持续腰池脑脊液引流治疗隐球菌性脑膜炎的临床探讨

0引言 隐球菌性脑膜炎(隐脑)是由隐球菌属中某些种或变种侵犯中枢神经系统引起的一种深部真菌病. 隐脑在我国仍以散发为主,近年来发病呈明显上升的趋势;而在一些发展中国家,AIDS患者隐脑的发病率更高[1]. 隐脑的误诊率较高,其治疗中存在较多问题,因为在现有的抗真菌治疗条件下,国内外文献报道其病死率仍高达25%～60%[1]. 现将我科1997-01/2005-01收治的19例中,进行了持续腰池脑脊液(CSF)引流的9例隐球菌脑膜炎患者与对照组10例观察报告如下,探讨有效的治疗手段.     

Coiled-spring sign of appendiceal intussusception

Appendiceal intussusception has been considered a rare entity that is difficult to diagnose radiographically. However, a characteristic coiled-spring appearance in the cecum with nonfilling of the appendix has been observed on double-contrast barium enema (DCE) examinations in 11 cases of apparent or proved appendiceal intussusception. In two surgically proved cases, the intussusception was precipitated by an appendiceal mucocele and by endometriosis implants in the appendix. In four other cases, the intussusception was transient and the coiled-spring defect in the cecum disappeared with filling of the appendix on the DCE examination (three cases) or on a subsequent barium enema study (one case). The remaining five cases were unproved, although two patients had undergone prior appendectomy and the coiled-spring finding presumably resulted from an intussuscepted appendiceal stump. Only one patient was found to have appendiceal-related symptoms. It appears that appendiceal intussusception often occurs as a transient phenomenon in asymptomatic patients, and that it can be diagnosed on the routine DCE examination by a characteristic coiled-spring defect in the cecum.     

The effect of renal artery stenting on hypertension and renal function in patients with atherosclerotic renovascular disease

IntroductionAtheroscleroticrenal arterystenosisisassociatedwithhypertension ,progressivelossofrenalfunctionandrecurrentpulmonaryedema [1 3].Althoughsurgicalrevascularizationhasbeenshowntoimprovebloodpressurecontrol,preserveorstabilizerenalfunction [4 ],andreverseend stagerenalfailure[5 ],itsmorbidityandmortalityrateshavebeenhigherthanthoseofstentrevascularization [6 ].Stentrevascularizationhasbeenshowntobesuperiorto“balloononly”angioplastyandsurgicalrevascularization [7].Thisstudyevaluatesth…     

维A酸受体药物的研究回顾及皮肤临床应用的评介

目的：人们对维生素A的认识始于1600年，本旨在探讨其衍生物维A酸（RA）和相应的靶位研究进展。方法；综合近年来国内外献进行分析，介绍研究进展和受体特点，对其临床应用进行评价。结论：维生素A酸类药物进展迅速，治疗范围在不断地拓展，为治疗皮肤疾病展现了良好的前景。     

Hemorrhagic intracranial malignant neoplasms: spin-echo MR imaging

Twelve patients with 15 separate, spontaneously hemorrhagic, intracranial malignant lesions (seven primary gliomas, eight metastatic lesions) were examined with spin-echo magnetic resonance imaging at 1.5 T, and with computed tomography. The signal intensity patterns of these lesions, as seen on both short repetition time (TR)/short echo time (TE) and long-TR/long-TE spin-echo pulse sequences, were compared with the previously described appearance at 1.5 T of non-neoplastic intracerebral hematomas. The images of hemorrhagic intracranial malignancies showed notable signal heterogeneity, often with identifiable nonhemorrhagic tissue corresponding to tumor; diminished, irregular, or absent hemosiderin deposition; delayed hematoma evolution; and pronounced or persistent edema, compared with non-neoplastic hematomas. The demonstration of these characteristics in the appropriate clinical setting may suggest malignancy as the cause of an intracranial hematoma.