听神经瘤术中面神经电生理监测的问题与对策

Objective To explore the solutions to some problems of intraoperative facial nerve monitoring during operation for acoustic neuroma and evaluate the function of anatomically preserved facial nerve. Methods The tumors were resected with suboccipital retrosigmoid approaches under microscope in 25 cases. Intraoperative monitoring was used to protect facial nerve and evaluated its function. Results Total removal was achieved in 25 patients( 100% ). The facial nerve was preserved anatomically in 23 cases(92% ),H - B Grade Ⅰ～Ⅱ in 19 cases, Grade Ⅲ～Ⅳ in 5, Grade Ⅴ～Ⅵ in 1. Stimulative intensity at the end of tumor resection was related to the function of facial nerve, and the lower was the better. The function of facial nerve might be Ⅰ～Ⅱ grade when stimulative intensity was lower than 0. 5 mA, and facial electromyograph response amplitudes was greater than 100 μV. The function of facial nerve was not ideal when stimilative intensity was above 2 mA and response amplitude was not clear. Conclusions Skilled technique of intraoperative facial nerve electrophysiologic monitoring can obviously increase the rate of anatomical and functional preservation of facial nerve, and quantitative analysis of electromyogram may help to evaluate its postoperative function.     

肾脏纤维化的负调节因素

肾脏纤维化过程十分复杂,受到多种因素的作用,但总体上可以归结为两方面,一方面是促进纤维化的因素,为正调节因素;另一方面是抗纤维化的因素,为负调节因素.近年来,发现了一些肾脏纤维化的内源性负调节因素,比较公认的有肝细胞生长因子,骨形态发生蛋白,核心蛋白聚糖和过氧化物酶体增殖物激活受体γ等,本文旨在对这四种负调节因素及其作用机制的研究进展作一综述.     

按摩治疗习惯性流产三例

习惯性流产系指自然流产连续三次以上者,其先兆症状多见有阴道少量出血,小腹坠胀,腰部疫痛等。本病多由气血不足,脾肾两虚,冲任不固所致。笔者按摩治疗本病三例,均经治一个疗程后,未再用保胎药物足月生产。其按摩的主要手法是:按、压、点、揉、推、击、气烧等。四十五天为一疗程,每天按摩一次。     

血浆血管紧张素Ⅱ、钠、钾浓度及血容量与肾血管性高血压发生发展的关系

无论原发性高血压或继发性高血压的发病机理,迄今尚未彻底阐明,近数十年来对肾性高血压的发病机理进行了广泛的研究,不少学者注意到肾素—血管紧张素系统与肾性高血压发生发展的关系,但关于该系统在肾性高血压发生发展中的作用并未得到统一的结论。许多人认为肾素—血管紧张素系统活性的增高是肾性高血压的发生基础,而另一些人在肾性高血压患者及实验性肾性高血压动物中却未发现有肾素—血管紧张素系统活性的增高,可见,这一问题还需要作深入的研究。     

听神经瘤术中面神经电生理监测的问题与对策

Objective To explore the solutions to some problems of intraoperative facial nerve monitoring during operation for acoustic neuroma and evaluate the function of anatomically preserved facial nerve. Methods The tumors were resected with suboccipital retrosigmoid approaches under microscope in 25 cases. Intraoperative monitoring was used to protect facial nerve and evaluated its function. Results Total removal was achieved in 25 patients( 100% ). The facial nerve was preserved anatomically in 23 cases(92% ),H - B Grade Ⅰ～Ⅱ in 19 cases, Grade Ⅲ～Ⅳ in 5, Grade Ⅴ～Ⅵ in 1. Stimulative intensity at the end of tumor resection was related to the function of facial nerve, and the lower was the better. The function of facial nerve might be Ⅰ～Ⅱ grade when stimulative intensity was lower than 0. 5 mA, and facial electromyograph response amplitudes was greater than 100 μV. The function of facial nerve was not ideal when stimilative intensity was above 2 mA and response amplitude was not clear. Conclusions Skilled technique of intraoperative facial nerve electrophysiologic monitoring can obviously increase the rate of anatomical and functional preservation of facial nerve, and quantitative analysis of electromyogram may help to evaluate its postoperative function.     

针药并施治疗单纯性肥胖症

采用针药并用以健脾燥湿、化痰理气、消食降脂之法治疗单纯性肥胖31例，痊愈18例，有效13例，总有效率达100％。此法安全、有效、简便、副作用少、宜推广。     

自身免疫性心肌炎小鼠心肌组织病理学及酶学指标分析

目的建立小鼠自身免疫性心肌炎模型,观察心肌组织学、酶学指标的变化。方法选择遗传易感的雄性Balb/c小鼠,于初次免疫后的第7、30d多点皮下重复注射猪心肌肌球蛋白,分别于免疫后的第21、63d处死小鼠,观察心肌组织病理变化情况;测定血清乳酸脱氢酶（LDH）、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）等心肌酶学指标。结果第21d,实验组小鼠呈现急性心肌炎表现,心外膜下、心肌间质单个核细胞浸润明显,心外膜下较心肌间质病变更为显著,心肌酶谱各项指标明显高于正常对照组（P〈0.05）。第63d,小鼠呈慢性心肌炎表现,炎症细胞浸润减少,心肌纤维化明显,单个核细胞浸润心肌间质较心外膜显著,心肌酶谱各项指标较急性期有所下降,但仍高于正常对照组（P〈0.05）。结论应用猪心肌肌球蛋白可成功建立小鼠自身免疫性心肌炎模型。     

脊柱转移瘤外科治疗的临床疗效

目的探讨脊柱骨转移瘤外科治疗的手术适应证、目的、方法和临床疗效。方法手术治疗脊柱骨转移瘤56例,原发灶：乳腺癌17例,肺癌8例,结肠癌11例,前列腺癌7例,横纹肌肉瘤、眼黑色素瘤、甲状腺癌、宫颈癌、胃癌各2例,原发灶不明确3例。术前神经受累34例,按Frankel分级：B级13例,C级16例,D级5例。结果随访时间6个月～3年,平均19.5个月,患者的疼痛症状均有不同程度的减轻,其中38例疼痛完全或基本消失。术前有神经症状者,随访时,C级14例,D级12例,E级8例。结论综合考虑患者一般情况、预期生存时间、脊柱骨转移瘤的部位、类型、集中不稳定的程度、神经受累的情况及原发灶的性质制定手术适应症。外科综合治疗脊柱骨转移瘤可以获得比较满意的疗效。