甲钴胺联合前列地尔治疗2型糖尿病周围神经病变疗效观察

目的：观察甲钴胺联合前列地尔治疗糖尿病周围神经病变的临床疗效,为临床治疗提供参考。方法选取90例2型糖尿病周围神经病变患者,随机平均分成治疗组和对照组,2组均进行降糖基础治疗,对照组在此基础上采用甲钴胺肌内注射治疗,治疗组采用甲钴胺联合前列地尔治疗,2组均连续治疗1个月。观察并比较2组临床疗效、肌电图神经传导速度变化及不良反应。结果治疗组总有效率84.4％（38／45）,对照组总有效率68.9％（31／45）,2组比较差异具有统计学意义（ P＜0.05）;治疗后,2组肌电图神经传导速度均有显著改善,与治疗前相比,差异有统计学意义（ P＜0.05）;与对照组相比观察组改善更显著（ P＜0.05）。2组均未出现严重不良反应。结论甲钴胺联合前列地尔治疗2型糖尿病周围神经病变的临床疗效明显,且不良反应少,值得推广应用。     

甲钴胺与前列地尔治疗老年2型糖尿病周围神经病变的疗效分析

目的比较前列地尔联合α-硫辛酸与甲钴胺联合α-硫辛酸治疗老年2型DPN的临床疗效和安全性。方法采用随机数字表法将95例老年2型DPN患者分为前列地尔组和甲钴胺组,均治疗30d后观察临床疗效、周围神经传导速度和药物安全性。结果甲钴胺组总有效率93.62%优于前列地尔组77.08%,P<0.05;甲钴胺组周围神经传导速度优于前列地尔组,P<0.01;组间不良反应发生率比较,P>0.05。结论甲钴胺联合α-硫辛酸从发病机制的不同环节和不同途径改善氧化应激引起的周围神经损伤,修复受损神经和改善神经传导速度,从而改善DPN患者的临床症状和体征。     

依帕司他与甲钴胺联合治疗糖尿病周围神经病变疗效观察

目的探讨依帕司他联合甲钴胺治疗糖尿病周围神经病变（DPN）的疗效。方法对96例DPN患者随机分为治疗组48例和对照组48例。在控制血糖血脂等治疗的基础上,治疗组采用依帕司他联合应用甲钴胺,对照组单用甲钴胺,8周后比较2组治疗前后症状、体征变化及神经传导速度（包括腓总神经和正中神经运动神经传导速度（MNCV）和感觉神经传导速度（SNCV）。结果治疗组总有效率87.50%,明显优于对照组64.58%（P〈0.01）;正中、腓总神经传导速度（MNCV和SNCV）2组间和组内进行比较,差异均有统计学性意义（P〈0.05）。结论采用依帕司他联合甲钴胺治疗DPN能明显改善患者症状、体征、传导功能,从而达到良好的治疗效果。     

甲钴胺联合前列地尔治疗46例糖尿病周围神经病变的疗效观察

目的探讨甲钴胺联合前列地尔治疗糖尿病周围神经病变的临床疗效和安全性。方法采用随机数字表法将91例糖尿病周围神经病变患者分为2组,对照组单用甲钴胺注射液肌内注射,治疗组给予甲钴胺联合前列地尔治疗,连续治疗30d,观察2组患者的临床疗效和药物安全性。结果治疗组周围神经传导速度明显高于对照组,P<0.01;治疗组总有效率95.65%,优于对照组的80.00%,P<0.05;组间药物不良反应比较,P>0.05。结论甲钴胺联合前列地尔治疗糖尿病周围神经病变疗效确切,能够有效改善周围神经血流供应和促进神经功能修复,药物不良反应发生率低,值得临床推广应用。     

神经节苷脂联合甲钴胺注射液治疗糖尿病周围神经病变的疗效

目的观察单唾液酸四己糖神经节苷脂钠(GM1)联合甲钴胺注射液治疗2型糖尿病周围神经病变(DPN)临床疗效。方法将DPN患者60例随机分成2组,均给予甲钴胺注射液500μg肌注,治疗组加用GMI 40mg+生理盐水250mL静滴,1次/d,连用2周,观察2组临床疗效及神经传导速度。结果治疗组临床疗效明显优于对照组(P0.05),神经传导速度增加亦优于对照组(P0.001),治疗过程中未见明显不良反应。结论 GM1联合甲钴胺注射液治疗DPN安全有效。     

甲钴胺 依帕司他与α-硫辛酸联合治疗糖尿病神经病变疗效观察

目的观察甲钴胺、依帕司他与α-硫辛酸联合治疗糖尿病神经病变患者的临床疗效。方法 164例糖尿病神经病变患者,随机分为观察组84例,采用甲钴胺、依帕司他与α-硫辛酸联合治疗,对照组80例采用常规治疗,比较2组的临床疗效。结果观察组显效率和总有效率分别为59.5%和92.9%,对照组分别为35.0%和75.0%,观察组疗效明显(P0.05);观察组治疗后的运动神经传导速度(MCV)与感觉神经传导速度(MNSI)均明显高于对照组(P0.05),2组不良反应发生率无差异(P0.05)。结论采用甲钴胺、依帕司他与α-硫辛酸联合治疗糖尿病神经病变效果确切,具有一定应用价值。     

依帕司他联合甲钴胺治疗糖尿病周围神经病变的疗效及复发率

目的探究依帕司他联合甲钴胺治疗糖尿病周围神经病变的疗效及复发率。方法采用随机数表法选取2013-01—2015-01我院收治的100例糖尿病周围神经病变患者为研究对象,分为观察组和对照组,观察组50例给予依帕司他联合甲钴胺治疗,对照组50例给予甲钴胺治疗。对比2组患者治疗前后的运动神经传导速度、感觉神经传导速度、临床疗效和复发率。结果治疗前2组患者的正中神经、胫神经、腓总神经的运动神经传导速度、感觉神经传导速度差异无统计学意义(P0.05)。治疗后2组患者的正中神经、胫神经、腓总神经的运动神经传导速度、感觉神经传导速度均显著改善,且观察组优于对照组,差异具有统计学意义(P0.05)。观察组临床总有效率90.0%,5例患者治疗无效,运动神经传导速度、感觉神经传导速度均无变化。对照组临床总有效率为64.0%,18例患者中11例运动神经传导速度、感觉神经传导速度均无变化,7例触觉、跟膝腱反应、温度觉等症状无变化,差异具有统计学意义(P0.05)。观察组2例患者复发,对照组9例复发,差异具有统计学意义(P0.05)。结论糖尿病周围神经病变患者给予依帕司他联合甲钴胺具有较好的临床疗效,能够改善运动神经传导速度和感觉神经传导速度,降低复发率。     

1,6-二磷酸果糖联合甲钴胺治疗糖尿病周围神经病变的疗效观察

目的观察1,6-二磷酸果糖(FDP)联合甲钴胺治疗糖尿病周围神经病变(DPN)的临床疗效.方法119例DPN患者随机分为两组.对照组55例,给予甲钴胺500μg肌肉注射,每日1次;治疗组64例,在甲钴胺治疗基础上加用FDP 10g静滴,每日1次.两组疗程均为20d.结果治疗组有效率93.8%,对照组有效率74.5%.两组疗效和症状恢复正常的时间均有显著性差异(P＜0.01或0.05).结论FDP联合甲钴胺是治疗DPN安全、有效的方法.     

α硫辛酸联合钾钴胺治疗糖尿病周围神经病变的疗效

目的探讨α硫辛酸联合甲钴胺应用于糖尿病周围神经病变(diabeitc peripheral neuropathy,DPN)治疗的临床疗效。方法选取2010-02—2015-01我院收治的80例糖尿病神经病变患者为研究对象,采用随机数字表法随机分为观察组与对照组,均给予降血糖、降脂及降压治疗,对照组给予甲钴胺治疗,观察组给予α硫辛酸联合甲钴胺治疗,对2组的临床疗效、治疗前后密西根糖尿病性周围神经病评分(MDNS)及神经传导速度进行对比。结果观察组与对照组的总有效率分别为97.50%、60.00%,观察组总有效率显著升高,差异有统计学意义(P0.01);与治疗前对比,2组患者治疗后腓总神经、正中神经、胫神经的感觉神经的传导速度及运动神经的传导速度均显著加快,治疗后,与对照组对比,观察组神经传导速度加快更显著,差异有统计学意义(P0.05);与治疗前对比,观察组患者的MDNS评分显著下降,对照组患者的MDNS评分无显著变化;治疗后与对照组对比,观察组患者MDNS评分显著降低,差异有统计学意义(P0.05)。结论α硫辛酸联合甲钴胺应用于DPN的治疗疗效显著,显著加快神经传导速度病改善患者症状及体征,值得临床推广应用。     

鼠神经生长因子联合依帕司他及甲钴胺治疗糖尿病周围神经病变的临床观察

目的观察鼠神经生长因子联合依帕司他及甲钴胺治疗糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的疗效。方法选取160例DPN患者,随机分为A、B、C、D 4组,A组患者(对照组)仅给予甲钴胺治疗,B组患者给予甲钴胺+依帕司他治疗,C组患者给予甲钴胺+鼠神经生长因子治疗,D组患者给予鼠神经生长因子+依帕司他+甲钴胺治疗,疗程均为4 w,比较4组患者临床症状、神经传导速度、感觉定量检测变化情况及治疗有效率差异。结果 4组患者治疗后神经症状评分均下降(P0.05),神经传导速度均增加(P0.05),4个不同部位的温度觉阈值、振动觉阈值平均值均较治疗前明显改善(P0.05);D组患者的神经症状评分下降程度、神经传导速度增加程度、温度觉阈值、振动觉阈值改善程度、治疗有效率均明显优于A组、B组、C组(P0.05),B组、C组患者的神经症状评分下降程度、神经传导速度增加程度、温度觉阈值、振动觉阈值改善程度、治疗有效率均明显优于A组(P0.05),B组患者与C组患者比较,差异无统计学意义(P0.05)。结论鼠神经生长因子联合依帕司他及甲钴胺治疗DPN临床疗效显著。     

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。