进展性与非进展性脑梗死患者阿托伐他汀治疗前后T淋巴细胞亚群的变化

目的通过研究进展性和非进展性脑梗死在阿托伐他汀治疗前后T淋巴细胞亚群的变化,探讨他汀类药物治疗脑梗死的免疫学机制。方法选择53例急性脑梗死患者,分为进展和非进展组,应用流式细胞分析仪检测两组患者阿托伐他汀治疗前后T淋巴细胞亚群相对计数,并且根据患者治疗前后神经功能缺损程度进行效果评价。结果进展组治疗前后比较:CD4+T细胞和CD4/CD8值显著升高,CD8+T细胞显著降低;非进展组治疗前后比较:CD4/CD8值显著升高;两组治疗前后神经功能缺损评分自身比较,均明显降低。结论阿托伐他汀治疗前后,进展性和非进展性脑梗死患者体内T淋巴细胞亚群分布发生了不同程度的变化。阿托伐他汀可能通过提高CD4+T细胞水平,促进急性脑梗死的恢复。     

阿托伐他汀联合氯吡格雷对脑梗死患者hs-CRP MMP-9 TNF-α IMT及血脂的影响

目的探讨阿托伐他汀联合氯吡格雷治疗对脑梗死患者hs-CRP、MMP-9、TNF-α、IMT及血脂的影响。方法选取来我院治疗的脑梗死患者90例为研究对象,随机分为观察组和对照组,每组45例。对照组给予氯吡格雷治疗,观察组给予阿托伐他汀联合氯吡格雷治疗。测定并比较2组患者治疗前后血清hs-CRP、MMP-9和TNF-α水平、内膜中层厚度(IMT)及血脂水平。结果治疗后观察组血清hs-CRP、MMP-9和TNF-α水平明显低于对照组,差异有统计学意义(P0.05);2组患者颈动脉IMT变薄,与治疗前比较差异均有统计学意义(P0.05),且观察组治疗后IMT较对照组减少(P0.05);治疗后2组患者血清血脂水平均明显下降,组间比较差异无统计学意义(P0.05)。结论阿托伐他汀联合氯吡格雷治疗脑梗死患者能更有效地降低血hs-CRP和MMP-9水平,使IMT变薄,更有利于抑制炎症从而降低卒中发病率,值得临床推广。     

阿托伐他汀对脑梗死患者hs-CRP、MMP-9水平的影响

目的 观察阿托伐他汀干预后脑梗死患者高敏C反应蛋白（hs-CRP）、基质金属蛋白酶-9（MMP-9）水平变化.方法 选取急性动脉粥样硬化性血栓性脑梗死44例,分为两组,分别服用阿托伐他汀、阿司匹林组（A组）和单独服用阿司匹林组（NA组）,测定3个月前后hs-CRP、MMP-9和血脂水平的变化.结果 A组hs-CRP,MMP-9水平均较治疗前显著下降（P〉0.05）,而NA组治疗前后无明显变化.治疗前后血脂水平比较A组TC、LDL-C水平显著下降,NA组变化不明显,TG在两组变化均不明显.结论 阿托伐他汀可能通过减轻炎症反应来稳定颈动脉粥样硬化斑块,从而降低脑血管疾病的发生率和病死率.     

阿托伐他汀对急性脑梗死患者血清基质金属蛋白酶9及预后的影响

目的 研究短期应用阿托伐他汀后急性脑梗死患者血清基质金属蛋白酶9（matrix metalloproteinase-9,MMP-9）及血脂水平的变化,探讨其对急性脑梗死患者预后的影响。方法 采用随机、双盲、安慰剂对照的研究方法,将发病48 h内入院的大面积脑梗死患者40例随机分为对照组和阿托伐他汀组（阿托伐他汀20 mg/d,连续用药14 d）。治疗前后检测血清MMP-9、血脂、血清谷草转氨酶（AST）及血清肌酸激酶（CK）水平,应用美国国立卫生研究院卒中量表（NIHSS）及Barthel指数（BI）记分法对入院后当天及3个月时神经功能缺损程度进行评分。结果 共39例进入结果分析（对照组20例,阿托伐他汀组19例）。全部患者治疗前MMP-9水平与入院时及3个月时病情显著相关（P＜0.01）,血脂水平则无此相关性。治疗后阿托伐他汀组MMP-9水平下降,且与对照组相比,差异有统计学意义（P＜0.05）。各组3个月后神经功能缺失程度评分与入院时相比,差异有统计学意义（P＜0.01）,但两组之间相比无统计学差异。治疗后各组AST及CK水平无明显变化。结论 急性脑梗死患者血清MMP-9水平与病情的严重程度及预后相关。短期应用阿托伐他汀可以降低急性脑梗死患者血清MMP-9水平,且安全性好,但对梗死后3个月的预后无明显改善作用。     

阿托伐他汀对急性缺血性卒中患者血清hs-CRP水平及预后的影响

目的观察阿托伐他汀对急性缺血性卒中患者血清超敏C反应蛋白(hs-CRP)水平及预后的影响。方法选取2014-03—2015-03我院收治的急性缺血性卒中患者140例,按照随机数字表法将患者分为实验组和对照组,每组70例,对照组给予常规治疗,实验组在对照组的基础上加用阿托伐他汀治疗。采用胶乳免疫比浊法检测并比较2组患者治疗前后血清的hs-CRP水平,应用美国国立卫生研究院卒中量表(NIHSS)和日常生活能力评定量表Barthel指数(BI)评价预后。结果(1)2组治疗前hs-CRP水平比较差异无统计学意义(P0.05),治疗后hs-CRP水平均显著降低,且实验组显著低于对照组,差异有统计学意义(P0.05);(2)2组患者治疗前NIHSS评分和BI评分比较差异无统计学意义(P0.05),治疗后两项评分均显著优于治疗前,且实验组优于对照组,差异有统计学意义(P0.05)。结论阿托伐他汀治疗急性缺血性卒中能显著降低患者的hs-CRP水平,改善患者预后,值得临床推广应用。     

阿托伐他汀对进展性脑梗死进展时间及神经功能的影响

目的探讨阿托伐他汀对进展性脑梗死进展时间及神经功能缺损程度的影响。方法选取2007-10~2010-05我院神经内科住院的进展性脑梗死患者120例,随机分为治疗组和对照组各60例,对照组采用阿司匹林肠溶片抗血小板治疗,应用脑保护剂,尼莫地平降颅压,以及常规内科综合治疗。治疗组在对照组治疗基础上加用阿托伐他汀片20 mg/d,睡前服用,连用4周。观察入院时、进展停止时、发病4周时神经功能缺损程度和发病至症状达高峰时间及治疗前后血脂变化。结果阿托伐他汀可以缩短发病至症状达峰时间,在发病4周时NIHSS评分方面与对照组相比差异有统计学意义。结论进展性脑梗死早期应用阿托伐他汀可降低血脂水平和改善预后。     

阿托伐他汀对急性缺血性脑卒中患者血清hs-CRP TNF-α的影响

目的探讨急性缺血性脑卒中(AIS)患者血清hs-CRP、TNF-α的变化及阿托伐他汀的干预作用。方法选择76例AIS患者为研究对象,根据临床神经功能缺损程度评分标准分为轻型组、中型组及重型组,30例健康体检者纳入对照组,比较各组患者血清hs-CRP、TNF-α水平;随机将76例患者分为2组,常规组予抗血小板等常规治疗,他汀组联合阿托伐他汀治疗,比较治疗前后2组血清hs-CRP、TNF-α水平的变化。结果轻型组、中型组、重型组AIS患者血清hs-CRP及TNF-α水平均明显高于对照组(P<0.05),且轻型组、中型组、重型组AIS患者血清hs-CRP及TNF-α水平依次升高(P<0.05);治疗后他汀组与常规组患者血清hs-CRP及TNF-α水平均有明显下降(P<0.05),且上述指标他汀组明显低于常规组(P<0.05)。结论急性缺血性脑卒中患者血清hs-CRP及TNF-α水平可反映患者病情严重程度,而阿托伐他汀可有效抑制AIS患者的炎症因子水平,进而改善患者预后。     

强化降脂治疗对急性脑梗死患者血清炎症因子hs-CRP、IL-8、IL-6及MMP-9水平的影响

目的 探讨短期内使用阿托伐他汀强化降脂对急性脑梗死患者血清高敏C反应蛋白(hs-CRP)、白细胞介素-8(IL-8)、白细胞介素-6(IL-6)及基质金属蛋白酶-9(MMP-9)的影响,以了解其对脑梗死炎症抑制和颈动脉斑块稳定作用.方法 120例急性脑梗死患者患者根据颈动脉超声检查结果分为颈动脉稳定斑块组(n=60)和颈动脉易损斑块组(n=60).抽血检查后随机分为常规治疗组60例(阿托伐他汀10mg/d,口服)和强化治疗组60例(阿托伐他汀40mg/d,口服).所有患者药物治疗前和治疗后2w检测血脂及血清hs-CRP、IL-8、IL-6和MMP-9水平.结果 治疗前常规治疗组和强化治疗组中血脂及血清hs-CRP、IL-8、IL-6和MMP-9水平差异无显著性(均P＞0.05).治疗后2w,强化治疗组中LDL-C、血清hs-CRP水平明显低于常规治疗组,差异具有著性(P＜0.01),强化治疗组中两亚组(尤其是易损斑块组)血清IL-8、IL-6和MMP-9水平明显低于常规治疗组,差异具有显著性(P＜0.01).结论 阿托伐他汀强化降脂能迅速降低脑梗死患者的血清炎症因子水平,具有抑制炎症和稳定斑块的作用.     

阿托伐他汀对急性脑梗死患者血清超敏C反应蛋白及一氧化氮水平的影响

目的研究阿托伐他汀对急性脑梗死(ACI)患者血清超敏C反应蛋白(hs-CRP)及一氧化氮(NO)水平的影响。方法将60例ACI患者随机分为阿托伐他汀组(30例)和常规治疗组(30例)。阿托伐他汀组在常规治疗基础上加用阿托伐他汀20mg,每日1次,连续服用14d。在治疗前后检测血清hs-CRP和NO含量,并进行神经功能缺损程度评分(NDS)评定。结果治疗14d时两组血清hs-CRP水平均较治疗前明显下降(均P<0.01),且阿托伐他汀组较常规治疗组下降明显(P<0.01);两组血清NO水平较治疗前明显升高(均P<0.01),且阿托伐他汀组较常规治疗组升高明显(P<0.05);两组NDS评分较治疗前明显下降(均P<0.01),且阿托伐他汀组较常规治疗组下降明显(P<0.05)。结论阿托伐他汀能明显降低ACI患者血清hs-CRP水平,升高NO水平;有助于ACI患者的神经功能恢复。     

阿托伐他汀对进展性脑梗死神经功能的影响

目的探讨阿托伐他汀对进展性脑梗死神经功能的影响。方法 2009-02-2011-02收治的164例符合入选标准进展性脑梗死患者,对照组80例采取常规治疗,治疗组84例在常规治疗基础上加用阿托伐他汀。结果 2组患者入院时神经功能缺损评分比较,差异无统计学意义（P〉0.05）;进展停止时、发病1周时神经功能缺损评分,差异有统计学意义（P〈0.05）。结论进展性脑梗死应用阿托伐他汀能够有效改善患者神经功能,减少致残率。     

Patients with Epilepsy and Psychosis Treated with Vigabatrin

Eight patients with difficult to control epilepsy and an active or a history of psychosis were treated with vigabatrin, and the results of this clinical intervention are described. In five cases there was no untoward deterioration of the mental state, in three cases a change was reversed by judicious adjustment of both the anticonvulsant and psychotropic medications. Recommendations for the use of new anticonvulsants in patients with comorbid psychopathology and epilepsy are given.     

Toxoplasma gondii in individuals with schizophrenia: association with clinical and demographic factors and with mortality

BACKGROUND: Increased rates of exposure to Toxoplasma gondii have been found in individuals with schizophrenia as compared with control groups, but the correlates of Toxoplasma exposure in schizophrenia have not been defined. METHODS: We measured IgG class antibodies to Toxoplasma gondii in 358 individuals with schizophrenia. We correlated Toxoplasma antibody status with clinical and demographic variables and examined the effect of Toxoplasma seropositivity on mortality in a follow-up period of up to 5 years. RESULTS: Individuals with schizophrenia who had serological evidence of Toxoplasma infection were more likely to be female but did not differ in age, race, total symptom score, or other demographic or clinical characteristics. However, we found that serological evidence of Toxoplasma was associated with a significantly increased risk of dying of natural causes during the follow-up period (Cox proportional hazard ratio of 4.70; 95% confidence interval, 1.27-17.31, P = .020) adjusted for age, gender, and other clinical and demographic variables. CONCLUSIONS: Toxoplasma infection may confer an increased risk for mortality from natural causes in schizophrenia. An understanding of the pathogenesis of Toxoplasma infections in individuals with schizophrenia might lead to new approaches to the management of this disorder.     

Children with ADHD and motor dysfunction compared with children with ADHD only

The purpose of this study was to identify group differences in children with attention-deficit-hyperactivity disorder and motor dysfunction (ADHD-MD) and ADHD only, and to evaluate the medication responsiveness of ADHD-MD. Sixty-three children (49 males and 14 females; mean age 9 years 10 months, SD 2 years 10 months) underwent a triple blind, placebo-controlled crossover study evaluating two dose levels of methylphenidate (0.3 mg/kg and 0.5 mg/kg [corrected], twice daily) and placebo. Forty-nine trials were completed. Nineteen were children with ADHD-MD, 44 had ADHD only. Behavior and functioning were assessed at home and at school. Treatment effects were assessed using the Abbreviated Symptom Questionnaire for Parents and Teachers. Children with ADHD-MD were more likely to have severe ADHD-combined type and other neurodevelopmental and behavioral problems. Both groups of children had a linear dose response to medication (placebo, low, high) and there was no evidence of a group by dose interaction or an overall group effect at home or school. The lack of group effect suggests that these children responded to medication like the other subgroups.     

Self-esteem and behavioural adjustment in children with epilepsy and children with diabetes

This paper describes a study to investigate the relationship between self-esteem and behavioural adjustment in two groups of children with chronic illness, one with epilepsy and the other diabetes. A total of 62 children with epilepsy and 91 children with diabetes were recruited from the total population of children aged 8–15 attending the epilepsy and diabetic clinics at a children's hospital over a 12 month period. Self-esteem and behavioural adjustment were assessed with the Harter and Achenbach Questionnaires respectively. The results showed the children with epilepsy were consistently more behaviourally disturbed and had lower self-esteem than children with diabetes. The independent completion of the questionnaires, (the Harter by the child and the Achenbach by the parents) increases the validity of the findings. Long duration of illness was the most consistent illness variable associated with poor behavioural adjustment in the two groups. The cross-sectional design of the study did not make it possible to draw any definite conclusions about the causal or temporal relationship between low self-esteem and behavioural disturbance. Once again, the potential value of prospective studies into the psychosocial adjustment of children with chronic illness is highlighted.     

Coping with stress by children and adolescents with cancer

Children and adolescents with cancer not only have to cope with everyday stressors and developmental tasks, as do their healthy peers, but also with illness-related stressors. Thus, it can be assumed, that children and adolescents with cancer differ from healthy peers in coping. Stress reactions and adjustment have been investigated in recent studies. In contrast, coping styles have not often been in the focus of research. In this study, the coping of children and adolescents with cancer (n = 60, 8-13 years of age) was compared to the norm, measured by the German Coping Questionnaire for Children and Adolescents (SVF-KJ; Hampel et al. 2001). The results indicated that the subjects with cancer used more positive and less negative coping strategies when confronted with school-related or social stressors. The results are discussed with respect to the experience with disease-related stress and the possibility of repressive coping.     

Anxiety associated with hyperlipoproteinemia with and without obesity]

From the literature considered, it appears that the relationship between anxiety and lipoproteinemia is worth being further explored. Taking into account the relative weight of 277 male Belgian-French-speaking and Flemish-speaking subjects (type IV, lipidogram, Fredrickson classification), different levels of anxiety, depression, and modes of anxiety expression, are examined and compared, as a homogeneous sub-sample, to the main larger heterogeneous one. Type IV individuals are hypothesized and indeed observed to be anxious and to show intermediate (in-between) responses to the anxiety questionnaire (Cattell Anxiety Scale). Similarly, relative weights and lipid concentrations exhibit higher values than those observed on the whole sample. Within type IV individuals, psychological self-report scores and relative weight values are highly but negatively related: anxiety and depression are at the lowest by extremely overweighted subjects, and in-between response tendency is at the highest. Extending the conclusions at hand still requires additional comparisons with other lipidic types.