梅毒住院患者63例血清学及脑脊液的临床分析

目的了解梅毒住院患者的流行病学、临床和血清学特征。方法对63例患者的临床资料及血清学、脑脊液等进行综合分析。结果87．30％（55例）患者血清TRUST呈低滴度表现（1：1～1：8）,14．29％（9例）为早期潜伏梅毒,15．87％（10例）为神经梅毒,52．38％（33例）为晚期潜伏梅毒,17．46％（11例）为无法判断病期的潜伏梅毒。73．02％（46例）传播途径为非婚性接触为主,性别分类中女性（49例）多于男性（14例）,低学历（54例）、待业者（18例）及性活跃期人群发病率高。结论潜伏（隐性）梅毒在梅毒分期中占有较大的比例;有必要对血清TRUST滴度持续（≥2年）不转阴患者进行神经梅毒的排查;有必要加强宣传性保护的重要性。     

脑脊液蛋白质组技术及临床应用研究进展

脑脊液(CSF)围绕并支持中枢神经系统(CNS),包括脑室和蛛网膜下腔,由于脑脊液与中枢神经系统直接接触,所以其是寻找中枢神经系统疾病生物标记物的重要来源。国内外学者开展了大量CSF蛋白质组学的研究工作,并取得了较大进展。文中综述了近年来CSF蛋白质组学技术及临床应用研究进展。     

老年脑肿瘤病人手术前护理临床效应

目的:总结老年脑肿瘤病人手术前的护理临床效应。方法:分析60例60-80岁脑肿瘤病人的临床及护理资料,根据老年人生理心理特点,有针对性的进行心理护理;对症护理;术前给予正确的护理评估;合理选择血管与输液的观察,并进行术前其他准备。结果:全部病人的合并症经术前处理稳定。病人术前恐惧心理消失,认知功能提高;对呕吐频繁、颅压高头痛和癫痫发作的的病人经药物治疗对症护理症状均缓解,无坠床等意外发生;整体评估患者的心、肺、肾等功能,术前合并原发高血压、糖尿病与慢性支气管炎病例,得到良好控制;采用静脉留置针,效果良好,无静脉炎及静脉血栓的发生。本组病例术中术后病情无加重及并发症发生。结论:根据老年人生理心理特点,有针对性加强术前护理是提高手术成功率,减少术后并发症和病死率的重要措施。     

神经梅毒5例临床分析

目的：探讨梅毒感染后致神经系统损害的临床特征,加强对神经梅毒的认识。方法：回顾性分析5例神经梅毒患者的临床特点、血清学变化、影像学资料。结果：5例梅毒血清学检查、脑脊液梅毒检查均阳性,5例头核磁检查存在特异性改变（4例冠状住可见海马异常信号）,临床特征缺乏特异性。结论：神经梅毒好发于中年男性,梅毒全身症状可不明显,其临床表现多样,容易误诊和漏诊,临床应重视对患者临床特征识别,尤其对患者脑脊液及影像学检查结果识别,对神经梅毒患者的诊治有重要的现实意义。     

神经梅毒5 例临床分析

目的:探讨梅毒感染后致神经系统损害的临床特征,加强对神经梅毒的认识。方法:回顾性分析5例神经梅毒患者的临床特点、血清学变化、影像学资料。结果:5例梅毒血清学检查、脑脊液梅毒检查均阳性,5例头核磁检查存在特异性改变(4例冠状位可见海马异常信号),临床特征缺乏特异性。结论:神经梅毒好发于中年男性,梅毒全身症状可不明显,其临床表现多样,容易误诊和漏诊,临床应重视对患者临床特征识别,尤其对患者脑脊液及影像学检查结果识别,对神经梅毒患者的诊治有重要的现实意义。     

中西医结合治疗脂肪肝64例临床观察

目的：探讨中西医结合治疗脂肪肝的临床疗效.方法：将64例患者随机分为治疗组和对照组,其中治疗组43例患者在西药治疗的基础上加入HD肝病治疗仪经络穴位中药局部导入;对照组采用西药治疗.结果：两组临床疗效总有效率、血生化改变、B超、CT、影像学改变总有效率经统计学处理,P〈0.05,有显著差异;治疗组优于对照组.结论：临床治疗观察表明,运用此法配合西药营养肝细胞改善代谢,发挥中西医的协同作用,疗效明显优于单纯运用西药.     

中西医结合治疗脂肪肝64 例临床观察

目的:探讨中西医结合治疗脂肪肝的临床疗效。方法:将64例患者随机分为治疗组和对照组,其中治疗组43例患者在西药治疗的基础上加入HD肝病治疗仪经络穴位中药局部导入;对照组采用西药治疗。结果:两组临床疗效总有效率、血生化改变、B超、CT、影像学改变总有效率经统计学处理,P<0.05,有显著差异;治疗组优于对照组。结论:临床治疗观察表明,运用此法配合西药营养肝细胞改善代谢,发挥中西医的协同作用,疗效明显优于单纯运用西药。     

精准肝切除术治疗原发性肝癌的临床效果分析

目的:探讨腹腔镜精准肝切除术的特点及效果,为普外科手术提供参考。方法:选取2011年10月-2013年7月我院收治的92例原发性肝癌患者的临床资料进行回顾分析。根据手术方式不同,将病例分为常规肝切除组和精准肝切除组,每组46例。观察并比较两组患者的评均术中出血量、手术时间、住院时间、手术前后的肝功能指标变化、并发症的发生率、肿瘤局部复发率及远期转移率等。结果:与常规肝切除组相比较,精准肝切除组患者的平均术中出血量少、住院时间短、术后并发症的发生率及肿瘤复发转移率低,但手术时间较长,组间比较差异显著,具有统计学意义(P0.05)。与手术前比较,两组患者手术后的血清TBIL、ALT及AST含量降低,ALB升高,精准肝切除组患者各项指标的变化程度更显著,肝功能优于常规肝切除组,组内及组间比较差异具有统计学意义(P0.05)。结论:精准肝切除术对于原发性肝癌的治疗具有良好临床的效果,不仅能够彻底清除病灶,而且降低了术后肝衰竭等并发症的发生率,值得推广应用。     

健胃消食口服液治疗消化不良临床效果观察

目的:探讨健胃消食口服液治疗消化不良的临床效果。方法:选自2013年1月至2013年12月进入到我院进行治疗的消化不良患者82例,将这82例患者随机分成2组,每组41例患者,分别命名为观察组和对照组,对观察组患者采用中药健胃消食口服液进行治疗,对对照组患者采用西药多潘立酮进行治疗,观察2组患者的临床治疗效果。结果:观察组患者临床治疗的总有效率为100%。对照组临床治疗的总有效率为91.2%。2组患者临床治疗的总有效率具有统计学意义,(P<0.05)。结论:健胃消食口服液治疗消化不良效果显著,值得临床推广。     

新辅助化疗配合手术治疗中晚期乳腺癌的临床效果分析

目的:观察新辅助化疗配合手术治疗中晚期乳腺癌的临床效果,为临床研究提供参考。方法:选取我院2009年5月-2011年4月收治的中晚期乳腺癌患者107例,根据治疗方法的不同,将患者分为新辅助化疗组和对照组。新辅助化疗组采取术前辅助化疗,而对照组术前不接受化疗。观察新辅助化疗组患者的近期临床疗效、毒副反应发生率;比较两组患者的手术时间、术中出血量等;术后随访三年,记录两组患者的肿瘤局部复发率及远处转移率。结果:新辅助化疗组患者治疗的总有效率为79.66%,毒副反应的发生率为33.89%;新辅助化疗组的平均手术时间、术中出血量均低于对照组,差异具有统计学意义(P0.05)。新辅助化疗组患者的局部复发率为5.08%,远处转移率为6.78%;对照组患者局部复发率为12.50%,远处转移率为18.75%。新辅助化疗组患者的肿瘤复发转移率低于对照组,差异具有统计学意义(P0.05)。结论:在中晚期乳腺癌的临床治疗中,术前对患者实施新辅助化疗具有明显的效果,患者近期疗效良好,毒副反应可耐受,且手术后的复发转移率相对较低,值得推广应用。     

Homeostasis of Brain and Cerebrospinal Fluid Calcium Concentrations During Chronic Hypo-and Hypercalcemia

Three-week-old rats were made hypocalcemic or hypercalcemic by being fed diets low or high in Ca. Both total and ionized [Ca]s in the plasma decreased about 40% and remained depressed for 4 weeks in rats fed a low-Ca diet. Plasma [Ca]s in rats fed a high-Ca diet increased by 30% and remained elevated for 7 weeks. After 8 weeks on the diets, cerebrospinal fluid (CSF) [Ca] changed by less than 30% whereas brain [Ca] changed by less than 20% of the chronic changes in plasma ionized [Ca]. Assuming a brain extracellular volume of 20% and noting that brain extracellular volume equilibrates freely with CSF, the findings demonstrate only small perturbations in the Ca content of the brain cellular compartment during sustained hypo or hypercalcemia. Partial regulation of CSF and brain extracellular Ca suggests a role for the blood-brain barrier in regulating CNS [Ca] during chronic changes in plasma [Ca].     

结核性脑膜炎颅神经损害与脑脊液特点的关系研究

目的:探讨结核性脑膜炎颅神经损害与脑脊液特点的关系。方法:回顾性收集我院神经内科确诊的173例结核性脑膜炎患者临床资料,将所有患者分为伴颅神经损害和不伴颅神经损害两组,对其临床特点及脑脊液外观、压力及细胞学、生化、免疫球蛋白结果进行统计学分析。结果:颅神经损害者占所有病人的22.5%(39/173),视神经损害占61.5%(24/39),外展神经损害占53.8%(21/39),动眼神经损害占15.4%(6/39),听神经损害占15.4%(6/39);颅神经损伤组较无颅神经损伤组脑脊液压力、蛋白质及Ig G、Ig M、Alb明显升高(P0.01或0.001),且颅神经损害者头颅MRI脑膜强化较无颅神经损害者差异有统计学意义(P0.001),而脑脊液外观、白细胞计数及比例两组间并无发现显著差异。结论:结核性脑膜炎患者伴颅神经损害时,脑脊液压力、蛋白质及部分免疫球蛋白较无颅神经损害者明显升高,这将有助于结核性脑膜炎合并颅神经损害的临床诊断,对于有颅神经损害的结核性脑膜膜炎患者加强并早期启动抗结核治疗,以减少蛋白质沉积,从而降低颅神经损害的发生率。     

实验用猴脑脊液采集技术方法的创新

脑脊液在艾滋病的研究中有着重要的意义。近年来脑脊液的检测逐步成为SIV/SHIV感染猴模型研究和应用中的重要指标。传统的采集方法不易学习和掌握。针对上述情况我们优化了脑脊液的采集方法,优化后的方法明显缩短穿刺时间,显著提高成功率。     

Ventricular Cerebrospinal Fluid Monoamine Transmitter and Metabolite Concentrations Reflect Human Brain Neurochemistry in Autopsy Cases

Concentrations of dopamine (DA), its metabolites 3-methoxytyramine and homovanillic acid (HVA), noradrenaline (NA), its metabolites normetanephrine (NM) and 3-methoxy-4-hydroxyphenylglycol (MHPG), 5-hydroxytryptamine (5-HT, serotonin), and its metabolite 5-hydroxyindoleacetic acid (5-HIAA) were measured in 14 brain regions and in CSF from the third ventricle of 27 human autopsy cases. In addition, in six cases, lumbar CSF was obtained. Monoamine concentrations were determined by reversed-phase liquid chromatography with electrochemical detection. Ventricular/lumbar CSF ratios indicated persistence of rostrocaudal gradients for HVA and 5-HIAA post mortem. Ventricular CSF concentrations of DA and HVA correlated positively with striatal DA and HVA. CSF NA correlated positively with NA in hypothalamus, and CSF MHPG with levels of MHPG in hypothalamus, temporal cortex, and pons, whereas CSF NM concentration showed positive correlations with NM in striatum, pons, cingulate cortex, and olfactory tubercle. CSF 5-HT concentrations correlated positively with 5-HT in caudate nucleus, whereas the concentration of CSF 5-HIAA correlated to 5-HIAA levels in thalamus, hypothalamus, and the cortical areas. These data suggest a specific topographic origin for monoamine neurotransmitters and their metabolites in human ventricular CSF and support the contention that CSF measurements are useful indices of central monoaminergic activity in man.     

Three Dimensional Modeling of the Cerebrospinal Fluid Dynamics and Brain Interactions in the Aqueduct of Sylvius

A computational fluid dynamics (CFD) method is presented to investigate the flow of cerebro-spinal fluid (CSF) in the cerebral aqueduct. In addition to former approaches exhibiting a rigid geometry, we propose a model which includes a deformable membrane as the wall of this flow channel. An anatomical shape of the aqueduct was computed from magnetic resonance images (MRI) and the resulting meshing was immersed in a marker-and-cell (MAC) staggered grid for to take into account fluid–structure interactions. The time derivatives were digitized using the Crank–Nicolson scheme. The equation of continuity was modified by introducing an artificial compressibility and digitized by a finite difference scheme.

Calculations were validated with the simulation of laminar flow in a rigid tube. Then, comparisons were made between simulations of a rigid aqueduct and a deformable one. We found that the deformability of the walls has a strong influence on the pressure drop for a given flow.     

Monitoring the Effect of a Tryptophan Load on Brain Indole Metabolism in Freely Moving Rats by Simultaneous Cerebrospinal Fluid Sampling and Brain Dialysis

Rats were given L-tryptophan, 50 mg/kg i.p., and its concentration in the CNS was monitored in individual freely moving animals using repeated sampling of cisternal CSF and concurrent striatal dialysis. The 5-hydroxytryptamine metabolite 5-hydroxyindoleacetic acid (5-HIAA) was also measured. Results were compared with changes of central tryptophan and 5-HIAA concentrations in brains of rats killed at various times after administration of L-tryptophan, 50 mg/kg i.p. Tryptophan changes in CSF were proportionate to those in whole brain and followed essentially identical time courses. Results for the striatal dialysate and whole striatum also paralleled each other. Similarly, results for 5-HIAA showed proportionality between CSF and brain and between dialysate and striatum. The data obtained were used to determine pharmacokinetic data for individual rats, i.e., areas under curves for both tryptophan and 5-HIAA and half-lives for the decline of tryptophan. Kinetic parameters varied considerably from rat to rat. However, mean half-lives for tryptophan in CSF, brain, dialysate, and striatum were all comparable. Results in general show the value of repeated CSF sampling and intracerebral dialysis for concurrent monitoring of changes of indole metabolism in the whole brain and a specific brain region, respectively. The methods should be suitable for the continuous monitoring of changes of central transmitter metabolism in parallel with observation of behavior following environmental or dietary changes or drug administration. They also should be of use in the investigation of drug kinetics in the CNS.     

MRS脑肿瘤分型诊断模型研究

基于对核磁波谱(MR Spectroscopy)的特征变量提取,利用模糊聚类算法来构建脑肿瘤分型诊断模型,实验结果表明该模型能准确对神经胶质细胞瘤分级诊断,为进一步实现更复杂的脑肿瘤诊断系统模型提供方法。     

High-Resolution Proton Magnetic Resonance Analysis of Human Cerebrospinal Fluid

High-resolution proton magnetic resonance spectroscopy was used to analyze human cerebrospinal fluid obtained from patients with several neurological problems. The major metabolites measured included glucose, lactate, glutamine, citrate, inositol, acetate, creatine, creatinine, beta-hydroxybutyrate, alanine, and pyruvate. A drug vehicle, propylene glycol, was also measured. Alterations in the cerebrospinal fluid of these metabolites provided information concerning metabolism of the brain. Magnetic resonance spectroscopy offered a simple and rapid means of assessing these and other exogenous and endogenous compounds in diseases affecting the nervous system.