舒血宁联合脑苷肌肽治疗血管性痴呆的疗效研究

目的 观察舒血宁联合脑苷肌肽治疗血管性痴呆患者的疗效及对精神行为症状的改善情况.方法 将58例血管性痴呆患者随机分为舒血宁联合脑苷肌肤治疗的观察组和单纯脑苷肌肤治疗的对照组,治疗结束后观察两组患者的临床疗效、简易智能量表(MMSE)、日常生活活动能力量表(ADL)评分以及安全性评价.结果 治疗后,观察组有效率为89.66％,优于对照组的72.41％,组间差异有统计学意义(P＜0.05).治疗后两组患者的MMSE、ADL评分均较治疗前明显增加,差异均有统计学意义(P＜0.05);而组间比较,观察组的MMSE、ADL评分均较对照组明显增加,差异亦有统计学意义(P＜0.05),且均未出现不良反应.结论 舒血宁联合脑苷肌肽治疗血管性痴呆患者,不仅疗效较佳,安全性高,而且可有效改善患者的精神行为症状.     

Effects of Wrist Weights on Kinematic and Myographic Movement Characteristics During a Reaching Task in Individuals With Parkinson Disease

Objective

To investigate the kinematic and myographic effects of weighted wrist cuffs on individuals with Parkinson disease (PD) during a reaching task.

一种改进的基于DFT-MMSE的信道估计方法

传统的DFT-LS算法在最小二乘(LS)估计的基础上对循环前缀以外的信道冲击响应置零,在性能优于最小二乘(LS)的同时,降低了估计算法的计算复杂度。理想的最小均方差(MMSE)算法与其相比,计算复杂度大,但是性能优于DFT-LS。本文在传统DFT-MMSE估计算法基础上提出了一种新的方法,针对传统DFT-MMSE算法只对循环前缀以外的信道冲击响应做置零处理的问题,对循环前缀以内的信道冲击响应设定阈值门限,有效滤除部分循环前缀以内的噪声。理论分析与仿真结果表明,本文方法的性能优于传统的DFT-MMSE估计算法,劣于理想情况下的MMSE估计算法;计算复杂度低于传统的DFT-MMSE估计算法和理想情况下的MMSE估计算法。     

Improvement of Risk Prediction After Transcatheter Aortic Valve Replacement by Combining Frailty With Conventional Risk Scores

Objectives

This study sought to evaluate whether frailty improves mortality prediction in combination with the conventional scores.

Feasibility and Exploratory Efficacy Evaluation of the Embrella Embolic Deflector System for the Prevention of Cerebral Emboli in Patients Undergoing Transcatheter Aortic Valve Replacement: The PROTAVI-C Pilot Study

ObjectivesThis study sought to determine the feasibility, safety, and exploratory efficacy of the Embrella Embolic Deflector (EED) system (Edwards Lifesciences, Irvine, California) in patients undergoing transcatheter aortic valve replacement (TAVR).BackgroundFew data exist on the value of using embolic protection devices during TAVR.MethodsThis pilot study included 52 patients who underwent transfemoral TAVR. The EED system was used in 41 patients, whereas 11 patients underwent TAVR without embolic protection (control group). Cerebral diffusion-weighted magnetic resonance imaging (DW-MRI) was performed at baseline and within 7 days and 30 days after TAVR.ResultsThe EED system was successfully deployed at the level of the aortic arch in all patients with no complications. The deployment of the EED system was associated with high-intensity transient signals (HITS) as evaluated by transcranial Doppler (median: 48 [interquartile range: 17 to 198] HITS), and a higher total number of HITS was observed in the EED group (p < 0.001 vs. control group). DW-MRI performed within 7 days after TAVR showed the presence of new ischemic lesions in all patients in both groups, with a median number of 7 (interquartile range: 3 to 13) lesions per patient. The use of the EED system was associated with a lower lesion volume compared with the control group (p = 0.003). All new cerebral lesions had disappeared on the DW-MRI performed at 30 days after TAVR. Two strokes unrelated to the EED system occurred 2 and 29 days after TAVR.ConclusionsThis study showed the feasibility and safety of using the EED system in TAVR procedures. The EED system did not prevent the occurrence of cerebral microemboli during TAVR or new transient ischemic lesions as evaluated by DW-MRI, but it was associated with a reduction in lesion volume. Further studies are warranted to determine the efficacy of using the EED system during TAVR procedures.     

丹红注射液联合多奈哌齐治疗阿尔茨海默病的临床研究

目的探讨应用丹红注射液联合多奈哌齐治疗阿尔茨海默病的临床效果。方法选取2015年6月—2017年6月中国人民解放军白求恩国际和平医院收治的阿尔茨海默病患者106例,随机分成对照组(53例)与治疗组(53例)。对照组睡前口服盐酸多奈哌齐片,5 mg/次,1次/d。治疗组在对照组基础上静脉滴注丹红注射液,40 m L加入250 m L生理盐水,1次/d。两组均连续治疗4周。评价两组患者临床疗效,同时比较治疗前后两组患者简易精神状态量表(MMSE)评分、脑血流动力学和血清学指标。结果治疗后,对照组临床有效率为77.4%,显著低于治疗组的92.5%,两组比较差异具有统计学意义(P0.05)。治疗后,两组MMSE评分较治疗前均显著增加(P0.05);且治疗组比对照组升高更显著(P0.05)。治疗后,治疗组基底动脉(BA)和双侧大脑中动脉(MCA)的平均血流速度(MFV)值均显著升高(P0.05),搏动指数(PI)值显著下降(P0.05);且治疗后治疗组BA和双侧MCA的MFV值和PI值比对照组改善更显著(P0.05)。治疗后,两组血清血清磷酸化tau蛋白(P-tau)、丙二醛(MDA)、白细胞介素(IL)-8和超敏C反应蛋白(hs-CRP)水平较治疗前均显著降低(P0.05),超氧化物歧化酶(SOD)水平均显著增加(P0.05);且治疗组上述血清学指标比对照组改善更显著(P0.05)。结论应用丹红注射液联合多奈哌齐治疗阿尔茨海默病可有效改善患者脑血流状态,减轻机体氧化应激与炎症损伤,提高认知功能,延缓病情进展。     

复方苁蓉益智胶囊联合卡巴拉汀治疗阿尔茨海默病的临床研究

目的探讨复方苁蓉益智胶囊联合重酒石酸卡巴拉汀胶囊治疗阿尔茨海默病的临床疗效。方法选取2014年1月—2017年1月在文昌市人民医院治疗的阿尔茨海默病患者98例为研究对象,将入组患者随机分为对照组(49例)和治疗组(49例)。对照组口服重酒石酸卡巴拉汀胶囊,起始剂量为1.5 mg/次,2次/d,连用4周后若对该剂量耐受良好,增至3.0mg/次,2次/d,继续连用4周后对该剂量耐受良好,可增至6.0 mg/次,2次/d。治疗组在对照组治疗的基础上口服复方苁蓉益智胶囊,1.2 g/次,3次/d。两组均持续治疗6个月。观察两组患者的临床疗效,比较治疗前后两组患者简易智力状态检查量表(MMSE)评分、阿尔兹海默病评定量表–认知(ADAS-Cog)评分、阿尔茨海默病行为病理评定量表(BEHAVE-AD)评分、日常生活能力量表(ADL)评分和血清学指标。结果治疗后,对照组和治疗组临床总有效率分别为81.63%和95.92%,两组比较差异有统计学意义(P0.05)。治疗后,两组MMSE评分、ADL评分均明显升高,ADAS-Cog评分、BEHAVE-AD评分均明显降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗后治疗组相关评分显著优于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清IL-6、Aβ、IL-1β、BK水平均显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗后治疗组血清学指标水平显著低于对照组,两组比较差异具有统计学意义(P0.05)。结论复方苁蓉益智胶囊联合重酒石酸卡巴拉汀胶囊治疗阿尔茨海默病具有较好的临床疗效,可有效提高患者认知功能和日常生活能力,降低炎性因子水平,具有一定临床推广应用价值。     

Elman neural network for the early identification of cognitive impairment in Alzheimer’s disease

Early detection of dementia can be useful to delay progression of the disease and to raise awareness of the condition. Alterations in temporal and spatial EEG markers have been found in patients with Alzheimer’s disease (AD) and mild cognitive impairment (MCI). Herein, we propose an automatic recognition method of cognitive impairment evaluation based on EEG analysis using an artificial neural network (ANN) combined with a genetic algorithm (GA). The EEGs of 43 AD and MCI patients (aged between 62 and 88 years) were recorded, analyzed and correlated with their MMSE scores. Quantitative EEGs were calculated using discrete wavelet transform. The data obtained were analyzed by the means of the combined use of ANN and GA to determine the degree of cognitive impairment. The good recognition rate of ANN fed with these inputs suggests that the combined GA/ANN approach may be useful for early detection of AD and could be a valuable tool to support physicians in clinical practice.     

灯盏生脉胶囊联合奥拉西坦治疗轻中度血管性痴呆的疗效观察

目的 探讨灯盏生脉胶囊联合奥拉西坦注射液治疗轻中度血管性痴呆的疗效。方法 选取濮阳市人民医院2012年1月—2015年3月收治的轻中度血管性痴呆患者90例,采用随机数字表法分为治疗组(45例)和对照组(45例)。所有患者均给予常规降血脂、抗血小板聚集治疗,对照组给予静脉滴注奥拉西坦注射液4 g,加入到0.9%生理盐水500 mL,1次/d。治疗组在对照组基础上口服灯盏生脉胶囊,2粒/次,1次/d。两组均连续治疗12周。治疗前后采用简易智能精神状态量表(MMSE)和蒙特利尔认知评估量表(MoCA)评价患者认知功能;采用日常生活能力量表(ADL)评价患者日常生活自理能力;比较两组患者血管内中膜厚度(IMT)。结果 治疗后2、4、12周,两组MMSE、MoCA评分均显著上升(P< 0.05),且治疗组MMSE、MoCA评分显著高于对照组(P< 0.05);治疗后2、4、12周,两组ADL评分均显著升高(P< 0.05),且治疗组ADL评分显著高于对照组(P< 0.05)。治疗后两组IMT均显著降低(P< 0.05),且治疗组IMT显著低于对照组(P< 0.05)。结论 灯盏生脉胶囊联合奥拉西坦注射液治疗轻中度血管性痴呆疗效确切,可显著改善患者的认知功能和日常生活行为,具有一定的临床推广应用价值。