INTRODUCTION:The aim of the study was to investigate the relationship between serum serotonin (5-HT) and central nervous system specific protein S100b application value in evaluating the severity of cognitive impairment after traumatic brain injury (TBI).MATERIAL AND METHODS:102 patients with TBI treated in Jilin Neuropsychiatric Hospital from June 2018 to October 2020 were selected. According to Montreal Cognitive Assessment (MoCA) scale, patients were tested for cognitive function from multiple levels, such as attention, executive function, memory, and language. Patients with cognitive impairment were included into study group ( n = 64), and those without cognitive impairment were assigned to control group ( n = 58). Serum 5-HT and S100b were compared between the two groups with b level. Serum 5-HT and S100b were analyzed by receiver operating characteristic curve (ROC), b application value judging cognitive impairment.RESULTS:Serum 5-HT and S100b levels in the study group were significantly higher than those in the control group ( p < 0.05). In serum 5-HT and S100b, there was a significant negative correlation with a MoCA score ( r = -0.527, r = -0.436; p < 0.05, p < 0.05). Combined detection of serum 5-HT and S100b's area under ROC curve (AUC) was 0.810 (95% CI: 0.742-0.936, p < 0.05), sensitivity was 0.842, and specificity was 0.813.CONCLUSIONS:Serum 5-HT and S100b levels are closely related to the cognitive function of TBI patients. Combined detection is helpful to improve the accuracy of predicting cognitive impairment.

目的 分析并点评抗精神病药物的应用情况以及医保控费情况.方法 随机选取2021年1月至12月吉林省神经精神病医院门诊的2 100张抗精神病药物处方,根据处方点评管理规范对其进行适宜性点评,并分析抗精神病药物的使用情况、用药频度(DDDs)、药品使用金额等指标及医保控费情况.结果 对2 100张处方进行点评,其中不合格处方占4.29％,未发现无适应证用药和超说明书等违规用药情况.该年度应用抗精神病药物共计14种(不考虑剂型),抗精神病药物用药频度(DDDs)前三名分别是奥氮平片、利培酮片、富马酸喹硫平片,用药金额前三名是利培酮片、富马酸喹硫平片、奥氮平片;全年人均用药消费金额为218.76(63.41,745.08)元,人均医保费用为152.0元;与上一年相比,医保费用下降11.63％.结论 通过对抗精神病药物进行处方点评,为规范临床医师处方开具、提升用药合理性提供了可靠的临床依据,同时该研究体现了药师的专业价值,减轻了医保部门的压力,具有保障医保基金安全和合理的价值.

目的 探讨鞘内注射甲泼尼龙对急性期多发性硬化患者神经功能和免疫功能的影响.方法 选取2019 年 1 月至 2022 年 1 月于吉林省神经精神病医院治疗的多发性硬化患者,选取实施甲泼尼龙静脉滴注治疗的患者 30 例作为对照组,选取实施甲泼尼龙鞘内注射治疗的患者 30 例作为观察组,比较两组治疗效果.结果 治疗后观察组总有效率高于对照组,差异有统计学意义(P<0.05).治疗前两组的神经功能状况评估量表(EDSS)评分比较,差异无统计学意义(P>0.05),观察组治疗后EDSS评分低于对照组,差异有统计学意义(P<0.05).观察组生活质量评分高于对照组,差异有统计学意义(P<0.05).观察组住院时间与住院费用低于对照组,差异有统计学意义(P<0.05).观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05).治疗前,两组CD4+、CD8+表达水平比较,差异无统计学意义(P>0.05),治疗后,观察组CD4+、CD8+表达水平高于对照组,差异有统计学意义(P<0.05).结论 针对多发性硬化患者,临床进行甲泼尼龙鞘内注射治疗效果较好,可推广应用.

目的 探讨血浆同型半胱氨酸与急性缺血性脑卒中的相关性.方法 选取我院2018年2月至2021年2月期间急性脑梗死住院患者98例设为治疗组,非急性脑梗死住院患者98例设为对照组.两组患者分别予以常规治疗后,另予以急性脑梗死患者维生素B6、维生素B12、叶酸口服治疗4周,再次测定两组患者血浆同型半胱氨酸水平,分析B族维生素、叶酸的应用是否对高同型半胱氨酸血症产生影响,进一步分析其对脑梗死患者的疗效.结果 急性脑梗死患者应用维生素B6、维生素B12、叶酸口服治疗4周后检测其血浆同型半胱氨酸水平,通过对对照组和治疗组各98例进行数据统计,治疗组治疗前后同型半胱氨酸降低具有统计学意义(P<0.05).结论 通过探讨维生素B6、维生素B12、叶酸及血浆同型半胱氨酸与缺血性脑卒中之间是否存在联系,为缺血性脑卒中的预防和治疗提供参考数据.通过对脑梗死患者治疗,维生素B6、维生素B12、叶酸口服,血浆同型半胱氨酸水平明显降低,证实维生素B6、维生素B12、叶酸对高血浆同型半胱氨酸血症治疗有效,从而评价脑梗死的预后.

目的 分析吉林省神经精神病医院药物临床试验的质量控制管理.方法 采用回顾性分析方法,对吉林省神经精神病医院药物临床试验机构2017年5月至2022年2月结题的9项临床试验项目进行质控,并对发现的问题进行分析.机构质控员对结题9项药物临床试验、156例筛选病例进行了39次质控.临床试验质控工作主要从以下方面进行:包括入选标准和排除标准、知情同意书的签署、病例报告表记录是否完整、实验室检查是否真实、可溯源、严重不良事件上报流程是否规范、受试者管理、试验用药品管理和记录是否真实、规范,对在质控中发现的问题进行分析汇总.结果 病例报告表记录是否完整占比12.18％,入选标准和排除标准占比4.49％,知情同意书的签署占比3.85％,受试者管理占比3.21％,试验用药品管理和记录是否真实、规范占比0.64％.根据PDCA循环方法,找出影响药物临床试验质量可能原因及解决办法.结论 通过对临床试验项目运行的各个环节进行监督、检查,临床试验机构将加强培训,加强临床试验质量管理等多种措施以提高临床试验的质量.

目的 应用品管圈方法提高中药注射剂合理使用率,促进医院合理用药工作开展.方法 收集吉林省神经精神病医院神经内科2016年12月至2017年1月使用中药注射剂病历,并对存在的问题进行汇总统计,根据品管圈活动的十大步骤逐一进行活动.结果 通过品管圈活动,中药注射剂合理使用率由63.91％提高到86.24％,目标达标率为106.79％;进步率为34.94％.根据工作情况,梳理现有的工作流程,完善相关制度,制订相应的措施,以期更好地提高中药注射剂合理使用,使患者用药达到安全、有效、经济.结论 开展品管圈活动提高了中药注射剂的合理使用率,提高了圈员们解决问题的能力,提升了药学服务质量.提高医院中药注射剂的合理使用,规避不安全性事件,减少医疗纠纷及医疗事故,充分发挥药师的作用.促进医院合理用药工作的开展,确保患者用药安全、有效、经济,完善临床合理用药相关制度,形成一体化的医药护团队,带动医疗质量持续改善.医院品管圈活动的开展提升了医疗质量,促进了管理理念的改变,是保障医疗质量的有效手段.

目的 研究注射用丹参多酚酸治疗急性脑梗死的临床疗效.方法 随机抽取吉林省神经精神病医院2017年3月-2018年7月入院的60例急性脑梗死患者为研究对象,按住院先后顺序编号,以随机选取分组法分为对照组与观察组,每组各30例.对照组采取常规抗血小板聚集、改善微循环等治疗方案,观察组在此基础上加用注射用丹参多酚酸治疗,两组疗程均为2周,比较治疗前后2组美国国立卫生研究院卒中量表(NIHSS)评分、日常生活能力(ADL)评分及蒙特利尔认知评估量表(MoCA)评分,评估治疗效果,统计不良反应.结果 治疗2周后,对照组总有效率为66.7％,观察组总有效率为80.0％,经对比差异有统计学意义(P＜0.05).治疗后两组NIHSS评分明显降低,ADL评分及MoCA评分均明显升高,同组治疗前后比较差异有统计学意义(P＜0.05);且治疗后观察组NIHSS评分明显低于对照组,ADL评分及MoCA评分均明显高于对照组,差异有统计学意义(P＜0.05).治疗期间2组均未见不良反应发生.结论 注射用丹参多酚酸对急性脑梗死的治疗安全、有效,在临床中值得推广.

目的 探讨血栓弹力图对急性缺血性脑卒中患者复发缺血的预测价值.方法 以160例急性缺血性脑卒中患者为研究对象,于初入院时、服药2w进行传统凝血检验及新型多通道血栓弹力图仪检测,出院后随访6个月,记录复发性缺血事件发生率,将其分为实验组(复发缺血事件)和对照组(无复发缺血事件),回顾性比较两组临床资料,并采用Logistic回归分析复发缺血的预测因素.结果 初入院时,两组凝血功能及血栓弹力图指标无明显差异(P>0.05);服药2 w后,对照组两种指标改善情况优于实验组(P<0.05).经Logistic回归分析,血栓弹力图可作为急性缺血性脑卒中患者复发缺血的预测因素.结论 血栓弹力图在预测急性缺血性脑卒中患者复发缺血中具有较高的临床价值.

目的 研究急性脑梗死患者口服阿托伐他汀钙对血清超敏C-反应蛋白(Hs-CRP)浓度变化和血脂的影响.方法 选择神经内科住院病房收治的116例急性脑梗死患者,均符合我国第四届脑血管病会议诊断标准,按入院先后顺序随机分成两组,各58例,对照组常规给予阿司匹林肠溶片抑制血小板聚集,改善循环类药物,治疗组在常规治疗的基础上加用阿托伐他汀钙片20 mg/d.4周后采静脉血测定血清Hs-CRP浓度和LDH-C水平.结果 与对照组相比治疗组hs-CRP及LDH-C浓度显著降低,差异有统计学意义(P<0.01).结论 阿托伐他汀可控制急性期炎性反应、降血脂、改善动脉粥样硬化,起到固化动脉粥样硬化斑块、治疗脑梗死的作用.

Objective To investigate the utilization of antibiotics for patients undergoing craniocerebral operations in a hospital and analyze the status quo of the use of antibiotics to promote a scientific and rational use of antibiotics. Methods 208 of cases of the type I incision operations in 2013 were investigated,meanwhile,the applications of antibacterial agents used in prevention including drug selection,curative opportunity,and treatment course were reviewed and analyzed. Results According to the selected 208 of cases,7 of antibacterial agents in our hospital were chosen to prevent infections in craniocerebral cleaning operation.The qualified rate was 70.53%,usage rate was 99.52%,and the average administration time was 3.28 days. Conclusion By analyzing the data, it is clearly shown that there exist abuse and inappropriate use of antibacterial agents in the type I incision operations in our hospital,which should be weighed by authority.

Objective To investigate the role of Survivin-siRNA recombinant plasmid on SH-SY5Y of human neurob-lastoma cell. Methods RNA interference (RNAi) technology was used to construct Survivin siRNA recombinant plasmid taking pGCsi/U6 plasmid as a carrier,and SH-SY5Y cell was transfected in v itro,the growth of the cell was measured by MTT method. Results The recombinant plasmid Survivin-siRNA was significantly inhibited the growth after trans-fecting SH-SY5Y cell. Conclusion It can significantly reduce the expression of Survivin gene of SH-SY5Y cell in hu-man neuroblastoma by silencing Survivin gene using RNAi technology to inhibit cell growth to promote apoptosis,and it incidates that Survivin gene play an important role in the occurrence and development in human neuroblastoma and it is involved in signal transduction and it will become a new target of gene therapy.

线粒体基因组也叫线粒体DNA(mtDNA,Mitochondrial DNA),结构与细菌DNA相似,呈双链环状,可独立编码一些蛋白质,是核外遗传物质,人们在线粒体中已发现RNA、DNA聚合酶、RNA聚合酶、tRNA、核糖体等全套装备,说明线粒体具有独立的遗传体系.

神经母细胞瘤是儿童常见的实质性肿瘤,主要起源于肾上腺,目前传统治疗方法效果不明显。Survivin是一种凋亡抑制蛋白,与肿瘤细胞的增殖及凋亡有关,其可能为肿瘤的基因治疗提供新方法。

现将间脑癫痫误诊为睡眠呼吸暂停综合征1例分析如下. 1 病历摘要 女,55岁.主因背痛、夜间阵发性呼吸困难10 d,于2009-03-30由循环内科转入神经内科治疗.

ObjectiveClinical features of Guillain-Barre Syndrome are analyzed.MethodGBS is analyzed from aspects of the general clinic data,lesion locations,clinical manifestations.ResultsAmong of 51 cases with GBS the first symptom is often symmetrical flaccid paralysis of limbs,and often involves the cranial nerves and the autonomic nervous.Proteins-cell separation often appears in cerebrospinal fluid.ConclusionAccording to clinical manifestations,combined with examination may improve the diagnosis rate of GBS.Immunoglobulin therapy is more effective than glucocorticoid treatment.

Objective To study the clinical features of multiple sclerosis.Methods We have retrospectively studied the cases on general clinic,lesion locations,imaging.Results Among 34 MS cases,MS mainly affected young and middle-aged women,the clinical manifestations were complex.Alleviation and recurrence happened alternately during the course.Diagnosis was difficult based on clinical manifestations only.Combination of magnetic resonance imaging,electrophysiology and cerebrospinal fluid examination contribute to the diagnosis.Glucocorticoid treatment and immunosuppressive agents were effective.Conclusion According to clinical manifestations,it combined with examination may improve the diagnosis rate of MS.

<正>大肠癌是最常见的恶性肿瘤之一,并且每年的发病人数仍呈现上升趋势。肿瘤的生长、侵袭和转移依赖于肿瘤的血管生成,肿瘤本身或宿主组织建立的新生血管网供给瘤体营养,促使肿瘤的生长、侵袭和转移。近年来,一个新的信号传导途径——血管生成素及其受体Tie-2被发现在血管生成