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Outcomes of patients awaiting lung transplantation after the implementation of donation after brain death

《医学前沿(英文)》 2022年 第16卷 第5期   页码 760-765 doi: 10.1007/s11684-021-0899-5

摘要: Voluntary contribution has become the only source of donor lungs in China since 2015. To elaborate the outcomes of patients awaiting lung transplantation (LTx) after the implementation of donation after brain death, we performed a retrospective study that encompassed 205 patients with end-stage lung disease who registered for LTx at Shanghai Pulmonary Hospital from January 1, 2015 to January 1, 2021. A total of 180 patients were enrolled in the study. The median waiting time was 1.25 months. Interstitial lung disease (ILD) (103/180, 57.2%) and chronic obstructive pulmonary disease (COPD) (56/180, 31.1%) were the most common diseases in our study population. The mean pulmonary artery pressure (mPAP) of patients in the died-waiting group was higher than that of the survivors (53.29±21.71 mmHg vs. 42.11±18.58 mmHg, P=0.002). The mortality of patients with ILD (34/103, 33.00%) was nearly twice that of patients with COPD (10/56, 17.86%) while awaiting LTx (P=0.041). In the died-waiting group, patients with ILD had a shorter median waiting time than patients with COPD after being listed (0.865 months vs. 4.720 months, P=0.030). ILD as primary disease and mPAP > 35 mmHg were two significant independent risk factors for waitlist mortality, with hazard ratios (HR) of 3.483 (95% CI 1.311–9.111; P=0.011) and 3.500 (95% CI 1.435–8.536; P=0.006). Hence, LTx is more urgently needed in patients with ILD and pulmonary hypertension.

关键词: lung transplantation     donation after brain death     waitlist    

Cooling strategies and transport theories for brain hypothermia resuscitation

LIU Jing

《能源前沿(英文)》 2007年 第1卷 第1期   页码 32-57 doi: 10.1007/s11708-007-0004-z

摘要: The brain is one of the most important organs in a biological body whose normal function depends heavily on an uninterrupted delivery of oxygen. Unlike skeletal muscles that can survive for hours without oxygen, neuron cells in the brain are easily subjected to an irreversible damage within minutes from the onset of oxygen deficiency. With the interruption of cardiopulmonary circulation in many cardiac surgical procedures or accidental events leading to cerebral circulation arrest, an imbalance between energy production and consumption will occur which causes a rapid depletion of oxygen due to the interrupted blood-flow to the brain. Meanwhile, the cooling function of the blood flow on the hot tissue will be stopped, while metabolic heat generation in the tissues still keeps running for awhile. Under such adverse situations, the potential for cerebral protection through hypothermia has been intensively investigated in clinics by lowering brain temperature to restrain the cerebral oxygen demands. The reason can be attributed to the decreased metabolic requirements of the cold brain tissues, which allows a longer duration for the brain to endure reduced oxygen delivery. It is now clear that hypothermia would serve as the principal way for neurologic protection in a wide variety of emergency medicines, especially in cerebral damage, anoxia, circulatory arrest, respiratory occlusion, etc. However, although brain cooling has been found uniquely significant in clinical practices, the serious lack of knowledge on the mechanisms involved prevents its further advancement in brain resuscitation. Compared with the expanded trials in clinics, only very limited efforts were made to probe the engineering issues involved, which turns out to be a major obstacle for the successful operation of brain hypothermia resuscitation. From the viewpoint of biothermal medical engineering, the major theories and strategies for administering brain cooling can generally be classified into three categories: heat transfer, oxygen transport and cooling strategy. Aiming to provide a complete overview of the brain hypothermia resuscitation, this article comprehensively summarizes the recent progresses made in theoretical, practical and experimental techniques in the area. Particularly, attention is paid to the mathematical models to quantify the heat and oxygen transport inside the cerebral tissues. Typical cooling strategies to effectively lower brain temperature and thus decrease oxygen consumption rate in the cerebral tissues are analyzed. Approaches to deliver oxygen directly to the target tissues are discussed. Meanwhile, some future efforts worth pursuing within the area of brain cooling are suggested.

关键词: mathematical     interruption     hypothermia     metabolic     generation    

Tramadol reinforces antidepressant effects of ketamine with increased levels of brain-derived neurotrophic

null

《医学前沿(英文)》 2012年 第6卷 第4期   页码 411-415 doi: 10.1007/s11684-012-0226-2

摘要:

Ketamine exerts rapid and robust antidepressant properties in both animal models and depressed patients and tramadol possesses potential antidepressant effects. Brain-derived neurotrophic factor (BDNF) is an important biomarker for mood disorders and tropomyosin-related kinase B (TrkB) is a high affinity catalytic receptor for BDNF. We hypothesized that tramadol pretreatment might reinforce ketamine-elicited antidepressant effects with significant changes in hippocampal BDNF and TrkB levels in rats. Immobility time of rats receiving different treatment in the forced swimming test (FST) was observed. Levels of BDNF and TrkB in hippocampus were measured by enzyme linked immunosorbent assay. Results showed that tramadol (5 mg/kg) administrated alone neither elicited antidepressant effects nor altered BDNF or TrkB level. However, pretreatment with tramadol (5 mg/kg) enhanced the ketamine (10 mg/kg) -elicited antidepressant effects and upregulated the BDNF and TrkB levels in hippocampus. In conclusion, tramadol pretreatment reinforces the ketamine-elicited antidepressant effects, which is associated with the increased levels of BDNF and TrkB in rat hippocampus.

关键词: tramadol     ketamine     antidepressant     brain-derived neurotrophic factor     tropomyosin-related kinase B    

The influence of brain death on donor liver and the potential mechanisms of protective intervention

null

《医学前沿(英文)》 2011年 第5卷 第1期   页码 8-14 doi: 10.1007/s11684-011-0109-y

摘要:

Brain-dead donors have become one of the main sources of organs for transplantation in Western countries. The quality of donor organs is closely related to the outcome of the transplantation. Experimental studies have confirmed the inferior graft survival of livers from brain-dead donors compared with those from living donors. Studies conducted in the past 10 years have shown that brain death is associated with effects on the decreased donor organ quality. However, whether the decrease in the viability of donor organs is caused by brain death or by the events before and after brain death remains uncertain. The purpose of this review is to introduce the advances and controversies regarding the influence of brain death on the viability of donor livers and to summarize the mechanisms of the different protective interventions for donor livers.

关键词: brain death     donor liver    

Various brain-eating amoebae: the protozoa, the pathogenesis, and the disease

《医学前沿(英文)》 2021年 第15卷 第6期   页码 842-866 doi: 10.1007/s11684-021-0865-2

摘要: Among various genera of free-living amoebae prevalent in nature, some members are identified as causative agents of human encephalitis, in which Naegleria fowleri followed by Acanthamoeba spp. and Balamuthia mandrillaris have been successively discovered. As the three dominant genera responsible for infections, Acanthamoeba and Balamuthia work as opportunistic pathogens of granulomatous amoebic encephalitis in immunocompetent and immunocompromised individuals, whereas Naegleria induces primary amoebic meningoencephalitis mostly in healthy children and young adults as a more violent and deadly disease. Due to the lack of typical symptoms and laboratory findings, all these amoebic encephalitic diseases are difficult to diagnose. Considering that subsequent therapies are also affected, all these brain infections cause significant mortality worldwide, with more than 90% of the cases being fatal. Along with global warming and population explosion, expanding areas of human and amoebae activity in some regions lead to increased contact, resulting in more serious infections and drawing increased public attention. In this review, we summarize the present information of these pathogenic free-living amoebae, including their phylogeny, classification, biology, and ecology. The mechanisms of pathogenesis, immunology, pathophysiology, clinical manifestations, epidemiology, diagnosis, and therapies are also discussed.

关键词: free-living amoebae     central nervous system infection     primary amoebic meningoencephalitis     granulomatous amoebic encephalitis    

Experimental study on the establishment and maintenance of brain death model with pigs

ZHANG Shuijun, SHI Jihua, ZHAI Wenlong, SONG Yan, CHEN Shi

《医学前沿(英文)》 2007年 第1卷 第2期   页码 161-166 doi: 10.1007/s11684-007-0030-6

摘要: It remains controversial that after the transplantation of using grafts from brain-dead donors, organs injury and rejection can influence the effects of transplantation. This study sought to explore methods of establishing a stable brain death (BD) model using Bama mini pigs and to maintain the brain-dead state for a comparatively long period to provide a model for investigating changes in brain death. Sixteen anesthetized Bama mini pigs were randomized into a control group ( = 5) and a BD group ( = 11). Intracranial pressure (ICP) was increased in a modified, slow, and intermittent way to establish BD. Respiration and circulation were sustained during the brain-dead state. Hemodynamic changes were monitored during the experiment. In the BD group, 10 pigs met the requirements for brain death and 1 died of cardiopulmonary complications following an increase in ICP. Brain death was maintained for more than 48 hours with artificial life support. During the experiment, the heart rate and blood pressure showed characteristic changes due to increased ICP. Prior to BD being established, a tic reaction inevitably occurred. We used an improved method of increasing ICP to establish a stable BD model. The BD state could be maintained for more than 48 hours with effective respiratory and circulatory support. Disappearance of the tic reaction was considered to be one of the verified indexes for BD via encephalic pressure increase.

关键词: BD     control     Hemodynamic     cardiopulmonary     modified    

富含sn-2 DHA脂质对大脑的益处及其酶法合成综述 Review

金俊, 金青哲, 王兴国, Casimir C. Akoh

《工程(英文)》 2020年 第6卷 第4期   页码 424-431 doi: 10.1016/j.eng.2020.02.009

摘要:

大脑中二十二碳六烯酸(DHA, ω-3脂肪酸)的含量与中枢神经系统的正常发育和功能维持高度相关。甘油酯sn-2位上的DHA可以被肠黏膜更好地吸收,从而实现机体对DHA的高效利用。然而,如今人们在饮食中摄入较多的饱和脂肪或富含ω-6脂肪酸的油脂,而摄入较少的DHA,从而导致了部分个体在行为和神经生理学方面的缺陷。为了全面了解DHA对大脑的有益功能,本文系统介绍了天然油脂甘油骨架上DHA的位置分布(sn-2和sn-1,3位)特征,并讨论了DHA补充和通过肠-脑轴传递信息的潜在功能机制。肠-脑轴包含的多条双向信息通道为DHA、肠道菌群和大脑健康的相互作用提供了新的研究思路。为了在日常饮食中摄入更多的sn-2 DHA,我们建议通过更为高效和经济的酯交换制造技术生产富含sn-2 DHA脂质,其中需要解决的关键技术包括强化酶的特异性和优化纯化工艺。这类饮食可满足对sn-2 ω-3脂质有强烈需求的人群,特别是婴儿、儿童、孕妇和哺乳期妇女。

关键词: DHA 和 sn-2 DHA     单甘酯     大脑     肠-脑轴     结构脂质    

从脑科学到人工智能 Review

范静涛, 方璐, 吴嘉敏, 郭雨晨, 戴琼海

《工程(英文)》 2020年 第6卷 第3期   页码 248-252 doi: 10.1016/j.eng.2019.11.012

摘要:

回顾人工智能(artificial intelligence, AI)的发展历史,我们可以清晰地看到脑科学给AI领域带来的巨大突破,如深度学习。目前,尽管AI及其应用的发展趋势已经超越了人类的预期,但AI与人类智能之间仍然存在着难以逾越的鸿沟。从脑科学到AI、从了解大脑到模拟大脑,在脑科学与AI研究之间建立起一座桥梁已经成为一种迫切需求。为此,我们首先需要通过研究新型脑成像技术来探索脑科学的秘密,建立大脑的动态连接图谱以及将神经科学实验与理论、模型和统计学相结合等。在此基础上,我们将进一步研究新一代AI理论和方法,从而建立起从机器感知和机器学习到机器思维和机器决策的颠覆性模型和工作模式。与此同时,本文还将讨论在脑科学启发新一代AI过程中的一些机遇与挑战。

关键词: 人工智能,脑科学    

Clean air captures attention whereas pollution distracts: evidence from brain activities

《环境科学与工程前沿(英文)》 2023年 第18卷 第4期 doi: 10.1007/s11783-024-1801-x

摘要:

● We find air pollution distracts attention and reveal the neurocognitive mechanisms.

关键词: Air pollution     Attention     Disengagement     Performance     Event-related potential    

Dietary Lipid Intervention in the Prevention of Brain Aging

Wei Xiong,Bing Fang,Xiaoyu Wang,Ming Zhang,Min Du,Jiazeng Sun,Juan Chen,Yixuan Li,Changhao Sun,Xingen Lei,Xue Zhang,Fazheng Ren,

《工程(英文)》 doi: 10.1016/j.eng.2023.04.012

摘要: As people live longer, the burden of aging-related brain diseases, especially dementia, is increasing. Brain aging increases the risk of cognitive impairment, which manifests as a progressive loss of neuron function caused by the impairment of synaptic plasticity via disrupting lipid homeostasis. Therefore, supplemental dietary lipids have the potential to prevent brain aging. This review summarizes the important roles of dietary lipids in brain function from both structure and mechanism perspectives. Epidemiological and animal studies have provided evidence of the functions of polyunsaturated fatty acids (PUFAs) in brain health. The results of interventions indicate that phospholipids—including phosphatidylcholine, phosphatidylserine, and plasmalogen—are efficient in alleviating cognitive impairment during aging, with plasmalogen exhibiting higher efficacy than phosphatidylserine. Plasmalogen is a recognized nutrient used in clinical trials due to its special vinyl ether bonds and abundance in the postsynaptic membrane of neurons. Future research should determine the dose-dependent effects of plasmalogen in alleviating brain-aging diseases and should develop extraction and storage procedures for its clinical application.

关键词: Brain aging     Nutritional intervention     Phospholipids     Phosphatidylcholine     Phosphatidylserine     Plasmalogen    

Autoimmunity in acute ischemic stroke and the role of blood—brain barrier: the dark side or the light

Nikolay V. Tsygan, Alexandr P. Trashkov, Igor V. Litvinenko, Viktoriya A. Yakovleva, Alexandr V. Ryabtsev, Andrey G. Vasiliev, Leonid P. Churilov

《医学前沿(英文)》 2019年 第13卷 第4期   页码 420-426 doi: 10.1007/s11684-019-0688-6

摘要: This article presents a synopsis of the current data on the mechanisms of blood—brain barrier (BBB) alteration and autoimmune response in acute ischemic stroke. Most researchers confirm the relationship between the severity of immunobiochemical changes and clinical outcome of acute ischemic stroke. Ischemic stroke is accompanied by aseptic inflammation, which alters the brain tissue and exposes the co-stimulatory molecules of the immune system and the neuronal antigens. To date, BBB is not considered the border between the immune system and central nervous system, and the local immune subsystems are found within and behind the BBB. BBB disruption contributes to the leakage of brain autoantigens and induction of secondary autoimmune response to neuronal antigens and long-term inflammation. Glymphatic system function is altered and jeopardized both in hemorrhagic and ischemic stroke types. The receptors of innate immunity (toll-like receptor-2 and toll-like receptor-4) are also involved in acute ischemia—reperfusion injury. Immune response is related to the key processes of blood clotting and fibrinolysis. At the same time, the stroke-induced immune activation may promote reparation phenomena in the brain. Subsequent research on the reduction of the acute ischemic brain injury through the target regulation of the immune response is promising.

关键词: stroke     blood–brain barrier     autoimmunity     innate immunity     inflammation     cell death    

智能源于人、拓于工——人工智能发展的一点思考

蒋昌俊,王俊丽

《中国工程科学》 2018年 第20卷 第6期   页码 93-100 doi: 10.15302/J-SSCAE-2018.06.015

摘要:

人工智能(AI)旨在模拟人脑中信息存储和处理机制等智能行为,使机器具有一定程度的智能水平。随着互联网、大数据、云计算和深度学习等新一代信息技术的飞速发展,目前AI领域的研究和应用已经取得重要进展。本文将深入分析与AI密切相关的计算机科学、控制科学、类脑智能、人脑智能等学科或领域之间的交融与历史演进;指出神经科学、脑科学与认知科学中有关脑的结构与功能机制的研究成果,为构建智能计算模型提供了重要的启发,并从逻辑模型及系统、神经元及网络模型、视觉神经分层机制等方面,分别阐述智能的驱动与发展;最后从互联网的计算理论、AI的演算和计算的融合、类脑智能的模型和机理、AI对神经科学的推动作用、反馈计算的算法设计与控制系统的能级五个方面,对AI的发展趋势进行了展望。

关键词: 人工智能     人脑智能     类脑智能     智能发展     学科演进    

Effects of hypoxia on mRNA expression of housekeeping genes in rat brain tissue and primary cultured

YANG Yingzhong, MA Lan, GE Rili, FAN Wenhong, ZHU Lingling, ZHAO Tong, WU Yan, FAN Ming

《医学前沿(英文)》 2008年 第2卷 第3期   页码 239-243 doi: 10.1007/s11684-008-0045-7

摘要: Internal standards are critical for quantitative RNA analyses. Housekeeping genes are often used as internal standards with the assumption that their expression levels remain relatively constant in different experimental conditions. In this study, four commonly used housekeeping genes, Glyceraldehyde-3-phosphate dehydrogenase (GAPDH), ?-actin, 28S rRNA and 18S rRNA were selected to test whether this assumption is tenable under hypoxic conditions. We tested the RNA expression level of these four genes in different hypoxic conditions. Rats subjected to acute hypoxia for 2 hours were used for tissue detection. Primary cultured neural stem cells from E13 fetal rats were treated with 3% O or 10% O for 24 hours for experiments. In both experiments, expression levels of 28S rRNA and 18S rRNA were constant, independent of hypoxia types. However, expression levels of GAPDH and ?-actin were all changed in all kinds of hypoxic conditions. In particular, the mRNA expression level of GAPDH was increased by 43.4% under 3% O hypoxic conditions. These results suggest that 18S rRNA and 28S rRNA are reliable internal controls for comparative analyses of transcription under hypoxia. GAPDH appears particularly unfavorable for this purpose in hypoxic conditions.

关键词: Glyceraldehyde-3-phosphate dehydrogenase     comparative     constant     unfavorable     independent    

Repetitive transcranial magnetic stimulation causes significant changes of chemical substances in the brain

GUO Tiecheng, CAO Xuebing, XIA Limin

《医学前沿(英文)》 2008年 第2卷 第4期   页码 406-409 doi: 10.1007/s11684-008-0078-y

摘要: More and more studies have reported the usefulness of repetitive transcranial magnetic stimulation (rTMS) in the treatment of stroke patients. This article is to explore if rTMS can cause changes of such chemical substances as N-acetylaspartate (NAA), choline (Cho) and creatine (Cr) in the surrounding area of experimental intracerebral hematoma of rabbits. A total of 36 rabbits were randomly divided into 3 groups: a control group (group A), a sham rTMS group (group B) and an rTMS group (group C). The experimental intracerebral hemorrhage (ICH) was induced by intracerebral injection of self-body blood of the animals in groups B and C, while those of the group A serving as controls were injected with normal saline. The rabbits of groups B and C were treated with sham and real rTMS, respectively, but those of group A were not. The contents of chemical substances including NAA, Cho and Cr in the perihematomal brain tissues were measured by using H-magnetic resonance spectroscopy (H-MRS) 12 hours, 72 hours, 1 week and 2 weeks after the experimental ICH was induced. The results show that the contents of NAA, Cr and NAA/Cr ratio were decreased significantly, but Cho, Cho/Cr increased significantly in groups B and C ( < 0.01) as compared against those in group A. A comparison between the groups B and C revealed that the contents of NAA, Cr, NAA/Cr were higher, but Cho and Cho/Cr were significantly lower in group C than those in group B ( < 0.01). It is concluded that rTMS could result in changes of the chemical substance contents in perihematomal brain tissues, which leads to neuroprotective effects in the brain.

基于驾驶脑的智能驾驶车辆硬件平台架构 Article

李德毅,高洪波

《工程(英文)》 2018年 第4卷 第4期   页码 464-470 doi: 10.1016/j.eng.2018.07.015

摘要:

不同智能驾驶试验平台的传感器型号、数量、安装位置各不相同,导致传感器信息处理模块也各不相同;不同驾驶地图,其提供信息的粒度也没有固定标准,由此构成的智能驾驶系统软件模块的数量、接口各不相同。基于以驾驶脑为核心的智能驾驶车辆软件与硬件架构,决策模块将不直接与传感器信息处理模块发生关联,通过驾驶认知的形式化语言,将驾驶认知形式化,由驾驶脑认知形成决策。驾驶认知的形式化降低了传感器数量、类型、安装位置的变化对整个软件架构的影响,使得软件架构可以在不同传感器配置车辆平台上方便地移植。

关键词: 驾驶脑     智能驾驶     硬件平台架构    

标题 作者 时间 类型 操作

Outcomes of patients awaiting lung transplantation after the implementation of donation after brain death

期刊论文

Cooling strategies and transport theories for brain hypothermia resuscitation

LIU Jing

期刊论文

Tramadol reinforces antidepressant effects of ketamine with increased levels of brain-derived neurotrophic

null

期刊论文

The influence of brain death on donor liver and the potential mechanisms of protective intervention

null

期刊论文

Various brain-eating amoebae: the protozoa, the pathogenesis, and the disease

期刊论文

Experimental study on the establishment and maintenance of brain death model with pigs

ZHANG Shuijun, SHI Jihua, ZHAI Wenlong, SONG Yan, CHEN Shi

期刊论文

富含sn-2 DHA脂质对大脑的益处及其酶法合成综述

金俊, 金青哲, 王兴国, Casimir C. Akoh

期刊论文

从脑科学到人工智能

范静涛, 方璐, 吴嘉敏, 郭雨晨, 戴琼海

期刊论文

Clean air captures attention whereas pollution distracts: evidence from brain activities

期刊论文

Dietary Lipid Intervention in the Prevention of Brain Aging

Wei Xiong,Bing Fang,Xiaoyu Wang,Ming Zhang,Min Du,Jiazeng Sun,Juan Chen,Yixuan Li,Changhao Sun,Xingen Lei,Xue Zhang,Fazheng Ren,

期刊论文

Autoimmunity in acute ischemic stroke and the role of blood—brain barrier: the dark side or the light

Nikolay V. Tsygan, Alexandr P. Trashkov, Igor V. Litvinenko, Viktoriya A. Yakovleva, Alexandr V. Ryabtsev, Andrey G. Vasiliev, Leonid P. Churilov

期刊论文

智能源于人、拓于工——人工智能发展的一点思考

蒋昌俊,王俊丽

期刊论文

Effects of hypoxia on mRNA expression of housekeeping genes in rat brain tissue and primary cultured

YANG Yingzhong, MA Lan, GE Rili, FAN Wenhong, ZHU Lingling, ZHAO Tong, WU Yan, FAN Ming

期刊论文

Repetitive transcranial magnetic stimulation causes significant changes of chemical substances in the brain

GUO Tiecheng, CAO Xuebing, XIA Limin

期刊论文

基于驾驶脑的智能驾驶车辆硬件平台架构

李德毅,高洪波

期刊论文