中西医结合治疗脑动脉瘤破裂后脑出血的效果评价

目的探讨中西医结合治疗脑动脉瘤破裂后脑出血的临床疗效。方法收集2010-01—2014-01我院收治的脑动脉破裂后脑出血78例,随机分为观察组与对照组各39例。2组均予以常规西医治疗,对照组行血管栓塞术治疗,观察组在对照组的基础上予以丹红注射液穴位注射,比较疗效。结果观察组的治疗总有效率为92.31%,显著高于对照组的79.49%(P0.05);治疗后2组NIHSS评分均显著降低,且观察组显著低于对照组(P0.05);观察组DCVS、消化道出血及肺部感染发生率显著低于对照组(P0.05)。结论中西医结合治疗动脉瘤破裂后脑出血可降低再出血率及DCVS发生率,提高临床疗效,值得推广应用。     

强化心理支持辅助治疗呼吸内科重症患者的临床效果

目的探讨强化心理支持辅助治疗呼吸内科重症患者的临床效果。方法选自我院于2015年1月~2016年3月期间收治的呼吸内科重症患者85例,随机分为观察组43例与对照组42例。对照组采用常规干预辅助治疗,观察组在对照组基础上采用强化心理支持辅助治疗。比较两组患者干预疗效和干预满意度。结果观察组治疗总有效率(95.35%)高于对照组(76.19%)(P0.05);观察组干预总满意率(95.35%)高于对照组(73.81%)(P0.05);观察组干预后自身疾病的疗效明显优于对照组(P0.05)。结论强化心理支持辅助治疗呼吸内科重症患者的临床效果明显,值得进一步推广应用。     

山莨菪碱与谷维素治疗小儿神经性尿频的疗效分析

目的探讨山莨菪碱与谷维素治疗小儿神经性尿频的临床疗效。方法收集2013-01-2014-01我院收治的小儿神经性尿频120例,随机分为观察组与对照组各60例。2组均予以常规心理疏导,对照组加用盐酸山莨菪碱,观察组加用盐酸山莨菪碱和谷维素,比较2组疗效。结果观察组治疗总有效率为93.33%,显著高于对照组的80.00%(P0.05);观察组复发率为1.67%,显著低于对照组的18.33%(P0.05);2组不良反应率差异无统计学意义(P0.05)。结论山莨菪碱与谷维素联合治疗小儿神经性尿频疗效显著,复发率以及不良反应率低,值得推广应用。     

早期高压氧联合法舒地尔治疗脑梗死临床效果分析

目的探讨早期高压氧联合法舒地尔治疗脑梗死的临床疗效。方法收集2013-01—2014-01我院收治的脑梗死患者90例,随机分为观察组与对照组各45例。2组均予以常规综合治疗,对照组予以高压氧治疗,观察组予以高压氧联合法舒地尔治疗,比较2组疗效。结果治疗后观察组的NIHSS评分显著低于对照组,ADL评分显著高于对照组(P0.05);治疗后2组的血液流变学指标均显著降低,观察组显著低于对照组(P0.05);观察组总有效率为93.93%,显著高于对照组的73.33%(P0.05)。结论早期高压氧联合法舒地尔治疗脑梗死可显著改善神经功能,降低血液黏度,提高临床疗效,改善患者的生活质量,值得推广应用。     

醒脑静注射液对脑出血后脑水肿的影响及临床疗效

目的探讨醒脑静注射液对于脑出血后继发脑水肿的影响及疗效。方法收集2012-01—2014-01我院收治的脑出血后脑水肿患者88例,随机分为观察组与对照组各44例,对照组予以常规治疗,观察组在对照组的基础上应用醒脑静注射液治疗,比较2组临床疗效。结果观察组总有效率86.4%,显著高于对照组的63.6%;治疗后2组血肿大小以及水肿体积均显著缩小,但观察组显著小于对照组(P0.05);2组SSS评分均显著降低,但观察组显著低于对照组(P0.05);2组ADL评分均显著提高,但观察组显著高于对照组(P0.05)。结论醒脑静注射液用于治疗脑出血后脑水肿,可有效减轻患者脑水肿,改善神经功能缺损及日常生活能力,值得推广应用。     

草酸艾司西酞普兰联合激素补充治疗女性更年期抑郁症合并高血压前期的临床疗效

目的观察用草酸艾司西酞普兰联合激素补充治疗(HRT)对女性更年期抑郁症合并高血压前期(PHT)的疗效。方法将更年期妇女抑郁症合并PHT患者82例随机分为观察组与对照组,各41例。对照组予以HRT,观察组予以HRT联合草酸艾司西酞普兰治疗。对比两组的治疗前后血压水平、汉密尔顿抑郁量表(HAMD)评分变化、抗抑郁效果。结果治疗后两组24h平均收缩压(24h SBP)、24h平均舒张压(24h DBP)、24h收缩压变异(24h SSD)及24h舒张压变异(24h DSD)均明显降低(P0.05),且观察组显著低于对照组(P0.05);观察组血压恢复正常率及抗抑郁总有效率为90.24%、85.37%,显著高于对照组的41.46%、58.54%(P0.05);治疗后2周、4周及8周,两组HAMD均较治疗前明显降低(P0.05),且观察组明显低于对照组(P0.05)。结论更年期妇女抑郁症合并PHT应用草酸艾司西酞普兰联合HRT治疗可提高抗抑郁效果,降低血压波动幅度,促进血压恢复正常。     

神经节苷酯辅治新生儿缺氧缺血性脑病的近期疗效评价

目的观察神经节苷酯辅助治疗新生儿缺氧缺血性脑病的近期疗效及对神经功能修复的影响。方法选取2013-04-2016-01南阳市中心医院收治的60例缺氧缺血性脑病新生儿患者,按随机平行分组法分为对照组和观察组各30例,其中对照组患儿给予临床常规治疗,观察组在对照组治疗基础上联合应用神经节苷酯辅助治疗,对比分析2组患儿治疗效果。结果治疗后观察组患儿临床总有效率明显高于对照组(P0.05),2组患儿NSE、TNF-α水平及NBNA评分均较治疗前明显改善(P0.05),组间比较观察组患儿各指标改善程度明显高于对照组(P0.05)。结论神经节苷酯辅助治疗新生儿缺氧缺血性脑病可明显提高临床疗效并对神经功能修复具有显著的积极作用,值得临床推广应用。     

颌内动脉栓塞术与鼻内镜下鼻腔电凝止血术治疗鼻出血合并脑梗死的随机对照研究

目的探讨颌内动脉栓塞术与鼻内镜下鼻腔电凝止血术治疗鼻出血合并脑梗死的临床疗效。方法收集2005-01—2014-01间我院收治的鼻出血合并脑梗死患者32例,随机分为观察组与对照组各16例。观察组采用颌内动脉栓塞术治疗,对照组采用鼻内镜下鼻腔电凝止血术治疗,比较2组的临床疗效与并发症。结果观察组治疗总效率为93.75%,显著高于对照组的75.00%(P0.05);观察组的住院时间较对照组显著缩短,复发率仅为6.25%,较对照组的31.25%显著降低(P0.05);观察组并发症发生率为37.50%,显著低于对照组的62.50%(P0.05)。结论颌内动脉栓塞术治疗鼻出血合并脑梗死可快速有效止血,疗效优于鼻内镜下鼻腔电凝止血术,术后康复更快,安全性好,值得推广应用。     

纳洛酮治疗慢性呼吸衰竭并发肺性脑病早期患者的疗效

目的探讨纳洛酮治疗慢性呼吸衰竭并发肺性脑病(PE)早期患者临床疗效。方法选取2013-01—2015-01我院诊治的慢性呼吸衰竭并发肺性脑病早期患者77例,随机分为观察组(n=40例)和对照组(n=37例)。观察组在吸氧、抗感染、维持水电解质和酸碱平衡等常规治疗的基础上加用纳洛酮治疗,对照组仅采用常规治疗,2组疗程均为1周。比较2组临床疗效。结果观察组治疗后通气功能明显改善,PaO2的升高和PaCO2的降低都显著优于对照组(P0.05);观察组精神症状改善时间短于对照组(P0.05);观察组治疗后总有效率(87.5%)显著优于对照组(67.6%),差异有统计学意义(P0.05)。结论纳洛酮治疗慢性呼吸衰竭并发肺性脑病早期,能够显著改善患者的临床症状,疗效较好,无不良反应,值得临床推广应用。     

影响不孕不育患者的精神因素及相关心理干预探讨

目的探讨不孕不育患者的精神因素压力来源的性别差异,建立相关心理干预措施,并观察其干预效果。方法选取本院就诊的不孕不育患者150例,通过问卷调查的方式,了解患者的情绪状态、抑郁及焦虑情况,并采用随机数字表法将患者分为观察组(进行心理干预)、对照组(进行常规护理),均为75例,对比两组患者治疗前后的生活满意度及受孕成功率情况。结果男性主要以疲乏、愤怒、外向性刺激为主,与女性比较存在显著差异(P0.05);女性主要以紧张、压抑、焦虑、内向性刺激为主,显著高于男性分值(P0.05);观察组患者治疗后生活满意度总分(156.74±29.46)分显著高于对照组治疗后总分(140.37±20.14)分(t=-4.167,P=0.000),观察组患者治疗后受孕成功率为77.33%(58例),对照组治疗后受孕成功率为61.33%(46例);观察组显著高于对照组(χ2=4.515,P=0.033)。结论不孕不育对于不同性别产生的精神因素的压力来源不同,对于不同性别患者需要区别其压力来源,建立合理的心理干预机制有助于患者获得主观幸福感以及良好的受孕成功率。     

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。