高血压性脑出血的治疗策略与临床疗效分析

目的：探讨保守治疗、开颅血肿清除术和微创颅内血肿清除术三种不同方法治疗高血压性脑出血的临床效果,以供临床参考。方法回顾性分析我院于2012年1月~2014年1月收治的120例高血压性脑出血患者的临床资料,根据治疗方法的不同将其分为三组,每组各40例。A组给予保守治疗,B组行传统开颅血肿清除术,C组则实行微创颅内血肿清除术,对比分析三组患者的治疗效果。结果C组(微创组)患者的临床疗效明显优于A组(保守治疗组)和B组(传统开颅组),其中C组的总有效率为34例(85.00%),A、B组的总有效率分别为21例(52.50%)、20例(50.00%),组间比较差异有统计学意义(P<0.05)。结论施行微创颅内血肿清除术治疗高血压性脑出血效果显著,明显优于保守治疗和传统开颅术,同时微创手术创伤小、安全性高、恢复快,值得在临床上推广应用。     

微创血肿穿刺抽吸术治疗高血压性脑出血36例临床分析

目的 探讨微创颅内血肿清除术治疗高血压脑出血的临床疗效.方法 采用对比分析方法,观察颅内血肿微创穿刺术与内科保守治疗高血压脑出血患者的疗效.结果 内科保守治疗组有效率50.00%,死亡率为34.21%;微创组有效率77.78%,死亡率为11.11%.结论 微创颅内血肿清除术安全、有效、简便,能提高有效率,降低死亡率.     

30例高血压性脑出血行微创颅内血肿清除术治疗疗效探讨

目的：观察分析临床面对高血压性脑出血患者时,对其实施微创颅内血肿清除术治疗后的临床疗效。方法择取我科室在近期内接诊的60例高血压性脑出血患者,按照患者治疗内容的不同对患者进行分组,其中A组30例患者实施内科保守治疗、B组30例患者实施微创颅内血肿清除术进行治疗。结果 B组患者的临床治疗有效率为90%,明显高于A组患者的70%(P<0.05)。结论临床面对高血压脑出血患者时,给予其实施微创颅内血肿清除术进行治疗后的疗效是理想的,值得临床广泛应用。     

微创血肿碎吸术合并盐酸纳美芬治疗高血压脑出血的临床研究

目的：评价微创血肿碎吸术合并盐酸纳美芬治疗高血压脑出血的疗效。方法对50例高血压脑出血患者随机分为两组：A组(微创治疗+盐酸纳美芬),B组(微创治疗),各25例,两组均使用微创血肿碎吸术清除血肿,A组另加用盐酸纳美芬0.2mg/d静滴,共用2w。分别观察两组的疗效及并发症。结果①A组有效率(88.00%)及显效率(68.00)均明显优于B组(68.00%、32.00%),二者存在显著差异(P<0.01、P<0.05)。②A组意识恢复明显短于B组(P<0.05)。③A组并发症发生率较B组明显减少(P<0.05)。4.两组死亡率无显著差异(P>0.05)。结论微创血肿碎吸术合并盐酸纳美芬治疗高血压脑出血较单用微创术疗效好,能明显提高有效率,意识恢复快,降低并发症,提高病人的生活质量。     

微创手术加尿激酶血肿清除治疗高血压性脑出血对照研究

目的探讨微创手术加尿激酶血肿清除在高血压性脑出血治疗中,微创手术加尿激酶血肿清除治疗组,对改善脑出血预后的机制。方法34例符合手术适应征的高血压性脑出血急性期患者被随机分为微创手术加尿激酶血肿清除治疗组和常规手术对照组,比较两组治疗后的临床转归。结果微创手术加尿激酶血肿清除治疗组疗效明显优于对照组(P<0.05)。结论微创手术加尿激酶血肿清除治疗高血压脑出血,治疗组疗效好,可能是脑出血周围水肿脑组织水肿挤压减轻,坏死减少,全脑水肿减轻,并发症减少。脑内血肿对周边脑组织局部生化反应和毒性作用减轻,继发性神经原损伤减轻所致。     

羚蝎胶囊治疗中小量急性脑出血的临床研究

目的 :观察羚蝎胶囊治疗中小量急性脑出血的临床疗效。方法 :纳入研究范围的患者共有 60例 ,随机分成羚蝎胶囊组、清开灵注射液组各 30例。治疗前两组患者在性别、年龄、出血部位、出血量、病情程度、发病时间、既往史积分、伴发病积分、中风病中医起始积分、神经功能缺损程度起始积分等方面经统计学处理无显著差异 (Ｐ >0 0 5)。通过治疗前后神经功能缺损积分、中风病中医积分、血肿大小、血肿吸收率观察羚蝎胶囊对急性脑出血的临床疗效。结果 :( 1 )治疗前后神经功能缺损程度积分 :羚蝎胶囊组分别为 2 6 82± 7 95、1 6 3± 1 0 8;清开…     

微创颅内血肿清除术治疗高血压性脑出血疗效分析

目的 探究微创颅内血肿清除术治疗高血压性脑出血疗效。 方法 将我院2016年3月~2017年3月收治的82例高血压脑出血患者,随机分为对照组与实验组,每组41例,对照组行传统手术治疗,实验组行微创颅内血肿清除术,比较两组治疗效果并分别于治疗前、治疗2周后记录两组血肿、水肿体积,NIHSS评分、观察治疗效果。 结果 实验组治疗有效率85.36%高于对照组51.22%,差异有统计学意义（P<0.05）;治疗2周后实验组血肿体积、水肿体积、NIHSS评分指标低于对照组,存在统计学差异（P<0.05）。结论 相比于传统手术而言,微创颅内血肿清除术手可有效降低手术对患者带来的侵入性伤害,可提高治疗效果,值得临床推广。     

微创手术治疗高血压脑出血55例体会

目的 总结55例高血压脑出血患者应用微创钻颅血肿清除术的临床诊治经验.方法 对55例高血压脑出血依据CT片显示血肿的大小、形态,选择适宜的穿刺部位行微创手术治疗.结果 显著进步:20例(36.4%);基本痊愈:25例(45.5%);严重残疾:7例(12.7%);死亡:3例(5.4%);总显效率为81.9%,死亡率5.4%.结论 选择合适的病例应用微创颅钻颅血肿清除术治疗高血压脑出血,手术简单,疗效确切.     

CT导向微创钻颅血肿引流术治疗高血压性脑出血的临床研究

目的：探讨微创钻颅血肿引流术治疗高血压性脑出血的临床疗效。方法;将73例高血压性脑出血患者随机分成两组,对照组（n=36）单纯给予药物治疗,治疗组（n=37）在与对照组相同治疗的基础上给予CT导向微创钻颅血肿引流冲洗术．比较两组的死亡率和生存患者半年后总的日常生活能力（ADL）。结果：治疗组死亡率为14％（5／37）明显低于对照组42％（15／36）,两组比较差异有统计学意义（P〈0．01）。生存者半年后的ADLⅠ-Ⅲ级,治疗组81％（26／32）明显优于对照组52％（10／21）,两组比较差异有统计学意义（P〈0．01）。结论：CT导向下微创钻颅血肿引流术是治疗高血压性脑出血的较好方法,可有效提高脑出血患者生存率及其生存质量。     

小骨窗与微创穿刺血肿引流术治疗高血压脑出血的疗效对比及复发影响因素分析

目的探讨小骨窗与微创穿刺血肿引流术治疗高血压脑出血的疗效,并分析其复发影响因素。方法随机选取2012年6月至2017年12月我院收治的100例高血压脑出血患者作为研究对象,按随机数字表法将其分为对照组和观察组,每组各50例,对照组患者采取硬通道微创手术治疗,观察组患者采取软通道微创手术治疗。观察比较两组患者治疗后近期疗效以及术后复发脑出血的影响因素。结果 (1)对照组患者恢复良好率为64.00%,观察组患者恢复良好率为58.00%,两组患者近期疗效比较无统计学意义(P0.05);(2)术后24h对两组患者进行头颅CT复查,其中23例出现血肿扩大。复发组患者术前收缩压、手术医师非准确操作高于未复发组,发病至手术的时间少于未复发组,差异均有统计学意义(P0.05);(3)发病至手术的时间、术前收缩压及手术医师非准确操作均为术后脑出血复发的独立危险因素。结论小骨窗血肿清除术与微创穿刺血肿引流术治疗高血压脑出血均具有较好的临床疗效,两者作用互补,脑出血复发的危险因素为临床应关注的重点。     

Development in in vitro toxicology

There are three principal pressures driving the development of in vitro toxicology: (1) the need for more efficient testing systems to cope with the large number of xenobiotics currently being developed; (2) public pressure to reduce animal experimentation; and (3) a need for a better understanding of the mechanisms of toxicity. Within this, in vitro toxicology is focused on local, systemic, and target-organ toxicity. It is becoming increasingly apparent that a step or decision-tree approach using input of a variety of experimental data (physicochemical properties, biokinetics, cytotoxicity) provides the most efficient system for predicting toxicity. Examples of the use of in vitro toxicity systems for prediction of systemic toxicity and target-organ (liver) toxicity are presented.Originally presented at ECCP 93.     

Seasonal variations in acute toxoplasmosis in pregnant women in Slovenia

Between December 1999 and December 2004, 40 081 pregnant women were examined for toxoplasmosis with Toxo-IgG, Toxo-IgM enzyme immunoassay. Women with positive results were then retested with the Toxo-IgG avidity assay for recent toxoplasmosis. Recent acute toxoplasmosis in pregnant women was found to be significantly more frequent (p < 0.01) during winter than summer. The incidence of acute toxoplasmosis during winter-spring was also significantly more frequent (p < 0.025) than summer-autumn. This phenomenon should be taken into account when formulating preventive measures for toxoplasmosis, especially for pregnant women.     

Age-related changes in polyamines in memory-associated brain structures in rats

Polyamines putrescine, spermidine and spermine are positively charged aliphatic amines and have important roles in maintaining normal cellular function, regulating neurotransmitter receptors and modulating learning and memory. Recent evidence suggests a role of putrescine in hippocampal neurogenesis, that is significantly impaired during aging. The present study measured the polyamine levels in memory-related brain structures in 24- (aged), 12- (middle-aged) and 4- (young) month-old rats using liquid chromatography/mass spectrometry and high performance liquid chromatography. In the hippocampus, the putrescine levels were significantly decreased in the CA1 and dentate gyrus, and increased in the CA2/3 with age. Significant age-related increases in the spermidine levels were found in the CA1 and CA2/3. There was no difference between groups in spermine in any sub-regions examined. In the parahippocampal region, increased putrescine level with age was observed in the entorhinal cortex, and age did not alter the spermidine levels. The spermine level was significantly decreased in the perirhinal cortex and increased in the postrhinal cortex with age. In the prefrontal cortex, there was age-related decrease in putrescine, and the spermidine and spermine levels were significantly increased with age. This study, for the first time, demonstrates age-related region-specific changes in polyamines in memory-associated structures, suggesting that polyamine system dysfunction may potentially contribute to aged-related impairments in hippocampal neurogenesis and learning and memory.     

休克过程中肾上腺髓质素变化的研究进展

Adrenomedullin (AM) is a new peptidergic regulator of vascular function. AM serves as a hormone, which has many biological properties, plays an important role in the many pathophysiological processes, especially shock. This review will highlight the structure, biological properties of AM and the relationship between AM and shock.     

Secular change in menarche in women in Madrid

The age at menarche was estimated by recollection in 1617 women between the ages of 18 and 60 in Madrid and a nearby suburb, Pinto. The population of Pinto is working-class and the Madrid group, taken from residential neighbourhoods , belongs to the upper middle class. In both groups we found a diminution in average age at menarche, from 14.04 to 13.02 years in Madrid and from 14.55 to 13.16 years from about 1935 to about 1965 in Pinto. These changes have been more intense in the group which is less well-off economically, where living conditions have varied much more drastically.     

Pitfalls in TRAP assay in routine detection of malignancy in effusions

Telomerase has been found to be reactivated in a majority of cancers but is inactive in most somatic cells. Our principal goal was to determine the potential use of the telomeric repeat amplification protocol (TRAP) assay as marker for malignancy in cytological effusions. The simple selection criterion was the cytological diagnosis, and routine samples were classified into malignant (58 samples) and nonmalignant (233 samples). Of the malignant samples, 44/58 (76%) were positive by TRAP assay. Of the 14 telomerase-negative cytology-positive samples, RNA integrity was poor in 9, indicating suboptimal sample conservation for molecular analysis. In 3 of the remaining 5 samples with a negative TRAP assay, a high number of malignant cells was observed, and these cells might have been telomerase-negative. Thus, the sensitivity of TRAP assay for the presence of malignant cells was about 76%. In the cytologically nonmalignant effusions, the presence of telomerase activity was observed in 24% (55/233). Of these, 6% were highly suspicious for malignancy, 9% were doubtful, and 9% were cytologically nonmalignant effusions confirmed by a follow-up of 12 mo or more. According to these data, the specificity of the TRAP assay to detect tumor cells in effusions ranged only between 82-91%. Our results indicate that, although the TRAP assay is positive in 6-15% of putative malignant effusions, the relatively high number of TRAP false-negative and false-positive cases renders this test unsuitable for routine diagnostic purposes.