神经内窥镜下微创手术治疗高血压脑出血的疗效观察

目的：探讨神经内窥镜下微创手术治疗高血压脑出血的疗效。方法：选取本院2006年1月--2011年12月治疗的60例高血压脑出血患者,分为研究组和对照组各30例,研究组使用神经内窥镜下微创手术治疗,对照组使用单纯颅内血肿抽吸治疗。对两组的神经功能缺损评分和疗效进行比较,评估其治疗效果。结果：治疗3个月后,研究组神经功能缺损评分明显下降,效果相当高。结论：神经内窥镜下微创手术治疗高血压脑出血能够避免穿刺时过于盲目导致脑组织受到损伤,和单纯颅内血肿抽吸相比治疗效果更明显。     

脑内窥镜治疗急性期高血压性脑出血30例疗效分析

目的 探讨脑内窥镜治疗高血压性脑出血的临床疗效。方法：用脑内窥镜治疗高血压性脑出血30例，并与常规治疗30例比较。结果：脑内空窥镜治疗术后12小时血压稳定（收缩压≤21KP,平均动脉压≤16KPa，舒张压≤13KPa）；术后2周肺部感染、上消化道出血的发生率和死亡率减少（P＜0．01）。结论：直视下脑内窥镜清除血肿能明显降低高血压性出血的并发症和病死率。     

非高血压脑出血患者DSA分析及临床对策探讨

目的探讨数字减影脑血管造影技术（DSA）在诊断非高血压脑出血患者的应用价值、非高血压脑血管患者的临床表现及治疗措施。方法对笔者所在医院收治的520例非高血压脑出血患者进行数字减影脑血管造影术（DSA），对患者临床资料进行整理总结和分析。结果520例非高血压脑出血患者中，血管病变387例，以动脉瘤最多，为301例，占总数的77．78％。此外，还包括颅内动脉畸形、颅底异常血管网等。临床诊断需结合患者的临床症状，各种辅助检查进行判断。治疗以手术治疗为主，保守治疗为辅。结论数字减影脑血管造影技术对诊断非高血压脑出血患者有很大的临床意义，医生对患者的疾病确诊应综合判断，并早期给予治疗。     

微创手术治疗高血压性脑出血112例的观察与护理

脑出血是神经外科比较常见的急症，一般患者发病急，病情凶险，其发展迅速，其死亡率及致残率均很高。随着现代科学技术的发展，先进医疗仪器在临床上的应用，笔者所在医院自2009年引进先进的神经外科手术显微镜后，开展微创显微手术治疗高血压脑出血112例，术前、术后的护理在本组病例中起到了重要作用。现将有关护理措施报告如下。     

脑外科的必备“武器”——神经内窥镜

内窥镜应用在神经外科方面在上世纪初就已经开始,但开始仅局限于切除脉络丛等狭小的范围内。近年由于CT及MRI影像学检查的发展,该项技术又重新开始应用于临床。随着发现许多位于脑室系统或凸向脑室的病变,加之内窥镜技术的不断完善及相应显微器械的研制,脑立体定向仪、激光、超声及神经导航的介入,神经内窥镜(Neuroendoscopy)技术作为“微侵袭神经外科(Minimally Invasive Neurosurgery)领域的重要分支已被国内外诸多学者所关注,并被认为是一项非常有发展前途的技术。 目前可用于神经外科手术的内窥镜有许多不同类型,     

高血压脑出血行微创颅内血肿清除术治疗的效果分析

目的对高血压脑出血行微创颅内血肿清除术治疗的效果进行观察和分析。方法选取2016年1~10月期间在我院46例高血压脑出血行微创颅内血肿清除术的患者作为本次研究的观察组,选取同时期行传统治疗手术的46例高血压脑出血患者作为对照组,观察并比较两组患者的手术相关指标、血清炎性因子水平、神经功能改善情况,以及并发症发生情况。结果两组患者经过治疗,观察组患者的手术相关指标、神经功能改善情况等方面均优于对照组;血清炎性因子水平以及并发症发生率均低于对照组,组间比较,差异具有统计学意义(P﹤0.05)。结论对高血压脑出血患者行微创颅内血肿清除术具有十分显著的治疗效果,可在临床中广泛推广应用。     

CT引导锥颅软通道技术治疗高血压脑出血50例临床体会

目的 探讨微创治疗高血压脑出血的临床效果.方法 根据CT定位,微创颅内定向置软管吸引术对颅内血肿引流.结果 术后恢复有效率为80 2%,手术致残率为26%,病死率为8%,再出血率为4%.结论 微创治疗高血压脑出血,操作简便、安全,疗效好,费用低,是对高血压脑出血有效的治疗方法,可减少脑组织的继发性损害.     

急性外伤性颅内血肿的非手术治疗

CT对急性外伤性颅内血肿的诊断已经没有困难,并为血肿的治疗提供有力的依据,但如何对CT发现的颅内血肿病例选择手术或非手术疗法是神经外科面临的一个新问题。本文结合我院经CT检查发现的81例急性外伤性颅内血肿的治疗讨论如下:     

微创颅内血肿清除技术治疗高血压脑出血临床应用

目的探讨颅内血肿穿刺抽吸、液化治疗高血压脑出血的临床效果.方法采用微创颅内血肿清除技术,即CT定位,经皮颅内血肿穿刺针穿刺、射流冲碎血肿,血肿腔内注入纤溶药物溶解引出血肿.结果治疗36例,死亡5例,存活出院31例.结论该项技术操作简便、安全,对高血压脑出血有满意的临床效果.     

颅内血肿微创清除术治疗高血压脑出血的重症监护分析

目的探讨颅内血肿微创清除术治疗高血压脑出血的重症监护方法,为治疗高血压脑出血提供临床依据。方法选取2010年6月—2012年6月来该院治疗高血压脑出血的重症患者60例,全部采用颅内血肿微创清除术治疗,同时抽吸血肿,注入尿激酶,疗程为7～14d。结果 60例患者痊愈39例,好转16例,死亡5例,总有效率为91.7%,死亡率为8.3%。结论颅内血肿微创清除术治疗高血压脑出血死亡率低,能有效缩短住院时间,手术简单,对患者的损伤小,是一种科学有效的方法,在临床上可大力推广。     

氯乙烯作业工人淋巴细胞DNA损伤的研究

目的探讨用单细胞微量凝胶电泳测试方法（ＭＧＥ）检测氯乙烯对人体外周血淋巴细胞ＤＮＡ损伤。方法选择５３名氯乙烯作业工人和５５名非氯乙烯接触工人用ＭＧＥ方法测定外周血淋巴细胞ＤＮＡ损伤的状况。结果氯乙烯作业工人ＤＮＡ损伤细胞数明显高于对照组（Ｐ＜００１）。结论氯乙烯可引起人体淋巴细胞ＤＮＡ链的断裂,单个细胞微量凝胶电泳技术是一项敏感的测试人体细胞ＤＮＡ损伤的方法。     

Presence of glycopeptide-encoding plasmids in enterococcal isolates from food and humans in Denmark

Enterococci and especially glycopeptides-resistant enterococci (GRE) are a growing concern due to their ability to cause infections in hospitals. Transmission of antimicrobial resistance between reservoirs such as animals, meat, and humans are in most cases linked to transmission of mobile genetic elements (MGE) such as plasmids and transposons. Presence of MGE was tested in all GRE isolated from food in Denmark in 2005-2007 including the first vanA mediated Enterococcus faecalis isolated from food. The ability of these plasmids to transfer and persist among enterococci was investigated using newly developed techniques for classification of plasmids. Replicons associated with sex pheromone-inducible plasmids were detected in all GR E. faecalis, whereas GR Enterococcus faecium contained plasmids known to be widely distributed among enterococci. vanA resistance is common in E. faecium isolates from meat and animals in Europe and is rarely found in E. faecalis. This article describes the first characterization of MGE from vanA mediated E. faecalis, thus linking this resistance genotype to pheromone responding plasmids.     

Women's empowerment and life expectancy at birth in Mexico]

OBJECTIVES: To assess the effect of women's empowerment (WE) on life expectancy at birth (LEB) in the federative states of Mexico and to compare the results of measuring WE with various compound indicators that reflect, to a greater or lesser degree, an individual or population focus.METHODS: This was an ecological study conducted in Mexico's 32 federative states. We estimated the correlations between overall and sex-specific LEB on the one hand, and a measure of gender empowerment (MGE), the index of women's ability to make decisions within the household (WADH), the index of women's autonomy (IWA), income inequality, certain aspects of the physical environment, the proportion of the population who spoke an indigenous language, and the net migratory rate on the other. By using robust regressions, we studied the effect on LEB of MGE, IWA, and WADH, after mutually adjusting for other independent variables.RESULTS: A very strong inverse correlation (-0.93) was found between overall LEB and factors of the physical environment linked to population vulnerability and biodiversity. Significant direct and inverse correlations were also found between LEB on the one hand and WADH, IWA, net migratory rate, the percentage of the population that spoke an indigenous language, and the Gini coefficient on the other. Multiple robust regressions showed inverse associations between MGE and LEB in women (beta: -1.44; 95% confidence interval [95% CI]: -2.71 to -0.17). WAI was positively associated with LEB in men (beta: 0.88; 95% CI: 0.01 to 1.75) and women (beta: 0.66; 95% CI: 0.03 to 1.30).CONCLUSION: The use of MGE as a surrogate for WE failed to reveal a positive effect of WE on LEB in Mexico. It is necessary to review the components that make up MGE and the relevance of using such a measure in different contexts. WAI showed a greater association with LEB and its effect was greater among men. This indicator made it possible to measure WE in Mexico and its use is recommended, as long as there are no other indicators available for capturing more effectively all the components that affect WE.     

Cognitive Outcomes and Activity of Daily Living for Neurosurgical Patients With Intrinsic Brain Lesions: A 1-year Prevalence Study

Background

No prevalence data on cognitive outcomes are available for general neurosurgical patients and few studies have assessed the correlation between common cognitive assessment tools of the occupational therapists and activity of daily living (ADL) at 1 year.

Methods

Consecutive neurosurgical patients with intrinsic brain lesions (brain tumours, traumatic intracerebral haematomas, spontaneous intracerebral haematomas, and cerebral arteriovenous malformations) were approached for consent to participate in the present study.

Results

At 1 year, the Montreal Cognitive Assessment score (mean ± standard deviation) was 20.4 (±8.6) and 42% of the patients had scores less than 22. The median number of the Neurobehavioral Cognitive Status Examination domains below the cutoff values was 8 (interquartile range: 3.5–9.75).

Conclusions

The cognitive assessments—the Montreal Cognitive Assessment, the Frontal Assessment Battery, and the Rivermead Behavioural Memory Test—showed satisfactory discriminating power for complete independence in instrumental ADL. Instrumental ADL was best correlated with the Rivermead Behavioural Memory Test.     

Effect of oral protein load on urinary protein excretion in workers exposed to cadmium and to lead

An acute oral protein load causes a transient hyperfiltration that might reveal a loss of glomerular permselectivity properties. The effect of an oral protein load on the urinary excretion rate of albumin (UAE), β-2-microglobulin (UB2MGE), and retinol-binding protein (URBPE) was thus examined in cadmium- and lead-exposed workers. The results show a transient increase in UB2MGE and URBPE without relevant changes in UAE. These changes were also observed in control groups and are due to competitive inhibition of tubular protein reabsorption by absorbed cationic amino acids. These results do not support the hypothesis that the acute protein load test is of great utility in revealing a silent glomerular filtration disturbance in lead- or cadmium-exposed workers. However, it might disclose imminent renal tubular dysfunction in cadmium workers not yet showing increased microproteinuria under baseline conditions. © 1996 Wiley-Liss, Inc.     

Bioactive Compounds and Antioxidant Properties of Goji fruits (Lycium barbarum L.) Cultivated in Serbia

Objective: Goji fruit extracts, methanol (MGE) and hexane (HGE), were subjected to evaluation as potential source of phenolic antioxidants and antiradical activity.

Methods: Some phenolic compounds (gallic, protocatechuic, vanillic, chlorogenic, coumaric, caffeic and ferulic acid and catechin and rutin), vitamin C and carotenoids were identified and quantified by HPLC. Antioxidant activity was tested by measuring ability to scavenge DPPH and hydroxyl radicals. Also, reducing power of goji fruit extracts was determined.

Results: HPLC analysis results showed predominance of gallic acid (40.44 mg/g g.f). Vitamin C content in MGE was 716.91 mg vitC/100 g g.f. IC₅₀^DPPH· varied from 26.64 μmolTEAC/g for HGE to 62.15 μmolTEAC/g for MGE, while RP_0.5 values varied from 952.23 μmolTEAC/g for MGE to 1360.48 mg/mL for HGE. IC₅₀·^OH for MGE was 1844.01 μmolTEAC/g.

Conclusions: Our results support the use of goji fruits as rich sources of phytochemicals for further utilization in the food industry as supplements and functional food ingredients.     

Current treatment of bilateral recurrent inguinal hernias using preperitoneal Marlex mesh prosthesis

In the literature recurrence after operation for a recurrent inguinal hernia varies from 3 to 36%. For bilateral recurrent hernia the risk of recurrence is even higher. The results of a preperitoneal Marlex prosthesis in these patients are excellent. After this procedure we saw no new recurrences in 35 patients with 70 recurrent hernias. There was no surgical mortality; in 2 patients superficial infection occurred and there were 4 inguinal haematomas. The preperitoneal Marlex prosthesis appears to be the ideal solution for bilateral recurrent inguinal hernias.     

Pattern, severity and aetiology of injuries in victims of assault.

Although the incidence of assault and other violent crime is increasing in the UK, the cause and overall pattern of injury, and the need for admission have not been defined in adult victims who attend hospital. In a prospective study, all 539 adult victims of assault attending a major city centre Accident & Emergency department in 1986 were therefore interviewed and examined. Facial injury was extremely common: 83% of all fractures, 66% of all lacerations and 53% of all haematomas were facial. The upper limb was the next most common site of injury (14% of all injuries). Twenty-six per cent of victims sustained at least one fracture and nasal fractures were the most frequently observed skeletal injuries (27%) followed by zygomatic fractures (22%) and mandibular body (12%), angle (12%) and condyle (9%) fractures. Seventeen per cent of victims required hospital admission. Overall, the type of injury observed correlated with the alleged weapon used (P = less than 0.001) though 20% of victims who reported attacks with sharp weapons sustained only haematomas or fractures. Injury most often resulted from punching (72% of assaults) or kicking (42% of assaults). Only 6% of victims reported injury with knives but 11% were injured by broken drinking glasses. Those who were kicked were most likely to need hospital admission.     

Diagnostic image (379). A confused man with tetraparesis and haemophilia

A 77-year-old haemophilic man presented with confusion, somnolence and tetraparesis due to massive bilateral subdural haematomas.     

围术期预防性使用抗生素对高龄起搏器置入患者安全性评价

目的评价围术期24 h内预防性使用抗生素对置入起搏器的高龄患者预防感染发生的安全性。方法对置入心脏起搏器的115例高龄患者分两组,围术期24 h内使用抗生素的预防组(55例)和常规术前及术后使用抗生素的常规组(60例),比较两组囊袋血肿、囊袋感染、伤口感染、肺部感染、住院天数、术后1~3个月感染、术后6个月再次入院等情况。结果术后发生并发症共20例(17.39%),预防组和常规组发生囊袋血肿分别为2例(3.64%)和3例(5.00%),肺部感染5例(9.09%)和6例(10.00%),住院天数(25.63±7.25)d和(23.87±8.12)d,术后1~3个月内发生感染3例(5.45%)和3例(5.00%),6个月内再入院14次(25.5%)和13次(21.7%)。术后并发症、术后肺部感染、住院天数、术后1~3个月内发生感染数、6个月内再入院数两组比较,差异均无统计学意义(P0.05)。结论对于置入心脏起搏器的高龄患者,围术期24 h内预防性使用抗生素并未增加术后感染风险,提倡在高龄起搏器置入患者围术期合理规范使用抗生素。