丙戊酸钠、拉莫三嗪联合心理干预对癫痫患儿认知功能、生活质量及心理状况的影响

目的 探讨在癫痫患儿治疗中,选择丙戊酸钠、拉莫三嗪联合心理干预的价值,并分析该方案对患儿认知功能、生活质量、心理状况的影响。方法 选取2020年1月～2022年12月本院收治的100例癫痫患儿,以随机数字表法分2组处理,一组接受丙戊酸钠联合拉莫三嗪治疗（对照组）,一组接受丙戊酸钠、拉莫三嗪联合心理干预治疗（观察组）,分析两组临床疗效、认知功能、生活质量、癫痫发作次数和心理状况。结果 观察组50例患儿经丙戊酸钠联合拉莫三嗪治疗后,临床疗效高于对照组（P<0.05）;观察组统计的认知功能评分高于对照组（P<0.05）;观察组生活质量评分高于对照组（P<0.05）;观察组焦虑、抑郁评分低于对照组（P<0.05）。结论 丙戊酸钠、拉莫三嗪联合心理干预对在癫痫患儿治疗中可行性较高,通过改善其认知功能及心理状态,可减轻疾病对患儿生活质量的影响。     

比较奥卡西平或拉莫三嗪联合丙戊酸钠治疗脑外伤术后癫疒间复发疗效

目的探讨丙戊酸钠治疗脑外伤术后癫疒间复发后,添加奥卡西平或拉莫三嗪联合治疗外伤性癫疒间效果。方法以治疗前3个月癫疒间发作频度为对照,对治疗12个月后的疗效、不良反应及安全性进行自身对比观察。结果应用奥卡西平或拉莫三嗪联合丙戊酸钠治疗12个月后,患者发作频率均较用药前明显减少;发作频率减少≥50%的患者分别为89.2%和89.7%,用药前后差异无统计学意义(P<0.05);奥卡西平或拉莫三嗪联合丙戊酸钠两组间差无明显统计学意义(P>0.05)。奥卡西平联合丙戊酸钠不良反应的发生率为19.3%,拉莫三嗪联合丙戊酸钠不良反应的发生率为9.1%,差异显著(P<0.05)。结论奥卡西平或拉莫三嗪联合丙戊酸钠治疗外伤性癫疒间复发疗效确切,副作用拉莫三嗪组明显低于奥卡西平组。     

拉莫三嗪联合丙戊酸钠治疗对癫痫患儿疗效改善不良事件及预后的影响研究

目的探讨拉莫三嗪联合丙戊酸钠治疗对癫痫患儿疗效改善、不良事件及预后的影响。方法选取我院2014-11-2015-11收治癫痫患儿124例予以回顾性分析,按临床不同治疗方案分成2组,行单纯丙戊酸钠治疗的56例患儿为对照组,行拉莫三嗪和丙戊酸钠联合治疗的68例患儿为观察组,对2组疗效改善、不良事件及预后情况进行对比。结果观察组治疗3、6个月后癫痫发作次数均减少,其减少幅度均比对照组显著(P0.01);观察组总不良事件发生率8.82%低于对照组37.50%(P0.01);观察组治疗3、6个月后TG、TC改善效果优于对照组(P0.01)。结论癫痫患儿行拉莫三嗪和丙戊酸钠联合治疗能够减少癫痫发作次数和不良事件发生,且促进预后改善,具有推广及应用价值。     

拉莫三嗪治疗卒中后癫(癎)的疗效观察

目的 探讨拉莫三嗪治疗卒中后癫(痫)的临床效果和预后.方法 60例卒中后癫(痢)患者随机分为观察组30例和对照组30例,对照组采用丙戊酸钠治疗,观察组口服拉莫三嗪,比较2组癫(痫)复发情况.结果 观察组癫(痫)发作率13.3％,对照组发作率36.7％,2组比较差异有统计学意义(P＜0.05).结论 拉莫三嗪治疗卒中后癫(痫)效果较满意,且无明显不良反应,值得临床推广.     

丙戊酸镁与拉莫三嗪联合治疗儿童癫痫的疗效与安全性分析

目的观察丙戊酸镁与拉莫三嗪联合治疗儿童癫痫的疗效及安全性,以期为儿童癫痫的临床联合用药提供依据。方法收集本院2014-04—2015-08收治的150例癫痫患儿为研究对象,随机分为丙戊酸镁组50例(A组)、拉莫三嗪组50例(B组)与丙戊酸镁联合拉莫三嗪组50例(C组)。统计3组治疗效果与不良反应发生率。结果 (1)C组总有效率明显优于A组和B组,差异有统计学意义(P0.05),A组与B组比较差异无统计学意义(P0.05)。(2)C组药物不良反应发生率明显少A组和B组,差异有统计学意义(P0.05);A组与B组比较差异无统计学意义(P0.05)。结论丙戊酸镁与拉莫三嗪联合治疗儿童癫痫临床疗效显著,安全性较高,值得推广应用。     

拉莫三嗪添加-替换治疗丙戊酸治疗无效的癫痫患者的临床疗效观察

目的观察拉莫三嗪添加-替换治疗丙戊酸治疗无效的癫痫患者的临床疗效。方法对丙戊酸治疗无效的78例癫痫患者加用拉莫三嗪,并逐渐转为拉莫三嗪单药治疗。观察联合用药阶段及拉莫三嗪单药治疗阶段结束时的癫痫发作控制情况、拉莫三嗪血药浓度变化及不良反应。结果 64例患者完成联合治疗阶段,其中完全控制46例(71.9%),有效10例(15.6%),无效8例(12.5%);总有效率为87.5%。42例患者转为拉莫三嗪单药治疗,其中控制31例(73.8%),有效4例(9.5%),无效7例(16.7%);总有效率为83.3%。拉莫三嗪单药治疗与联合用药阶段的完全控制率、总有效率比较,差异无统计学意义(均P0.05)。联合用药阶段患者的拉莫三嗪血药浓度显著高于拉莫三嗪单药治疗阶段(P0.01)。拉莫三嗪单药治疗阶段再发患者的拉莫三嗪血药浓度与控制患者的差异无统计学意义。18例患者出现不良反应。结论拉莫三嗪单用或联合丙戊酸治疗丙戊酸治疗无效的癫痫患者效果较好,不良反应少。     

小剂量拉莫三嗪与丙戊酸合用治疗成人癫痫临床观察

目的 研究小剂量拉莫三嗪与丙戊酸合用治疗成年人各种类型癫痫的有效件和安全性.方法 对100例成年癫痫患者采用逐步增量的方法给予拉莫三嗪至每目100 mg,加约期4周,并继续服用原剂量的丙戊酸治疗,连续观察6月,记录患者发作的情况及不良反应.结果 小剂量拉其三嗪与丙戊酸合用总有效率为77.2%,完全控制50.O%,各种类型发作之间疗效比较差异无显著性(χ2=1.37,P>0.05);各型癫痫在人组4～6个月后较入组前3个月发作频率均减少,差异有显著性(P<0.05).不良反应发生率23.7%,与入组前后小良反应发牛率相比无显著变化(χ2=0.21,P>0.05).结论 小剂量托莫二三嗪与丙戊酸合用治疗成年人各种类犁癫痫均取得良好疗效,不良反应无增加.     

拉莫三嗪治疗卒中后癫的疗效观察

目的探讨拉莫三嗪治疗卒中后癫的临床效果和预后。方法 60例卒中后癫患者随机分为观察组30例和对照组30例,对照组采用丙戊酸钠治疗,观察组口服拉莫三嗪,比较2组癫复发情况。结果观察组癫发作率13.3%,对照组发作率36.7%,2组比较差异有统计学意义（P〈0.05）。结论拉莫三嗪治疗卒中后癫效果较满意,且无明显不良反应,值得临床推广。     

拉莫三嗪联合丙戊酸治疗癫痫的疗效及其对认知功能和血脂的影响

目的探究拉莫三嗪联合丙戊酸治疗癫痫的疗效及其对认知功能和血脂的影响。方法选择2015-04-2016-10郑州儿童医院收治的癫痫患儿198例为研究对象,采用随机数字法将其分为观察组(101例)和对照组(97例);对照组给予丙戊酸治疗,观察组给予丙戊酸联合拉莫三嗪治疗;观察并比较2组疗效,分析2组患儿治疗前后认知功能及血脂的变化。结果观察组疗效优于对照组(Z=5.483,P0.01),且观察组总有效率(86.14%)显著高于对照组(65.98%);治疗后2组蒙特利尔认知评估量表(MoCA)评分均升高(P0.05),且观察组MoCA评分高于对照组(P0.05);治疗后观察组低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)及总胆固醇(TC)均无变化(P0.05),对照组间LDL-C、TG及TC升高(P0.05),2组间HDL-C均无差异(P0.05);2组患儿均未出现严重药物不良反应。结论丙戊酸联合拉莫三嗪治疗癫痫的疗效明显,能够显著提高患儿认知功能,且对患儿血脂影响较小,值得在临床应用推广。     

拉莫三嗪对脑外伤术后患者癫痫与认知功能的影响

目的探讨拉莫三嗪对脑外伤术后患者认知功能和癫痫发生率的影响。方法采用随机数字表法将我院119例重症颅脑外伤患者分组,两组患者均给予开颅减压术治疗,对照组59例术前给予丙戊酸钠,观察组60例给予拉莫三嗪,两组均治疗到术后30天,对比两组患者术后癫痫发生率、认知功能变化及不良事件发生率。结果观察组早期、晚期癫痫发生率及不良事件发生率均低于对照组,术后1月、3月、6月MMSE评分均高于对照组(P0.05)。结论拉莫三嗪能够有效减少重症颅脑损伤术后患者癫痫发作,改善认知功能,安全性高。     

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.     

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。     

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.     

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.     

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.     

《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。