阿托伐他汀联合苯磺酸氨氯地平治疗冠心病合并脑梗死的疗效及对血脂水平的影响

目的分析阿托伐他汀及苯磺酸氨氯地平治疗冠心病合并脑梗死患者的疗效及对血脂指标的影响。方法选择我院2014-03—2016-03冠心病合并脑梗死患者96例,通过随机数字表法分为研究组和对照组各48例。对照组给予苯磺酸氨氯地平片治疗,研究组给予阿托伐他汀及苯磺酸氨氯地平片治疗。观察2组临床疗效、不良反应发生情况,并比较治疗前后2组血脂相关指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]水平变化情况。结果研究组总有效率(93.75%)明显高于对照组(77.08%),差异显著(P0.05);治疗前研究组HDL-C、LDL-C、TG、TC水平与对照组比较差异无统计学意义(P0.05),治疗后研究组各指标水平优于对照组,差异有统计学意义(P0.05);2组不良反应发生率比较差异无统计学意义(P0.05)。结论给予冠心病合并脑梗死患者阿托伐他汀及苯磺酸氨氯地平片可取得良好效果,能改善患者血脂水平,提高治疗效果,且不会增加不良反应发生率,具有安全性。     

阿托伐他汀对急性脑梗死患者CRP的影响

目的观察降脂药物阿托伐他汀对急性脑梗死患者的疗效,以探讨他汀类降脂药物治疗急性脑梗死的作用机制。方法 162例患者以随机数字法随机分为2组,观察组采用阿托伐他汀口服治疗,对照组采用依达拉奉注射治疗,21d后比较2组疗效、血脂和CRP变化情况。结果观察组有效率82.72%,对照组76.54%,2组比较差异有统计学意义(Ridit Z=10.378,P<0.0001);治疗21d后,观察组TC、TG、LDL和CRP 4个指标与治疗前相比均降低,差异有统计学意义(P<0.05);对照组TC、TG和CRP 3个指标与治疗前相比均降低,差异有统计学意义(P<0.05),LDL与治疗前相比差异无统计学意义(P>0.05);2组TC、TG、LDL和CRP 4个指标比较差异均有统计学意义(P<0.05)。结论阿托伐他汀可以改善患者血脂水平,降低C反应蛋白含量,对急性脑梗死具有显著疗效。     

脑心通联合阿托伐他汀治疗脑梗死颈动脉粥样硬化的疗效观察

目的观察脑梗死动脉粥样硬化患者采用脑心通胶囊联合阿托伐他汀治疗的临床效果。方法选用2013-06—2015-03在我院进行治疗的脑梗死颈动脉粥样硬化患者80例,随机分为实验组和对照组。对照组在常规治疗下,选用阿托伐他汀片口报,再服用阿司匹林肠溶片,均每天服用1次;实验组在服用阿托伐他汀片和阿司匹林肠溶片的基础上加用脑心通胶囊治疗,治疗6个月。比较2组血脂水平、颈动脉内膜-中层厚度(IMT)、颈动脉粥样硬化斑块的面积、同型半胱氨酸水平。结果治疗后2组血脂水平较治疗前相比有所改变,TG、TC、LDL-C与治疗前相比明显降低,且实验组降低的水平较对照组高,差异有统计学意义(P0.05)。HDL-C水平较治疗前有所升高,与治疗前相比差异有统计学意义(P0.05)。IMT、粥样硬化斑块的面积减少,实验组减少的面积多于对照组,差异有统计学意义(P0.05)。治疗后2组同型半胱氨酸水平低于治疗前,实验组下降较对照组明显,差异有统计学意义(P0.05)。结论脑梗死颈动脉粥样硬化患者采用脑心通胶囊联合阿托伐他汀治疗可有效提高临床效果,降低危险,减少颈动脉粥样硬化的程度,在临床治疗中有极大的应用价值。     

阿托伐他汀联合苯磺酸氨氯地平对冠心病合并脑梗死患者血脂水平及神经功能缺损的影响

目的探讨苯磺酸氨氯地平联合阿托伐他汀对冠心病合并脑梗死患者血脂水平及神经功能缺损的影响。方法选取我院收治的94例冠心病合并脑梗死患者,依据治疗方法分为2组各47例。单一组应用苯磺酸氨氯地平治疗,联合组于此基础上应用阿托伐他汀治疗。统计对比2组临床效果、治疗前后神经功能缺失程度、血清心肌酶[LDH(血清乳酸脱氢酶)、CK-MB(血清肌酸激酶)]、血脂相关指标[LDL-C(低密度脂蛋白胆固醇)、HDL-C(高密度脂蛋白胆固醇)、TC(总胆固醇)]水平变化及不良反应发生情况。结果联合组总有效率95.74%(45/47),显著优于单一组的76.60%(36/47),差异有统计学意义(P0.05);2组治疗前神经功能评分、LDH、CK-MB水平比较差异无统计学意义(P0.05);治疗后,联合组明显低于单一组,差异有统计学意义(P0.05);2组治疗前血脂相关指标水平差异无统计学意义(P0.05);与单一组相比,联合组治疗后LDL-C、TC较低,HDL-C较高,差异均有统计学意义(P0.05);联合组不良反应发生率4.26%(2/47),显著低于单一组的21.28%(10/47),差异有统计学意义(P0.05)。结论苯磺酸氨氯地平与阿托伐他汀联合应用于冠心病合并脑梗死治疗中,可显著改善患者血脂及血清心肌酶水平,促进其神经功能恢复,且安全性较高。     

瑞舒伐他汀治疗脑梗死患者颈动脉斑块疗效观察

目的 探讨瑞舒伐他汀治疗脑梗死患者颈动脉斑块的疗效.方法 对78例脑梗死患者常规治疗外,加用瑞舒伐他汀10 mg,每晚1次.治疗3个后测血清C反应蛋白(CRP)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和肝肾功能,采用彩色多普勒测定颈动脉内-中膜的厚度(IMT).结果 瑞舒伐他汀治疗3个月后,患者TC、TG、LDL-C和CRP显著低于治疗前水平(P＜0.05).双侧颈动脉内-中膜厚度缩小,与治疗前比较差异有统计学意义(P＜0.05).结论 瑞舒伐他汀除降脂作用外,还可以稳定并缩小脑梗死患者颈动脉斑块.     

瑞舒伐他汀与阿托伐他汀对急性脑梗死患者血脂、血清超敏C反应蛋白及颈动脉粥样硬化斑块作用的比较

目的比较瑞舒伐他汀与阿托伐他汀对急性脑梗死患者血脂、超敏C反应蛋白(hs-CRP)及颈动脉粥样硬化斑块的影响。方法在标准缺血性脑卒中治疗的基础上,瑞舒伐他汀组加用瑞舒伐他汀10mg/d,阿托伐他汀组加用阿托伐他汀片20 mg/d,治疗6个月。于治疗前及治疗后6个月,检测患者血脂、hsCRP水平,颈动脉超声检查颈动脉粥样硬化斑块情况。结果与治疗前比较,瑞舒伐他汀组与阿托伐他汀组6个月时总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和hs-CRP水平均显著降低(均P0.05)。6个月时,瑞舒伐他汀组TC、TG、LDL-C及hs-CRP水平显著低于阿托伐他汀组及对照组(均P0.05)。3组间治疗前内-中膜厚度(IMT)差异无统计学意义;与治疗前及对照组比较,瑞舒伐他汀组与阿托伐他汀组6个月时IMT及低回声斑块比率显著降低,高回声斑块率显著增高(均P0.05)。瑞舒伐他汀组、阿托伐他汀组及对照组患者第6个月的NIHSS评分及mRS评分均显著低于治疗前(均P0.05)。治疗前及治疗后6个月时,3组间NIHSS评分及mRS评分差异无统计学意义。结论瑞舒伐他汀与阿托伐他汀能显著降低急性脑梗死患者血脂及血清hs-CRP水平,抑制动脉粥样硬化斑块的形成。瑞舒伐他汀的降脂及抗炎作用比阿托伐他汀更强。     

血小板拮抗剂与阿托伐他汀对颅内外动脉粥样硬化斑块的影响

目的探讨血小板拮抗剂联合阿托伐他汀治疗对颅内外动脉粥样硬化斑块的影响。方法选择我院神经内科2012-06—2014-12收治的85例脑梗死患者为研究对象,分为治疗组(n=48)与对照组(n=47)。对照组口服阿托伐他汀,治疗组采取阿司匹林联合阿托伐他汀治疗,比较2组治疗前后血脂水平、颅内外动脉IMT(内膜中层厚度)及不良反应发生率。结果 2组治疗前各项血脂指标比较差异均无统计学意义(P0.05);治疗后均获得改善,组内前后对比差异有统计学意义(P0.05),治疗后治疗组TC、TG、LDL-C低于对照组,HDL-C高于对照组,差异有统计学意义(P0.05)。治疗前2组颅内外动脉IMT比较差异无统计学意义(P0.05);治疗后观察组颈动脉颅外段、椎动脉颅外段IMT均低于对照组,差异有统计学意义(P0.05)。结论血小板拮抗剂联合阿托伐他汀治疗脑梗死可有效提高颅内外动脉粥样硬化斑块的稳定性,改善血脂水平,减小IMT,值得推广。     

普罗布考联合阿托伐他汀对急性脑梗死患者脂质代谢的疗效

目的观察普罗布考联合阿托伐他汀治疗急性脑梗死的临床疗效及对脂质代谢的影响。方法选取我院2012-05—2014-08收治的急性脑梗死患者114例,随机分为观察组与对照组,对照组使用阿托伐他汀治疗,观察组加用普罗布考联合治疗,对比观察其临床疗效及脂质代谢情况。结果观察组治疗后临床显效及总有效率明显高于对照组,TC、TG、LDL-C、HDL-C、ox-LDL等血脂指标水平均明显优于对照组,差异有统计学意义(P0.05)。结论对急性脑梗死患者使用普罗布考联合阿托伐他汀治疗,可明显促进神经功能恢复,且能够有效改善脂质代谢状况,临床疗效理想,值得进一步推广。     

瑞舒伐他汀与阿托伐他汀治疗高脂血症脑梗死的近远期疗效对比

目的探讨瑞舒伐他汀和阿托伐他汀在治疗脑梗死合并高脂血症的近远期临床疗效。方法 2013-10—2015-10收住我院的脑梗死患者144例,入院后经检查均显示合并高脂血症。依据随机数字表法将其分为研究组(n=70)与对照组(n=74),在常规治疗基础上,对照组给予阿托伐他汀降低血脂,研究组给予瑞舒伐他汀治疗。比较两种方案的近远期疗效。结果治疗1个月后,2组患者总胆固醇(TC)等血液学指标无显著差异(P0.05)。治疗6个月后,研究组患者颈动脉内膜中层厚度(IMT)低于对照组(P0.05)。结论瑞舒伐他汀与阿托伐他汀治疗脑梗死合并高脂血症近期疗效相当,但瑞舒伐他汀远期疗效更佳。     

瑞舒伐他汀与阿托伐他汀对急性脑梗死患者血脂CRP及颈动脉粥样硬化斑块的影响比较

目的比较瑞舒伐他汀与阿托伐他汀对急性脑梗死患者血脂、CPR及颈动脉粥样硬化斑块的影响。方法将480例急性脑梗死患者随机分为瑞舒伐他汀组和阿托伐他汀组各240例,2组采用相同的基础治疗,瑞舒伐他汀组在此基础上加载瑞舒伐他汀,10mg/(次·d),阿托伐他汀组则加载阿托伐他汀,10mg/(次·d),均连续治疗24周。所有患者均于治疗前及治疗后12、24周采血,测定血脂四项,并于治疗前及治疗后12、24周行颈动脉超声检查,测量颈动脉粥样斑块内膜-中膜厚度(IMT)并采血测量C反应蛋白(CRP)。结果治疗后12周、24周,2组TC、TG、LDL-C和CRP较疗前有不同程度的下降,其治疗后瑞舒伐他汀组中者TC、TG、LDL-C水平均显著低于阿托伐他汀组;瑞舒伐他汀组颈动脉粥样硬化斑块厚度较疗前显著下降且低于同时期阿托伐他汀组(P0.05)。结论急性脑梗死患者长期应用瑞舒伐他汀,可降低血脂水平并减少颈动脉斑块IMT及斑块内炎症反应,疗效优于阿托伐他汀。     

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.     

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.     

广西农村壮族妇女精神分裂症患者生活质量状况调查

目的研究农村壮族妇女精神分裂症患者的生活质量及影响因素。方法前瞻性的队列研究。采用随机分层抽样法分为农村壮族妇女精神分裂症组、农村汉族妇女精神分裂症组、农村正常妇女对照组,应用“世界卫生组织生存质量测定报告”(WHOQOL-100)及PANSS量表调查其生活质量和疾病的严重程度。结果农村壮族妇女精神分裂症患者生活质量明显低于农村汉族妇女精神分裂症患者,影响其生活质量的相关因素是生活环境及精神支柱/个人信仰。结论经济贫困、环境条件、缺乏有效的医疗服务和社会保障是农村壮族妇女精神分裂症患者生活质量低的关键。因此,建立农村壮族社区精神卫生服务网络势在必行。     

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.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

The origins of innervation of the esophagus of the dog

This study defined the origins of extrinsic efferent and afferent innervation of the normal canine esophagus. When all the layers of the wall of the 3 esophageal regions (cervical, thoracic and abdominal) were injected with horseradish peroxidase (HRP), labeled nerve cells were found in the nucleus ambiguus (NA) and parasympathetic nucleus of X (PX) of the brainstem. Most labeled cells in the NA were located in the compact column (retrofacial nucleus) while labeled cells in the PX were located in separate rostral and caudal areas. There was no somatotopic organization in either the NA or PX. Labeled sympathetic postganglionic neurons were found in the cranial cervical, middle cervical, cervicothoracic, thoracic sympathetic trunk and celiacomesenteric ganglia. The HRP injection of the esophageal wall labeled sensory cell bodies in the glossopharyngeal, proximal and distal vagal, and C2-T6 spinal ganglia. There was no discernible pattern of distribution of labeled cells in the autonomic or sensory ganglia. When the HRP injections were confined to the mucosa-submucosa layers of the thoracic esophagus, a small number of labeled cells were identified in the NA; however, no labeled cells were found in the NA when injections were confined to the mucosa-submucosa of either the cervical or abdominal esophageal regions. With these confined injections, the labeled nerve cells appeared in the rostral part of the PX. Thus, it appeared that the internal tunics of the esophagus (i.e., the mucosa and submucosa) were innervated by neurons in the rostral PX while the muscular tunic was innervated by neurons in the caudal PX and the rostral NA. After mucosa-submucosa injections, labeled sympathetic neurons appeared in the same ganglia that were identified after whole wall injections and these had a similar random distribution. These injections also labeled neurons in the glossopharyngeal, proximal vagal, and distal vagal ganglia, but unlike the whole wall injections there was no labeling in the spinal ganglia. This suggested that the labeled cells of the spinal ganglia seen after whole wall injections conveyed impulses from the tunica muscularis and serosa.