Volume 90  ·   Issue 29  ·  2010

In the past century, brain electrophysiology technology has been developed rapidly [1]. In 1929, German psychiatrist Berger published the first study on human brain waves, which marked the founding of brain electrophysiology. In 1947, the International Society of Electroencephalography and Clinical Neurophysiology was founded, and in 1949, he published the study on brain waves<EEG Clin Neurophysiol, a milestone in the history of electrophysiology of the brain. Electroencephalogram (EEG) technology was introduced in China in the late 1940s and published in 1965<In 1986, the Electroencephalography Group of the Neuropsychiatric Society of Chinese Medical Association was established. At present, there are two professional journals on electrophysiology of brain- -<Journal of Clinical Neuroelectrophysiology>and<The Journal of Modern Electrophysiology has accumulated rich research data and clinical practice experience for more than 20 years, forming an independent subject branch, which is called "clinical neuroelectrophysiology".

Objective To explore the efficacy of paliperidone extended-release tablets in the improvement of social functions in schizophrenics. Methods A total of 81 schizophrenics were randomly divided into study group with paliperidone extended-release tablets and control group with risperidone for a 12-week treatment. They were assessed and analyzed by positive and negative symptoms scales( PANSS),social disability screening schedule (SDSS)and treatment emergent symptom scale (TESS)at baseline, 6th weekend and 12th weekend. Results In study group, the factors and total scores of PANSS in the 12th weekend of treatment [( 12. 0 ± 2. 8), ( 12. 1 ± 3. 6), ( 26. 2 ± 5.0), (50. 2 ± 8.7 )] were all significantly lower than those at baseline [(24.7 ±5.3), (23.8 ±3.6), (45.0 ±2.9), (93.5 ±6.8)] (t =9.60-16. 78, P＜0. 05). In study group, the positive factor, negative factor and total scores of PANSS in the 12th weekend of treatment [( 12. 0 ± 2. 8), ( 12. 1 ± 3.6), (50. 2 ± 8. 7 )] were all significantly lower than those in the 6th weekend of treatment [(14.2 ±1.8),(14.6 ±2.4),(56.5 ±6.4)] (t =2.58-4. 26, P＜0.05).In the 12th weekend of treatment, the factors and total scores of PANSS in study group [( 12. 0 ± 2. 8),( 12. 1 ± 3.6 ), ( 26. 2 ± 5.0 ), ( 50. 2 ± 8.7 )] were all significantly lower than those in control group [(16.9 ±4.9), (18.7±5.3), (32.5 ±5.1), (68. 1 ±13.0)](t= -4.28-5.67,P＜0.05). In study group, the total scores of SDSS in the 12th weekend of treatment(5.93 ±2. 78) were significantly lower than those at baseline ( 13. 9 ± 3.4) ( t = 10. 83, P ＜ 0. 05 ). In study group, the total scores of SDSS in the 12th weekend of treatment (5.9 ± 2. 8 )were significantly lower than those in the 6th weekend of treatment (7.6 ±2. 9) (t =5.21, P ＜0. 05). But there was no significant improvement in control group(t = 1.88, P ＞0. 05).In the 12th weekend of treatment, the total scores of SDSS in study group (5.9 ± 2. 8) were significantly lower than those in control group(8. 8 ± 2. 9 ) ( t = - 4. 49, P ＜ 0. 05 ). No severe adverse effect was reported in either group. Conclusion Paliperidone extended-release tablets are effective to improve social functions and psychiatric symptoms of schizophrenics.

Objective To explore N400 changes elicited by Chinese sentences ending with matching (congruent) or mismatching (incongruent) words in first episode schizophrenia. Methods ERP ( event-related potentials) component N400 were recorded by an ERP device in 56 first episode schizophrenia (FES) and 62 normal controls (NC) according to a paradigm of Chinese sentences ending with matching or mismatching words. Results ( 1 ) Latencies: compared with NC, FES showed prolonged N400 latencies in five areas at pre-treatment: in Cz. The latencies were (358 ms ±32 ms vs 394 ms ±45 ms,P ＜0.01 ) in congruent and(410 ms ± 29 ms vs 446 ms ± 35 ms, P ＜ 0.01 )in incongruent situation. And so did in Fz,Pz, C3 and C4; (2)amplitudes: compared with NC, FES also showed smaller N400 amplitudes in five areas at pre-treatment. The amplitudes were (8.6 μV ± 5.1 μV vs 5.2 μV ±4.6 μV, P ＜ 0.01 )in congruent and ( 13.4 μV ± 6.7 μV vs 8.5 μV ± 5.9 μV, P ＜ 0.01 ) in incongruent situation. And so did in Fz, Pz, C3 and C4; (3)the prolonged N400 latencies and decreased amplitudes were negatively correlated with the patients' positive scale and total scale of PANSS. Conclusion With clear priming effect in first episode schizophrenia, Chinese sentences are suitable stimuli in N400 experiment. They may be used for further study of neural mechanism and early diagnosis of schizophrenia.

Objective To conduct a systematic review of P50 sensory gating studies in schizophrenics and the change between before and after treatment. Methods Standard search strategy for the Cochrane Review Group was performed by two review authors. Searches were made in PubMed,EMBase, Web of knowledge, PsycINFO, Cochrane Library, CNKI, Wanfang, VIP and CBMDisc databases.STROBE (strengthening the reporting of observational studies in epidemiology) was used to assess the methodological quality of the studies. RevMan 5. 0. 23 software was employed to conduct a Meta analysis.Results Seventy-one literatures were reviewed and 7 studies met the inclusion criteria for a Meta analysis.The meta-analysis of random effects showed that S1 amplitude was lower in the schizophrenia group than in the normal control group (P=0. 02). And S2 amplitude was significant higher in schizophrenia group than the normal control group ( P = 0. 001 ). There were no statistical significance in S1 and S2 latency between two groups (P = 0. 34 and P = 0. 19 respectively). P50 Ratio in schizophrenia group was significantly higher than the normal control group. And the difference was statistically significant [Z = 11.46, P ＜0. 00001,combined SMD =44. 18, 95% CI (36. 62, 51.74)]. However the P50 difference showed no significant difference (P = 0. 14). An analysis of fixed effects showed that the P50 Ratio difference was not statistically significant in schizophrenics between before and after treatment (P = 0. 19 ) . Conclusion The schizophrenics have a sensory gating dysfunction. P50 Ratio is a stable and reliable indicator of sensory gating function. Antipsychotics may partly enhance P50 sensory gating in schizophrenics, but can not completely reverse the defect of P50 suppression.

Objective To analyze the epidemiolngy and clinical characteristics of influenza A ( H1N1 ). Methods A retrospective analysis was performed on the clinical data of 137 cases of influenza A (H1N1 ) admitted into our hospital during May to August 2009. Results In the early stage, most cases were imported from the US, Australia, Canada and the UK. While in the later stage, most of them were secondary. The patients were mainly children and youngsters. And the most common clinical manifestations were fever ( n = 108 ), cough ( n = 93 ) and sore throat ( n = 67 ) while the most common signs congestive throat (n=99) and swelling tonsil (n=46). The average fever period was 3.3 ± 1.5 days. The clinical symptoms vanished in 4. 4 ± 1.9 days. And the average length of stay was 5. 5 ± 2. 1 days. Laboratory tests:the count of leukocytes declined while that of lymphocytes increased in 39 cases ( 39.5% ). The test of influenza A (H1N1) nucleic acid was positive. The chest radiograph showed intensive pulmonary markings or patchy pneumonia-like signs. Treatments: the groups of patients using Chinese herbs, western medicine plus Chinese herbs, symptomatic relief and placebo showed no significant difference in fever period, recovery time and the negative-converting period of influenza A (H1N1) nucleic acid tests became negative.Conclusion Influenza A (H1N1) may be recessive or dominant. Despite a strong infectivity, the clinical symptoms are mild and the clinical course is self-limited, similar to the seasonal influenza.

Objective To evaluate the immediate efficacy and acute toxicity of cisplatin-based induction chemotherapy followed by weekly concomitant chemoradiotherapy and concomitant chemoradiotherapy followed by consolidation chemotherapy in unresectable stage Ⅲ NSCLC. Methods A total of 118 patients were pathologically diagnosed as stage Ⅲ N SCLC. Among them, 77 patients (A group)received two cycles of cisplatin-based induction chemotherapy, followed by 6 weekly cycles of paclitaxel 45 mg/m2 ( n =45 ) and gemcitabine 350 mg/m2 ( n = 32 ) in combination with thoracic radiotherapy; 41 patients (B group) received concomitant chemoradiotherapy (cisplatin 50 mg/m2, d1, 8, 29, 36/ etoposide 50 mg/m2, d1-5, 29-33, n = 18, paclitaxel 45 mg/m2/weekly × 6/carboplatin AUC = 2/weekly × 6, n =23 ) followed by consolidation chemotherapy. All thoracic radiotherapy dose are 2 Gy per fraction and day to a total dose of 58-60 Gy. Results The total response rate of A and B groups was 80. 5% and 75.6% respectively(P = 0. 534). According to subgroup analyses, no statistically significant differences existed according to chemotherapy (P = 0. 557 ). The main side-effects were neutropenia, radiation esophagitis,radiation pneumonitis and nausea/vomiting. The gemcitabine group was statistically significant different in neutropenia. Conclusion Different chemotherapeutic agents in combination with thoracic radiotherapy are clinically feasible with a moderate toxicity. Their profiles of efficacy and toxicity are comparable to each other.

Objective Retrospective analyze the long-term efficacy and compensatory sweating of thoracoscopic sympathicotomy in the treatment of palmar hyperhidrosis by different operative methods in order to search after a better operative method. Methods Retrospective study of 643 cases (498 cases available)palmar hyperhidrosis who accepted video-assisted thoracoscopic bilateral sympathecotomy during from 1995 to Aug 2008. The patients were divided into four groups by different operative methods. ( 1 ) Group A( n = 82 ):Thoracoscopic T2-4 sympathecotomy was performed. (2) Group B (n = 135 ) :Thoracoscopic T2 sympathetomy was performed. ( 3 ) Group C ( n = 41 ): Thoracoscopic T2 sympathetic nerve clipped. (4) Group D ( n = 240 ):Thoracoscopic T3-4 level sympathecotomy plus bypass fiber ( Kuntz fiber) resection on same level was performed. Results All procedures were successfully performed under thoracoscope without severe morbidity and mortality. The curative rate of palmar hyperhidrosis was 100. 00%. The incidence of compensatory sweating were 54. 9% ( group A) ,48. 1% ( group B) ,48.8% ( group C) and 28. 8% ( group D) respectively with significantly decrease in group D contrast to other three groups. The incidence of high-grade compensatory sweating which have important infleuces on daily life were 9. 8% (group A), 10. 4% (group B) ,9.8% (group C) and 2.9% (group D) respectively with significantly decrease in group D. Other pairings have nonsignificance. The relapse rate were 1.2% ( group A ), 2. 2% ( group B), 7. 3% ( group C )and 0. 8% (group D). Only when group D contrasted to group C has significantly decrease in the relapserate (x2 = 8. 423, P = 0. 004 ). Other pairings have nonsignificance. Conclusion The procedure of T3-4 sympathicotomy plus bypass fiber resection is reasonable operative method to cure hyperhidrosis with the better curative effect and lowest incidence of compensatory hyperhidrosis.

Objective To investigate the influence of coronary artery variation on the outcome of arterial switch operation for transposition of great arteries. Methods Among 280 patients undergoing arterial switch operations at our hospital from 2001 to 2008, 73 (26. 1% ) had concurrent coronary arteries variation (54 males and 19 females; median age: 0. 6 ± 1.1 years old; mean body weight: 5. 8 ±2. 6 kg). Of these 73 patients (variant group), 21 cases had transposition of great arteries with a ventricular septal defect and 30 cases with an intact ventricular septum. The other 22 cases were of Taussig-Bing anomalies. Another 207 cases had usual coronary arteries (usual group). Coronary artery transfer was achieved by implantation of buttons to the previously anastomosed neo-aorta. Results There were 29 early death ( 10. 4% ) including 12 cases (16.4%) in variant group and 17 cases (8.21%) in usual group (P ＜0.05). Mean cardiopulmonary bypass and cross-clamp durations were 229 ± 84 and 146 ± 48 min in variant group while 206 ± 59 and 137 ± 40 min in usual group ( P ＜ 0. 05 ). Six cases were confirmed intra-operatively as coronary compression or obstruction. Complications included infection (n = 11 ), low output syndrome ( n =7 ), diaphragm paralysis ( n = 3 ), pericardial effusion ( n = 2 ) and atrioventricular block ( n = 2 ).Conclusion Coronary artery variation increases the operative difficulty and influences the outcome. The operative proficiency may decrease the mortality.

Objective To study the technique and experience of selective radiofrequency thermocoagulation ( SRFTC ) for trigeminal neuralgia ( TN ) and the application of neuronavigation in SRFTC for TN. Methods SRFTC was performed in 3269 TN patients and neuronavigation-assisted SRFTC in 36 of them. Follow-up was carried out for over 2 years in 1722 cases. Results An excellent efficacy was achieved in 2590 cases, a fair outcome in 548 cases and no response in 131 cases. The recurrence rates at one and two years were 10.5% and 25.0% respectively. The efficacy was excellent in all cases treated by neuronavigation-assisted SRFTC. The effective rate was 96%. Neither serious complication nor death occurred in this series. Conclusion SRFTC for TN is both safe and effective. And the neuronavigation technique can not only increase the surgical efficacy of SRFTCP for TN but also decrease the surgical risks.

Objective To analyze the cause and treatment of intracranial hypertension after sylvian cystoperitoneal shunting. Methods Sixteen cases were retrospectively reviewed. There were 10 males and 6 females. The age range was 2-19 years old (mean: 9.94). All patients had a sylvian cystoperitoneal shunt via a common low-pressure tube. Results The onset time of intracranial hypertension after cystoperitoneal shunting was 3 months to 7 years ( mean: 3.20 yr). Three cases underwent the operation of adjusting intracranial location of shunt tube. The original tube was removed in 12 cases. Among them, 10 cases were operated by lateral ventricle-peritoneal shunt. The other two and two cases with a remaining tube were treated successfully with dehydration drugs. Conclusion The cause of intracranial hypertension is probably due to tube blockage or less draining after the shrinking or disappearance of arachnoid cyst. Adjusting the location of intracranial tube or performing a lateral ventricle-peritoneal shunt has an excellent efficacy if a dehydration therapy is unresponsive or auto-compensation fails.

Objective To evaluate the right ventricular functions of patients with acute organophosphate poisoning patient(AOPP) by measuring the velocities of tricuspid annular motion through Doppler tissue imaging (DTI). Methods Tissue Doppler velocity mode was employed to observe tricuspid annulus movement in 78 AOPP patients and 32 healthy adults. After tricuspid annular pulsed-wave rate of E/A were measured by traditional echocardiographic, the peak values of tricuspid annular early diastolic velocity (Em) and late diastolic velocity ( Am ) were analyzed by DTI. Results E/A ＞ Em/Am ＞ 1 was observed in health control group as well as the mild-moderate AOPP; Em/Am ＜E/A ＜ 1 was observed in the severe AOPP group. There was significant difference between two groups. The right ventricular E/A correlated positively with Em/Am (P ＜0. 001 ). Pulmonary arterial pressure (PAP) correlated positively with right ventricular E/Em, Tei Index ( P ＜ 0. 001 ) and negatively with right ventricular Sm, Em and Em/Am (P ＜ 0. 001 ). Conclusion The right ventricle functions, in terms of contraction and relaxation, decrease in severe AOPP patients versus health control and mild-moderate groups. TDI is a useful tool to assess the right ventricle functions of AOPP patients.

Objective To explore the safety, efficacy and side effect of Supreme laryngeal mask airway (LMA) used in gynecological laparoscopy. Methods From Oct 2009 to Apr. 2010 in First Hospital of Peking University, 125 patients undergoing general anesthesia for elective gynecological laparoscopy were reviewed, 69 of which were dealt with Supreme LMA (S) and 56 with endotracheal tube (T). After anesthesia induction, changes of HR and MAP were observed during intubation and extubation.The peak inspiratory airway pressure ( Ppeak ) and PETCO2 were monitored. Relevant perioperative side effects were recorded. Results HR and MAP in group T were increased right after intubation and during extubation (P ＜ 0. 05 ), which were significantly decreased in group S (P ＜ 0. 01 ). Ppeak and PETCO2 were comparable in the two groups at all the time points ( P ＞ 0. 05 ). There was no body movement or coughing at the time of intubation. Group S had less incidence of body movement, coughing and sore throat than group T during extubation (P ＜ 0. 05). Conclusion Supreme LMA can provide the same safe and effective ventilation as intubation and less stress response and side effects in gynecological laparoscopy.

Objective To investigate the effects of SF injection on coagulation function, p-selectin and D-dimer concentrations in plasma of elderly patients undergoing total hip replacemen(THR). Methods Twenty-four ASA Ⅱ/ Ⅲ patients aged 65 to 85 were divided equally into two groups (n = 12). In Group S, SF injection was administered by peripheral intravenous infusion at initially 0. 2 ml/kg and then 0. 8 ml(kg/h) until the end of operations. In Group N, normal saline was administered similarly. All the patients were given patient-controlled epidural analgesia (PCEA) after operations. Blood samples were taken before operations ( T0 ), immediately post-operation ( T1 ) and 24 h post-operation to detect the levels of p-selectin, D-dimer, blood platelet count and clotting time at all time points. Results The concentrations of p-selectin and D-dimer in Group N increased at T1 and T2 while those in Group S decreased at T1 (P ＜0. 05). Compared with Group N, they were significantly lower in Group S ( P ＜ 0. 05 ). There was no significant difference at T2 between two groups. Conclusion The plasma concentrations of p-selectin and Ddimer increase obviously in elderly THR patients. SF injection can decrease the plasma concentrations of pselectin and D-dimer in patients during surgery. Thus it may protect the vascular endothelial cells and attenuate the activation of platelet and fibrinolysis.

Objective To study the expression of cell cycle related factor Gli2 in autogenous vein graft and its relation with neointima formation. Method Autogenous vein graft model were established in 36 male wistar rats of 8 weeks old, 140 g, by transplanting the left jugular vein to intra renal abdominal aorta with microsurgical technique. Graft veins were harvest at 14, 28 days after transplantation. The IF and W-B were used to detect the protein expression in the vein graft. At the same time Gli2- mRNA was measured by RT-PCR. Results Immunofluorescent staining showed that the Gli2 + cells was only 3.2% ±0. 4% in the normal vein, but was much more in the vein graft after surery, was 41.3% ± 0.6%, 58.3 ± 0.6%respectively; The expression of Gli2 and PCNA were both elevated in the vein graft. There is a positive correlation between them which indicated by W-B, the relation index was 0. 826; the Gli2 mRNA content was also increased in vein graft,was 8. 9, 13.6 fold compared with normail vein as 1 repectively. Conclusion Gli2 is upregulated in autogenous vein grafts and may correlated with the proliferation of vascular smooth muscle cells.

Objective To study the relationship between oxidative DNA damage and mitochondrial apoptosis relative proteins in rat striatum induced by 6-hydroxydopamine (6-OHDA) during the pathogenesis of Parkinson's disease (PD). Methods 6-OHDA was stereotacticly injected into the bilateral right striatum of rats to produce PD models. Assays for 8-oxo-dG immunohistochemistry and Western blot for MTH1,Cytochrome c, Cl-caspase 9 and Cl-caspase 3 in right striatum was separately conducted. Results In 10successful PD rats, compared with either sham or normal group, there were obvious more 8-oxo-dG positive cells in lesioned striatum while there was a lower expression of MTH1. Furthermore, the expressions of such intrinsic apoptotic pathway factors as cytoplasmic Cytochrome c, Cl-caspase 9 and Cl-caspase 3 were highly up-regulated in lesioned striatum. Conclusion Oxidative DNA damage plays a key role in the pathogenesis of PD. Furthermore Cytochrome c, caspase 9 and caspase 3 are involved in the regulation of apoptosis under oxidative DNA damage induced by 6-OHDA.

Germinal center is an important place for B cell activation and antibody maturation in lymphoid organs during immune response.Ectopic germinal center can be formed in non-lymphoid organs during lymphoid tissue regeneration.Ectopic germinal center induced by antigen may be one of the important pathogenic mechanisms in autoimmune diseases.The formation and possible pathogenic mechanism of ectopic germinal center in autoimmune diseases and the research progress of ectopic germinal center as therapeutic target in recent years are reviewed.

Objective To evaluate the feasibility and surgical procedure of bone grafting with elastic trephine. Methods A total of 42 cases of thoracolumbar fracture received pedicle screw fixations by combining bone grafting with elastic trephine through pedicle of fractured vertebra. The ratios of the altitude of traumatic vertebra to normal altitude, kyphosis Cobb angle and sagittal index were measured by preoperative and postoperative X-ray images. Results A follow-up visit of 12-26 months (average: 14. 8)showed that the dislocations of vertebrae were corrected and fusions completed. Proportion of the height of anterior edge of traumatic vertebra to normal height was ( 53.89 ± 6. 57 ) % at pre-operation, ( 92. 31 ±11.25) % at post-operation and ( 91.39 ± 10. 28 ) % at an one-year follow-up ( P ＜ 0. 05 ). The kyphosis was (23. 19 ±5.74) ° Cobb angle at pre-operation, (4. 92 ± 1.03 ) ° at post-operation and (5.13 ± 1.41 ) °at an one-year follow-up ( P ＜ 0. 05 ). In contrast with 86% (78 % -97% ) on average at post-operation, the pre-operative sagittal index was 54% (32% -66% ) on average. Conclusion Application of bone grafting with elastic trephine can reconstruct the altitude of injured vertebral body, increase the compressive stability of anterior column as well as effectively correct the kyphosis deformity. With a convenient application,elastic trephine plays a variety of roles in both auxiliary reduction and bone grafting reconstruction.