头穴围刺结合运动疗法对脑梗死大鼠血管新生机制的影响

目的:观察头穴围刺结合运动疗法对脑梗死大鼠血管新生的影响。方法:采用健康雄性wistar大鼠75只随机分为假手术组、模型组、头穴围刺组、运动组、围刺+运动组,每组15只。参照Zea-Longa报道的线栓法,制备大脑中动脉梗死(MCAO)脑缺血再灌注模型,采用对应的方法进行干预,干预14天后进行行为学评估;每组随机选取5只大鼠用TTC染色法测定脑梗死面积比;RT-PCR法检测β-catenin mRNA、GSK-3βmRNA表达水平,western-blot检测血管内皮细胞VEGF水平。结果:14天后围刺+运动组mNSS评分、脑梗死面积比优于模型组、头穴围刺组和运动组(P<0.01)。围刺+运动组与其它各组相比可明显上调β-catenin蛋白表达、下调GSK-3β水平、增加VEGF表达(P<0.01)。结论:头穴围刺结合运动疗法可促进脑梗死大鼠的血管新生。     

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.     

血液透析内瘘的简便术式-动静脉套接法

血液透析是慢性肾功能衰竭患者重要的替代治疗手段之一.目前临床用动静脉端端、端侧吻合的方法建立动静脉内瘘.本组报告一种简单安全、并发症少的动静脉套接内瘘术方法,现报道如下.……     

胎心监护在羊水过少患者产程中的应用

羊水能够保护胎儿，使胎儿活动自如，防止胎体粘连致畸，给胎儿一定的活动空间，使其不致受到挤压和机械损伤；临产时使宫缩压力均匀分布，避免胎体或脐带直接受压引起胎儿窘迫。对于母体同样有保护作用，缓冲了胎动引起的不适，并在临产时对产道有润滑冲洗作用。羊水过少对围产儿预后的不良影响已受到广泛重视。下面以我院近期羊水过少患者的胎心监测及处理结果共同探讨胎心监护在羊水过少患者产程中的应用。[第一段]     

完全性胸腹腔内脏反位合并十二指肠壶腹周围癌一例报告与文献复习

目的总结完全性胸腹腔内脏反位合并十二指肠壶腹周围癌的临床诊治方法。方法报道2006年3月收治的1例极为罕见的完全性胸腹腔内脏反位合并十二指肠壶腹周围癌行胰十二指肠切除术的病例,并复习国内外相关文献。结果本例患者病理诊断为十二指肠乳头及壶腹部腺癌Ⅰ-Ⅱ级。术后1周胆红素降至正常;但2周后出现胃-空肠吻合输出袢粘连性不完全性梗阻,经内镜下置管、鼻饲、营养支持、针灸等处理,40d后痊愈出院。经检索,全球自1936-2006年间报道的全胸腹腔内脏反位合并恶性肿瘤的患者仅15例;其中只有5例全胸腹腔内脏反位合并胰头与壶腹周围癌的报道。结论完全性胸腹腔内脏反位合并肿瘤时,若无明显禁忌证,应同样予以积极的外科治疗,术中操作应注意完全相反的解剖学结构。     

RP-HPLC法测定大鼠血浆中苦参碱的含量

苦参碱类生物碱以苦参碱为代表，来源于豆科植物苦参Sophora flavescens Ait．、苦豆子S.alopecuroides L.及广豆根S．subprostrata Chun et T. Chen中。苦参碱有多方面的药理作用和功效，如抗菌、抗炎、抗肿瘤、抗过敏、抗心律失常、消肿利尿、免疫及生物反应调节作用等。本实验建立了RP-HPLC法测定大鼠血浆中苦参碱含量的方法，为进行苦参碱的药动学研究提供了一个灵敏、可靠的检测手段。     

腹腔镜诊治外科急腹症的体会（附14例报业）

目的探讨腹腔镜在外科急腹症中的应用。方法回顾性分析本院收治的14例外科急腹症的临床资料。结果12例术中明确诊断，1例经细菌培养后确诊，1冽探查阴性；6例腹腔镜手术成功，5例中转开腹完成手术，1例延长戳孔完成手术，1例内科治疗，均痊愈。结论腹腔镜诊治急腹症具有创伤小、视野清晰、恢复快的优点。     

北京地区医疗急救网调查分析及探讨

随着人类社会文明进程和科学技术的不断更新，城市建设及交通、旅游的不断发展，人口的老龄化，使各种急、危、重症发病率增高。同时，民众对医疗的需求也在增加。北京是全国的政治文化中心、按照将北京建成国际大都市的要求，医疗卫生工作水平的提高是必不可少的。鉴于此，本文通过对1988年～1995年北京地区院外急救情况的调查分析，探讨了如何更好地健全急救网络、开展医疗急救服务。调查资料北京市总面积17800平方公里，18个区县，人口1164．3万，流动人口约102．5万，旅游景点达200余个。市级医院156所，区县级医院18所，中央级医院13所…