百乐眠胶囊治疗功能性消化不良伴焦虑症状的疗效

目的：观察百乐眠胶囊治疗功能性消化不良（ FD ）伴焦虑症状患者的临床疗效。方法选取66例FD伴焦虑症状患者,随机分为研究组和对照组,每组各33例,研究组给予百乐眠胶囊治疗,对照组给予多塞平治疗,疗程为1个月,比较两组患者的汉密尔顿焦虑量表（HAMA）评分、FD症状评分、总有效率及不良反应发生率。结果两组患者治疗后HAMA评分和FD症状评分均较治疗前降低,差异有统计学意义（P＜0．05）,但两组间治疗后比较,差异无统计学意义（P＞0．05）。两组患者总有效率差异无统计学意义（ P＞0．05）,研究组不良反应发生率为6．06％,对照组为27．27％,差异有统计学意义（ P＝0．044＜0．05）。结论百乐眠胶囊可改善 FD伴焦虑症状患者的临床症状及焦虑水平。     

百乐眠胶囊治疗老年脑卒中后失眠的效果

目的 探讨百乐眠胶囊治疗老年脑卒中后失眠的临床疗效及可能作用途径.方法 将120例老年脑卒中后失眠患者分为研究组和对照组,各60例,分别给予百乐眠胶囊和艾司唑仑治疗.8周治疗后观察患者的匹兹堡睡眠质量指数(PSQI)、多导睡眠图指标及脑内神经递质水平的情况.结果 研究组的治疗效果优于对照组(P<0.05).研究组患者治疗后脑内5-羟色胺(5-HT)水平及γ-氨基丁酸/谷氨酸(GABA/Glu)比值均高于治疗前和对照组治疗后,差异有统计学意义(P<0.05).两组患者治疗后的PSQI得分、入睡时间、觉醒次数和浅睡眠时间均较治疗前明显降低,而总睡眠时间和深度睡眠时间均较治疗前明显增加(P<0.05),但组间比较差异无统计学意义(P>0.05).结论 百乐眠胶囊能有效改善老年脑卒中失眠患者脑内的神经递质水平,从而提高睡眠质量.     

柴胡疏肝散联合归脾汤治疗心脾两虚型不寐的疗效

目的：观察柴胡疏肝散联合归脾汤治疗心脾两虚型不寐的临床疗效。方法将64例心脾两虚型不寐患者分为两组,观察组服用柴胡疏肝散联合归脾汤治疗,对照组服用归脾汤治疗,采用匹兹堡睡眠质量指数（PSQI）量表评价患者治疗前、治疗第2周和治疗第4周的睡眠情况,并分析量表总分及各睡眠因子的改善情况。结果观察组和对照组治疗第2、4周的PSQI总分与基线比较,差异均有统计学意义（P＜0．05）。在治疗第4周时,两组患者睡眠质量、入睡时间、睡眠障碍和日间功能障碍因子项的差异均有统计学意义（P＜0．05）。结论柴胡疏肝散联合归脾汤可有效提升心脾两虚型不寐患者的睡眠质量,为中药治疗不寐提供新的治疗思路。     

百乐眠胶囊联合双抗治疗进展性脑梗死伴睡眠障碍的效果及对血清神经递质水平的影响

目的百乐眠胶囊联合双抗疗法治疗进展性脑梗死伴睡眠障碍患者的效果。方法随机将我院115例进展性脑梗死伴睡眠障碍患者分组,对照组57例予双抗治疗,观察组58例增加百乐眠胶囊,对比血清神经递质、炎症因子、睡眠质量、神经功能及负性情绪变化。结果观察组治疗后DA、BDNF、5-HT、EPH、TNF-α、IL-6、ET-1水平、夜间觉醒次数、睡眠潜伏期及PSQI、NIHSS、HAMA、HAMD评分均低于对照组,NO水平及总睡眠时间高于对照组(P0.05)。结论百乐眠胶囊联合双抗有效改善进展性脑梗死伴睡眠障碍患者睡眠质量及神经功能,其机制可能与抑制炎症反应,调节神经递质水平有关。     

百乐眠胶囊联合小重量持续牵引对神经根型颈椎病患者的焦虑、抑郁情绪及睡眠的影响

目的百乐眠胶囊联合小重量持续牵引治疗神经根型颈椎病患者的疗效及患者的焦虑、抑郁情绪变化。方法采用随机数字表法将我院111例神经根型颈椎病患者分组,两组患者均给予小重量持续牵引治疗,对照组55例增加心理放松干预,观察组56例在对照组基础上增加百乐眠胶囊口服,观察两组患者治疗后焦虑(SAS)、抑郁情绪(SDS)、疼痛(VAS)、睡眠障碍(PSQI)、颈部残障指数(NDI)评分变化,并对比临床疗效。结果观察组治疗后SAS、SDS、VAS、PSQI及NDI评分均低于对照组,总有效率高于对照组(P0.05)。结论百乐眠胶囊联合小重量持续牵引能够有效改善神经根型颈椎病伴睡眠障碍患者睡眠质量,减轻疼痛,消除负性情绪及症状体征,促进颈部功能恢复。     

百乐眠胶囊结合全天麻胶囊治疗偏头痛的疗效观察

目的：探讨应用百乐眠结合全天麻的方法治疗偏头痛的实际临床效果。方法将344例偏头痛患者随机分为对照组与观察组各172例。对照组在治疗期间采取服用全天麻胶囊。观察组患者在治疗期间采取服用全天麻胶囊,并加服百乐眠胶囊。在治疗2周后,观察2组临床疗效。结果治疗2周后,观察组患者头痛减轻程度明显高于对照组（P＜0.05）,观察组治愈率为88.95％,明显高于对照组的67.77％（ P＜0.05）。结论在临床实际治疗中,应用百乐眠结合全天麻的方法治疗偏头痛可以取得更好的疗效。     

通心络胶囊治疗急性脑梗死的临床对照研究

目的观察通心络胶囊对急性脑梗死患者的临床疗效。方法收集急性脑梗死住院患者100例,随机分为通心络组和对照组,随访3个月,通过记录日常生活活动能力（ADL）、改良Rankin量表（mRS）和死亡评价脑梗死患者近期预后。结果通心络组脑梗死患者3个月后ADL、mRS好于对照组,差别有统计学意义（P〈0．05）。结论配合西药应用通心络胶囊能改善急性脑梗死患者3个月后的预后。     

百乐眠联合氟哌噻吨美利曲辛治疗冠心病合并焦虑症状患者的疗效

目的：探讨百乐眠联合氟哌噻吨美利曲辛（商品名：黛力新）对冠心病合并焦虑症状患者的疗效。方法将冠心病合并焦虑症状患者随机分为两组,对照组只给予常规冠心病治疗药物＋黛力新治疗,试验组给予常规冠心病治疗药物＋百乐眠＋黛力新治疗,治疗时间为4周。观察比较两组患者的有效率和汉密尔顿焦虑量表（HAMA）评分。结果治疗2周和4周时,两组患者与治疗前比较, HAMA评分均明显降低,且试验组评分更低,差异均有统计学意义（P＜0．01）。治疗4周后,试验组总有效率为92.9％,明显高于对照组的80．5％,差异有统计学意义（χ2＝18．28,P ＜0．01）。结论百乐眠联合黛力新能够有效改善冠心病患者的焦虑症状。     

生物反馈治疗对150例脑卒中后睡眠障碍患者的临床观察

目的观察生物反馈治疗脑卒中后睡眠障碍的临床疗效。方法将150例脑卒中后睡眠障碍患者随机分为治疗组和对照组各75例,全部患者常规治疗原发病及进行康复训练,治疗组接受生物反馈治疗,对照组进行药物治疗,治疗前后进行匹兹堡睡眠质量指数量表（PSQI）评定及使用睡眠多导仪监测,比较两组疗效。结果治疗后,治疗组PSQI总分及睡眠潜伏期、觉醒次数较治疗前显著降低,睡眠总时间、睡眠效率、深睡眠时间、REM时间明显增加;与对照组比较,治疗组治疗后睡眠潜伏期、觉醒次数、深睡眠时间等的改善更明显。差异有统计学意义（P〈0．05）。结论生物反馈治疗可以明显改善脑卒中后的睡眠障碍,疗效优于传统药物治疗。     

卒中后抑郁患者睡眠障碍的治疗

目的卒中后抑郁患者应用奥氮平治疗后症状改善情况。方法对卒中后抑郁患者86例,对照组卒中患者92例进行匹兹堡睡眠质量指数（PSQI）问卷调查,分析两组患者及组中后抑郁患者奥氮平治疗前后的睡眠情况。结果卒中后抑郁组的睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能等因子评分和PSQI总分均高于对照组（P〈0．05）,经奥氮平治疗后,PSQI评分明显好转（P〈0．05）。结论情感障碍可以影响患者的睡眠质量,经奥氮平治疗后睡眠障碍明显改善,显著提高了患者生活质量。     

视频脑电图在小儿癫痫诊断中的应用

目的评价视频脑电图(video-EEG)在小儿癫诊断中的应用价值。方法对126例具有发作性症状的患儿进行连续8h的包括清醒、睡眠、诱发试验及必要的认知测验的视频脑电图监测。结果经发作期视频脑电图证实,39例初诊为癫性发作的患儿中14例(35%)为非癫性发作;15例其他症状发作中13例(86%)为非癫性发作。64例样放电患儿中51例(80%)确定发作类型,22例(34%)确定癫类型。视频脑电图可发现短暂轻微的癫发作及样放电引起的一过性认知损伤。结论视频脑电图在排除非癫性发作、确定癫性发作的类型、评价脑电-临床关系方面可提供准确可靠的证据,进一步提高癫的临床诊断水平。     

Neuroprotective properties of memantine in different in vitro and in vivo models of excitotoxicity

The pathogenesis of stroke, trauma and chronic degenerative diseases, such as Alzheimer's disease (AD), has been linked to excitotoxic processes due to inappropriate stimulation of the N-methyl-D-aspartate receptor (NMDA-R). Attempts to use potent competitive NMDA-R antagonists as neuroprotectants have shown serious side-effects in patients. As an alternative approach, we were interested in the anti-excitotoxic properties of memantine, a well-tolerated low affinity uncompetitive NMDA-R antagonist presently used as an anti-dementia agent. We explored in a series of models of increasing complexity, whether this voltage-dependent channel blocker had neuroprotective properties at clinically relevant concentrations. As expected, memantine protected neurons in organotypic hippocampal slices or dissociated cultures from direct NMDA-induced excitotoxicity. However, low concentrations of memantine were also effective in neuronal (cortical neurons and cerebellar granule cells) stress models dependent on endogenous glutamate stimulation and mitochondrial stress, i.e. exposure to hypoxia, the mitochondrial toxin 1-methyl-4-phenylpyridinium (MPP+) or a nitric oxide (NO) donor. Furthermore, memantine reduced lethality and brain damage in vivo in a model of neonatal hypoxia-ischemia (HI). Finally, we investigated functional rescue (neuronal capacity to migrate along radial glia) by memantine in cerebellar microexplant cultures exposed to the indirect excitotoxin 3-nitropropionic acid (3-NP). Potent NMDA-R antagonists, such as (+)MK-801, are known to block neuronal migration in microexplant cultures. Interestingly, memantine significantly restored the number of neurons able to migrate out of the stressed microexplants. These findings suggest that inhibition of the NMDA-R by memantine is sufficient to block excitotoxicity, while still allowing some degree of signalling.     

脑电图预测痫性发作研究进展

癫痫(epilepsy)是由脑部神经元高度同步化异常放电所致的临床综合征,系神经系统的常见病,困扰着全世界约1%的人群.每次神经元的阵发性放电或短暂的脑功能异常称为痫性发作(seizures).     

Storage of lipofuscin in neurons in mucopolysaccharidosis

Summary A histochemical and ultrastructural study was made on the brain of a 23-year-old man with Sanfilippo's syndrome. In accordance with previous reports the cortical nerve cells contained a PAS-positive lipid storage substance. This showed intense autofluorescence in UV-light and was positive with various stains for lipofuscin. The storage material appeared ultrastructurally as inclusion bodies composed of short lamellated membranes, granular material, and vacuoles. In addition, concentrically and transversely lamellated membranous cytoplasmic bodies were observed in the nerve cells. It is concluded that the PAS-positive lipid storage material in the neurons was composed partly of lipofuscin in addition to other lipids presumably glycosphingolipids.Supported by a grant from the Expressen Prenatal Research Foundation     

Role of vincristine in the inhibition of angiogenesis in glioblastoma

Objective: Vincristine, a microtubule-destabilizing drug, was found to exhibit anti-angiogenic effects and anti-tumoral activity. However, the precise mechanism by which vincristine inhibits angiogenesis in glioblastomas is not well understood. Our aim was to investigate whether vincristine affects vascular endothelial growth factor (VEGF) expression in glioblastoma cells and determine whether it is mediated by the downregulation of hypoxia-inducible factor-1α (HIF-1α).

Methods: We investigated the expression of HIF-1α in glioblastoma tissues resected from patients and in human glioblastoma cell lines using immunohistochemistry, Western blot analysis, and immunocytochemistry. In addition to an MTT assay assessing the effect of vincristine on cell proliferation and viability, the effects of vincristine on VEGF mRNA expression and HIF-1α protein were examined using real-time RT-PCR and Western blot analysis under 1% O₂ (hypoxia).

Results: HIF-1α was expressed in the majority of glioblastoma tissues and was detected mainly in the nucleus. Strong immunoreactivity for HIF- 1 α was found often in the hypercellular zones. Under hypoxic conditions, HIF-1α protein levels in the glioblastoma cell lines increased, primarily localizing into the nucleus similar to glioblastoma tissues. Exposure of glioblastoma cells to vincristine resulted in enrichment of the G₂-M fraction of the cell cycle, which suggests that vincristine-mediated growth inhibition of glioblastoma is correlated with mitotic inhibition. Using doses lower than those found to reduce the viability and proliferation of cells by 50% (IC₅₀), vincristine decreased both the expression of VEGF mRNA and the level of HIF-1α protein in hypoxic glioblastoma cells. In addition, following exposure to vincristine, the expression of VEGF mRNA was correlated with HIF-1α protein levels.

Conclusions: Our results suggest that the mechanism by which vincristine elicits an anti-angiogenic effect in glioblastomas under hypoxic conditions might be mediated, in part, by HIF-1α inhibition.     

自噬参与帕金森病发病的研究进展

近年来,蛋白质的降解障碍被认为是帕金森病（Parkinson’Sdisease,PD）发病过程中的重要因素,人们已经公认泛素一蛋白酶体系统（ubiquitin--pro—teasomesystem,UPS）功能异常或衰竭能够导致细胞内异常蛋白蓄积、细胞功能障碍,甚至细胞凋亡。与此同时,蛋白降解的另一条途径——自噬-溶酶体途径（autophagy—lysosomepathway,ALP）也已成为了生命科学领域的研究热点,自噬与神经变性疾病,尤其是PD的关系日益受到人们的重视。     

Midazolam in treatment of various types of seizures in children

Midazolam is a recently developed water-soluble benzodiazepine that shares anxiolytic, muscle relaxant, hypnotic and anticonvulsant actions with other members of this class. There are limited studies that midazolam can be used successfully to treat seizures in adults and children. In this study, 0.2 mg/kg intramuscular (IM) midazolam was administered to 11 children (eight boys and three girls), aged 3 days to 4 years (mean age 1.8±1.4 years), with seizures of various types. In all but one child, seizures stopped in 15 s–5 min after injection. No side effects were observed. These results suggest that IM administration of midazolam may be useful in a variety of seizures during childhood, especially in case of intravenous (IV) line problem.     

Characteristics of nociceptors in the periodontium--an in vitro study in rats

Recent studies have indicated that nociceptors can be classified into various types according to their physiological properties. These studies have clarified that the frequency distribution of various nociceptor types is different among body sites and animal species. In the present study, we investigated the physiological properties of rat's periodontal nociceptors in an in vitro jaw-nerve preparation. Responses were recorded from functional single filaments in the inferior alveolar nerve. To determine the nociceptor type, calibrated von Frey filaments, heat, and bradykinin (BK) stimuli were used. We found five subtypes of nociceptors in the periodontal ligaments of the lower incisor: Adelta-high threshold mechanonociceptors (Adelta-HTM, n=28), Adelta-mechanoheat nociceptors (Adelta-MH, n=6), Adelta-polymodal nociceptors (Adelta-POLY, n=26), C-high threshold mechanonociceptors (C-HTM, n=3) and C-polymodal nociceptors (C-POLY, n=4). Most nociceptors were Adelta-innervated, while only a small number of C-innervated nociceptors were found. The present results suggest that periodontal nociceptors transmit mainly fast pain, and may thus play a role in rapid detection of injure-related stimuli during mastication.     

Issues in evaluation of cognition in the elderly in developing countries

Background:

Developing regions of the world host the majority of elderly subjects who are at risk for dementia. Reliable epidemiological data from these countries is invaluable in tackling this global problem. Scarcity of such data in literature is largely attributable to problems that are unique to developing communities worldwide.

Objective:

To classify and describe the problems that interfere with the collection of reliable epidemiological data on cognitive impairment in the elderly in developing communities, and to suggest practical solutions for some of them.

Methods:

Inferring from the experiences of a large, ongoing, population-based study on the cognitive impairments in the elderly in South India and from the review of literature.

Conclusion:

A fatalistic attitude regarding aging in the communities, significant heterogeneity in educational abilities and activities of daily living, high illiteracy among rural subjects, and lack of an organized health care system and updated demographic figures are some of the major factors that contribute to technical, namely, methodology-related problems and practical, namely, subject-related problems in such epidemiological studies.