奇曼丁治疗晚期癌症疼痛的疗效

Itisestimatedthat７０％patientssufferedfromadvancedtumorsdevelopedpainofdifferentextent．Painaffectsqualityoflifedirect－ly，mind，psychology，socialandpersonalrelationandleadtodis－comfort犤１犦．WiththespreadingofWHOthree－stepmanagement，ad－ministrationwaysaretransformedfromdemanddependanttotimedepend犤１犦．Tramcontin（slowreleasedtramadol），theweakthebaicdrug，cancontrolmoderatepain．１Subjectandmethod１．１Subject１１６caseswithpathologicallyandradiologicallyprovedadvancedtumors（６…     

小儿脑性瘫痪患者腰骶段选择性后根神经切断术的麻醉处理

Selectiveposteriorrhizotomy（SPR）atlumbarandsacralregions（L＆S）isoneofsurgicalmethodsthatcaneffectivelyreleasethespasmoflowerextremitiesincerebralpalsy（CP）patients犤１犦，whichpossessescertainfeaturesthatarejuvenilepatientsdominateinpop－ulation；operationsshouldbeperformedwithpatientsinpronepositionandnerverootelectricstimulus（NRES）isrequiredasaconvention－ality，etc犤２犦．１４４CPpatientsbelow１０yearshavebeensuccessfullyperformedSPRatL＆Sundercombinedintravenousandinhalationan…     

中国汉人 X染色体上情感障碍易感性基因的遗传学研究及关联分析

Affectivedisorder（AD）ormooddisorder（MD）isasetcommondiseaseswhichischaracteristicbyachangingofremarkableandlastingsensibilityandmentalstate．Somegeneticepidemiological，familytwinandadoptionstudiesindicatedthatthereisintensegenetictendency犤１犦．OverseaADmorbiditywasover１％．Recently，thein－vestigativeinformationinsevenregionsinChinashowedthatthehourmorbidityforADwas５．２‰，thelifetimemorbiditywas０．８３‰犤２犦．TheetiologyandgeneticsofADandgeneticmechanismforADarenotclearsofar…     

军队干体所老年人轻度认知功能损害的患病率调查

INTRODUCTIONMildcognitiveimpairment（MCI）isconsideredtobeatransitionalstagebetweenagingandAlzheimerdisease（AD），whichisanewfocusinclinicalresearchofAD犤１－８犦．MCIisbelievedtobeahigh－riskconditionforthedevelopmentofADandhasbeenproposedasanosologicalentity犤３－８犦．However，theepidemiologyofMCIisnotwellknowninChina．ThisstudywasdesignedtodeterminetheprevalenceofMCIinanelderlypopulation．MATERIALSANDMETHODSMaterialsAlltheveteranssanatoriumsinShijiazhuangcitywereinves…     

黛力新及心理疏导疗法对神经症的治疗研究

AccordingtoCCMD－２－RandSCL－９０犤１犦，wediagnosedandclassifiedneurosisdefinitelyduringMay１９９８～November２０００．Deanxitcombinedwithdredgingpsychotherapywereusedtocontrolnuerosis犤２犦，andfavorableeffectswereobserved犤３犦．１Subjectandmethod１．１Subject１３４outpatientswerechosenaccordingtodiagnosticcriteriaofCCMD－２－R．PatientswereevaluatedusingSCL－９０．Thesepatientsincluded５８menand７６womenaged１９～６７yearsold，meanage：（４５．５±７．４３）．Diseaseofcourseranged…     

尼莫地平对脑梗死患者康复期认知功能干预的临床和实验研究

Rehabilitationofpatientswithcerebralinfarctionreliesondrugtherapyprimarily．Nimodipine，asthebrain－protectingdrugfortreatmentofdementia犤１犦isoneofwidelyuseddrugsinclinicinChina．However，recently，therewasmuchmorecontroversiesovertheeffectofnimodipineoncognitivefunctioninavarietyofre－ports犤２～５犦．Combininganimalexperimentwithclinicalfingidngs，weinvestigateimpactofnimodipineoncognitionrehabilitation．１Materialandmethod１．１Material（１）Animals：IsolatedWistarratswereprovidedbyAni…     

pSVPoMCAT微基因修饰雪旺氏细胞移植治疗实验性脊髓损伤的酶及免疫组化评价

Genetherapyofspinalcordinjury（SCI）remainsintheexper－imentalstage．Now，neurotrophicfactortomodifySchwanncell（SC）orfibroblastsareimplantedintoSCIregiontoobservetheregenera－tionsofaxons犤１犦．WefirstbuildPo－５＇－flankinginducedmicrogeneforbasicproteinofmyelinsheathwhichistransientlynamedaspSVPoMcat．ThepSVPoMcatgenewasintroducedintoSCthroughcationliposome．ItwasprovedthatpSVPoMcatcouldenhancefunc－tionofSCandelongateitssurvivalperiodinvitro犤２犦．pSVPoMcatwasimplantedintoS…     

Relationship of peripheral blood re lated factors changes and nerve function defection degree in acute c erebral infarction patients

INTRODUCTIONInflammatoryreactioninducedbycellimmunologyistheimportantmechanismofneuroninjury，degenertionandprogressivenecrosisduringischemia－reperfusioncourse犤１－２犦．Humanleucocyteantigen－II（HLA－II）ismainlyexpressedbypresentingantigenpresentingcell（APC）．WhileHLA－DRantigenexpressedmainlyontheactivatedTcellsandhadahighlyspecificityandplayedanimportantroleinimmunologyreactionandimmunologyadjustment犤２犦．Inourexperi－ment，weexploredresearchinCD３／CD（１６＋５６）andC…     

颌骨嗜酸性肉芽肿临床X线分析

骨嗜酸性肉芽肿（EosinophilicGranulomaofBone，EGB）与韩－薛－柯氏病（Hand－Schüller－ChristianDisease）、勒－雪氏病（Letterer－SiweDisease）具有类似的病理学基础，同属非脂质性网状内皮增生症（Non－LipidReticuloendothelisis），但其临床表现及X线改变却各不相同犤１犦，１９５３年Lichten－stein犤２犦统称它们为组织细胞增生症X（HistiocytosisX，HX）。HX以EGB最为常见，约占５０％～６０％犤３犦，EGB可侵犯除手、足以外的任何骨骼犤４犦，颅骨最常受累犤５犦，而发生于颌骨的嗜酸性肉芽肿文献上记载甚少，X…     

男性非器质性性功能不全的行为康复治疗

Sexualincompetenceiscommonamongmen，amongwhich３０％～４０％belongstonon－organicsexualincompetence犤１犦．Managementapproacheshavereceivedmoreattentioninrecentyears．Wetreatedmenwithnon－organicsexualincompetenceusing“five－step”behaviorandrehabilitationmanagementduringFebruary１９９５～May２０００．Therapeuticeffectwasfavorable．Hereisthereport．１Subjectandmethod１．１Inclusioncriteria（１）ED：insertionandinductionwereimpossibleduringsexualintercourse，erectionoccurredonceduringsleepi…     

硫酸镁逆转SAH后脑血管痉挛的实验研究

目的:探讨硫酸镁对蛛网膜下腔出血(SAH)后脑血管痉挛的防治作用。方法:采用“枕大池一次注血法”复制兔SAH模型,治疗组予硫酸镁静脉输入,单纯注血组则予等量生理盐水。术前和术后全程观察实验动物的饮食及神经功能变化情况,利用HE染色及透射电镜分别观察各组处理后第5天兔基底动脉血管形态学及超微结构改变。结果:(1)单纯注血组兔摄食量逐渐下降、神经功能障碍逐渐加重;治疗组摄食量稍有下降,神经功能障碍较轻,且逐渐好转。(2)单纯注血组兔基底动脉血管管径显著小于正常组(P<0.01),而经硫酸镁处理后,治疗组血管管径明显大于单纯注血组(P<0.05),与正常组差异无显著性(P>0.05),部分管径甚至大于正常组。(3)单纯注血组血管壁增厚、结构紊乱,内皮细胞紧密连接消失,内弹力膜皱折、虫蚀样改变,平滑肌细胞变性、核扭曲等。治疗组上述结构改变较轻。结论:硫酸镁能明显逆转SAH后的脑血管痉挛,且有良好的神经保护作用。     

通脉活血汤治疗腔隙性脑梗死临床疗效观察

目的观察通脉活血汤治疗腔隙性脑梗死的临床疗效。方法将65例确诊为腔隙性脑梗死的患者随机分为治疗组33例,对照组32例。治疗组采用自拟通脉活血汤治疗,1剂/d,水煎分2次服用,14d为1个疗程,连续服用2个疗程。对照组用脑复康片,3次/d,每次0.8g,14d为1个疗程,连续服用2个疗程。结果治疗组33例中,临床基本痊愈1例,显效13例,有效13例,无效6例,总有效率为81.82%。对照组32例中,临床基本痊愈0例,显效8例,有效11例,无效13例,总有效率为59.37%。2组对比,治疗组疗效明显优于对照组(P<0.05)。结论自拟通脉活血汤治疗腔隙性脑梗死有显著疗效。     

L精氨酸枕大池注射对兔脑血管痉挛的影响及作用机制

目的 研究 L 精氨酸枕大池注射对兔蛛网膜下腔出血后血管痉挛的影响及作用机制. 方法 采用双侧颈动脉结扎及枕大池二次注血法制造兔蛛网膜下腔出血模型.在蛛网膜下腔出血后第 4天,以比色法测定血清及脑脊液中一氧化氮及脑组织的浓度.光镜下测定基底动脉的动脉壁厚度和基底动脉的内径,以其比值作为脑血管痉挛的指标.治疗组分为 300 μ mol/L及 500 μ mol/L组,在蛛网膜下腔出血后第 4天,枕大池持续微泵滴注 L 精氨酸,在滴注后再分别研究上述指标. 结果 蛛网膜下腔出血后第 4天,基底动脉的动脉壁厚度和内径的比值 (0.085± 0.007)明显升高 (t=20.26,P< 0.05);血清一氧化氮 [(24.34± 7.36) μ mol/L,t=6.72 ,P < 0.05]及脑脊液中一氧化氮 [(10.68± 3.43) μ mol/L,t=4.25,P < 0.05]及脑组织 NOS[(0.007± 0.001) nmol/(s@ g),t=6.14,P < 0.05].的浓度降低.在 L 精氨酸滴注后,脑血管痉挛缓解.血清一氧化氮 [(37.38± 6.42) μ mol/L,t=3.27,P < 0.05]、脑脊液中一氧化氮 [(14.16± 3.36) μ mol/L, t=1.98,P < 0.05]脑组织一氧化氮合酶 (nitric oxygenase, NOS)[(0.011± 0.002) nmol/(s@ g ),t=3.10,P < 0.05]的浓度较对照组明显升高. 结论 L-精氨酸枕大池注射对兔蛛网膜下腔出血后的血管痉挛具有治疗作用. L-精氨酸可能通过影响一氧化氮及 NOS而起作用.     

The effect of vasospasm on cerebral perfusion: a colour duplex study of the extra- and intracranial cerebral arteries

To assess whether middle cerebral artery (MCA) vasospasm reduces the flow volume in the corresponding extracranial internal carotid artery (ICA) or global cerebral blood flow volume (CBFV) in subarachnoid haemorrhage (SAH) patients, a colour duplex ultrasound study of the intra- and extracranial cerebral arteries was performed. MCA vasospasm was defined as a time-averaged maximum flow velocity (TAMX) exceeding 120 cm/s. ICA flow volumes and CBFV, were compared in each patient at maximum TAMX recorded in one MCA ("maximum-vasospasm") and when TAMX in the same vessel was closest to mean reference values ("no-vasospasm"). Additionally, the CBFV course during the first 3 weeks after SAH was evaluated longitudinally. Data from age- and gender-matched healthy test persons served as control. In 28 patients with MCA vasospasm, 337 measurements were completed. Global CBFV was significantly reduced starting from day 3 after SAH. ICA flow volumes and CBFV were not different when comparing at "maximum-vasospasm" and "no-vasospasm". Compared with the control group, both were lower at either condition. Thus, in SAH patients, vasospasm even severe, in general does not further diminish ICA flow volumes and global CBFV, which are reduced already before the onset of vasospasm.     

超声血管造影测量颅内动脉痉挛状态脑血流量的实验研究

目的 探讨超声血管造影(USA)检测痉挛状态下大脑动脉内径、流速以及血流量的作用,为临床提供一种准确、无创的测量脑血管直径及血流量的方法.方法 18只兔颅骨开窗,建立蛛网膜下腔出血(SAH)模型,利用USA技术测量SAH建模前及建模后大脑中动脉(MCA)流速,用图像分析软件Getcolorpixel分析大脑中动脉(MCA)血管内径,并利用公式计算MCA的血流量,对照研究.结果 (1)在二维超声(2DUS)模式下USA测量MCA血管内径变化分别为SAH建模前(713±10.1)μm和SAH建模后3 d(475±6.4)μm,有明显差异(P<0.05).同时超声多普勒测得其流速分别为(34.67±3.11)cm/s和(55.4±3.81)cm/s(P<0.05).(2)计算血流量,分别为SAH建模前为(13.86±1.11)×10~(-2) ml/s,SAH建模后3 d为(9.19±0.71)×10~(-2) ml/s;二者差异显著(P<0.01).结论 USA可用于脑血流量测量,对SAH后血管痉挛及脑血流变化具有一定的诊断价值.     

辛伐他汀对蛛网膜下腔出血严重并发症的影响

目的探讨辛伐他汀对蛛网膜下腔出血严重并发症及其预后的影响.方法 98例蛛网膜下腔出血患者随机分为治疗组和对照组（最终治疗组32例、对照组48例）,治疗组给予辛伐他汀20 mg/d;对照组予常规治疗,比较两组患者脑血管痉挛、脑积水和再出血的发生率,以及死亡率.结果治疗组脑积水发生率3.13%,与对照组的18.75%有显著性差异（P＜0.05）,而脑血管痉挛、再出血及死亡率与对照组无显著性差异（P＞0.05）.结论辛伐他汀可以减少蛛网膜下腔出血后慢性脑积水的发生.     

蛛网膜下腔出血后血浆心房钠尿肽与低钠血症及脑血管痉挛的关系

目的探讨血浆心房钠尿肽（ANP）与蛛网膜下腔出血（SAH）后脑血管痉挛（CVS）及低钠血症的关系.方法动态测定42例SAH患者发病后第1～3天和第7天、第14天的血浆ANP、血钠水平及颅内主要动脉的血流速度,分析三者间的关系.结果 42例SAH患者中,28例出现CSV,其血浆ANP水平高于对照组及无CVS者（P＜0.05）;CVS患者低钠血症发生率高于无CVS患者（P＜0.05）;SAH后第7天和第14天的血浆ANP水平与血钠浓度呈负相关（r 2=-0.778和r3=-0.653;P＜0.01和P＜0.05）;出血后第7天的ANP与大脑中动脉平均血流速度呈正相关（r3=0.702,P＜0.05）;病后第7天和第14天的大脑中动脉平均流速与血钠浓度呈负相关（r 2=-0.693和r 3=-0.653,均为P＜0.05）.结论 ANP可能导致了SAH后的低钠血症,并在早期CVS的发病机制中起重要的作用.     

补肾活血方对原发性免疫性血小板减少症小鼠的药效学研究

目的通过观察补肾活血方对原发性免疫性血小板减少症(ITP)模型小鼠的体重变化、外周血小板计数、外周血常规指标、脏器指数的影响来探讨补肾活血方的药效。方法 168只小鼠随机分为正常组(生理盐水)、模型组(ITP模型+生理盐水)、阳性药物强的松组[ITP模型+阳性药物强的松0.2 ml/(10 g·d)]、补肾活血高剂量组[ITP模型+补肾活血0.4 ml/(10 g·d)]、补肾活血中剂量组[ITP模型+补肾活血0.2 ml/(10 g·d)]和补肾活血低剂量组[ITP模型+补肾活血0.1 ml/(10 g·d)],造模8 d后每日灌胃一次,连续给药14 d。比较各组体重变化、脏器指数、外周血小板数量、外周血常规等指标。结果与正常组比较,模型组小鼠状态萎靡、体重下降、血小板数量明显降低、脾脏系数明显增大,有显著差异(P<0.05);给药后阳性药物强的松组、补肾活血方高剂量组小鼠精神状态恢复,血小板计数回升,外周血常规指标得到改善,脾脏系数降低,与模型组比较有显著差异(P<0.05)。并且血小板数随着补肾活血方剂量增加呈浓度依赖回升,补肾活血方高剂量组血小板数量与阳性对照强的松组相比无显著差异(P>0.05)。结论补肾活血方能够剂量依赖性地改善ITP小鼠整体精神状态,对血小板数量、血常规指标、降低脾脏系数等方面都具有明显的改善作用,0.4 ml/(10 g·d)补肾活血方与强的松0.2 ml/(10 g·d)疗效相当。     

经颅彩色多普勒超声评价外伤性蛛网膜下腔出血患者大脑中动脉血管痉挛

目的探讨经颅彩色多普勒超声(TCCS)在评价外伤性蛛网膜下腔出血患者大脑中动脉痉挛程度中的作用。方法对经CT确诊的外伤性蛛网膜下腔出血患者100例,采用TCCS观察大脑中动脉彩色血流束的走行、方向、有无局部充盈缺损和色彩混叠,频谱多普勒检测大脑中动脉收缩期峰值血流速度(VMCA)及同侧颈内动脉入颅段的血流速度(VICA),计算Lindegaard指数=VMCA/VICA。检查时间分别在脑外伤后1~3d、10d、14d,每次均测量3次取平均值。根据有无脑血管痉挛症状,分为有症状和无症状组,并对两组血流参数进行比较分析。结果外伤后3~7d蛛网膜下腔出血患者开始出现不同程度的脑血管痉挛症状,以6~10d最显著,2周以后逐渐减轻,其中外伤后10d35例符合大脑中动脉痉挛的诊断标准;有症状组VMCA和Lindgaard指数明显大于无症状组(P<0.01或P<0.05)。结论TCCS检测外伤性蛛网膜下腔出血患者的大脑中动脉VMCA和Lindgaard指数可以很好地了解大脑中动脉痉挛程度。     

一种蛛网膜下腔出血后脑血管痉挛的动物模型

目的建立一种简便、稳定的脑血管痉挛模型。方法取新西兰大白兔18只,随机分成SAH组、手术对照组、生理盐水组3组,每组6只,每组分别于手术后第3、7、14d行DSA(脑血管造影)、TCD(经颅多普勒超声)、组织学检查。结果TCD检查表明仅SAH组脑血流速度明显增加;组织学检查示SAH组动物脑血管壁均存在不同程度的炎性反应;DSA证实SAH组动物发生了明显痉挛。结论此方法适合制作蛛血后脑血管痉挛模型。