An overview on sleep research based on functional near infrared spectroscopy / 生物医学工程学杂志

Sleep is a complex physiological process of great significance to physical and mental health, and its research scope involves multiple disciplines. At present, the quantitative analysis of sleep mainly relies on the "gold standard" of polysomnography (PSG). However, PSG has great interference to the human body and cannot reflect the hemodynamic status of the brain. Functional near infrared spectroscopy (fNIRS) is used in sleep research, which can not only meet the demand of low interference to human body, but also reflect the hemodynamics of brain. Therefore, this paper has collected and sorted out the related literatures about fNIRS used in sleep research, concluding sleep staging research, clinical sleep monitoring research, fatigue detection research, etc. This paper provides a theoretical reference for scholars who will use fNIRS for fatigue and sleep related research in the future. Moreover, this article concludes the limitation of existing studies and points out the possible development direction of fNIRS for sleep research, in the hope of providing reference for the study of sleep and cerebral hemodynamics.

Analysis of the acute mountain sickness risk factor behind chinese young men’s acute exposure to high altitude: A field cohort study on plateau / 解放军医学杂志

[Abstract] Objective To investigate the risk factors and predictive factors for acute mountain sickness (AMS) after acute exposure to high altitude. Methods Eighty-three subjects were airlifted from Chengdu (elevation 500m) to Lhasa (elevation 3700m) in 2 hours, and divided into AMS(+) group and AMS(–) group according to the LLS AMS scores (2018). Subjects were tested both in plain (Chengdu) and plateau (Lhasa). With the case report form (CRF), the demographic data, AMS related symptoms, self-rating anxiety scale (SAS) and fatigue self-assessment scale (FSAS) were collected, meanwhile the heart rate, blood pressure and percutaneous oxygen saturation (SpO2) were detected. The cardiac ultrasound was performed, and the subjects' venous blood was collected to detect vasoconstriction and vasodilatation factors with ELISA. Logistic regression analysis was performed to screen the independent risk factors for AMS. Results As 4 subjects were lost, a total of 79 subjects were eventually included in present study. After acutely exposed to high altitude, the subjects' SAS, FSAS and HR aroused obviously (P<0.05), while the SpO2 decreased markedly (P<0.05). There was also a significant increase in systemic and cerebral hemodynamics (P<0.05). Plasma levels of endothelin-1 and bradykinin increased (P<0.05), while of nitric oxide, prostaglandin E and serotonin decreased (P<0.05). Furthermore, when the subjects were located in plain area, the left ventricular end-diastolic diameter (LVEDD) was obviously higher in AMS(+) group [(47.11±2.90)mm] than in AMS(–) group [(45.51±2.17)mm, P=0.008], while after acutely exposed to high altitude, the SAS and FSAS were markedly higher in AMS(+) group than in AMS(–) group (P=0.001), and the systolic blood flow velocity of basilar artery was also higher in AMS(+) group [(70.30±15.71)cm/s] than in AMS(–) group [(63.06±11.81)cm/s, P=0.026]. With regression analysis, it is shown that LVEDD could independently indicate the occurrence of AMS in the plain area (OR=1.293, 95%CI 1.058-1.581, P=0.012), and the systolic blood flow of basilar artery (OR=1.055, 95%CI 1.005-1.107, P=0.030), right atrium diameter (RAD, OR=0.731, 95%CI 0.543-0.984, P=0.039), SAS (OR=1.219, 95%CI 1.027-1.447, P=0.023) and FSAS (OR=1.105, 95%CI 1.016-1.201, P=0.019) were closely correlated with AMS after acutely exposed to high-altitude (P<0.05). Conclusions The baseline LVEDD has predictive value for AMS in plain area. After exposure to high altitude, the posterior cerebral circulation hemodynamics, anxiety and fatigue may trigger the occurrence of AMS.

Key-points of cerebral hemodynamic therapy in neuro critical cases / 中国实用内科杂志

Cerebral hemodynamic therapy has the ultimate goal of brain function improvements.The therapeutic endpoint is to optimize cerebral perfusion in order to stop primary or secondary injury and promote brain function recovery.Clinically,cerebral perfusion can be indirectly measured by brain oxygenation instruments including Near-infrared spectroscopy.Cerebral blood flow optimization should be the core target of cerebral hemodynamic therapy.Transcranial Color-Coded Duplex and Transcranial Doppler sonography are essential techniques to quantify cerebral blood flow,evaluate vascular resistance,and alert for increased intracranial pressure non-invasively by bedside measurements of optic nerve sheath diameter.Hemodynamic targets including blood pressure,cardiac output,and oxygen delivery require extra considerations beyond traditional hemodynamic therapy in order to promote cerebral function.Brain electricity monitoring should be read with caution where low brain activity might indicate insufficient cerebral perfusion,whereas overactive brain function shows high oxygen consumption.In clinical practice,the integrated monitoring of cerebral blood flow,brain oxygenation and brain function would improve the management of neurocritical patients.

Clinical Observation of Naloxone Hydrochloride Combined with Danshen Injection in the Treatment of Neo-natal Hypoxic Ischemic Encephalopathy / 中国药房

OBJECTIVE:To observe clinical efficacy and safety of naloxone hydrochloride combined with Danshen injection in the treatment of neonatal hypoxic ischemic encephalopathy(HIE). METHODS:104 patients with HIE were randomly divided into observation group and control group with 52 cases in each group. The control group was treated with Naloxone hydrochloride injec-tion 0.02 mg/kg,ivgtt,qd and conventional symptomatic treatment;while observation group was additionally treated with Danshen injection 4-6 ml+10% Glucose injection 20 ml,ivgtt,qd,on the basis of the control group. Treatment course of 2 groups lasted for 7 d. Clinical efficacy,symptom and sign recovery of 2 groups were compared,as well as levels of serum MMP-9,IL-6 and TNF-α,cerebral hemodynamic parameters and ADR. RESULTS:There was no statistical significance in MMP-9,IL-6,TNF-α and cerebral hemodynamic parameters before treatment(P>0.05). The total effective rate of observation group(92.31%)was signifi-cantly higher than that of control group (75.00%);after treatment,the recovery time of consciousness disturbance,primitive re-flex and muscle tension in the observation group were shorter than those in the control group;the levels of serum MMP-9,IL-6 and TNF-α in observation group were significantly lower than those in control group;peak systolic flow velocity(PSFV),end-dia-stolic flow velocity (EDTV) were higher in the observation group than in the control group,with statistical significance (P0.05). No ADR was ob-served in 2 groups. CONCLUSIONS:Naloxone hydrochloride combined with Danshen injection can significantly promote HIE and signs recovery,reduce the levels of serum MMP-9,IL-6 and TNF-α,and improve hemodynamic parameters with good safety.

Study on the cerebral hemodynamic changes by transcranial Doppler ultrasonography from emergency ;periods to stable periods in severe acute encephalopathy children / 中国小儿急救医学

Objective To evaluate the correlations between the cerebral hemodynamic changes of severe acute encephalopathy with the clinical features from emergency periods to stable periods and the value of transcranial Doppler ultrasonography( TCD)in cerebral function assess. Methods Thirty patients with acute brain diseases by assisted mechanical ventilator from Jun 2014 to May 2015 in PICU were included and followed up to Nov 2015,then grouped by Glasgow Coma Scale( GCS),MRI,prognosis( mental sequelae after half a year). Each subject was examined through the temporal bone window by TCD at emergency peri-ods and stable periods. The systolic cerebral blood flow velocity( sCBFV),and pulsatility index( PI)of bilat-eral middle cerebral artery( MCA),anterior cerebral artery,posterior cerebral artery were analyzed. Multivari-ant analysis of variance,repeated measures analysis of variance was conducted to compare sCBFV and PI of MCA among groups in different clinical periods. The variants included sex,disease diagnosis,prognosis, MRI,GCS,and the first abnormal TCD. The variation within groups was tested via a Hotelling T2 test. All sCBFV and PI of each artery and the D-value of sCBFV between the different periods were compared accord-ing to the prognosis groups. Results (1)Five patients could be lateralized,and their lateralization of MRI focus was consistent with the abnormal sides of sCBFV in the stable periods.(2)The D-value of sCBFV in left MCA between the different periods in the poor prognosis group was significantly higher than that in the good prognosis group[(71. 93 ± 58. 21)cm/s vs.(33. 20 ± 30. 23)cm/s,t = -2. 287,P =0. 033].(3) Multivariant analysis of variance showed that GCS classification and disease diagnosis were significantly cor-related with the cerebral hemodynamic changes respectively(P =0. 042,0. 005,respectively).(4)sCBFV and PI of left MCA reduced significantly in the stable periods than those in the emergency periods( P =0. 002,0. 003,respectivly). Conclusion The cerebral hemodynamic changes by TCD from emergency peri-ods to stable periods are consistent with the clinical status,dynamic evaluation by TCD may facilitate the evaluation of brain dysfunction in the severe acute encephalopathy.

Isquemia encefálica, cascatas vasodilatadoras e alterações bioquímicas / Biochemical and hemodynamic alterations in brain ischemia

Procede-se a uma revisão das alterações bioquímicas e hemodinâmicas causadas pela isquemia do tecido nervoso. Trata-se de uma visão introdutória que aborda a fisiopatologia e as repercussões da terapêutica sobre a hemodinâmica encefálica.

This is a review on the biochemical and hemodynamic alterations caused by the isquemia in the neural tissue. This text introduce the pathophysiology and the therapeutic effects of this ischemic alterations.

Hemodinâmica do vasoespasmo: [revisão] / Cerebral hemodynamic alterations due to vasospasm: [review]

Os autores descrevem as alterações hemodinâmicas encefálicas que ocorrem na vigência do vasoespasmo após a hemorragia subaracnoidea por aneurismas. O conhecimento dessas alterações facilita o entendimento das medidas terapêuticas.

The authors describe the hemodynamic encephalic alterations that occur during the vasospasm after aneurysmal subarachnoid hemorrhage. The knowledge of these alterations promotes better understanding of the therapeutic procedures.