马来酸桂哌齐特与硫酸镁联合治疗外伤性蛛网膜下腔出血的临床观察

目的探讨马来酸桂哌齐特与硫酸镁联合应用治疗外伤性蛛网膜下腔出血（tSAH）的疗效。方法选择240例tSAH病例随机分为对照组及治疗I、Ⅱ、Ⅲ组，每组60例。对照组采用常规治疗（止血、脱水、激素及促神经功能恢复药等）治疗I、Ⅱ、Ⅲ组均在常规治疗基础上．分别采用马来酸佳哌齐特、硫酸镁及马来酸桂哌齐特＋硫酸镁治疗。结果在头痛症状减轻程度及持续时间、脑膜刺激征持续时间、脑脊液恢复正常时间方面，治疗Ⅲ组效果均优于其它3组（P〈0．05）。结论马来酸桂哌齐特联合硫酸镁治疗tSAH，对患者临床症状的改善优于单独使用马来酸桂哌齐特或硫酸镁治疗，值得临床推广应用。     

血管内支架置入术联合马来酸桂哌齐特治疗缺血性脑血管病的临床效果

目的观察血管内支架置入术联合马来酸桂哌齐特治疗缺血性脑血管病的临床效果。方法 120例脑血管病患者随机分为对照组和观察组,每组60例。2组均给予缺血性脑血管病常规治疗,对照组在常规治疗的基础上采用马来酸桂哌齐特治疗,观察组在对照组的基础上加用血管内支架置入术治疗。比较2组治疗前后神经功能改善情况、梗死面积改善情况。结果观察组治疗后神经功能缺损评分显著优于对照组,观察组治疗后梗死面积显著少于对照组。结论血管内支架置入术联合马来酸桂哌齐特治疗缺血性脑血管病可促进患者神经功能恢复,减少梗死面积,值得临床推广应用。     

马来酸桂哌齐特治疗急性脑梗死的疗效分析

目的 探讨马来酸桂哌齐特在辅助治疗急性脑梗死中的应用价值.方法 选择我院2011-03-2013-03收治的急性脑梗死患者80例,按不同治疗方式随机均分为对照组（常规治疗辅以血栓通）和实验组（常规治疗辅以马来酸桂哌齐特）,对2组患者的治疗效果进行比较.结果 实验组总有效率82.5%,明显高于对照组的55.0%（P＜0.05）;实验组治疗14 d后神经功能缺损评分均明显低于对照组（P＜0.05）;2组患者经治疗14 d后的血浆纤维蛋白原水平比较差异有统计学意义（P＜0.05）.结论 马来酸桂哌齐特治疗急性脑梗死效果显著,能明显改善患者神经功能,值得临床推广应用.     

马来酸桂哌齐特治疗椎基底动脉供血不足的临床观察

目的 观察马来酸桂哌齐特对椎基底动脉供血不足的临床疗效及安全性.方法 收集我院住院部椎基底动脉供血不足患者79例,按入组顺序随机分为2组,分别给予马来酸桂哌齐特与复方丹参注射液治疗,比较二者治疗效果.结果 总有效率马来酸桂哌齐特组为97.5%,复方丹参组为79.5%,2组差异具有统计学意义(P＜0.05).马来酸桂哌齐特起效时间明显短于复方丹参,24h内有效率高于复方丹参组(P＜0.05).结论 马来酸桂哌齐特治疗椎基底动脉供血不足疗效肯定,不良反应少,值得临床推广应用.     

马来酸桂哌齐特联合依达拉奉治疗急性脑梗死临床疗效及安全性分析

目的研究马来酸桂哌齐特联合依达拉奉治疗急性脑梗死的临床疗效和安全性。方法将我院收治的119例急性脑梗死患者为观察对象,随机均分为观察组和对照组,分别给予马来酸桂哌齐特和依达拉奉及血栓通和胞磷胆碱进行治疗,评价不同用药方法治疗急性脑梗死的效果。结果采用马来酸桂哌齐特和依达拉奉联合治疗的观察组无斑块38例(64.40%),斑块稳定17例(28.81%),斑块不稳定4例(6.77%);采用血栓通和胞磷胆碱联合治疗的对照组无斑块32例(4.23%),斑块稳定13例(22.03%),斑块不稳定14例(23.72)%;观察组治疗后CCS评分14.13±6.85,Barthel评分76.24±19.24,对照组治疗后CCS评分25.32±10.54,Barthel评分44.25±12.05,差异具有统计学意义P0.05。结论马来酸桂哌齐特联合依达拉奉治疗急性脑梗死能显著改善患者的神经功能缺损程度,值得推广应用。     

低分子肝素钙联合马来酸桂哌齐特治疗短暂性脑缺血发作的疗效及安全性观察

目的研究低分子肝素钙联合马来酸桂哌齐特治疗短暂性脑缺血发作的疗效及安全性。方法选取2014-02—2015-07我科治疗的短暂性脑缺血发作患者90例,按随机数字表法分为观察组及对照组各45例,对照组给予马来酸桂哌齐特治疗,治疗组在对照组常规治疗基础上加用低分子肝素钙治疗,记录并分析治疗前后2组患者活化部分凝血酶原时间APTT变化状况、2组血液流变学和血小板计数变化状况、纤维蛋白原变化状况。结果 (1)治疗2周后观察组患者APTT为(35.8±3.1)s,明显优于对照组(41.6±2.7)s,差异有统计学意义(P0.05)。(2)治疗后观察组血液流变学和血小板计数明显优于对照组,差异有统计学意义(P0.05)。(3)治疗后观察组纤维蛋白原为(4.1±1.3)g/L明显优于对照组(8.6±1.6)g/L,差异有统计学意义(P0.05)。结论低分子肝素钙联合马来酸桂哌齐特在短暂性脑缺血发作疗效肯定、确切,与单独应用马来酸桂哌齐特治疗相比无明显不良反应,能显著提高短暂性脑缺血发作治愈率、降低复发率,值得临床应用。     

马来酸桂哌齐特治疗椎基底动脉供血不足的临床观察

目的 观察马来酸桂哌齐特对椎基底动脉供血不足的临床疗效及安全性.方法 收集我院住院部椎基底动脉供血不足患者79例,按入组顺序随机分为2组,分别给予马来酸桂哌齐特与复方丹参注射液治疗,比较二者治疗效果.结果 总有效率马来酸桂哌齐特组为97.5%,复方丹参组为79.5%,2组比较差异具有统计学意义(P＜0.05).马来酸桂哌齐特起效时间明显短于复方丹参,24h内有效率高于复方丹参组(P＜0.05).结论 马来酸桂哌齐特治疗椎基底动脉供血不足疗效肯定,不良反应少,值得临床推广应用.     

马来酸桂哌齐特联合长春西汀治疗急性脑梗死疗效观察

目的观察马来酸桂哌齐特联合长春西汀治疗急性脑梗死的临床疗效及安全性。方法选择临床确诊的急性脑梗死患者76例,随机分成治疗组和观察组各38例。治疗组给予马来酸桂哌齐特注射液320mg,长春西汀30mg,阿司匹林0.1g口服,每晚1次;对照组给予长春西汀30mg,阿司匹林0.1g口服,每晚1次,连用14d。治疗期间采用中国卒中量表（CSS）对神经功能缺损进行评定。结果 治疗组临床总有效率89.5%,对照组为65.8%,治疗组疗效明显优于对照组,2组总有效率比较差异有统计学意义（P〈0.01）。结论 马来酸桂哌齐特联合长春西汀治疗脑梗死疗效显著,能有效改善脑梗死患者神经功能,值得临床进一步推广。     

马来酸桂哌齐特注射液对后循环缺血患者的血液流变学和血流动力学的影响

目的观察马来酸桂哌齐特注射液对后循环缺血(PCI)患者的血液流变学和血流动力学的影响。方法选取100例PCI患者为研究对象,将其随机分为观察组和对照组各50例。对照组给予常规治疗,观察组在常规治疗的基础上加用马来酸桂哌齐特注射液治疗。对2组患者治疗前后的血液流变学指标、血清超敏C反应蛋白(hs-CRP)水平和血流动力学指标进行检测和比较;对2组患者的临床疗效和不良反应发生情况进行观察和比较。结果经治疗,2组患者的各项血液流变学指标和血清hs-CRP水平均出现显著下降(t=4.328~6.356,P0.05),且观察组各项血液流变学指标和血清hs-CRP水平均显著低于对照组(t=3.655~4.759,P0.05),2组椎动脉及基底动脉血流速度指标均出现显著上升(t=3.987~5.035,P0.05),且观察组椎动脉及基底动脉血流速度指标均显著高于对照组(t=3.394~4.358,P0.05);观察组临床疗效和临床有效率均优于对照组(U=3.703,χ~2=4.882,P0.05),2组患者的不良反应总发生率及各类不良反应发生率差异均无统计学意义(χ~2=0.211~1.010,P0.05)。结论马来酸桂哌齐特注射液治疗PCI,可有效改善患者的血流动力学指标和血液流变学指标,缓解患者的神经功能缺损症状,提高治疗效果,有利于改善患者的预后。     

马来酸桂哌齐特联合舒血宁治疗急性脑梗死的疗效观察

目的观察马来酸桂哌齐特联合舒血宁治疗急性脑梗死的疗效及安全性。方法选取我院2009-02—2012-10收治的急性脑梗死患者200例,随机分成对照组和联合治疗组各100例。对照组在常规治疗的基础上加用舒血宁;联合治疗组在对照组的基础上加用马来酸桂哌齐特。治疗前后检查血、尿常规、血脂、血糖、肝肾功能、凝血功能、心电图等。结果经数理统计学分析,联合治疗组明显优于对照组(P<0.05);2组安全性方面比较差异无统计学意义(P>0.05)。结论马来酸桂哌齐特联合舒血宁在治疗急性脑梗死方面疗效确切、安全。     

沙盘游戏疗法在地中海贫血患儿心理干预中的应用

本文目的是对沙盘游戏疗法在地中海贫血患儿心理干预中的应用进行综述,以期为地中海贫血患儿的心理康复提供参考。地中海贫血是以珠蛋白生成障碍为主要特征的遗传性疾病,由于长期输血治疗,患儿存在较多的心理和行为问题。沙盘游戏疗法作为一种有效、实用的儿童心理治疗方法,对提高地中海贫血患儿的康复效果、改善生存质量有重要的临床意义。     

癫痫共病抑郁的机制及临床诊疗

本文目的是探讨癫痫共病抑郁的可能机制及临床诊疗。癫痫是一种常见的、慢性的、致残性的神经疾病,癫痫患者生活质量下降,存在明显的负性情绪,常伴发各种精神疾病。癫痫与抑郁具有共同的神经生物学基础,可能存在共同的发病机制。本文从癫痫共病抑郁的发病机制、临床诊断及治疗方面予以总结归纳。     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Cultural Identity and Experiences of Prejudice and Discrimination of Afghan and Iranian Immigrant Youth

In culturally diverse and immigrant receiving societies, immigrant youth can be subject to prejudice and discrimination. Such experiences can impact on immigrant youth’s cultural identity and influence their psychosocial outcomes. This paper presents findings of a study that examined cultural identity and experiences of prejudice and discrimination among Afghan (N = 9) and Iranian (N = 17) immigrant youth in Canada. The study had a prospective, comparative, longitudinal qualitative design. Data was gathered through focus groups, interviews, journals and field logs. Four main themes emerged on participants’ experiences of prejudice and discrimination: (a) societal factors influencing prejudice; (b) personal experiences of discrimination; (c) fear of disclosure and silenced cultural identity; and (d) resiliency and strength of cultural identity. Drawing from Rosenberg’s (Conceiving the self, Basic Books, New York, 1979) self-concept framework and Romero and Roberts (J. Adolesc., 21:641–656, 1998) distinction between prejudice and discrimination, results indicated that youth’s extant and presenting cultural identity were affected. Inclusive policies and practices are needed to promote youth integration in multicultural and immigrant receiving settings.

发作性睡病与异态睡眠的诊治

本文目的是探讨发作性睡病与异态睡眠的诊断与治疗.发作性睡病被漏诊和误诊的几率较高,危害较大,共患异态睡眠比例高.文章从发作性睡病临床特征、REM睡眠的作用、发作性睡病与异态睡眠(睡眠瘫痪、睡眠幻觉、快眼动睡眠期行为障碍)共病特征及治疗这四个方面进行了讨论.     

Effects of Agonists and Antagonists of Cholecystokinin on Contractile and Myoelectric Activity of Isolated Muscle of Colon and Ileum in the Dog and Guinea Pig

This study evaluates the effects of agonists and antagonists of cholecystokinin (CCK) on contractile and myoelectrical activity in isolated longitudinal muscle strips from colon or ileum of guinea pigs or beagle dogs. Caerulein and CCK-8 caused a dose-dependent increase of contractile and myoelectrical spike activity in both species with maximal effects seen between 10⁻⁸ and 3 × 10⁻⁸ M. The dose responses were identical for both CCK agonists and species. The dose-related effects of CCK compounds on colonic muscle were slightly shifted to the right when compared to ileum in both species. All antagonists, the proglumide-derivatives CR1409, CR1392, and CR1505, as well as the nonpeptide substances asperlicin and L-364,718, caused a parallel rightward shift of CCK's dose-dependent motor activity response, indicating the competitive nature of inhibition. The antagonists displayed a rank order of potency in antagonizing CCK's action on intestinal motility similar to their ability to antagonize CCK's action on pancreas and gallbladder. L-364,718 was the most potent antagonist, followed by CR1409, CR1505, CR1392, asperlicin, and proglumide. The antagonists did not affect contractile or myoelectrical responses to acetylcholine, histamine, motilin, or substance P. Thus compounds that have been described as CCK antagonists for pancreas and gallbladder also act as specific and competitive antagonists of CCK's action on contractile and myoelectrical activity of Heal and colonie muscle.     

The neuroendocrinology of stress and the pathophysiology and therapy of depression and anxiety

Clinical and preclinical studies have gathered substantial evidence that stress response alterations play a major role in the development of major depression, panic disorder, and post-traumatic stress disorder. The stress response, the hypothalamic pituitary adrenocortical (HPA) system and its modulation by corticotropin-releasing hormones (CRH),corticosteroids,and their receptors, and the roles of natriuretic peptides and neuroactive steroids are described. We review the role of the HPA system in major depression, panic disorder, and post-traumatic stress disorder and its possible relevance for treatment. Impaired glucocorticoid receptor function in major depression is associated with an excessive release of neurohormones such as CRH, to which a number of signs and symptoms characteristic of depression can be ascribed. In panic disorder, a role of central CRH in panic attacks has been suggested. Atrial natriuretic peptide (ANP) is causally involved in sodium lactate-induced panic attacks. Furthermore, preclinical and clinical data on its anxiolytic activity suggest that nonpeptidergic ANP receptor ligands may be potentially useful in the treatment of anxiety disorders. Post-traumatic stress disorder is characterized by a peripheral hyporesponsive HPA system and elevated CRH concentrations in the CSF. This dissociation is probably related to an increased risk of this disorder. We further review recent data that describe an important role of GABA(A)-receptor modulatory,3 alpha-reduced neuroactive steroids in major depression, anxiety, and its treatment. Antidepressants are effective in both depression and anxiety disorders and have major effects on the HPA system,especially on glucocorticoid and mineralocorticoid receptors. Normalization of HPA system abnormalities is a strong predictor of the clinical course, at least in major depression and panic disorder. Currently,CRH-R1 or glucocorticoid receptor antagonists and ANP receptor agonists are being studied and may provide future treatment options more closely related to the pathophysiology of these disorders.     

小胶质细胞和少突胶质细胞前体的培养和鉴定

目的 探讨新生大鼠脑组织小胶质细胞(MG)和少突胶质细胞(OL)前体的分离和体外培养方法 . 方法 取新生2 d SD大鼠脑组织,体外原代培养混合胶质细胞7 d后,分别采用"改良振荡伴差速贴壁"法和"营养缺失伴振荡"法纯化培养MG和OL前体,并分别应用免疫荧光染色异凝集素-B4(IB4)和OL前体标记物(O4)进行鉴定.结果 混合胶质细胞培养7 d后呈明显三层增长,其中MG位于上层,星型胶质细胞位于底层,两者之间为2型少突星型(O2A)祖细胞.纯化培养后OL前体胞体呈小圆形,有双极或三极突起,MG则以阿米巴形、圆形居多,或边缘呈毛刺状.免疫荧光染色IB4显示绿色荧光,MG纯度达到90%以上.免疫荧光染色O4显示棕黄色荧光,OL前体纯度达到95%以上. 结论 采用"改良振荡伴差速贴壁"法以及"营养缺失伴振荡"法分别成功获取大量纯度高、活力好的MG和OL前体.     

Review and meta-analysis of the phenomenology and clinical characteristics of mania in children and adolescents

OBJECTIVE: Using predetermined criteria for study quality and methods, a literature review and meta-analysis of seven reports about pediatric bipolar disorder (BPD) was conducted to determine if there is a consistent picture of the phenomenology and clinical characteristics of BPD in children and adolescents. METHODS: Searches were conducted in MedLine and PsycINFO using the terms mania, BPD, children and adolescents, and was limited to published articles in peer-reviewed journals. Seven reports were selected that met the following criteria: a systematic method for the elicitation and reporting of symptoms and clinical characteristics of subjects; subjects were interviewed by a trained researcher or clinician; ages 5-18 years; use of a diagnostic system, either DSM or RDC for categorization; a consensus method for the establishment of the diagnosis of BPD. RESULTS: Most DSM-IV symptoms of mania were common in the children and adolescents with BPD with the most common symptoms being increased energy, distractibility, and pressured speech. On average, four of five bipolar cases also showed threshold levels of irritable mood and grandiosity, and more than 70% of all cases showed elated/euphoric mood, decreased need for sleep, or racing thoughts. Roughly 69% of cases also showed poor judgment, whereas only half of bipolar cases demonstrated flight of ideas, and slightly more than one-third showed hypersexuality or psychotic features. CONCLUSIONS: The clinical picture that emerges is that of children or adolescents with periods of increased energy (mania or hypomania), accompanied by distractibility, pressured speech, irritability, grandiosity, racing thoughts, decreased need for sleep and euphoria/elation.