依达拉奉治疗急性重型颅脑损伤的疗效观察

目的 观察依达拉奉治疗急性重型颅脑损伤的临床疗效、不良反应及预后.方法 将30例急性重型颅脑损伤患者(GCS≤8分)随机分为依达拉奉治疗组(16例)和常规治疗组(14例),观察治疗前后患者的颅内压(ICP)、头部CT(脑水肿)、格拉斯哥昏迷评分(GCS)和格拉斯哥预后评分情况.结果 2组患者治疗14d后,颅内压及脑水肿程度都有所减轻,但依达拉奉治疗组减轻程度好于常规治疗组.治疗14d后依达拉奉治疗组GCS评分显著高于常规治疗组,伤后3个月依达拉奉治疗组GOS评分也显著高于常规治疗组(P均＜0.05).治疗期间未见严重不良反应发生. 结论应用依达拉奉治疗急性重型颅脑损伤有较好的临床疗效,安全性高,值得临床推广使用.     

重型颅脑损伤神经源性肺水肿的早期机械通气治疗

目的 探讨早期机械通气对重型颅脑损伤并神经源性肺水肿(NPE)的疗效.方法 36例重型颅脑损伤并神经源性肺水肿(NPE)患者,随机分为2组,早期机械通气治疗组(治疗组),常规机械通气PaO2<60 mmHg组(对照组),比较2组治疗2周后GCS评分、撤机时间,6个月后 GOS评分评定预后.探讨机械通气时机与预后的关系.结果 治疗组2周后GCS评分明显高于对照组,撤机时间明显早于对照组.6个月后2组病死率无统计学意义,但经秩和检验,治疗组生存质量明显较对照组高.结论 NPE是继发于重型颅脑损伤的严重并发症,早发现,早诊断,早期合理机械通气治疗是NPE治疗的关键.     

高压氧联合纳洛酮治疗重型颅脑损伤疗效分析

目的观察高压氧联合纳洛酮治疗重型颅脑损伤（STBI）的临床疗效。方法将60例重型颅脑损伤患者按治疗方法不同随机分为对照组和观察组各30例,对照组给予常规治疗,观察组在常规治疗基础上加用纳洛酮静滴和高压氧治疗,观察2组治疗前后GCS评分及伤后3个月GOS评分改善情况。结果与治疗前比较,2组患者治疗14dGCS评分均优于治疗前,且观察组GCS评分改善优于对照组（P〈0.05）;观察组患者治疗3个月后临床疗效明显优于对照组,差异有统计学意义（P〈0.05）。结论高压氧联合纳洛酮治疗重型颅脑损伤患者可提高临床疗效,促进神经功能恢复,改善预后和提高患者生存质量,值得临床推广应用。     

成人重型颅脑损伤患者肢体运动功能恢复的影响因素

目的 探讨成人重型颅脑损伤患者肢体运动功能的影响因素。方法 选取广安市人民医院2017-10—2022-01收治的162例成人重型颅脑损伤患者,回顾分析其出院时肢体运动功能障碍的发生率,对患者的基线资料、损伤类型、意识障碍时间、住院时间、康复治疗介入时间采用Logistic回归法分析,探讨其出院3个月时肢体运动功能障碍的相关影响因素。结果 162例患者出院3个月时肢体运动功能障碍31例,发生率为19.14%;单因素分析显示,年龄>50岁、GCS评分6～8分、运动功能区损伤、脑疝、意识障碍时间>10 d、康复治疗介入时间>30 d患者的肢体运动功能障碍发生率明显高于相应对立因素患者（P<0.05）;多因素分析显示,年龄>50岁、GCS评分6～8分、运动功能区损伤、脑疝、意识障碍时间>10d、康复治疗介入时间>30 d是重型颅脑损伤患者肢体运动功能的独立危险因素。结论 成人重型颅脑损伤患者肢体运动功能障碍有较高的发生率,针对相关的独立影响因素进行干预,对于改善患者预后具有重要价值。     

标准大骨瓣减压术治疗重型颅脑损伤疗效分析

目的 探讨应用标准大骨瓣减压术治疗重型颅脑损伤的临床疗效及并发症发生情况.方法 对我院2010-01-2013-01收治的31例重型颅脑损伤患者应用标准大骨瓣减压术治疗,设为观察组;另选择本院2007-03-2009-11收治的30例应用常规骨瓣减压术治疗的重型颅脑损伤患者（设立为对照组）,对比2组的临床疗效、术后GCS评分及并发症情况.结果 2组临床疗效及预后比较差异有统计学意义（P＜0.05）,术后1个月GCS评分与手术前比较均有显著提高,但观察组优于对照组,差异有统计学意义（P＜0.05）,2组并发症比较,差异无明显统计学意义.结论 标准大骨瓣减压术治疗重型颅脑损伤临床疗效好,并发症发生率低,预后好,值得推广和应用.     

高压氧治疗重型颅脑损伤的临床研究

目的 探讨高压氧(HBO)治疗重型颅脑损伤的疗效.方法 将60例重型颅脑损伤患者随机分为治疗组和对照组各30例,对照组行神经外科常规治疗,治疗组在常规治疗基础上给予高压氧治疗,比较2组患者治疗前后格拉斯哥昏迷评分(GCS)变化情况、治疗结果,并于治疗后3个月和6个月进行格拉斯哥预后评分(GOS).结果 治疗组GCS评分较对照组明显改善(P<0.05或P<0.01),治疗组疗效明显优于对照组,2组疗效比较差异具有统计学意义(P<0.05),治疗组GOS亦较对照组改变明显(P<0.05).结论 在重型颅脑损伤的治疗中,高压氧是一种见效快、疗程短、治愈率及总有效率高,致残率低、并发症少、无痛苦的治疗方法,改善预后,提高了患者的生存质量,减轻了社会负担.     

依达拉奉治疗急性重型颅脑损伤的疗效观察

目的探讨早期应用依达拉奉对急性重型颅脑损伤患者的治疗效果及对预后的影响。方法将70例重型颅脑损伤患者(GCS≤8分)分成2组。治疗组35例在常规治疗的基础上加用依达拉奉治疗,对照组35例。观察2组患者GCS评分的变化及伤后3个月GOS评分情况,比较2组患者的意识好转率。结果2组患者治疗7d、14d后GCS评分比较差异均有统计学意义(P<0.001);依达拉奉组治疗后1个月清醒21例,而对照组12例,其清醒率显著高于对照组(P<0.05);3个月后恢复良好率(57.14%)明显高于对照组(31.43%)。结论早期应用依达拉奉有助于缩短急性重型颅脑损伤患者昏迷期,能促进患者神经功能恢复和提高生活质量。     

重型颅脑损伤合并脑疝的救治与预后分析

目的总结重型颅脑损伤合并脑疝的救治经验并分析其预后情况。方法回顾性分析68例重型颅脑损伤合并脑疝患者的临床资料,根据不同手术方法、GCS评分与病情分别分析其预后情况。结果GCS评分3～5分患者的死亡率显著高于GCS评分6～8分患者(P＜0．05),幕上去大骨瓣减压 颅内血肿清除 小脑幕切开手术方式治疗的患者死亡率明显低于单侧幕上去大骨瓣减压 颅内血肿清除手术方式治疗的患者(P＜0．05)。结论重型颅脑损伤合并脑疝的临床疗效与GCS评分和手术方式密切相关。     

依达拉奉治疗急性重型颅脑损伤的临床疗效观察

目的探讨依达拉奉对急性重型颅脑损伤的疗效及安全性。方法69例急性重型颅脑损伤患者,分为3组,依达拉奉治疗组32例;阳性药物对照组32例,用脑苷肌肽注射液治疗;空白对照组5例,给予常规治疗。治疗10d后,观测GCS、APACHE-Ⅱ评分及不良反应。结果与空白对照组相比,治疗组和阳性药物对照组GCS评分明显升高(P<0.05),APACHE-Ⅱ评分显著下降(P<0.01),但两组间差异无显著性。结论早期应用依达拉奉治疗急性重型颅脑损伤,可促进患者神经功能恢复,降低死亡风险,且副作用少,安全可靠。     

重型颅脑创伤长期意识障碍患者清醒预测的MRI分级研究

目的 探讨MRI对重型颅腩创伤后长期意识障碍患者清醒预测的分级标准.方法 记录66例重型TBI意识障碍超过2周患者的MRI表现,以MRI的表现分为3级:Ⅰ级:仅有大脑半球的损伤;Ⅱ级:丘脑、胼胝体的损伤,伴或不伴有I级的损伤灶,包括:Ⅱa级(单侧丘脑的损伤)和Ⅱb级(胼胝体、双侧丘脑的损伤);Ⅲ级:脑干背外侧的损伤,伴或小伴有Ⅰ级和(或)Ⅱ级的损伤灶.预后以颅脑创伤后6个月患者是否清醒为标准.结果 MRI分级与清醒的概率有显著相关性,Pearson相关系数-0.722(P＜0.05),分级越高,预后越差;Ⅱb级、Ⅲ级作为预后不良的指标,判断的敏感性为85.7%,特异性为87.5%,准确率为86.4%,错误率为13.6%;ROC曲线下面积为0.89,95%可信区间为(0.808,0.978).结论 MRI分级可客观、准确地反映颅脑创伤程度和清醒的概率.     

早年创伤对认知功能影响的研究进展

早年创伤是一个全球普遍存在的问题,严重影响儿童、青少年的大脑发育,继而导致认知功能、人格水平、社会行为的改变。早年创伤主要是父母、监护人或其他年长者对孩子施加躯体虐待、躯体忽视、情感虐待、情感忽视或性虐待。美国一项调查显示：儿童虐待事件的发生率高达1．2％[1]。早年创伤影响认知功能的多个领域,包括学习／工作记忆、视觉空间能力、执行功能、言语智能、复杂推理搜决策、学业表现等比]。创伤造成的认知功能改变是目前国内外神经科学和精神医学领域研究的热点,但其发病机制仍不明确,鉴于早年创伤与认知功能的关系问题,现就早年创伤对大脑发育、神经认知的影响加以综述。     

Brain network markers of abnormal cerebral glucose metabolism and blood flow in Parkinson＇s disease

Neuroimaging of cerebral glucose metabolism and blood flow is ideally suited to assay widely-distributed brain circuits as a result of local molecular events and behavioral modulation in the central nervous system. With the progress in novel analytical methodology, this endeavor has succeeded in unraveling the mechanisms underlying a wide spectrum of neurodegenerative diseases. In particular, statistical brain mapping studies have made significant strides in describing the pathophysiology of Parkinson＇s disease （PD） and related disorders by providing signature biomarkers to determine the systemic abnormalities in brain function and evaluate disease progression, therapeutic responses, and clinical correlates in patients. In this article, we review the relevant clinical applications in patients in relation to healthy volunteers with a focus on the generation of unique spatial covariance patterns associated with the motor and cognitive symptoms underlying PD. These characteristic biomarkers can be potentially used not only to improve patient recruitment but also to predict outcomes in clinical trials.     

Chaotic electrical stimulation of the subthalamic nucleus – mossy fiber sprouting, epileptic seizures, and brain electrical activity in pentylenetetrazol-kindled rats★

BACKGROUND： Previous studies have demonstrated that appropriate interventions can alter brain electrical activity of epileptic patients prior to and during a seizure, leading to maintenance of a highly chaotic state, thereby inhibiting abnormal epileptic discharges, and eventually controlling epileptic seizure. OBJECTIVE： This study was designed to observe the effects of chaotic electrical stimulation to the subthalamic nucleus on mossy fiber sprouting, epileptic seizures, and electrical discharges, and to summarize the most suitable intervention. DESIGN, TIME AND SETTING： This randomized grouping, neuroelectrophysiological study was performed at the Laboratory of Neurology, Union Hospital Affiliated to Fujian Medical University in September 2007. MATERIALS： Fifty-five healthy, male, Sprague Dawley rats were subjected to an epileptic model by an intraperitoneal injection of pentylenetetrazol. The YC-2 programmed electrical stimulator was provided by Chengdu Instrument Factory, China; the video electroencephalographic system （KT-88-2400） and 24-hour active electroencephalographic system were products of Contec Medical System Co., Ltd., China; pentylenetetrazol was purchased from Sigma, USA. METHODS： The present interventional method consisted of electrical stimulation to the subthalamic nucleus with an intensity of 500 μA, pulse width 0.05 ms, frequency 30 Hz, and a duration of 20 minutes for 14 successive days. Fifty-five rats were divided into 6 groups： （1） pre-stimulation （n = 10）, pentylenetetrazol was administered and 30 minutes later, chaotic electrical stimulation was performed; （2） synchronous stimulation （n = 10）, rats received pentylenetetrazol and chaotic electrical stimulation concurrently; （3） post-administration stimulation （n = 10）, after pentylenetetrazol administration, chaotic electrical stimulation was performed immediately after cessation of a seizure; （4） sham-stimulation （n = 10）, following pentylenetetrazol administration, an electrode was con     

Differential cognitive responses to guqin music and piano music in Chinese subjects： an event-related potential study

Objective To compare the cognitive effects of guqin （the oldest Chinese instrument） music and piano music. Methods Behavioral and event-related potential （ERP） data in a standard two-stimulus auditory oddball task were recorded and analyzed. Results This study replicated the previous results of culture-familiar music effect on Chinese subjects： the greater P300 amplitude in frontal areas in a culture-familiar music environment. At the same time, the difference between guqin music and piano music was observed in NI and later positive complex （LPC： including P300 and P500）： a relatively higher participation of right anterior-temporal areas in Chinese subjects. Conclusion The results suggest that the special features of ERP responses to guqin music are the outcome of Chinese tonal language environments given the similarity between Guqin＇s tones and Mandarin lexical tones.     

氧化应激与认知功能障碍的研究进展

氧化应激（Oxidative Stress）不仅在糖尿病、高血压病等身心疾病中起着重要作用,而且对阿尔茨海默病（AlzheimerDisease,AD）、帕金森病（Parkin-son Disease,PD）等神经精神障碍的认知功能也有一定影响。强烈或持续性的氧化应激可通过诱导细胞凋亡和炎性反应导致细胞、组织损害。流行病学及动物研究均表明,母孕期遭受应激可能会影响胎儿的神经心理发育过程,造成胎儿大脑某区域的缺陷,引起持续性认知改变、神经内分泌和行为反应,增加后代精神疾病的患病风险。现对氧化应激与认知功能障碍的机制进行综述。     

Intrathecal MK-801 inhibits formalin-induced activation of spinal p38-MAPK in rats**★

BACKGROUND： p38 mitogen-activated protein kinase （MAPK） plays an instrumental role in signal transduction from the cell surface to the nucleus, while subcutaneous injection of formalin can induce increased activation of spinal p38 MAPK. However, the mechanisms underlying the formalin-induced activation of spinal p38 MAPK in rats are unclear. OBJECTIVE： To observe the effects of N-methyl-D-aspartic acid （NMDA） receptor antagonist MK-801 on the formalin-induced activation of spinal p38 MAPK in rats. DESIGN, TIME AND SETTING： This randomized grouping, controlled animal experiment was performed at the Department of Physiology and Neurobiology, Shanxi Medical University between May and November 2007. MATERIALS： Forty eight healthy, adult Wistar rats were randomly divided into two groups： formalin ＋ normal saline （n = 12） and formalin ＋ MK-801 （n = 36）. The formalin ＋ MK-801 group was further divided into three subgroups according to the dosage of MK-801 （10, 50, and 100 nmol/L, 12 rats for each subgroup） METHODS： Following anesthesia, polyethylene tubing filled with sterile normal saline was implanted into the subarachnoid cavity. On postoperative days 5-8, rats received a 15 minute perfusion of normal saline or MK-801 （10, 50, and 100 nmol/L） in the formalin ＋ normal saline and formalin ＋ MK-801 groups, respectively, followed by formalin injection for the induction of nociceptive behavior. MAIN OUTCOME MEASURES： Detection of total p38 MAPK and of phosphorylated p38 MAPK by western Blot analysis; observation of nociceptive behaviors in the 1 hour after formalin injection. RESULTS： Western Blot analysis revealed that injection of formalin had no effect on total p38 MAPK expression but resulted in increased phosphorylation of p38 MAPK in the spinal cord. This increase was apparent after 5 minutes, peaked at 20 minutes, and thereafter descended and reached control levels after 45 minutes. Pretreatment with MK-801 （10, 50, 100 nmol/L） resulted in a dose-dependent reduc     

Effect of Ganoderma lucidum spore on expression of insulin-like growth factor-1, nuclear factor-kappa B, and neuronal apoptosis in the epileptic rat brain*★

BACKGROUND：It has been reported that Ganoderma lucidum spore powder, a very well known Chinese traditional medicine, can affect immunoregulation, free radical scavenging, and anti-hypoxia responses. OBJECTIVE： To investigate the effect of Ganoderma lucidum spore powder on expression of insulin-like growth factor-1 （IGF-1）, nuclear factor-κB （NF-κB） and neuronal apoptosis in rats with pentylenetetrazol （PTZ）-induced epilepsy. DESIGN, TIME AND SETTING： A cellular and molecular biology experiment with randomized controlled study design was performed at the Central Laboratory of Basic Medical College of Jiamusi University from June to August 2005. MATERIALS： Thirty healthy, adult, male, Wistar rats were selected and randomly divided into 3 groups （10 rats per group）： control, epilepsy model, and Ganoderma lucidum spore powder. A sub-eclampsia PTZ dose （35 mg/kg） was intraperitoneally injected to induce epilepsy in the latter two groups. Wild Ganoderma lucidum spore powder （30 g/L） was provided by the wild Ganoderma lucidum plant nursery at Jiamusi, China. Immunohistochemical detection and terminal deoxynucleotidyl transferase-mediate dUTP nick end-labeling （TUNEL） kits were purchased from Wuhan Boster Biological Technology Co., Ltd., China. METHODS： Ganoderma lucidum spore powder was intragastrically administered at a dose of 10.0 mL/kg, once a day for 28 days. In the epilepsy and control groups, an equivalent volume of normal saline was intragastrically administered. MAIN OUTCOME MEASURES： Immunoreactivity for IGF-1 and NF-κB/P65 were detected by immunohistochemical staining. Neuronal apoptosis was detected using TUNEL methods. RESULTS： The hippocampus and cerebral cortex of rats with PTZ-induced epilepsy exhibited a higher number of apoptotic cells at high magnification （×400）, compared with the control group. Expression of IGF-1 and NF-κB were higher in the epilepsy group, compared with the control group （P 〈 0.01）. In Ganoderma lucidum spore-treated rats,     

Naoxintong dose effects on inflammatory factor expression in the rat brain following focal cerebral ischemia

BACKGROUND： Certain components of tetramethylpyrazine, a traditional Chinese medicine, exhibit protective effects against brain injury. OBJECTIVE： To investigate the effects of different Naoxintong doses on expression of nuclear factor-kappa B （ kB）, interleukin-6, tumor necrosis factor-α, and complement 3 in rats following focal cerebral ischemia. DESIGN, TIME AND SETTING： The randomized experiment was performed at the Laboratory of Neurology, Second Hospital of Hebei Medical University from June 2004 to June 2006. MATERIALS： A total of 150 adult, healthy, male, Sprague Dawley rats, weighing 280-320g, were selected. Naoxintong powder （mainly comprising szechwan lovage rhizome, milkvetch root, danshen root, and radix angelicae sinensis） was obtained from Buchang Pharmacy Co., Ltd. in Xianyang City of Shanxi Province of China, lot number 040608. METHODS： The rats were randomly assigned into sham operation, saline, high-dose Naoxintong, moderate-dose Naoxintong, and low-dose Naoxintong groups, with 30 rats in each group. Rat models of middle cerebral artery occlusion were established using the suture method, with the exception of the sham operation group. Rats in the high-dose, moderate-dose and low-dose Naoxintong groups received 4, 2, and 1 g/kg Naoxintong respectively, by gavage. Rats in the saline group were treated with 1 mL saline by gavage All rats were administered by gavage at 5 and 23 hours following surgery, and subsequently, once per day. MAIN OUTCOME MEASURES： At 6, 24, 48, 72 hours, and 7 days following model establishment, brain water content was measured. Histopathological changes in brain tissues were detected using hematoxylin-eosin staining. Expression of nuclear factor- kB, interleukin-6, tumor necrosis factor- α, and complement 3 was examined by immunohistochemistry. RESULTS： A total of 150 rats were included in the final analysis with no loss. Brain water content was significantly increased in the ischemic hemisphere of rats from the saline, as well as the high-dose, mo     

Effects of acrous gramineus and its component, alpha-asarone, on apoptosis of hippocampal neurons after seizure in immature rats**☆

BACKGROUND： α-asarone and acrous gramineus have been shown to play a necessary function in enhancing the reactivity and convulsant threshold to electric stimulation of immature rats. They have also been shown to effectively suppress epileptic seizures induced by pentylenetetrazol in young rats. However, the mechanisms for these roles have been still unclear. OBJECTIVE： To observe the effects in immature rats of acrous gramineus and α -asarone on apoptosis of hippocampal neurons after epileptic seizure at the protein level, and to analyze the mechanism for these effects. DESIGN： A randomized controlled animal experiment. SETTINGS： Department of Pediatrics, First Hospital of Jilin University; Department of Histology and Embryology, Norman Bethune Medical School of Jilin University; Department of Internal Medicine, Children＇s Hospital of Changchun City; Department of Neurology, First Clinical Hospital affiliated to Harbin Medical University. MATERIALS： Fifty 3-week old Wistar rats, 34-40 g, irrespective of gender, were provided by Gaoxin Research Center of Medical Animal Experiment, Changchun. The animals were treated according to the animal ethical standards. The following chemicals were used for this study： acrous gramineus powders or infusion （Batch No, 0307113, Tianjiang Medicine Company Limited, Jiangyin）, α-asarone tablets （Batch No. 030219, Tianwei Pharmaceutical Factory, Shenyang）, and phenobarbital sodium tablets （Batch No. 020608, Xinya Medicine Company Limited, Shanghai）. The animals were divided into five groups randomly. First, ten rats were chosen as the normal controls. The remaining rats were treated with i.p. injections of pentylenetetrazol to stimulate an epileptic model. METHODS： The experiments were performed at the Neurological Laboratory of the First Hospital of Jilin University between October and December 2004. The rats were treated with i.p. injections of pentylenetetrazol （60 mg/kg） to establish an epileptic model. According to Racine＇ s standard, animal