鼻咽癌放射性脑病16例诊治体会

目的 探讨鼻咽癌放疗后并发放射性脑病的临床特点、治疗方法及预防措施.方法 对解放军第421医院自1999年10月至2009年10月收治的16例鼻咽癌放疗后致放射性脑病患者的临床资料、治疗方法及预后进行回顾性研究,明确诊断后对患者采用药物治疗及高压氧治疗,早期应用激素、脱水剂治疗,并辅以神经营养剂、血管扩张剂、维生素等药物治疗.结果单程放疗后出现症状者11例,再程放疗后出现症状者5例;均有不同程度头痛,头晕,记忆力下降,智力减退,性格改变等症状;均有颞叶病变(双侧颢叶同时受累5例,单侧受累11例).全组随访率100%,1例因并发肺部感染死亡,15例仍存活,其中7例伴有严重症状,生存质量差.结论 鼻咽癌放疗后所致的放射性脑病治疗效果不理想,预后较差.根据各种相关因素制定对应的有效预防措施是防治鼻咽癌放疗后放射性脑病的关键.     

15例放射性脑病临床分析

本文对15例鼻咽癌放疗后，引起放射性脑病进行了临床分析，结果发现，放射性脑病发生在放疗后1～5年内占73．3％，5年以后者占26．8％。临床表现：有脑干症状占86．7％，伴颅内压升高占20％。通过应用肾上腺糖皮质激素配合支持营养治疗，早期治疗效果较好。     

依达拉奉联合高压氧治疗一氧化碳中毒迟发性脑病的临床研究

目的 探讨依达拉奉联合高压氧治疗一氧化碳中毒迟发性脑病的临床疗效.方法 将70例一氧化碳中毒后迟发性脑病患者随机分为治疗组和对照组各35例,对照组给予高压氧及综合治疗,对照组在此基础上加用达拉奉,在治疗前和治疗后30 d进行临床疗效评定.结果 治疗组总有效率 88%,明显优于对照组.结论 依达拉奉联合高压氧治疗一氧化碳中毒发性脑病(DEACMP)疗效确切.     

依达拉奉联合高压氧治疗一氧化碳中毒迟发性脑病的疗效

目的观察依达拉奉联合高压氧治疗一氧化碳中毒迟发性脑病(DEACMP)的疗效。方法将50例DEACMP患者随机分为观察组和对照组各25例。在常规治疗基础上,观察组给予依达拉奉联合高压氧治疗,对照组仅给予高压氧治疗,治疗30d后评定疗效。结果治疗组总有效率90%,对照组总有效率70%,2组疗效比较差异有统计学意义(P0.05)。结论依达拉奉联合高压氧治疗DEACMP疗效确切。     

新型脑保护剂依达拉奉治疗放射性脑病的临床研究

目的探讨新型脑保护剂依达拉奉治疗放射性脑病的疗效。方法将42例鼻咽癌放疗后放射性脑病患者随机分为试验组(传统常规治疗方法合用依达拉奉)和对照组(传统常规治疗方法)。观察两组治疗前后的临床评分、凝血功能指标、头颅磁共振以及世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评分的变化。结果试验组临床治疗的显效率(50．0%)和总有效率(88．9%)明显高于对照组(14．3%和42．9%)；头颅MRI显示治疗后实验组病灶体积较对照组明显缩小；WHOQOL-BREF评分显示在生理、心理、社会环境、总的生活评分方面试验组均较对照组有明显的改善：且两组在凝血功能方面无明显差异。结论依达拉奉对放射性脑病的治疗具有明显的效果。     

七叶皂苷钠联合甲强龙冲击疗法对急性视神经炎患者视力恢复的影响

目的探究七叶皂苷钠联合甲强龙冲击疗法对急性视神经炎(AON)患者视力恢复的影响。方法选取2014-10—2016-10许昌市中心医院AON患者104例(共104只眼),随机数字表法分为2组各52例(各52只眼)。对照组予以甲强龙冲击疗法,研究组予以甲强龙冲击疗法+七叶皂苷钠,2组均治疗1个月。统计2组临床疗效、视力及视野恢复情况、不良反应发生情况。结果研究组临床疗效(98. 08%)高于对照组(80. 77%),差异有统计学意义(P0. 05);治疗后研究组在≥1. 0、0. 5～0. 9所占比例均高于对照组,在0. 1～0. 4、0. 1所占比例低于对照组,差异有统计学意义(P0. 05);治疗后研究组在中心暗点、哑铃状暗点、旁中心暗点、生理盲点扩大、周边视野向心性缩小所占比例均低于对照组,差异有统计学意义(P0. 05);研究组不良反应发生率(11. 54%)与对照组比较(17. 31%),差异无统计学意义(P0. 05)。结论七叶皂苷钠联合甲强龙冲击疗法可明显改善AON患者视力及视野恢复情况,提高治疗效果,且具有较高安全性。     

神经节苷脂与依达拉奉联合高压氧治疗一氧化碳中毒迟发脑病疗效分析

目的分析神经节苷脂与依达拉奉联合高压氧治疗一氧化碳中毒迟发脑病的临床疗效。方法选取我院神经科2011-09—2013-06收治的120例一氧化碳中毒迟发脑病患者为研究对象,按单双号平分为2组。对照组给予高压氧、高流量吸氧、减轻脑水肿与脑细胞营养药物等基础支持疗法,观察组在此基础上加用神经节苷脂与依达拉奉。对比2组总有效率。结果观察组总有效率为95.0%,对照组为80.0%,差异有统计学意义（P〈0.05）。结论神经节苷脂、依达拉奉、高压氧联合治疗一氧化碳中毒迟发脑病效果显著,值得临床推广。     

高压氧联合神经节苷脂治疗中重度新生儿缺氧缺血性脑病

目的分析并探讨高压氧联合神经节苷脂治疗中重度新生儿缺氧缺血性脑病的临床疗效。方法足月新生儿缺氧缺血性脑病患儿110例,随机分为观察组与对照组,每组55例。2组均给予常规的支持治疗(如脱水、抗感染、纠正酸碱平衡等)。在此基础上,观察组给予高压氧联合神经节苷脂治疗。观察2组治疗临床效果及NBNA评分。结果观察组治疗有效率为96.36%,对照组治疗有效率为83.64%。观察组治疗有效率明显高于对照组,差异具有统计学意义(P0.05);观察组治疗后NBNA评分为(38.43±1.11)分,对照组治疗后NBNA评分为(36.43±1.23)分。观察组NBNA评分明显高于对照组,差异具有统计学意义(P0.05)。结论高压氧联合神经节苷脂治疗中重度新生儿缺氧缺血性脑病临床效果显著,值得推广。     

鼻咽癌放疗后迟发放射性脑脊髓病

鼻咽癌放疗后迟发放射性脑脊髓病邹立，张幸运，石尚金鼻咽癌放疗后迟发放射性脑脊髓病，给予地塞米松、能量合剂、Ｂ族维生素及高压氧治疗，部分病例可获得满意疗效，亦有部分病例疗效不佳甚至死亡。本科近１５年共收治２１例，发现疗效与病损部位有一定关系，现结合文献...     

大剂量甲泼尼龙冲击治疗急性一氧化碳中毒迟发型脑病疗效分析

目的分析大剂量甲泼尼龙冲击疗法治疗急性一氧化碳中毒迟发型脑病(DEACMP)的临床疗效。方法将46例急性一氧化碳中毒迟发型脑病(DEACMP)患者随机分成观察组23例和对照组23例。对照组采用传统的高压氧疗和药物治疗,观察组在上述疗法的基础上加用大剂量甲泼尼龙冲击治疗。通过对2组治疗前、治疗后2个月的日常生活自理能力(Barthel指数)、简易智力状况检查表(MMSE)的评定,评价临床疗效。结果观察组治疗后Barthel指数和MMSE评分较对照组明显改善,差异有统计学意义(P0.05)。观察组总有效率91.3%,对照组为60.9%,2组比较差异有统计学意义(P0.05)。结论大剂量甲泼尼龙冲击治疗DEACMP疗效显著,使患者日常生活自理能力明显提高,认知功能明显改善,减轻痴呆及残疾程度,值得临床推广。     

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.     

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。     

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。     

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。     

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.     

他汀类药物的使用和颅内动脉瘤破裂相关性分析

目的 探讨他汀类药物对颅内动脉瘤破裂的影响。方法 2010年3月至2014年3月收治颅内囊状动脉瘤67例,其中破裂者32例,未破裂者35例。采用多变量Logistic回归评估他汀类药物的使用和颅内动脉瘤破裂的关系。结果 破裂组术前使用他汀类药物4例（12.5%,4/32）,未破裂组16例（45.7%,16/35）。破裂组服用他汀类药物的百分比显著低于未破裂组（P<0.01）。纠正潜在的混杂干扰后（or值: 0.30,95%可信空间:0.12~="" 0.64）显示,颅内动脉瘤破裂与他汀类药物的使用呈显著负相关,也与高血清总胆固醇浓度有关。结论 本结果提示他汀类药物对颅内动脉瘤破裂有一定的预防效果。