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Why Should We Must Evaluate Cognitive Function in Hypertensive Patients 为什么我们必须评估高血压患者的认知功能
Pub Date : 2021-01-01 DOI: 10.35248/2168-975X.21.10.135
A. Vicario, G. Cerezo
Hypertension and dementia are two highly prevalent pathologies that affect the brain in the same period (persons over 60 years). One-third of patients with dementia have hypertension and, hypertension was reported in two-third of patients 65 years and older with dementia [1]. Thus, the brain is a target organ for hypertension and hypertension is the main modifiable vascular risk factor for developing cognitive impairment, dementia or Alzheimer's disease. Among the vascular risk factors, hypertension is the main cause of small vessel disease (leukoaraiosis, lacunar infarcts, microbleeds and dilated perivascular spaces) that mainly affects the cerebral subcortex. Vascular brain damage (hypoperfusion, hipoxia, ischemia, brainblood barrier disruption) affects the neurovascular unit (vascular, oligodendrocytes and neurons) and demyelinates the association fibers in the most vulnerable regions of subcortex (periventricular area has high density of long associating fibers), disconnecting the cortico-subcortical association circuits. The dorsolateral prefrontal cortex and the nuclei of the base is the most frequently circuit affected, resulting in impairment of executive functions [2].
高血压和痴呆是同一时期(60岁以上人群)影响大脑的两种非常普遍的病理。三分之一的痴呆患者存在高血压,65岁及以上痴呆患者中有三分之二存在高血压[1]。因此,大脑是高血压的靶器官,高血压是发生认知障碍、痴呆或阿尔茨海默病的主要可改变的血管危险因素。在血管危险因素中,高血压是主要影响大脑皮层下的小血管疾病(白质变、腔隙性梗死、微出血和血管周围间隙扩张)的主要原因。血管性脑损伤(低灌注、缺氧、缺血、脑血屏障破坏)影响神经血管单元(血管、少突胶质细胞和神经元),使皮层下最脆弱区域的关联纤维脱髓鞘(脑室周围区域有高密度的长关联纤维),断开皮质-皮层下关联回路。背外侧前额叶皮层和基底核是最常受影响的回路,导致执行功能受损[2]。
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引用次数: 0
Subjective of Brain Stem 脑干主观性
Pub Date : 2021-01-01 DOI: 10.35248/2168-975X.21.10.E138
Samy I McFarlane
The midbrain (mesencephalon) contains the atomic complex of the oculomotor nerve just as the trochlear core; these cranial nerves innervate muscles that move the eye and control the state of the focal point and the breadth of the student. Also, between the midbrain reticular arrangement (referred to here as the tegmentum) and the crus cerebri is a huge pigmented core called the substantia nigra. The substantia nigra comprises of two sections, the standards reticulata and the standards compacta. Cells of the standards compacta contain the dim shade melanin; these cells integrate dopamine and undertaking to either the caudate core or the putamen. By restraining the activity of huge aspiny striatal neurons in the caudate core and the putamen (depicted above in the segment Basal ganglia), the dopaminergic cells of the standards compacta impact the yield of the synapse GABA from prickly striatal neurons. The prickly neurons thus task to the cells of the standards reticulata, which, by extending strands to the thalamus, are important for the yield arrangement of the corpus striatum. At the caudal midbrain, crossed filaments of the predominant cerebellar peduncle (the significant yield arrangement of the cerebellum) encompass and halfway end in a huge midway found construction known as the red core. Most crossed rising filaments of this pack undertaking to thalamic cores, which approach the essential engine cortex. Fewer filaments neural connection on huge cells in caudal locales of the red core; these lead to the crossed strands of the rubrospinal plot (see the part The spinal rope: Descending spinal lots). The rooftop plate of the midbrain is shaped by two combined adjusted swellings, the unrivaled and mediocre colliculi. The unrivaled colliculus gets contribution from the retina and the visual cortex and takes part in an assortment of visual reflexes, especially the following of items in the contralateral visual field. The mediocre colliculus gets both crossed and uncrossed hear-able filaments and undertakings upon the average geniculate body, the hear-able hand-off core of the thalamus
中脑(中脑)包含动眼神经的原子复合体,就像滑车核一样;这些脑神经支配着眼球运动的肌肉,控制着焦点的状态和瞳孔的宽度。此外,在中脑网状结构(这里称为被盖)和大脑底部之间是一个巨大的色素核心,称为黑质。黑实质包括两部分,网状标准和紧凑标准。标准致密细胞含有暗色黑色素;这些细胞将多巴胺和神经整合到尾状核或壳核。通过抑制尾状核和壳核中巨大的刺状纹状体神经元的活动(如上基底神经节段所示),标准致密的多巴胺能细胞影响刺状纹状体神经元突触GABA的产量。因此,多刺神经元的任务是标准网状细胞,这些细胞通过延伸到丘脑,对纹状体的产出安排很重要。在中脑尾部,主要的小脑脚(小脑的重要产出结构)的交叉细丝包围并在中间形成一个巨大的中间结构,称为红核。大多数交叉的上升细丝向靠近基本引擎皮层的丘脑核行进。红核尾侧大细胞上丝状神经连接较少;这些导致了交叉股的脊髓束(见部分脊髓:下行脊髓束)。中脑的屋顶板是由两个组合调整的肿胀形成的,无与伦比的和平庸的丘顶。无与伦比的脑丘得到视网膜和视觉皮层的贡献,并参与各种视觉反射,特别是对侧视野中的以下项目。普通丘上有交叉的和未交叉的可听纤维,在普通膝状体上,也就是丘脑的可听传递核心
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引用次数: 0
PTSD Treatment Literature: Old and Fresh Approaches 创伤后应激障碍治疗文献:新旧方法
Pub Date : 2021-01-01 DOI: 10.35248/2168-975X.21.10.136
Steven G. Koven
PTSD is a brain disorder that exacts large costs to individuals, families, and society in general. Direct monetary costs that are associated with PTSD symptoms of U.S. military veterans have been increasing steadily. Less direct indicators of PTSD costs to society include the externalities of lower economic productivity, family dysfunction, PTSD comorbidities, drug, and alcohol addictions. Veteran awards linked to PTSD are conferred with the tacit assumption that “cures” for PTSD do not exist. Veterans Administration policies adopt the pharmacological strategy of dispensing drugs that have not been approved for PTSD usage by the U.S. Food and Drug Administration. Despite the existing government policies regarding PTSD treatment of veterans, emerging literature indicates that innovative PTSD treatments are available, that they deserve further scrutiny, and that they may present better alternatives to status quo options. In particular, noteworthy research regarding the use of stellate ganglion block or SGB appears to be promising. In addition to SGB research, literature has shown that approaches to PTSD such as physical activity, meditation, wilderness therapy, and self-help hold promise as treatments. Two treatment drugs, the selective serotonin reuptake inhibitor (SSRI) medications sertraline (Zoloft) and paroxetine (Paxil) have been approved by the Food and Drug Administration (FDA) for relieving symptom of PTSD. However, the U.S. Food and Drug Administration warned that these drugs are accompanied with the risk of suicidal thoughts, hostility, and agitation. Equally, if not more troubling, the literature indicates that physicians commonly prescribe benzodiazepine tranquilizers (such as Valium and Xanax) to veterans even though Veterans Administration guidelines advise against their use for PTSD. The Veterans Administration dispensed these drugs to almost a third of veterans being treated for PTSD even though they recognized the need to exercise caution in their use. A review of the literature indicates that PTSD is a growing societal problem; that existing treatments show signs of being problematic, and that innovative treatment strategies deserve greater attention.
创伤后应激障碍是一种脑部疾病,对个人、家庭和社会造成巨大损失。与美国退伍军人创伤后应激障碍症状相关的直接货币成本一直在稳步上升。创伤后应激障碍对社会造成的损失的不太直接的指标包括经济生产率降低、家庭功能障碍、创伤后应激障碍合并症、药物和酒精成瘾等外部性。与创伤后应激障碍有关的退伍军人奖励是在默认的假设下授予的,即创伤后应激障碍的“治疗方法”不存在。退伍军人管理局的政策采用药理学策略,分配未被美国食品和药物管理局批准用于PTSD的药物。尽管现有的政府政策对退伍军人的创伤后应激障碍的治疗,新出现的文献表明,创新的创伤后应激障碍治疗是可行的,他们值得进一步的审查,他们可能提供更好的替代现状的选择。特别是,关于使用星状神经节阻滞或SGB的值得注意的研究似乎很有希望。除了SGB研究,文献表明,治疗创伤后应激障碍的方法,如体育活动、冥想、野外治疗和自助,都有希望成为治疗方法。两种治疗药物,选择性血清素再摄取抑制剂(SSRI)药物舍曲林(Zoloft)和帕罗西汀(Paxil)已被美国食品和药物管理局(FDA)批准用于缓解PTSD症状。然而,美国食品和药物管理局警告说,这些药物伴随着自杀念头、敌意和躁动的风险。同样,如果不是更麻烦的话,文献表明医生通常会给退伍军人开苯二氮平类镇静剂(如安定和阿普唑仑),尽管退伍军人管理局的指导方针建议不要将其用于治疗创伤后应激障碍。退伍军人管理局给将近三分之一接受创伤后应激障碍治疗的退伍军人配发了这些药物,尽管他们认识到在使用这些药物时需要谨慎。文献综述表明,PTSD是一个日益严重的社会问题;现有的治疗方法显示出问题的迹象,创新的治疗策略值得更多的关注。
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引用次数: 0
Subjective of Brain Tumor 脑肿瘤的主观性
Pub Date : 2021-01-01 DOI: 10.35248/2168-975X.21.S2.E001
A. Hameed
Before beginning treatment, you would possibly need a second opinion concerning your diagnosing and treatment set up. Some folks worry that the doctor are going to be pained if they raise a second opinion. Typically the other is true. Most doctors welcome a second opinion. and lots of insurance firms pays for a second opinion if you or your doctor requests it. Some firms need a second opinion. If you get a second opinion, the doctor might believe your initial doctor's diagnosing and treatment set up. Or the second doctor might recommend another approach. Either way, you'll need a lot of data and maybe a bigger sense of management. You’ll feel a lot of assured concerning the selections you create, knowing that you have checked out your choices. It may take your time and energy to assemble your medical records and see another doctor. In several cases, it isn't a retardant to require many weeks to urge a second opinion. The delay in beginning treatment typically will not build treatment less effective. To form positive, you ought to discuss this delay together with your doctor. Some folks with a brain tumor want treatment at once. There are some ways to seek out a doctor for a second opinion. You’ll raise your doctor, a neighborhood or state medical society, a close-by hospital, or a graduate school for names of specialists. Also, you'll request a consultation with specialists at the National Institutes of Health Clinical Center in Bethesda, Maryland.
在开始治疗之前,你可能需要一个关于你的诊断和治疗设置的第二意见。有些人担心,如果他们提出另一种意见,医生会感到痛苦。通常另一种说法是正确的。大多数医生都欢迎第二种意见。如果你或你的医生提出要求,许多保险公司会支付第二意见的费用。有些公司需要第二意见。如果你得到第二意见,医生可能会相信你最初医生的诊断和治疗设置。或者第二个医生可能会推荐另一种方法。无论哪种方式,您都需要大量数据,也许还需要更强的管理意识。你会对你所创建的选择感到非常放心,因为你知道你已经检查了你的选择。这可能会花费你的时间和精力去收集你的医疗记录并去看另一位医生。在某些情况下,需要数周时间征求第二意见并不是一种阻碍。延迟开始治疗通常不会降低治疗效果。为了形成肯定,你应该和你的医生讨论这个延迟。一些患有脑瘤的人希望立即接受治疗。有一些方法可以寻求医生的第二意见。你会向你的医生、邻居或州医疗协会、附近的医院或研究生院询问专家的名字。此外,您将要求与马里兰州贝塞斯达国立卫生研究院临床中心的专家进行会诊。
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引用次数: 0
Commentary of Mental Disorder 精神障碍评论
Pub Date : 2021-01-01 DOI: 10.35248/2168-975X.21.10.129
A. Hameed
Sitting and failing to help extensive stretches of time or exiting recently appreciated exercises. It’s critical to take note of that the presence of a couple of these signs alone doesn't imply that you have a psychological maladjustment. In any case, it demonstrates that you may require further assessment. In case you're encountering a few of these manifestations all at once and they're keeping you from approaching your day by day life, you should
久坐不动,无法帮助长时间锻炼,也无法退出最近很受欢迎的锻炼。重要的是要注意,仅仅出现这些迹象并不意味着你有心理失调。无论如何,这表明你可能需要进一步的评估。如果你同时遇到了一些这样的表现,它们让你无法接近你的日常生活,你应该这样做
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引用次数: 0
Out Lines of Brain Cancer 脑癌的底线
Pub Date : 2021-01-01 DOI: 10.35248/2168-975X.21.10.127
M. Tan
Indications of cerebrum malignancy are impacted by what portion of the mind is included and the utilitarian framework it influences (e.g., engine, tangible, language, and so forth) For instance, vision issues may result from a tumor close to the optic nerve. A tumor in the forward portion of the cerebrum may influence the capacity to focus and think. A tumor situated in a region that controls engine capacity may cause shortcoming, deadness or trouble with discourse. Any tumor that is fundamentally huge may cause various side effects due to the pressing factor made by the mass. Individuals with a mind tumor may encounter the accompanying indications or signs. Once in a while, individuals with a mind tumor don't have any of these changes. Or on the other hand, the reason for a side effect might be an alternate ailment that isn't a cerebrum tumor.
大脑恶性肿瘤的指征取决于大脑的哪个部分被包括在内,以及它所影响的实用框架(例如,引擎、有形、语言等等)。例如,视力问题可能是由靠近视神经的肿瘤引起的。大脑前部的肿瘤可能影响集中和思考的能力。肿瘤位于控制发动机能力的区域,可能导致缺陷、死亡或说话困难。任何本质上巨大的肿瘤都可能由于肿块造成的压迫因素而产生各种副作用。患有脑瘤的人可能会遇到伴随的症状或体征。偶尔,患有脑瘤的人不会有任何这些变化。或者另一方面,副作用的原因可能是另一种疾病,而不是脑肿瘤。
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引用次数: 0
Cerebellum and its Function 小脑及其功能
Pub Date : 2021-01-01 DOI: 10.35248/2168-975X.21.10.E139
A. Hameed
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引用次数: 0
Editorial Note on Psychosis 关于精神病的社论注释
Pub Date : 2021-01-01 DOI: 10.35248/2168-975X.21.S2.E003
Samy I McFarlane
Psychosis is a condition that influences the manner in which your cerebrum measures data. It makes you put some distance between the real worlds. You may see, hear, or accept things that aren't genuine. Psychosis is a side effect, not a disease. A psychological or actual disease, substance misuse, or outrageous pressure or injury can cause it. Maniacal problems, similar to schizophrenia, include psychosis that normally influences you without precedent for the late teenager years or early adulthood. Youngsters are particularly prone to get it, yet specialists don't have the foggiest idea why. Indeed, even before what specialists call the principal scene of psychosis (FEP), you may show slight changes in the manner in which you act or think. This is known as the prodromal period and could last days, weeks, months, or even years. Some of the time you can put some distance between realities in any event, when you don't have an essential maniacal ailment like schizophrenia or bipolar problem.
精神病是一种影响大脑测量数据方式的疾病。它让你在现实世界之间拉开了距离。你可能会看到、听到或接受不真实的东西。精神病是一种副作用,不是疾病。心理上的或实际的疾病、药物滥用、过分的压力或伤害都可能导致它。狂躁问题,类似于精神分裂症,包括精神病,通常影响你的青少年晚期或成年早期没有先例。年轻人尤其容易得这种病,但专家们对其中的原因却一点也不清楚。事实上,甚至在专家们称之为精神错乱的主要场景(FEP)出现之前,你的行为或思维方式就可能出现细微的变化。这就是所谓的前驱期,可能持续几天,几周,几个月,甚至几年。有些时候,你可以在任何情况下与现实保持一定距离,当你没有精神分裂症或躁郁症等基本的疯狂疾病时。
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引用次数: 0
Quarantine, Brain, and Health 隔离,大脑和健康
Pub Date : 2020-01-01 DOI: 10.35248/2168-975X.20.9.258
M. Altable
Since Herophilus of Chalcedon (a.335) studied the brain and considered it the center of the nervous system, all the cognitive, psychological, emotional, and individual behavior processes of the human being have been linked to the brain, which has developed until our days the current neuropsychology. This helps us to explain the changes in the neurological functioning of our brain in situations such as social isolation and sensory deprivation.
自从迦克顿的希罗菲勒斯(公元前335年)研究了大脑并认为它是神经系统的中心以来,人类所有的认知、心理、情感和个人行为过程都与大脑联系在一起,直到我们今天的神经心理学才得以发展。这有助于我们解释在社会孤立和感觉剥夺等情况下大脑神经功能的变化。
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引用次数: 0
Patterns of Dystrophin Gene Deletion/Duplication in a Sample of Saudi Patients with Duchenne Muscular Dystrophy 沙特杜氏肌营养不良患者样本中肌营养不良蛋白基因缺失/重复模式
Pub Date : 2019-04-07 DOI: 10.35248/2157-7439.19.8.252
Ayman A. Abdelhady, Salem T. Abdelhady, Hebatallah R. Rashed
Introduction: Duchenne muscular dystrophy (DMD) is caused by the lack of functional dystrophin molecules, either due to nonsense mutations (premature stop codons) or by large rearrangements (deletions or duplications) that disturb the reading frame and in consequence abolish the production of dystrophin in muscles. Methods: Twenty patients with muscular dystrophy diagnosed by clinical history, family pedigree, CK total and histopathology of muscle biopsy is subjected to screening for all 79 exons of dystrophin gene for deletions and duplications. Results and Discussion: Deletion was detected in 80% of patients, while 15% showed duplication, one patient shows nucleotide substitution (c.10033C>T) in exon 69. Most common deletion found between exon 44 and 52. Conclusion: Our study detected high incidence of gene deletion compared to other studies, the most common deletion is multi exon deletion in the major hot spot of the gene (exon 44-52), also we detected lower incidence of duplication with higher percentage of duplication found distally.
杜氏肌营养不良症(DMD)是由于缺乏功能性肌营养不良蛋白分子引起的,要么是由于无义突变(过早停止密码子),要么是由于大量重排(缺失或重复)扰乱了阅读框,从而消除了肌肉中肌营养不良蛋白的产生。方法:对20例经临床病史、家系、CK总值及肌肉活检病理诊断为肌营养不良的患者,进行肌营养不良蛋白基因全部79个外显子的缺失和重复筛选。结果与讨论:80%的患者存在缺失,15%的患者存在重复,1例患者外显子69出现核苷酸替换(c.10033C>T)。最常见的缺失发生在外显子44和52之间。结论:与其他研究相比,我们的研究发现了较高的基因缺失发生率,最常见的缺失是基因主要热点(44-52外显子)的多外显子缺失,并且我们发现了较低的重复发生率,远端发现的重复比例较高。
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引用次数: 2
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Brain disorders & therapy
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