Objective To investigate the levels of T helper cell 17 (Th17), Th17-related cytokines in-terleukin 17 (IL-17) and interleukin 23 (IL-23) and regulatory T cell (Treg) in relapsing remitting multiple sclerosis (RRMS). Methods In a case-control study, plasma was collected from RRMS patients (n=20) and healthy subjects as control group (n=20). The percentages of Th17 and Treg cells and the levels of IL-17 and IL-23 were tested. The levels of Th17, Treg, IL-17 and IL-23 of the two groups were compared. Patients were treated with methylprednisolone. The levels of Th17, Treg, IL-17 and IL-23 of multiple sclerosis (MS) patients b efore and after treatment were compared. Expanded disability status scale (EDSS) score and the number of Gd-enhancing lesions were evaluated in the case group. Statistical analysis was made by body mass index (IBM) statistical program for social sciences (SPSS) 17.0 software. Independent sample t test was conducted to compare the measurement data of the case group and the healthy control group, and enumeration data were compared by χ2 test; paired sample t test was performed to compare the data of the case group before and after treatment; Pearson correlation analysis was made forthe variables of the MS group before treatment. Results In the RRMS group, the percentage of Th17 cells in peripheral blood was significantly higher than the control group [(2.10±0.45)％vs (1.09±0.20)％](t=9.130, P<0.01), the levels of Th17-related cytokines IL-17 and IL-23 were remarkably higher than the control group (IL-17:t=19.843, P<0.01;IL-23:t=22.747, P<0.01), and the percentage of Treg cells was significantly lower than the control group [(1.33 ±0.30)％vs (2.52±0.30)％], (t=12.422, P<0.01). The levels of Th17 and IL-17 were positively associated with EDSS score (Th17: r=0.458, P<0.05; IL-17: r=0.480, P<0.05), there was no significant-correlation between the level of IL-23 and EDSS score (r=0.368, P>0.05), and Th17, IL-17 and IL-23 were positively correlated with the number of Gd-enhancing lesions (Th17: r=0.446, P<0.05; IL-17: r=0.544, P<0.05; IL-23: r=0.461, P<0.05). The levels of Th17, IL-17 and IL-23 in the RRMS group after the treatment with methylprednisolone were obviously decreased than before treatment (Th17: t=5.747, P<0.01; IL-17: t=9.967, P<0.01; IL-23: t=14.697, P<0.01), while that of Treg was apparently increased (t=10.050, P<0.01). Compared with the control group, the levels of Th17, IL-17 and IL-23 in the RRMS group after treatment were higher (Th17: t=6.889, P<0.01;IL-17:t=7.185, P<0.01;IL-23:t=13.284, P<0.01), and the percentage of Treg was lower (t=7.622, P<0.01). EDSS score of the RRMS group after treatment was remarkably decreased than before treatment(t=6.190, P<0.01), but the number of Gd-enhanced lesions after treatment was no significantiy changed (t=1.453, P>0.05). Conclusion Th17/Treg expression imbalance and Th17-related cytokines IL-17, IL-23 may participate in the pathological process of MS, and they might be therapeutic target for MS.

目的探讨大面积脑梗死的诊断治疗及临床特点。方法对我院21例大面积脑梗死患者的临床资料进行回顾性分析。结果 21例中存活16例,死亡5例,存活的16例患者均遗留神经功能缺失。结论大面积脑梗死应及早诊断,采取综合治疗措施,可有效降低病死率,提高生活质量。

目的探讨急性脑卒中并发肺部感染的高危因素,提高救治水平。方法回顾性分析我院神经内科2009年1月—2011年12月间收治的679例急性脑卒中患者的临床资料。结果并发肺部感染87例,发生率为12.81%;死亡11例,病死率为12.64%,其中7例死亡原因直接与肺部感染有关。肺部感染的发生与年龄、营养、合并基础疾病、卒中类型、意识障碍、高颅压、住院时间等有密切关系;检出致病菌123株,且病原菌均表现出不同程度的耐药。结论医护人员对每位脑卒中患者须进行客观准确的评估,尽早采取有效防治措施;注意医疗环境的清洁、消毒;医疗活动中操作应规范;合理应用抗菌药物等,可有效降低脑卒中并发肺部感染发生率。

目的观察丹红注射液治疗急性脑梗死的临床疗效。方法将急性脑梗死患者80例随机分为两组。对照组40例,应用维脑路通注射液400mL加入生理盐水250mL或5%葡萄糖注射液250mL中静脉输注,1次/日,共14d。治疗组40例,应用丹红注射液30mL加入生理盐水250mL或5%葡萄糖注射液250mL中静脉输注,1次/日,共14d。治疗前后监测神经功能缺损评分。结果治疗组总有效率95%,对照组75%,治疗组临床疗效优于对照组(P<0.05)。两组神经功能缺损评分比较,治疗组治疗前后及对照组比较差异均有统计学意义(P<0.05)。结论丹红注射液治疗急性脑梗死疗效好,应用方便安全。

目的:探讨腰椎穿刺脑脊液置换治疗蛛网膜下腔出血(SAH)的临床疗效。方法:采用腰椎穿刺脑脊液置换方法治疗继发性SAH和原发性SAH,间隔2d~3d置换1次,可置换2次~5次。结果:27例首次脑脊液置换后头痛明显减轻,烦躁病人变安静,明显优于单用甘露醇的效果。结论:腰椎穿刺脑脊液置换疗法能降低原发性SAH和继发性SAH的颅内压,改善脑脊液循环,清除脑血管内活性物质,防止脑血管痉挛,减少蛛网膜粘连,降低病死率。

随着抗生素品种的大量涌现,治愈了无数感染患者,但其不合理应用,也产生了种种恶果[1],本文对121例急性脑血管病患者使用抗生素情况进行调查分析,旨在强调抗生素的合理应用.