三叉神经痛的诱发电位和动作电位研究及其机制探讨

对２０例三叉神经痛患者减压手术前后及８０名无三叉神经痛的正常人分别进行了三叉神经体感诱发电位（ＴＳＥＰ）检测，并对其中１２例在术中三叉神经减压前后进行了三叉神经动作电位（ＴＣＡＰ）测量，并就其结果的对比研究，确定ＴＳＥＰ的早期成分Ｐ３（或Ｎ３）属三叉神经诱发电位，而不是肌电位。认为Ｐ３（或Ｎ３）是三叉神经根及三叉神经脊束核的突触后的混合电位。对减压前后ＴＳＥＰ和ＴＣＡＰ的比较，推测原发性三叉神经痛     

001 18F-FDG PET显像对常规影像预选为根治性的NSCLC病人的分期

目的 :已知 １８Ｆ＿ＦＤＧ( １８Ｆ＿氟代脱氧葡萄糖 )ＰＥＴ显像对可切除的ＮＳＣＬＣ(非小细胞肺癌 )分期具有高灵敏度和特异性。现探讨该法对常规影像预选为根治性放疗的ＮＳＣＬＣ分期的作用。方法 :前瞻性研究了连续１５３例ＮＳＣＬＣ病人(均是ＣＴ为主的常规影像分期定为不能手术切除病变、而宜行根治性放疗者 ) ,每例均经 １８Ｆ＿ＦＤＧＰＥＴ全身显像重新分期 ,并接受按新分期确定的治疗方案 ;对 １８Ｆ＿ＦＤＧＰＥＴ显像前后分期与存活状况的关联进行了分析。结果 :１５３例患者 １８Ｆ＿ＦＤＧＰＥＴ显像前后分期有显著差异 ,…     

GANGLIOSIDE GM_1 POTENTIATES NERVE GROWTH FACTOR EFFECTS ON REGENERATION OF CRUSHED SCIATIC NERVE IN RATS

ＧＡＮＧＬＩＯＳＩＤＥＧＭ１ＰＯＴＥＮＴＩＡＴＥＳＮＥＲＶＥＧＲＯＷＴＨＦＡＣＴＯＲＥＦ┐ＦＥＣＴＳＯＮＲＥＧＥＮＥＲＡＴＩＯＮＯＦＣＲＵＳＨＥＤＳＣＩＡＴＩＣＮＥＲＶＥＩＮＲＡＴＳＷＡＮＧＭｉｎ－ｓｈｅｎｇ（王民生），ＣＨＥＮＺｈｏｎｇ－ｗｅｉ（陈...     

高原老年人右心室舒张功能的脉冲多普勒超声研究

海拔２２６０ｍ老年１３例（Ａ组），海拔３５００～４２００ｍ老年１２例（Ｂ组），年龄６０～７４岁。ＥＣＧ、ＵＣＧ、心三位片和肺功能无右室肥大和器质性心脏病及慢阻肺。脉冲多普勤测定三尖瓣口Ｅ＿ｖ、Ａ＿ｖ、Ｅ＿Ｉ、Ａ＿Ｉ、Ａ＿ｖ／Ｅ＿Ｉ、ＥＤＴ、ＡＴ。结果发现Ｂ组的Ａ＿ｖ／Ｅ＿ｖ增大（Ｐ＜０．００１）；ＥＤＴ及ＡＴ缩短（分别Ｐ＜０．００１）；ＡＴ与ＥＤＴ呈高度正相关（ｒ＝０．９３５、Ｐ＜０．０１）；ＡＴ与Ａ＿ｖ／Ｅ＿ｖ呈高度负相关（ｒ＝－０．９１６、Ｐ＜０．０１）；且ＥＤＴ与Ａ＿ｖ／Ｅ＿ｖ亦呈高度负相关（ｒ＝－０．９０７、Ｐ＜０．０１）；表明尚无高原心脏病的海拔３５００ｍ以上高原老年人，右室舒张功能减低，右室后负荷已有一定程度增加，两者间呈高度正相关关系。     

PERIPHERAL NERVE REPAIR IN RATS USING VASCULARIZED FROZEN IN-SITU MUSCLE AUTOGRAFT

ＰＥＲＩＰＨＥＲＡＬＮＥＲＶＥＲＥＰＡＩＲＩＮＲＡＴＳＵＳＩＮＧＶＡＳＣＵＬＡＲＩＺＥＤＦＲＯＺＥＮＩＮ┐ＳＩＴＵＭＵＳＣＬＥＡＵＴＯＧＲＡＦＴＷＡＮＧＹａｎ（王岩）１，ＺＨＵＳｈｅｎｇ－ｘｉｕ（朱盛修）１，ＨＵＮＧＬＫ２，ＬＥＵＮＧＰＣ２１．Ｄｅｐ...     

AN EVALUATION OF PREOPERATIVE CT SCANNING FOR SELECT-ING ADAPTIVE NAILS IN 78 CASES OF SHAFT FRACTURE

ＡＮＥＶＡＬＵＡＴＩＯＮＯＦＰＲＥＯＰＥＲＡＴＩＶＥＣＴＳＣＡＮＮＩＮＧＦＯＲＳＥＬＥＣＴ┐ＩＮＧＡＤＡＰＴＩＶＥＮＡＩＬＳＩＮ７８ＣＡＳＥＳＯＦＳＨＡＦＴＦＲＡＣＴＵＲＥＣＡＩＲｕ－ｂｉｎ（蔡汝宾），ＬＩＬｉ－ｑｕｎ（李力群），ＤＥＮＧＬｅｉ（邓磊...     

EFFECTS OF NIMODIPINE ON CALCIUM CURRENTS IN CORTICAL NEURONS AFTER IMPACTING BRAIN INJURY

ＥＦＦＥＣＴＳＯＦＮＩＭＯＤＩＰＩＮＥＯＮＣＡＬＣＩＵＭＣＵＲＲＥＮＴＳＩＮＣＯＲＴＩＣＡＬＮＥＵＲＯＮＳＡＦＴＥＲＩＭＰＡＣＴＩＮＧＢＲＡＩＮＩＮＪＵＲＹＮＩＮＧＫｅ（宁可），ＷＡＮＧＺｈｅｎｇ－ｇｕｏ（王正国），ＣＨＥＮＣｈａｎｇ－ｃａｉ（陈长才...     

EXPERIMENTAL STUDY AND CLINICAL OBSERVATION ON CHANGES OF β-ENDORPHIN AFTER HEAD INJURY

ＥＸＰＥＲＩＭＥＮＴＡＬＳＴＵＤＹＡＮＤＣＬＩＮＩＣＡＬＯＢＳＥＲＶＡＴＩＯＮＯＮＣＨＡＮＧＥＳＯＦβ┐ＥＮＤＯＲＰＨＩＮＡＦＴＥＲＨＥＡＤＩＮＪＵＲＹＺＨＡＮＧＧｕａｎｇ－ｊｉ（张光霁），ＺＨＵＣｈｅｎｇ（朱诚），ＪＩＡＮＧＪｉ－ｙａｏ（江基尧），...     

CLINICAL AND EXPERIMENTAL STUDIES ON RENAL INJURIES AFTER EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY

ＣＬＩＮＩＣＡＬＡＮＤＥＸＰＥＲＩＭＥＮＴＡＬＳＴＵＤＩＥＳＯＮＲＥＮＡＬＩＮＪＵＲＩＥＳＡＦＴＥＲＥＸＴＲＡＣＯＲＰＯＲＥＡＬＳＨＯＣＫＷＡＶＥＬＩＴＨＯＴＲＩＰＳＹＦＡＮＧＹｕ－ｈｕａ（方玉华），ＪＩＡＮＧＪｕｎ（江军），ＤＵＷｅｉ－ｇｕｏ（都卫...     

南昌飞机制造公司学龄前儿童乙型肝炎表面抗原携带情况调查

本文采用反向血凝试验对本公司２１７４例学龄前儿童进行了乙型肝炎表面抗原携带情况调查，阳性人数２４９例，阳性率为１１．４５％，结果显示携带率高于全国人群平均携带率，（８．３％，属高度感染区。经过对已接对乙肝疫苗与未接种乙肝疫苗儿童间表面抗原携带率的对比性分析，提示需加强幼托机构的卫生管理，对婴幼儿进行乙肝疫苗的免疫接种，以做到有效地避免和控制乙肝病毒的传播。ＴＨＥＩＮＶＥＳＴＩＧＡＴＩＯＮＯＦＨＥＰＡＴＩＴＩＳＢＶＩＲＵＳＡＮＴＩＧＥＮＣＡＲＲＩＥＤＢＹＰＲＥＳＣＨＯＯＬＥＲＳＩＮＮＡＮＣＨＡＮＧＡＩＲＣＲＡＦＴＭＡＮＵＦＡＣＴＵＲＩＮＧＣＯＭＰＡＮＹＣｈｅｎＷｅｉｑｉ１９９４．５（２）：１１９（Ｎａｎｃｈａｂｇ３３４Ｈｏｓｐｉｔａｌ）ＡｂｓｔｒａｔＨｅｐａｔｉｔｉｓＢｖｉｒｕｓａｎｔｉｇｅｎｗａｓｉｎｖｅｓｔｉｇａｔｅｄｂｙｒｅｖｅｒｓｅｈｅｍａｇｇｌｕｔｉｎａｔｉｏｎｔｅｓｔｉｎ２１７４ｃａｓｅｓｏｆｐｒｅｓｃｈｏｏｌｅｒｔｏｏｕｒｃｏｍｐａｎｙ．Ａｍｏｎｇｔｈｅｍ２４９（１１．４５％）ｗｅｒｅｐｏｓｉｔｉｖｅ．ＴｈｅｐｏｓｉｔｉｖｅｒａｔｅｓｉｎｐｒｅｓｃｈｏｏｌｅｒｓｗｉｔｈｈｅｐａｔｉｔｉｓＢｖｉｒ     

Venous angioma adjacent to the root entry zone of the trigeminal nerve: implications for management of trigeminal neuralgia

Detection of a venous angioma at the root entry zone is important for surgical planning, so that the neurosurgeon will be aware that both veins and arteries may require microvascular decompression. In selected cases, alternative treatment may be indicated to avoid the potential surgical complication of a venous infarct. Trigeminal neuralgia typically occurs in the middle-aged to elderly population, usually the result of compression of the trigeminal nerve at its root entry zone by an ectatic, aging artery or, less commonly, a regional vein [1, 2, 3]. When associated with a venous angioma at the root entry zone, trigeminal neuralgia usually presents at a younger age [4, 5, 6]. We review the imaging examinations and clinical data of five patients with trigeminal neuralgia who had a venous angioma adjacent to the root entry zone of the trigeminal nerve, and discuss how the imaging findings affected their management.     

Magnetic resonance tomographic angiography: diagnostic value in trigeminal neuralgia

A combination of MRI, MR angiography and MR tomographic angiography (MRTA) was used to study the relationship to the root exit zone of the trigeminal nerve to surrounding vascular structures in seven patients with trigeminal neuralgia (TN) and ten patients with no evidence at a lesion in this region. MRTA is the technique for showing the relationship between vessels, cranial nerves and brain stem. MRTA clearly demonstrated the presence of a vessel at the root exit zone of the trigeminal nerve in all patients with TN. In the ten other patients, examination of 20 trigeminal nerves revealed that only one nerve (5%) was in contact with a vessel at the root exit zone. This study supports vascular compression of trigeminal nerves as a cause of TN, and demonstrates the value of MRTA as noninvasive technique for demonstrating compression.     

Role of enhanced MRI in the follow-up of patients with medically refractory trigeminal neuralgia undergoing stereotactic radiosurgery using the gamma knife: initial experience

PURPOSE: The purpose of this work was to evaluate the early posttreatment MR findings, and their clinical utility, in patients with trigeminal neuralgia undergoing stereotactic radiosurgery using the gamma knife. METHOD: Twenty-six patients with medically refractory trigeminal neuralgia underwent stereotactic radiosurgery. A single dose of 70-90 Gy was administered to the proximal root entry zone (n = 21) or the retrogasserian portion (n = 5) of the trigeminal nerve. Posttreatment enhanced MRI and clinical assessment were performed at 3-6 months. RESULTS: Five patients did not have radiologic follow-up. There were no changes identified in the treated trigeminal nerve or adjacent brainstem in 19 of 21 patients. Two patients with multiple sclerosis developed abnormal signal and enhancement in the brainstem and/or trigeminal nerve; neither had clinical complications. Onset of therapeutic effect ranged from 3 weeks to 3 months; 19 patients had a beneficial response. CONCLUSION: Results of enhanced MRI 3-6 months after stereotactic radiosurgical treatment of trigeminal neuralgia do not correlate with the clinical response. Because beneficial clinical responses or treatment failures are apparent by 3 months, routine posttreatment MRI in these patients is not warranted.     

Trigeminal neuralgia: MR imaging features

Magnetic resonance (MR) imaging was used to evaluate the relationship of the cisternal portion of the fifth cranial nerve to surrounding vascular structures in six patients with documented trigeminal neuralgia and in 85 asymptomatic patients. MR imaging clearly demonstrated the course of the fifth nerve from its root entry zone (REZ) to the Meckel cave and its relationship to the surrounding vertebrobasilar system. In the six patients with trigeminal neuralgia, the presence of a vascular structure at the REZ of the fifth nerve was identified. In the 85 asymptomatic patients, examination of 170 trigeminal nerves revealed that 30% had contact between a vascular structure and the fifth nerve at the REZ, but only 2% had actual deformity. These results indicate that although neurovascular contact may be asymptomatic, MR demonstration of a vascular structure at the REZ of the fifth cranial nerve in a patient with trigeminal neuralgia may implicate this as the cause of symptoms, which may influence the treatment of choice. Because of the inherent limitations of computed tomography in the visualization of posterior fossa structures, MR imaging should be considered the initial screening procedure in the assessment of patients with trigeminal neuralgia.     

3D-CISS序列MR成像在血管压迫性三叉神经痛中的应用

目的　探讨三叉神经痛患者的神经血管解剖关系。方法　应用 3D -CISS序列并结合 3D -TOF血管造影及MPR重建技术对 49例三叉神经痛患者进行MR检查并部分与手术结果对照。结果　 (1) 13例手术患者中 ,10例 3D -CISS和 3D -TOF序列均显示血管压迫的患者经手术证实为动脉压迫 ,另 3例仅在 3D -CISS序列显示的压迫血管 ,手术证实为静脉压迫。 (2 ) 2 0例伴有上颌神经症状的病人有 18例 (90 % )在三叉神经根部内侧有压迫点 ;19例伴有下颌神经症状的病人有 15例 (79% )在三叉神经外侧有压迫点 (经 χ2 检验 ,P <0 .0 0 1)。结论　 3D -CISS序列对显示三叉神经痛病人的神经血管关系、三叉神经的压迫部位与三叉神经痛区域相关性有重要作用。     

Trigeminal neuralgia: evaluation of neuralgic manifestation and site of neurovascular compression with 3D CISS MR imaging and MR angiography

PURPOSE: To evaluate three-dimensional (3D) constructive interference in steady-state (CISS) magnetic resonance (MR) imaging and MR angiography with multiplanar reconstruction (MPR) for detection of neurovascular compression (NVC) in patients with trigeminal neuralgia and to evaluate the relationship between clinical symptoms related to trigeminal branches and those related to the site of trigeminal nerve compression. MATERIALS AND METHODS: Fifty-four consecutive patients with trigeminal neuralgia were examined at 3D CISS imaging and MR angiography with a 1.5-T MR system. Original transverse and four reformatted images were used for image interpretation. Vascular contact with the trigeminal nerve at the root entry zone (REZ) was determined, and the nature of the involved vessels was identified. The position of the blood vessel compressing the nerve was classified into cranial, caudal, medial, or lateral sites. Statistical analysis was performed with the chi2 test or the Fisher exact test between two groups and with the chi2 test among more than two groups. RESULTS: In 12 of 15 patients who underwent surgery, the artery that was considered a responsible vessel at 3D CISS imaging and MR angiography was confirmed as such. In the other three patients, the vein was the responsible vessel, which was detected only at 3D CISS imaging. Sixteen (89%) of 18 patients with symptoms related to the maxillary division had NVC at the medial site of the REZ, while 16 (76%) of 21 patients with symptoms related to the mandibular division had NVC at the lateral site (P <.001, chi2 test). CONCLUSION: 3D CISS MR imaging with MPR is useful in the detection of NVC in patients with trigeminal neuralgia, compared with MR angiography. A close relationship was found between the region of neuralgic manifestation and the site of trigeminal nerve compression.     

三维时间飞跃对三叉神经痛的诊断价值

目的 探讨三叉神经痛神经患者的ＭＲ表现为其诊断价值。方法 应用三维时间飞跃（３Ｄ－ＴＯＦ）序列,结合ＳＥ及快速液体衰减反转恢复（ＦＬＡＩＲ）序列,回顾性分析了１０４例三叉神经痛患者ＭＲ表现及手术结果。结果 （１）１０４例三叉神经痛患者中ＭＲＩ诊断为血管压迫或接触的为７５例,术中证实有血管压迫或接触的为６９例;桥小脑角肿瘤共１４例,ＭＲＩ确诊１３例,另１例由手术确诊;血管性病变的为５例,均由微血管减     

显微外科神经血管减压术治疗三叉神经痛

1986年4月以来,作者采用显微外科神经血管减压手术,治疗三叉神经痛26例,全部有效。根据显微镜下所见,结合文献资料,提出三叉神经与周围血管多接触现象是三叉神经痛的解剖学基础。蛛网膜粘连、增厚使神经和/或血管产生移位和固定,二者间的接触变成压迫并无缓冲余地,这种蛛网膜的炎性改变是导致三叉神经痛的病理基础。     

3D-TOF磁共振血管成像诊断血管压迫性三叉神经痛的价值

目的　探讨增强薄层三维体积扫描时间飞跃法磁共振血管成像 ( 3D -TOFMRA)诊断血管压迫性三叉神经痛的价值。方法　回顾性分析 37例临床拟诊为血管压迫性三叉神经痛患者的常规颅脑MRI及增强薄层 3D -TOF磁共振血管成像资料。结果　增强薄层 3D -TOFMRA发现 37例中 2 4例共 2 7侧三叉神经存在血管压迫或接触 ,其中症状侧三叉神经有血管压迫或接触 2 4例 ,无症状侧三叉神经有血管压迫或接触 3例 ,本组病例统计学分析表明 ,三叉神经痛患者症状的出现与三叉神经存在血管压迫或接触有显著相关关系 (Ρ <0 .0 0 5 )。 13例为非血管压迫性三叉神经痛。压迫三叉神经的血管为小脑上动脉 (SCA) 14例 ,小脑前下动脉(AICA) 5例 ,起源不清的血管 3例 ,扭曲的椎动脉 1例 ,血管畸形 1例。结论　增强薄层 3D -TOFMRA可清楚显示三叉神经脑池段与毗邻血管的关系 ,明显优于常规颅脑MRI,是目前检测血管压迫性三叉神经痛最佳的影像学检查方法 ,对明确诊断和指导治疗三叉神经痛具有重大意义。     

3D-TSE序列在三叉神经痛病因诊断中的价值

目的　探讨MRI三维快速自旋回波 (3D TSE)序列在三叉神经痛 (TN)病因研究中的价值。资料与方法　应用 3D TSE序列 ,结合常规MRI序列 ,分析 5 0例TN患者和 5 0名正常对照者的MRI表现及手术结果。结果　 (1) 5 0名正常对照者 10 0侧脑池段三叉神经MRI检查中 ,11侧存在三叉神经血管接触。 5 0名TN患者疼痛侧有血管压迫或接触的为 32例 ,非疼痛侧 5 0侧三叉神经中 ,有血管接触的为 7例 ,经统计学分析 ,TN患者疼痛有无与是否存在血管压迫或接触有统计学意义 (P <0 .0 0 5 )。 (2 ) 5 0例TN患者疼痛侧 ,MRI诊断TN病因中血管压迫或接触占 6 4 % (32 / 5 0 ) ;肿瘤性病变占 16 % (8/ 5 0 ) ;其他占 2 0 % (10 / 5 0 )。 (3)根据手术结果 ,3D TSE序列对TN诊断的敏感性为 10 0 % ,特异性为 80 %。结论　三叉神经脑池段的血管压迫或接触是TN的主要病因 ,3D TSE成像能清晰显示三叉神经与邻近血管、肿瘤性病变或其他病变之间的关系 ,为临床确定治疗方案有重要的指导意义