小金丸联合加巴喷丁治疗带状疱疹后遗神经痛疗效观察

目的探讨小金丸联合加巴喷丁治疗带状疱疹后遗神经痛的临床疗效。方法 2015-07-2016-01我院诊治的带状疱疹后遗神经痛患者中抽取91例为研究对象,并随机抽签方法进行分组,治疗组(n=46)采取小金丸联合加巴喷丁治疗,对照组(n=45)单纯使用加巴喷丁治疗,对比2组临床疗效、治疗前后神经疼痛程度变化及不良反应发生率。结果 (1)治疗组有效率95.87%,治疗后1周、治疗后1个月的VAS疼痛评分分别为(1.2±0.5)分和0分;对照组有效率68.9%,治疗后1周、治疗后1个月的VAS疼痛评分分别为(4.7±1.2)分和(1.9±0.8)分;2组指标组间对比差异均有统计学意义(P0.05或P0.01);(2)治疗组、对照组不良反应发生率分别是8.7%与8.9%,差异无统计学意义(P0.05)。结论小金丸联合加巴喷丁治疗带状疱疹后遗神经痛的临床疗效显著,可逐步解除患者神经疼痛症状,且未发生严重不良反应,安全可靠,值得借鉴。     

加巴喷丁联合甘草酸苷治疗带状疱疹后遗神经痛疗效观察

目的探讨加巴喷丁联合甘草酸苷治疗带状疱疹后遗神经痛的临床疗效。方法将68例带状疱疹后遗神经痛患者分为单药组与联合组,单药组给予单纯加巴喷丁治疗,联合组给予加巴喷丁联合甘草酸苷治疗。对比2组不同时刻疼痛评分、睡眠时间,评估综合疗效及不良反应。结果疼痛评分及睡眠时间在时间、组间及交互作用方面比较差异均有统计学意义(P0.05),且组内疼痛评分均呈显著降低趋势,睡眠时间均呈显著延长趋势,每2个时刻比较差异均有统计学意义(P0.05),不同时刻联合组疼痛评分均显著低于单药组,睡眠时间均显著长于单药组,差异均有统计学意义(P0.05)。联合组与单药组综合疗效等级比较存在显著差异(P0.05),且联合组综合有效率远高于单药组(P0.05)。2组均无不良反应。结论加巴喷丁联合甘草酸苷治疗带状疱疹后遗神经痛能够显著减轻疼痛评分、延长睡眠时间,改善综合疗效。     

左乙拉西坦添加治疗儿童难治性部分性癫痫疗效的Meta分析

目的系统评价左乙拉西坦添加治疗儿童难治性部分性癫痫的疗效和耐受性。方法计算机检索1998年1月-2017年1月Cochrane图书馆、PubMed、EMbase、中国知网中国期刊全文数据库和万方及中国生物医学文献数据库,并手工检索相关杂志,RevMan 5.3统计软件进行Meta分析。结果根据Cochrane 5.0.2版随机对照临床试验质量评价标准,纳入4项随机对照临床试验共498例受试者(左乙拉西坦组268例、安慰剂对照组230例)。Meta分析结果显示,左乙拉西坦组部分性癫痫发作频率减少≥50%的病例数高于对照组[OR=2.940,95%CI(1.99,4.34),P0.000 01];完全不发作病例明显高于对照组[OR=5.310,95%CI(2.49,11.32),P0.000 01]。左乙拉西坦组失访率与安慰剂对照组之间差异无统计学意义[OR=0.760,95%CI(0.32,1.82),P=0.54]。药物不良反应中嗜睡[OR=2.57,95%CI(1.36,4.86)]及精神行为改变[OR=2.54,95%CI(1.56,4.14)]与左乙拉西坦组显著相关(P0.05),其他不良反应与左乙拉西坦组无显著相关。结论现有Meta分析显示,左乙拉西坦添加治疗难治性部分性癫痫的疗效与安慰剂组相比效果显著。左乙拉西坦添加治疗儿童难治性癫痫部分性发作有确切的疗效,且长期治疗效果稳定,有良好的安全性,保留率较高,可在临床进一步推广使用。     

加巴喷丁治疗带状疱疹后神经痛的疗效和药理解析

目的分析加巴喷丁治疗带状疱疹后神经痛的临床疗效和药理作用。方法以2015-06—2016-07我院收治的带状疱疹后神经痛的患者82例为研究对象,随机分为实验组和对照组,实验组应用加巴喷丁治疗,对照组应用安慰剂,对比2组临床疗效。结果实验组总有效率(97.6%)高于对照组(78.0%),差异有统计学意义(P0.01);治疗后,实验组VAS评分低于对照组(P0.01);2组不良反应发生率无显著差异(P0.05)。结论在带状疱疹后神经痛的治疗中应用加巴喷丁,可明显缓解患者的疼痛,提高治疗效果,且不会增加不良反应。     

左乙拉西坦添加治疗难治性部分性发作癫痫疗效的Meta分析

目的系统评价左乙拉西坦添加治疗难治性部分性发作癫癎的疗效和药物安全性。方法计算机检索1998年1月-2010年12月Cochrane图书馆、MEDLINE、EMbase、社会科学引文索引、维普中文科技期刊、中国知网中国期刊全文数据库和中国生物医学文献数据库,并手工检索相关杂志,由两名研究者独立进行质量评价及数据分析,RevMan 5.0统计软件进行Meta分析。结果根据Cochrane5.0.2版随机对照临床试验质量评价标准,纳入11项随机对照临床试验共1981例受试者(左乙拉西坦组1192例、安慰剂对照组789例)。Meta分析结果显示,左乙拉西坦组每周部分性癫癎发作频率减少≥50%的病例数高于对照组(1000 mg/d:OR=2.990,P=0.000;2000 mg/d:OR=3.870,P=0.000;3000 mg/d:OR=3.440,P=0.000);每周发作频率减少≥75%的病例明显高于对照组(1000 mg/d:OR=3.130,P=0.000;2000 mg/d:OR=5.060,P=0.000;3000 mg/d:OR=4.730,P=0.000);完全不发作病例明显高于对照组(1000 mg/d:OR=5.080,P=0.001;2000 mg/d:OR=4.420,P=0.050;3000 mg/d:OR=4.150,P=0.000)。左乙拉西坦组失访率与安慰剂对照组之间差异无统计学意义(P>0.05)。治疗期间常见药物不良反应包括嗜睡、头晕、乏力、鼻咽炎、精神行为异常等,两组精神行为不良反应方面存在异质性(P=0.360,I~2=8.000%)。结论现有证据显示,左乙拉西坦添加治疗难治性部分性发作癫癎的疗效与安慰剂组相比效果显著,保留率高;药物安全性应注意其所引起的精神行为异常。     

拉莫三嗪添加治疗癫(痫)合并抑郁障碍的Meta分析

目的 对拉莫三嗪添加治疗癫(痫)合并抑郁障碍的疗效进行系统评价.方法 以拉莫三嗪(lamotrigine)、癫(痫)(epilepsy)、抑郁(depressive)等中英文词汇,计算机检索1998年1月-2014年6月美国国立医学图书馆生物医学信息检索系统、Cochrane临床对照试验中心注册库、中国知网中国知识基础设施工程、万方数据库等关于拉莫三嗪添加治疗癫(痫)合并抑郁障碍的临床研究,分别以Cochrane系统评价手册5.0.2随机对照试验质量评价标准和RevMan 5.1.1统计软件行文献质量评价和Meta分析.结果 经剔除重复和不符合纳入标准文献,48篇文献中最终仅纳入3项临床试验共668例癫(痫)合并抑郁障碍患者.Meta分析显示:拉莫三嗪组患者Beck抑郁量表第2版(MD =-8.400,95％CI:-10.890 ～-5.920;P=0.000)、康奈尔精神抑郁量表(MD=-8.240,95％CI:-11.180～-5.290;P=0.000)以及简明心境量表(MD=-24.210,95％CI:-30.740 ～-17.680;P=0.000)评分改善程度均优于对照组;POMS量表6项分量表评分中拉莫三嗪组患者紧张-焦虑(MD=-3.360,95％CI:-4.620 ～-2.100;P=0.000)、抑郁-沮丧(MD=-5.490,95 ％CI:-7.420 ～-3.560;P=0.000)、愤怒-敌意(MD=-3.870,95％CI:-5.510-2.230;P=0.000)、疲乏-迟钝(MD =-4.480,95％CI:-5.630～-3.320;P=0.000)、迷惑-混乱(MD =-2.720,95％CI:-3.730～-1.720;P=0.000)评分均低于对照组,而精力-活力评分高于对照组(MD=3.970,95％CI:2.870 ～ 5.070;P=0.000).结论 拉莫三嗪添加治疗癫(痫)合并抑郁障碍疗效良好,主要不良反应为皮疹、中枢神经系统兴奋等.     

丘脑底核脑深部电刺激术联合药物治疗帕金森病有效性和安全性的Meta分析

目的评价丘脑底核脑深部电刺激术联合药物治疗帕金森病的有效性和安全性。方法以subthalamic nucleus、deep brain stimulation、DBS、STN、Parkinson disease、random等英文检索词,计算机检索1980年1月1日-2016年10月1日美国国立医学图书馆生物医学信息检索系统、荷兰医学文摘、Cochrane图书馆等数据库收录的关于丘脑底核脑深部电刺激术联合药物治疗帕金森病的随机对照临床试验,采用Jadad量表、Cochrane系统评价手册和Rev Man 5.2统计软件进行文献质量评价和Meta分析。结果共获得3245篇文献,经剔除重复和不符合纳入标准者,最终纳入6项高质量(Jadad评分≥4分)临床试验共958例帕金森病患者。Meta分析显示:与单纯药物治疗相比,丘脑底核脑深部电刺激术联合药物治疗可以显著降低帕金森病患者服药(SMD=-0.570,95%CI:-0.710~-0.430;P=0.000)和未服药(SMD=-1.170,95%CI:-1.500~-0.850;P=0.000)状态下统一帕金森病评价量表第三部分(UPDRSⅢ)评分,以及UPDRSⅠ评分(SMD=-0.150,95%CI:-0.290~-0.010;P=0.030)和39项帕金森病调查表评分(SMD=-0.510,95%CI:-0.660~-0.370;P=0.000);但增加严重不良事件(RD=0.140,95%CI:0.090~0.190;P=0.000)和构音障碍不良事件(RD=0.070,95%CI:0.010~0.120;P=0.020)发生率,而减少运动障碍不良事件发生率(RR=0.450,95%CI:0.330~0.620;P=0.000)。结论丘脑底核脑深部电刺激术联合药物治疗能够显著改善帕金森病患者运动功能、精神状态和生活质量,但术后发生严重不良事件和构音障碍不良事件的风险增加,应引起临床医师的重视。     

早期氦氖激光并红外线干预治疗对带状疱疹患者后遗神经痛的影响

目的 探讨早期氦氖激光并红外线干预治疗对带状疱疹患者后遗神经痛的效果.方法 66例带状疱疹伴严重神经痛患者分为治疗组和对照组,每组33例.治疗组在常规治疗的基础上早期加用氦氖激光并红外线治疗,对照组则待皮疹消退后才进行氦氖激光并红外线治疗,对两组的疗效进行比较. 结果 以视觉模拟评分法(VAS)评价治疗效果,治疗组的疗效优于对照组,两组比较差异有统计学意义(U=193.520,P=0.000).治疗组优良率为90.9%.有效率为100.0%,无后遗神经痛发生;对照组优良率为63.6%,有效率为81.8%,后遗神经痛发生3例,发生率为9.1%.结论 早期配合氦氖激光并红外线治疗带状疱疹,能较快地控制病情及缩短疗程,减少后遗神经痛发生.     

神经阻滞联合加巴喷丁治疗带状疱疹后神经痛的观察

目的探讨神经阻滞联合加巴喷丁治疗带状疱疹后神经痛的效果。方法选择2010年1月至2015年6月期间,本院收治的带状疱疹后遗神经痛患者68例,随机分为对照组和观察组。对照组34例,给予加巴喷丁、甲钴胺、维生素B_1口服;观察组34例,给予神经阻滞联合加巴喷丁、甲钴胺、维生素B_1,观察比较两组患者治疗前和治疗后1w、4w和6w的疼痛视觉模拟评分,临床治疗有效率及不良反应发生情况。结果观察组患者治疗后1w、4w和6w的疼痛视觉模拟评分较对照组明显降低,临床治疗总有效率以及不良反应发生率均明显优于对照组(P0.05)。结论应用神经阻滞联合加巴喷丁治疗带状疱疹后神经痛,疗效显著。恶心呕吐、头晕、困倦、视物模糊、皮肤瘙痒、尿潴留、肝肾功能异常、心率增快等不良反应发生率与对照组比较明显降低。     

加巴喷丁治疗带状疱疹后神经痛临床观察

目的 观察加巴喷丁对带状疱疹后神经痛的临床疗效.方法 30例带状疱疹后神经痛患者分为2组, 治疗组15例应用加巴喷丁(GBP)治疗,对照组15例应用卡马西平(CBZ)治疗,于治疗1、2、4周进行视觉模拟评分(visual analogue scale, VAS).结果 加巴喷丁组在治疗后VAS明显低于卡马西平组( P<0.0 5 ).结论 加巴喷丁对带状疱疹后神经痛疗效优于卡马西平.     

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。