原发性中枢神经系统淋巴瘤43例临床分析

目的探讨原发性中枢神经系统淋巴瘤（PCNSL）的临床特征、治疗及预后。方法对43例PCNSL患者的临床资料进行回顾性分析。结果PCNSL患者临床表现无特异性，颅内压增高、神经功能缺失为常见症状。本组患者中位生存时间18．0个月（95％CI14．2～21，8个月）。Cox回归分析显示室管膜、脑膜受累与否是影响预后的因素（P=0．002）。结论PCNSL预后差且术前诊断困难，其最佳治疗方案仍在探索之中。     

原发性中枢神经系统淋巴瘤29例临床分析

目的:原发性中枢神经系统淋巴瘤(PCNSL)是一种较少见的中枢神经系统恶性肿瘤。近年发病率有逐年增高的趋势,本文探讨PCNSL的临床、影像学表现、病理特征及治疗。方法:回顾性分析我院近10年来经手术及病理证实的29例PCNSL的临床、影像学表现、病理特征及治疗。结果:本组共29例(男性18例,女性11例,年龄8～72岁,病程15天～5个月)。本病以中老年人多见,发病急,病程短,病情进展快。CT扫描多表现为等密度肿块,MRI显示T1加权像多呈低信号,T2加权像多呈高信号,CT和MRI增强扫描病灶多呈均匀明显强化;肿瘤常发生于幕上,可单发或多发,极少发生出血、钙化或囊变;对放疗、化疗敏感。结论:PCNSL是一组异质性肿瘤,侵袭性强,预后差,其临床、影像学表现复杂多变,无特异性,术前诊断困难,确诊主要依靠病理检查。最佳治疗方案是手术加放疗、化疗的联合治疗。     

原发性中枢神经系统淋巴瘤22例临床分析

目的探讨原发性中枢神经系统淋巴瘤（PCNSL）的临床诊断、治疗方法及预后。方法回顾总结我院22例PCNSL患者的临床表现、影像学特征、治疗方法及预后。结果肿瘤位于颅内17例，患者主要以颅内压增高及癫痫等症状为主；位于脊髓内5例．患者以节段性的腰背部疼痛及压迫症状为主。手术全切15例，立体定向活检7例，术后均行常规放、化疗。随访14例，其中5例立体定向活检患者，平均生存期为15．8个月：8例颅内手术切除患者，平均生存期为44．5个月，有3例肿瘤全切患者生存期〉5年，最长者已达13年；1例髓内肿瘤患者生存期为7个月。结论PCNSL在影像学上大多呈团块状、明显且较均匀的强化，大多周围有较明湿的水肿带．手术切除并行放、化疗可使部分病人获得长期生存：而立体定向活检并行放、化疗的．疗效稍筹．     

原发性中枢神经系统淋巴瘤影像学特征和疗效分析

目的探讨原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)的影像学诊断、治疗及预后,提高临床对PCNSL的认识。方法回顾性分析经术后病理证实的30例免疫正常的原发性中枢神经系统淋巴瘤患者的临床资料。单纯手术8例,手术+化疗14例,手术+化疗+放疗8例。Kaplan-Meier法分析患者生存期。结果PCNSL临床表现主要为颅内压增高和神经功能缺损为主,误诊率高达93.3%。24例PCNSL(占80.0%)MRI明显均匀强化,表现为团块状及结节状强化,或出现具有特异性的"缺口征"、"尖角征"。病理检查均为B细胞淋巴瘤,以弥漫性大B淋巴瘤最多见。Kaplan-Meier分析全组中位生存期32.0个月,2年生存率46.7%。手术+化疗(中位生存期29个月)及手术+化疗+放疗组(34个月)的生存期高于单纯手术组(3个月)。手术+化疗组(64.3%)及手术+化疗+放疗组(62.5%)的2年生存率均高于单纯手术组(0)。放化疗患者肿瘤全切组与次全切组的生存率未见明显的统计学差异(P>0.05)。结论原发性中枢神经系统淋巴瘤影像学缺乏特异性,易误诊;单纯手术治疗不是首选,应尽早采取以放、化疗为主的全身综合治疗。     

原发性中枢神经系统淋巴瘤5例报告

目的回顾分析5例原发性中枢神经系统淋巴瘤（PCNSL）患者的临床资料，探讨其合理治疗方式及影响预后的因素。方法对本病的临床特征，病理学检查，治疗方法结果及预后因素进行分析。结果PCNSL患者的临床表现复杂，颅高压和神经系统损害的症状和体征为主要表现。结论PCNSL的临床表现或影像学均缺乏特异性表现，术前诊断十分困难，脑活组织病理检查是确诊本病的唯一手段。发病机制不明确，预后差。手术不能根治，对延长生存期无益，其作用限于明确组织学诊断，降低颅压，结合放疗化疗行综合治疗。     

29例原发性中枢神经系统淋巴瘤的诊断与治疗

目的探讨原发性中枢神经系统淋巴瘤（PCNSL）的诊断、治疗及效果。方法收治29例经病理证实的PCNSL患者，根据治疗方法的不同分为3组：6例患者肿瘤切除范围较小（包括2例活检），因颅高压不能承受进一步的治疗；7例术后接受放疗；16例术后接受放疗＋化疗的综合治疗。出院后皆随访。结果单纯手术治疗者平均生存时间3．20个月，手术＋放疗和手术＋放疗＋化疗者平均生存时间分刖为32及40个月，综合治疗效果显著提高（P〈0．05）。结论单纯手术不能有效控制PCNSL的发展，术后及时辅以放疗和（或）化疗可显著延长患者的生存时间。手术应以充分降低颅内压为目的，使患者能承受进一步的放疗和化疗。     

立体定向活检诊断原发性中枢神经系统淋巴瘤(118例临床及影像学特征)

目的总结原发性中枢神经系统淋巴瘤(PCNSL)的临床、影像学特征,提高PCNSL诊治水平。方法回顾性分析经立体定向活检病理证实的118例PCNSL的临床和影像学资料。结果 118例PCNSL患者的病理类型均为B细胞性,其中男性73例,女性45例,男:女=1.62∶1,患者年龄11～83岁(平均53.4±15.9岁)。首发症状到确诊的时间为7d～3年(3.47±6.65个月),病程在3个月以内的占78.75%,其中57.5%的患者病程在1个月以内。本组病例最常见的症状包括高颅压症状(51.1%)和肢体功能障碍(47.7%)。单发病灶63例(53.4%),多发病灶55例(46.6%),基底节区和丘脑是最常见的受累部位。CT检查病灶多为稍高密度影,MRI检查病灶多为长T1、等或长T2信号影,多数病灶增强扫描为片状均匀强化。结论 PCNSL多发于中老年人,男性多见,病程短,单发病灶多见,但多发病灶的比例也较高,影像学检查病灶多均匀强化,病灶边界不清,但缺乏特异性,确诊需依赖于立体定向活检病理诊断。     

原发性中枢神经系统淋巴瘤的诊治分析

目的探讨原发性中枢神经系统淋巴瘤（PCNSL）的诊断与治疗方法。方法2009年1月至2012年12月收治12例PCNSL患者,手术＋放疗＋化疗6例,手术＋放疗1例,活检＋放疗＋化疗4例,活检＋放疗1例。结果本组仅2例术前诊断为PCNSL。病理学检查示弥漫性大B细胞型非霍奇金淋巴瘤10例,小细胞T细胞淋巴瘤2例。10例患者出院后随访10个月至5年,手术＋放疗＋化疗5例,生存2～40个月,平均12．4个月;活检＋放疗＋化疗4例,平均生存11．9个月;活检＋放疗1例生存3个月。结论PCNSLIN床表现缺乏特异性,确诊依赖病理学检查;化疗结合放疗是主要治疗手段;部分病例可考虑个体化手术治疗。     

原发性中枢神经系统淋巴瘤的影像学特征

目的总结原发性中枢神经系统淋巴瘤(PCNSL)的影像学特征,提高PCNSL诊治水平。方法回顾性分析经病理证实的PCNSL的影像学资料。结果 CT检查病灶多为稍高密度影,MRI检查病灶多为长T1、等或长T2信号影,多数病灶增强扫描为片状均匀强化,MRI增强扫描时会出现"蝴蝶征"等特征性表现,有助于PCNSL的诊断,磁共振波谱表现为Cho峰升高、NAA峰中度降低、Cr轻度降低,出现高大的Lip峰,对鉴别淋巴瘤与其它实性肿瘤具有高度的特异性。结论 MRI在PCNSL的诊断中具有重要作用,掌握PCNSL的特征性影像学特点有助于提高诊断的阳性率。     

原发性中枢神经系统淋巴瘤21例临床分析

目的探讨原发性中枢神经系统淋巴瘤(PCNSL)的临床特点及治疗方法。方法回顾性分析我院2000年～2009年收治的21例原发性中枢神经系统淋巴瘤患者的临床资料。结果本组21例患者以中年为主,临床表现和影像学缺乏特异性,病灶主要分布于幕上,单发病灶常见,全部经手术切除,病理均为B细胞型,其中弥漫大B细胞型19例,非生发中心起源占84.2%,1例EB病毒基因阳性,单纯手术5例,术后全脑放疗6例,联合化放疗10例,联合治疗的生存期明显比单纯手术或术后单纯化疗者延长。结论PCNSL表现复杂,术前诊断困难,确诊依靠病理,弥漫大B细胞型为主要病理类型,EB病毒可能参与疾病的发病机制,最佳治疗方案是包括大剂量甲氨蝶呤的化疗、放疗的综合治疗。     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

Modelling of movement of the lamprey: Control of oscillators

This article discusses the control methods of the central pattern generator (CPG). First a control model of the CPG is presented using 2 oscillators, and we suggest that phasic modulation to the CPG by means of phasic information is effective for controlling the phase difference between oscillators. Next, two models for controlling the CPG of a lamprey are proposed. One model describes a control system from the brain stem, in which the reticulospinal neurons control the CPG by receiving feedback signals and sending control signals to the neck region of the CPG. The other is a model for learning an localized control system to generate a desired motor pattern. By means of these models, a role of the efference copy is suggested.     

利培酮对精神分裂症患者生活质量的影响

目的：比较利培酮与氟哌啶醇对精神分裂症患者生活质量的影响。方法：对门诊72例服用氟哌啶醇及74例服用利培酮的精神分裂症患者用生活质量综合评定问卷（GQOLI）、阳性与阴性症状量表（PANSS）、副反应量表（TESS）进行评定。结果：利培酮组患者治疗后生活质量有所提高,而氟哌啶醇组患者生活质量有所下降。结论：利培酮治疗有利于患者提高生活质量。     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

Effect of high simple dose of cisplatinum and of radiation on the brain of rabbit

Abstract

In former studies of intracarotid and intravenous administration of cisplatinum, separate and combined with brain irradiation, we found no cerebral damage. In this study! gradually increasing high doses (above the therapeutic ones) of cisplatinum were administered intravenously to one series of rabbits arid increasing high amounts of irradiation (above the therapeutic amounts) were given to another series. Although the rabbits that received highest doses of irradiation developed areas of alopecia and skin ulcers on the head! the general clinical and histopathologic examination of the rabbits brains in both series was normal. The purpose of this study was to establish the effects of high doses of intravenous cisplatinum and irradiation on the rabbits brains. [Neural Res 1997; 19: 216–218]