动脉瘤术后血管痉挛的综合治疗(附284例报告)

目的总结动脉瘤手术后血管痉挛及延迟性缺血性神经功能障碍(DIND)的防治经验。方法回顾性分析284例接受颅内动脉瘤夹闭术病人的临床资料,对颅多普勒超声(TCD)的结果与DIND的发生情况进行统计分析。结果137例病人手术后发生血管痉挛,79例发生DIND。TCD所示血流速度与DIND的发生有密切的相关关系。经治疗,62例DIND病人(78.5%)症状消失。病死率2.5%。结论血管痉挛是导致DIND的主要因素,个体化的综合治疗能明显提高疗效。     

一种胰岛素抵抗的糖尿病特殊类型报告

报告５例对胰岛素抵抗的糖尿病特殊类型病例，其均具有胰岛素应用指征，但使用胰岛素后血糖却反而上升，逐渐增加胰岛素用量，则血糖值亦呈上升趋势。对该类病人的治疗，首先停用胰岛素，改用自制中药制剂及优降糖、降糖灵治疗，取得了良好效果。     

高血压性脑出血外科治疗体会

报告33例高血压性脑出血施行外科手术治疗的临床体会。结合术前病情分级、血肿类型、血肿量、中线结构移位程度等,对手术治疗的适应症选择、手术方式及入路、提高治疗效果、减少术后并发症等作了讨论。提出了手术治疗重要性。     

Pathological laughter and crying in patients with multiple system atrophy-cerebellar type.

In the cerebellar type of multiple system atrophy (MSA-C), the burden of pathological changes involves the cerebellum and its associated brainstem structures in the basis pontis and the inferior olivary nucleus, and as a result, the clinical phenotype is dominated early on by the cerebellar dysfunction. We report our clinical and post mortem findings in a patient with MSA-C who exhibited pathological laughter in the absence of any congruent changes of mood. A review of the clinical notes of 27 other patients with MSA-C revealed a problem with pathological laughter, or crying, or both in 9 more patients. Our finding of about 36% occurrence suggests that the problem of dysregulation of emotional expression is more prevalent in MSA-C than the paucity of reports in the literature suggests. Our findings are consistent with the view that the cerebellum and its interconnected structures may be involved in the regulation of emotional expression.     

有机氮源对红霉素发酵影响的具体分析

红色糖多孢菌的摇瓶培养基中使用不同有机氮源时红霉素的效价明显不同。通过对不同有机氮源所含营养成分的逐步回归分析,我们得到有机氮源中的苏氨酸为影响红霉素效价的主要因子。最后向对照培养基中添加苏氨酸,则使红霉素的效价比对照培养基提高了22.85%。