ABSTRACT
Objective To investigate the effects of continuous positive airway pressure (CPAP) on sleep status,neuropsychological characteristics in patients with stroke combined with obstructive sleep apnea syndrome (OSAHS).Methods Fifty-four patients hospitalized with stroke in Tianjin Medical University General Hospital from May 2014 to January 2016,who were with snoring and met the OSAHS diagnostic criteria,were randomly divided into CPAP combined with drug treatment group (25 cases) and drug treatment alone group (29 cases).The sleep structure and respiratory parameters were evaluated by polysomnography,and the changes of the patients' sleep status was assessed by Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI).The changes of neurocognitive function were assessed by Montreal Cognitive Assessment (MoCA),Digital Span Test (DST) and Hopkins Verbal Learning Testrevised (HVLT),and Patient Health Questionnaire-9 (PHQ9) was used to evaluate the depression mood changes.The changes of sleep status,cognitive function and mood in the CPAP combined with drug treatment group were compared before and three months after CPAP combined with drug treatment,and with the drug treatment alone group.Results Because five cases were dropped off,there were 20 patients in the CPAP combined with drug treatment group and 29 patients in the drug treatment alone group who completed the study.After three months of CPAP combined with drug treatment,the respiratory parameters apnea hypopnea index (AHI) in the CPAP combined with drug treatment group (29.32 ± 16.57) was significantly lower than that before treatment (41.66 ± 21.84;t =3.926,P =0.001),and the minimum blood oxygen saturation (LSaO2;82.11％ ± 5.66％) was significantly higher than that before treatment (76.11％ ± 8.90％;t=-5.054,P=0.000).However,the sleep structure parameters did not show statistically significant changes compared with those before treatment.The ESS,PSQI and PHQ9 scores in the CPAP combined with drug treatment group (4.53 ± 3.86,3.00 ± 2.45,0.00 (0.00,2.00)) were significantly decreased compared with those before treatment (10.58 ± 7.82,7.53 ± 2.87,3.00 (1.00,9.00);t =-3.883,P =0.001;t =-6.522,P =0.000;Z =-3.549,P =0.000),whereas MoCA,HVLT (total scores,recall and recognition) and DST 1,2 scores in the CPAP combined with drug treatment group (23.37 ± 4.75,22.32 ± 6.90,7.47 ± 3.82,7.84 ± 2.59,5.32 ± 2.81) were increased compared with those before treatment (22.16±4.94,19.16 ±7.66,6.68 ±3.74,7.32 ±2.67,5.00 ±3.00;t=-2.773,P=0.013;t=-6.857,P=0.000;t=-2.704,P=0.015;t=-2.249,P=0.037;t=-2.882,P =0.010).The ESS,PSQI and PHQ9 scores were significantly reduced in the CPAP combined with drug treatment group compared with the drug treatment alone group (8.76 ± 6.92,7.59 ± 5.49,5.00 (2.50,9.50);t=-2.711,P=0.009;t=-3.941,P=0.000;Z=-4.555,P=0.000),whereas the DST1 score was significantly increased compared with the drug treatment alone group (6.45 ± 1.43;t =2.144,P =0.042).Conclusions Three-month CPAP combined with drugs mainly improved the daytime sleepiness and depression of patients with stroke combined with OSAHS.Cognition especially in attention was significantly improved,and the degree of low ventilation and hypoxia was alleviated,whereas there was no significant change in sleep structure disorder.
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Objective To investigate the quantity and species distribution of diatoms in Chuanyang River of Pudong new area of Shanghai and provide references for the invesitigation of water body in forensic practice. Methods The water samples collected from 15 areas in Chuanyang River of Pudong new area in September 2012 were examined by microscope to identify the species of diatoms. Results Cyclotella and Pinnularia were found to be the dominant species within the 12 species of diatoms in Chuanyang River, which showed differences in species among the sections of Huangpu River, the center and the East China Sea. Conclusion The differences in subsectional distribution of diatom species in Chuanyang River may provide a new foundation for forensic identification in drowning cases especially in the deter-mination of falling location.
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ObjectiveThe purpose of this research was to investigate functional connectivity of 16-channel electroencephalograph(EEG) in δ frequency band based on Granger causality analysis.MethodsThe experimental data was recorded at a sampling rate of 200 Hz from temporal lobe epilepsy (TLE) patients(6 left and 3 right TLE,and 9 normals as control group.Ten of EEG segments of 20 s length for three different states:epileptiform discharges (ED) state in interictal durations,non-ED state for TLE patients,and control state for the normal.The δ band components (1～4 Hz) were filtered from EEGs.The functional connection values Iδ between two EEG δ components were calculated separately by Granger causality analysis.The two EEG components were from inferoposterior temporal lobe (left:T5,right:T6) to frontal lobe (Fp1,Fp2,F3,F4,and parietal lobe (C3,C4) for three states.ResultsThe Iδ values for ED state was 0.1323±0.0329～0.1670±0.028 9,which was significantly higher than that of non-ED state (0.0300±0.0130～0.0420±0.0072) (P＜0.05).The Iδ values for the control group (0.0153±0.0028～0.0193±0.0057) was much lower than that of ED state (P＜0.01),and no obvious distinctions were observed compared with non-ED state at P=0.05 level.ConclusionThere is a stronger connection of EEG' s δ bands from the inferoposterior temporal lobe to frontal and parietal lobe for the ED state,and the over-discharges transmission is from inferoposterior temporal lobe to other brain regions.There is a weaker connection from the top temporal lobe to frontal and parietal lobe for non-ED state and control group,and the onset zones is not inferoposterior temporal lobe.
ABSTRACT
The work of hospital management and evaluation began in 1991 in Shangtung.Up till 1995,the first phase has basically ended.From the three years of hospital evaluation,we find the prob- lems of superficial understanding of evaluation rules,hasty preparation of materials,etc.To solve the- seproblems,relevant documents must be well studied and hurried work avoided.Key points must be grasped with the guiding principle kept in mind.Defunct ideas must be scrapped with new ideas put into practice.A scientific evaluation is to render the evaluation conclusions authoritative and viable.Super- vision must be tightened.The point for evaluation is quality to.solve the problems of quality control and the monitoring of case history and illness specification.