复方樟柳碱联合川芎嗪治疗急性缺血性视神经病变

急性缺血性视神经病变是由于营养视神经的小血管发生循环障碍,使视神经缺血、缺氧,而致组织水肿,从而导致视功能下降,视野象限性缺损为特征的一种眼底病[1].表现为发病急,如不及时治疗可造成不可逆性的视力丧失.临床上主要是应用扩血管药物加皮质类固醇激素治疗.1999年以来我院应用复方樟柳碱联合川芎嗪治疗急性缺血性视神经病变80例(86眼),取得了较好疗效,现报告如下.     

22例糖尿病视神经病变综合治疗的疗效观察

目的：总结诊断及治疗糖尿病性视神经病变（diabeticopticneuropathy,DON）的临床经验,为本病的治疗和预防提供依据。方法：回顾性研究22例糖尿病视神经痛变的发病特点,在接受治疗的患者中严格控制血糖,应用复方樟柳碱注射液病侧颞浅动脉旁皮下注射,口服或静脉滴注活血化瘀药物,并口服维生素B1、维生素B2、肌苷片等营养视神经的药物,同时给予全身检查,包括对高血压、糖尿病等全身疾病的治疗,观察经综合治疗前后的视力、眼底、视野改变及眼底荧光血管造影（fundusfluoresceinall-giography,FFA）的特点等。结果：接受治疗的患者共有22例（29只眼）,治愈10例（12只眼）;好转7例（10只眼）,总有效率为79．3％。结论：糖尿病性视神经病变的及时正确诊断、系统的综合治疗,可有效提高视力,扩大视野。     

22 例糖尿病视神经病变综合治疗的疗效观察

摘要目的：总结诊断及治疗糖尿病性视神经病变（diabetic optic neuropathy,DON）的临床经验,为本病的治疗和预防提供依据。方 法：回顾性研究22 例糖尿病视神经病变的发病特点,在接受治疗的患者中严格控制血糖,应用复方樟柳碱注射液病侧颞浅动脉 旁皮下注射,口服或静脉滴注活血化瘀药物,并口服维生素B1、维生素B2、肌苷片等营养视神经的药物,同时给予全身检查,包括 对高血压、糖尿病等全身疾病的治疗,观察经综合治疗前后的视力、眼底、视野改变及眼底荧光血管造影（fundus fluorescein angiography, FFA）的特点等。结果：接受治疗的患者共有22 例（29 只眼）,治愈10 例（12 只眼）;好转7 例（10 只眼）,总有效率为 79.3%。结论：糖尿病性视神经病变的及时正确诊断、系统的综合治疗,可有效提高视力,扩大视野。     

双歧四联活菌多药联合对根除幽门螺杆菌患者的临床疗效观察

目的:研究双歧四联活菌多药联合对根除幽门螺杆菌(Helicobacter pylori,Hp)患者的临床疗效。方法:从2012年3月到2013年3月,共计60例病患因腹部不适就诊。以数字法随机分成实验组及对照组。对照组以埃索美拉唑镁肠溶片(剂量为20 mg bid)和胶体酒石酸铋钠(剂量为165 mg qid)以及克拉霉素片(剂量为0.5 bid)和阿莫西林胶囊(剂量为1.0 bid)等药物治疗。实验组则在对照组基础之上另以双歧四联活菌(剂量为1.5 tid)药物治疗。对比两组疗效和治疗后不良反应,以及治疗依从性情况。结果:实验组的根除率为86.67%(26/30),显著高于对照组的63.33%(19/30);未根除率为13.33%(4/30),显著低于对照组的36.67%(11/30)。实验组有不良反应者8例,占比26.67%,显著少于对照组的17例,占比56.67%;实验组在治疗后的依从性为好者占比90.00%(27/30),显著高于对照组的66.67%(20/30),依从性为差者占比10.00%(3/30),显著低于对照组的33.33%(10/30),差异均有统计学意义(均P0.05)。结论:双歧四联活菌采用多药联合方式可明显提升对于Hp的根除率,同时减少不良反应,增加病患依从性。效果显著,值得临床推荐。     

前部缺血性视神经病变患者图形视觉诱发电位与视功能改变的关系及其临床意义

目的:探究前部缺血性视神经病变(AION)患者图形视觉诱发电位(P-VEP)检查结果与预后间的关系。方法:选择2016年12月-2019年12月于我院就诊并确诊的AION患者作为研究对象,入院后接受综合治疗,治疗后评估患者的视功能,评价患者的治疗效果,采用相关性分析探究患者入院后P-VEP检查结果与经治疗后患者视功能改善值间的相关性。结果:研究组15'棋盘格和60'棋盘格P100波潜伏时均高于对照组,P100波振幅均低于对照组,差异均具有统计学意义(P0.05)。治疗后3个月AION患者最佳矫正视力和视野平均敏感度(MS)高于治疗前,视野平均缺失值(MD)低于治疗前,差异均具有统计学意义(P0.05)。AION患者治疗前后视力差值与15'棋盘格P100波振幅呈正相关,视野MD差值和视野MS差值与P-VEP四项反应值不具有相关性。结论:P-VEP检查结果 15'棋盘格P100波振幅与患者视力改善差值间存在显著的正相关性,可提示患者视功能恢复程度及预后。     

LEEP刀治疗宫颈病变的临床疗效分析

目的探讨LEPP刀治疗宫颈病变的临床疗效。方法将我院收治的172例宫颈病变患者作为研究对象,采用分组方式进行治疗。观察组86例应用LEEP刀对病变组织进行切除,对照组采用常规手术方式进行治疗,并对两组患者的手术时间、出血量、并发症等以及术后2年的预后恢复情况进行比较。结果观察组平均手术时间显著短于对照组(P0.05),术中出血量及并发症发生率均显著少于对照组(均P0.05)。术后随访,观察组预后恢复情况优于对照组。结论 LEPP刀治疗宫颈病变的手术时间短,出血少,术后反应小,见效快,患者预后好,是治疗宫颈病变安全有效的方法,值得推广应用。     

甲基强的松龙对急性脊髓损伤患者神经生长因子水平变化的影响及其临床疗效

目的:探讨甲基强的松龙对急性脊髓损伤患者神经生长因子水平变化及临床疗效的影响。方法:回顾性研究我院收治的68例急性脊髓损伤患者的临床资料,随机分为实验组和对照组,每组34例。对照组患者给予常规治疗,实验组患者在对照组基础上给予甲基强的松龙治疗。观察并比较治疗前后两组患者神经生长因子(NGF)、脑源性神经营养因子(BDNF)水平变化及神经功能评分和并发症的发生情况。结果:与治疗前相比,两组患者治疗后血清NGF及BDNF水平均升高,且感觉功能评分及运动功能评分均升高,差异具有统计学意义(P0.05);与对照组相比,实验组患者治疗后血清NGF及BDNF水平较高,感觉功能评分及运动功能评分较高,差异具有统计学意义(P0.05);与对照组相比,实验组患者并发症的发生率较低,差异具有统计学意义(P0.05)。结论:甲基强的松龙治疗急性脊髓损伤的临床疗效较好,能够提高患者血清NGF及BDNF水平,改善感觉功能评分及运动功能评分,同时降低并发症的发病率。     

r-tpa合并甘露醇治疗血管壁病变性脑梗死的临床疗效分析

目的:观察r-tpa合并甘露醇治疗血管壁病变性脑梗死临床疗效。方法:将临床发病6 h以内的急性脑梗死患者随机分为治疗组与对照组,每组60例,治疗组用r-tpa合并甘露醇静脉滴注,对照组用川芎嗪注射液静脉滴注,对治疗组和对照组连续使用15天观察对照组和治疗组的临床疗效及神经功能恢复情况。结果:采用r-tpa合并甘露醇静脉滴注和川芎嗪静脉注射液疗效比较,治疗组总有效率93.33%,明显优于常规治疗组78.33%,两组差异有统计学意义(P0.05)。两组患者治疗后CSS评分均显著低于治疗前,且治疗组明显低于对照组(P0.05);两组患者治疗后ADL评分均显著高于治疗前,且治疗组明显高于对照组(P0.05)。结论:r-tpa合并甘露醇治疗血管壁病变性脑梗死临床疗效显著,且对6个小时内没有出血倾向的血管病变性脑梗死安全实用,患者后期恢复效果良好。     

吡拉西坦联合鼠神经生长因子对急性缺血性脑卒中患者的疗效及Hcy、PCT和皮质醇水平的影响

目的:探讨吡拉西坦联合鼠神经生长因子对急性缺血性脑卒中患者的疗效及对同型半胱氨酸(Hcy)、降钙素原(PCT)和皮质醇水平的影响。方法:回顾性分析我院2017年2月～2018年11月收治的73例急性缺血性脑卒中患者为研究对象,依据入院先后顺序分为对照组(n=35)和观察组(n=38)。对照组患者采用吡拉西坦治疗,观察组基于对照组加以鼠神经生长因子治疗。观察并比较两组临床疗效,治疗前后美国国立卫生研究院卒中量表(NIHSS)、日常生活能力(ADL),治疗前及治疗2周结束时用全自动生化分析仪测定血浆Hcy水平,用放射免疫学分析法测定PCT水平,用化学发光法测定皮质醇水平,用超声多普勒诊断仪测定基底动脉、左右大脑中动脉血流。结果:治疗后,观察组NIHSS评分低于对照组(8.96±1.21)vs(11.27±1.59)分,ADL评分高于对照组(74.21±9.75)vs(66. 04±8.03)分(P0.05)。观察组总有效率高于对照组89.47%vs 68.57%(P0.05)。治疗后,观察组Hcy、PCT及皮质醇水平低于对照组(14.27±2.01)vs (18.51±2.84)μmol/L、(0.25±0.03)vs (0.31±0.04)μg/L、(171.93±23.86)vs(228.75±30.27)nmol/L(P0.05)。治疗后,观察组脑血流学指标高于对照组基底动脉(43.81±6.84)vs(39.62±5.27)mL/min、左大脑中动脉血流(64.27±9.95)vs(57.03±7.52)mL/min、右大脑中动脉血流(62.85±9.01)vs(56.64±7.42)mL/min(P0.05)。结论:吡拉西坦联合鼠神经生长因子能够提高急性缺血性脑卒中的疗效,降低Hcy、PCT及皮质醇水平,促进神经功能的恢复。     

龙津降纤酶治疗急性缺血性卒中临床疗效观察

目的 观察龙津降纤酶对急性缺血性情卒中的治疗效果。方法 选择诊断明确的急性因性卒中病人８０例,随机分为２组,对照组４０例,５％葡萄糖液５００ｍｌ加血塞通小射液０．４ｇ静脉滴注,连用１４天,降纤酶组４０例,入院后第１～３天分别给降酶１０ｕ加入生理盐水１００ｍｌ,静脉主１ｈ以上,按临床神经功能缺失程度评分标准于治疗前及治疗在进行疗效评定。结果 降纤酶组总有效率达９２．５％,显效率为７２．５％,明显优于     

神经生长因子药效学研究

目的考察神经生长因子对视神经损害的疗效。方法腹腔注射二硫化碳致视神经损害的大鼠模型,给药组球后注射或肌内注射神经生长因子,每天一次,每周6d,共计3周,空白对照组球后注射等量生理盐水,于治疗前后测定大鼠模式翻转（FREP）和闪光视觉诱发电位。结果球后注射高剂量组大鼠在治疗10d和20d时各波潜伏时比对照组有显著缩短,而球后注射低剂量组和肌内注射高剂量组大鼠于治疗10d时FVEP各波潜伏时也显著缩短,肌内注射低剂量组大鼠于治疗20d时FEP的P1和P2波潜伏时也显著或非常显著缩短。结论神经生长因子对大鼠视神经损害有明显的治疗作用。     

Acute Regulation of the Epidermal Growth Factor Receptor in Response to Nerve Growth Factor

PC12 cells possess specific receptors for both nerve growth factor and epidermal growth factor, and by an unknown mechanism, nerve growth factor is able to attenuate the propagation of a mitogenic response to epidermal growth factor. The differentiation response of PC12 cells to nerve growth factor, therefore, predominates over the proliferative response to epidermal growth factor. We have observed that the addition of nerve growth factor to PC12 cells rapidly produces a decrease in surface 125I-epidermal growth factor binding capacity. Unlike previously described nerve growth factor effects on 125I-epidermal growth factor binding capacity, which required several days of nerve growth factor exposure, the decreases we report occur within minutes of nerve growth factor addition: A 50% decrease in 125I-epidermal growth factor binding capacity is evident at 10 min. This rapid nerve growth factor response is concentration dependent; inhibition of 125I-epidermal growth factor binding is detectable at nerve growth factor levels as low as 0.2 ng/ml and is maximal at approximately 50 ng/ml, consistent with known ranges of biological activity. No demonstrable differences in the rate of epidermal growth factor receptor synthesis or degradation were observed in cells acutely exposed to nerve growth factor. Scatchard analysis revealed that acute nerve growth factor treatment decreased the number of both high- and low-affinity 125I-epidermal growth factor binding sites, while the receptor affinity remained unchanged. We have also investigated the involvement of various potential intracellular mediators of nerve growth factor action and of known intracellular modulatory systems of the epidermal growth factor receptor for their capacity to participate in this nerve growth factor activity.     

Regulation by Interleukin-1 of Nerve Growth Factor Secretion and Nerve Growth Factor mRNA Expression in Rat Primary Astroglial Cultures

Primary cultures of neonatal rat cortical astrocytes contain low cellular levels (about 2 pg/mg of protein) of nerve growth factor (NGF), but secrete significant amounts of NGF into the culture medium (about 540 pg of NGF/mg of cell protein/38-h incubation). Incubation of astrocytes with interleukin-1 (IL-1) increased the cellular content of NGF and the amount secreted by about threefold. In comparison, cerebellar astrocytes secreted significant amounts of NGF, and the secretion was also stimulated by IL-1. The stimulatory action of IL-1 on astrocytes prepared from cortex was dose- and time-dependent. Concentrations of IL-1 causing half-maximal and maximal stimulation of NGF secretion were 1 and 10 U/ml, respectively). Maximal NGF secretion induced by IL-1 (10 U/ml) was seen following 38 h of incubation. The basal secretion of NGF was reduced by about 50% under Ca2(+)-free conditions; however, the percent stimulation of NGF secretion by IL-1 was the same in the absence or presence of Ca2+. The stimulatory action of IL-1 was specific, because other glial growth factors and cytokines were almost ineffective in stimulating NGF secretion from cortical astroglial cells. IL-1 treatment also increased cellular NGF mRNA content twofold. The results indicate that IL-1 specifically triggers a cascade of events, independent of cell growth, which regulate NGF mRNA content and NGF secretion by astrocytes.     

Expression of Nerve Growth Factor and Nerve Growth Factor Receptor Genes in Human Tissues and in Prostatic Adenocarcinoma Cell Lines

Nerve growth factor (NGF) mRNAs were detected and quantified in a variety of normal and neoplastic human tissues by northern blot hybridization. Human heart contained the highest NGF mRNA levels, whereas lower but comparable levels were found in the placenta, prostate, and kidney. All tissues examined coexpressed the low-affinity NGF receptor (LNGFR), whereas none of these tissues expressed the high-affinity NGF receptor encoded by the trk protooncogene. The widespread distribution of the LNGFR suggests that it plays a role in the regulation of normal cell growth. No overexpression of NGF or LNGFR mRNA was detected in neoplastic tissues, whereas LNGFR-like immunoreactivity was localized outside of tumor cells. Transforming growth factor-alpha and protooncogene c-fos expression in these tissues did not show a systematic correlation with NGF/LNGFR expression. Furthermore, regulation of the human NGF gene was studied in DU145 cells, a prostatic adenocarcinoma cell line that synthesizes significant NGF mRNA levels. Serum induced, whereas dexamethasone inhibited, NGF mRNA synthesis in these cells. Serum induction was preceded by a rapid and transient activation of the c-fos protooncogene.     

Characteristics of Partially Purified Nerve Growth Factor Receptor

Receptors for the nerve growth factor protein (NGF) have been isolated from three cell types [embryonic chicken sensory neurons (dorsal root sensory ganglia; DRG), rat pheochromocytoma (PC12) and human neuroblastoma (LAN-1) cells] and have been shown to be similar with respect to equilibrium dissociation constants. The present results demonstrate that there are multiple molecular weight species for NGF receptors from DRG neurons and PC12 cells. NGF receptors can be isolated from DRG as four different molecular species of 228, 187, 125, and 112 kilodaltons, and PC12 cells as three molecular species of 203, 118, and 107 kilodaltons. The NGF receptors isolated from DRG show different pH-binding profiles for high- and low-affinity binding. High-affinity binding displays a bell-shaped pH profile with maximum binding between pH 7.0 and 7.9, whereas low-affinity binding is constant between pH 5.0 and 9.1, with a twofold greater binding at pH 3.6. At 22 degrees C, the association rate constant was found to be 9.5 +/- 1.0 X 10(6) M-1 s-1. Two dissociation rate constants were observed. The fast dissociating receptor has a dissociation rate constant of 3.0 +/- 1.5 X 10(-2) s-1, whereas the slow dissociating receptor constant was 2.4 +/- 1.0 X 10(-4) s-1. The equilibrium dissociation constants calculated from the ratio of dissociation to association rate constants are 2.5 X 109-11) M for the high-affinity receptor (type I) and 3.2 X 10(-9) M for the low-affinity receptor (type II). These values are the same as those determined by equilibrium experiments on the isolated receptors.(ABSTRACT TRUNCATED AT 250 WORDS)     

鼠神经生长因子对2型糖尿病周围神经病变的影响

目的:探讨鼠神经生长因子治疗2型糖尿病周围神经病变(DPN)临床疗效及安全性。方法:选择89例DPN患者分为观察组45例和对照组44例,两组都给予糖尿病的基础治疗,观察组在基础治疗基础上,加用注射用鼠神经生长因子,对照组加用甲钴胺注射液和丹红注射用,治疗前后测定正中神经和腓总神经的感觉传导速度(SNCV)、运动传导速度(MNCV),行多伦多临床评分系统(TCSS)评分。结果:治疗前,两组患者TCSS评分、正中神经、腓总神经的MNCV及SNCV相似,差异无统计学意义(P0.05);疗程结束时,两组TCSS评分较治疗前均下降,正中神经、腓总神经的MNCV及SNCV较治疗前均增加,差异有统计学意义(P0.05),但是观察组改善幅度较对照组更显著(P0.05)。观察组显效20例、有效23例和无效2例;对照组显效15例、有效21例和无效8例,差异有统计学意义(P0.05)。两组患者治疗期间未见严重不良反应发生。结论:加用鼠神经生长因子可以有效缓解2型糖尿病DPN的临床症状,提高神经传导速度,安全性高。