脑卒中后致残的成因复杂,而脑卒中后认知功能障碍(PSCI)因其高发病率已成为其中一个重要原因.本研究主要从流行病学、临床表现、诊断依据、综合管理及治疗、医学影像学评价等方面系统地阐述PSCI的最新研究进展,以期为临床早期诊断和防治PSCI提供参考依据.

目的:基于双能X线骨密度测量法,对比分析骨质疏松症患者不同中医辨证分型的骨密度值,初步探索骨密度值、骨质疏松症与中医症候三者之间的关联.方法:选取241例骨质疏松症患者,根据中医辨证分型分为肝肾阴虚型、脾肾阳虚型、气滞血瘀型及肾阳虚衰型4组.应用双能X线骨密度测量法测量患者腰椎(L1～4)和左右侧股骨近端3个部位的骨密度值.对比分析4组上述3个部位骨密度的平均值T.结果:241例中肝肾阴虚型56例,脾肾阳虚型50例,气滞血瘀型81例,肾阳虚衰型54例,其中气滞血瘀型骨密度平均值T最低(-3.03).对比组间骨密度平均值T,发现肝肾阴虚型与脾肾阳虚型,肝肾阴虚型与肾阳虚衰型,气滞血瘀型与脾肾阳虚型,气滞血瘀型与肾阳虚衰型组间差异均有统计学意义(均P<0.05);而肝肾阴虚型与气滞血瘀型、脾肾阳虚型与肾阳虚衰型组间差异均无统计学意义(均P>0.05).结论:骨质疏松症患者气滞血瘀型较多见,符合骨质疏松症的中医病机"多虚多瘀"的特点.同时,不同证型间的骨密度差异,可初步反向证实中医辨证的精确性,同时使量化骨质疏松症中医证型成为可能.

目的 基于静息态脑功能分析梅尼埃病发作期和静息期患者海马的脑功能连接模式差异,初步探讨梅尼埃病眩晕的中枢机制.方法 选取9例符合2017年《梅尼埃病临床诊断和治疗指南》的梅尼埃病发作期患者和13例静息期患者,进行脑静息态功能MRI扫描,影像学数据经预处理后,以双侧海马为感兴趣区,应用AFNI软件进行图像的统计学分析,采用独立样本t检验,以年龄、性别为协变量,比较2组海马功能连接的差异.结果 与静息期患者比较,梅尼埃病发作期患者组双侧海马种子点与右侧小脑的功能连接减弱,而与右侧楔前叶、左侧额中回、额上回、枕中回及右侧颞中回功能连接增强.结论 梅尼埃病发作期与静息期患者存在静息态双侧海马功能连接差异,且该区域与前庭功能密切相关,可能为梅尼埃病眩晕的中枢机制.

Objective:To study the correlation between syndrome differentiations and MRI and dynamic contrast-enhanced MRI (DEC-MRI)signs of breast cancer. Methods:60 patients of breast cancer were treated as research subjects,TCM syndrome dif-ferentiation and DCE-MRI were performed,and the morphological and DCE-MRI characteristics of all types were analyzed. Re-sults:The TCM syndrome type of breast cancer was divided into three types,including a total of 37 cases of liver qi depression and phlegm,15 cases Chong and Ren disorders card,8 cases positive imaginary poison Chi card. Correlation analysis between syndrome differentiations and MRI morphology and hemodynamics showed that the irregular shape,spicule sign in morphology and the DCE-MRI TIC type had significant differences in different types of TCM syndrome(all P<0.05). Conclusions:Breast cancer syndrome differentiations has a certain correlation between morphological and hemodynamic MRI. Parameters can provide a favorable basis for TCM syndrome.