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世界核心医学期刊文摘（神经病学分册） 2006年第6期2卷 31-32页

作者： Tiberio M. Chard d.T. Altmann d.R. d.h. miller 周永 NMR Research Group Institute of Neurology Queen Square London WC1N 3BG United Kingdom Prof.

Previous in vivo proton magnetic resonance spectroscopic imaging ( 1h-MRSI) studies have found reduced levels of N-acetyl-aspartate (NAA) in multiple sclerosis (MS) lesions, the surrounding normal-appearing white matter (NAWM) and cortical grey matter (CGM), suggesting neuronal and axonal dysfunction and loss. Other metabolites, such as myoinositol (Ins), creatine (Cr), choline (Cho), and glutamate plus glutamine (Glx), can also be quantified by 1h-MRSI, and studies have indicated that concentrations of these metabolites may also be altered in MS. Relatively little is known about the time course of such metabolite changes. This preliminary study aimed to characterise changes in total NAA (tNAA, the sum of NAA and N-acetyl-aspartyl-glutamate), Cr, Cho, Ins and Glx concentrations in NAWM and in CGM, and their relationship with clinical outcome, in subjects with clinically early relapsing-remitting MS (RRMS). Twenty RRMS subjects and 10 healthy control subjects underwent 1h-MRSI examinations yearly for two years. Using the LCModel, tNAA, Cr, Cho, Ins and Glx concentrations were estimated both in NAWM and CGM. At baseline, the concentration of tNAA was significantly reduced in the NAWM of the MS patients compared to the control group (-7 %, p = 0.003), as well as in the CGM (-8.7 %, p = 0.009). NAWM tNAA concentrations tended to recover from baseline, but otherwise tissue metabolite profiles did not significantly change in the MS subjects, or relatively between MS and.h.althy control subjects. While neuronal and axonal damage is apparent from the early clinical stages of MS, this study suggests that initially it may be partly reversible. Compared with other MR imaging measures, serial 1h-MRSI maybe relatively less sen sitive to progressive pathological tissue changes in early RRMS.

关键词：缓解型多发性硬化症早期复发患者随访研究代谢改变质子磁共振波谱成像代谢产物谷氨酸盐

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复发-缓解型多发性硬化症早期表面正常灰质和白质磁化传递率(MTR)异常的增加

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世界核心医学期刊文摘(神经病学分册) 2006年第1期 18-19页

作者： davies G.R. Altmann d.R. hadjiprocopis A. d.h. miller 袁海峰 NMR Research Unit Institute of Neurology University College London Queen Square London WC1N 3BG United Kingdom Prof.

Abnormalities within normal-appearing grey and white matter (NAGM and NAWM) occur early in the clinical course of multiple sclerosis (MS) and can be detected in-vivo using the magnetisation transfer ratio (MTR). To better characterize the rates of change in both tissues and to ascertain when such changes begin, we serially studied a cohort of minimally disabled, early relapsing-remitting MS patients, using NAGM and NAWM MTR histograms. Twenty-three patients with clinically definite early relapsing-remitting MS (mean disease duration at baseline 1.9 years), and 19 healthy controls were studied. A magnetisation transfer imaging sequence was acquired yearly for two years. Twenty-one patients and 10 controls completed followup. NAWM and NAGM MTR histograms were derived and mean MTR calculated. A hierarchical regression analysis, adjusting for brain parenchymal fraction,was used to assess MTR change over time. MS NAWM and NAGM MTR were significantly reduced in comparison with controls at baseline and, in patients, both measures decreased further during follow-up: (-0.10pu/year, p = 0.001 and -0.18pu/year, p he rate of MTR decrease was significantly greater in NAGM than NAWM (p = 0.004). Under the assumption that such changes are linear, backward extrapolation of the observed rates of change suggested that NAWM abnormality began before symptom onset. We conclude that increasing MTR abnormalities in NAWM and NAGM are observed early in the course of relapsing-remitting MS. It is now important to investigate whether these measures are predictive of future disability, and consequently, whether MTR could be used as a surrogate marker in therapeutic trials.

关键词：白质磁化传递率髓质灰质 MTR

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视神经炎后的视皮质选择性磁化传递率降低

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世界核心医学期刊文摘（眼科学分册） 2006年第8期2卷 2-3页

作者： Audoin B. Fernando K.T.M. Swanton J.K. d.h. miller 张磊 NMR Research Unit Department of Neuroinflammation Institute of Neurology Queen Square London WC1N 3BG United Kingdom Prof.

Patients with clinically isolated syndromes suggestive of multiple sclerosis have evidence for abnormality in normal appearing grey matter detected using the magnetization transfer ratio (MTR), a quantitative MRI measure. One potential mechanism for the decreased grey matter MTR (GM MTR) observed is trans-synaptic morphological abnormality secondary to demyelinating lesions that are in an anatomically linked pathway but remote location. We investigated this potential association by studying the location of abnormalities using voxel-based analysis of GM MTR maps in a group of 80 patients studied within 6 months of presenting with isolated optic neuritis and compared the findings with those seen in 50 age-and sex-matched.h.althy controls. Occipital cortex and whole brain analysis comparing all optic neuritis patients and controls revealed a selective decrease of MTR bilaterally in the visual cortex in patients [Brodmann area (BA) 17]. Whole brain analysis of patients fulfilling the Mcdonald criteria for multiple sclerosis (n=20) showed a lower MTR compared to controls bilaterally in the visual cortex (BA 17/18), left hippocampus, bilateral superior temporal gyrus, bilateral lenticular nuclei and the right cerebellum. There was no significant difference in the percentage of grey matter between patients and controls in the regions of abnormal MTR detected in the visual cortex. The intrinsic MTR decrease seen in patients suggests that there are structural changes in the visual cortex following an attack of optic neuritis. Potential mechanisms for this include trans-synaptic neuronal degeneration and cortical synaptic morphological changes; such abnormalities may also contribute to MTR abnormalities observed in the normal appearing grey matter in multiple sclerosis.

关键词：视神经炎磁化传递率脱髓鞘病变多发性硬化右侧小脑颞上回形态学异常豆状核性别匹配潜在机

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早期RRMS灰质和白质体积改变的一项2年纵向研究

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世界核心医学期刊文摘（神经病学分册） 2005年第9期1卷 47-47页

作者： Tiberio M. Chard d.T. Altmann d.R.etal. d.h. miller 周永 NMR Research Group Institute of Neurology Queen Square London WC1N 3BG United KingdomProf.

Background: Brain atrophy, in excess of that seen with normal aging, has been observed early in the clinical course of relapsing-remitting multiple sclerosis (RRMS). Previous work has suggested that at this stage of the disease, gray mat ter (GM) atrophy progresses more rapidly than the white matter (WM) atrophy. Obj ectives: To characterize the evolution of GM and WM volumes over 2 years, and th eir associations with lesion loads in a cohort of patients with clinically early RRMS. Methods: Twenty-one patients with RRMS (mean age 37.5 years, mean diseas e duration from symptom onset 2.1 years) and 10 healthy control subjects (mean a ge 37.1 years)-were studied. Tissue volumes, as fractions of total intracranial volumes, were estimated at baseline and 1-and 2-year follow-up. Brain parenc hymal fractions (BPF), GM fractions (GMF), and WM fractions (WMF) were estimated . In subjects with MS, brain lesion loads were determined on conventional T2-we ighted along with pre-and post-gadolinium (Gd) enhanced T1-weighted images at each timepoint. Results: A decrease in GMF was observed in subjects with MS vs normal controls over the 2 years of the study (mean -2.1%vs -1.0%, p=0.044), while no change was seen in WMF over the same period (mean -0.09%vs +0.09%, p=0.812). however, when the MS cohort was divided in half, dependent upon chang e in Gd-enhancing lesion load over 2 years (n=20), a decrease in WMF was seen i n the group (n=10) with the largest decline in Gd volume, whereas WMF increased in the other half (n=10) concurrent with a net increase in volume of Gd-enhanci ng lesions (difference between groups: p=0.034). Conclusions: Increasing gray ma tter but not white matter (WM) atrophy was observed early in the clinical course of relapsing-remitting multiple sclerosis. Fluctuations in inflammatory WM les ions appear to be related to volume changes in WM over this time period.

关键词：纵向研究 RRMS 临床病程加权成像正常老化脑萎缩加权和随访研究净增加

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临床孤立综合征患者多发性硬化症MRI诊断标准的改良

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世界核心医学期刊文摘(神经病学分册) 2006年第11期 33-33页

作者： Swanton J.K Fernando K dalton C.M d.h. miller 郭俊 NMR Research Unit Institute of Neurology Queen Square London WC1N 3BG United Kingdom Prof.

Background: The Mcdonald criteria include MRI evidence for dissemination in space and dissemination in time for the diagnosis of multiple sclerosis in young adult patients who present with clinically isolated syndromes (CIS) typical of the disease. Although a major advance, the criteria have limited sensitivity for making an early diagnosis. Objective: To compare the performance of Mcdonald criteria and modified Mcdonald criteria for dissemination in space and time for assessing the development of clinically definite multiple sclerosis. Methods: Mcdonald criteria were modified using the combination of a less stringent definition for dissemination in space and allowing a new T2 lesion per se after three months as evidence for dissemination in time. Modified and Mcdonald criteria were applied in 90 CIS patients at baseline and at three month follow up scans. Results: Both criteria were highly specific ( > 90%)but the modified criteria were more sensitive (77%v 46%) and more accurate (86%v 73%). Conclusions: These modified criteria should be evaluated in other CIS cohorts.

关键词：临床孤立综合征多发性硬化症 MRI 患者

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伊特鲁利亚人的灵魂英国名作家d.h.劳伦斯的考古游记

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2006年

作者：（英）d.h.劳伦斯何悦敏译

本书是作者到位于意大利中南部古代伊特鲁利亚人的遗址进行的考古游历，进而对伊特鲁利亚文化、宗教信仰和民族特性进行了深刻分析。

ISBN: (数字)7801489713

ISBN: (纸本)7801489713

本书是作者到位于意大利中南部古代伊特鲁利亚人的遗址进行的考古游历，进而对伊特鲁利亚文化、宗教信仰和民族特性进行了深刻分析。

关键词：历史、地理各国文物考古欧洲文物考古

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早期复发-缓解型多发性硬化症患者的持续脊髓萎缩:一项为期3年的研究

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世界核心医学期刊文摘（神经病学分册） 2006年第5期2卷 46-46页

作者： Rashid W davies G.R Chard d.T. d.h. miller 樊慧婷 department of Neuroinflammation Institute of Neurology University College London Queen Square London WC1N 3BG United KingdomProf.

Objectives: Previous studies have shown that upper cervical cord atrophy (UCCA) occurs in multiple sclerosis (MS), particularly in those disabled and with primary or secondary progressive disease. It is less clear how early it can be detected in relapsing-remitting (RR) MS, and whether early cord atrophy relates to the concurrent or future clinical course. Methods: Twenty seven RR MS patients (median disease duration 1.7 years, in all cases d along with 20 controls. They were followed for up to 3 years with a yearly assessment of UCCA and clinical function measured by the Expanded disability Status Scale (EdSS) and MS Functional Composite Score (MSFC). Clinical and MRI correlations were investigated. Statistical models adjusted for covariates including total intracranial volume. Results: Longitudinal analysis showed a significant decrease in UCCA in patients both within the patient cohort (p d in comparison with controls (p = 0.001). There was a significant increase in EdSS (p = 0.008) but no significant change in MSFC. The rate of UCCA loss did not correlate with clinical change or with change in brain volume. Conclusions: In summary, serial UCCA measurement detects the development of spinal cord atrophy in clinically early RR MS.

关键词：缓解型多发性硬化症疾病患者脊髓萎缩早期复发 RRMS 临床病程临床表现评分法发病时间临床功能

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视神经炎导致视皮质的选择性磁化传递率下降

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世界核心医学期刊文摘（神经病学分册） 2006年第9期2卷 40-40页

作者： Audoin B. Fernando K.T.M. Swanton J.K. d.h. miller 张慧 NMR Research Unit Department of Neuroinflammation Institute of Neurology Queen Square London WC1N 3BG United Kingdom Prof.

Patients with clinically isolated syndromes suggestive of multiple sclerosis have evidence for abnormality in normal appearing grey matter detected using the magnetization transfer ratio (MTR), a quantitative MRI measure. One potential mechanism for the decreased grey matter MTR (GM MTR) observed is trans-synaptic morphological abnormality secondary to demyelinating lesions that are in an anatomically linked pathway but remote location. We investigated this potential association by studying the location of abnormalities using voxel-based analysis of GM MTR maps in a group of 80 patients studied within 6 months of presenting with isolated optic neuritis and compared the findings with those seen in 50 age-and sex-matched.h.althy controls. Occipital cortex and whole brain analysis comparing all optic neuritis patients and controls revealed a selective decrease of MTR bilaterally in the visual cortex in patients [Brodmann area (BA) 17]. Whole brain analysis of patients fulfilling the Mcdonald criteria for multiple sclerosis (n = 20) showed a lower MTR compared to controls bilaterally in the visual cortex (BA 17/18), left hippocampus, bilateral superior temporal gyrus, bilateral lenticular nuclei and the right cerebellum. There was no significant difference in the percentage of grey matter between patients and controls in the regions of abnormal MTR detected in the visual cortex. The intrinsic MTR decrease seen in patients suggests that there are structural changes in the visual cortex following an attack of optic neuritis. Potential mechanisms for this include trans-synaptic neuronal degeneration and cortical synaptic morphological changes; such abnormalities may also contribute to MTR abnormalities observed in the normal appearing grey matter in multiple sclerosis.

关键词：视皮质区视神经炎磁化传递多发性硬化症形态学异常 MRI检查正常对照脱髓鞘损伤

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Fractional delay compensated discrete-time SMC for networked control system

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digital Communications and Networks 2017年第2期3卷 112-117页

作者： d.h. Shah A.J. Mehta Gujarat Technological University Gujarat India Institute of Infrastructure Technology Research and Management Gujarat India

Time-varying network induced delay in the communication channel severely affects the performance of closed loop network control systems. In this paper, a novel idea of compensating the fractional time varying communication delay in the sliding Surface is presented. The fractional time delay in the sensor to controller and controller to actuator channel is approximated using the Thiran approximation technique to design the sliding surface. A discrete-time sliding mode control law is derived using the proposed surface that compensates fractional time delay in sensor to controller and controller to actuator channels for uncertain network control systems. The sufficient condition for closed loop stability of the system is derived using the Lyapunov function. The efficacy of the proposed strategy is supported by the simulation results.

关键词： discrete-time sliding mode control Networked control Network delay

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恋爱中的女人

恋爱中的女人

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作者： (英)d.h. 劳伦斯(d.h. Lawrence)

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