Is magnesium neuroprotective following global and focal cerebral ischaemia? A review of published studies.

Neuroprotective activity with magnesium associated with animal models of cerebral ischaemia, seizure, perinatal hypoxia/ischaemia, subarachnoid haemorrhage and traumatic brain injury has provided the justification for clinical stroke trials. However, the recent IMAGES stroke clinical trial found magnesium to be largely ineffective. Hence, due to the negative stroke trial outcome, current FAST-MAG trial and our own experience with magnesium in cerebral ischaemia animal models, we thought it prudent to review these preclinical and clinical studies. We reviewed nine studies describing the use of magnesium following global cerebral ischaemia and fourteen following focal cerebral ischaemia. Four global ischaemia and six focal ischaemia studies did not show a significant neuroprotective effect with magnesium. In the majority of positive magnesium studies animal body temperature was not monitored post-ischaemia. Thus the effects of post-ischaemic hypothermia cannot be ruled out as a confounding factor in positive magnesium cerebral ischaemia studies. Moreover, data from our own laboratory indicates that magnesium is only neuroprotective when combined with post-ischaemic hypothermia. These data provide a possible explanation of why the IMAGES trial was largely unsuccessful, as current stroke patient management does not involve hypothermia induction. Future preclinical and clinical cerebral ischaemia trials with magnesium should consider combining treatment with mild hypothermia.     

住院精神病人院内感染的部位及高峰时间分析

目的　探讨精神科住院病人院内感染的部位及高峰时间。方法　采用圆形统计法对 1997年 1月～2 0 0 2年 12月间每月院内感染人数作圆形统计分析。结果　精神科住院病人院内感染以呼吸系统最多见 ,占5 6 4 8% ;感染高峰时间具有显著性差异 (Y =0 14 5 ,P <0 0 5 ) ,高峰时间约为 12月 17日 (按季节为初冬 )。结论　在感染高峰季节应加强对院内感染的监控和防治     

阿拉瑞林与小剂量利维爱联合应用治疗子宫内膜异位症合并不孕症的研究

目的:探讨阿拉瑞林与小剂量利维爱(替勃龙)联合应用治疗子宫内膜异位症合并不孕症的疗效及其耐受性。方法:研究对象为1998年1月～2001年6月期间在我院诊治的40例子宫内膜异位症合并不孕症患者。实验组给以阿拉瑞林及利维爱,对照组单用阿拉瑞林。结果:用药后两组患者血清E2、P、FSH、LH水平及AEMAb、CA125阳性率均明显下降;症状体征明显改善;在治疗结束后6个月,实验组中55％、对照组中45％患者妊娠,两组间差异无统计学意义(P>0.05)。实验组未出现低雌激素症候群,而对照组中85％患者出现该症候群,两组差异有统计学意义(P<0.05)。结论:阿拉瑞林与小剂量利维爱联合应用不仅疗效好,而且副作用小。     

微血管减压术治疗舌咽神经痛16例临床分析

目的　研究舌咽神经痛 (glossopharyngealneuralgia,GPN)手术治疗的最佳术式 ,评估微血管减压手术(microvasculardecompression ,MVD)的效果、并发症和随访结果 ,探讨可能的治疗机制。方法　 2 0 0 0年 12月到2 0 0 3年 10月间 ,16例GPN患者接受了MVD ,无一例行神经根切断术。患者全部进行了电话或信件随访。结果　15例患者术后疼痛消失 ,1例患者为不典型GPN ,术后疼痛减轻。 1例患者术后出现轻度声音嘶哑和吞咽困难 ,1例患者出现偶发干咳。本组患者平均随访时间为 14 .1± 6 .3月 ,随访期间无一例复发。结论　MVD是治疗舌咽神经痛的一种安全、有效的手术方式 ,尤其适用于典型的GPN患者。     

大鼠自体异体表皮细胞悬液混合移植的实验研究

目的　探讨自、异体表皮细胞悬液混合移植技术在创面修复中的应用。　方法　 30只大鼠随机配成 15对后 ,分成细胞悬液移植组 (A组 ,10对 )和细胞膜片移植组 (B组 ,5对 )。取每只大鼠全厚皮 ,分离表皮细胞 ,并根据配对情况按 1∶1的细胞比例混合 ,体外常规培养。 4d后收获A组混合细胞悬液 ,14d后收获B组混合细胞膜片。将此细胞悬液和膜片分别转移至A、B组相应供体大鼠的去全厚皮创面。随后A组每对大鼠的创面交叉覆盖配对方的异体全厚皮 ;B组创面覆盖胶原膜及“优妥”敷料。比较移植后 2～ 3周两组的创面修复情况。　结果　术后 2～ 3周 ,A组创面大多愈合 ,表面光滑 ,与皮下连接紧密。术后第 5天 ,B组创面部分细胞膜片脱落 ,部分成活 ,膜片成活的创面后期再次出现小创面 ,经久不愈。　结论　自、异体表皮细胞悬液混合移植是一种可行的、体内构建皮肤、修复创面的方法。     

骨巨细胞瘤的MRI诊断价值

目的探讨骨巨细胞瘤的MRI表现特点及其病理基础。资料与方法搜集经手术病理证实的12例骨巨细胞瘤患者资料，分析其MRI征象并与病理结果对照。结果T1WI上肿瘤实体表现为低、等信号，T2WI上为不均匀高信号，Gd-DTPA增强扫描呈中度到明显强化。此外，MRI还可显示肿瘤内坏死、出血、含铁血黄素沉着等。结论MRI能够提供比较全面的影像学信息，可提高对骨巨细胞瘤诊断的准确性。     

小切口胆囊切除术108例临床观察

本文报告腹部切口５－８ｃｍ的小切口胆囊切除术１０８例，与同期大切口胆囊切除术相比，具有创伤较小、恢复较快、并发症少、切口疤痕小的优点，虽不如腹腔镜胆囊切除术（ＬＣ）的疼痛轻、恢复快，但并症比ＬＣ少，只要适应症选择得当，在术者的经验和技术较成熟的情况下，不昔为一种可供选择的方法。     

舒必利治疗精神分裂症患者脑脊液HVA含量的对照研究

为了探讨精神分裂症患者治疗期间多巴胺的变化,我们选择舒必利治疗组20例,非舒必利治疗组10例作为病例组;15例非精神病患者作为对照组;检测脑脊液中多巴胺代谢产物高香草酸的含量;结果显示两组无显著性差异。精神分裂症患者治疗后舒必利组高香草酸含量升高,非舒必利组则降低,进一步分析显示舒必利治疗组非显效者较显效者治疗后高香草酸显著升高。提示机体对药物阻滞多巴胺受体后代偿反应的强弱与疗效有一定关系。     

Effect of Central Muscarine Receptor Blockade with DKJ-21 on the Blood Pressure and Heart Rate in Stress-Induced Hypertensive Rats

Da-Nian Zhu, Long-Mei Xue, Peng Li. Effect of central muscarine receptor blockade. with DKJ-21 on the blood pressure and heart rote in stress-induced hypertensive rats.

The experiments were performed on Wistar or Sprague-Dawley rats of both sexes divided at random into stress and control groups. The rats in the stress groups were put into cages and subjected to electric foot-shocks and noises for 9-15 days, which caused an increase in blood pressure (BP) and heart rate (HR). In hypertensive rats DKJ-21 (4mg/lml) was injected intravenously (i.v.), and 0.5-1.0h after administration the BP and HR dropped from the high level to normotensive level. In normotensive rats, however, administration of DKJ-21 had no effect on BP or HR. In separate groups of normotensive rats, pretreatment of DKJ-21 (4 mg/l ml, i.v.) blocked the pressor and tachycardiac effect induced by microinjection of physostigmine (0.4μg/0.1 /μl/site), corticosterone (40μg/0.1μl/site) or aldosterone (40 μg/0.1 μl/site) into the rostral ventrolateral medulla (rVLM). Furthermore, DKJ-21 also attenuated the enhancement of the pressor response to stimulation of the defense area in the midbrain, which was induced by microinjection of drugs (mentioned above) into the rVLM. These results indicate that i.v. DKJ-21 can selectively block the muscarinic receptors in the rVLM in stress-induced hypertensive rats, which suggests that abnormal enhancement of cholinergic mechanism in the rVLM may be related to hypertensive effects of corticoids in this area.     

Features of pediatric head injury in Hong Kong

Head injury in children causes special concern in most communities. From 1989 to 1994, 2,785 children younger than 16 years old were admitted to our neurosurgical service because of head injury. Fall from a height was the major cause of head injury leading to admission in infants and children in preschool age groups, whereas traffic-related or bicycle-related accidents were more likely to be the cause of head injury for those aged 11–15 years. In all age groups there was a male preponderance. The overall mortality was 0.6%. Traffic-ralated accidents caused more severe injury and accounted for 67% of all fatalities. For patients under 6 years old, about 40% of head injuries occurred at home. Preventive measures for pediatric head injury in Hong Kong are suggested.