严重烧伤后早期大鼠肾脏细胞粘附分子1和白介素6的表达与肾功能损害的相关性研究

Intheearlyphaseofsevereburn，kidneyinjuryoccurredandpersistedforalongtime，whichismaincauseofdeathofpatientswithsevereburn．Earlykidneyinjurywillleadtoeventualrenalfailureandbringaboutaseriesofpathologicalchange．Inpresentstudy，weinvestigatemechanismofearlykidneyinjuryandprovidebasisforearlypreventionofkidneyinjuryfollowingsevereburn．１Materialandmethod１．１EstablishmentofanimalmodelAccordingtoreference１，weestablishedratmodelwithsevereburngradeII犤１犦．１．２Irrdiationwaysandconditions…     

带蒂筋膜管的耳大神经移植治疗面神经缺失性损伤

Inthepresentstudy，greatauricularnervecoatedbypediculatedfascialtubenearfacialnervetrunkwasusedtotreatdefectivedamageoffacialnerve．Andthefunctionalrecoveryoffacialnervewasmoreapparentthangraftinggreatauricularnervealone．Thestudyisre－portedasfollowing．１Subjectandmethod１．１Subject（１）Threecasesofotogenicfacialparalysis．Case１，male，８yearsold．Hasnecrotizingexternalotitisintherightearandfacialparalysisfor１２months．Case２，female，３６yearsold．Haspa－pillomaofexternalauditorycanal…     

椎-基动脉缺血发作与睡眠呼吸障碍

Therelationshipbetweencerebro－vasculardiseases（CVD）andSRBDhasattractedpeople’sattentionmoreandmoreinthepastyears．WepresentinthispapertherelationshipofVBIandSRBDwhichhasnoteverbeenreportedbefore．１Subjectandmethod１．１SubjectFortyfivepatients，male３２，female１３，withanageof２７～７４yearsandanaveragedurationofillnessof２．１years（５daysto１０years）．１．２Criteriaofdiagnosis犤１犦（１）Transientvertigoattacksaccom－paniedbyotherVBIsymptomssuchasdiplopia，scintillation，visua…     

高压氧对动物有机磷中毒后神经损害恢复的实验研究

１Subjectandmethod１．１Subject１６healthyNewZealandrabbitsaging６monthsandweightingfrom１．５kgto２．０kg，meanweight：（１．６７±２．０）kg，wereprovidedbyAnimalcenterDepartmentofGeneralHospitalofFuzhouMilitaryRegion．５０％oxidizingorgor（orgonicphospho－rus）wereperfusedintorabbit＇sstomach，５０mg／kg．Acutepoisoningmodelsofratswereestablished．Allratswererandomlydividedintohyperbaricoxygenandcontrolgroups．１．２MethodRabbitsinhyperbaricoxygengroupweretreatedwithHBO，２０minutesea…     

Clinical study on effect of Tongyong Tongfeng Decoction combined with methotrexate on pain and swelling after rheumatoid arthritis

Rheumatoidarthritis（RA）causesjointinjury，abnormality，anddysfunction，anddisability．Patients＇qualityoflifeandlaborabilityareseriouslyaffected．Noeffectiveinterventionsarenowavailable．Inthisstudy，wetreatedRAbycombinedtherapyoftraditionalmedicineandwesternmedicine，whichrelievedarthroncusandpain．Clinicaleffectsaresatisfying．Hereisthereport．１Subjectandmethod１．１SubjectAllpatientswerediagnosedaccordingtodiagnosticstandardsforRAissuedinAmericanRAassociationin１９８７犤１犦．Nopat…     

焦虑情绪与海员高血压及相关因素的分析

FromAugusttoOctober１９９７，wefoundanxietycorrelatewithbloodpressureapparently．Sowemakefurtherstudyontherela－tionshipofanxietyandprevalencerateofmarinehypertensionandmarinehypertensionrelatedsusceptiblefactors．１Subjectsandmethod１．１Subjects４２０１seamenreceivedSASandquestionnaireinquiry，４０４８caseswerevalid．Allthecasesweremale，averageagewas（２３．８１±４．３２）．Allthecasesworknormally１weekbeforeinquirywithoutspecialmissioninfluencesuchasdistalsail，longsail．１．２Method（…     

奇曼丁治疗晚期癌症疼痛的疗效

Itisestimatedthat７０％patientssufferedfromadvancedtumorsdevelopedpainofdifferentextent．Painaffectsqualityoflifedirect－ly，mind，psychology，socialandpersonalrelationandleadtodis－comfort犤１犦．WiththespreadingofWHOthree－stepmanagement，ad－ministrationwaysaretransformedfromdemanddependanttotimedepend犤１犦．Tramcontin（slowreleasedtramadol），theweakthebaicdrug，cancontrolmoderatepain．１Subjectandmethod１．１Subject１１６caseswithpathologicallyandradiologicallyprovedadvancedtumors（６…     

脑脊液蛋白质氯烃基二甲基代苯甲胺比浊测定法

氯烃基二甲基代苯甲胺（ｂｅｎｚａｌｋｏｎｉｕｍｃｈｌｏｒｉｄｅ，ＢＡＣ）季胺化合物能与蛋白质反应形成浊度［１］，据此，用于脑脊液蛋白质含量的测定。１　材料与方法１．１　试剂１．１．１　ＢＡＣ贮存液　于９０ｍｌ蒸馏水中溶解ＢＡＣ（Ｓｉｇｍａ，Ｂ－６２９５）１１３ｍｇ，ＥＤＴＡ二钠盐３．６５ｇ，ＮａＯＨ８ｇ，然后用１ｍｏｌ／ＬＮａＯＨ调ｐＨ至１２．８，最终加蒸馏水至１００ｍｌ。１．１．２　ＢＡＣ应用液　取ＢＡＣ贮存液１份加０．１５ｍｏｌ／ＬｐＨ７．０磷酸盐缓冲液４份。１．１．３　蛋白标准液　总蛋白标…     

大叶性肺炎并中毒性休克病人的护理

护理评估１．１一般资料：李某某，男，５６岁，已婚，干部。１．２活动运动型态：１．２．１全身皮肤湿冷，肢体末梢紫绀，烦躁不安，血压１１／６ｋＰａ。１．２．２端坐呼吸。血气分析：氧分压降低，二氧化碳分压上升，氧饱和度下降。１．２．３由于吸氧、发热及机械通...     

尼莫地平对脑梗死患者康复期认知功能干预的临床和实验研究

Rehabilitationofpatientswithcerebralinfarctionreliesondrugtherapyprimarily．Nimodipine，asthebrain－protectingdrugfortreatmentofdementia犤１犦isoneofwidelyuseddrugsinclinicinChina．However，recently，therewasmuchmorecontroversiesovertheeffectofnimodipineoncognitivefunctioninavarietyofre－ports犤２～５犦．Combininganimalexperimentwithclinicalfingidngs，weinvestigateimpactofnimodipineoncognitionrehabilitation．１Materialandmethod１．１Material（１）Animals：IsolatedWistarratswereprovidedbyAni…     

应用在线经颅直流电刺激探查外侧裂后部对失语症恢复的作用

目的:采用汉语失语症心理语言评价(PACA)及在线经颅直流电刺激(tDCS),探查两半球外侧裂后部周围区(PPR)是否可以促进失语症语言功能的改善,以及语言功能恢复的可能机制。方法:利用PACA对7例脑卒中后恢复期失语症患者(基底核区损伤4例,皮质损伤3例)进行语言评价,同时实施在线tDCS。在无刺激、左PPR区和右PPR区阳极刺激三种试验条件下进行失语症评价。语言评价任务为听觉词-图匹配、图命名。结结果论::阳对极恢刺复激期左失P语PR症区患时者,采图用命名tD成CS绩阳显极著刺改激善左(PP相似文献   

中重度皮层下失语的语言特征及训练疗效分析

目的筛查影响皮层下失语严重程度的因素,分析中重度皮层下失语患者语言障碍的特点及语言训练的疗效.方法选择皮层下失语症患者22例,其中中度10例,重度12例,于语言训练前后,分别采用汉语标准失语症检查法(CRRCAE)、波士顿失语症检查(BDAE)进行评估,筛查失语症严重程度的影响因素,分析语言障碍的特点及神经语言学特征,比较治疗前后各项语言能力差异.结果年龄、有无并发言语失用两个因素进入失语症严重程度的回归方程.皮层下失语症患者听理解、阅读理解、复述及出声读等语言能力相对保留.语言训练后,中度皮层下失语患者各项语言能力明显改善,重度皮层下失语患者听理解、复述、说、出声读、阅读等语言能力明显改善,书写能力改善不明显.结论年龄、是否并发言语失用可能是影响皮层下失语严重程度的重要因素.脑卒中后皮层下失语有特定的神经语言学特点,语言训练疗效显著,中重度皮层下失语患者语言训练疗效有差异.     

Overt propositional speech in chronic nonfluent aphasia studied with the dynamic susceptibility contrast fMRI method

This study examined activation levels in the left (L) supplementary motor area (SMA) and the right (R) SMA (separately), and activation in nine R perisylvian language homologues during overt, propositional speech in chronic nonfluent aphasia patients. Previous functional imaging studies with a variety of chronic aphasia patients have reported activation in these regions during different language tasks, however, overt propositional speech has not been examined. In the present research, four nonfluent aphasia patients were studied during overt elicited propositional speech at 4-9 years post-single L hemisphere stroke, which spared the SMA. The dynamic susceptibility contrast (DSC) method of functional MRI was used to calculate relative cerebral blood volume (relCBV) for cortical regions of interest (ROIs) during the first-pass bolus of gadolinium during two conditions: (1) pattern (silent viewing of checkerboard patterns) and (2) story (overt, elicited propositional speech describing sequential pictures, which formed a story). During the story condition, controls had significantly higher relCBV in L SMA than in R SMA; aphasics, however, had significantly higher relCBV in R SMA than in L SMA. During the pattern condition, no significant differences were observed between the L SMA and the R SMA for either controls or aphasics. In addition, aphasics had significantly higher relCBV in the R sensorimotor mouth during story than pattern. This R sensorimotor mouth relCBV was also significantly higher in aphasics than controls during story, and the two groups did not differ during pattern. The overall mean relCBV for the nine R perisylvian ROIs was significantly higher for aphasics than controls during both story and pattern. These results suggest that poor modulation, including possible over-activation of R sensorimotor mouth and other R perisylvian language homologues may underlie in part, the hesitant, poorly articulated, agrammatic speech associated with nonfluent aphasia.     

脑卒中后语言障碍

失语症是脑卒中后的主要语言障碍。它通常是由于左侧大脑损害造成理解和运用语言符号系统表达的能力受损,并伴有右侧运动机能减弱或偏瘫。它不属于智能减弱、知觉丧失或运动机能障碍。在Framingham研究中,分别有18%和16%的长期脑卒中存活者被发现有失语症和呐吃。失语症严重影响了患者的生活。一个多世纪以来,学者们对失语症进行了各方面的研究与发展。介绍失语症的分类、评估及治疗。     

脑血管意外后空间方位和时间词句的听理解研究

运用空间方位词、时间词对４５例正常成人、３１例右半球脑血管意外病人、２０例左半球脑血管意外无失语病人和２０例左半球脑血管意外失语病人进行了听理解测验。结果表明，失语组、右半球病变组的空间方位词句测验成绩与对照组有差异，而且失语组与右半球病变组的成绩也有差异。失语组时间词句的听理解成绩与其它三组的成绩有差异。结果表明失语组的是否句与语段成绩无差异；可逆被句、方位词句、时间词句的成绩无差异。但是否句、语段与可逆被动句、方位词句、时间词句的成绩有差异。认为失语组听理解是否句、语段较理解可逆被动句、方位词句、时间词句容易。失语组倾向于按事件发生的时间顺序理解时间词句。     

Depression, nonverbal intellectual impairment and quality of life following left-brain ischemic insult--results of a catamnestic study]

The purpose of the present study was to establish the relationship between persisting aphasia and the extent of overall disability in the long-term outcome following left hemisphere ischaemic stroke. 55 right-handed patients who had sustained an initial left-sided cerebral infarction, verified by CT scan, were investigated after a mean observation period of six years. 39 patients were categorized as being non-aphasic, and 16 as being aphasic (3 Global, 6 Broca's, 1 conduction, 1 transcortical motor and 5 anomic aphasics) at the end of the follow-up period. Regarding motor and sensory functions, a correlation between the presence of aphasia and the severity of deficits could be established at the end of the follow-up period. With respect to activities of daily living, a significantly larger number of aphasic stroke victims had to rely on help by others. Furthermore, the persistence of aphasia also negatively influenced the subsequent occupational capacity. With regard to social participation and leisure activities, a significant reduction was found in aphasic long-term stroke survivors as compared to non-aphasics. Concerning quality of life, both groups reported a marked decline at the end of the observation period; the presence of aphasia had an additional negative effect. However, as regards the long-term non-verbal cognitive impairment, statistical analysis revealed no significant differences between both groups. In addition, aphasic stroke survivors did not demonstrate a higher incidence of depressive states than those without language deficit. On the basis of our results it is concluded that the presence of aphasia in left-hemispheric ischaemic stroke survivors indicates a more severe stroke, resulting in greater physical disability and social handicap in the long-term outcome.(ABSTRACT TRUNCATED AT 250 WORDS)     

汉语失语症心理语言评价与汉语标准失语症检查对命名困难定性的比较

目的：探讨汉语失语症心理语言评价(PACA)与汉语标准失语症检查(ABC)哪一方法可以揭示命名困难产生的根源。方法：采用汉语失语症心理语言评价,以及汉语标准失语症检查的相关测验对2例命名困难的失语症患者进行检查。结果：例1的ABC名词听理解、名词阅读理解、图画命名完全正常,但词复述和命名言语含糊不清。PACA的名词听理解、同义词判断检查提示该患者的语义系统接近正常;语音判断、读音一致性判断及起始音分类基本正确,表明语音输出词典正常;复述检查未显示出词长效应;根据PACA确定该患者的语言损害主要定位于言语运动计划水平。例2的ABC名词听理解与阅读理解全部正确;字、词复述全部正确;命名困难。PACA的听理解、阅读理解测验表明该患者存在词汇语义损害。语音输出词典有关测验表明语音输出词典的损害比语义认知更严重。词复述和非词复述正常,提示词典后加工正常。结论：汉语失语症心理语言评价可以揭示命名产生的根源,有帮于分析和确定造成命名困难的语言加工受损水平,从而为命名困难受损的认知加工进行针对性的治疗。     

Transcranial Doppler monitoring during language tasks in stroke patients with aphasia

Purpose. To investigate the pattern of hemispheric activation, according to cerebral blood flow changes, as measured by Transcranial Doppler Ultrasonography (TCD) during language tasks in stroke patients with aphasia.

Method. Prospective study investigating results of TCD monitoring during language naming and recognition tasks in ischemic stroke patients (n = 32) with and without aphasia and 5 control subjects.

Results. Delta mean flow velocity (MFV) in the left Middle Cerebral Artery (MCA) was found to be much lower in aphasia patients as compared to healthy subjects. Negative statistical correlation was found between the improvement of language ability and the blood flow velocity parameters in the left hemisphere. Aphasia patients with good language ability showed much higher MFV in the right MCA during the first test. Left hemispheric blood flow velocity shift was found to be higher during speech tasks in the patients with poor language ability.

Conclusions. Our study suggests that the performance of language tasks in aphasia patients during early recovery after stroke is associated with relatively high right hemisphere activation. High blood flow velocity in the right MCA of aphasia patients was found to be a good prognostic sign for better language ability. Arterial blood flow that shifted towards the left hemisphere during speech tasks was associated with poor language ability.     

Contribution of the left and right inferior frontal gyrus in recovery from aphasia. A functional MRI study in stroke patients with preserved hemodynamic responsiveness

The relative contribution of dominant and non-dominant language networks to recovery from aphasia is a matter of debate. We assessed with functional magnetic resonance imaging (fMRI) to what extent the left and right hemispheres are associated with recovery from aphasia after stroke. fMRI with three language tasks was performed in 13 aphasic stroke patients and in 13 healthy subjects. Severity of aphasia was examined within 2 months after stroke and after at least 1 year. Recovery of naming ability and scores on the Token Test were correlated with data from fMRI in the chronic phase. A breath-hold paradigm was used to investigate hemodynamic responsiveness.Overall language performance in the chronic phase correlated with higher relative activation of left compared to right perisylvian areas. Recovery of naming ability was positively correlated with activation in the left inferior frontal gyrus (IFG) for semantic decision and verb generation. Recovery on the Token Test was positively correlated with activation in both left and right IFG during semantic decision and verb generation. Hemodynamic response to the breath-hold task was similar in patients and controls.Our study suggests that in the chronic stage after stroke left IFG activity is associated with improvement of picture naming and sentence comprehension, whereas activity in the right IFG may reflect up-regulation of non-linguistic cognitive processing. Altered hemodynamic responsiveness seems an unlikely confounder in the interpretations of fMRI results.     

脑卒中后运动性失语的功能磁共振成像研究

目的：探讨脑卒中后运动性失语症患者的语言功能恢复机制。方法：应用3T MR扫描仪对6例脑卒中患者失语后及康复后分别进行两次图片命名任务的BOLD fMRI扫描。实验采用组块设计方案,利用SPM5软件的总体线性模型（General linear model, GLM）进行后处理产生激活脑区图像。并对所有患者在发病后与康复后的脑内激活分布、大小、强度进行分析与比较。结果：所有患者在失语后左侧大脑半球语言相关脑区激活部分出现激活,其中3例右侧Broca’s镜像区出现激活。而在康复后所有患者的左侧大脑半球语言相关脑区激活增多,激活强度增加,其中左侧Broca’s区均出现激活,右侧Broca’s镜像区激活减弱。结论：失语后优势半球丧失功能的语言区移至对侧镜像区和优势半球未受累语言区的功能重组这两种机制都参与了语言功能恢复的过程,近期以右侧半球为主,远期左侧半球发挥更重要作用。