目的 探究正天丸(Zhengtian pills,ZTP)对硝酸甘油诱导的偏头痛大鼠痛觉过敏和畏光的缓解作用及其机制.方法 大鼠随机分成对照组、偏头痛模型组和ZTP治疗组,每组15只.用von Frey测痛仪检测大鼠机械痛阈值,评估机械痛觉敏感性;用热水浴法检测大鼠撤尾潜伏期,评估热痛觉敏感性;用黑白箱实验检测观察大鼠的畏光行为;用HE染色观察三叉神经节中的卫星胶质细胞;用免疫荧光染色观察三叉神经节中CGRP和c-Fos的表达.结果 偏头痛模型组大鼠机械痛阈值降低,热痛觉阈值降低,表现出明显的痛觉过敏;ZTP可缓解偏头痛大鼠的痛觉过敏现象.黑白箱实验结果显示,偏头痛模型组大鼠待在白箱中的时间明显降低,表现出畏光行为;ZTP可改善偏头痛大鼠的畏光行为.HE染色显示,偏头痛模型组大鼠的三叉神经节中卫星细胞明显增多;ZTP可降低偏头痛大鼠三叉神经节中卫星细胞数.免疫荧光染色表明,偏头痛模型组大鼠三叉神经节中CGRP和c-Fos表达均增加;ZTP可降低偏头痛大鼠CGRP和c-Fos的表达.结论 ZTP能缓解硝酸甘油诱导的偏头痛大鼠的痛觉过敏和畏光行为,且这种作用可能与降低中枢敏化相关.

目的:探讨阿托伐他汀联合多奈哌齐对阿尔茨海默病患者精神行为、痴呆程度的改善效果及安全性.方法:抽取2018年7月～2020年3月本院收治的182例阿尔茨海默病患者为研究对象,采用随机数字表法分为对照组和研究组,每组91例.对照组在常规治疗基础上给予多奈哌齐治疗,研究组在对照组基础上加用阿托伐他汀片治疗,治疗周期6个月.采用日常生活活动量表(ADL)、简易精神状态检查量表(MMSE)、Blessed痴呆量表(BDS)评价治疗前后两组患者生活质量及认知功能改善情况,比较治疗前后两组患者血清学指标变化情况,采用治疗伴发症状量表(TESS)评价联合用药安全性.结果:治疗前,两组患者ADL、MMSE、BDS评分及总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等血清指标无统计学差异(P>0.05);治疗后,研究组ADL、MMSE、BDS评分及TC、TG、HDL-C、LDL-C等血清学指标改善优于对照组,具有统计学差异(P<0.05).两组TESS量表各项评分无统计学差异(P>0.05).结论:阿托伐他汀与多奈哌齐联合用药可有效改善阿尔茨海默病患者精神行为、痴呆程度、认知能力及血清学指标,提升日常生活能力,且不增加药品不良反应,临床疗效及安全性较好.

目的:观察正天丸联合西药治疗偏头痛瘀阻脑络证的临床疗效及对血管源性活性介质的调节作用.方法 :将100例符合要求的患者按随机数字表法分成对照组和观察组各50例.2组患者在发作期均予对乙酰氨基酚片治疗,疼痛不能控制者加用佐米曲普坦片,症状缓解后停用;缓解期口服盐酸氟桂利嗪胶囊,连续治疗8周.观察组加服正天丸,连续治疗8周.记录治疗前后的头痛发作次数,评价头痛程度评分、头痛持续时间评分及偏头痛特异性生活质量量表(MSQ)评分,治疗前后检测一氧化氮(NO)、内皮素1(ET-1)、降钙素基因相关肽(CGRP)及6-酮-前列腺素Flα(6-keto-PGF1α)等血管源性活性因子.比较2组的临床疗效.结果 :治疗后,观察组临床疗效优于对照组(P<0.05).2组头痛发作次数、头痛程度评分及持续时间评分与治疗前比较均减少或降低(P<0.01);观察组头痛发作次数少于对照组(P<0.01),头痛程度评分及持续时间评分均低于对照组(P<0.01).2组MSQ的角色限制维度(RR)、角色妨碍维度(RP)及情感功能维度(EF)评分与治疗前比较均较治疗前升高(P<0.01),观察组3项维度的评分均高于对照组(P<0.01).2组NO水平均较治疗前升高(P<0.01),6-keto-PGF1α、CGRP、ET-1水平均较治疗前降低(P<0.01);观察组NO水平高于对照组(P<0.01),6-keto-PGF1α、CGRP、ET-1水平均低于对照组(P<0.01).结论 :正天丸配合常规西药治疗,可显著改善偏头痛的发作情况,提高患者的生活质量,其可能通过调节血管活性介质,纠正患者的血管舒缩功能失调状态,从而发挥治疗作用.

Objective:To investigate the efficacy of alteplase combined with salvianolic acids on acute cerebral infarction.Methods:A total of 100 patients with acute cerebral infarction treated in Nanyang Central Hospital from March 2017 to March 2020 were selected as research objects. And they were divided into control group and study group by random number table method, with 50 cases in each group. All patients were given conventional symptomatic treatment. The control group was given alteplase for thrombolysis, and the study group was given alteplase combined with salvianolic acids for treatment. The efficacy, neurological deficit status, living ability, cerebral perfusion parameters and adverse reactions were compared between the two groups.Results:The total effective rate of study group was 96.00%(48/50), significantly higher than 76.00%(38/50) in control group ( P<0.05). After treatment, the National Institute of Health stroke scale (NIHSS) score of the two groups was significantly reduced ( P<0.05), while the Barthel index score was significantly increased, compared with those before treatment ( P<0.05); and the postoperative NIHSS score of study group was significantly lower than that of control group ( P<0.05), while the postoperative Barthel index score was significantly higher than that in control group ( P<0.05). The levels of cerebral perfusion parameters (cerebral blood volume, cerebral blood flow) in the two groups were significantly increased, compared with those before treatment ( P<0.05); after treatment, the mean transit time of cerebral blood flow and time to peak of the two groups were significantly decreased, compared with those before treatment ( P<0.05). After treatment, the levels of cerebral blood flow and cerebral blood volume in study group were higher than those in control group ( P<0.05), while the levels of mean transit time of cerebral blood flow and time to peak were significantly lower than those in control group ( P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment ( P>0.05). Conclusions:Alteplase combined with salvianolic acids has significant efficacy, and it is safe and reliable in the treatment of acute cerebral infarction. It can effectively improve cerebral blood perfusion, thereby improving the neurological deficit status and enhancing the living ability.

目的 研究超声刺激(ultrasound stimulation,US)在红藻氨酸(kainate,KA)诱导的小鼠癫痫模型中的抗癫痫作用.方法 将小鼠随机分为对照组(n=11)、KA组(n=12)和KA+US组(n=12).通过侧脑室注射KA建立小鼠癫痫模型,并给予US处理2周.通过视频监控记录US对KA诱发的小鼠癫痫相关行为的影响;通过脑电图检测US对小鼠癫痫发作时的脑电活动的影响;通过尼氏染色观察US对海马CA3区神经元大体形态和密度的影响;通过FJB与NeuN共定位观察US对海马CA3区神经元退化变性的影响;通过GFAP免疫组织化学染色观察US对海马CA3区星形胶质细胞活化增生的影响.结果 US可显著减少KA处理后小鼠癫痫发作次数并延长癫痫发作潜伏期.脑电图记录结果显示,US可显著降低棘波频率.尼氏染色显示,KA组海马CA3区神经元呈现核固缩且神经元密度降低;相对于KA组,KA+US组海马CA3区神经元核固缩明显减少,神经元密度明显增加.FBJ和NeuN共定位染色显示,US可显著降低KA引起的海马CA3区神经元退化变性.GFAP免疫组织化学染色显示,KA组海马CA3区星形胶质细胞明显增多,而US可减少其数量.结论 US具有抗癫痫作用,且这一作用可能与其抑制海马CA3区的神经元退化并降低星形胶质细胞活化增生相关.

目的:观察在常规疗法基础上加用舒筋止痉方内服、熏洗治疗缺血性脑卒中后痉挛性偏瘫的临床疗效.方法:选取120例缺血性脑卒中后痉挛性偏瘫患者,随机分为对照组和观察组各60例.2组均采用常规现代医学疗法与康复技术训练进行治疗,观察组加用舒筋止痉方内服、熏洗.2组均连续治疗6周.治疗前、治疗6周后评定Ashworth痉挛评定量表(MAS)评分、临床痉挛指数量表(CSI)评分、日常生活活动能力(ADL)量表评分、美国国立卫生研究院卒中量表(NIHSS)评分与Fugl-Meyer运动功能评定量表(FMA)评分,比较2组治疗后的临床疗效.结果:治疗6周后,观察组临床疗效优于对照组(P＜0.05).2组MAS评分、CSI评分、NIHSS评分均较治疗前降低(P＜0.01),观察组3项评分均低于对照组(P＜0.01).2组ADL评分均较治疗前升高(P＜0.01),观察组ADL评分高于对照组(P＜0.01).2组FMA上肢评分、下肢评分及总分均较治疗前升高(P＜0.01),观察组3项分值均高于对照组(P＜0.01).结论:在常规现代医学疗法的基础上加用舒筋止痉方内服、熏洗治疗缺血性脑卒中后痉挛性偏瘫患者,可进一步减轻痉挛程度,同时改善神经功能缺损,提高患者的日常生活能力和运动能力,疗效较好.

目的 观察透明质酸或自体脂肪面部注射并发眼动脉及脑动脉阻塞的临床特征,分析其发病机制,探讨治疗效果及预后.方法 采用回顾性病例分析研究法,纳入2015年1月～2020年9月南阳市某院收治的21例透明质酸或自体脂肪面部注射后发生眼动脉及脑动脉阻塞患者,对其注射部位、注射物质、阻塞部位、临床症状、影像检查等临床资料进行分析.所有患者给予尿激酶溶栓、血管活性药物治疗,有肢体功能障碍者增加高压氧治疗,存在注射局部部位水肿、溃烂者增加局部透明质酸酶注射剂局部抗感染治疗.结果 21例患者中,透明质酸注射16例(76.19％),自体脂肪注射5例(23.81％);注射部位在鼻唇部6例(28.57％),鼻部5例(23.81％),颞部3例(14.29％),眉间3例(14.29％),眶周2例(9.52％),额部2例(9.52％);单纯眼动脉阻塞7例(33.33％),单纯脑动脉阻塞5例(23.81％),眼动脉合并脑动脉阻塞9例(42.86％);合并注射部位水肿、缺血溃烂坏死7例(33.33％);核磁共振成像检查发现颅内新发缺血灶5例(23.81％).经药物治疗及神经康复,3个月后随访,眼动脉阻塞者视力均无恢复,脑动脉阻塞者NIHSS评分及肢体功能明显改善,局部溃烂愈合,瘢痕评分(4.16±0.85)分.结论 眼动脉及脑动脉阻塞是面部注射严重的并发症之一,经相应治疗后神经功能及局部血管并发症能够得到改善,但眼动脉阻塞导致失明较难治疗,因此,在面部注射时做好预防措施很关键.

目的 研究miR-106a-5p对阿尔茨海默病(AD)细胞模型存活率和凋亡的影响及潜在分子机制.方法 实时荧光定量-聚合酶链式反应(qRT-PCR)检测OSTM1和miR-106a-5p mRNA的表达,噻唑蓝(MTT)法测定AD细胞的存活率,流式细胞术测定AD细胞凋亡率,Western印迹检测OSTM1蛋白表达,双荧光素酶报告系统验证miR-106a-5p与OSTM1的调控关系.结果 与对照组相比,模型组miR-106a-5p表达量显著下降(P<0.05),OSTM1 mRNA和蛋白表达量均显著升高(P<0.05);过表达miR-106a-5p和抑制OSTM1表达均可提高AD细胞存活率,抑制AD细胞凋亡;双荧光素酶报告系统结果表明,miR-106a-5p靶向负调控OSTM1的表达;过表达miR-106a-5p会降低OSTM1的表达,抑制miR-106a-5p表达则会提高OSTM1的表达;过表达OSTM1逆转了上调miR-106a-5p对AD细胞存活和凋亡的影响作用.结论 miR-106a-5p通过抑制OSTM1表达提高AD细胞存活率,抑制细胞凋亡.miR-106a-5p有望成为AD临床治疗的分子靶点.

目的 探讨颈动脉支架置入术(CAS)后发生高灌注脑出血(HICH)的危险因素.方法 选取南阳市中心医院既往实施CAS手术治疗的症状性颈动脉重度狭窄患者为研究对象,其中18例患者在CAS术后出现颅内出血(HICH组),选取年龄及性别基本与HICH组匹配的54例CAS手术患者为对照组,对比2组患者的年龄、性别、血压、血脂、血糖、吸烟、饮酒、合并疾病等基础资料,分析可能导致症状性颈动脉重度狭窄患者实施CAS后发生HICH的危险因素.结果 HICH组和对照组年龄、性别、吸烟、饮酒、BMI、DBP、TG、TC、HDL-C、LDL-C、血糖比较差异均无统计学意义(P>0.05);HICH组患者冠心病合并率27.78％,侧支循环不良率44.44％,颈动脉狭窄程度(81.33±4.50)％,SBP(137.2±10.7)mmHg,均高于对照组[分别为7.41％、16.67％、(78.20±4.13)％、(132.0±8.4)mmHg],差异均有统计学意义(P<0.05).经Logistic回归分析,CAS术后侧支循环不良、颈动脉狭窄程度增大、SBP测定值增大是症状性颈动脉重度狭窄患者实施CAS后发生HICH的独立危险因素(OR值分别为1.941、2.257、0.044,P<0.05).结论 CAS术后侧支循环不良、颈动脉狭窄程度增大、SBP增大可能会增加症状性颈动脉重度狭窄患者实施CAS后发生HICH风险.

Objective:To investigate the effects of ketogenic diet therapy combined with antiepileptic therapy on children with intractable epilepsy.Methods:A total of 90 children with intractable epilepsy admitted to Nanyang Central Hospital from April 2017 to September 2019 were included in the study. And they were divided into combined group and control group according to the random number table method, with 45 cases in each group. Children in control group were given antiepileptic therapy, and children in combined group were given ketogenic diet therapy based on the treatment of control group. The effective rate of treatment was compared between the two groups after 6 months of treatment. The levels of inflammatory factors, including interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and brain-derived neurotrophic factor (BDNF), serum glutamic acid decarboxylase antibody (GADA) and ganglioside antibody (GM1-A) were analyzed in the two groups before treatment and 6 months after treatment. The occurrence of adverse reactions were observed in the two groups during 6 months of treatment.Results:The effective rate of treatment and decrease of epilepsy attack frequency≥50% in combined group were lower than those in control group ( P<0.05). After 6 months of treatment, the levels of IL-6, TNF-α, and IL-1β in the two groups were lower than those before treatment, and the levels in combined group were lower than those in control group ( P<0.05). After 6 months of treatment, the BDNF in the two groups was higher than that before treatment ( P<0.05), while the GADA and GM1-A were lower than those before treatment ( P<0.05). During 6 months of treatment, there were no statistically significance differences in the incidences of adverse reactions between the two groups ( P>0.05). Conclusions:Ketogenic diet therapy combined with antiepileptic therapy can reduce the inflammatory response and improve the neurological function of children with intractable epilepsy, and it has a good inhibitory effect on neuronal excitability.

目的 探究丹珍头痛胶囊联合氟桂利嗪治疗偏头痛患者的临床效果.方法 选取2019年2月～2019年12月我院偏头痛患者98例,依照治疗方案不同分为观察组和对照组,各49例.对照组采用氟桂利嗪胶囊治疗,观察组采用氟桂利嗪胶囊联合丹珍头痛胶囊治疗.比较两组疗效、治疗前后头痛发作频率及发作持续时间.结果 两组治疗总有效率对比,观察组95.91％(47/49)高于对照组83.67％(41/49)(P<0.05);治疗后观察组头痛发作频率、发作持续时间低于对照组(P<0.05).结论 丹珍头痛胶囊联合氟桂利嗪治疗偏头痛患者疗效显著,能有效抑制头痛发作.

目的:探讨氟桂利嗪与尼莫地平在偏头痛临床治疗中的效果.方法:随机选用在本院接受偏头痛治疗的100例患者作为研究对象,将其平均分组治疗,即观察组(氟桂利嗪+尼莫地平)与对照组(氟桂利嗪),各50例.对比两组的疗效及不良反应发生率.结果:观察组的总有效率(94.00％)高于对照组的80.00％,对应值差异较大(P<0.05);观察组的并发症发生率(2.00％)低于对照组(16.00％),其对应值较为显著(P<0.05).结论:氟桂利嗪与尼莫地平在偏头痛临床治疗中具有极大的积极影响,疗效非常理想,可有效缓解症状,安全指数较高,值得推广.