氟桂嗪对急性脑梗死患者血小板线粒体Ca^2＋含量的影响

目的：探讨氟桂嗪对脑缺血后血小板线粒体钙超载的影响，并研究其治疗机理。方法：把急性脑梗死患者分为氟桂嗪治疗组（口服氟桂嗪5mg,每晚一次）和普通治疗组以及对照组，抽取其不同时期静脉血，用差异分离法分离血小板粒体，FURA－3荧光法测定血小板线粒体游离Ca^2 的含量。结果：脑梗死后（起病24小时内，无论是否接受氟桂嗪治疗）血小板线粒体游离Ca^2 浓度增加（P＜0．01）；氟桂嗪治疗后第3天和7天时血小板线粒体游离Ca^2 浓度降低（P＜0．05）。普通治疗组血小板线粒体游离Ca^2 浓度无明显变化（P＞0．05）.结论：氟桂嗪降低急性脑梗死患者血小板线粒体游离Ca^2 含量。     

沙土鼠脑缺血再灌注诱导线粒体通透性转换和氟桂嗪的影响

目的　进一步探讨盐酸氟桂嗪对缺血再灌注后神经细胞保护作用的机制。方法　制作沙土鼠全脑缺血 /再灌注模型 ,随机分为脑缺血组、氟桂嗪预处理组和对照组 ,分别于术后 1h、6h、1d分离前脑线粒体 ,用分光光度法检测线粒体通透性转换以及线粒体游离Ca2 + 的含量。结果　 (1)前脑线粒体游离Ca2 +浓度在缺血再灌注后 1h、6h、1d均高于氟桂嗪预处理和对照组 (P <0 .0 1或P <0 .0 5 ) ,以缺血再灌注后 6h最明显 (P <0 .0 1) ;(2 )缺血再灌注后 1h、6h、1d前脑线粒体通透性转换开放程度较对照组和氟桂嗪预处理组均高 (P <0 .0 5 ) ;(3)氟桂嗪预处理组以缺血再灌注后 6h前脑线粒体通透性转换开放程度降低最为显著(P <0 .0 1)。结论　氟桂嗪抑制急性脑缺血再灌注诱导的线粒体通透性转换     

急性脑梗死患者CD62P与红细胞内、外钙离子浓度变化的研究

目的观察急性脑梗死患者的血小板CD62P,红细胞内、外钙离子(Ca2+)浓度变化,旨在探讨血小板活化因子(PAF)、Ca2+稳态失调对大脑的损害.方法采用流式细胞免疫技术,以抗血小板单克隆抗体及钙离子荧光剂为分子探针,检测了40例急性脑梗死患者,36例健康查体者的血小板CD62P、红细胞内钙(IECa2+)及血清钙(SCa2+)浓度.结果脑梗死患者CD62P、IECa2+明显高于对照组,SCa2+则明显低于对照组,两组比较差异非常显著(p＜0.01).IECa2+随着CD62P的增高而增高,两者呈正相关(p＜0.05);而血清Ca2+则随着IECa2+的增高而降低,两者呈负相关(p＜0.05).CD62P、IECa2+及SCa2+与病情程度、梗塞面积大小相关,病情重、面积大者CD62P、IECa2+增高显著,SCa2+降低亦显著.结论PAF在Ca2+稳态失调中起着重要作用;PAF及Ca2+稳态失调与脑梗死的发生发展密切相关.     

氟桂利嗪对低ABCD2评分的短暂性缺血发作患者的脑梗死预防作用

目的 探讨氟桂利嗪对低危短暂性缺血发作(TIA)患者脑梗死的预防作用.方法 按照ABCD2的评分标准,将126例评分为1-3分的低危患者随机分成治疗组和对照组.治疗组在常规治疗的基础上给予氟桂利嗪.比较两组治疗对脑梗死发病的预防效果.结果 治疗组在90 d内的脑梗死发生率为1.6%,明显低于对照组的12.6%(P<0.05),且无不良反应.结论 氟桂利嗪可降低低危TIA患者的脑梗死发生风险.     

养血清脑颗粒对偏头痛患者LPA、TNF水平影响的研究

目的 探讨养血清脑颗粒对偏头痛患者溶血磷脂酸(LPA)、肿瘤坏死因子(TNF)水平的影响.方法 治疗组:160例,采用盐酸氟桂利嗪胶囊加养血清脑颗粒治疗;对照组:58例,单独使用盐酸氟桂利嗪胶囊;健康组:35例.均采用酶免法及严格按试剂说明书操作,对3组受检者外周血LPA、TNF水平进行了检测.结果 治疗组偏头痛患者外周血LPA及TNF水平在用药24h前和用药2周均较健康组高(P＜0.01),用药4周基本恢复健康组水平(P＞0.05);治疗组在用药2周、4周LPA、TNF水平均较对照组低(P＜0.05).而对照组在用药的2周、4周均较健康组高(P＜0.01),P＜0.05).结论 采用盐酸氟桂利嗪胶囊加养血清脑颗粒较单独使用盐酸氟桂利嗪胶囊治疗能更显著的降低偏头痛患者外周血LPA及TNF水平,并能更快更好的缓解头痛症状.提示LPA、TNF增高在偏头痛发作期的发病中发挥一定作用,养血清脑颗粒可有效降低偏头痛发作时LPA、TNF水平和缓解头痛症状.     

小鼠皮质神经元类缺血/再灌注后氟桂利嗪对胞质内游离钙离子和神经元凋亡的实验研究

目的研究类缺血/再灌注后不同时间点神经元胞质内游离钙离子及神经元凋亡比例变化,探讨类缺血/再灌注后神经元的凋亡与神经内钙离子的关系及氟桂利嗪的治疗意义.方法利用Ca2 指示剂Flu-3/AM作为细胞内钙离子的荧光探针负载培养的神经元,共聚焦技术检测细胞内荧光强度的变化,原位末端标记法(TUNEL)观察神经元类缺血再灌注后不同时间点神经元凋亡情况.结果与类缺血/再灌注组相比,氟桂利嗪对类缺血/再灌注后神经元胞质内游离钙离子浓度增高和神经元凋亡有显著抑制作用(P＜0.05);再灌注3 h两组无显著差异.结论氟桂利嗪可明显抑制类缺血/再灌注后神经元胞质内钙离子的升高,减少神经元凋亡比例.     

急性脑梗死患者血小板钙含量的变化

目的 研究急性脑梗死患者血小板钙含量的改变,探讨前、后循环区脑梗死与血小板钙含量的关系.方法 采用流式细胞仪检测87例急性脑梗死患者(前循环区脑梗死40例、后循环区脑梗死47例)及20名健康体检者(正常对照组)外周血血小板钙含量,比较前循环区与后循环区脑梗死患者及与正常对照组的血小板钙含量.结果 急性脑梗死组血小板钙含量显著高于正常对照组(P＜0.01);前循环梗死组血小板钙含量显著高于后循环梗死组(P＜0.05).结论 急性脑梗死患者血小板钙含量显著增高,尤以前循环区脑梗死更明显.     

正天丸与氟桂利嗪联合治疗偏头痛疗效观察

目的 观察正天丸与氟桂利嗪联合治疗偏头痛的临床疗效.方法 将80例偏头痛患者,随机分为2组,治疗组40例,服用正天丸6 g,3次/d,氟桂利嗪10 mg,每晚睡前服;对照组40例,服用氟桂利嗪10 mg,每晚睡前服;2组均连续治疗4周,观察2组疗效,比较有效率.结果 治疗组总有效率92.5% ,其中治愈12例(30.0%),显效15例(37.5%),好转20例(25.0%);对照组总有效率72.5%,其中治愈7例(17.5%),显效13例(32.5%),好转9例(22.5%);治疗组总有效率明显优于对照组(P＜0.05).结论 正天丸与氟桂利嗪联合治疗偏头痛疗效好且不良反应小,值得临床推广.     

急性脑梗死患者血小板磷酸二酯酶活性变化及共影响因素研究

目的 观察急性脑梗死患者血小板磷酸二酯酶(PDE)亚型活性变化,探讨影响其因素.方法 对30例急性脑梗死患者分别于发病第1、4、8、15天检测血小板PDE活性、环核苷酸含量、[Ca2+]I水平,并以10例年龄相当的健康体检者为正常对照.结果 与对照组比较,急性脑梗死患者发病第1、4、8天时血小板PDE2、PDE3亚型活性降低,环腺苷酸(cAMP)含量降低,胞浆[Ca2+]I水平升高,差异均有统计学意义(P<0.05);PDE5亚型活性及环鸟苷酸(cGMP)含量则无明显变化.相关分析显示,PDE2活性、PDE3活性与cAMP含量、[Ca2+]I水平均无相关关系,cAMP含量与[Ca2+]I水平间呈负相关关系(R2=0.921,P<0.05).结论 脑梗死急性期血小板胞浆cAMP含量降低,[Ca2+]I水平升高,血小板处于活化状态;血小板PDE2、PDE3通过降低活性、减轻cAMP降低程度、抑制血小板活化而在脑梗死急性期发挥保护作用.     

双重抗血小板治疗对急性脑梗死患者血小板活化及聚集的影响

目的 观察急性脑梗死患者血小板CD62p表达及血小板聚集的变化,并探讨双重抗血小板治疗对其的影响.方法 将60例急性脑梗死患者随机分为阿司匹林治疗组(A组)和阿司匹林+银杏达莫注射液治疗组(B组),每组各30例.采用流式细胞技术,于发病次日及治疗2周后对血小板CD62p的表达进行检测,并观察2组患者治疗前后Scandinavian卒中量表(SNSS)评分、血小板聚集率(PAR)的变化.结果 与治疗前比较,2组治疗后PAR(ADP) 、PAR(AA)、 CD62p均显著降低,差异有统计学意义(P＜0.01);2组治疗后SNSS评分均高于治疗前,差异有统计学意义(P＜0.05);2组治疗后比较,B组PAR(ADP)、 CD62p低于A组,差异有统计学意义(P＜0.01).结论 与单用阿司匹林相比,阿司匹林联用银杏达莫注射液具有更强的抑制血小板活化及聚集的作用.     

Mental illness in England,in Scotland and in Scots living in England

Summary Beginning from the observation that Scots living in England have much higher rates of mental hospital admission than do the English, several hypotheses are proposed to account for this. Much of the excess in rates of mental illness is accounted for by those diagnosed as having alcohol-related disorders and behaviour and personality problems. The results of an examination of offical statistics in the two countries enabled some explanations to be offered. It was found that rates of admissions to mental hospitals are higher in Scotland than in England but not as high as those found among Scots migrants who have a much higher rate of readmission to hospitals than either of the other groups. In fact, if first admissions only are considered the rates of admission in Scotland are not only higher than rates for English natives but also higher than for Scottish migrants. It seems that Scots living in England are somewhat less likely to become mental patients than Scots in Scotland but that once they do achieve this status they are very much more likely to be readmitted on subsequent occasions. It was concluded that there might be two fairly distinct groups of migrants from Scotland to England who have different backgrounds, different reasons for migrating and different psychological characteristics. On the one hand there are stable, economically motivated migrants who move south for definite employment related reasons and who show few psychological symptoms. While on the other hand there is a group of migrants who perhaps have psychological problems and who move more in hope than expectation without definite prospects and who account for the high rates of mental hospital admission found in Scottish migrants.     

Prostacyclin release in the coronary circulation during sustained stimulation in in vitro and in in vivo experimental systems

Prostacyclin release from rat isolated perfused hearts and from dog coronary circulation was studied by measuring immunoreactive 6-keto-PGF1 alpha (6-keto-PGF1a) in heart perfusate and in plasma obtained from the great cardiac vein respectively. Continuous infusion of arachidonic acid at constant concentration in isolated perfused hearts induced an increased prostacyclin release. This release showed a rapid peak within 10 min and a subsequent decrease. Low-flow ischemia induced an increased perfusate concentration of 6-keto-PGF1a but, considering the decreased flow, prostacyclin release was actually reduced. During the whole period of ischemia (60 min) prostacyclin release was constant. In open-chest anesthetized dogs 6-keto-PGF1a concentration in the great cardiac vein was increased after ligation of the left anterior descending coronary artery. A prolonged period of coronary occlusion (4.5 hours) resulted in a progressive rise of prostacyclin release. 6-keto-PGF1a determinations in the femoral vein and in the aorta did not show relevant variations during the observation period.     

癫痫与抑郁关系的研究进展

抑郁是癫痫患者中常见的精神障碍,严重地影响了患者的生活质量。传统的观点认为癫痫患者因为存在着诸多社会学问题易出现抑郁倾向,癫痫和抑郁是单向的联系,但大量的研究已经证明癫痫和抑郁之间存在双向的联系,一种异常状态的存在可能易转化为另一种异常状态的发展。癫痫和抑郁存在着共同的发病机制。本文主要就癫痫和抑郁的双向联系以及抗抑郁药物在癫痫患者中的应用进行阐述。     

神经介入：回眸2022

<正>2022年,国际上公布了多项大型神经介入领域的随机对照试验（randomized controlled trial,RCT）结果,在血管内治疗（endovascular treatment,EVT）急性大血管闭塞（large vessel occlusion,LVO）适应证的扩展、药物治疗、管理,症状性颅内动脉粥样硬化性狭窄（symptomatic intracranial atherosclerotic stenosis,sICAS）治疗,无症状性颈动脉狭窄治疗,     

Neuroimaging in epilepsy in tropics

Epilepsy is a major public health problem in many tropical countries. Also, some of the tropical diseases are major contributors to the higher prevalence of epilepsy in these countries. The etiologic factors responsible for epilepsy in these countries are quite different from those in the developed world. This article discusses the etiologic factors and neuroimaging of epilepsy in light of the conditions in these tropical countries.