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.     

药用鼠尾草根中的二萜醌体外对人结肠癌细胞和肝癌细胞的细胞毒活性和DNA损伤作用

药用鼠尾草Saliva officinalis·L.根的石油醚提取物含有3种二萜醌(罗勒酮,SAR3;浩米酮,SAR26;乙酰浩米酮,SAR43),它们的结构与具有抗肿瘤作用的taxodiol和落羽松酮相似。作者研究了这3个化合物对人结肠癌细胞Caco-2和人肝细胞癌细胞HepG-2的细胞毒和DNA损伤作用。     

脸色腰段椎间盘突出症21例临床分析

胸腰段椎间盘突出症罕见,约占椎间盘突出的0.6％～4％。随着CT及MRI的应用,其发病率有增加的趋势。因其发病率低,报道较少。但由于病变位于脊髓圆椎段,其发病较下腰段椎间盘突出有很大的特殊性,故有必要结合我院近年收治的21例对其作一回顾性分析。1 临床资料     

氯喳咪酮:治疗血小板增多症的新药

氯咪喹酮(anagrelide)是一种咪唑并(2,1-b)喹唑啉-2-酮类化合物,对血小板有很强的抗聚集作用。人体试验显示,少量用药便可引起血小板减少。本文报告用氯咪喹酮治疗20例慢性骨髓增生性疾病重度血小板增多的疗效。病人和方法 20例中,17例为原发性血小板增多症,2.例为真性红细胞增多症并血小板增多,1例为慢性粒细胞白血病并血小板增多。     

缩短肝脏移植无肝期的护理探讨

肝移植手术是治疗终末期肝病的根本治疗手段，由于手术常伴有大量出血、渗血、渗液及输血治疗，而在无肝前期、无肝期、新肝期这三个不同阶段中，无肝期为病肝切除至新肝的大血管吻合开放，期间纤维蛋白原和凝血酶原等凝血因子不能合成，而类肝素样物质增加，出现明显的纤溶亢进，如伴有供肝情况不良，凝血因子合成减少而合成不能，就会产生凝血功能障碍，在无肝期中一旦发生则出血情况较为严重。     

持续性非瓣膜病性心房颤动患者复律前后血浆BNP水平的变化

脑型利钠肽(brainnatriureticpeptide,BNP)是一种由心脏和脑分泌的循环激素,由32个氨基酸残基组成,其分泌与心腔的容量负荷及压力负荷密切相关,现在临床较多用于心衰的早期识别和危险程度分级.持续性非瓣膜病性心房颤动是临床较为常见的一组疾病,因其有导致中风等致残事件的增加而倍受临床医师的关注,本文旨在评价该组病人的外周静脉血BNP水平以及在转复为窦性心律时的变化情况.     

小针刀疗法治疗第三腰椎横突综合征2例

目的探讨小针刀疗法治疗第三腰椎横突综合征的疗效和治疗机理。方法2例经保守治疗效果不佳的第三腰椎横突综合征患者改用小针刀松解术治疗。结果2例第三腰椎横突综合征痊愈。结论此法治疗，病人痛苦小、安全、易接受，值得推广。     

透析病人高血压对贫血的影响

大多数透析病人并发高血压，临床中发现一些高血压病人贫血较重，且促红素治疗效果欠佳；高血压对透析病人的贫血有没有影响，目前还没有文献报道。现调查镇江两所医院的血液净化中心，了解透析病人的高血压对其贫血的影响。[第一段]     

还原型谷胱甘肽在预防糖尿病大鼠勃起功能障碍中的研究

目的探讨还原型谷胱甘肽(GSH)在预防糖尿病大鼠勃起功能障碍中的作用。方法通过腹腔注射链脲佐菌素65mg/kg建立糖尿病大鼠模型,然后随机分成DM组和DM+GSH组,DM+GSH组每天肌肉注射GSH200mg/kg。10周后观察大鼠勃起功能,并获取海绵体组织检测其谷胱甘肽、一氧化氮合酶(NOS)与丙二醛(MDA)水平,用TUNEL法检测细胞凋亡。结果成功建立糖尿病大鼠模型。与未注射GSH的DM组相比,DM+GSH组和正常对照组(C组)勃起功能更好,勃起率分别是20%,62.5%和100%。GSH水平DM+GSH组和C组明显比DM组高,其3组含量每克蛋白分别是(75.83±15.62)、(61.47±8.65)和(35.03±12.29)mg(P<0.05);NOS水平在DM+GSH组每毫克蛋白为(133.9±31.9)U,与正常对照组每毫克蛋白为(142.2±31.2)U相当,但较DM组每毫克蛋白为(58.4±18.9)U高(P<0.05);MDA含量在DM组每毫克蛋白为(3.71±0.62)nmol,明显高于正常对照组和DM+GSH组(P<0.05),这两组每毫克蛋白为(2.08±0.34)nmol和(2.44±0.28)nmol;细胞凋亡率在DM组、DM+GSH组和C组的分别是(22.6±3.6)%、(10.8±1.7)%和(7.2±2.1)%(P<0.05)。结论还原型谷胱甘肽对糖尿病大鼠阴茎组织有较好的抗氧化作用,能减少细胞凋亡,对延缓糖尿病性ED的发生有一定的作用。