小脑后下动脉动脉瘤的诊断和治疗

目的探讨小脑后下动脉动脉瘤的临床特征、诊断、鉴别诊断和治疗。方法回顾性分析12例小脑后下动脉瘤的临床表现、影像学特征、手术效果及诊治过程中存在的相关问题。结果12例中有11例因动脉瘤破裂出血而发病,单纯第四脑室出血4例,全脑室系统出血2例,小脑半球出血3例,小脑蚓部伴第四脑室出血1例,侧脑室伴第三脑室出血1例,以后颅窝占位病变表现1例。8例术前行DSA检查明确诊断,4例术中明确诊断。12例均行后颅窝开颅显微手术治疗,其中动脉瘤颈夹闭9例,孤立切除2例,动脉瘤加固术1例,术后2例因脑积水加重行脑室-腹腔分流术。12例中除1例术后留有轻偏瘫外,其余11例恢复良好。结论小脑后下动脉瘤多以第四脑室出血发病,少数以小脑半球或蚓部出血发病,及早治疗效果满意。手术方式应尽量夹闭动脉瘤颈,对于小脑后下动脉末端动脉瘤,可以采用孤立切除术。     

上颌骨Le Fort I型截骨进路切除巨大鼻咽纤维血管瘤

目的:探讨上颌骨LeFortI型截骨进路切除累及翼腭凹、颞下凹巨大鼻咽纤维血管肿瘤的可行性。方法:采用矫正上颌骨先天或后天畸形的LeFortI型截骨术式进路,切除位于鼻咽部、筛窦等深在部位的纤维血管瘤。结果:该进路术野显露充分,取得了理想的治疗效果。结论:上颌骨LeFortI型截骨进路是切除鼻咽、颅底部纤维血管瘤的理想进路。     

Nerve growth factor and tyrosine kinase A in human salivary adenoid cystic carcinoma: expression patterns and effects on in vitro invasive behavior.

PURPOSE: Perineural invasion is a frequent occurrence in salivary adenoid cystic carcinoma (ACC) and may prevent complete surgical resection. Studies have indicated that nerve growth factor (NGF) and its high-affinity receptor tyrosine kinase A (TrkA) may play a role in perineural invasion in several malignancies in which perineural invasion is observed. The present study was conducted to investigate the expression of NGF and TrkA in salivary ACC and to examine the effects of NGF on adhesion, migration and invasion capacities of a salivary ACC cell line (SACC-83) in vitro. PATIENTS AND METHODS: Expression of NGF and TrkA was explored using immunohistochemistry in paraffin-embedded tissues of 32 cases of salivary ACC. The effects of NGF on in vitro adhesion, migration, and invasion capacities of the SACC-83 cell line were examined using an MTT assay and a modified Boyden chamber assay respectively. RESULTS: In ACC specimens, 31 (96.9%) and 32 (100%) tumors showed immunoreactivity for NGF and TrkA respectively. Significant correlations were found between NGF/TrkA expression levels and perineural invasion (P < .05). In cell adhesion assay, the percent adherences of SACC-83 cells co-cultured with 25 ng/ml NGF at 1.5 hours and 5, 25 ng/ml NGF at 6 hours were significantly higher than that co-cultured with 0 ng/ml NGF (P < .05). However, high concentration of NGF (500 ng/ml) resulted in a significant inhibition of invasion (P < .05). CONCLUSION: Overexpression of NGF and TrkA in human salivary ACC tissues may constitute a reason for perineural invasion in salivary ACC.     

几种手性药物对映体的HPLC分离与生物样品分析

使用ＣＨＩＲＡＬ－ＡＧＰ柱，通过优化色谱条件，以ＨＰＬＣ法对３种手性药物ＳＦＺ－４７〔（±）－３Ｈ－１，２－二氢－２－（４－甲基苯胺基）－甲基－１－吡咯里嗪酮〕，ＫＭＢＺ－００９〔（±）－反式－４－苯基－５－（邻氯苄基）－吡咯烷酮－２〕和地丙苯酮〔（±）－２′－（２－羟基－３－（特戊胺基）丙氧基）－３－苯基苯丙基酮〕进行了对映体的直接分离，达到良好的分离效果．在此基础上测试了动物血浆样品中ＳＦＺ－４７的对映体，对其药物动力学的对映体选择性进行了初步研究．     

周围神经65KD蛋白单克隆抗体的制备

神经化学诱向生长的研究是神经科学中的一个重要方向。本文以自然系统聚丙酰胺凝胶电泳,分离提取坐骨神经损伤后的远侧端中具有诱神经生长作用的65KD蛋白。以该蛋白作为抗原免疫BALB/C小鼠,通过杂交瘤技术获得一株(VI5E)稳定分泌单克隆抗体的杂交瘤细胞株。免疫印迹法表明,该单克隆抗体特异性地与65KD区带结合。免疫组化法显示,在损伤后的坐骨神经远侧端组织中的雪旺氏细胞呈阳性反应。单克隆抗体的制备为进一步阐明该蛋白的生物学特性奠定了基础。     

Root avulsion of brachial plexus in infants and children.

Twenty-one patients, under 6 years of age, with root avulsion of the brachial plexus were treated from 1975 to 1987. Among them, 9 had root avulsion of the upper trunk, 2 root avulsion of the lower trunk with middle trunk broken, and 10 root avulsion of the whole brachial plexus. Follow-up of 16 patients showed excellent results in 2 patients, good in 11, fair in 1 and poor in 2. It is suggested that good results can be obtained if multi-paired nerve transfer is adopted in treatment. We conclude that owing to anatomical and physiological characteristics of the respiratory system in children, it is harmful to perform phrenic nerve transfer concomitantly with intercostal nerve transfer. Advisably, two-stage operation is required, otherwise dyspnea and pneumonia are liable to occur. In addition, the time of the operation could be extended to 4-5 years after injury in children, but best results are obtained if the operation is performed within 1 year.

     

微波等离子体化学气相沉积合成TiN超细颗粒

热力学计算表明，Ｈ２，Ｎ２的过量有助于提高ＴｉＮ的产率，但能耗也相应增加。为此考察了温度，流量，ＴｉＣｌ４携带量，混合方式对产物性能的影响。结果表明，流量增加，温度升高，ＴｉＣｌ４携带量增加，混合愈好，则产物粒径愈小。在此基础上采用微波等离子体化学气相沉积法，合成了粒径为１２３－２８４ｎｍ的ＴｉＮ超细颗粒     

老年重症急性胰腺炎手术治疗探讨

目的：讨论老年重症急性胰腺炎的手术治疗。方法：我院1984年1月－2000年10月共收治60岁以上手术证实的重症急性胰腺炎26例，本对其手术治疗的方法和时机以及相应的并发症和死亡率进行回顾性分析。结果：本组术后死亡6例，其中4例死于MOF，2例死于ARDS。在发病24小时内手术8例中无1例死亡，24－36小时内手术14例有2例死亡，36小时后手术4例均死亡。结论：老年重症胰腺炎患多伴有心、肺、肾等重要器官慢性疾病，脏器代偿功能差，较易出现MOF，因此如有手术指证或经短期非手术治疗效果不明显，应及时手术，并在术中和术后采用合理的治疗措施，有利于减少术后并发症，降低手术死亡率。