Concomitant mitral valve repair and left ventricular reconstruction in a patient with chronic ischemic mitral regurgitation and inferior left ventricular aneurysm

The surgical approach to ischemic mitral regurgitation with concomitant inferior left ventricular aneurysm remains uncertain in terms of the indication for operation and the short-and long-term outcomes. We performed concomitant mitral valve repair, left ventricular reconstruction, and aortic valve replacement on a 71-year-old male with severe ischemic mitral regurgitation, inferior left ventricular aneurysm, and degenerative aortic regurgitation. Postoperative status was in New York Heart Association functional class I without mitral regurgitation 8 months after operation. We discuss, and review the procedures reported in the literature.     

Hemiballismus from a parietal stroke in a Parkinson patient.

Stroke-induced hemiballismus (HB) has been reported to improve motor function in people with Parkinson's disease (PD). We report on a patient who developed HB from a parietal infarct. The HB was improved by very low-dose clozapine but the HB did not improve the parkinsonism. This suggests that HB itself, whether from a lesion in the subthalamic nucleus or elsewhere, is not what improves motor function in PD; instead, the physiological function of the damaged structure is the determining factor.     

脑梗死急性期降压治疗对预后的影响

目的 研究脑梗死急性期降压及在不同时间进行降压治疗对患者近期预后的影响.方法 据发病后是否降压及进行降压的时间,将198例急性脑梗死患者分为6组,观察各组患者神经功能缺损程度及心脑血管事件的再发生率和病死率.结果 在发病后进行降压治疗的患者中其心脑血管事件再发率和病死率明显低于未降压组（P＜0.01） 3d后降压组患者神经功能恢复的程度明显好于未降压组（P＜0.01）.结论 降压治疗可以降低患者心脑血管事件的发生率和病死率3d后进行降压治疗的患者神经功能恢复明显要好.     

大鼠脑缺血再灌注后水孔蛋白-4的免疫组化表达与脑水肿关系的研究

目的　研究大鼠脑缺血再灌注后脑组织中水孔蛋白 - 4 (AQP- 4 )的表达与脑水肿的关系。方法　采用大鼠大脑中动脉栓塞 (MCAO)模型 ,经免疫组化法测定 AQP- 4表达阳性细胞数 ,干、湿重法测定脑水含量 ,脑水肿以脑水含量评价。结果　脑缺血再灌注后 12 h,脑缺血坏死周边区 AQP- 4表达阳性细胞及脑水含量增加 ,于 4 8～ 12 0 h 达到高峰 ,16 8h后仍处于较高水平 ,两者之间呈正相关 (r=0 .95 8,P<0 .0 1)。结论　脑缺血再灌注后AQP- 4参与脑水肿的发生 ,为脑缺血再灌注损伤的重要因素之一。     

Non-HIV-Related Progressive Multifocal Leukoencephalopathy (PML): A Tertiary Cancer Center Experience

In the course of 1 year at a tertiary cancer center, 3 patients (2 men; 1 woman; age 51-75 years) were seen in neurological consultation (1.5% of all consultations). Clinical course in all patients was of a progressive neurologic disorder not consistent with either a primary or secondary malignancy. Magnetic resonance (MR) imaging was most informative with respect to diagnosis and subsequent management. Brain biopsy was performed in all patients to assist in both diagnosis and prognostication. All patients were determined to have progressive multifocal leukoencephalopathy (PML) by brain biopsy.     

对脑卒中患者家庭照顾者护理指导的意义

目的探讨对脑卒中患者家庭照顾者实施护理指导对脑卒中患者日常生活活动能力及生活质量的影响。方法选择60例脑卒中出院患者随机分成观察组32例和对照组28例。指导组针对患者的康复训练和家居环境等问题,采用家庭访诊、电话随访等方法对脑卒中家庭照顾者进行为期1年的护理指导。用Barthel指数评价日常生活活动能力。用生存质量测评表(quality of living,QOL)评价患者的生存质量。结果指导组Barthel指数变化较明显(P<0.05),QOL也有一定程度提高。结论对脑卒中家庭照顾者实施护理指导,能够改善患者的日常生活活动能力和生活质量。     

1,6-二磷酸果糖治疗新生儿缺氧缺血性脑病合并心肌损害疗效观察

目的探讨1,6-二磷酸果糖(FDP)治疗新生儿缺氧缺血性脑病(HIE)合并心肌损伤的疗效.方法随机分成治疗组和对照组,均给予常规治疗,治疗组加用FDP 0.25～0.4g/(kg·次),1 次d静滴,10 d为一疗程,治疗前后均进行心肌酶测定.结果治疗组临床症状改善及心肌酶恢复效果均优于对照组,两组差异有显著性(P＜0.05).结论 FDP对HIE时的脑损伤及心肌损伤均有良好效果.     

纳洛酮、丽珠赛乐、复方丹参联合治疗新生儿缺氧缺血性脑病疗效观察

目的：观察纳洛酮，丽珠赛乐，复方丹参联合治疗中，重度新生儿缺氧缺血性脑病（HIE）的效果。方法:将52例中，重度HIE患儿随机分为治疗组和对照组。在综合治疗基础上观察两组患儿意识，呼吸，肌张力，原始反射，惊厥改善所需时间，并作统计学处理。结果：治疗组意识，呼吸，肌张力，原始反射，惊厥改善所需时间少于对照组，P均＜0．01，治疗组治疗5d的有效率63．33％，大于对照组的31．82％，P＜0．05。结论：在综合治疗基础上联合应用纳洛酮，丽珠赛乐，复方丹参治疗中，重度HIE可较快改善临床表现，缩短病程，提高治愈率。     

Acute subcortical stroke and early serotonergic modification: a IDAP study

The intensity dependence of the auditory-evoked potentials (IDAP) is inversely related to serotonergic tone. Depression is frequently observed after stroke, associated with cognitive impairment and increased mortality. Aim of this study was to investigate the serotonergic tone in acute stroke patients by IDAP. Consecutive patients with an acute stroke admitted in our stroke unit were evaluated using clinical and instrumental examinations and compared with healthy controls. The IDAP was calculated as the linear amplitude/stimulus intensity function (ASF) slope, by measuring the peak-to-peak amplitude of Nl-P2 on four blocks of different stimulus intensities. Twenty patients were enrolled; 11 had a right brain infarction; nine had depressive symptoms (DS). The ASF slope of the auditory-evoked potentials was markedly increased in stroke patients compared with controls ( P  = 0.021). Stroke patients with DS had a significant steeper ASF slope than controls ( P  = 0.017). There was no statistical difference in ASF slope between stroke patients without DS and controls. Post-stroke depression pathophysiology is still debated. Our study suggests that in acute stroke patients with DS, there is a direct involvement of the serotonergic system, regardless the degree of disability and the site of the lesion.