依达拉奉联合氯吡格雷治疗急性脑梗死疗效观察

目的 探讨依达拉奉联合氯吡格雷治疗急性脑梗死的临床疗效.方法 自2008-01-2011-08我院共接诊急性脑梗死患者90例,平均分为A、B、C 3组,A组在常规治疗的基础上给予依达拉奉联合氯吡格雷治疗,B组单用氯吡格雷治疗,C组单用依达拉奉治疗,连续用药14 d观察治疗结果.结果 A组总有效率96.7%,B组80.0%,C组83.3%.B组和C组分别与A组比较,差异有统计学意义(P＜0.05),B组和C组比较差异无统计学意义(P＞0.05).结论 依达拉奉联合氯吡格雷治疗急性脑梗死的临床效果优于单用氯吡格雷或依达拉奉,是一种有效组合.     

疏血通联合丁咯地尔治疗脑梗死的疗效观察

目的：观察疏血通联合丁咯地尔治疗脑梗死的临床疗效。方法102例急性脑梗死患者随机分为治疗组60例,应用疏血通和盐酸丁咯地尔治疗。对照组42例,单用疏血通。2组均治疗2周后观察比较2组临床疗效。结果治疗组总有效率96·7％,显效率90％。对照组总有效率88·1％,显效率69％。2组比较差异有统计学意义（ P＜0·05）。结论疏血通联合丁咯地尔治疗急性脑梗死的疗效优于单用疏血通。     

肌肉神经生物电治疗联合抗生素静滴对盆腔炎患者的疗效与复发率控制

目的：观察肌肉神经生物电治疗联合抗生素静滴对盆腔炎患者的疗效与复发率情况。方法选取150例盆腔炎急性发作患者，随机分为A、B、C组，各50例。A组给予单种抗生素治疗，B组给予两种抗生素静滴治疗，C组在B组基础上，增加肌肉神经生物电治疗，观察疗效，治疗后3个月复发率。结果 A组总有效率为68％，B组为72％，C组为84％，差异有统计学意义（ P＜0·05）；A 组复发12例（35·29％），B组10例（27·78％），C组5例（11·90％），差异有统计学意义（ P＜0·05）。结论使用肌肉神经生物电联合两种抗生素静滴治疗盆腔炎，有较好的近期疗效，且3个月的复发率较单用抗生素低，值得推广。     

依达拉奉联合丹参酮Ⅱ A治疗急性脑梗死疗效观察

目的：观察依达拉奉与丹参酮ⅡA联用治疗急性脑梗死的临床疗效。方法选取安阳市人民医院收治的69例急性脑梗死患者为研究对象,随机分为观察组35例,对照组34例。观察组采用依达拉奉注射液联合丹参酮ⅡA治疗,对照组单用依达拉奉注射液治疗。2组均14 d为一个疗程,共2个疗程。治疗期间观察并记录药物的不良反应,疗程结束前后分别检测血、尿常规和肝、肾功能等。结果观察组总有效率91.4％,优于对照组的70.6％,差异有统计学意义（ P＜0.05）。2组不良反应比较差异无统计学意义（ P＞0.05）。结论依达拉奉联用丹参酮ⅡA治疗急性脑梗死临床疗效满意,且不良反应少,值得临床应用。     

依达拉奉联合丹参酮ⅡA治疗急性脑梗死疗效观察

目的：观察依达拉奉与丹参酮ⅡA联用治疗急性脑梗死的临床疗效。方法选取安阳市人民医院收治的69例急性脑梗死患者为研究对象,随机分为观察组35例,对照组34例。观察组采用依达拉奉注射液联合丹参酮ⅡA治疗,对照组单用依达拉奉注射液治疗。2组均14 d为一个疗程,共2个疗程。治疗期间观察并记录药物的不良反应,疗程结束前后分别检测血、尿常规和肝、肾功能等。结果观察组总有效率91.4％,优于对照组的70.6％,差异有统计学意义（ P＜0.05）。2组不良反应比较差异无统计学意义（ P＞0.05）。结论依达拉奉联用丹参酮ⅡA治疗急性脑梗死临床疗效满意,且不良反应少,值得临床应用。     

葛根素注射液治疗急性脑梗死40例临床观察

目的:观察葛根素注射液治疗脑梗死的临床疗效。方法:选择脑梗死患者80例,随机分为葛根表注射液组(简科治疗组40例)和复方丹参注射液组(简称对照组40例)进行临床观察。结果:治疗组总有效率90.5%,对照组总有效率77.5％,2组总有效率比较差异有显著性意义(P<0.05)。结论:葛根素注射液治疗急性脑梗死有良好的疗效。     

急性脑梗死患者采用奥扎格雷钠联合低分子肝素钙治疗对血栓前状态及预后的影响

目的探讨急性脑梗死患者采用奥扎格雷钠联合低分子肝素钙治疗对血栓前状态以及长期临床预后的影响。方法选取自2009-01—2011-04来我院就诊的急性脑梗死患者127例为研究对象,随机分为A、B、C 3组,A组49例(38.58%)采用奥扎格雷钠联合低分子肝素钙治疗,B组37例(29.13%)采用奥扎格雷钠治疗,C组41例(32.28%)采用低分子肝素钠治疗,观察3组患者治疗前后临床症状和体征改善情况,采用美国国立卫生研究院卒中评分量表(NIHSS)对患者治疗前后神经功能进行评分,比较3组患者的临床疗效,检测血栓前状态vWF、GMP140指标的变化及不良反应的发生状况。结果在NIHSS评分上,3组患者治疗前后存在显著差异(P0.01),治疗后A组与B、C间存在显著差异(t P0.01);3组患者治疗前后vWF、GMP140指标均存在差异(P0.01),治疗后A组与B、C组存在显著差异(P0.01);A组有效率91.84%,B组有效率72.97%,C组有效率73.17%,A组疗效优于B、C组(P0.05);3组不良反应发生率差异无统计学意义(P0.05)。结论对于急性脑梗死患者,奥扎格雷钠联合低分子肝素钙效果显著,改善血栓前状态,临床长期不良反应少,值得推广应用。     

降纤酶联合低分子右旋糖酐治疗糖尿病并进展性脑梗死临床观察

目的 观察降纤酶联合低分子右旋糖酐注射液治疗糖尿病并进展性脑梗死的疗效。方法130例脑梗死患者随机分成2组，对照组采用常规西医治疗，配合静滴血塞通和脑蛋白水解物注射液，治疗组在对照组的基础上，再加用降纤酶和低分子右旋糖酐注射液治疗。结果治疗组显效率72．7％，总有效率89．3％；对照组显效率32．8％，总有效率62．5％，2组比较差异有统计学意义（P〈0．01）。结论降纤酶联合低分子右旋糖酐治疗糖尿病并进展性脑梗死疗效好，无明显不良反应。     

大面积脑梗死94例临床分析

目的 探讨大面积脑梗死的治疗方法及预后.方法 对住院经治的94例大面积脑梗死病例进行了回顾性研究,根据治疗方法不同分为A、B、C 3组,A组54例内科保守治疗,B组16例溶栓治疗,C组24例在A组的基础上给予去颅骨瓣减压.根据有无梗死后出血再分为出血性梗死组(20例)和非出血性梗死组(74例).对各组的疗效进行比较.结果 A、B、C 3组病死率分别为54.41%、18.75%和29.17%,A组与B组比较,P<0.01;A组与C组、B组与C组比较均为P>0.05;A、B、C 3组总有效率分别为20.37%、56.25%和48.83%,A组与B组比较,P<0.025;A组与C组比较P<0.05,B组与C组比较P>0.05;A、B、C 3组的基本治愈率分别为0、25%、0,A组与B组比较,P<0.005,B组与C组比较P<0.05.出血性脑梗死和非出血性脑梗死病死率分别为55%、40.54%,总有效率分别为25%、35.14%,二者比较,P>0.05.结论 溶栓治疗及去颅骨瓣减压术与内科保守治疗相比均能降低病死率,仅有溶栓治疗方能提高基本治愈率,降低致残率;梗死后出血对大面积脑梗死的预后影响不大.     

卡托普利硝苯地平与阿替洛尔治疗高血压对比观察

目的探讨卡托普利、硝苯地平、阿替洛尔治疗高血压的临床疗效。方法120例高血压患者随机分为3组，A组给予卡托普利治疗，B组给予硝苯地平治疗，C组采用阿替洛尔治疗，观察3组治疗效果。结果A组总有效率90．O％，B组总有效率87．5％，C组总有效率92．5％，3组比较差异无统计学意义（P〉O．05）。3组治疗过程中均无不良反应。结论卡托普利、硝苯地平和阿替洛尔治疗高血压均具有较好的应用效果，而且三种药物治疗的效果比较相近。     

Factors associated with satisfaction with care among patients with epilepsy

OBJECTIVE: The purpose of the work described here was to determine those variables associated with satisfaction with care among patients with epilepsy. METHODS: We interviewed patients followed at a tertiary epilepsy center. Predictor variables included age, gender, race, education, income, insurance, seizure frequency, and Quality of Life in Epilepsy-10 inventory (QOLIE-10) results. Target variables were the subscales of the Short Form Patient Satisfaction Questionnaire (PSQ-18). We used univariate analysis to identify those variables significantly associated with the subscales and multiple linear regression to determine those independently significant. RESULTS: The study population comprised 193 patients. Lower education and better QOLIE-10 scores were independently associated with general satisfaction with care. The mental health scale was associated with general satisfaction with care. Lower educational level was the only variable independently associated with patient satisfaction with communication, the financial aspect of care, and time spent with physician. CONCLUSION: Lower educational level and better quality of life are the main variables associated with higher general satisfaction with care among patients with epilepsy.     

Treatment with rituximab in patients with polyneuropathy with anti-MAG antibodies

Journal of Neurology -     

Surgical Outcome in Patients with Epilepsy with Occult Vascular Malformations Treated with Lesionectomy

Summary: Purpose: This retrospective study reports the long-term surgical outcome of patients with medically refractory epilepsy and vascular malformations who were treated with lesionectomy. A detailed analysis of surgical failures had been performed in an attempt to define predictors of surgical success and failure.
Methods: Fifteen patients with medically intractable epilepsy and angiographically occult vascular malformations (AOVMs) were treated surgically with lesionectomy at Duke University Medical Center. Lesionectomy consisted of removal of the AOVM and surrounding hemosiderin-stained brain only, without the use of electrocorticography (ECoG) to guide resection.
Results: Eleven (73%) patients are seizure free after lesionectomy. Three showed no significant improvement, and one patient died, presumably after a seizure. Age of onset, duration of seizures, age at resection, and gender did not affect outcome. All patients with neocortical AOVMs in whom EEG findings correlated with the site of the lesion were seizure free after lesional resection. Treatment failures were associated with the presence of multiple intracranial lesions, poorly localized or diffuse EEG findings, discordant positron emission tomography (PET) imaging, or with a lesion in close proximity to the limbic system.
Conclusions: Lesionectomy, with removal of surrounding hemosiderin-stained brain, can be considered the procedure of choice in carefully selected patients with epilepsy with occult vascular malformations.     

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.     

Valproate is associated with new-onset oligoamenorrhea with hyperandrogenism in women with bipolar disorder.

BACKGROUND: Preliminary evidence suggests that valproate is associated with isolated features of polycystic ovarian syndrome (PCOS), while contradictory data support an association between epilepsy and PCOS. The development of PCOS features after initiation of valproate was therefore examined in women with bipolar disorder using a standardized definition of PCOS. METHODS: Three hundred women 18 to 45 years old with bipolar disorder were evaluated for PCOS at 16 Systematic Treatment Enhancement for Bipolar Disorder sites. A comparison was made between the incidence of hyperandrogenism (hirsutism, acne, male-pattern alopecia, elevated androgens) with oligoamenorrhea that developed while taking valproate versus other anticonvulsants (lamotrigine, topiramate, gabapentin, carbamazepine, oxcarbazepine) and lithium. Medication and menstrual cycle histories were obtained, and hyperandrogenism was assessed. RESULTS: Among 230 women who could be evaluated, oligoamenorrhea with hyperandrogenism developed in 9 (10.5%) of 86 women on valproate and in 2 (1.4%) of 144 women on a nonvalproate anticonvulsant or lithium (relative risk 7.5, 95% confidence interval [CI] 1.7-34.1, p = .002). Oligoamenorrhea always began within 12 months of valproate use. CONCLUSIONS: Valproate is associated with new-onset oligoamenorrhea with hyperandrogenism. Monitoring for reproductive-endocrine abnormalities is important when starting and using valproate in reproductive-aged women. Prospective studies are needed to elucidate risk factors for development of PCOS on valproate.     

血管内栓塞治疗未破裂脑动静脉畸形并发癫痫患者的预后分析

目的分析血管内栓塞治疗未破裂脑动静脉畸形(CAVM)并发癫痫患者的预后情况。方法选择2013年3月至2017年6月收治的符合诊断标准的CAVM并发癫痫发作患者49例为研究对象,分析血管内栓塞治疗后患者的临床症状、生活质量(QOLIE-31)改善情况。结果患者经血管内栓塞治疗后,QOLIE-31各项指标(除了药物影响)评分均明显提高,高于治疗前(P0.05);Spetzler-Martin分级与Engel分级的I~II级例数多于治疗前(P0.05),同时Spetzler-Martin分级I~II级生活质量评分(76.04±18.33)分明显高于III~V级的(65.65±16.76)分(P0.05);Engel分级I~II级的生活质量评分(75.25±17.78)分明显高于III~V级的(66.23±13.22)分(P0.05);血管内栓塞比例80%的生活质量总评分(78.37±18.87)分明显高于栓塞比例80%的(64.16±16.92)分(P0.05);术后患者的头疼症状中重度例数明显低于治疗前(P0.01);患者的NIHSS评分和MRS评分均明显低于治疗前,头疼症状的生活质量评分高于治疗前(均P0.05)。结论血管内栓塞能明显改善未破裂脑动静脉畸形并发癫痫患者的头疼症状、癫痫发作情况、神经功能缺损,提高血管内栓塞比例能够提高患者生活质量。