慢性紧张型头痛与睡眠障碍的相关性研究

目的 探讨慢性紧张型头痛（chronic tension type headache,CTTH）与睡眠障碍的关系,评价睡眠障碍对慢性紧张型头痛的发生、发展及头痛病理生理的影响.方法 依据国际头痛学会2004 ISH-Ⅱ头痛性疾病的分类和诊断标准,选取2012年4月至2013年8月我院神经内科门诊及住院符合慢性紧张型头痛诊断的患者141例,根据头痛程度分为轻度头痛、中度头痛、重度头痛三组,对纳入研究患者性别、年龄、失眠情况、疼痛程度、医后随访、健康指导等指标进行研究,分析睡眠障碍与慢性紧张型头痛发病原因、头痛严重程度等因素的关系.结果 慢性紧张型头痛患者睡眠障碍的发生率为49.6％,与于守臣等调查的正常人群睡眠障碍发生率9.4％有明显的统计学差异（x2=153.63,P＜0.001）,中、重度头痛患者睡眠障碍的发生率明显高于轻度头痛患者（x2=11.017,P＜0.05）,慢性紧张型头痛患者睡眠障碍与性别及家族史无明显相关性（P＞0.05）.结论 慢性紧张型头痛与睡眠障碍存在明显相关性,睡眠障碍可能是慢性紧张型头痛最重要的病因,临床医生应重视慢性紧张型头痛患者睡眠质量,治疗睡眠障碍可能对慢性紧张型头痛的预防及治疗有积极作用.     

睡眠呼吸暂停综合征护理查房报告

护士长：今天要与各位一起讨论的主题是睡眠呼吸暂停综合征(SAS)，系在睡眠时出现严重打鼾，阵发性吸气后呼吸暂停，以及伴有白昼嗜睡、晨起头痛、逆行性健忘、性格改变、肥胖等症状为特征的一种综合征。目前，国内外对此研究较深入，认为睡眠呼吸暂停可引起多系统器官损害。今结合我科病例，组织护理个案查房，请责任护士报告病历。     

玉树地震灾后重建工人中高原头痛及与高原睡眠关系的研究

目的对在玉树海拔4520m灾后重建人员中最常见的"高原头痛"及与高原睡眠的关系进行了系统研究。方法高原头痛按国际头痛协会标准结合高原发病特点加以判定,高原睡眠按国际统一的睡眠检测及判定方法。同时测定动脉血氧饱和度。结果在调查的1680名工人中,806名符合高原头痛诊断,发生率为48%。头痛程度与动脉血氧饱和度呈负相关,脑脊髓液压力增高,睡眠监测1期及2期非快眼动睡眠明显延长,而3+4期非快眼动睡眠则明显缩短,处于浅睡眠并有明显的睡眠低氧血症。结论高原头痛与低氧血症及颅内压增高有关,与高原睡眠障碍关系密切,故防治应从提高机体高原整体习服能力及改善高原睡眠同时着手。     

治疗阻塞性睡眠呼吸暂停和发作性睡病的新药：solriamfetol

solriamfetol是选择性多巴胺-去甲肾上腺素再摄取抑制剂,于2019年3月被美国食品和药物管理局批准用于治疗阻塞性睡眠呼吸暂停和发作性睡病成年患者的白天过度睡眠。solriamfetol最常见的不良反应包括头痛、恶心、食欲下降、焦虑和失眠。     

褪黑激素治疗偏头痛的作用机制和临床应用的研究进展

偏头痛是一种临床常见的原发性头痛疾病,其发病率、致残率逐年升高,给患者、家庭和社会带来沉重负担.目前偏头痛发病机制尚不明确.有研究表明压力、睡眠障碍等与偏头痛周期性发作有密切联系.褪黑激素在临床上广泛应用,尤其在其节律性减少或失调有关的疾病中,如昼夜节律性睡眠障碍、阿尔茨海默病等.偏头痛患者被证明存在时间生物学功能障碍,并且褪黑激素被证明具有抗炎、抗氧化、抗焦虑、镇痛等作用,因此对褪黑激素治疗偏头痛的作用机制和临床应用研究进展进行概括,以期为偏头痛的防治提供参考.     

鸡尾酒疗法改善慢性每日头痛患者的头痛症状和睡眠质量

慢性每日头痛是神经科常见病、多发病,且呈日益增多趋势。近年来研究表明心理因素,特别是焦虑、抑郁及睡眠改变是其发病主要原因,影响头痛发生、发展及转归。慢性头痛患者往往病情迁延反复,单纯药物治疗常不能达到满意治疗效果。本研究应用理化治疗结合心理治疗的鸡尾酒疗法改善患者头痛及睡眠质量,为临床推广应用心理疗法提供参考。     

发作性睡病23例病例分析

目的 探讨发作性睡病的临床表现、辅助检查、诊断、治疗及预后.方法 对23例明确诊断的发作性睡病患者进行多导睡眠脑电图分析,采用苯丙胺、哌醋甲酯、丙咪嗪、阿米替林治疗,并进行随访3年.结果 23例患者均有日间不能克制的短暂睡眠发作,睡眠潜伏期缩短.结论 发作性睡病是慢性神经系统疾病,结合其临床表现及睡眠脑电图可以早期诊断,尽早给予患者规范药物治疗、心理疏导,以提高患者的生活质量.     

睡眠呼吸暂停低通气综合征72例临床分析

目的探讨睡眠呼吸暂停低通气综合征（SAHS）患者的临床特征及相关因素。方法回顾性分析我科确诊的睡眠呼吸暂停低通气综合征72例临床资料。结果阻塞性睡眠呼吸暂停低通气综合征（OSAHS）69例,混合性睡眠呼吸暂停低通气综合征（MSAHS）3例;男∶女=11∶1;多有体质肥胖、咽腔结构异常;以夜间打鼾、晨起头痛头晕、白天困倦乏力为主要临床表现。结论以阻塞性睡眠呼吸暂停低通气最常见,男性多于女性,肥胖是主要易患因素,多导睡眠监测是诊断金标准。     

发作性睡病的研究进展

发作性睡病是一种慢性神经系统疾病。常于青春期前起病，并持续终生。本病以发作性不可抗拒入睡、猝倒症、睡眠瘫痪、幻觉及提前出现的快速动眼(REM)睡眠为特征．部分病例可伴有自动症，以及头痛、耳鸣、忧郁、焦虑、记忆力减退等其它神经、精神症状。易与其它疾病相混淆．本文介绍其病理生理改变及其发生的可能因素、诊断、鉴别诊断及治疗。     

老年人失眠的原因及治疗方法

失眠是老年人的常见睡眠障碍。老年人失眠的原因可以归纳为生理性、躯体疾病性、药源性、精神障碍性、睡眠卫生问题和环境因素6个方面。针对老年人的失眠,治疗目标是维护和促进他们的睡眠觉醒节律功能,具体处理对策主要有治疗原发疾病/驱除诱因、合理应用镇静催眠药、心理行为治疗和睡眠卫生教育等。     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.     

Biochemical and molecular characterisation of cubozoan protein toxins

Class Cubozoa includes several species of box jellyfish that are harmful to humans. The venoms of box jellyfish are stored and discharged by nematocysts and contain a variety of bioactive proteins that are cytolytic, cytotoxic, inflammatory or lethal. Although cubozoan venoms generally share similar biological activities, the diverse range and severity of effects caused by different species indicate that their venoms vary in protein composition, activity and potency. To date, few individual venom proteins have been thoroughly characterised, however, accumulating evidence suggests that cubozoan jellyfish produce at least one group of homologous bioactive proteins that are labile, basic, haemolytic and similar in molecular mass (42-46 kDa). The novel box jellyfish toxins are also potentially lethal and the cause of cutaneous pain, inflammation and necrosis, similar to that observed in envenomed humans. Secondary structure analysis and remote protein homology predictions suggest that the box jellyfish toxins may act as α-pore-forming toxins. However, more research is required to elucidate their structures and investigate their mechanism(s) of action. The biological, biochemical and molecular characteristics of cubozoan venoms and their bioactive protein components are reviewed, with particular focus on cubozoan cytolysins and the newly emerging family of box jellyfish toxins.     

Dose tolerability of chronically inhaled voriconazole solution in rodents

Invasive pulmonary aspergillosis (IPA) is a fungal disease of the lung associated with high mortality rates in immunosuppressed patients despite treatment. Targeted drug delivery of aqueous voriconazole solutions has been shown in previous studies to produce high tissue and plasma drug concentrations as well as improved survival in a murine model of IPA. In the present study, rats were exposed to 20 min nebulizations of normal saline (control group) or aerosolized aqueous solutions of voriconazole at 15.625 mg (low dose group) or 31.25 mg (high dose group). Peak voriconazole concentrations in rat lung tissue and plasma after 3 days of twice daily dosing in the high dose group were 0.85 ± 0.63 μg/g wet lung weight and 0.58 ± 0.30 μg/mL, with low dose group lung and plasma concentrations of 0.38 ± 0.01 μg/g wet lung weight and 0.09 ± 0.06 μg/mL, respectively. Trough plasma concentrations were low but demonstrated some drug accumulation over 21 days of inhaled voriconazole administered twice daily. Following multiple inhaled doses, statistically significant but clinically irrelevant abnormalities in laboratory values were observed. Histopathology also revealed an increase in the number of alveolar macrophages but without inflammation or ulceration of the airway, interstitial changes, or edema. Inhaled voriconazole was well tolerated in a rat model of drug inhalation.