显微镜下经外侧裂清除高血压壳核血肿的手术体会

目的:探讨显微镜下经外侧裂-岛叶入路治疗30例高血压壳核出血的手术体会。方法:选择高血压壳核出血患者30例,采取经翼点-外侧裂-岛叶入路显微手术治疗高血压壳核出血的方法,观察记录上述患者手术一般资料及手技体会、手术治疗临床效果及术后第6个月患者的恢复情况。结果:上述患者平均输血量93.3±45.6ml,平均手术时间2.5±0.4小时,平均住院时间23.1±3.3天;血肿清除量>90%者18例,80%～70%者10例,<70%者2例;术后第6个月评价上述患者的ADL,Ⅰ级7例(23.3%),Ⅱ级13例(43.3%),Ⅲ级8例(26.7%),Ⅳ级2例(6.7%),Ⅴ级0例(0.0%),临床疗效满意病例20例(66.7%)。结论:经外侧裂显微手术治疗壳核出血,具有手术时间短、患者创伤小、术后恢复快的优点,值得临床推广。     

尼莫地平治疗高血压性脑出血疗效观察

目的:尼莫地平治疗高血压性脑出血的临床疗效。方法:90例高血压脑出血患者随机分为实验组(45例)和对照组(45例),对照组仅采用常规治疗,实验组在常规治疗的基础上采用尼莫地平进行治疗,比较两组临床疗效、治疗前后的临床神经功能缺损评分、临床残疾评分以及血肿和水肿带体积改变。结果:实验组和对照组的治疗有效率为73.33%和42.22%,差异具有统计学意义(P<0.05)。实验组和对照组治疗前、后临床神经功能缺损评分分别为(18.58±3.06)、(12.31±2.74)和(18.28±2.97)、(15.22±2.72),实验组和对照组治疗前、后临床残疾评分分别为(38.93±3.37)、(61.57±3.03)和(37.51±4.962)和(43.48±7.19),实验组和对照组治疗前、后的血肿体积分别为(17.23±5.48)cm3、(7.93±3.33)cm3和(17.60±5.46)cm3、(10.97±4.25)cm3,实验组和对照组治疗前、后的水肿带体积分别为(7.73±3.20)cm3、(4.21±1.60)cm3和(7.83±3.19)cm3和(5.67±1.82)cm3,所有患者治疗后各指标均优于治疗前,治疗后两组组间比较均有有显著性(P<0.01)。结论:尼莫地平能够明显的减少血肿体积和水肿带的体积,提高治疗的效果,减少脑出血患者发生神经功能缺损和残疾的可能。     

外科手术在高血压脑出血治疗中的应用

高血压脑出血是当今社会一种发病率及死亡率都非常高的神经科疾病,对于它的治疗,则是神经内外科的重点难点。目前治疗高血压脑出血的方法分为内科保守治疗和外科手术治疗两种,作者阅读了大量国内外临床相关文献,综述了高血压脑出血相关内外科治疗的方法,以及具体应用,望能为其相关研究提供有益的思路。     

影响经动脉子宫颈癌热灌注化疗临床疗效的多因素分析

目的:探讨宫颈癌热灌注化疗栓塞的治疗作用及对临床疗效的影响因素分析。方法:对34例宫颈癌病人进行子宫动脉热灌注化疗及栓塞术,分析肿瘤病理类型,肿块大小,周围浸润及淋巴结转移情况等因素对介入治疗的影响。结果:经过对临床疗效的多因素分析肿块大小对治疗效果影响最大,其次为病理类型。其余影响较小。结论:宫颈癌热灌注化疗栓塞术是治疗宫颈癌的一种适合疗法,尤其适用于肿块较小的病人。可以使疾病得到有效控制,增加手术机会。     

苏州市玻璃体积血的临床病因分析

目的:探讨苏州市不同年龄组玻璃体积血的常见病因,为疾病预防提供依据。方法:对在2009年~2011年住我院的287例295眼玻璃体积血患者的临床资料进行回顾性分析。结果:在所有玻璃体积血患者中,糖尿病性视网膜病变(diabetic retinopathy,DRP)111例(38.7%),眼外伤60例(20.9%),视网膜静脉阻塞(retinal vein occlusion,RVO)59例(20.6%),孔源性视网膜脱离(rhegmatogenous retinal detachment,RRD)32例(11.1%)。年龄<45岁的青年组中,眼外伤导致的玻璃体积血最多,为36例(48.6%),其次为DRP 26例(35.1%),视网膜血管炎(retinal vasculitis,RV)10例(13.5%)。45~59岁中年组中,DRP导致玻璃体积血最多,为61例(50.8%),其次为RVO 20例(16.7%)、眼外伤17例(14.2%)、RRD 16例(13.3%)。≥60岁老年组中,RVO导致玻璃体积血最多,为38例(40.9%),其次为DRP 24例(25.8%),RRD 15例(16.1%)。结论:DRP、眼外伤、RVO、RRD是引起玻璃体积血最常见的病因。青年患者的主要病因是眼外伤、DRP和RV,而中老年患者的主要病因是DRP及RVO。     

子宫肌瘤复发的相关因素分析

目的:探讨子宫肌瘤剔除术后复发的相关因素,为临床降低复发率提供科学依据和有效途径.方法:收集2002年1月至2010年12月北京市怀柔区第一医院妇科门诊收治的445例子宫肌瘤剔除术患者的临床资料及子宫肌瘤术后复发随访情况,对相关因素进行单因素和多因素logistic分析.结果:随访的445例患者复发94例,复发率为21.12％,复发距手术时间6～96个月,平均(38.5±12.8)个月.年龄、BMI、肌瘤数目、肌瘤大小、肌瘤部位、既往分娩史、术后用药与肌瘤复发显著相关,其中年龄、BMI、肌瘤数目是子宫肌瘤复发的独立危险因素,术后妊娠是子宫肌瘤复发的保护因素.结论:年龄、BMI、肌瘤数目是子宫肌瘤复发的独立危险因素,术后妊娠是保护因素.     

Molecular characterization and expression analysis of interferon- inducible protein 56 gene in large yellow croaker Pseudosciaena crocea

In mammals, interferon-inducible protein 56 (IFI56) has been considered to play a role in mediating inhibition of viral replication and cell growth, and possibly in mediating cell apoptosis. Here, we reported the cloning of an IFI56 homologue from the spleen of large yellow croaker, a marine fish (LycIFI56). The complete cDNA of LycIFI56 gene is 1628 nucleotides (nt) encoding a protein of 437 amino acids (aa), with a putative molecular weight of 50.8 kDa. The deduced LycIFI56 protein has a high-level homology with all members of IFIT (IFN-inducible proteins with TPR domain) family, and its 9 putative TPR motifs all locate the corresponding position of these IFIT proteins. Phylogenetic analysis showed that five fish IFIT members form a unique clad independent of mammalian homologues, reflecting a distant evolutionary relationship from mammals. LycIFI56 gene was constitutively expressed in various tissues examined, such as gills, intestine, liver, kidney, heart, spleen, muscle and blood. Upon induction with poly(I:C), LycIFI56 gene expression is obviously up-regulated in spleen, gills, intestine, liver and kidney at 24 h post-induction, suggesting that LycIFI56 may be involved in the immune response induced by poly(I:C). Analysis of the expression kinetics of LycIFI56 and IRF1 genes revealed that the up-regulation of LycIRF-1 expression by poly (I:C) was apparently earlier than that of LycIFI56. These results would facilitate a better understanding of the expression regulation of fish IFI56 gene, and of its roles in immunity of bony fish.     

Spontaneous coronary artery dissection in the postpartum period

Spontaneous coronary artery dissection is a very uncommon cause of acute coronary syndrome. It occurs predominantly in young to middle-aged women during or after pregnancy. The aetiology remains uncertain. Possible factors are hormonal changes, haemodynamic stress and changes in autoimmune status. In case of single-vessel dissection and normal blood flow, conservative treatment often leads to complete angiographic resolution. This case report describes the clinical presentation, diagnosis and therapy of spontaneous coronary artery dissection in a 37-year-old woman in the postpartum period. (Neth Heart J 2008;16: 412-4.)     

Age-dependent Increases of Calcium, Phosphorus, and Sodium in the Uterine Arteries of Thai

To elucidate compositional changes of the uterine artery with aging, the authors investigated age-related changes of elements in the uterine arteries of Thai. After ordinary dissection by medical students at Chiang Mai University was finished, the uterine arteries were resected from Thai subjects. Thai subjects ranged in age from 27 to 86 years (average age = 63.3 +/- 17.7 years). The element content of the uterine arteries was analyzed by inductively coupled plasma-atomic emission spectrometry. It was found that the Ca, P, and Na contents increased progressively in the uterine arteries of Thai with aging. A significant accumulation of Ca and P in the uterine arteries of Thai was found in the sixties patients, and the accumulation increased markedly in the seventies. Regarding the uterine arteries in subjects more than 60 years, the extent of accumulation of Ca and P in the uterine arteries of Thai was one half of that in the uterine arteries of Japanese. Regarding the relationships among elements, extremely significant direct correlations were found among the contents of Ca, P, Mg, Zn, and Na in the uterine arteries of Thai. As Ca increased in the uterine arteries of Thai, P, Mg, Zn, and Na increased simultaneously in the arteries.     

墨旱莲对4种蝮蛇毒引起的炎症和出血的影响

目的探讨墨旱莲提取液对短尾蝮蛇毒、蛇岛蝮蛇毒、白眉蝮蛇毒及尖吻蝮蛇毒所致的炎症和出血的影响。方法应用短尾蝮蛇毒、蛇岛蝮蛇毒、白眉蝮蛇毒及尖吻蝮蛇毒所致大鼠足跖肿胀的致炎模型,观察墨旱莲提取液对蛇毒所致大鼠足跖肿胀的影响。墨旱莲提取液分别与不同蛇毒混合,给小鼠腹部皮下注射,观察其对蛇毒引起的小鼠皮下出血的影响。结果墨旱莲提取液15g／kg连续2次灌胃给药,对短尾蝮蛇毒、蛇岛蝮蛇毒、白眉蝮蛇毒或尖吻蝮蛇毒所致大鼠足跖肿胀的急性炎症造模和短尾蝮蛇毒棉球肉芽肿的慢性炎症造模(20g／kg)均有明显的抑制作用,对这些蛇毒引起的小鼠皮下出血也能明显抑制。结论墨旱莲提取液对短尾蝮蛇毒、蛇岛蝮蛇毒、白眉蝮蛇毒及尖吻蝮蛇毒引起的炎症和出血均有明显的抑制作用。