电视纤维内窥镜在耳鼻咽喉科的应用

纤维内窥镜是由许多导光玻璃纤维束组成,采用冷光源,镜管前端可随意弯曲,便于检查治疗,患者痛苦小;另一端由目镜组成,可连接摄像机,边检查边录像。　　　　使方方法　　　检查时,让患者取仰 度虚弱者,暂不作检查;高血压病可卧位或坐位,头稍后仰,纤维内窥镜 在血压控制后检查;心肺功能显著不经鼻或口腔插入。必须先令患者咬住 良者不能检查。(张凌整理)咬口并做适当固定,然后术者调节目镜视度环,将成像调至最请晰后进镜,活检钳缓慢插入取样时活检钳头扣牢以免活组织脱落。　　　　适应症　　　检查喉部及喉咽部,行活检、息…     

神经导航下经岩骨幕上下联合入路中面神经管的解剖研究

OBJECTIVE: To study the value of neuronavigation in the transpetroal approach, and to provide anatomic data for the protection of the nerves in the facial nerve canal (FNC) during surgeries. METHODS: Simulated surgery through the transpetroal approach was performed on 16 sides of 8 adult cadaver heads with the assistance by neuronavigation. The anatomy of the facial nerve and the relationship of related structures were observed and the distances from the utmost external edge of the mastoid to different segments of the FNC were measured. RESULTS: Neuronavigation was successful with all the FNC, with the mean error of less than 0.9 mm. The FNC could be divided into 3 segments, the labyrinthine, the tympanic and the mastoid segments, stretching 3.6+/-1.2 mm, 11.2+/-2.5 mm and 16.1+/-3.6 mm respectively and with diameters of 1.2+/-0.3 mm, 1.4+/-0.1 mm and 1.7+/-0.2 mm, respectively. CONCLUSION: Neuronavigation may help protect the FNC during surgical procedures, and a thorough knowledge of the anatomic features of the FNC can be significant for preservation of the facial nerves.     

2007世界神经创伤新进展大会纪要

2007年9月19-22日,由世界神经外科联合会(WorldFederation of Neurosurgical Societies,WFNS)神经创伤委员会主办,中国医师协会神经外科医师分会、天津市神经科学学会、天津市环湖医院及天津医科大学总医院联合承办的"2007世界神经创伤新进展大会(International Conference onRecent Advances in Neurotraumatology2007,ICRAN2007)"在天津市滨海新区成功举办。到会的嘉宾分别来自全球20多个国家和地区,逾450人报到参会,其中境外专家60余名。大会共收到论文近200篇,38人作了大会发言,举办了1场专题沙龙。     

铁调节蛋白2基因多态性与阿尔茨海默病及血管性痴呆的相关分析

Objective To evaluate the association of 2616c/T polymorphism in iron regulatory protein 2(IRP2)gene with Alzheimer disease(AD)and Vascular dementia(VD).Methods In this study,281 patients with AD,60 with VD,and 285 normal aged were recruited.The 2616C/T polymorphism in IRP2 gene was analyzed by using polymerase chain reaction-restriction fragment length polymorphism.And the cognitive function was assessed with the Mini-Mental State Examination(MMSE).Results (1)No significant difieFences were demonstrated in IRP2 genotype or allele frequencies between AD patients and controls(χ2=2.46,P=0.292;χ2=2.17,P=0.141 respectively).However,when AD patients were stratified by disease severity.the frequency of T allele carriers in the moderate to severe AD patients was 78.0%,significantly higher than that in controls(69.8%;χ2=4.106,P＜0.05).Logistic regression analysis demonstrated that the age-,sex-and ApoE-adiusted OR of modcrate to severe AD patient with T allele was 1.62(95% CI=1.03-2.54).The frequency of T allele carriers or T allele in VD patients was higher than that of controls,but the difference was not statistically significant(P＞0.05).(2)The frequency of tit genotype or T allele in the moderate to severe AD patients was significantly higher than that in mild AD patients(25.8%vs.12.5%,χ2=5.477,P＜0.05;51.9%vs.40.3%,χ2=5.803,P＜0.05 respectively).(3)MMSE scores of the AD patients with TT genotype was significantly lower than ones with CC or CT genotype(P=0.028;P=0.014 respectively).Conclusion The 2616C/T polymorphism in the IRP2 gene is possibly associated with moderate to severe AD.but not associated with VD.And the TT genotype may be a risk factor for cognitive impairment of patients with AD in Chinese Han.     

刺激神经干悬吊式助走装置治疗创伤性截瘫

应用刺激神经干悬吊式助走装置治疗创伤性截瘫。结果表明 :获得疗效 ,简便安全 ,减轻了护理强度 ,对截瘫患者的身体和心理状态的恢复极为有利     

神经精神性狼疮临床资料分析

目的探讨神经精神性狼疮的临床特点。方法以神经精神性狼疮或狼疮脑病为检索词,检索2000年~2006年国内公开发表的中文文献,选取其中有关临床分析及诊断的文献进行临床分析。结果神经精神性狼疮发生率占系统性红斑狼疮患者的15.1%,男女性别比约为1∶12,平均年龄31岁。神经精神症状以头痛(40.4%),癫痫发作(32.9%),意识障碍(21.8%),精神行为异常(12.8%)最多见;其他临床症状有发热(62.2%),关节疼痛(46.0%),面部红斑或皮肤损害(34.7%),肾损害(20.7%);脑电图约61%异常,颅脑CT有45.8%局灶或弥漫异常,MRI有66.7%弥漫性异常;抗核抗体阳性率49.2%,抗双链DNA阳性率33.4%。结论神经精神性狼疮以青年女性多见,常累及全身多系统和器官,诊断主要依据临床表现,影像学、血清抗体检查有一定参考价值,但特异性不高。     

经一侧半椎板入路显微手术切除椎管内神经鞘瘤

目的探讨经一侧半椎板入路在椎管内神经鞘瘤显微切除术中的应用。方法我们从1999年6月至2006年6月经一侧半椎板显微切除38例椎管内神经鞘瘤。其中肿瘤位于颈段13例，胸段19例，腰段6例。结果所有肿瘤均被全切除，病人术后2周即可下床活动，随访期内（2-48个月）患者的症状和体征均有明显改善，无手术并发症和脊柱畸形。结论经一侧半椎板入路能够最大程度保留脊柱后部的肌肉、韧带和骨结构，有利于脊柱的稳定性，具有手术创伤小、安全、卧床时间短等优点，值得进一步推广应用。     

格林-巴利综合征患者的神经肌电图分析

近年来，神经肌电图已广泛应用于临床，对格林-巴利综合征（GBS）具有重要的诊断价值。本文对我院近年来收治的20例GBS患者进行了神经肌电图检查。现将检查结果分析报道如下。     

遗传性神经纤维瘤病Ⅱ型一家系报告

神经纤维瘤病（NF）是基因缺陷造成神经嵴细胞发育异常、导致多系统损害的常染色体显性遗传性疾病。根据临床表现和基因定位分为神经纤维瘤病Ⅰ型（NFI）和Ⅱ型（NFⅡ）。其中NFⅡ较少见，现报告NFⅡ一家系如下。