头针对脑缺血再灌注大鼠血脑屏障影响的实验研究

目的:探讨头针对大鼠脑缺血再灌注后血脑屏障(BBB)超微结构、血清S100B含量及脑水含量的影响,揭示头针对BBB的保护作用。方法:选取SD大鼠,采用线栓法复制右侧大脑中动脉缺血再灌注模型,针刺大鼠患侧百会透曲鬓穴;电镜观察BBB超微结构的改变;采用ELISA法测定血清中S100B含量,观察BBB通透性的变化;应用干湿比重法测定各组大鼠脑水含量。结果:①电镜观察显示:与模型组比较,头针组血管内皮细胞以及毛细血管周围的星型胶质细胞的足突肿胀减轻,血管周围的电子空白区变小,TJ和基底膜的结构破坏减轻;②血清S100B蛋白含量及脑水含量测定结果显示:头针组大鼠在再灌注24 h、48 h、72 h,脑组织水含量以及血清中S100B蛋白含量较模型组显著降低(P<0.05)。结论:头针能够在早期减轻脑缺血再灌注后的BBB结构和功能的损伤,降低BBB的通透性,减少脑组织中的水含量,对脑缺血再灌注大鼠BBB具有保护作用。     

头皮糜烂性脓疱性皮病及其治疗

头皮糜烂性脓疱性皮病是一种少见的皮肤病.其临床特点为老年人头皮部红斑,无菌性脓疱,糜烂甚至溃疡,斑块结痂;伴疼痛为主;慢性病程易反复,最终可导致瘢痕性脱发,并可在瘢痕上发生鳞状细胞癌.其病因不明,目前认为相关的致病因素包括,头皮外伤、日光损伤及自身免疫性疾病.诊断为排除性,组织病理及微生物培养后排除其他疾病后方可诊断此病.已有文献报道多种治疗方法,其中以口服异维A酸疗效最佳.

Abstract：

Erosive pustular dermatosis of the scalp (EPDS ) is an uncommon and painful skin disease characterized by erythema,sterile pustules,erosion,ulceration,and crusted plaques of the scalp of elderly patients,which is often chronic and relapsing,and can eventually cause scarring alopecia and even squamous cell carcinoma.The etiology is unknown,but predisposing factors have been reported such as trauma,prolonged exposure to sunlight as well as coexistence of autoimmune diseases.EPDS is a diagnosis of exclusion based on histological examination and microbial cultures.Multiple therapies have been documented for the treatment of EPDS,and oral isotretinoin is supposed to be the most effective.     

头针体针并用治疗脑梗死疗效观察

目的 观察头针体针并用治疗脑梗死的临床疗效。方法 150例患者随机分成三组，头针组50例，体针组50例，头体针组50例，分别给予头针、体针、头体针并用方法治疗20日，观察三组疗效。结果 三种疗法均能改善患者的肢体功能和肌力。头针组、体针组、头体针组的总有效率分别为76％、82％、94％，其中头体针组与前两组比较有显著性差异（P＜0.05）。结论 头体针结合治疗脑梗死疗效显著。     

对头皮静脉反向穿刺方法的实践

目的 降低头皮静脉穿刺处肿胀发生率，减轻患儿痛苦，提高患者家属的满意度，减少护患纠纷。方法 选择年龄在1月-3岁的住院患儿104例，分成观察组和对照组。观察组按反向静脉穿刺各52例，对照组按常规法穿刺。结果 观察组患儿头皮静脉穿刺处肿胀发生4例，少于对照组15例p〈0．01（x^2=7．792），观察组家属对穿刺护士的满意度达92.3％，对照组57．7％，p〈0．01（u=4．074）。结论 反向穿刺可降低头皮静脉穿刺处肿胀发生率，提高患者     

头针与脑梗塞后血管的早期再通

目的　观察头针对脑梗塞患者脑血管的早期再通及梗塞灶的影响。方法　采用针刺患者头皮血管舒缩区的方法 (头针组 )治疗脑梗塞患者 35例 ,并与单纯药物治疗 (对照组 )进行比较。结果　经 TCD及 CT检查显示 ,头针组在脑血管的早期再通 ,梗塞灶的收缩及临床症状的改善与对照组比有显著差异 (P<0 .0 1)。结论　脑梗塞患者早期进行头皮针治疗 ,可以提早血管的再通时间、缩小梗塞灶及改善临床症状。同时减少由于早期使用血管扩张剂而引起梗塞后出血的危险。     

头皮扩张术结合颞浅血管岛状头皮瓣转移修复不规则烧伤性秃发

在应用头皮组织扩张技术修复头皮瘢痕秃发区的基础上，我们结合颞浅血管为蒂的岛状头皮瓣移植，修复特殊的部位，如发际、鬓角及不规则的秃发区，弥补了常规头皮扩张后以局部皮瓣转移的方式进行修复的不足。同时可将片状瘢痕无发区中存留下来的一块或几块有头发的头皮，形成以颞浅血管为蒂的岛状皮瓣，充分利用，合理分配残留下来的头皮资源，结合头皮扩张来修复其它秃发区及岛状皮瓣的供区。本组病人１２ 例，均为男性，其中修复鬓角８ 例，额部发际４ 例；最大秃发面积１６５ｃｍ２ ，岛状瓣最大面积５５ｃｍ２ ；最小面积为６ｃｍ２ ，秃发区修复率达９６％ ，岛状头皮瓣成活率１００ ％ ，术后随访２～５ 年，疗效满意。     

Partitioning of deep versus superficial intracranial sources using current source densities is not valid

Summary An analytic method has recently been proposed for partitioning scalp-recorded EEG and evoked potential (EP) data into parts arising from deep (i.e., subcortical) vs. superficial (i.e., cortical) sources. The method is based on the observation that the current source density (CSD) is selectively sensitive to electrical activity arising from superficial sources, and the conjecture that the residual potential which remains after subtracting the CSD from the scalp potentials, represents activity from deep sources. We investigated the validity of this procedure by simulating scalp potential data for superficial and deep dipole sources with known locations and orientations. Our single-dipole simulations demonstrated that, when the actual location of the source was superficial, the partitioning procedure erroneously attributed a sizeable proportion of the total topographic variance to the activity of deeper sources. This produced a consistent bias in the simulations with two dipoles, when both superficial and deep sources were present. In such cases, the relative contribution of the deeper source was consistently overestimated, and the scalp topography of the deep source activity was profoundly misrepresented by the residual which results from subtracting the CSD from the scalp potential. We conclude that the proposed method for partitioning EEG and EP data into components arising from deep vs. superficial intracranial sources is not valid.Acknowledgements: This work was supported by general medical research funds from the Department of Veterans Affairs, by a VA psychiatry research training award to Dr. Turetsky and by NIDCD grant #R01 DC00328.     

Dermabrader: a different use in preparing scalp defects without periosteum for immediate skin grafting

Summary To cover a very large scalp defect, one may mobilize the remaining scalp to effect closure. However, sometimes skin grafting may be unavoidable. For this procedure, the prepared raw surface should be smooth and well vascularized. To achieve this in one case, a dermabrader has been used as an osteoabrader to remove the outer table to provide a surface with punctate bleeding. A good result was obtained with minimal hospitalization.     

Cirsoid aneurysms of the scalp

This study reviewed the surgical management of cirsoid aneurysms of the scalp, which are rarely encountered in the neurosurgical practice, and compares the results with embolization. 21 patients with cirsoid aneurysm underwent surgery. There were 1 female and 20 male patients. Trauma was present in four patients. Selective internal and external carotid artery angiograms and cranial magnetic resonance imaging studies were performed on all patients. All angiograms were staged according to published procedures. There were 15 (71.4%) Stage 1a, 4 (19.1%) Stage 1b, and 2 (9.5%) Stage 3 patients.Total excision of the lesion was achieved in 19 patients (90.5%). We operated on only one patient for a second time, because of a residual lesion, and we resected the lesion totally. Only two patients developed necrosis of the scalp (button hole). Both scalp necroses were on the frontal area. Other patients all had good cosmetic results. Surgical resection of cirsoid aneurysms seems to be the most effective treatment with good results. There may be a tendency for the occurrence of necrosis on the frontal area. Staging of the scalp aneurysms has no effect on surgical outcome.     

Seizure-induced miosis

Ictal autonomic pupillary dilation is common; however, miosis is rare. We describe a case of focal seizures secondary to cortical dysplasia presenting with bilateral pupillary miosis, rendered seizure free by resective surgery. The seizure-onset zone was localized within the left middle parietal gyrus by intracranial electrographic recording. Seizure onset was coincident with focal left centroparietal fast spike activity on electroencephalography (EEG). A large region of the left frontocentral cortical dysplasia was demonstrated on magnetic resonance imaging (MRI). Complete resection of the area of cortical dysplasia and additional cortical regions of ictal activity, identified using intracranial EEG, rendered the patient seizure free.