-body relations

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ISRAdIPINE TREATMENT FOR HYPERTENSION IN GENERAL PRACTICE IN HONG KONG

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中华医学杂志(英文版) 1992年第6期105卷 446-450页

作者： Tomlinson J Woo JAJH critchley RTeoh departments of Clinical Pharmacology and Medicine Prince of Wales Hospital Shatin Hong Kong The Chinese University of Hong Kong Sandoz Pharmaceuticals Ltd Hong Kong

A 6-week open study of the introduction ofisradipine treatment was conducted in general practicein Hong Kong.303 Chinese patients with mild to mod-erate hypertension entered the *** effects werereported in 21% of patients and caused withdrawalfrom the study in 3 *** main side-effectswere headache,dizziness,palpitation and flushing andthese were not more frequent than reported in otherstudies with isradipine or with *** bloodpressure was reduced(Pd144±14/87±6 mmHg at 2,4 and 6 weeksrespectively in evaluable *** reductionsoccurred in standing blood pressure and there was noevidence of postural *** andresponder rates at 6 weeks were 86% and 69%*** was increased from 2.5 mg ***5 mg *** 4 weeks in patients with diastolic bloodpressure greater than 90 mmHg and their further re-sponse was greater than those remaining on 2.5 mgb.d.

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A Prospective Survey Comparing Patients’ Experience of a Nurse-Led Clinic and Consultant-Led Clinic for Surveillance of Patients with dilatation of the Intrathoracic Aorta

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World Journal of Cardiovascular Surgery 2019年第2期9卷 24-34页

作者： Bhuvaneswari Krishnamoorthy Rashmi Birla William R. critchley Paul d. Waterworth department of Cardiothoracic Surgery Manchester Foundation NHS Trust Manchester UK division of Cardiovascular Sciences Faculty of Biology Medicine and Health The University of Manchester Manchester UK Faculty of Health and Social Care Edge Hill University Ormskirk UK The Endothelial Cell Biology Unit School of Molecular and Cellular Biology University of Leeds Leeds UK

Background: Increasing workload in consultant-led clinics often means patients to wait a long time for clinic appointments. To address this, there is an increasing trend in developing nurse-led clinics across many specialities in the National Health Service. This study aims to assess whether the implementation of a nurse-led clinic in thoracic aortic surgery will optimise the utilisation of health care services and improve overall patient satisfaction. Methods: 80 follow-up patients were asked to complete a questionnaire following their appointment in an aortic clinic, which was led either by a consultant (n = 40) or an aortic specialist nurse (n = 40). All patients seen by a nurse in the clinic were assessed by a consultant surgeon prior to the clinic for suitability. No new patients were seen by a nurse. Any patient with an aortic dimension of 5 cm or greater was seen by the consultant. If there were any complicated clinical features, the patient was seen in the consultant-led clinic. Patients were asked questions about their time spent with the respective health care professionals across 12 categories (punctuality, preparedness, understanding of concerns, clarity of speech, listening, respect, explaining, letting you talk, putting you at ease, emotional support, advice and advice for next follow-up). Patients rated each category using an ordinal scale from 0 - 10. Results: Patient scores were greater in nurse-led clinics compared to consultant-led clinics across a number of categories although only punctuality reached significance (mean 9.2 vs. 6.8, p 0.05). Conclusion: Patients were highly satisfied with the nurse-led clinic across all categories, with greater satisfaction for punctuality. These findings suggest that a nurse-led clinic can be implemented for the management of carefully selected thoracic aortic surgery patient without reduction in patient satisfaction.

关键词： Nurse-Led Clinic Consultant-Led Clinic Thoracic Aortic Surgery Surveillance Patient Satisfaction

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月经期不适妇女分泌中期和晚期子宫内膜活检组织的基因表达情况

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世界核心医学期刊文摘（妇产科学分册） 2006年第12期2卷 13-14页

作者： critchley H.O.d. Robertson K.A. Forster T. 王淑珍 Centre for Reproductive Biology Queens Medical Research Institute Dr.

Objective:The purpose of this studywas to test whether a quantitative high-throughput molecular screen can be used to probe human endometrium and initiate the development of molecular diagnostic tools with potential for identification of therapeutic targets in women with menstrual complaints. Study design:Endometrium was collected from 10 patients with complaint of heavy bleeding,classified into mid or late secretory phase of the menstrual cycle by histologic dating and serum progesterone concentration. Total RNA was extracted and gene activity assessed using high-density oligonucleotide arrays. Results:Statistical testing identified 83 ‘signature’genes whose expression levels differentiated the mid and late secretory phases of the menstrual cycle. Conclusion:The results show that the endometrium,a complex heterogeneous tissue,is amenable to high-throughput molecular analyses and this work provides further support for the future application of molecular profiling to clinical diagnosis.

关键词：子宫内膜活检月经期基因表达月经周期寡核苷酸阵列血清孕酮人子宫内膜浓度测定分子形态诊

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采用功能脑部成像探讨脊髓损伤的情绪和自主反应后果

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世界核心医学期刊文摘(神经病学分册) 2006年第8期 42-43页

作者： Nicotra A. critchley H.d. Mathias C.J. dolan R.J. 赵天智 Neurovascular Medicine Unit Queen Elizabeth Queen Mother Wing St. Mary's Hospital Praed Street London W2 1NY United Kingdom Dr.

In health, emotions are integrated with autonomic bodily responses. Emotional stimuli elicit changes in somatic (including autonomic) bodily states, which feedback to influence the expression of emotional feelings. In patients with spinal cord injury (SCI), this integration of emotion and bodily arousal is partially disrupted, impairing both efferent generation of sympathetic responses and afferent sensory feedback of visceral state via the spinal cord. A number of theoretical accounts of emotion predict emotional deficits in SCI patients, particularly at the level of emotional feelings, yet evidence for such a deficit is equivocal. We used functional MRI (fMRI) and a basic emotional learning paradigm to investigate the expression of emotion- related brain activity consequent upon SCI. We scanned seven SCI patients and seven healthy controls during an aversive fear conditioning task. Subjects viewed randomized presentations of four angry faces. One of the faces (CS + arm) was associated with delivery of electrical shock to the upper arm on 50% of trials. This shock was painful to all subjects. A face of the same gender acted as a ‘ safe’ control stimulus (CS- arm). In both control subjects and SCI patients, painful cutaneous stimulation of the arm evoked enhanced activity within components of a central pain matrix, including dorsal anterior cingulate, right insula and medial temporal lobe. However, SCI patients differed from controls in conditioning- related brain activity. SCI patients showed a relative enhancement of activity within dorsal anterior cingulate, periaqueductal grey matter (PAG) and superior temporal gyrus. Conversely, SCI patients showed relative attenuation of activity in subgenual cingulate, ventromedial prefrontal and posterior cingulate cortices to threat of painful arm stimulation (CS + arm >CS- arm). Our findings provide evidence for differences in emotion- related brain activity in SCI patients. We suggest that the observed functional abnormal

关键词：脊髓损伤患者反应背侧前扣带回情绪 SCI 功能亚属

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delayed neural damage induced by lightning and electrical injury: neural death, vascular necrosis and demyelination?

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Neural Regeneration Research 2014年第9期9卷 907-908页

作者： Andrew d. Reisner Forensic diagnostic Center of district Nine

The structural damage to vascular endothelial cell In a recent article in the journal Brain Injury, four potential hypotheses for delayed neurological disorders following lightning and electrical injury were suggested （Reisner, 2013）. The phenomenon of delayed neurodegenerative syndromes following lighting and electrical injury has been known since the early 1930s （critchley, 1934）, but to the present day, the mechanisms involved have been poorly un- derstood. An initial and still plausible theory is that the electrical insult causes damage to the vascular structures feeding the spinal cord via damage to vascular endothelial cells （Farrell and Starr, 1968）.

关键词： neural death delayed neural damage induced by lightning and electrical injury

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脑磁共振影像三维结构分析揭示精神分裂症灰质分布异常

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国际医学放射学杂志 2010年第3期 304-304页

作者：张清 B. Ganeshan K.A. Miles R.C.d. Young C.R. Chatwin H.M.d. Gurling H.d. critchley department of Engineering and design University of Sussex

摘要目的利用三维选择性和比对分割的结构分析(TA)方法分析脑磁共振结构影像,定量检测与精神分裂症有关的脑灰质(GM)和

关键词： 3d结构分析结构脑 MRI 精神分裂症 PCM1基因

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