慢性意识障碍患者结局预测模型的系统综述北大核心CSCD

目的系统评价慢性意识障碍患者结局预测模型的组成因子和准确率。方法采用主题词检索方式,检索PubMed、Web of Science、中国知网、万方数据建库至2021年9月30日慢性意识障碍患者结局预测模型的相关文献,提取内容为作者、出版年份、研究对象、监测项目、主要结局指标和结论。结果共返回文献4313篇,最终纳入37篇,文献类型包括随机对照试验、队列研究,发表时间主要集中在2012年至2021年,研究对象为慢性意识障碍患者,预测模型的组成因子包括临床量表、神经影像学检查、神经电生理学检查和实验室指标。结论预测模型对慢性意识障碍患者的远期结局有一定的参考价值。目前的预测模型大多数只由有限的一项或几项技术手段构成,准确率参差不齐,其中昏迷恢复量表修订版、默认网络、联合多种诱发电位的脑电图分析相关的预测模型具有较高准确率,但尚未建立统一的适配标准。     

柴胡加龙骨牡蛎汤加减治疗更年期综合征38例

岳沛芬主任继承父业、师从其父——当代著名中医学家岳美中教授，潜心钻研中医学术，在从事中医临床工作30余年中积累了丰富的临床经验，理论造诣深厚，特别是在妇科疾病的治疗方面独具特色，2002年被市中医药管理局确定为市级名老中医、研究生导师。笔者有幸从师多年，现将岳老师用柴胡加龙骨牡蛎汤加减治疗妇女更年期综合征38例疗效观察总结如下。     

浅谈我国药品费用构成、增长及控制的机制

药品费用上涨是一个国际性问题。发达国家药品费用占卫生费用的比例在10％～20％之间，而在发展中国家，政府卫生支出的40％～60％是花费在药品费用上。我国人口占世界人口的22％，但卫生资源仅占世界的2％，有相当部分人群未被纳入医疗保险计划，甚至未享受到初级医疗保健。     

本院门诊癌症患者麻醉处方分析

目的依据WHO“癌症三阶梯止痛疗法”指导原则,调查本院门诊对癌症患者麻醉药品使用情况。方法以DDD和DUI值为指标,对本院2004年1月至2005年5月门疹1 529张麻醉处方其中癌症患者所用1 160张麻醉处方进行统计分析。结果哌替啶注射液DUI值为1.59,盐酸吗啡缓释片为1.23,磷酸可待因片为0.91。结论本院癌症患者麻醉药品使用基本合理,但哌替啶的使用频率过高,与“癌症三阶梯止痛疗法”有一定差距。     

Effects of copper on A-type potassium currents in acutely dissociated rat hippocampal CA1 neurons

The effects of copper on voltage-gated A-type potassium currents were investigated in acutely dissociated rat hippocampal CA1 neurons using the whole-cell patch-clamp technique. Extracellular application of various concentrations of copper (1-1000 microM) reversibly reduced the amplitude of voltage-gated A-type potassium currents in a dose-dependent manner with a 50% inhibitory concentration value of 130 microM. Copper (300 microM) increased the V1/2 of the activation curve and state-inactivation curve by 17.2 and 9.0 mV, respectively. Thus, copper slowed down the activation and inactivation process of voltage-gated A-type potassium currents. This study indicated that copper reversibly inhibits the hippocampal CA1 neuronal voltage-gated A-type potassium current in a dose-dependent and voltage-dependent manner, and such actions are likely involved in the regulation of the neuronal excitability and the pathophysiology of Wilson's disease.     

Taurine-induced modulation of voltage-sensitive Na+ channels in rat dorsal root ganglion neurons

The physiological role of taurine, an abundant free amino acid in the neural system, is still poorly understood. The aim of this study was to investigate its effect on TTX-sensitive (TTX-S) and TTX-resistant (TTX-R) Na+ currents in enzymatically dissociated neurons from rat dorsal root ganglion (DRG) with conventional whole-cell recording manner under voltage-clamp conditions. A TTX-S Na+ current was recorded preferentially from large DRG neurons and a TTX-R Na+ current preferentially from small ones. For TTX-S Na+ channel, taurine of the concentration > or = 10 mM shifted the activation curve in the depolarizing direction and the inactivation curve in the hyperpolarizing direction. There was no change in the activation curve for TTX-R Na+ channel and the inactivation curve was shifted in the hyperpolarizing direction slightly in the presence of taurine > or = 20 mM. When the recovery kinetics was examined, the presence of taurine resulted in a slower recovery from inactivation of TTX-S currents and no change of TTX-R ones. All the effects of taurine were weakly concentration-dependent and partly recovered quite slowly after washout. Our data indicate that taurine alters the properties of Na+ currents in intact DRG neurons. These may contribute to the understanding of taurine as a natural neuroprotectant and the potential of taurine as a useful medicine for the treatment of sensory neuropathies.     

Acupoint electrogymnastics therapy in stroke hemiplegia

BACKGROUND： Electrogymnastics can offer a range of proprioceptive, motor, and cutaneous sensation impulses to the central nerve system. The center receives perception of the paralyzed muscle through the aid of these impulses. During this process, functional reorganization of connecting network between segment and intersegment takes place. OBJECTIVE： To observe the therapeutic efficacy of acupoint electrogymnastics and traditional electroacupuncture on stroke hemiplegia. DESIGN, TIME AND SETTING： A multicenter, randomized, controlled, blinded, clinical study was performed at the College of Acu-moxibustion and Massage in Shanghai University of Traditional Chinese Medicine from May 2004 to September 2006. PARTICIPANTS： A total of 153 patients suffering from stroke hemiplegia, comprising 83 males and 70 females, aged 63-70 years, were admitted to outpatient and inpatient at LongHua Hospital Affiliated Shanghai University of Traditional Chinese medicine, Putuo District Traditional Chinese Medicine Hospital and Changqiao Street Community Health Service Center of Shanghai. METHODS： The patients were randomly divided into treatment （n = 77） and control （n = 76） groups. They were treated with acupoint electrogymnastics and traditional electroacupuncture, respectively. In the treatment group, two pairs of positive and negative JD-2008 type electrodes from a hemiplegia treatment apparatus were directly pasted on the Shousanli （LI 10） and Waiguan （SJ5） acupoints of the upper limb, as well as the Zusanli （S36） and Yanglingquan （GB34） acupoints of the lower limb, respectively. In the control group, needles were consecutively inserted into the above acupoints. Using the method of lifting-inserting and twisting-rotating, the needle was manipulated with small amplitude of 5-7 mm and a fast frequency of 80-120 times/min when the needle was inserted to a suitable depth. When the sensation of needling was attained, the two pairs of positive and negative electrodes of type G6805-Ⅱelectro-acupunctur     

Liposome formulated with TAT-modified cholesterol for enhancing the brain delivery

Delivery of drugs to the brain is a major challenge due to the presence of the blood-brain barrier (BBB). The cell penetrating peptide TAT, which appears to enter cells with alacrity, can pass through the BBB efficiently. With this in mind, a novel TAT-modified liposome (TAT-LIP) was developed for overcoming the ineffective delivery of normal drug formulation to the brain. Targeting liposomal formulations are always composed of modified phospholipids as an anchor. However, cholesterol, another liposomal component, which was more stable and cheaper, has not been fully investigated as an alternative anchor. In this study, TAT was covalently conjugated with the cholesterol to prepare the liposome. The cellular uptake by brain capillary endothelial cells (BCECs) of rats and the mechanism of TAT-LIP pathway of endocytosis was explored. The blood brain barrier model in vitro was established to evaluate the transendothelial ability crossing the BBB and its transport mechanism. The biodistribution of each formulation was further identified. The results showed that the positive charge of the TAT-LIP played an important role in enhancing its brain delivery. The absorptive endocytosis might be one of the mechanisms of TAT-LIP crossing the BBB. In conclusion, the experimental data in vitro and in vivo indicated that the TAT-LIP was a promising brain drug delivery system due to its high delivery efficiency across the BBB.     

Protective effect of oxysophoridine on cerebral ischemia and reperfusion injury in mice

OBJECTIVE The purpose of this study was to obseve the protective effects of OSR(oxysophoridine,OSR) on cerebral ischemia and reperfusion injury in mice and to explore its possible protective mechanism.METHODS ICR mice were divided into a sham-operated group,a vehicle group,OSR(62.5,125,250 mg·kg-1) groups and a nimodipine(6 mg·kg-1) group.I.p.administration of OSR(62.5,125,250 mg·kg-1) in OSR groups for 7 d,ig administration of nimodipine(6 mg·kg-1) in nimodipine group for 7 d,ip administration of the same volume saline in sham-operated group and vehicle group for 7 d.Mice models of focal cerebral ischemia and reperfusion injury were established by occlusion of the right middle cerebral artery for 2 h followed by 24 h reperfusion except the sham-operated group.After 24 h of reperfusion,mice were tested for neurological deficit scores with the method of Bederson′s score,the cerebral infarct volume were assessed with the method of TTC staining in mice,the brain water content were determined by dry/wet weight method and the cerebral index were counted in mice,the levels of adenosine-triphosphate(ATP),maleic dialdehydle(MDA),glutathione peroxidase(GSH-PX),superoxide dismutase(SOD),catalase(CAT),nitric oxide(NO),nitric oxide synthase(NOS) and lactate dehydrogenase(LDH) in the brain tissues were measured with the method of spectrophotometry.RESULTS Compare to the model group,OSR(125,250 mg·kg-1) and nimodipine(6 mg·kg-1)reduced the neurological deficits scores(P<0.01) and the cerebral infarct volume(P<0.05).Compare to the model group,OSR(62.5,125,250 mg·kg-1) and nimodipine(6 mg·kg-1)reduced the brain water content(P<0.01).Compare to the model group,OSR(125,250 mgp·kg-1) and nimodipine(6 mg·kg-1)reduced the cerebral index(P<0.05).Compare to the model group,OSR(62.5,125,250 mg·kg-1) and nimodipine(6 mg·kg-1)reduced the contents of MDA,NO(P<0.01) and increased the contents of ATP(P<0.01).Compare to the model group,OSR(62.5,125,250 mg·kg-1) and nimodipine(6 mg·kg-1)enhanced the activities of SOD,GSH-PX,LDH and CAT(P<0.01),also decreased the activity of NOS(P<0.01).CONCLUSION OSR has significant protective effects of cerebral ischemia and reperfusion injury in mice,the effective mechanism of OSR might relate to the alleviation of oxidative stress.