膝骨关节炎严重程度与关节液和血清中chemerin含量的关系

背景:研究发现,chemerin受刺激后可进一步扩增炎症信号,导致炎症因子和基质金属蛋白酶的释放。提示chemerin可能作为软骨代谢的重要调控因子,在骨关节炎的病理过程中发挥重要的作用。目的:分析膝骨关节炎患者关节液和血清中chemerin水平与骨关节炎严重程度的相关性。方法:选择经临床确诊的膝骨关节炎患者80例,采用酶联免疫吸附试验(ELISA)法对关节液和血清中的chemerin水平进行检测,骨关节炎影像学严重程度评分采用国际公认的Kellgren-Lawrence(K-L)评分系统。结果与结论:患者关节液和血清中chemerin水平与Kellgren-Lawrence分级有显著相关性(r=0.981,P<0.001和r=0.901,P<0.001),且血清中chemerin水平与关节液中chemerin水平呈正相关(r=0.596,P<0.01)。结果表明,骨关节炎患者关节液和血清中chemerin水平与影像学K-L分级严重程度正相关,chemerin水平可作为骨关节炎诊断及判断严重程度的参考指标。     

血清chemerin含量与膝骨关节炎严重程度的相关性

目的通过测定不同严重程度的骨关节炎患者血清中chemerin水平,探讨chemerin水平与骨关节炎严重程度的相关性。方法收集临床收治的膝骨关节炎患者血清80例作为研究组,20名正常人血清作为对照组,采用酶联免疫吸附试验法(ELISA)对其血清中的chemerin水平进行检测,膝骨关节炎影像学严重程度评分采用国际公认的Kellgren-Lawrence(K-L)评分系统。结果骨关节炎组血清中chemerin水平显著高于对照组,差异有统计学意义(t=4.983,P<0.01)。骨关节炎组血清chemerin水平与K-L分级有显著相关性(r=0.901,P<0.001)。结论血清chemerin水平在骨关节炎患者中显著升高,且与影像学K-L分级严重程度正相关,血清chemerin水平可作为骨关节炎诊断及判断严重程度的参考指标。     

远外侧枕下入路切除高颈段椎管内外哑铃形肿瘤(附4例报告)

目的 :探讨经远外侧枕下入路切除高颈段椎管内外哑铃形肿瘤的治疗效果及手术技巧。方法 :回顾分析 4例经远外侧枕下入路切除高颈段椎管内外哑铃形肿瘤病人的临床资料及手术治疗结果。结果 :肿瘤全切 3例 ,1例因肿瘤包绕椎动脉而次全切除。所有患者术后恢复良好 ,未出现与手术入路有关的严重并发症。结论 :远外侧枕下入路具有手术路径短、视野宽广、显露硬膜内外病变清楚等优点 ,是治疗高颈段椎管内外哑铃形肿瘤的一种实用手术入路     

高渗氯化钠羟乙基淀粉40注射液对颅内压的影响

一、资料与方法 选择胶质瘤开颅手术患者40例,男24例,女16例,ASAⅠ或Ⅱ级,随机分为高渗氯化钠羟乙基淀粉40注射液组(}IH40组)和20%甘露醇组(M组),每组20例.     

结核性脑膜炎合并急性梗阻性脑积水11例治疗分析

目的探讨治疗结核性脑膜炎并发重度脑积水的效果。方法对11例结核性脑膜炎并发重度脑积水的患者进行脑室外引流术、脑室-腹腔分流术治疗,观察其疗效。结果术后全部病例颅内压增高症状很快缓解;1例术后出现分流管阻塞,拔除后再行分流术治愈。结论脑室外引流术、脑室腹腔分流术配合积极药物抗痨治疗是作为治疗结核性脑膜炎合并重度脑积水的有效手段。     

颅内原发性黑色素瘤的诊断和治疗

目的 探讨颅内原发性黑色素瘤的临床特点,提高对此病的诊断治疗水平.方法 回顾性分析自2000年1月至2009年12月收治的8例颅内原发性黑色素瘤患者,男6例,女2例;年龄24～68岁;病灶均为单发,位于额叶4例,顶叶1例,枕叶1例,镰旁1例,小脑脑桥角1例.8例患者均行开颅手术,6例达全切;2例行次全切除+辅助伽玛刀治疗.结果 病理结果均为原发性黑色素瘤;术后7例患者获随访,随访时间10-82个月.死亡2例,分别于术后14个月及21个月死于肿瘤复发;1例于术后6个月复发,再次行手术全切,术后化疗,术后6个月MRI未见复发征象;1例于术后9个月复发,再次行手术全切,术后化疗,术后6个月MRI示肿瘤再次复发;余3例未见复发征象.结论 颅内原发性黑色素瘤发病率低,误诊率较高,治疗以手术切除为主,不全切除者应辅助伽玛刀治疗,复发者可行辅助化疗,延缓复发时间,改善患者预后.

Abstract：

Objective To investigate the clinical features, imaging findings and treatment for primary intracranial melanoma. Method The clinical data including presentation, imaging, treatment and prognosis of 8 patients with primary intracranial melanoma underwent surgery were reviewed during the past ten years. The patients included six males and two females and the age range was from 24 to 68 years. Four lesions were located in frontal lobe and the other four were located in parietal lobe, Occipital lobe, parafalcine and cerebellopontine angle respectively. Total removal was achieved in 6 patients and subtotal resection in 2 who had adjuvant radiosurgery. Results Histological examination showed that all cases were melanoma. Follow - up study was gained in seven cases and the follow - up duration was from 10 to 82 months. Two patients died from recurrence at postoperative 14th months and 21st months respectively. One case had tumor recurrence 6 months after surgery and another operation was performed to gain total removal. Adjuvant chemotherapy was performed and there was no recurrence found in MRI 6 months after the surgery. One patient had tumor recurrence 9 months after surgery and another operation was performed to gain total removal. Adjuvant chemotherapy was performed and follow - up MRI showed recurrence 6 months after surgery. There was no recurrence in the other 3 cases. Conclusions Primary intracranial melanoma is an extremely rare tumor and difficult to get correct preoperative diagnosis. Surgical removal of tumor plays an important role in its treatment. Part of patients could gain profits from radiotherapy and chemotherapy. The prognosis is very poor.     

高血压脑出血术后颅外并发症及防治

高血压脑出血的发病在近年呈上升趋势,外科手术治疗是当前不可缺少的重要手段之一,而术后顿外并发症的发生和防治是影响预后的重要因素之一。我院自94年7月至98年7月共行高血压脑出血手术247例,报告如下。1临床资料男103例,女144例。年龄37岁～79岁,平均61．2岁。出血部位：基底出血154例;丘脑出血27例;皮质下出血45例;小脑出血21例。出血量：20～50ml62例;50～80ml147例;80ml以上38例。本组病例破人脑室者73例,治愈161例,死亡86例（34．8％）。颅外并发症情况：肺部感染135例占54．6％;糖尿病（或高血糖症）117例占47．3％;…     

经单鼻孔蝶窦入路切除垂体腺瘤46例

目的 探讨经单鼻孔蝶窦入路切除垂体腺瘤的手术适应证和手术技巧.方法 对46例经临床确诊为垂体瘤患者,采用经单鼻孔堞窦入路切除肿瘤,术中严格中线操作,有序切除肿瘤,重建鞍底.结果 全切肿瘤39例,大部切除7例,无严重并发症发生,无死亡.结论 经单鼻孔蝶窦入路切除垂体瘤创伤小,安全性高,并发症少.手术中严格中线操作,有序切除肿瘤,重建鞍底是手术成功的关键.