雌孕激素对马桑内酯致癫痫大鼠大脑皮层和海马氨基酸含量的影响

我们已经在动物身上证明了雌激素的致癫病性和孕激素的抗癫癌作用,然而其作用机制尚不清楚。为此,我们采用高效液相色谱仪（HPLC）结合紫外分光光度仅检测了马桑内酯（CL）致癫痫大鼠大脑皮层、海马谷氨酸（Glu）、门冬氨酸（Asp）、甘氨酸（Gly）及γ-氨基丁酸（GABA）的含量变化及雌二醇（E2）、孕酮对它们的影响,旨在探讨雌、孕激素的作用机制。材料和方法：雌性SD大鼠24只,体重ito－180g,行双侧卵巢摘除术。术后随机分为正常对照组（l组）、几致癫病组（2组）、应用马后致癫病组（3组）及应用孕酮后致癫病组（4组）。l、2组…     

口服营养补充疗法联合康复治疗对脑卒中患者早期康复效果的影响

目的探讨口服营养补充疗法联合康复对卒中单元患者的早期康复效果。方法选取河南理工大学第一附属医院2017-12—2018-12由卒中单元转入的早期康复患者60例,随机分为对照组和观察组,对照组给予综合康复治疗,观察组在康复治疗的基础上给予口服营养补充疗法,比较2组干预前后前白蛋白(PA)、白蛋白(ALB)、血红蛋白(Hb)及肱三头肌皮脂厚度(TSF)、上臂中部肌围(AMC),对比建立坐位平衡、建立立位平衡的时间及60 d后改良Barthel指数评分。结果干预后观察组PA、ALB、Hb,建立坐位平衡、建立立位平衡的时间,改良Barthel指数评分均明显高于对照组,差异有统计学意义(P0.05)。2组TSF、AMC比较差异无统计学意义(P0.05)。结论口服营养补充疗法联合康复治疗可提高卒中单元患者早期康复效果。     

脑卒中的预防

卒中的预防分为一级预防及二级预防.所谓的一级预防就是筛选脑血管病的高危个体,对未发病者提供相关危险因素的治疗.     

癫痫发作与雌、孕激素的相互影响

本文主要综述雌、孕激素变化对癫痫发作的影响,癫痫、抗癫痫药物对雌、孕激素的影响,以及与雌、孕激素有关的癫痫治疗。     

疏血通联合血栓通治疗缺血性脑卒中的疗效分析

目的探讨分析疏血通联合血栓通治疗缺血性脑卒中的临床疗效。方法选取2011-02—2012-06我院收治的缺血性脑卒中患者90例,采用随机数表法平均分为实验组和对照组,实验组患者采用疏血通联合血栓通进行治疗,对照组患者仅使用血栓通治疗,对比观察2组患者治疗后效果。结果实验组治疗有效率为93.3%,对照组治疗有效率为77.8%,差异具有统计学意义(P<0.05),在血液流变学指标对比方面,实验组患者治疗后血浆黏稠度和全血黏稠度分别为1.55±0.28和4.11±0.17,对照组为2.09±0.51和5.36±0.21,差异有统计学意义(P<0.05),在红细胞比积和纤维蛋白原含量方面实验组治疗效果也显著优于对照组。结论临床使用疏血通联合血栓通治疗缺血性脑卒中安全有效,对疾病愈后恢复具有良好促进作用,提高患者生活质量,降低医药支出,适合在农村以及偏远地区的基层医院推广使用。     

垂体腺瘤雌孕激素受体的研究

目的:为了解垂体腺瘤的雌、孕激素受体分布情况及临床意义。方法:采用免疫组化方法检测了60例手术治疗的垂体腺瘤的雌激素受体(ER)、孕激素受体(PR),并结合内分泌功能分类和临床影像学检查进行研究。结果:研究表明,垂体腺瘤ER阳性率为77％,PR阳性率为67％。大的巨腺瘤ER、PR阳性率低于微腺瘤(PR间x~2=8.158,P=0.017<0.05)。细胞生长活跃的腺瘤ER、PR常阴性。不同功能类型的垂体腺瘤ER、PR阳性率亦不同。结论:研究提示ER、PR与垂体腺瘤的分化侵袭有关,ER、PR检测可能是垂体腺瘤选择治疗和评估预后的一项指标。     

糖尿病患者脑卒中预防

卒中的大量流行病学研究证实:糖尿病是缺血性卒中的一个重要危险因素。糖尿病患者患脑卒中的风险是非糖尿病患者的2～3倍,有致死率高、致残率高、恢复缓慢的特点。缺血性脑血管病急性期和恢复期的血糖水平对其患卒中的危险性起决定性作用。此外,在调脂、抗凝、改善血小板功能等方面积极主动地干预治疗对糖尿病患者卒中的一、二级预防有着重要的意义。     

脑卒中肩关节半脱位的预防和治疗

肩关节半脱位在脑血管病中极为常见，尤其在上肢完全迟缓性瘫痪时，其发生率高达60％～80％。多在病后3周内发生，患者常因肩痛影响整个康复过程，采用神经发育促进技术中的一些疗法。我们主要应用Bobath疗法和Rood疗法，可以帮助患者恢复正常的肌张力，抑制不正常运动模式，从而使肩关节半脱位得到预防和治疗。     

川芎嗪预防脑卒中复发的临床研究

目的：探讨川芎嗪预防脑卒中复发的作用。方法：持续5年用川芎嗪治疗脑卒中后恢复期患者171例（治疗组），观察治疗后患者神经功能缺损积分、脑卒中的复发率及血液流变学的改变，并与周期的脑卒中恢复期患者164例（对照组）进行比较。结果：治疗组脑卒中复发率、全血粘度、血浆比粘度及纤维蛋白原均明显低于对照组，而总有效率明显高于对照组。结论：川芎嗪可能通过改善脑卒中恢复期患者的脑血液循环而降低脑卒中的复发率。     

中西医联合康复治疗对急性期脑卒中并发抑郁患者的治疗效果研究

目的探究中西医联合康复治疗对急性期脑卒中并发抑郁患者的治疗效果。方法选取我院收治的急性期脑卒中后抑郁患者310例,随机分为观察组和对照组。对照组给予常规康复治疗,观察组给予中西医联合康复治疗。比较两组患者治疗前后神经功能NIHSS评分和抑郁HAMD评分,和治疗后两组患者抑郁情绪、睡眠障碍、迟缓、焦虑和疑病因子评分。结果与治疗前比较,治疗后两组患者的NIHSS评分和HAMD评分均明显减小(P0.05);与对照组比较,观察组治疗后的NIHSS评分和HAMD评分均较低(P0.05)。治疗后观察组抑郁情绪、睡眠障碍、迟缓、焦虑和疑病5个因子评分水平显著低于对照组(P0.05)。结论中西医联合康复治疗对于急性期脑卒中后抑郁患者有很好的临床治疗效果,有利于脑卒中患者康复。     

Hormone replacement therapy with estrogens may reduce lamotrigine serum concentrations: A matched case–control study

Lamotrigine (LTG) is an antiepileptic drug that is metabolized via glucuronidation. Since the glucuronidizing enzyme is inducible by estrogens, LTG serum concentrations may fall by 50–60% when combined with hormonal contraceptives that contain ethinyl estradiol (EE). Little is known about a possible interaction between estrogens used for hormone replacement therapy (HRT) and LTG, and the few available data are conflicting. Data from serum samples analyzed for LTG were therefore retrieved from a routine therapeutic drug monitoring database. Users of HRT and EE were identified and matched with controls for age and dose. No enzyme‐inducing or enzyme‐inhibiting comedication was allowed. LTG serum concentration‐to‐dose ratios (CDRs) were calculated. Case groups and their respective control groups were compared by the Mann‐Whitney U test. Seventy‐nine HRT users (dose range 1–4 mg/day) and 200 EE users (dose range 20–40 μg/day), as well as 158 and 400 matching controls, respectively, could be included. Both EE users and HRT users had significantly lower mean LTG CDRs than their respective matched controls. These results suggest that HRT with estrogens may reduce serum LTG concentrations.     

Akt1 gene deletion and stroke

Activation of Akt has been implicated as a major contributor to neuronal survival after an ischemic insult. Numerous neuroprotective agents have been shown to augment Akt activity, suggesting that this protein represents a major mechanism of cellular salvage after injury. Estrogen is known to augment Akt, but the possibility that Akt plays a differential role in the male and female brain has yet to be evaluated. In this study, we employed both pharmacological and genetic approaches to investigate the role of Akt in stroke. Utilizing a focal stroke model we show that deletion of the Akt1 isoform does not affect stroke outcome in either male or female mice. Akt1 deficient mice had equivalent levels of phosphorylated Akt (p-Akt) when compared to their WT controls following stroke suggesting that alternative isoforms can compensate for Akt1 loss. Secondly, estrogen's neuroprotective effect is maintained in Akt1^−/− mice and estrogen exposure did not enhance p-Akt levels in WT female mice. Thirdly, we show that inhibiting Akt using the direct pan-Akt inhibitor triciribine has no effect on stroke outcome despite dramatic reductions in p-Akt. Our study demonstrates the limitations of genetic mouse models and suggests that the importance of Akt to ischemic outcome remains unclear.     

Aspirin and stroke prevention

According to meta-analyses aspirin provides a relative reduction in the rate of major vascular events of 19% in patients with arterial disease in general, whereas for patients with ischaemic cerebrovascular disease this reduction is only 13%. The discrepancy may well result from pathophysiological differences and not from a play of chance. There is no proven difference in efficacy according to dose. The evidence for this equivalence is most compelling in the range between 75 and 1300 mg daily, but still fairly convincing for doses between 30 and 50 mg. In contrast, side effects are clearly more frequent as the dose is higher. Other antiplatelet agents (sulfinpyrazone, ticlopidine, clopidogrel, dipyridamole, orally administered IIb/IIIa inhibitors) have no clear advantages over aspirin and in some cases definite disadvantages; the combination of aspirin and dipyridamole may be more efficacious than aspirin alone, but the evidence hinges on a single trial. If recurrent TIAs occur under treatment with aspirin, the rational response is not to change to a different antiplatelet agent, but to review the diagnosis and consider causes other than artery-to-artery embolism. Platelet aggregation can probably still occur despite complete acetylation of platelets, via pathways other than COX-1 inhibition, but in vitro aggregation tests are an unreliable measure.     

预防缺血性卒中的抗血小板治疗

抗血小板治疗是通过药物阻滞血小板聚集而起到预防血栓形成,减少缺血性卒中事件的发生,是缺血性卒中一级和二级预防的重要组成部分。本文对抗血小板治疗在IS一级和二级预防中的应用等临床相关问题加以综述。     

Bromocriptine and speech therapy in non-fluent chronic aphasia after stroke

The objectives of this study were to investigate the efficacy of bromocriptine (BR) combined with speech therapy (ST) to improve a late recovery in non-fluent aphasic stroke patients. We performed a double-blind study with high dosage of BR, prescribed according to a dose-escalating protocol, comprehensive of clinical data, relatives' impression, and language evaluations. The study was divided into the following phases: t-0, inclusion; t-30, language re-test to evaluate the stability of aphasia; t-90, placebo (PL) and ST; t-150, BR and ST; t-210, BR; t-270, wash-out. With respect to the baseline assessment, a significant improvement was observed in the following tests: dictation (F, 4.8; p < .004), reading-comprehension (F, 8.1; p < .0003), repetition (F, 3.8; p < .01) and verbal latency (F, 4.9; p < .01). High dosage of BR promoted a late recovery in stable chronic non-fluent aphasia and this improvement was enhanced by combination with ST. Received: 13 July 1999 / Accepted in revised form: 16 November 1999     

血浆同型半胱氨酸与脑卒中的关系研究

目的探讨血浆同型半胱氨酸（homocysteine,HCY）与脑卒中之间的关系以及在诊疗中的意义。方法收集脑卒中患者173例,采用ADVIA Centaur全自动免疫化学发光仪测定同型半胱氨酸水平,奥林巴斯AU5400全自动生化分析仪检测血脂、血糖水平,分析脑卒中患者血压、血脂、血糖（GLU）、和HCY水平的特征。结果男性脑卒中患者不同亚组血浆HCY水平均高于女性患者中的相应亚组（P〈0.05）。缺血性脑卒中患者血浆HCY、总胆固醇（TC）、甘油三酯（TG）、GLU水平均明显高于对照组（P〈0.01）,出血性脑卒中患者血浆HCY、TG、GLU水平均高于对照组（P〈0.01）。缺血性脑卒中伴高血压病Ⅲ级患者血浆HCY水平明显高于出血性脑卒中伴高血压病Ⅲ级患者（P〈0.01）。结论脑卒中患者血浆HCY水平对照组明显增高,HCY可能是脑卒中发生的危险因素之一。     

急性缺血性卒中血管内治疗研究进展

急性缺血性卒中发病率、病残率和病死率均较高,是目前对人类危害最严重的疾病之一。血管内治疗已获得临床充分肯定。血管内治疗适应证的选择、治疗时间窗的确定、机械取栓装置的选择对预后至关重要。本文拟对急性缺血性卒中血管内治疗研究进展进行阐述。     

Intra-arterial stem cell therapy modulates neuronal calcineurin and confers neuroprotection after ischemic stroke

Abstract

Aim: Calcineurin (CaN) is a threonine/phosphatase which play roles in neuronal homeostasis. Ischemic stroke induces hyperactivation of CaN which further triggers apoptotic signaling. CaN inhibition has limited therapeutic output and neurotoxicity due to its intricate roles in the neuronal network and requires a strategic modulation. Intra-arterial (IA) mesenchymal stem cells (MSCs) have shown to interact with the milieu in a paracrine manner as compared to CaN inhibitors to ameliorate the neuronal damage triggered by ischemia/reperfusion injury. The present study investigates the role of IA MSCs in modulating neuronal CaN after stroke onset.

Materials and methods: To validate, middle-aged ovariectomized female rats exposed to MCAo (90?min) were treated with IA MSCs (1?×?10⁵ MSCs) or phosphate-buffered saline (PBS) at 6?hours to check CaN expression in different groups.Tests for assessing functional and motor coordination were performed along with biochemical estimations. Furthermore, an inhibition study by non-selective inhibitor of neuronal calcium channel, flunarizine, was performed to explore the possible underlying mechanism by which IA MSCs may interact with CaN.

Results: The study suggests that IA MSCs seemingly reduce the expression of CaN after ischemic stroke. IA MSCs have shown to improve the functional outcome and normalize oxidative parameters.

Conclusion: Our study provides a preliminary evidence of role of IA MSCs in modulating CaN expression.     

激素替代治疗围绝经期抑郁症疗效观察

目的 探讨激素替代治疗围绝经期抑郁症患者的临床疗效.方法 将201 8年12月～2019年12月本院接收的104例围绝经期抑郁症患者通过电脑随机分为两组,每组52例患者.常规组予以单纯抗抑郁药物治疗,研究组予以抗抑郁药物治疗+激素替代治疗.比较两组的效果.结果 研究组临床疗效高于常规组(P＜0.05);研究组用药之后第...