脑梗死后癫痫患者血清细胞因子水平的改变

目的研究脑梗死后癫痫患者血清细胞因子水平的改变。方法应用放射免疫法检测87例脑梗死后癫痫患者（脑梗死癫痫组）和75名健康体检者（正常对照组）的血清肿瘤坏死因子α（TNF-α），白细胞介素（IL）-2和IL-6水平。结果脑梗死癫痫组血清TNF-α[（2．5±0．57）ng／L]、．89±0．36）ng／L，IL-2（4．3±1．5）ng／L，IL-6（13．3±11．1）ng／L]（均P〈0.01）。结论脑梗死后癫痫患者的血清细胞因子TNIL-2[2（9、0±0．83）ng／L]及IL-6[（97．5±13．1）ng／L]水平明显高于正常对照组[TNF-α（0F-α、IL-2及IL-6水平显著升高，提示细胞因子可能在脑梗死后癫痫的发病中起重要作用。     

亚低温对局灶性脑缺血大鼠血清白细胞介素和缺血局部细胞间黏附分子-1表达的影响

目的观察亚低温对局灶性脑缺血大鼠缺血局部细胞间黏附分子-1（ICAM-1）表达和血清白细胞介素-6（IL-6）含量的影响，探讨亚低温对脑缺血性损害的神经保护作用机制。方法将30只体质量在250-300g的雌性Sprague—Dawley大鼠随机分为亚低温组（n=151和对照组（n=15），采用线栓法阻断大鼠一侧大脑中动脉制作局灶性脑缺血模型，制模成功后，将亚低温组和对照组大鼠分别置于冰毯机和常温操作台上，使其肛温保持在（33±1）℃和（37±0．5）℃。12h后，自左心室取血，断头取脑，采用免疫组化方法检测缺血区ICAM-1阳性血管数目和应用免疫放射测定法（IRMA）检测血清IL-6含量。结果免疫组化分析示缺血局部ICAM-1的表达较对照组下降，IRMA检测的血清IL-6含量亚低温组较对照组降低。结论亚低温可降低局灶性脑缺血大鼠血清IL-6含量和减少缺血局部ICAM—1的表达，推测亚低温降低IL-6和ICAM—1的表达为亚低温减轻脑缺血性损害的神经保护作用之一。     

依达拉奉治疗急性脑梗死的临床观察

目的 探讨急性脑梗死的常规治疗和加用依达拉奉治疗的疗效变化。方法60例急性脑梗死患者随机分为治疗组和对照组各30例,对照组用常规治疗方法（川穹嗪和胞二磷胆碱静滴,口服阿司匹林等）,治疗组在常规治疗的基础上加用依达拉奉注射液30mg静滴,2次／d,7～14d为1个疗程,进行疗效评定。结果1周后治疗组和对照组ESS评分、B1分别为（65．31±20．33）、（60．34±20．72）和（48．3±29．33）、（41．3±23．42）。2周后治疗组和对照组ESS评分、B1分别为（81．37±20．56）、（69．73±20．84）和（61．78±27．72）、（54．22±23．92）,2组对比差异均有统计学意义（P〈0．05或P〈0．01）。结论依达拉奉能有效改善急性脑梗死的神经功能缺失和日常生活能力,并能更好地控制脑梗死的进展。     

脑梗死患者血清E2与可溶性细胞间黏附分子-1白介素-6的关系研究

目的探讨可溶性细胞间黏附分子1(sICAM-1)、白细胞介素6(IL-6)及血清雌二醇(E2)在脑梗死患者中的表达情况以及sICAM-1、IL-6与E2的关系。方法选取2011-01—2014-06 92例脑梗死患者为研究对象(观察组);急性期52例,缓解期40例;根据体积大小分为3组,小梗死灶组42例,梗死灶体积5cm3;中梗死灶组28例,梗死灶体积5~10cm3;大梗死灶组22例,梗死灶体积10cm3。选择70例健康人为对照组。检测受试者血清E2、sICAM-1、IL-6水平,并对脑梗死患者血清E2、sICAM-1、IL-6表达与年龄、病情、梗死灶大小、BMI进行相关性分析。结果观察组血清sICAM-1和IL-6水平均高于对照组(P0.01);观察组血清E2水平低于对照组(P0.01);随着脑梗死病情的加重,血清sICAM-1和IL-6水平均呈上升趋势(P0.01),血清E2水平呈下降趋势(P0.01);随着脑梗死体积的增加,血清sICAM-1和IL-6水平均呈上升趋势(P0.01),血清E2水平呈下降趋势;sICAM-1和IL-6的表达与脑梗死病情、梗死灶大小均呈正相关(P0.05);E2的表达与脑梗病情、梗死灶大小均呈负相关(P0.05);E2的表达与sICAM-1和IL-6的表达均呈负相关(P0.05),sICAM-1和IL-6的表达呈正相关(P0.05)。结论 sICAM-1、IL-6在脑梗死患者血清中高表达,E2在脑梗死患者血清中低表达,上述指标与脑梗死发病及病情进展密切相关。     

急性脑梗死患者血浆脑利钠肽变化及左心室功能的研究

目的 通过血浆N端脑利钠肽前体（NT-proBNP）测定及超声心动图检查,观察急性脑梗死患者血浆N端脑利钠肽（NT-proBNP）的变化及与心脏左心室功能（LVF）的关系,为防治急性脑梗死所致心脏损害提供依据。方法选择发病48h内经临床和颅脑CT检查确诊的急性脑梗死患者25例作为研究对象,所有患者既往无心脏病史,并除外心功能不全、心律失常等心脏并发症。选择性别和年龄相当的25例正常人作为对照组。以上2组均行超声心动图检查,同时抽血检测血浆NT-proBNP,对结果进行分析。结果（1）急性脑梗死组血浆NT-proBNP浓度高于正常对照组,二者比较差异有统计学意义（P〈0．01）。（2）急性脑梗死组心脏每搏输出量（SV）、心输出量（CO）明显低于正常对照组（39.4-13vs54±12,P〈0．01;3．10±1．49vs3．89±1．34,P=0．020）。（3）急性脑梗死组左室射血分数（LVEF）明显低于正常对照组（45±15VS66±10,P〈0．01）。（4）急性脑梗死组E峰最大速度／A峰最大速度（E／A）与正常对照组比较差异有统计学意义（0．98±0．30vs1．46±0．21,P〈0．01）。结论急性脑梗死发病后血浆NT-proBNP浓度升高;急性脑梗死可引起左心室收缩及舒张功能下降,可能主要与急性脑梗死本身的病理生理机制有关。     

亚低温治疗大面积脑梗死的临床研究

目的　研究亚低温治疗对大面积脑梗死患者血糖、血乳酸、颅内压的影响及其临床疗效。方法　发病24h内入院的大面积脑梗死患者30例,随机分为亚低温治疗组和对照组,各15例。亚低温组给予32~34℃的低温治疗并于治疗前后持续监测颅内压;两组患者分别于入院时、第2天和第4天测定血糖、血乳酸水平,并采用神经功能缺损评分量表评估患者的预后。结果　亚低温组患者急性脑梗死后颅内压为(14 2±4 2)mmHg(1mmHg=0 133kPa), 经(32±9)h的低温治疗后,明显下降至(11. 3±2. 8)mmHg;亚低温组治疗结束时血糖和血乳酸分别下降了2 53mmol/L和2 .48mmol/L,与对照组相比,高血糖高乳酸血症得到明显改善。低温治疗期间未发生严重并发症,预后相对较好。结论　亚低温治疗大面积脑梗死安全有效,是临床上值得进一步研究应用的脑保护手段。     

急性脑梗死血清C反应蛋白水平的临床意义

目的 探讨急性脑梗死（ACI）患者血清C反应蛋白（CRP）水平的意义及其机制。方法 测定129例ACI患者、46名健康对照者血清CRP水平,观察比较ACI患者在不同病情、不同梗死面积时血清CRP水平的变化,对发病后48h病情发展变化进行评定,根据评分结果分为进展型与完全型脑梗死两组进行观察比较。结果 ACI患者血清CRP水平[（0.81±0.48）mg/dL]明显高于健康对照组[（0.27±0.16）mg/dL]（P〈0.01）,且CRP水平随神经功能缺损程度评分增高亦明显升高;进展性脑梗死患者血清CRP水平明显高于非进展性患者（P〈0.01）。结论 CRP一定程度上是预测ACI患者病情严重程度及进展的相关生化指标之一。     

亚低温治疗重症脑梗死的疗效观察

目的 :探讨亚低温技术治疗重症脑梗死的临床效果。方法 :30例住院的重症脑梗死患者 ,分为治疗和对照两组 ,在给予抗脑梗死治疗的同时 ,治疗组加用亚低温技术 ,治疗后 7天、2 1天分别进行神经功能缺损评分 ,和病死率等一起进行分析。结果 :治疗 7天与 2 1天后 ,治疗和对照两组的评分分别为 30 .4 5± 5 .86 ,34.1 4± 5 .37( P=0 .0 5 ) ;和 2 1 .92± 2 .4 6 ,2 6 .82± 1 .99( P<0 .0 5 ) ;病死率分别为 2 0 %和 2 6 % ( P>0 .0 5 )。结论 :亚低温技术可以明显改善重症脑梗死患者的神经功能和预后。     

奥扎格雷钠对急性脑梗死患者血清IL-6和sICAM-1的影响

目的 探讨奥扎格雷钠对急性脑梗死(ACI)患者血清白介素-6(IL-6)和可溶性细胞间黏附分子-1(sICAM-1)的影响.方法 80例ACI患者随机分为治疗组和对照组.2组均给予常规治疗,治疗组加用奥扎格雷钠治疗,对照组加用维脑路通,采用双抗体酶联免疫吸附法(ELISA)分析.结果 2组治疗后血清IL-6和sICAM-1水平均降低,治疗组下降更明显.结论 血清sICAM-1及IL-6水平升高可能是脑梗死发病的危险因素,奥扎格雷钠对急性脑梗死患者血清中异常升高的IL-6和sICAM-1有降低作用.     

急性脑梗死患者血清IL-8、IL-6水平的研究

目的　探讨炎性细胞因子 IL-8、IL-6在急性脑梗死免疫病理损伤中的作用。方法　用 ELISA法检测 4 5例急性期脑梗死患者血清 IL-8、IL-6水平 ,并与匹配年龄的 2 7例正常对照组比较。结果　急性期脑梗死组 IL-8水平为 ( 1 .39± 0 .1 1 ) ng/m L,IL-6检测阳性者为 4 6 .6 7% ,较正常对照组显著升高 (均 P<0 .0 0 1 )。相关性分析显示 ,脑梗死急性期 IL-8含量与梗死灶体积及神经功能缺失评分均呈直线正相关 ( r=0 .4 37,P<0 .0 0 5 ;r=0 .394 ,P<0 .0 1 ) ;血清 IL-6含量与梗死灶体积及神经功能缺损评分均呈等级正相关 ( rs=0 .4 6 7,P<0 .0 0 2 ;rs=0 .40 1 ,P<0 .0 1 )。结论　脑梗死急性期血清 IL-8、IL-6水平增高 ,且与梗死灶体积和神经功能缺损评分密切相关     

Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults

A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

Bibliography of officers of department of mental hygiene

Psychiatric Quarterly -