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.     

颈内动脉起始部血管成形术治疗缺血性脑血管病的疗效观察

目的 探讨颈内动脉起始部血管成形术治疗缺血性脑血管病的临床效果。方法 对15例缺血性脑血管病术前行全脑血管造影与超声检查，狭窄部位支架置入、球囊扩张，比较术前、术后狭窄程度的改善，术后随访1～34个月。结果 术后狭窄程度明显改善，围手术期无并发症。随访期内无缺血性脑血管病事件发生．但有脑出血的发生。结论 支架置入血管成形术是值得选择的缺血性脑血管病病因治疗方法之一；多个部位支架置入是安全的；支架的选择、手术的技巧以及严格的适应证掌握是影响手术的重要因素，特别要警惕预防高灌注综合征的发生，注意患者的心理评价与治疗。     

老年冠心病患者血清脂质和MDA,SOD含量变化的临床研究

本文检测了４４例老年冠心病（ＣＨＤ）患者血清脂质丙二醛（ＭＤＡ）和超氧化物岐化酶（ＳＯＤ）的含量，并与健康老年人对照比较，同时对心绞痛作期与缓解病人比较分析，结果显示，除胆固醇外其余各种指标两组间均有显著差异（Ｐ〈０．０５）。多元回归分析表明，血清低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）与ＭＤＡ呈显著正相关（Ｐ〈０．００１），血清高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）与ＳＯＤ亦呈显著正相关（Ｐ〈０．００１）。提     

脸色腰段椎间盘突出症21例临床分析

胸腰段椎间盘突出症罕见,约占椎间盘突出的0.6％～4％。随着CT及MRI的应用,其发病率有增加的趋势。因其发病率低,报道较少。但由于病变位于脊髓圆椎段,其发病较下腰段椎间盘突出有很大的特殊性,故有必要结合我院近年收治的21例对其作一回顾性分析。1 临床资料     

巡回性诊疗护理与老年人保健

饭富病院地处日本本州山黎县,远离大都市,地偏人稀,但环境优美,气候宜人,的确是疗养的好地方。饭富病院属公立医院,虽规模较小,但是一所综合性医院。我们在此院研修3个月,时间虽短,但期间的所见所闻,尤其护理方面给我们的启发和教益却是十分深刻的。现介绍几个片断,以飨读者。1     

常见食源性感染致病菌属、种用PCR-RFLP及PCR-SSCP技术鉴定探讨

[目的]探讨运用聚合酶链反应．限制性片段长度多态性分析(IZCR-RFLP)和聚合酶链反应一单链构象多态性分析(PCR-SSCP)进行食源性感染常见致病菌属种鉴定的可行性。[方法]选择细菌23S rDNA基因作为鉴别细菌属的靶基因，通过设计合适的通用引物进行PCR扩增，并对13属食源性感染常见致病菌和5种不同血清型大肠杆菌扩增产物的酶切片段进行RFLP分析和SSCF，分析。[结果]运用通用引物可以扩增出13属食源性感染常见致病菌的23S rDNA基因Hpa Ⅱ酶切产物的RFLP分析表明，不同种属的致病菌表现出不同的RFLP图谱，利于进行细菌属的鉴定。不同种属食源性感染常见致病菌SSCF，图谱变异性更大，不利于进行种属间鉴别。对5种不同血清型大肠杆菌的23S rDNA基因扩增产物的RFLP和SSCP分析表明，不同血清型大肠杆菌表现出相似的RFLP图谱，SSCP图谱的变异性较大，这有利于进行血清型间鉴别甚至株间的鉴别。[结论]PCR-RFLP和PCR-SSCP具有应用于食源性感染常见致病菌种、属鉴别诊断的潜力。     

贫血患者血清红细胞生成素浓度的测定及临床意义

用小鼠胎肝细胞体外血浆凝块培养红系集落(Erythroid colong formig unit inculturc,E-CFUc)方法,以红细胞生成素(Erythropoietin,EPO)850323为标准试剂,测定正常人、贫血病人血清EPO浓度。实验用妊娠13～15d小鼠胎肝细胞。血清均经透析处理,培养液中加量最大不超过10％。EPO(850323)在培养液中浓度为2.5～100mU/ml。血清EPO(mU/ml)测定结果:28例正常人为48.O±17.7,12例再生障碍性贫血病人为946～>10000,1例巨幼细胞性贫血病人为500,1例缺铁性贫血病人为400和18例慢性肾功能衰竭病人则为94.2±87.6。结果表明:贫血病因对血清EPO浓度有影响。     

异位心(胸腹型)1例报告

异位心是罕见的先天性畸形,以胸部型心异位最为常见。我们遇到1例胸腹型异位心,为明确心内畸形作了全面检查,现报告如下.患者,女,19岁,自幼发现心脏杂音,平时易受凉发烧,活动后气喘,一岁后逐渐出现紫绀,无蹲踞及晕厥史.发育营养较差,口唇、面部紫绀,杵状指趾。BP110/70mmHg,P88次/分。胸部对称,     

常染色体显性遗传视网膜色素变性致病基因Peripherin/RDS的突变筛选

目的：了解中国视网膜色素变性患者（rtinitis pigmentosa,RP)中peripherin/RDS基因的突变谱及突变率。方法：应用聚合酶链-异源双链-单链构象多态性（polymerase chain reaction heteroduplex-single strand conformation polymorphism,PCR-SSCP)及DNA序列分析技术对收集的15个常染色体显性遗传视网膜色素变性家系和55例散发视网膜色素变性病人peripherin/RDS基因的第一、二外显子进行检测。结果：15个家系及55例散发病人未检测到peripherin/RDS基因突变。结论：本研究所检测的视网膜色素变性病人与RDS基因无关。显示视网膜色素变性的遗传异质性。