3.0T MRI及MRA对成人烟雾病的诊断价值

目的：通过对成人烟雾病患者的高场强磁共振成像（MRI）及磁共振血管成像（MRA）图像分析,探讨高场强MRI在诊断本病中的应用价值。方法：回顾性分析9例成人烟雾病患者的3.0T MRI、MRA图像资料,其中5例行数字减影血管造影（DSA）检查,同时对比分析其MRA图像与DSA图像。结果：3.0T MRI平扫图像除能明确显示烟雾病患者的脑内缺血、梗死灶及微小出血灶,亦可显示患者狭窄或闭塞血管的流空信号减弱或消失,也可清晰显示两侧基底节区侧支循环血管的流空信号;3.0T MRA图像能有效显示颅内血管的狭窄或闭塞,还可显示异常烟雾状血管网。DSA图像能更清晰显示颅内血管的狭窄、闭塞、烟雾状血管以及更多的细节。结论：高场强MRI及MRA可清晰显示成人烟雾病的脑实质及血管病变,可作为烟雾病的首选筛查或诊断方法,也可作为临床随访及术后复查的首选检查方法,但在显示细节方面如烟雾血管、侧支循环血管等DSA仍优于MRA。     

颞浅动脉-大脑中动脉分支吻合术结合脑-硬脑膜-肌肉血管融合术治疗成年烟雾病的临床疗效

目的 探讨颞浅动脉-大脑中动脉分支吻合术结合脑-硬脑膜-肌肉血管融合术在治疗成年烟雾病中的效果.方法 23例成年烟雾病中,缺血首发者18例,出血首发者5例,均接收颞浅动脉-大脑中动脉分支吻合结合脑-硬脑膜-肌肉血管融合术的治疗,其中3例接收同侧两支吻合,8例接收双侧手术.结果 经该手术治疗后,手术侧血流均有立即改善,手术侧缺血症状均有缓解,随访效果好.手术并发症1例,在吻合区附近出现小梗死灶.结论 直接手术结合间接手术,即将颞浅动脉用作与大脑中动脉分支直接吻合的血管供体,将硬脑膜(脑膜中动脉)、颞肌(颞深动脉)用作血管融合术的血管供体,在成年烟雾病的治疗中是有效而合理的选择.     

应用颅骨多处钻孔硬膜翻转并骨膜贴敷术治疗烟雾病

目的 探讨颅骨多处钻孔硬膜翻转并骨膜贴敷术治疗烟雾病的临床疗效。方法 19例烟雾病患者以缺血首发17例,出血首发2例,均行颅骨多处钻孔硬膜翻转并骨膜贴敷术,术后随访2~48个月,随访数据进行统计学分析。结果 缺血型患者中TIA患者术后TIA未再发作,脑梗塞患者术后原有缺血症状改善或消失。2例出血型患者术后随访至今未发生再出血。10例患者术后行DSA复查,45个骨孔均有新生血管向颅内生长,新生血管来自脑膜中动脉和颞浅动脉。1例伴发动脉瘤患者术后DSA复查动脉瘤未显影。结论 颅骨多处钻孔硬膜翻转并骨膜贴敷术治疗烟雾病简便、安全、有效。     

烟雾病的临床DSA表现分析

烟雾病是指双侧颈内动脉末端或(和)基底动脉末端狭窄、闭塞,脑底部出现丰富的毛细血管扩张样网状血管为特征的血管性疾病.病因不明,常于儿童或青春期发病,也见于成人.临床多表现为反复发作性脑缺血、梗死以及脑实质、脑室内和蛛网膜下腔出血.确诊需要数字减影血管造影(DSA)检查证实.现将我院1999年5月至2005年3月行DSA诊断的13例烟雾病报告如下.     

数字减影脑血管造影在烟雾病诊断中的应用

烟雾病是一组以脑底动脉狭窄或闭塞并伴有脑底异常毛细血管网增生为特点的脑血管病，为脑血管疾病的单独类型。临床上常以头痛，脑缺血发作，肢体无力，脑内出血或偏瘫为主要症状。本组15例患者均行CT检查怀疑脑血管畸形或颅内有出血而行脑血管造影检查，确诊为烟雾病。现对烟雾病血管造影的影像学表现分析如下。     

首例烟雾病患者行脑-硬脑膜-动脉粘贴术的手术配合

烟雾病（moyamoya diease，MMD）即脑底异常血管网病，是一种少见的脑血管病，是指原发性颈内动脉末端狭窄、闭塞及脑底出现异常血管网扩张所致的脑出血或缺血性疾病。因脑底部异常血管网在脑血管造影片上模糊不清，状如抽烟喷出的烟雾，因此命名烟雾病。此病多见于10岁以上儿童和40～50岁的成人，儿童以实发性偏瘫和癫痫最为常见，成人常以颅内出血的表现为主。为了建立脑动脉的正常循环，预防脑缺血和避免异常血管破裂的颅内出血，我院于2003年5月首次为一MMD患者行脑-硬脑膜-动脉粘贴术（EDAS），疗效满意。现将手术配合报告如下。     

颞浅动脉-大脑中动脉分支吻合术治疗烟雾病的围手术期护理

<正>烟雾病最早发现于日本(Takeuchi,1961),是一种原因不明、慢性进行性的脑血管闭塞性疾病。烟雾病的诊断主要依靠血管造影,主要表现为单侧或双侧颈内动脉远端、大脑中动脉和大脑前动脉的近端狭窄或闭塞,伴脑底部和软脑膜烟雾状细小血管网形成[1]。烟雾病的临床表现主要有脑缺血、脑出血、癫痫、头痛、智力下降,极少病人还可出现单侧舞蹈样动作、面部不随意动作等。我院从2007年1月~2012年1月共开展颞浅动脉-大脑中动脉分支吻合术(STA-MCA Bypass)治疗烟雾病7例,现将护理体会总结如下。     

联合血管重建术治疗成人缺血型烟雾病的效果分析

目的探讨颞浅动脉-大脑中动脉搭桥联合颞浅动脉分支贴敷术治疗成人缺血型烟雾病的效果。方法对行颞浅动脉-大脑中动脉搭桥联合颞浅动脉分支贴敷术的47例成人缺血型烟雾病患者的临床资料进行回顾性分析。比较术前与术后3~36个月患者神经功能、血流动力学及血管重建情况,分析术后并发症发生情况。结果45例患者症状有不同程度缓解,2例症状未缓解。46例患者颅内血管重建良好,1例血管重建不佳。与术前相比,术后大脑中动脉分布区域脑血流量(CBF)增加,达峰时间(TTP)和平均通过时间(MTT)缩短,差异有统计学意义(P<0.05)。术后脑血容量(CBV)与术前比较,差异无统计学意义(P>0.05)。术后高灌注综合征6例,新发脑梗死2例,脑出血1例。结论颞浅动脉-大脑中动脉搭桥联合颞浅动脉分支贴敷术是治疗成人缺血型烟雾病的有效方式。     

成人烟雾病的DSA表现类型分析

目的 探讨成人烟雾病的DSA表现类型.方法 回顾性分析33例临床诊断为烟雾病患者的DSA表现,并与现行文献中所定义的血管造影特征表现相比较. 结果 33例患者的DSA表现有4种类型:①双侧颈内动脉末端及大脑前、中动脉狭窄或闭塞23例,双侧颅底大量血管网形成.②单侧颈内动脉末端闭塞伴基底动脉狭窄或闭塞5例,闭塞处颅底有血管网形成.③单侧颈内动脉末端闭塞伴对侧大脑前、中动脉水平段严重狭窄或闭塞3例;有不同程度颅底血管网形成.④单纯双侧大脑前、中动脉水平段闭塞2例,闭塞处颅底有血管网形成.其中后3种均不符合文献中所定义的烟雾病的特征表现. 结论 成人烟雾病的DSA表现有多种多样化的表现类型.提议将烟雾病在血管造影上的表现分为典型性和非典型性两类,可以最大程度涵盖烟雾病的血管造影表现.     

间接脑血管重建术治疗烟雾病12例临床分析

目的间接脑血管重建术治疗烟雾病。方法12例经DSA证实为烟雾病患者,手术采用脑-硬脑膜-动脉-肌肉-血管融合敷贴术(EDAMS)进行治疗。结果12例患者随访6~18个月,平均13.5个月,均未再发生脑缺血或脑出血。9例术前有神经功能障碍的患者术后恢复正常。复查DSA或MRA,除2例术前相同外,其余10例颅底异常血管网不同程度减少并伴侧支血管形成(改善率达83.33%)。结论EDAMS治疗烟雾病安全、近期有效。     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.     

Development Is A High Level Inheritance for China Time-honored Brand Products

<正>As culture is the soul of a nation,the three books,"History of Chinese Philosophy,""History of Chinese Culture"and"History of Chinese Science and Technology"have demonstrated the superiority of our great Chinese culture,and its significant impact in the field of international culture.Both core value and practical value of the Chinese culture are very clear,reflected in the views of universe,nature,life,health,disease,and therapy and related considerations,concepts,and technical methods.