S—100B，NSE和MBP评估重型颅脑损伤预后的研究

目的 研究重型颅脑损伤后血清S—100B蛋白、神经特异性烯醇化酶(NSE)和碱性髓鞘蛋白(MBP）浓度在预后评估中的价值。方法 对2002年1月至2002年12月40例重型颅脑损伤住院病人在伤后12h内进行血清S—100B、NSE和MBP浓度检测，并结合GOS评分进行比较分析。结果 本组40例重型颅脑损伤病人伤后血清S—100B、NSE和MBP浓度均显著高于正常对照组，不同预后组之间S—100B、NSE和MBP浓度存在显著差异。分别以伤后12h血清S-100B浓度2．0μg／L、NSE浓度30ng/ml和MBP浓度10ng/ml为分界标准评估预后，S—100B评估预后的特异度为91％，敏感度72％；NSE特异度为77％，敏感度67％；MBP特异度为63％，敏感度61％。结论 伤后血清S-100B蛋白、NSE和MBP浓度对评估重型颅脑损伤预后具有较高的特异性和敏感性。而S—100B浓度在预后评估中的作用较NSE和MBP更为敏感，特异，因此可作为评估重型颅脑损伤预后的一种可靠的临床指标。     

重型颅脑损伤患者血清S-100B蛋白含量检测及临床意义

目的 通过检测重型颅脑损伤患者血清S-100B蛋白含量,研究S-100B蛋白含量与重型颅脑损伤严重程度及预后的关系,为预后评估及治疗提供理论依据.方法 选取100例正常体检者为对照组,取其血清标本检测S-100B蛋白含量.选取重型颅脑损伤患者(GCS≤8分)48例,分别于伤后早期(2～6h)及伤后1、3、5、7、10d采血,检测血清中S-100B蛋白含量,比较其在伤后不同时期的血清S-100B蛋白含量.结果 100例正常体检者血清S-100B蛋白含量测定结果 证实,正常人血清S-100B含量与年龄、性别无关.重型颅脑损伤患者伤后血清S-100B蛋白含量与对照组相比有显著性差异(P＜0.01).GCS 3～5分组与GCS 6～8分组患者及不同预后组之间血清S-100B蛋白含量有显著性差异(P＜0.05).结论 S-100B蛋白在诊断重型颅脑损伤及判断严重程度中有高度敏感性和特异性,是一种有效的生化指标,能为预后评估及治疗提供理论依据,值得推广.     

NSE、MBP对重型脑外伤的临床评估

目的　研究重型脑外伤后神经元特异性烯醇化酶 (neuron specific enolase,NSE)、碱性髓鞘蛋白 (myelinbasic protein,MBP)血清浓度变化 ,以期为临床重型脑外伤后脑损伤监测及预后评估提供直观的定量指标。方法　对 3 0例重型脑外伤住院患者伤后 1 2 h至第 4天进行连续血清 NSE、MBP浓度检测 ,并结合格拉斯哥预后计分 (GOS)及头颅 CT表现进行比较分析。结果　 3 0例重型脑外伤患者伤后 1 2 h血清 NSE、MBP均显著高于正常对照组 ,且与患者预后密切相关。此后 NSE、MBP浓度虽均呈下降趋势 ,但仍高于正常值 ,预后恶劣组伤后每天 NSE浓度均持续高于预后良好组 ,差异有显著性。结论　重型脑外伤后血清标记物 NSE、MBP浓度与患者预后关系密切 ,且伤后 NSE浓度动态变化对继发性脑损害评估亦有重要意义 ,其为临床救治效果及病情转归的判断提供了有效手段。     

复方黄芪注射液对急性重型颅脑损伤患者血清NSE，MBP和S-100B含量的影响

目的观察复方黄芪注射液对急性重型颅脑损伤患者血清神经元特异性烯醇化酶（NSE），髓鞘碱性蛋白（MBP）和S-100蛋白B（S-100B）含量的影响。方法按标准选取急性重型颅脑损伤患者196例，随机分成常规治疗组和黄芪治疗组两组。黄芪治疗组在常规治疗基础上加用复方黄芪注射液治疗。治疗前和治疗后不同时间点分别检测患者血清NES、MBP和S-100B浓度,并行GCS评分，3个月后行GOS评分；同时检测96例健康成人血清的NES、MBP和S-100B的浓度，然后对所得资料进行统计学分析。结果急性重型颅脑损伤患者血清的NES、MBP和S-100B的浓度均显著高于健康成年人（P〈0．05）。治疗后黄芪治疗组血清NSE、MBP和S-100B均低于常规治疗组，差异均有显著性意义（P〈0．05）。黄芪治疗组在入院时的GCS评分与常规治疗组比较无显著性差异（P〉0．05），但治疗后1周和2周其GCS评分显著高于常规治疗组（P〈0．05）。治疗3月后其GOS评分显著高于常规治疗组（P〉0．05）。结论黄芪能降低急性重型颅脑损伤患者血清NSE，MBP，S-100B含量，并能改善患者的预后。     

急性脑卒中患者血清神经元特异性烯醇化酶、S-100B蛋白、髓鞘碱性蛋白水平的变化

目的探讨急性脑卒中患者血清神经元特异性烯醇化酶(NSE)、S-100B蛋白、髓鞘碱性蛋白(MBP)水平变化及其临床意义。方法回顾性对照分析发病在48 h内的45例急性脑卒中患者(其中脑梗死组19例,脑出血组15例,短暂性脑缺血发作组11例)血清NSE、S-100B蛋白、MBP水平变化及其与脑梗死、脑出血患者神经功能缺损程度的相关性。结果脑梗死组和脑出血组患者血清NSE、S-100B蛋白、MBP水平均较对照组有不同程度增高(P<0.05),而短暂性脑缺血发作组与正常对照组比较均无明显变化。脑梗死组和脑出血组患者中神经功能缺损较重的中重型亚组患者血清NSE、S-100B蛋白、MBP水平较轻型亚组水平高(P<0.05)。结论血清NSE、S-100B蛋白、MBP水平可作为急性脑卒中患者病情判断、预后评估的指标之一,对早期脑梗死与短暂性脑缺血发作也有鉴别诊断价值,尤其适用于无法进行影像学检查的脑卒中患者。     

醒脑注射液对急性重型颅脑损伤患者血清S-100B蛋白浓度的影响

目的 动态观察醒脑注射液对急性重型颅脑损伤患者血清S-100B蛋白浓度的影响,探讨醒脑注射液在急性重型颅脑损伤治疗中的作用.方法 将120例急性重型颅脑损伤患者随机分为醒脑注射液组和常规组各60例.醒脑注射液组在常规治疗的基础上,给醒脑注射液30ml+5%葡萄糖或生理盐水100m1静滴,30min内滴完,1次/d,7d为1个疗程.所有患者于入院6h内和入院后第2、3、4、5、6 天检测血清S-100B蛋白浓度.结果 重型颅脑损伤患者的血清S-100B蛋白浓度明显高于正常对照组(P＜0.05);醒脑注射液组第2～6天血清S-100B蛋自浓度明显低于常规组,差异有显著性(P＜0.05).结论 急性重型颅脑损伤患者血清S-100B蛋白浓度明显升高.醒脑注射液能降低患者血清S-100B蛋白浓度,从而保护神经功能.     

亚低温治疗重型颅脑损伤患者的血清S-100B蛋白含量分析

目的 通过检测亚低温治疗后重型颅脑损伤患者血清S-100B蛋白含量的变化来证实亚低温治疗的脑保护作用,探讨其可能的作用机制.方法 选取100例正常体检者为对照组,选取100例重型颅脑损伤患者(GCS≤8分1并分为亚低温治疗组50例和常温治疗组50例,分别于伤后早期(2～6 h)及伤后不同时间(1 d、3 d、5 d、7 d、10 d)采血,检测血清中S-100B蛋白含量,比较其在伤后不同时期的血清S-100B蛋白含量.结果 正常体检者血清S-100B蛋白含量测定结果证实,正常人血清S-100B蛋白含量与年龄、性别无关.亚低温治疗组、常温治疗组患者伤后血清S-100B蛋白含量与对照组相比差异有统计学意义(P<0.01).伤后1 d、3 d、5 d、7 d、10 d时亚低温治疗组血清S-100B含量明显低于常温治疗组,差异有统计学意义(P(0.05).结论 血清S-100B蛋白在重型颅脑损伤的诊断巾有高度敏感性和特异性,是一种有效的生化指标.亚低温治疗对重型颅脑损伤具有脑保护作用.     

急性颅脑损伤病人血清神经元特异性烯醇化酶水平改变及临床意义

目的:研究急性颅脑损伤病人伤后血清神经元特异性烯醇化酶(NSE)水平改变的规律,并探讨其临床意义。方法:应用双抗体夹心酶标免疫分析法,测定34例急性脑外伤病人血清NSE浓度,都作NSE连续检测。结果:中型和重型脑外伤病人血清NSE含量。伤后结果:NSE水平升高明显,生存者以后逐渐下降,死亡者则持续升高;重型脑外伤病人首次血清NSE水平与格拉斯哥结果分级评分之间无相关关系。结论:急性脑外伤病人伤后血清NSE水平增高反映了脑损害的严重性,NSE连续测定有助于病人转归的预测。     

脑出血患者血清S-100β蛋白与神经元特异性烯醇化酶的检测及意义

目的 探讨脑出血患者血清S-100β蛋白与神经元烯醇化酶(NSE)的表达水平及与临床预后的关系.方法 采用酶联免疫吸附法对36例脑出血患者起病第1、3、5天血清S-100β蛋白与NSE水平进行了动态测定.结果 脑出血患者血清S-100β蛋白与NSE浓度在起病第1、3、5天均显著高于对照组(P<0.01),其表达水平的高低与临床预后有显著相关性.结论 血清S-100β蛋白与NSE水平测定对判断脑出血病变的严重度、评估预后有重要参考价值.     

硫酸镁对急性重型颅脑损伤患者血清S100B浓度和预后的影响

目的观察急性重型颅脑损伤(asTBI)后血清S100B浓度的变化及其与预后的关系,研究硫酸镁对asTBI患者血清S100B浓度和预后的影响。方法69例患者随机分为硫酸镁治疗组(n=34)和常规治疗对照组(n=35)。按入院时GCS评分分为特重组(GCS3～5分)和重型组(GCS6～8分),于入院时,伤后1、4、7、14天,检测血清镁、S100B浓度和GCS评分。治疗组首剂给予25%硫酸镁16ml静脉滴注,15分钟输完,继予25%硫酸镁60ml静脉滴注,匀速24h输完。对照组除未用硫酸镁外其余治疗与治疗组完全相同。伤后3个月时纪录GOS评分。结果与健康对照组比较,asTBI后血清镁离子浓度下降(P0.05),血清S100B浓度升高,特重组(ssTBI)S100B浓度高于重型组(sTBI)(P0.05)。伤后第4、7天,治疗组血清S100B浓度低于对照组(P0.05)。入院时血清S100B浓度高于1.2μg/L者预后不良,其敏感度为(sensitivity,SEN)为75.8%,特异度(specificity,SPE)为69.4%。治疗组与对照组预后的比较无统计学意义(P0.05)。结论asTBI后,血清镁离子浓度下降,血清S100B浓度升高,且伤情越重,血清S100B浓度越高,预后越差。早期应用硫酸镁提高asTBI患者血清镁离子浓度可降低伤后第4、7天血清S100B浓度,提示硫酸镁具有一定的神经保护作用,但并不能改善预后。     

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.     

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.     

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。     

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.     

Effect of high simple dose of cisplatinum and of radiation on the brain of rabbit

Abstract

In former studies of intracarotid and intravenous administration of cisplatinum, separate and combined with brain irradiation, we found no cerebral damage. In this study! gradually increasing high doses (above the therapeutic ones) of cisplatinum were administered intravenously to one series of rabbits arid increasing high amounts of irradiation (above the therapeutic amounts) were given to another series. Although the rabbits that received highest doses of irradiation developed areas of alopecia and skin ulcers on the head! the general clinical and histopathologic examination of the rabbits brains in both series was normal. The purpose of this study was to establish the effects of high doses of intravenous cisplatinum and irradiation on the rabbits brains. [Neural Res 1997; 19: 216–218]