埋线治疗血管性帕金森综合征的临床观察

目的观察埋线治疗血管性帕金森综合征(VP)的临床疗效。方法 62例VP患者随机分成2组,治疗组采用埋线联合常规西医疗法治疗,对照组采用常规西医疗法治疗,疗程均60d,观察2组治疗前后统一帕金森评定量表(UPDRS)积分。结果 2组治疗前后UPDRS积分比较差异均有统计学意义(P0.05),总有效率比较差异有统计学意义(P0.05)。结论埋线疗法对VP患者治疗有效,可作为治疗VP的一种选择。     

血管性帕金森综合征多巴反应异质性的队列研究

目的 研究基于病变部位的血管性帕金森综合征（vascular parkinsonism,VP）亚型队列的多巴反应性差异。 方法 对41例VP和45例帕金森病（Parkinson’s disease,PD）患者在基线和2年期随访时进行急性左旋多巴试验评测患者的多巴反应性。将VP组按照磁共振（magnetic resonance imaging,MRI）显示的病变部位分型。对VP各亚型和PD组在基线、2年期随访的多巴反应性进行了比较。应用一致性检验评价基线急性左旋多巴试验对2年期随访时多巴反应性的预测价值。 结果 在基线以及2年期随访时,VP组中基底节病变亚组的多巴反应性程度和急性左旋多巴试验阳性率均高于白质病变亚组,但低于PD组（P<0.05）。2年期随访时VP总体以及基底节病变亚组的多巴反应性低于基线（P<0.05）;白质病变亚组的多巴反应性与基线的差异无统计学意义（P>0.05）。VP组基线急性左旋多巴试验结果与2年期随访时急性左旋多巴试验结果的一致性有统计学意义,kappa值为0.438（P<0.05）;其中白质病变组的阳性预测率和阴性预测率分别为0和100%;基底节病变组的阳性预测率和阴性预测率分别为14.3%和100%。 结论 VP的基底节病变亚组和白质病变亚组的急性多巴反应性随病程进展有不同的变化特征。     

神经节苷脂联合普拉克索治疗血管性帕金森综合征效果分析

目的分析神经节苷脂联合普拉克索治疗血管性帕金森综合征的临床疗效。方法将2009-01—2014-02在我院治疗的96例血管性帕金森综合征患者分为2组,治疗组48例应用神经节苷脂联合普拉克索治疗;对照组48例应用美多巴治疗。治疗12个月后,比较2组治疗效果,观察2组治疗前后UPDRS评分、Webster评分和NHISS评分的变化。结果治疗组总有效率为91.67%,大于对照组的72.92%,差异有统计学意义(P0.05)。治疗后治疗组日常活动积分、情绪积分、运动功能积分均低于对照组,Webster评分和NHISS评分也均明显低于对照组,差异有统计学意义(P0.05)。结论神经节苷脂联合普拉克索治疗血管性帕金森综合征的临床疗效显著,具有临床推广价值。     

血管性帕金森综合征的临床、影像学特征及嗅觉功能的研究

目的 研究血管性帕金森综合征(VP)患者的临床、影像学特征及嗅觉功能.方法 对37例VP患者的临床资料进行分析,进行统一帕金森病(PD)评分量表(UPDRS)、美国国立卫生研究院卒中量表(NIHSS)评分和头颅MRI检查;并与46例PD患者比较.采用康涅狄格州化学感觉临床研究中心(CCCRC)试验对31例VP患者、40例PD患者及40名正常对照者进行嗅觉功能检查.结果 与PD组比较,VP组发病年龄及脑卒中危险因素、脑卒中病史、铅管样肌张力增高、姿势性震颤、阔基步态和智能障碍的比率明显增高,静止性震颤、屈曲体姿和症状两侧不对称的比率显著降低(P＜0.05～0.001);NIHSS评分显著增高(P＜0.001).两组UPDRS评分的差异无统计学意义.VP组患者MRI示基底节区和脑室周围多发性脑梗死,伴脑叶萎缩及白质疏松.VP组CCCRC评分(56.97±12.86)与正常对照组的差异无统计学意义,而明显高于PD组(36.43±23.04)(P＜0.001).结论 VP患者的临床特点为有锥体外系和锥体束损害表现的非典型帕金森综合征,影像学特点为脑缺血改变,嗅觉功能无异常.嗅觉功能测试可作为鉴别VP与PD的方法.     

抗癫痫药与骨健康

现已明确癫痫患者可因发作跌倒,特别是抗癫痫药(AEDs)通过对维生素D、甲状旁腺素等影响而对骨代谢产生不良影响作用,使患者骨折危险性增加2倍以上。临床上应对长期服用AEDs的患者进行骨矿密度等监测,适当活动、补充维生素D、钙剂可改善患者骨健康,降低骨折发生率。     

血管性帕金森综合征和帕金森病患者智能与事件相关电位的对比研究

目的:对血管性帕金森综合征(VP)患者和帕金森病(PD)患者的智能和事件相关电位(ERP)进行对比研究,以期探讨两者智能障碍及其电生理变化的特点。方法:用简易智能状态量表对51例VP及50例PD进行评分,并检测其ERP各波的潜伏期及波幅,并与32例正常者作对照。结果:1.VP组痴呆的发生串明显高于PD组;重症痴呆发生率高,提示症状重。2.VP组的N_2、P 300潜伏期较PD组、正常对照组均明显延长,P_(300)波幅较两者均明显降低。3.VP组痴呆者较非痴呆者N_2、P_(300)潜伏期明显延长,P_(300)波幅明显降低,4.VP组痴呆者较PD组痴呆者N_2、P_(300)潜伏期明显延长,P_(300)波幅明显降低。结论:VP与PD比较,智能障碍发生率高,程度重,电生理改变更明显。     

血管性帕金森综合征患者抗心磷脂抗体变化及意义

目的 :探讨血管性帕金森综合征患者血清ACLA的变化及其在发病中的意义。方法 :采用ELISA法检测 42例VP ,3 5例PD ,3 0例MCI及 3 0例正常对照组血清ACLA变化并对照分析。结果 :①VP与MCI组ACLA的IgG与IgM阳性率明显高于PD与正常对照组 (P <0 0 5 ) ;②VP组ACLA的IgG阳性率明显高于IgM(P <0 0 5 ) ;③运动障碍重 ,伴痴呆的VP患者ACLA之IgG阳性率明显增高(P <0 0 5 )。结论 :IgG型ACLA可能作为致病性抗体参与VP的发病过程     

三七通舒胶囊对血管性帕金森综合征的疗效观察

目的观察三七通舒胶囊对血管性帕金森综合征(VP)的疗效。方法选取VP患者97例,随机分为观察组50例和对照组47例。其中观察组予以三七通舒胶囊+常规治疗,疗程为3个月;对照组给予常规治疗。比较2组患者治疗前、后UPDRS、Hoehn-Yahr、ADL、MMSE评分变化;同时记录2组治疗前、后的血脂、血清Hcy、血液黏稠度变化。结果治疗后,观察组与对照组在UPDRS、Hoehn-Yahr下降,ADL、MMSE评分升高,差异有统计学意义(P0.05);观察组与对照组在血脂、Hcy及血液黏稠度比较均有下降,差异有统计学意义(P0.05)。结论三七通舒胶囊对VP治疗有益。     

高压氧治疗血管性帕金森综合征的疗效观察

目的 观察高压氧治疗血管性帕金森综合征(VP)的疗效.方法 68例VP患者随机分为高压氧治疗组(35例)和对照组(33例),两组均给予美多芭治疗;高压氧组患者同时给予高压氧治疗,每日1次,连续90 d.分别在治疗前和治疗后90 d对两组患者进行Webster评分及美多芭用量统计.结果 两组治疗后Webster评分均比治疗前显著降低(均P<0.01);高压氧组治疗后Webster评分显著低于对照组(P<0.05),治疗前后Webster评分差值(3.62±1.15)显著大于对照组(3.09±1.21)(P<0.05).高压氧组的总有效率(88.6%)显著高于对照组(72.7%)(P<0.05).高压氧组治疗后美多芭用量较治疗前及对照组明显减少(均P<0.01);对照组治疗前后美多芭用量比较,差异无统计学意义.结论 高压氧治疗对VP有显著效果,并且可以减少美多芭的用量.     

血管性帕金森综合征临床病例对照研究

目的 探讨脑血管病及其危险因素在帕金森综合征发病中的作用,分析血管性帕金森综合征（VP）与帕金森病（PD）的临床特点。方法 收集在我科住院的86例帕金森综合征及PD,根据有无高血压病、动脉硬化或脑卒中病史,分为VP组和PD组,并对两组的临床特点进行回顾性对比分析。结果 脑血管病及其危险因素在两组间的发生率有显著性差异（P＜0.001),与PD组比较,VP组病人发病年龄偏大（P＜0.01）,临床表现以少动－四肢强直为主,而静止性震颤少见（P＜0.05）,常伴发假性延髓麻痹、尿失禁（P＜0.01）、智能障碍（P＜0.001）等,头颅MRI以基底节区腔隙性脑梗死多见。且左旋多巴的治疗效果多不满意（P＜0.05）。结论 VP是病因、发病机理及临床特征不同于PD的一种帕金森综合征。     

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.     

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.     

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.     

《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。