Pediatric intracranial aneurysms——clinical characteristics and therapeutic strategies

Objective To assess the radiological characteristics and therapeutic strategies of intracranial aneurysms in children. Methods From our dedicated neurovascular databank of patients, we reviewed 23 consecutive children who had 24 intracranial aneurysms. There were 14 boys and 9 girls with a mean age of 9.09 years ( range 1 - 14 years ). Results Intracranial aneurysms in children ≤ 14 years constituted 1.3% of all intracranial aneurysms. Internal Carotid artery (ICA) and middle cerebral artery (MCA) were the most frequent sites for aneurysms. About 58.3% of the aneurysms were complex, including dissecting, pseudoaneurysm, giant and fusiform aneurysm. 1/3 of all aneurysms were located in posterior circulation. Only 1 case had multiple aneurysms in this case series. Almost half of all cases presented with subarachnoid hemorrhage and others presented with mass effect. 14 cases underwent endovascular treatment. 4 patients received microsurgical therapy. 5 cases did not receive microsurgical or endovascular therapy, 2 of them whose aneurysms spontaneously thrombosed during follow up. One boy with left vertebral artery giant aneurysm died after endovascular therapy owing to gradual thrombosis in basilar artery. Another child had poor outcome because of rerupture of aneurysm before operation. Whereas the majority had a favorable outcome. Conclusions Intracranial aneurysms in children had many clinical and radiological characteristics different from those in adults : ( 1 ) remarkable male predominance; ( 2 ) ICA and MCA were the most common sites for aneurysms; (3) high incidence of large, traumatic, infectious, dissecting and fusiform aneurysms. (4)For pediatric intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. Endovaacular therapy was the best choice for complex aneurysms.     

父母为供者的异基因外周血干细胞移植治疗白血病六例

异基因造血干细胞移植是治疗白血病的有效方法，限于我国的国情，青少年患者要获得HLA位点完全相合的供者，机会很小。我们于2003年5月至2004年12月间，以父母为供者，对6例白血病患者进行了HLA位点不相合的干细胞移植，报告如下。     

大鼠静脉窦高压致硬膜血管变化的研究

目的探讨大鼠静脉窦高压后硬膜血管变化及其静脉窦高压在硬脑膜动静脉瘘形成中的作用。方法体重200～250g的SD雄性大鼠110只,随机分为静脉窦高压组(85只)和假手术组(25只),将静脉窦高压组85只大鼠闭塞左侧横窦和上矢状窦前1／3,并吻合右侧颈总动脉和颈外静脉,制成静脉窦高压模型。假手术组大鼠单纯解剖相应的颈部血管和硬脑膜窦,但不行吻合或闭塞。术后90d,随机取7只静脉窦高压组大鼠和5只假手术组大鼠,行硬脑膜血管明胶墨汁灌注,观察硬膜血管的状况。结果术后90d静脉窦高压组和假手术组大鼠的硬膜血管数分别为(10.7±1.5)条／mm,(10.3±0.6)条／mm,差异无显著性。在静脉窦高压组中1只大鼠有硬脑膜动静脉瘘,其形态和结构与生理性动静脉短路类似。结论大鼠静脉窦高压一段时间后,颅内硬膜血管无明显增生。颅内硬脑膜动静脉瘘的形成很可能是由动静脉间的短路发展而来。     

拉坦前列素可导致睫毛下垂

目的:报道因拉坦前列素导致的1例睫毛下垂。设计:观察性病例报道。方法:回顾性图表综述。结果:1例61岁双眼高眼压患者因使用拉坦前列素导致双侧睫毛增多、下垂,停止拉坦前列素后6个月,睫毛下垂症状仍未缓解,后进行前部眼睑睑板位置调整术。手术治疗后的8个月内,眼睑位置正常,但睫毛增多症状仅轻度改善。结论:睫毛下垂可能是拉坦前列素所致的并发症。拉坦前列素可导致睫毛下垂@Casson R.J.$Glaucoma Unit, Department of Ophthalmology, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia @Selva D. @张…     

雌激素替代疗法与视网膜血管管径

目的:尚不清楚雌激素替代疗法(ERT)是否对视网膜循环有作用,本研究旨在明确ERT、女性生育因素与视网膜血管管径的联系。设计:基于人群的横断面研究。受试者:在威斯康星州BeaverDam居住的43～84岁妇女。方法:对基线时拍摄的受试者视网膜照片数字化处理,用已公认的方法测量小动脉及小静脉直径,通过访谈明确雌激素替代疗法的应用及女性生育因素。主要观察指标:小动脉及小静脉直径。结果:分析2469例受试妇女的数据,10.5%正在接受ERT,7.4%在过去接受过ERT。对年龄、血压(BP)、体重指数、吸烟及其他因素矫准后,正在接受ERT者的视网膜小动…     

非自杀原因引起有机磷中毒45例临床分析

目的：分析45例非自杀原因引起有机磷中毒的临床表现，以提高其早期诊断率，减少误诊误治。方法：对1996年6月－2001年9月收治的45例非自杀原因引起有磷中毒患，通过病史、就诊时症状、体征，初步诊断，全血胆碱酯酶活力测定进行回顾性分析，并对如何防范误诊、漏诊，提高早期诊断率进行了讨论。结果：45例非自杀原因引起的有机磷中毒就诊时初步诊断为有机磷中毒12例（27％），急性胃肠炎16例（36％），神经官能症5例（11％），中暑5例（11％），低血糖2例（4％），心肌炎2例（4％），肺部感染3例（7％），初诊误诊率达73％。结论：出现不明原因的恶心、呕吐，腹痛、腹泻，皮肤麻木，大汗淋漓，面色苍白，呼吸困难等症状的患，应警惕有机磷中毒，须详细询问饮食史及有机磷农药接触史，作全血胆碱酯酶活力测定，以便早期明确诊断，防止误诊、漏诊的发生。     

多沙唑嗪胃肠道治疗系统(GITS)对急性尿潴留疗效好

为评价多沙唑嗪胃肠道治疗系统（GITS，多沙唑嗪控释片）对于良性前列腺增生症（BPH）导致的急性尿潴留（AUR）的有效性，Lorente Garin等进行了一项随机、前瞻性的研究。入选了40例因BPH初次患AUR的患者。随机选出20例在拔除尿管前服用7d的4mg多沙唑嗪控释片治疗。未治疗而未恢复自主排尿的患者也应用4mg多沙唑嗪控释片治疗。     

经鼻内镜切除复发性腺样体21例报告

近年，我们在鼻内镜下行21例病人腺样体再手术，取得了良好疗效，报道如下。