坎地沙坦与缬沙坦对轻中度原发性高血压患者的降压效果及心脏重构与舒张功能的影响

目的探讨坎地沙坦、缬沙坦对轻中度原发性高血压患者的降压效果及对心脏重构与舒张功能的影响。方法选取我院2015-07—2016-07收治的106例轻中度原发性高血压患者为研究对象,观察组53例采用坎地沙坦治疗,对照组53例采用缬沙坦治疗。治疗2个月后对比2组治疗效果、不良反应及对心脏重构与舒张功能影响情况。结果治疗后2组舒张压与收缩压均较治疗前显著下降,且观察组优于对照组,差异有统计学意义(P0.05);2组血压达标率差异无统计学意义(P0.05);治疗期间2组均未出现不良反应事件(P0.05);2组治疗后左心房容积指数均较治疗前有所改善,且观察组优于对照组,差异有统计学意义(P0.05);治疗后2组N末端脑钠肽原浓度均较治疗前有所下降,且观察组下降幅度优于对照组,差异有统计学意义(P0.05);2组治疗前后左心房质量指数差异无统计学意义(P0.05)。结论坎地沙坦治疗轻中度原发性高血压患者可确保降压效果,在心脏重构效果上远优于缬沙坦,可临床推广。     

马来酸左旋氨氯地平与依那普利治疗原发性高血压的疗效观察

目的观察马来酸左旋氨氯地平联合依那普利治疗原发性高血压的疗效。方法选取2010-12—2012-12我院心内科原发性高血压患者108例,随机分为2组,观察组54例,采取马来酸左旋氨氯地平2.5mg,qd,依那普利10mg,bid;对照组54例给予马来酸左旋氨氯地平片2.5mg,qd;2组均治疗8周。观察2组患者疗效及不良反应发生情况。结果 2组治疗后临床疗效比较,差异有统计学意义(P<0.05);不良反应均较轻微,2组比较差异无统计学意义(P>0.05)。结论马来酸左旋氨氯地平联合依那普利对原发性高血压疗效优于单用马来酸左旋氨氯地平,降压效果肯定,作用平稳持久,且不良反应较少,值得临床推广。     

不同分型短暂性脑缺血发作患者的血压变异性研究

目的探讨不同分型TIA患者的血压变异性。方法采集246例TIA患者和246例同期健康者的临床资料。根据受累血管的不同,将TIA患者分为前循环系统TIA组(AC-TIA)160例和后循环系统TIA组(PC-TIA)86例。24 h动态血压仪监测血压值和血压变异性。结果与对照组比较,PC-TIA组和AC-TIA组收缩压和舒张压明显升高(P0.05~0.01);与AC-TIA组比较,PC-TIA组收缩压和舒张压明显升高(均P0.05)。与对照组比较,PC-TIA组和AC-TIA组24 h、白天、夜间平均收缩压和舒张压以及脉压指数均明显升高(P0.05~0.01);与AC-TIA组比较,PC-TIA组24 h、白天、夜间平均收缩压和舒张压以及脉压指数均明显升高(均P0.05)。与对照组比较,PC-TIA组和AC-TIA组24 h、白天、夜间收缩压变异性明显增大(P0.05~0.01);与AC-TIA组比较,PC-TIA组24 h、白天、夜间收缩压和舒张压变异性均明显增大(均P0.05)。结论短暂性脑缺血发作患者的血压变异性尤其是收缩压变异性明显增大,不同分型短暂性脑缺血发作患者的血压变异性存在差异。     

喹硫平与阿立哌唑治疗伴发高血压精神分裂症患者的临床疗效及安全性比较

目的对比喹硫平与阿立哌唑治疗伴发高血压的精神分裂症(SCH)患者的疗效及安全性。方法选取伴发高血压的SCH患者92例随机分为A组与B组,每组46例。A组与B组在常规降压治疗基础上分别予以喹硫平和阿立哌唑治疗,比较两组治疗前后阳性症状和阴性症状量表(PANSS)评分、24h平均收缩压(24hSBP)、24h平均舒张压(24h DBP)、24h收缩压变异(24hSSD)及24h舒张压变异(24hDSD),比较副反应发生情况。结果 A组和B组的总有效率比较差异无统计学意义(93.48%vs 91.30%,P0.05);治疗8周后,两组24h SBP、24hDBP比较差异无统计学意义(P0.05),但A组的24hSSD、24h DSD均显著低于B组(P0.05);治疗后两组PANSS总分及各因子评分均显著降低(P0.05),但组间比较差异无统计学意义(P0.05);A组副反应发生率较B组显著降低(28.26%vs 56.52%,P0.05)。结论喹硫平与阿立哌唑治疗伴高血压SCH患者均具有肯定疗效,但喹硫平具有更好的辅助降压作用且副反应更少。     

伊贝沙坦对原发性高血压、血小板功能的影响

目的 观察伊贝沙坦对原发性高血压(EH)的疗效及血小板功能的变化.方法 EH患者(EH组)50例,口服伊贝沙坦80mg/d,共12周.比较用药前后24h动态血压,血小板最大聚集率(PAGTMAX),血小板a颗粒膜蛋白(GMP-140)含量的变化,并与健康者(对照组)42例比较.结果 EH患者PAGTMAX、血小板GMP-140含量较对照组明显下降(P<0.01),应用伊贝沙坦后,24h平均血压值降低,同时PAGTMAX,血小板-140含量均较治疗前明显下降(P<0.01),与对照组相比,差异有统计学意义(P<0.05).结论 原发性高血压存在血小板活性增强,伊贝沙坦在有效降低血压同时能抑制血小板活化.     

氨氯地平联合厄贝沙坦治疗糖尿病伴高血压的效果观察

目的探讨厄贝沙坦联合氨氯地平对糖尿病合并高血压患者QT间期离散度(QTcd)的影响。方法收集2014-06-2016-06入信阳职业技术学院附属医院诊疗的210例高血压合并2型糖尿病患者的临床资料,根据用药方案的不同将210患者分为观察组和对照组A、对照组B三组,每组70例,观察组采用氨氯地平联合厄贝沙坦用药方案,对照组A采用氨氯地平用药方案,对照组B采用厄贝沙坦治疗方案,连续用药8周后,统计3组血压水平、QT间期离散度,评估3组治疗总有效率。结果经8周的连续治疗,观察组QTcd(31.5±10.2)ms,显著低于两个对照组(P0.05);观察组平均收缩压(SBP)(143.8±15.9)mmHg,舒张压(DBP)(89.4±11.5)mmHg,均显著低于两个对照组(P0.05);观察组治疗总有效率显著优于两个对照组(P0.05)。结论采用氨氯地平联合厄贝沙坦治疗高血压合并糖尿病患者能显著降低其QT间期离散度,抑制心肌肥厚,改善预后,提高治疗效果。     

厄贝沙坦预处理对脑缺血再灌注损伤大鼠脑组织含水量以及IgG和水通道蛋白4表达的影响

目的 探讨厄贝沙坦预处理对脑缺血再灌注(CIR)损伤大鼠脑组织含水量以及IgG和水通道蛋白4(AQP4)表达的影响.方法 用厄贝沙坦灌胃预处理SD大鼠,连续21d后用改良Longa法建立CIR模型,分别于缺血90 min再灌注2 h和48 h后测定其脑组织含水量,并采用免疫组化法测定相应时间点IgG及AQP4的表达.结果 与假手术组及CIR对照组进行比较.结果 各组中,CIR对照组大鼠脑组织含水量最高,其次是厄贝沙坦低剂量组,然后是厄贝沙坦高剂量组,假手术组最低(P＜0.05～0.01).再灌注2 h时,各组大鼠脑组织IgG表达差异无统计学意义;再灌注48 h时,CIR对照组大鼠脑组织IgG表达最高,其次是厄贝沙坦低剂量组,然后是厄贝沙坦高剂量组,假手术组最低(P＜0.05～0.01).再灌注2 h时,各组中厄贝沙坦高剂量组大鼠脑组织AQP4表达最多,然后是厄贝沙坦低剂最组与CIR对照组,假手术组最少(均P＜0.01);再灌注48 h时,各组中厄贝沙坦高剂量组及低剂量组大鼠脑组织AQP4表达最多,其次是CIR对照组,假手术组最少(均P＜0.01).结论 厄贝沙坦预处理可能通过上调CIR大鼠脑组织AQP4的表达以减少其脑组织含水量和IgG表达,从而起到脑保护作用.     

血清瘦素、一氧化氮浓度在高血压左室肥厚患者中的表达及厄贝沙坦、培哚普利的影响

目的 探讨高血压并左心室肥厚(LVH)与血清瘦素(Leptin)、一氧化氮(NO)浓度的关系,及厄贝沙坦、培哚普利对其影响.方法 选取58例高血压并LVH患者(Ⅰ组),随机平均分为2亚组(Ⅰ a、Ⅰ b),Ⅰ a、Ⅰ b组分别给予24周的厄贝沙坦、培哚普利干预;选取58例高血压无LVH患者(Ⅱ组).Ⅱ组及Ⅰ组治疗前后放免法测定血清Leptin浓度,硝酸还原酶法测定NO活性.结果 Ⅰ组治疗前血清Leptin水平较Ⅱ组高,NO活性较Ⅱ组低(P<0.01);LVMI与Leptin呈正相关,NO呈负相关(r分别为0.276和-0.268,P均<0.05):Ⅰ a、Ⅰ b组治疗前各指标比较差异无统计学意义(P>0.05);经24周治疗后Ⅰ b组较Ⅰ a组血清NO升高及LVMI降低水平差异有统计学意义(P<0.01).结论 Leptin、NO分别是促进和抑制LVH的重要物质;培哚普利在逆转LVH和升高血清NO方面优于厄贝沙坦.     

川东北地区脑出血患者急性期降压治疗现状调查研究

目的观察川东北地区高血压脑出血患者急性期降压治疗现状及其对院内病死率的影响。方法回顾性抽样2011-01—12在川东北地区部分医院住院发病24h内高血压脑出血患者,了解急性期降压治疗现状,降压治疗对脑出血患者院内病死率的影响。结果抽样调查起病24h内脑出血患者876例,血压升高者比例占93.2%,急性期内启动降压治疗率68.6%,超早期启动静脉降压13.2%。3级血压水平患者降压组病死率低于非降压组(P0.05),其中静脉降压组显著低于非静脉降压组(P0.01);启动降压≤24h和24h院内病死率亦差异有统计学意义(P0.05)。结论脑出血患者早期血压升高明显;川东北地区多数脑出血患者在急性期内启动降压治疗;降压治疗尤其合并超早期静脉降压可以降低3级血压水平患者的院内病死率。     

厄贝沙坦用于治疗原发性高血压临床观察

目的通过采用随机、双盲平行对照试验方法,考察厄贝沙坦治疗原发性轻中度高血压的疗效。方法将试者随机分为对照组(伲福达组30例)和观察组(厄贝沙坦组30例),对照组每天口服伲福达20 mg,观察组每天口服厄贝沙坦150 mg。结果对照和观察组临床疗效总有效率分别为83.3%和96.7%。结论观察其间,厄贝沙坦无不良反应,表明厄贝沙坦是一种耐受性好,且安全有效的降压药物。     

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.     

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.     

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。     

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.     

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.     

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.     

《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。     

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。