血红素加氧酶系统在脑出血损伤中的意义和作用机制

自发性脑出血是脑内血管破裂导致血液溢出至脑实质内,有很高的病死率和致残率.自发性脑出血在西方国家中占脑卒中的10%～15%,但在亚洲国家中所占的比例高达35%[1].     

不同病因所致脑出血后认知功能障碍的药物治疗进展

卒中已经成为我国的首位死因,我国脑出血占全部卒中的24%,显著高于欧美国家的平均水平(10%)[1-3]。认知功能障碍是卒中病程进展中常见的临床表现,其恢复慢、预后差,认知功能障碍严重的患者卒中复发或死亡的风险也较高[4]。目前关于脑出血患者合并认知功能障碍方面的研究较少,可能与脑出血发病率较低和死亡率较高(第一年高达60%)有关[3]。     

脑小血管病认知功能障碍的脑网络研究

<正>脑小血管病(cerebralsmallvessel disease,CSVD)是导致VCI的最常见原因,VCI起病隐匿,渐进发展,早期表现为执行和信息处理速度减慢,晚期可累及记忆、语言、视空间等多个认知领域,最终可能发展为痴呆[1-2]。CSVD导致的皮质下型VCI是最多见的VCI亚型,占VCI患病率的50%～70%,其病理机制目前仍不清楚,且缺乏特异性的治疗方法,因此早期识别、诊断和干预尤为重要[3]。VCI的诊断需依     

脑卒中急性期康复治疗

<正>脑卒中是首要病残原因,我国有70%~80%脑卒中患者因残疾不能生活自理[1-2]。我国脑卒中患者病残率较高,与未开展有效的急性期康复治疗有关。尽管关于缺血性卒中和自发性脑出血急性期的时间划分尚未达成共识,但通常认为缺血性卒中急性期指发病2周内[1],自发性脑出血急性期指发病4周内[3]。脑卒中急性期的定义与《中国脑卒中康复治疗指南(2011完全版)》[2]中一级康复开始时     

自发性幕上脑出血外科手术治疗的研究进展

<正>自发性幕上脑出血(Spontaneous supratentorial intracerebral hemorrhage, SSICH)是脑卒中的常见类型，占全球所有脑卒中的9%～27%^1],每年影响人数超过500万^2]。在中国自发性脑出血患者发病率明显高于西方国家，2017年Circulation调查了中国480,687名成人，结果显示中国自发性脑出血患病率为191.9/10万人(0.19%),发病率为66.2/10万人年(0.066%),占脑卒中的比例高达23.8%^3],是发病率最高的国家之一。自发性脑出血是一种致死性和高度致残性的疾病^4-6],患者30d病死率高达40%^7],1年内病死率增加至54%^8],长期存活者中接近75%的患者有不同程度残疾^9],仅有12%～39%患者能恢复到生活自理^7,10]。     

颅内压监测在血管淀粉样变致脑出血治疗中的临床研究

自发性脑出血(intracerebral hemorrhage,ICH)具有高死亡率和致残率的特点[1],而血管淀粉样变致脑出血(hemorrhage related to cerebral amyloid angiopathy,CAAH)是高血压外最主要的致病原因[2]。我科自2005年8月至2012年2月,对39例CAAH中的22例采用了术后持续颅内压     

铁在脑出血后脑水肿形成中的机制研究进展

脑出血(intracerebral hemorrhage,ICH)是常见的脑血管疾病,病死率及致残率都较高。国内的一项流行病学调查显示脑出血占中风的39.9%,脑出血的发病率高达85.4/10万,其病死率更高达41.3%,且脑出血患者的慢性伤残率达到39.1%[1]。而在美国,自发性脑出血所致的死亡人数占脑血管病总死亡数的15%,其中许多脑内血肿的病人因继发性脑水肿的形成而病情迅速恶化[2]。脑出血的病死率及致残率与出血后脑水肿的发生和发展密切相关。国内外研究表明,脑血肿降解产生的铁离子可以催化自由基反应产生以活性氧簇(reactive oxygen species,ROS)为主的大量自…     

自发性脑出血患者的血糖分析

<正>自发性脑出血(spontaneous intracerebral hemorrhage)是一种发病急、病情凶险、病死率高、致残率高的急性脑血管疾病,在我国约占全部脑卒中的20%~30%[1],因此找到自发性脑出血的危险因素具有重要意义。为探讨血糖对自发性脑出血的影响,本文分析了我院神经外科2012年1月至6月收治的62例自发性脑出血患者的临床资料,现报告如下。一、对象与方法1.一般资料:选取我院2012年1月至6月收治的自发性脑出血62例作为观察组,选取62例健康人作为对照组。观察组患者均符合美国成人自发性脑出血治疗指南(2010)的诊断     

自发性小脑出血显微手术40例疗效分析

<正>自发性小脑出血(spontaneous cerebellar hemorrhage,SCH)是指非外伤引起的小脑实质的脑出血。发病高峰在60~80岁,其死亡率报道相差较大,约在20%~75%之间[1]。由于后颅窝空间狭小,代偿空间有限,一旦出血量较大或合并脑积水临床上多采用外科手术治疗[2]。作者回顾性分析2011年5月至2015年5月显微手术治疗的40例自发性小脑出血患者的临床资料,旨在探讨枕下开颅显微镜下血肿清除术治     

双侧脑室穿刺治疗脑室铸型93例分析

脑室出血(intraventricular hemorrhag,IVH)是脑出血中最为严重的情况,占自发性颅内出血的20%～60%[1].     

Mental illness in England,in Scotland and in Scots living in England

Summary Beginning from the observation that Scots living in England have much higher rates of mental hospital admission than do the English, several hypotheses are proposed to account for this. Much of the excess in rates of mental illness is accounted for by those diagnosed as having alcohol-related disorders and behaviour and personality problems. The results of an examination of offical statistics in the two countries enabled some explanations to be offered. It was found that rates of admissions to mental hospitals are higher in Scotland than in England but not as high as those found among Scots migrants who have a much higher rate of readmission to hospitals than either of the other groups. In fact, if first admissions only are considered the rates of admission in Scotland are not only higher than rates for English natives but also higher than for Scottish migrants. It seems that Scots living in England are somewhat less likely to become mental patients than Scots in Scotland but that once they do achieve this status they are very much more likely to be readmitted on subsequent occasions. It was concluded that there might be two fairly distinct groups of migrants from Scotland to England who have different backgrounds, different reasons for migrating and different psychological characteristics. On the one hand there are stable, economically motivated migrants who move south for definite employment related reasons and who show few psychological symptoms. While on the other hand there is a group of migrants who perhaps have psychological problems and who move more in hope than expectation without definite prospects and who account for the high rates of mental hospital admission found in Scottish migrants.     

Prostacyclin release in the coronary circulation during sustained stimulation in in vitro and in in vivo experimental systems

Prostacyclin release from rat isolated perfused hearts and from dog coronary circulation was studied by measuring immunoreactive 6-keto-PGF1 alpha (6-keto-PGF1a) in heart perfusate and in plasma obtained from the great cardiac vein respectively. Continuous infusion of arachidonic acid at constant concentration in isolated perfused hearts induced an increased prostacyclin release. This release showed a rapid peak within 10 min and a subsequent decrease. Low-flow ischemia induced an increased perfusate concentration of 6-keto-PGF1a but, considering the decreased flow, prostacyclin release was actually reduced. During the whole period of ischemia (60 min) prostacyclin release was constant. In open-chest anesthetized dogs 6-keto-PGF1a concentration in the great cardiac vein was increased after ligation of the left anterior descending coronary artery. A prolonged period of coronary occlusion (4.5 hours) resulted in a progressive rise of prostacyclin release. 6-keto-PGF1a determinations in the femoral vein and in the aorta did not show relevant variations during the observation period.     

Neuroimaging in epilepsy in tropics

Epilepsy is a major public health problem in many tropical countries. Also, some of the tropical diseases are major contributors to the higher prevalence of epilepsy in these countries. The etiologic factors responsible for epilepsy in these countries are quite different from those in the developed world. This article discusses the etiologic factors and neuroimaging of epilepsy in light of the conditions in these tropical countries.     

癫痫与抑郁关系的研究进展

抑郁是癫痫患者中常见的精神障碍,严重地影响了患者的生活质量。传统的观点认为癫痫患者因为存在着诸多社会学问题易出现抑郁倾向,癫痫和抑郁是单向的联系,但大量的研究已经证明癫痫和抑郁之间存在双向的联系,一种异常状态的存在可能易转化为另一种异常状态的发展。癫痫和抑郁存在着共同的发病机制。本文主要就癫痫和抑郁的双向联系以及抗抑郁药物在癫痫患者中的应用进行阐述。     

神经介入：回眸2022

<正>2022年,国际上公布了多项大型神经介入领域的随机对照试验（randomized controlled trial,RCT）结果,在血管内治疗（endovascular treatment,EVT）急性大血管闭塞（large vessel occlusion,LVO）适应证的扩展、药物治疗、管理,症状性颅内动脉粥样硬化性狭窄（symptomatic intracranial atherosclerotic stenosis,sICAS）治疗,无症状性颈动脉狭窄治疗,