多烯磷脂酰胆碱对癫患者认知功能的影响

目的观察多烯磷脂酰胆碱治疗癫患者认知功能的临床疗效。方法选取2011-02—2013-02我院收治的50例癫患者,按数字法随机分为观察组和对照组各25例。对照组给予卡马西平,观察组给予多烯磷脂酰胆碱,比较2组患者认知功能情况。结果观察组蒙特利尔认知评分及MMSE评分均显著优于对照组,差异有统计学意义(P<0.05)。结论应用多烯磷脂酰胆碱治疗癫,可促进患者认知功能的恢复。     

吡拉西坦联合盐酸多奈哌齐对血管性认知障碍患者MMSE评分和日常生活能力的影响

目的 观察吡拉西坦联合盐酸多奈哌齐治疗血管性认知障碍(VCI)患者的临床疗效.方法 选取2018-03—2020-02安阳市人民医院收治VCI患者114例为研究对象,按随机数表法分为联合组及对照组各57例.对照组患者给予单纯吡拉西坦治疗,联合组患者给予吡拉西坦联合盐酸多奈哌齐治疗,观察治疗前后2组认知功能、日常生活能力...     

奥拉西坦与吡拉西坦治疗脑卒中后认知功能障碍的疗效对比

目的探讨奥拉西坦治疗脑卒中后认知功能障碍的临床疗效和安全性。方法选取2013-02—2014-02我院收治的脑卒中后认知功能障碍患者120例,按照随机数字表法分为观察组和对照组各60例,观察组给予奥拉西坦治疗,对照组给予吡拉西坦治疗,2组疗程均为6个月。观察2组治疗前后蒙特利尔认知评估量表(MoCA)、简易智能量表(MMSE)及日常生活能力量表(ADL)评分的变化,并评价疗效。结果治疗前2组MoCA、MMSE、ADL评分比较差异无统计学意义(P0.05);治疗后,2组MoCA、MMSE、ADL评分均较治疗前明显改善,观察组改善情况明显优于对照组,差异具有统计学意义(P0.05);观察组MoCA、MMSE、ADL评分改善总有效率均明显高于对照组,差异具有统计学意义(P0.05)。2组不良反应发生率均较低,差异无统计学意义(P0.05)。结论奥拉西坦可明显改善脑卒中患者的认知功能,临床疗效优于吡拉西坦,且安全性较好。     

认知功能训练联合尼莫地平对急性脑梗死认知功能障碍患者的影响

目的 探讨尼莫地平联合认知功能训练对急性脑脑梗死认知功能障碍患者的影响.方法 选择我院2007-11～2009-11急性脑梗死认知功能障碍患者81例,将以上患者随机分为2组,观察组和对照组.对照组患者给予常规神经内科治疗,同时给予物理治疗、作业治疗等.在对照组治疗基础上,观察组给予认知功能训练和尼莫地平治疗.2组患者均治疗3个月.患者治疗前和治疗3个月后,采用神经行为认知状态测试(NCSE)量表、画钟试验(CDT)、欧洲神经功能缺损评分(ESS)、Fugl-Meyer(FMA)量表、Barthel Index对患者进行评分.结果 观察组治疗3个月后NCSE总评分和画钟试验(CDT)评分分别与对照组治疗3个月后比较,差异有统计学意义(P<0.05);观察组治疗3个月后ESS评分、FAM评分和日常生活活动能力评分分别与对照组治疗3个月后比较,差异有统计学意义(P<0.05).结论 尼莫地平联合认知功能训练有助于改善急性脑脑梗死后认知功能障碍,有利于提高患者的肢体运动功能和日常生活活动能力,临床效果显著,值得借鉴.     

壳聚糖、磷脂酰胆碱对轻度认知功能障碍患者脑组织氢质子磁共振波谱成像的影响

目的观察壳聚糖、磷脂酰胆碱对轻度认知功能障碍(MCI)患者海马氢质子磁共振波谱成像(1H-MRSI)的影响。方法对15例MCI患者(MCI组)和15名正常老年人(正常对照组)进行海马1H-MRSI检查。给予MCI组患者壳聚糖、磷脂酰胆碱治疗2个月后对其进行复查,比较N-乙酰天门冬氨酸(NAA)/肌酸(Cr)、胆碱(Cho)/Cr、肌醇(mI)/Cr的比值。结果与正常对照组相比,MCI组服药前、后NAA/Cr比值显著降低,mI/Cr比值显著升高(均P<0.05),Cho/Cr的差异无统计学意义。MCI组治疗后的NAA/Cr比值较治疗前明显升高(P<0.05),mI/Cr比值明显降低(P<0.05),Cho/Cr比值治疗前后的差异无统计学意义。结论1H-MRSI显示,壳聚糖和磷脂酰胆碱能改善脑组织的代谢,可能对MCI有一定的治疗作用。     

多烯磷脂酰胆碱注射液对大鼠局灶性脑缺血的保护作用

目的研究多烯磷脂酰胆碱注射液对局造性脑缺血大鼠的保护作用。方法若干只SD雄性大鼠,参照Longa法略加修改制作大脑中动脉闭塞模型,并进行神经功能评分,将神经功能评分为2分的18只脑缺血模型的大鼠随机分为3组,即模型组、早期药物干预组、晚期药物干预组,每组6只。药物干预组分别于术后2h、术后第3天开始连续3d腹腔注射多烯磷脂酰胆碱注射液80mg/(kg.d),各组未使用药物时分别给予等量生理盐水注射。造模后第6天清晨再次进行神经功能评分,并采血分离血清,用酶联免疫吸附测定法(ELISA)检测血清中NSE和TNF-α含量。结果用药前3组神经功能评分差异无统计学意义(P>0.05);血清NSE含量和TNF-α含量比较,早期药物干预组、晚期药物干预组与模型组间,差异有统计学意义(P<0.05),但早期药物干预组与晚期药物干预组比较,差异无统计学意义(P>0.05)。结论多烯磷脂酰胆碱注射液能通过减轻炎症反应,对缺血性脑损伤有一定的保护作用。     

养血清脑颗粒联合奥拉西坦对脑梗死认知功能障碍的疗效

目的探讨联合用药治疗脑梗死认知功能障碍患者的临床效果。方法选择2014-03-2016-03漯河医学高等专科学校第二附属医院收治的脑梗死认知功能障碍患者80例。对照组40例给予奥拉西坦单药治疗,观察组40例在对照组基础上给予养血清脑颗粒治疗。比较2组认知功能改善情况。结果治疗前2组MMSE各项评分比较差异无统计学意义(P0.05);治疗后2组MMSE各项评分均有改善,其中观察组各项评分显著高于对照组(P0.05)。治疗后,对照组和观察组治疗有效率分别为75.0%和95.0%,差异有统计学意义(P0.05)。结论脑梗死认知功能障碍患者采用奥拉西坦联合养血清脑颗粒治疗效果显著,认知功能障碍可得到有效改善,促进患者恢复,值得在临床中推广应用。     

多奈哌齐联合认知训练对脑卒中后认知功能障碍患者神经功能恢复的影响

目的探讨多奈哌齐联合认知训练对脑卒中后认知功能障碍患者神经功能恢复的影响。方法选取2013-02-2015-02我院46例脑卒中后认知功能障碍患者,根据随机数字法分为对照组(常规治疗)和观察组(多奈哌齐联合认知训练),每组23例,观察和比较2组临床疗效、治疗前后简易精神状态量表(MMSE)、蒙特利尔认知评估量表(MOCA)、日常生活能力量表(BI指数)变化情况。结果与对照组相比,观察组总有效率明显提高,治疗后MMSE、MOCA、BI指数分值均明显增高(P0.05)。结论多奈哌齐联合认知训练能够明显促进脑卒中后认知功能障碍患者神经功能的恢复,提升患者的日常生活能力。     

脑卒中急性期护理观察

目的探讨脑卒中急性期护理方法。方法选择2015-01—2016-01在我院治疗的急性脑卒中患者70例,所有患者住院期间均接受药物治疗,随机分为对照组和观察组,对照组35例给予常规护理,观察组35例给予早期康复护理。对2组治疗效果进行比较。结果治疗前2组运动功能评分、日常生活能力评分、认知功能评分比较无显著差异,治疗后观察组三项指标评分显著高于对照组(P0.05)。结论接受药物治疗的脑卒中急性期患者给予早期康复护理可使临床症状得到有效改善,运动功能、认知功能及生存质量可得到有效提高,值得临床推广应用。     

利培酮与奥氮平治疗首发精神分裂症患者的效果及对认知功能与血脂的影响

目的探讨首发精神分裂症患者应用利培酮与奥氮平治疗后的疗效及其认知功能、血脂代谢水平变化。方法将2013年3月～2018年10月期间我院收治的120例首发精神分裂症患者按照入院先后顺序分为对照组及观察组,每组60例,对照组患者给予奥氮平治疗,观察组患者应用利培酮治疗,比较两组患者治疗前后的症状评分、认知功能、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)及血清三酰甘油(TG)水平变化。结果治疗后两组患者的PANSS评分均低于治疗前,MCCB评分均高于治疗前(P0.05),治疗后两组患者的PANSS评分和MCCB评分无统计学差异(P0.05);治疗前两组患者的血脂水平没有明显差异,治疗后观察组的HDL-C水平高于对照组,LDL-C、TC、TG水平低于对照组(P0.05)。结论利培酮和奥氮平均能够有效改善首发精神分裂症患者认知功能及精神症状,利培酮对血脂水平影响较小。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

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     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.