急性脑梗死行rt-PA静脉溶栓治疗的安全性和有效性研究

目的探讨重组组织纤溶酶原激活物(rt-PA)静脉溶栓治疗急性脑梗死的安全性和有效性。方法选取我院收治的急性脑梗死患者121例,随机分为溶栓治疗组和对照组,溶栓治疗组在抗凝治疗的基础上给予rt-PA静脉溶栓治疗,对照组给予单纯抗凝治疗。治疗14d后,比较2组NIHSS评分,随访3个月,采用中国卒中量表(CSS)评分和ADL指数评价临床疗效并记录不良反应发生率。结果 2组治疗前NIHSS评分差异无统计学意义(P0.05),治疗后溶栓治疗组总有效率96.7%,显著高于对照组的83.3%,NIHSS评分、CSS评分与ADL均显著优于对照组(P0.05),2组不良反应发生率无显著性差异(P0.05)。结论 rt-PA静脉溶栓治疗急性脑梗死具有较好的临床疗效,安全、有效,值得临床推广使用。     

蚓激酶胶囊治疗脑梗死病人的临床观察

蚓激酶是从露天红赤子爱胜蚓中提取的一种丝氨酸蛋白酶,具有典型的胰凝乳蛋白酶类丝氨酸蛋白酶的多肽链折叠形式,与纤维蛋白原有特异的亲和力,且具有纤溶活力.蚓激酶胶囊能明显降解纤维蛋白原,降低血小板聚集率及血液粘度.我们采用随机双盲、安慰剂对照(2:1)观察蚓激酶胶囊治疗脑梗死病人的临床疗效及安全性,尤其关注对纤维蛋白原等实验指标的影响,现报告如下.     

脑脉泰胶囊对急性脑梗死病人血总胆固醇水平的影响

目的 探讨脑脉泰胶囊对脑梗死病人总胆固醇(TC)水平的影响.方法 对经计算机X射线断层扫描技术(CT)/磁共振成像(MRI)诊断的87例脑梗死病人,随机分为治疗组(41例)和对照组(46例),所有病人均于治疗前及治疗4周后进行总胆固醇检测,并进行统计学处理.结果 治疗4周后,治疗组总胆固醇水平显著低于对照组(P<0.05).结论 脑脉泰胶囊有助于降低病人总胆固醇水平,提高临床疗效.     

抗抑郁治疗对老年脑卒中后抑郁及康复的影响

目的:观察抗抑郁治疗对老年缺血性脑卒中后抑郁症状及神经功能康复的作用.方法:将老年脑卒中后抑郁患者356例分为文拉法辛组128例、阿米替林组116例及对照组112例,于治疗前后进行汉密尔顿抑郁量表(HAMD)和神经功能缺损量表(CSS)、日常生活能力量表(ADL)评定.结果:文拉法辛组和阿米替林组治疗第2周HAMD评分和第12周CSS评分较治疗前和对照组均明显降低;文拉法辛组和阿米替林组3个月后ADL亦明显改善(P均＜0.05),但阿米替林组不良反应明显高于文拉法辛组.结论:抗抑郁治疗有利于老年脑卒中后抑郁患者神经功能康复,提高生活能力,减少并发症.     

脑心康颗粒剂治疗脑梗死的临床观察

目的观察脑心康颗粒剂治疗脑梗死的临床疗效.方法临床上选择脑梗死患者160例,随机分为治疗组80例,对照组80例,分别服用脑心康颗粒剂及尼莫地平片,疗程为8周.观察治疗前后患者的临床症状、神经功能缺损评定(CSS)及简易智力状态检查表(MMSE)的积分改变、血液流变学、纤维蛋白原等各项指标.结果临床观察表明脑心康颗粒剂能改善脑梗死患者临床症状,降低临床症状积分,降低CSS积分,提高MMSE积分及改善血液流变学.与对照组比较,治疗组的临床症状积分、CSS积分、血粘度高切等指标优于对照组,差异有显著性,P＜0.01.结论脑心康颗粒剂是治疗脑梗死的有效中药制剂.     

血清铁蛋白对急性脑梗死患者的临床评估

目的评估脑梗死急性期血清铁蛋白与患者病损的程度及恢复情况的关系.方法用化学发光法检测48例脑梗死患者急性期血清铁蛋白, 行中国神经功能缺损程度(CSS)评分(入院及住院3周时), 患者恢复情况以CSS减分值表示.结果入院时CSS≥15分组血清铁蛋白水平明显高于CSS＜15分组(P＜0.01), 两者呈正相关(r=13.47,P＜0.01).入院3周时CSS减分值少组血清铁蛋白水平高, 且在CSS≥15分组中差异有显著性(P＜0.05).结论脑梗死患者急性期血清铁蛋白的含量与脑梗死病损的严重程度及恢复密切相关.     

复方海蛇胶囊治疗血管性痴呆的疗效观察

目的 探讨复方海蛇胶囊治疗血管性痴呆的临床疗效及安全性。方法 103例血管性痴呆病人随机分为治疗组（52例）和对照组（51例）。治疗组给予复方海蛇胶囊口服,用法为3次/d,3粒/次;对照组给予脑复康片口服,3次/d,2粒/次。两组病人疗程均为3个月。治疗前后以MMSE和ADL进行评分。治疗前后查心电图、血常规、肝肾功能、血糖、电解质等。结果 治疗组有效率（86.54％）和显效率（65．38％）均高于对照组（68．63％和45．10％）,有显著性差异（P〈0.05）。两组均未发现有严重的不良反应。结论 复方海蛇胶囊治疗血管性痴呆安全有效。     

依达拉奉治疗急性脑梗死临床观察

目的 观察依达拉奉治疗急性脑梗死的有效性和安全性.方法 采用随机、双盲、安慰剂对照试验,选择发病48h内急性脑梗死患者 102 例,随机为为依达拉奉治疗组 52例,对照组 50 例.治疗组给予依达拉奉 30mg静滴,2次/d,共14d,2组同时给予疏血通、阿司匹林.治疗前后定期对患者进行欧洲卒中评分(ESS),日常生活活动能力(ADL)评定和常规检查,以治疗第7、14、21天 ESS增分率与第 90天 ADL增分率作为主要疗效判断标准.结果 21d 治疗组与对照组增分率分别为(58.8±16.2)%、(25.1±11.7)%,2组对比差异有统计学意义(P＜0.01),90d治疗组与对照组增分率分别为(72.5±19.8)%、(46.1±28.6)%,2组相比差异有统计学意义(P＜0.01),治疗组无明显不良反应.结论 依达拉奉治疗脑梗死安全有效.     

依帕司他与甲钴胺治疗糖尿病末梢神经病变的疗效

目的探讨依帕司他联合甲钴胺治疗糖尿病末梢神经病变的疗效和安全性。方法选取2009-2—2014-07我院就诊的糖尿病末梢神经病变患者90例为研究对象,随机分为对照组39例,采用常规血糖监测、控制血糖、控制饮食和适量运动措施,配合甲钴胺治疗,持续8周;研究组51例,在常规治疗基础上配合依帕司他联合甲钴胺治疗,连续8周。分析2组临床症状体征变化,用肌电图测定2组患者正中神经、腓总神经传导速度和血糖含量变化及不良反应状况。结果对照组有效率为69.23%(27/39),研究组为90.19%(46/51),差异有统计学意义(P0.05)。在正中神经和腓总神经传导速度上,对照组治疗前后无变化(P0.05),研究组治疗前后差异有统计学意义(P0.01)。在血糖监测方面,2组治疗前后空腹和餐后2h血糖含量均有显著变化(P0.01),组间比较无显著差异(P0.05)。2组均无严重不良反应。结论依帕司他联合甲钴胺治疗糖尿病末梢神经病变效果显著,神经改善状况良好,安全性高,值得应用。     

奥扎格雷钠联合蚓激酶治疗进展性脑梗死疗效观察

目的观察奥扎格雷钠联合蚓激酶治疗进展性脑梗死的疗效。方法 240例进展性脑梗死患者被随机分为治疗组和对照组各120例,治疗组在对照组常规治疗的基础上加用奥扎格雷钠+蚓激酶,疗程14d,所有患者治疗前后行NIH-SS评分、血小板计数、凝血酶原时间及纤维蛋白原测定。结果治疗14d后,治疗组的治愈率和总有效率显著高于对照组(χ2=11.345,18.404,P<0.01),差异有统计学意义;治疗组能显著降低纤维蛋白原,差异有统计学意义(P<0.05);治疗组能降低血小板计数,延长凝血酶原时间,结果无显著统计学差异。结论奥扎格雷钠联合蚓激酶治疗进展性脑梗死疗效显著,不增加出血风险,安全性较好。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Summary of legislation of 1935 of interest to the department of Mental Hygiene

Psychiatric Quarterly -     

Summary of legislation of 1941 of interest to the Department of Mental Hygiene

Psychiatric Quarterly -     

Asymmetry of on- and off-pathways of blue-sensitive cones of the retina of macaques

Macaque retinal ganglion cells whose receptive-field center recieves input from blue-sensitive cones show an overt asymmetry of the frequency of ON-center and OFF-center varieties, an asymmetry not present in ganglion cells whose center receives input from the other two cone types. A similar asymmetry of ON/OFF responses is found in the local electrotetinogram (d-wave) mediated by signals from blue-sensitive cones. ‘Blue-ON-center’ ganglion cells have larger receptive-field centers and shorter conduction latencies than other opponent-color varieties, suggesting an appreciable degree of receptor convergence and presumably large cell bodies. Intracellular stainings of these neurons with Procion Yellow show that they correspond to diffuse stratified (Parasol) ganglion cells whose flat-topped dendritic arborization stratifies in the sclerad half of the inner plexiform layer. In view of the known characteristics of macaque bipolar cells and of the ON/OFF asymmetry, it is proposed that these ganglion cells are postsynaptic to cone-specific flat bipolars possibly mediating sign-inverting synaptic contacts. The results also indicate a reversal, for the blue-cone pathway, of the ON/OFF lamination of the inner plexiform layer that has recently been described in other species.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.