磁敏感加权成像对脑静脉性血管畸形的诊断价值

目的 探讨磁敏感加权成像(SWI)对脑静脉性血管畸形的临床诊断价值.方法 回顾分析23例脑静脉性血管畸形患者SWI特点,并与常规MRI和全脑血管造影检查结果进行对比分析.结果 常规MRI扫描显示.23例患者中20例呈单发病灶,4例伴海绵状血管瘤;3例为多发病灶.T1WI呈点状或片状稍低信号改变.T2WI呈短条形或条形低信号改变;增强扫描呈明显放射状线样强化改变.全脑血管造影检查于静脉期显示扩张的髓静脉及引流静脉.SWI可见扩张的髓静脉和粗大的引流静脉.与MRI和全脑血管造影检查相比.其病灶显示范围更全面、广泛,且图像更加清晰.结论 SWI诊断脑静脉性血管畸形快捷、无创,可替代全脑血管造影作为脑静脉性血管畸形的筛查及手术前评价方法.     

大鼠急性脑缺血血浆及脑组织NO,ET1含量的变化

通过对大鼠急性脑缺血模型及假手术对照组血浆及脑组织一氧化氮（ＮＯ）、内皮素１（ＥＴ１）含量的测定，并观察脑缺血局部脑血流量及病理学改变。与对照组比较，模型组局部脑血流量降低，病理学改变加重，血浆中ＮＯ呈下降趋势，ＥＴ１水平明显升高；脑组织ＮＯ合成酶活性升高，ＮＯ及ＥＴ１含量明显升高。     

脑静脉及静脉窦血栓形成的临床分析

目的 探讨脑静脉及脑静脉窦血栓形成(CVT)的诊断及治疗策略.方法 对23例确诊为脑静脉及脑静脉窦血栓形成的患者的病因、临床表现、影像学特征、治疗方法及预后进行回顾性分析.结果 23例患者中,经降颅压、抗炎及抗凝等对症及支持治疗后,19例好转出院,3例死亡,1例自动出院.结论 脑静脉及脑静脉窦血栓病因复杂,临床表现无特异性,确诊须行MRL/MRV或DSA检查.早期给予抗凝及溶栓治疗可获得较好效果.     

糖尿病对血-脑屏障的损害及其机制

血-脑屏障是中枢神经系统特有的重要结构.血-脑屏障损害与多种中枢神经系统疾病的发生与发展有关.糖尿病所致血-脑屏障病理学改变、屏障功能损害、转运功能障碍和脑微血管紧密连接性质改变,是糖尿病引起中枢神经系统并发症的重要原因之一.     

脑小血管病病理生理学概念研究进展

脑小血管是指直径5μm至2 mm的血管,包括小动脉、微动脉、毛细血管、微静脉和小静脉,不同直径的血管病理生理改变不同。脑小血管病的主要病理学特点为腔隙性梗死、脑白质高信号和脑微出血,具有不同的病理生理学基础,危险因素亦存在一定差异。动脉僵硬度是脑小血管病的独立危险因素。     

脑猪囊尾蚴病临床及病理学特点

目的 探讨脑猪囊尾蚴病的临床及病理学特点.方法 回顾性分析13例脑猪囊尾蚴病患者的临床资料,并结合文献对其影像学、病理学进行分析.结果 本组13例患者中,11例以癫痫发作为主要症状;6例病理学检查均发现囊尾蚴虫体;9例病灶周围脑组织可见炎症反应;在病灶及其周围的脑组织中可见散在的石灰小体.头部CT检查表现为片状或点状低密度影,病灶区MRI表现为囊性异常信号.结论 脑猪囊尾蚴病首发症状以癫痫发作多见;影像学检查对脑猪囊尾蚴病诊断有帮助,但最后确诊需病理学检查;病理学检查除找到囊尾蚴虫体外,脑组织中发现散在的石灰小体是诊断陈旧性病变的重要依据.     

精神分裂症脑神经影像学及神经病理学的研究进展

精神分裂症的病因及发病机制迄今未明。影像学、神经化学、分子生物学等方法的快速发展和应用 ,使人们能够从宏观及微观两个水平 ,对精神分裂症大脑的神经病理学改变有更多认识 ,从而不断加深对精神分裂症病因及发病机制的理解。我们结合精神分裂症脑影像学和尸检大脑神经病理学研究的文献复习 ,对其研究进展作简要论述。一、大体结构改变1 脑室和脑皮质 :精神分裂症患者的脑室扩大和脑体积减小 ,是有关的影像学研究结果一致性很高的发现[1,2 ] 。如在超过 10 0篇CT的研究中 ,75 %报道精神分裂症患者有侧脑室扩大 ,83%报道第 3脑室扩大 ,6 …     

以出血为表现的脑静脉畸形的诊断和治疗

目的 探讨脑静脉畸形出血的影像学特点及其手术治疗方法.方法 回顾性分析8例脑静脉畸形出血的临床资料.7例采取显微手术治疗,1例出血破入脑室系统采取双侧脑室穿刺体外引流术.结果 8例经影像学及手术确诊为静脉畸形,其中2例合并海绵状血管瘤.随访2-60个月,平均21个月.所有患者均未发生再次出血,4例恢复日常生活工作,3例有不同程度恢复,但遗留神经功能缺损,1例加重(卧床).结论 静脉畸形MRI、DSA表现呈"水母头"改变.血肿量大、反复出血及神经功能障碍进行性加重是脑静脉畸形的手术指征,手术应尽量保留有正常引流功能的静脉畸形.     

桥本脑病的临床、影像学及病理学特点(附1例报告)

目的 研究桥本脑病的临床、影像学和病理学特点.方法 回顾性分析1例桥本脑病患者的临床资料.结果 本例患者的主要临床表现为快速进展的认知功能障碍及癫(癎)发作.血清抗甲状腺抗体显著增高,甲状腺功能基本正常.颅脑MRI显示双侧额、顶、颞、枕叶皮质及皮质下多发性长T1、长T2病灶,以皮质更加明显.增强扫描全部病灶均无强化.病理学检查显示反应性胶质细胞、小血管增生及少量淋巴细胞浸润.电镜检查显示神经细胞部分空泡样变性和线粒体肿胀,白质内可见小囊腔形成.经用糖皮质激素和免疫抑制剂治疗,患者的症状和影像学改变均得到了明显的缓解.结论 桥本脑病的临床特点为亚急性大脑皮质功能障碍,血抗甲状腺抗体增高而甲状腺功能正常,糖皮质激素治疗有效.影像学表现为广泛脑皮质及皮质下异常病灶;病理学改变无特异性.     

大鼠脑缺血再灌注后神经病理学、脑超微结构及Ca~(2 )细胞化学定位观察及脑脉宝的保护作用(论著摘要)

脑缺血缺氧引起的神经损伤是临床和脑病理学研究的重要课题。‘“钙反常”或“钙超载”现象对神经组织损伤起着关键作用，国内尚未见到在超微结构水平对脑缺血再灌注后钙在神经细胞内精确分布及定位的形态学研究。本实验观察大鼠缺血再灌损伤后神经病理学和脑超微结构及Ca’“分布的改变及脑脉宝的保护作用。1材料和方法脑脉宝由生黄茂、丹参、川芍、地龙、水蛙、牛磺酸等组成。雄性Wistar大鼠（每组5只）按改良Pulsinelll四血管阻断法，造成弥漫性全脑缺血，30min后去除动脉夹使其再灌流30min。取脑做HE、尼氏体及髓鞘染色、光镜观察。应…     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Presence and severity of anorexia and bulimia among male and female Omani and non-Omani adolescents

OBJECTIVE: The population of Oman is a heterogeneous mix of nationalities providing a natural setting for studying the cross-cultural differences in the presence and severity of eating disorders as well as an opportunity for evaluating the performance of measurement instruments for these disorders. METHOD: Disordered eating screening instruments (the Eating Attitude Test and the Bulimic Investigatory Test) were administered to Omani teenagers, non-Omani teenagers, and Omani adults. RESULTS: On the Eating Attitude Test, 33% of Omani teenagers (29.4% females and 36.4% males) and 9% of non-Omani teenagers (7.5% of males and 10.6% females) showed a propensity for anorexic-like behavior. On the Bulimic Investigatory Test, 12.3% of Omani teenagers showed a propensity for binge eating or bulimia (13.7% females and 10.9% males). Among the non-Omani teenagers, 18.4% showed a tendency toward bulimia, with females showing a slightly greater tendency than males. In contrast, barely 2% of Omani adults showed either a presence of or a severity of disorderly behavior with food. CONCLUSION: Omani teenagers scored significantly higher than other ethnic groups and Omani adults. This finding is discussed in the light of emerging evidence from many parts of the world suggesting that cultural transition, compounded by demographic constraints, plays a significant role in abnormal eating attitudes.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

Abstract

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Micro-affirmations and Recovery for Persons with Mental Health and Alcohol and Drug Problems: User and Professional Experience-Based Practice and Knowledge

Recurrent factors contributing to a recovery process from co-occurring mental health and addiction problems mentioned by users and professionals have been analyzed as part of working alliances and helpful relationships. Still, we lack knowledge about how helpful relationships are developed in daily practice. In this article, we focus on the concrete construction of professional helpful relationships. Forty persons in recovery and fifteen professionals were interviewed. The interviews were analyzed according to thematic analysis, resulting in three themes presented as paradoxes (1) My own decision, but with the help of others; (2) The need for structures and going beyond them; and (3) Small trivial things of great importance. Micro-affirmations have a central role in creating helpful relationships by confirming the individuals involved as more than solely users or professionals. More attention and appreciation should be paid to practices involving micro-affirmations.

     

Opiate and digitalis receptor assays distinguish between neuroexcitant and inactive organochlorines and between anesthetics and convulsants

Specific binding of [3H]naloxone to rat brain tissue in vitro was inhibited by the excitant organochlorinated insecticides (OCI), by ether (E) and octanol (OCT), and by the convulsant indoklon (IND) and its anesthetic isomer, isoindoklon (ISO). In the presence of 100 mM NaCl the inhibition of naloxone binding by E, OCT and ISO was greatly potentiated, whereas that by OCI and IND was attenuated. KCl (100 mM) was equally effective as NaCl on the action of anesthetics, but the effect of the excitant drugs was, in contrast to NaCl, unaffected by KCl. Specific binding of [3H]ouabain in the absence of Na, was depressed by anesthetics and enhanced by neuroexcitants. In the presence of NaCl, which by itself inhibits ouabain binding to brain, both anesthetics and excitants enhanced ouabain binding. DDE, a non-insecticidal analog of DDT, and the dimethyl derivative of the OCI, lindane, were inactive in the receptor assays. These observations point to a unique isolated system which responds consistently to anesthetic agents as a class and, in a different way, to neuroexcitant compounds.