脑脊液置换联合鞘内给药治疗结核性脑膜炎疗效观察

目的 观察脑脊液置换联合鞘内给药治疗结核性脑膜炎的临床疗效.方法 将37例结核性脑膜炎患者分为治疗组26例和对照组11例,对照组采用正规抗结核疗法,治疗组在其基础上加用脑脊液置换联合鞘内注药疗法.结果 治疗组治愈23例,治愈率为88.46%, 对照组治愈8例,治愈率72.72%, 2组的临床疗效之间差异有统计学意义(P＜0.05).结论 脑脊液置换联合鞘内给药法对结核性脑膜炎安全、有效,能明显提高治愈率.     

脑脊液置换联合鞘内注药治疗结核性脑膜炎临床分析

目的研究脑脊液置换联合鞘内注药对结核性脑膜炎的治疗价值。方法选取2015-01—2016-06结核性脑膜炎患者76例,将其随机分2组。常规治疗组用常规抗结核方法进行治疗,联合治疗组在常规治疗组基础上采用脑脊液置换联合鞘内注药治疗。比较2组治疗总有效率,不良反应发生率;治疗前和治疗后患者脑脊液压力、脑脊液白细胞数、蛋白定量的差异。结果 2组患者治疗的总有效率有明显差异,联合治疗组高于常规治疗组,P0.05;2组不良反应发生率无明显差异(P0.05);2组患者的脑脊液白细胞数、脑脊液压力、蛋白定量等基线数据比较差异无统计学意义(P0.05);治疗后联合治疗组脑脊液压力、脑脊液白细胞数、蛋白定量改善幅度更大,P0.05。结论脑脊液置换联合鞘内注药对治疗结核性脑膜炎具有明显的临床价值,可有效改善脑脊液情况,降低蛋白定量,无明显不良反应,对患者预后和转归有益,值得推广。     

脑脊液置换联合鞘内给药治疗结核性脑膜炎临床分析

目的探讨脑脊液置换注药联合治疗结核性脑膜炎的临床价值。方法32例结核性脑膜炎患者随机分组后,将脑脊液置换联合注药治疗组与非联合治疗组临床疗效比较。结果脑脊液置换联合注药治疗组疗效和预后明显优于非联合治疗组,住院时间明显短于非联合治疗组。结论在全身系统化疗基础上行脑脊液置换注药联合治疗可明显提高结核性脑膜炎疗效、改善其预后、缩短住院时间、节省住院治疗费用,具有明显的社会效益,值得临床推广。     

脑脊液置换联合鞘内注射治疗结核性脑膜炎疗效观察

目的观察脑脊液置换联合鞘内注射对结核性脑膜炎患者脑脊液生化的影响,并探讨其疗效。方法 128例结脑患者随机分为治疗组（n=65）和对照组（n=63）,对照组常规治疗,治疗组在常规治疗的基础上采用脑脊液置换联合鞘内注射,治疗结束后对2组疗效进行比较分析。结果治疗组在改善脑脊液生化指标方面均优于对照组（P〈0.05）。治疗组总有效率为96.72%,治愈率为65.57%;对照组总有效率为76.67%,治愈率为45.00%,差异有统计学意义（P〈0.01）。结论脑脊液置换联合鞘内注射治疗结核性脑膜炎疗效显著。     

改良腰大池外引流治疗重症结核性脑膜炎

目的探讨改良腰大池外引流治疗重症结核性脑膜炎的疗效与安全性。方法回顾性分析39例重症结核性脑膜炎病例资料。治疗组18例,对照组21例。在化疗方案HRZE基础上,治疗组行皮下潜行腰大池外引流、鞘内注药治疗;对照组间断腰椎穿刺、鞘内注药(2次/周)。比较两组病人意识状态、GCS评分,脑脊液实验室检查指标变化。结果治疗组治疗后病人意识状态、GCS评分、脑脊液实验室检测指标及痊愈率较对照组统计学差异显著(P0.05)。结论皮下潜行腰大池持续外引流并鞘内注药治疗结核性脑膜炎安全而有效。在内科抗结核治疗基础上,联合皮下潜行腰大池持续外引流并鞘内注药治疗重症结核性脑膜炎,临床疗效优于传统治疗方案。     

脑脊液置换联合鞘内注射治疗结核性脑膜炎临床疗效评价

目的：评估脑脊液置换联合鞘内注射治疗结核性脑膜炎的临床效果。方法结脑患者64例随机分为对照组32例和观察组32例。对照组予以异烟肼、利福平、吡嗪酰胺、乙胺丁醇等抗结核治疗及地塞米松激素治疗。观察组在常规抗结核治疗的基础上加用脑脊液置换联合鞘内注入异烟肼,地塞米松,胞二磷胆碱等药物治疗。分别记录2组脑脊液转阴时间,临床症状消失时间,住院时间,观察周期3个月,比较2组疗效。结果观察组总有效率脑脊液转阴时间、临床症状消失时间、住院时间方面均明显优于对照组（ P＜0.05）。结论脑脊液置换联合鞘内注射治疗结核性脑膜炎可有效缓解结核性脑膜炎患者的临床症状,缩短疗程,临床效果显著。     

脑脊液置换、鞘内注药治疗结核性脑膜炎(附20例临床观察)

目的　观察脑脊液置换术 鞘内注药治疗结核性脑膜炎的疗效和安全性。方法　对无腰穿禁忌症的 2 0例结核性脑膜炎在常规药物治疗的基础上 ,采取脑脊液置换术 鞘内注药。结果　 14例痊愈 ,5例好转 ,自动出院 1例 ,临床效果较为满意。结论　对结核性脑膜炎辅以脑脊液置换术 鞘内注药有助于提高临床疗效 ,是一种安全有效的方法 ,值得在基层医院推广应用。     

持续引流脑脊液并鞘内注药治疗隐球菌性脑膜炎17例临床疗效观察

目的:探讨持续引流脑脊液并鞘内注药治疗隐球菌性脑膜炎的临床疗效。方法:以住院时间的先后顺序为配伍因素将病人分设治疗组和对照组,对照组采用常规疗法,治疗组采用持续引流脑脊液并鞘内注药疗法,比较两组的临床疗效。结果:治疗组治愈10例,好转4例,无效或死亡3例;对照组治愈3例,好转6例,无效或死亡6例,两组的临床疗效之间有显著性差异(P<0.05)。结论:本疗法安全且能进一步提高对隐球菌性脑膜炎的疗效。     

左氧氟沙星辅助治疗重症结核性脑膜炎的可行性及安全性分析

目的探讨左氧氟沙星辅助治疗重症结核性脑膜炎的可行性及安全性,进一步指导临床治疗。方法选取2011-12—2014-10我院收治的68例重症结核性脑膜炎为研究对象,采用随机数字表法将患者分为研究组和对照组各34例。对照组给予抗结核、降颅压及鞘内注药等常规治疗,研究组在对照组的基础上给予左氧氟沙星静滴,比较2组患者治疗总有效率及不良反应。结果研究组总有效率为94.1%,高于对照组的70.6%(P0.05);2组患者不良反应发生率差异无统计学意义(P0.05)。结论左氧氟沙星配合鞘内注药治疗重症结核性脑膜炎效果确切,可有效缓解患者临床症状,安全性高。     

短期加用利奈唑胺治疗难治性结核性脑膜脑炎的疗效分析

目的观察短期加用利奈唑胺治疗难治性结核性脑膜脑炎的临床疗效及安全性。方法选取2014-09-2018-09郑州市第六人民医院结核科收治的难治性结核性脑膜脑炎患者63例,通过回顾性队列研究将所有患者分为对照组(32例)和治疗组(31例),对照组给予常规抗结核药物加脑脊液置换联合鞘内注药,治疗组在对照组的基础上加用利奈唑胺(LZD,linezolid),治疗4周后分析比较2组总有效率、脑脊液指标(脑脊液压力、脑脊液细胞数、脑脊液蛋白量)、不良反应发生率。结果治疗4周后,治疗组总有效率明显高于对照组,差异有统计学意义(P0.05)。治疗组颅内压数值、脑脊液白细胞计数、脑脊液蛋白量均明显低于对照组,差异均有统计学意义(P0.05)。所有患者治疗过程中均未发生严重不良反应。结论抗结核治疗中短期加用利奈唑胺,可促进难治性结核性脑膜脑炎患者病情恢复,且安全性良好。     

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.