股浅动脉支架治疗动脉硬化闭塞症慢性下肢缺血20例

下肢动脉硬化闭塞症(atheriosclerosis obliterans,ASO)是引起慢性下肢缺血的主要原因,随年龄的增长发病率逐渐升高。国外报道70岁以上老年人群中该病患病率为15%～20%[1]。我院2006年12月—2008年4月经股浅动脉腔内支架置入治疗20例ASO慢性缺血患者,报告如下。     

光学相干断层成像技术在颈动脉支架置入术中的应用进展

颈动脉支架置入术作为治疗颈动脉狭窄患者经典手术之一,术后常见斑块组织脱垂、支架贴壁不良等并发症。文章介绍了在冠状动脉系统疾病诊治中已经成熟应用的高分辨率成像技术即光学相干断层成像(OCT)技术在颈动脉支架置入术中应用的成像原理和具体流程、OCT技术识别颈动脉病变的常见图像、OCT技术在颈动脉支架置入术中的应用进展,并总结OCT技术在颈动脉支架置入术中应用的优缺点和应用前景。     

早期立体定向置管引流治疗内囊区小血肿的临床研究

目的比较内囊区小血肿早期立体定向治疗与保守治疗的临床疗效。方法选择肌力在1~2级的60例内囊区小血肿患者按入院先后顺序随机分两组,每组30例,分别行早期立体定向血肿排空术和保守治疗。结果按日常生活能力(ADL)分级:立体定向组Ⅰ级19例,Ⅱ级8例,Ⅲ级3例,无死亡病例。保守治疗组Ⅰ级8例,Ⅱ级9例,Ⅲ级7例,Ⅳ级5例,死亡1例(3.3%),随访1~6个月,立体定向组恢复良好率90%,致残率10%。保守治疗组恢复良好率58.6%,致残率41.4%。两组ADL能力、致残率方面差异有显著统计意义,P<0.01。结论立体定向治疗内囊区小血肿,定位准确,创伤小,神经功能恢复快,其临床疗效明显优于内科保守治疗,可以降低致残率,提高患者生存质量。     

超早期立体定向治疗内囊区小血肿

目的 探讨内囊区小血肿超早期立体定向治疗与保守治疗的临床疗效.方法 选择肌力在2级以下的76例内囊区小血肿患者,按入院先后顺序随机分两组,每组各38例,分别行超早期立体定向血肿排空术和保守治疗.结果 随访6个月,按日常生活能力(ADL)分级:立体定向组Ⅰ级15例,Ⅱ级16例,Ⅲ级5例,死亡2例(5.3%),保守治疗组Ⅰ级3例,Ⅱ级16例,Ⅲ级13例,Ⅳ级3例,死亡3例(7.9%),立体定向组恢复良好率81.6%,致残率13.2%.保守治疗组恢复良好率50%,致残率42.1%.两组ADL能力、致残率方面差异有显著统计意义,P＜0.01.结论 内囊区小血肿的立体定向治疗,其临床疗效明显优于内科保守治疗,可以降低致残率,提高患者生存质量.     

PowerPoint在神经外科教学中的应用

神经外科由于自身发展局限性,在过去的医学教学中常被忽视,即使安排一定课时的教学时间,也由于其固有特点和传统教学方法的缺陷与不足,教学质量和效果差强人意。根据神经外科的教学特点,我们利用PowerPoint进行神经临床教学,使教学质量得到明显提高,现报告如下。     

超声介导下经皮肾镜气压弹道联合超声碎石术治疗鹿角形结石(附600例报告)

目的评价超声介导经皮肾镜下气压弹道联合超声碎石术治疗鹿角形肾结石的临床疗效。方法回顾性分析本院2006-09~2009-07间,应用超声引导经皮肾镜气压弹道联合超声碎石治疗600例鹿角形结石患者的临床资料,对其治疗方法、临床疗效及其优点等资料进行评价。结果600例均Ⅰ期成功建立经皮肾通道,双通道取石456例。手术时间82~180 min,术中失血40~800 mL,Ⅰ期手术结石取尽率为70.3%(422/600);手术总的结石取尽率88.8%(533/600),肾盂梗阻解除率100%。本组有428例随访1~6个月,无严重出血、感染及患肾功能丧失,亦无肾周积液、结石复发。结论超声介导下经皮肾镜超声联合气压弹道碎石清石术治疗鹿角形肾结石可明显提高碎石、清石率,缩短手术时间,减少并发症,值得临床推广应用。     

先天性马蹄内翻足动物模型胚胎后肢(芽)评分系统的建立

Objective Quantification of the severity of congenital clubfoot is essential for its re-search and treatment. Up to date, no scoring system is available for hind limb bud development. In this study,a scoring system was established based on a murine model Methods Sixty female Wistar rats weighing 220～250 g were randomized into the six control groups and six experimental groups. Vaginal sperm plug detection day was considered to be day 0 of gestation. Hind limb buds from fetuses of E13, 14, 15,16,17 and 18 days were removed and processed. Results Morphogenetic differentiation changes were detected in the experimental groups. According the new scoring system, clubfoot-like deformity was present in 80.9% of the experimental fetuses. We were able to quantify the extent morphogenetic diffcrentiation of the hind limb accordingly. Conclusions Congenital clubfoot deformities begin at early developmental stage and become exaggerated as the fetuses mature. The scoring system can quantify the extent of congenital clubfoot deformity and facilitate its management.     

先天性马蹄内翻足动物模型胚胎后肢(芽)评分系统的建立

Objective Quantification of the severity of congenital clubfoot is essential for its re-search and treatment. Up to date, no scoring system is available for hind limb bud development. In this study,a scoring system was established based on a murine model Methods Sixty female Wistar rats weighing 220～250 g were randomized into the six control groups and six experimental groups. Vaginal sperm plug detection day was considered to be day 0 of gestation. Hind limb buds from fetuses of E13, 14, 15,16,17 and 18 days were removed and processed. Results Morphogenetic differentiation changes were detected in the experimental groups. According the new scoring system, clubfoot-like deformity was present in 80.9% of the experimental fetuses. We were able to quantify the extent morphogenetic diffcrentiation of the hind limb accordingly. Conclusions Congenital clubfoot deformities begin at early developmental stage and become exaggerated as the fetuses mature. The scoring system can quantify the extent of congenital clubfoot deformity and facilitate its management.     

三七总皂甙对骨髓基质细胞成骨分化及成骨作用的调节

目的 探讨三七总皂甙对骨髓基质细胞体外成骨分化及成骨作用的影响.方法 分离、纯化大鼠骨髓基质细胞(bone marrow strowal cells,BMSCs),采用常规培养液、成骨诱导液及含100 mg/L PNS的成骨诱导液培养,对各组细胞进行形态学观察,采用MTT法、对硝基苯磷酸盐法、茜素红染色方法及ELISA法观察各组细胞增殖、ALP活性、矿化结节的形成及RANKL的表达.结果 骨诱导组、PNS组较培养液组细胞增殖明显(P<0.05),而PNS组高于骨诱导组(P<0.05);骨诱导组、PNS组ALP活性、钙结节形成高于培养液组 (P<0.01),PNS组高于骨诱导组(P<0.05);骨诱导组、PNS组RANKL表达低于培养液组(P<0.05),PNS组低于骨诱导组(P<0.05).结论 BMSCs成骨诱导过程中,PNS可促进其成骨分化、下调其RANKL表达从而具有抑制破骨细胞生成的潜能.