脊髓空洞症的发病机制和外科治疗

目的探讨脊髓空洞症的发病机制和外科治疗。方法对1993年1月-2012年6月我科治疗的78例脊髓空洞症,男56例,女22例,年龄16~58岁,平均36.5岁。对所有患者行术前评估及MRI检查,根据原发疾病及MRI结果采用不同的手术方式。结果术后随访3个月~10年,根据症状、体征评定,明显改善46例,改善18例,无变化11例,恶化3例,总有效率82.1%。结论脊髓空洞症保守治疗无效,病情逐渐进展的脊髓空洞症应尽早手术治疗。手术方式主要根据患者原发疾病、症状、体征及MRI结果决定。     

脊髓空洞症的发病机制和外科治疗

目的探讨脊髓空洞症的发病机制和外科治疗。方法对1993年1月-2012年6月我科治疗的78例脊髓空洞症,男56例,女22例,年龄16~58岁,平均36.5岁。对所有患者行术前评估及MRI检查,根据原发疾病及MRI结果采用不同的手术方式。结果术后随访3个月至10年,根据症状、体征评定,明显改善46例,改善18例,无变化11例,恶化3例,总有效率82.1%。结论脊髓空洞症保守治疗无效,病情逐渐进展的脊髓空洞症应尽早手术治疗。手术方式主要根据患者原发疾病、症状、体征及MRI结果决定。     

寰枕部畸形合并脊髓空洞症患者的再手术治疗

目的 探讨寰枕部畸形合并脊髓空洞症再手术治疗的方法和手术指征。方法 对12例手术后疗效差或复发患者进行了再手术治疗，颅后窝减压术(PFD)后再手术行脊髓空洞蛛网膜下腔分流术(SAS)3例；SAS术后再手术行SAS PFD9例，术后常规行腰椎穿刺术。结果 再手术治疗后随访5个月至5年2个月，按照charles标准，疗效优4例，良3例，差5例，有效率58．3％。结论 根据畸形具体情况选择恰当术式，脊髓空洞症再手术治疗仍可取得较好疗效。     

空洞- 腹腔分流术治疗单纯性脊髓空洞症13 例

目的　研究空洞 -腹腔分流手术对单纯性脊髓空洞症的治疗效果。方法　采取空洞 -腹腔分流手术治疗单纯性脊髓空洞症 (不伴有小脑扁桃体下疝 ) 13例 ,观察手术前后空洞大小以及患者症状体征的改善情况。结果　术后 1～ 2周内行MRI复查 ,所有患者空洞均有不同程度缩小 ,平均SSR为 0 .2 ,与术前相比具有显著性差异 (P <0 .0 1)。随访 6个月～ 5年 ,平均 2 .5年。以Tator评定标准进行评定 ,好转 6例 ,稳定 5例 ,有效率为 84.61% (11/13 )。结论　空洞—腹腔分流手术应用于单纯性脊髓空洞症 ,具有创伤小、疗效明显等优点。     

脊髓空洞症8例手术治疗体会

1994年～2000年。我科对8例伴有Amold—chiariⅠ型畸形的脊髓空洞症患者实施了手术治疗，现报告如下：     

改良手术方法治疗Chiari畸形并脊髓空洞

目的探讨Chiari畸形并脊髓空洞症的操作技巧及手术效果。方法总结我科近3年间采取改良小切口、小骨窗枕大孔减压,枕大池成形手术治疗35例Chiari畸形并脊髓空洞症患者的临床表现,手术前后影像学特征,手术疗效。结果随访平均1．5年,MRI评价有效31例,临床有效24例。结论改良小切口、小骨窗枕大孔减压,枕大池成形手术治疗Chiari畸形并脊髓空洞创伤小,并发症少,显微镜下小心松解第四脑室出口粘连,复位下疝扁桃体是手术关键。     

Arnold-Chiari畸形合并脊髓空洞症的外科治疗(附32例报告)

目的：探讨Chiari畸形合并脊髓空洞症的手术治疗方法。方法：分析我科收治的32例Chiari畸形合并脊髓空洞症患者进行手术治疗，以后颅窝减压、小脑扁桃体切除、脊髓空洞穿刺、松解四脑室正中孔蛛网膜粘连为主，达到解除后脑受压，解除粘连，恢复枕大孔区CSF循环通畅的目的。结果：随访24例患者中，临床症状完全消失18例，好转2例，术前有头痛、颈痈或肩臂病症状者均有显著减轻，3例自觉症状无变化，复查MRI显示21例空洞明显缩小。结论：后颅窝减压、松解四脑室正中孔蛛网膜粘连，恢复枕大孔区CSF循环通畅是手术治疗Chiari畸形合并脊髓空洞症的关键。     

脊髓空洞症显微外科手术治疗

目的 探讨脊髓空间症的显微外科手术治疗方法。方法 根据脊髓空洞病灶位置不同，在显微镜下分别采用Pudens硅胶管行空洞－蛛网膜下腔分流术4例；后颅凹减压＋Pudens硅胶管空洞－蛛网膜下腔分流术2例。结果 本组6例，经随访3－8年，治愈2例，好转4例，手术有效率100％。结论 后颅凹减压和／或空洞－蛛网膜下腔显微外科分流术是脊髓空洞症的一种有效的治疗方法。     

Arnold—Chiari畸形并脊髓空洞症的手术治疗

目的 根据MRI影像，探讨Chiari畸形并脊髓空洞症的手术方法，评价其疗效。方法 对28例Chiari畸形并脊髓空洞症患者依据MRI影像，通过分型选择4种不同的手术方法。结果 通过分型手术，获得了满意的治疗效果。对15例轻度畸形病例施行后颅窝减压术；对7例中度畸形病例施行后颅窝减压联合小脑扁桃体切除术；对3例重度畸形病例施行后颅窝减压联合小脑扁桃体切除及脊髓空洞切开引流术；另有3例轻度小脑扁桃体下疝畸形合并重度脊髓空洞者，行后颅窝减压联合脊髓空洞切开引流术。结论 依据MRI影像分型，选择不同的手术方式，可使延、颈髓充分减压，能有效缓解临床症状，并时脊髓空洞症有明显的治疗作用。     

Chiari畸形Ⅰ型显微外科手术治疗效果观察

目的探讨Chiari畸形Ⅰ型的显微外科手术治疗方法及临床效果。方法回顾性分析2013年6月至2015年6月于新乡医学院第一附属医院行显微外科手术治疗的36例Chiari畸形Ⅰ型患者的临床资料。结果 36例患者均行手术治疗,其中后颅窝骨性减压+硬脑膜扩大修补术8例,后颅窝骨性减压+蛛网膜下腔粘连松解术+硬脑膜扩大修补术6例,后颅窝骨性减压+蛛网膜下腔粘连松解术+小脑扁桃体切除(或电凝回缩)术+硬脑膜扩大修补术19例,后颅窝骨性减压+脊髓空洞-蛛网膜下腔分流术+硬脑膜扩大修补术3例。术后3个月复查评估,神经系统症状改善30例,无变化4例,加重2例。随访6~36个月,28例患者小脑扁桃体恢复至正常位置,其余8例患者较术前不同程度回缩;25例合并脊髓空洞症患者中,18例脊髓空洞不同程度缩小,5例稳定无变化,2例空洞增大。结论显微外科手术是Chiari畸形Ⅰ型有效的治疗方法,可以有效缓解患者病情。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.