丙种球蛋白及干扰素治疗手足口病并发病毒性脑炎疗效观察

目的观察丙种球蛋白及干扰素在治疗小儿手足口病(HFMD)并发病毒性脑炎的临床疗效、症状改善状况及安全性。方法选取我院2012-12—2013-12收治的手足口病并发病毒性脑炎患儿87例为研究对象,随机分为3组,丙种球蛋白组30例,连续5d静滴人血丙种球蛋白,剂量1g/(kg·d);干扰素组27例,采用肌内注射重组人干扰素80μg/(次·d),持续3d;联合组30例,采取丙种球蛋白和干扰素联合治疗。3组患儿在降颅压、退热、预防细菌感染、营养脑细胞等治疗和护理方式上均相同,观察3组患儿1周内临床症状改善情况,对比临床疗效及安全性。结果 3组在生理指标恢复时间上差异无统计学意义(P0.05),在热程、疱疹消失时间和神经系统病理征转阴时间上差异有统计学意义,联用组所需时间显著少于干扰素组和丙种球蛋白组(P0.01),干扰素组和丙种球蛋白组间无显著性差异(P0.05);联用组有效率(93.33%)大于干扰素组(77.78%)和丙种球蛋白组(76.67%),但两两比较差异无统计学意义(P0.05);联用组不良反应发生率高于干扰素组和丙种球蛋白组,但3组间差异无统计学意义(P0.05)。结论小儿手足口病并发病毒性脑炎采用丙种球蛋白联合干扰素治疗的效果较单独使用明显,缩短了病程,且不良反应可耐受,具有一定临床意义。     

甲泼尼龙琥珀酸钠与丙种球蛋白对手足口病合并病毒性脑炎患儿神经及免疫的影响

目的研究甲泼尼龙琥珀酸钠与丙种球蛋白对手足口病合并病毒性脑炎儿童神经及免疫的影响。方法选取我院2014-02—2015-08诊治的48例手足口病合并病毒性脑炎儿童,随机分为2组,常规组24例给予常规治疗,观察组24例在常规治疗基础上给予丙种球蛋白联合大剂量甲泼尼龙琥珀酸钠治疗,对比2组治疗前后不同时间段患儿红细胞各项指数及其免疫水平和神经功能因子水平变化情况。结果治疗前2组患儿神经功能因子水平、红细胞免疫、各项红细胞指数相比,差异均无统计学意义(P0.05);治疗后观察组患儿的各项红细胞指数均明显优于治疗前,且均优于常规组,差异有统计学意义(P0.05);治疗后观察组RBC-C3bR、RBC-ICR均低于常规组,FEER高于常规组,且均优于治疗前,差异有统计学意义(P0.05)。治疗后观察组各项神经功能因子水平均明显低于治疗前,且均优于常规组,差异有统计学意义(P0.05)。结论丙种球蛋白联合大剂量甲泼尼龙琥珀酸钠治疗手足口病合并病毒性脑炎患儿效果显著,对其红细胞多项指数及其免疫水平和神经功能因子水平影响较大,能有效改善机体状态,缓解病情、阻止病情进展。     

安脑丸治疗手足口病脑炎临床观察

目的观察安脑丸在手足口病脑炎治疗中的临床效果。方法选取2014-03—2016-02我院收治的手足口病并发病毒性脑炎住院患儿100例,随机分为对照组和观察组。2组均给予利巴韦林抗病毒静滴,甲基泼尼松龙联合丙种球蛋白冲击治疗,防治脑水肿等对症治疗;观察组在上述治疗基础上加用安脑丸治疗。观察对比2组治疗后体温、神志恢复及神经系统症状缓解情况及不良反应等。结果观察组显效率高于对照组,差异有统计学意义(P0.05)。结论安脑丸治疗手足口病并发病毒性脑炎,有助于患儿体温及神经系统症状恢复,治疗效果确切,值得推广。     

丙种球蛋白联合神经节苷脂治疗小儿病毒性脑炎效果评价

目的探讨丙种球蛋白联合神经节苷脂治疗小儿病毒性脑炎的临床效果。方法将漯河医学高等专科学校第一附属医院2014-10—2016-10收治的64例病毒性脑炎患儿随机分为观察组与对照组,每组32例,对照组给予常规治疗,观察组在对照组基础上给予丙种球蛋白加神经节苷脂静滴。结果观察组治疗有效率(93.75%)远高于对照组(75.00%),差异具有统计学意义(P0.05);观察组退热、精神意识改善、抽搐停止、脑膜刺激征消失以及脑脊液恢复正常时间、住院时间均短于对照组,差异有统计学意义(P0.05);观察组CGRP表达水平高于对照组,TNF-α、S100B、MBP、NGF各指标表达水平低于对照组,差异均有统计学意义(P0.05)。结论丙种球蛋白联合神经节苷脂治疗病毒性脑炎效果显著,值得临床推广应用。     

脑炎合并重症手足口病患儿的综合护理效果分析

目的探讨脑炎合并重症手足口病患儿的临床护理效果。方法 60例脑炎合并重症手足口病患儿随机分为观察组和对照组,对照组采取常规治疗与护理,观察组在此基础上采取综合护理,分析比较2组患儿退热、皮疹消退、神经系统症状消失时间、住院时间和满意度情况。结果观察组患儿退热、皮疹消退、神经系统症状消失时间以及住院时间均明显短于对照组,差异具有统计学意义(P0.05);观察组的满意度显著高于对照组(93.3%66.7%),差异具有统计学意义(P0.05)。结论综合护理干预对脑炎合并重症手足口病患儿的病情改善显著,患儿家属的满意度较高,值得临床广泛应用。     

丙种球蛋白与热毒宁治疗手足口病并发病毒性脑炎的效果比较

目的比较丙种球蛋白与热毒宁治疗手足口病并发病毒性脑炎(HFMD)的治疗效果及用药安全。方法随机抽取我院2012-04—2013-06收治的100例手足口病并发病毒性脑炎患者,并按照随机数字表法分为对照组33例,丙种球蛋白组34例,热毒宁组33例。3组患者均给予常规对症治疗,丙种球蛋白组在常规对症治疗基础上静脉注射丙种球蛋白400mg·kg~(-1)·d~(-1),连用4d,热毒宁组在常规对症治疗基础上静脉注射0.6mL·kg~(-1)热毒宁,1次/d,连用4d。比较3组患者的临床治疗效果。结果对照组有效率81.8%,丙种球蛋白组为94.1%,热毒宁组为93.9%。丙种球蛋白组和热毒宁组与对照组有效率相比,差异有统计学意义(P0.05),但丙种球蛋白组与热毒宁组相比,差异无统计学意义(P0.05)。结论丙种球蛋白和热毒宁均可有效治疗手足口病并发病毒性脑炎患者。     

神经节苷脂联合丙种球蛋白治疗小儿重症病毒性脑炎的疗效及安全性观察

目的观察神经节苷脂及丙种球蛋白治疗小儿重症病毒性脑炎的临床疗效及安全性。方法选取2013-03—2015-03我科室收治的重症病毒性脑炎患儿50例,按随机数字表法分为实验组及对照组各25例,对照组给予抗病毒、降颅压、解痉挛、稳定酸碱电解质平衡、营养支持等常规治疗,实验组在对照组常规治疗基础上加用神经节苷脂联合丙种球蛋白治疗,分析治疗4周后2组患儿症状体征变化及治疗状况。结果 (1)治疗4周后实验组患儿发热呕吐、抽搐、意识障碍、精神症状、住院时间分别为(2.1±0.3、1.6±0.3、3.8±0.7、3.6±0.7、5.1±1.2、14.5±2.3)d,均低于对照组(3.6±0.5、3.0±0.6、4.9±1.1、4.7±1.0、8.4±1.6、19.8±3.2)d,且差异均具有统计学意义(P0.05);(2)实验组治愈数、无效数及总有效率分别为(13例、1例、96%),均有优于对照组(8例、5例、80%)且差异均具有统计学意义(P0.05);(3)2组患儿均未见心、肝、肾、胃肠道等器官明显不良反应。结论神经节苷脂联合丙种球蛋白治疗小儿重症病毒性脑炎疗效肯定、确切,与常规治疗相比无明显不良反应,能显著提高患儿治愈率,降低患儿病死率,值得临床进一步研究和应用。     

短程甲基强的松冲击疗法加干扰素治疗小儿病毒性脑炎

目的：观察短程甲基强的松冲击疗法加干扰素治疗小儿病毒性脑炎的疗效。方法收集小儿病毒性脑炎患儿34例,随机分对照组15例和观察组19例。对照组采用干扰素治疗,观察组采用短程甲基强的松冲击疗法加干扰素治疗。比较2组患儿临床症状改善时间及疗效。结果观察组发热、抽搐、脑膜刺激征、病理征、意识障碍、颅内高压的恢复时间均显著短于对照组（P＜0.05）。观察组总有效率94.74％,显著高于对照组的60.00％（P＜0.05）。结论短程甲基强的松冲击疗法加干扰素治疗小儿病毒性脑炎能有效缩短临床症状改善时间并提高疗效。     

人血丙种球蛋白治疗手足口病合并脑炎的疗效分析

目的 分析人血丙种球蛋白治疗手足口病合并脑炎的临床疗效.方法 随机将115例确诊手足口病合并脑炎患儿分为2组,基础治疗组给予口腔护理、甘露醇、糖皮质激素及利巴韦林等常规对症治疗,丙种球蛋白组在常规对症治疗基础上静滴人血丙种球蛋白,连续治疗7 d后对比临床疗效.结果 丙种球蛋白组退热时间、惊颤控制时间、神经系统受累时间和住院时间明显短于基础治疗组（P＜0.01）;丙种球蛋白组总有效率91.38%,明显高于基础治疗组的77.19%（P＜0.05）.结论 人血丙种球蛋白治疗手足口病合并脑炎疗效确切,能够有效缩短退热时间、惊颤控制时间、神经系统受累时间和住院时间,在阻止病情进行性加重和改善预后方面具有非常重要的意义,值得临床对作用机制继续研究和探讨.     

大剂量丙种球蛋白治疗小儿病毒性脑炎的疗效观察

目的：观察大剂量丙种球蛋白联合应用于小儿病毒性脑炎中的治疗效果。方法选取我院小儿科2010‐01—2013‐01收治的病毒性脑炎患儿中105例作为研究对象,所有患儿均给予降温、降颅压、解痉、改善脑循环、抗感染、维持水电解质平衡等常规治疗措施,随机分为对照组与观察组,观察组在常规治疗基础上应用大剂量丙种球蛋白1.0g／（kg·d）,1次／d,连用2～3d。观察2组患者临床疗效及临床症状、体征缓解时间、出院时间、不良反应。结果观察组疗效明显优于对照组,观察组患者发热、脑膜刺激征、惊厥、昏迷消失时间及住院治疗时间均较对照组明显缩短,差异均有统计学意义（P＜0.05）。2组均无严重不良反应。结论大剂量丙种球蛋白治疗小儿病毒性脑炎,可显著改善患儿免疫功能,有效缩短患儿症状和体征消退时间,减轻脑组织及细胞的损伤,未见严重不良反应。     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

Modelling of movement of the lamprey: Control of oscillators

This article discusses the control methods of the central pattern generator (CPG). First a control model of the CPG is presented using 2 oscillators, and we suggest that phasic modulation to the CPG by means of phasic information is effective for controlling the phase difference between oscillators. Next, two models for controlling the CPG of a lamprey are proposed. One model describes a control system from the brain stem, in which the reticulospinal neurons control the CPG by receiving feedback signals and sending control signals to the neck region of the CPG. The other is a model for learning an localized control system to generate a desired motor pattern. By means of these models, a role of the efference copy is suggested.     

利培酮对精神分裂症患者生活质量的影响

目的：比较利培酮与氟哌啶醇对精神分裂症患者生活质量的影响。方法：对门诊72例服用氟哌啶醇及74例服用利培酮的精神分裂症患者用生活质量综合评定问卷（GQOLI）、阳性与阴性症状量表（PANSS）、副反应量表（TESS）进行评定。结果：利培酮组患者治疗后生活质量有所提高,而氟哌啶醇组患者生活质量有所下降。结论：利培酮治疗有利于患者提高生活质量。     

Effect of high simple dose of cisplatinum and of radiation on the brain of rabbit

Abstract

In former studies of intracarotid and intravenous administration of cisplatinum, separate and combined with brain irradiation, we found no cerebral damage. In this study! gradually increasing high doses (above the therapeutic ones) of cisplatinum were administered intravenously to one series of rabbits arid increasing high amounts of irradiation (above the therapeutic amounts) were given to another series. Although the rabbits that received highest doses of irradiation developed areas of alopecia and skin ulcers on the head! the general clinical and histopathologic examination of the rabbits brains in both series was normal. The purpose of this study was to establish the effects of high doses of intravenous cisplatinum and irradiation on the rabbits brains. [Neural Res 1997; 19: 216–218]