脑脊液细胞学在蛛网膜下腔出血中的应用价值

目的：应用细胞玻片离心仪和50例蛛网膜下腔出血（SAH）患者进行了不同时期脑脊液细胞学检查。方法：常规抽取脑脊液,经FMU-5细胞玻片离心仪直接离心制片,进行MGG染色,进行细胞分类。结果：蛛网膜下腔出血后脑脊液中白细胞在不同时期的细胞特征是：急性期：大量红细胞及高比例的嗜中性粒细胞期,嗜中性粒细胞比率在70%以上,48～72 h达高峰,一周后逐渐消失。吸收期：激活单核细胞增多,可出现红细胞吞噬细胞及特征性细胞-含铁血黄素吞噬细胞,持续2～3周。恢复期：主要以激活单核细胞为主,持续数周或几月。结论：应用该法进行脑脊液细胞学检查,可给临床提供一个直观、准确的诊断依据。对蛛网膜下腔出血病人的病理学监测、鉴别诊断和治疗具有重要价值。     

小儿脑膜炎患者脑脊液IGF-Ⅱ IGFBP-3水平的测定及意义

目的测定小儿脑膜炎患者脑脊液中胰岛素样生长因子Ⅱ(IGF?Ⅱ)、胰岛素样生长因子结合蛋白-3(IGFBP-3)水平变化,探讨其临床意义,为疾病鉴别诊断提供依据。方法选取2006-03—2014-03于我院儿科收治的脑膜炎患儿75例为研究对象,化脓性脑膜炎25例,病毒性脑膜炎25例,结核性脑膜炎25例,另选取于我院同期进行体检的健康儿童25例为对照组。对所有研究对象进行腰椎穿刺术提取脑脊液,用于脑脊液生化检测,观察并比较小儿脑脊液中IGF?Ⅱ、IGFBP-3水平变化情况。结果与对照组比较,化脓性脑膜炎组、病毒性脑膜炎组、结核性脑膜炎组患儿脑脊液IGF?Ⅱ、IGFBP-3水平均明显升高,差异均具有统计学意义(P0.05);经治疗后,化脓性脑膜炎组、病毒性脑膜炎组、结核性脑膜炎组患儿脑脊液IGF?Ⅱ、IGFBP-3水平较治疗前明显下降,差异具有统计学意义(P0.05);化脓性脑膜炎组与对照组、病毒性脑膜炎组、结核性脑膜炎组比较,差异具有统计学意义(P0.05)。结论对小儿脑膜炎患者进行脑脊液IGF?Ⅱ、IGFBP-3水平的测定,能够为不明类型的脑膜炎鉴别诊断提供依据。     

Biogenic amine metabolites in human CSF after hypoxia due to cardiac arrest

The concentrations of 3-methoxy-4-hydroxyphenylglycol (MHPG), 5-hydroxyindole-3-acetic acid (5-HIAA) and homovanillic acid (HVA) were determined in CSF of patients with hypoxia due to circulatory arrest. Patients were divided into neurologically disabled and recovered according to the Glasgow Coma Scale. CSF was collected 4, 28, 76 and 172 h after commencement of resuscitation and once from control patients subjected to spinal anaesthesia. The initial concentrations of MHPG, 5-HIAA and HVA were significantly higher in a subgroup of neurologically disabled patients who died within 76 h. In recovered patients the concentration of MHPG declined with time to the value of the control group, whereas it increased in neurologically disabled patients. In the latter group the concentration of 5-HIAA also showed an increase with time, whereas in recovered patients it declined after an initial rise. It is concluded that high concentrations of MHPG, 5-HIAA and HVA in CSF may be prognostic for hypoxic brain injury after cardiac arrest.     

精神分裂症患者脑脊液中神经元特异性烯醇化酶和髓鞘碱性蛋白的研究

目的 探讨精神分裂症患者是否有脑损伤。方法 对33例精神分裂症患者和9例对照组手术病人的脑脊液（CSF）中神经元特异性烯醇化酶（NSE）和髓鞘碱性蛋白（MBP）采用双抗体夹心酶联法测定。结果 病例组的NSE的含量与对照组比较有显著性差异（P<0.01）。病例组脑脊液中NSE和MBP的含量呈正相关。结论　提示精神分裂症患者有脑损伤。     

脑脊液置换在重症结核性脑膜炎治疗中的应用

目的探讨侧脑室引流及脑脊液置换在重症结核性脑膜炎治疗中的应用。方法治疗组患者(26例)进行侧脑室引流及脑脊液置换加内科药物治疗,对照组患者(25例)采取单纯内科药物治疗。结果两组根据体温恢复正常时间、意识恢复正常时间、脑脊液压力、脑脊液常规、生化指标恢复正常时间、脑积水发生情况等进行比较,治疗组优于对照组(P<0.05)。结论侧脑室引流及腰穿脑脊液置换是治疗重症结核性脑膜炎的一种有效治疗措施。     

He-Ne激光辐射充氧液疗对改善局灶性兔脑梗死病理损害的研究

目的 研究He-Ne激光辐射充氧液疗(简称LQL),能有效地改善实验性局灶性兔脑梗死的病理损害。方法 用光化学诱导建立局灶兔梗死模型60只,分为生理盐水(NS)和5％葡萄糖液(5％GS)两大治疗组。其中每一大组又分为LOL研究组、单纯充氧对照组和输液对照组。每组10只兔,观察和分析末次治疗后的兔脑梗死的面积(mm2)和损害程度。结果 无论NS或5％GS的LQL研究组治疗后均能有效地缩小脑梗死的面积和减轻损害程度。与对照组比较,经单元方差分析有显著差异(P<0.01)。结论 LQL与紫外线辐射充氧血液疗法治疗缺血性脑梗死有相似效果,He-Ne激光辐射是治疗的决定性因素,这还有助于LQL进一步应用于缺氧缺血性脑病。     

六例神经型布鲁菌病患者临床特点分析

目的探讨神经型布鲁菌病的临床特点,以提高对该病的诊治能力。方法对运城市中心医院感染科自2014年1月至2019年12月收治的6例确诊为神经型布鲁菌病的患者,收集并分析其流行病学史、临床表现、辅助检查结果、治疗经过、预后等临床资料。结果6例患者均为男性,2例患者有明确的流行病学史,1例患者合并睾丸炎,1例患者伴脑血管病变相关影像学异常;3例患者脑脊液培养出马耳他布鲁菌,1例患者血培养出马耳他布鲁菌;2例患者脑脊液虎红平板凝集试验阳性,脑脊液二代测序结果为布鲁菌属核酸序列;予抗生素治疗后6例患者均预后良好。结论神经型布鲁菌病的临床表现多样,脑脊液培养、脑脊液布鲁菌凝集试验、脑脊液二代测序等多种方法联合应用可以提高神经型布鲁菌病的诊断率。     

缺氧对牙周炎大鼠龈沟液中可溶性细胞间黏附分子-1变化的影响

目的研究平原常氧和模拟高原缺氧条件下慢性牙周炎SD大鼠模型龈沟液(GCF)中可溶性细胞间黏附分子-1(sICAM-1)浓度的变化,以探讨sICAM-1与高原牙周炎的关系。方法选取40只SD大鼠,雌雄各半,分为平原对照组(A组)、平原牙周炎组(B组)、缺氧对照组(C组)、缺氧牙周炎组(D组),每组10只。B、D组大鼠分别建立平原、高原牙周炎模型,A、C组分别作为平原、高原对照组。8周后采用ELISA法检测4组大鼠GCF中sICAM-1浓度变化,并进行比较。结果A、B、C、D组GCF中sICAM-1浓度分别为21.98±2.93、32.20±3.80、23.44±3.81、36.64±2.64ng/ml,B组与A组、D组与C组、C组与A组、D组与B组比较,差异均有统计学意义(P<0.05),其中D组显著高于其他三组(P<0.05)。结论缺氧牙周炎组大鼠GCF中的sICAM-1水平高于平原牙周炎组,提示高原缺氧环境对机体的免疫黏附能力有一定影响。     

Evaluation of in-stent stenosis by magnetic resonance phase-velocity mapping in nickel-titanium stents

PURPOSE: To evaluate different grades of in-stent stenosis in a nickel-titanium stent with MRI. MATERIALS AND METHODS: Magnetic resonance phase velocity mapping (MR-PVM) was used to measure flow velocity through a 9-mm NiTi stent with three different degrees of stenosis in a phantom study. The tested stenotic geometries were 1) axisymmetric 75%, 2) axisymmetric 90%, and 3) asymmetric 50%. The MR-PVM data were subsequently compared with the velocities from computational fluid dynamic (CFD) simulations of identical conditions. RESULTS: Good quantitative agreement in velocity distribution for the 50% and 75% stenoses was observed. The agreement was poor for the 90% stenosis, most likely due to turbulence and the high-velocity gradients found in the small luminal area relative to the pixel resolution in our imaging settings. CONCLUSION: The accuracy of the MRI velocities inside the stented area renders MRI a modality that may be used to assess moderate to severe in-stent restenosis (ISR) in medium-sized vascular stents in peripheral vessels, such as the iliac, carotid, and femoral arteries. Advances in MR instrumentation may provide sufficient resolution to obtain adequate velocity information from smaller vessels, such as the coronary arteries, and allow MRI to substitute for invasive and expensive catheterization procedures currently in clinical use.