单唾液酸四己糖神经节苷脂钠联合脑蛋白水解物治疗帕金森病的疗效观察

目的：探讨单唾液酸四己糖神经节苷脂钠联合脑蛋白水解物治疗帕金森病的疗效。方法按照随机数字表法将86例帕金森病患者均分为实验组和对照组,对照组患者单用单唾液酸四己糖神经节苷脂钠注射液治疗,实验组患者采取单唾液酸四己糖神经节苷脂钠注射液联合注射用脑蛋白水解物治疗,比较两组患者治疗效果。结果两组患者治疗后UPDRS总评分均显著下降,与治疗前比较,差异具有统计学意义（P＜0.05）;实验组患者UPDRS总评分显著低于对照组,总有效率显著高于对照组,差异具有统计学意义（P＜0.05）;两组患者不良反应发生率比较,差异无统计学意义（P＞0.05）。结论单唾液酸四己糖神经节苷脂钠联合脑蛋白水解物能够显著改善帕金森病患者UPDRS评分,临床疗效显著。     

单唾液酸四己糖神经节苷脂治疗进展性脑梗死疗效分析

目的观察单唾液酸四己糖神经节苷脂治疗进展性脑梗死的临床疗效。方法选择2006年1月至2008年1月住院的符合纳入标准的急性脑梗死患者64例,采用计算机随机分组法分为治疗组（33例）和对照组（31例）,治疗组给予单唾液酸四己糖神经节苷脂80mg,对照组给予胞二磷胆碱注射液0.75g,两组均同时给予阿司匹林和洛伐他汀行抗血小板聚集和调脂、稳定斑块治疗。治疗前和治疗14d时进行神经功能缺损程度评定,并进行比较。结果两组治疗后神经功能缺损程度评分均明显减少（P〈0.05）;治疗组减少更明显（P〈0.05）。治疗组与对照组总有效率分别为87.9％（29／33）、51.6％（16／31）,差异有统计学意义（P〈0.01）。结论单唾液酸四己糖神经节苷脂治疗进展性脑梗死临床疗效肯定,能减少患者的临床神经功能缺损程度评分,改善患者预后。     

GM-1治疗急性脊髓损伤

在外伤性急性脊髓损伤（ＳＣＩ）的治疗中,外科治疗的主要目的是通过减压等方法恢复脊髓的残存功能,稳定脊柱和限制脊髓的继发性损害,而对原发性脊髓损伤尚无有效的治疗方法。目前,急性脊髓损伤的药物治疗受到了重视〔１〕。单唾液酸四己糖神经节苷脂（Ｍｏｎｏｓｉａ...     

神经节苷脂治疗重型颅脑损伤临床研究

目的:探讨神经节苷脂在重型颅脑损伤治疗中的作用。方法:选择我院收治的重型颅脑损伤患者62例,分为常规组和神经节苷脂组。分析比较昏迷时间、死亡率、GOS等神经功能指标。结果:神经节苷脂组昏迷时间和GOS明显优于常规组,死亡率低。结论:神经节苷脂可缩短重型颅脑损伤患者的昏迷时间,有助于降低其死亡率和致残率,是值得推广的一种神经保护剂。     

重症颅脑损伤患者入院前早期插管的应用

目的 研究重症颅脑损伤患者入院前早期插管联合神经节苷脂注射液治疗的可行性。方法 选取2021年1月至2023年1月急诊收治的88例重症颅脑损伤患者，入院前未合并呼吸衰竭，格拉斯昏迷指数（GCS）评分为6～8分。依据气管插管时机将所有患者分成早期插管组（n=48）和入院后插管组（n=40）。两组入院后均给予心电监护、血氧监测、复方甘露醇注射液200 m L、神经苷脂钠盐静脉滴注、抗感染治疗等。比较两组血气分析、血清学、入院后相关指标及预后。结果 经分析，早期插管组中预后良好、中残者占比高于入院后插管组（P<0.05）。治疗后12、24、72 h，观察组的血清中神经特异性烯醇化酶（NSE）及血清S100B蛋白浓度低于对照组（P<0.05）。治疗后3 d，早期插管组的氧分压（PaO2）、氧合指数（PaO2/FiO2）高，二氧化碳分压（PaCO2）低于入院后插管组（P<0.05）。治疗后3、7、14 d，早期插管组的GCS评分高于入院后插管组（P<0.05）。结论 对于重症颅脑损伤患者而言，院前急救时给予气管插管，利于改善机体氧供，早期保护脑组织，入院后加以神经节苷脂钠...     

脑外伤促进骨折局部骨痂快速形成机制的研究进展

合并脑外伤的骨折患者其骨痂形成速度乃至骨折愈合速度通常快于单纯骨折患者,本文综述体液因素、神经营养因子及神经肽等在脑外伤后骨折愈合加速过程中的作用。单唾液酸四己糖神经节苷脂作为脑外伤的常用治疗药物,有可能在脑外伤后骨折愈合加速这一过程中起作用。     

纳络酮治疗急性重型颅脑损伤患者血浆内皮素含量变化及其临床意义

目的 探讨纳络酮治疗急性重型颅脑损伤患者血浆内皮素（ET）含量变化及其临床意义，评价纳络酮治疗急性重型颅脑损伤的意义。方法 观察了52例纳洛酮治疗急性重型颅脑损伤患者血浆ET含量在治疗前1d、治疗后3、8d及2周的变化，并且以46例颅脑损伤患者按常规治疗作对照组。结果 颅脑损伤24h内两组患者血浆内皮素较正常人均明显升高（P〈0．05），伤后第3天、第8天两治疗组血浆内皮素较治疗前均明显下降（P〈0．05），但纳络酮治疗组低于常规治疗组（P〈0．05），治疗2周后两组ET水平基本恢复到正常水平。结论 急性重型颅脑损伤患者血浆内皮素含量明显升高，与病情轻重相关，纳络酮治疗较常规治疗能更迅速地降低血浆ET水平。     

GM-1预处理减轻布比卡因诱导的N2a细胞凋亡

目的 研究单唾液酸四己糖神经节苷脂(GM-1)预处理对布比卡因诱导N2a细胞凋亡后对c-Jun氨基末端激酶(JNK)、CCAAT/增强子结合蛋白同源蛋白(CHOP)表达的影响.方法 体外培养小鼠神经母细胞瘤细胞N2a细胞株,取对数生长期N2a细胞,将细胞随机分为四组:对照组(C组),N2a细胞无任何药物处理;GM-1组...     

神经节苷脂治疗弥漫性轴索损伤的临床观察

目的观察应用神经节苷脂治疗弥漫性轴索损伤(DAI)的临床疗效。方法将DAI患者60例随机分成观察组和对照组两组,每组各30例。对照组患者予保持呼吸道通畅、降低颅内压、改善微循环、早期冬眠治疗等常规治疗。观察组在常规治疗的基础上配合神经节苷脂药物治疗,观察两组的疗效及并发症发生情况。结果观察组患者恢复良好率明显高于对照组,病死率明显低于对照组,两组对比,差异有统计学意义(P0.05)。两组患者的并发症情况对比,差异无统计学意义(P0.05)。结论对DAI患者应用神经节苷脂可积极改善脑功能作用,且不增加并发症发生率,疗效肯定。     

神经节苷脂有髓损伤的保护作用观察

目的：观察神经节苷脂对损伤脊髓神经组织的保护作用,并初步探讨其作用机制。方法：重度脊髓损伤大鼠随机分为对照组及神经节苷脂治疗组（n=15)。在蛛网膜下腔注射生理盐水20μl或神经节苷脂30μg。观察体重变化局部血流量、凋亡细胞原位标记、神经功能评价和定量组织学分析。结果：局部血流量2组无明显差异,治疗组存活8率、体重、神经功能评分和残余神经组织面积明显高于对照组,而TUNEL阳性细胞数量明显低于对照组。结论：神经节苷脂对损伤脊髓组织有明显保护作用,可能是通过对神经细胞凋亡的阻断来发挥作用的。     

Effect of AVP on brain edema following traumatic brain injury

Objective: To evaluate plasma arginine vasopressin (AVP) level in patients with traumatic brain injury and investigate the role of AVP in the process of brain edema. Methods: A total of 30 patients with traumatic brain injury were involved in our study. They were divided into two groups by Glasgow Coma Scale: severe traumatic brain injury group (STBI, GCS≤8) and moderate traumatic brain injury group ( MTBI, GCS >8). Samples of venous blood were collected in the morning at rest from 15 healthy volunteers (control group) and within 24 h after traumatic brain injury from these patients for AVP determinations by radioimmunoassay. The severity and duration of the brain edema were estimated by head CT scan. Results: plasma AVP levels (ng/L) were (mean±SD): control, 3. 06±1. 49; MTBI, 38. 12±7. 25; and STBI, 66. 61±17. 10. The plasma level of AVP was significantly increased within 24 h after traumatic brain injury and followed by the reduction of GCS, suggesting the deterioration of cerebral injury (P<0. 01). And the AVP level was correlated with the severity (STBI r =0.919, P < 0.01; MTBI r = 0.724, P < 0.01) and the duration of brain edema (STBI r = 0. 790, P < 0. 01; MTBI r = 0. 712, P<0.01). Conclusions: The plasma AVP level is closely associated with the severity of traumatic brain injury. AVP may play an important role in pathogenesis of brain edema after traumatic brain injury.     

过表达B细胞淋巴瘤/白血病-2对重度创伤性脑损伤大鼠的治疗作用及其机制

目的:观察过表达B细胞淋巴瘤/白血病-2(bcl-2)对重度创伤性脑损伤大鼠神经保护作用。方法:2018年1月至2019年9月,60只SD大鼠采用随机数字法分为对照组、模型组和bcl-2组。对照组和模型组大鼠经脑室注射对照腺相关病毒1×10 11 v.g/只,bcl-2组经脑室注射bcl-2过表达腺相关病毒...     

创伤性脑损伤患者脑脊液中嗜中性白细胞碱性磷酸酶-1的表达及意义

目的探讨炎性体蛋白嗜中性白细胞碱性磷酸酶-1(NALP-1)在创伤性脑损伤患者脑脊液中表达水平及其与预后相关性。方法选取2017年2月至2018年9月来自首都医科大学附属北京同仁医院的120例创伤性脑损伤患者,选取同期健康体检者30例作为对照组,采用免疫印迹化学发光法检测研究对象脑脊液中炎性体蛋白NALP-1表达水平,根据格拉斯哥预后评分(GOS)将创伤性脑损伤患者分为预后良好组(GOS>3分)和预后不良组(GOS≤3分)。χ²检验和t检验分析预后良好组和预后不良组NALP-1和临床资料差异,采用多因素Logistic回归模型分析创伤性脑损伤后患者预后影响因素。结果创伤性脑损伤患者脑脊液中NALP-1表达(1.64±0.52)高于对照组(0.94±0.28,t=7.108,P<0.05),差异有统计学意义。NALP-1高表达组急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)得分(26.4±5.4)分、脑挫伤比例(76.62%)、蛛网膜下腔出血比例(77.27%)高于低表达组[(22.3±4.5)分、23.38%、22.73%],差异有统计学意义(χ²/t=4.135、9.586、7.424,P<0.05)。年龄[比值比(OR):2.175,95%可信区间(CI):1.167~8.767,P<0.05]、蛛网膜下腔出血(OR:1.241,95%CI:1.101~3.794,P<0.05)、NALP-1(OR:2.841,95%CI:1.675~10.717,P<0.05)、纤维蛋白原水平(OR:1.215,95%CI:1.056~3.627,P<0.05)、APACHEⅡ得分(OR:1.615,95%CI:1.314~5.485,P<0.05)是预后不良独立影响因素,差异均有统计学意义。结论创伤性脑损伤脑脊液中NALP-1表达增加,且表达量升高与预后不良相关。     

Increased serum creatine kinase BB and neuron specific enolase following head injury indicates brain damage

The aim of this study was to examine whether an increase in the serum concentrations of the two brain enzymes creatine kinase BB (CK-BB) and neuron specific enolase (NSE) can be demonstrated in patients with acute head injury and whether such an increase reflects release from damaged brain tissue. In 60 patients who had suffered minor to severe head injury, serial blood samples were drawn during the first hours after impact, and CK-BB and NSE were measured by radioimmunoassay. Computed tomography (CT) was also performed shortly after admission to hospital, and was repeated 1-3 days later in selected patients. Increased serum concentrations of both CK-BB and NSE were found in 88% of the patients with moderate to severe head injury (group 1, n = 18) and in 23% of the patients with minor head injury (group 2, n = 42), whereas CT showed contusion in only 41% and 2% of the group 1 and 2 patients, respectively. The following findings suggest that the enzymes had been released from brain tissue: 1) The maximum concentrations of CK-BB and NSE correlated with the severity of injury as assessed clinically and with the volume of contusion as estimated from CT (r = 0.79 with CK-BB, r = 0.72 with NSE). 2) The maximum concentrations of CK-BB and NSE were closely correlated (r = 0.87).(ABSTRACT TRUNCATED AT 250 WORDS)     

颅脑损伤患者血浆纤维蛋白原的测定及其意义

目的 探讨颅脑损伤患者血浆纤维蛋白原(FIB)对颅脑损伤的诊断和预后价值.方法 对92例颅脑损伤患者、40例正常人,采用Clauss凝固法分别测定血浆FIB.结果 血浆FIB下降程度与颅脑损伤严重程度相关,轻型组、中型组及重型组血浆FIB分别为(2.24±0.51)、(1.71±0.46)及(1.09±0.34)g/L,均低于正常对照组(P<0.01),其中重型组血浆FIB低于中型组(P<0.05),中型组血浆FIB又低于轻型组(P<0.05).结论 颅脑损伤患者血浆纤维蛋白原测定对颅脑损伤可能具有诊断和预后价值.     

标准外伤大骨瓣开颅术治疗重型颅脑损伤的临床研究

目的探讨重型颅脑损伤行标准外伤大骨瓣开颅术的临床疗效。方法将本院2005年1月至2012年12月,重型颅脑损伤患者112例纳入率研究,随机分为观察组和对照组,每组56例,观察组采用标准外伤大骨瓣开颅术,对照组采用常规骨瓣开颅术,对比两组术后疗效,并发症情况以及手术前后神经功能缺损程度评分。结果观察组术后良好率为55．36％,明显高于对照组28．57％,,差异有统计学意义（P〈0．05）;观察组术后死亡率为8．93％,显著低于对照组14．29％,差异有统计学意义（P〈0．05）;观察组术后脑切口疝与硬膜下积液发生率明显低于对照组,差异有统计学意义（P〈0．05）;手术后1个月,观察组神经功能缺损评分为（12．90±2．41）,显著低于对照组（21．24±1．99）,差异有统计学意义（P〈0．05）。结论标准外伤大骨瓣开颅术治疗重型颅脑损伤疗效确切,预后良好,并发症少,值得临床推广应用。     

Establishment of a mechanical injury model of rat hippocampal neurons in vitro

Objective： To establish a simple, reproducible, and practical mechanical injury model of hippocampal neurons of Sprague-Dawley rats in vitro. Methods ： Hippocampal neurons isolated from 1-2-day old rats were cultured in vitro. Mild, moderate and severe mechanical injuries were delivered to the neurons by syringe needle tearing, respectively. The control neurons were treated identically with the exception of trauma. Cell damage was assessed by measuring the Propidium Iodide （PI） uptaking at different time points （0.5, 1, 6, 12 and 24 hours） after injury. The concentration of neuron specific enolase was also measured at some time points. Results ： Pathological examination showed that degeneration, degradation and necrosis occurred in the injured cultured neurons. Compared with the control group, the ratio of PI-positive cells in the injured groups increased significantly after 30 minutes of injury （P 〈 0.05）. More severe the damage was, more PI-positive neurons were detected. Compared with the control group, the concentration of neuron specific enolase in the injured culture increased significantly after 1 hour of injury （ P 〈 0.05）. Conclusions： The established model of hippocampal neuron injury in vitro can be repeated easily and can simulate the damage mechanism of traumatic brain injury, which can be used in the future research of traumatic brain injury.     

Biochemical markers in the acute stage of head injury--aldosterone and CK-BB

In the acute stage of head injury biochemical markers are valuable in the assessment of tissue damage and outcome. In this study, in addition to evaluating computed tomographic (CT) scans, we measured plasma aldosterone and brain type of serum creatine kinase isozyme (CK-BB) to determine whether or not the values obtained reflect the degree of morphological brain changes caused by injury. All 152 patients studied were diagnosed with CT and blood samples were taken on admission. On the basis of clinical and CT findings they were classified into seven groups according to the nature and severity of the insult. Slightly over one half had severe brain injury. Aldosterone was measured by radioimmunoassay and CK-BB by electrophoresis. Aldosterone and CK-BB levels were high in patients with severe cerebral contusion and in those whose CT scan showed a marked midline shift and disappearance of the perimesencephalic cistern. Aldosterone, but not CK-BB, was markedly elevated in patients with epidural hematoma and was only moderately increased in those with a slight midline shift. The results of this study indicate that aldosterone and CK-BB may be useful as biochemical markers in the acute stage of head injury.     

标准大骨瓣开颅术结合颅内压监测治疗重型颅脑损伤

目的探讨标准大骨瓣开颅术结合颅内压监测治疗重型颅脑损伤的疗效。方法回顾性分析手术治疗重型颅脑损伤患者78例的临床资料,采用标准大骨瓣减压结合颅内压监测治疗38例患者为A组,采用常规骨瓣减压治疗40例患者为B组。比较两组患者术后6个月的临床疗效。结果 A组患者的临床效果好于B组。两组在术后6个月临床疗效方面比较,差异有统计学意义（P〈0.05）。结论标准大骨瓣开颅术结合颅内压监测显著改善重型颅脑损伤患者的预后。     

重症颅脑外伤患者急诊手术的麻醉疗效研究

目的：探讨重症颅脑外伤患者急诊手术的有效麻醉方法。方法选择2011年1月～2013年10月我院接收的60例重症颅脑外伤患者为研究对象,随机分成两组,实验组与对照组,各30例。实验组患者给予全凭静脉麻醉,对照组患者实施静吸复合麻醉,比较疗效患者的麻醉疗效。结果实验组患者切皮、切硬脑膜的心率和平均动脉压均较对照组有明显降低,患者的苏醒时间和拔管时间也较对照组明显缩短,两组比较差异有统计学意义（P＜0.05）。结论重症颅脑外伤患者急诊手术时实施静吸复合麻醉可以有效控制患者心率和血压的稳定,麻醉效果显著,同时缩短了患者的苏醒时间和拔管时间,维持了良好的麻醉深度,对患者手术的顺利实施具有重要作用。