Neuroform支架在颅内宽颈动脉瘤栓塞治疗中的应用

目的评估Neuroform支架对颅内宽颈动脉瘤的栓塞治疗效果。方法11例颅内宽颈动脉瘤使用Neuroform自膨式颅内支架结合电解可脱弹簧圈进行栓塞治疗。将预装好的Neuroform支架系统引入载瘤动脉处,通过同轴导管释放支架覆盖动脉瘤颈;支架释放后,行可脱弹簧圈栓塞术;术后维持全身肝素化48h。结果动脉瘤100%栓塞8例,95%栓塞2例,1例后交通动脉瘤,在支架释放后,颈内动脉痉挛,放弃栓塞,改为二期栓塞治疗。4例术后6个月复查脑血管造影,动脉瘤消失,载瘤动脉通畅。结论Neuroform支架结合电解可脱弹簧圈栓塞颅内宽颈动脉瘤可克服目前血管内治疗的技术障碍,既可保护载瘤动脉通畅,又可改善宽颈动脉瘤栓塞效果。     

Solitaire AB支架辅助弹簧圈栓塞治疗后交通动脉宽颈动脉瘤

目的 探讨应用新型自膨胀颅内专用支架(Solitaire AB支架)与弹簧圈栓塞相结合治疗后交通动脉宽颈动脉瘤的临床价值. 方法 深圳市南山区人民医院神经外科自2010年3月至2012年9月采用新型Solitaire AB支架结合机械可脱弹簧圈栓塞治疗后交通动脉宽颈动脉瘤28例,回顾性分析患者的临床资料和疗效. 结果 本组患者中24例致密栓塞,4例部分栓塞.所有患者均恢复良好出院.全部患者术后3个月血管造影随访:24例致密栓塞的动脉瘤均未显影,其中23例载瘤动脉通畅,1例载瘤动脉闭塞;4例部分栓塞动脉瘤颈仍有残留,但无变化. 结论 Solitaire AB颅内支架使用安全,适用于颅内后交通动脉宽颈动脉瘤的支架辅助弹簧圈栓塞,尤其适用于迂曲的脑血管,并发症少.     

Neuroform自膨式支架结合弹簧圈栓塞治疗颅内宽颈动脉瘤

目的探讨使用Neuroform自膨式支架结合电解可脱弹簧圈栓塞治疗颅内宽颈动脉瘤的适应证、技术要点及并发症的防治。方法19例颅内宽颈动脉瘤均采用Neuroform支架结合电解可脱弹簧圈栓塞,其中16例采用先放置支架再将微导管经支架网孔放入瘤腔进行栓塞,另外3例是微导管进入瘤腔后再释放支架进行栓塞。结果11例宽颈动脉瘤完全闭塞,7例闭塞95%以上,1例闭塞95%以下,支架到位均满意,载瘤动脉保持通畅。结论Neuroform支架与弹簧圈联合使用是治疗颅内宽颈动脉瘤的微创、安全、有效的方法,但其远期疗效仍需随诊证实。     

血管内支架结合电解可脱弹簧圈治疗颅内宽颈动脉瘤

目的 总结101管内芰架结合电解可脱弹簧圈治疗颅内宽颈动脉瘤的经验。方法 6例颈内动脉宽颈动脉瘤植入Neuroform支架掇盖动脉瘤颈，再将微导管通过支架网眼超选入动脉瘤腔填塞电解可脱弹簧圈，结果 5例动脉瘤达到致密填塞，1例大部填塞，载瘤动脉通畅，患者均恢复良好。结论 血管内支架结合微弹簧陶是治疗颅内宽颈动脉瘤的有效方法。     

血管内支架治疗颅内动脉瘤的临床疗效初步报告

目的 探讨使用血管内支架结合电解可脱弹簧圈(GDC)治疗颅内宽颈及梭形动脉瘤的可行性。方法 15例颈内动脉宽颈囊状动脉瘤及2例椎动脉梭形动脉瘤，经全脑血管造影确诊后将支架置入载瘤动脉，跨动脉瘤颈放置。其中13例通过支架网孔将微导管送入动脉瘤腔，填塞电解可脱弹簧圈，4例仅放置支架治疗。结果 1例术后1周死亡，2例失访。3～6个月造影随访14例，11例动脉瘤消失，2例动脉瘤大部消失，1例动脉瘤复发。载瘤动脉均保持通畅。结论 血管内支架置入是治疗颅内动脉瘤的新技术，结合GDC技术可为颅内宽颈囊状动脉瘤和梭形动脉瘤的治疗提供新的选择。     

颅内宽颈动脉瘤的血管内治疗

目的总结使用neuroform支架或球囊辅助瘤颈重塑技术与电解可脱弹簧圈结合治疗颅内宽颈动脉瘤的体会，探讨两种方法的适应症、存在问题、技术要点及临床应用前景。方法25例颅内宽颈动脉瘤中，19例采用neuroform支架置入结合电解可脱弹簧圈栓塞，6例采用球囊辅助瘤颈重塑技术结合电解可脱弹簧圈栓塞。结果以neuroform支架与电解可脱弹簧圈栓塞的动脉瘤中，10例完全闭塞，8例闭塞90％以上，1例闭塞90％以下。球囊辅助瘤颈重塑技术结合电解可脱弹簧圈栓塞的动脉瘤中，3例完全闭塞，3例闭塞90％以上。结论Neuroform支架或球囊辅助瘤颈重塑与电解可脱弹簧圈结合是治疗颅内宽颈动脉瘤的有效方法；两种方法各有优缺点，应根据宽颈动脉瘤的具体情况选择neuroform支架或球囊辅助进行栓塞。     

血管内支架结合电解可脱弹簧圈治疗颅内宽颈动脉瘤

目的：总结使用血管内支架结合电解可脱弹簧圈（GDC）治疗颅内宽颈动脉瘤的体会，探讨其适应证、方法、疗效及并发症。方法：18例颅内宽颈动脉瘤，首先将冠脉支架跨动脉瘤颈放置，通过支架上的网孔将微导管送入动脉瘤腔，应用GDC栓塞动脉瘤。结果：15例动脉瘤达到致密堵塞，3例大部堵塞，载瘤动脉通畅。无手术 并发症，患均恢复良好。结论：联合使用支架及微弹簧圈是治疗颅内宽颈动脉瘤的有效方法，远期疗效尚需进一步随访。     

颅内动脉瘤血管内栓塞治疗的临床分析

目的总结颅内动脉瘤血管内栓塞治疗技巧及结果。方法采用血管内栓塞治疗76例80个颅内动脉瘤。对23个宽颈动脉瘤采用瘤颈成形辅助技术栓塞治疗,其中球囊辅助成形术治疗动脉瘤4个,微导丝辅助瘤颈成形技术治疗5个,支架结合弹簧圈栓塞治疗14个。6个巨大动脉瘤5个用可脱性球囊闭塞载瘤动脉,1个用电解可脱性弹簧圈闭塞载瘤动脉。结果栓塞程度:致密栓塞48个(64.9%。48/74),90%以上栓塞11个(14.9%,11/74),疏松(90%以下)栓塞15个(20.3%,15/74)。术中动脉瘤破裂出血4例(5.3%,4/76),2例死亡。结论电解可脱性弹簧圈栓塞颅内动脉瘤具有微创、安全、效果可靠等优点。采用微导丝辅助瘤颈成形技术、瘤颈重塑形技术、血管内支架等方法,可以明显提高宽颈动脉瘤的致密栓塞率和减少脑梗死并发症发生。     

球囊辅助弹簧圈联合Onyx胶栓塞治疗颅内大型或宽颈动脉瘤

目的探讨弹簧圈联合Onyx胶栓塞治疗颅内大型或宽颈动脉瘤的可行性及有效性。方法回顾性分析2014年11月2016年10月收治15例颅内大型或宽颈动脉瘤的临床资料,其中采用单纯弹簧圈栓塞治疗5例,采用支架辅助弹簧圈栓塞治疗4例,采用球囊辅助弹簧圈联合Onyx胶栓塞治疗6例。结果术后立即造影示动脉瘤完全栓塞12例,部分栓塞3例。1例因年龄较大拒绝随访,其余14例栓塞术后随访6~12个月;单纯弹簧圈栓塞治疗的4例中,复发3例;支架辅助弹簧圈栓塞治疗的4例中,复发1例;球囊辅助弹簧圈联合Onyx胶栓塞治疗的6例均无复发,但2例大脑后动脉P3~P4段巨大夹层动脉瘤出现载瘤动脉远端动脉闭塞。结论球囊辅助弹簧圈联合Onyx胶治疗颅内大型或宽颈动脉瘤可提高动脉瘤的栓塞率,减少复发率。     

支架植入重构载瘤动脉治疗颅内复杂动脉瘤

目的 探讨41例巨大及复杂颅内动脉瘤的支架植入重构载瘤动脉治疗方法以及选择不同支架结合不同型号弹簧圈栓塞动脉瘤的适应证,急性期使用支架的安全性.方法 采用Neuroform(Ⅰ、Ⅱ)、LEO以及SolitaireAB支架,弹簧圈主要采用Matrix、Orbit圈.急性期支架辅助栓塞宽颈动脉瘤28例,择期栓塞13例.结果 41例44个动脉瘤栓塞均顺利完成,无手术并发症;2例巨大动脉瘤90％栓塞,其他均95％以上栓塞.结论 支架植入重构载瘤动脉结合不同型号弹簧圈栓塞,提高了颅内巨大及复杂动脉瘤的治疗成功率;急诊栓塞时未行抗血小板聚集药物准备而使用支架,虽无相应并发症出现,但还需慎重.     

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     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

Release of endogenous catecholamines from slices of hypothalamus of rats

The release of endogenous catecholamines from superfused slices of rat hypothalamus was studied under basal conditions and during release evoked by 40 mM K⁺. Catecholamines in superfusates, and in extracts of the tissue after stimulation, were isolated by column chromatography and quantitated by liquid chromatography with electrochemical detection. Norepinephrine (NE) was not consistently demonstrable in superfusate collected under basal conditions, but 40 mM K⁺ caused the release of from 2 to 4 ng/g of tissue per min. The addition of cocaine to the superfusate caused increases in basal and evoked release of NE. Epinephrine (E) could be measured in superfusates of slices from male but not female rats and then only when cocaine was added to the superfusate. Accordingly, the concentration of E in hypothalamus was greater in male rats than in female rats. Dopamine (DA) was not consistently measurable in the spontaneous overflow from slices either in the presence or absence of cocaine. K⁺-evoked release of DA could be demonstrated in slices from female rats. The addition of cocaine increased the evoked release of DA from slices from both sexes. Corticosterone, added to cocaine, had no effects on the efflux of any of the catecholamines. The experiments suggest that neuronal reuptake of all catecholamines is very efficient in the hypothalamus both under basal conditions and during evoked release.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。