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气体类神经递质与神经系统疾病
新发现的气体类神经递质一氧化碳(CO)和一氧化氮(NO)在神经系统疾病中的作用愈来愈受到重视.自20世纪90年代以来,由血红素氧合酶(HO)催化血红素分解代谢产生的内源性一氧化碳(CO),和由一氧化氮合成酶(NOS)催化精氨酸产生的一氧化氮(NO)的生物学研究取得了重要进展.近的研究表明,与NO分子结构类似的CO不仅是1种重要的信使分子,而且可能是1种新型的神经递质,与NO一道在神经系统参与了复杂的多种生理病理过程,这2种气体分子不仅在呼吸系统、心血管系统、免疫系统中发挥信使分子和递质的作用,也在神经系统疾病的病生理过程中起了重要的作用.
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Antiepileptic drugs are the preferred treatment approach for epileptic patients. However, informal treatment is important for intractable epilepsy. In this study, 500 epileptic patients were recruited from the General Hospital of Beijing Military Area Command of Chinese PLA during the period of October 2009 to January 2012. These involved patients that had been medical y treated for at least 1 year. Information on the initial treatment and changes to treatment regimens for each patient was col ected through questionnaires. The survey results showed that 52.3% of the epileptic patients searched for treatment after the first seizure, and the mean numbers of seizures was 12.8;59.8%of the epileptic patients were diagnosed at the first visit, and the mean onset time was 17 months after the first seizure. After diagnosis, patients were treated for an average of 20 days, and the median time was 1 day. Formal anti-epileptic drugs were selected as the first treatment regimen by 67.8%of patients, and 77.5%of these drugs were monotherapies. The mean and median numbers of seizure were respectively 36.9 and 3.0 times before the first regimen was changed. The regimen was changed within the first 6 months by 46.6% of patients, and after the first and second years of treatment, the proportions increased to 54.0%and 71.8%, respectively. In total, 78.5%of the regi-mens were changed to informal treatments. The informal treatment of epilepsy in China is common, being initiated by either patients or physicians. Enhancing epileptic treatment services in hospital, improving physicians’ professional quality, and strengthening health propaganda may promote the normalization of drug treatment of epilepsy in China.
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中枢神经系统疾病的治疗市场再认识
中枢神经系统疾病的治疗市场竞争日趋白热化,2002年,中枢神经系统疾病治疗药物销售额仅次于心血管疾病治疗药物,达600亿美元,而且每年以10%~12%的速度增长.对于这个市场,医药企业需要更深入、更广泛、更有创意的战略思考才能利于不败之地.
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无创颅内压监测在中枢神经系统疾病中的应用
颅内压增高是颅内疾病或颅内继发性病变的一种反映,颅内高压亦是神经科的危重症,如不能及时发现并采取有效治疗措施,可导致脑疝形成,于短时间内危及患者生命,因此颅内压监测是颅脑疾病治疗的重要前提之一.近年来,研究显示,连续性颅内压监测可作为"早期报警系统",有利于早期发现和及时处理高颅压症[1].
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小儿神经系统疾病诊治进展
1 癫癎和惊厥性疾病脑电图(EEG)在我国儿科的临床应用相对不够普遍,随着人们对EEG在癫癎诊断、分型和治疗中重要价值的深入认识,越来越多医院开展小儿EEG检查.然而,能否正确描记与判断不同年龄期小儿EEG,直接影响该技术对癫癎的诊治价值.为此,结合近年来国内外EEG技术新进展,在成都会议上,中华医学会儿科学分会神经学组,对1991年制定的小儿脑电图操作技术和注意事项进行了全面修订,特别增加了"对癫癎患者进行长时程脑电图监测基本技术要求的建议"文件,将推动EEG在儿科临床的更广泛和正确应用(中华医学会儿科分会神经学组.2003年全国小儿癫癎暨第十届小儿神经学术会议论文汇编,2003.1~44.以下简称汇编).
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小儿神经系统疾病诊治进展
1 癫癎和惊厥性疾病癫癎是小儿神经系统常见疾病,约占儿科神经门诊病例的1/2.脑电图是癫疒间诊断与鉴别诊断重要的辅助检查,其对癫疒间的确定诊断、判断发作或综合征类型、指导治疗、估计预后均具有不可替代的作用,但在临床应用过程中还常有片面甚至错误的认识.为促进脑电图的规范应用,在第十届全国小儿神经学术会议(成都,2003)上经过专题讨论、修改,形成了有关儿科常规脑电图描记、脑电图报告、长时程脑电图监测、判断脑电图结果注意事项等指导性文件.进一步规范了脑电图在我国小儿神经临床的应用,提高对癫疒间的诊断水平.
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小儿神经系统疾病诊治进展
1癫(癎)(epilepsy)与癫(癎)发作(epileptic seizure)国际抗癫(癎)联盟(international league against epilepsy,ILAE)和国际癫(癎)病友联合会(international bureau of epilepsy,IBE)协作,对癫(癎)定义提出了新的建议[Epilepsia,2005,46(4):470-472.],要点包括:(1)至少1次癫(癎)发作;(2)脑内存在持久性损害;(3)伴随其他方面的多种损害.
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兔脑出血灶周围脑组织bFGF,VEGF及TNF-α的表达
Intracerebral hemorrhage frequently occurs in nervous system diseases, and le ads to secondary cerebral lesion, such as ischemia, edema of perihematomal brain r egions and the biochemical change of the cell. Recent studies have confirmed tha t cytokines such as basic fibroblast growth factor(bFGF), vascular endothelial g r owth factor(VEGF) and tumor necrosis factor(TNF-α) are involved in the pathoge n esis of cerebral hemorrhage. In nervous system, positive expressions of bFGF and TNF-α are in neurons and astrocytes, and that of VEGF is in vascula r endothelial cells. The content of bFGF protein in brain regions is different a t different time after brain injuries. There was no literature about detectin g the expressions of bFGF, VEGF and TNF-α protein in the perihematomal brain r egion s after intracerebral hemorrhage. Using immunohistochemical technique,the author detected the expressions of bFGF,VEGF and TNF-α in the perihematomal brain re g ions in order to research the pathological mechanism of intracerebral hemorrhage.
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骨髓基质细胞与神经性疾病的治疗
骨髓基质细胞(bone marrow stromal cells,BMSCs)又名成纤维细胞样克隆形成单位(fibroblast colony-forming units,CFU-F)、间质干细胞(mesenchymal stem cells,MSCs)、间质祖细胞(mesenchymal progenitor cells,MPCs).本文统一用BMSCs这一概念,重点对BMSCs的生物学特性及其神经损伤修复作用进行综述.
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磁敏感成像在中枢神经系统疾病的研究进展
磁敏感加权成像(susceptibility weighted imaging,SWI)是一种利用不同组织间的磁敏感性差异产生影像对比的磁共振成像方法,目前已被广泛应用于中枢神经系统.本文就SWI在脑外伤、出血、梗死、脑血管畸形、脑肿瘤、铁质沉积及某些神经变性疾病中的应用作一综述.
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磁敏感加权成像在中枢神经系统疾病的应用
磁敏感加权成像(susceptibility-weighted imaging,SWI)是一种新的磁共振成像法,不同于传统的成像方式,它是一项利用不同组织间磁敏感度差异产生图像对比的技术.