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Clinical observation of physiological and psychological reactions to electric stimulation of the amygdaloid nucleus and the nucleus accumbens in heroin addicts after detoxification

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Chinese Medical Journal 2012年第1期125卷 63-66页

作者： FANG Jun GU Jian-wen YANG Wen-tao QIN Xue-ying HU Yong-hua Department of epidemiology and Biostatistics School of Public Health Peking University Beijing 100191 China Department of Neurosurgery General Hospital of the Chinese People＇s Liberation Army Chengdu Military District Chengdu 610083 Sichuan China

Background Stereotactic surgery has been used to treat heroin abstinence in China since 2000 by ablating the amygdaloid nucleus （AMY） and the nucleus accumbens （NAc）,which also provides opportunity to identify the relationship between these nuclei and *** study aimed to explore the physiological and psychological effects of electrically stimulating the AMY and the NAc in herein addicts after detoxification by observing changes of heart rate,arterial pressure and occurrence of euphoria similar to heroin induced *** A total of 70 heroin addicts after detoxification were recruited,and 61 of them were eligible to be given stereotactic surgery for heroin *** operation was carried out after determining the coordinates of all target nucleuses,and stimulation was performed at the AMY and the NAc solely or *** rate,arterial pressure and occurrence of euphoria similar to heroin induced euphoria were recorded and *** The average heat rate was （66±10） beats/min before electric stimulation,and significantly increased to （84±14） beats/min during stimulation,and changed to （73±12） beats/min 10 minutes after *** was a significant elevation of the average arterial pressure from 83 mmHg before stimulation to 98 mmHg during the stimulation,and it then decreased to 90 mmHg after ***-three of the 61 patients showed intense euphoria similar to heroin induced *** largest number （118/186） of euphoric responses occurred when the AMY and the NAc were stimulated at the same *** ratio was 5.4 （95% CI： 2.4-11.9,P 〈0.0001） to quantify the *** from a Logistic regression model showed a positive correlation between unilateral stimulation of either the AMY or NAC and induction of euphoria （OR 〉1 ）,especially when the left AMY or left NAc was stimulated （P 〈0.05）.Conclusions Our data are consistent with existing results that the AMY and the NAc are related to *** roles i

关键词： the amygdaloid nucleus the nucleus accumbens heroin dependence electric stimulation

Limited Knowledge of Safe Driving Practice among Drivers with Diabetes in Armenia: Association with Greater Risk of Motor Vehicle Accidents

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Journal of Diabetes Mellitus 2019年第1期9卷 14-23页

作者： Lilit Petrosyan Zhanna Ghazaryan Greta Muradyan Elena Aghajanova Marek Brabece Denisa Janickova Zdarska Katarina Halciakova Jan Polak Brian MFrier Jan Broz N8 Policlinic Yerevan State Medical UniversityYerevanArmenia “SourbAstvatsamayr”Medical Centers YerevanArmenia Armenian-American Wellness Center YerevanArmenia Department of Endocrinology Yerevan State Medical University“Muratsan”University HospitalYerevanArmenia Institute of Computer Science The Czech Academy of SciencesPragueCzech Republic Czech Institute of Informatics Roboticsand CyberneticsCzech Technical University in PraguePragueCzech Republic Department of Internal Medicine Second Medical Faculty of Charles UniversityPragueCzech Republic Department for the Study of Obesity and Diabetes Third Medical Faculty of Charles UniversityPragueCzech Republic british heart foundation Centre for cardiovascular Science The Queen’s Medical Research InstituteUniversity of EdinburghEdinburghUK

Aims: The aims of the study were to assess the degree of knowledge and adherence to the recommended safe practice for driving and the risk of road traffic accidents among people with diabetes mellitus in Armenia. Methods: A total of 628 respondents, including 200 drivers, out of 641 consecutive attendees at six diabetes clinics, participated in the survey. A modified british questionnaire on driving and diabetes was used to obtain the relevant data. The information from all 103 drivers treated with insulin and 73 taking sulfonylureas was reviewed. Results: The study revealed that of 176 insulin and sulfonylurea-treated drivers, 161 (91.5%) had never received any advice about safe driving practices. Among the drivers, 156 (88.6%) never measured their blood glucose before, or during driving. The survey revealed that 86 (51.2%) of 168 patients had a history of at least one motor vehicle accident within the previous 5 years. The average road traffic accident rate per person/year was 0.21. Conclusions: The study revealed a lack of knowledge among drivers with diabetes treated with insulin or sulfonylureas concerning recommended safe practices for driving. This was associated with significant hypoglycemia while driving and an elevated rate of road traffic accidents.

关键词： Driving Hypoglycemia Road Traffic Accident

Clustering of cardiovascular Risk Factors and Diabetes： A Prospective Cohort Study on the Inner Mongolian Population in China

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Biomedical and Environmental Sciences 2018年第10期31卷 749-756页

作者： WANG Ting Ting LIN Bo CUI Wen Xiu ZHANG Ming Zhi ZHANG Yong Hong ZHANG Shao Yan Department of epidemiology School of Public Health andJiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Medical College of Soochow University Suzhou 215123 Jiangsu China Harbin Center for Disease Control and Prevention Harbin 150000 Heilongjiang China

Objective To evaluate the effect of clustering of cardiovascular risk factors（CVRFs） on type 2 diabetes mellitus（T2 DM） incidence and identify some high predictive clusters in the Inner Mongolian population in China. Methods A total of 1,884 Mongolian individuals aged 20 years or above were followed up from 2002 to 2013 and included in the final analysis. We categorized the participants into two subgroups according to the study outcome event. A Cox proportional hazards model was used to evaluate the effect of clustering of CVRFs on the incidence of T2 DM. Areas under the curve were used to compare the effect of every cluster on T2 DM and identify those having higher predictive value. Results We found 203 persons with T2 DM. Subjects with incident T2 DM tended to be older, had a higher prevalence of drinking, had higher systolic and diastolic pressures; total cholesterol, triglyceride, low-density lipoprotein cholesterol, and C-reactive protein levels; waist circumference; body mass index; and heart rate and lower HDL-C level than did those without T2 DM. The multivariable adjusted hazard ratio（95% confidence interval） of T2 DM was calculated based on comparisons with subjects with 0 CVRFs; in participants with 2 and ≥ 3 factors, the adjusted hazard ratios were 2.257（1.448, 3.518） and 3.316（2.119, 5.188）, respectively. Conclusion The clustering of CVRFs increased the risk of T2 DM. On the basis of fast heart rate, the cluster of abdominal obesity and other CVRFs had higher predictive value for T2 DM than the other three CVRF clusters.

关键词： Type 2 diabetes cardiovascular risk factors Abdominal obesity heart rate

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成人高血压:NICE指南更新概要

英国医学杂志中文版 2020年第4期23卷 225-231页

作者： Rebecca J Boffa Margaret Constanti Christopher N Floyd Anthony S Wierzbicki 杨靓(译) 刘靖(校) National Guideline Centre LondonUK Department of Clinical Pharmacology King's College London British Heart Foundation CentreLondonUK Biomedical Research Centre Clinical Research FacilityGuy's and St Thomas'NHS Foundation TrustLondonUK Guy’s&St Thomas'NHS foundation Trust LondonUK 北京大学人民医院急诊科

高血压是全球发病率和死亡率的首位原因。超过25%的英国成年人患有高血压,其中有近30%患者的血压未得到控制。8月,英国国家健康与临床优选研究所(NICE)发表了更新的高血压诊疗指南。指南回顾了自2011年更新指南以来有关启动、监测及降... 详细信息

高血压是全球发病率和死亡率的首位原因。超过25%的英国成年人患有高血压,其中有近30%患者的血压未得到控制。8月,英国国家健康与临床优选研究所(NICE)发表了更新的高血压诊疗指南。指南回顾了自2011年更新指南以来有关启动、监测及降压治疗内容,选择新的随机临床试验证据。更新指南的内容有所增加,纳人了合并2型糖尿病的患者,但对合并慢性肾脏疾病、心血管疾病或妊娠期高血压未给予推荐(译者注:这些部分有专业指南)。

关键词：慢性肾脏疾病随机临床试验妊娠期高血压降压治疗心血管疾病诊疗指南成年人

Association of psychological risk factors and acute myocardial infarction in China： the INTER-heart China study

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Chinese Medical Journal 2011年第14期124卷 2083-2088页

作者： XU Tao LI Wei Koon Teo WANG Xing-yu LIU Li-sheng Salim Yusuf cardiovascular Institute & Fuwai Hospital Chinese Academy of Medical Sciences & Peking Union Medical CollegeBeijing 100037China The Population Health Research Institute and McMaster University Hamilton ONCanada Beijing Hypertension League Institute Beijing 100037 China

Background Most data about psychological factors relating to acute myocardial infarction （AMI） were obtained from studies carried out in western countries. Results from small descriptive cross-sectional studies in China were inconclusive. The aim of this study was to explore possible associations between psychological risk factors and AMI among the Chinese population with a large-scale case-control *** This study was part of the INTER-heart China study, itself part of the large international INTER-heart study of cardiovascular risk factors. In this case-control study, 2909 cases and 2947 controls were recruited from 17 *** stress, negative life events, depression and controllability of life circumstances were *** Cases reported more psychological stress at home or work and odds ratios （ORs） were 3.2 （95% CI 2.1-4.9）for permanent stress and 2.1 （95% CI 1.5-2.8） for several periods of stress respectively. More cases experienced depression compared with controls （19.6% vs. 9.3%） and ORs were 2.2 （95% CI 1.9-2.6）. Subjects with 1, 2 and 3 or more depressive symptoms had increased risk of AMI by 2.1, 2.2 and 2.6 fold, respectively, i.e., more depressive symptoms were associated with higher risks of AMI （P for trend ＜0.0001）. Women had a greater risk of AMI from depression （OR 3.0, 95% CI 2.2-4.0） compared to men （OR 2.0, 95% CI 1.6-2.4）, P for interaction =0.0364. Negative life events in subjects were associated with increased risk of AMI, OR 1.7 （95% CI 1.4-2.0） for one event and 1.8 （95% CI 1.3-2.4） for two or more events. High levels of controllability of life circumstances reduced the risk for AMI （OR 0.8, 95%CI 0.7-1 .0）.Conclusions Several psychological factors were closely associated with increased AMI risk among Chinese *** stress had a greater AMI risk in men but depression was more significant among women.

关键词： acute myocardial infarction psychological factors stress depression negative life event China

Association of mineral and bone biomarkers with adverse cardiovascular outcomes and mortality in the German Chronic Kidney Disease(GCKD)cohort

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Bone Research 2023年第4期11卷 764-771页

作者： Katharina Charlotte Reimer Jennifer Nadal Heike Meiselbach Matthias Schmid Ulla T.Schultheiss Fruzsina Kotsis Helena Stockmann Nele Friedrich Matthias Nauck Vera Krane Kai-Uwe Eckardt Markus P.Schneider Rafael Kramann Jürgen Floege Turgay Saritas Department of Nephrology Rheumatologyand Clinical ImmunologyUniversity Hospital RWTH AachenAachenGermany Institute of Experimental Medicine and Systems Biology RWTH Aachen UniversityAachenGermany Institute for Cell and Tumor Biology RWTH Aachen UniversityAachenGermany Institute of Medical Biometry Informatics and EpidemiologyUniversity Hospital of BonnBonnGermany Department of Nephrology and Hypertension University of Erlangen-NürnbergErlangenGermany Institute of Genetic epidemiology Faculty of Medicine and Medical Center-University of FreiburgFreiburgGermany Department of Medicine IV-Nephrology and Primary Care Faculty of Medicine and Medical Center-University of FreiburgFreiburgGermany Department of Nephrology and Medical Intensive Care Charité-Universitätsmedizin BerlinBerlinGermany Department of Nephrology University Medical Center RegensburgRegensburgGermany Institute of Clinical Chemistry and Laboratory Medicine University Medicine GreifswaldGreifswaldGermany DZHK(German Centre for cardiovascular Research) Partner Site GreifswaldUniversity MedicineGreifswaldGermany Department of Medicine I Division of NephrologyUniversity Hospital WürzburgWürzburgGermany

Mineral and bone disorder(MBD)in chronic kidney disease(CKD)is tightly linked to cardiovascular disease(CVD).In this study,we aimed to compare the prognostic value of nine MBD biomarkers to determine those associated best with adverse cardiovascular(CV)outcomes and *** 5217 participants of the German CKD(GCKD)study enrolled with an estimated glomerular filtration rate(eG FR)between 30–60 mL·min-1 per 1.73 m2 or overt proteinuria,serum osteoprotegerin(OPG),C-terminal fibroblast growth factor-23(FGF23),intact parathyroid hormone(iP TH),bone alkaline phosphatase(BAP),cross-linked C-telopeptide of type 1 collagen(CTX1),procollagen 1intact N-terminal propeptide(P1NP),phosphate,calcium,and 25-OH vitamin D were measured at *** with missing values among these parameters(n=971)were excluded,leaving a total of 4246 participants for *** a median follow-up of6.5 years,387 non-CV deaths,173 CV deaths,645 nonfatal major adverse CV events(MACEs)and 368 hospitalizations for congestive heart failure(CHF)were *** and FGF23 were associated with all outcomes,with the highest hazard ratios(HRs)for *** the final Cox regression model,adjusted for CV risk factors,including kidney function and all other investigated biomarkers,each standard deviation increase in OPG was associated with non-CV death(HR 1.76,95%CI:1.35–2.30),CV death(HR 2.18,95%CI:1.50–3.16),MACE(HR 1.38,95%CI:1.12–1.71)and hospitalization for CHF(HR 2.05,95%CI:1.56–2.69).Out of the nine biomarkers examined,stratification based on serum OPG best identified the CKD patients who were at the highest risk for any adverse CV outcome and mortality.

关键词： Kidney cardiovascular vitamin

Clinical management of cerebral small vessel disease:a call for a holistic approach

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Chinese Medical Journal 2021年第2期134卷 127-142页

作者： Una Clancy Jason P.Appleton Carmen Arteaga Fergus N.Doubal Philip M.Bath Joanna M.Wardlaw Centre for Clinical Brain Sciences and UK Dementia Research InstituteUniversity of EdinburghChancellor's Building49 Little France CrescentEdinburghEH164SPUK Stroke Trials unit Division of Clinical NeuroscienceUniversity of NottinghamNottingham NG51PBUK Stroke University Hospitals Birmingham NHS Foundation TrustMindelsohn WayEdgbastonBirmingham B152GWUK Stroke Nottingham University Hospitals NHS TrustNottingham NG51PBUK.

Cerebral small vessel disease(SVD)is a common global brain disease that causes cognitive impairment,ischemic or hemorrhagic stroke,problems with mobility,and neuropsychiatric *** brain damage,seen as focal white and deep grey matter lesions on brain magnetic resonance imaging(MRI)or computed tomography(CT),typically accumulates"covertly"and may reach an advanced state before being detected incidentally on brain scanning or causing *** have typically presented to different clinical services or been recruited into research focused on one clinical manifestation,perhaps explaining a lack of awareness,until recently,of the full range and complexity of *** this review,we discuss the varied clinical presentations,established and emerging risk factors,relationship to SVD features on MRI or CT,and the current state of knowledge on the effectiveness of a wide range of pharmacological and lifestyle *** core message is that effective assessment and clinical management of patients with SVD,as well as future advances in diagnosis,care,and treatment,will require a more"joined-up"’*** approach should integrate clinical expertise in stroke neurology,cognitive,and physical *** requires more clinical trials in order to improve pharmacological interventions,lifestyle and dietary modifications.A deeper understanding of the pathophysiology of SVD is required to steer the identification of novel *** essential prerequisite to accelerating clinical trials is to improve the consistency,and standardization of clinical,cognitive and neuroimaging endpoints.

关键词： Dementia Magnetic resonance imaging Mild cognitive impairment Risk factors Small vessel disease Stroke Symptoms Treatment

The clinical differentiation of blood culture-positive and -negative sepsis in burn patients: a retrospective cohort stu

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Burns & Trauma 2023年第1期11卷 627-638页

作者： Jaechul Yoon Dohern Kym Jun Hur Jongsoo Park Myongjin Kim Yong Suk Cho Wook Chun Dogeon Yoon Department of Surgery and Critical Care Burn CenterHangang Sacred Heart HospitalHallym University Medical Center12Beodeunaru-ro 7-gilYoungdeungpo-guSeoul 07247Korea Graduate school of Medicine Kanwon National University1Kangwondaehak-gilChuncheon-siGangwon-doRepublic of Korea Burn Institutes Hangang Sacred Heart HospitalHallym University Medical Center12Beodeunaru-ro 7-gilYoungdeungpo-guSeoul 07247Korea

Background:Sepsis is a potentially life-threatening condition that occurs when the body’s response to infection leads to widespread inflammation and tissue *** cultures can make it difficult for clinicians to make a diagnosis and may raise questions about the validity of the definition of *** addition,the clinical distinctions between burn patients with blood culturepositive and-negative sepsis are also poorly ***,this study aimed to examine the clinical differences between blood culture-positive and-negative sepsis in burn patients in order to improve the understanding of the pathophysiology and epidemiology of sepsis in this ***:This study had a retrospective design,and the participants were adults aged≥18 *** diagnosed with sepsis were divided into two groups based on their blood culture results within 1 week of sepsis ***:We enrolled 1643 patients admitted to our institution’s burn intensive care unit between January 2010 and December ***,platelet count,bicarbonate and haematocrit were significant in both the positive and negative ***,lymphocyte,red cell distribution width and blood urea nitrogen were significant only in the positive group,whereas lactate dehydrogenase was significant only in the negative *** baumannii,Pseudomonas aeruginosa,and Klebsiella pneumonia are common gram-negative bacterial species,and Staphylococcus aureus and Staphylococcus epidermidis are common gram-positive bacterial species seen in burn patients with positive blood *** resistance was found to be associated with an unfavourable prognosis in gram-negative bacteria,with the exception of ***:pH,platelet count,bicarbonate and haematocrit were routine biomarkers that demon-strated statistical significance in both *** dehydrogenase was significant in the blood-negative group,while red cell distribution width,blood urea nitrogen and lym

关键词： Sepsis Blood culture Longitudinal Resistance Antibiotics k-Means clustering

History and present status of pulmonary metastasectomy in colorectal cancer

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World Journal of Gastroenterology 2014年第40期20卷 14517-14526页

作者： Tom Treasure Miel Miloevi Francesca Fiorentino Joachim Pfannschmidt Clinical Operational Research unit University College London London WC1E 6BT United Kingdom Clinic for Thoracic Surgery Institute for Pul-monary Diseases of Vojvodina University of Novi Sad Novi Sad 402920 Serbia Department of Cardiothoracic Surgery National Heart and Lung Institute Imperial College London W12 0NN United Kingdom HELIOS Klinikum Emil von Behring Lungenklinik Heckeshorn 14165 Berlin Germany

Clinical practice with respect to metastatic colorectal cancer differs from the other two most common cancers,breast and lung,in that routine surveillance is recommended with the specific intent of detecting liver and lung metastases and undertaking liver and lung resections for their *** trace the history of this approach to colorectal cancer by reviewing evidence for effectiveness from the 1950s to the present *** sources included published citation network analyses,the documented proposal for randomised trials,large systematic reviews,and meta-analysis of observational *** present consensus position has been adopted on the basis of a large number of observational studies but the randomised trials proposed in the 1980s and 1990s were either not done,or having been done,were not *** opinion is the mainstay of current practice but in the absence of randomised trials there remains a possibility of selection *** controlled trials(RCTs)are now routine before adoption of a new practice but RCTs are harder to run in evaluation of already established *** such trial is recruiting and shows that controlled trial are possible.

关键词： Colorectal cancer Metastasectomy Liver resection Pulmonary metastasectomy Oligometastatic state