沙土鼠短暂性脑缺血后海马损伤的形态学特征

本实验通过结扎沙土鼠双侧颈总动脉20分钟,再灌流7天内,动态观察背侧海马组织的形态学变化。光镜观察表明:海马各区对缺血的反应性不同,其中以 CA_1区锥体细胞对缺血最为敏感,并且 CA_1区神经元的损伤是迟发性的,再灌流4天后才出现大量神经元的坏死、消失,即“迟发性神经元死亡”(NDN)。电镜下发现:缺血再灌流早期(1～2天),CA_1区神经细胞质内有大量粗面内质网增多。本实验结果表明:短暂性脑缺血所致的海马损伤与脑组织其他区域神经元损伤不同。     

32例出血性梗塞研究分析

对32例出血性梗塞研究分析，发现常出现于脑栓塞及大面积脑血栓病人。以治疗中病情突然加重或持久症状不改善为特征，动态CT检查对本病的诊断及治疗有重要意义。     

Protective effects of serotonin reuptake inhibitors, citalopram and clomipramine, against hippocampal CA1 neuronal damage following transient ischemia in the gerbil

To clarify the role of serotonin in cerebral ischemia, we examined the effects of selective serotonin reuptake inhibitors, citalopram and clomipramine, on ischemic neuronal damage in the gerbil. Pretreatment with citalopram (40 mg/kg i.p.) and clomipramine (20 mg/kg i.p.) protected against neuronal destruction of hippocampal CA1 pyramidal cells following 5 min of forebrain ischemia. Furthermore, microdialysis assays showed that a striking increase in extracellular excitatory amino acid levels during ischemia was significantly inhibited by pretreatment with citalopram and clomipramine. However, citalopram (40 mg/kg i.p.) did not alter the extracellular amino acid concentrations in normal gerbils. Thus, serotonin reuptake inhibitors have a protective effect against ischemic neuronal damage. Furthermore, the present result suggests that the protective effect is mediated through prevention of the accumulation of extracellular excitatory amino acids during and after ischemia.     

新生儿缺氧缺血性脑病血浆内皮素与肺功能的关系

目的 :探讨内皮素 (ET)、在新生儿缺氧缺血性脑病 (HIE)中的作用及与肺功能关系。方法 :将 4 2例 HIE患儿按病情分为轻、中、重三组 ,各组均在入院后第 2天采用婴儿体描箱进行潮气呼吸分析、有效气道阻力及功能残气量等肺功能测定同时用放射免疫法测定血浆 ET水平。结果 :中、重度 HIE组血浆 ET水平均高于轻度组及对照组 ;中、重度HIE组肺功能测定提示 TPTEF/ TE、VPEF/ VE、PEF的下降。重度 HIE组潮气量下降 ,有效气道阻力增高。结论 :血浆ET水平增高与 HIE病情的严重程度相一致 ,肺功能检测指标可以解释血浆 ET水平的增高在新生儿中、重度 HIE发生肺动脉高压及急性肺损伤中起的作用 ,对 HIE临床治疗有一定的指导作用     

Local fibrinolysis for superior mesenteric artery thromboembolism

A 66-year-old man with atrial fibrillation was referred soon after developing left lower limb and abdominal pain with rectal bleeding. An immediate flush aortogram showed embolic occlusion of the left distal superficial femoral artery and superior mesenteric artery (SMA), 3 cm from its ostium. Recombinant tissue plasminogen activitor (rtPA) 40 mg was selectively in stilled in the SMA in two boluses. Abdominal symptoms resolved within 48 h, and complete recanalization of the SMA was shown on angiography. Exploratory laparotomy after 72 h showed a normal small bowel and right colon, and was completed by femoropopliteal embolectomy. Six months later, the patient remained asymptomatic.     

蝮蛇抗栓酶-3治疗糖尿病并发症94例

应用腹蛇抗栓酶-3治疗94例糖尿病患者并发的脑血栓形成、高脂血症、动脉硬化、神经病变和心绞痛取得较好的疗效。脑血栓形成急性期采用冲击疗法,瘫痪肢体功能恢复迅速、合并神经病变者,治疗后症状消失、神经功能改善。TG、TC、β-脂蛋白水平和TC/HDL比值均降低(P<0.01),HDL水平上升(P<0.01),对比治疗前后血6-Keto-PGF_(1α)、TXB_2和纤维结合素FN的水平改善,具有统计学意义(P<0.01)。     

Perfusion imaging by a flow-sensitive alternating inversion recovery (Fair) technique: Application to functional brain imaging

Perfusion is a crucial physiological parameter for tissue function. To obtain perfusion-weighted images and consequently to measure cerebral blood flow (CBF), a newly developed flow-sensitive alternating inversion recovery (FAIR) technique was used. Dependency of FAIR signal on inversion times (TI) was examined; signal is predominantly located in large vessels at short TI, whereas it is diffused into gray matter areas at longer TI. CBF of gray matter areas in the human brain is 71 ± 15 SD ml/100 g/min (n = 6). In fMRI studies, micro- and macrovessel inflow contributions can be obtained by adjusting TIs. Signal changes in large vessel areas including the scalp were seen during finger opposition at a TI of 0.4 s; however, these were not observed at a longer TI of 1.4 s. To compare with commonly used BOLD and slice selective inversion recovery techniques, FAIR and BOLD images were acquired at the same time during unilateral finger opposition. Generally, activation sites determined by three techniques are consistent. However, activation of some areas can be detected only by FAIR, not by BOLD, suggesting that the oxygen consumption increase couples with the CBF change completely. Relative and absolute CBF changes in the contralateral motor cortex are 53 ± 17% SD (n = 9) and 27 ± 11 SD ml/100 g/min (n = 9), respectively.     

Intracerebral haemorrhage as a manifestation of Lyme Neuroborreliosis?

Lyme Neuroborreliosis (LNB) has repeatedly been reported to cause cerebral vasculitis. However, there is no reliable information about the incidence of cerebral vessel affection. The majority of reports deal with ischaemic consequences, and there are a few reports of subarachnoid haemorrhage (SAH). We report a case of otherwise unexplained intracerebral haemorrhage (ICH) where clinical and laboratory tests have shown LNB. Late stage LNB might not only cause ischaemic, but haemorrhagic stroke as well.     

溶血磷脂胆硷对缺血性心室肌电生理的影响

用台氏液加溶血磷脂胆硷（ＬＰＣ）３ｘｌ０－４灌流离体绵羊心室小梁肌，其０期去极化最大速率（Ｖｍａｘ）、静息电位（ＲＰ）、动作电位幅值（ＡＰＡ）、动作电位复极达ＡＰＡ５０％和９０％的时程ＡＰＤ５０、ＡＰＤ９０分别下降３９．８％、１０．４％、１４．５％、２１．３％和１４．８％；用“模拟缺血溶液”加ＬＰＣ３×ＩＯ－４灌流，其Ｖｍａｘ、ＲＰ、ＡＰＡ、ＡＰＤｓ０和ＡＰＤ９０分别下降７８％、２２．７％、２６％、３５．４％和２１％；实验中对“模拟缺血溶液”中各种成分对ＬＰＣ效应的影响进行分析，发现主要的因素是酸中毒。结果表明：ＬＰＣ是心肌缺血中心律失常的重要因素之一，缺血诱导的酸中毒更加重了ＬＰＣ对心肌细胞的毒性作用。