偏头痛患儿的大脑血流动力学变化

目的　研究偏头痛患儿的脑动脉血流动力学改变 ,探讨其在小儿偏头痛发生中的作用。方法　应用经颅多普勒 (TCD)技术 ,检测 90例 7～ 14岁头痛间歇期的偏头痛患儿和 80例健康同龄儿童脑动脉血管血流动力学指标。结果　 90例偏头痛患儿中脑动脉血流动力学异常者 77例 (86 % ) ,其中 6 0例 (6 7% )流速增快 ,9例 (10 % )减慢 ,与对照组相比 ,差异具有显著性 (P <0 0 1) ;90例中 2 3例 (2 6 % )存在双侧同名动脉血流速度不对称 ,其中伴有血流速度异常者15例 ,血流速度正常者 8例 ,差异具有显著性 (P <0 0 1)。结论　脑动脉血流动力学因素异常改变 ,在小儿偏头痛的发生中具有重要作用。尤其值得注意的是 ,双侧同名动脉流速不对称的改变 ,在小儿偏头痛的发生中同样可能起着重要的作用。     

120例典型偏头痛发作期的经颅多普勒观察

目的：探讨典型偏头痛发作期的脑血流动力学变化。方法：应用经颅多普勒（ＴＣＤ）对１２０例典型偏头痛患发作期进行观察。结果：平均血流速度（Ｖｍ）加快７０例（５８．３％）与对照组比较有非常显差异（Ｐ〈０．０１）;Ｖｍ减慢３８例（３１．７％）,与对照组比较有显差异（Ｐ〈０．０５）;Ｖｍ正常１２例（１０％）。结论：应用ＴＣＤ对典型偏头痛的检查,有助于诊断和指导治疗,亦有助于对偏头痛发生机理的研究。     

无先兆型偏头痛患者颅外血管经颅多普勒的检测分析

目的探讨经颅多普勒（TCD）对无先兆型偏头痛患者头痛间歇期顿外血管的血液动力学变化。方法应用经颅多普勒（TCD）对96例无先兆型偏头痛患者的576根颅外血管进行TCD检测,并与29名正常人进行对照。结果在受检的576根颅外血管中,有283根血管峰血流速度异常升高,异常率为49．13％。颅外血管的异常高速血流主要表现为颈总动脉和颈外动脉,较正常人显著升高（P均＜0.01）。结论在偏头痛病人TCD检测中,不仅要考虑颅内血管的血流变化,更要注意观察顿外血管的血液动力学的改变。     

Hormone levels of follicular fluids with and without oocytes in patients who received gonadotropin-releasing hormone analogues and gonadotropins in an in vitro fertilization program

Background Are follicles where no oocytes are retrieved empty follicles?Methods The levels of estradiol (E₂), progesterone (P), testosterone (T), cortisol (F), and prolactin (PRL) of follicular fluids (FF) aspirated individually from 34 randomly selected IVF patients in whom no oocytes were recovered were compared with the respective hormone levels of FF obtained from the same patients when oocytes were retrieved. Two FF without oocytes of a 35th patient in whom no oocytes were retrieved were analyzed.Results Hormones did not differ significantly in the paired samples, while in the two FF of the 35th woman they were in agreement with cystic follicles.Conclusions It is necessary to differentiate aspirated follicles where no oocytes are retrieved from the empty follicle syndrome, which was not observed in the IVF series studied and should be rare in IVF patients.     

5-HT2 receptor antagonists and migraine therapy

5-Hydroxytryptamine (5-HT; serotonin) has been implicated in the pathophysiology of migraine, and several drugs with potent 5-HT₂ receptor blocking activity (methysergide, pizotifen, cyproheptadine and mianserin) have been recognized as being clinically effective in migraine prophylaxis, although the selective 5-HT₂ receptor antagonist ketanserin (the principal agent used to identify 5-HT₂ receptor-mediated actions) seems to be ineffective in migraine. Pizotifen is the most widely used 5-HT₂ receptor antagonist in migraine prophylaxis, because of its superior efficacy compared with cyproheptadine, and because the incidence and severity of adverse effects with pizotifen is lower compared with methysergide and mianserin. These agents have additional antagonistic effects at histamine H₁, muscarinic cholinergic, ₁-adrenergic, ₂-adrenergic and dopamine receptors, but drugs which are selective for these non-5-HT receptors appear to be of no benefit in migraine. Actions mediated by 5-HT₂ receptors which could be of relevance to migraine comprise cranial vasoconstriction, increased cranial capillary permeability and platelet aggregation, and some central nervous system effects and neuroendocrine functions. Although pizotifen, cyproheptadine and mianserin are considered to be relatively specific for 5-HT₂ receptors, these agents and methysergide all share a high affinity for 5-HT_1C binding sites; ketanserin, however, has little affinity for these sites, thus activation of 5-HT_1C receptors may be an important step in the pathogenesis of migraine. It is not yet known which 5-HT_1C receptor-mediated actions of 5-HT are relevant to migraine, but some behavioural actions and cranial vasodilatation via release of endothelium-derived relaxing factor may be involved. If 5-HT_1C rather than 5-HT₂ receptor-mediated actions are important, then other 5-HT₂ receptor antagonists with a high affinity at 5-HT_1C binding sites, such as LY 53857, metergoline, mesulergine, ritanserin and SCH 23390, may also prove to be effective in migraine. The efficacy of methysergide may also depend on other 5-HT₁-like receptor-mediated actions such as cranial vasoconstriction, and inhibition of cranial vascular neurogenic inflammation. The efficacy of these agents implies that 5-HT is causally involved in at least some of the underlying pathophysiology of migraine.     

Pharmacology of antimigraine drugs

The drugs used in migraine therapy can be divided into two groups: agents that abort an established migraine attack and agents used prophylactically to reduce the number of migraine attacks. Both groups have drugs that are specific for migrainous headaches and that are non-specific, and are used to treat the accompanying headache (analgesics), vomiting (anti-emetics), anxiety (sedatives and anxiolytics), or depression (antidepressants). The main drugs with specific action on migraine include ergot alkaloids (ergotamine, dihydroergotamine), agonists (sumatriptan) or partial agonists (methysergide) at a specific subtype of 5-HT₁-like receptors, -adrenoceptor antagonists (propranolol, metoprolol), calcium antagonists (flunarizine) and anti-inflammatory agents (indomethacin). The pharmacological basis of therapeutic action of several of these drugs is not well understood. In the case of the ergot alkaloids and 5-HT₁-like receptor agonists, however, it is likely that the antimigraine effect is related to the potent and rather selective constriction of the large arteries and arteriovenous anastomoses in the scalp and dural regions. In addition, these drugs inhibit plasma extravasation into the dura in response to trigeminal ganglion stimulation, but it is possible that this effect is related to the selective vasoconstriction in the extracerebral vascular bed. The selectivity of the pharmacological effects of these antimigraine drugs (constriction of the extracerebral arteries and arteriovenous anastomoses, poor penetration into the central nervous system and the absence of an antinociceptive effect even after intrathecal administration) strongly suggests that excessive dilatation in the extracerebral cranial vasculature, probably initiated by a neuronal event, is an integral part of the pathophysiology of migraine.     

针刺治疗偏头痛及其对自主神经系统功能的影响

目的:探索针刺治疗偏头痛的疗效及其对自主神经系统(ANS)功能的影响。方法:采用针刺C1～T4夹脊穴、太阳、头维等治疗偏头痛,心率变异频谱分析(SAHRV)测定ANS功能。结果:针刺治疗组总有效率94.3％,西药对照组76.7％,两组相比差异有显著性意义(P<0.05)。针刺治疗组治疗后与治疗前ANS功能相比差异有非常显著性意义(P<0.01)。针刺治疗组治疗后与正常人组ANS功能相比差异无显著性意义(P>0.05)。结论:针刺治疗偏头痛具有较好的疗效,并能改善偏头痛患者ANS功能。     

实验性偏头痛动物模型c-fos、c-jun基因表达

目的　复制实验性偏头痛动物模型并探讨其c -fos、c -jun基因表达。方法　采用CristinaTassorelli硝酸甘油法复制大鼠实验性偏头痛模型。免疫组化ABC法研究偏头痛大鼠脑组织即刻早期基因c -fos、c -jun的表达。结果　硝酸甘油型实验性偏头痛大鼠出现双耳发红、甩头、前肢频繁搔头 ,活动增加等外在表现 ,脑组织c -fos、c -jun基因表达阳性细胞数增加 ,基因表达阳性细胞的面积扩大、灰度降低或变化不大。结论　硝酸甘油型实验偏头痛大鼠模型复制方法简单、重复性较好、脑组织c -fos和c -jun基因异常表达明显 ,可以作为偏头痛治疗药物筛选、药效评价和发病机理研究的动物模型。     

布洛芬软胶囊治疗偏头痛的临床试验

目的 评价布洛芬软胶囊治疗偏头痛急性发作的疗效和安全性。方法 随机、双盲、安慰剂交叉对照的多中心临床试验。共入组偏头痛病例120例,实际完成病例数为111例,其中先服布洛芬后服安慰剂组55例;先服安慰剂后服布洛芬组56例。治疗前两组的一般资料、临床评价和实验室指标无显著性差异。结果 布洛芬组和安慰剂组2小时内头痛消失率分别为(48.65±4.74)%和(19.82±3.78)%(P<0.01)。布洛芬组和安慰剂组2小时内头痛缓解率分别为(79.28±3.85)%和(45.05±4.72)%(P<0.01)。结论 布洛芬治疗偏头痛安全性好,可作为治疗偏头痛急性发作的有效药物。     

A Case of Subcortical Meningioma

Subcortical meningioma, which has been reported as meningioma without dural attachment, a cerebral subcortical lesion, is extremely rare. Very few findings of radiological examination of subcortical meningioma have been described. Pre-operative differentiation of this lesion is generally difficult. We characterize the peritum oural oedema adjacent to the meningioma in this region, and we suggest that radiological findings of peritum oural oedema contribute to differential diagnosis of subcortical meningiomas.