急性脑梗死患者临床神经功能缺损程度与血小板及纤维蛋白原状态的相关性

Large numbers of researches indicate that platelets (PLT) and fibrinogen (FIB)play important roles in the pathogenesis and progress of cerebral thrombosis. In the present study,PLT,platelet mean volume (MPV),platelet aggregation ratio (PtAgt) and FIB concentration were observed,and the pathogenesis and the progress were discussed.     

The relativity of the activity change of tissue—type plasminogen activator and type 1 plasminogen activator inhibitor in patients with cerebral infarction and defect of nerve function

AIM：To explore the dynamic changes of the activity of tissue-type plasminogen activator(t-PA) and type 1 plasminogen activator inhibitor (PAI-1) and its clinical significance by observing the activity of t-PA and PAI-1 in patients in acute and recovery phases of arteriosclerotic cerebral infarction.METHODS:Testing the activity of plasme t-PA and PAI-1 of 91 patients with arteriosclerotic cerebral infarction and 80 healthy old ages by Chromgenic substrate methods and controlling them.RESULTS:The activity of t-PA in acute and recovery stage of arteriosclerotic cerebral infarction patients were apparently lower than that of control and the activity of PAI-1 were higher than that of control.volume of cerebral infarction was negatively related to the activity of t-PA and positively related to the activity of PAI-1.CONCLUSION:The plasma fibrinolytic activities of the acute and recovery stage patients with arteriosclerotic cerebral infarction declined.     

The correlation between clinical neurologic impairment in acute cerebral thrombosis patients and the status of platelet and fibrinogen

Large numbers of researches indicate that platelets(PLT) and fibrinogen(FIB) play important roles in the pathogenesis and progress of cerebral thrombosis,In the present study,PLT,platelet mean volume(MPV),platelet aggregation ratio(Pt Agt）and FIB concentration were observed,and the pathogenesis and the progress were discussed.     

伴有阻塞性睡眠呼吸暂停综合征的急性脑梗死患者血浆溶血磷脂含量的测定

Objective To observe the changing characteristics of plasma lysophosphatidic acid (LPA) or acidia phospholipid (AP) levels in patients with obstructive sleep apnea syndrome-associated(OSAS)acute cerebral infarction and to explore the pathophysiological mechanisms of OSAS-related stroke so as to provide basis for clinical antithrombotic therapy. Methods Thirty-six patients of OSAS, 32 patients of OSAS-related acute stoke and 36 patients of acute stoke without OSAS diagnosed by clinical and accessory examinations were enrolled in the current study. Thirty-eight age-matched healthy subjects were recruited as controls. The changes of the plasma LPA and AP levels were measured. Results Within 24 hours after symptom onset, the plasma LPA and AP levels in the OSAS-related acute cerebral infarction group (LPA(3. 78 ±0. 56) μmol/L; AP(7. 63 ± 1. 38) μmol/L) were significantly higher than those in the OSAS group(LPA(3. 17 ±0. 65) μmol/L; AP(6. 60 ± 1. 20) μmol/L) ,the not OSAS-related acute cerebral infarction group (LPA (3. 40 ± 0. 59)μmol/L; AP (6. 41 ± 1. 37)μmol/L) and the control group (LPA(2.76±0.45)μmol/L;AP(4.52±0. 83) μmol/L (P < 0. 01)) . The levels of LPA and AP in the OSAS group and the not OSAS-related acute cerebral infarction group were significantly higher than those in the control group(P<0. 01). Seven days after symptom onset, the plasma LPA and AP levels in the OSAS-associated acute cerebral infarction group (LPA(3.08 ± 0. 58) μmol/L; AP(6. 15 ±1. 14)μmol/L) were still higher(P < 0. 01) . The plasma LPA levels were not significantly different among the OSAS-related acute cerebral infarction group, the not OSAS-related acute cerebral infarction group and the control group 21 days after symptom onset, whereas the plasma AP levels in the OSAS-related acute cerebral infarction group (5. 04 ± 0. 83) μmol/L were still significantly higher than those in the not OSAS-related acute cerebral infarction group (4. 57 ± 0. 94) μmol/L and the control group (P < 0.05). Conclusions The significantly elevated plasma LPA and AP levels in patients with OSAS suggested that platelets in vivo are in an activated state and in cerebral ischemia and hypoxia state, especially for the OSAS-related acute cerebral infarction patients. The activated state of platelet may persist for a long time, thus the time window for antithrombotic therapy may be longer.     

伴有阻塞性睡眠呼吸暂停综合征的急性脑梗死患者血浆溶血磷脂含量的测定

Objective To observe the changing characteristics of plasma lysophosphatidic acid (LPA) or acidia phospholipid (AP) levels in patients with obstructive sleep apnea syndrome-associated(OSAS)acute cerebral infarction and to explore the pathophysiological mechanisms of OSAS-related stroke so as to provide basis for clinical antithrombotic therapy. Methods Thirty-six patients of OSAS, 32 patients of OSAS-related acute stoke and 36 patients of acute stoke without OSAS diagnosed by clinical and accessory examinations were enrolled in the current study. Thirty-eight age-matched healthy subjects were recruited as controls. The changes of the plasma LPA and AP levels were measured. Results Within 24 hours after symptom onset, the plasma LPA and AP levels in the OSAS-related acute cerebral infarction group (LPA(3. 78 ±0. 56) μmol/L; AP(7. 63 ± 1. 38) μmol/L) were significantly higher than those in the OSAS group(LPA(3. 17 ±0. 65) μmol/L; AP(6. 60 ± 1. 20) μmol/L) ,the not OSAS-related acute cerebral infarction group (LPA (3. 40 ± 0. 59)μmol/L; AP (6. 41 ± 1. 37)μmol/L) and the control group (LPA(2.76±0.45)μmol/L;AP(4.52±0. 83) μmol/L (P < 0. 01)) . The levels of LPA and AP in the OSAS group and the not OSAS-related acute cerebral infarction group were significantly higher than those in the control group(P<0. 01). Seven days after symptom onset, the plasma LPA and AP levels in the OSAS-associated acute cerebral infarction group (LPA(3.08 ± 0. 58) μmol/L; AP(6. 15 ±1. 14)μmol/L) were still higher(P < 0. 01) . The plasma LPA levels were not significantly different among the OSAS-related acute cerebral infarction group, the not OSAS-related acute cerebral infarction group and the control group 21 days after symptom onset, whereas the plasma AP levels in the OSAS-related acute cerebral infarction group (5. 04 ± 0. 83) μmol/L were still significantly higher than those in the not OSAS-related acute cerebral infarction group (4. 57 ± 0. 94) μmol/L and the control group (P < 0.05). Conclusions The significantly elevated plasma LPA and AP levels in patients with OSAS suggested that platelets in vivo are in an activated state and in cerebral ischemia and hypoxia state, especially for the OSAS-related acute cerebral infarction patients. The activated state of platelet may persist for a long time, thus the time window for antithrombotic therapy may be longer.     

短暂性脑缺血发作导致的脑梗死与脑血栓形成神经功能恢复比较

Background: Ischemia of brain has the highest incidence rates in cerebral apoplexy. Most of transient ischemia attacks( TIA) break out repeatedly, and end in cerebral infarction. Now reports on comparison of neural function defects and rehabilitation degree caused by them are rare.     

高压氧对脑梗死患者血浆SOD和CRP的影响及临床意义

Objective To study the effect of hyperbaric oxygenation(HBO) therapy on the activities of serum SOD and CRP of patients with cerebral infarction and its clinical significance. Methods 78 patients with cerebral infarction were randomly divided into hyperbaric oxygen group (HBO Group, 40 cases)and clinical group (38 cases). The clinical group was treated with clinical conventional treatment only. HBO group was treated with HBO combined with clinical conventional treatment. 21 healthy volunteers were assigned to control group. Before and after treatment, the activities of serum SOD and CRP level were measured, and the curative effect were evaluated. Results The pretreatment serum SOD and CRP of the HBO group and clinical group were significantly different from the control group (P＜ 0. 01). Compared with the pretreatment and posttreatment serum level of the HBO group, SOD raised, CRP lowered, the difference was significant(P＜ 0. 01).Compared with clinical group, SOD raised, CRP lowered and the total cure rate of the HBO group were more significant different(P ＜0.01). Conclusion HBO therapy raised the activities of SOD and lower the level of CRP in serum of the patients with cerebral infarction, and improved the free radicals scavenging ability in the body. Therefore, HBO therapy has a good effect for cerebral infarction. The experiment suggests that the activities of SOD and CRP level in serum can be used to judge the curative effect and prognosis of HBO therapy for cerebral infarction.     

脑卒中合并真性红细胞增多症19例临床分析

Objective To explore the clinical features and treatment of stroke complicating polycythemia vera(PV). Methods Clinical data of 19 cases of stroke complicating PV were analysed retrospectively.Results ①Among all the cases, cerebral infarction complicating PV were 14 cases (14/19,73.4%), among the 14 cases, 12 cases(12/14,85.7%) of multiple cerebral infarction, 2 cases(2/15,13.3%) of transientischemis attack ;2 cases (2/19,10. 5 %) of cerebral hemorrhage, 1 case (1/19,5.3 %) of subarachnoid hemorrhage (SAH). The patients's clinical manifestation, physical sign, hemogram, marrow characteristic were consistentwith that of PV diagnosis criteria. ② Imageology check show that small infarction focus were common (13/19,68.4%). Lobe of brain, basal ganglia, capsula intema were common place of cerebral infarction. The density of hemorrhagic focus was asymmetrical, there was obvious edema around the hem orrhagic focus. ③Applied vein blood-letting and small dose chemotherapy, 7 cases were covery, 11 cases were obviously inproved, 1 case of stroke was invalid. Conclusion The cerebral infarction is common in stroke complicating PV. Among all the stroke complicating PV cases, multiple cerebral infarction are the most common, cerebral hemorrhage and subarachnoid hemorrhage are few, vein blood-letting and small dose chemotherapy has a good curative effect for the patients.     

脑卒中合并真性红细胞增多症19例临床分析

Objective To explore the clinical features and treatment of stroke complicating polycythemia vera(PV). Methods Clinical data of 19 cases of stroke complicating PV were analysed retrospectively.Results ①Among all the cases, cerebral infarction complicating PV were 14 cases (14/19,73.4%), among the 14 cases, 12 cases(12/14,85.7%) of multiple cerebral infarction, 2 cases(2/15,13.3%) of transientischemis attack ;2 cases (2/19,10. 5 %) of cerebral hemorrhage, 1 case (1/19,5.3 %) of subarachnoid hemorrhage (SAH). The patients's clinical manifestation, physical sign, hemogram, marrow characteristic were consistentwith that of PV diagnosis criteria. ② Imageology check show that small infarction focus were common (13/19,68.4%). Lobe of brain, basal ganglia, capsula intema were common place of cerebral infarction. The density of hemorrhagic focus was asymmetrical, there was obvious edema around the hem orrhagic focus. ③Applied vein blood-letting and small dose chemotherapy, 7 cases were covery, 11 cases were obviously inproved, 1 case of stroke was invalid. Conclusion The cerebral infarction is common in stroke complicating PV. Among all the stroke complicating PV cases, multiple cerebral infarction are the most common, cerebral hemorrhage and subarachnoid hemorrhage are few, vein blood-letting and small dose chemotherapy has a good curative effect for the patients.     

Establishment of rabbit model of cerebral infarction for interventional treatment

AIM:To establish a model of cerebral infarction in order to study the interventional treatment.METHODS:An improved 3.0F SP Cobra catheter was introduced to the internal carotid artery by puncturing the femoral artery.After intemal carotid arteriography thrombus was injected to embolize its MCA.3 hours later,clinic observe and computed tomography was examined to analyze results.RESULTS:Clinic observation confirmed that the rabbit had some nerve defect symptoms and CT exam proved cerebral infarction.CONCLUSION;This technique is convenient for application and the model can meet the standard of study of clinical interventional treatment.     

韶关市农村留守儿童孤独感状况调查

目的了解广东省韶关市农村地区留守儿童孤独感现状及其影响因素。方法对韶关市某地区两所农村小学3～6年级学生中的489名留守儿童采用儿童孤独量表和自编调查表进行问卷调查。结果17．6％留守儿童存在孤独感，不同性别孤独感发生率无差异性，不同年龄及不同年级间孤独感发生率差异均有极显著性（P〈0.01）；随年级增加，孤独感发生率呈下降趋势（X^2趋势=5．970，P〈0.05）。留守儿童孤独感与健康状况、学习成绩、学习困难程度、父母教育方式、父母间关系和老师教育方式等因素显著相关（P〈0.01～0．05）。结论农村地区留守儿童中存在一定程度的孤独感问题，老师和家长应以正确的态度和方法对待留守儿童，以减少其孤独感的发生。     

产科新生儿不同部位经皮测黄报警预值的可靠性观察

目的对比观察产科新生儿不同部位经皮胆红素（TCB）报警预值的可靠性。方法132例产科新生儿采取随机数字分组法分为正常产组和剖宫产组各66例,新生儿均于产后第4天同一时间点应用KJ8000经皮测黄仪分别测量额、胸、腹、额胸、额胸腹TCB值,TCB〉12．9mg／dl者,取得亲属同意抽取静脉血检测血清胆红素（SB）,对比分析不同部位TCB及其与sB值的差异。结果两组分别有17例或21例达到TCB报警预值。两组TCB或sB相同方法及相同部位比较,差异无统计学意义（P〉0．05）;两组TCB不同部位对比,额部值最低、胸部值最高,且与其他部位同组对比差异均有统计学意义（P〈0．01）;两组sB值对比差异无统计学意义（t=1．53,P〉0．05）,与不同部位TCB对比均以胸部数值差异无统计学意义（P〉0．05）,而与其他部位TCB两组差异均有统计学意义（P〈0．01）。结论正常产与剖宫产新生儿术后sB对比差异无意义;TCB动态监测以胸部结果更接近SB。     

Determination of loss of quality of life

Physiatrists are a valuable resource in legal settings, where assessment of functional capacity to perform work and of future medical needs must be determined. Physiatrists help determine what future medical care is needed to restore and maintain an individual at the maximum level of life function. This article focuses on the use of a quality of life (QOL) rehabilitation model, rather than a medical model, for enhancing functional performance, modifying environments, and facilitating patient coping. We discuss use of the QOL model to describe and influence a patient's physical, psychological, cognitive, vocational/economic, and social/leisure domains.     

血液透析患者家庭护理提供者的生活质量调查

目的:了解江汉油田血液透析(血液透析)患者家庭护理提供者(护理者)的生活质量。方法:对60例血液透析患者的家庭护理提供者进行一般情况和生活质量综合评定问卷(QOLI-74)调查,并进行相关性和多因素回归分析。结果:家庭护理提供者各维度的主观生活满意度与其客观指标相关,但也与其需求、年龄、文化程度、与患者的关系有关。结论:客观状态是影响主观生活满意度的重要因素,同时应考虑护理者的需求、年龄、文化程度、与患者的关系对护理者主观生活满意度的影响。     

星状神经节阻滞治疗失眠疗效观察

失眠症又称不寐，指入睡困难，或维持睡眠障碍（易醒、早醒和再入睡困难）导致睡眠时间减少或睡眠质量下降，不能满足身体生理需要，明显影响日间社会功能和生活质量。现将星状神经节阻滞治疗失眠疗效观察总结如下。