Stereotactic radiosurgery for deep intracranial arteriovenous malformations,part 2: Basal ganglia and thalamus arteriovenous malformations

The aim of this review is to critically analyze the outcomes following stereotactic radiosurgery (SRS) for arteriovenous malformations (AVM) of the basal ganglia and thalamus. The management of these deep-seated lesions continues to challenge neurosurgeons. Basal ganglia and thalamic AVM show a higher risk of hemorrhage, and an associated devastating morbidity and mortality, as compared to AVM in more superficial locations. Any of the currently available treatment modalities may fail or result in iatrogenic neurologic deterioration. Recent evidence from A Randomized Trial of Unruptured Brain AVM (ARUBA) further deters aggressive approaches that carry a significant risk of treatment-related adverse events. Microsurgical resection, endovascular embolization and SRS all play a role in the treatment of AVM. SRS is an effective therapeutic option for AVM of the thalamus and basal ganglia that are deemed high risk for resection. SRS offers acceptable obliteration rates, with generally lower risks of hemorrhage occurring during the latency period compared to the AVM natural history. Considering that incompletely obliterated lesions still harbor the potential for rupture, additional treatments such as repeat SRS and microsurgical resection should be considered when complete obliteration is not achieved by an initial SRS procedure. Patients with AVM of the basal ganglia and thalamus require continued clinical and radiologic observation and follow-up after SRS, even after angiographic obliteration has been confirmed.     

针灸刀与封闭治疗屈指肌腱狭窄性腱鞘炎疗效对照观察

目的:比较针灸刀与封闭治疗屈指肌腱狭窄性腱鞘炎的疗效差异,探寻较优疗法.方法:将304例患者随机分为针灸刀组(164例)和封闭组(140例).于患指压痛点和硬结处,针灸刀组应用任氏钩型针灸刀行勾割治疗,封闭组行常规封闭治疗.治疗1～2次后观察两组疗效以及治疗后6个月的复发情况.结果:针灸刀组治愈率为98.2％(161/164),优于封闭组的65.7％(92/140);针灸刀组复发率为1.9％(3/161),低于封闭组的37.0％(34/92),组间差异均有统计学意义(均P＜0.01).结论:针灸刀治疗屈指肌腱狭窄性腱鞘炎疗效优于封闭治疗,且复发率低.     

SBRT临床应用结果的思考

体部立体定向放射治疗（Stereotactic Body Radiation Therapy,SBRT）是应用立体定位技术和特殊射线装置,将多源、多线束或多野三维空间聚焦的高能射线聚焦于体内某一靶区,使病灶组织受到高剂量照射,周围正常组织受量减少,从而获得临床疗效高,副作用小的一类放疗技术的总称,采用γ射线所完成的SBRT简称为γ刀,采用X射线所完成的SBRT简称为X刀。SBRT的优势是采用高分次荆量、短疗程分割模式,具有明显的放射生物学优势。无论是国外还是国内,SBRT治疗肿瘤的临床结果均令人鼓舞,治疗早期非小细胞肺癌的3年生存率和局控率均优于常规放疗,与手术效果无差异,而且副作用小,治疗肝癌和胰腺癌的局控率和生存率也获得了大幅度提高。我国的γ刀技术具有独特的剂量聚焦优势和完全自主知识产权,符合我国“十一五”科技自主创新的要求,而且疗效显著、性价比高、易于推广应用符合我国国情。但由于种种原因,SBRT技术在中国尚未引起足够重视,中国γ刀技术需要从设备完善、加大政府支持力度和规范临床应用三个方面进行改进,SBRT的健康发展对推动我国放射肿瘤专业发展具有重要意义。     

伽玛刀治疗震颤麻痹27例初步报告

伽码刀（r-刀）是治疗震颤麻痹有效而安全的方法，作者设计了一套MR定位的方法。本组27例均以震颤为主，近期症状改善为75％，未出现近期并发症。     

岩斜脑膜瘤的伽玛刀治疗

目的评估伽玛刀治疗岩斜区脑膜瘤的疗效。方法1995～2000年,我们对66例岩斜区脑膜瘤病人进行了伽玛刀治疗,肿瘤体积0.32～29.4cm3,平均(5.87±5.10)cm3。周边剂量为7～14.4Gy,平均(12.4±1.6)Gy;中心剂量16～65Gy,平均(27.9±5.9)Gy。结果60例随访25～94个月,平均(57.8±22.3)个月:肿瘤体积缩小23例(38.3%),不变35例(58.3%),增大2例(3.3%);神经系统症状好转37例(61.7%),稳定20例(33.3%),加重3例(5.0%)。无严重并发症发生。结论伽玛刀治疗能很好地控制肿瘤,副作用轻微,可作为神经外科较大肿瘤的辅助性治疗,也可作为较小肿瘤或不适合手术的病人的主要治疗。     

LEEP刀对重度宫颈糜烂患者宫颈局部微循环状态的影响研究

目的 研究分析LEEP刀对重度宫颈糜烂患者宫颈局部微循环状态的影响.方法 将2011年10月～2013年12月于本院进行诊治的80例重度宫颈糜烂患者采用随机数字表法分为对照组（传统电刀治疗组）40例和观察组（LEEP刀治疗组）40例,然后统计并比较两组患者治疗前和治疗后1、2及3 w的宫颈局部微血供相关指标及宫颈水肿程度.结果 观察组治疗后1、2及3 w的宫颈局部血流灌注、微血管管径及毛细血管管径均高于对照组,而宫颈水肿程度及宫颈颜色也均好于对照组,两组治疗后差异有统计学意义（P＜0.05）.结论 LEEP刀对重度宫颈糜烂患者宫颈局部微循环状态的影响较大,更有利于患者宫颈局部尽快康复.     

眼球后肿瘤伽玛刀治疗的近期疗效

通过对４例眼球后肿瘤的伽玛刀治疗，探讨了伽玛刀治疗眼球后肿瘤的可行性和有效性，同时对视力的治疗后的改变进行了动态观察，经随访２～７个月，所有病例肿瘤均见明显缩小，没有出现失明的并发症，实施治疗时，立体定位头架应尽量前置，肿瘤侧旋向中线使其尽量居中，若肿瘤压迫视神经则使视神经所受剂量低于１４Ｇｙ，对恶性肿瘤，应给予足够照射剂，不应过分强调保存视神经而致肿瘤复发。     

Influence of diet palatability on the meal taking behavior of hypothalamic hyperphagic and normal rats.

Female rats made hyperphagic by parasagittal hypothalamic knife cuts overate a palatable milk diet by greatly increasing their meal size, while meal frequency was only slightly increased. Reducing the palatability of the diet by quinine or salt adulteration decreased to normal levels the total intake and meal size, but not meal frequency of hyperphagic rats. The disruption in the diurnal feeding pattern displayed by the hyperphagic rats was relatively unaffected by diet palatability changes. The results are discussed in terms of the short and long term regulatory deficits thought to be responsible for the hypothalamic hyperphagia syndrome.