Huntington’s disease (HD) is characterized by chorea, cognitive impairment, and psychiatric symptoms. Sleep and circadian rhythm disturbances are one of the important symptoms of HD that have been gradually recognized in recent years, and have a serious impact on the quality of life of patients and their caregivers. The clinical manifestations of sleep and circadian rhythm disturbances in HD are different from those of other neurodegenerative diseases. The exact pathological mechanisms of these disturbances remain unclear and there is no specific treatment. This article reviews the current progress in the study of sleep and circadian rhythm disturbances in HD, including its pathological mechanisms, clinical manifestations, assessment methods, correlation with cognitive impairment and psychiatric symptoms, treatment and management.
Epilepsy is a prevalent neurological disorder characterized by recurrent, transient episodes of central nervous system dysfunction resulting from abnormal neuronal discharges in the brain. Diagnosis of epilepsy integrates clinical manifestations, electroencephalogram (EEG) findings, and imaging studies. Clinical presentations are diverse and variable, with abnormal EEG serving as a critical diagnostic indicator; however, some patients exhibit normal EEG results. Moreover, there are still many patients who were underdiagnosed because of atypical epilepsy symptoms. With advancements in EEG and multimodal imaging technologies, diagnostic strategies based on biorhythm theory have emerged. This paper reviewed the diagnostic approaches for epilepsy grounded in biorhythm theory, in order to provide more effective support for the clinical management of epilepsy.
The study of atrial fibrillation (AF) has been known as a hot topic of clinical concern. Body surface potential mapping (BSPM), a noninvasive electrical mapping technology, has been widely used in the study of AF. This study adopted 10 AF patients’ preoperative and postoperative BSPM data (each patient’s data contained 128 channels), and applied the autocorrelation function method to obtain the activation interval of the BSPM signals. The activation interval results were compared with that of manual counting method and the applicability of the autocorrelation function method was verified. Furthermore, we compared the autocorrelation function method with the commonly used fast Fourier transform (FFT) method. It was found that the autocorrelation function method was more accurate. Finally, to find a simple rule to predict the recurrence of atrial fibrillation, the autocorrelation function method was used to analyze the preoperative BSPM signals of 10 patients with persistent AF. Consequently, we found that if the patient’s proportion of channels with dominant frequency larger than 2.5 Hz in the anterior left region is greater than the other three regions (the anterior right region, the posterior left region, and the posterior right region), he or she might have a higher possibility of AF recurrence. This study verified the rationality of the autocorrelation function method for rhythm analysis and concluded a simple rule of AF recurrence prediction based on this method.
The Chinese Guidelines on Diagnosis and Management of Atrial Fibrillation, jointly formulated by the Chinese Society of Cardiology, Chinese Medical Association and the Heart Rhythm Committee of Chinese Society of Biomedical Engineering, was first released on June 15, 2023. The guidelines elaborate the various aspects of atrial fibrillation management, in which emergency management of atrial fibrillation is also an integral part. This article interpreted the emergency management part in the guidelines in detail by reviewing relevant literature.
Objective To systematically review the health economic evaluations of using long-term rhythm-control antiarrhythmic drugs (AAD) for patients with paroxysmal or persistent atrial fibrillation (AF). Methods Databases including PubMed, EMbase, Scopus, CNKI, SinoMed, WanFang Data, and official websites of well-established health technology assessment (HTA) institutions were electronically searched to present the economic evaluations of AAD and the recommendations of HTA institutions based on drug economy from inception to April 23rd, 2022. Two reviewers independently screened the literature, extracted data and systematic review was then performed. Results A total of 19 studies were included, including 11 cost-effectiveness or cost-utility analysis studies and 8 official documents from HTA institutions. Only 5 (45.5%) economic evaluations were of relatively high quality, and English language studies were of higher quality than Chinese language studies ones. The included studies lacked elements that CHEERS 2022 concerns, such as health economics analysis plans, equity and distributional effects, engagement with patients and other stakeholders and the impact on the study. Dronedarone and amiodarone were the main focus of the evaluation, and the study results showed that dronedarone was cost-effective compared with other drugs in different study designs and national settings. However, there were differences between the recommendations of HTA agencies and the results of economic evaluation studies. Conclusion The completeness of health economics evaluations needs to be improved, along with the quality of clinical evidence in the field of AF-AAD for Chinese patients. Additionally, the informational value of drugs should be thoroughly investigated through budget impact analysis and distributional cost-effectiveness analysis to provide evidence of high-quality studies for decision-makers in China.
目的:观察氨氯地平片治疗非杓型老年高血压患者对血压昼夜节律异常及对动态动脉硬化指数(AASI)的影响。方法:80例患者每日晨8时顿服氨氯地平5～10mg/d,服药前及治疗8周后行24h动态血压监测。结果:80例完成治疗的患者中,60例血压昼夜节律异常逆转,同时改善AASI。而20例血压昼夜节律无逆转,AASI与治疗前比较无差异。结论:经氨氯地平片治疗后,75%的非杓型高血压患者,可改善血压昼夜节律异常及AASI。
The present paper reports the effect of pancreatitis induced by cholecystokinin (CCK) on free-running rhythm of locomotor activity of the ICR mice, and analyzes the interaction of inflammatory diseases and acute pancreatitis with circadian rhythm system. In the study, the mice were modeled under different phases of acute pancreatitis in DD status (Double Dark，constant dark condition). By comparing of the inflammatory status and the indicators of rhythm before and after modeling of the running wheel activity group and the rest group, it was observed that the rest group showed more possibility of inflammation than the activity group did in ICR mice model of acute pancreatitis. In the rest phase model, the extension of the period is particularly longer. The results presented indicated that CCK-induced acute pancreatitis impacted free activity rhythm of ICR mice. Also in a free running model under different phase, the inflammation severity was proved significantly different. This study provides possible clues for the research of the pathogenesis of acute pancreatitis severe tendency.