显微外科治疗丘脑肿瘤临床分析

目的探讨丘脑肿瘤的显微手术方法和疗效。方法回顾性分析13例丘脑肿瘤患者手术入路的选择、手术技巧以及术后并发症。结果13例丘脑肿瘤患者中,全切8例,次全切除4例,部分切除1例。术后短期症状和神经功能明显改善3例,改善5例,无明显变化2例,症状加重1例,死亡2例。余11例均获得随访3个月-2年,复发3例,死亡1例。结论显微手术切除是丘脑肿瘤的首选治疗方法,术中须注意保护周围重要结构,脑深部引流静脉损伤引发的静脉性脑梗死是造成手术失败的重要原因,术后应辅以必要的放疗及化疗。     

丘脑肿瘤的显微外科治疗临床分析

目的 结合临床实践经验,对丘脑肿瘤的显微外科治疗的患者进行临床分析.方法 选取我院2007年1月至2009年12月期间,进行丘脑肿瘤显微外科治疗的患者35例为研究对象,对其治疗方法 和治疗效果进行总结分析,探讨丘脑肿瘤的显微外科治疗的临床价值.结果 本次研究的患者中,肿瘤全切除18例,大部分切除11例,部分切除6例.切除术后的病理检查证实,患者中星形细胞瘤20例,生殖细胞瘤6例,淋巴瘤4例,神经节细胞瘸3例,转移瘤2例.术后大部分患者短期临床症状和神经功能好转,术后有31例患者随访6个月～2年,其中有2例肿瘤复发(于0.5年内死亡),其余生存期均超过1.5年.结论 丘脑肿瘤由于位于脑深部,因而手术难度大,危险度大.可以借助显微镜,采用适当的手术八路与方法 ,获得满意的疗效.     

手术治疗丘脑肿瘤21例临床分析

目的 总结丘脑肿瘤的临床特点和外科手术方法.方法 分析21例丘脑肿瘤病人的临床资料.采用胼胝体-透明膈-穹隆间入路8例,经顶枕皮质侧脑室入路10例.结果 肿瘤全切10例,近全切7例,大部切除4例;术后症状改善15例,无明显改善4例,加重2例.无死亡病例.结论 外科手术是治疗丘脑肿瘤风险高但疗效明确的方法,选择合适的入路是手术成功的关键.     

婴幼儿后颅凹肿瘤43例临床分析

目的 探讨婴幼儿后颅凹肿瘤的临床特点及治疗方法.方法 回顾性分析43例婴幼儿后颅凹肿瘤的临床资料.结果 婴幼儿后颅凹肿瘤的常见症状为呕吐和共济失调.43例中,肿瘤全切除32例(74.4%),近全切除8例(18.6%),大部切除3例(7.0%),本组无手术死亡.33例随访13个月～7年,其中术后放疗13例,12例存活,1例术后2年死亡;术后未放疗的20例患儿中,8例存活,12例于术后2个月～2年死亡.结论 显微镜下肿瘤全切除是良好预后的关键.恶性肿瘤单纯手术预后不好,术后分子病理学指导下的放化疗是今后治疗的方向.     

丘脑肿瘤临床特点及显微手术治疗的研究

目的 探讨丘脑肿瘤的临床特点及显微手术治疗效果.方法回顾性分析37例经显微手术治疗丘脑肿瘤的资料.结果 全切22例,次全切11例,大部分切除4例.术后各种神经功能及体征较术前明显改善者17例,无明显变化10例,病情加重8例,死亡2例.随访结果,其中可正常生活14例,基本生活能自理12例,严重功能障碍6例,死亡5例.术后并发脑积水12例,复发11例.结论 丘脑肿瘤好发于低年龄段,以低级别胶质瘤多见.选择适当的手术入路,可以取得满意的治疗效果.辅以神经导航等显微手术技术可以提高这类手术的成功率,降低术后并发症.     

14例丘脑肿瘤的显微手术与放疗

目的 探讨丘脑肿瘤的综合治疗效果.方法 本组14例病例全经头颅CT及MRI增强扫描确诊.均经开颅显微镜下手术切除肿瘤.6例经侧脑室前角入路;5例经胼胝体侧脑室入脑;3例经颞后下皮层入路.所有这些入路均获得良好的显露.术后使用美国产Varian2003CD高能X线直线加速器外放疗.结果 手术全切除3例;次全切除5例;部分切除6例.出院时症状明显较入院时改善5例;有改善6例;无变化3例.经1年至5年的随访,症状无变化或进一步改善者6例;恶化者4例;死亡4例.在生存中有7例生活能自理或基本自理.结论 丘脑肿瘤应积极手术,术后进行放疗、化疗综合治疗,才能有效延长病人的生命和提高生存质量.     

改良经皮层脑室入路切除丘脑肿瘤

目的探讨提高丘脑肿瘤的切除率和减少术后并发症的手术方法。方法对17例丘脑肿瘤采用改良经皮层脑室入路进行显微手术切除并获得6个月至3年的随访。结果肿瘤全切除11除、次全切除4例、大部切除1例，无手术死亡。结论改良经皮层脑室入路可提高丘脑肿瘤的手术全切率和减少术后并发症。     

丘脑肿瘤的临床特点及外科治疗

目的探讨丘脑肿瘤的临床特点和手术治疗效果。方法回顾性研究了37例经开颅手术治疗的丘脑肿瘤病人,并进行了2个月～6年的随访。结果肿瘤全切20例;次全切14例;大部切除3例。术后神经缺失症状和体征改善者27例;无明显变化者5例;加重者4例;死亡1例。结论同多数脑肿瘤患者相比丘脑肿瘤低龄较多,肿瘤性质多为低级别星形细胞瘤,积极的开颅手术和恰当的辅助治疗对这部分病人的预后是有利的。结合患者临床表现和应用现代神经影像学技术、神经导航技术的辅助可以明显降低手术并发症,改善患者生活质量和延长生存时间。     

丘脑神经节胶质细胞瘤6例并文献复习

目的探讨丘脑神经节胶质细胞瘤(ganglioglioma,GG)的临床特点、治疗和预后。方法对6例经手术和病理证实的丘脑神经节胶质细胞瘤患者的临床资料进行回顾性分析并复习文献。结果丘脑神经节胶质细胞瘤主要临床表现为颅内压增高和偏身运动感觉障碍,患者平均发病年龄12.5岁。6例肿瘤镜下全切除2例,近全切除3例,大部切除1例。术后3例出现对侧肢体偏身运动感觉障碍加重。6例患者平均随访29个月,2例恢复正常工作,3例生活可自理,1例间变性神经节胶质细胞瘤患者复发后死亡。结论丘脑神经节胶质细胞瘤由于缺乏特异的临床症状和神经影像学表现,术前诊断困难,明确诊断需要组织病理学检查。手术治疗是主要的治疗方法,间变性神经节胶质细胞瘤预后差,术后应长期严密随访。     

胃肠间质瘤的现状及未来附12例病理分析

目的:探讨胃肠道间质瘤(GIST)的临床特点及诊断治疗.方法:收集12例GIST的临床资料进行回顾性分析.结果:本组平均发病年龄48.6岁.本组病例术前均未能确诊.最常见的症状是腹痛和腹胀,消化道出血,12例均行外科手术切除,病理证实良性6例,恶性5例,交界2例,肿瘤的大小与良恶性相关.术后随访:良性GIST 6例,平均随访时14.3个月,4例无局部复发、转移,3例术后1年内复发再手术;恶性GIST 5例,平均随访16.2个月,2例局部复发再手术,2例肝肺转移,1例死亡.2例恶性GIST术后辅以不规则化疗,但生存期未见明显变化.结论:①GIST消化道症状无特异性,术前确诊率低;②肿瘤的大小是判断良恶性GIST的重要指标;③目前间质瘤治疗仍以手术切除为主,对复发或远处转移者应积极再次手术,可延长生存期.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.