MRI检查中脑膜瘤位置与瘤周水肿的相关性分析

目的:通过研究脑膜瘤的MRI表现,探讨脑膜瘤瘤周水肿(peritumoral brain edema,PTBE)与脑膜瘤部位的关系.方法:对106例行MRI检查的脑膜瘤患者进行回顾性研究.分析脑膜瘤位置,测量脑膜瘤体积及PTBE体积,计算水肿指数(edema index,EI),并对PTBE形状进行分类,采用SPSS1...     

颅内肿瘤周围水肿药物治疗专家共识(第1版)

一、前言 肿瘤周围水肿(peritumoral brain edema,PTBE)多见于胶质瘤、脑膜瘤和转移瘤,是神经外科常见的临床问题,直接影响肿瘤的诊断、治疗及预后.本文旨在加深神经外科医生对神经系统PFBE的认识,明确对PTBE诊断和治疗的基本原则,提供切实可行的规范化的药物治疗建议.     

脑膜瘤部位、大小及病理分型对瘤周水肿的影响

目的:探讨脑膜瘤瘤周水肿(PTBE)与瘤体位置、大小及病理分型的关系.方法: 对151例颅内脑膜瘤手术切除患者进行回顾性分析研究.术前利用CT或MR检查评估瘤体部位、体积及瘤周水肿指数(EI),术后进行脑膜瘤组织学分型.采用秩和检验和χ2检验对瘤周水肿指数与瘤体位置、体积及组织学分型进行比较.结果: 前颅窝及中颅窝脑膜瘤PTBE发生率和EI较其他部位均增高(P《0.05);恶性脑膜瘤(WHO-Ⅲ)PTBE发生率和EI较典型脑膜瘤(WHO-Ⅰ)均升高,分别为81.8% vs 57.8%(P《0.01), 3.4 vs 2.5 (P《0.01);纤维型脑膜瘤瘤周水肿EI较低,同分泌型和过渡型脑膜瘤相比,差别均具有统计学意义,分别为1.5 vs 7.4 (P《0.01), 1.5 vs 2.8 (P《0.05);脑膜瘤体积在80 cm3以下时肿瘤体积增加与PTBE的发生率增高有关,且肿瘤体积增大与EI降低有关.结论: 脑膜瘤位置、大小及病理分型与PTBE的发生及程度密切相关.     

人脑星形细胞瘤瘤周水肿机制的探讨

目的 探讨人脑星形细胞瘤瘤周水肿产生的机制,指导临床医生对患者病情判断、预后估计和治疗。方法 透射电镜观察星形细胞瘤微血管超微结构改变;免疫组织化学方法检测33例人脑星形细胞瘤血管内皮生长因子（vascular endothelial growth factor,VEGF）表达,并研究其与肿瘤病理分级和瘤周水肿（peritumoral brain edema,PTBE）的关系。结果 星形细胞瘤微血管超微结构表现为：微血管形态不规则,结构不完整,内皮细胞缺氧退变,毛细血管通透性增强。星形细胞瘤VEGF表达与肿瘤病理分级和PTBE明显相关（P＜0．002和P＜0．02）。结论 人脑星形细胞瘤瘤内微血管超微结构的特征性改变是PTBE产生的形态学基础。星形细胞瘤VEGF表达与肿瘤病理分级和PTBE明显相关。肿瘤细胞分泌VEGF是星形细胞瘤PTBE产生的重要原因。临床上可把PTBE和VEGF表达程度作为参考因素进行星形细胞瘤分级,分期判断和预后估计。     

脑膜瘤血管内皮生长因子与肿瘤增殖活性及瘤周脑水肿关系的研究

目的：研究血管内皮生长因子（VEGF）在脑膜瘤中的表达及其与脑膜瘤增殖活性，微血管密度及瘤周脑水肿（PTBE）的关系。方法：应用免疫组化方法检测36例脑膜瘤组织中VEGF，增殖细胞核抗原（PCNA），第Ⅷ因子（F8）的表达，测定其阳性细胞数；PTBE通过术前颅脑MRI／CT来评估。结果：脑膜瘤VEGF表达率为72％（26／36），5例可疑表达；PCNA，F8全部表达，VEGF表达与PTBE和微血管密度有显著正相关关系，其r分别为0．878和0．631，VEGF表达与PCNA表达没有相关性，其r为0．087。PCNA标记指数＜25％占97％（35／36）。结论：VEGF存在于脑膜瘤组织中，在PTBE和微血管形成 方面起着重要的作用。脑膜瘤属于低增殖活性的良性肿瘤。     

卵巢巨大浆液性交界性囊肿的危险因素分析

<正>脑转移瘤的发生率远超过颅内原发肿瘤,成为最常见的中枢神经系统肿瘤[1]。由于诊疗水平提升及恶性肿瘤患者生存时间的延长,脑转移成为限制生存时间进一步延长的主要因素。除外恶性肿瘤细胞自身不断的侵袭性增殖,超过90%的脑转移瘤还伴有瘤周水肿（peritumoral brain edema,PTBE）,加重颅内占位效应,不仅可导致颅内高压或脑疝形成,增加了局灶性神经缺失的发生率和死亡率。皮质类固醇激素始于1957年用于脑肿瘤所致的PTBE,     

EphB2在脑膜瘤中的表达及其与瘤周水肿关系的研究

目的 研究酪氨酸激酶EphB2在脑膜瘤中如何表达，以及与瘤周水肿的关系，并探讨瘤周水肿(PTBE)的可能发生机制。方法 收集44例脑膜瘤病人手术切除的肿瘤标本和作为对照的14例正常脑膜标本，采用免疫组化的方法分析、评价EphB2在不同类型的脑膜瘤中表达情况，根据病人术前的MRI资料、按照0～4级5点法评估瘤周水肿等级，并探讨它们之间的关系。结果 ①EphB2在44例脑膜瘤标本表达情况：“4”级7例，“3．5”级5例，“3”级6例，“2．5”级2例，“2”级8例，“1”级13例，“0”级3例，平均“2．19”级；②EphB2在14例正常脑膜中表达情况：“1”级4例，“0”级10例；③44例病人术前MRI显示33例有不同程度的PrBE，占75％。PTBE指数分别为：“4”级4例，“3”级11例，“2．5”级4例，“2”级3例，“1．5”2例，“1”级8例，“0”11例，平均“1．82”级。结论 ①EphB2在多数脑膜瘤细胞质中表达；②EphB2在脑膜瘤中表达与瘤周水肿呈正相关，提示EphB2参与脑膜瘤PTBE。     

脑膜瘤瘤周水肿形成机制的研究进展

临床观察脑膜瘤中有60%左右出现瘤周水肿(peritumoralbrain edema.PTBE)[1].PEBE增加了肿瘤的占位效应,破坏了血脑屏障,引起了持久的弥散性颅内压增高,加重了已有的临床症状,使脑膜瘤患者术后治疗时间延长,并增加了术后并发症.PEBE与脑膜瘤的大小、位置、组织学类型有一定关系[1],最近研究发现脑膜瘤与正常脑组织之间的接触面的形态变化以及水动力学等理化因素也与PEBE形成相关.     

分子生物学技术在中药作用机理研究中的应用

在文献检索的基础上,对近10年来在中药作用机理中主要应用的分子生物学技术——核酸分子杂交技术、反转录-聚合酶链式反应技术、差异显示PCR技术和DNA阵列技术的基本原理、应用实例、优势与不足做了概述,并对未来的中药机理研究技术、方向和前景做了展望。     

再生障碍性贫血发病机理的探讨

再生障碍性贫血(再障)是一组病因及发病机理较为复杂的造血功能障碍综合征,以往由于缺少研究手段,对其发病机理研究不够深入,临床治疗针对性不强,疗效差异也较大。晚近采用造血祖细胞培养技术对再障的病因及发病机理研究作了一些探讨,并试图对临床治疗作出有益的贡献。本文采用体内琼脂培养技术,对6例再障患者进行了检查,目的在于对发病机理及再障分型方法作一些探讨。     

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…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…