蜕皮甾酮及尼莫地平对家兔蛛网膜下腔出血的作用

目的 观察蜕皮甾体(ecdysterone)对家兔蛛网膜下腔出血(subarachnoid hemorrhage,SAH)后症状性脑血管痉挛(cerebral vasospasm,CVS)、神经功能及脑血管痉挛的改变,并与尼莫地平(nimodipine)的治疗效果相比较,为蜕皮甾酮治疗SAH后CVS的临床应用提供依据.方法 采用改良的Endo法建立家兔脑血管痉挛模型,将日本大耳兔随机分为4组,即生理盐水对照组(枕大池注入生理盐水,A组)、蛛网膜下腔出血组(B组)、尼莫地平治疗组(C组)及蜕皮甾酮治疗组(D组),各组5只.对每组动物分别行神经功能评分和脑血管造影.结果 SAH组家兔食量明显降低,神经症状明显;而其它组食量降低较少,神经症状也相对较轻.血管造影示与基础直径相比,较基础值比较,SAH组、尼莫地平组和蜕皮甾酮组3组在SAH后,基底动脉狭窄程度分别为:(23.20±0.06)%,(20.06±0.03)%,(14.42±0.03)%.结论 蜕皮甾酮能在一定程度上改善家兔症状性脑血管痉挛的神经症状,缓解基底动脉血管痉挛,其缓解血管痉挛的效果较尼莫地平好.     

首例中国女性数字化可视人体数据集完成

本课题组继 2 0 0 2年 8月完成首例数字化可视人体之后[1 ] ,于 2 0 0 3年 2月完成了一例女性数字化可视人体数据集的建立。　　材料与方法　选择经肉眼观察、ＣＴ和ＭＲＩ检查无器质性病变的中等身材、青年女性人体标本 1例 ,经外形测量、血管灌注后 ,用 5 %明胶包埋 ,置入 -3 0℃冰库中冰冻 1周 ,然后在 -2 5℃低温实验室中用ＴＫ 63 5 0型数控铣床 (铣切精度为 0 0 0 1ｍｍ)从头至足逐层铣切。逐层用高清晰度数码相机摄影 ,完成人体模型数据获取 ,得到人体结构数据集。利用连续断层图像数据 ,在ＳＧＩ图像工作站上 ,利用本课题组自主开…     

立体定向多靶点毁损术治疗顽固性精神分裂症伴强迫状态1例

患者,女,30岁,因行为异常7年,反复乱想2年入院.入院前曾在多家精神医院住院治疗,效果不佳.查体:行为乱,反复想或做某事,有强迫思维和强迫动作,情感平淡.BPRS评分(简明精神病评定量表):53分,有病感.魏氏智力测验IQ:75.结合CCMD-3诊断标准,精神分裂症伴强迫状态诊断明确.     

高压氧治疗颅脑创伤疗效及机制分析

目的 从转化医学角度分析高压氧治疗(hyperbaric oxygen therapy,HBOT)对颅脑创伤患者的治疗作用,并评估不同治疗疗程和时机对疗效的影响.方法 本文回顾性分析自2003年3月至2010年10月联合采用HBOT满30次以上的颅脑创伤住院患者138例和同期未行HBOT者29例,评估高压氧不同治疗疗程和时机对格拉斯哥昏迷评分(glasgow coma scale,GCS)的改善作用,并结合前期相关实验研究对比分析.结果 联合HBOT的患者GCS评分由(8.06±1.68)分提高到(12.54±1.54)分,提高(4.45±2.85)分;不行HBOT的患者GCS评分由(7.86±2.85)分提高到(10.24±2.39)分,提高(2.38±2.16)分(P＜0.01).HBOT 50次以上者GCS评分由(7.50±1.67)分提高到(13.15±1.08)分,提高(5.66±3.14)分;50次以下者GCS评分由(8.40±1.61)分提高到(12.16±1.66)分,提高(3.72±2.40)分(P＜0.01).颅脑伤后1个月内开始行HBOT者GCS评分由(7.50±1.80)分提高到(12.76±1.77)分,提高(5.25±2.80)分;受伤1个月以后开始行HBOT者GCS评分(8.84±1.24)分提高到(12.22±0.98)分,提高(3.34±2.44)分(P＜0.01).结论 颅脑创伤患者在常规治疗的基础上,应该尽早开始HBOT,疗程最好不少于30次,条件允许可延长治疗时间到50次,可显著改善患者的GCS评分.

Abstract：

Objective To evaluate the effects of hyperbaric oxygen therapy (HBOT) on Glasgow Coma Scale(GCC) after traumatic brain injury(TBI) in patients. Method One hundred and thirty eight patients with traumatic brain injury were treated by routine therapy combined with HBOT and 29 patients by routine therapy. Influences of different treatment sessions and therapeutic window on the improvement of GCS were analyzed. Results The GCS improvement of patients treated by combined therapy was (4. 45 ± 2. 85),which was higher than that (2. 38 ±2. 16) without HBOT. In the patients who received the treatment more than 50 times,the score raised by (5.66 ±3. 14) ,which was more than that(3.72 ±2.40) of the patients whose treatment number was less than 50 times. In the 138 TBI patients with conscious disturbance,GCS increased by (5.25 ±2.80) in those who received HBOT in 30 days after TBI, and by (3. 34 ± 2. 44) in those 30 days post -injury.Conclusions HBOT should be initiated as early as possible except for the routine therapy. The course of HBOT should better not be less than 30 times in patients with conscious disturbance.     

光动力学治疗后C6胶质瘤血管内皮生长因子的表达

目的 探讨光动力学治疗（PDT）后C6胶质瘤血管内皮生长因子（VEGF）的表达。方法 在不同剂量（5mg/kg，10mg／kg，20mg/kg，30mg／kg）光敏剂——血卟啉衍生物（HPD）条件下，激光照射裸鼠皮下C6胶质瘤。在治疗后不同时间检测瘤组织中VEGF的表达。结果 在5mg/kg剂量组VEGF的表达在PDT24h后达高峰，与对照组及治疗后3d、7d和10d相应值比，差异显著（P〈0．01）。其它剂量组VEGF表达亦在治疗后24h达高峰，但与治疗后其它时间比，相差无显著性（P〉0．05）。结论 PDT治疗后24hVEGF表达达高峰，针对VEGF的抗血管治疗应在24h内进行。     

神经减压术治疗糖尿病性周围神经病变

糖尿病在我国的发病率不断攀升,目前2型糖尿病发病率已跃居世界首位.中国最新糖尿病流行病学调查结果表明,在年龄大于或等于20岁的中国人群中,糖尿病和糖尿病前期患病率分别高达9.7%和15.5%.以此推算目前中国有9 240万成年人患有糖尿病,有1.482亿人处于糖尿病前期,这一疾病已经成为威胁人们的首要疾病[1].     

结核性脑膜炎抗结核治疗中并发椎管内髓外硬膜下结核瘤1例

髓外硬膜下结核瘤被认为是结核性脑膜炎的一种罕见的并发症,它可以在抗结核治疗过程中出现[1],并可造成严重的神经功能障碍,我们近日手术治疗一例髓外硬膜下结核瘤的病人,特报道如下。1病例患者,女,21岁,因右下肢麻木无力3月,加重伴左下肢     

颞骨巨细胞瘤合并动脉瘤性骨囊肿1例

骨巨细胞瘤(giant cell tumor of bone,GCT)是一种常见的原发性骨肿瘤,约占所有骨肿瘤的5%,发生于颅骨的GCT少见,仅占总数的1%～2%[1],颞骨巨细胞瘤(giant cell tumor oftemporal bone,GCTT)更为少见;动脉瘤性骨囊肿(aneurysmalbone cyst,ABC)是一种原因不明的瘤样病变,好发于长骨干骺端,发生于颅骨的ABC少见,仅占总数的3%～6%[2]。颅骨     

微电极引导立体定向手术治疗帕金森病的研究

Objective To study the methods and outcome of 71 patients with Parkinson's disease treated with microelectrode-guided stereotactic pallidotomy and thalamotomy. Method Pallidal and thalamal target sites are chosen by supervision of microelectrode recording technique in 71 patients with Parkinson's disease. The UPDRS motor score was used to evaluate the outcomes 12 weeks before and after operation Result After 12 months follow-up, tremor disappeared completely or nearly completely in 12 patients who underwent unilateral and l bilateral ventrolateral thalamotomy. Dramatic improvement of tremor, rigidity, bradykinesia were observed in 57 patients underwent posteroventral pallidotomy,including 6 underwent bilateral posteroventral pallidotomy. Intracerebral hemorrhage was observed in l patient. Conclusion Microelectrode-guided stereotactic pallidotomy and thalamotomy are effective in treatmenting Parkinson's disease, but with serious complications