海风藤、氟桂嗪和绞股蓝皂甙对犬脑干缺血保护作用的对比研究

结扎犬脑基底动脉后６ｈ，发现脑干听觉诱发电位ＢＡＥＰ，各波的峰潜伏期（ＰＬ）及峰间期（ＩＰＬ）明显延长（Ｐ＜０．０１）；脑干神经元形态结构发生缺血性改变（光镜及电镜），脑干组织ＰＬＡ２活性升高５．８倍（Ｐ＜０．０１），超氧化物歧化酶（ＳＯＤ）活性降低５８．８％（Ｐ＜０．０１）。海风藤３００ｍｇ·ｋｇ－１、氟桂嗪１ｍｐ·ｋｇ－１、绞股蓝皂甙１５０ｍｇ·ｋｇ－１，分别于结扎脑基底动脉前３ｈ经十二指肠造瘘管给药，皆能缩短ＰＬ及ⅠＰＬ的延长（Ｐ＜０．０１），明显减轻神经元形态结构的缺血性改变，三者作用相当。与缺血组相比较，三药分别使ＰＬＡ２活性降低８０．２％。７４．２％和７２．４％（Ｐ＜０．０１），使ＳＯＤ活性升高２．１、１．９５和１．８４倍（Ｐ＜０．０１）。上述结果提示三药抗脑缺血损伤的作用与其降低ＰＬＡ２活性和增强ＳＯＤ活性有关。     

脑卒中患者血浆血栓素、前列环素与脑血流量的关系

为进一步研究血栓素Ａ２（ＴＸＡ２）、前列环素（ＰＧＩ２）与脑血管病的关系，我们测定了６４例脑卒中患者ＴＸＡ２和ＰＧＩ２的代谢产物ＴＸＢ２和６－酮－前列腺素Ｆ１α（６－Ｋ－ＰＧＦ１α）血浆浓度，并同步观察了它们与局部脑血流量（ｒＣＢＦ）的关系。１资料１...     

阿尔茨海默病患者早老素-1基因内含子多态性分布的研究

目的 探讨早老素－１（ＰＳ－１）基因第８外显子３’端内含子等位基因多态性在散发性阿尔茨海默病（ＳＡＤ）发病机制中的作用。方法 应用聚合酶链反应－限制性片段长度多态性（ＰＣＲ－ＲＦＬＰ）方法检测７５例ＳＡＤ患者（ＳＡＤ组）和７３例正常老年人（对照组）的ＰＳ－１基因第８外显子３’端内含子等位基因多态性分布。结果 ＳＡＤ组１等位基因频率明显高于对照组（Ｐ〈０．０１,ＲＲ＝１．８３）,２等位基因频率明显低于对照组（Ｐ〈０．０１,ＲＲ＝０．５５）;ＳＡＤ组２／２基因型频率低于对照组（Ｐ〈０．０５,ＲＲ＝０．３２）。结论 ＰＳ－１基因多态性与ＳＡＤ发病有关,ＳＡＤ发病与ＰＳ－１基因２等位基因呈明显负关联,与１等位基因呈明显正关联。ＰＳ－１基因２等位基因对ＳＡＤ发病可能有保护作用,１等位基因可能是ＳＡＤ发病的危险因素之一。     

Alzheimer病与老年脑中β-淀粉样蛋白免疫组化的研究

目的探讨β－淀粉样蛋白（β－ＡＰ）与Ａｌｚｈｅｉｍｅｒ病（ＡＤ）、脑老化之间的关系。方法采用免疫组化方法检查经过临床与病理确诊的３例ＡＤ与６例非痴呆老年对照（ＮＡＤ）脑组织广泛部位中β－ＡＰ的沉积，并且与淀粉样蛋白组化染色的方法如刚果红、爱先蓝（ＳＡＢ）染色相对比。结果发现１ＡＤ脑组织中β－ＡＰ的沉积较ＮＡＤ不仅部位广泛，而且程度严重。２β－ＡＰ的免疫组化染色方法较淀粉样蛋白组化染色方法敏感而可靠。结论β－ＡＰ在脑中的沉积可能与神经元的变性以致智能衰退、ＡＤ的发生有关。β－ＡＰ的免疫组化检测可作为ＡＤ组织学诊断的重要参考。     

新生儿缺氧缺血性脑病25例临床分析

新生儿缺氧缺血性脑病（ＨＩＥ）是围产或窒息导致的缺氧缺血性损害,是造成新生儿死亡及小儿智力发育障碍的重要原因。其临床表现多样。严重时可导致永久性神经功能缺陷,表现为智力低下、脑瘫、癫痫等后遗症。我院儿科１９９６年－１９９７年收治２５例患儿,现分析如下。１临床资料１．１一般资料２５例中男１６例,女９例。≤１天,１７例;－２天,６例;－３天,２例。胎龄３８－４２周２４例;４２周１例。顺产１３例,剖腹产７例,胎头吸引 ５例。出生体重 ２９００－４０００ ｇ。Ａｐｇａｒ评分１分钟≤３分,７例;－６分,１５…     

蛛网膜下腔出血和脑梗死患者IL-6水平研究

目的分析蛛网膜下腔出血（ＳＡＨ）和脑梗死患者血清、脑脊液（ＣＳＦ）的白细胞介素-６（ＩＬ－６）水平变化特点．探讨ＩＬ－６与ＳＡＨ和脑梗死的关系。方法用双抗体夹心ＥＬＩＳＡ法测定２０例ＳＡＨ患者、３８例脑梗死患者及２０例正常人血清、ＣＳＦ的ＩＬ－６水平。结果脑梗死组血清ＩＬ－６水平较对照组明显增高（Ｐ＜０．０１）：ＳＡＨ组血清、ＣＳＦ的ＩＬ－６水平较对照组明显增高（Ｐ＜０．０１）。ＳＡＨ组ＣＳＦ的ＩＬ－６水平比血清的ＩＬ－６水平明显增高（Ｐ＜０．０１）。ＳＡＨ组第１天血清和第６天ＣＳＦ的ＩＬ－６平均水平为最高值。结论ＩＬ－６与脑梗死、ＳＡＨ发病有关，ＳＡＨ患者中枢神经系统与颅外免疫系统一样存在严重的免疫和炎症反应．而中枢神经系统与颅外免疫系统的免疫调节可能是不相同的。ＩＬ－６异常增高可能与ＳＡＨ后的脑血管痉挛（ＣＶＳ）和迟发性脑梗死有关。     

脑脊液置换术治疗急性出血性脑卒中34例疗效分析

目的：探讨ＣＳＦ置换术治疗急性出血性脑血管病的效果及安全性。方法：回顾ＣＳＦ置换术治疗原发性脑室出血２例,继发性脑室出血１２例,脑ＳＡＨ１８例,脊髓ＳＡＨ２例。 ４组出血的临床表现、特点、治疗方法及预后。结果： ３４例均于首次置换后头痛、呕吐明显减轻, ２～４次置换后颅压降至正常,脑膜刺激征消失。无脑疝、脑积水、低颅压并发症。 ４组住院患者除２例脑ＳＡＨ分别再次或多次出血死亡外,３２例均在４周内痊愈出院。结论：ＣＳＦ置换术选择脑实质血肿量不多而破入脑室,原发性脑室出血,脑、脊髓ＳＡＨ的患者进行治疗,疗效可靠,简单易行,无并发症。     

环孢菌素治疗用激素类药无效的多发性硬化

目的探讨环孢菌素（ＣｓＡ）治疗用激素类无效的多发性硬化（ＭＳ）的效果。方法对激素等治疗５个月以上病情无明显好转或仍在加重的１０例ＭＳ，用ＣｓＡ５ｍｇ·ｋｇ－１·ｄ－１，疗程至少２个月，然后根据病情逐渐减量，最后小剂量维持用药。统计各个治疗期及最后随访（６～３２个月后）的扩充致残量表（ＥＤＳＳ）评分和脑ＭＲＩ病灶数。结果激素治疗前后ＥＤＳＳ差异无显著性意义（Ｐ＞０．２０）；ＣｓＡ足量治疗使ＥＤＳＳ评分下降及脑ＭＲＩ病灶数减少（Ｐ＜０．０５）；最后随访ＥＤＳＳ评分进一步下降（Ｐ＜０．０１），其中４例复查了ＭＲＩ，３例病灶数进一步减少。ＣｓＡ治疗未见严重毒副作用。结论ＣｓＡ可治疗用激素类无效的ＭＳ。     

脑动静脉畸形显微手术及其选择性治疗

目的 探讨脑ＡＶＭ显微手术,血管内栓塞及放射外科治疗的选择。方法 以综合分级标准分级,对７３例脑ＡＶＭ治疗分析,显微直视手术脑ＡＶＭ６７例;基中行脑ＡＶＭ切除术６０例,畸形血管电凝夹闭术７例。对重要功能区的脑ＡＶＭ分别行血管内栓塞和γ－刀治疗各３例。结果 术后死亡１例,脑ＡＶＭ切除后５９例经造影复查,见ＡＱＶＭ血管团消失。栓塞的病例经ＤＳＡ复查,显示畸形血管１例消失,２例缩小５０％;３例γ－刀治疗     

肠溶阿斯匹林剂量和血阿斯匹林及水杨酸盐浓度与药效关系探讨

本文探讨了ＡＳＡ剂量与药效的关系及血ＡＳＡ、ＳＡ药物浓度监测的临床意义，结果表明：（１）ＡＳＡ剂量与６－ｋｅｔｏ－ＰＧＦ_（１α）抑制率呈正相关（Ｐ＜０．０１），而与ＴＸＢ_２及ＰＡｇＲ抑制率无相关性（Ｐ＞０．１）；（２）本文采用ＨＰＬＣ内标法同时测定血ＡＳＡ和ＳＡ浓度，结果准确，方法简便；（３）当口服小剂量ＡＳＡ防治ＣＩ时，监测血ＡＳＡ和ＳＡ以调整ＡＳＡ用药剂量的临床价值并非十分重要。     

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.     

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.     

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     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.