Neuropsychological evaluation in transient ischaemic attack and minor stroke

Summary Two groups of patients with transient ischaemic attack and minor stroke without detectable haemodynamic stenotic lesions were evaluated by neuropsychological tests and compared with a control group. The mean values of the scores adjusted for age and educational background demonstrated that (a) the patients with transient ischaemic attack did not have a worse performance than normal subjects in any of the tests, (b) the patients with minor stroke had a worse performance than normals, particularly in Rey's figure-copying test (P<0.025), and (c) the latter test was not affected by educational background or age of the subjects. The results are discussed with reference to other case series, and the importance of age and cerebral damage in causing intellectual impairment evaluated by neurophysiological tests is stressed.     

北京市一起新型冠状病毒Omicron变异株聚集性疫情特征分析

目的 分析北京市海淀区一起新型冠状病毒肺炎聚集性疫情流行病学特征及传播链。方法 采用描述性流行病学方法分析疫情流行病学特征,应用现场调查和大数据技术分析传播链。结果 2022年4月27日至5月13日, 海淀区发生一起新型冠状病毒肺炎聚集性疫情,全基因组测序系Omicron变异株（BA.2.2进化分支）;涉及感染者38例,确诊病例34例,无症状感染者4例;临床分型以轻型（88.2%）为主,无重型、危重型和死亡病例;早期临床症状以咽部不适（50.0%）、咳嗽（29.4%）为主;17 d内传播7代,涉及3起社区聚集、2起单位聚集和8个家庭内传播;暴露方式以同住（47.6%）、同时空暴露（31.6%）为主;代间距M（Q₁,Q₃）为3（1,6）d;总续发率为1.5%（37/2 482）,其中家庭续发率为36.7%（18/49）。结论 本起Omicron变异株疫情临床症状轻,家庭、社区聚集性明显,疫情传播速度较快,同时空暴露感染风险较高,需利用信息化技术全面摸排密切接触者,以快制快,有效阻断疫情传播。     

椎基底动脉短暂缺血性眩晕患者脑血流量与脑干听力诱发电位的关系研究

为探讨椎基底动脉短暂缺血性眩晕 (VBTIV)患者的脑干听力诱发电位 (BAEP)与脑血流量 (CBF)和病理改变的关系 ,对 6 5例 VBTIV患者 (患者组 )作磁共振血管成像 (MRA)、经颅多普勒 (TCD)和 BAEP检查 ,对 2 6例对照组患者作 MRA和 TCD检查。结果 :MRA显示患者组 5 0例血管病理改变明显 ,1 5例改变不明显或无改变 ;对照组脑血流量为 1 1 2 .3～ 2 78.9ml/ min(2 s) ,较患者组 48.0～ 2 6 2 .0 m l/ min高 (P<0 .0 1 ) ,患者组 1 5例脑血流量下降 ,5 0例脑血流量正常 ;患者组 BAEP异常 47例 (72 .3% ) ,其中 ,1 5例脑血流量下降者 ,1 4例(93.3% ) BAEP异常 ,比 5 0例脑血流量正常者中的 33例 (6 6 % ) BAEP异常高 (P<0 .0 5 ) ;5 0例血管病理改变明显者 ,BAEP异常 40例 (80 % ) ,比 1 5例血管病理改变轻或无改变者中的 7例 (43.3% ) BAEP异常高 (P<0 .0 5 ) ,说明BAEP与 CBF和血管病理改变密切相关     

降纤酶治疗青年人短暂性脑缺血发作的临床研究

目的 探讨降纤酶对青年人短暂性脑缺血（ＴＩＡ）发作的治疗效果。方法 将７２例患者随机分为两组。治疗组３７例,给予降纤酶静滴至ＴＩＡ发作终止或治疗达１周;对照组３５例,给予阿司匹林、尼莫地平、低分子右旋糖酐、脉络宁治疗２周。两组于治疗前、后分别采静脉血检测血浆纤维蛋白原、红细胞压积、全血粘度和血浆粘度的变化。结果 总有效率治疗组为９１．６６％,对照组为７７．１４％,２组间有显著性差异（Ｐ〈０．０１）     

Intravenous glycerol therapy should not be used in patients with unrecognized fructose-1,6-bisphosphatase deficiency

BACKGROUND: In Asian countries, glycerol solution that contains fructose (5%) is often used for management of brain edema. However, glycerol and fructose may cause severe hypoglycemia and metabolic acidosis in patients with fructose-1,6-bisphosphatase (FBPase) deficiency, even under stable conditions. The aim of the present study was to determine whether glycerol solution was used for brain edema during acute metabolic decompensation of hypoglycemia and metabolic acidosis in patients with unrecognized FBPase deficiency in Japan and to examine a long-term prognosis of the patients who had this kind of severe metabolic decompensation with or without glycerol therapy. METHODS: A retrospective study of 20 children with FBPase deficiency was conducted, based on their medical records. RESULTS: Six of the 20 children were given glycerol solution for the presence or possibility of brain edema during acute metabolic decompensation of hypoglycemia and metabolic acidosis; two of the six patients administered with glycerol were given dialysis. In four patients treated with glycerol alone without dialysis, two had no brain edema before glycerol administration but it developed later after the administration. These four patients treated with glycerol alone died or developed severe neurological complications. Fourteen patients who were not treated with glycerol solution had no brain edema and showed good prognosis. CONCLUSIONS: Glycerol solution, which contains fructose in Asian countries including Japan, should not be used as an osmotic agent for treatment of brain edema in patients who have hypoglycemia and retention-type metabolic acidosis, until FBPase deficiency is ruled out by measuring blood concentration of lactate.     

药物性生理失调的后果-畅销镇痛药罗非昔布另解

Selective cyclo-oxygenase-2(COX-2) inhibitor, VI-OXX(rofecoxib), was voluntarily withdrawn worldwide from drugstores by its maker Merck & Co., Inc. on Sep-tember 30, 2004, for its potential lethal side effects of heart attack or stroke.     

长春西汀注射液对实验性短暂脑缺血样发作磷脂水平的影响

目的 :研究长春西汀注射液对实验性短暂性脑缺血发作 (TIA)磷脂水平的影响。方法 :尾静脉注射过氧化物建立小鼠TIA模型 ,腹腔注射不同剂量的长春西汀 ,诱发 2次TIA后隔日断头取血测定血浆中溶血磷脂酸 (LPA)和酸性磷脂 (PA)的含量。结果 :实验对照组的评分为 7.0 90± 0 .6 96 ,给予0 .7mg·kg-1·d-1长春西汀后 ,评分为 3.5 76± 0 .5 6 9(P <0 .0 5 )。TIA组小鼠血浆中LPA比对照组明显升高 ,两组分别为 6 .30 5± 0 .190和 2 .170±0 .12 3μmol·L-1。长春西汀可逆转这一变化 ,为4 .5 2 3± 0 .4 0 6 μmol·L-1。TIA组小鼠血中PA比对照组明显升高 ,两组分别为 9.10 0± 0 .185和 3.80 1± 0 .2 5 7U ,而长春西汀组中PA可降至 6 .972±0 .2 4 7U。结论 :实验性TIA样小鼠出现血浆LPA和PA水平的异常。长春西汀有逆转作用 ,可用于缺血性脑血管病的治疗。     

短暂性脑缺血发作对后继脑梗死影响的研究

目的:评价短暂性脑缺血发作(T IA)对后继脑梗死是否有保护作用。方法:选择2000~2005年我院老年神经病科及神经内科既往有同侧T IA的脑梗死患者98例,并对有同侧T IA的脑梗死患者根据T IA发作持续时间分为<10m in(26例)、10~20m in(38例)及>20m in(34例),并选择同期住院无T IA的脑梗死患者102例进行病例对照观察。在入院及病程一月时采用改良的爱丁堡-斯堪的那维亚卒中量表进行神经功能缺损评分,病程一月时进行预后评分。结果:两组患者年龄及其他危险因素包括高血压病、糖尿病、高脂血症及冠心病无差异(P>0.05);入院及病程一月时,无T IA的脑梗死患者其神经功能缺损评分及近期预后与T IA持续时间在10~20m in的脑梗死患者有显著性差异(P<0.05),但与T IA持续时间<10m in及>20m in的脑梗死患者无差异(P>0.05),且T IA持续时间在10~20m in之间与<10m in、>20m in比较有显著性差异(P<0.05)。结论:T IA对后继脑梗死有保护作用。     

神昌滴丸对脑神经元凋亡的影响

目的:观察神昌滴丸(石菖蒲、冰片等)对脑神经元凋亡的影响和对脑的保护作用.方法:大鼠造成不完全性脑缺血再灌注损伤模型,ig给予神昌滴丸后,测定脑皮质神经元凋亡积分、脑皮质病理组织评分、血脑屏障通透性.结果:神昌滴丸能减轻脑缺血大鼠脑神经元凋亡,降低病理组织学评分.结论:神昌滴丸能抑制脑神经元凋亡,减轻脑水肿及其所致脑神经元坏死程度,对脑组织有一定的保护作用.