并发于颅脑损伤的颈项损伤症候群的诊治

目的 探讨纤溶酶原激活剂抑制物-1（PAI-1）活性及启动子区4G／SG基因多态性在急性脑梗死（ACI）发病过程中的作用。方法发色底物法测定血浆PAI-1活性，应用酚提取法提取DNA，通过聚合酶链反应限制性片段长度多态技术（PCR-RFLP），检测ACI组和正常对照组白细胞PAI-1基因4G／5G多态性。结果ACI组PAI-1活性明显高于正常对照组（t=2．734，P〈0．01）；以4G／4G基因型血浆PAI-1活性最高。ACI组4G／4G纯合子基因型比正常对照组明显增多（X^2=5．96，P〈0．05），4G等位基因分布频率明显高于正常对照组（X^2=4，31，P〈0．05），两组4G／5G杂合子基因型和5G／5G纯合子基因型比较差异无统计学意义（X^2=1．17、0．31，P〉0．05）。结论ACI组4G／4G基因型频率较高，血浆PAI-1活性较高，4G／4G基因型个体可能是本地区ACI的易患者，在ACI高危人群的筛查中可考虑增加PIA-1基因4G／SG基因多态性检查。

Diagnosis and managements in neck injury syndrome associate with craniocerebral injury

Objective To analyze the clinical behavior and correlative mechanism of the patients with the syndrome of neck injury associate with craniocerebral injury,to investigate its incidence for contributing to the diagnosis and therapy of the patients with the craniocerebral injury and improving the postoperative result. Methods Two hundred and eighty-three patients with craniocerebral injury treated from June 2000 to July 2003 were studied retrospectively. Results In 283 patients, 42( 14.8%) patients presented the syndrome of neck injury clearly in symptom or sign, of whom 39 ( 13.7% ) patients were diagnosed neck injury finally, 3 (1.1%) patients were clinically conclude neck injury. The syndrome mainly presents with noncerebral and nonaural vertigo incorresponding with the recovery of brain injury. Noncerebral, nonaural and nondigestive vomit. Intractable nuchal rigidity incorresponding with the recovery of brain injury. Motion and position limited, stubborn neck malaise, transient spinal cord injury. The symptoms were easy to be improved by neck motion control, neck traction,block therapy, massage and physiotherapy lamp. Conclusion The syndrome of brain-neck injury is a common injury. To learn the syndrome and take the regular therapy can improve the therapeutic efficacy of the craniocerebral injury.