伴阿尔茨海默病生物标志物特征性改变的抗AMPAR抗体相关自身免疫性痴呆2例并文献复习

<正>1病例报告病例1:患者女,49岁。因"记忆力逐渐减退2年,加重1周"于2020-03-16入院。患者2年前出现记忆功能减退,近记忆损害明显,偶有迷路,反应迟钝,伴语言表达能力、计算能力下降,无明显幻觉。症状逐步加重,性格由外向变得沉默,日常生活需要他人协助。入院前1周,出现可疑癫痫发作。     

中药芪参复康胶囊对首发抑郁症患者事件相关电位P300的影响

目的:探讨中药芪参复康胶囊治疗首发抑郁症前后患者临床症状、认知功能的变化。方法:对40例抑郁症患者给予芪参复康胶囊治疗,分别于治疗前后评定24项汉密尔顿抑郁量表(HAMD)及进行P300检查,与38名健康志愿者的结果进行比较。结果:①治疗后试验组的HAMD分均显著性下降[(30.01±5.41)分vs.(10.45±3.18)分];②与治疗前相比,试验组治疗后P2、N2、P3潜伏期均显著性缩短,波幅均显著性升高(P<0.05);③与对照组相比,试验组治疗前P2、N2、P3潜伏期均显著性延迟,波幅均显著性降低(P<0.05);治疗后P2、N2、P3潜伏差异无统计学意义,P2、N2波幅仍显著性偏低(P<0.05),P3波幅差异无统计学意义。结论:首发抑郁症患者应用芪参复康胶囊治疗后其临床症状明显缓解、认知功能明显改善,疗效肯定。     

精神分裂症患者事件相关电位P300的对照研究

目的:探讨精神分裂症患者听觉诱发电位P300的特征及病程对P300的影响。方法:对68例精神分裂症患者(研究组)和30名正常对照(正常对照组)进行事件相关电位P300的检测,并分析比较不同病程对P300的影响。结果:研究组Fz、Cz、FC1的P300潜伏期较对照组明显延迟(t分别=2.67,3.48,3.36;P均<0.01);Fz、Cz、FC1、FC2的波幅较对照组显著降低(t分别=5.97,2.54,4.57,3.80;P均<0.01)。对研究组中病程<6个月组和病程>5年组的患者比较发现,病程>5年组的患者Fz、Cz潜伏期延迟(t=9.23,7.63;P均<0.01),波幅降低(t=11.97,6.66;P均<0.01)。结论:精神分裂症患者认知功能受损,病程越长,受损越重。     

青年和中年精神分裂症患者心理旋转信息加工系统研究

目的 探讨年龄因素对精神分裂症患者心理旋转信息加工系统的影响.方法 对78例精神分裂症患者,按不同年龄段将其分成两组,青年组38例,中年组40例,和76名(青年组36名,中年组40名)健康被试进行心理旋转任务的测定,测量其错误数和反应时.结果 (1)与对照组[(15.2±5.8)％]相比,患者组错误率升高[(42.8±7.6)％,P＜0.05].在对照组内,青年组正像和镜像错误率均低于中年组,差异有统计学意义(P＜0.05);在患者组内,青年组与中年组相比差异无统计学意义(P＞0.05).(2)与对照组[(744.3±93.1)ms]相比,患者组反应时升高[(947.8±97.8)ms,P＜0.05].在对照组内,青年组正像和镜像反应时均短于中年组,差异有统计学意义(P＜0.05);在患者组内,青年组与中年组相比差异无统计学意义(P＞0.05).(3)线性回归分析发现,对照组青年、中年组正镜像错误率、反应时均随着旋转角度递增呈线性递增函数(P＜0.001);患者组无此线性关系.结论 精神分裂症患者心理旋转信息加工机制受损,且年龄效应消失,其中青年受损程度大于中年患者.提示大脑神经系统的中年化在一定程度上能对心理旋转信息加工系统起保护作用.     

Short-term Effect of Combined Therapy with Jinlong Capsule(金龙胶囊)and Transcatheter Arterial Chemoembolization on Patients with Primary Hepatic Carcinoma and Its Influence on Serum Osteopontin Expression

<正>Objective:To observe the clinical combination effect of Jinlong Capsule(金龙胶囊,JLC) and transcatheter arterial chemoembolization(TACE) on the patients with primary hepatic carcinoma(PHC) and JLC's influence on serum osteopontin(OPN) expression and elucidate the correlation between the serum OPN level and curative effect of JLC and TACE.Methods:A total of 98 patients with PHC were observed in a randomized controlled trial(RCT).They were assigned to the Chinese medicine(CM) group(53 patients who were treated with TACE and JLC) and the intervention group(45 patients who were treated with TACE only).The serum OPN levels were measured before and after treatment by quantitative sandwich enzyme-linked immunosorbent assay(ELISA).Forty healthy people were assigned to the control group.The clinical efficacy was observed and Karnofsky score(KPS) was graded.Results:The clinical efficacy of the CM group(60.38%) was better than that of the intervention group(40.00%),and the KPS(84.35±12.19) was higher than the intervention group(69.86±11.58)(P0.05).The serum OPN levels before and after treatment in the patients with PHC were significantly elevated compared with those in the control group(P0.01).After treatment,the OPN levels in CM group(117.69±78.50) were significantly lower compared with those in intervention group(151.09±83.90,P0.05).The OPN levels of responders were remarkably lowered than the non-responders after treatment,and the level of OPN in the CM group was lower than the intervention group(P0.05).Conclusions:The short-term clinical efficacy and the quality of life of patients with PHC can be improved by combining JLC with TACE.The serum OPN levels in PHC patients can reflect the curative effect of treatment and the prognosis of the disease.     

轮流换班护士记忆功能的对比研究

目的探讨不同班次护士值班前后记忆功能的变化差异,以便为进一步改善护士工作效率提供客观指标。方法将本院150名护士按随机数字表法分3组,白班组、小夜组、大夜组各50例。3组于值班前后进行韦氏记忆评定。分析3组记忆功能的差异。结果与值班前比较,小夜组和大夜组值班后长时记忆差异不显著(t=0.82,0.67,P>0.05),短时记忆再认(t=3.24,3.64)、联想(t=2.54,3.01)、触摸(t=2.36,2.88)、理解(t=2.81,3.31)因子均降低(除图片因子,P<0.05),瞬时记忆(t=2.68,3.25)、记忆商(t=4.11,5.26)评分均降低(P<0.05);白班组值班后所有记忆成绩差异不显著;且小夜组降低值小于大夜组(P<0.05)。结论小夜班、大夜班护士短时记忆、瞬时记忆功能下降,且小夜班下降程度小于大夜班。     

百尺竿头 精益求精——访中国人民武装警察部队总医院

在北京市海淀区永定路西侧，你会看到一片乳白色的建兢群。整齐规划的院容、典雅的建兢、川流不息的人群．随时让体感到军队医院雷厉风行的作风和恢宏的气派。     

玉杖丹对大鼠肝损伤的保护作用研究

慢性肝损伤在临床十分常见，任其发展会导致肝纤维化甚至肝硬化的发生。在保护肝脏的众多药物中，中药以其多环节、多层次及多靶点的综合作用已显出较明显的优势。复方中药玉杖丹由金钱草、虎杖、郁金这些具有清热解毒、活血化瘀等多种功效的中药组成。观察了玉杖丹煎剂对大鼠慢性肝损伤模型的保护作用，并探讨其作用机制。