目的:探讨表皮生长因子受体(EGFR)抑制剂PD168393对体外氧糖剥夺/复氧(OGD/R)诱导的血脊髓屏障(BSCB)损伤的保护作用及其可能的机制.方法:体外培养大鼠来源的脊髓微血管内皮细胞和混合胶质细胞,应用transwell培养体系建立体外BSCB模型;将培养的细胞分为3组:对照组(正常培养)、损伤组(OGD/R处理)和治疗组(OGD/R后给予10 nM PD168393干预).损伤组和治疗组复氧3 h、6 h和12 h后,应用荧光素渗漏实验及内皮细胞跨膜电阻值(TEER)测定来评估各组BSCB通透性变化;应用免疫荧光、Western Blot技术检测各组内皮细胞间紧密连接蛋白ZO-1、Occludin表达的差异;应用ELISA法检测各组细胞分泌致炎因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和诱导型一氧化氮合酶(iNOS)的差异.结果:损伤组在各个时间点的荧光素渗漏量均高于对照组(均P<0.05),而治疗组荧光素渗漏量均低于损伤组(均P<0.05);损伤组TEER值显著低于对照组(均P<0.01),而治疗组TEER值显著高于损伤组(均P<0.05);损伤组紧密连接蛋白ZO-1和Occludin的表达量低于对照组(均P<0.05),而治疗组ZO-1和Oc-cludin的表达量较损伤组显著提高(均P<0.05);损伤组分泌的致炎因子IL-6、iNOS、TNF-α均显著高于对照组,治疗组在各时间点致炎因子IL-6、iNOS、TNF-α的分泌均低于损伤组(均P<0.05).结论:EGFR抑制剂PD168393有助于维持OGD/R损伤后BSCB的完整性;其机制可能与抑制致炎因子的表达及减少BSCB紧密连接蛋白的破坏有关.

目的 明确表皮生长因子(epidermal growth factor receptor,EGFR)抑制剂奥希替尼治疗脊髓损伤(spinal cord injury,SCI)的最佳时机.方法 将60只大鼠随机分为6组(每组10只):损伤对照组(injury组)和5个奥希替尼治疗组:0天组(0d组)、1天组(1d组)、3天组(3d组)、5天组(5d组)、7天组(7d组).建立大鼠脊髓损伤模型后,奥希替尼治疗组分别于术后即刻、术后1d、3d、5d、7d给予奥希替尼进行干预,损伤对照组使用溶剂(生理盐水)作为对照.应用BBB评分量表于术后1d及术后每周评估各组大鼠行为学的改变,每天记录各组残余尿量;术后14 d,各组随机选择5只大鼠处死,取脊髓组织,应用Western blot技术检测GAP-43的表达.结果 (1)0d组、1d组和3d组大鼠的后肢运动功能评分(BBB评分)明显优于5d组、7d组和injury组(P＜0.05),0d组、1d组和3d组无明显差异(P＞0.05);(2)0 d组、1d组和3d组大鼠残余尿量明显少于其他各组(均P＜0.05),0d组、1d组和3d组无明显差异(P＞0.05);(3)大鼠脊髓损伤后14d,0d组、1d组和3d组的GAP-43表达量明显高于其他各组(分别P ＜0.05,P＜0.01),0d组、1d组和3d组无明显差异(P＞0.05).结论 EGFR抑制剂奥希替尼治疗大鼠脊髓损伤的最佳时机是脊髓损伤后0h～72 h.

目的 研究表皮生长因子受体(EGFR)抑制剂奥希替尼对大鼠脊髓损伤(SCI)后血脊髓屏障通透性的影响.方法 60只8周龄雌性SD大鼠(200～250 g)按照随机数字表法分为假手术组(n=20)和SCI模型组(n=40),采用随机数字表法将40只SCI模型大鼠分为损伤组和奥希替尼组,每组20只.奥希替尼组给予浓度为0.4 mg/mL奥希替尼溶液灌胃(2 mL/d),假手术组和损伤组给予生理盐水灌胃(2 mL/d),三组均干预3 d.SCI后3 d测定脊髓组织含水量,Western blot技术检测水通道蛋白-4(AQP-4)表达量,采用伊文思蓝(EB)染料渗漏实验及免疫荧光技术测定脊髓白蛋白含量评估血脊髓屏障通透性变化.采用Basso-Beattie-Bresnahan(BBB)评分评估大鼠运动功能.结果 SCI后3 d奥希替尼组脊髓含水量明显低于损伤组(P<0.05);奥希替尼组AQP-4蛋白表达量明显低于损伤组(P<0.01);奥希替尼组脊髓组织EB染料聚集较损伤组少,EB荧光强度较损伤组弱(P<0.05);奥希替尼组白蛋白免疫荧光强度较损伤组弱.奥希替尼组总体BBB评分高于损伤组(P<0.05).结论 EGFR抑制剂奥希替尼可改善SCI后血脊髓屏障的破坏并减轻脊髓继发性损伤,促进神经功能恢复.

目的 研究表皮生长因子受体(EGFR)抑制剂奥希替尼对大鼠脊髓损伤(spinal cord injury,SCI)后致炎因子、紧密连接蛋白表达及神经功能的影响.方法 将60只SD大鼠随机分为:假手术组、损伤组、奥希替尼组,建立大鼠脊髓损伤模型.造模后3、7 d采用Western blot检测各组大鼠脊髓组织紧密连接蛋白ZO-1、Occludin和致炎因子IL-1β、TNF-α、COX-2、iNOS以及p-EGFR、EGFR蛋白的表达;造模后7 d应用免疫荧光染色及Western blot技术检测各组大鼠脊髓组织GFAP、CD11b的表达;应用Luxol Fast Blue染色评估各组大鼠髄鞘脱失情况,应用BBB评分量表评估大鼠运动功能,应用膀胱残余尿量评估大鼠排尿功能.结果 ①SCI后3、7 d,奥希替尼组致炎因子IL-1β、TNF-α、COX-2、iNOS表达量明显低于损伤组(均P<0.05);②SCI后3、7 d,奥希替尼组紧密连接蛋白ZO-1、Occludin蛋白表达量明显高于损伤组(均P<0.05);③SCI后3、7 d,奥希替尼组EGFR活化较损伤组减少(均P<0.05);④SCI后7 d损伤组GFAP及CD11b表达均明显增加,而奥希替尼组两者表达均较损伤组明显减少(均P<0.05);⑤与损伤组比较,奥希替尼组脊髓组织髄鞘脱失面积明显减少(P<0.05),BBB评分明显升高(P<0.05),残余尿量明显减少(P<0.05).结论 EGFR抑制剂奥希替尼可有效抑制SCI后EGFR活化,降低脊髓组织致炎因子表达,减少紧密连接蛋白缺失,抑制胶质细胞活化,缓解髄鞘脱失,促进神经功能恢复.

By means of brain connectomics, structural patterns of the brain nerve cells can be abstracted into a highly complex network, and epilepsy is one of the most common disorders of brain network. Although focal epilepsy (FE) is once thought to be a focal brain disease, current researches have confirmed that extensive changes exist in the FE brain network. With the development of brain connectomics in the field of epilepsy, the brain network characteristics of FE are gradually characterized. In this paper, the recent advance in human brain connectomics of FE is reviewed to summarize the characteristics of FE brain network.

OBJECTIVES:To evaluate whether inferior vena cava compression (IVCC) can be an alternative for valsalva maneuver (VM) in contrast-enhanced transcranial doppler (c-TCD).METHODS:Patients diagnosed with ischemic stroke, transient ischemic attack, and migraine were enrolled in this study. C-TCD was conducted at resting state, after VM and IVCC to detect right to left shunt (RLS). Then, the RLS was compared to examine whether IVCC could be an alternative for VM in c-TCD.RESULTS:A total of 246 patients were enrolled in this study. Via Wilcoxon signed-rank test of paired data, the detection for RLS of c-TCD conducted after IVCC was superior to at resting state, but inferior to after VM (P ＜ .001, P = .01, respectively); the detection for RLS of c-TCD conducted after IVCC was inferior to after VM for patients with good cooperation of VM, but was superior for patients with poor cooperation of VM (P ＜ .001, P ＜ .001, respectively); the detection for RLS of c-TCD conducted after IVCC and after VM showed no significant difference for patients with good cooperation of VM and without abdominal obesity, or with poor cooperation of VM and with abdominal obesity (P = .201, P = .157, respectively); the detection for RLS of c-TCD conducted after IVCC was superior to at resting state for patients with abdominal obesity (P ＜ .001).CONCLUSIONS:For patients with poor cooperation of VM, IVCC could be used as an effective supplement to increase the detection of RLS in c-TCD.

目的：探讨护理干预对慢阻肺再入院率及肺功能的影响。方法在我院住院治疗的126例AE-COPD患者出院后，随机分为观察组52例，对照组74例。观察组实施护理干预，每月随访，内容包括吸入制剂药物、无创辅助通气治疗、家庭氧疗、举办医患交流会，对照组则不进行任何干预。结果出院1年后统计两组再入院率，观察组5.7%vs对照组20.2%， P=0.03；FEV1 pre%观察组(47.95±10.54) vs对照组(39.01±6.76)， P=0.03；FVC%pre、FEV1/FVC%pre两组无统计学差异。结论护理随访干预能降低慢阻肺再入院率，改善肺功能。

[目的]探讨预见性护理在预防脑出血病人中的疗效观察。[方法]将2012年2月—2014年5月在本院确诊为脑出血病人98例,随机分为对照组和观察组,每组各49例,对照组采用常规护理,观察组在常规护理的基础上实施预见性护理干预措施,观察两组病人并发症(口腔感染、肺部感染、泌尿系感染、压疮)的发生情况以及住院时间。[结果]观察组49例病人中并发症的发生率为6.0%,对照组为42.9%；观察组并发症发生率明显低于对照组(P <0.05)；对照组住院时间为38.91 d±6.42 d,观察组住院时间20.56 d±5.87 d,观察组住院时间明显短于对照组(P <0.05)。[结论]脑出血并发症对脑出血的护理效果有较大影响,采用预见性护理能降低脑出血并发症的发生率,提高护理效果,缩短住院时间。

目的探讨规范化护理管理对脑血管意外患者的应用价值。方法将我院134例脑血管意外患者随机分为两组各67例，实验组在规范化管理模式下实施精细护理，对照组实施常规护理，比较两组患者护理效果。结果实验组健康教育知晓率、依从性明显高于对照组，平均住院时间和并发症发生率低于对照组，差异均有统计学意义(P<0.05)。结论对脑血管意外患者实施规范化护理管理，能有效提高护理质量，提高患者满意度，临床意义显著。

Objective:To explore the function of nursing intervention on improving the sleep quality of elderly stroke patients, comparing the effect of routine care and nursing intervention on the sleep quality of elderly stroke patients. Methods:197 cases of elderly stroke patients diagnosed and treated in hospital were randomly divided into control and experimental groups; control group was received routine care, while the experimental group was given nursing intervention on the basis of routine care. Pittsburgh Sleep Quality Index Scale was used to assess the patients, sleep quality before and after the implementation of nursing intervention. The logistic regression analysis was used to judge the main factors that affects the sleep quality of elderly stroke patients. Results:Compared with the control group after routine care and the experimental group before the intervention, the difference of sleep quality, sleep latency, sleep time, sleep efficiency, sleep disorders, sleeping pills, daytime function, and total score of PSQI in experimental group after nursing intervention had statistical significance(P<0.05).The sleep quality of patients got different degrees of improvement after given different care implementation in control group and experimental group, but the experimental group was significantly better than the control group (P<0.01).Education level, environmental factors, psychological factors, psychological factors, and brain tissue damage were the risk factors of affecting the sleep quality of in patients with logistic regression analysis; Compared with the control group, the odds ratio (OR) of the risk factors in experimental group reduced. Conclusion:Nursing intervention can improve the sleep quality of elderly stroke patients.

目的探讨脑卒中患者急性治疗期的营养护理方法。方法选择急性脑卒中60例,分成实验组与对照组。实验组给予早期的静脉营养支持,结合积极的肠内营养支持,对照组采用传统的营养方法;治疗10～14d后,观察患者营养状况,测定血浆蛋白含量;治疗期间观察分析全身情况与并发症发生情况。结果实验组患者的营养状况优于对照组,血浆白蛋白含量高于对照组;并发症发生情况,实验组较对照组也明显减少。结论强化早期静脉营养支持,并结合积极的肠内营养支持方法,在急性脑卒中患者治疗中具有重要作用。

AIM: To observe the change of index of cerebral blood stream admittance in acute cerebral infarction and compare with the normal people. METHODS: Fifty patients with cerebral infarction, who were hospitalized in the Shenzhen Municipal People' s Hospital, were selected, and detected at the bilateral cerebral blood stream admittance. The features and clinical significance of various indexes were analyzed, and contrasted with 50 normal people who were in the same period of age.RESULTS: Totally 100 testees were involved in the result analysis. ①Ratio of entering volume speed: It was lower in the cerebral infarction than that in the control group (left:1.51±0.60 vs 2.33±1.02;right:1.46±0.65 vs 2.25±1.05,P < 0.001). ②Ratio of entering resistant index: It was lower in the cerebral infarction than that in the control group (left:0.64±0.13 vs 0.73±0.12;right:0.66±0.12 vs 0.76±0.12,P < 0.01,0.001). ③The percentage of the phase IV area that reflected the reflu resistance of vein and the ratio of admittance differentail loop(ADL) Ⅳ/ I+II in the cerebral infarction group were higher than that in the control group. The index of ADL Ⅳ was lower than that in the control group (P < 0.01,0.001). ④The defect etching score on centric branch at the I phase of cerebral infarction focus was higher than that in the control group (P < 0.001=. CONCLUSION: ①Cerebral blood stream admittance plethysmogram in acute cerebral infarction patients shows that remarkably characterized changes; the ratio of entering volume speed and the ratio of entering resistant index decrease significantly; the percentage of the phase Ⅰ+Ⅱ area of lateral cerebral admittance at the injured side decreases obviously; the ratio of the ADL Ⅳ/Ⅰ+Ⅱ increases, and the score on centric branch incisure increases markedly. ②This detection can provide objective index for assessing the cerebral vessels and the states of cerebral blood supply in acute cerebral infarction patients.

目的:了解头晕头痛病人的焦虑抑郁状况及其与性别、年龄、文化程度的关系.方法:采用焦虑自评量表和抑郁自评量表,对614例头晕头痛病人进行测评和调查;同时记录下病人的性别、年龄、文化程度.结果:头晕头痛病人的焦虑和抑郁评分均明显高于全国常模(P＜0.01);焦虑与抑郁存在正相关性;女性头晕头痛病人有焦虑和/或抑郁的概率高于男性病人(P＜0.01);年龄小于40岁的头晕头痛病人有焦虑和/或抑郁的概率高于年龄大于40岁的头晕头痛病人(P＜0.01).结论:头晕头痛病人存在明显焦虑抑郁的心理问题,特别是女性或年龄小于40岁的病人.为了促进其康复,临床上要重视对其心理干预.