神经节苷脂联合苯巴比妥治疗新生儿脑病的研究

目的探讨神经节苷脂联合苯巴比妥治疗新生儿缺氧缺血性脑病的临床疗效及对新生儿神经功能的影响。方法选取2017年3月-2019年3月本院收治的缺氧缺血性脑病新生儿106例,随机分为两组,对照组应用苯巴比妥治疗,研究组应用神经节苷脂联合苯巴比妥治疗。比较临床治疗有效率、神经功能恢复效果、治疗前后NBNA评分统计。结果研究组临床治疗有效率、不同程度的时间恢复效果、治疗后NBNA评分均高于对照组(P<0.05)。结论治疗新生儿缺氧缺血性脑病治疗过程当中,神经节苷脂联合苯巴比妥的治疗效果理想,可改善新生儿神经功能。     

脑血管畸形致脑出血患者手术治疗效果观察

目的分析脑血管畸形致脑出血患者应用手术治疗的临床疗效。方法纳入本院2018年1月—2020年1月收治的60例脑血管畸形致脑出血患者,随机分组(每组样本容量共计30例),参照组给予保守治疗,观察组给予手术治疗,对比两组临床疗效、治疗前、治疗1月后NIHSS评分、住院时间。结果临床总有效率观察组(93.33%)明显高于参照组(63.33%),观察组治疗1月后NIHSS评分明显低于参照组,观察组住院时间明显比参照组短,差异均具有统计学意义(P<0.05)。结论脑血管畸形致脑出血患者采纳手术治疗,可有效减轻患者神经功能受损情况,缩短治疗时间。     

MR fingerprinting ASL: Sequence characterization and comparison with dynamic susceptibility contrast (DSC) MRI

MR Fingerprinting (MRF)‐based Arterial‐Spin‐Labeling (ASL) has the potential to measure multiple parameters such as cerebral blood flow (CBF), bolus arrival time (BAT), and tissue T₁ in a single scan. However, the previous reports have only demonstrated a proof‐of‐principle of the technique but have not examined the performance of the sequence in the context of key imaging parameters. Furthermore, there has not been a study to directly compare the technique to clinically used perfusion method of dynamic‐susceptibility‐contrast (DSC) MRI. The present report consists of two studies. In the first study (N = 8), we examined the dependence of MRF‐ASL sequence on TR time pattern. Ten different TR patterns with a range of temporal characteristics were examined by both simulations and experiments. The results revealed that there was a significance dependence of the sequence performance on TR pattern (p < 0.001), although there was not a single pattern that provided dramatically improvements. Among the TR patterns tested, a sinusoidal pattern with a period of 125 TRs provided an overall best estimation in terms of spatial consistency. These experimental observations were consistent with those of numerical simulations. In the second study (N = 8), we compared MRF‐ASL results with those of DSC MRI. It was found that MRF‐ASL and DSC MRI provided highly comparable maps of cerebral blood flow (CBF) and bolus‐arrival‐time (BAT), with spatial correlation coefficients of 0.79 and 0.91, respectively. However, in terms of quantitative values, BAT obtained with MRF‐ASL was considerably lower than that from DSC (p < 0.001), presumably because of the differences in tracer characteristics in terms of diffusible versus intravascular tracers. Test–retest assessment of MRF‐ASL MRI revealed that the spatial correlations of parametric maps were 0.997, 0.962, 0.746 and 0.863 for B₁⁺, T₁, CBF, and BAT, respectively. MRF‐ASL is a promising technique for assessing multiple perfusion parameters simultaneously without contrast agent.     

腔隙性脑梗死患者血清Chemerin Vaspin和Apelin水平的变化及意义

目的探讨腔隙性脑梗死患者血清趋化素(Chemerin)、丝氨酸蛋白酶抑制剂(Vaspin)及脂肪素(Apelin)水平及意义。方法选取2018-01—2019-03在河南科技大学第一附属医院治疗的腔隙性脑梗死患者120例(观察组),其中轻度32例,中度61例,重度27例,同时选取健康志愿者100例为对照组,检测2组血清Chemerin、Vaspin和Apelin,观察组给予常规治疗。结果观察组血清Chemerin和Apelin分别为(60.03±10.02)mg/L和(180.02±41.12)μg/L,明显高于对照组(P<0.05),而Vaspin为(6.72±1.01)μg/L,明显低于对照组(P<0.05);观察组重度患者血清Chemerin和Apelin分别为(72.44±13.30)mg/L和(209.34±50.28)μg/L,明显高于轻度和中度患者(P<0.05),而Vaspin为(4.23±0.92)μg/L,明显低于轻度和中度患者(P<0.05);中度患者血清Chemerin和Apelin分别为(62.22±12.28)mg/L和(180.02±41.18)μg/L,明显高于轻度患者(P<0.05),而Vaspin为(6.72±1.09)μg/L,明显低于轻度患者(P<0.05);Chemerin和Apelin与DNS评分呈正相关(r=0.332、0.319,P<0.05),而Vaspin与DNS评分呈负相关(r=-0.422,P<0.05);观察组治疗后血清Chemerin和Apelin较治疗前降低(P<0.05),而Vaspin较治疗前升高(P<0.05)。结论腔隙性脑梗死患者血清Chemerin和Apelin明显升高,而Vaspin明显降低,与神经功能缺损程度有一定关系。     

脑瘫患儿发生癫痫持续状态的急救护理体会

目的对脑瘫患儿发生癫痫持续状态的急救护理方法和效果进行探讨。方法选择2018年4月—2018年9月在医院收治的50例脑瘫发生癫痫持续状态的患儿作为对照组,对其实施常规急救护理,同时选择2018年10月—2019年3月在医院收治的50例脑瘫发生癫痫持续状态的患儿作为观察组,对其实施强化急救护理,对比两组护理满意度、生命体征评分、护理有效率。结果观察组的总体满意率、护理有效率、生命体征评分均优于对照组,两组差异明显,有统计学意义,P<0.05。结论对脑瘫发生癫痫持续状态的患儿实施强化急救护理能够提升治护效果,提高患儿家长满意度,更好的改善患儿生命体征。     

Ischémie reperfusion en transplantation rénale

Ischemia-reperfusion injury is an inescapable phenomenon in kidney transplantation. It combines lesional processes of biochemical origin associated with oxydative stress and of immunological origin in connection with the recruitment and activation of innate immunity cells. Histological lesions associate acute tubular necrosis and interstitial œdema, which can progress to interstitial fibrosis. The extent of these lesions depends on donor characteristics (age, expanded criteria donor, etc.) and cold ischemia time. In the short term, ischemia-reperfusion results in delayed recovery of graft function. Cold ischemia time also impacts long-term graft survival. Preclinical models, such as murine and porcine models, have furthered understanding of the pathophysiological mechanisms of ischemia-reperfusion injury. Due to its renal anatomical proximity to humans, the porcine model is relevant to assessment of the molecules administered to a donor or recipient, and also of additives to preservation solutions. Different donor resuscitation and graft perfusion strategies can be studied. In humans, prevention of ischemia-reperfusion injury is a research subject as concerns donor conditioning, additive molecules in preservation solutions, graft reperfusion modalities and choice of the molecules administered to the recipient. Pending significant advances in research, the goal is to achieve the shortest possible cold ischemia time.     

益智活血汤联合拜阿司匹林治疗脑梗死恢复期患者的临床疗效及对神经功能的影响

目的:探讨益智活血汤联合拜阿司匹林治疗脑梗死恢复期的临床疗效及对患者神经功能的影响。方法:选取2017年10月至2019年1月在本院治疗的脑梗死恢复期患者84例,随机分为对照组和观察组各42例。对照组采用拜阿司匹林肠溶片治疗,每次0.2 g,日1次,口服。观察组在对照组治疗的基础上采用益智活血汤治疗,日1剂,早晚温服,两组均治疗8周。结果:对照组有效率为80.95%,观察组有效率为95.24%,两组有效率比较,差异有统计学意义(P<0.05)。两组患者治疗后半身不遂评分、舌謇不语评分、口舌歪斜评分、肢体麻木评分、气短懒言评分均显著低于本组治疗前,差异有统计学意义(P<0.05),组间比较,差异有统计学意义(P<0.05)。两组患者治疗后NIHSS评分、MRS评分均显著低于本组治疗前,BI评分显著高于本组治疗前,差异均有统计学意义(P<0.05),组间比较,差异有统计学意义(P<0.05)。两组患者治疗后全血高切黏度(high bloodshear viscosity,HWBV)、全血低切黏度(low bloodshear viscosity,LWBV)、血浆黏度(plasma viscosity,PV)、血小板聚集率(platelet agglutination test,PAG)水平均显著低于本组治疗前,差异有统计学意义(P<0.05),组间比较,差异有统计学意义(P<0.05)。两组患者治疗后中动脉(middle cerebral artery,MCA)、前动脉(anterior artery,ACA)、后动脉(posterior communicating artery,PCA)血流速度均显著高于本组治疗前,差异有统计学意义(P<0.05),组间比较,差异有统计学意义(P<0.05)。结论:益智活血汤联合拜阿司匹林治疗脑梗死恢复期患者,可明显改善其神经功能、血液循环及日常生活能力。