脑卒中临床治疗康复ADL的应用

介绍了日常生活活动在脑卒中临床治疗和康复中中的应秀，提出了评价ＡＤＬ的注意事项的对ＡＤＬ恢复的影响因素的认识。     

脑出血患者的护理体会

目的：探讨有效护理措施在脑出血预后中的作用．方法：总结37例脑出血患者的护理经验．结果：37例患者，根据脑出血日常生理神经预后标准评分（ADL），Ⅰ级4例，Ⅱ级15例，Ⅲ级14例，Ⅳ级2例，Ⅴ级1例，死亡1例．结论：脑出血治疗过程中的有效护理，能够明显减少并发症的发生，促进患者的康复，从而减少了死亡率和致残率．     

心血管病监测脑卒中发病趋势回顾性研究

目的 对吉林省心脑血管病人群监测区10a脑卒中发病率的动态趋势进行回顾性研究。方法 按WHO－MONICA方案和北京市心肌血管研究中心编印的《心血管病人群监测手册》的具体要求进行。结果 10a监测人群总数622万人,平均年监测62．2万人。10a间共发生脑卒中9037例,标化发病率为0．141％。男性脑卒中标化发病率0．187％,女性脑卒中标化发病率0．101％,脑卒中发病率随年龄增长而升高,且发病年龄呈年轻化趋势,与9a前相比,脑卒中发病率提前10a。脑卒中城市标化发病率0．194％,农村标化发病率0．094％,城市发病率明显高于农村（P＜0．01）。结论 结论 提示我们要尽早地采取一、二级预防措施,降低脑卒中的发病率、致残率和病死率。     

通心络对脑梗死患者颈动脉粥样硬化软斑块影响的临床研究

目的探讨通心络治疗脑梗死伴颈动脉粥样硬化软斑块其能否有效干预颈动脉粥样硬化斑块中软斑块的发生发展及其能否降低脑梗死复发。方法符合人选标准的100例患者随机分成通心络治疗组和对照组,每组50例。对照组为常规治疗组,通心络治疗组在常规治疗组的基础上加用通心络胶囊3粒（0．7Sg）3次／d,疗程均为6月。两组每3月后复查色多普勒颈动脉和椎动脉超声,记录斑块性质、大小和数目,并检查血糖和血脂,同时记录不良事件。结果通心络治疗组和对照组在性别、年龄方面及斑块数目体积等各危险因素等方面比较,差异无显著性（P〉0．05）。治疗组和对照组经治疗后在软斑块消退、软斑转为硬斑、软斑体积数目减少、无变化和恶化等方面比较,差异有显著性（P〈0．01）。两组治疗6个月后至1年脑血管病事件发生和再住院情况比较,治疗组较对照组低,差异有显著性（P〈0．01）。结论通心络能有效地干预颈动脉粥样硬化斑块中软斑块的发生发展和降低脑血管疾病事件复发。     

猴子大脑皮层组织的拉曼光谱研究

猴子的大脑皮层主要由灰质和神经元组成,是大脑中调控行动和思维的区域。选取在生命成长过程中具有代表性的3个年龄段(幼年、成年、老年)猴子的大脑皮层组织,首次测得其拉曼光谱。实验结果显示,3个不同年龄段的猴子大脑皮层的拉曼光谱最明显的差异表现在1 000～1 400 cm~(-1)和2 800～3 000cm~(-1)范围内。随着年龄的增长,归属于脂类的拉曼峰1 313和2 885 cm~(-1)的强度越来越强,而归属于蛋白的拉曼峰1 338和2 932 cm~(-1)的强度却逐渐减弱,并且在老年猴子大脑皮层的拉曼谱中出现了2个归属于脂类的拉曼峰1 296和2 850 cm,I_(1313)/I_(1338)和I_(2885)/I_(2932)的变化趋势很好地描述了这种差异。研究表明,随着年龄的不断增长,猴子大脑皮层中脂类的含量逐渐增加,这样可以很好地说明大脑皮层中脂类的聚积是导致衰老的一个重要原因,为进一步研究人类和动物的生命活动规律、疾病的形成机理提供了很有价值的参考。     

颈动脉药物滴注治疗急性脑梗塞疗效对比

对急性脑梗塞(acute cerebral infarction,ACI)60例,随机分为颈动脉加压滴注瘫康灵组和常规治疗对照组,治疗后效果有显著差异(P<0.01)。颈动脉药物滴注组效果明显。     

高血压脑出血急性期手术治疗

目的探讨高血压脑出血急性期手术治疗的疗效。方法回顾分析高血压脑出血急性期手术治疗82例临床资料。结果恢复良好41例,有功能障碍但生活能自理30例,需他人照顾4例,死亡7例。结论高血压脑出血急性期手术治疗能降低死亡率,减少致残率。     

Tissue similarity maps (TSMs): A new means of mapping vascular behavior and calculating relative blood volume in perfusion weighted imaging

This study introduces a new processing means that uses the original signal (rather than contrast agent concentration) from dynamic susceptibility contrast (DSC) perfusion weighted imaging (PWI) to calculate a relative cerebral blood volume map and a tissue similarity map (TSM). Ten healthy volunteers and eight multiple sclerosis (MS) patients were studied using high resolution PWI. The TSM is found by choosing a reference region in one slice and comparing its signal in a mean squared error sense to the signal from every pixel in all images throughout the brain. The TSMs provide a means to determine which tissues have similar flow characteristics with high contrast and signal-to-noise ratios. The effective blood volume measured from this approach is nearly identical to that from conventional relative cerebral blood volume (rCBV) maps but with better signal-to-noise. Of interest is the fact that choosing one MS lesion as the reference tissue appears to be enough to find nearly all lesions throughout the brain. That is, these lesions all behave the same from a vascular point of view. The TSM results are robust within and across slices properly nulling the same type of tissue throughout the brain for a given reference region. TSM derived rCBV agrees well with the conventional derived rCBV using contrast agent concentration. TSM may provide a new means to study similarities between blood flow patterns in tissue in the brain and in better diagnosing vascular differences between tissues and lesions.     

Evaluation of MRI issues for a new neurological implant,the Sensor Reservoir

Background and Purpose

A new neurological implant, the Sensor-Reservoir, was developed to provide a relative measurement of ICP, which permits a noninvasive technique to detect and localize occlusions in ventricular drainage systems and, thus, to identify mechanical damage to shunt valves. The “reservoir” of this device can be used to administer medication or a contrast agent, to extract cerebral spinal fluid (CSF), and with the possibility of directly measuring ICP. The Sensor-Reservoir was evaluated to identify possible MRI-related issues at 1.5-T/64-MHz and 3-T/128-MHz.

Materials and Methods

Standard testing techniques were utilized to evaluate magnetic field interactions (i.e., translational attraction and torque), MRI-related heating, and artifacts at 3-T for the Sensor-Reservoir. In addition, 12 samples of the Sensor-Reservoir underwent testing to determine if the function of these devices was affected by exposures to various MRI conditions at 1.5-T/64-MHz and 3-T/128-MHz.

Results

Magnetic field interactions for the Sensor-Reservoir were not substantial. The heating results indicated a highest temperature rise of 1.8 °C, which poses no patient risks. Artifacts were relatively small in relation to the size and shape of the Sensor-Reservoir, but may interfere diagnostically if the area of interest is near the device. All devices were unaffected by exposures to MRI conditions at 1.5-T/64-MHz and 3-T/128-MHz.

Conclusion

When specific guidelines are followed, the Sensor-Reservoir is “MR conditional” for patients undergoing MRI examinations at 3-T or less.     

首发脑梗死患者认知功能与1H- MRS的相关性研究

目的探讨首发脑梗死患者认知功能与左前额叶白质氢质子磁共振波谱（1H- MRS）、日常生活能力量表（ADL）的关系。方法对38例首发脑梗死患者在发病1周内、3个月末、6个月末检测左前额叶白质1H- MRS中的氮-乙酰门冬氨酸（NAA）、胆碱（Cho）、肌酐（Cr）,同时进行中文版蒙特利尔认知评估量表（MoCA）、ADL评分。按MoCA结果分为脑梗死后血管性认知功能损害（VCI）组、正常组、变化组,分析3组间各时间点1H- MRS（Cho、Cho/Cr、NAA、NAA/Cr）、ADL的差异。结果3个月末VCI组与变化组各1H- MRS差异均有统计学意义（均P＜0.05）,VCI组与正常组各1H- MRS差异均有统计学意义（P＜0.01或0.05）;6个月末VCI组与正常组、变化组各1H- MRS差异均有统计学意义（P＜0.01或0.05）。1周内、3个月末VCI组与正常组的ADL评分差异均有统计学意义（P＜0.01或0.05）;3个月末VCI组与变化组的ADL评分差异有统计学意义（P＜0.05）;6个月末VCI组与变化组、正常组ADL评分差异均有统计学意义（均P＜0.01）。结论首发脑梗死后VCI患者左前额叶白质1H- MRS出现变化,3个月末的1H- MRS对VCI的转变有预测价值。