丁苯酞软胶囊联合依达拉奉注射液治疗脑梗死疗效及对血清神经营养因子与炎症反应影响

目的探讨丁苯酞软胶囊联合依达拉奉注射液治疗脑梗死的疗效及对血清神经营养因子和炎症反应的影响。方法选取沧州市人民医院自2014年1月至2016年12月收治的脑梗死患者140例为研究对象。采用随机数字表法将患者分为A、B两组,每组各70例。A组患者给予依达拉奉注射液治疗,B组患者在A组治疗的基础上给予丁苯酞软胶囊治疗。比较两组患者治疗前后血清神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)、神经生长因子(NGF)、C反应蛋白(CRP)、白细胞介素-8(IL-8)及白细胞介素-10(IL-10)水平,记录治疗过程中不良反应的发生情况,并评价临床疗效。结果 B组的总有效率为92.8%(65/70),高于A组的72.8%(51/70),两组比较,差异有统计学意义(P<0.05)。两组治疗后血清NSE水平降低、血清BDNF、NGF水平升高,且B组血清NSE、BDNF、NGF水平相比A组均改善更明显,两组比较,差异有统计学意义(P<0.05)。两组治疗后血清CRP、IL-8、IL-10水平降低,且B组炎症因子水平低于A组,两组比较,差异有统计学意义(P<0.05)。两组患者治疗过程中不良反应发生率比较,差异无统计学意义(P>0.05)。结论丁苯酞软胶囊联合依达拉奉注射液治疗脑梗死的临床疗效显著,能够明显调节神经营养因子和炎症反应,且安全性较好。     

BDNF用于抑郁症辅助诊断和疗效判断的初步研究

目的 检测脑源性神经营养因子(BDNF)在抑郁症发生发展和治疗中的变化,探讨其用于抑郁症辅助诊断和疗效判断的可行性.方法 42例明确临床诊断抑郁症患者,其中中重型各13、15例,接受6 w常规抗抑郁治疗,治疗前后用酶联免疫吸附法(ELISA)测定血清BDNF水平,并与88例非抑郁症人群比较.结果 与对照组比较,轻中重度抑郁症患者血清BDNF水平均有明显下降(P＜0.01);且抑郁程度与BDNF水平负相关.治疗后,中重度患者血清BDNF水平均明显升高(P＜0.01).在临床症状显著改善患者,其血清BDNF水平与治疗前比较均呈现不同程度的升高.结论 血清BDNF水平可作为临床抑郁症诊断,特别是治疗反应的参考指标.     

草酸艾司西酞普兰联合普拉克索对帕金森病非运动症状的疗效

 目的 观察并探讨草酸艾司西酞普兰联合普拉克索治疗帕金森病患者非运动症状的临床疗效,并分析两组患者血生化指标及其相关性。方法 选取2017-01至2020-01解放军总医院第三医学中心收治的帕金森病患者72例,以给药种类不同分为对照组和试验组,每组36例。对照组患者给予帕金森常规治疗(多巴丝肼与普拉克索),试验组患者在对照组基础上加用小剂量草酸艾司西酞普兰片(10 mg/d)治疗。比较治疗前及治疗后1、2、3个月的汉密尔顿抑郁量表评分(HAMD)及帕金森病综合评分(UPDRS),测定并比较两组治疗前及治疗后3个月血清同型半胱氨酸(HCY)、胱抑素C(CysC)及尿酸(UA)水平。结果 试验组用药3个月后,HAMD评分为(12.98±1.92)分,UPDRSⅢ评分为(15.77±2.04)分,均低于对照组,差异有统计学意义(P<0.05);试验组用药3个月后血清HCY为(12.50±3.84)μmol/L,CysC为(0.70±0.10)mg/L,UA为(312.17±54.21)μmol/L,血清 HCY和 CysC的水平均低于对照组,尿酸的水平高于对照组,差异有统计学意义(P<0.05)。结论 给予小剂量草酸艾司西酞普兰联合普拉克索治疗帕金森病,可缓解患者非运动症状,调节相关血液学指标水平。     

高压氧联合西酞普兰对创伤性颅脑损伤后抑郁患者的有效性研究

目的探讨高压氧(HBO)联合西酞普兰治疗创伤性颅脑损伤(TBI)后抑郁患者的临床疗效及其作用机制。方法选取2019年1月至2021年12月烟台山医院收治的TBI后发生抑郁的患者114例作为研究对象, 采用随机数字表法将患者分为对照组和观察组, 每组57例。对照组患者采用西酞普兰治疗, 观察组在对照组治疗的基础予以HBO治疗。在治疗前和治疗2、4、6周后采用汉密尔顿抑郁量表(HAMD)进行评分, 并计算其治疗有效率;采用酶联免疫吸附法检测患者血清5-羟色胺(5-HT)和多巴胺(DA)水平。结果治疗6周后观察组总有效率(94.74%)明显高于对照组(80.70%), 差异有统计学意义(P<0.05)。2组患者血清5-HT和DA水平与治疗前比较均明显升高, 观察组治疗4、6周后血清5-HT和DA水平明显高于对照组, 差异均有统计学意义(P<0.05)。2组患者的HAMD评分与治疗前比较明显降低, 观察组治疗4、6周后HAMD评分低于对照组, 差异均有统计学意义(P<0.05)。结论 HBO联合西酞普兰能够改善TBI患者的抑郁症状, 其治疗机制主要是通过提高患者血清DA和5-...     

高压氧综合治疗帕金森病患者认知功能障碍68例疗效观察

目的 探讨高压氧(HBO)治疗对帕金森病(PD)患者认知功能障碍的康复作用.方法 将68例有认知功能障碍的PD患者分为HBO组(38例)和对照组(30例),2组均给予吡拉西坦治疗.HBO组每周治疗5次,连续8周.2组治疗前后均进行韦氏成人智力量表(WAIS-RC)、韦氏成人记忆量表(WMS-RS)、帕金森病统一评分量表(UPDRS)评定及P300听觉事件相关电位检测.结果 2组治疗后总智商、言语智商、操作智商、记忆评分、UPDRS精神、行为和情绪、UPDRS日常生活活动及UPDRS运动检查评分均较治疗前有改善(P＜0.05),其中HBO组改善程度更为显著(P＜0.05);HBO组治疗后潜伏期各组数据均较治疗前有显著改变(P＜0.05),对照组仪P3Fz、P3Cz有显著改变(P＜0.05).结论 HBO治疗有助于改善PD患者的认知功能障碍.     

艾司西酞普兰联合认知行为治疗抑郁症患者的临床效果与安全性探讨

目的：探讨艾司西酞普兰联合认知行为治疗抑郁症患者的临床疗效及安全性。方法选取收治的抑郁症患者作为研究对象共44例,将患者随机分为对照组和观察组,两组各纳入患者22例,对照组患者给予艾司西酞普兰进行治疗,观察组在艾司西酞普兰的基础上加以认知行为治疗,比较两组患者治疗前后HAMD、GQOLI、TESS量表评分情况。结果①两组患者治疗后HAMD及GQOLI评分均有显著改善,差异有统计学意义（ P＜0.05）,观察组患者治疗后的HAMD及GQOLI评分显著优于对照组患者,差异有统计学意义（P＜0.05）;②观察组的TESS评分显著低于对照组,两组间差异有统计学意义（ P＜0.05）。结论艾司西酞普兰联合认知行为治疗对抑郁症患者临床效果较好,提高患者生活质量,不良反应轻微。     

亚低温治疗对急性脊髓损伤患者康复情况及血清降钙素基因相关肽、5-羟色胺的影响

目的分析采用亚低温疗法对脊髓损伤患者干预治疗后,患者康复情况及血清中血清降钙素基因相关肽(calcitonin gene related peptide,CGRP)、5-羟色胺(5-hydroxytryptamine,5-HT)的影响。方法将2013年8月—2015年12月收治的50例脊柱骨折伴脊髓损伤患者分为对照组和观察组:对照组患者采用常规疗法干预,观察组患者采用亚低温疗法干预,体温控制在30~35℃,梯度回温,12~20h体温恢复正常;在治疗前及治疗后3个月对患者运动功能、感觉功能及康复情况进行评价,并检测血清中CGRP、5-HT水平;使用生活满意指数A(LSIA)及Barthel指数评分对患者生活质量及能力进行评价,使用Zung抑郁状态自评量表对抑郁状态进行评定。结果经治疗后两组患者运动功能、感觉功能及总体康复评分均显著升高(P0.05),且观察组患者运动功能、感觉功能及总体康复评分均显著高于对照组,差异有统计学意义(P0.05);治疗后两组血清中CGRP、5-HT水平均显著升高,差异有统计学意义(P0.05),且观察组血清中CGRP、5-HT水平显著高于对照组,差异有统计学意义(P0.05);两组Barthel指数、Zung评分及LSIA评分均显著改善(P0.05),且观察组Barthel指数、Zung评分及LSIA评分改善水平显著优于对照组,差异有统计学意义(P0.05)。结论采用亚低温疗法对脊髓损伤患者干预后可有效提高患者康复情况及生活质量、能力和心理抑郁状态,改善血清中CGRP、5-HT水平,具有较高的临床应用价值。     

亚低温治疗重型颅脑损伤患者临床疗效分析及对患者血清GFAP、UCH-L1、NSE、CRP水平的影响

目的探讨亚低温治疗重型颅脑损伤患者临床疗效及对患者血清神经胶质纤维酸性蛋白(GFAP)、泛素羧基末端水解酶L1(UCH-L1)、神经元特异性烯醇化酶(NSE)、C反应蛋白(CRP)水平的影响。方法 106例重型颅脑损伤患者根据随机数字表法分为治疗组(n=53)和对照组(n=53)。对照组给予降低颅内压、脱水以及营养脑细胞等常规治疗,治疗组在对照组基础上结合亚低温治疗。对比分析两组入院时、治疗后1d和治疗后5d颅内压、血糖、血清GFAP、UCH-L1、NSE、CRP指标变化以及治疗6个月后预后情况。结果两组颅内压第1天、第5天较入院时明显降低(P0.05);治疗组治疗后1、5d颅内压明显低于对照组(P0.05);两组第1、第5天血糖水平显著低于入院时(P0.05);治疗组治疗后1、5d血糖水平显著低于同期对照组(P0.05);两组血清GFAP、UCH-L1水平治疗后1、5d较入院时显著降低(P0.05);治疗组血清GFAP、UCH-L1水平治疗后1、5d显著低于对照组(P0.05);两组NSE、CRP水平治疗前比较差异无统计学意义(P0.05);治疗组NSE、CRP治疗后1d和5d明显低于同期对照组(P0.05);治疗组良好率显著高于对照组(P0.05),病死率显著低于对照组(P0.05);而两组中残、重残及植物状态对比差异无统计学意义(P0.05)。结论亚低温治疗重型颅脑损伤患者临床疗效显著,降低血清GFAP、UCH-L1、NSE、CRP水平,改善患者预后,值得进一步推广应用。     

丁苯酞软胶囊治疗急性脑梗死30例临床观察

目的：观察丁苯酞软胶囊治疗急性脑梗死的临床疗效。方法：将60例急性脑梗死患者随机分为丁苯酞软胶囊治疗组（30例）和对照组（30例）。对照组给予马来酸桂哌齐特注射液静滴,1次/d;治疗组在对照组基础上给予丁苯酞软胶囊口服,疗程为2周。评价两组患者分别在治疗前、治疗后第7 d、第14 d的神经功能缺损程度（NDS）、日常生活活动能力（ADL）。结果：治疗组及对照组患者和治疗前相比,神经功能缺损程度评分及B I评分均有明显改善（P〈0.05）。两组均未发现明显不良反应。结论：丁苯酞软胶囊治疗急性脑梗死疗效确切。     

高压氧联合西酞普兰治疗抑郁症睡眠障碍患者的临床疗效观察

目的:探讨高压氧(HBO)联合西酞普兰治疗抑郁症睡眠障碍患者的临床疗效及其作用机制。方法:收集2016年3月至2019年6月在山西白求恩医院精神卫生科诊治的抑郁症睡眠障碍患者140例,按随机数字表法分为观察组和对照组,每组70例。对照组给予西酞普兰治疗,观察组给予西酞普兰联合HBO治疗,均治疗4周后观察2组患者的治疗效果、抑郁评分、睡眠障碍情况以及血清白细胞介素-1(IL-1)、IL-6、肿瘤坏死因子-α(TNF-α)和皮质醇水平。结果:治疗4周后,观察组患者治疗总有效率(94.29%)显著高于对照组(77.14%),差异有统计学意义( P<0.05);治疗后2组患者睡眠质量、入睡时间、抑郁状态评分均显著低于治疗前,且观察组治疗后下降更显著,差异均有统计学意义( P<0.05或 P<0.01);治疗后2组患者的IL-1、IL-6、TNF-α和皮质醇水平均明显低于治疗前,且观察组治疗后较对照组下降更显著,差异有统计学意义( P<0.05或 P<0.01)。 结论:HBO联合西酞普兰治疗可降低抑郁症睡眠障碍患者血清IL-1、IL-6、TNF-α、皮质醇水平,显著改善抑郁状况和睡眠障碍,有较好的临床疗效。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.