心、脑电图持续监护下非优势侧有抽搐与无抽搐抗精神病电疗治疗精神分裂症的对照研究

本文采用EEG,ECG持续监护,进行非优势侧有抽搐(30例)和无抽搐(30例)抗精神电疗治疗精神分裂症。通过对临床疗效,副反应,记忆损害及EEG,ECG影响的对照研究,发现两组间治效疗果无显著差异,而有抽搐EAT的副反应及对EEG、ECG的影响较明显。     

利培酮与氯丙嗪对代谢影响随访研究

目的：研究氯丙嗪与利培酮对精神分裂症患者血糖、血脂和体质量的影响。方法：198例精神分裂症患者随机分为氯丙嗪组与利培酮组,随访1年,采集患者空腹血糖、总胆固醇、和体质量的数据。结果：氯丙嗪组和利培酮组总胆固醇、三酰甘油、空腹血糖、糖化血红蛋白、体质量、体质量指数在治疗后均显著升高;以氯丙嗪组更显著为高。结论：氯丙嗪与利培酮对血糖、血脂和体质量的影响不同,但都可使之升高。     

表现为反复头痛、眩晕伴耳鸣的双侧海绵窦区硬脑膜动静脉瘘1例报道并文献复习

目的 探讨海绵窦区硬脑膜动静脉瘘(CSDAVFs)的病因、诊断及相关治疗。方法 分析1例累及双侧海绵窦区硬脑膜动静脉瘘患者的临床表现、相关检查及治疗,并复习相关文献。结果 患者临床表现为眩晕、头痛、视物重影及动脉搏动相关的耳鸣,经全脑血管造影术确诊为双侧海绵窦区硬脑膜动静脉瘘。结论 CSDAVFs 早期临床表现多样化,缺乏特异性,病情复杂,易误诊漏诊。全脑血管造影是目前诊断可靠的检查方法,血管内治疗是目前主要的治疗手段。     

强迫障碍的核磁共振研究

虽然药物治疗提示强迫障碍有5-羟色胺功能障碍,但对此障碍的病理生理学和神经解剖学仍不清楚。由于对难治性强迫障碍切断额叶或环绕纤维有效,这些区域可能是强迫障碍的重要解剖学基础。在观察许多神经     

中枢神经系统血管母细胞瘤的诊断和手术治疗

目的探讨中枢神经系统血管母细胞瘤的诊断和手术治疗。方法回顾性分析本院2001～2003年收治的22例中枢神经系统血管母细胞瘤患者,均经手术和病理证实。结果肿瘤发病年龄常见为21～46岁。发生于小脑者男7例,女5例。发生于脊髓者男2例,女8例。均行CT及MRI检查。脊髓血管母细胞瘤均行DSA检查和栓塞。所有病例均手术全切,无死亡病例。结论中枢神经血管母细胞瘤在MRI上有特征性表现,易于诊断和鉴别诊断。术前行DSA血管造影及栓塞,并联合外科手术是治疗脊髓血管母细胞瘤的最佳方案。     

尼莫地平对大鼠面神经损伤的保护作用及GDNF表达的影响

目的 探讨尼莫地平对大鼠面神经损伤的保护作用及对胶质细胞源性神经生长因子(GDNF)表达的影响.方法 96只大鼠按随机数字表法分为假手术组、单纯损伤组、尼莫地平预处理组、尼莫地平后处理组,后三组建立大鼠面神经电损伤模型.应用HE染色、Western blotting等方法,观察大鼠面神经损伤后不同时期(1、3、6月)GDNF的动态表达变化及尼莫地平不同给药时间对其表达的影响.结果 与单纯损伤组相比,尼莫地平预处理组大鼠面神经损伤程度减轻,GDNF表达升高,持续时间延长;尼莫地平预处理组GDNF表达和尼莫地平后处理组间比较差异有统计学意义(P＜0.05);尼莫地平后处理组GDNF表达在3月、6月时与单纯损伤组比较差异无统计学意义(P＞0.05).结论 预防性应用尼莫地平可以保护面神经,其机制可能是通过调节GDNF的表达而实现的.

Abstract：

Objective To study the protective function of nimodipine on facial nerve injury and its effect on the expression of glial cell line-derived neurotrophic factor (GDNF). Methods Ninety-six SD rats were randomly divided into sham-operated group, facial nerve injury group, nimodipine pretreatment group, and nimodipine post-treatment group. Rat models of facial nerve injury in thc later 3groups were established. The dynamic changes of expression of GDNF were observed by HE staining and Western blotting in different treatment groups and at different time points (1, 3 and 6 months after the injury). Restdts Compared with the facial nerve injury group, the nimodipine pretreatment and post-treatment groups had significantly less severe nerve damage and significantly up-rcgulated expression of GDNF (P＜0.05). The expression of GDNF in the nimodipine pretreatment group was statistically higher than that in the nimodipine post-treatment group (P＜0.05). However, the expression of GDNF in the nimodipine post-treatment group was not statistically different from that in the facial nerve injury group 3 and 6 months after the injury (P＞0.05). Conclusion Nimodipine has significant facial nerve protective effect, and one of the mechanisms of nimodipine to protect the facial nerve is to regulate the GDNF expression.     

脑恶性胶质瘤的局部治疗现状

脑恶性胶质瘤是最常见的颅内原发性肿瘤，大多呈浸润性生长，单靠手术难以治愈，术后复发率高，而传统的放疗、化疗副作用较大，所以，国内外许多学者十分重视除手术以外的其他局部治疗措施包括局部放疗、化疗、生物治疗和免疫治疗等，现总结国外文献对胶质瘤的局部治疗作综述。     

以素质教育为重点的实验教学体系改革

医学教育改革的关键是医学生素质和能力的培养,而实验教学是培养学生创新精神、探索意识、实践经验能力、科学思维的重要手段,为达到这一目的,我们在借鉴兄弟院校实验教学改革经验的基础上,于2000年将生理学、病理生理学及药理学三个实验内容相关的实验室合并成"机能实验中心",其目的是使学生掌握系统的实验学知识和方法,提高学生的实验基本素质,提高学生解决实验问题的能力.教学系统进行了全面更新,部分实验通过设计综合性实验并采用计算机模拟实验替代了传统的医学基础实验教学,收到了很好的效果,现浅谈一下应用的体会.     

盆腔侧方淋巴结转移对低位直肠癌预后的影响

Objective To evaluate the prognostic value of lateral pelvic lymph node metastasis on low rectal cancer. Methods One hundred and seventy-six patients with low rectal cancer who underwent radical resection combined with lateral pelvic lymph node dissection between 1994 and 2005 were reviewed. The data of the cases was investigated to define the prognostic value of lateral pelvic lymph node metastasis on the patients. Results Lateral node metastasis occurred in 33 patients (18.8%), and 51.5% of the metastasis occurred in internal iliac nodes or nodes at middle rectal roots and 39.4% in obturator nodes. Age ≤40 years, infiltrative cancer, T3-4 tumor, upward lymph node metastasis were risk factors for lateral node metastasis in low rectal cancer (P ＜ 0.05). The overall 5-year survival rate was 64.1%, and it was 94.1%, 79.1%, 42.1% for patients with TNM stage Ⅰ , Ⅱ , Ⅲ cancer, respectively. Tumor size, depth of infiltration, upward lymph node metastasis, lateral node metastasis was correlated significantly with prognosis (P ＜ 0.05). The 5-year survival rate of the patients without lateral metastasis was 73.6%, which was significant higher than that of patients with lateral metastasis (21.4%, P ＜0.05). Conclusion Lateralpelvic lymph node metastasis is an important prognostic factor for low rectal cancer.     

肝移植术后谷氨酰胺的应用

目的 探讨传统全胃肠外营养（TPN）及添加丙氨酰谷氨酰胺（Gln，商品名力太）的TPN对肝移植后移植肝蛋白合成功能、机体免疫功能及对感染、排斥反应发生率的影响。方法 将50例肝移植患者随机分两组：不添加Gln的TPN组（传统组）和添加Gln的TPN组（Gln组）。术后第2天予等热量[104．6kJ／kg（体重）]、等氮量[0．16g／kg（体重）]共7d。监测术后第2和9天IgG，IgA，IgM，CD3，CD4／CD8及前清蛋白（PAB）。结果 术后第9天与术后第2天比较Gln组IgG和IgA较之传统组明显升高，组间比较P〈0．01；Gln组应用前后比较P〈0．01：Gln组CD3，CD4／CD8平均值较之传统组明显升高，组间比较P〈0．01；Gln组应用前后比较P〈0．05；Gln组感染率（20．0％）较之传统组（40．0％）明显降低（P〈0．05）；术后PBA增高幅度Gln组明娃高于传统组（P〈0．01）；两组比较IgM变化及急性排斥反应差异无显著性。结论 肝移植后静脉营养中添加Gln可增强免疫功能，尤以体液免疫增强为著，但并不增加急性排斥反应；使用Gln同时增加移植肝蛋白合成功能及降低感染发生率。