左旋多巴联合普拉克索对帕金森病患者应激反应的影响

目的探讨左旋多巴联合普拉克索对帕金森病患者运动功能调节及机体氧化应激反应的影响。方法选取濮阳市中医院2014-10—2016-09收治的63例帕金森病患者,随机分为对照组31例,观察组32例;对照组予以单一左旋多巴治疗,观察组予以左旋多巴联合普拉克索治疗,观察比较2组运动功能评分(UPDRSⅢ)、氧化应激反应各指标[血浆谷胱甘肽(GSH)、谷胱甘肽过氧化物酶(GSH-Px)、过氧化氢酶(CAT)、超氧化物歧化酶(SOD)]水平及不良反应发生情况。结果治疗后观察组UPDRSⅢ评分低于对照组,GSH、GSH-Px、CAT及SOD水平均高于对照组,差异具有统计学意义(P0.05);观察组不良反应发生率为21.88%(7/32),对照组为19.35%(6/31),差异无统计学意义(P0.05)。结论左旋多巴联合普拉克索治疗可改善帕金森病患者机体氧化应激反应及运动功能,安全性高。     

普拉克索对帕金森病运动障碍的影响

目的分析普拉克索对治疗帕金森病运动障碍的临床疗效。方法选择我院收治的60例帕金森病患者为研究对象,随机数字表分为对照组(30例)与观察组(30例),对照组予以左旋多巴、司来吉兰等常规治疗药,观察组在对照组治疗基础上加用盐酸普拉克索,2组患者均治疗8周,治疗后采用帕金森评定量表(UPDRS)Ⅱ、Ⅲ及总体评分量表评价运动功能,并判断疗效。结果治疗前比较,2组UPDRSⅡ、UPDRSⅢ及总评分均差异无统计学意义(P0.05);治疗后,2组各量表评分较治疗前均显著下降,且观察组下降幅度明显高于对照组,组间差异均具有统计学意义(P0.05);对照组总不良反应发生率23.3%,观察组13.3%,差异无统计学意义(P0.05)。结论普拉克索可作为治疗帕金森病患者的加强药,在左旋多巴、司来吉兰等药物基础治疗上,可显著增强其治疗疗效,缓解运动症状障碍,且具有较高的安全性,值得临床推广。     

普拉克索联合左旋多巴对晚期帕金森病患者临床症状及负性情绪的影响

目的探讨普拉克索联合左旋多巴对晚期帕金森病患者临床症状及负性情绪的影响。方法采用抽签法将我院神经内科收治的125例晚期帕金森病患者进行分组,对照组62例给予左旋多巴治疗,观察组63例给予普拉克索联合左旋多巴治疗,观察比较2组治疗后的临床症状及负性情绪的。结果观察组治疗后改善UPDRS评分优于对照组(P0.05);观察组降低HAMA及HAMD评分优于对照组(P0.05);观察组不良反应发生率为6.35%低于对照组的19.35%(P0.05)。结论普拉克索联合左旋多巴通过兴奋纹状体,恢复多巴胺,以改善晚期帕金森病患者的临床症状及负性情绪效果确切,安全性高,值得临床应用及推广。     

马来酸氟伏沙明联合普拉克索对帕金森性抑郁非运动症状的效果观察

目的观察马来酸氟伏沙明联合普拉克索对帕金森性抑郁患者非运动症状的改善效果。方法收集2016-01—06安阳地区医院收治的70例帕金森性抑郁病例,依据随机抽签法分为2组各35例,对照组给予普拉克索,观察组给予马来酸氟伏沙明联合普拉克索方案,比较2组治疗前后蒙特利尔认知量表(MoCA)评分、汉密尔顿抑郁(HAMD)评分、汉密尔顿焦虑(HAMA)评分、帕金森病综合评分(UPDRS)、肢体感觉异常率、用药不良反应状况。结果经过治疗,观察组MoCA量表中记忆、抽象与视空间评分均明显高于对照组(P0.05);观察组HAMD、HAMA评分、UPDRS量表中精神行为和情绪、日常活动及运动功能评分均明显低于对照组(P0.05);治疗期间,观察组肢体痛、不宁腿综合征、肢体痉挛以及嗅觉异常发生率均明显低于对照组(P0.05),2组不良反应总发生率比较无显著差异(P0.05)。结论马来酸氟伏沙明联合普拉克索治疗帕金森性抑郁患者,可促进神经认知功能恢复,减少抑郁焦虑情绪,显著改善帕金森病情,降低肢体感觉异常出现率,且不加重药物不良反应。     

普拉克索添加治疗帕金森病的疗效观察

目的 观察添加普拉克索治疗帕金森病(PD)的疗效和安全性.方法 78例Hoehn-Yahr分级为Ⅱ～Ⅲ级的PD患者在接受左旋多巴达到剂量稳定≥30 d的基础上随机分为3组.A组添加普拉克索0.125 ng,每日2次,4周滴定至0.75 mg/d,维持8周.B组添加普拉克索0.125 mg,每日2次,6周滴定至1.5 mg/d,维持6周.C组不添加普拉克索.治疗前后应用统一PD评定量表(UPDRS)评分并评估疗效,观察不良反应.结果 与治疗前相比,治疗12周A组、B组的UPDRSⅡ、Ⅲ评分明显下降(均P＜0.05);B组显效率(21例,80.8%)显著高于A组(12例,46.2%)(P＜0.01).3组均未发生严重不良反应.B组2例出现轻度头晕、恶心,未影响治疗.结论 应用左旋多巴治疗的PD患者添加普拉克索可以有效缓解症状,改善生活质量;添加普拉克索1.5 mg/d的疗效优于0.75 mg/d.     

多巴丝肼联合多巴胺受体激动剂治疗帕金森病的疗效观察

目的：探讨多巴丝肼联合普拉克索治疗帕金森病的临床疗效及安全性。方法60例帕金森病患者根据治疗方式分为观察组及对照组各30例。2组均采用多巴丝肼治疗,观察组加用多巴胺受体普拉克索,连续治疗12周,采用帕金森统一评分量表（UPDRS）对患者治疗效果进行评价,同时观察用药过程中的不良反应。结果观察组 UDPRS各单项评分降低明显,与对照组比较差异有统计学意义（P＜0.05）。2组不良反应差异无统计学意义（P＞0.05）。结论多巴丝肼联合普拉克索治疗帕金森病能明显改善患者的临床症状,值得临床推广。     

多巴丝肼片与盐酸普拉克索缓释片联用对帕金森病患者功能评分及非运动症状发生率的影响

目的探讨对帕金森病患者联用多巴丝肼片、盐酸普拉克索缓释片的疗效,并分析对其功能评分及非运动症状发生率的影响。方法将99例帕金森病患者按简单随机化方法分为3组,A组(n=33)给予多巴丝肼片治疗;B组(n=33)给予盐酸普拉克索缓释片;C组(n=33)给予多巴丝肼片联合盐酸普拉克索缓释片。对比临床疗效,治疗前后日常活动功能、运动功能变化,治疗期间非运动症状发生率和不良反应。结果治疗后3组改良Webster评分、UPDRS Ⅱ、Ⅲ评分对比差异显著(P0.05),均较本组治疗前显著下降(P0.05),且C组治疗后评分均明显低于A组和B组(P0.05);3组临床疗效分布和总有效率对比差异均有统计学意义(P0.05),其中C组总有效率明显高于A组和B组(P0.01);3组治疗期间精神症状、自主神经症状、感觉症状、睡眠障碍发生率对比差异均有统计学意义(P0.05),C组均明显低于A组和B组(P0.01);3组总不良反应发生率对比差异无统计学意义(P0.05)。结论对帕金森病患者采用多巴丝肼片联合盐酸普拉克索缓释片可显著减轻症状,疗效显著,还可改善其日常活动功能和运动功能,控制非运动症状发生率,作用明显优于单药治疗者,且两者联用不会显著增多不良反应,安全可靠。     

普拉克索与溴隐亭治疗帕金森病患者疗效及安全性对照研究

目的观察普拉克索与溴隐亭治疗帕金森病的临床效果及安全性。方法选择我院收治的86例帕金森病患者为研究对象,随机分为对照组和观察组,2组均给予美多芭片治疗。观察组加用普拉克索治疗,对照组加用溴隐亭治疗。比较2组的治疗效果及不良反应发生情况。结果观察组治疗后UPDRSⅡ、UPDRSⅢ、UPDRSⅣ显著优于对照组,观察组治疗后HAMD评分显著优于对照组,观察组不良反应发生率显著低于对照组。结论普拉克索联合美多芭治疗帕金森病可显著改善患者运动评分、日常生活评分,可显著改善患者抑郁状况,降低患者不良反应发生率,值得临床推广应用。     

普拉克索治疗帕金森病运动并发症的临床疗效观察

目的 评估普拉克索治疗帕金森病运动并发症的临床疗效及安全性.方法 收集92例晚期帕金森病患者并随机分为治疗组和对照组,每组46例.对照组给予多巴丝肼治疗,治疗组在对照组的基础上给予普拉克索,疗程均为12周.两组患者于治疗前后分时间点进行统一帕金森病评定量表修正(UPDRSⅣ-)的评分、不良反应的记录,疗程结束后评估疗效.结果 治疗后对照组和治疗组UPDRSⅣ-评分与基线比较均有下降,治疗组下降更显著,两组比较差异有统计学意义(P＜0.01).治疗组第12周剂末现象(93.75％vs 70.59％)、开关现象(91.67％ vs 63.64％)以及异动症(84.62％ vs48.00％)的总有效率优于对照组,差异均有统计学意义(P＜0.05).两组不良反应发生率差异无统计学意义(P＞0.05).结论 普拉克索治疗帕金森病运动并发症有效,安全性好.     

盐酸普拉克索添加治疗帕金森病的临床疗效及对视觉诱发电位P100潜伏期的影响

目的探讨盐酸普拉克索联合多巴丝肼片治疗帕金森病(PD)的临床疗效及对视觉诱发电位P100潜伏期的影响。方法选择2014年3月至2016年4月收治的PD患者60例为研究对象,将60例患者分为对照组(28例)和观察组(32例)。对照组予以多巴丝肼片治疗,观察组在多巴丝肼片基础上联合盐酸普拉克索,共治疗12周。两组患者治疗前及治疗后均采用PD评分量表第III部分(UPDRS III)进行评分,比较治疗疗效。两组患者在治疗前及治疗12周后行视觉诱发电位检查,观察P100潜伏期情况。结果观察组治疗的显效率(71.88%)和总有效率(90.63%)明显高于对照组(39.29%和64.29%),差异有统计学意义(P0.05,P0.01)。治疗12周后UPDRS评分,观察组(24.21±12.12)明显低于对照组(16.14±10.12),差异有统计学意义(P0.05)。两组患者治疗前P100潜伏期均明显延长,两组之间无显著差异(P0.05)。治疗12周后,观察组P100潜伏期较治疗前显著缩短(P0.05);对照组P100潜伏期较治疗前无变化(P0.05)。结论盐酸普拉克索联合多巴丝肼片治疗帕金森病,可显著改善患者运动症状,且可以显著缩短P100潜伏期。     

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     

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.     

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.     

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.     

Modelling of movement of the lamprey: Control of oscillators

This article discusses the control methods of the central pattern generator (CPG). First a control model of the CPG is presented using 2 oscillators, and we suggest that phasic modulation to the CPG by means of phasic information is effective for controlling the phase difference between oscillators. Next, two models for controlling the CPG of a lamprey are proposed. One model describes a control system from the brain stem, in which the reticulospinal neurons control the CPG by receiving feedback signals and sending control signals to the neck region of the CPG. The other is a model for learning an localized control system to generate a desired motor pattern. By means of these models, a role of the efference copy is suggested.     

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.     

利培酮对精神分裂症患者生活质量的影响

目的：比较利培酮与氟哌啶醇对精神分裂症患者生活质量的影响。方法：对门诊72例服用氟哌啶醇及74例服用利培酮的精神分裂症患者用生活质量综合评定问卷（GQOLI）、阳性与阴性症状量表（PANSS）、副反应量表（TESS）进行评定。结果：利培酮组患者治疗后生活质量有所提高,而氟哌啶醇组患者生活质量有所下降。结论：利培酮治疗有利于患者提高生活质量。     

《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。