肿瘤标志物TSGF在脑肿瘤检测中的临床意义

目的 评价肿瘤特异生长因子（TSGF）对脑恶性肿瘤的诊断和疗效判定价值.方法 用分光光度法测定186例脑恶性肿瘤患者血清中的TSGF水平,与69例脑良性肿瘤及65例正常对照组进行比较,并对186例脑恶性肿瘤治疗前后进行血清TSGF水平检测,以判定疗效.结果 脑恶性肿瘤患者血清中的TSGF水平显著高于脑良性肿瘤（P＜0.05）,良、恶性肿瘤明显高于正常对照组（P＜0.05）;治疗后脑恶性肿瘤患者血清中TSGF的含量较治疗前明显降低（P＜0.05）.结论 TSGF是一种对脑恶性肿瘤诊断和疗效判断的有效、使用方便的、有价值的肿瘤标志物.     

脑肿瘤患者血清和脑脊液中β-葡萄糖醛酸酶测定的临床意义

目的 探讨脑肿瘤患者血清和脑脊液中β-葡萄糖醛酸酶(β-G)活性测定的临床意义. 方法对临床确诊的26例(脑膜瘤8例,胶质瘤18例)脑肿瘤患者行酶联免疫吸附(ELISA)实验方法测定脑肿瘤与正常对照组、脑挫裂伤组、头痛组血清及脑脊液中β-G活性,并以CT,MRI及病理结果为参照,进行确诊诊断试验研究.结果 ①脑胶质瘤患者血清β-G活性均明显高于正常对照组、脑外伤组及头痛组(P均《0.05);脑胶质瘤患者脑脊液β-G活性均明显高于对照组、脑外伤组及头痛组(P《0.01);脑胶质瘤患者脑脊液β-G活性高于脑膜瘤患者(P《0.05).②脑胶质瘤患者无论血清和脑脊液其β-G活性均明显高于正常对照组、良性脑病组患者(P均《0.05).结论 血清和脑脊液中β-G活性升高对恶性脑肿瘤有重要诊断价值,尤其脑胶质瘤的诊断.     

脑脊液细胞学检查对脑实质外肿瘤的诊断作用

目的通过研究脑脊液细胞学在诊断以神经系统症状为表现的脑实质外肿瘤中的作用,提高这类肿瘤的临床诊断水平.方法总结我院22例以神经系统表现为主,最后确诊为脑实质外肿瘤的病例的脑脊液细胞学和其他临床特点.结果22例患者的脑脊液细胞学发现几种不同的异型细胞,根据其特征性的提示追查出各种原发肿瘤.结论脑脊液细胞学对诊断以神经系统症状为表现的脑实质外肿瘤有很大帮助.     

六例被长期误诊的脑实质内生殖细胞性肿瘤的MRI特点

目的探讨脑实质内生殖细胞性肿瘤（GCT）的MRI特点。方法回顾分析6例被长期误诊的脑实质内GCT患者MRI的动态变化，每例患者至少接受2次MRI平扫和1次增强扫描。结果初次MRI检查4例表现为软化灶，2例表现脱髓鞘样改变，无占位性病变；5例患者在确诊时出现占位性病变，分别位于基底节区和胼胝体，囊性变多见，病灶有明显增强；5例患者出现病灶侧大脑脚萎缩，3例出现病灶侧的皮层萎缩，多数在首次MRI检查时已出现。结论脑实质内GCT早期常无占位性病变，容易导致同侧皮层和大脑脚的萎缩，往往到晚期才出现占位性病变，是早期误诊的主要原因。     

蛛网膜下腔出血患者西比灵治疗前后血浆及脑脊液内皮素降钙基因相关肽水平的变化

目的 :探讨西比灵对蛛网膜下腔出血 (SAH)后观察两组治疗前后与对照组血浆 ,脑脊液 (CSF)内皮素 (ET)、降钙基因相关肽(CGRP)水平变化。方法 :将 62例SAH患者随机分为西比灵组及非西比灵组测定治疗前后血和脑脊液ET、CGRP。结果 :西比灵及非西比灵组治疗前ET水平较对照组明显升高 ,CGRP明显降低 ;西比灵组治疗后ET水平较治疗前明显降低 ,CGRP明显升高 ,非西比灵组治疗前后ET、CGRP水平无显著变化。结论 :西比灵治疗后通过抑制ET产生和释放 ,增加CGRP合成有关。可能有防治SAH后脑血管痉挛作用     

颅内肿瘤诊断中血清和脑脊液β2-微球蛋白测定的临床意义

目的研究颅内肿瘤诊断中血清和脑脊液β2-微球蛋白(β2-microglobulin,β2-MG)测定的临床意义。方法用免疫比浊法测定75例颅内肿瘤患者和24例对照组血清和脑脊液β2-MG含量。颅内肿瘤组分为良、恶性两组。运用方差分析或秩和检验方法对对照组与颅内肿瘤患者检测结果及良、恶性颅内肿瘤患者检测结果之间进行统计分析。结果恶性肿瘤组的脑脊液和血清β2-MG含量明显高于对照组(P<0.01和P<0.05),有统计学意义。良性肿瘤组脑脊液β2-MG含量明显高于对照组(P<0.01),但血清β2-MG含量与对照组比较无统计学意义(P=0.375)。病理Ⅰ级和Ⅲ级之间比较有统计学意义(P<0.01)。结论β2-MG是良好的肿瘤生化标志物。同时测定血清和脑脊液β2-MG含量有助于颅内良、恶性瘤肿瘤的诊断和鉴别,脑脊液β2-MG还可以辅助诊断肿瘤的部位,有助于临床医生设计治疗方案。     

脑脊液MMP-9 IGF-Ⅱ水平检测在颅内感染鉴别诊断中的意义

目的探讨血清和脑脊液中基质金属蛋白酶9(MMP-9)、胰岛素样生长因子-2(IGF-Ⅱ)在化脓性脑膜脑炎和病毒性脑炎鉴别诊断中的应用价值。方法选取入院24h内92例明确诊断中枢神经系统感染患者,其中化脓性脑膜脑炎(化脑组)18例,病毒性脑炎(病脑组)74例和20例非中枢神经系统感染者(对照组)的脑脊液,应用酶联免疫吸附(ELISA)法测定血清及脑脊液(CSF)中MMP-9及IGF-Ⅱ浓度。结果血清及CSF中MMP-9含量比较:化脓性脑膜脑炎和病毒性脑炎组均较对照组显著升高(P0.05),化脓性脑膜脑炎组明显高于病毒性脑炎组(P0.05)。血清及CSF中IGF2Ⅱ含量比较,化脓性脑膜脑炎组CSF中IGF2Ⅱ含量高于病毒性脑炎组及对照组(P0.01),血清IGF2Ⅱ含量化脓性脑膜脑炎组低于病毒性脑炎组及对照组(P0.01),病毒性脑炎组与对照组比较差异无显著性。结论联合测定血清及脑脊液MMP-9及IGF-Ⅱ含量的变化,有助于颅内感染早期鉴别诊断。     

脑实质内生殖细胞瘤临床特点

目的　探讨脑实质内生殖细胞瘤的特点。方法　总结 5例脑实质内生殖细胞瘤的临床表现和辅助检查结果 ,并回顾复习相关文献。结果　 5例患者全部为男性 ,平均发病年龄 2 0 .2岁 ,最常见的临床症状是偏侧肢体无力 ,一般呈慢性进展性病程。部分患者伴有性早熟及血、脑脊液人绒毛膜促性腺激素、胎盘碱性磷酸酶升高。CT、MRI扫描显示 ,肿瘤组织信号混杂不均 ,边界不清 ,一般伴有斑片或环状不规则增强。结论　脑实质内生殖细胞瘤是一种好发于儿童和少年期男性的少见病 ,临床表现缺乏特异性 ,正确的诊断依赖于对患者症状、体征和辅助检查结果的综合分析 ,必要时需进行脑组织活检     

脑脊液中肿瘤坏死因子测定对各型脑膜炎的诊断价值

测定８８例不同病因的脑膜炎患者脑脊液肿瘤坏死因子（ＴＮＦ）含量，发现化脓性脑膜炎、结核性脑膜炎、病毒性脑膜炎患者脑脊液ＴＮＦ含量均较正常对照组明显升高（Ｐ＜０．０１），其中以化脓性脑膜炎升高最为显著，与病毒性脑膜炎患者脑脊液ＴＮＦ含量相比有显著性差异（Ｐ＜０．０１）。因此，脑脊液ＴＮＦ水平可作为鉴别细菌性与非细菌性脑膜炎的指标。     

隐球菌性脑膜炎患者抗原及抗体检测的临床评价

目的:评价隐脑患者血液、脑脊液中抗原抗体检测的临床意义。方法:应用乳胶凝集试验和试管凝集法检测28例隐脑患者脑脊液和血液中的抗体和抗原并对部分患者的抗原抗体进行动态监测。结果:应用乳胶凝集试验检测,28例隐脑患者脑脊液和血液中的抗原全部阳性,15位患者血液中抗体12例阳性,3例阴性。结论:应用乳胶凝集法检测脑脊液和血液中的抗原对隐脑的早期诊断有重要临床诊断意义。动态监测抗原可对隐脑的治疗效果进行评价     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Summary of legislation of 1935 of interest to the department of Mental Hygiene

Psychiatric Quarterly -