注射用肉毒毒素制剂及其研发进展

肉毒毒素(Botulinum Toxin,BoNT)已成为现代医学最具多用途的治疗药物之一。通过将肉毒毒素注射到特定过度活动的肌肉中,可以阻断神经和肌肉之间的信号传导,引起肌肉的松弛性麻痹,从而达到治疗的功效。从业者应熟悉各类产品的特性,以实现安全有效地使用。除了已经上市的众多肉毒毒素产品外,目前还在开发其他新型制剂,这些产品将会进一步扩大肉毒毒素的适用范围,以及给患者提供更多的选择。     

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.     

血液透析内瘘的简便术式-动静脉套接法

血液透析是慢性肾功能衰竭患者重要的替代治疗手段之一.目前临床用动静脉端端、端侧吻合的方法建立动静脉内瘘.本组报告一种简单安全、并发症少的动静脉套接内瘘术方法,现报道如下.……     

太原及周边地区6500例乳腺肿块手术统计分析

目的通过统计了解乳腺肿块的发病情况,提示预防重要性。方法以6500例乳腺肿块术后病检诊断为依据。结果乳腺肿块发病逐年呈20%左右增加,乳腺癌的发病呈25%左右增加。结论保持良好心态、提高自身免疫功能、发现无痛性乳房肿块及时就医。     

活血溶栓汤配合低分子右旋精苷静滴治疗脑梗塞50例临床观察

脑梗塞是临床常见病，具有发病率高、死亡率高、致残率高、治愈率低的特点。自1997年3月～1997年12月我们用活血溶栓汤配合静滴低分于右旋糖昔治疗脑梗塞50例，井与低分子右旋糖昔配合阿斯匹林对照治疗50例，结果显示，治疗组优于对照组。现将观察结果报道如下。l对象与方法1．l一般资料本研究治疗组病例50例，男26例，女24例，年龄最大70岁，最小17岁，个均年龄58．63岁；病程最长52大，最短（）．5天，平均’｛柠37．16天；合并高血压10例，糖尿病6例．冠心。39例，其他25例；对照组病例50例，男26例，女上1例，年龄最大70岁，最小43岁，…     

外在性压迫误诊食管、贲门癌手术病例分析

<正> 我院1982年至1985年2月共做食管、贲门癌手术365例,其中发现4例为外在性压迫所致:3例为纵隔淋巴结核压迫食管,1例肝左叶肿大压迫贲门。其中两例分别切除了食管、贲门、胃底,1例摘除了肿大淋巴结,1例因与纵隔粘连未能切除。切除标本病理检查未发现癌组织。手术后分别随访8—36个月均健在。本文就其外在性压迫误诊为食管、贲门癌病例进行分析,以寻求误诊原因和吸取教训。     

AmpC酶的检测方法及在临床耐药菌检测中的意义

抗生素耐药性问题已成为全球关注的焦点,而我国又是世界上滥用抗生素最为严重的国家之一,因此,有必要加强对细菌耐药性的检测、监测,才能及时发现并控制耐药菌的传播.目前,对于耐药菌产生的重要β-内酰胺酶-超广谱β-内酰胺酶(ESBLs),大家有比较深入的认识,其检测技术也日趋成熟,但是对于在革兰氏阴性杆菌耐药中扮演着同样重要角色的酶-AmpC 酶却了解甚少.     

完全性胸腹腔内脏反位合并十二指肠壶腹周围癌一例报告与文献复习

目的总结完全性胸腹腔内脏反位合并十二指肠壶腹周围癌的临床诊治方法。方法报道2006年3月收治的1例极为罕见的完全性胸腹腔内脏反位合并十二指肠壶腹周围癌行胰十二指肠切除术的病例,并复习国内外相关文献。结果本例患者病理诊断为十二指肠乳头及壶腹部腺癌Ⅰ-Ⅱ级。术后1周胆红素降至正常;但2周后出现胃-空肠吻合输出袢粘连性不完全性梗阻,经内镜下置管、鼻饲、营养支持、针灸等处理,40d后痊愈出院。经检索,全球自1936-2006年间报道的全胸腹腔内脏反位合并恶性肿瘤的患者仅15例;其中只有5例全胸腹腔内脏反位合并胰头与壶腹周围癌的报道。结论完全性胸腹腔内脏反位合并肿瘤时,若无明显禁忌证,应同样予以积极的外科治疗,术中操作应注意完全相反的解剖学结构。     

腹腔镜诊治外科急腹症的体会（附14例报业）

目的探讨腹腔镜在外科急腹症中的应用。方法回顾性分析本院收治的14例外科急腹症的临床资料。结果12例术中明确诊断，1例经细菌培养后确诊，1冽探查阴性；6例腹腔镜手术成功，5例中转开腹完成手术，1例延长戳孔完成手术，1例内科治疗，均痊愈。结论腹腔镜诊治急腹症具有创伤小、视野清晰、恢复快的优点。