脑梗死与脑出血患者血脂及脂蛋白含量的对比研究

目的：为了研究血脂与因管疾病的关系。方法：对２００例脑血管病患者血总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、高密度脂蛋白（ＨＤＬ）、低密度脂蛋白（ＬＤＬ）、载脂蛋白－Ａ１（ＡＰＯ－Ａ１）、载脂蛋白（ＡＰＯ－Ｂ）水平进行了检测,并与１００例年龄、性别,匹配的非脑血管对照组患者进行了对比分析。结果：脑梗死组血ＴＣ、ＴＧ、ＬＤＬ、ＡＰＯ－Ｂ含量显著高于脑出血组及非脑血管病对照组,ＡＰＯ－Ａ和ＨＤＬ脑梗死组显著     

脑血管病分类亚型与血脂关系的研究

目的：阐明血脂与脑血管病分类亚型的关系。方法：检测了２０８例脑血管病患者血清血脂７项指标含量。并与对照组５０例结果进行比较。ＴＧ、ＴＣ及ＨＤＬ－Ｃ采用酶法测定，ＡＰＯＡ－１、ＡＰＯＢ１００及ＬＰ（ａ）用免疫多点定标法测定，ＬＤＬ－Ｃ由ＴＧ、ＨＤＬ－Ｃ结果按公式计算。结果：脑梗塞（ＣＩ）患者ＴＧ、ＴＣ、ＬＤＬ－Ｃ、ＡＰＯ１００及ＬＰ（ａ）含量显著高于对照组，其ＴＧ、ＡＰＯＢ１００、含量也显著高于脑出血组，且ＬＰ（ａ）与ＡＰＯＢ１００，ＨＤＬ－Ｃ相关，复发ＣＩ亚组ＴＣ、ＬＤＬ－Ｃ、ＡＰＯＢ１００含量，首发及老年ＣＩ亚组ＴＧ、ＴＣ、ＡＰＯＢ１００含量显著高于对照组。结论：血清ＴＧ、ＴＣ、ＬＤＬ－Ｃ、ＡＰＯＢ１００及ＬＰ（ａ）水平升高是ＣＩ的危险因素，其中ＴＣ、ＬＤＬ－Ｃ、ＡＰＯＢ１００对复发ＣＩ危险性大，而首发及老年ＣＩ可能主要与ＴＧ、ＴＣ、ＡＰＯＢ１００有关     

载脂蛋白E与脑动脉硬化症

本文观察７８例脑动脉硬化症患者与对照组４４例，对其血清载脂蛋白Ｅ（ＡＰＯＥ）和高密度脂蛋白（ＨＤＬ－Ｃ）、低密度脂蛋白（ＬＤＬ－Ｃ）、胆固醇（ＴＣ）、甘油三脂（ＴＧ）、载脂蛋白ＡＩ（ＡＰＯＡＩ）、载脂蛋白Ｂ（１００）（ＡＰＯＢ（１００））进行含量测定，并将ＡＰＯＥ与ＨＤＬ－Ｃ、ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡＰＯＡＩ、ＡＰＯＢ（１００）逐一进行相关比较，结果发现：脑动脉硬化症病人（ＣＡＳ）血清ＡＰＯＥ、ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡＰＯＢ（１００）明显高于正常对照组（Ｐ＜０．０１），ＨＤＬ－Ｃ显著低于正常对照组（Ｐ＜０．０１），ＡＰＯＡＩ无明显变化（Ｐ＞０．０５），且ＡＰＯＥ与ＨＤＬ－Ｃ呈负相关；与ＬＤＬ－Ｃ、ＴＣ、ＴＧ、ＡＰＯＢ（１００）呈正相关；与ＡＰＯＡＩ无直线相关关系。提示ＡＰＯＥ可做为诊断脑动脉硬化症的重要指标。     

绝经后妇女脑梗死患者性激素变化与胰岛素抵抗的关系

目的：为探讨绝经后妇女脑梗死患者性激素水平变化及与胰岛素抵抗的关系。方法：对３３例绝经１年以上妇女脑梗死患者（Ａ组）与２１例绝经１年以上无脑梗死健康妇女（Ｂ组）的血清雌二醇（Ｅ２）、促卵泡刺激素（ＦＳＨ）、促黄体生成素（ＬＨ）、睾酮（Ｔ）、血浆葡萄糖（Ｇ）、血浆胰岛素（ＩＮＳ）及胰岛素敏感指数（ＩＳＩ）进行检测。结果：Ａ组Ｅ２水平较Ｂ组明显降低,ＦＳＨ、ＬＨ、Ｔ水平显著增高。相关分析发现,Ｅ２与ＩＳＮ是显著负相关,而Ｅ２与ＩＳＩ呈显著正相关;Ｔ与ＩＮＳ呈显著正相关,与ＩＳＩ是显著负相关。结论：绝经后妇女脑梗死患者存在严重的性激素失调,且与胰岛素抵抗并存,可能参与绝经后妇女脑梗死发生和发展。     

急性脑梗塞超早期溶栓治疗tPA、PAI、PLG、D-D监测

目的　探讨溶栓治疗对纤维系统的影响以及各指标与临床疗效的关系。方法　对 ６９ 例病后 ２４ｈ 内就治的急性脑梗塞病人随机分 ４ 组,在治疗前及治疗后 ２ｈ、２４ｈ、７～１０ｄ 进行组织型纤溶酶原激活物（ｔ Ｐ Ａ）、纤溶酶原激活物抑制物（ Ｐ Ａ Ｉ）、纤溶酶原（ Ｐ Ｌ Ｇ）、 Ｄ二聚体（ Ｄ Ｄ）检测。结果　对照组ｔ Ｐ Ａ、 Ｐ Ａ Ｉ、 Ｐ Ｌ Ｇ、 Ｄ Ｄ 在治疗前及治疗后各时期无变化,溶栓治疗组于治疗后 ２ｈ ｔ Ｐ Ａ 及 Ｄ Ｄ 明显升高, Ｐ Ａ Ｉ、 Ｐ Ｌ Ｇ 下降。溶栓治疗并发出血的病例,于治疗后 ２４ｈ Ｐ Ａ Ｉ仍明显降低。结论　溶栓治疗病例存在超早期纤溶激活,凝血障碍是溶栓治疗并发出血的重要机制。     

脑血栓形成者血清胰岛素及与PAI-1关系的探讨

目的探讨脑血栓形成者是否存在胰岛素抵抗（ＩＲ）,并进一步探讨其与血浆纤溶酶原激活物-１（ＰＡＩ－１）活性的关系。方法选择６７例无糖尿病病史的ＣＴＢ患者,根据梗死面积分为大中病灶组（４３例）和小灶组（２４例）、另取２８例健康成人作对照组。分别用发色底物法和放免法测定血浆ＰＡＩ－１活性、ＩＳ、Ｃ肽水平。结果（１）ＣＴＢ组ＰＡＩ－１活性、ＩＳ、Ｃ肽水平明显高于对照组（Ｐ均＜０．０１）;但两不同梗死面积组间无显著差别：（２）ＣＴＢ组ＰＡＩ－１与ＩＳ、Ｃ肽及ＩＳ与Ｃ肽间呈显著正相关（Ｐ均＜０．００１）,有极显著性差异。结论（１）ＩＲ和／或ＨＩ可能参与了ＣＴＢ的发生;（２）血浆ＰＡＩ－１活性增高与ＩＳ及Ｃ肽有关．ＰＡＩ－１活性增高致血浆纤溶活性降低．可能是ＩＲ与ＣＴＢ的中间环节。     

溶栓治疗急性脑梗死对纤溶系统的影响

目的　探讨溶栓治疗对纤维系统的影响以及各指标与临床疗效的关系。方法　本研究对９１ 例病后２４ ｈ 内就治的急性脑梗死随机分为４ 组,其中进行血样检测者对照组１４ 例,应用尿激酶（ＵＫ）６×１０５ Ｕ 组２２ 例,１６×１０５ Ｕ 组２２ 例,２６×１０５ Ｕ组１１ 例。在治疗前及治疗后２ ｈ、２４ ｈ、７～１０ 天（ｄ）进行组织型纤溶酶原激活物（ｔＰＡ）、纤溶酶原激活物抑制物（ＰＡＩ）、纤溶酶原（ＰＬＧ）、Ｄ－二聚体（Ｄ－Ｄ）检测。结果　对照组ｔＰＡ、ＰＡＩ、ＰＬＧ、Ｄ－Ｄ在治疗前及治疗后各时期无变化,溶栓治疗组于治疗后２ ｈ ｔＰＡ 及Ｄ－Ｄ明显升高,ＰＡＩ、ＰＬＧ下降。溶栓治疗并发出血的病例,于治疗后２４ ｈＰＡＩ仍明显降低。结论　溶栓治疗病例存在超早期纤维激活,凝血障碍是溶栓治疗并发出血的重要机制     

脑出血与8项血脂指标的关系探讨

测定了１２５例脑出血病人的血总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、高密度脂蛋白（ＨＤＬ）、低密度脂蛋白（ＬＤＬ）、载脂蛋白Ａ－１、Ｂ－１００（ＡｐｏＡ－１、ＡｐｏＢ－１００）、脂蛋白（ａ）［ＬＰ（ａ）］和氧化修饰低密度脂蛋白（ｏｘＬＤＬ）浓度。结果显示：与对照组比较，ＡｐｏＢ－１００、ｏｘＬＤＬ显著增高，ＨＤＬ、ＡｐｏＡ－１显著降低（Ｐ＜０．０１），ＬＤＬ明显降低（Ｐ＜０．０５），ＴＣ、ＴＧ、ＬＰ（ａ）无明显变化（Ｐ＞０．０５）。提示：血ＬＤＬ、ＡｐｏＢ－１００、ｏｘＬＤＬ浓度增高和ＨＤＬ、ＡｐｏＡ－１浓度降低与脑出血有一定的相关关系，可作为脑出血的危险因素。     

脑梗死患者血纤溶系统活性指标的改变和预后的关系

目的 研究脑梗死患者血浆组织型纤溶酶原激活物（ｔ－ＰＡ）及其抑制物（ＰＡＩ－１）水平的改变和预后的关系。方法 对１１２例脑梗死患者进行了血浆ｔ－ＰＡ、ＰＡＩ－１、血糖、血脂的检测及神经功能缺损程度的评分。分为脑梗死组,再梗死组和正常对照组进行比较;并根据神经功能缺损程度的评分分型、重型３组比较各组间的血浆ｔ－ＰＡ、ＰＡＩ－１水平差异及其和预后的关系。结果 脑梗死组、再梗死组的血浆ｔ－ＰＡ、ＰＡＩ－     

急性脑卒中患者血浆t—PA,PAI—1活性变化及意义

采用发色底物显色法检测了３６例多发性脑梗塞患者、１６例脑出血患者以及２９例同期住院的非脑血管病患者血浆组织型纤溶酶原激活物（ｔ－ＰＡ）、纤溶酶原激活物抑制物（ＰＡＩ－１）活性。结果：脑梗塞组ｔ－ＰＡ活性减低，ＰＡＩ－１活性增高（均Ｐ＜０．０５）。表明脑梗塞患者有血浆纤溶功能损害。提示血浆ｔ－ＰＡ、ＰＡＩ活性变化以及两者之间的平衡失调在脑梗塞的发生、发展中起一定作用     

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 -