纳洛酮辅助治疗小儿病毒性脑炎的疗效观察

目的探讨纳洛酮辅助治疗小儿病毒性脑炎的临床疗效。方法将78例小儿病毒性脑炎患儿随机分为观察组(39例)和对照组(39例),对照组给予传统治疗,观察组在此基础上加用纳洛酮治疗,疗程均为7~14d。对比2组临床疗效,并记录2组惊厥、体温和脑膜刺激征恢复正常的时间。结果观察组治疗总有效率(94.87%)高于对照组(76.92%),差异有统计学意义(P0.05);观察组惊厥恢复时间(1.17±0.29)d、体温恢复时间(1.49±0.41)d及脑膜刺激征恢复时间(2.37±0.58)均低于对照组,差异均有统计学意义(P0.05)。结论纳洛酮辅助治疗可加快小儿病毒性脑炎临床症状和体征的恢复时间,有效提高治疗效果,值得临床推广使用。     

更昔洛韦与纳洛酮治疗小儿病毒性脑炎的疗效观察

目的：观察更昔洛韦联合纳洛酮应用于小儿病毒性脑炎的临床疗效。方法选取我院2010-01-2012-12收治的85例病毒性脑炎患儿,随机分为2组,2组患者均采取降低颅内压、降温、改善脑代谢等常规治疗。对照组41例患儿在此基础上采用更昔洛韦5 mg/（kg ·次）入5％葡萄糖溶液100 mL中静滴,q12h;观察组44例患者在对照组基础上,加用纳洛酮0.01～0.03 mg/（kg ·次）入葡萄糖溶液100 mL中静滴,q12h。2组均治疗10～14 d为1个疗程,观察2组临床疗效。结果对照组总有效率65.85％,观察组为88.64％,2组比较差异有统计学意义（ P＜0.05）。观察组患儿临床症状、体征控制或消失时间明显较对照组缩短（ P＜0.05）。对照组患儿后遗症发生率17.07％,观察组为2.27％,观察组明显低于对照组（ P＜0.05）。结论更昔洛韦联合纳洛酮治疗小儿病毒性脑炎疗效优于单一使用更昔洛韦,可提高治疗效果,减少远期后遗症的发生,安全性较高。     

小儿病毒性脑炎90例临床分析

目的：分析更昔洛韦与干扰素联合治疗小儿病毒性脑炎的临床效果。方法选择我院2008‐01—2013‐10收治90例小儿病毒性脑炎患儿为研究对象，随机分为对照组和治疗组。对照组：静滴更昔洛韦，5 mg／（kg ·次），q 12 h。治疗组：静滴更昔洛韦治疗，5 mg／（kg ·次），q 12 h；重组人干扰素α‐2b ，肌内注射，10万IU／（kg ·次），1次／d。观察2组患儿临床疗效和临床症状、体征恢复时间及不良反应。结果观察组有效率93.33％（42／45），明显高于对照组的82.22％（37／45）（χ2＝24.23，P＜0.05）。观察组临床症状、体征恢复时间明显短于对照组（ P＜0.05）。2组均未发生明显不良反应。结论相比单独采用更昔洛韦治疗来说，采用更昔洛韦联合干扰素治疗能促进患儿症状尽快恢复，提高疗效。     

大剂量丙种球蛋白治疗小儿病毒性脑炎的疗效观察

目的：观察大剂量丙种球蛋白联合应用于小儿病毒性脑炎中的治疗效果。方法选取我院小儿科2010‐01—2013‐01收治的病毒性脑炎患儿中105例作为研究对象,所有患儿均给予降温、降颅压、解痉、改善脑循环、抗感染、维持水电解质平衡等常规治疗措施,随机分为对照组与观察组,观察组在常规治疗基础上应用大剂量丙种球蛋白1.0g／（kg·d）,1次／d,连用2～3d。观察2组患者临床疗效及临床症状、体征缓解时间、出院时间、不良反应。结果观察组疗效明显优于对照组,观察组患者发热、脑膜刺激征、惊厥、昏迷消失时间及住院治疗时间均较对照组明显缩短,差异均有统计学意义（P＜0.05）。2组均无严重不良反应。结论大剂量丙种球蛋白治疗小儿病毒性脑炎,可显著改善患儿免疫功能,有效缩短患儿症状和体征消退时间,减轻脑组织及细胞的损伤,未见严重不良反应。     

丙种球蛋白及干扰素治疗手足口病并发病毒性脑炎疗效观察

目的观察丙种球蛋白及干扰素在治疗小儿手足口病(HFMD)并发病毒性脑炎的临床疗效、症状改善状况及安全性。方法选取我院2012-12—2013-12收治的手足口病并发病毒性脑炎患儿87例为研究对象,随机分为3组,丙种球蛋白组30例,连续5d静滴人血丙种球蛋白,剂量1g/(kg·d);干扰素组27例,采用肌内注射重组人干扰素80μg/(次·d),持续3d;联合组30例,采取丙种球蛋白和干扰素联合治疗。3组患儿在降颅压、退热、预防细菌感染、营养脑细胞等治疗和护理方式上均相同,观察3组患儿1周内临床症状改善情况,对比临床疗效及安全性。结果 3组在生理指标恢复时间上差异无统计学意义(P0.05),在热程、疱疹消失时间和神经系统病理征转阴时间上差异有统计学意义,联用组所需时间显著少于干扰素组和丙种球蛋白组(P0.01),干扰素组和丙种球蛋白组间无显著性差异(P0.05);联用组有效率(93.33%)大于干扰素组(77.78%)和丙种球蛋白组(76.67%),但两两比较差异无统计学意义(P0.05);联用组不良反应发生率高于干扰素组和丙种球蛋白组,但3组间差异无统计学意义(P0.05)。结论小儿手足口病并发病毒性脑炎采用丙种球蛋白联合干扰素治疗的效果较单独使用明显,缩短了病程,且不良反应可耐受,具有一定临床意义。     

高压氧治疗儿童病毒性脑炎的效果分析

目的：探讨高压氧治疗儿童病毒性脑炎的临床疗效,为临床相关研究提供借鉴和参考。方法儿童病毒性脑炎患者92例随机将患儿分为对照组和观察组各46例。对照组采用常规基础治疗,观察组加用高压氧治疗。结果（1）2组失语改善时间、面瘫改善时间、肢瘫改善时间比较,观察组均显著优于对照组,差异有计学意义（P均＜0.05）;（2）观察组总有效率显著高于对照组,差异有统计学意义（χ2＝6.4519,P＝0.0111）。结论与常规治疗方法比较,高压氧治疗儿童病毒性脑炎患儿疗效显著,是临床治疗儿童病毒性脑炎的理想选择。     

丙种球蛋白联合干扰素治疗手足口病合并病毒性脑炎的疗效

目的探讨丙种球蛋白联合干扰素治疗手足口病合并病毒性脑炎的疗效。方法选取2013-03-2015-03我院收治的手足口病合并病毒性脑炎患儿60例,根据入院治疗顺序随机分成对照组与观察组各30例,对照组给予常规治疗措施,观察组采用丙种球蛋白联合干扰素治疗。治疗后统计对比2组临床疗效及病情改善时间。结果治疗后,观察组有效率为96.67%(29/30),显著优于对照组83.33%(25/30),差异有统计学意义(P0.05);观察组各项病情改善时间显著低于对照组,差异有统计学意义(P0.05)。结论手足口病合并病毒性脑炎应用丙种球蛋白联合干扰素治疗具有较好疗效,缩短了病程,减轻了患儿的痛苦,值得推广。     

静脉注射用人免疫球蛋白治疗小儿病毒性脑炎的效果观察

目的探讨静脉注射用人免疫球蛋白治疗小儿病毒性脑炎的临床疗效。方法选择我院2011-05—2013-04收治的120例病毒性脑炎患儿,观察组60例使用人免疫球蛋白进行治疗,对照组60例采用常规治疗,比较2组患儿的临床疗效。结果观察组总有效率为98.33%,明显高于对照组83.33%,差异具有统计学意义(P0.05);观察组患儿的住院时间、退热时间及止吐时间分别为(4.2±1.1)d、(2.4±1.2)d、(1.8±0.4)d,均明显短于对照组,差异具有统计学意义(P0.05);此外,观察组血清免疫指标IL-1、TNF-α、lg G均较对照组明显改善,差异具有统计学意义(P0.05)。结论静脉注射用人免疫球蛋白治疗小儿病毒性脑炎具有显著疗效,可明显改善患儿的临床症状,促进患儿的预后恢复,值得临床应用。     

更昔洛韦联合干扰素治疗小儿病毒性脑炎的临床效果分析

目的分析更昔洛韦联合干扰素治疗小儿病毒性脑炎的临床效果。方法选择我院2012-06—2014-06收治180例小儿病毒性脑炎患儿为研究对象,随机分为对照组和治疗组。对照组静滴更昔洛韦,5mg/(kg·次),q12h。治疗组静滴更昔洛韦,5mg/(kg·次),q12h;肌内注射重组人干扰素α-2b,10万IU/(kg·次),1次/d。观察2组临床疗效和症状、体征恢复时间及不良反应。结果观察组有效率93.33%,明显高于对照组的82.22%(χ2=24.23,P0.05)。观察组临床症状、体征恢复时间明显短于对照组(P0.05)。2组均未发生明显不良反应。结论联合干扰素治疗明显优于单独采用更昔洛韦治疗,可有效促进患儿症状尽快恢复,提高疗效。     

鼠神经生长因子辅助治疗小儿重症病毒性脑炎的疗效观察

目的：评价鼠神经生长因子辅助治疗小儿重症病毒性脑炎的临床疗效。方法选取我院2011‐01—2014‐05收治的65例重症病毒性脑炎患儿,按照治疗方法不同分为研究组34例与对照组31例,对照组给予常规抗病毒、对症支持等治疗,研究组在此基础上加用鼠神经生长因子注射液肌内注射,连续治疗4周为1个疗程,比较2组患儿的临床疗效。结果2组总有效率比较差异无统计学意义（χ2＝1.025,P＝0.145）,但研究组临床治愈率明显高于对照组（χ2＝12.163,P＝0.001）;治疗后2组患者MMSE评分均较治疗前明显增高（P＜0.05）,研究组较对照组增高明显,差异有统计学意义（P＜0.05）。结论鼠神经生长因子辅助治疗小儿重症病毒性脑炎有助于提高神经功能恢复水平,改善患儿预后。     

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。