目的 研究弥散张量成像(DTI)在诊断帕金森病(PD)合并快速眼动睡眠行为障碍(RBD)中的临床意义.方法 连续收集南昌大学第二附属医院2020-04—2021-06门诊及住院部的PD患者45例,根据PSG检查结果分为PD+RBD组25例,PD-RBD组20例,另选取25名健康者为对照组(NC组).所有受试者均进行DTI、薄层扫描,分别测量其蓝斑、脑干(中脑、脑桥、延髓)、黑质以及内囊前肢区域的部分各向异性分数(FA)值.结果 PD-RBD组与PD+RBD组UPDRS-Ⅲ分数比较差异无统计学意义(P=0.297).3组中脑、延髓及内囊前肢区域中FA均值差异无统计意义(P>0.05).相较于NC组,PD伴或不伴RBD组蓝斑FA值均减少(P<0.05),但后2组间比较差异无统计学意义(P>0.05).与NC组相比,PD伴或不伴RBD组黑质FA值均减少,差异有统计学意义(P≤0.001),而后2组间黑质FA值差异无统计学意义(P>0.05).与NC组相比,脑桥区域FA值在PD+RBD组中出现下降(P左=0.016,P右=0.003),PD-RBD组无显著变化(P>0.05);与PD-RBD组相比,PD+RBD组降低(P<0.05).结论 黑质区域及蓝斑在DTI检查中诊断PD有一定的敏感性,但无法明确其是否合并RBD,脑桥在识别是否有RBD具有临床意义.

>吉兰-巴雷综合征（Guillain-Barre syndrome,GBS）是由自身免疫障碍导致的周围神经病,表现为对称进展性的肢体无力、腱反射减弱或消失、感觉异常和自主功能障碍 [1] 。其中糖尿病酮症酸中毒（diabetic ketoacidosis, DKA）合并GBS十分少见,国内外鲜有报道,二者之间的联系及发病机制目前仍

卒中后运动障碍包括舞蹈症、震颤、肌张力障碍、肌阵挛、血管性帕金森综合征等 [1] ,患病率在1%～4%之间 [2-4] 。血管性舞蹈症是一种不规则、无节律、幅度大的旋转或交叉性快速不自主运动,主要累及肢体,也可累及身体其他部位 [4] ,可分为偏侧舞蹈症、单肢舞蹈症和全身性舞蹈症,患病率约为0.54% [5] 。其机制可能与基底核神经回路失衡有关,基底核、丘脑与大脑皮质共同构成复杂的直接和

Objective To investigate the relationships between the clinical and subclinical REM sleep behavior disorder(sRBD)and the cognitive function in patients with PD. Methods We enrolled 53 patients with PD from the Second Affiliated Hospital of Nanchang University. The age ,gender and education level of each patient were recorded. Patients with dementia were excluded. The correlative scales were assessed by the form of face to face,including Montreal cognitive function score(MoCA),Unified Parkinson Disease Rating Scale(UPDRS), Parkinson Disease Sleep Scale (PDSS) and so on. The sleep quality was assessed by polysomnography(PSG), meanwhile PD patients were divided into the RBD group(PD-RBD),the subclinical RBD group(PD-sRBD)and the normal REM group(PD-REM)based on the polysomnography. The cognitive function was compared among the three groups. Results (1)MoCA score of PD patients in the RBD group was lower than that in the normal REM group(P = 0.032.(2)No significant difference was observed in the cognitive function between the sRBD group and the normal REM group.(3)Length of morbidity of PD patients with RBD was longer than that of PD patients with sRBD(P=0.021). Conclusions The presence of RBD may be an important relative factor for the develop-ment of cognitive dysfunction in PD patients. We haven′t detected that the subclinical RBD was associated with the cognitive dysfunction in patients with PD. It is not clear whether the subclinical RBD in PD patients develops to RBD in all patients,which needs further investigation.

慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)是一种具有气流受限特征的肺部疾病.这类患者呈现阻塞性通气障碍问题,容易长期受困于呼吸困难、疲劳、咳嗽咳痰、活动耐受力降低等身心问题[1].疲劳作为COPD患者除呼吸困难外的第2大症状[2],会引起身体及心理的疲乏,导致患者出现精神困扰、注意力不集中,影响治疗效果,加重病情,从而直接影响患者生活质量[3].现将本院收治的因急性发作入院的COPD患者64例阶段性护理干预的结果报道如下.

Objective To investigate the physical and functional relation between ERɑ and p73ɑ in breast cancer cells.Methods Protein expressions of ERɑ and p73ɑ were examined by Western Blot.The binding assay for ERɑ and p73ɑ was tested with Co-IP and immunoblot.Transcriptional activity of ERɑ and p73ɑ was analysed by Luciferase assay.Results and Conclusion(1)ERɑ and p73ɑ can bind to each other.(2)ERɑ and p73ɑ can be combined to form complex and mutually inhibit protein expression of each other in breast cancer cells.

人感染H7N9禽流感是由H7N9亚型禽流感病毒引起的急性呼吸道传染病.2013年2月以来,上海市、安徽省、江苏省、浙江省先后发生不明原因重症肺炎病例,其中确诊人感染H7N9禽流感33例,9例死亡[1].患者一般表现为流感症状,早期均有发热(38℃以上),起病急,起病5～7d出现呼吸困难,重症肺炎并进行性加重,部分病例迅速发展为呼吸窘迫综合征、感染性休克、多器官功能障碍并死亡.该病为一种新型传染病,起病急、发展快、死亡率高,迄今没有成熟的安全防护指南和护理经验借鉴,此疾病的护理难度大,护理经验缺乏.2013年4月25日我们成功救治了1例感染H7N9禽流感的重症患者,于5月17日康复出院,现报道如下。