人硫氧还蛋白对脑缺血作用的CT灌注与SOD相关性的实验研究

目的研究人硫氧还蛋白(hTRX)对局灶性兔脑缺血/再灌注损伤后脑组织的保护作用,并探讨其清除氧自由基的生物学活性.方法采用线栓法制成一侧兔脑缺血/再灌注模型(栓塞6 h,再灌注18 h),将25只雄性新西兰白兔随机分成假手术组(Sham组,5只)、缺血/再灌注组(I/R组,10只)和缺血/再灌注 hTRX治疗组(I/R hTRX组,10只),I/R hTRX组给予hTRX(0.75 mg/kg体质量),Sham组、I/R组以等容积的生理盐水取代hTRX;分别于梗死后6 h及再灌注后18 h做CT灌注图像,观察脑梗死面积,计算出其所占同侧大脑半球面积的百分比(HLA%);检测脑组织匀浆中SOD,MDA含量.结果脑缺血/再灌注后,脑梗死范围显著,脑组织匀浆中SOD明显下降,MDA明显升高(与假手术组比较,P<0.01);而应用hTRX能显著减小脑梗死面积,降低MDA及升高SOD含量(与B组比较,P<0.01).结论重组hTRX对脑缺血/再灌注损伤有显著的治疗作用.     

A metabonomic approach applied to predict patients with cerebral infarction

Cerebral infarction is always of sudden onset, and usually leading to serious consequence. It is of therapeutic significance to develop fast and accurate diagnosis methods for cerebral infarction so that patients can be treated timely and properly. A metabonomic approach was then proposed to investigate the potential biomarkers and metabolic pathways associated with cerebral infarction and also establish a prediction model of cerebral infarction for the fast diagnosis. Serum metabolic profiling of sixty-seven cerebral infarction patients and sixty-two controls was obtained using UPLC-TOF MS. The resulting data were then processed by multivariate statistical analysis to graphically demonstrate metabolic variations. The PLS-DA model was validated with cross validation and permutation tests to assure the model's reliability, and significant difference was obtained between the original and hypothetical models (p < 0.0001). A series of endogenous metabolites in the one-carbon cycle, such as folic acid, cysteine, S-adenosyl homocysteine and oxidized glutathione, were determined as potential biomarkers of cerebral infarction. A prediction model developed using PLS-KNN algorithm was established to differentiate cerebral infarction patients from controls, and an average accuracy of 100% was obtained. In conclusion, metabonomic approach is a powerful tool to investigate the pathogenesis of stroke and is expected to be developed as a useful method for the fast diagnosis.     

速碧林联合纳络酮治疗急性脑梗死疗效观察

目的观察速碧林联合纳络酮治疗急性脑梗死的临床效果。方法采用速碧林0.4ml皮下注射每天1次,纳络酮1.2m g 0.9%NS250ml静点,1次d/。结果联合用药疗效优于单一用药组(P<0.01)。结论速碧林联合纳络酮治疗急性脑梗死治愈率高,显效及肌力开始恢复的时间明显提前。     

磁共振灌注及弥散成像在早期脑梗塞诊断的价值

磁共振弥散加权成像和血流灌注成像不仅可以超早期诊断脑梗塞，明确缺血部位，范围，估计缺血半暗带的大小和鉴别短暂性脑缺血发作；特殊磁共振序列还可以确诊早期颅出血，有助于溶栓对象的筛选和预后的判断。为溶栓治疗提供直观的影像学依据。     

奥扎格林钠治疗早期脑梗死的疗效观察

目的：观察丹奥对早期脑梗死患者的治疗效果。方法：在临床选取早期脑梗死患者,随机分为两组各80例。治疗组在常规治疗的基础上,给丹奥对照组只用常规治疗。采用全国第四届脑血管病学术会议通过的“脑卒中患者临床神经功能缺损程度评分标准”进行疗效评定。结果：丹奥治疗早期脑梗死,两周后评定临床神经功能缺损程度。结果优于对照组。结论：丹奥治疗早期脑梗死,疗效明显,未发现不良反应,可作为治疗早期脑梗死的主要药物之一。     

磁共振快速场梯度回波技术在急性期脑出血中的应用价值探讨

目的：探讨磁共振快速场梯度场回波技术（FFE）在急性期脑出血中的应用价值．方法：对30例临床怀疑急性期脑出血的患者在行CT及常规MR头颅平扫序列后均加做FFE序列检查,比较其诊断价值．结果：30例临床怀疑急性期脑出血的病例中,21例在CT上清晰显示的24个血肿在FFE序列均能清晰显示,而另外3例脑干小血肿显示较CT清晰,有6例在FFE发现的多个直径2-5mm的圆形或斑点状的低信号在CT及常规T2WI上均未显示．结论：FFE序列在急性期脑出血中以及微量出血中有明确的应用价值．     

Morphometry in temporal lobe epilepsy

We demonstrate a method for quantitating changes in volume and morphology of the temporal lobe in epilepsy. The temporal lobes of 10 neurologically normal subjects and six subjects with well defined left-sided mesial temporal epilepsy were studied. From high resolution T₁-weighted magnetic resonance images, the grey and white matter were manually segmented over a predetermined extent. The volumes of the grey and white matter were determined. Using the segmented images, the grey matter/CSF surface and the white matter/grey matter surface were reconstructed, allowing estimates of the surface area and calculation of indices of curvature for the two surfaces. The index of curvature was calculated for each vertex of a polygonal mesh that was fitted to the surfaces. An index of grey matter thickness (grey matter volume/white matter surface area) was also calculated. There was a significant bilateral decrease in the total volume (p < .01), grey matter volume (p < .001) and grey matter thickness index (p < .05) in epileptic subjects. In addition, there was a bilateral decrease in white matter surface area (p < .05) and a small left-sided decrease in white matter volume (p < .05) in epileptic subjects. The average distributions of indices of curvature for both surfaces differed significantly (p < .05) between normal and epileptic subjects. In the grey matter/CSF surface of normal subjects, a large peak corresponding to surface concavity was present. The amplitude of this peak was significantly lower in epileptic subjects (p < .05 for the right hemisphere; p < .001 for the left hemisphere).     

烟雾病6例临床分析及文献复习

目的探讨成人出血型烟雾病的病因、发病机制及诊断治疗方法。方法回顾性分析6例成人出血型烟雾病患者的临床资料。结果成人出血型烟雾病以突发头痛、呕吐、意识障碍及偏瘫为主要临床表现。脑血管造影显示双侧病变4例,单侧2例,6例病变区均可见异常增生小血管。经治疗,4例临床治愈。结论成人出血型烟雾病临床表现多种多样。脑血管造影是诊断成人出血型烟雾病的主要方法。     

微创穿刺治疗高血压脑出血32例临床分析

高血压脑出血是高血压病最严重的并发症，死亡率较高，内科保守治疗死亡率在50％左右，传统外科开颅手术治疗死亡率在40％～60％之间，使用一次性颅内血肿碎吸穿刺针治疗高血压脑出血32例，死亡率为21．9％，达到了理想的治疗效果。     

外伤性脑梗塞58例临床分析

目的：探讨外伤性脑梗塞的诊断及预后，方法：对58例年龄在50岁以下外伤引起脑梗塞患者，经过早期扩血管改善微循环及神经营养药物等综合治疗．结果：腔隙性或局灶性梗塞效果较好，大面积梗塞及脑干梗塞伴合并伤患者病死率与病残率均较低．结论：梗塞部位、面积及早期诊断治疗有助于判断临床预后．