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1.
目的对依洛尤单抗联合依折麦布治疗难治性血脂升高并冠心病进行研究,明确治疗的有效性与可行性。方法选取河南神火集团总医院2019年1月至2021年4月90例难治性血脂升高并冠心病患者,以随机数字表分为研究组(n=45,依洛尤单抗联合依折麦布组)与对照组(n=45,依折麦布组),对比两组治疗前、后血脂指标、心功能变化及远期心脏不良事件(MACE)的发生情况。结果治疗前,研究组、对照组总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、天冬氨酸氨基转移酶(AST)及谷氨酸氨基转移酶(ALT)水平比较,差异无统计学意义(t=0.800、0.600、0.231、0.042、0.080,P>0.05),治疗后,研究组TC、LDL-C显著低于对照组,HDL-C、AST及ALT显著高于对照组(t=7.141、14.906、8.239、2.216、2.084,P<0.05);治疗前,研究组、对照组左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)比较,差异无统计学意义(t=0.071、0.540、0.051,P>0.05),治疗后,研究组LVEDD、LVESD显著低于对照组,LVEF显著高于对照组(t=2.792、15.161、5.611,P<0.05);随访1年内,研究组心脏不良事件(MACE)发生率8.89%明显低于对照组33.33%,两组比较差异有统计学意义(χ2=8.072,P=0.004)。结论依洛尤单抗联合依折麦布治疗难治性血脂升高并冠心病,能够发挥良好的降脂效果,改善患者心功能并有效降低MACE发生率。  相似文献   
2.
While the adductor musculature of the primate jaw has been extensively analyzed within the context of dietary and social ecology, little is known about the corresponding muscles of jaw abduction. Nonetheless, these muscles significantly contribute to a species' maximum gape potential, and thus might constrain dietary niche diversity and impact social display behaviors. In this study, we quantify the architectural properties of the digastric (a jaw abductor) and lateral pterygoid (a jaw abductor and anterior translator) across a broad sample of male and female anthropoid primates. We test the hypothesis that the abductor musculature reflects specialization to dietary and behavioral ecology. Our sample comprises 14 catarrhine and 13 platyrrhine species spanning a wide range of dietary and social categories. All specimens were sharp dissected and muscles subsequently chemically digested using a standardized protocol. Our findings demonstrate that relative fascicle lengths within the lateral pterygoid (but not the digastric) are significantly greater within species that habitually consume larger food items. Meanwhile, canine length is more strongly associated with fascicle lengths in the digastric than in the lateral pterygoid, particularly within males. Neither dietary mechanical resistance nor the intensity of social competition relates to the size or architectural properties of the jaw abductors. These findings suggest that dietary—and to a lesser extent, socioecological—aspects of a primate's life history may be reflected in the architecture of these muscles, albeit to varying degrees. This underlines the importance of considering the complete masticatory apparatus when interpreting the evolution of the primate jaw.  相似文献   
3.
郭双辉  张玉梅 《中国全科医学》2022,25(12):1524-1528
认知功能障碍在肌萎缩侧索硬化(ALS)患者中是普遍存在的,ALS伴认知功能障碍常提示预后不良。近年来对ALS患者认知功能障碍的研究取得了一定的进展,本文对ALS伴认知功能障碍的临床特点、生物标志物、遗传学特征和最新治疗进展进行综述,以期为ALS伴认知功能障碍的临床诊疗提供新思路。  相似文献   
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5.
This commentary focuses on the emerging intersection between BMP/TGF-β signaling roles in nervous system function and the amyotrophic lateral sclerosis (ALS) disease state. Future research is critical to elucidate the molecular underpinnings of this intersection of the cellular processes disrupted in ALS and those influenced by BMP/TGF-β signaling, including synapse structure, neurotransmission, plasticity, and neuroinflammation. Such knowledge promises to inform us of ideal entry points for the targeted modulation of dysfunctional cellular processes in an effort to abrogate ALS pathologies. It is likely that different interventions are required, either at discrete points in disease progression, or across multiple dysfunctional processes which together lead to motor neuron degeneration and death. We discuss the challenging, but intriguing idea that modulation of the pleiotropic nature of BMP/TGF-β signaling could be advantageous, as a way to simultaneously treat defects in more than one cell process across different forms of ALS.  相似文献   
6.
《Clinical neurophysiology》2021,132(9):2003-2011
ObjectiveA large N20 and P25 of the median nerve somatosensory evoked potential (SEP) predicts short survival in amyotrophic lateral sclerosis (ALS). We investigated whether high frequency oscillations (HFOs) over N20 are enlarged and associated with survival in ALS.MethodsA total of 145 patients with ALS and 57 healthy subjects were studied. We recorded the median nerve SEP and measured the onset-to-peak amplitude of N20 (N20o-p), and peak-to-peak amplitude between N20 and P25 (N20p-P25p). We obtained early and late HFO potentials by filtering SEP between 500 and 1 kHz, and measured the peak-to-peak amplitude. We followed up patients until endpoints (death or tracheostomy) and analyzed the relationship between SEP or HFO amplitudes and survival using a Cox analysis.ResultsPatients showed larger N20o-p, N20p-P25p, and early and late HFO amplitudes than the control values. N20p-P25p was associated with survival periods (p = 0.0004), while early and late HFO amplitudes showed no significant association with survival (p = 0.4307, and p = 0.6858, respectively).ConclusionsThe HFO amplitude in ALS is increased, but does not predict survival.SignificanceThe enlarged HFOs in ALS might be a compensatory phenomenon to the hyperexcitability of the sensory cortex pyramidal neurons.  相似文献   
7.
8.
ObjectiveIn this study, we aimed to select the best diaphragm ultrasonography (DUS) parameter as an alternative index for the diagnosis of lung function impairment in amyotrophic lateral sclerosis (ALS).MethodsTwenty-nine patients with ALS and 15 healthy subjects were enrolled in the study. DUS, lung function tests, phrenic nerve conduction study and arterial blood gas analysis were performed.ResultsPatients with respiratory dysfunction had a significantly lower level of ΔTmax than those without (P = 0.039). Significant correlations (P < 0.05) were found between forced vital capacity (FVC) and Tdi-ins (r = 0.665, P < 0.0001) and ΔTmax (r = ?0.748, P < 0.0001) and Δins-exp (r = 0.627, P < 0.0001) and ΔTdi (r = 0.485, P < 0.0001). Receiver Operating Curves analysis demonstrated that ΔTmax (AUC = 0.76, P = 0.044) had a better overall accuracy for detection of respiratory dysfunction compared with Tdi-ins (AUC = 0.27, P = 0.067), Δins-exp (AUC = 0.312, P = 0.139), and ΔTdi (AUC = 0.38, P = 0.359).ConclusionΔTmax is the most valuable DUS index in the diagnosis of diaphragmatic dysfunction.SignificanceDUS can provide functional and structural information of diaphragm and help to diagnose diaphragmatic dysfunction in ALS.  相似文献   
9.
目的在口服利鲁唑片基础上,观察雷火灸对肌萎缩侧索硬化(ALS)患者呼吸功能的影响。方法将60例患者随机分为对照组和观察组,每组30例。对照组予口服利鲁唑片,观察组在对照组治疗基础上加用雷火灸。治疗前后,评定ALS功能评定量表修订版(ALSFRS-R)、ALS评估问卷(ALSAQ-40),测定用力肺活量(FVC)、第1秒用力呼气量(FEV1)的肺通气功能指标及最大吸气压(MIP)、最大呼气压(MEP)的呼吸肌力指标,测定血清脂联素(APN)、补体因子D(CFD)水平。结果治疗后,对照组ALSFRS-R、ALSAQ-40与治疗前比较差异无统计学意义(P>0.05),观察组ALSFRS-R、ALSAQ-40较治疗前均明显升高(P<0.05),且均明显高于对照组(P<0.05);对照组FVC占预计值百分比、FEV1占预计值百分比均较治疗前明显降低(P<0.05),观察组FVC占预计值百分比、FEV1占预计值百分比与治疗前比较差异无统计学意义(P>0.05),且高于对照组(P<0.05);对照组MIP占预计值百分比、MEP占预计值百分比均较治疗前降低(P<0.05),观察组MIP占预计值百分比、MEP占预计值百分比与治疗前比较差异均无统计学意义(P>0.05),且高于对照组(P<0.05);观察组血清APN水平明显升高(P<0.05),血清CFD水平降低(P<0.05),且与对照组比较差异均有统计学意义(P<0.05)。结论在口服利鲁唑片基础上加用雷火灸可改善ALS患者的神经功能及生活质量,延缓肺通气功能及呼吸肌力的减退,这可能与其调节患者血清APN、CFD水平相关。  相似文献   
10.
Posterior stabilization is a common surgical procedure, which aims for rigid stabilization by facet fusion. Facet non-union has a potential risk of the screw loosening and malalignment. Although some authors have reported the influencing factors about screw loosening in the lumbar spine, there are few reports about the risk factor contributing to the facet non-union in the cervical spine. In all, 22 patients (78 facets and 122 screws) with degenerative cervical kyphosis or spondylolisthesis who underwent decompression and lateral mass screw (LMS) fixation were analyzed. Age, gender, smoking, bone mineral density (BMD), the degree of facet decortication with bone packing, and screw loosening were investigated as risk factors contributing to the facet non-union at each segmental fused level. Facet fusion rate was 85.9% (67/78 facets) and the incidence of loosening was 4.9% (6/122 screws, 4 patients). Insufficient facet decortication with bone packing is a significant risk factor of facet non-union (p <0.05, odds ratio: 26.5). All six loosened screws were associated with bony non-union of the facet and were located in the uppermost or lowermost vertebrae. Comparing loosened screws and stable screws, the average maximal insertional screw torque (MIT) was 9.8 cNm and 39.5 cNm, respectively (p <0.05). Additionally, the length of the stable screws was significantly longer versus the loosened screws (p <0.05). Lower MIT and shorter screw length located near the ends of the lateral mass may predict loosening, which can lead to facet non-union. Sufficient facet decortication with bone packing is one of the important factors contributing to the facet fusion.  相似文献   
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