Background: The relationship between monosymptomatic resting tremor (mRT) and Parkinson's disease (PD) remains controversial. In this study, we aimed to assess the function of presynaptic dopaminergic neurons in patients with mRT by dopamine transporter positron emission tomography (DAT-PET) and to evaluate the utility of clinical features or electrophysiological studies in differential diagnosis. Methods: Thirty-three consecutive patients with mRT were enrolled prospectively. The Unified Parkinson's Disease Rating Scale and electromyography were tested before DAT-PET. Striatal asymmetry index (SAI) was calculated, and a normal DAT-PET was defined as a SAI of <15%. Scans without evidence of dopaminergic deficits (SWEDDs) were diagnosed in patients with a subsequent normal DAT-PET and structural magnetic resonance imaging. Results: Twenty-eight mRT patients with a significant reduction in uptake of DAT binding in the striatum were diagnosed with PD, while the remained 5 with a normal DAT-PET scan were SWEDDs. As for UPRDS, the dressing and hygiene score, walking in motor experiences of daily living (Part II) and motor examination (Part III) were significant different between two groups (P < 0.05 and P < 0.01, respectively). Bilateral tremor was more frequent in the SWEDDs group (P < 0.05). The frequency of resting tremor and the amplitude of postural tremor tend to be higher in the SWEDDs group (P = 0.08 and P = 0.05, respectively). Conclusions: mRT is heterogeneous in presynaptic nigrostriatal dopaminergic degeneration, which can be determined by DAT-PET brain imaging. Clinical and electrophysiological features may provide clues to distinguish PD from SWEDDs.

<正>α突触核蛋白是一个由140个残基组成的神经元蛋白。在生理条件下,大部分存在于神经突触前末梢,靠近突触小泡。它是包括β突触核蛋白和γ突触核蛋白在内的保守的蛋白质家族中的一员,并且最初被描述为组成阿尔茨海默病老年斑的非淀粉样蛋白前体蛋白。研究证实,α突触核蛋白的聚集物存在于许多病理进程中。例如,它存在于帕金森

Objective To study the metabolic characteristics of dopamine transporter in patients with asymmetric resting tremor by position emission computer(PET)-assisted tomography.Methods Forty patients with asymmetric resting tremor,who underwent PET-assisted tomography for the metabolism of～(11)C-β-CFT in their brain,were divided into scans without evidence of dopaminergic deficit(SWEDD) group(n= 6)and non-SWEDD group(n = 34).Metabolic characteristics of dopamine transporter were compared between the two groups.Results The uptake of～(11)C-β-CFT,a dopamine transporter contrast medium,was symmetrical and intact in bilateral striatum of SWEDD group,and asymmetrical in bilateral striatum of non-SWEDD group,which was decreased in 11 patients of SWEDD group and in 23 patients of non-SWEDD group.The average disease course was significantly longer in SWEDD group than in non-SWEDD group(9.42±11.40 years vs 3.64±2.70 years,P0.05).Conclusion Metablism of dopamine transporter is heterogeneous in patients with asymmetric resting tremor.PET-assisted tomography can show dopaminergy deficit evidence in some of them.Dopamine transporter imaging helps to discriminate dopaminergy deficit evidence from Parkinson's disease.

本指南对预测一个人发生首发卒中的风险的方案进行了评估.首发卒中的危险因素或者危险标识根据是否能被干预分类(不可干预的、可干预的和潜在可干预的),或者根据证据强度分类(证据充分和证据不充分).不可干预的险因素包括年龄,性别、低出生体重、种族和遗传易感性.证据充分并可干预的危险因素包括高血压、暴露于吸烟环境、糖尿病、心房颤动和某些其他心脏疾病、血脂异常,颈动脉狭窄,镰状细胞病、绝经后激素治疗、饮食不当、缺乏运动,肥胖和身体脂肪分布.证据不充分或者潜在可干预的危险因素包括代谢综合征、酗酒、滥用药物、口服避孕药、睡眠呼吸紊乱、偏头痛、高同型半胱氨酸血症,高脂蛋白(a)、高凝状态、炎症和感染.本指南还对使用阿司匹林预防首次卒中的数据进行了回顾,针对各种危险因素,提出了减少卒中风险可采取的策略.本指南综述了各种已经明确和近期明确的危险因素的证据,对2006年的指南进行了完整的修订.新版指南涉及的范围更加广泛.2006年指南着重于缺血性卒中的预防,由于危险因素和预防措施的重叠,本指南新加了出血性卒中的预防,并将重点放在以患者为本的个体化卒中预防.

康复医学在我国是一门年轻的学科，近20年来发展非常迅速，国内已有多所大学设立了康复相关专业。但是，随着我国经济的飞速发展和人民生活水平的日益提高，人们对康复的需求不断提高，而同时中国康复治疗专业人员的数量远不能满足社会的需求。据报道，中国目前需要康复治疗师约30万人，而现有专业人员只有1万人左右[1]。

(上接第8期第670页) 2 证据充分的可干预危险因素 2.1 高血压高血压既是脑梗死的危险因素,也是脑出血(intracerebral hemorrhage, ICH)重要的危险因素.血压和卒中之间存在强烈的、连续的、分级别的、一致的和独立的相关性,而且是有预测意义以及病因学意义的.

Objective To investigate the prevalence and risk factors of hallucination in patients with Parkinson disease(PD)，and to analysis the relationship between hallucination and different types of PD. Methods We recruited 163 patients with PD from outpatient department in Beijing Tiantan Hospital. The subjects were divided into two groups， the hallucination group and the non­hallucination group. We assessed both the two groups respectively with UPDRS， Hohen­Yahr rank， Hamilton Depression Scale(HAMD)， Pittsburgh Sleep Quality Index(PSQI)， Fagitue Severity Scale(FSS)， Parkinson fatigue scale(PFS)，Mini­Mental State Examination(MMSE) and Montreal Cognitive Assessment (MoCA). Then we compared the difference between the two groups， statistical cluster analysis was used to study the relationship between heterogeneity and hallucination. Results In our 163 patients with PD， 20 of them (12.27%) had hallucination. The hallucination and non­hallucination groups had no difference in sex， age， age of onset， duration of illness， long­term complications and the scores of UPDRS， PSQI， FSS， PFS， MMSE and MoCA (P>0.05). The proportion of dyskinesia (35.0%) in hallucination group was significantly higher than that (9.1%) in the non­hallucination group. There were also significant differences in scores of postural stability， H­Y， UPDRS I， UPDRS II， HAMD and Levodopa Equivalents between the two groups. Logistic regression revealed that depression was the independent risk factor for hallucination in PD patients.

<正> 在卢旺达的迈昂热,想随时喝到干净的饮用水,那真是一种奢望!为试图解决这一问题,美国加州雷德兰滋大学的两位教授和学生们来到这里,他们运用GIS技术和GPS设备,探测绘制出这里的水源区域图,并采集整合相关水资源信息。他们的这一工