双侧标准外伤大骨瓣减压术治疗特重型颅脑损伤20例临床分析

目的 探讨双侧标准外伤性大骨瓣减压术治疗特重型颅脑损伤的临床疗效。方法 回顾性分析近5年来采用双侧标准外伤性大骨瓣减压术治疗的20例病例资料，通过GOS观察疗效，并结合文献进行讨论。结果 其死亡率为35％（7/20），较文献报道低；重残率为50％，中残率为25％。结论 双侧标准外伤性大骨瓣减压术可降低特重型颅脑损伤的死亡率，早诊早治、充分减压是提高疗效的关键。     

标准大骨瓣减压治疗以额颞挫伤为主的重型颅脑损伤

目的探讨标准大骨瓣减压和传统骨瓣减压对治疗额颞挫伤为主的重型颅脑损伤的疗效。方法回顾性分析标准大骨瓣减压和传统骨瓣减压两种不同手术方式治疗重型颅脑损伤的疗效对比。结果采用标准大骨瓣减压组死亡27例(病死率45%),恢复良好与中残21例(35%),采用传统骨瓣减压组死亡35例(62%),恢复良好与中残11例(18.9%),两组病死率有显著差异,两组恢复良好与中残率有显著差异,P<0.05。结论标准大骨瓣减压对治疗额颞挫伤为主的重型颅脑损伤明显优于传统骨瓣减压。     

双侧标准外伤大骨瓣减压术治疗特重型颅脑损伤20例临床分析

目的探讨双侧标准外伤性大骨瓣减压术治疗特重型颅脑损伤的临床疗效.方法回顾性分析近5年来采用双侧标准外伤性大骨瓣减压术治疗的20例病例资料,通过GOS观察疗效,并结合文献进行讨论.结果其死亡率为35%(7/20),较文献报道低;重残率为50%,中残率为25%.结论双侧标准外伤性大骨瓣减压术可降低特重型颅脑损伤的死亡率,早诊早治、充分减压是提高疗效的关键.     

大骨瓣减压术治疗重型颅脑损伤的效果观察

目的：探究大骨瓣减压术治疗重型颅脑损伤的临床效果。方法抽取2013年3月~2014年3月在我院就诊的60例重型颅脑损伤患者的临床资料进行回顾性分析,以选取手术方法的不同分为对照组与观察组,各为30例;对照组采用常规去骨瓣减压术,观察组采用标准大骨瓣减压术,对两组患者的治疗效果进行观察比较。结果经治疗后,观察组患者的总有效率明显高于对照组,两组数据差异明显(P<0.05),有统计学意义;观察组患者术后并发症明显低于对照组,两组数据差异明显(P<0.05),有统计学意义。结论对于重型颅脑损伤患者,采用大骨瓣减压术进行治疗,效果良好,能够使颅内压有效降低,减少并发症的发生,并提高患者的存活率,因此值得在临床中推广及使用。     

重型颅脑损伤采用标准大骨瓣开颅减压手术治疗的临床察

目的：分析研究重型颅脑损伤采用标准大骨瓣开颅减压手术治疗的效果。方法取样分析我院收治的63例重型颅脑损伤患者,按照手术方法不同划分为两组,对照组33例采用常规减压手术治疗,观察组30例患者采用标准大骨瓣开颅减压手术治疗,对比分析不同手术方法的治疗效果。结果对比分析两组患者的病死率以及中残率情况,有显著差异有统计学意义(<0.05)。结论给予重型颅脑损伤患者采用标准大骨瓣开颅减压手术治疗,可有效减少死亡率以及致残率发生,提高患者生命质量,效果显著。     

标准大骨瓣减压术中硬脑膜减张程度的量化研究

目的探讨与标准大骨瓣容积代偿相匹配的硬脑膜减张程度。方法通过对20例标准大骨瓣减压术患者减压窗的测量,算出成人平均容积代偿容积。通过尸体颅骨,模拟硬脑膜张力性缺损的过程,求出此容积引起硬脑膜张力性缺损的程度(面积用cm2表示),以此来量化硬脑膜减张程度。结果成人标准大骨瓣减压术平均容积代偿为81ml,其引起硬脑膜张力性缺损的面积为26.5cm2。影响因素包括:年龄、骨瓣范围、脑萎缩程度、迟发颅内血肿、脑水肿、脑梗塞程度、头皮张力等。结论硬脑膜减张缝合时,最佳硬脑膜减张程度为硬脑膜修补面积26.5cm2,实际工作中应结合容积代偿的影响因素略做增减。     

小脑幕切开术配合大骨瓣减压术治疗 重型颅脑损伤的效果分析

目的 观察颅脑重型损伤患者采用小脑幕切开术辅助下的大骨瓣减压术的治疗效果。方法 该院2017年1~12月入院的颅脑重型损伤患者80例作为主要观察对象,采用随机数字表法将患者分为观察组及对照组,每组40例。观察组采用小脑幕切开术辅助下的大骨瓣减压术,对照组采用大骨瓣减压术,对比两组患者手术前后的颅脑损伤昏迷程度（GCS）评分及术后并发症发生情况。结果 观察组患者术后GCS评分1周及4周均低于对照组,差异有统计学意义（P＜0.05）;观察组术后并发症发生率为10.00%,低于对照组37.50%,差异有统计学意义（P＜0.05）。结论 通过小脑幕切开术配合大骨瓣减压术的治疗,重型颅脑损伤患者的GCS评分显著降低,术后并发症明显减少,是重型颅脑损伤患者的安全性高,临床效果更优的新型手术方式。     

额颞部大骨瓣减压术救治额颞部重型颅脑伤

目的 探讨额颞部大骨瓣开颅减压术在额颞部重型颅脑伤治疗中的应用效果。方法 回顾分析36例额颞部重型颅脑损伤，均采用额颞部大骨瓣开颅（以yasiarjia手术入路为基础，扩大手术切口）减压术。结果 36例病人，恢复良好25例（41．7％）中残。7例（19．4％）重残4例（11．1％）植物生存1例，死亡9例（25％）。结论 额颞部大骨瓣开颅减压术是治疗额颞部重型颅脑伤较理想的术式。     

改良标准大骨瓣开颅术在重型颅脑损伤中的应用

目的探讨改良标准大骨瓣开颅术治疗重型颅脑损伤的疗效。方法分别采用改良标准大骨瓣开颅术与经典开颅术治疗重型颅脑损伤的患者140例,将其分为改良标准大骨瓣组（治疗组n=68例）和经典开颅组（对照组n=72例）,采用格拉斯哥预后（GOS）评分比较两组术后3个月的愈后。结果术后GOS评分,治疗组68例中,4-5分30例（44.1%）,2-3分21例（30.9%）,1分17例（25.0%）,对照组72例中,4-5分20例（27.8%）,2-3分23例（31.9%）,1分29例（40.3%）。GOS 1分及4-5分两者相比较,差异有统计学意义（P〈0.05）。结论在重型颅脑损伤患者,行改良标准大骨瓣术者预后较优于经典骨瓣开颅术者。     

部分迷路切除对桥小脑角区显露及其损伤程度的评价

目的:对迷路入路对桥小脑角区的显露程度及其损伤程度进行定量综合评价.方法:通过对成年国人带颈头颅标本6具(12侧),模拟常规的经迷路入路的手术操作,在迷路后入路的基础上,分别磨除部分半规管(上半规管和后半规管)和全部半规管.每个手术步骤完成后,按Ammirat标准进行评价不同手术入路及其扩大后对桥小脑角区的显露程度,用Horgan法计算出显露面积,并根据损伤程度评分评价3种手术入路及其扩大后的损伤程度.结果:经迷路后入路及其磨除部分半规管和全部半规管的显露程度评分分别为1分、1分和2分,显露面积分别为(304.29±39.74)mm<'2>、(416.13±90.14)mm<'2>和(610.47±109.36)mm<'2>,磨除部分半规管后显露面积较迷路后入路明显增加(P<0.001),而磨除全部半规管后显露面积较磨除部分半规管无显著扩大(P=0.562).而经迷路后入路及其磨除部分半规管和全部半规管的损伤程度评分分别为1分、9分和12分.结论:单纯迷路后入路对桥小脑角区显露有限,在单纯迷路后入路的基础上磨除部分半规管(上半规管和后半规管),对桥小脑角区的显露程度和显露面积明显扩大,但相应的损伤程度扩大,磨除全部半规管较磨除部分迷半规管路并不能明显扩大显露程度和显露面积,且损伤程度明显扩大.     

Lipid peroxidation,detoxification capacity,and genome damage in mice after transplacental exposure to pharmaceutical drugs

Data on genome damage, lipid peroxidation, and levels of glutathione peroxidase (GPX) in newborns after transplacental exposure to xenobiotics are rare and insufficient for risk assessment. The aim of the current study was to analyze, in an animal model, transplacental genotoxicity, lipid peroxidation, and detoxification disturbances caused by the following drugs commonly prescribed to pregnant women: paracetamol, fluconazole, 5-nitrofurantoin, and sodium valproate. Genome damage in dams and their newborn pups transplacentally exposed to these drugs was investigated using the in vivo micronucleus (MN) assay. The drugs were administered to dams intraperitoneally in three consecutive daily doses between days 12 and 14 of pregnancy. The results were correlated, with detoxification capacity of the newborn pups measured by the levels of GPX in blood and lipid peroxidation in liver measured by malondialdehyde (HPLC-MDA) levels. Sodium valproate and 5-nitrofurantoin significantly increased MN frequency in pregnant dams. A significant increase in the MN frequency of newborn pups was detected for all drugs tested. This paper also provides reference levels of MDA in newborn pups, according to which all drugs tested significantly lowered MDA levels of newborn pups, while blood GPX activity dropped significantly only after exposure to paracetamol. The GPX reduction reflected systemic oxidative stress, which is known to occur with paracetamol treatment. The reduction of MDA in the liver is suggested to be an unspecific metabolic reaction to the drugs that express cytotoxic, in particular hepatotoxic, effects associated with oxidative stress and lipid peroxidation.     

Protective effect of tetrahydrobiopterin on hepatic and renal damage after acute cadmium exposure in male rats

Cadmium (Cd) has been recognized as one of the most important environmental and industrial pollutants. This study investigated the impact of acute exposure to Cd on oxidative stress and the inflammatory marker interleukin-6 (IL-6) in the plasma of rats and the histological picture of liver and kidney, as well as to examine the potential protective effect of tetrahydrobiopterin (BH4). Methods: Rats were divided into control group, Cd group that received a single intraperitoneal (i.p.) dose of 4 mg/kg b.w. of CdCl2 and BH4+ Cd group that received a single dose of BH4 (20 mg/kg, i.p.) and subsequently exposed to a single dose of Cd 24 h after the BH4 treatment. Results: Cd increased the plasma levels of hepatic enzymes (ALT and AST), urea, creatinine, malondialdehyde (MDA), and IL-6 and decreased the superoxide dismutase (SOD) activity. Also, it induced histopathological alterations in the liver with severe degeneration, especially in centrilobular zones. Renal tubular epithelium showed vacuolated cytoplasm and dense nuclei. VEGF expression was mild. Ultrastuctural changes were seen in some renal tubules. The nuclei appeared distorted with electron dense chromatin. Mitochondria with destructed cristae were observed. BH4 pretreatment had protective effects, since it significantly reduced the levels of IL-6 and ameliorated the alteration in oxidative status biomarkers induced by Cd. Improvement of histopathological alterations was observed in Cd-groups. The nuclei were vesicular euchromatic, intact mitochondria and normal appearance of the filtration membrane. Moderate expression of VEGF was noted. Conclusion: This study has provided clear evidence for the protective efficacy of BH4 against experimental Cd toxicity.     

Oxidative stress and DNA damage induced by spinosad exposure in Spodoptera frugiperda Sf9 cells

Spinosad, a neurotoxic insecticide, is widely used for crop protection. In order to elucidate the effects of spinosad on oxidative stress and genotoxicity in Sf9 cells, the levels of lipid peroxidation, the activity of antioxidative enzymes, and DNA damage were measured. The results showed that spinosad caused a time-dependent increase in the formation of malondialdehyde and decrease in the activity of superoxide dismutase and catalase. Further studies confirmed that spinosad induced 8-oxoguanine accumulation in Sf9 cells, which is accompanied by increased expression of DNA repair enzymes (OGG1 and MTH1). The neutral comet assay revealed that spinosad induced significant time-related increases of DNA double-strand breaks in Sf9 cells. Our results indicate that spinosad effectively induced oxidative stress and DNA damage in Sf9 cells.     

Bixin and norbixin protect against DNA‐damage and alterations of redox status induced by methylmercury exposure in vivo

Populations in the Amazon are exposed to organic mercury via consumption of contaminated foods. These ethnic groups consume a specific plant seed “annatto” which contains certain carotenoids. The aim of this study was to find out if these compounds (bixin, BIX and norbixin, NOR), protect against DNA‐damage caused by the metal. Therefore, rats were treated orally with methylmercury (MeHg) and with the carotenoids under conditions that are relevant to humans. The animals were treated either with MeHg (30 μg/kg/bw/day), BIX (0.1–10 mg/kg/bw/day), NOR (0.01–1.0 mg/kg/bw/day) or combinations of the metal compound and the carotenoids consecutively for 45 days. Subsequently, the glutathione levels (GSH) and the activity of catalase were determined, and DNA‐damage was measured in hepatocytes and leukocytes using single cell gel electrophoresis assays. Treatment with the metal alone caused a decrease in the GSH levels (35%) and induced DNA damage, which resulted in increased DNA migration after electrophoresis in liver and blood cells, whereas no effects were seen with the carotenoids alone. When BIX or NOR were given in combination with organic mercury, the intermediate and the highest concentrations of the carotenoids (1.0 and 10.0 mg/kg/bw/day BIX and 0.1 and 1.0 mg/kg/bw/day NOR) protected against DNA‐damage. Furthermore, we found with both carotenoids, a moderate increase in the GSH levels in both metal‐treated and untreated animals, while the activities of catalase remained unchanged. Our results indicate that consumption of BIX and NOR may protect humans against the adverse health effects caused by exposure to organic mercury. Environ. Mol. Mutagen., 2012. © 2012 Wiley Periodicals, Inc.     

Attenuation of epilepsy-induced brain damage in the temporal cortices of rats by exposure to LTP-patterned magnetic fields

To test the feasibility that whole body exposure to structurally matched, physiologically patterned magnetic fields could reduce cellular injury within specific regions of the brain, young rats were seized with lithium and pilocarpine and then exposed to a sham field or to one of three computer-generated magnetic field patterns. They were digitized equivalents of the pulsed patterns of electric current known to produce long-term potential (LTP) in slices of hippocampus or entorhinal cortices. Histological analyses of their brains as adults indicated the earlier exposure to the LTP-patterned fields produced a robust reduction of damage within the primary and association areas of the right temporal cortices and the CA1/CA2 hippocampal fields. The results suggest physiologically patterned magnetic fields could be employed to target specific nuclei anywhere within the brain by matching intrinsic activity.     

Preparation and evaluation of the 1st international standard for the quantitation of HIV-2 RNA in plasma

An international standard for the quantitation of HIV-2 RNA in plasma samples was developed. A collaborative study involving 29 laboratories from 15 countries was carried out in order to evaluate HIV-2 RNA candidate materials for use with nucleic acid-based tests (NATs). Candidate reference standards consisted of duplicate copies of two HIV-2 genotype A viruses, HIV-2 CAM2 and HIV-2 ROD and were coded S1-S4. Each laboratory assayed all four candidates on at least three separate occasions and data were collated and analysed at NIBSC. Of the data sets returned the majority were from qualitative assays. All assays detected both candidate standards with the exception of one commercial assay, the Nuclisens Easy Q, which was designed primarily for HIV-1 detection which did not detect HIV-2 CAM2 but showed good detection of HIV-2 ROD. This highlighted possible cross reactivity with HIV-2 ROD with some NAT primer/probe combinations; as a result the HIV-2 CAM2 material was established as the 1st international standard for HIV-2 RNA with an assigned unitage of 1000 International Units (IU) per ampoule and is available upon request from the National Institute for Biological Standardisation and Control (NIBSC) (www.nibsc.ac.uk).