尤瑞克林治疗急性脑梗死的疗效及对血清MMP-9的影响

目的探讨尤瑞克林治疗急性脑梗死的临床疗效及对血清基质金属蛋白酶-9（matrix metalloproteinase-9,MMP-9）水平的影响。方法采用随机单盲对照研究,将发病48h内入院的大面积脑梗死患者40例分为对照组和治疗组（尤瑞克林组）。评价治疗前后血清MMP-9水平,应用美国国立卫生研究院卒中量表（NIHSS）及Barthel指数（BI）记分法对入院后当天及治疗2周时神经功能缺损程度进行评分。结果各组2周后神经功能缺失程度评分与入院时相比,差异均有统计学意义（P〈0.01）,尤瑞克林组优于对照组（P〈0.05）。治疗后2组血清MMP-9水平均下降,与对照组相比,尤瑞克林组下降更明显（P〈0.05）。结论短期应用尤瑞克林可改善脑梗死患者的预后,其机制可能与降低血清MMP-9水平有关。     

阿托伐他汀对急性脑梗死患者血清基质金属蛋白酶9及预后的影响

目的 研究短期应用阿托伐他汀后急性脑梗死患者血清基质金属蛋白酶9（matrix metalloproteinase-9,MMP-9）及血脂水平的变化,探讨其对急性脑梗死患者预后的影响。方法 采用随机、双盲、安慰剂对照的研究方法,将发病48 h内入院的大面积脑梗死患者40例随机分为对照组和阿托伐他汀组（阿托伐他汀20 mg/d,连续用药14 d）。治疗前后检测血清MMP-9、血脂、血清谷草转氨酶（AST）及血清肌酸激酶（CK）水平,应用美国国立卫生研究院卒中量表（NIHSS）及Barthel指数（BI）记分法对入院后当天及3个月时神经功能缺损程度进行评分。结果 共39例进入结果分析（对照组20例,阿托伐他汀组19例）。全部患者治疗前MMP-9水平与入院时及3个月时病情显著相关（P＜0.01）,血脂水平则无此相关性。治疗后阿托伐他汀组MMP-9水平下降,且与对照组相比,差异有统计学意义（P＜0.05）。各组3个月后神经功能缺失程度评分与入院时相比,差异有统计学意义（P＜0.01）,但两组之间相比无统计学差异。治疗后各组AST及CK水平无明显变化。结论 急性脑梗死患者血清MMP-9水平与病情的严重程度及预后相关。短期应用阿托伐他汀可以降低急性脑梗死患者血清MMP-9水平,且安全性好,但对梗死后3个月的预后无明显改善作用。     

丹红注射液治疗脑梗死的疗效观察

目的 观察丹红注射液治疗脑梗死的临床疗效.方法 将123例脑梗死患者随机分为治疗组和对照组.治疗组62例用丹红注射液40ml加入5%葡萄糖注射液500ml静滴,1次/d;对照组应用长春西汀20ml,加入5%葡萄糖注射液250ml静滴,1次/d.2组疗程均为2周.结果 治疗组总有效率为83.9%,对照组为65.6%;2组治疗前神经功能缺损评分无显著差异(P>0.05),治疗2周后神经功能缺损评分有显著差异(P＜0.01),血液流变学指标差异有统计学意义(P<0.01).结论 丹红注射夜可改善脑梗死患者临床症状.     

脑苷肌肽治疗急性脑梗死的疗效及对血清基质金属蛋白酶-7水平的影响

目的探讨脑苷肌肽注射液治疗急性脑梗死患者的临床效果及对血清基质金属蛋白酶7(MMP-7)水平的影响。方法选取我院住院治疗的急性脑梗死患者70例,随机均分为2组,分别行常规治疗与脑苷肌肽治疗,对比2组疗效与MMP-7水平。结果治疗3周后观察组治疗有效率显著高于对照组,NIHSS评分与血清MMP-7水平显著低于对照组。结论脑苷肌肽注射液能够有效改善患者神经功能缺损情况,并有效降低患者血清基质蛋白酶水平。     

醒脑静注射液对脑梗死患者疗效及炎性因子MMP-2 MMP-9水平的影响

目的观察醒脑静注射液对急性脑梗死(ACI)患者疗效及炎性因子、MMP-2、MMP-9水平的影响。方法将124例急性脑梗死患者随机分为2组,对照组(n=62)给予常规西医治疗,观察组(n=62)给予常规西医联合醒脑静注射液治疗;比较2组治疗前后的临床效果及血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)水平的变化。结果观察组总有效率优于对照组(P0.05);2组治疗后的TNF-α、IL-6、MMP-2、MMP-9均较治疗前降低(P0.05),且观察组上述四指标改善程度较对照组更佳(P0.05)。结论醒脑静注射液有利于改善脑梗死患者的神经功能缺损,且能够减轻细胞因子介导的炎性反应,对脑组织具有良好的保护作用。     

银杏达莫注射液对急性脑梗死患者血清MMP-9和hs-CRP的影响

目的探讨银杏达莫注射液对急性脑梗死患者血清MMP-9和hs-CRP的影响。方法采用抽签法将许昌市中心医院2014-01—2015-02收治的117例急性脑梗死患者进行分组,对照组58例给予西医常规治疗,观察组59例在对照组的基础上给予银杏达莫注射液治疗,观察2组临床疗效、神经功能及血清MMP-9和hs-CRP的改善情况。结果观察组总有效率94.92%,高于对照组的79.31%(P0.05);观察组治疗后神经功能及血清MMP-9、hs-CRP指标的改善幅度均优于对照组(P0.05)。结论在西医常规治疗的基础上,增加银杏达莫注射液能够更快的溶栓扩张血管及抗血小板聚集,改善急性脑梗死患者血清MMP-9和hs-CRP的效果确切,值得临床应用。     

普罗布考对急性脑梗死患者血清MMP-9及oxLDL-Ab浓度的影响

目的探讨普罗布考对急性脑梗死患者血清基质金属酶9(MMP-9)及氧化型低密度脂蛋白自身抗体(oxLDLAb)浓度的影响。方法根据治疗方案将107例急性脑梗死患者分为对照组(45例)与观察组(62例),对照组接受常规治疗,观察组在常规治疗基础上联合使用普罗布考。治疗前以及治疗第15天测定血清MMP-9、oxLDL-Ab,测定方法均为酶联免疫吸附试验(ELISA)。结果治疗前2组血清MMP-9、oxLDL-Ab相比差异无统计学意义(P0.05)。治疗第15天,观察组MMP-9、oxLDL-Ab显著低于对照组(P0.05)。治疗前2组美国国立卫生院神经功能缺损评分(NIHSS)相比差异无统计学意义(P0.05)。治疗第15天观察组NIHSS显著低于对照组(P0.05)。结论普罗布考可降低急性脑梗死患者血清MMP-9、oxLDL-Ab水平,提高疗效,值得临床推广。     

药物性亚冬眠对大鼠急性脑梗死的影响

目的 探讨冬眠合剂对大鼠急性脑梗死早期脑组织中基质金属蛋白激酶-9(Matrix metalloprotein-ase-9,MMP-9)和血小板活化因子(Platelet-Activating Factor,PAF)表达的变化及可能的作用机制.方法 成年雄性SD大鼠126只随机分成对照组、模型组及亚冬眠组(造模后肌注冬眠合剂Ⅱ号)3组,均于缺血后4h、12h、24h进行神经功能评分,随之进行HE染色观察大鼠脑梗死的大体形态,免疫组化Sp法检测PAF、RT-PCR技术检测MMP-9的表达.结果 与模型组相比,亚冬眠组MMP-9及PAF的含量减少(P＜0.05),神经功能缺损评分降低(P＜0.05).结论冬眠合剂对大鼠急性脑梗死损伤早期有脑保护作用.     

奥扎格雷钠治疗急性脑梗死的临床疗效分析

目的 观察奥扎格雷钠注射液在急性脑梗死治疗中的临床疗效.方法 对72例急性脑梗死患者随机分2组,治疗组用奥扎格雷钠注射液进行治疗,对照组用生理盐水代替,观察2组治疗前后,神经功能缺损程序(SSS)评分、血液流变学的变化、日常生活能力(ADL).结果 治疗组有效率75. 0%,对照组有效率58.3%,治疗组疗效优于对照组(P＜0.01).2组治疗后SSS及ADL评分均较治疗前有显著改善(P＜0.05),但治疗组明显优于对照组(P＜0.05).结论 奥扎格雷钠可明显减少脑梗死患者的神经功能缺损,提高日常生活能力,其治疗急性脑梗死临床疗效确切.     

阿托伐他汀对急性颈内动脉系统脑梗死患者基质金属蛋白酶-9的影响

目的 观察阿托伐他汀对急性脑梗死患者血清基质金属蛋白酶-9（matrix metalloproteinase-9,MMP-9）的影响。方法 入选急性脑梗死患者128例,根据入院后颈动脉彩超结果,分为颈动脉粥样硬化（atherosclerosis,AS）稳定斑块组51例、颈动脉AS易损斑块组46例,无斑块组31例。各组给予阿托伐他汀20mg/d口服干预治疗,疗程2周。比较治疗前及治疗2周后患者血清MMP-9水平变化。结果 ①治疗前易损斑块组和稳定斑块组血清MMP-9浓度分别为（419.93±113.12）μg/L和（271.45±80.34）μg/L,均高于无斑块组（147.36±23.62）μg/L,易损斑块组也高于稳定斑块组（均P＜0.01）。②阿托伐他汀治疗2周后易损斑块组、稳定斑块组及无斑块组血清MMP-9水平分别下降至（242.58±101.63）μg/L、（191.36±79.28）μg/L和（126.72±22.86）μg/L,与本组治疗前相比,差异具有统计学意义（均P＜0.01）。结论 急性脑梗死患者中血清MMP-9的水平与AS斑块的发生和稳定性相关,阿托伐他汀治疗能显著降低急性颈内动脉系统脑梗死患者MMP-9水平。     

Oligodendrocytose réactionnelle au cours de la dégénérescence expérimentale du cortex cérébral

The electrolytic destruction of a thalamic relay centre—in this case the medial geniculate body—provokes manifestations of degeneration in the auditory region of the cerebral cortex, involving the afferent axons and the neurones. It also produces neuroglial reactions of the classical “replacement gliosis” type.

A statistical study of the neuroglial cell population, in particular of the oligodendrocytes, has been undertaken in the cat at various postoperative stages by using cresyl violet-counterstained cerebral cortex preparations impregnated by the Golgi-Cox technique. Electron-microscopic observations complemented the statistical study.

The oligodendrocytosis which is observable in the deeper tissues of the cerebral cortex brings about a hyperplasia. The multiplication process of the nuclei, apparently amitotic, goes through a bi- or tri-nucleation phase, which may be transitory or final. Cellular migration seems likely to be one of the processes which may play a part in the oligodendrocytosis but this hypothesis lacks confirmation.     

Atrophies systématisées multiples, arriération mentale, amyotrophie neurogène et fragilité osseuse congénitale: Une nouvelle affection neuro-dégénérative

Five cases of a congenital neurological disorder are reported. Four patients, born after a breech delivery, belong to one sibship while the fifth patient is the only child in another family. The clinical features include quadriplegia, amyotrophy, a peripheral neuropathy, severe mental retardation and a subluxation of the hips. X-rays reveal diffuse osteoporosis and multiple spontaneous fractures.

Autopsies in 3 patients showed multiple system atrophies involving the spinal cord and the cerebellum, coarse cerebral gyri and a marked reduction in volume of the white matter. These various pathological features are compared with the lesions found in a few other cases reported in the literature, none of which can be considered to be identical to the ones described. It is therefore felt that the condition under discussion represents a new syndrome to be classified, at least temporarily, within the group of multiple system atrophies.

Résumé

L'étude anatomo-clinique de cinq observations nous permet de décrire une affection originale, se manifestant dès avant la naissance et que caractérisent des atrophies systématisées spinales et cérébelleuses, une polynévrite, une arriération mentale profonde, une fragilité osseuse avec fractures multiples. La transmission semble être autosomale récessive. En l'absence de tout facteur étiologique reconnu, il nous faut provisoirement situer cette affection dans le groupe des atrophies systématisées multiples dont elle constitue un exemple exceptionnel si l'on tient compte des signes d'accompagnement et de l'âge de début.     

Actimétrie: analyse simplifiée des rythmes veille-sommeil chez le nouveau-né. Résultats préliminaires

Actimetry in new-borns is relevant if two actimeters are placed, one on each ankle. This study has been conducted on nine normal three days old new-borns. It has shown an indisputable link between the lack of activity and the observed sleep during the night that was missing during the day. The longest period of wake was recorded during the day and the longest period of sleep or inactivity was during the night. This study has confirmed the existence of an ultradian rhythm of quiet sleep and wake. It is also possible that a beginning of a circadian rest-activity rhythm exists already in the neonatal period, that is still discussed in the litterature.     

Les atrophies péronières en Tunisie: Étude de 70 observations pures ou associées à d''autres affections hérédodégénératives

Seventy cases of hereditary peripheral neuropathy of Charcot-Marie-Tooth type have been studied. One group of 40 cases from 30 families had a pure peripheral neuropathy, the other 30 from 20 families having other associated inherited nervous defects. The classification of Dyck and Lambert (1968) modified by Dyck (1975) was used, but it proved difficult to distinguish pure types and transitional forms were common. Histological criteria appeared more reliable than clinical features and were the most constant finding within a given family.

In forms associated with other abnormalities a hypertrophic and a neuronal form could be distinguished but similar difficulties in classification were encountered as the mode of genetic transmission, age of onset, clinical features and nerve conduction velocity were comparable in the two groups. Discrepancies between electrophysiological and histological findings may result from examining motor nerves with the former technique and sensory with the latter. Despite subdivision there is still a sharp distinction between the various forms of Charcot-Marie-Tooth disease and the hypertrophic neuropathy of Déjerine-Sottas. The genetic pattern is complicated by the frequent association with other inherited abnormalities.     

Méthodes et intérêt clinique de la mesure de la période réfractaire nerveuse périphérique chez l''homme

Immediately after action potential occurrence, owing to transient sodium channel inactivation, axon excitability is reduced for a short period of time, including the absolute refractory period, a first period of total inexcitability, followed by the relative refractory period. There are basically two different stimulation protocols to estimate axonal refractoriness, i.e. "paired-pulse" and "collision" techniques. Refractory period has been assessed in various conditions and appeared to depend on several physiological or methodological factors, featuring the type of nerve or the characteristics of the subject, but also the technique of stimulation or the method of data analysis. In addition, refractory periods can be altered by pathological conditions. Several studies showed prolonged refractory periods in patients suffering from alcoholic, diabetic or toxic neuropathies. Refractory period abnormality is a sensitive marker of axonal dysfunction as observed in Guillain-Barré syndrome, carpal tunnel syndrome or multiple sclerosis. Thus, the measurement of the refractory periods is a valuable tool to study the pathophysiology of peripheral nerves, complementary to standard nerve conduction studies. However, the application of these techniques in the routine practice of clinical neurophysiology remains limited.     

Quelques données sur les troubles des processus mnésiques chez des sujets porteurs de lésions cérébrales

56 sujets porteurs de lésions cérébrales ont été examinés á l'aide d'épreuves de différents niveaux d'organisation afin d'évaluer leur capacité mnésique immédiate et á long terme. Les résultats en fonction des niveaux d'organisation montrent une hiérarchie des oublis en fonction de ces niveaux. 44 sujets dont les lésions étaient belativement bien localisées ont été retenus pour étudier les différences dans les déficits observés en fonction de la localisation des lésions. Trois groupes de lésions ont été ainsi constitués, frontales, temporales et pariétales montrant des différences dans les rapports entre mémoire immédiate et mémoire á long terme, caractéristiques respectivement de ces trois groupes. Un essai d'interprétation de ces troubles est tenté en termes de processus d'indexation et de recherche dans le stock mnśique.

56 patients with brain tumours have been seen with memory tasks of different level of organization. A group of patients learned the tasks to a criterion of one exact recall, another did not. The results show that importance of forgetting is function of the level of organization for both groups. 44 patients whose localization of tumours was well defined are studied to see whether differences between short term and long term memory processes would appear. Three groups of tumours show differences between STM and LTM processes respectively characteristic of frontal, temporal and parietal tumours. A tentative interpretation is given in terms of indexing processes and searching processes in the memory store.