目的:探讨在帕金森病患者治疗中采用神经生长因子联合盐酸多奈哌齐胶囊对脑神经递质及CRP、IL-6水平的影响.方法:选取2017年7月～2021年1月接受治疗的110例帕金森病患者作为研究对象,根据随机数字表法将患者分为观察组(n=55)与对照组(n=55),对照组使用盐酸多奈哌齐胶囊治疗,观察组在对照组基础上联合神经生长因子治疗,对两组临床疗效、氧化应激指标、炎性因子及脑神经递质进行比较.结果:观察组治疗总有效率明显高于对照组,差异有统计学意义(P<0.05);两组治疗后血清超氧化物歧化酶(SOD)较治疗前明显提高,差异有统计学意义(P<0.05),且观察组高于对照组,差异有统计学意义(P<0.05),丙二醛(MDA)较治疗前明显下降,差异有统计学意义(P<0.05),且观察组低于对照组,差异有统计学意义(P<0.05);两组治疗后C-反应蛋白(CRP)、白介素-6(IL-6)较治疗前明显下降,差异有统计学意义(P<0.05),观察组较对照组下降更明显,差异有统计学意义(P<0.05);两组治疗后去甲肾上腺素(NE)、多巴胺(DA)、5羟色胺(5-HT)明显高于治疗前,差异有统计学意义(P<0.05),观察组明显高于对照组,差异有统计学意义(P<0.05).结论:将神经生长因子联合盐酸多奈哌齐胶囊应用于帕金森病患者治疗中可降低CRP、IL-6水平,促进脑神经递质的改善.

Objective:To evaluate the efficacy of Zhuang moxibustion on Shenque acupoint with spasmolysis prescription in the treatment of phlegm-heat and internal resistance type anti-N-methyl-D-aspartate (NMDA) receptor encephalitis and its related mechanism.Methods:Sixty patients with anti-NMDA receptor encephalitis in Guangdong 999 Brain Hospital from January 1, 2019 to June 30, 2020 were included in this study, and were divided into a control group and an observation group with the random number table, 30 cases in each group. There were 10 males and 20 females in the control group, with an age of (22.1±9.4) years old. There were 12 males and 18 females in the observation group, with an age of (26.8±11.9) years old. Both groups were given conventional western medicine treatment, and the observation group was given Zhuang moxibustion on Shenque acupoint with spasmolysis prescription on the basis, once daily for 3 weeks. The scores of Abnormal Involuntary Movement Scale (AIMS), Mini-Mental State Examination (MMSE), and Ability of Daily Living (ADL) were recorded before the treatment and 1, 2, 3, and 4 weeks after the treatment. Adverse reactions related to scald, burn, or other allergies during and after the treatment were recorded.Results:There were no statistically significant differences in gender distribution, age, course of disease, cerebrospinal fluid antibody titer, and MMSE, AIMS, and ADL scores between the 2 groups (all P>0.05). The MMSE scores of the observation group 2, 3, and 4 weeks after the treatment were (19.8±2.4) points, (20.8±2.3) points, and (22.1±1.9) points, respectively, which were higher than those of the control group [(18.3±2.9) points, (19.3±2.0) points, and (20.8±2.1) points], with statistically significant differences (all P<0.05). There was a statistically significant difference in the AIMS score between the 2 groups 1 week after the treatment ( P<0.05). The ADL scores of the observation group 2 and 4 weeks after the treatment were (58.1±7.9) points and (69.2±9.9) points, respectively, which were higher than those of the control group [(54.0±7.6) points and (62.3±7.7) points], with statistically significant differences (both P<0.05). During the treatment, there was no case of scald, burn, or other allergic reactions related to Zhuang moxibustion in the observation group. Conclusion:It is safe and effective to treat phlegm-heat and internal resistance type anti-NMDA receptor encephalitis with Zhuang moxibustion on Shenque acupoint with spasmolysis prescription, worthy of further clinical application.

Objective:To analyze the risk factors of deep vein thrombosis (DVT) in patients with intracerebral hemorrhage (ICH) and establish a personalized predictive nomogram model.Methods:The clinical data of 102 patients with intracerebral hemorrhage from January 2019 to June 2020 were retrospectively analyzed. The risk factors of DVT in patients with intracerebral hemorrhage were screened by univariate and multivariate logistic regression analysis. The personalized predictive nomogram model was established, and the included data were repeated 1 000 times for internal validation.Results:The amount of bleeding ≥30 ml ( OR=3.770, 95%CI: 1.536～9.251), long stay in bed ( OR=2.754, 95%CI: 0.996～7.616), homocysteine metabolic abnormalities ( OR=3.758, 95%CI: 1.155～12.230), usage of vascular stimulants ( OR=2.649, 95%CI: 0.838～8.369), lower limb swelling ( OR=7.185, 95%CI: 2.144～24.079), and elevated D-Dimer ( OR=4.559, 95%CI: 1.668～12.459) were independent risk factors of DVT in patients with intracerebral hemorrhage. Based on the six independent risk factors selected from the above regression analysis, a nomogram model for predicting DVT in patients with intracerebral hemorrhage was constructed and verified. The predictive value was almost equal to the actual value, and the C-index was 0.831 (95%CI: 0.814～0.851), which indicated that the personalized risk nomogram model had a high accuracy in predicting DVT in patients with intracerebral hemorrhage. Conclusion:The amount of bleeding, long stay in bed, homocysteine metabolic abnormalities, use of vascular stimulants, lower extremity swelling, and elevated D-Dimer are independent risk factors of DVT in patients with intracerebral hemorrhage. The nomogram model can predict the risk of DVT individually.

巨细胞病毒(CMV)在人群中感染非常普遍,多为亚临床不显性感染和潜伏感染.当机体免疫功能低下时CMV感染可累及多器官系统出现临床症状,以肺部最常见,其次为肝脏,肾脏等组织,脑组织少见.

Objective To explore the association between complement factor H Y402H gene polymorphism and atherosclerotic cerebral infarction and to investigate its effect on carotid intima-media thickness(IMT) in patients with atherosclerotic cerebral infarction.Methods PCR-RFLP technique was used to detect complement factor H Y402H gene polymorphism in 190 patients with atherosclerotic cerebral infarction and 200 healthy controls.Carotid IMT as measured by carotid color ultrasonographic Doppler for the patients.Results In atherosclerotic cerebral infarction group, subjects with complement factor H CC and TC genotype had higher carotid IMT than TT genotype,but the distriubition of frequencies of every genotype was not significantly associated with atherosclerotic cerebral infarction.Conclusion The polymorphism of complement factor H Y402H is associated with atherosclerosis,but no association of complement factor H Y402H gene polymorphism with risk of atherosclerotic cerebral infarction is found.

Objective To investigate the relationship between peroxisome proliferator activated receptorγ2(PPARr2) gene Pro12Ala polymorphism and cerebral infarction in Changsha population.Methods Pro12Ala of PPARr2 in 190 patients with cerebral infarction and 200 non-cerebral infarction control subjects were analyzed by PCR-RFLP and electrophoresis,and their data of TG,TC,HDL,LDL,fasting glucose,blood pressure,BMI and IMT were collected and reviewed.Results Allele frequencies of Pro12Ala mutation of PPARγ2 Pro12Ala polymophism in the cerebral infarction group were PP 0.900 and PA 0.095,and PP 0.884 and PA 0.116 in the control group.No statistical significiant difference was found in distribution of genotype between these two groups (P0.05).Distribution of frequencies of each genotype of Pro12Ala variant of PPAR-γ2 was not significantly associated with BMI,fasting glucose,blood pressure,and lipid profiles.In the cerebral infarction group,subjects with PPARγ2 allele had higher carotid IMT(P0.05).Conclusion The Pro12Ala mutation in PPARγ2 is not associated with cerebral infarction;but the variant of PPAR-γ2 might promote the increase of carotid IMT in patients suffering from cerebral infarction.