丁苯酞联合依达拉奉治疗急性缺血性脑卒中对细胞凋亡的影响

目的探讨丁苯酞注射液联合依达拉奉对急性缺血性脑卒中的临床疗效及对细胞凋亡的影响。方法选择急性脑梗死患者136例,随机分为联合用药组和依达拉奉组,每组68例。依达拉奉组给予依达拉奉注射液治疗,联合用药组在依达拉奉组治疗的基础上加用丁苯酞,共治疗14 d。比较治疗前后NIHSS、ADL评分,测定细胞脂质过氧化水平及抗氧化酶活性及血清Bax、Bcl-2含量。结果联合用药组治疗后NIHSS评分低于依达拉奉组,ADL评分高于依达拉奉组,丙二醛(MDA)、超氧化物歧化酶(SOD)水平低于依达拉奉组(P0.05);联合用药组治疗后血清Bax含量低于依达拉奉组,血清Bcl-2含量高于依达拉奉组(P0.05)。结论丁苯酞注射液联合依达拉奉治疗急性缺血性脑卒中,可减轻缺血再灌注过程中氧化应激反应及细胞凋亡,从而减轻脑缺血再灌注(I/R)所引起的脑损伤。     

依达拉奉联合早期高压氧疗对急性缺血性卒中的疗效观察

目的 研究依达拉奉联合早期高压氧疗对急性缺血性卒中(ACI)患者的疗效观察.方法 120例急性脑梗死患者随机分为依达拉奉治疗组60例和常规治疗组60例(予常规抗血小板聚集、改善脑循环、营养脑细胞等治疗),依达拉奉治疗组在常规治疗的基础上予依达拉奉注射液及早期高压氧疗,治疗后7、14、28 d用美国国立卫生院神经功能缺损评分量表(NIHSS)评分并进行疗效评定.结果 2组NIHSS评分在治疗前差异无统计学意义 (P＞0.05);2组NIHSS评分在治疗后均明显低于常规治疗组(P＜0.01).结论 依达拉奉联合早期高压氧疗治疗后NIHSS评分明显低于常规治疗组,疗效明显优于常规治疗对照组.     

依达拉奉联合奥扎格雷钠治疗进展性缺血性脑卒中疗效观察

目的探讨依达拉奉联合奥扎格雷钠治疗进展性缺血性脑卒中的疗效。方法将88例进展性缺血性脑卒中患者随机分为治疗组和对照组,治疗组应用依达拉奉联合奥扎格雷钠治疗,对照组应用奥扎格雷钠,其余常规抗血小板治疗及辅助治疗均相同。结果分别在治疗前、治疗后7、14、30d,评估神经功能缺损程度和有效率:与治疗前比较,2组神经功能缺损评分均降低,但治疗组降低更明显,治疗7、14、30d后治疗组总有效率明显高于对照组。结论依达拉奉联合奥扎格雷钠治疗进展性缺血性脑卒中疗效显著。     

依达拉奉联合针灸治疗缺血性脑卒中的疗效观察

目的观察依达拉奉联合针灸治疗缺血性脑卒中的应用效果。方法选择64例缺血性脑卒中患者,采用数字随机法分为对照组和观察组各32例,对照组给予降颅压、抗凝、控制血脂、血糖等常规治疗,观察组在对照组基础上给予依达拉奉联合针灸治疗,比较治疗前及治疗2周后2组神经功能缺损(NIHSS)评分、日常生活活动能力(Barthel指数)评分,记录治疗过程中的不良反应。结果 2组治疗前NIHSS评分、Barthel评分比较,差异均无统计学意义(P0.05);治疗2周后2组NIHSS评分及Barthel评分均明显优于治疗前,差异有统计学意义(P0.05),观察组明显优于对照组,差异有统计学意义(P0.05);2组治疗期间均无明显不良反应。结论针灸联合依达拉奉治疗缺血性脑卒中患者能更好促进神经功能恢复效果,提高患者生活质量,且安全性高。     

依达拉奉治疗急性脑出血后脑水肿变化及清除自由基的临床观察

目的 研究自由基清除剂依达拉奉在治疗急性脑出血后脑水肿及自由基的变化.方法 97例确诊为急性脑出血的患者被随机分为依达拉奉组52例和常规治疗组45例,同时设正常对照组30例.依达拉奉组是在常规治疗基础上加用依达拉奉静脉滴注,14d为一个疗程.结果治疗前依达拉奉组、常规治疗组与正常对照组比较血清NO、LPO平均值均升高(P<0.05),SOD、GSH-Px平均值均减低(P<0.05);而依达拉奉组与常规治疗组各指标未见统计学差异(P>0.05).治疗后3d、7d,依达拉奉组NO、LPO低于常规治疗组,SOD、GSH-Px高于常规治疗组,两组差异有统计学意义(P<0.05).治疗后14d,两组差异无统计学意义(P>0.05).治疗前依达拉奉组、常规治疗组水肿体积/血肿体积平均值无统计学差异(P>0.05),治疗后3d、7d水肿体积/血肿体积平均值依达拉奉组较常规治疗组降低,有统计学意义(P<0.05).结论依达拉奉能有效清除脑出血后体内产生的大量自由基,减轻脑出血后脑水肿的形成.     

尤瑞克林联合依达拉奉治疗急性缺血性脑卒中的临床对照研究

目的探讨尤瑞克林联合依达拉奉治疗缺血性脑卒中的临床疗效及安全性。方法将40例急性缺血脑卒中患者随机分为联合治疗组和对照组,联合治疗组:尤瑞克林针联合依达拉奉针静滴治疗;对照组:单用依达拉奉针静滴;疗程均为14d;治疗前、治疗后14d分别进行美国国立卫生研究院卒中量表(theNational Institutes of Health Stroke Scale,NIHSS)评分,同时于治疗前、后第14及90d行日常生活活动能力量表(Activities of Daily Living Scale,ADL)评分。结果联合治疗组和对照组治疗前、治疗后14d NIHSS评分组内比较有明显差异(P<0.01),有效率分别为80%及75%,组间比较无差异(P>0.05)。联合治疗组和对照组治疗后第14d的ADL评分组间比较无差异(P>0.05),治疗后第90d的ADL评分组间比较有差异(P<0.01)。结论在缺血性脑卒中的治疗中尤瑞克林联合依达拉奉能有效、安全发挥疗效;其急性期疗效与单用依达拉奉比较无明显差异,但远期疗效及改善患者日常生活活动能力方面明显优于单用依达拉奉。     

依达拉奉对急性脑出血患者血浆S-100β蛋白表达及神经功能的影响

目的 探讨依达拉奉对急性脑出血患者血浆S-100β蛋白表达及神经功能的影响.方法 73例急性脑出血患者随机分为依达拉奉组(37例)和常规组(36例).依达拉奉组在常规治疗基础上加用依达拉奉注射液30 mg于100 ml生理盐水中静脉滴注,每日2次,连续14 d.分别于脑出血后2d(治疗前)、6d、11d时进行血浆S-100β蛋白检测和斯堪的纳维亚卒中量表(SSS)评分.结果与30名健康对照者(正常对照组)进行比较.结果 与正常对照组比较,依达拉奉组和常规组血浆S-100β蛋白水平明显升高(均P＜0.05).与依达拉奉组比较,常规组脑出血后6d、11d时血浆S-100β蛋白水平明显升高(均P＜0.05).依达拉奉组和常规组脑出血后6d时血浆S-100β蛋白水平最高,且明显高于治疗前(均P＜0.05).与常规组比较,依达拉奉组治疗后6d、11d时SSS评分均明显升高(均P＜0.05).依达拉奉组和常规组脑出血后6d时SSS评分最低,且明显低于治疗前(均P＜0.05).直线相关分析显示,依达拉奉组和常规组血浆S-100β蛋白水平与SSS评分均呈负相关(r=-0.9018,P＜0.01;r=-0.8483,P＜0.01).结论 急性脑出血患者的血浆S-100β蛋白表达水平可以反映神经功能的损害程度.依达拉奉可明显降低急性脑出血患者血浆S-100β蛋白表达并能改善神经功能缺损.     

依达拉奉对急性缺血性脑卒中患者再灌注后脑保护作用

目的依达拉奉对急性缺血性脑卒中患者再灌注后脑保护作用。方法选取我科2013-09—2015-09住院的急性缺血性脑卒中患者113例,随机分为观察组(57例)和对照组(56例),对照组仅接受rt-PA进行溶栓治疗,观察组则在接受rt-PA溶栓治疗基础上联合自由基清除剂(依达拉奉)治疗,将2组治疗后的神经系统功能评分情况和血清氧化应激指标水平进行对比。结果观察组治疗后NIHSS评分为(12.99±1.42)分、ADL评分为(56.27±9.21)分,较对照组和治疗前均有显著改善(P0.05)。观察组治疗后血清MDA为(5.64±0.72)U/mL,Hcy为(7.95±1.64)μmol/L,较对照组和治疗前均有显著下降(P0.05)。结论依达拉奉联合rt-PA治疗急性缺血性脑卒中疗效显著,可明显改善患者神经功能缺损、提高日常生活能力,具有较好的临床应用价值。     

依达拉奉对急性脑梗死患者血清血管内皮生长因子和肿瘤坏死因子水平的影响

目的 探讨依达拉奉对急性脑梗死患者血清血管内皮生长因子(VEGF)和肿瘤坏死因子(TNF)-α水平的影响.方法 84例急性脑梗死患者随机分为依达拉奉组和对照组;在脑梗死常规治疗的基础上,依达拉奉组加用依达拉奉60 mg/d静脉滴注14 d.治疗前、治疗后14 d及28 d应用改良爱丁堡斯堪的那维亚量表( SSS)对患者进行临床神经功能缺损程度评分;应用酶联免疫吸附测定法检测患者发病3d、7d及14 d血清VEGF及TNF-α水平.结果 两组患者治疗14 d及28 d时SSS评分均较治疗前明显降低(P＜0.05 ～0.01),依达拉奉组各时间点SSS评分明显低于对照组(均P＜0.05).两组血清VEGF及TNF-α水平发病后各时间点较正常值明显增高,发病第7d时明显高于第3d和第14 d(均P＜0.05);依达拉奉组各时间点血清VEGF水平明显低于对照组(均P＜0.01);两组各时间点血清TNF-α水平差异无统计学意义.结论 依达拉奉可明显降低急性脑梗死患者血清VEGF水平,减轻脑梗死后自由基导致的脑损害.     

丹参多酚酸盐联合依达拉奉治疗急性脑梗死对照研究

目的研究丹参多酚酸盐联合依达拉奉治疗急性缺血性脑卒中临床疗效。方法选自郑州大学附属郑州中心医院2015-06—2017-01收治的急性缺血性脑卒中患者92例。按照随机数字表法分为观察者46例与对照组46例。对照组采用依达拉奉治疗,观察组在对照组基础上联合丹参多酚酸盐治疗。2组疗程均为14d。比较2组治疗疗效,以及治疗前后ADL评分、NIHSS评分、血液流变学及炎症因子水平变化。结果观察组总有效率(93.48%)高于对照组(71.47%,P0.05);观察组治疗后ADL评分高于对照组而NIHSS评分低于对照组(t=19.299、19.523,P0.05);观察组治疗后全血高切还原黏度、血浆黏度值、全血低切还原黏度低于对照组(t=11.804、11.161、9.343,P0.05);观察组治疗后CRP和IL-6低于对照组(t=20.421、31.097,P0.05)。结论丹参多酚酸盐联合依达拉奉治疗急性缺血性脑卒中疗效明显,具有重要临床意义。     

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.     

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.     

Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults

A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.