原发性脑干损伤的治疗（附126例报告）

目的 探讨原发性脑干损伤的治疗方法与效果。方法 总结分析126例原发性脑干损伤病例的治疗与效果。对其中的大部分病例采用早期控制性通气，亚低温，钙拮抗剂及神经节苷脂治疗，结果 伤后2周，死亡35例（27.78%)。主要死因为中枢性呼吸功能衰竭。伤后半年，死亡50例（39.68%)。植物生存12例（9.52%)，重残11例（8.73%)。中残17例（13.40%)。恢复良好38例（30.16%)。结论 早期控制性通气，亚低温，钙拮抗剂及神经节苷脂治疗可明显降低原发性脑干损伤的死残率。     

高温、亚低温对大鼠脑缺血再灌注损伤的作用及其机制研究

目的：研究轻度高温、亚低温对大鼠脑缺血再灌注损伤组织兴奋性氨基酸（EAA）与氧自由基的相互关系及病理损伤程度的影响。方法：60只Wistar大鼠按不同脑温条件随机分为生化组（n=28）和病理组（n=32)，采用改良Nagasawa局灶脑缺血再灌注模型，观察脑缺血再灌注损伤组织谷氨酸（Glu），超氧化物歧化酶（SOD）、丙二醛（MDA）的变化及光镜，电镜下的病理变化。结果：轻度高温明显加重常温脑缺血再灌注损伤组织Glu、MDA的升高（P＜0．01）及SOD的下降（P＜0．05），加重常温脑缺血再灌注组织病理损伤程度，亚低温的作用则相反，结论：轻度高温可能通过同时促进EAA合成，释放和氧自由基生成系统活化，造成大鼠脑缺血再灌注损组织损伤加重；亚低温可能通过同时抑制EAA合成，释放和氧自由基生成系统活化，减轻大鼠脑缺血再灌注组织损伤程度，对大鼠脑缺血再灌注损伤组织起保护作用。     

冰帽头部低温治疗丘脑出血53例分析

丘脑出血约占全部脑出血的10％，发病部位靠近中线，紧邻下丘脑，临床上一般不选择手术治疗，其常见发病原因为高血压病，起病急，并发症多，死亡率高。我们使用冰帽头部低温治疗丘脑出血病人53例，疗效满意，特总结如下：     

血流阻断局部低温肾实质切开取石66例临床分析

目的 提高肾脏多发性、鹿角形结石的治疗效果。方法 对66例肾脏多发性和鹿角形结石进行血流阻断局部低温肾实质切开取石手术治疗。结果 本组66例中，一次性取尽结石61例，出院时常规照片发现在肾小盏内残留小结石5例，均小于0．5cm。漏尿1例，经充分引流，加强抗感染2周后治愈；肾周感染2例；均保存了患者的肾脏。结论本术式操作简单，术中出血少，并发症少。     

血绒毛膜促性腺激素β亚单位在早期诊断异位妊娠中的作用

异位妊娠又名宫外孕，是指受精卵种植在子宫腔以外部位的妊娠。近年来国内外文献报道异位妊娠发病率呈上升趋势，可能与性病、流产等高危因素增加、助孕技术广泛开展等有关。异位妊娠在早期与先兆流产有时不易鉴别，为了探讨血绒毛膜促性腺激素β亚单位（β-hcG）值在早期诊断异位妊娠中的价值，我们对比分析研究了同期住院的异位妊娠和先兆流产患者的血β-hcG值。     

五味子低温水提取物HPLC特征图谱的研究

目的 建立HPLC法测定五味子低温水提取物有效成分含量的方法.方法 用外标法测定五味子醇甲的含量.色谱柱Kromasil C18柱(250 mm×4.6 mm,5 μm),流动相为乙腈-水系统(梯度洗脱),流速1.00 mL/min,柱温30℃,流速1.0 mL/min,检测波长240 nm.结果 五味子醇甲的线性范围为5.0-200.0 μg/mL;r=0.999 9:平均加样回收率为101.27%(RSD为1.97%;n=6).结论 该测定方法简便可靠,专属性强,重现性好,可为五味子制剂的质控标准提供参考依据.     

弥漫性轴索损伤行亚低温治疗的护理

弥漫性轴索损伤（diffuse axonal injury DAI）是外伤直接引起的脑白质广泛性轴索损伤，是闭合性颅脑损伤中最严重的原发性损伤之一，占重型颅脑损伤20％，占死亡病人的29％-43％。其临床特点为病情危重，昏迷时间长，并发症多，这就给临床治疗和护理提出了更高要求，早期行亚低温治疗并给予护理干预，将大大提高病人的生存率，降低死亡率，提高病人的生命生存质量。     

Changes in T .lymphocyte subsets after severe traumatic brain inJury

BACKGROUND： Besides local changes of cranial parenchymal cells, hemorrhage, etc., severe traumatic brain injuries also cause the changes of total body fluid and various functions, and the changes of lymphocytes and T lymphocyte subsets should be paid more attention to. OBJECTIVE： To reveal the changing laws of T lymphocyte subsets after severe traumatic brain injury, and compare with mild to moderate brain injury. DESIGN： A comparative observation. SETTINGS： Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City; Central Laboratory of Shenzhen Hospital of Prevention and Cure for Chronic Disease. PARTICIPANTS： All the subjects were selected from the Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City from August 2002 to August 2005. Thirty patients with severe brain injury, whose Glasgow coma score （GCS） was ≤ 8 points, were taken as the experimental group, including 21 males and 9 females, aging 16 - 62 years. Meanwhile, 30 patients with mild traumatic brain injury were taken as the control group （GCS ranged 14- 15 points）, including 18 males and 12 females, aging 15 -58 years. All the subjects were in admission at 6 hours after injury, without disease of major organs before injury Informed consents were obtained from all the patients or their relatives. METHODS： （1） The T lymphocytes and the subsets in peripheral blood were detected with immunofluorescent tricolor flow cytometry at l, 3, 7 and 14 days after injury in both groups. （2） The conditions of pulmonary infections were observed at 4 days after injury. The differences of measurement data were compared with the t test. MAIN OUTCOME MEASURES： Changes of T lymphocytes subsets at 1 - 14 days after severe and mild or moderate traumatic injury. RESULTS： Finally, 28 and 25 patients with mild to moderate traumatic brain injury, whereas 25 and 21 patients with severe traumatic brain injury were analyzed at 7 and 14 days respectively, and the missed ones died due to the development of disease. （1） Changes of T lymphocyte subsets： At 1 and 3 days after injury, CD3, CD4, CD8, CD4/CD8 began to decrease, whereas CD8 increased in the experimental group, which were very significantly different from those in the control group （t =2.77 - 3.26, P 〈 0.01）, and began to recover at 7 days, which were significantly different from those in the control group （t = 2.06 - 2.24, P 〈 0.05）, and generally recovered to the normal levels at 14 days （P 〉 0.05）. （2） Conditions of pulmonary infections： At 4 days after injury, the rate of pulmonary infection was significantly different between the experimental group and control group [73% （22/30）, 0, x2=37.29, P 〈 0.01]. CONCLUSION： Patients with severe traumatic brain injury suffer from damages of cellular immune function at early period （within 7 days）, and they are easily to be accompanied by pulmonary infections.     

人血管生长素的亚细胞定位

已有大量研究表明血管生成素（angiogenin，ANG）与肿瘤的快速生长和转移有密切的关系，肺癌、胰腺癌、乳腺癌等患者的外周血血清中，ANG的水平明显升高，血清ANG的水平与这些肿瘤的发展及转移呈显著正相关，因此，可以检测血清中ANG的水平来预测肿瘤的发生与发展情况。此外，ANG对于创伤、烧伤及血循环较差的股骨头、半月板等损伤的修复具有较大的临床应用价值。在本研究中我们构建了人ANG真核表达质粒，转染人脐静脉内皮细胞（HUVEC）进行表达，并作了初步的亚细胞定位。