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Objective To explore the correlation between pregnancy-related anxiety and serum 25 (OH)D level during early pregnancy. Methods A radioimmunoassay was used to determine the serum 25 (OH)D levels of 2 122 early pregnant women in Maanshan Maternal and Child Health Care Hospital, from June 2015 to 2016. Data were collected using a questionnaire. Results The mean serum 25(OH)D level was(29.71±32.27)nmol/L.About 15.2% of the subjects had adequate,22.6% had insufficient,45.1% had deficient,and 17.1% had severely deficient serum 25(OH)D levels.The type of housing and testing seasons were significantly associated with the serum 25(OH)D level.Single factor logistic regression analysis results show that pregnancy-related anxiety incidence in the group deficient in 25(OH)D was higher than that in the adequate group, which has a statistically significant difference (P<0.05). After adjusting for the maternal age,BMI,and educational level,multivariate logistic regression analysis results showed that the difference was statistically significant. Conclusion The serum 25(OH)D level in early pregnant women was inadequate. Furthermore, lack of serum 25(OH)D in early pregnancy and pregnancy-related anxiety were negatively correlated.
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Objective To investigate the influence of deep brain stimulation (DBS) at high frequency to the bilateral nucleus accumbens on morphine-induced conditioned place preference (CPP) and relapse behaviors during extinction phase in rats. Methods Twenty adult SD rats were employed in the experiment. Through stereotactic operation, outer electrode cannula was implanted into rats' bilateral nucleus accumbens. After 5 days of rest, the morphine-dependent rat model with CPP was established through intraperitoneal morphine injection (10 mg/kg). The rats, after being randomly divided into experimental group (morphine+DBS) and control group (morphine+sham DBS), were electrically stimulated using DBS circuits. Rats in the experimental group were given high frequency electrical stimulations while the control group was given sham stimulation. The CPP score of the two groups was recorded the day after stimulation until successful extinction and then the extinction time was compared between the two groups. After successful extinction the rats were given small dose of morphine to trigger relapse within 24 hours, and the CPP score was recorded and compared between the two groups.Results Compared with the control group (six days), the experimental group (26 days) had a longer extinction time. After relapse, the retention time within the drug-paired chamber of the experimental group was (357.01±192.72) s, obviously shorter than that of the control group ((704.91±181.35) s;t=2.370, P=0.034 6). Conclusion High frequency DBS to rats' bilateral nucleus accumbens can prolong extinction time but inhibit relapse behavior.
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Objective To investigate the effect of high frequency stimulation of bilateral nucleus accumbens on relapse behaviors in morphine-dependent rats.Methods Twenty adult SD rats were employed in the experiment.Through stereotactic operation,outer electrode cannula was implanted into rats' bilateral nucleus accumbens.After 5 days of rest,the morphine-dependent rat model with conditioned place preference (CCP) was established through intraperitoneal morphine injection (10 mg/kg).After acquisition of CPP,normal saline was replaced with morphine for CPP extinction training.CPP test was used to exam the effect of extinction.The rats,after being randomly divided into experimental group (morphine+DBS) and control group (morphine+sham DBS),were electrically stimulated using modified DBS circuits.Rats in the experimental group were given high frequency electrical stimulation while the control group was sham stimulation.After consecutive stimulation for 7 days,rats in the two groups were given small dose of morphine (3 mg/kg)to trigger relapse.Results (1) The CPP score increased after the establishment of rat models compared with pre-establishment of the rat models((616.2±74.7) s vs (353.9±84.3) s,P＜0.01).(2) The CPP score after extinction training decreased compared with pre-conditioned CPP score ((456.4± 148.8) s vs (353.9±84.3) s),P=0.0847) and had no statistical difference compared with post-conditioned CPP score ((456.4±148.8) s vs (616.2± 74.7) s,P=0.0219).(3) When the relapse was induced by small doses of morphine within 24h after the last stimulation,the CPP score of the experimental group decreased compared with the CPP score of control group ((330.1 ±212.6) s vs (684.2±230.2)s,P=0.0029),and the relapse was restrained.Conclusion High frequency DBS of bilateral nucleus accumbens can attenuate relapse behavior in rats
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Objeetive To follow up the patients with Parkinson's disease (PD) who underwent subthalamic nucleus (STN) deep brain stimulation (DBS) therapy,and to compare the changes of cognitive function before and after this functional surgery.Methods The authors set up a series of clinical tests including unified Parkinson's disease rating scale (UPDRS) Ⅱ & Ⅲ,Hoehn & Yahr stage (H-Y stage),mini mental state examination (MMSE),Wechsler memory scale (WMS),serial reaction time task (SRTT),degraded picture naming (DPN),verbal fluency (VF),clock drawing test (CDT) to measure the performance of both clinical characteristics and cognitions 1 week before and 12 months after STN-DBS operation in 20 PD patients,matched with 20 healthy adults who just assessed by the neuropsychological tests.Results Activity of daily life (UPDRS Ⅱ),motor manifestations (UPDRS Ⅲ) and disease condition (H-Y stage) were all significantly improved whether they were on period or off period (P ＜ 0.01).In the test of WMS,the memory quotient (MQ) scores of PD patients (88.10 ± 16.70) were significantly lower (t =-3.187,P ＜0.01) than the control group (100.90 ± 6.45).By SRTT test,the mean average response time (Tavg) of the control group,pre-operation and post-operation groups was (1.09 ± 0.32) s,(1.58 ± 0.83) s and (1.62 ± 0.83) s,respectively.As to the comparison of the blocks,no changes were found within each group of PD (pro-F =0.329,P =0.964 ; post-F =0.377,P =0.945),by contrast,it had been proved to be statistically significant in the control group (F =2.316,P ＜0.05).The mean error rates of the control group,pre-operation and post-operation groups were 4.84％ ± 4.27％,9.76％ ± 1.52％ and 13.41％ ± 1.11％ respectively,and the control group was not different from pre-operation group (t =1.388,P =0.173) while significantly different compared with post-operation group (t =3.225,P ＜0.01).As for MMSE and DPN results,no significant benefits were obtained in the control,pre-operation and post-operation groups.In regard to VF,there was a statistically significant difference between control group and pre-operation group (Z =-2.927,P ＜ 0.01),and it was significantly worse after surgery (Z =-2.469,P =0.014).As for CDT,significant benefits were obtained in both preoperation (Z =-2.762,P ＜ 0.01) and post-operation groups (Z =-2.165,P =0.03) compared with control group.Conelusions To some extent,STN-DBS can affect the cognition of PD patients,such as lowing VF,improving visual-spatial function and attention,a decreasing trend of implicit memory and executive function.Explicit memory is partly dissociated with implicit memory.文章序号>=10.3760/cma.j.issn.1006-7876.2014.09.005
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Objective To investigate the effects of the expressions of thymidine kinase 1 (TK1) and Ki67 alone or their combination on the recurrence and metastasis of breast cancer.Methods Sixty-five samples were selected from the Second Affiliated Hospital of Guangzhou Medical University from March 2005 to June 2007,which were resected by surgical operation and confirmed as breast carcinoma by pathology.They were individed into two groups including 37 cases with recurrence or metastasis in 5 years (group A),28 cases without recurrence or metastasis in 5 years (group B).The expressions of TK1 and Ki67 in the two groups were detected by immunohistochemical staining assay.Then,Kaplan-Meier assay was used to describe survival curve.Results The positive expression rate of TK1 in group A was 91.8％,which was dramatically higher than that in group B 67.8％ (x2 =6.116,P =0.013).The positive expression rates of Ki67 in group A and B were 78.4％ and 42.9％ (x2 =8.635,P =0.003).The positive expression rates of TK1 combined with Ki67 in group A and B were 67.6％ and 39.3％ (x2 =5.159,P =0.023).Moreover,disease free survival of patients with positive expression of TK1 combined with Ki67 decreased significantly,compared with patients with positive expression of TK1 or Ki67 alone (x2 =6.137,P =0.046).Conclusion Positive expression of TK1 combined with Ki67 is the high risk factor of the reccurence or metastasis of breast carcinoma,and indicates poorer prognosis compared with positive expression alone.
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Objective To explore the use of lamivudine alone induced the poor response,especially the related factors of the occurrence of YMDD.Methods Retrospective analysis of 160 cases of the poor answering cases after lamivudine treatment,the baseline parameter values,the time appearing to the poor answering and the HBVDNA load in treatment were analyzed,to study their relationship with poor response.Results The lamivudine prolonged,the poor response to the probability gradually increase.The mutation rate in the 12nd month was 19.67％ and in the 36th month was 49.18％ ( P ＜ 0.05 ).Response to the many reasons,the YMDD mutation is the more common one.The relationship among HBVDNA load,ALT level on baseline and the rate of poor response emergence,the YMDD mutation rate was clear.By comparison in groups,the difference was significant (P＜0.05).Conclusion The lower baselins of ALT level,the higher of HBVDNA load,the greater probability of the poor response and the YMDD mutation.
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OBJECTIVES: This study analyzed risk factors for hemorrhage in a large series of deep brain stimulation (DBS) and ablation procedures in patients with advanced Parkinson's disease (PD). METHODS: Six hundred and forty four subjects with advanced PD treated with DBS or ablation procedures between March 1999 and December 2007 were enrolled in the study. Procedures were performed by the same surgeon, and included DBS in 126 patients, ablation in 507 patients and DBS after prior unilateral ablation procedures in 11 patients. Of 796 target procedures, 207 were DBS including 202 subthalamic nucleus (STN) targets, 3 ventralis intermedius nucleus (Vim) targets and 2 globus pallidus internus (GPi) targets, and the others were 589 ablation procedures including 474 GPi targets and 115 Vim targets. Postoperative CT or MRI was performed in all patients within 24 h of lead implantation or ablation treatment. Statistical correlation analysis of risk factors for intracranial hemorrhage (ICH) was performed by stepwise logistic regression. Explanatory variables were patient age, sex, blood pressure, anatomical targets, the number of microelectrode recording (MER) penetrations and surgical modality. RESULTS: Postoperative symptomatic ICH occurred in 10 cases (8 pallidotomy and 2 thalamotomy) and asymptomatic ICH in 14 cases (9 pallidotomy, 4 thalamotomy and 1 DBS). Hypertension and surgical modality were significant factors contributing to hemorrhage (both P < 0.05). The likelihood of hemorrhage in hypertensive patients was 2.5 times that in normotensive patients. The risk of hemorrhage during ablation was 5.4 times that in DBS. The number of MER trajectories did not significantly correlate with ICH occurrence (P = 0.07). No statistically significant difference was found in age, sex and anatomical targets. CONCLUSION: This study demonstrated that hypertension is a risk factor for ICH in PD patients. DBS is generally a safe surgical modality as compared with ablation. Increasing microelectrode trajectories seemed to increase the risk of ICH, but no statistically significant difference was found (P = 0.07).
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Técnicas de Ablação/efeitos adversos , Estimulação Encefálica Profunda/efeitos adversos , Hemorragias Intracranianas/etiologia , Doença de Parkinson/terapia , Fatores de Risco , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Lateralidade Funcional/fisiologia , Globo Pálido/fisiologia , Humanos , Hemorragias Intracranianas/diagnóstico por imagem , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Núcleo Subtalâmico/fisiologia , Tomografia Computadorizada por Raios X/métodosRESUMO
ObjectiveTo evaluate the clinical effects of microelectrode guided stereotactic pallidotomy and/or thalamotomy and deep brain stimulation (DBS) in the management of Parkinson's disease.MethodsA total of 510 patients with P arkinson's disease underwent stereotactic operations and 30 patients underwent D BS from April 1999 to March 2003. The 510 cases consisted of 385 cases of poster oventral pallidotomy (PVP), 91 cases of ventral intermedius (Vim) thalamotomy, 1 2 cases of PVP together with Vim thalamotomy on the same side, 8 cases of PVP on both sides at the same time, 10 cases of PVP on both sides at different times, and 4 cases of PVP on one side while Vim thalamotomy on the other at different t imes. Of the 30 cases of DBS (unilateral, 18 cases; bilateral, 12 cases), target s were located in subthalamic nucleus(STN) in 29 cases and ventralis intermedius nucl eus in 1 case.ResultsUnified Parkinson's disease rating scal e (UPDRS) scores were recorded postoperatively. Of the 510 cases, during the “off” and “on” stat es, symptoms improved by 47 3% and 38 7%, respectively. “On-off” phenomena a nd m otor symptoms disappeared. Follow-up information with a mean of 11 6 months in 2 20 cases revealed excellent outcomes in 130 cases (59 1%), improved in 75 (34 1%), a nd no change in 15 (6 8%). Of the 30 cases of DBS, during the “off” and “on ” state s, symptoms improved by 45 2% and 25 7%, respectively. All the 30 patients wer e followed for a mean of 10.3 months. No parameter adjustment was needed after 1 p ostoperative month in 18 cases, while the adjustment after operation was require d in the remaining 12 cases.ConclusionsPallidotomy is much m ore effective th an thalamotoy in Parkinson's patients with tremor. DBS can effectively control t he patient's motor symptoms.
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ObjectiveTo evaluate the efficacy of the dual channel deep brain s timulation (DBS) for Parkinson's disease (PD). MethodsThirte en patients with PD presenting bilateral symptoms underwent dual channel DBS of bilateral subthal amic nucleus. The targets were identified by a combination of MRI scanning and m icroelectrode recording. Unified Parkinson's Disease Rating Scale (UPDRS) scores were evaluated postoperatively.ResultsAll the 13 patients w ere followed for 3 months～3 years, with a mean of 6 3 months. When the pulse generator was tur ned on, UPDRS motor scores showed 62 3% symptomatic improvement (75 5% improve me nt in those responsive to dopaminergic therapy) during the “off” status and 24 2% during the “on” status. No complications occurred.Conclusions DBS of bilateral subthalamic nucleus may significantly improve the motor functions in PD patients.
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ObjectiveTo study the clinical effects of X-kn ife in the treatment of intracranial meningiomas.MethodsA retrospective analysis of 52 cases of intracranial meningioma treated by X-knife was made. The peripheral dose was (10 ～20) Gy, with a mean of 13 Gy. Follow-up checkups consisted of clinical examina tions and contrast-enhanced CT scans.ResultsAfter the treatm ent, unilateral m ild hemiplegia occurred in 1 case (1 9%) and local epileptic attack occurred in 2 cases (3 8%). Imaging findings revealed asymptomatic transient peritumoral ed e ma in 12 cases (23 1%). Follow-up imaging lasting (3～92) months (mean, 23 mont hs ) in 40 cases (76 9%) found regression of tumor in 18 cases (45 0%) and unchan ge d tumor size in 22 cases (55 0%).ConclusionsX-knife is an e ffective and safe procedure for meningiomas.
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ObjectiveTo discuss the causes and the managem ent of hemorrhagic c omplications after sterotactic surgery for Parkinson's disease (PD).Me thodsA total of 350 PD patients unresponsive to drug therapy from April 1999 to Decemb er 2001 underwent sterotactic surgery. Intracranial hemorrhage occurred in 6 cas es, consisting of 3 cases of lesion hemorrhage and 3 cases of puncture path hemo rrhage.ResultsOf the 6 cases, 4 were treated by surgical ope rations, with re covery of consciousness but hemiplegia left, and 2 were treated conservatively w ithout dysfunction left. No fatal cases were seen in the study.Conclus ionsHe morrhagic complications are often in association with repeated puncture, excessi ve heat, operative skills, patient's general condition and so on. Accurate targe t location by MRI combined with microelectrode guidance, reduce of microelectrod e recording times, lowering of the lesion temperature, and sufficient perioperat ive care contribute to the prevention of intracranial hemorrhagic complications.
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Objective:To investigate the metabolism changes in corpus striatum of hemiparkinsonian monkeys after chronic high frequency stimulation in subthalamic nucleus (STN) by SPECT and PET imaging. Methods: Two hemiparkinsonian monkeys, induced by unilateral internal carotid artery infusion of 1-methyl-4-phenyl-1,2,3,6-tetrahydropy-rindine (MPTP), were implanted with stimulation electrodes in STN of lesioned side according to stereotaxic atlas of the monkey brain. SPECT and PET examination were performed before and 1, 3 months after stimulation. Results: PD symptoms of monkeys, including rigidity, bradykinesia and gait abnormality, were significantly improved. SPECT imaging indicated that dopamine transporter (DAT) binding to corpus striatum in stimulated side increased and D 2 receptor (D 2 R) decreased to the level of unlesioned side after stimulating. PET imaging showed that right corpus striatum had lower density than left corpus striatum before stimulation. One month after chronic high frequency stimulation, bilateral corpus striatum had low density, but the right was slightly higher than that of the left;3 months after stimulation the right was obviously higher than the left . Conclusion: The symptoms of hemiparkinsonian monkeys can be obviously improved by STN deep brain stimulation(DBS). The increased DAT binding and glucose metabolism of corpus striatum in stimulated side and the decreased D 2 R binding after stimulation suggest that the activity of striatal dopaminergic system may be promoted by STN DBS.
