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岛叶病变的临床特征及其微创手术治疗(附30例报告)   总被引:10,自引:2,他引:8  
目的 总结岛叶病变的临床长期持征及其手术治疗的技巧。方法 对经侧裂手术入路治疗的30例岛叶病变病人的症状、病理结果进行回顾性分析。结果 29例以癫痫为首发症状;病变发生于优势半球212例;胶质瘤26例(低分级23例),脑动静脉畸形1例,海绵状血管瘤3例。结论 岛叶病变常以癫痫为首发表现,病理以低分级胶质瘤和其他良性病变为主,手术仍是目前主要的治疗手段。  相似文献
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目的 探讨伴有癫痫发作的岛叶病变患者癫痫发作特点、手术策略及癫痫预后.方法 分析18例岛叶病变切除患者的临床表现、手术及癫痫预后等情况. 结果 18例患者中14例首发症状为癫痫发作.左侧病变4例,右侧14例.单纯岛叶病变9例.全切11例,次全切7例.星形细胞瘤14例,海绵状血管瘤4例.术后随访11-33个月,13例(72%)癫痫发作完全消失.Engel疗效分级:Ⅰ级13例;Ⅱ级2例;Ⅲ级2例,Ⅳ级1例. 结论 手术切除岛叶病变,安全可靠,癫痫控制满意.  相似文献
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目的 检测活性调节细胞骨架蛋白(Arc)在模型大鼠海马组织中的表达,探讨Arc与岛叶点燃大鼠学习记忆的关系.方法 成年SD大鼠随机分为模型组、假手术组和空白对照组.应用避暗试验检测各组大鼠学习记忆功能.采用免疫组化、Western blot检测不同时间点Arc蛋白在海马组织中表达水平,运用RT-PGR检测其基因表达水平.结果 慢性电点燃成功后第1天(即点燃0周),点燃组、假手术组及空白对照组学习记忆能力差异无统计学意义(P>0.05).点燃2周:潜伏期(LT)(48.87±3.42)s,穿梭次数(EN)(2.75±0.99)次.点燃3周:LT为(48.71±2.77)s,EN为(2.75±1.15)次.点燃2周、3周与0周相比学习记忆功能增强(P<0.05).点燃4周与0周组比学习记忆功能明显下降(P<0.05).Arc在各组内蛋白及基因的表达均在1 h开始增加,6 h达到高峰,12 h恢复到基线水平.组间对比,2-3周内峰值最高,上升幅度明显(P<0.01),4周峰值及幅度明显下降(P<0.05),假手术组、空白对照组差异无统计学意义(P>0.05).结论 岛叶电点燃大鼠学习记忆功能及Arc在海马中表达变化趋势一致.Arc与岛叶点燃大鼠学习记忆功能密切相关.
Abstract:
Objective To research the expression of activity- regulated cytoskeletal protein in Insula Chronic Electricity igniting epilepsy rat's hippocampus,and to study the relation between Arc and electricity igniting epilepsy rat's learning and memory.Methods Adult SD rats were divided into model groups,sham operation groups,blank control groups.The model of rat insula chronic electricity igniting was built,and rats learning and memory ability were examined by way of passive avoidance test.The expression level of Arc in hippocampus was test by both immunohistochemistry and western blot,and the expression of Arc gene was test by RT- PCR.ResultThere was no significant difference of learning- remembering ability of rats between igniting group,control group and sham groups (P > 0.05) in the first week after insular chronic ignition when passive avoidance test was examined.The increased learning- remembering ability appeared in the 2nd week (LT:48.87 ± 3.42 s; EN:2.75 ± 0.99) ,3rd week(LT:48.71 ± 2.77 s;EN:2.75 ± 1.15) after the ignition(P <0.05).After 4 weeks,there was obvious decline of learn and memory (P<0.05 ).When testing the molecular biology of Arc,there was an enhancement in expression of protein and gene for Arc in subgroup time point from 1 h,to the submit when 6 h,and to primary level when 12 h.The general tendency was to rise when one week(w),to rise fast when 2w-3w,to rise obviously slowly when 4w(P <0.05).There was no sense for false operation sets and blank comparison sets.Conclusion The general tendency of the expression of Arc in rat hippocampus after the chronic insular electricity ignition is consistent with the learning- remembering ability of epilepsy rats.Arc is closely associated with the learning- remember ability for epilepsy rats.  相似文献
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岛叶解剖结构及生理功能都非常复杂,与岛叶相连的多个皮质区域参与到岛叶起始或扩散到岛叶的局灶性癫痫发作中,所以岛叶癫痫发作症状常与其他脑叶癫痫相混淆。研究发现岛叶癫痫的主要症状学特点为咽喉不适伴抓颈姿势、口周区感觉异常、发音困难或构音障碍、以局灶躯体运动表现结束。颅内电极埋藏是临床诊断隐源性岛叶癫痫的重要手段。对病灶性岛叶癫痫,手术切除岛叶病灶可获得满意的癫痫控制效果,而隐源性岛叶癫痫患者行岛叶皮层切除术或射频消融术的效果仍需进一步证实。本文拟对岛叶解剖,岛叶癫痫症状学、检查评估及手术治疗等方面的进展作一综述。  相似文献
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