头部亚低温联合神经节苷脂治疗新生儿缺氧缺血性脑病的疗效

目的探讨头部亚低温联合神经节苷脂治疗对新生儿缺氧缺血性脑病的疗效。方法将94例新生儿缺氧缺血性脑病患儿随机分为观察组47例和对照组47例。2组患儿均给予对症支持治疗,对照组加用神经节苷脂治疗,观察组加用头部亚低温联合神经节苷脂治疗。2组患儿治疗后分别进行神经学评分和新生儿神经行为评定(NBNA),并记录反射恢复时间和肌张力恢复时间。结果治疗后2组患儿神经学评分呈下降趋势,且观察组治疗24h、48h和72h的神经学评分低于对照组,差异均有统计学意义(P0.05);观察组治疗5d和10d的NBNA评分高于对照组,差异均有统计学意义(P0.05);观察组反射恢复时间和肌张力恢复时间低于对照组,差异均有统计学意义(P0.05)。结论头部亚低温联合神经节苷脂治疗可促进新生儿缺氧缺血性脑病患儿神经功能恢复,有效提高治疗效果。     

神经节苷脂联合头部亚低温治疗新生儿缺氧缺血性脑病

目的观察神经节苷脂(GM-1)联合头部亚低温治疗新生儿缺氧缺血性脑病(HIE)的临床疗效。方法新生儿缺氧缺血性脑病患儿60例,随机分为治疗组和对照组各30例,对照组给予心电监护、常规治疗和神经节苷脂应用,保持良好通气与换气功能,维持脑部及全身的血液灌注,维持血糖和水、电解质平衡,控制惊厥、降颅压等支持治疗,患儿直肠温度维持在(37±0.5)℃,神经节苷脂20mg/次,qd,2周为1疗程;治疗组在对照组治疗的基础上,加用头部亚低温治疗,使患儿鼻咽部温度维持在(34±0.2)℃,直肠温度维持在(34±0.5)℃,持续72h,然后自然复温,观察2组患儿意识、反射、肌张力恢复时间。结果治疗组意识恢复时间、反射恢复时间、肌张力恢复时间均少于对照组;治疗组总有效率(90.17%)高于对照组(59.84%),差异有统计学意义(P0.05)。2组患儿均无严重低血压、心律失常、硬肿症和肾功能衰竭。结论神经节苷脂联合头部亚低温治疗新生儿缺氧缺血性脑病疗效显著,安全性好,值得临床推广应用。     

高压氧联合神经节苷脂治疗中重度新生儿缺氧缺血性脑病

目的分析并探讨高压氧联合神经节苷脂治疗中重度新生儿缺氧缺血性脑病的临床疗效。方法足月新生儿缺氧缺血性脑病患儿110例,随机分为观察组与对照组,每组55例。2组均给予常规的支持治疗(如脱水、抗感染、纠正酸碱平衡等)。在此基础上,观察组给予高压氧联合神经节苷脂治疗。观察2组治疗临床效果及NBNA评分。结果观察组治疗有效率为96.36%,对照组治疗有效率为83.64%。观察组治疗有效率明显高于对照组,差异具有统计学意义(P0.05);观察组治疗后NBNA评分为(38.43±1.11)分,对照组治疗后NBNA评分为(36.43±1.23)分。观察组NBNA评分明显高于对照组,差异具有统计学意义(P0.05)。结论高压氧联合神经节苷脂治疗中重度新生儿缺氧缺血性脑病临床效果显著,值得推广。     

神经节苷脂联合丹参注射液在新生儿缺氧缺血性脑病中的应用

目的探讨丹参注射液联合神经节苷脂的作用机制及其在新生儿缺氧缺血性脑病(HIE)中的应用效果。方法将我院确诊的HIE患儿80例随机分为治疗组(40例)和对照组(40例)。治疗组接受常规治疗及神经节苷脂与丹参注射液联合治疗,对照组进行常规治疗与神经节苷脂治疗。经10d治疗后评定治疗效果,统计病死率及临床表现恢复时间,分析2组治疗前后NABA评分、CT值。结果治疗组总有效率、NABA评分及CT值均明显高于对照组,而治疗组病死率、原始反射、意识状态及肌张力的恢复时间均低于对照组(P0.05)。结论神经节苷脂与丹参注射液治疗HIE有效率高、不良反应少、脑神经功能恢复快。     

神经节苷脂联合纳洛酮治疗新生儿缺氧缺血性脑病的疗效分析

目的探讨神经节苷脂联合纳洛酮治疗治疗新生儿缺氧缺血性脑病的临床疗效。方法将63例新生儿缺氧缺血性脑病患儿随机分为观察组(32例)和对照组(31例),均采取常规症状治疗,对照组给予纳洛酮治疗,观察组给予神经节苷脂联合纳洛酮治疗,7d为1疗程。对2组新生儿进行神经行为评定(NBNA),并观察疗效。结果观察组出生后7d和14dNBNA评分(分别为35.22±5.33分和38.09±5.68分)均高于对照组,差异有统计学意义(P0.05);观察组治疗总有效率(31例,96.88%)明显高于对照组(25例,80.65%),差异有统计学意义(P0.05)。结论神经节苷脂联合纳洛酮治疗可以有效促进患儿神经功能恢复,提高治疗效果,具有较好的临床应用价值。     

神经节苷脂治疗新生儿缺氧缺血性脑病疗效观察

目的 观察神经节苷脂辅助治疗新生儿缺氧缺血性脑病﹙HIE﹚的疗效. 方法 80例患儿随机分为2组,每组40例,治疗组在综合治疗的同时早期加用神经节苷脂20mg/d,连用7d. 结果 40例患儿,平均病程(9±0.4)d,1例出现神经系统后遗症,1例死亡;对照组40例,平均病程(14±0.5)d,4例出现神经系统后遗症,2例死亡.结论 早期神经节苷脂辅助治疗新生儿缺氧缺血性脑病,可以缩短病程,同时可以明显降低患儿的病死率及神经系统后遗症的发生率.     

神经节甘酯治疗新生儿缺氧缺血性脑病疗效分析

目的 了解神经节甘酯在治疗新生儿缺氧缺血性脑病的疗效.方法 将60例新生儿缺氧缺血性脑病随机平均分为治疗组和对照组,治疗组患者静脉给予单唾液酸四己糖神经节苷脂钠静滴,对照组患者静脉给予常规治疗联合胞二磷胆碱,2组均同时行激素、扩血管药物、高压氧等治疗,以10 d为一疗程.结果 单唾液酸四己糖神经节苷脂钠治疗组平均有效率（87±2.1）%,常规治疗联合胞二磷胆碱治疗组平均有效率（56±1.3）%,2组差异有统计学意义（P〈0.05）.结论 单唾液酸四己糖神经节苷脂钠治疗新生儿童缺氧缺血性脑病疗效相对于常规治疗联合胞二磷胆碱疗效较好.     

神经节苷脂治疗新生儿缺氧缺血性脑病疗效观察

目的 观察神经节苷脂治疗新生儿缺氧缺血性脑病的疗效.方法 70例患儿随机分为2组,每组35例,治疗组在综合治疗的基础上加用神经节苷脂20 mg/d,连用10 d.结果 治疗组总有效率及NBNA评分均优于对照组.结论 神经节苷脂治疗新生儿缺氧缺血性脑病,能提高治愈率及减少神经系统的后遗症.     

神经节苷酯注射液治疗新生儿缺氧缺血性脑病的疗效

目的探讨单唾液酸神经节苷酯注射液(GM)治疗新生儿缺氧缺血性脑病(HIE)的疗效。方法选取我院2007-01—2011-06收治的160例HIE患儿,随机分成对照组和研究组,对照组在常规治疗基础上运用胞二磷胆碱治疗,研究组在常规治疗基础上应用GM治疗。观察2组患者临床主要表现症状、恢复所需时间、患儿神经行为评分(NBNA)等各种指标。结果治疗后与对照组相比,研究组患儿原始反射时间、意识障碍和肌张力恢复所需要时间、惊厥消除时间均减少,差异均具有统计学意义(P<0.05);研究组NBNA评分较对照组明显高,差异也有统计学意义(P<0.05)。结论单唾液酸神经节苷酯注射液治疗新生儿缺氧缺血性脑病疗效果显著,具有临床应用价值。     

丹参注射液与神经节苷脂联合治疗新生儿缺氧缺血性脑病疗效观察

目的观察丹参注射液与神经节苷脂联合治疗新生儿缺氧缺血性脑病(HIE)的疗效,并探讨其作用机制。方法将入选的78例患儿随机分为2组各39例,均采用常规治疗,观察组加用丹参注射液与神经节苷脂联合治疗,对照组加用单纯神经节苷脂治疗,评定2组疗效,治疗前后进行NABA(新生儿神经行为评分)评定,测定血液流变学相关指标,记录主要临床表现恢复时间、病死率及不良反应。结果 2组临床症状均明显改善,观察组总有效率89.74%,对照组76.92%,2组比较差异显著(Z=2.032,P0.05);观察组1例(2.56%)死亡,对照组2例(5.13%)死亡,2组比较差异无统计学意义(χ2=1.353,P0.05)。2组入院时NBNA评分无显著差异,治疗后7、30d时,均较治疗前明显升高,且观察组升高更明显,与对照组比较有显著差异(P0.05)。治疗前2组患儿血液流变学指标无显著差异,治疗后观察组相关指标有明显改善,与治疗前及对照组治疗后比较有显著差异(P0.05);观察组意识、肌张力及原始反射恢复时间明显短于对照组(P0.05)。2组患儿治疗期间均无明显不良反应。结论丹参注射液联合神经节苷酯治疗新生儿HIE可显著改善脑微循环,保护脑细胞,疗效显著,安全性高,值得临床推广应用。     

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     

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。     

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.     

《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.     

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。