马来酸桂哌齐特联合奥扎格雷钠治疗急性脑梗死的疗效观察

目的 观察马来酸桂哌齐特联合奥扎格雷纳注射液治疗急性脑梗死（ACI）的疗效.方法 将116例ACI患者随机分为治疗组（马来酸桂哌齐特联合奥扎格雷钠）60例和对照组（单用奥扎格雷钠）56例,分别于入院时、治疗后7,14,28 d进行临床神经功能缺损程度（NDS）评分和治疗后28 d疗效评定,治疗90 d时的Barthel指数;分别在治疗前后测血液流变学、经颅多普勒（TCD）检查;两组进行比较.结果 2组治疗后14 d及21 d神经功能缺损评分均有明显改善,但治疗组与对照组的NDS、Barthel指数、血液流变学、TCD变化等比较差异均有统计学意义（P＜0.05）.结论 马来酸桂哌齐特联合奥扎格雷钠可增加急性脑梗死的脑血流,改善微循环,并有助于ACI患者的神经功能恢复.     

马来酸桂哌齐特治疗急性脑梗死的疗效分析

目的 探讨马来酸桂哌齐特在辅助治疗急性脑梗死中的应用价值.方法 选择我院2011-03-2013-03收治的急性脑梗死患者80例,按不同治疗方式随机均分为对照组（常规治疗辅以血栓通）和实验组（常规治疗辅以马来酸桂哌齐特）,对2组患者的治疗效果进行比较.结果 实验组总有效率82.5%,明显高于对照组的55.0%（P＜0.05）;实验组治疗14 d后神经功能缺损评分均明显低于对照组（P＜0.05）;2组患者经治疗14 d后的血浆纤维蛋白原水平比较差异有统计学意义（P＜0.05）.结论 马来酸桂哌齐特治疗急性脑梗死效果显著,能明显改善患者神经功能,值得临床推广应用.     

马来酸桂哌齐特注射液治疗急性脑梗死血液流变学变化及疗效观察

目的 观察马来酸桂哌齐特注射液治疗急性脑梗死的临床疗效和对血液流变学的影响.方法 选择发病72 h内的脑梗死患者152例,按随机数字表法分为观察组(n=88)和对照组(n=64).观察组给予马来酸桂哌齐特注射液320mg.对照组给予复方丹参注射液20mL,均静脉滴注,1次/d,连用14d,观察两组临床疗效和血液流变学指标变化.结果 观察组治疗14d后的中国卒中量表(CSS)评分与对照组比较差异有统计学意义(P<0.05);观察组疗效、显效率(62.5%)优于对照组(35.9%),差异有统计学意义(P<0.05);观察组治疗后的各血液流变学指标下降程度较对照组明显,差异有统计学意义(P<0.05).结论 马米酸挂哌齐特注射液治疗急性脑梗死疗效显著,并能有效降低血液黏度.     

马来酸桂哌齐特注射液对急性缺血性脑卒中患者注意网络功能的影响

目的观察马来酸桂哌齐特注射液对急性缺血性轻型脑卒中患者注意网络功能治疗后的影响。方法选取2016-03—2017-05内江市第二人民医院收治的缺血性脑卒中患者29例,按随机数字表法分为对照组14例与观察组15例。对照组采用常规治疗,观察组在对照组基础上加用马来酸桂哌齐特注射液治疗;2组患者均连续治疗13d。比较2组治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、MoCA量表评分、注意网络功能效率变化。结果治疗前后2组患者NIHSS评分、MoCA量表评分比较,差异无统计学意义(P0.05);注意网络功能中的警觉网络功能、定向网络功能效率较对照组提高(P0.05),但执行控制网络功能效率无明显变化(P0.05)。结论马来酸桂哌齐特注射液对轻型缺血性脑卒中患者的注意网络的功能有一定疗效,且安全性较高。     

马来酸桂哌齐特注射液对后循环缺血患者的血液流变学和血流动力学的影响

目的观察马来酸桂哌齐特注射液对后循环缺血(PCI)患者的血液流变学和血流动力学的影响。方法选取100例PCI患者为研究对象,将其随机分为观察组和对照组各50例。对照组给予常规治疗,观察组在常规治疗的基础上加用马来酸桂哌齐特注射液治疗。对2组患者治疗前后的血液流变学指标、血清超敏C反应蛋白(hs-CRP)水平和血流动力学指标进行检测和比较;对2组患者的临床疗效和不良反应发生情况进行观察和比较。结果经治疗,2组患者的各项血液流变学指标和血清hs-CRP水平均出现显著下降(t=4.328~6.356,P0.05),且观察组各项血液流变学指标和血清hs-CRP水平均显著低于对照组(t=3.655~4.759,P0.05),2组椎动脉及基底动脉血流速度指标均出现显著上升(t=3.987~5.035,P0.05),且观察组椎动脉及基底动脉血流速度指标均显著高于对照组(t=3.394~4.358,P0.05);观察组临床疗效和临床有效率均优于对照组(U=3.703,χ~2=4.882,P0.05),2组患者的不良反应总发生率及各类不良反应发生率差异均无统计学意义(χ~2=0.211~1.010,P0.05)。结论马来酸桂哌齐特注射液治疗PCI,可有效改善患者的血流动力学指标和血液流变学指标,缓解患者的神经功能缺损症状,提高治疗效果,有利于改善患者的预后。     

马来酸桂哌齐特联合长春西汀治疗急性脑梗死疗效观察

目的观察马来酸桂哌齐特联合长春西汀治疗急性脑梗死的临床疗效及安全性。方法选择临床确诊的急性脑梗死患者76例,随机分成治疗组和观察组各38例。治疗组给予马来酸桂哌齐特注射液320mg,长春西汀30mg,阿司匹林0.1g口服,每晚1次;对照组给予长春西汀30mg,阿司匹林0.1g口服,每晚1次,连用14d。治疗期间采用中国卒中量表（CSS）对神经功能缺损进行评定。结果 治疗组临床总有效率89.5%,对照组为65.8%,治疗组疗效明显优于对照组,2组总有效率比较差异有统计学意义（P〈0.01）。结论 马来酸桂哌齐特联合长春西汀治疗脑梗死疗效显著,能有效改善脑梗死患者神经功能,值得临床进一步推广。     

丁苯酞与马来酸桂哌齐特联合治疗对急性脑梗死患者神经功能的影响

目的 观察丁苯酞联合马来酸桂哌齐特治疗急性脑梗死的疗效及安全性。方法 连续选择符合入选条件的160例急性脑梗死的患者,采用随机数字表法分为4组。联合治疗组（n=40）、丁苯酞组（n=40）、马来酸桂哌齐特组（n=40）和常规治疗组（n=40）。在治疗前、治疗后第14天及180天分别采取美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）和Barthel指数（Barthel Index，BI）评定神经功能缺损程度及日常生活活动能力，并统计不良事件发生情况。结果 治疗后第14天的NIHSS评分，与常规治疗组比较，丁苯酞组或马来酸桂哌齐特组均无统计学差异（P>0.05），使用联合治疗组有很好的协同作用（P＜0.01）。治疗后第14天的Barthel指数，丁苯酞组或马来酸桂哌齐特组均有统计学差异（P=0.029，P=0.002），且使用联合治疗组疗效更显著（P=0.001）。治疗后第180天NIHSS评分和Barthel指数，丁苯酞组或马来酸桂哌齐特组以及联合治疗组均有疗效（P均<0.01），且联合治疗组效果更显著。联合治疗组有1例、丁苯酞组有2例、常规治疗组有1例出现胃部不适,给予对症治疗后好转。结论 丁苯酞联合马来酸桂哌齐特治疗急性脑梗死具有很好的协同作用，是治疗急性脑梗死的一种安全而有效方法。     

奥扎格雷钠治疗急性脑梗死的临床疗效分析

目的 观察奥扎格雷钠注射液在急性脑梗死治疗中的临床疗效.方法 对72例急性脑梗死患者随机分2组,治疗组用奥扎格雷钠注射液进行治疗,对照组用生理盐水代替,观察2组治疗前后,神经功能缺损程序(SSS)评分、血液流变学的变化、日常生活能力(ADL).结果 治疗组有效率75. 0%,对照组有效率58.3%,治疗组疗效优于对照组(P＜0.01).2组治疗后SSS及ADL评分均较治疗前有显著改善(P＜0.05),但治疗组明显优于对照组(P＜0.05).结论 奥扎格雷钠可明显减少脑梗死患者的神经功能缺损,提高日常生活能力,其治疗急性脑梗死临床疗效确切.     

马来酸桂哌齐特联合舒血宁治疗急性脑梗死的疗效观察

目的观察马来酸桂哌齐特联合舒血宁治疗急性脑梗死的疗效及安全性。方法选取我院2009-02—2012-10收治的急性脑梗死患者200例,随机分成对照组和联合治疗组各100例。对照组在常规治疗的基础上加用舒血宁;联合治疗组在对照组的基础上加用马来酸桂哌齐特。治疗前后检查血、尿常规、血脂、血糖、肝肾功能、凝血功能、心电图等。结果经数理统计学分析,联合治疗组明显优于对照组(P<0.05);2组安全性方面比较差异无统计学意义(P>0.05)。结论马来酸桂哌齐特联合舒血宁在治疗急性脑梗死方面疗效确切、安全。     

马来酸桂哌齐特在颅脑损伤患者的治疗效果观察

目的通过随机分组对照观察探讨马来酸桂哌齐特对颅脑损伤患者的治疗效果。方法100例急性闭合性颅脑损伤患者，分为对照组和用药组，各50例病人。分析对比治疗后对照组和用药组的实验室各项检查指标：血液流变学，TCD检查结果等变化情况。并且对出院后3—6个月随访调查结果进行比较分析。结果治疗后血液流变学检查中，用药组（马来酸桂哌齐特组）各项指标均低于对照组（P〈0．05）。经颅多普勒检测结果显示：用药组的脑血流速度与对照组相比明显减慢（P〈0．05），血管痉挛得到缓解。对比两组出院后随访结果可以看出，用药组的GOS评分、KPS评分及Barthel指数预后明显好于对照组（P〈0.05）。结论初步证明急性颅脑损伤早期应用马来酸桂哌齐特可增加病变区的脑血流，改善微循环，改善颅脑损伤患者的预后。值得推广和进一步研究。     

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。