Intraoperative cerebral blood flow monitoring in neurosurgery: A review of contemporary technologies and emerging perspectives

Intraoperative monitoring of cerebral blood flow (CBF) has become an invaluable adjunct to vascular and oncological neurosurgery, reducing the risk of postoperative morbidity and mortality. Several technologies have been developed during the last two decades, including laser-based techniques, videomicroscopy, intraoperative MRI, indocyanine green angiography, and thermography. Although these technologies have been thoroughly studied and clinically applied outside the operative room, current practice lacks an optimal technology that perfectly fits the workflow within the neurosurgical operative room. The different available technologies have specific strengths but suffer several drawbacks, mainly including limited spatial and/or temporal resolution. An optimal CBF monitoring technology should meet particular criteria for intraoperative use: excellent spatial and temporal resolution, integration in the operative workflow, real-time quantitative monitoring, ease of use, and non-contact technique. We here review the main contemporary technologies for intraoperative CBF monitoring and their current and potential future applications in neurosurgery.     

甘肃省武威市胃癌发病率对比分析

目的:探讨甘肃省武威市胃癌发病特征及其流行趋势。方法:通过建立恶性肿瘤登记报告获取胃癌发病资料。结果:武威市胃癌发病率1991 ~ 1995 年为 61 62/10 万,1996~ 2000 年为 55 .96/10 万,后期低于前期。年龄组发病率前后两期均随年龄的增高而上升,65 岁以前各组前期高于后期,65岁及以后各组后期明显高于前期。结论:武威市胃癌发病呈下降趋势。     

活动性肺结核患者血清Fad D9重组蛋白、sCD14-ST及单核细胞P糖蛋白水平及其临床意义

目的探讨活动性肺结核(APTB)患者血清Fad D9重组蛋白、可溶性白细胞分化抗原14亚型(sCD14-ST)、单核细胞P糖蛋白(Pgp)表达及其临床意义。 方法选取96例APTB患者(APTB组),按照肺部病灶有无空洞和病灶肺叶数分亚组。同期选择体检健康且经γ干扰素释放试验检测阴性者(健康对照组,HC组)及阳性者(结核潜伏感染组,LTBI组)各48例。比较各组血清Fad D9重组蛋白、sCD14-ST、Pgp水平。评估Fad D9重组蛋白、sCD14-ST、Pgp诊断APTB和鉴别APTB、LTBI的价值。 结果Fad D9重组蛋白、sCD14-ST、Pgp水平APTB组＞LTBI组＞HC组,且有空洞者高于无空洞者,病灶肺叶≥3个者高于＜3个者(P＜0.05)。Fad D9重组蛋白、sCD14-ST、Pgp对APTB诊断和APTB、LTBI鉴别有良好效能(P＜0.05)。 结论APTB患者血清Fad D9重组蛋白、sCD14-ST及Pgp明显升高,且与肺部病灶的严重程度有关。     

Risk Factors of Gastric Cancer in Wuwei City- an Endemic Region of Gastric Cancer

OBJECTIVE Studies have shown that risk factors of gastric cancer include living habits, eating moldy pickled food, dystrophy, lack of nutrients, and genetics, etc. This study explores the prevalence of these factors in Wuwei, a city in northwest China with a high incidence of gastric cancer.METHODS Family histories of the residents in Wuwei City were investigated with a case-control method. Segregation ratio and heredity degree of gastric cancer were calculated using theLi-Mantel-Cart and Falconer's regression methods. Chronic gastritis patients were followed-up by home visits, gastroscopy, and pathology. Carcinogenic fungi and volatilile N-nitroso compounds were noted in the residents' meals. Helicobactor pylori (Hp) was assessed in their gastric mucosa and the total content of serum vitamin C in 293 healthy adults was determined.RESULTS In Wuwei City, the segregation ratio of gastric cancer was 0.077. The heredity degree of first-degree relatives was 22.91%. The incidence rate of cancer per year in people in an atrophic gastritis group was 1.09%. Eight kinds of nitrosamines and 14 kinds of carcinogenic fungi were detected in the residents' food. Total average vitamin C in the serum of the 293 healthy adults in the summer was 5.74±2.79 mg/L. The positive rate of Hp in gastric mucosa of the residents was 67%.CONCLUSION The majorextrinsic factors include infection of Hp, atrophic gastritis (especially atrophic hyperplasia), and genetic susceptibility.     

咪达唑仑导致神经功能损伤及作用机制研究

目的：探讨镇静药咪达唑仑导致神经功能损伤及其机制。方法：将72 只大鼠分为生理盐水对照组、咪达唑仑组、右美托咪定组三个组别，每组各24 只，比较三组大鼠的神经元特异性烯醇化酶（neuron-specific enolase，NSE）、中枢神经特异性蛋白（central nervous specific protein，S100β）、细胞死亡受体Fas 水平、逃逸潜伏期、游泳速度、穿过原平台次数，对NSE、S100β、Fas 病理切片进行分析。结果：与对照组和右美托咪定组相比，咪达唑仑组 NSE、S100β、Fas 水平较高，逃逸潜伏期较长，穿过原平台次较少（P<0.05）。结论：咪达唑仑对神经功能损伤以及学习记忆功能影响较大。     

积极护理干预对甲状腺功能减退孕妇妊娠结局及胎儿的影响

目的 探讨积极护理干预对甲状腺功能减退孕妇妊娠结局及胎儿的影响。方法 选择2015年3月至2016年3月在武威市妇幼保健计划生育服务中心建档并最终分娩的145例妊娠合并甲状腺功能减退的孕妇作为研究对象,按就诊号顺序编号,随机数字表法分为对照组（72例）和干预组（73例）。对照组患者给予常规孕期指导并给予左旋甲状腺素替代治疗,干预组患者在对照组药物治疗的基础上,增加积极的护理干预措施,包括制定详细诊疗及护理方案,定期进行甲状腺功能减退知识普及、心理疏导、饮食、运动干预。观察并比较两组患者妊娠结局及对胎儿的影响。结果 干预组患者早产及贫血的发生率低于对照组,差异有统计学意义（P<0.05）。干预组的新生儿出生体重高于对照组（P<0.05）,胎儿窘迫、胎儿生长受限的发生率均低于对照组（P<0.05）。两组患者在胎膜早破、死胎、新生儿窒息等方面相比,差异均无统计学意义（P>0.05）。结论 积极护理干预可以有效降低不良妊娠结局发生率,减少对围生期胎儿的不良影响。     

2型糖尿病胃轻瘫脾胃亏虚证患者实施中药治疗的效果分析

目的分析2型糖尿病胃轻瘫脾胃亏虚证实施中药治疗的临床疗效。方法研究对象选择该院2018年1—12月收治的68例2型糖尿病胃轻瘫脾胃亏虚证患者,将其划分为观察组和对照组,每组34例。对照组选择常规基础治疗结合莫沙必利片口服治疗,观察组则采用基础治疗配合中药汤剂治疗。比较两组患者治疗后的临床症状改善情况来判定疗效。结果该次研究结果表明,观察组的临床疗效达到了94.1%,而对照组的临床疗效只有79.4%,数据差异有统计学意义(P<0.05)。结论2型糖尿病胃轻瘫脾胃亏虚证患者实施中药治疗能够保障患者胃动力恢复正常,且在不影响血糖水平的前提下有效改善临床症状。     

自身免疫性胰腺炎诊治进展

自身免疫性胰腺炎(AIP)是一种由自身免疫介导、以胰腺肿大及胰管不规则狭窄为特征的胰腺慢性炎症性疾病,病理以胰管纤维化伴有淋巴浆细胞浸润为特征,其治疗尚缺乏统一标准。本文就自身免疫性胰腺炎的流行病学、发病机制、临床特点、影像学检查、病理学特点、诊断标准、治疗及预后七个方面的相关研究进展进行综述,以加深对其认识及了解。     

VEGFR-3小干扰RNA对结肠癌裸鼠移植瘤生长的影响

目的:研究血管内皮生长因子受体3(vascularendothelial growth factor receptor 3,VEGFR-3)小干扰RNA对结肠癌细胞移植瘤模型生长的影响.方法:构建VEGFR-3小干扰RNA表达载体.将结肠癌LoVo细胞注射入裸鼠皮下建造裸鼠移植瘤模型.将15只裸鼠结肠癌模型随机分成3组:实验组(pG-siRNA/VEGFR-3重组质粒)、阴性对照组(pG-HK重组质粒)与空白对照组.分别瘤体内注射相应的siRNA混合物或转染剂混合液,每3 d注射1次,共注射3次,观察肿瘤体积的变化;6 wk后处死裸鼠,肿瘤称取质量,并进行qRT-PCR和Western blot测定VEGFR-3 mRNA和蛋白的变化,通过免疫组织化学进行微淋巴管计数.结果:实验组移植瘤体积和质量明显小于阴性对照组和空白对照组,有显著的统计学意义(P<0.001).实验组抑制率为52.75%,与对照组相比,差异有显著(P<0.001).qRT-PCR和Western blot测定VEGFR-3 mRNA和蛋白的变化比较,实验组有明显降低(P<0.001).实验组淋巴管计数较对照组差异显著(P<0.05).结论:VEGFR-3 siRNA可以抑制裸鼠结肠癌细胞移植瘤的生长,并减少裸鼠移植瘤淋巴管生成,能有效抑制结肠癌细胞的生长.