老年糖尿病性脑梗死患者血清脂蛋白(a)水平的变化

目的 探讨老年糖尿病性脑梗死(CI)患者血清脂蛋白(a)[Lp(a)]的水平变化.方法 根据病史及空腹血糖水平,将272例老年CI患者分为糖尿病CI组(DCI组,128例)和非糖尿病CI组(NDCI组,144例),另设正常对照绀160人,分别检测其血清Lp(a)、血脂、血糖、体质昔指数(BMI);对CI两组行影像学检查,并进行比较.结果 与正常对照组血清Lp(a)水平[(148.4±145.5)ms/L]比较,DCI组[(398.0±132.9)mg/L]与NDCI组[(253.2±119.3)mg/L]明显增高(均P<0.01);DCI组明显高于NDCI组(P<0.01).DCI组三酰甘油(TG)[(3.62±1.76)mmol/L]、低密度脂蛋白(LDL)[(4.63±0.79)mmol/L]水平较NDCI组[(1.50±0.37)mmol/L、(3.20±0.80)mmol/L]明显增高,而高密度脂蛋白(HDL)水平[(0.85±0.33)mmol/L]较NDCI组[(1.77±0.81)mmol/L]明显降低(P<0.05～0.01),总胆固醇(TC)水平差异无统计学意义.DCI组BMI[(26.72±2.67)ks/m2]明显高于NDCI组[(23.12±2.11)ks/m2](P<0.01).影像学结果显示,DCI组以腔隙性脑梗死多见(46.9%),而NDCI组以单发性脑梗死多见(52.8%).结论 Lp(a)水平升高与老年DCI发病密切相关.     

脑梗死早期血清铁蛋白水平变化的临床意义

目的探讨脑梗死早期血清铁蛋白水平变化的临床意义。方法根据斯堪的纳维亚卒中量表(SSS)评分将642例急性脑死患者分为进展性脑梗死(PS)组(94例)和非PS(NPS)组(548例),检测两组患者发病24 h内血清铁蛋白水平,并与对照组比较。结果 PS组血清铁蛋白水平[(325.67±98.34)μg/L]显著高于NPS组[(236.19±84.12)μg/L](P<0.01);此两组亦显著高于对照组[(150.99±65.42)μg/L](均P<0.01)。结论脑梗死早期血清铁蛋白水平显著升高的患者可能为PS。     

脑梗死患者的亚临床炎症及胰岛素抵抗

目的观察脑梗死患者的亚临床炎症及胰岛素抵抗(IR)情况。方法检测114例脑梗死患者(脑梗死组)血清C-反应蛋白(CRP)、白介素-6(IL-6)及空腹胰岛素(Fins)、空腹血糖(FPG)、血脂、血压水平,分析胰岛素敏感指数(ISI)与炎症指标的关系,并与70例非脑梗死患者(对照组)进行比较。结果⑴脑梗死组血清CRP水平[(2.73±0.87)mg/L]、IL-6水平[(0.14±0.03)ng/ml]明显高于对照组[(1.63±0.93)mg/L、(0.12±0.03)ng/ml](均P<0.01),ISI(-4.31±0.53)明显低于对照组(-3.92±0.43)(P<0.01);⑵脑梗死组中,CRP>8.2mg/L患者的ISI(-4.63±0.71)明显低于CRP≤8.2mg/L患者的ISI(-4.18±0.54)(P<0.05)。结论脑梗死患者存在血清炎症的证据及IR;并且IR和亚临床炎症反应水平相一致。     

单纯性糖耐量异常脑梗死患者血同型半胱氨酸及超敏C反应蛋白水平的改变

目的 研究单纯性糖耐量异常(IGT)脑梗死患者血同型半胱氨酸(Hcy)及超敏C反应蛋白(hs-CRP)水平的改变.方法 根据血糖水平及糖耐量试验将756例脑梗死患者分为糖耐量正常组、IGT组及糖尿病组.采用免疫透射比浊法测定血清hs-CRP水平,荧光偏振免疫分析法测定血浆Hcy水平.结果 血糖正常组331例,IGT组142例,糖尿病组283例.血Hcy及hs-CRP水平IGT组[(19.17±9.35)μmol/L,(8.0±11.9) μg/ml]及糖尿病组[(20.46±10.56) μmol/L,(7.7±20.7) μg/ml]明显高于血糖正常组[(16.17 ±7.35) μmol/L,(3.5 ±9.2) μg/ml](均P＜0.001),IGT组与糖尿病组间的差异无统计学意义.结论 IGT脑梗死患者的血 Hcy和hs-CRP水平明显升高.     

脑梗死后癫(癎)患者血清细胞因子水平的改变

目的 研究脑梗死后癫(癎)患者血清细胞因子水平的改变.方法 应用放射免疫法检测87例脑梗死后癫癎患者(脑梗死癫(癎)组)和75名健康体检者(正常对照组)的血清肿瘤坏死因子α(TNF-α),白细胞介素(IL)-2和IL-6水平.结果 脑梗死癫(癎)组血清TNF-α[(2.5±0.57)ng/L]、IL-2[(9.0 4-0.83)ns/L]及IL-6[(97.5±3.1)ng/L]水平明显高于正常对照组[TNF-α(0.89 4-0.36)ng/L,IL-2(4.3±1.5)ng/L,IL-6(13.3 4-11.1)ng/L](均P＜0.01).结论 脑梗死后癫(癎)患者的血清细胞因子TNF-α、IL-2及IL-6水平显著升高,提示细胞因子可能在脑梗死后癫(癎)的发病中起重要作用.     

急性腔隙性脑梗死患者血清C反应蛋白和白介素-8水平的变化及临床意义

目的 探讨急性腔隙性脑梗死患者血清高敏C反应蛋白(hs-CRP)、白介素-8水平(IL-8) 的变化及其在发病机制中的作用.方法 分别检测36例腔隙性脑梗死和36例脑梗死患者及36例健康对照者血清hs-CRP和IL-8含量.结果 腔梗组和脑梗组hs-CRP含量分别为(10.42±0.68)mg/L和(18.45±1.28)mg/L,均显著高于对照组的(1.28±0.47)mg/L(P<0.01),CI组hs-CRP含量亦显著高于健康对照组(P<0.01);腔梗组和脑梗组IL-8含量分别为(29.65±18.24)ng/ml和(36.57±19.01)ng/ml,显著高于对照组的(25.98±16.87)ng/ml(P<0.01).在脑梗患死者中,大面积脑梗死组(≥9ml,n=16)hs-CRP为(21.36±1.48)mg/L,显著高于小面积脑梗死组(<9ml,n=20)的(15.30±0.97)mg/l(P<0.01),2组IL-8含量分别为(38.1±19.87)ng/ml和(33.45±18.67)ng/mL,差异亦有统计学意义(P<0.01).结论 炎症过程参与了脑小血管病变;hs-CRP和IL-8水平与脑缺血程度以及脑的小血管病变范围密切相关.hs-CRP 及IL-8是预测脑梗死患者病情严重程度的重要生化指标.     

糖化血红蛋白及高敏C反应蛋白与脑梗死急性期患者颈动脉粥样硬化的关系

目的 探讨脑梗死急性期患者糖化血红蛋白(HbA1c)、高敏C反应蛋白(hs-CRP)与颈动脉粥样硬化斑块的关系. 方法 连续收集广州医学院第二附属医院神经内科自2010年1月1日至12月31日收治的110例脑梗死急性期患者(急性脑梗死组)和同期98例健康体检者(正常对照组),通过颈动脉彩超测量颈总动脉内中膜厚度(IMT)并根据其值将脑梗死组分为3个亚组(正常组、轻度粥样硬化组、重度粥样硬化组),同时观察有无颈动脉斑块形成;全自动生化仪器检测HbA1c、hs-CRP水平. 结果 与正常对照组相比,急性脑梗死组HbA1c、hs-CRP水平[(4.8±0.3)％vs(5.9±0.6)％;(0.78±0.11) mg/Lvs(3.25±0.72) mg/L]明显升高,差异有统计学意义(P＜0.05).轻度粥样硬化组HbA1c水平[(5.1±0.5)％]明显高于正常组[(4.3±0.3)％],重度粥样硬化组HbA1c、hs-CRP水平[(7.1±0.9)％;(1.37±1.5)mg/L]高于正常组、轻度粥样硬化组[(1.11±1.1) mg/L;(1.02±0.3) mg/L].脑梗死急性期患者颈动脉IMT值与HbA1c、hs-CRP水平及二者乘积均呈明显正相关关系(r=0.437,P=0.000;r=0.215,P=0.000; r=0.729,P=0.000). 结论 糖耐量异常和炎症的联合作用与脑梗死急性期患者颈动脉粥样硬化有一定的相关性.     

重症肌无力患者血清可溶性Fas水平变化及其临床意义

目的探讨重症肌无力(MG)患者血清可溶性Fas(sFas)水平变化及其临床意义。方法采用流式细胞术及酶联免疫吸附法(ELISA)分别测定45例MG患者(MG组)及40例对照者(对照组)外周血T细胞亚群分布和血清sFas水平,并对其中24例MG患者应用糖皮质激素(GC)治疗前后的血清sFas水平进行比较。结果(1)MG组外周血中CD8 T细胞百分率为(21.50±2.21)%,明显低于对照组[(27.75±3.00)%](P<0.01);CD4 /CD8 比值(1.92±0.26)明显高于对照组(1.48±0.16)(P<0.01);血清sFas水平[(3542.06±706.23)pg/m l]显著高于对照组[(2568.18±562.48)pg/m l](P<0.01)。(2)MG组全身型血清sFas水平为(3914.23±804.81)pg/m l,极明显高于眼肌型[(2797.72±592.83)pg/m l](P<0.001);病情中、重度患者明显高于病情轻度者(均P<0.005);预后良好者[(3254.69±661.73)pg/m l]显著低于预后不良者[(4178.38±841.65)pg/m l](P<0.001)。(3)24例MG患者经GC治疗后sFas水平[(2864.59±617.43)pg/m l]较治疗前[(3539.67±705.92)pg/m l]极显著降低(P<0.001)。结论MG患者血清凋亡抑制因素sFas水平增高,并与MG类型、病情及预后相关;GC治疗可以改善MG患者的免疫功能。     

急性脑卒中患者血清红细胞生成素水平改变及其意义

目的探讨急性脑卒中患者血清红细胞生成素(EPO)水平改变及其临床意义。方法应用放射免疫法检测60例脑梗死(脑梗死组)、45例脑出血(脑出血组)和40例其他神经系统疾病患者(对照组)的血清EPO水平。用美国国立卫生研究院卒中量表(NIHSS)对急性脑卒中患者进行评分。结果脑梗死组和脑出血组血清EPO水平[(1.64±0.41)ng/ml,(1.59±0.54)ng/ml]显著高于对照组[(1.17±0.86)ng/ml](均P<0.05),脑梗死组及脑出血组的NIHSS评分[(10.42±3.75)分,(11.58±4.16)分]与血清EPO水平呈负相关(r=-0.482,r=-0.537,均P<0.05)。结论急性脑卒中患者的血清EPO水平明显升高,并且病情越重的患者血清EPO水平越低。     

急性脑梗死患者血清可溶性CD40L与C-反应蛋白含量的改变及其意义

目的 探讨急性脑梗死(ACI)患者血清可溶性CD40L(sCD40L)和C-反应蛋白(CRP)含量的改变及其意义.方法 采用双抗体夹心酶联免疫法及比浊法检测40例ACI患者及30人正常对照者的血清sCD40L和CRP含量,比较不同病情、不同梗死面积ACI患者的血清sCD40L和CRP含量变化,对二者之间的关系进行相关性分析.结果 ACI组血清sCD40L[(3.57±0.86) ng/ml]、CRP[(17.53±7.61) mg/L]的含量明显高于正常对照组(均P<0.01),ACI病情重度组、大面积梗死组血清sCD40L、CRP的含量明显高于病情中度、轻度组和小面积、腔隙性脑梗死组,病情中度组、小面积梗死组又明显高于病情轻度组、腔隙性脑梗死组(均P<0.05).血清sCD40L与CRP含量呈正相关(r=0.817,P<0.01).结论 ACI患者血清sCD40L、CRP含量升高,并与病情严重程度和梗死面积有关.提示其可作为判断ACI病情的血清生物学指标.     

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     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

Release of endogenous catecholamines from slices of hypothalamus of rats

The release of endogenous catecholamines from superfused slices of rat hypothalamus was studied under basal conditions and during release evoked by 40 mM K⁺. Catecholamines in superfusates, and in extracts of the tissue after stimulation, were isolated by column chromatography and quantitated by liquid chromatography with electrochemical detection. Norepinephrine (NE) was not consistently demonstrable in superfusate collected under basal conditions, but 40 mM K⁺ caused the release of from 2 to 4 ng/g of tissue per min. The addition of cocaine to the superfusate caused increases in basal and evoked release of NE. Epinephrine (E) could be measured in superfusates of slices from male but not female rats and then only when cocaine was added to the superfusate. Accordingly, the concentration of E in hypothalamus was greater in male rats than in female rats. Dopamine (DA) was not consistently measurable in the spontaneous overflow from slices either in the presence or absence of cocaine. K⁺-evoked release of DA could be demonstrated in slices from female rats. The addition of cocaine increased the evoked release of DA from slices from both sexes. Corticosterone, added to cocaine, had no effects on the efflux of any of the catecholamines. The experiments suggest that neuronal reuptake of all catecholamines is very efficient in the hypothalamus both under basal conditions and during evoked release.     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。