可脱性弹簧圈血管内栓塞治疗颅内破裂动脉瘤

随着可脱性弹簧圈栓塞技术的进步和可脱性弹簧圈栓塞系统的不断升级,在破裂颅内动脉瘤的治疗中,使血管内介入治疗颅内动脉瘤的适应证不断扩大,相关学科医生及患者群体对血管内介入治疗的认识增多,使更多颅内动脉瘤患者通过血管内介入治疗获得治愈.中国医科大学附属第二医院神经外科与北京市神经外科研究所在2004年4月至2005年1月共收治Hunt-Hess Ⅰ～Ⅴ级破裂动脉瘤患者63例,64个颅内动脉瘤,并对其中的50例患者于急性期（3 d内） 行可脱性弹簧圈栓塞治疗.现将结果报道如下.……     

PTEN蛋白在人脑星形细胞瘤中的表达及意义

目的：探讨PTEN蛋白在不同分化程度的星形细胞瘤组织中的表达。方法：应用S-P免疫组化技术检测46例星形细胞瘤中PTEN蛋白的表达。结果：人脑星形细胞瘤组织中PTEN蛋白的阳性表达率为63．4％，星形细胞瘤组织中PTEN蛋白的阳性表达低分化（Ⅲ～Ⅳ级）显著低于高分化（Ⅰ～Ⅱ级）（P〈0．01）；病理分级与PTEN蛋白的阳性表达呈负相关（r=-0．612．P〈0．01）。结论：PTEN基因突变、缺失与脑星形细胞瘤的分化程度及演进密切相关。     

大脑后动脉第一段动脉瘤破裂因素分析和栓塞体会

目的 对本院2010年以来治疗的6例大脑后动脉第一段（P1段）动脉瘤易破裂的因素和栓塞体会回顾性分析.方法 6例患者均行血管内弹簧圈栓塞治疗,有两例患者入院后发生二次破裂.结果 有4例患者栓塞后恢复较好,1例患者栓塞后偏瘫伴偏盲,1例患者造影时2次破裂,急诊动脉瘤栓塞后,CT复查发现出血量较大,后引起脑疝,经去骨瓣减压治疗无效死亡.结论 P1段动脉瘤多见于年轻人,动脉瘤均较大,易发生2次破裂,急诊行血管内栓塞治疗可减少2次破裂出血几率.进而减少并发症的发生降低死亡率.     

能谱-X线微束分析检测新生大鼠额叶皮质神经干细胞定向分化为神经元样细胞各时段α辅肌动蛋白的表达

BACKGROUND： Alpha-actinin （ a -actinin） plays a key role in neuronal growth cone migration during directional differentiation from neural stem cells （NSCs） to neurons. OBJECTIVE： To detect in situ microdistribution and quantitative expression of a -actinin during directional differentiation of NSCs to neurons in the temporal lobe cerebral cortex of neonatal rats. DESIGN, TIME AND SETTING： Between January 2006 and December 2008, culture and directional differentiation of NSCs were performed at Department of Histology and Embryology, Preclinical Medical College, China Medical University. Immune electron microscopy was performed at Department of Histology and Embryology and Department of Electron Micrology, Preclinical Medical College, China Medical University. Spectrum analysis was performed at Laboratory of Electron Microscopy, Mental Research Institute, Chinese Academy of Sciences. MATERIALS： Basic fibroblast growth factor, epidermal growth factor, brain-derived nerve growth factor, type-1 insulin like growth factor, and a -actinin antibody were provided by Gibco BRL, USA; rabbit-anti-rat nestin monoclonal antibody, rabbit-anti-rat neuron specific enolase polyclonal antibody, and EDAX-9100 energy dispersive X-ray analysis were provided by PHILIPS Company, Netherlands. METHODS： NSCs, following primary and passage culture, were differentiated with serum culture medium （DMEM/F12 ＋ 10% fetal bovine serum ＋ 2 ng/mL brain-derived nerve growth factor ＋ 2 ng/mL type-1 insulin like growth factor）. MAIN OUTCOME MEASURES： Expression of a -actinin in neuron-like cells was quantitatively and qualitatively detected with immunocytochemistry using energy dispersive X-ray analysis. RESULTS： Immunocytochemistry, combined with electron microscopy, indicated that positive α -actinin expression was like a spheroid particle with high electron density. In addition, the expression was gradually concentrated from the nuclear edge to the cytoplasm and expanded into developing neurites, during differentiation of neural stem cells to neurons. Conversely, energy dispersive X-ray analysis indicated that the more mature the neural differentiation was, and the greater the expression of α -actinin. CONCLUSION： The gradual increase of α -actinin expression is related to growth, development, and maturity of differentiated neuron-like cells, in neonatal rat frontal lobe cortex, at different differentiating time points of NSCs to neurons.     

应用高顺应性球囊辅助弹簧圈技术治疗颅内宽颈动脉瘤

目地探讨应用高顺应性球囊辅助弹簧圈治疗颅内宽颈动脉瘤。方法回顾分析33例颅内宽颈动脉瘤,颈/体≥0.7或瘤颈宽≥4mm,6例动脉分叉部动脉瘤应用高顺应性HyperForm球囊辅助弹簧圈技术治疗,其他27例宽颈动脉瘤应用HyperGlide球囊辅助弹簧圈技术治疗。结果33例应用高顺应性球囊辅助弹簧圈技术治疗的颅内宽颈动脉瘤的病例,25例完全填塞,5例次全填塞(≥90%),3例不全填塞(<90%);1例术中动脉瘤破裂,2例术中血管痉挛,23例影像随访6-12个月,无动脉瘤复发,载瘤动脉保持通畅其他10例临床随访,9例症状好转,1例死亡。结论在填塞颅内宽颈动脉瘤时选择合适的高顺应性球囊,可使部分颅内宽颈动脉瘤得到致密稳定的填塞。     

动脉瘤性蛛网膜下腔出血54例手术夹闭和介入栓塞治疗术后出现血管痉挛的对比研究

<正>颅内动脉瘤(aneurismal,AN)破裂是蛛网膜下腔出血(subarachnoid hemorrhage,SAH)最常见的病因,病死率和致残率都很高。目前脉瘤性蛛网膜下腔出血的外科治疗方式有手术夹闭治疗和介入栓塞治疗2种方式。一般认为显微手术完全夹闭AN是最理想的治疗方法[1],但随着血管内介入技术的提高可栓塞材料的改进,AN介入栓塞治疗     

应用新型光敏剂ATX-S10.Na(Ⅱ)的光动力疗法治疗脑胶质瘤的实验研究

目的探讨在胶质瘤的光动力疗法中应用新型光敏剂ATX-S10.Na(Ⅱ)的可能性。方法首先对5种含有不同浓度的ATX-S10.Na(Ⅱ)的鼠和人的胶质瘤细胞中应用波长为670nm的激光照射,应用MTT法测定不同的肿瘤细胞对PDT治疗的反应。接着,在SD大鼠的C6胶质瘤皮下肿瘤模型应用中进行PDT治疗,探讨ATX-S10.Na(Ⅱ)介导的光化学反应所致的抗肿瘤作用。结果体外实验表明,PDT对肿瘤细胞的毒性作用既依靠ATX-S10.Na(Ⅱ)的药物浓度又依靠激光辐照的累计能量。每个细胞系的50%抑制浓度(IC50)波动于5-15μg/ml之间。在皮下肿瘤模型中,PDT治疗导致的肿瘤内部破坏面积随着激光能量的提高而增大,尤其是当照光剂量大于75J/cm时,与对照组相比有统计学意义。结论体外和在体的实验表明,新型光敏剂ATX-S10.Na(Ⅱ)介导的光动力疗法显示出极强的抗胶质瘤作用。     

地铁工程余泥渣土产生量估算及空间流向分析

大规模城市地铁施工产生了巨量的余泥渣土,给城市环境治理造成了巨大的压力.为此,准确量化余泥渣土产生量和厘清处理处置空间流向是对其进行有效管理的前提.本研究构建了综合考虑松散系数、风井开挖规模和盾构机直径的地铁工程余泥渣土产生量估算模型.基于实地调研、半结构化访谈和过程拓扑法,厘清了地铁工程余泥渣土"产生—处置"全过程涉...     

难治性颈动脉海绵窦瘘治疗的探讨

目的 探讨栓塞治疗复发及难治性颈动脉海绵窦瘘的对策。方法 回顾分析52例颈动脉海绵窦瘘患者中的5例，3例外伤性颈动脉海绵窦瘘和2例自发性颈动脉海绵窦瘘病例。结果 2例球囊栓塞后复发再次调整球囊型号或增加球囊而完全闭塞瘘口，1例球囊栓塞后复发以微弹簧圈填塞小瘘口，1例经动脉途径失败而经静脉途径填塞弹簧圈使瘘口闭塞，1例自发性颈动脉海绵窦瘘病例因瘘口巨大应用4枚球囊仍有较大瘘口残余而经BOT实验后将同侧颈内动脉及瘘口闭合而使之临床治愈。结论 对颈动脉海绵窦瘘球囊栓塞后复发，瘘口过大、过小、动脉途径治疗困难等情况应用不同材料及治疗途径可取得良好的治疗效果。