血肿腔注药技术的改进

钻孔引流术是治疗脑出血、亚急性硬膜外血肿的常用方法．术后血肿腔注药是彻底清除血肿的重要措施。我们使用三通阀做连接物，使注药、闭管、引流操作简便、安全可靠。     

静滴小牛血清去蛋白注射液对ASBI患者IR及血清乳酸、C肽水平的影响

目的观察静滴小牛血清去蛋白注射液对急性重型颅脑损伤患者胰岛素抵抗（IR）及对血清乳酸（LA）、C肽水平的影响。方法将80例急性重型颅脑损伤患者随机分成A、B组,各40例,A组予以常规治疗,B组在常规治疗基础上静滴小牛血清去蛋白注射液。均治疗15d。比较两组血清胰岛素（INS）、血糖、LA、C肽水平,计算胰岛素敏感指数（ISI,其用来反映IR）。结果B组治疗后血清INS、LA、血糖、C肽值均低于治疗前及A组治疗后（P均〈0．05）,ISI高于治疗前及A组治疗后（P〈0．01）。结论静滴小牛血清去蛋白注射液能明显降低急性重型颅脑损伤患者的IR和高血糖反应,抑制LA生成。     

大型、巨大型听神经瘤的显微手术治疗

目的探讨显微神经外科技术在大型、巨大型听神经瘤切除术中的应用。方法回顾性分析30例大型、巨大型听神经瘤显微外科手术治疗病例的临床资料。结果肿瘤全切除27例，次全切除3例。面神经保留率达63．3％，功能保留率35．0％，听神经解剖保留率25．0％。结论对大型、巨大型的听神经瘤选择不同的手术入路，应用显微外科技术，可提高肿瘤全切除率，有效地保护颅神经的功能。     

颅骨修补术后局部疼痛分析1例报告

1 GENERAL DATA Case condition:Famle,aged 35 years old,craninal bone repair was performed on May 1998.deficiency of cranial 5 cm× 5 cm,region:tempora and parietal area.Operative time:type of operation is II type repair,repair material was fixed with double size 7 silk,and moulded under local intensified anesthesin.Wound were duched with gentamycin sulfate liquid,drain was laid,removed on next day.Secondary operation:Result of exploration(leading to pain):subcutaneous hydrops.     

显微手术联合间质内核素治疗丘脑胶质瘤1例报告

患者，男，44岁，2年前无明显诱因幻嗅，未予重视，近3个月右侧上下肢体轻瘫伴癫痫发作，癫痫呈大发作，意识丧失，四肢躯干伸位强直伴震颤，口内垂涎，尿失禁，每次持续2～3min，共发作3次。查体：神志清，精神差，反应迟钝，双眼球运动正常，双侧眼底视乳头水肿，右上下肢肌力Ⅳ级，肌张力增高，右膝腱反射亢进，右Babinshi征阳性。MRI示左丘脑外侧区T1WI短信号。     

Analysis of local pain after cranial deficiency repair：1 case report

Background:Radical clearance of cervical lymph nodes is an effective method to treat malignant tumor of maxillofacial region and prevent diffusion and relapses.But postoperative contour and dysfunction of shoulder due to dysfunction of trapezius muscle that is caused by injury of accessory nerve affect patients‘ lining qualinty.Objective:To explore therapeutic method of dysfunction of shoulder after radical clearance of cervical lymph nodes of maxilloracial region.Unit:Oral Medical College,Fourth Military Medical University.Subjects:21 males and 17 females aged 49-71 years old were investigated,among which were 14 cases of carcinoma of tongue,1 cases carcinoma of cheek,9 cases of carcinoma of gingival ,others,5 cases.All cases were treated by radical clear ance of unilateral cervical lymph nodes.Intervention:(1)Local massage:Affected trapezius muscle region was massaged from 2th day after operation.Soft concentric massage and local rubbing were taken by nurses and families,times every day to prevent atrophy or muscles.(2)Passive and active movement training:Moving training began within 1 week,Passive training of shoulder was taken t first,under instruction of nurses and cooperation of families,including shrugging of shoulder,elevation and abduction of upper limb.Same moving was taken under instruction to healthy shoulder to experience voluntary moving.If atrophy of affected trapezius muscle was obsered.active movement training was taken supplied with passive moving and transited to active moving successively,3-5 times every day and 5-10 minutes every time.(3)Occupational training:Occupational training was to take muscle exercises using functional movement of shoulder which effect was superior to simple muscle exerciese.When antagonistic effect was found,fitful external force was adopted to antagonist moving of affected shoulder and promote recovery of muscle.(4)Physical therapy:Local radiation infrared ray was adopted 1 week after operation,once a day,2 weeks as a therapeutic course and kept for 3-5 therapeutic courses.Results:Dysfunction evaluation of affected shoulder after 6 months of follow-up survey.Affected degrees were divided into 4 grades;Grade I,no influence compared with that before operation,3 cases;Grade,Ⅱ,mild influence,20 cases;Grade Ⅲ，moderate influence,13 cases;Grade Ⅳ ,serious influence, cases ,Function evaluation of shrugging,evaluawtion abductor of upper limb,patients could accomplish common moving besides 2 cases of patients with grade Ⅳ.Conchlusion:Systematic rehabilitation nursing could effectively promote recovery of postoperative function of affected shoulder.     

人参皂甙Rh2对人脑胶质瘤细胞株U251凋亡的影响及机制探讨

目的观察人参皂甙Rh2（GS-Rh2）对人脑胶质瘤细胞株U251凋亡的影响,并探讨其机制。方法人脑胶质瘤细胞株U251经GS-Rh2处理后,采用MTT法测算细胞抑制率,用流式细胞术测算细胞凋亡率,用RT-PCR检测U251中Bcl-2、Caspase-3 mRNA,用Western blot法检测U251中Bcl-2、Caspase-3蛋白。结果 GS-Rh2对U251具有抑制作用,并呈剂量依赖性;根据细胞增殖抑制曲线计算出GS-Rh2作用于细胞的抑制浓度（IC）,求得IC30、IC50、IC70值分别为10.6、22.3、70.2μg/ml;GS-Rh2可诱导U251凋亡,并呈剂量依赖性。在GS-Rh2作用下,U251中Bcl-2 mRNA、蛋白呈明显低表达,随着GS-Rh2作用时间延长,Caspase-3 mRNA、蛋白表达逐渐增高。结论 GS-Rh2可明显抑制U251增殖,诱导其凋亡,其机制与GS-Rh2下调U251中Bcl-2 mRNA及蛋白表达、上调Caspase-3 mRNA及蛋白表达有关。     

外伤性脑性盐耗综合征治疗体会

外伤性脑性盐耗综合征治疗体会黎铁伟（附属第一医院）缴焕财（盘锦市大洼县医院）刘国栋（锦州市铁路中心医院）外伤性脑性盐耗综合征是因原发或继发丘脑下部损伤所致，引起生命体征的改变及内分泌功能紊乱，轻者表现为多饮、多尿、尿比重低及口渴等，称为尿崩症。重者不...     

苯妥英钠对实验性脊髓损伤的神经保护作用研究

目的探讨大鼠实验性脊髓半横断损伤后，钠通道阻滞剂苯妥英钠在减轻脂质过氧化反应和超微结构保护中的作用。方法参考Ramberg和Borgens法建立大鼠半横断型脊髓损伤模型，72只Sprague-Dawley大鼠均接受T10节段的脊髓损伤，然后被随机分为3组：甲基强的松龙（MP）组，于伤后通过腹腔注射甲基强的松龙30mg／kg；苯妥英钠（PHT）组，于伤后通过腹腔注射苯妥英钠10mg／kg；对照（NS）组，于伤后通过腹腔注射等体积生理盐水。在脊髓损伤4h，8h，24h后，每组各取7只大鼠，麻醉后处死取损伤区脊髓，测定丙二醛（MDA）浓度和超氧化物歧化酶（SOD）活性，并于24h每组取3只大鼠麻醉后处死，取出损伤区脊髓制成标本，在电镜下观察超微结构改变。结果苯妥英钠组脊髓组织MDA浓度明显低于各时相点NS对照组，SOD活性显著升高（P〈0.01），而与MP治疗组无明显差异（P〉0.05）。电镜下苯妥英钠组和MP组大鼠脊髓损伤部位观察到灰质出血坏死，线粒体水肿，髓鞘分离，髓鞘板层结构排列松散，较NS组轻。结论钠通道阻滞剂苯妥英钠可以增强脊髓损伤后的抗氧自由基的能力，减轻脂质过氧化反应，对脊髓神经组织有保护作用。     

松果体区蛛网膜囊肿1例

松果体区蛛网膜囊肿１例黎铁伟（附属第一医院）患者，女，４０岁。头迷半年，劳累后头迷加重，无头痛，呕吐及二便障碍，病来无发烧。查体：Ｂｐ，１４／１１ｋＰａＰ７５次／分。双侧视乳头水肿，颅神经未见异常，四肢肌力、张力正常，膝反射（＋），病理征（－），颈项...