Isolated angiitis of the central nervous system: involvement of penetrating vessels at the base of the brain

Summary Isolated angiitis of the central nervous system (IAC) was diagnosed in a 40-year-old Caucasian male by histological examination of a leptomeningeal biopsy specimen, and the exclusion of systemic inflammatory or infective disease. Therapy with prednisone 30 mg/day and cyclophosphamide 100 mg/day resulted in clinical and radiological improvement, which have been maintained for an 8-month follow-up period. Magnetic resonance imaging (MRI) showed lesions implicating involvement of specific penetrating vessels at the base of the brain, an unusual complication of IAC, and allowed an accurate MRI-clinical correlation.     

Tagawa髋臼旋转截骨术治疗髋臼发育不良的评价

目的　评价Tagawa髋臼旋转截骨术治疗髋臼发育不良的临床效果。方法　采用Tagawa髋臼旋转截骨术治疗髋臼发育不良 ,用Harris评分和测量X线髋臼指数来评估手术的临床效果和髋臼 股骨头解剖关系的变化。结果　Harris评分从术前的平均 ( 80± 7.7)分提高到 ( 95± 1.8)分 ,主要表现为疼痛明显改善。X线显示髋臼CE角、AC角、AHI获得明显改善 ,但HLI没有变化。所有病例没有重大并发症发生。结论　Tagawa髋臼旋转截骨术治疗髋臼发育不良能较好地重建髋臼和股骨头的解剖关系 ,可以明显改善患者髋部疼痛症状 ,延迟髋关节骨关节病的发生     

Glioblastoma multiforme of the hippocampus in advanced Alzheimer''s disease

An 87-year-old woman suffered from Alzheimer's disease diagnosed 6 years prior to her death. Autopsy showed in addition to far-advanced Alzheimer's disease, a large, partially necrotic glioblastoma occupying her right hippocampus. Occurrence of a glial neoplasm in Alzheimer's disease could well be coincidental, since both entities are fairly common in elderly individuals; it is however, uncommon for gliomas to centre on the hippocampus itself. For these reasons it is possible (although cannot be proven from a single case), that florid reactive gliosis commonly associated with Alzheimer's disease, may have played a role in eventually initiating neoplastic proliferation of astrocytes in this patient.     

Nocturnal sleep in huntington's disease

Summary Nocturnal sleep was studied in 16 inpatients with Huntington's disease. In comparison with healthy controls, patients exhibited a disturbed sleep pattern with increased sleep onset latency, reduced sleep efficiency, frequent nocturnal awakenings, more time spent awake and less slow wave sleep. These abnormalities correlated in part with duration of illness, severity of clinical symptoms, and degree of atrophy of the caudate nucleus. Patients showed an increased density of sleep spindles.     

BiPAP ViSION 在慢性阻塞性肺疾病Ⅱ型呼吸衰竭的应用和护理

目的 探讨经鼻(面)罩双水平气道内正压通气(BiPAP)ViSION型呼吸机对慢性阻塞性肺疾病(COPD)伴Ⅱ型呼吸衰竭患者疗效及护理特点。方法 应用BiPAP ViSION型呼吸机对21例COPD伴Ⅱ型呼吸衰竭患者采用鼻/面罩连接单向呼气活瓣行双水平气道正压通气,观察其通气前后动脉血气及临床表现变化。结果 通气治疗后19例患者动脉血氧分压(PaO_2)及氧饱和度(SaO_2)明显升高(P<0.01),二氧化碳分压(PaCO_2)显著降低(P<0.05);肺性脑病症状消失,昏迷患者神志转清。2例病情恶化,其中1例改用有创通气后好转,1例拒绝有创通气死亡。结论BiPAP ViSION呼吸机治疗COPD伴Ⅱ型呼吸衰竭的疗效较为肯定,正确的护理对提高其疗效和减少并发症至关重要。     

罗格列酮对2型糖尿病患者冠脉支架内再狭窄的预防作用

目的 探讨罗格列酮对2型糖尿病患者行冠脉成形及支架植入术后支架内再狭窄的预防作用。方法 选择行冠脉成形及支架植入术的2型糖尿病患者60例。在原有降糖药物治疗的基础上，研究组(n=31)加服罗格列酮；对照组(n=29)用药方案不变。术后随访6mo，观察患者死亡、急性心肌梗死及再次血管重建术等心血管事件的发生情况，在随访结束时行活动平板检查，结果 阳性的再次行选择性冠脉造影术。结果2组患者随访期间均无死亡、急性心肌梗死等心血管事件发生。6mo内研究组9例再次心绞痛发作，5例活动平板试验阳性，其中5例(16．1％)冠脉支架内再狭窄；而对照组18例再次心绞痛发作，其中15例活动平板阳性，15例(48．4％)冠脉造影术证实支架内再狭窄，2组再狭窄对比有显著差异(P=0．013)。结论 对于2型糖尿病合并冠心病行冠脉成形及支架植入术患者，罗格列酮能有效降低支架内再狭窄。     

静息能量消耗测定在慢性肝病中的应用

慢性肝病患者的静息能量消耗应采用开放式间接测热法测得,合理的能量代谢调整有助于肝功能改善并防止并发症发生,测定静息能量消耗可为慢性肝病患者营养支持治疗个体化提供依据。     

黑质内注射FeCl3对大鼠纹状体多巴胺释放量及含量的影响

①目的探讨黑质(SN)内注射不同剂量的FeCl3对大鼠纹状体(CPu)多巴胺(DA)释放量和含量的影响.②方法实验用SD大鼠32只,分成4组6只大鼠为正常对照组;9只大鼠左侧SN内注射 FeCl3溶液10 μg(Ⅰ组);8只大鼠左侧SN内注射FeCl3溶液20 μg(Ⅱ组);9只大鼠左侧SN内注射FeCl3溶液40 μg(Ⅲ组),3周后采用快速周期伏安法(FCV)监测纹状体D A的释放量,高效液相色谱法(HPLC)检测纹状体DA含量.③结果在FeCl3单侧损毁大鼠中,损毁侧CPu DA释放量的减少和DA含量的降低与注射FeCl3剂量之间有明显剂量依赖关系(F=93.78,164.51,q=3.50～29.79,P<0.05).Ⅲ组损毁侧CP u DA的更新率[以(DOPAC+HVA)/DA表示]明显加快,与其他组比较差异有显著性(F=13 6.22,q=22.32～22.72,P<0.05);而Ⅰ,Ⅱ组变化较小,与正常大鼠相比差别无统计学意义 (q=0.25,2.04,P>0.05).④结论黑质内Fe3+含量升高可使CPu内DA释放量和含量均降低,铁含量高可能参与帕金森病的病理改变.