急性脑梗死患者血清尿酸、超敏C反应蛋白的改变及其临床意义

目的探讨急性脑梗死(ACI)患者血清尿酸(UA)和超敏C反应蛋白(hs-CRP)水平的改变及其临床意义。方法采用尿酸酶比色法和免疫散射比浊法检测101例ACI患者(ACI组)及40例正常对照者(正常对照组)的血清UA和hs-CRP水平。采用NIHSS评分评价ACI组患者的神经功能缺损程度。根据NIHSS评分,将患者分为轻度缺损亚组(≤5分)、中度缺损亚组(5~15分)及重度缺损亚组(15分)。结果ACI组血UA及hs-CRP水平显著高于正常对照组(均P0.01)。与轻度缺损亚组比较,中度缺损亚组及重度缺损亚组的UA及hs-CRP水平均显著升高(均P0.05)。重度缺损亚组UA及hs-CRP水平均显著高于中度缺损亚组(均P0.05)。结论 ACI患者血清尿酸和超敏C反应蛋白水平显著增高,与ACI严重程度有关。     

急性脑梗死患者血清脂蛋白相关磷脂酶A2水平的改变及其与病情的关系

目的 研究急性脑梗死(ACI)患者血清脂蛋白相关磷脂酶A2(LP-PLA2)水平的改变及其与病情的关系.方法 91例ACI患者按照美国国立卫生研究院卒中量表(NIHSS)评分分为轻型ACI组(NIHSS评分＜4分)、中型ACI组(4～15分)、重型ACI组(＞15分).应用酶联免疫吸附法测定ACI患者及31名正常对照者的血清LP-PLA2水平.ACI患者NIHSS评分与血清LP-PLA2水平的关系用Spearman相关分析.结果 ACI组的血清LP-PLA2水平显著高于正常对照组(P＜0.01);重型ACI亚组血清LP-PLA2水平又显著高于中型ACI亚组和轻型ACI亚组(均P＜0.01).经Spearman相关分析,ACI患者的NIHSS评分与血清LP-PLA2水平呈正相关(r=0.485,P＜0.001).结论 ACI患者的血清LP-PLA2水平显著升高,病情越重者升高越明显.     

影响急性脑梗死患者治疗效果的相关因素分析

目的 探讨影响急性脑梗死患者治疗效果的相关因素.方法 对360例急性脑梗死患者予以卒中单元规范化治疗;在治疗前、治疗14 d时进行美国国立卫生研究院卒中量表(NIHSS)评分,以及检测有关血常规、生化指标.采用多因素Logistic回归分析对与患者治疗后NIHSS评分相关的指标进行分析.结果 与治疗前比较,脑梗死各亚组的血浆脂蛋白[Lp(a)]、尿酸、D-二聚体(D-D)、超敏C反应蛋白(hs-CRP)水平明显降低;轻、中度亚组血糖及中、重度亚组直接胆红素水平明显降低;中度亚组三酰甘油、低密度脂蛋白(LDL)及重度亚组总胆红素水平明显降低(均P＜0.05).重度亚组治疗前的血同型半胱氨酸(Hcy)水平明显高于轻、中度亚组(均P ＜0.05).多因素Logistic回归分析显示,治疗后NIHSS评分与血糖、hs-CRP、Hcy、尿酸、D-D、LDL、Lp(a)水平相关(OR=1.235～4.042,P＜0.05～0.001).结论 血糖、hs-CRP、Hcy、尿酸、D-D、LDL和Lp(a)为影响急性脑梗死患者治疗效果的相关因素.     

延边地区朝鲜族急性脑梗死患者hs-CRP,Hcy,D-二聚体水平的研究

目的 检测延边地区朝鲜族急性脑梗死患者hs-CRP、Hcy、D-D的水平,探讨其在脑梗死诊治中的临床意义.方法 选择2009年1月～2010年12月在延边大学附属医院神经内科住院的首次发病的ACI患者200例,将其分为入院时神经功能缺损评分(NIHSS)评分≥7分者为A组,神经功能缺损评分(NIHSS)评分＜7分者为B组.于入院后第2天清晨空腹采取静脉血,检测血清hs-CRP水平、血清Hcy水平、血浆D-D水平.同时将在医院体检科进行体检的100名健康汉族列为对照组,检测三者血清水平.结果 ACI患者的hs-CRP、Hcy、D-D水平均高于对照组,A组高于B组,3组间比较及组内比较,差异均有统计学意义(P＜0.05).A组患者hs-CRP、Hcy、D-D阳性率均显著高于B组,差异均有统计学意义(P＜0.05).结论 Hs-CRP、Hcy、D-D水平升高是延边地区朝鲜族急性脑梗死患者发病的危险因素.     

中青年脑梗死患者颈动脉粥样硬化及其血清基质金属蛋白酶-9、组织基质金属蛋白酶抑制剂-1、超敏C反应蛋白水平的改变

目的研究中青年脑梗死患者颈动脉粥样硬化及其血清基质金属蛋白酶-9(MMP-9)、组织基质金属蛋白酶抑制剂-1(TIMP-1)、超敏C反应蛋白(hs-CRP)水平的改变。方法应用彩色多普勒超声仪探测42例急性脑梗死患者(ACI组)、29例无症状颈动脉硬化患者(ACA组)及17名健康体检者(NC组)的双侧颈动脉粥样硬化的情况。采用酶联免疫吸附法检测各组血清MMP-9和TIMP-1水平,免疫散射比浊法检测血清hs-CRP水平。结果 NC组均未检出颈动脉粥样硬化斑块。ACI组易损斑块的比例(69.2%)及检出率(47.6%)均明显高于ACA组(46.4%,20.7%)(均P<0.05)。ACI组血清MMP-9、TIMP-1、hs-CRP水平及MMP-9/TIMP-1比值均明显高于ACA组(均P<0.05);ACA组血清MMP-9、TIMP-1、hs-CRP水平均明显高于NC组(均P<0.05)。ACI组中,易损斑块亚组血清MMP-9、TIMP-1、hs-CRP水平及MMP-9/TIMP-1比值均明显高于稳定斑块亚组(均P<0.05);稳定斑块亚组血清MMP-9、TIMP-1、hs-CRP水平均明显高于无斑块亚组(均P<0.05)。结论血清MMP-9、TIMP-1、hs-CRP可作为反映颈动脉粥样硬化及斑块稳定性的血清学指标。MMP-9/TIMP-1比值增高及颈动脉易损斑块可能提示中青年脑梗死的风险。     

急性脑梗死血清hs-CRP脂蛋白(a)及D-二聚体水平与颅内动脉狭窄的相关性研究

目的 通过检测急性脑梗死患者血清脂蛋白(a)[Lp(a)]、超敏C反应蛋白(hs-CRP)及D-二聚体水平,观察其与颅内动脉狭窄相关性。方法 对入院后确诊的急性脑梗死患者进行颈动脉彩超、头颅MRA筛查,对存在颅内动脉狭窄的患者行全脑血管造影(DSA)检查,同时采用免疫散色比浊法和免疫透射比浊法检测其血清hs-CRP、Lp(a)和D-二聚体水平。DSA显示脑动脉内径正常或狭窄50%为非狭窄组,颅内动脉[颈内动脉(ICA)、大脑前动脉(ACA)、大脑中动脉(MCA)、基底动脉(BA)、椎动脉颅内段(VA)]中至少有1支内径狭窄≥50%的为狭窄组。结果 狭窄组入组病例150例,非狭窄组入组病例148例,狭窄组Lp(a)、hs-CRP、D-二聚体水平均较非狭窄组显著升高,差异有统计学意义(P0.05);其中单支病变亚组和多支病变亚组比较,多支病变亚组患者Lp(a)、hs-CRP、D-二聚体水平较单支病变亚组明显升高(P0.05)。结论 伴颅内动脉明显狭窄的急性脑梗死患者血清Lp(a)、hs-CRP、D-二聚体水平较无颅内动脉狭窄者显著升高,多支颅内动脉狭窄者升高尤为明显,炎症机制可能参与了颅内动脉狭窄的发生发展过程。     

血清脂蛋白相关磷脂酶a2、hs-CRP和血小板活化 因子在后循环供血区梗死患者中的水平变化

目的 探讨血清脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,LP-PLA2)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)和血小板活化因子(platelet activating factor,PAF)在后循环供血区梗死患者中的水平变化。方法 选取2014年1月-2017年1月本院神经内科住院部162例后循环供血区梗死患者作为病例组,同期选取健康体检中心160例体检健康者作为对照组,参照NIHSS标准将病例组分为轻度亚组(<4分,n=59),中度亚组(4～15分,n=53)与重度亚组(>15分,n=50),依据预后状况分为预后良好亚组(NIHSS评分差值>4分,n=77)与预后不良亚组(差值≤4分,n=85),采用ELISA测定血清LP-PLA2、PAF水平,采用免疫速率散射比浊法测定血清hs-CRP水平。结果 病例组血清LP-PLA2、hs-CRP、PAF水平明显高于对照组(P<0.05); 重度亚组血清LP-PLA2、hs-CRP、PAF水平明显高于轻中度亚组,中度亚组上述指标明显高于轻度亚组; 预后不良亚组血清LP-PLA2、hs-CRP、PAF水平明显高于预后良好亚组(P<0.05); 经Pearson相关分析显示,病例组血清LP-PLA2、hs-CRP、PAF与NIHSS评分呈正相关(r=0.412,0.503,0.498,P<0.05)。结论 后循环供血区梗死患者血清LP-PLA2、hs-CRP和PAF水平可能参与疾病发生发展与预后转归过程。     

2型糖尿病合并急性脑梗死hs-CRP、Lp(a)检测的临床价值

目的探讨2型糖尿病(DM)合并急性脑梗死(ACI)患者检测高敏C反应蛋白(hs-CRP)、脂蛋白a[Lp(a)]的临床价值。方法收集42例2型糖尿病合并急性脑梗死病例(DM+ACI组),40例单纯T2DM(DM组)及同期40例健康体检者(正常对照组),测定3组人群的hs-CRP、Lp(a)及其他生化指标,并对结果进行统计学分析。结果 DM+ACI组及DM组的血清hs-CRP、Lp(a)水平均显著高于正常对照组(P<0.05)。DM+ACI组血清Lp(a)显著高于DM组(P<0.05),2组hs-CRP水平比较差异无统计学意义(P>0.10)。结论 hs-CRP、Lp(a)检测对2型糖尿病并发急性脑梗死的风险度具有一定的预测价值。     

血清炎性因子联合NIHSS评分评价急性缺血性卒中患者病情的临床研究

目的 探讨急性缺血性卒中患者血清炎性因子及美国国立卫生研究院卒中量表(NIHSS)评分变化对病情评价的临床意义.方法 分别检测90例急性缺血性卒中患者治疗前后血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)水平和NIHSS评分变化,并与正常对照受试者进行比较.结果 根据梗死灶体积将患者分为大型(＞10 cm 3)、中型(5～10cm 3)和小型(＜5cm3)共3个亚组,治疗前3组患者血清IL-6 、TNF-α和hs-CRP水平均高于正常对照组(P＜0.01),治疗后各项炎性因子和NIHSS评分降低,与治疗前差异仍有统计学意义(均P＜0.01).结论 血清炎性因子水平和NIHSS评分可作为急性缺血性卒中患者的病情评价和疗效监测指标.     

急性脑梗死患者C反应蛋白、ApoA1、Fib检测的临床意义

目的 探讨急性脑梗死(ACI)患者血清C反应蛋白(CRP)、载脂蛋白A(ApoA1)、纤维蛋白原(Fib)检测的临床意义.方法 测定136例ACI患者、67例正常对照组血清CRP、ApoAl、Fib的水平,观察比较不同类型ACI患者的血清CRP、ApoAI、Fib含量差异,对发病后48h后病情发展变化进行评定,将(ACI)患者分为进展型与完全型脑梗死两组.根据NIHSS评分将临床神经功能损害程度分为:轻型、中型、重型.结果 CRP水平:进展组高于完全组和对照组(P＜0.05),NIHSS重型组明显高于中型、轻型组(P＜0.05);ApoAl水平:进展组明显低于完伞组和对照组,重型组明显低于中型、轻型组(P＜0.05).Fib水平:进展组和完全组均明显高于对照组,NIHSS重型组明显高于中型、轻型组(P＜0.05)CRP与ApoAl,Fib均有相关性,相关系数分别是(r=-0.557,r=0.643)P＜0.05.结论 CRP、ApoAl、Fib一定程度上是预测ACI患者病情及发展方向的生化指标.     

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.