老年人糖尿病并发压疮患者的护理

我科于2003～2006年成功地护理26例老年糖尿病并发压疮患者,报告如下. 1 临床资料 本组26例,男18例,女8例,年龄49～87岁,平均75.5岁,糖尿病病史6～26年不等,平均17.4年,均为2型糖尿病病人.其中尾骶部压疮14例,髋部压疮7例,多发性压疮5例;压疮面积最大10cm×11cm, 最小2cm×3cm,最严重深达骨膜,多伴有脓性分泌物及坏死腐烂组织,有腥臭味.其中单纯糖尿病并发压疮6例,同时伴有高血压偏瘫18例,冠心病3例,合并低蛋白血症2例.     

带状疱疹后遗顽固神经痛1例报告

1 临床资料 患者男,1927-09出生,有慢性支气管炎病史50余年,合并阻塞性肺气肿40余年,合并肺大泡近30年,原发性高血压史33年,冠心病史30年,另外还患有慢性胃炎、胆囊炎等多种疾病.于2001-01发生自发性气胸,并复发数次,在某医院住院行闭式引流.于2001-01-21自行转至省人民医院做胸腔镜手术,术中因大出血至失血性休克,经全力抢救病情才逐渐稳定.     

《中国卒中杂志》2007年工作总结及2008年工作安排

<中国卒中杂志>创刊已2年了,在2年的时间内,在杂志社领导吕伟伟社长的关怀下,在杂志主编王拥军教授的精心策划下,在杂志编委会所有成员的大力支持下,在编辑部工作人员的勤奋工作以及许多的医药及医疗器械公司的赞助下,<中国卒中杂志>茁壮成长,受到国内外学者的广泛关注,也成为脑血管病相关研究领域学者,特别是广大的临床医生提高业务水平的良师益友,成为某些医院科室业务学习的必备教材或参考书.……     

10例脑干脑炎的临床分析

目的 探讨脑干脑炎的临床特点. 方法 对10例脑干脑炎的发病年龄、性别、临床特点及辅助检查进行分析,并结合文献对病因进行探讨. 结果 男性明显多于女性,以青壮年居多,多侵犯脑桥至延髓锥体交叉以上,可合并其他部位受累,脑脊液改变不明显,MRI可发现病灶.结论 脑干脑炎的病因未明,可能与病毒感染后的自身免疫有关,激素治疗有效,预后良好.     

主动脉弓源性栓子致双侧大脑前动脉区梗死1例

1 病例介绍患者,男,47岁,主因“头痛伴左侧肢体力弱2d”于2010年7月18日收住入院.患者于2010年7月16日出现两侧颞部疼痛,持续性,伴头晕,视物模糊,无黑朦,左侧肢体乏力,左上肢不能持物,行走跛行,无视物旋转,无复视,无恶心呕吐,无意识丧失.患者未及时就诊,次日患者左侧肢体力弱加重,不能行走,同时伴有言语不利,来我院急诊就诊,查颅脑磁共振成像(magnetic resonance imaging,MRI)及磁共振弥散成像(Diffusion weighted imaging,DWI) (2010年7月18日)示:左侧额叶及右侧顶叶急性多发性脑梗死(图1),以“急性脑梗死”收入院.     

气泡浴+涡流浴对痉挛型小儿脑瘫的康复疗效

目的 观察气泡浴 涡流浴对痉挛型小儿脑瘫的康复疗效. 方法 127例痉挛型小儿脑瘫患儿分治疗组65例,观察组62例,所有患儿均进行功能训练(OT、PT)、针灸等治疗,治疗组在此基础上加用气泡浴 涡流浴,1次/d,20min/次,20次为1疗程,共3个疗程.治疗前、后进行小儿脑瘫评估,包括运动功能评价、症状及体征评价. 结果 治疗组有效率93.8%,对照组有效率79.0%,2组总有效率相比有明显差异,χ2=4.09,P＜0.05. 结论 气泡浴 涡流浴能有效降低患儿肌张力,改善平衡能力,扩大关节活动度,治疗师能有更多时间进行运动通和异常姿势矫正.     

延髓出血1例报告

患者,男,47岁,因突发右肢体麻木、无力伴吞咽困难、饮水呛咳半天,于2009年3月入院.入院前于晨起突发右上肢麻木、无力,右手无法持物,抬举费力,右下肢拖拽伴吞咽困难、饮水呛咳、言语含糊、声音嘶哑,能够理解旁人对话,恶心、呕吐胃内容物数次,非喷射性.     

Skeletal muscle-derived cells repair peripheral nerve defects in mice

Skeletal muscle-derived cells have strong secretory function,while skeletal muscle-derived stem cells,which are included in muscle-derived cells,can differentiate into Schwann cell-like cells and other cell types.However,the effect of muscle-derived cells on peripheral nerve defects has not been reported.In this study,5-mm-long nerve defects were created in the right sciatic nerves of mice to construct a peripheral nerve defect model.Adult female C57BL/6 mice were randomly divided into four groups.For the muscle-derived cell group,muscle-derived cells were injected into the catheter after the cut nerve ends were bridged with a polyurethane catheter.For external oblique muscle-fabricated nerve conduit and polyurethane groups,an external oblique muscle-fabricated nerve conduit or polyurethane catheter was used to bridge the cut nerve ends,respectively.For the sham group,the sciatic nerves on the right side were separated but not excised.At 8 and 12 weeks post-surgery,distributions of axons and myelin sheaths were observed,and the nerve diameter was calculated using immunofluorescence staining.The number,diameter,and thickness of myelinated nerve fibers were detected by toluidine blue staining and transmission electron microscopy.Muscle fiber area ratios were calculated by Masson’s trichrome staining of gastrocnemius muscle sections.Sciatic functional index was recorded using walking footprint analysis at 4,8,and 12 weeks after operation.The results showed that,at 8 and 12 weeks after surgery,myelin sheaths and axons of regenerating nerves were evenly distributed in the muscle-derived cell group.The number,diameter,and myelin sheath thickness of myelinated nerve fibers,as well as gastrocnemius muscle wet weight and muscle area ratio,were significantly higher in the muscle-derived cell group compared with the polyurethane group.At 4,8,and 12 weeks post-surgery,sciatic functional index was notably increased in the muscle-derived cell group compared with the polyurethane group.These criteria of the muscle-derived cell group were not significantly different from the external oblique muscle-fabricated nerve conduit group.Collectively,these data suggest that muscle-derived cells effectively accelerated peripheral nerve regeneration.This study was approved by the Animal Ethics Committee of Plastic Surgery Hospital,Chinese Academy of Medical Sciences(approval No.040)on September 28,2016.     

获得性肝脑变性1例报告

患者,男,51岁,工人,主因渐进性双侧肢体无力3年,反应迟钝1年于2010年3月11日入院.患者于入院前3年出现左侧肢体活动无力,行走100米即感左下肢拖曳,左上肢持物无力,于当地医院按"颈椎病"行颈椎手术治疗.术后左侧肢体无力进行性加重,左手不能持物,左上肢抬起费力不能过肩,左下肢单肢站立无力,未诊治.入院前2年半出现右侧肢体无力,右上肢可抬过肩但费力,右下肢可站立但行走无力,自行在当地卫生所输液治疗,无好转.     

Progress in clinical trials of cell transplantation for the treatment of spinal cord injury:how many questions remain unanswered?

Spinal cord injury can lead to severe motor,sensory and autonomic nervous dysfunctions.However,there is currently no effective treatment for spinal cord injury.Neural stem cells and progenitor cells,bone marrow mesenchymal stem cells,olfactory ensheathing cells,umbilical cord blood stem cells,adipose stem cells,hematopoietic stem cells,oligodendrocyte precursor cells,macrophages and Schwann cells have been studied as potential treatments for spinal cord injury.These treatments were mainly performed in animals.However,subtle changes in sensory function,nerve root movement and pain cannot be fully investigated with animal studies.Although these cell types have shown excellent safety and effectiveness in various animal models,sufficient evidence of efficacy for clinical translation is still lacking.Cell transplantation should be combined with tissue engineering scaffolds,local drug delivery systems,postoperative adjuvant therapy and physical rehabilitation training as part of a comprehensive treatment plan to provide the possibility for patients with SCI to return to normal life.This review summarizes and analyzes the clinical trials of cell transplantation therapy in spinal cord injury,with the aim of providing a rational foundation for the development of clinical treatments for spinal cord injury.