平山病的临床神经电生理学特点

目的:探讨平山病的临床神经电生理学特点及其可能的发病机制。方法:对45例平山病患者进行神经传导速度、F波以及针极肌电图检测。结果:神经传导速度测定总异常率为24.4%(44/180),主要表现为运动神经DML延长以及CMAP波幅减低,感觉神经传导速度均正常。F波平均最小潜伏期为(26.64±3.10)ms,平均出现率为(58.77±35.53)%,总异常率为75.6%(34/45)。针极肌电图检测中57.7%表现为神经源性损害,主要异常为出现自发电位,MUPs时限延长、波幅增宽、多相波增多,募集相异常。前臂肌肉的异常率为患侧伸指总肌(100%)≥健侧伸指总肌(100%)>患侧拇短展肌(97.8%)>患侧小指展肌(97.7%)>健侧拇短展肌(82.6%)>患侧肱二头肌(75.0%)。双侧三角肌、健侧肱二头肌、下肢胫骨前肌、胸锁乳突肌肌电图正常。结论:根据平山病临床神经电生理学表现推测平山病可能为颈段脊髓病变。     

柴芍六君子汤配合耳穴压豆预防微创保胆取石后结石复发

目的:观察中药柴芍六君子汤配合耳穴压豆预防微创保胆内镜取石术后患者胆囊结石复发的疗效。方法:80例行微创保胆取石术后患者随机分成观察组和对照组各40例,两组术后均给予饮食和生活习惯改变的指导,观察组加用中药柴芍六君子汤配合耳穴压豆,对照组加用牛磺熊去氧胆酸(TUDCA,商品名:滔罗特)。结果:观察组患者治疗前后胆囊壁厚度、胆囊收缩功能相比均有显著性差异(P<0.05);对照组患者治疗前后胆囊壁厚度、胆囊收缩功能相比均有显著性差异(P<0.05);两组患者治疗后胆囊壁厚度比较及胆囊收缩功能组间比较,无明显差异(P>0.05)。两组患者均有1例胆囊结石复发,复发率2.5%。结论:中药柴芍六君子汤配合耳穴压豆有利于减轻胆囊壁的炎症,增强胆囊的收缩功能,有助于防止胆囊结石的复发。     

脂肪干细胞移植修复周围神经损伤的研究进展

<正>周围神经损伤后,受该神经支配区的运动、感觉和营养均将发生障碍。临床上表现为肌肉瘫痪,皮肤萎缩,感觉减退或消失。目前周围神经损伤的修复仍是临床一大难题。近年来许多学者开始探索用胚胎干细胞、骨髓间充质干细胞等移植修复周围神经损伤[1],但都存在伦理学或取材难等问题。近年来很多科学家开始对脂肪组织来源的干细胞(adipose-derived stem cells,ADSCs)进行研究。ADSCs的分离方法由Zuk等[2]于2001年首次提     

针刺配合中药治疗中风后偏身汗出1例

脑血管病为中、老年人的常见病、多发病,也是导致人类死亡的三大主要疾病之一,临床多表现为肢体运动及感觉功能障碍,及不同程度的认知功能障碍等症状。而部分患者同时伴有不同程度的汗液排泄异常,或全身,或偏身,或局部的多汗、无汗。西医除治疗脑血管病外无相应的有效治疗方法     

上海市宝山区电焊工人极低频磁场暴露与心理状态现况调查

[目的]评估上海市宝山区电焊工人极低频磁场暴露水平和焦虑、抑郁状况。[方法]选取宝山区4家企业81名电焊工人,采用个体测量仪EMDEX—LITE收集8h极低频磁场暴露数据,调查个人基本信息及当天活动情况,同时发放焦虑自评量表（SAS）和抑郁自评量表（SDS）进行调查。[结果]研究对象为男性67人、女性14人,年龄19～53岁;工人8h累积暴露量中位数为15．49μT／h,四分位数间距（IQR）为23．01μT／h;35．8％的被调查工人瞬时暴露中位数高于界点（0．4μT）;工人极低频磁场平均累积暴露水平明显高于对照人群（高校学生）;所有工人（100％）暴露峰值均出现于电焊作业时;与国内常模相比,工人SDS总标准分无明显差异,SAS总标准分明显增高,但未达到轻度焦虑（抑郁）症的标准;相关分析显示SDS总分与工龄呈正相关（r=0．256,P〈0．05）。[结论]电焊作业与极低频磁场的暴露强度密切相关,尚不能认为极低频磁场暴露可增加工人焦虑或抑郁症的发生。     

脂肪干细胞侧脑室定向移植改善脑出血大鼠的神经功能

Objective To study improvement of neural function by stereotaxic transplantation of adipose-derived stem cells (ADSC) into lateral cerebral ventricle after intracerebral hemorrhage in rats and its mechanism. Methods ADSC were cultured and proliferated in vitro, which had been marked with Brdu for 48 h before transplantation. The rat caudate nucleus hemorrhage (ICH) models were divided into 2 groups. ADSC were stereotaxically transplanted into the right lateral ventricles in ADSC group, and equal volume of saline was transplanted into control group. The score of neurological behavior were evaluated at modeling and 1, 3, 7, 14, 28 days after transplantation respectively.Double-staining immunofluorescence technique was used to detect Brdu-positive cells and the differentiation of neurons and astrocytes. In accordance with the instructions of TUNEL kit, cell apoptosis, and the expression of VEGF and angiogenesis were assayed. Results In vitro ADSC expressed undergo osteogenic and adipogenic differentiation. Compared with the control group, ADSC group had better motor function at 3, 7, and 14 days (P＜0. 05). Double-staining immunofluorescence showed mostly grafted Brdu-reactive ADSC had migrated to the hematoma zone, and some survivedand expressed Neun of Gfap. TUNEL analysis revealed that, 3 days after transplantation, the number of apoptotic cells in ADSC group was significantly less than in the control group (P＜0. 05). Three days after transplantation, VEGF expression levels in ADSC group were significantly higher than in the control group (P＜0. 05). Conclusion ADSC stereotaxially transplanted into the lateral ventricle can survive and differentiate into neuron-like cells. ADSC transplantation may reduce apoptosis and secret VEGF to promote the angiogenesis, and improve neural functional in intracerebral hemorrhage rats.     

麻果中毒性脑病1例临床分析

<正>患者,男,28岁。因"记忆力减退10月,精神异常7月,加重1月"入院。患者于10月前渐出现记忆力减退,以近事记忆减退明显,7月前出现精神行为异常,脾气怪戾,在当地医院诊断为"精神分裂     

强直性肌营养不良症的周围神经传导及磁刺激脑部中枢运动传导

<正> 强直性肌营养不良症的神经肌肉损害特征为肌强直、进行性肌无力和肌萎缩,其电生理呈现惯常的肌病型式及典型的高频放电。中枢神经系统也可受累,脑电图检查θ、δ波过多并有局灶性尖波发放,有脑萎缩、局灶性白质病变和脑室系统弥漫性扩大。为了阐明中枢神经受累是否反映出中枢运动通路的传导异常,作者采用磁刺激头皮和颅骨,为5个家系中15例有典型临床表现的强直性肌营养不良症患者作了检查。中枢传导时间(CCT)以ms记,并根据以下公式计算:     

肌萎缩侧索硬化的研究进展

肌萎缩侧索硬化是选择性侵犯运动神经元的进行性神经系统变性疾病。目前对于其发病机制有较多理论 ,但都并非结论性的 ,而且至今尚未发现可阻止其病情发展的有效治疗方法。本文对肌萎缩侧索硬化的发病机制及治疗方法的研究进展作一综述。