Principles for managing penetrating craniocerebral injuries caused by firearm missiles

Penetrating craniocerebral firearm injuries remain one of the most lethal causes of all trauma and are common both in war or peace time. Data were reviewed for 4140 severely head-injured patients (Glasgow Coma Scale (GCS) scores 3-8) treated at Xi-Jing Hospital between 1973 and 1993; 51 of these patients had acute penetrating craniocerebral injuries caused by firearm missiles. These patients consisted of 46 males (90.2%) and 5 females (9.8%) ranging in age from 3 months to 48 years (median 22.4 years). The lesion types included 2 tangential wounds, 37 tubular wounds and 12 through-and-through wounds. All cases were urgent with the patients in severe and unstable states. After emergency treatment and operation, 5 cases died (9.8%). Follow up studies at three months showed that 23 cases (45.1%) had made a good recovery. Moderate disability, severe disability and vegetative states in this series were 29.4%, 13.7% and 2.0% respectively. Long term follow up studies indicated that 32 were able to resume their occupation. The principles for managing penetrating craniocerebral firearm injuries and suggestions for operation are discussed.     

脑干区占位病变的手术入路

本文报告了1990年5月以来脑干区大型、复杂占位病变15例.其中,位于脑干内3例,脚间窝2例,岩尖部4例,全岩骨区1例,全斜坡区2例,第四脑室内3例.本组采用以扩大了的岩骨入路为主的联合入路,行肿瘤全切除8例,次全切除5例.2例仅作了活检加减压术.除1例死亡外,均恢复良好.本文结合文献,对脑干区手术入路进行了讨论.     

上睑下垂78例手术分析

用额肌悬吊术或提上睑肌缩短术治疗７８例上睑下垂病例，治愈７眼，基本治愈１２眼，矫正不足３眼，矫正过度２眼，笔者认为，术前分析病因；注意提上睑肌肌力的测定；采用适当的手术方法，是手术成功的关键。     

负载型丝光沸石催化剂的催化性能研究

运用二元碱氮置换吸附红外光谱法、分子筛孔径分布测定技术、XPS技术,考察了丝光沸石表面酸性与孔结构的相互关系、钯在丝光沸石上分布情况和价态及其与沸石的相互作用。结果表明,随着丝光沸石脱铝程度的增加,表面出现大量不规整晶格,存在较多的次级孔道。强质子酸中心主要分布在它的“外表面”。钯在其表面富集,并与“外表面”上的质子酸中心协同作用,促进了轻质烷烃异构化反应。     

Juvenile Xanthogranuloma on the Palm

Abstract: Juvenile xanthogranuloma is a xanthomatous and granulomatous condition that frequently arises before 1 year of age and mainly occurs on the head and trunk. We report a rare solitary juvenile xanthogranuloma on the right palm of a 10-year-old girl, present for one year. This solitary involvement of the palm has been reported only twice before.     

日本血吸虫感染小鼠脾细胞IL—2及IFN—γ动态观察

本文观察８ｗｋ龄Ｃ５７ＢＬ／６小鼠感染日本血吸虫尾蚴后不同时期脾细胞经ＳＥＡ或ＣｏｎＡ刺激，体外诱生的ＩＬ－２和ＩＦＮ－γ活性变化。结果表明两种细胞因子活性均在感染后第４－６ｗｋ开始上升，第６—８ｗｋ达高峰，第１２—１４ｗｋ恢复至感染前水平。ＩＦＮ－γ高峰时间略先于ＩＬ－２。非特异性刺激原诱生组和特异性刺激原诱生组各阶段细胞因子活性动态基本一致，前组活性高于后组。提示ＩＦＮ－γ与ＩＬ－２活性与血吸虫卵肉芽肿的诱导、成熟与维持有密切关系。     

蛛网膜下腔注射神经降压素对大鼠血压和心率的影响

本文研究了蛛网膜下腔注射神经降压素（ｎｅｕｒｏｔｅｎｓｉｎ，ＮＴ）对大鼠血压和心率的影响，结果表明：注射ＮＴ后血压立即下降，继而有所回升，但不及正常水平，然后再次降低，持续６０ｍｉｎ；心率无明显改变。Ｈ１受体阻断剂苯海拉明能部分阻断ＮＴ的降血压效应，Ｈ２受体阻断剂甲氰咪胍无翻转作用。注射组胺释放剂Ｃｏｍｐｏｕｎｄ４８／８０使血压下降，待血压恢复正常水平后，再注射ＮＴ，其降压效应减弱。结果提示：蛛网     

对居民使用液化气健康效应的初步探讨

对液化气燃烧后室内空气污染进行了流行病学调查，结果显示，液化气燃烧可造成ＳＯ＿２、ＮＯ＿２、空气总悬浮颗粒物和总烃类的室内空气污染。小鼠接触三个月出现Ｔ淋巴细胞计数降低、睡眠时间延长、骨髓嗜多染红细胞微核率增加、肺组织匀浆Ａｍｅｓ试验阳性率增高、雄性小鼠精子畸形率增加，并有明显的剂量－反应关系。对接触５年以上的人群调查发现，呼吸道、鼻和眼的自觉症状明显增加，咽炎、鼻炎、结膜炎患病率增高。人群尿液浓缩物Ａｍｅｓ试验和外周血红细胞微核率检出阳性结果，可能与液化气燃烧废气中含有致突变污染物有关。     

重型颅脑损伤持续颅内压及脑灌注压监护与预后关系

作者对５０例重型颅脑损伤患者（ＧＣＳ３－８分），及５０例伤情与诊断和手术方式基本相似的另一组患者进行颅内压（ＩＣＰ）与脑灌注压（ＣＣＰ）连续监测对比研究。结果表明，监护组除８例ＩＣＰ压力＜２．００ｋＰａ，ＣＰＰ＞９．３３ｋＰａ外，余４２例均有不同程度ＩＣＰ增高与ＣＰＰ降低。这些患者分别为创伤性颅内血肿、广泛性脑挫裂伤、继发性脑水肿或脑肿胀等，均采取积极的手术及综合治疗。死亡率为１４％。非监护组治疗方法与监护组相同，预后较差且并发症多，死亡率为２８％。作者认为，对重型颅脑损伤患者施行连续ＩＣＰ、ＣＰＰ监护，是降低并发症和死亡率，提高疗效的有力措施，具有重要的临床应用价值。     

Gadolinium-enhanced breath-hold three-dimensional time-of-flight MR angiography of the abdominal and pelvic vessels: The value of ultrafast MP-RAGE sequences

MR angiography (MRA) was performed in 50 consecutive subjects (mean age, 59 years), who had been referred for abdominal MRA, on a 1.5-T superconductive unit that used a body phased-array coil. Three breath-hold three-dimensional sequences were evaluated both in phantom and clinical studies: (a) standard fast three-dimensional gradient-echo sequence (TR = 15, TE = 6; imaging time, 32 seconds), (b) ultrafast three-dimensional gradient-echo sequence (TR = 8.2, TE = 3; imaging time, 18 seconds), and (c) ultrafast magnetization-prepared (MP) rapid acquisition gradient echo (RAGE) (TR = 5.8, TE = 2.9, inversion time [TI] = 20; imaging time, 15 seconds). The initial 30 patients were randomized into three groups by three separate sequences. For the remaining 20 patients, ultrafast-gradient-echo and ultrafast MP-RAGE sequences were performed. Conventional angiography was performed on 36 patients. Signal measurements of the phantom and clinical images of the aorta, visceral branches of the aorta, iliac arteries, inferior vena cavae, and portal veins were performed. The overall image quality and background fatty tissue contrast of the vessels were rated subjectively. Comparison of images between MRA and conventional angiography also was performed. The contrast between the vessels and background fatty tissue was significantly higher in the ultrafast MP-RAGE sequence in both quantitative and qualitative analysis, and image-quality ultrafast MP-RAGE was superior to the other two sequences (P < .01). The aorta and iliac arteries could be visualized in all pulse sequences, and abnormalities of these vessels were diagnosed correctly. The renal artery was visualized more clearly with the two ultrafast sequences.