基底节区进展性脑梗死侧支循环形成及其对近期神经功能缺失的影响

目的探讨基底节区进展性脑梗死脑侧支循环形成及其对近期神经功能缺失的影响。方法将该院收治的200例基底节区进展性脑梗死患者作为研究对象,在其入院后均采用头部CT血管造影(CTA)评估患者侧支循环建立情况,根据患者是否建立侧支循环将其分为侧支循环建立组和无侧支循环建立组,并以美国国立卫生研究院卒中量表(NIHSS)评估其入院时、卒中进展时和侧支循环建立后的神经功能缺损情况,探讨不同分级侧支循环、不同侧支循环开放类型的脑梗死患者神经功能缺失情况。结果 200例基底节区进展性脑梗死患者中有146例患者成功建立侧支循环,54例患者无侧支循环建立。侧支循环建立组在入院时和卒中进展时的NIHSS评分与无侧支循环建立组比较,差异均不显著(P 0.05);治疗2周时NIHSS评分低于无侧支循环建立组(P 0.05)。3～4级侧支循环患者在入院时和卒中进展时的NIHSS评分与1～2级侧支循环患者比较,差异均不显著(P 0.05);治疗2周时NIHSS评分低于1～2级侧支循环患者(P 0.05)。前循环脑梗死患者侧支循环建立数多于后循环脑梗死患者(P 0.05)。前循环脑梗死患者入院时和卒中进展时的NIHSS评分与后循环脑梗死患者比较,差异均不显著(P 0.05);治疗2周时NIHSS评分低于后循环脑梗死患者(P 0.05)。结论脑侧支循环形成可改善基底节区进展性脑梗死患者近期神经功能缺失情况。     

丁苯酞注射液治疗急性前循环脑梗死的疗效观察

目的 观察丁苯酞注射液治疗急性前循环脑梗死的临床疗效及对侧支循环的影响。 方法 将100例急性前循环脑梗死患者随机分为治疗组50例和对照组50例。对照组给予基础治疗。 治疗组在基础治疗上加用丁苯酞注射液100 ml,静滴,2次/日,14 d为1个疗程。治疗后观察两组临床 疗效、美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale,NIHSS）评分,并通过 经颅多普勒超声检测血流动力学,判断侧支循环的代偿情况。 结果 治疗组侧支循环的建立比例显著高于对照组（P <0.05）。治疗14 d治疗组的NHISS评分显著低 于对照组（P <0.05）。 结论 丁苯酞注射液治疗急性前循环脑梗死疗效显著,可促进侧支循环的建立,改善神经功能缺损 评分。     

丁苯酞注射液对急性脑梗死不同OCSP分型的疗效及对Hs-CRP、FIB水平的影响

目的探讨丁苯酞注射液用于治疗不同OCSP分型的急性脑梗死患者的临床疗效及对Hs-CRP、FIB的影响。方法收集本院收治的急性脑梗死患者248例,随机分为对照组113例,观察组135例,观察组在对照组治疗的基础上加用丁苯酞注射液,所有患者入院时均进行OCSP分型,同时在入院时、2 w进行NIHSS评分、Hs-CRP测定、FIB测定,比较两组患者总体及不同亚型的疗效及Hs-CRP、FIB的变化。结果治疗2 w,观察组NIHSS评分、Hs-CRP、FIB水平较对照组明显降低(P 0.05),观察组的总体有效率高于对照组(P 0.05);不同OCSP分型中,完全前循环脑梗死型(TACI)、部分前循环脑梗死型(PACI)、后循环脑梗死型(POCI)、腔隙性脑梗死型(LACI) NIHSS评分、FIB水平观察组均较对照组降低,各个亚组观察组与对照组疗效比较,TACI、POCI组疗效观察组优于对照组(P 0.05),而PACI、LACI组观察组与对照组比较差异无统计学意义(P 0.05); NIHSS评分与Hs-CRP、FIB均呈正相关。结论丁苯酞注射液治疗不同OCSP分型的急性脑梗死均具有较好的疗效,同时可有效降低炎症反应,其中丁苯酞治疗TACI、POCI的疗效更显著,其机制可能是通过降低炎症反应而达到治疗疗效。     

丁苯酞注射液联合巴曲酶治疗急性进展性脑梗死的疗效

目的观察丁苯酞注射液联合巴曲酶治疗急性进展性脑梗死的疗效。方法 80例急性进展性脑梗死患者随机平均分为治疗组和对照组,治疗组给予丁苯酞注射液联合巴曲酶治疗,对照组给予巴曲酶治疗。在治疗前和治疗后14 d时进行美国国立卫生院神经功能缺损程度评分标准(NIHSS)评分和Barthel指数(BI)。观察并监测两组患者的不良反应。结果与治疗前比较,两组患者治疗后的NIHSS评分明显降低,BI明显升高(均P0.05)。与对照组相比,治疗组治疗后的NIHSS评分明显降低,BI明显升高(均P0.05)。两组患者均无严重不良反应。结论丁苯酞注射液联合巴曲酶治疗急性进展性脑梗死安全有效,值得推广。     

丁苯酞氯化钠注射液治疗前循环进展性脑梗死的疗效观察

目的探讨丁苯酞氯化钠注射液治疗前循环进展性脑梗死的临床效果。方法选取于我院住院的60例急性前循环进展性脑梗死患者,按照随机数字表法分为2组各30例。2组均应用胞二磷胆碱针、肠溶阿司匹林片等治疗,治疗组加用丁苯酞氯化钠注射液治疗。比较2组治疗前后NIHSS及BI评分变化。结果 2组NIHSS及BI指数评分治疗前后差异有统计学意义(P0.05)。结论应用丁苯酞氯化钠注射液可改善患者中枢神经功能的损伤,不良反应少。     

丁苯酞氯化钠注射液用于脑梗死患者治疗对脑梗死后抑郁的预防效果评价

目的探究丁苯酞氯化钠注射液对脑梗死后抑郁患者的预防效果。方法选取2015.12~2016.6之间河北大学附属医院收治的60例急性脑梗死患者,数字表法随机分组,对照组30例进行常规治疗,研究组30例在此基础上应用丁苯酞氯化钠注射液治疗,两组患者均连续治疗14d,采用美国国立卫生研究院卒中量表(NIHSS)评价神经功能缺损状况,并采用汉密尔顿抑郁量表(HAMD)评价抑郁表现情况。结果治疗后两组患者的NIHSS评分均显著改善,但研究组改善程度显著优于对照组(P0.05);治疗后两组患者的HAMD评分均显著改善,但研究组改善程度显著优于对照组(P0.05)。结论丁苯酞氯化钠注射液能够有效改善脑梗死患者的神经功能缺损,同时可减少脑梗死后抑郁的发生。     

丁苯酞注射液联合依达拉奉治疗老年急性脑梗死的临床疗效

目的观察丁苯酞注射液联合依达拉奉对老年急性脑梗死的临床效果。方法将75例老年急性脑梗死患者随机分为3组,每组25例,观察组、对照组1、对照组2,常规治疗包括控制血糖、血压,抗血小板、稳定斑块、改善循环、营养脑细胞等,观察组为常规治疗加用丁苯酞注射液、依达拉奉注射液,对照组1为常规治疗加用依达拉奉注射液,对照组2仅常规治疗,疗程均14d,治疗前后采用神经功能缺损程度(NIHSS)评分、日常生活活动能力量评分,评价治疗效果。结果观察组治疗后NIHSS评分及ADL评分较对照组改善明显,且临床总有效率高于对照组,差异均有统计学意义(P0.05)。结论丁苯酞注射液联合依达拉奉治疗老年急性脑梗死疗效显著,值得临床推广。     

丁苯酞对急性脑梗死患者血清NSE S-100β及氧化标记物的影响

目的观察丁苯酞注射液对急性脑梗死患者神经功能、预后及血清神经元特异性烯醇化酶(NSE)、S-100β蛋白、丙二醛(MDA)和超氧化物歧化酶(SOD)的影响。方法将60例急性脑梗死患者随机分为丁苯酞组和对照组各30例。2组均给予常规治疗,丁苯酞组在此基础上给予丁苯酞注射液静滴,2次/d。于治疗前、治疗后7d和14d检测2组患者血清NSE、S-100β、MDA和SOD的水平变化,并比较2组治疗前后美国国立卫生研究院卒中量表评分(NIHSS)和2组3个月后改良Rankin量表(modified Rankin Scale,mRS)评分变化。结果丁苯酞组在治疗后7d和14d,血清NSE、S-100β和MDA水平均较对照组明显降低(P0.05),血清SOD水平较对照组明显升高。丁苯酞组在治疗后7d和14d,NIHSS评分较对照组明显降低,差异有统计学意义(P0.05);3个月后,丁苯酞组mRS评分较对照组明显降低,差异有统计学意义(P0.05)。结论丁苯酞注射液可降低急性脑梗死患者血清NSE、S-100β和MDA水平,提高血清SOD水平,有助于神经功能恢复,改善患者预后。     

丁苯酞对60例部分前循环闭塞型脑梗死的疗效观察

目的 观察丁苯酞治疗部分前循环闭塞型脑梗死(PACI)的疗效.方法 对120例PACI患者随机分为治疗组和对照组,对照组按脑血管防治指南给予规范治疗,治疗组在规范治疗基础上加用丁苯酞,分别在治疗第7、21天用NIHSS和日常生活能力进行评分.结果 21d后治疗组的NIHSS评分显著降低,日常生活能力显著提高,2组比较差异有统计学意义(P＜0.05).结论 丁苯酞对PACI疗效显著.     

丁苯酞注射液联合依达拉奉治疗急性脑梗死的疗效观察

目的观察丁苯酞注射液联合依达拉奉治疗急性脑梗死的有效性和安全性。方法选择105例急性脑梗死患者,随机分为丁苯酞治疗组、依达拉奉治疗组和丁苯酞联合依达拉奉治疗组(简称联合治疗组)3组。联合治疗组在常规急性脑梗死治疗的基础上给予丁苯酞注射液联合依达拉奉治疗,丁苯酞治疗组在常规急性脑梗死治疗的基础上单加丁苯酞注射液;依达拉奉治疗组在常规急性脑梗死治疗的基础上单加依达拉奉,共治疗14d。于治疗前及治疗后14d采用美国国立卫生研究院卒中量表评分(NIHSS)和Barthel指数对各组患者进行疗效评定。结果 3组患者治疗后NIHSS评分均较治疗前降低(分别t=3.270,P0.01;t=2.314,P0.05;t=2.946,P0.01),Barthel指数升高(分别t=-3.466,P0.01;t=-2.098,P0.05;t=-2.059,P0.05)。联合治疗组治疗后其NIHSS评分均低于丁苯酞治疗组和依拉奉达治疗组(均P0.05),而Barthel指数高于丁苯酞治疗组和依拉奉达治疗组(均P0.05)。联合治疗组有效率为80.00%,高于丁苯酞治疗组的57.14%和依拉奉达治疗组的54.29%(χ2=4.242,P0.05;χ2=5.245,P0.05)。3组均未发生严重不良反应。结论丁苯酞注射液联合依达拉奉治疗急性脑梗死有效且安全。     

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.     

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.     

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。     

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。