该协议是支持国家研究所老龄补助金K23 AG031925和R01 AG038471。

1。成立EEG设备<ol><li>我们的实验室使用128通道BioSemi ActiveTwo脑电采集系统与“主动”的电极（阿姆斯特丹，荷兰; <a href="http://www.biosemi.com">http://www.biosemi.com</a> ）和ActiveTwo电极帽（行为脑科学中心，伯明翰，英国）获得ERP数据。 </li><li>确保电池完全充电和连接到放大器。 </li><li>收集所有需要完成设置的参与者，包括材料：注射器，凝胶，卷尺，各种大小的脑电图帽，酒精棉签，面部电极贴，魔术贴绑带，以确保电极电缆。 </li><li>放在五个面部电极贴。 </li></ol> 2。刺激演示和数据采集计算机<ol><li>开启刺激演示计算机和数据采集计算机。 </li><li>我们的实验室使用的电子首相软件（宾夕法尼亚州匹兹堡）目前的刺激和收购行为数据。 </li><li>检查，以确保实验数据采集计算机发送适当的触发代码。 </li><li>要做到这一点： <ul><li>参与者室（注：无电极或电缆需要插入做到这一点），开放的数据采集计算机数据采集软件，点击开始（不要保存）打开放大器。 </li><li>转到刺激演示计算机，打开你的实验文件，并创下运行。 </li><li>您现在应该看到相应的触发器，你进入你的实验文件上显示的数据采集软件程序编程代码。 </li></ul></li></ol> 3。参与者的制备<ol><li>详细的所有参与者和解决任何安全问题的研究程序。此外，保证患者充分理解的协议，由他们报告的协议在他们自己的话说研究员。 </li><li>有参与者在中等高度硬背椅舒适的坐姿。 </li><li>参与者一旦就位，确保他/她的视力线显示实验（这里我们使用48英寸）的标准。 </li><li>测量参与者的头部周长，以确定应使用脑电图第。 </li><li>请参与者，以消除任何珠宝或发饰，以确保适当的配合脑电图帽和准确记录。另外，如果参与者戴着眼镜，最好能有他/她在这一点上，直到所有的面电极已应用。 </li><li>同样重要的是，审查每个主题下面： <ul><li>删除任何口香糖或糖果/薄荷糖，以减少电机运动</li><li>请参与者使用前开始作为设施不中断脑电记录</li><li>询问参与者，要尽力保持到最低限度的运动和眨眼，但不必过分担心这样做</li></ul></li><li>使用酒精棉球消毒，清洗参与者的皮肤油和/或化妆，面部将被放置电极：每个乳突，在每个寺庙之一，直接低于左眼之一。 </li><li>将少量的凝胶进行到每个面电极，取出从参与者的贴纸和地方的支持，运用少量的压力，以确保电极将留在原地。 </li><li>现在到参与者的头部放置的脑电图帽和固定在他/她的下巴下的表带。如果参与者戴着眼镜，他/她把帽之前把这些。 </li><li>下一步，衡量（以厘米为单位），从鼻根（鼻梁）枕外隆凸尖（头部腰背突）。乘以0.5（发现中点）的测量，这是应该由前向后放置电极A1。下一步，衡量一只耳朵到其他（上耳软骨以上的缩进）前耳。这种测量的中点，是应该从一侧到另一侧的电极A1。 </li></ol> 4。数字化源定位和电极放置<ol><li>我们的实验室使用Polhemus爱国者数字转换器/定位器（科尔切斯特，VT），获得三维交涉，在每个参与者的头上的电极位置（或头部模型）。这控制每个参与者在颅骨的形状变异，使得更准确源定位。此外，这些头模型可以共同注册与结构的磁共振图像，以配合优越的空间分辨率的MRI和上级的事件相关电位的时间分辨率。 </li><li>首先，将根据第左耳后部定位发射器，多余的线下保持在南极夹着。 </li><li>将接收到木椅在参与者的头部，从发射机约6英寸以下位置。 </li><li>打开数字化软件，并采取electr测量ODE与手写笔的位置作为提示的软件。 </li><li>生成的3D头部模型电极定位软件议员职务，并接受原始脑电数据的本地化。 </li><li>一旦参与者的3D头部模型已在计算机上显示的验证，我们已经准备好，放置在每个预先定义的位置上ActiveTwo第电极。 </li><li>填补与导电凝胶，并在所有电极插入电极帽井。收集所有参与者背后的电缆和面部电极插入放大器。 </li><li>提供参与者年龄较大的一个突破，特别是阿尔茨海默氏症患者，他们可能需要频繁的休息，以保持集中和持续地注意实验任务。 </li><li> ActiView软件的使用，以确保所有电极的神器和阻力水平是可以接受的。毕竟电极放置，参与者已准备好开始实验时，应检查电极的阻力水平使用ActiView软件在数据采集计算机。胶印水平应在+ / -25μV。 </li><li>一旦所有的阻力水平是可以接受的的，该实验是准备运行。 </li></ol> 5。脑电图数据和实验数据采集<ol><li>我们的实验室使用BioSemi的ActiView软件来查看和获取原始脑电数据。 </li><li>加载行为数据的演示文稿文件。输入参与者的数量。实验软件节省了与会者的响应，并自动生成一个数据文件，实验完成后，运行这个参与者数量。 </li><li>执行检查，以确保参与者坐在48英寸显示器的中心。 </li><li>一旦加载实验，应该是阅读和行为指令与参与者核实。 </li><li>在我国目前的识别记忆体设计，在实验开始研究阶段，参与者将是一系列的图片或文字提出。 </li><li>开始保存数据采集计算机脑电图数据的原始文件。 </li><li>启动刺激呈现计算机刺激交付。 </li><li>与老年人按钮盒上的输入响应的研究员工作。认知功能障碍患者，这一点尤为重要。 </li><li>监视器参与者行为的任务期间，包括休息的需要。 </li><li>一旦所有的行为的刺激已经提出，必须保存原始脑电数据。再次，行为数据，由电子总理的软件会自动保存。 </li><li>节能研究或数据编码后，前9个步骤将重复测试阶段，参与者将再次提出的一系列图片或文字。在测试阶段，项目的一半将由阶段的研究和项目的一半将小说。与会者将确定该项目的旧/新的状态，报告他们的答案大声研究员。然后研究人员将参与者的响应输入按钮盒。 </li></ol> 6。数据后处理管道<ol><li>我们的实验室使用EMSE套件5.3 </li><li>的原始数据，必须先准备和数字滤波去除信号噪声和工件前就可以完成任何类型的分析。 </li><li>首先，时间的过滤器，如无限脉冲响应和带通滤波器，必须应用。 </li><li>接下来，数据必须引用一些头部穴位。选择参考。在目前的协议，我们使用共同的平均参考。 </li><li>下一步，必须过滤空间数据和坏的渠道插值。目视检查数据进行适当的过滤器是到位。 </li><li>最后，眼神器校正方法必须使用正确的眨眼和眼球运动神器的信号。 </li></ol> 7。代表性的成果我们的工作表明，在早期额叶新/旧效应（点击&gt;正确拒绝），通常的概念处理或纪念熟悉相关的，保持健康的老年人相比，轻度阿尔茨海默病患者完好的图片，但不为字（盟友McKeever，华林，与Budson，2009）。盟军等人。 （2009）表明，顶叶新/旧效应，通常与回忆相关的图片和字的同龄人相比，患者受损。换言之，正面的纪念与识别相关的进程似乎与AD患者和健康老年人之间的图片类似。相反，这些过程受损患者的话，当我们检查两组之间的差异。这组与组之间的显着区别是显而易见的图片和文字后的记忆过程。虽然有关联的认知过程与早期的正面发送相当多的争论ffect，我们推测，轻度阿尔茨海默氏症患者能成功地利用概念处理或纪念熟悉，以增加他们的歧视相比，以文字的图片，而这些过程可能背后强大的图像优势效应与阿尔茨海默氏症患者。 前腰ERP与成功的文字和图片检索相关的活动是非常轻度阿尔茨海默氏病和健康老年人的控制（图1）患者表现出。这些图片是在300至500毫秒的时间通常与概念处理或纪念熟悉相关的时间间隔。请注意类似的正面为图片新/旧效应（红色伪），但群体之间的话减少的影响。 （青色伪）。 <img src="/files/ftp_upload/2715/2715fig1.jpg" alt="图1" /> 图1：代表在检索任务的ERP在阿尔茨海默氏症患者和健康人的活动。

<ol>
	<li>Ally, B. A., Budson, A. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+worth+of+pictures:+Using+high+density+event-related+potentials+to+understand+the+memorial+power+of+pictures+and+the+dynamics+of+recognition+memory.">The worth of pictures: Using high density event-related potentials to understand the memorial power of pictures and the dynamics of recognition memory.</a> Neuro Image. 35, 378-395 (2007).</li><li>Ally, B. A., McKeever, J. D., Waring, J. D., Budson, A. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pictures+preserve+frontal+memorial+processes+in+patients+with+mild+cognitive+impairment.">Pictures preserve frontal memorial processes in patients with mild cognitive impairment.</a> Neuro psychologia. 47, 2044-2055 (2009).</li><li>Ally, B. A., Budson, A. E., Kowall, N. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Using+EEG+and+MEG+to+understanding+brain+physiology+in+dementia.">Using EEG and MEG to understanding brain physiology in dementia.</a> The Handbook of Alzheimer's disease and other dementias. , (2011).</li></ol>

没有利益冲突的声明。

ERP和行为数据，我们可以提供不同的和互补的信息。鉴于行为数据，我们对病人的表现，资源规划可以让我们记录大脑活动的离散的变化。由于其良好的时间分辨率，资源规划已被证明非常有用，在游离和理解纪念进程中的作用（例如，处理概念和熟悉的回忆，检索后监控流程）先前已与特定的新/旧的组件相关浪潮ERP（早额叶，顶叶，额叶后期，分别）（见盟友Budson，2007年）。在学习与认知功?...

<table border="1"><tbody><tr><td> 产品 </td><td> 公司 </td></tr><tr><td> BioSemi活动两个脑电采集系统* </td><td> Cortech解决方案，公司</td></tr><tr><td> Polhemus爱国者数字化仪</td><td> Cortech解决方案，公司</td></tr><tr><td>电子首相2.0专业版软件</td><td>心理学的软件工具， </td></tr></tbody></table> *此系统包括放大器，积极两个脑电图帽，注射器，SignaGel（导电胶），和面部电极贴。

examining the characteristics of episodic memory using event-related potentials in patients with alzheimer's disease

我们的实验室使用事件相关脑电图潜力（资源规划），情节记忆与遗忘型轻度认知功能损害（AMCI）和阿尔茨海默氏病（AD）患者的理解和支持的行为调查。鉴于行为数据，了解病人的表现，有效保护率让我们记录大脑活动的离散的变化。此外，资源规划可以让我们洞察到发病，持续时间，和独立的认知过程与记忆提取相关的互动。在患者人群中，这些类型的研究是用来检查内存的哪些方面受损和控制人口相比保持相对完好。 ERP数据收集从一个脆弱的病人人口，而这些参与者进行识别记忆任务的方法是审查。该协议包括参与者准备，质量保证，数据采集，数据分析和。除了基本的设置和收购，我们也将展示定位技术，以获得更大的空间分辨率和源定位，采用高密度电极阵列（128频道）。

Watch this Scientific Journal Video about Examining the Characteristics of Episodic Memory using Event-related Potentials in Patients with Alzheimer's Disease at JoVE.com

Examining the Characteristics of Episodic Memory using Event-related Potentials in Patients with Alzheimer&#039;s Disease

高密度事件相关电位数据收集的方法，而与阿尔茨海默氏症患者进行识别记忆任务是审查。该协议将包括受编制，质量保证，数据采集和数据分析。

情节记忆的特点，采用事件相关电位研究在阿尔茨海默氏症患者

Our laboratory uses event-related EEG potentials (ERPs) to understand and support behavioral investigations of episodic memory in patients with amnestic ...

examining-characteristics-episodic-memory-using-event-related

Research

JoVE Journal

Medicine

Examining the Characteristics of Episodic Memory using Event-related Potentials in Patients with Alzheimer's Disease

13.4K 次观看.  Vanderbilt University. 高密度事件相关电位数据收集的方法，而与阿尔茨海默氏症患者进行识别记忆任务是审查。该协议将包括受编制，质量保证，数据采集和数据分析。

视频: Examining the Characteristics of Episodic Memory using Event-related Potentials in Patients with Alzheimer's Disease

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Patients with chronic kidney disease (CKD) have significantly increased risk of cardiovascular disease (CVD) compared to the general population, and this is only partially explained by traditional CVD risk factors. Vascular dysfunction is an important non-traditional risk factor, characterized by vascular endothelial dysfunction (most commonly assessed as impaired endothelium-dependent dilation [EDD]) and stiffening of the large elastic arteries. While various techniques exist to assess EDD and large elastic artery stiffness, the most commonly used are brachial artery flow-mediated dilation (FMDBA) and aortic pulse-wave velocity (aPWV), respectively. Both of these noninvasive measures of vascular dysfunction are independent predictors of future cardiovascular events in patients with and without kidney disease. Patients with CKD demonstrate both impaired FMDBA, and increased aPWV. While the exact mechanisms by which vascular dysfunction develops in CKD are incompletely understood, increased oxidative stress and a subsequent reduction in nitric oxide (NO) bioavailability are important contributors. Cellular changes in oxidative stress can be assessed by collecting vascular endothelial cells from the antecubital vein and measuring protein expression of markers of oxidative stress using immunofluorescence. We provide here a discussion of these methods to measure FMDBA, aPWV, and vascular endothelial cell protein expression.

The degree of vascular dysfunction and contributing physiological mechanisms can be assessed in patients with chronic kidney disease by measuring brachial artery flow-mediated dilation, aortic pulse-wave velocity, and vascular endothelial cell protein expression.

血管功能在慢性肾脏疾病的评估

Patients with chronic kidney disease (CKD) have significantly increased risk of cardiovascular disease (CVD) compared to the general population, and this ...

科研

医学

Motor and Hippocampal Dependent Spatial Learning and Reference Memory Assessment in a Transgenic Rat Model of Alzheimer's Disease with Stroke

Alzheimer&#39;s disease (AD) is a debilitating neurodegenerative disease that results in neurodegeneration and memory loss. While age is a major risk factor for AD, stroke has also been implicated as a risk factor and an exacerbating factor. The co-morbidity of stroke and AD results in worsened stroke-related motor control and AD-related cognitive deficits when compared to each condition alone. To model the combined condition of stroke and AD, a novel transgenic rat model of AD, with a mutated form of amyloid precursor protein (a key protein involved in the development of AD) incorporated into its DNA, is given a small unilateral striatal stroke.
For a model with the combination of both stroke and AD, behavioral tests that assess stroke-related motor control, locomotion and AD-related cognitive function must be implemented. The cylinder task involves a cost-efficient, multipurpose apparatus that assesses spontaneous forelimb motor use. In this task, a rat is placed in a cylindrical apparatus, where the rat will spontaneously rear and contact the wall of the cylinder with its forelimbs. These contacts are considered forelimb motor use and quantified during video analysis after testing. Another cost-efficient motor task implemented is the beam-walk task, which assesses forelimb control, hindlimb control and locomotion. This task involves a rat walking across a wooden beam allowing for the assessment of limb motor control through analysis of forelimb slips, hindlimb slips and falls. Assessment of learning and memory is completed with Morris water maze for this behavioral paradigm. The protocol starts with spatial learning, whereby the rat locates a stationary hidden platform. After spatial learning, the platform is removed and both short-term and long-term spatial reference memory is assessed. All three of these tasks are sensitive to behavioral differences and completed within 28 days for this model, making this paradigm time-efficient and cost-efficient.

Motor and Hippocampal Dependent Spatial Learning and Reference Memory Assessment in a Transgenic Rat Model of Alzheimer&#039;s Disease with Stroke

To investigate the co-morbid Alzheimer&#39;s disease (AD) and stroke condition in a novel model, three behavior tasks are described that assess both motor control and cognitive behaviors. These tasks include the beam-walk task, cylinder task and Morris water maze.

汽车和海马依赖空间学习和记忆参考评估与中风阿尔茨海默氏病的转基因大鼠模型

Alzheimer&#39;s disease (AD) is a debilitating neurodegenerative disease that results in neurodegeneration and memory loss. While age is a major risk ...

Quantitative 3D In Silico Modeling (q3DISM) of Cerebral Amyloid-beta Phagocytosis in Rodent Models of Alzheimer's Disease

Neuroinflammation is now recognized as a major etiological factor in neurodegenerative disease. Mononuclear phagocytes are innate immune cells responsible for phagocytosis and clearance of debris and detritus. These cells include CNS-resident macrophages known as microglia, and mononuclear phagocytes infiltrating from the periphery. Light microscopy has generally been used to visualize phagocytosis in rodent or human brain specimens. However, qualitative methods have not provided definitive evidence of in vivo phagocytosis. Here, we describe quantitative 3D in silico modeling (q3DISM), a robust method allowing for true 3D quantitation of amyloid-&#946; (A&#946;) phagocytosis by mononuclear phagocytes in rodent Alzheimer&#39;s Disease (AD) models. The method involves fluorescently visualizing A&#946; encapsulated within phagolysosomes in rodent brain sections. Large z-dimensional confocal datasets are then 3D reconstructed for quantitation of A&#946; spatially colocalized within the phagolysosome. We demonstrate the successful application of q3DISM to mouse and rat brains, but this methodology can be extended to virtually any phagocytic event in any tissue.

Quantitative 3D In Silico Modeling q3DISM of Cerebral Amyloid-beta Phagocytosis in Rodent Models of Alzheimer&#039;s Disease

We developed a methodology for quantitative 3D in silico modeling (q3DISM) of cerebral amyloid-&#946; (A&#946;) phagocytosis by mononuclear phagocytes in rodent models of Alzheimer&#39;s disease. This method can be generalized for the quantitation of virtually any phagocytic event in vivo.

定量3D<em&gt;在硅片</em&gt;建模阿尔茨海默病的啮齿动物模型脑淀粉样蛋白-β吞噬（q3DISM）

Neuroinflammation is now recognized as a major etiological factor in neurodegenerative disease. Mononuclear phagocytes are innate immune cells responsible ...

Application of Granger Causality Analysis of the Directed Functional Connection in Alzheimer's Disease and Mild Cognitive Impairment

Impaired functional connectivity in the Default Mode Network (DMN) may be involved in the progression of Alzheimer&#39;s Disease (AD). The Posterior Cingulate Cortex (PCC) is a potential imaging marker for monitoring the progression of AD. Previous studies did not focus on the functional connectivity between the PCC and nodes in regions outside the DMN, but our study is an effort to explore these overlooked functional connections. For collecting data, we used functional Magnetic Resonance Imaging (fMRI) and Granger Causality Analysis (GCA). fMRI provides a non-invasive method for studying the dynamic interactions between the different brain regions. GCA is a statistical hypothesis test for determining whether one-time series is useful in forecasting another. In simple terms, it is judged by comparing the &#34;Known all the information on the last moment, the distribution of the probability of X at this time&#34; and the &#34;Known all the information on the last moment except Y, the distribution of the probability of X at this time&#34;, to determine whether there is a causal relationship between Y and X. This definition is based on the complete information source and stationary chronological sequence. The main step of this analysis is to use X and Y to establish the regression equation and draw a causal relationship by a hypothetical test. Since GCA can measure causal effects, we used it to investigate the anisotropy of the functional connectivity and explore the hub function of the PCC. Here, we screened 116 participants for MRI scanning, and after preprocessing the data obtained from neuroimaging, we used GCA to derive the causal relationship of each node. Finally, we concluded that the directed connection is significantly different between the Mild Cognitive Impairment (MCI) and AD groups, both from the PCC to the whole brain and from the whole brain to the PCC.

Application of Granger Causality Analysis of the Directed Functional Connection in Alzheimer&#039;s Disease and Mild Cognitive Impairment

Based on resting-state functional magnetic resonance imaging with Granger causality analysis, we investigated the alterations in the directed functional connectivity between the posterior cingulate cortex and whole brain in patients with Alzheimer&#39;s Disease (AD), patients with Mild Cognitive Impairment (MCI), and healthy controls.

在阿尔茨海默病和轻度认知功能损害的定向功能连接格兰杰因果关系分析中的应用

Impaired functional connectivity in the Default Mode Network (DMN) may be involved in the progression of Alzheimer&#39;s Disease (AD). The Posterior ...

Multi-Modal Home Sleep Monitoring in Older Adults

The gold standard for sleep monitoring is attended in-lab polysomnography; however, this method may be cost-prohibitive and inconvenient for patients and research participants. Home sleep testing has gained momentum in the field of sleep medicine due to its convenience and lower cost, as well as being more naturalistic. The accuracy and quality of home sleep testing, however, may be variable because studies are not monitored by sleep technologists. There has been some success in improving the accuracy of home sleep studies by having trained sleep technicians assist participants inside their homes with putting on the devices, but this can be intrusive and time-consuming for those involved. In this protocol, participants undergo at-home sleep monitoring with multiple devices: 1) a single-channel EEG device; 2) a home sleep test for sleep-disordered breathing and periodic limb movements; 3) actigraphy; and 4) sleep logs. A major challenge of this study is obtaining high-quality sleep monitoring data on the first attempt in order to minimize participant burden. This protocol describes the implementation of educational manuals with step-by-step instructions and photos. The goal is to improve the quality of home sleep testing.

Here, we present a protocol to improve the quality of data from home sleep testing by providing a method to enhance instructions through a structured participant visit. This protocol includes the implementation of a step-by-step educational manual with photos to ensure proper placement of equipment.

老年人多式家庭睡眠监测

The gold standard for sleep monitoring is attended in-lab polysomnography; however, this method may be cost-prohibitive and inconvenient for patients and ...

Fertility Preservation in Patients with Severe Ovarian Dysfunction

Ovarian function progressively declines during aging and in some pathophysiological conditions including karyotype abnormality, autoimmune diseases, chemo- and radiation-therapies, as well as ovarian surgeries. In unmarried women with severe ovarian dysfunction, fertility preservation is important for future pregnancies. Although oocyte cryopreservation is an established method for fertility preservation, these patients could only preserve a limited number of oocytes even after ovarian hyperstimulation, leading to repeated stimulations to ensure sufficient oocytes to guarantee future pregnancy. To solve this issue, we have recently developed a drug-free in vitro activation (IVA) procedure, which enable us to stimulate early stages of ovarian follicles to develop to the preantral follicle stage. These preantral follicles can respond to the unique protocol of gonadotropin stimulation, resulting in increased number of retrieved oocytes per ovarian stimulation for cryopreservation. The drug-free IVA comprised from the surgical approach and ovarian stimulation. We removed a part of cortex from one or both ovaries from patients under laparoscopic surgery. The ovarian cortical tissues were cut into small cubes to disrupt the Hippo signaling pathway and stimulate the development of early stage follicles. These cubes were grafted orthotropically into remaining ovaries as well as beneath the serosa of both Fallopian tubes. We have already published the surgical procedure of the drug-free IVA and the protocol of subsequent ovarian stimulation, but herein we present the details of laboratory methods required for drug-free IVA.

We present details of laboratory procedures for drug-free in vitro activation (IVA) of ovarian follicles for patients with severe ovarian dysfunction. This method could increase the number of retrievable oocytes per ovarian hyperstimulation and benefit fertility preservation for those patients.

严重卵巢功能障碍患者的生育保护

Ovarian function progressively declines during aging and in some pathophysiological conditions including karyotype abnormality, autoimmune diseases, ...

Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery

For recurrent choledocholithiasis, abdominal adhesions in previous surgeries lead to changes in anatomical structures, and a secondary injury occurs easily when performing another operation for laparoscopic common bile duct exploration (LCBDE), which was once considered a relative contraindication. In view of the limitations of the current surgical technique, this study summarized the surgical approaches and crucial anatomical landmarks for reoperation for LCBDE. Four general surgical approaches were proposed to expose the common bile duct, including the ligamentum teres hepatis approach, the anterior hepatic duodenal ligament approach, the right hepatic duodenal ligament approach, and the hybrid approach. Additionally, this study highlighted seven crucial anatomical landmarks: the parietal peritoneum, the gastrointestinal serosa, the ligamentum teres hepatis, the inferior margin of the liver, the gastric antrum, the duodenum, and the hepatic flexure of the colon, which were helpful to safely separate abdominal adhesions and expose the common bile duct. Moreover, to shorten the time of choledocholithotomy, a sequential method was innovatively applied for the removal of the stones in common bile duct. Mastering the above surgical approaches, including identifying crucial anatomical landmarks and adopting the sequential method will improve the safety of reoperation for LCBDE, shorten the operation time, promote the fast recovery of patients, reduce postoperative complications, and contribute to the popularization and application of this technique.

Programmed surgery based on surgical methods and anatomical markers helps shorten the operation time, reduce complications, and improve the safety of the surgery. This study investigated and summarized the surgical methods and anatomic markers of laparoscopic common bile duct exploration in patients with a history of biliary tract surgery.

有胆道手术史患者的腹腔镜胆总管探查

For recurrent choledocholithiasis, abdominal adhesions in previous surgeries lead to changes in anatomical structures, and a secondary injury occurs ...

Evaluation of Hydration Status by Bioelectrical Impedance Vector Analysis in Patients with Ischemic Heart Disease Undergoing Exercise Stress Test

Ischemic heart disease (IHD) represents a group of clinical syndromes characterized by myocardial ischemia, leading to an impairment in the myocardial blood supply and compromised perfusion. Several clinical variables assessed through a stress test, such as oxygen uptake (VO2) and heart rate oxygen pulse (HR/O2), have been attributed as cardiopulmonary prognostic factors in patients with IHD. However, other factors like hydration status (HS), potentially affecting the cardiopulmonary response, have been barely addressed. Unbalanced HS has a short-term effect on plasma volume and the sympathetic nervous system, which impacts blood volume, and lowers VO2 and HR/O2. Recently, bioelectrical impedance analysis (BIA), a method based on the opposition of body tissues (including fluid volume) to a low electrical current, has been widely used to assess HS by obtaining two components: resistance (R) and reactance (Xc) and using prediction formulas. However, several limitations as chronic illness or abnormal fluid status, may affect the results. In this sense, alternative BIA methods, such as bioelectrical impedance vector analysis (BIVA), have become relevant. R and Xc (adjusted by height) result in a vector plotted on the R/Xc graph, which allows interpreting the HS as normal or abnormal according to the distance of the mean vector. This study aims to describe how to determine HS by BIVA using a single-frequency device and compare the results with the cardiopulmonary response in patients with IHD.

Hydration status imbalances can have a short-term effect on direct and indirect determinants of oxygen uptake and pulse, and morbidity and mortality prognostic factors in ischemic heart disease. This protocol describes the technique for assessment of hydration status through bioelectrical impedance vector analysis and cardiopulmonary response during exercise stress test.

通过生物电阻抗矢量分析评估缺血性心脏病患者接受运动负荷试验的水合状态

Ischemic heart disease (IHD) represents a group of clinical syndromes characterized by myocardial ischemia, leading to an impairment in the myocardial ...

干燥综合征的唾液腺超声检查技术

Ultrasonographic Evaluation of Salivary Glands for Sjogren's Syndrome: Diagnostic and Monitoring Insights

Sjogren's syndrome (SS) is a chronic autoimmune condition commonly affecting the exocrine glands, causing oral or ocular dryness and extraglandular manifestations including arthralgia, cytopenia, and lymphoma. The presence of autoantibodies against SSA/Ro, labial salivary gland biopsy, ocular staining, Schirmer's test, or salivary flow assessment are included in the current classification criteria of SS. However, the availability and invasiveness of these procedures limit their widespread use in clinical settings. Salivary gland ultrasonography (SGUS) is a non-invasive imaging modality for the evaluation of the salivary gland parenchyma and is increasingly utilized to aid diagnosis and monitoring in SS. 
This article presents the protocol of SGUS for image acquisition at the parotid and submandibular glands. The objective is to present a standardized, reproducible, and practical approach to diagnostic SGUS for SS in daily clinical settings. Major salivary glands are scanned in a stepwise approach, beginning at the angle of the mandible for the superficial lobe of the parotid gland, followed by the deep lobe below the ramus of the mandible. Submandibular areas are then scanned for the submandibular glands. The steps in obtaining salivary gland images at each anatomical site are explained in the accompanying video. The echogenicity and echotexture at the thyroid gland are taken as a reference. The homogeneity, the presence and distribution of hypoechoic areas within the glands, and the border of the salivary glands are examined. The sizes and features of intra-/peri-glandular lymph nodes are recorded. The most distinctive sonographic feature in SS is glandular heterogeneity with the presence of hypoechoic/hyperechoic areas within the glands. 
In summary, while SGUS cannot diagnose SS on its own, it can supplement the current classification criteria of SS and guide the clinical decision for salivary gland biopsy to support the diagnosis of SS in patients with sicca syndrome or suspicious systemic features, combined with autoantibody testing.

作者聚焦：结缔组织病研究中标准化唾液腺超声方案的重点

Salivary gland ultrasonography is a promising tool for the diagnosis and evaluation of disease activity and complications in Sjogren's syndrome (SS). The scanning technique for salivary gland ultrasound examination relevant to SS is described in the article.

干燥综合征唾液腺的超声评估：诊断和监测见解

Sjogren's syndrome (SS) is a chronic autoimmune condition commonly affecting the exocrine glands, causing oral or ocular dryness and extraglandular ...