Cognition in stroke

Introduction – Despite the current interest in criteria for vascular dementia, global, as opposed to focal, cognitive change after cerebral infarction has rarely been studied. Material and methods – We documented the neuropsychological changes one to three weeks and three months post infarct in 25 unselected patients with acute, first cerebral infarcts. Results – Improvements were seen in processes thought to have a large subcortical component and in those mediated in the right hemisphere. Memory was relatively lightly affected. Conclusion – The minimal deficits seen in memory and the predominance of subcortical changes are at variance with the currently suggested criteria for vascular dementia. Further data of this kind are needed before firm criteria can be proposed for the global pattern of cognitive changes expected in vascular dementia.     

中西医结合治疗股骨头缺血性坏死

股骨头缺血性坏死是世界骨科难题之一。作者致力于中草药治疗本病的研究三十多年，近来又在手术治疗方面倾注心血，对该病的防治、康复创立了一整套中西医结合新方法，取得了满意效果。自１９８２年以来，共治疗各种股骨头坏死１１０１例，其中单纯中医治疗４３３例，手术配合中药治疗６６８例。按作者制定的百分评分法，总有效率９８％，优良率８４％，无一例需再作人工关节置换术。     

The Testes in Cadmium Intoxication: Morphological and vascular aspects

Cadmium toxicity was tested on young male Wistar rats by injecting 1 mg/ml of cadmium chloride (CdCl2) intra-peritoneally. Post-mortem examination was done 4 hours, 24 hours and 14 days after cadmium administration to observe time-sequence cadmium-induced alterations in vascular permeability of the mesothelium in the pleura, peritoneum and tunica vaginals. This paper mainly reports the alterations observed in the testes. Vascular permeability was assessed by the colloidal carbon technique. Vascular labelling was evidenced as early as 4 hours after CdCl2, injection; 24 hours later severe oedema with leakage of particles to the interstitium and also into the tubules was patent. Fourteen days after CdCl2 administration atrophy of the testes with necrosis of the tubules, fibrosis of the interstitium and vascular thrombosis was found, compatible with chemical castration.     

VASCULAR COMPLICATIONS OF ELECTIVE LOWER LUMBAR DISC SURGERY

Lower lumbar disc surgery is an extremely common operation from which vascular complications are reported rarely. However vascular injury can occur with perforation of the anterior longitudinal ligament. External haemorrhage is uncommon and the true cause of the patient's hypotension may be misdiagnosed. If the hypotension is severe or prolonged laparotomy is indicated, to prevent exsanguination and to effect a repair of the vascular injury. Alternatively, if the injury is missed, an arteriovenous fistula may develop; this diagnosis may be delayed for months or years. One case of severe haemorrhage following lower lumbar disc surgery is reported and a further 69 cases of similar arterial injury have been reviewed from the world literature.     

Acute heart failure and acute renal failure in Kawasaki disease

Acute renal failure and acute heart failure are rare in Kawasaki disease. We experienced two patients with Kawasaki disease who presented acute renal failure and acute heart failure. These two patients gave us an important insight into the understanding of water balance and fluid therapy in Kawasaki disease. One patient showed acute prerenal failure due to fluid exudation from the intravascular to the extravascular space, and subsequent acute heart failure. The other patient showed acute heart failure caused by fluid infusion for the treatment of dehydration. It is suggested that acute renal failure could be caused by a fluid shift from the intravascular to the extravascular space in Kawasaki disease. It is also demonstrated that the reserve of cardiac function could be decreased in patients with Kawasaki disease due to myocarditis even with normal echocardiography and chest X-rays.     

Digital sonomicrometer system for measuring small vascular diametersin situ

Although present sonomicrometer techniques for measuring continuous changes in vascular diameter are very useful, two problems with available methods are difficulty in maintaining crystal alignment throughout an acute experiment and inability to measure absolute dimensions less than 1 mm. We have designed and ultrasonic dimension gauge system to over come these problems. The design uses a gate to pass a 20 MHz signal to a counter during the sonic travel time between crystals, and then converts the digital count to an analogue voltage. Interference from the transmitting impulse in the received signal was minimised using MOSFET transistors allowing measurements of absolute dimensions from 0.00 mm to 99.9 mm. An averaging effect which depends upon the asynchrony between the basic timer and the counter clock results in a resolution of at least 10 μm. Repeated calibration curves showed an accuracy of 2.5 μm without significant bias. Piezoelectric crystals were mounted to a lighweight stainless-steel clip to facilitate attachment to the vessel and to maintain the crystals in focus during changes in diameter. Mean and phasic diameters measured in the femoral artery with the clip device correlated well with measurements obtained with crystals sewn to the adventitia of the femoral artery of the dog (slope =0.97, r=0.99).     

乳腺癌患者血清Leptin和VEGF的表达

目的：研究瘦素（Leptin）、血管内皮生长因子（VEGF）在乳腺癌患者血清中的表达，探讨其在乳腺癌诊断中的意义。方法：选择乳腺癌患者36例，乳腺良性增生病变患者31例，另选56例健康女性作为对照。分别用放射免疫分析（RIA）和酶联免疫吸附试验（ELISA）测定这些患者术前血清Leptin、VEGF。结果：正常对照组与良性病变组、乳腺癌组Leptin存在明显差异，正常对照组与乳腺癌组，良性病变组与乳腺癌组VEGF存在明显差异。乳腺癌患者术前血清Leptin、VEGF含量与有无淋巴结转移具有相关性。结论：乳腺癌患者术前血清Leptin、VEGF可作为鉴别乳腺良恶性肿瘤有无转移的指标。     

X刀治疗脑内病变283例长期随访研究

目的:总结X刀治疗脑内病变的长期随访结果.方法:对283例X刀治疗的脑瘤和脑血管畸形患者进行临床和影像学随访,随访时间为1～8年,平均(2.05±4.66)年.结果:82例转移瘤消失35例(42.7％),缩小28例(34.1％),无变化11例(13.4％),增大8例(9.8％);61例胶质瘤消失10例(16.4％),缩小19例(31.1％),无变化16例(26.2％),增大16例(26.2％);55例动静脉畸形消失29例(52.7％),缩小20例(36.4％),无变化6例(10.9％);17例海绵状血管瘤缩小4例(23.5％),无变化13例(76.5％);35例脑膜瘤消失5例(14.3％),缩小15例(42.9％),无变化13例(37.1％),增大2例(5.7％);12例神经鞘瘤消失3例(25.0％),缩小6例(50.0％),无变化2例(16.7％),增大1例(8.3％);10例生殖细胞瘤消失8例(80.0％),缩小2例(20.0％);11例其他肿瘤消失2例(18.2％),缩小4例(36.4％),无变化4例(36.4％),增大1例(9.0％).影像检查还发现病灶有坏死表现99例,囊性变19例,周边环状强化73例,胶质细胞增生20例,暂时性反应性肿大23例,放射性脑水肿28例.结论:X刀对小型脑肿瘤和血管畸形是一种安全有效的治疗方法,X刀治疗的主要并发症是放射性脑水肿.     

新型血管吻合用支架对血管内膜的影响

目的：研制一种可溶性血管内支架辅助血管断端吻合，并检测该支架在血管吻合的过程中对血管内膜的影响。方法：选用高纯度低分子量明胶为主要原料制备血管吻合用支架，利用该支架进行血管吻合操作，观察支架对血管内膜的作用，并从超微结构方面进行研究。结果：明胶类可容性血管内支架表面光滑，在血管吻合的过程中不会对血管壁造成损伤；与同类支架相比具有明显的优势。结论：明胶类可溶性血管内支架具有光滑的外表面，适合于进行血管吻合操作。