颅神经血管压迫症的MR血管断层表现与微血管减压术疗效的相关性

Objective To explore the correlation of the operation effects of the miorovascular decompression(MVD) and the findings on magnetic resonance tomographic angiography(MRTA) in patients of neurovascular compression of the cranial nerves.Methods Two hundred and twenty three patients treated with the microvascular decompression were analyzed retrospectively.They were grouped and graded according to the vessel compression on the cranial nerves.The compression were grouped as none, moderate and severe, and the operation effects were graded as Ⅰ ( complete relief), Ⅱ ( partial relief) and Ⅲ ( no relief).The operation effects grades were correlated according to the compression groups by Kruskal-Wallis test and the operation effects between each two of the groups were compared using Nemenyi test.P < 0.05 was defined as statistic significant.Results Of the 53 cases of non-compression group, 31 cases were graded as Ⅰ , 13 cases were graded as Ⅱ and 9 cases were graded as Ⅲ, according to the operation-effects of the decompression.Of the 110 cases of moderate group,95 cases were grade as Ⅰ , 11 cases were graded as Ⅱ and 4 cases were graded as Ⅲ.Of the 60 cases of severe group, 48 cases were graded as Ⅰ, 7 cases were graded as Ⅱ and 5 cases were graded as Ⅲ.There were statistic significance among the three groups,where χ2= 16.84 and P <0.05.The mean rank of the non-compression, the moderate and the severe group was 134.21,102.37 and 110.4 ,respectively.The difference of the mean ranks between the non-compression group and the moderate group was 31.84, and between the non-compression and the severe group was 24.17, respectively, where P < 0.05 both.Conclusions There was close relationship between the findings on magnetic resonance tomographic angiography and the operation effects of the MVD.The operation effects of patients with moderate and severe vessel compression were much better than the non-compression group.MRTA is helpful for MVD surgical indication and its prognosis.     

氧化应激在多囊卵巢综合征中的作用机制及中医药治疗研究进展

综述氧化应激(OS)在多囊卵巢综合征(PCOS)中的作用机制及中医药治疗研究进展。研究表明,OS在PCOS中,因雄激素过多、胰岛素抵抗、线粒体功能障碍以及炎症等进一步加重PCOS患者体内代谢紊乱,并影响PCOS患者孕期宫内环境,造成不良妊娠结局。中医药治疗应用中药单体、复方及针灸等,可有效改善患者体内OS水平,从而缓解患者临床症状,提高其生活质量。     

颅内转移性黑色素瘤术前诊断(附6例报告)

１９８１～１９９７年,我院共发现６例脑转移性黑色素瘤,现将黑痣恶变的特点及颅内转移性黑色素瘤的诊断报告如下。１临床资料１．１一般资料本组病人６例,男４例,女２例;年龄３６～６１岁,平均４８．５岁。６例病人均经活检诊断为黑色素瘤。１．２临床特点６例病人...     

小骨窗开颅治疗高血压病脑出血疗效分析

探讨小骨窗开颅治疗高血压病脑出血的疗效。采用小骨窗开颅血肿清除术治疗幕上高血压病脑出血66例,分析术后1月内疗效及影响因素,参照GOS评定术后1月内有自理能力41例(62.1％),不能自理15例(22.7％),死亡10例(15.2％)。选择性超早期或早期手术及提高手术质量,减少再出血的发生,是改善手术疗效的重要因素,并提出本术式的适应征。     

HAG预激方案治疗低增生性急性髓细胞白血病临床研究

目的探讨HAG预激方案对低增生性急性髓细胞白血病患者的临床疗效及不良反应。方法对28例低增生性急性髓细胞白血病（AML）患者采用HAG预激方案化疗,监测临床症状、体征、血常规及骨髓细胞形态学检查。结果 28例患者中第1个疗程完全缓解15例,第2个疗程完全缓解5例,3例部分缓解,4例未缓解,1例治疗中死于脑出血;1个疗程完全缓解率53.6%,总疗程完全缓解率71.4%,总有效率82.1%。外周血WBC低于1.0×109/L的中位时间为7.2（1～16）d。结论 HAG预激方案治疗低增生性AML近期疗效显著,不良反应轻,患者耐受性较好,且有利于减轻患者的经济负担,有一定的临床推广价值。     

预后不同的双侧大脑脚梗死二例报告并文献复习

双侧大脑脚梗死(Bilateral cerebral peduncular infarction,BCPI)是一种极少见的急性缺血性卒中,最常见的临床表现是闭锁综合征和意识障碍,其他常见的临床表现还包括四肢瘫痪、言语不清、共济失调、假性球麻痹等,其在头部弥散加权成像(Diffusion-weighted imaging,DWI)上呈典型的"米老鼠耳征"("Mickey Mouse ears" sign)~([4])。文献报道的大多数患者预后不良,仅有少数几例患者预后较好。本文报道2例预后差别较大的双侧大脑脚梗死病例,综合其临床表现、影像学特点等因素并结合相关文献,分析其预后差别原因。     

两个三指节拇指轴前多指家系的ZRS突变分析北大核心CSCD

目的明确两个中国汉族具有三指节拇指特征的轴前多指家系的致病突变。方法知情同意下采集家系1的9名家系成员（患者2例）、家系2的14名家系成员（患者7例）的外周血,提取基因组DNA;应用实时定量PCR与PCR-Sanger测序,对SHH基因的调控元件“极化活性区调控序列”（zone of polarizing activity regulatory sequence,ZRS）分别进行拷贝数与序列突变检测;应用变性聚丙烯酰胺凝胶电泳,检测家系1ZRS附近短串联重复序列的基因型,结合Sanger测序发现的点突变,进行单倍型分析。结果定量PCR显示两家系患者在ZRS区域均不存在拷贝数改变。Sanger测序结果显示,家系1的2例患者均存在ZRS406A〉G杂合突变、家系2的7例患者均存在ZRS105C〉G杂合突变,且突变在各自家系中均与多指表型共分离,在200名正常对照中均未检测到上述突变。已有报道ZRS的105C〉G杂合突变可引起典型的三指节拇指轴前多指;而ZRS的406A〉G杂合突变仅见于1个胫骨发育不良伴多指（趾）家系中。单倍型分析及测序结果提示,家系1中第1例出现肢端畸形的患者为ZRS406A〉G杂合突变的体细胞及生殖细胞嵌合体。结论SHH基因调控元件ZRs的406A〉G与105C〉G杂合突变分别为两个中国汉族三指节拇指轴前多指家系的致病突变。