脑实质型脑囊虫病的诊断与治疗

目的探讨单纯脑实质内泡型脑囊虫病的诊断与治疗。方法对9例脑实质型脑囊虫病患者的临床资料及手术效果进行分析总结。结果单囊患者7例,双囊患者2例。术前误诊5例。7例患者病灶全部摘除（头节＋囊壁）,另2例患者行囊虫结节囊壁大部分摘除,无新的神经功能障碍产生,无手术死亡。随访3个月～6年,有癫痫的5例患者术后癫痫均控制良好,术前肌力障碍的1例患者术后肌力恢复正常,有共济失调症的1例患者术后该症状亦明显减轻。结论脑实质型脑囊虫病误诊率较高,其显微手术治疗效果良好。     

脑囊虫病与癫痫

癫痫不是一种独立的疾病，是由各种病因引起的综合征。在我国北方地区脑囊虫病是症状性癫痫的主要原因之一。现将我院２０年来［１－３］诊治２６００例脑囊虫病发生癫痫的特点分析如下。临床资料一、一般资料：据１９８５年全国脑囊虫病会议拟定脑囊虫病诊断标准、分型标准［４］，我院１９７０～１９９０年确诊脑囊虫病患者２６００例。癫痫型８８６例（３４％），以癫痫为唯一症状；脑实质型６６２例（２５％），以癫痫为主要表现；混合型６９２例（２６．６％），部分患者有癫痫表现。蛛网膜下腔型１７５例（６．７％），脑室型１７０例…     

CT脑立体定向显微直视手术切除脑功能区及深部病变

采用CT脑立体定向技术引导开颅显微外科手术切除脑重要功能区及脑深部病变18例,其中位于运动区皮质下28例、语言中枢皮质下12例、脑深部8例 临床表现主要为癫痫、偏瘫、失语 病变性质主要为脑囊虫病、慢性炎性组织、结核瘤、肺吸虫病、海绵状血管瘤、脂肪瘤及血吸虫病.术后所有病人症状均逐渐消失,完全恢复健康,无手术并发症及死亡.     

CT脑立体定向显微直视手术切除脑功能区及深部病变

采用CT脑立体定向技术引导开颅显微外科手术切除脑重要功能区及脑深部病变48例．其中位于运动区皮质下28例、语言中枢皮质下12例、脑深部8例。临床表现主要为癫痛，偏瘫．失语。病变性质主要为脑囊虫病、慢性炎性组织．结核瘤、肺吸虫病、海绵状血管瘤，脂肪瘤及血吸虫病。术后所有病人症状均逐渐消失．完全恢复健康．无手术并发症及死亡。     

脑囊尾蚴病癫痫型治疗的转归与临床分析

目的 分析脑囊尾蚴病（即脑囊虫病）癫痫型治疗的转归。探讨不良转归的干预对策。方法 根据临床和3年随访资料对124例脑囊虫病癫痫型的治疗效果进行观察。结果 痊愈56例，坚持服用抗癫痫药控制发作36例，仍然发作癫痫27例，驱虫治疗后并发颅内高压2例。其中并发脑疝死亡1例。驱虫药致肝功能受损19例，复查头频CT病灶消失61例。病灶数减少或范围缩小17例。无明显变化37例。发现脑内新增钙化点6例。新生肉芽肿2例。并发脑积水1例。结论 单纯的驱虫治疗不一定能彻底控制癫痫等并发症的发生，综合治疗方案应包括驱虫，降颅压，正规抗癫痫和防治重复感染。     

641例脑囊虫病致癫痫临床分析

目的 探讨脑囊虫病致癫痫的临床特点及治疗方法。方法 通过对641例脑囊虫病致癫痫患者的回顾性分析，总结其临床特点、免疫水平、影像学及脑电图资料和治疗方法。结果 脑囊虫病致癫痫男性患者占78．47％，女性患者占21．53％，发作频率平均每年2—4次，发作类型以全身强直—阵挛发作(GTC)多见，囊虫免疫反应血IHA及血ELISA均为71．92％，脑脊液CAg阳性率78．40％，脑电图无特异性改变，影像学显示有各种类型脑囊虫病，胞二磷胆碱辅助治疗较用复方丹参更易诱发癫痫(P＜0．01)。结论 脑囊虫病致癫痫男性多于女性，发作频率不高，发作类型多样，免疫力低下，各种类型脑囊虫病均可导致癫痫，脑囊虫病辅助治疗慎用促脑代谢药物。     

皮层电极描记配合立体定向切除癫痫灶

目的 评价皮层电极描记在立体定向切除癫痫灶手术中的应用和价值。方法 对25例以癫痫为首发症状的继发性癫痫患者采用MRI导向下，立体定向环钻开颅，切除病灶前行皮层电极描记，记录有无癫痫波和范围，切除病灶后再次描记，如仍有癫痫波，则在不影响神经功能的基础上将有癫痫波的皮层尽可能切除。结果 25例患者中有19例在切除病灶前记录到棘波、棘-慢波、尖波或尖-慢波，切除后有15例上述癫痫波完全消失，4例仍有散在的少许癫痫波；另有6例患者未记录到癫痫波，但表现为基本的节律异常，切除病灶后好转。25例患者中胶质瘤6例，脑囊虫病5例，蛛网膜囊肿3例，软化灶3例，皮层发育不全2例，血管畸形2例，转移癌2例，炎症1例，胶质细胞增生1例，病灶直径在0．8～4．7cm。手术后24例癫痫发作消失，1例仍偶有癫痫发作，比例能够被口服抗癫痫药物控制。手术后患者无神经功能损害加重。结论 皮层电极描记和立体定向方法相结合，既能明确癫痫灶的范围，又能以微侵袭的方法切除癫痫灶，尤其适用于直径小于4cm的癫痫灶的切除。     

高颅压型脑囊虫病术后服吡喹酮的组织病理学研究

目的 从病理组织学厅面研究手术并服毗喹酮治疗高颅压型脑囊虫病的优越性。方法 对1984-2002年收治的230例高颅胝型腑囊虫病人进行手术并服吡喹酮治疗，摘出囊虫后进行病理观察。结果 随访89例6个月，癫痫发作减少75％以上；高颅压症状完全消失；腰穿脑脊液压力正常；血常规及血生化检查正常；复查CT示脑室系统对称性扩大及梗阻性脑积水影像消失，皮肌内囊虫消失90％者72例。结论 术后服用吡喹酮是治疗高颅压型脑囊虫病较为有效的方法。     

大脑中央区脑囊虫病灶的立体定向手术治疗

目的 ;探讨CT或MRI导向的立体定向手术切除中央区脑囊虫病灶的应用价值,总结手术治疗的经验。方法采用Leksell-G型立体定向仪,在CT或MRI导向下对25例中央区脑囊虫病灶,通过环钻开颅和显微外科技术摘除病灶。结果 25例脑囊虫病灶均能精确定位后完全切除,全组无新的神经功能损伤出现。结论 CT或MRI导向下的立体定向手术治疗中央区脑囊虫病灶安全有效。     

脑实质型囊性囊虫病的显微手术治疗

目的 探讨脑实质型囊性囊虫病的诊断与显微手术治疗效果.方法 对11例行显微手术治疗的脑实质型囊性囊虫病患者的手术效果进行分析总结.结果 病灶内有头节的患者头节均被摘除,9例患者囊壁全部摘除,2例患者囊壁大部分摘除,术后病理均证实为脑囊虫.随访3个月-6年,有癫痫的6例患者术后癫痫均控制良好,术前有颅高压的5例患者术后症状立即明显改善,术前有肌力障碍的2例患者术后6个月内肌力均恢复正常,有共济失调症的1例患者该症状亦明显减轻.失访1例.结论 脑实质型囊性囊虫病误诊率较高,但显微手术治疗效果良好.     

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     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Release of endogenous catecholamines from slices of hypothalamus of rats

The release of endogenous catecholamines from superfused slices of rat hypothalamus was studied under basal conditions and during release evoked by 40 mM K⁺. Catecholamines in superfusates, and in extracts of the tissue after stimulation, were isolated by column chromatography and quantitated by liquid chromatography with electrochemical detection. Norepinephrine (NE) was not consistently demonstrable in superfusate collected under basal conditions, but 40 mM K⁺ caused the release of from 2 to 4 ng/g of tissue per min. The addition of cocaine to the superfusate caused increases in basal and evoked release of NE. Epinephrine (E) could be measured in superfusates of slices from male but not female rats and then only when cocaine was added to the superfusate. Accordingly, the concentration of E in hypothalamus was greater in male rats than in female rats. Dopamine (DA) was not consistently measurable in the spontaneous overflow from slices either in the presence or absence of cocaine. K⁺-evoked release of DA could be demonstrated in slices from female rats. The addition of cocaine increased the evoked release of DA from slices from both sexes. Corticosterone, added to cocaine, had no effects on the efflux of any of the catecholamines. The experiments suggest that neuronal reuptake of all catecholamines is very efficient in the hypothalamus both under basal conditions and during evoked release.     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。