显微外科治疗Chiaril畸形并脊髓空洞症33例分析

我科2001—01-2005—12共收治Chiaril畸形并脊髓空洞33例，均经MRI证实并行显微外科手术治疗．效果满意．现分析如下。     

脐带间充质干细胞在颅脑损伤模型鼠体内的迁徙与定位

BACKGROUND: Choosing an effective means to label and trace the distribution, differentiation and migration of cells in vivo help to further explore the specific mechanism of cells that exert a therapeutic effect.OBJECTIVE: To understand the migration and localization of BrdU-labeled human umbilical cord mesenchymal stem cells in brain injury model rats.METHODS: Human umbilical cord blood samples were obtained, and the isolation of human umbilical cord mesenchymal stem cells was carried out. The primary and passage culture were performed. The phenotype of cells was detected by flow cytometry. Passage 3 human umbilical cord mesenchymal stem cells were labeled using BrdU, and the cell proliferation was detected using MTT method. BrdU-labeled cells were injected into brain injury rats via the tail vein. At 14 days after transplantation, brain tissues in the injury region were cut into sections and the migration and location of the umbilical cord mesenchymal stem cells were observed under inverted fluorescence microscope.RESULTS AND CONCLUSION:Cell surface specific markers CD45 and CD34 were detected by flow cytometry, but the cells could not express CD44, CD105 and CD29. Based on the cell growth curve, the cells came into a conditioning period at 1-3 days of seeding and came into a logarithmic phase at 3-5 days. BrdU-positive cells were visible at the injury region after 14 days, indicating that in the rats, transplanted human umbilical cord mesenchymal stem cells migrated from the peripheral blood to the site of brain injury to achieve the effective repair of injured parts.  中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程     

双侧脑室外引流及腰池引流治疗重度脑室出血

目的探讨重度脑室出血的治疗方法。方法:对23例重度脑室出血的病例行双侧脑室外引流及腰池持续引流治疗。结果:存活率80．5％(29／36),死亡率19．5％(7／36),CT显示三、四脑室内血肿清除时间3-6天,平均4．3天。结论:及早疏通脑室系统梗阻是脑室出血的治疗关键,双侧脑室外引流及腰池引流治疗重度脑室出血是一种积极有效的方法。     

重型颅脑损伤并发急性呼吸窘迫综合征26例分析

对我科1998—01-2005—12收治的重型颅脑损伤中并发急性呼吸窘迫综合征（ARDS）26例分析如下。     

慢性硬膜下血肿术后复发诊治分析

目的探讨慢性硬膜下血肿(CSDH)术后复发的原因及其治疗方法。方法12例复发者再次手术,切取的包膜作病理切片,光镜下观察包膜组织的变化。结果11例复发者经再次手术治疗治愈,1例在一周内再次复发,经第三次手术治愈。手术标本光镜下观察发现包膜内血管增生伴大量嗜酸性粒细胞浸润。结论手术操作轻柔,避免颅内压急剧变化和血肿残留,保持引流通畅,是降低CSDH术后复发的有效措施。慢性硬膜下血肿复发的首选治疗方法是钻孔引流术。     

原发性高血压性脑出血的早期血肿扩大的诊断与治疗

本文总结 12例原发性高血压性脑出血早期血肿扩大患者的诊断治疗体会 ,现报告如下。1　临床资料1 1　一般资料　男 8例 ,女 4例。年龄 42～ 68岁 ,平均 5 5 8岁。患高血压 1 2～ 8年 ,平均 5 6年。没有治疗或不正规治疗7例 ,有肝病史者 3例 ,长期酗酒者 1例。1 2　临床表现及ＣＴ检查　见表 1。　　　表 1　临床表现及ＣＴ检查结果ＧＣＳ 血　　　压(从入院至血肿扩大时 )发病距首次ＣＴ时间 两次ＣＴ间隔时间 血肿部位内囊 /丘脑 /壳核 /其它 血　肿　量8 8分(入院时 ) 1 80～ 2 50 / 95～ 1 2 0ｍｍＨｇ <6ｈ8例<2 4ｈ9例 3/ 4 / 2 / 3(…     

重型颅脑损伤并发急性呼吸窘迫综合征的诊断和治疗

目的探讨重型颅脑损伤后并发急性呼吸窘迫综合征(ARDS)的诊断与治疗。方法对26例重型颅脑损伤并发ARDS患者的临床资料进行回顾性分析,并结合文献,对重型颅脑损伤后并发ARDS的发病原因、诊断标准及治疗方法进行讨论。结果26例患者诊断治疗正确,15例抢救成功,11例死亡。结论重型颅脑损伤后并发ARDS死亡率较高。早期诊断是其抢救成功的关键。     

慢性硬膜下血肿的手术治疗

目的:总结手术治疗慢性硬膜下血肿的经验及疗效。方法:分析147例慢性硬膜下血肿患者的临床及影像学特征、手术方法、疗效和经验。结果:147例患者,133例治愈,12例术后症状无改善,1例因引流管移位进入脑组织致术后偏瘫加重,1例术后1 mon内死于其他疾病。结论:慢性硬膜下血肿的首选治疗方法是钻孔引流术。     

病毒转染骨髓基质干细胞在不同移植点对颅脑损伤的保护

BACKGROUND:Bone marrow stromal cells can differentiate into nerve cells to promote nerve tissue repair, but the exact mechanism has not been fully elucidated. OBJECTIVE:To explore the influence of adenovirus-mediated β nerve growth factor transfection on bone marrow stromal stem cell transplantation fighting against brain injury in rats. METHODS:(1) Rat bone marrow stromal stem cells were cultured in vitro, transfected with the adenovirus-mediated β nerve growth factor and directionally induced using β-mercaptoethanol. (2) A total of 210 Sprague-Dawley rats were randomized into induction+tranfection group, induction+non-transfection group, induction+medium group, model group, and sham group (n=42 per group). Rat skull injury models were made, and given corresponding treatments at different time points (12, 24, 36, 48, 72 hours). Neurological function of rats was evaluated based on neurological severity scores on the day that the rats were given transplantation, and 1, 2, 3, 4 weeks after transplantation. (3) Another 75 Sprague-Dawley rats were also divided into five groups (n=15 per group) as above, followed by model establishment and corresponding treatments at 24 hours after modeling. Neurological severity scores were recorded at the same day, 1, 2, 3, 4 weeks after transplantation. Five rats from each group were sacrificed to detect levels of malondialdehyde and superoxide dismutase in the rat brain at the same day, 2 and 4 weeks after transplantation, respectively. RESULTS AND CONCLUSION:If the cells were transplanted within 48 hours after modeling, the neurological severity scores in the induction+transfection group decreased significantly compared with the induction+non-transfection group and model group at 1 and 2 weeks after transplantation (P < 0.05). If the cells were transplanted at different time, the neurological severity scores in the induction+transfection group were decreased significantly compared with the induction+non-transfection group and model group at 3 and 4 weeks after transplantation (P < 0.05). If the cells were transplanted within 24 hours after modeling, the neurological severity scores in the induction+transfection group decreased significantly compared with the model group at 1 week after transplantation (P < 0.05), and the neurological severity scores in the induction+transfection group and induction+non-transfection group both were significantly lower than those in the model group (P < 0.05). Two weeks after cell transplantation, the level of superoxide dismutase was significantly higher in the induction+transfection group than the induction+medium group and model group (P < 0.05), but the level of malondialdehyde was significantly lower (P < 0.05). All these findings indicate that adenovirus-mediated β nerve growth factor transfer plays a certain neuroprotective role in bone marrow stromal stem cell transplantation for brain injury in rats.