脑梗死患者颈动脉粥样硬化斑块稳定性与血清C反应蛋白水平的关系

目的探讨脑梗死患者颈动脉粥样硬化斑块的稳定性与血清C反应蛋白(CRP)水平的关系。方法对112例颈内动脉系统脑梗死患者进行颈动脉彩色多普勒超声检查,明确粥样硬化斑块类型,同时测定血清CRP水平。结果脑梗死患者中不稳定斑块组、稳定斑块组、无斑块组血清CRP水平比较差异有统计学意义(P<0.01)。结论血清CRP水平可反映脑梗死患者颈动脉粥样硬化斑块的稳定性。     

急性脑梗死患者颈动脉粥样硬化斑块与血液炎症因子水平的关系

目的探讨急性脑梗死患者颈动脉粥样硬化斑块与血液炎症因子水平的关系。方法 164例急性脑梗死患者经颈动脉超声检查分为无斑块组(42例)、稳定斑块组(58例)及不稳定斑块组(64例);其中Ⅰ、Ⅱ、Ⅲ级斑块各为37、45、40例。检测各组患者血清超敏C反应蛋白(hs-CRP)及血浆肿瘤坏死因子-α(TNF-α)、白介素6(IL-6)水平,并进行比较。结果稳定斑块组及不稳定斑块组血清hs-CRP及血浆TNF-α、IL-6水平明显高于无斑块组(均P<0.05);不稳定斑块组明显高于稳定斑块组(均P<0.05)。且随着斑块严重程度的增加,其血清hs-CRP及血浆TNF-α、IL-6水平也明显增高(均P<0.05)。结论血清hs-CRP及血浆TNF-α、IL-6水平可以反映急性脑梗死患者颈动脉粥样硬化的严重程度。     

急性脑梗死患者颈动脉粥样硬化斑块稳定性与血清脂联素、白介素-8水平的相关性

目的探讨急性脑梗死(ACI)患者颈动脉粥样硬化斑块稳定性与血清脂联素和白介素-8(IL-8)水平的相关性。方法根据颈动脉彩色多普勒超声仪检查结果,将113例ACI患者分为无斑块组(39例)、稳定斑块组(34例)和不稳定斑块组(40例);采取酶联免疫法检测ACI患者发病<48 h和14 d时,以及31名健康体检者(正常对照组)血清脂联素和IL-8水平;分析血清脂联素、IL-8水平与ACI患者颈动脉粥样硬化斑块稳定性的关系。结果 (1)ACI患者发病<48 h和14 d时血清脂联素水平明显低于正常对照组,IL-8水平明显高于正常对照组(均P<0.05)。与发病<48 h相比,ACI患者发病14 d时血清脂联素水平明显升高,IL-8水平明显降低(均P<0.05)。(2)不稳定斑块组血清脂联素水平明显低于稳定斑块组和无斑块组,IL-8水平明显高于稳定斑块组和无斑块组(均P<0.05)。(3)ACI患者颈动脉斑块稳定性与血清脂联素水平呈正相关(r=0.348,P<0.05),与血清IL-8水平呈负相关(r=-0.798,P<0.05)。结论血清脂联素水平下降、IL-8水平增高的ACI患者,颈动脉粥样硬化斑块的稳定性降低。     

急性脑梗死患者颈动脉粥样硬化与血清高敏C反应蛋白水平的关系

目的 探讨颈动脉粥样硬化与高敏C反应蛋白(hs-CRP)、急性脑梗死之间的关系.方法 应用彩色多普勒超声检测仪对58例急性脑梗死患者及35例健康对照者进行颈动脉超声检查,观测颈动脉内膜-中膜厚度(IMT)、粥样斑块类型,同时检测血清hs-CRP水平.结果 脑梗死组患者血清hs-CRP、颈动脉IMT及粥样斑块发生率较对照组明显增加(P＜0.05);脑梗死患者中不稳定斑块、稳定斑块、无斑块组血清hs-CRP水平差异有统计学意义(P＜0.05);血清hs-CRP水平与颈动脉IMT呈正相关.结论 颈动脉IMT、粥样硬化斑块、血清hs-CRP与脑梗死有密切的关系,hs-CRP能反映颈动脉粥样硬化的程度及斑块的稳定性.     

血浆同型半胱氨酸水平与颈部动脉粥样硬化患者脑梗死复发的相关性研究

目的探讨血浆同型半胱氨酸(homocysteine,Hcy)水平与颈动脉粥样硬化患者复发性脑梗死的关系。方法颈动脉粥样硬化患者160例,根据脑梗死发生次数,分为脑梗死复发组52例,脑梗死初发组54例,无脑梗死或脑出血对照组54例;检测并比较各组血浆Hcy的水平及颈动脉粥样硬化斑块类型。结果脑梗死复发组及初发组血浆Hcy水平和高同型半胱氨酸血症(HHcy)发生率均显著高于对照组(P<0.01),脑梗死复发组血浆Hcy水平和HHcy发生率亦显著高于脑梗死初发组(P<0.05);脑梗死复发组易损斑块发生率显著高于脑梗死初发组(88.5%比64.8%,P<0.05);脑梗死组检出易损斑块患者的血浆Hcy水平显著高于硬斑块患者[(28.96±7.01)μmol/L比(23.56±6.98)μmol/L,P<0.05]。结论血浆Hcy水平与颈动脉粥样硬化患者易损斑块的形成及脑梗死的复发可能相关。     

血清Hcy、hsCRP及UA水平与颈动脉粥样硬化的相关性分析

目的探讨血清同型半胱氨酸、高敏C反应蛋白和尿酸与颈动脉粥样硬化的关系。方法对我院2010-02—2011-10就诊的130例颈动脉粥样硬化患者进行彩色超声检查,按照颈动脉粥样硬化的程度分为不同狭窄组,按照斑块稳定性分为稳定与不稳定组,对130例患者进行血清Hcy、hsCRP及UA水平检查,分析检查结果与颈动脉粥样硬化的关系。结果颈动脉狭窄程度越高,患者的血清Hcy、hsCRP及UA水平越高(P<0.05);不稳定斑块组患者血清Hcy、hsCRP及UA水平高于稳定性斑块组,差异有统计学意义(P<0.05)。结论血清Hcy、hsCRP及UA水平与颈动脉粥样硬化有明显的相关性,且随着动脉粥样硬化程度加重其值逐年升高。     

血浆脂蛋白相关磷脂酶A2水平与急性颈动脉硬化性脑梗死防治效果及硬化斑块稳定性的相关性研究

目的 探讨血浆脂蛋白相关磷脂酶A2水平与急性颈动脉硬化性脑梗死防治效果及硬化斑块稳定性的关系。方法 收集2015年1月-2016年12月来中信惠州医院就诊的急性颈动脉硬化性脑梗死患者80例,为患病组; 同期收集来本院进行体检的正常志愿者40例,为健康对照组; 患病组脑梗死各时间点(入院后第1 d、第2、4、8周)对患者的Lp-PLA2水平进行检测,健康对照组人群在体检时进行相同检测,对比2组间的差异。采用颈动脉超声检测患者的颈动脉硬化斑块稳定性,计算颈动脉粥样硬化斑块Crouse积分,分析Crouse积分与Lp-PLA2水平的相关性。治疗后应用NIHSS和改良Rankin量表(mRS)对治疗效果进行评估,分析其与LP-PLA2水平的关系。结果 各时间点患病组患者的血浆Lp-PLA2水平均高于健康对照组(P<0.05),患病组患者从发病到缓解血浆Lp-PLA2水平逐渐改善(P<0.05); 患者的Crouse积分比较,患病组中不稳定斑块组>混合斑块组>稳定斑块组>无斑块组(P<0.05); 患病组中患者Lp-PLA2水平比较,不稳定斑块组>混合斑块组>稳定斑块组>无斑块组(P<0.05); Lp-PLA2水平与斑块稳定存在相关性,并与稳定斑块呈负相关(OR=-2.586,P<0.05); 治疗后各时间点神经功能缺损轻型患者的Lp-PLA2水平低于中型与重型患者(P<0.05),预后良好患者的Lp-PLA2水平低于预后不良的患者(P<0.05)。结论 Lp-PLA2可能是颈动脉硬化性脑梗死发生的重要危险因素之一,其水平可能与动脉粥样硬化斑块的稳定性有关。     

血浆同型半胱氨酸水平与动脉粥样硬化和脑梗死的关系

目的 探讨血浆同型半胱氨酸(Hcy)水平与颈动脉粥样硬化和脑梗死关系.方法 2005-05～2006-02收治的91例脑梗死住院患者被列入研究对象.根据病灶大小分3组大片梗死21例,小片梗死44例,腔隙性梗死26例.根据颈动脉彩超检测结果将研究对象分为颈动脉斑块组34例,无颈动脉斑块组57例.全部患者测定血浆Hcy、血清叶酸、VitB12水平.分析血浆Hcy水平与脑梗死的危险因素、病灶大小、颈动脉粥样硬化斑块及血清叶酸、VitB12的关系.结果 血浆Hcy水平(1)与高血压、糖尿病、血脂、性别、年龄各指标无明显相关关系.(2)与脑梗死病灶大小无关.(3)与颈动脉粥样硬化斑块有关,有斑块34例,血浆Hcy(20.73±9.31)μmol/L,无斑块57例,血浆Hcy (15.46±11.4) μmol/L,前者高于后者(P＜0.05).(4)与血清叶酸、VitB12水平呈负相关(r1s=-0.264,r2s=-0.16,P＜0.05).结论 血浆Hcy水平与脑梗死病灶大小无关;Hcy水平升高与颈动脉粥样硬化斑块密切相关;与血清叶酸、VitB12水平呈负相关.高血浆Hcy血症可能是颈动脉粥样硬化的危险因素,但与脑梗死关系不明确.     

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。     

MCP-1、VE-cadherin与急性前循环脑梗死及其颈动脉粥样硬化关系的研究

目的 探讨单核细胞趋化蛋白-1( MCP-1)、血管内皮细胞钙粘蛋白(VE-cadherin)与急性前循环脑梗死及其颈动脉粥样硬化的关系.方法 选取112例急性前循环脑梗死患者,根据颈动脉超声结果分内膜正常组、增厚组及斑块组,并按其颈部斑块性质分为强回声组、混合回声组及低回声组,49例健康体检者为对照组,比较脑梗死组与对照组、脑梗死各亚组间血清MCP-1、VE-cadherin的水平.结果 脑梗死组血清MCP-1、VE-cadherin水平高于对照组;脑梗死颈动脉斑块组血清MCP-1、VE-cadherin水平较内膜正常组及内膜增厚组高;且以低回声斑块组升高明显.结论 急性前循环脑梗死患者血清MCP-1、VE-cadherin水平升高;颈动脉粥样硬化斑块低回声组血清MCP-1、VE-cadherin水平升高明显.     

Mechanisms of the suppression of the nociceptive reflex of the opening of the mouth during stimulation of the structures of the limbic brain

The comparative effectiveness of the inhibitory influence of tetanic stimulation of hypothalamus, amygdala and limbic cortex on EMG-response of m. digastricus evoked by electrical stimulation of tooth pulp nociceptive afferents was studied in cats anesthetized with a mixture of chloralose and nembutal. It was found that inhibition of the EMG-component of the jaw-opening reflex is most pronounced in case of stimulation of medial and lateral region of the hypothalamus, the inhibitory effect of central and medial nuclei of the amygdala is less pronounced and the effect of the limbic cortex is the weakest. It was shown that the mechanism of the antinociceptive effect of tetanic stimulation of the hypothalamus is not related to the concomitant increase of the blood pressure. After stabilization of the blood pressure the suppressive effect of the hypothalamus remains without changes, that points out to a direct, primary, not baro-afferent mechanism of the inhibition of the activity of nociceptive neurons of the trigeminal sensory nuclei. Noradrenaline, injected intravenously, induced a large increase of the blood pressure accompanied by a pronounced inhibition of the pain reflex. Angiotensin causes the same degree of blood pressure elevation without changes in the amplitude of the EMG-response of the pain reflex. Hypothalamic and noradrenergic mechanisms for control of pain sensitivity are discussed.     

药物治疗与合并认知行为治疗对强迫症疗效的比较

目的探讨认知行为心理治疗(CBT)在强迫症(OCD)患者各亚型治疗中的有效性和规律性。方法本研究为临床对照研究。符合入组标准的强迫症患者按患者自愿原则分为两组,治疗观察3、6、12个月。疗效评定分别运用Yale-Brown强迫量表,自拟的自评好转程度量表和临床疗效评定。结果认知行为心理治疗合并药物治疗组31例,临床有效率70.9%,其中治愈率1.8%。单纯药物治疗组24例,临床有效率33.3%。Yale-Brown强迫量表和自评量表得分在6个月和12个月两组有显著差异(P<0.05)。其中强迫症亚型(怕脏型、反复检查型和反复担心型)的疗效比较,怕脏型在治疗3个月末两组间自评量表评分有显著性差异(P<0.05);反复担心型在治疗6个月末两组间Yale-Brown强迫量表总分有显著性差异(P<0.05);反复检查型两组间无统计学差异。结论认知行为心理治疗合并药物治疗强迫症的疗效明显优于单纯药物治疗。强迫症的亚型在治疗中的有效性次序为:反复担心型>怕脏型>反复检查型。     

Characteristics of the sympathetic innervation of the nictitating membrane and of the vasculature of the nose and tongue of the cat

Summary Vasomotor responses from the nasal mucosa and tongue, and contractions of the nictitating membrane, were recorded on stimulation of the cervical sympathetic or internal carotid nerves.Preganglionic sympathetic nerve fibres which elicited a membrane response possessed a lower threshold than those which evoked nasal vasoconstriction, while the latter displayed a lower threshold than fibres which evoked tongue vasoconstriction. The sympathetic vasodilator fibres to the tongue, whose activity was revealed after-receptor blockade, had a similar threshold to the vasoconstrictor fibres.Membrane contraction, nasal vasoconstriction and occasionally tongue vasoconstriction could be evoked by stimulating the internal carotid nerve. The postganglionic fibres innervating the nasal mucosa had a similar threshold to those of the nictitating membrane, which may indicate that there are small myelinated fibres innervating the mucosa.The preganglionic compound nerve action potential had four major components, S₁–S₄. S₁, S₂ and usually S₃ fibres were associated with membrane contraction; S₂, S₃ and sometimes S₁ fibres were associated with nasal vasoconstriction; and S₃, usually S₂ and occasionally S₁ fibres were associated with vasoconstriction in the tongue. It is concluded that each of these three groups of nerve fibres, but not S₄ fibres, may include fibres associated functionally with the three effectors.There was a considerable difference between the relative amplitude of the responses of the three effectors elicited by stimulation of the cervical sympathetic nerve at frequencies between 0.2 and 2 Hz. Vasoconstrictor responses were relatively larger than membrane contractions suggesting differences in the mechanisms of neurotransmission at the neuroeffector junctions.     

Development of the projection from the nucleus of the brachium of the inferior colliculus to the superior colliculus in the ferret

Neurons in the deeper layers of the superior colliculus (SC) have spatially tuned receptive fields that are arranged to form a map of auditory space. The spatial tuning of these neurons emerges gradually in an experience-dependent manner after the onset of hearing, but the relative contributions of peripheral and central factors in this process of maturation are unknown. We have studied the postnatal development of the projection to the ferret SC from the nucleus of the brachium of the inferior colliculus (nBIC), its main source of auditory input, to determine whether the emergence of auditory map topography can be attributed to anatomical rewiring of this projection. The pattern of retrograde labeling produced by injections of fluorescent microspheres in the SC on postnatal day (P) 0 and just after the age of hearing onset (P29), showed that the nBIC-SC projection is topographically organized in the rostrocaudal axis, along which sound azimuth is represented, from birth. Injections of biotinylated dextran amine-fluorescein into the nBIC at different ages (P30, 60, and 90) labeled axons with numerous terminals and en passant boutons throughout the deeper layers of the SC. This labeling covered the entire mediolateral extent of the SC, but, in keeping with the pattern of retrograde labeling following microsphere injections in the SC, was more restricted rostrocaudally. No systematic changes were observed with age. The stability of the nBIC-SC projection over this period suggests that developmental changes in auditory spatial tuning involve other processes, rather than a gross refinement of the projection from the nBIC.     

A contribution to the study of the architecture of the autonomic nervous system of the digestive tract of the rat

Summary The distribution of aminergic and non-aminergic nerve fibres to the different constituents of the wall of the digestive tract in various regions is described. Aminergic fibres synapse with all nervous perikarya. Densely interlacing networks of nerve fibres are found in both layers of the tunica muscularis and in the lamina muscularis mucosae. A finely meshed plexus is observed in relation to the wall of the blood vessels in the wall of the gut. There are many fibres connecting the muscular and the vascular plexus. No nerve fibres have been observed in direct relation to the epithelium.The functional implications of these findings are discussed.