脑磁图描记联合术中唤醒用于显微镜下切除功能区胚胎发育不良性神经上皮瘤

目的总结脑磁图(magnetoencephalography,MEG)描记与术中唤醒联合应用切除功能区胚胎发育不良性神经上皮瘤(dysembroplastic neuroepithelial tumor,DNT)的经验。方法根据MEG结果大体确定功能区范围,在唤醒麻醉下应用术中皮质电刺激刺激相应区域皮质,明确功能区和DNT边界。在显微镜下切除DNT 4例,观察治疗效果。结果 4例患者手术效果良好,无功能区损害。长期随访未出现癫发作及DNT复发。结论联合应用MEG与术中唤醒技术显微镜下切除肿瘤是治疗功能区DNT安全、有效的方法。     

A DNA vaccine against extracellular domains 1-3 of flk-1 and its immune preventive and therapeutic effects against H22 tumor cell in vivo

AIM: To construct a DNA vaccine against extracellular domains 1-3 of fetal liver kinase-1(flk-1), and to investigate its preventive and therapeutic effect against H22 cell in vivo. METHODS: Flk-1 DNA vaccine was produced by cloning extracellular domains 1-3 of flk-1 and by inserting the cloned gene into pcDNA3.1(+). Fifteen mice were divided into 3 groups and inoculated by vaccine, plasmid and saline respectively to detect specific T lymphocyte response. Thirty Mice were equally divided into preventive group and therapeutic group. Preventive group was further divided into V,P,andS subgroups, namely immunized by vaccine,pcDNA3.1(+) and saline, respectively, and attacked by H22 cell. Therapeutical group was divided into 3 subgroups of V,P and S, and attacked by H22, then treated with vaccine, pcDNA3.1(+) and saline, respectively. The tumor size, tumor weight, mice survival time and tumor latency period were compared within these groups. Furthermore,intratumoral microvessel density (MVD) was assessed by immunohistochemistry. RESULTS: DNA vaccine pcDNA3.1(+)flk-1-domains 1-3 was successfully constructed and could raise specific CTL activity. In the preventive group and therapeutic group,tumor latency period and survival time were significantly longer in vaccine subgroup than that in P and S subgroups (P＜0.05);the tumor size, weight and MVD were significantly less in vaccine subgroup than that in P and S subgroups (P＜0.05). The survival time of therapeutic vaccine subgroup was significantly shorter than that of preventive vaccine subgroup (P＜0.05);the tumor size, and MVD of therapeutic vaccine subgroup were significantly greater than that of preventive vaccine subgroup (P＜0.05).CONCLUSION: DNA vaccine against flk-1 domains 1-3 can stimulate potent specific CTL activity; and has distinctive prophylactic effect on tumor H22, and also can inhibit the tumor growth in vivo. This vaccine may be used as an adjuvant therapy because it is less effective on detectable tumor.     

SPECT脑血流灌注显像在脑动静脉畸形中的应用

文章回顾了单光子发射计算机体层摄影术(SPECT)脑血流灌注显像技术的发展及其影像特征，并对应用SPECT研究脑动静脉畸形(AVM）与盗血、术后出血的关系、AVM与癫痫的关系以及癫痫灶的定位、功能区AVM的定位、术后复查和随访方法等作了介绍。     

术中直接电刺激在功能区病变手术中的应用（附86例分析）

目的总结术中直接电刺激技术在功能区病变手术中应用的经验。方法对大脑功能区病变手术中应用直接电刺激的86例临床资料进行回顾性总结。本组均在功能区得到保护的前提下,最大程度地切除病灶。结果术中定位出运动区74例。语言相关的功能区37例,感觉区11例。病变全切除51例（59.3％）,次全切除26例（30．2％）,部分切除9例（10．5％）。术后出现短暂性一侧肢体活动障碍23例,短暂语言障碍17例,永久性肢体运动障碍2例。结论皮质电刺激是一种可靠、无创的脑功能区定位方法,正确合理使用该方法有助于提高脑功能区病变的手术质量。     

大脑半球语言功能定位技术

大脑半球语言区胶质瘤的手术治疗是神经外科临床工作的一大难题。运用术前及术中语言功能定位技术有利于在尽可能保护正常脑功能的前提下,最大程度切除病灶,避免术后功能障碍。本文即对近年来采用的大脑半球语言功能定位技术进行综述。     

功能区肿瘤神经导航手术的新进展

传统神经导航技术能提高手术疗效,但对涉及大脑功能区的肿瘤效果并不理想.如何在手术时对功能区肿瘤进行精确定位,有效识别肿瘤附近的功能皮质及传导束,在最大程度切除肿瘤的同时尽可能保全病人的神经功能显得尤其重要.术中神经电生理监测技术(IOM)一直被视为定位功能区皮质及其传导纤维的金标准,而功能磁共振(fMRI)、弥散张量成像(DTI)及纤维示踪技术(FT)能无创显示大脑功能皮质及传导束的功能状态,近年来也备受关注.在涉及功能区肿瘤切除手术中,传统导航结合IOM、fMRI及DTI,并运用术中磁共振(iMRI)纠正术中脑移位成为近年来的研究方向.     

外伤性侧裂区血管损伤手术治疗体会

脑外侧裂区血管是分布于大脑半球功能区重要的脑供血动脉及回流静脉,其结构和位置特殊,较易损伤,处理困难,损伤后易致脑梗死或脑肿胀。本院自2003年至2008年对32例外侧裂区血管损伤患者及时手术治疗,疗效明显。现结合分析报告如下。     

肺腺癌A549细胞KDR基因沉默后对厄罗替尼敏感性的影响

目的研究激酶功能区受体(KDR)基因沉默对人肺腺癌A549细胞增殖和对化疗药物厄罗替尼敏感性的影响。方法设计合成KDR的si RNA序列,LipofectamineTM2000转染人A549细胞。RT-PCR和Western印迹检测KDR在干扰后m RNA和蛋白的表达情况,通过流式细胞仪检测细胞周期。MTT法和细胞克隆形成试验观察KDR基因沉默后A549细胞对厄罗替尼的敏感性。结果 KDR基因沉默48 h后,A549细胞的KDR基因和蛋白表达明显降低(P<0.05)。细胞周期被阻滞在G0/G1期,S期细胞数明显减少(P<0.05)。KDR基因沉默组细胞对厄罗替尼的敏感性显著性增强。结论 KDR特异性si RNA能显著沉默A549细胞KDR基因,抑制细胞增殖,并增强A549细胞对厄罗替尼的敏感性。     

fMRI对老年运动皮层功能区脑肿瘤手术应用价值的研究

目的研究血氧水平依赖法成像（blood oxygen level dependent,BOLD）fMRI在运动中枢受损老年脑肿瘤患者手术治疗的应用价值。方法36例顶叶区老年脑肿瘤患者随机分为对照组与功能组,对照组行常规MRI检查,功能组手术前后行常规MRI和fMRI。结果术前功能组18例中,由于肿瘤和（或）周边水肿的占位效应引起SMC和SMA功能区均有不同程度移位,术后复查9例功能区较术前有明显改善修复。功能组中术后肌力较术前有明显改善者占15例,与对照组手术前后肌力改变对比差异显著（P〈0.05）。结论fMRI对老年运动中枢受损脑肿瘤患者手术前制定方案具有重要临床意义。     

结直肠癌缺失基因功能区诱导结肠癌细胞凋亡

目的检测结直肠癌缺失(DCC)基因功能区转染表达后对结肠癌细胞SW1116凋亡的诱导作用。方法通过脂质体法将含有DCC基因胞内区功能域(3 727～3 792 bp)的重组表达载体pIRES2-EGFP-DCC转染到结肠癌细胞SW1116,MTT比色法检测细胞增殖情况,TUNEL、AO/EB染色法检测细胞凋亡情况。结果转染SW1116细胞36 h后,MTT比色法检测结果表明实验组细胞数目低于对照组,并且具有显著性差异;AO/EB染色及TUNEL法检测结果表明实验组有大量凋亡细胞,对照组未见凋亡细胞。结论 DCC基因的胞内功能域(3 727～3 792 bp)具有诱导结肠癌细胞凋亡的作用。