血清MMP-9与NSE在ACI患者中检测的意义

目的探讨血清基质金属蛋白酶-9(MMP-9)与神经烯醇化酶(NSE)水平检测在急性脑梗死(ACI)患者中的临床价值。方法分析2014-12-2015-09在开封市中心医院神经内科接受诊治的94例ACI患者的临床资料。根据病灶面积的大小分为A组(大面积脑梗死,21例)、B组(中等面积脑梗死,46例)和C组(小面积脑梗死,27例)。另选取同期健康体检的92例健康者为对照组。比较2组基线资料、血清MMP-9与NSE的表达水平,并分析ACI患者血清MMP-9与NSE的关系。结果ACI组血清MMP-9与NSE浓度明显较对照组高(P0.05)。其中,ACI组血清MMP-9与NSE水平随着梗死面积的增大而逐渐上升,A、B、C 3组组间比较有显著性差异(P0.05)。ACI患者血清MMP-9与血清NSE水平存在正相关性(r=0.568,P0.05)。结论血清MMP-9与NSE水平的检测可用于判断ACI患者病情严重程度及其预后情况,具有重要的临床价值。     

高血压、糖尿病和高脂血症对脑梗死患者血管内皮功能损伤的相关研究

目的探讨脑梗死危险因素与血管内皮功能的相关性。方法选取血管性假血友病因子(vWF)与可溶性血管内皮细胞蛋白C受体(sEPCR)作为脑梗死患者血管内皮功能的评价指标。将急性脑梗死患者分为多危险因素脑梗死组、单危险因素脑梗死组,并选取健康对照组,采用ELISA方法检测其血清中vWF与sEPCR含量。组间比较采用独立样本t检验。且分别将vWF、sEPCR作为因变量,高血压、糖尿病和高脂血症作为自变量行多元线性回归分析。结果多危险因素脑梗死组血浆中vWF与sEPCR含量显著高于单危险因素脑梗死组(P<0.001)。高血压、糖尿病和高脂血等脑梗死危险因素均与vWF和sEPCR存在线性回归关系。结论脑梗死危险因素越多,则血管内皮功能损伤可能越严重。     

急性脑梗死患者颈动脉粥样硬化斑块的稳定性与血管内皮功能的相关性研究

目的探讨急性脑梗死患者颈动脉粥样硬化斑块的稳定性与血管内皮功能的相关性。方法应用颈动脉彩色多普勒超声技术检查研究对象颈动脉粥样硬化斑块的大小、数目及性质。选取血管性假血友病因子(Von Willebrand factor,vWF)与可溶性血管内皮细胞蛋白C受体(Soluble endothelial protein C receptor,sEPCR)作为急性脑梗死患者血管内皮功能的评价指标。采用ELISA方法检测其血浆中vWF与sEPCR含量。根据颈动脉彩超的结果,将急性脑梗死患者分为不稳定性斑块脑梗死组、稳定性斑块脑梗死组,并选取健康对照组,组间比较采用独立样本t检验,并行简单相关分析。结果不稳定性斑块脑梗死组血浆中vWF与sEPCR含量显著高于稳定性斑块脑梗死组(P<0.001),急性脑梗死患者颈动脉粥样硬化斑块的稳定性与vWF及sEPCR呈负相关(P<0.001)。结论急性脑梗死患者血管内皮功能损伤越严重,则颈动脉粥样硬化斑块可能越不稳定。     

早期高压氧治疗对急性脑梗死患者血清hs-CRP、IL-6、IL-8、ET-1的影响及预后的临床分析

目的 探讨早期高压氧治疗后急性脑梗死(ACI)患者血清超敏反应蛋白(hs-CRP)、IL-6、IL-8和ET-1水平变化及临床意义.方法 将120例急性脑梗死患者随机分为2组,应用放射免疫法测定血清hs-CRP水平,用ELISA法检测血清IL-6、IL-8和ET-1水平以及用NIHSS对患者的神经功能进行评估.结果 高压氧治疗组1周后血清 hs-CRP、IL-6、IL-8、ET-1水平较对照组明显下降(P均＜0.05),并与神经功能恢复有关.结论 急性脑梗死患者血清hs-CRP、IL-6、IL-8、ET-1水平与神经功能缺损程度评分有关.     

超声检测颈动脉表现特征及血LDH、FA、IL-6水平变化在评估急性脑梗死病情进展中的价值分析

目的 探讨超声检测颈动脉表现特征及血LDH、FA、IL-6水平检测在评估急性脑梗死病情进展中的临床价值分析。方法 收集2017年1月-2018年7月间在我院收治的急性脑梗死患者,其中急性脑梗死组(ACI组) 106例,对照组为同期在我院非脑梗死患者110例。采集血清乳酸脱氢酶(LDH)、叶酸(FA)、白细胞介素(IL-6)及颈动脉超声检查结果,进行统计学分析。结果 ACI组患者血清LDH、FA、IL-6水平分别为(254. 56±62. 87) U/L、(7. 63±4. 13) ng/ml、(88. 35±13. 56) ng/L,血清LDH及IL-6水平高于对照组(P 0. 05),血清FA水平低于对照组(P 0. 05);超声检测显示ACI组患者斑块发生率及颈动脉狭窄发生率明显高于对照组(P 0. 05);ACI组患者颈动脉粥样硬化斑块超声类型以不均质回声斑块最多,发生率高于对照组(P 0. 05),低回声斑块发生率高于对照组(P 0. 05)。结论 与对照组相比,ACI组患者血清LDH、FA、IL-6水平出现异常,颈动脉超声检测显示颈动脉内膜增厚、不光滑,内径减小,斑块形成,表明超声检测颈动脉表现特征和血LDH、FA、IL-6水平检测在急性脑梗死病情评价中具有一定的临床价值。     

检测Hcy hs-CRP与IL-6水平对急性脑梗死患者的诊断价值

目的探讨检测同型半胱氨酸(homocysteine,Hcy)、超敏C反应蛋白(high sensitivity C-reactive protein,hsCRP)与白细胞介素-6(interleukin-6,IL-6)水平对急性脑梗死(acute cerebral infarction,ACI)患者的诊断价值。方法选择2012-03—2013-03在我院接受治疗的ACI患者46例为研究对象,纳入观察组。另选同期于我院接受健康体检的志愿者46例为对照组。对比2组治疗前后Hcy、hs-CRP及IL-6水平,不同程度脑梗死患者Hcy、hs-CRP及IL-6水平,以及分析各指标间的相关性。结果观察组治疗前Hcy、hs-CRP及IL-6水平均显著高于对照组,差异均有统计学意义(均P0.05)。但治疗后与对照组相比,差异均无统计学意义(均P0.05)。中型脑梗死患者的Hcy、hs-CRP及IL-6水平均显著高于轻型脑梗死者,而重型脑梗死患者Hcy、hs-CRP及IL-6水平亦均显著高于中型脑梗死者,差异均有统计学意义(均P0.05)。随脑梗死程度的逐渐加重,患者Hcy、hs-CRP及IL-6水平均呈现上升趋势,Hcy与hs-CRP、Hcy与IL-6及hs-CRP与IL-6均呈正相关。结论 Hcy、hs-CRP与IL-6水平的检测对于ACI患者的临床诊断具有较大价值,临床上应予以重视。     

急性脑梗死患者同型半胱氨酸与炎症因子的相关性分析

目的研究急性脑梗死患者肿瘤坏死因子-α（TNF-α）及白介素-6（IL-6）与同型半胱氨酸（Hcy）之间的相关性,以探讨其与急性脑梗死发生的关系。方法收集158例急性脑梗死患者（ACI组）、122例健康人（对照组）血液标本,采用循环酶法检测血浆同型半胱氨酸（Hcy）水平,用ELISA法即酶联免疫吸附法测定血清肿瘤坏死因子-α（TNF-α）,白介素-6（IL-6）水平。结果 ACI组Hcy、TNF-α和IL-6的水平均较对照组显著升高（P均〈0.05）。ACI组Hcy与TNF-α、IL-6水平存在显著性正相关（r=0.346,P〈0.05）,TNF-α与IL-6水平之间也存在显著性正相关（r=0.382,P〈0.05）。结论 Hcy、TNF-α、IL-6水平与急性脑梗死的发生密切相关,三者联合检测对急性脑梗死的预防、早期诊断及治疗和预后均有重要价值。     

急性脑梗死患者血清白介素-6、白介素-18水平与颈动脉内中膜厚度关系的探讨

目的 探讨急性脑梗死(ACI)患者血清细胞因子白介素-6(IL-6)、白介素-18(IL-18)水平与颈动脉内中膜厚度(IMT)的关系.方法 以64例ACI患者作为ACI组,30例健康体检者为正常对照组,利用放射免疫法(RIA)和酶联吸附法(ELISA)分别测定其血清IL-6和IL-18水平,分别测量其颈动脉内中膜厚度(IMT)值并分为IMT<1.0mm和IMT≥1.0mm两个亚组.结果 ACI组中IMT≥1.0mm者IL-6、IL-18含量与正常对照组相比差异有统计学意义(P<0.05),与IMT<1.0mm者相比差异亦有统计学意义(P<0.05).ACI组中IMT≥1.0mm者IMT与IL-18水平呈明显正相关(r=0.549,P=0.001),与IL-6水平无明显相关性(P>0.05).结论 ACI患者IMT增厚者血清IL-6、IL-18水平也升高.     

血清中IL-6、IL-8及TNF-α水平与高血压致急性脑梗死损伤的相关性

目的 探讨血清中炎性细胞因子与高血压致急性脑梗死(ACI)的相关性. 方法 选择河北医科大学第三医院心血管一科和神经内科自2007年6月至2009年6月收治的ACI并高血压患者102例(其中小体积梗死30例,中体积梗死45例,大体积梗死27例)和单纯ACI患者30例,同期门诊健康体检正常者30例作为对照组,ELISA检测ACI并高血压组患者入院第1、3、5、7、14天,单纯ACI组、对照组入院第1天血清细胞介素6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子α(TNF-α)水平,分析血清IL-6、IL-8、TNF-α水平与ACI体积的相关性. 结果 入院第1天ACI并高血压组、单纯ACI组、对照组血清IL-6、IL-8、TNF-α水平均依次降低,差异有统计学意义(P＜0.05).第1、3、5、7天对照组、小体积梗死组、中体积梗死组、大体积梗死组血清IL-6、IL-8及TNF-α水平依次升高,差异均有统计学意义(P<0.05).第14天4组TNF-α水平依次升高,差异有统计学意义(P＜0.05);ACI并高血压患者血清IL-6、IL-8水平在第1、3、5、7天与ACI体积呈正相关关系,TNF-α水平在在第1、3、5、7、14天与ACI体积呈正相关关系. 结论 IL-6、IL-8、TNF-α水平与高血压对ACI的发病有协同作用,ACI并高血压患者血清IL-6、IL-8、TNF-α水平与脑梗死的体积相关.     

血小板活化特异性标志物PAC-1和CD62p与急性脑梗死病情严重程度的相关性

目的 探讨急性脑梗死(acute cerebral irlflarction,ACI)患者血小板膜糖蛋白(glycoprotein Ⅱb/Ⅲa,GPⅡb/Ⅲa)纤维蛋白原受体PAC-1和P选择素(P-Selectin,CD62p)与ACI患者病情严重程度的相关性.方法 采用流式细胞仪技术分别检测58例ACI患者急性期(<7d)外周血PAC-1和CD62p含量,同时采用Barthel指数和NIHSS量表评分法对ACI患者进行神经功能学评分,并选取20名健康人作为对照组进行参考值测定.结果 与对照组(0.22±0.13;4.21±1.11)相比,ACI患者PAC-1含量(0.92±0.40)和CD62p含量(7.07±3.07)在急性期(<7 d)显著升高(P<0.05;P<0.05),且与ACI患者病情严重程度成正相关(P<0.05;P<0.01).结论PAC-1和CD62p与ACI患者病情严重程度呈正相关.早期检测PAC-1和CD62p水平对于预防ACI发生、评估病情轻重以及判断预后有着重要的意义.     

Toxoplasma gondii in individuals with schizophrenia: association with clinical and demographic factors and with mortality

BACKGROUND: Increased rates of exposure to Toxoplasma gondii have been found in individuals with schizophrenia as compared with control groups, but the correlates of Toxoplasma exposure in schizophrenia have not been defined. METHODS: We measured IgG class antibodies to Toxoplasma gondii in 358 individuals with schizophrenia. We correlated Toxoplasma antibody status with clinical and demographic variables and examined the effect of Toxoplasma seropositivity on mortality in a follow-up period of up to 5 years. RESULTS: Individuals with schizophrenia who had serological evidence of Toxoplasma infection were more likely to be female but did not differ in age, race, total symptom score, or other demographic or clinical characteristics. However, we found that serological evidence of Toxoplasma was associated with a significantly increased risk of dying of natural causes during the follow-up period (Cox proportional hazard ratio of 4.70; 95% confidence interval, 1.27-17.31, P = .020) adjusted for age, gender, and other clinical and demographic variables. CONCLUSIONS: Toxoplasma infection may confer an increased risk for mortality from natural causes in schizophrenia. An understanding of the pathogenesis of Toxoplasma infections in individuals with schizophrenia might lead to new approaches to the management of this disorder.     

Patients with Epilepsy and Psychosis Treated with Vigabatrin

Eight patients with difficult to control epilepsy and an active or a history of psychosis were treated with vigabatrin, and the results of this clinical intervention are described. In five cases there was no untoward deterioration of the mental state, in three cases a change was reversed by judicious adjustment of both the anticonvulsant and psychotropic medications. Recommendations for the use of new anticonvulsants in patients with comorbid psychopathology and epilepsy are given.     

Children with ADHD and motor dysfunction compared with children with ADHD only

The purpose of this study was to identify group differences in children with attention-deficit-hyperactivity disorder and motor dysfunction (ADHD-MD) and ADHD only, and to evaluate the medication responsiveness of ADHD-MD. Sixty-three children (49 males and 14 females; mean age 9 years 10 months, SD 2 years 10 months) underwent a triple blind, placebo-controlled crossover study evaluating two dose levels of methylphenidate (0.3 mg/kg and 0.5 mg/kg [corrected], twice daily) and placebo. Forty-nine trials were completed. Nineteen were children with ADHD-MD, 44 had ADHD only. Behavior and functioning were assessed at home and at school. Treatment effects were assessed using the Abbreviated Symptom Questionnaire for Parents and Teachers. Children with ADHD-MD were more likely to have severe ADHD-combined type and other neurodevelopmental and behavioral problems. Both groups of children had a linear dose response to medication (placebo, low, high) and there was no evidence of a group by dose interaction or an overall group effect at home or school. The lack of group effect suggests that these children responded to medication like the other subgroups.     

Delirium with manic and psychotic features associated with amantadine

While clinicians are familiar with psychosis as a complication in the long-term treatment with amantadine, rapid psychiatric complications are of much less concern. In the case presented, severe decompensation in mental status occurred within 48 h of initiation of standard doses of amantadine hydrochloride. Clinicians should be alert not only for delayed complications but also for early-onset mental decompensation in elderly patients with influenza A treated with amantadine.     

Self-esteem and behavioural adjustment in children with epilepsy and children with diabetes

This paper describes a study to investigate the relationship between self-esteem and behavioural adjustment in two groups of children with chronic illness, one with epilepsy and the other diabetes. A total of 62 children with epilepsy and 91 children with diabetes were recruited from the total population of children aged 8–15 attending the epilepsy and diabetic clinics at a children's hospital over a 12 month period. Self-esteem and behavioural adjustment were assessed with the Harter and Achenbach Questionnaires respectively. The results showed the children with epilepsy were consistently more behaviourally disturbed and had lower self-esteem than children with diabetes. The independent completion of the questionnaires, (the Harter by the child and the Achenbach by the parents) increases the validity of the findings. Long duration of illness was the most consistent illness variable associated with poor behavioural adjustment in the two groups. The cross-sectional design of the study did not make it possible to draw any definite conclusions about the causal or temporal relationship between low self-esteem and behavioural disturbance. Once again, the potential value of prospective studies into the psychosocial adjustment of children with chronic illness is highlighted.     

Coping with stress by children and adolescents with cancer

Children and adolescents with cancer not only have to cope with everyday stressors and developmental tasks, as do their healthy peers, but also with illness-related stressors. Thus, it can be assumed, that children and adolescents with cancer differ from healthy peers in coping. Stress reactions and adjustment have been investigated in recent studies. In contrast, coping styles have not often been in the focus of research. In this study, the coping of children and adolescents with cancer (n = 60, 8-13 years of age) was compared to the norm, measured by the German Coping Questionnaire for Children and Adolescents (SVF-KJ; Hampel et al. 2001). The results indicated that the subjects with cancer used more positive and less negative coping strategies when confronted with school-related or social stressors. The results are discussed with respect to the experience with disease-related stress and the possibility of repressive coping.