Pediatric intracranial aneurysms——clinical characteristics and therapeutic strategies

Objective To assess the radiological characteristics and therapeutic strategies of intracranial aneurysms in children. Methods From our dedicated neurovascular databank of patients, we reviewed 23 consecutive children who had 24 intracranial aneurysms. There were 14 boys and 9 girls with a mean age of 9.09 years ( range 1 - 14 years ). Results Intracranial aneurysms in children ≤ 14 years constituted 1.3% of all intracranial aneurysms. Internal Carotid artery (ICA) and middle cerebral artery (MCA) were the most frequent sites for aneurysms. About 58.3% of the aneurysms were complex, including dissecting, pseudoaneurysm, giant and fusiform aneurysm. 1/3 of all aneurysms were located in posterior circulation. Only 1 case had multiple aneurysms in this case series. Almost half of all cases presented with subarachnoid hemorrhage and others presented with mass effect. 14 cases underwent endovascular treatment. 4 patients received microsurgical therapy. 5 cases did not receive microsurgical or endovascular therapy, 2 of them whose aneurysms spontaneously thrombosed during follow up. One boy with left vertebral artery giant aneurysm died after endovascular therapy owing to gradual thrombosis in basilar artery. Another child had poor outcome because of rerupture of aneurysm before operation. Whereas the majority had a favorable outcome. Conclusions Intracranial aneurysms in children had many clinical and radiological characteristics different from those in adults : ( 1 ) remarkable male predominance; ( 2 ) ICA and MCA were the most common sites for aneurysms; (3) high incidence of large, traumatic, infectious, dissecting and fusiform aneurysms. (4)For pediatric intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. Endovaacular therapy was the best choice for complex aneurysms.     

NP方案治疗晚期肺鳞癌36例临床疗效

目的：观察NP方案治疗晚期肺鳞癌36例临床疗效。方法：应用NP（NVB＋DDP）方案，NVB30mg/m^2ivd1.8,DDP30mg/m^2ivgtt d1-3(适当水化）；21－28d为1个周期，至少治疗3个周期。结果：治疗肺鳞癌患36例，近期有效率为55．56％（20／36），初、复治有效率分别为60．7％和37．5％，结论：对不能手术的晚期肺鳞癌，NP方案是一个较为理想的治疗选择，可作为一线临床用药。     

脸色腰段椎间盘突出症21例临床分析

胸腰段椎间盘突出症罕见,约占椎间盘突出的0.6％～4％。随着CT及MRI的应用,其发病率有增加的趋势。因其发病率低,报道较少。但由于病变位于脊髓圆椎段,其发病较下腰段椎间盘突出有很大的特殊性,故有必要结合我院近年收治的21例对其作一回顾性分析。1 临床资料     

网络教育的探讨

随着计算机、网络、多媒体技术的出现和迅速发展,网络教育(E-learning)正以前所未有的深度和速度在教育教学领域推开,为优化学生的学习环境提供了现代化的工具和手段.可以把传统的课堂教学放到网上,利用多媒体计算机所具有的综合处理声音、文字、图像和视频信息的能力,将知识和信息以形象丰富的文本、图形、声音、视频及动画等形式表示出来,使学生能更形象、更直接地接受知识和信息,提高学生的学习兴趣和学习效果.同时依托网络,发挥网络信息资源丰富和不受时空限制的优点,为广大受教育者,特别是那些无集中学习时间或正常学习时间进行学习的人们,提供灵活、方便和有效的学习环境,从而使学习者能更快地掌握自身所需的知识和技能,以应付越来越激烈的工作竞争.本文将对E-learning的作用和影响做一些初步的探讨.     

还原型谷胱甘肽在预防糖尿病大鼠勃起功能障碍中的研究

目的探讨还原型谷胱甘肽(GSH)在预防糖尿病大鼠勃起功能障碍中的作用。方法通过腹腔注射链脲佐菌素65mg/kg建立糖尿病大鼠模型,然后随机分成DM组和DM+GSH组,DM+GSH组每天肌肉注射GSH200mg/kg。10周后观察大鼠勃起功能,并获取海绵体组织检测其谷胱甘肽、一氧化氮合酶(NOS)与丙二醛(MDA)水平,用TUNEL法检测细胞凋亡。结果成功建立糖尿病大鼠模型。与未注射GSH的DM组相比,DM+GSH组和正常对照组(C组)勃起功能更好,勃起率分别是20%,62.5%和100%。GSH水平DM+GSH组和C组明显比DM组高,其3组含量每克蛋白分别是(75.83±15.62)、(61.47±8.65)和(35.03±12.29)mg(P<0.05);NOS水平在DM+GSH组每毫克蛋白为(133.9±31.9)U,与正常对照组每毫克蛋白为(142.2±31.2)U相当,但较DM组每毫克蛋白为(58.4±18.9)U高(P<0.05);MDA含量在DM组每毫克蛋白为(3.71±0.62)nmol,明显高于正常对照组和DM+GSH组(P<0.05),这两组每毫克蛋白为(2.08±0.34)nmol和(2.44±0.28)nmol;细胞凋亡率在DM组、DM+GSH组和C组的分别是(22.6±3.6)%、(10.8±1.7)%和(7.2±2.1)%(P<0.05)。结论还原型谷胱甘肽对糖尿病大鼠阴茎组织有较好的抗氧化作用,能减少细胞凋亡,对延缓糖尿病性ED的发生有一定的作用。     

巡回性诊疗护理与老年人保健

饭富病院地处日本本州山黎县,远离大都市,地偏人稀,但环境优美,气候宜人,的确是疗养的好地方。饭富病院属公立医院,虽规模较小,但是一所综合性医院。我们在此院研修3个月,时间虽短,但期间的所见所闻,尤其护理方面给我们的启发和教益却是十分深刻的。现介绍几个片断,以飨读者。1     

血透患者的营养状态和死亡率

血透患者的营养状态和死亡率谢红浪季大玺关键词血液透析慢性肾衰营养状态死亡率中图法分类号Ｒ４５９．５Ｓｃｒｉｂｎｅｒ等最初用血液透析（ｈｅｍｏｄｉａｌ－ｙｓｉｓ，ＨＤ）治疗慢性肾衰时，就指出营养不良将会是个严重问题，多年的实践已证实了这一点。许多因素会...     

肝切除术治疗肝内结石354例

10年间收治肝内结石745例．其中354例(475％)作肝切除治疗。手术切除左外叶287例、左半肝36例、部分肝方叶14例、右半肝10例、部分尾叶1例，部分左、右肝切除6例。同时作胆管-空肠Roux-Y吻合166例(46．9％)。手术并发症60例(169％)、死亡4例(1．1％)。术后随访276例(78O％)，效果优、良者占88％％。本院肝切除治疗肝内结石的病例每年大致相等，左外叶肝切除仍占多数．但比前减少。本组病例再手术均为左外叶切除后患者，故应重视手术中的再诊断，术中B超和术中胆镜检查是避免结石残留的重要手段。作者强调．肝切除只是治疗肝内结石的一个方面，肝切除后通畅的胆道引流是必要的。作者还提出尽量避免急性炎症期作肝切除是防止术后严重并发症的重要措施。