天智颗粒联合奥拉西坦治疗轻中度血管性痴呆临床观察

目的研究天智颗粒联合奥拉西坦治疗轻中度血管性痴呆的临床疗效和安全性。方法将80例轻中度血管性痴呆患者随机分为2组,治疗组40例用天智颗粒联合奥拉西坦治疗;对照组40例用同等量奥拉西坦治疗,疗程60 d。治疗前后进行简易智力状态量表(MMSE)和日常生活能力量表(ADL)评定。结果 2组患者治疗后的MMSE和ADL评分较治疗前差异均有统计学意义(P<0.05);组间比较,治疗组评分改善明显优于对照组,无明显不良反应。结论天智颗粒联合奥拉西坦治疗轻中度血管性痴呆安全有效。     

天智颗粒治疗血管性痴呆的临床观察

目的观察天智颗粒改善血管性痴呆(VD)认知能力的疗效。方法选择57例血管性痴呆患者,随机分为观察组和对照组,对照组常规治疗,观察组加用天智颗粒冲服。应用韦氏记忆量表(MQ)、简易智能状态量表(MMSE)、长谷川痴呆量表(HDS)、日常生活能力量表(ADL)等评价临床疗效。结果治疗前2组MMSE、MQ、HDS、ADL评分比较差异均无统计学意义(P>0.05),治疗后治疗组MMSE MQ HDSADL评分优于对照组(P<0.05)。结论天智颗粒治疗血管性痴呆可有效改善患者的认知功能,提高日常生活能力。     

尼麦角林联合盐酸多奈哌齐治疗血管性痴呆的临床疗效观察

目的研究血管性痴呆患者采用尼麦角林联合盐酸多奈哌齐的治疗效果。方法抽取2014-03—2015-06在我院治疗的60例血管性痴呆进行分组研究,随机分为观察组与对照组各30例,对照组服用尼麦角林,观察组联合服用尼麦角林及盐酸多奈哌齐,对比观察2组患者治疗效果及日常生活能力量表评分(ADL)、简易智能状态检查量表评分(MMSE)和不良反应。结果观察组治疗总有效率80.00%,对照组56.67%,差异有统计学意义(P0.05);治疗前观察组与对照组ADL及MMSE评分对比,差异无统计学意义(P0.05);经治疗后,观察组ADL评分明显低于对照组,MMSE评分均明显高于对照组,差异有统计学意义(P0.05);2组患者均未出现不良反应。结论采用尼麦角林联合盐酸多奈哌齐治疗血管性痴呆患者疗效确切,治疗有效率较高,安全性较高,能够显著改善患者认知功能和日常生活能力,对提高患者生活质量具有重要意义,值得推广运用。     

天智颗粒对血管性痴呆认知功能及事件相关电位P300的影响

目的观察天智颗粒对认知功能及事件相关电位P300的影响。方法 60例血管性痴呆患者随机分为治疗组和对照组各30例,应用简易智力状态检查量表（MMSE）和日常生活能力量表（ADL）检测2组治疗前后认知功能状态及日常生活能力,并进行治疗前后P300检查,共观察30d。结果治疗前2组MMSE、ADL评分及P300潜伏期和波幅差异均无统计学意义（P〉0.05）;治疗后治疗组P300潜伏期缩短、波幅提高,MMSE、ADL评分优于对照组（P〈0.05）。结论天智颗粒能改善VaD患者认知功能、提高患者的日常生活能力。     

丁苯酚软胶囊联合奥拉西坦注射液对血管性痴呆病人认知功能的影响及安全性分析

目的探讨丁苯酚软胶囊联合奥拉西坦注射液对血管性痴呆患者认知功能的影响及安全性。方法选取血管性痴呆患者80例,随机分为2组,每组40例,对照组采用奥拉西坦注射液治疗,研究组在使用奥拉西坦注射液治疗的基础上联合丁苯酚软胶囊治疗,2组均连续治疗1个月,治疗前后采用简易智能状态量表(MMSE)和日常生活能力量表(ADL)评价临床疗效,并观察不良反应发生情况。结果研究组治疗后MMSE评分明显增加,ADL总分显著下降,治疗前后比较差异具有统计学意义(P0.05),且研究组治疗后的MMSE评分明显高于对照组,ADL总分明显低于对照组(P0.05);2组在治疗过程均未出现明显不良反应。结论丁苯酚软胶囊联合奥拉西坦注射液治疗血管性痴呆的疗效确切,无明显不良反应,能明显提高病人的认知功能和生活质量,值得应用。     

丁苯酞软胶囊联合多奈哌齐治疗血管性痴呆临床疗效观察

目的评价丁苯酞软胶囊联合多奈哌齐治疗血管性痴呆的疗效及安全性。方法 120例血管性痴呆患者随机分为治疗组和对照组各60例,两组均服用多奈哌齐5mg,1次/晚,治疗组在上述治疗基础上联合应用丁苯酞软胶囊0.2,3次/日,治疗前及治疗90天后应用简易智力状态检查量表(MMSE)和日常生活能力量表(ADL)评定疗效。结果最后能按计划完成治疗和定期随访的患者治疗组57例,对照组58例。治疗组总有效率为86.0%,对照组总有效率为69.0%,两组比较有统计学差异(P<0.05)。治疗组治疗后患者MMSE评分较治疗前明显增加(P<0.05),ADL有明显减低(P<0.05),与对照组比较差异均有统计学意义(P<0.05)。结论丁苯酞软胶囊联合多奈哌齐治疗轻中度血管性痴呆可明显改善患者智能障碍和生活能力,安全性好,优于单用多奈哌齐。     

丁苯酞联合高压氧治疗老年血管性痴呆的疗效及对同型半胱氨酸的影响

目的观察丁苯酞联合高压氧对老年血管性痴呆的疗效及对同型半胱氨酸的影响。方法选取2010-01—2013-12我院治疗的老年血管性痴呆患者80例为研究对象,采用随机数表法分2组各40例;对照组给予高压氧治疗,观察组在对照组基础上给予丁苯酞胶囊治疗;治疗前及治疗后3月比较2组简易智力状态检查量表(MMSE)评分和日常生活能力量表(ADL)评分;分析2组治疗前及治疗后1、3月患者血清同型半胱氨酸浓度的变化。结果观察组MMSE评分治疗后明显高于同期对照组,差异有统计学意义(P0.05)。观察组治疗后ADL评分明显高于对照组,差异具有统计学意义(P0.05)。观察组有效率87.5%,对照组为67.5%,观察组明显高于对照组(P0.05)。2组Hcy浓度治疗后3月均明显低于治疗前(P0.05)。观察组Hcy浓度治疗后3月明显低于对照组(P0.05)。结论联合治疗可明显提高患者的MMSE评分及ADL评分,降低患者血浆Hcy浓度,是一种有效的治疗方式,值得临床使用。     

长春西汀联合脑蛋白水解物治疗血管性痴呆的疗效观察

目的观察长春西汀注射液联合脑蛋白水解物治疗血管性痴呆(VD)的临床疗效。方法 128例血管性痴呆患者随机分为2组,观察组和对照组各64例。治疗前和治疗后1个月进行简易智能检查(MMSE)和日常生活能力量表(ADL)评分,并进行对比分析。结果 2组治疗后MMSE和ADL评分均有明显改善(P0.05),观察组改善情况优于对照组(P0.05)。结论长春西汀注射液联合脑蛋白水解物治疗能明显改善血管性痴呆患者的认知功能和生活能力,疗效优于单纯脑蛋白水解物治疗,且安全性高。     

养血清脑颗粒治疗血管性痴呆60例疗效观察

目的 观察养血清脑颗粒对血管性痴呆(VD)患者认知功能和行为能力的改善作用.方法 将VD患者120例随机分为治疗组与对照组各60例,治疗组采用养血清脑颗粒,对照组采用脑复康片.2组病人在治疗前后分别用简易智力状态检查量表(MMSE)及长谷川痴呆量表(HDS)进行认知功能评价,用日常生活能力(ADL)量表进行日常行为能力评价.结果 治疗组患者治疗后认知、行为能力均较治疗前明显改善(P<0.05).结论 养血清脑颗粒对VD患者认知、行为能力有明显改善作用.     

电针智三针对血管性痴呆患者认知功能和行为能力的影响

目的探讨电针智三针对血管性痴呆的疗效,为临床应用提供依据。方法采用随机数字表法将56例血管性痴呆(VD)患者随机分为电针组(电针治疗4周)和药物组(尼莫通,30mg,3次/d,治疗4周),治疗前后进行简易智能状态检查量表(MMSE)、长谷川痴呆修改量表(HDS)、日常生活能力(ADL)和P300等监测,观察2组治疗前后的变化。结果MMSE、HDS、ADL评分和P300监测均显示2组治疗后比治疗前明显改善,差异有统计学意义(P0.05);电针组的疗效优于药物治疗组(P0.01)。结论电针智三针可改善VD患者的认知功能和生活行为能力,疗效优于尼莫通。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Summary of Legislation of 1933 of interest to the Department of Mental Hygiene

Psychiatric Quarterly -