精神分裂症住院患者合并躯体疾病临床分析

目的:研究精神分裂症住院患者合并躯体疾病的临床特点及影响因素。方法:将184例患者按入院后有无合并躯体疾病分为有合并症组及无合并症组,以研究合并症发生的有关因素。结果:慢性精神分裂症患者入院后发生躯体疾病者124例(67.4)%,躯体疾病依次为高脂血症(54.0%)、心电图异常(49.2%)和低钾血症(33.9%)等。合并症的发生与患者年龄及病程均相关(P<0.001~0.01),与抗精神病药类型、合并用药及剂量无显著关系(P>0.05)。结论:对慢性精神分裂症住院患者应充分重视可能发生的躯体疾病,并对躯体疾病给予及时合理的诊断和治疗。     

合并三高症状的脑血管病患者血清NO及NOS含量测定

我国为脑血管疾病的高发国家,年发病率为185～219/10万,每年约有200万新发病例和150万的死亡病例[1].其发病率有逐年上升的趋势.而三高(高血压、高脂血症、高血糖)是老年患者心脑血管疾病发生的重要危险因素.脑血管病发生时人体内氧化与抗氧化系统的平衡状态被打破,致使体内氧化与抗氧化物质浓度发生改变.     

Orexin系统在神经系统疾病中的作用

Orexin及其受体在神经系统分布广泛,其分布区受损或Orexin系统功能损害均导致某些神经系统疾病的发生、发展。本文综述了睡眠障碍、急性颅脑损伤、蛛网膜下腔出血、吉兰-巴雷综合征、亨廷顿病、丛集性头痛、强直性肌萎缩、糖尿病性神经痛等神经系统疾病患者脑脊液或血浆中Orexin浓度的改变及某些疾病发生改变的可能机制,提示Orexin系统与这些疾病的机制有关,为今后从神经内分泌学角度诊断和治疗这些疾病奠定了基础。     

PCSK9在肝细胞和脑组织中的不同生物作用

随着人们平均期望寿命的增长,心脑血管疾病成为常见病,而且其病死率越来越高.有效地预防心脑血管疾病的发生、发展成为当今医学研究的热点.动脉粥样硬化侵犯心、脑血管,是导致心脑血管疾病发生的主要原因[1].预防和控制动脉粥样硬化成为降低心脑血管疾病发生、发展的主要治疗措施.动脉粥样硬化属于多病因疾病,主要危险因素有高血压病、糖尿病、年龄、性别、吸烟等,脂质异常是最重要的危险因素之一[1].降低血清低密度脂蛋白胆固醇（low density lipoprotein-cholesterol,LDL C）浓度可以有效地预防冠心病、脑梗死的发生和再发生.     

178例肢体瘫痪病人院内感染因素分析

目的了解肢体瘫痪住院病人中发生院内感染与其他疾病住院病人有无明显的差异,以及肢体瘫痪病人发生院内感染的相关因素。方法对178例肢体瘫痪病人资料进行整理并作回顾性调查分析。结果178例肢体瘫痪病人,34例发生院内感染,感染率为19.1%。>60岁的患者感染率最高,为62.25%;住院时间>30d的患者感染率最高,为42.8%;院内感染部位以上呼吸道为主,占总感染人数的35.2%;侵入性操作、广谱抗生素的使用都与院内感染有关,基础疾病引起的肢体瘫痪与院内感染无关。结论肢体瘫痪患者院内感染率明显高于其他疾病的院内感染率,其发生与医院内某些危险因素有关,并严重影响肢体瘫痪患者的预后。     

hnRNPD在神经发育过程中的作用

hnRNPD是核不均一核糖核蛋白(hnRNPs)家族成员之一,是多种生物学途径的中枢调节因子,参与炎症、癌症、心血管疾病和病毒感染等多种疾病发生发展。最近研究显示,hnRNPD在神经发育过程中特异性表达,调控相关基因参与神经元等分化成熟以及相关疾病的发生发展,但其作用机制不详。本文将hnRNPD在神经发育和参与神经疾病中的作用以及可能调控机制作一综述,为深入认识和了解hnRNPD在神经发育和疾病致病过程中的作用提供理论参考。     

脑卒中后癫痫药物修饰治疗进展

脑卒中后癫痫患者对低剂量抗癫痫发作药物治疗反应良好,但仍有部分患者进展为耐药性癫痫,因此亟待研发有效预防或逆转癫痫发生和发展且具备疾病修饰治疗作用的药物。业已证实,左乙拉西坦、拉莫三嗪、唑尼沙胺等新型抗癫痫发作药物,大麻二酚、多酚类化合物等天然化合物,线粒体抗氧化药、非甾体抗炎药等药物不仅能控制癫痫发作,甚至能够阻止脑卒中后癫痫的发生,以此发挥抗癫痫发生及疾病修饰治疗作用。本文对具有疾病修饰治疗作用的药物进行归纳,以为脑卒中后癫痫的疾病修饰治疗提供新的研究思路。     

老年人跌倒和神经系统疾病

该文概述了患有神经系统疾病老年人跌倒发生的流行病学现况，神经系统疾病及其用药对跌倒的影响，跌倒危险性的评估及预防。以便为临床防治提供参考。     

铁死亡在神经系统疾病中的研究进展

正铁死亡(Ferroptosis)是一种铁离子依赖的、以脂质过氧化产物和致死活性氧的积累为特点的非典型的细胞死亡方式,近几年的机制研究发现,铁死亡参与某些神经系统疾病的发生发展,本文将系统的介绍铁死亡在神经系统疾病中的最新研究进展,为临床、疾病发病机制研究提供更多思路。细胞死亡对哺乳动物的生长发育、疾病的发生等各方面至关重要。细胞死亡命名委员会认为细胞死亡有两种方式~([1]):(1)细胞意外死亡:常由物理、化学、生物等因素导致,     

妊娠与产褥期脑血管疾病的临床分析

妊娠期高血压疾病(妊高症)是妊娠期特有的疾病,国内发病率9.4%～10.4%,国外为7%～12%[1]。若不能及时诊治而发生脑血管疾病,常危及母儿生命。2006-01～2011-01我院共收治8例因妊娠、分娩并发脑血管疾病患者,现分析报道如下。1资料与方法1.1一般资料本组8例均为农村及外来务工产妇,年龄     

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.     

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.     

失匹配负波在意识障碍评估中的临床价值探讨

自失匹配负波(MMN)于20世纪70年代被发现以来,我们对规律性声音被打破后所诱发的前注意检测有了进一步认识,而MMN成为了开启认知大门的钥匙。至今为止,MMN的研究范围从产生机制发展到神经精神疾病相关的临床试验,特别是对于急性脑损伤(ABI)昏迷以及进展后的慢性意识障碍(DoC)患者,MMN被认为是一个可靠的预后预测指标。然而,由于MMN难以用于个体评估,目前在临床实践中的应用仍十分有限,广大临床医师对MMN的了解甚少。因此,本文就MMN的产生机制、在意识障碍中的临床意义、判读方法及其影响因素做一综述。     

Onset of action of antipsychotics in the treatment of mania

Introduction: An important consideration in treating acute mania is the promptness with which a chosen therapy can bring symptom amelioration. This article reviews the available published data from controlled, blinded studies regarding the latency of responses to antipsychotics in patients with acute mania.

Methods: Articles for this review were obtained from a search of the Medline database (1966–1999), using the following keywords and phrases: antipsychotic, atypical, bipolar disorder, mania, neuroleptic, typical. The bibliographic sections of articles gleaned from this search were used to direct further inquiries.

Results: Although information regarding the onset of action of antipsychotics is limited, we discovered data for four typical and three atypical antipsychotics. Drugs with the fastest onsets include haloperidol, risperidone, and olanzapine, with onsets appearing in 2–6 days. Chlorpromazine and thiothixene were at the slowest end of the continuum, with onsets of 2 weeks or longer. Data regarding pimozide are mixed, with some studies showing an onset equivalent to that of the 'fast' compounds and others showing one similar to that of the 'slow' compounds.

Conclusions: Choice of therapy should consider not only efficacy and safety, but also onset speed. Atypical antipsychotics appear to offer safer, faster, and more effective therapies.     

The Institute of Epileptology of King's College, University of London

Summary: The Institute of Epileptology of King's College, London has arisen from need and from opportunity. The need is due to the relative neglect nationally and internationally of the most common serious brain disorder with important physical, psychological, and social complications. The relative neglect is reflected in services, research, charitable donations, public profile, and stigma and in a serious lack of professional education. The opportunity arose because of the existence in several medical institutions at Denmark Hill, London, of a group of medical and related colleagues with a special interest covering almost every aspect of this multidisciplinary disorder who agreed to combine their expertise in this initiative. The idea was born and developed in 1991–1992 and was supported by all the parent institutions: The Maudsley and King's College Hospitals, St Piers Lingfield, The Institute of Psychiatry, King's College School of Medicine and Dentistry, and the School of Life, Basic Medical and Health Sciences, all under the umbrella of King's College, University of London. Further stimulus and help came from a group of dedicated supporters in private and public life. There are three strands to this initiative: (a) a charity, The Fund for Epilepsy; (b) the clinical Centre for Epilepsy, which was formally opened at the Maudsley Hospital in July 1994; and (c) the academic Institute of Epileptology for research and teaching, which was launched on November 15, 1994.     

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.     

肌萎缩侧索硬化三例误诊分析

目的掌握肌萎缩侧索硬化(ALS)的诊断标准,以便早期准确诊断,避免误诊。方法分析3例ALS患者早期被误诊的临床资料。结果 3例患者均以下肢无力发病,逐渐波及上肢或对侧肢体,脊柱MR I示颈部或腰部椎间盘突出压迫硬膜囊,手术治疗后,症状无缓解,病情仍进行性加重,经肌电图检查证实为ALS。结论临床医师应熟知ALS的诊断标准,对患者详细询问病史、认真查体和电生理检查是减少ALS误诊的关键。     

Application of Coregistration for Imaging of Animal Models of Epilepsy

Summary:  The past decade has seen a surge in the utilization of small animal imaging for epilepsy research. In vivo imaging studies have the potential to provide important insights into the structural and functional correlates of the development and progression of epilepsy in these models. However, the small size of the rodent brain means that anatomic resolution is often relatively poor for many imaging modalities, particularly those providing functional information such as positron emission tomography. Coregistration of these images with those of higher structural resolution, such as MRI, provides an attractive approach to this problem, and also allows correlations between structural and functional imaging data. Image coregistration is commonly utilized in clinical research and practice. However, its application for small animal images has been, to date, relatively under utilized and largely unvalidated. The current review aims to provide an overview of image coregistration methods, particularly for MRI and PET, and their application to imaging of small animal models of epilepsy. Methodological advantages and potential traps are highlighted.