重组干扰素α—2a治疗病毒性中枢神经系统感染前后体液干扰素水平变化

目的探讨病毒性中枢神经系统感染时，血液和脑脊液干扰素（IFN）变化情况。方法70例患者应用重组干扰素α-2a（rHuIFNα-2a）治疗，采用微量细胞病变抑制法测定血液和脑脊液IFN.结果治疗前血液IFN测定阳性率为84.3％（59／70），平均含量为8.4IU／ml，治疗后2／小时内IFN均呈阳性，平均含量升至26.8IU／ml（P＜0.01）;脑脊液IFN变化轻微，阳性率由61.4％（43／70）升至74.3％（52／70），平均含量由9.IIU／ml升至11.3IU／ml（P＞0.05）。结论在炎症情况下，IFN分布受血脑屏障影响，临床用药时应予重视。     

环枢关节紊乱症的临床研究

环枢关节紊乱症，从发病机理到临床表现，乃是颈椎病中较复杂的疑难顽症。用常规诊治方法，疗效不佳。本研究提出新的诊断依据与治疗方法，对３２０例病者随机分为治疗组１６６例（采用改进的诊治方法），对照组１５４例（用常规诊治方法）对照进行疗效观察。结果显示：治疗组治愈率与总有效率及康复率均高于对照组。有非常显著差异，Ｐ＜０．０１。而疗程较对照组短。环枢关节紊乱症的临床研究有利于颈椎病诊治水平的提高，运用于临床，疗效好，效益高，具有推广应用价值。     

百合更年安冲剂主要药效学研究Ⅰ

百合更年安部皮１．５、３．０、６．０ｇ／ｋｇ给小鼠灌胃，中、大剂量组均能显著抑制活动，减少被动活动能对抗去水吗啡引起动物的运动增加；与戊巴比妥钠有协同作用；有一定的镇痛效果。对交感神经兴奋有对抗作用。     

细胞核DNA含量与神经系统良恶性肿瘤关系的研究

目的：探讨DNA含量定量分析在中枢神经良、恶性肿瘤的判定及星形细胞瘤分级诊断中的应用价值。方法：运用计算机辅助图象分析并结合组织细胞化学技术测定肿瘤细胞核的DNA含量及DNA倍体细胞分布情况。结果：星形细胞瘤按WHO分级标准分为Ⅰ～Ⅳ级，其DNA相对含量和DNA指数分别为1级4．11±0．75，1．44±0．28；Ⅱ级4．52±1．20，1．71±0．34；Ⅲ级6．35±1．82，2．54±0．44；Ⅳ级7．07±1．32，3．13±0．59。髓母细胞瘤与听神经瘤与DNA相对含量和DNA指数分别为5．61±2．10，2．33±0．83；3．18±0.94，1．35±0．26，方差分析显示组间存在显著差异（P＜0．01），运用Q值法两两比较，髓母细胞瘤与Ⅲ级星形细胞瘤组间、听神经瘤与Ⅰ级星形细胞瘤组间、Ⅰ级星形细胞瘤与Ⅱ级星形细胞瘤组间均无显著差异（P均＞0．05），余各组间均差异显著（P均＜0．01）。结论：DNA含量测定是判定中枢神经肿瘤良、恶性程度及辅助星形细胞瘤分级诊断的良好手段。     

Neurotoxicity of combination chemotherapy with procarbazine,CCNU and vincristine (PCV) for recurrent glioma

In cerebral glioma combination chemotherapy with procabazine, CCNU and vincristine (PCV) is used as adjuvant therapy in cases of recurrence. Standard PCV is usually well tolerated, but intensive PCV (CCNU 130 mg/m² on day 1, procarbazine 75 mg/m² on day 8–21, vincristine 1.4 mg/m² on day 8 and 29; 6 courses every 6 weeks) is less well tolerated. We observed central neurotoxic side effects (focal neurological deficit, cognitive disturbances, slowing of EEG background activity, atrophy on cerebral MR) in combination with hematological and hepatic toxicity in four of 26 PCV treated patients with recurrent glioma. Prolonged myelosuppression and/or ongoing (partial reversible in two patients) neurological deficit still influence daily life in three of four patients months after discontinuation of chemotherapy. Despite the fact that all four patients used anticonvulsants and have been treated with radiotherapy in the past, we have the strong impression that central neurotoxic side effects are related to intensive PCV therapy. We advocate to use the standard PCV regimen in patients with recurrent glioma, because of this potential toxicity and the lack of evidence that intensive PCV leads to better tumor control than standard PCV in cerebral glioma.     

Marked enhancement of anti-allodynic effect by combined intrathecal administration of the adenosine A1-receptor agonist R-phenylisopropyladenosine and morphine in a rat model of central pain

BACKGROUND: There is often no satisfactory treatment for chronic pain after spinal cord injury. We have previously reported that intrathecal (i.t.) administration of the adenosine A1-receptor agonist R-phenylisopropyl-adenosine (R-PIA) or the opioid morphine has anti-allodynic effects in a model of presumed chronic central pain after photochemically induced spinal cord injury in rats. In the present study, we set out to investigate the possible interaction between i.t. R-PIA and morphine in spinally injured rats. METHODS: Sprague-Dawley rats displaying allodynia-like behaviors to mechanical and cold stimuli after photochemically induced spinal cord injury with minor motor deficits were used. R-PIA and morphine, either alone or in combination, were administered i.t. through an implanted catheter to lumbar spinal cord. RESULTS: Cumulative doses of R-PIA or morphine dose-dependently reduced the mechanical allodynia-like behavior, with a threshold of 1 nmol and 1.5 nmol, respectively. When co-administrated, R-PIA and morphine produced marked suppression of mechanical allodynia at doses of 5 pmol and 7.5 pmol, respectively. The effect of i.t. co-administration of R-PIA and morphine on cold allodynia was comparable to i.t. R-PIA alone. The combination of R-PIA and morphine did not increase adverse effects such as motor deficits in comparison to either drug alone. CONCLUSION: These results demonstrate a supra-additive interaction between the adenosine A1-receptor agonist R-PIA and morphine to reduce mechanical allodynia-like behavior in rats with chronic spinal cord injury. The combination of R-PIA and morphine administered spinally may be superior to R-PIA or morphine alone for treating such pain.     

青光眼的中枢损伤

青光眼性损伤的形态学特征及病理机制 ,在视网膜节细胞水平及视神经水平已得到广泛研究 ;最近研究表明 ,青光眼对外侧膝状体、视皮质等中枢视路也存在相应损伤 ,并且提示青光眼的中枢损伤可能参与视功能状态的进一步恶化。我们对近年来青光眼中枢损伤的病理形态学及病理机制研究作一综述。     

Video urodynamic findings in men with the central cord syndrome

PURPOSE: The central cord syndrome reportedly has a favorable prognosis and rehabilitation outcome. However, to our knowledge the status of the lower urinary tract in patients with the central cord syndrome is unclear. We report on 22 men with the central cord syndrome who were evaluated by video urodynamics. MATERIALS AND METHODS: From 1986 to the present we identified 22 men with a mean age of 51 years who had the central cord syndrome and were included in the Houston Veterans Affairs spinal cord registry. All patients underwent video urodynamic evaluation a mean of 34.5 months after injury. RESULTS: Video urodynamic testing for vesicourethral dysfunction was normal in 3 patients, while it showed bladder outlet obstruction secondary to benign prostatic hyperplasia in 2, detrusor areflexia in 4, external detrusor-sphincter dyssynergia in 11, detrusor hyperreflexia with a synergistic external urethral sphincter in 1 and detrusor hypocontractility in 1. Urinary tract infection recurred in 3 patients with external detrusor-sphincter dyssynergia and urolithiasis developed in 2. CONCLUSIONS: Urodynamic testing revealed a high incidence of external detrusor-sphincter dyssynergia in men with the central cord syndrome. Due to the potential for upper tract deterioration all patients with the central cord syndrome should undergo baseline urodynamic studies. Those at high risk for upper tract deterioration with external detrusor-sphincter dyssynergia or a loss of compliance should be treated more aggressively with clean intermittent catheterization and anticholinergic medication when possible.     

中枢性尿崩症50例病因及治疗分析

目的　探讨小儿中枢性尿崩症的病因及治疗措施。方法　对中枢性尿崩症 5 0例患儿临床资料、实验室检查结果、病因及治疗方法进行总结。结果　 1.病因 :以特发性居多 ,继发性中以肿瘤为最多见 ,遗传性仅 1例。 2 .治疗 :肿瘤以手术及放疗为主 ,其他以补充激素为主。结论　对中枢性特发性尿崩症患儿应询问家族史 ,其中有些病例可能属遗传性中枢性尿崩症 ,因抗利尿激素基因突变所致。MRI对早期诊断及追踪治疗有重要意义。弥凝替代治疗安全有效     

中枢神经细胞瘤全基因组的比较基因组杂交分析

目的研究中枢神经细胞瘤全基因组的遗传学异常,探讨该肿瘤的发病机制。方法应用比较基因组杂交技术,研究10例中枢神经细胞瘤的遗传学改变。结果10例中枢神经细胞瘤中,6例发现有染色体的失衡,主要表现为遗传物质在染色体2p(4/10)、10 q(4/10)和18 q(3/10)上的获得。结论染色体2p、10 q和18 q的遗传学改变很可能与中枢神经细胞瘤的发病机制有关。