大剂量辛伐他汀强化治疗对缺血性脑血管患者脑血管储备能力的影响

目的探讨大剂量辛伐他汀强化治疗对缺血性脑血管患者脑血管储备能力的影响及安全性。方法将108例缺血性脑血管病患者随机分成观察组与对照组各54例,2组均在常规治疗的基础上口服辛伐他汀,观察组40mg/次,对照组20mg/d,2组均1次/d,疗程均为6个月。比较2组患者临床疗效、脑血管储备功能(CVR)及屏气指数(BHI)、药物不良反应、复发率及病死率。结果观察组CVR(35.19±5.24)、BHI(1.54±0.33)明显高于对照组;不良反应发生率为(31.48%)、复发率、病死率(5.77%、3.85%)明显低于对照组(P0.05、0.01)。结论大剂量辛伐他汀强化治疗能有效改善脑血管储备能力,降低复发率及病死率,但需严密监测药物不良反应。     

大剂量辛伐他汀强化治疗对缺血性脑血管病患者血脂水平及脑血管储备能力的影响

目的探讨大剂量辛伐他汀强化治疗对缺血性脑血管病患者血脂水平及脑血管储备能力的影响。方法选择113例缺血性脑血管病患者为研究对象,按就诊顺序随机分为研究组57例和对照组56例,2组常规治疗方案相同,在此基础上,2组均联合辛伐他汀口服治疗,研究组40mg/次,qd,对照组20mg/次,qd,均以6个月为1个疗程。观察2组患者治疗前后血脂水平、脑血管储备能力、近期与远期疗效。结果研究组TC、LDL-C、TG明显低于对照组,HDL-C明显高于对照组;研究组CVR、BHI均明显高于对照组(P0.05);2组近期疗效比较差异无统计学意义(P0.05);研究组复发率、病死率(7.27%、1.82%)均明显低于对照组(P0.05)。结论大剂量辛伐他汀强化治疗有助于调节缺血性脑血管患者血脂水平,改善脑血管储备能力,提高近期及远期疗效。     

强化剂量辛伐他汀对缺血性脑血管病患者脑血管储备能力的影响

目的探讨强化剂量辛伐他汀对缺血性脑血管病患者脑血管储备能力(CVR)的影响。方法随机选取我院2012-04-2015-04收治的80例缺血性脑血管病患者,随机分为研究组(n=40)和对照组(n=40)。研究组给予强化剂量辛伐他汀治疗,对照组给予常规剂量辛伐他汀治疗,对比2组临床疗效、CVR和炎症因子水平及药物不良反应。结果 2组总有效率(97.5%vs 90.0%)比较差异无统计学意义(P0.05);治疗前2组CVR、BHI、CRP、TNF?α、MMP-9水平差异均无统计学意义(P0.05),治疗后研究组CVR、BHI均显著高于对照组(P0.05),CRP、TNF?α、MMP-9水平均显著低于对照组(P0.05);研究组药物不良反应发生率42.5%(17/40),显著高于对照组的17.5%(7/40)(P0.05)。结论辛伐他汀强化剂量能够有效增强缺血性脑血管病患者的CVR,但会增加药物不良反应,值得临床重视。     

阿托伐他汀钙对症状性大脑中动脉狭窄患者脑血管储备能力影响的研究

目的探讨阿托伐他汀钙对症状性大脑中动脉狭窄患者脑血管储备能力的影响。方法连续纳入2015年9月-2017年4月在广州医科大学附属第三医院荔湾医院神经内科住院就诊的症状性MCA狭窄患者(包括单侧和双侧狭窄),随机分成低剂量组(阿托伐他汀钙10 mg/d)及高剂量组(阿托伐他汀钙40 mg/d)。治疗3 m后,比较阿托伐他汀钙对脑血管储备能力的影响。结果共纳入症状性MCA狭窄患者208例,其中低剂量组102例,高剂量组106例。(1)低剂量组治疗前CVR为(18. 13±4. 8)%,治疗后为(21. 01±3. 9)%;高剂量组治疗前CVR为(17. 88±4. 9)%,治疗后为(25. 62±5. 5)%,低剂量组及高剂量组治疗前后CVR差异均有统计学意义(P0. 05);(2)低剂量组治疗前后CVR差值(2. 89±4. 0)%,与高剂量组(7. 74±6. 7)%相比,两者差异有统计学意义(P 0. 05)。结论阿托伐他汀钙能改善症状性MCA狭窄患者的脑血管储备能力,强化剂量疗效更佳。     

阿托伐他汀对皮质下小血管病患者脑血管反应性的影响

目的 观察不同剂量阿托伐他汀对皮质下小血管病患者脑血管反应性的影响.方法 48例皮质下小血管病患者,分成常规治疗组和强化治疗组.2组分别予以10 mg/d和40 mg/d的阿托伐他汀降脂治疗,疗程为半年.应用经颅多普勒超声,通过检测治疗前后屏气实验的屏气指数,观察阿托伐他汀对脑血管反应性的影响.结果 2组治疗后屏气指数较治疗前均增加.治疗后,强化治疗组屏气指数较常规治疗组显著增加.结论 阿托伐他汀可以改善皮质下小血管病患者的脑血管反应性.强化降脂对脑血管反应性的改善更显著.     

阿托伐他汀治疗急性脑梗死的疗效及对脑血管反应性的影响

目的观察不同剂量阿托伐他汀对急性脑梗死的临床疗效及对脑血管反应性(CVR)的影响。方法采用双盲法,随机抽样,将75例脑梗死患者分为治疗组和强化治疗组。2组入院后均给予常规处理,分别以10mg/d和40mg/d的阿托伐他汀治疗,疗程3个月。应用经颅多普勒超声,检测治疗前后屏气指数,观察阿托伐他汀对脑血管反应性的影响。结果 2组治疗后屏气指数较治疗前均有显著增加,强化治疗组较常规治疗组增加更显著。结论阿托伐他汀能有效改善急性脑梗死患者的脑血管反应性,强化治疗改善更明显。     

大脑中动脉狭窄患者脑血管反应性变化与脑梗死的关系

目的探讨大脑中动脉狭窄患者脑血管反应性变化与脑梗死的关系。方法 56例大脑中动脉狭窄患者（观察组）,按影像学表现和临床症状分为无脑梗死组（I组）30例,脑梗死（II组）26例,另设60例年龄、性别配对的健康者为对照组。常规经颅多普勒检查后进行屏气试验,记录屏气前后中动脉收缩期流速、舒张期流速、平均流速、搏动指数,计算屏气指数。结果观察组56例中,大脑中动脉单侧狭窄31例,双侧狭窄25例;中度狭窄37条血管,重度狭窄44条血管;屏气后各组搏动指数均减低,但对照组有显著性差异,中动脉狭窄组没有显著性差异;对照组屏气指数显著高于中动脉狭窄组,无症状组显著高于有症状组,中度狭窄组显著高于重度狭窄组。结论大脑中动脉狭窄患者脑血管反应性和脑储备功能减低,屏气指数是检测脑血管储备功能的重要指标,可以用于脑卒中的预测。     

灯盏细辛注射液对脑梗死恢复期脑血管反应性的影响

目的 观察灯盏细辛注射液对脑梗死恢复期脑血管反应性的影响.方法 50例轻中度脑梗死恢复期患者,随机分为对照组和实验组.对照组给予常规治疗;实验组在常规治疗的基础上,应用灯盏细辛注射液40ml,bid,疗程14d.通过检测治疗前后屏气实验屏气指数的改变,观察灯盏细辛注射液对脑血管反应性的影响.结果 实验组治疗结束后屏气指数较治疗前及对照组显著改善.结论 灯盏细辛注射液可改善脑梗死恢复期患者的脑血管反应性.     

脑血管反应性与缺血性卒中

目的观察缺血性卒中患者脑血管反应性（CVR）变化,确定两者之间的相关性。方法采用经颅多普勒超声（TCD）结合屏气试验检测76例缺血性卒中患者及62例对照病例的屏气指数（BHI）。结果缺血性卒中患者组的BHI明显低于对照组（P〈0.001）,Logistic 回归显示,由BHI所表示的CVR是缺血性卒中的独立影响因素（P=0.000）。结论降低的CVR是缺血性脑卒中的独立危险因素,应该重视CVR在脑缺血发生、发展过程中的独立影响作用。     

经颅多普勒超声结合屏气试验评价健康吸烟者脑血管反应性

目的 应用经颅多普勒超声联合屏气试验研究健康吸烟者脑血管反应性。方法 选取男性健康吸烟者46例,男性健康不吸烟者42例,采用经颅多普勒超声检测并记录双侧大脑中动脉（middle cerebral artery,MCA）多普勒频谱,检测参数包括收缩期峰值流速（peak systolicvelocity,PSV）,搏动指数（pulsatility index,PI）,阻力指数（resistance index,RI）,嘱受检者做屏气试验,记录屏气末双侧MCA多普勒频谱,测量参数同上,并计算屏气前后各参数变化率,通过参数变化率的大小分析脑血管反应性。结果 屏气后两组MCA峰值流速均表现为随屏气时间延长而增快,两组的PI及RI均降低,屏气前后各参数差异有统计学意义（P <0.05）。吸烟组屏气试验后PSV变化率为（23±7）％,不吸烟组为（37±9）％,两组间差异有统计学意义（P <0.05）;吸烟组屏气试验后PI值变化率为（19±5）％,不吸烟组为（25±8）％,两组间差异有统计学意义（P <0.05）;吸烟组屏气试验后RI值变化率为（21±6）％,不吸烟组为（35±7）％,两组间差异有统计学意义（P <0.05）。结论 健康吸烟者屏气后MCA的PSV、PI及RI的变化率均较健康不吸烟者减低,吸烟可使脑血管反应性降低。     

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.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

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。