目的 探讨显微血管减压术治疗面肌痉挛的疗效及预后.方法 回顾采用显微血管减压术治疗的286例面肌痉挛患者,分析其临床表现、手术效果和并发症之间的关系,并于术后半年进行电话随访和来院复查,分析其长期的疗效.结果 286例患者起病时均表现为单侧面部肌肉阵发性、不自主、无痛性抽搐,随病程延长呈逐渐加重的趋势.本组术中均能见到有动脉或静脉血管异常而压迫面神经根出脑干处.术后随访6月至1年,230例症状完全缓解,52例明显减轻,4例手术无效.结论 显微血管减压术是治疗面肌痉挛的一种安全而有效的手术方法.

目的 探讨经翼点入路显微手术切除巨大型垂体腺瘤的技术方法.方法 回顾性分析收治的巨大型垂体腺瘤患者52例,肿瘤直径均＞3 cm,向鞍上及鞍周发展.对患者均采用显微镜下经翼点硬膜内开颅切除肿瘤,随访观察其疗效.结果 肿瘤全切除45例,次全切除7例.术后并发鞍区积气10例,多饮、多尿8例,脑膜炎2例,瘤床少量出血1例,上述并发症均经治疗后痊愈.本组患者视力术后均有不同程度恢复,20例垂体激素增高者术后有16例降至正常范围,无死亡病例.术后均随访6个月至3年,肿瘤残余与复发患者8例,均给予伽马刀治疗;术后6个月的垂体泌乳素水平仍高于正常者4例,予溴隐亭治疗后恢复正常.结论 对巨大型突入鞍上和鞍旁的垂体腺瘤,可采用经翼点入路显微手术方式切除,其疗效满意;术后应定期随访观察.

<正>干细胞是一类具有自我复制和多向分化潜能的原始细胞,在特定条件下,它可以分化成不同类型、具有特征形态、特异分子标志和特殊功能的成熟细胞。干细胞按来源可分为胚胎干细胞和成体干细胞,胚胎干细胞来源于胚胎和胎儿组织,成体干细胞则来源于

Objective To analyze and conclude the motor function of cerebral palsy children patients undergoing umbilical cord mesenchymal stem cells transplantation.Methods 97 cerebral palsy children patients undergoing umbilical cord mesenchymal stem cells transplantation.Neurotrophic factors and physical therapy were necessary.Investigate the healing process in 6～12 month,average 9.5month.Gross Motor Function Measure-88(GMFM-88) was applied for motor function assessment;SPSS v18.0 statistical software was used for analyzing the results.Results After one stem cell treatment course,the motor functions of children patients improved at different levels comparing before transplantation;and the healing process were keeping improved after treatment 6 month and more.Conclusion Stem cell transplantation is safe and effective,which can improve cerebral palsy children patients’ motor function significantly;the best effective curative effect after graft 6 month but therapeutic mechanism needs to investigate and research in depth in the future.

Objective To analyze and summarize the effect of umbilical cord mesenchymal stem cells(UCMSCs) transplantation on the motor functions of children with cerebral palsy.Methods After regular body check,40 children patients were selected randomly for UCMSCs transplantation.UCMSCs transplantation was performed every other week with four times as one treatment course,which includes venoclysis transplantation for once and subarachnoid space transplantation for three times by lumbar puncture.Neurotrophic factors and physical therapy were also applied to the patients.All the patients were followed-up for 6~12 months(average 8.5 months).Gross Motor Function Measure-88 and Ashworth scale were applied for motor function assessment;SPSS statistical software was used for the analysis of results.Results After one treatment course,the motor functions were improved at different degrees and they were continuously improved 6 months after discharge.Conclusion UCMSCs transplantation can improve the motor functions of cerebral palsy children patients significantly,but the mechanism needs the further research.

原发性三叉神经痛乳突后切口微血管减压术后,并发约氏不动杆菌化脓性脑膜炎,在临床上较少见,我科自2002年3月-2009年2月共收治了原发性三叉神经痛193例,手术187例,其中3例术后并发约氏不动杆菌化脓性脑膜炎.

本研究旨在探讨腰穿及静脉脐血干细胞移植对脑脊液常规及生化检验结果的影响. 1资料与方法 选择确诊为脑性瘫痪患儿40例,男23例,女17例;年龄为2～12岁,平均7.6岁.

Objective: To test the effects of Luschka ankle on later spinal stability under the physiological conditions. Methods: This experiment had used thirty-two functional spinal units(FSU) which come from sixteen two specimens died of trauma. Abstract randomly, thirty-two specimens were divided into two groups.The groupⅠ was removed bilateral Luschka ankles, the groupⅡ was retained Luschka ankles. The two groups were tested by biomechanics. According to White of later spine clinical instability diagnosis standard score, the effects of Luschka ankle on later spinal stability had been studied.Results:Luschka ankle could limit spine move to lateral distance. It could also limit the last spine move to two sides and rotary when later spine contracted and extended under the physiological conditions. Conclusion:Luschka ankle has significant effect on later spinal stability. Luschka ankle is an important structure involved in later spinal stability.

为观察养血清脑颗粒治疗外伤后不同程度头痛的疗效,222例患者随机分为治疗组(112例,养血清脑颗粒治疗)和对照组(110例,安慰剂治疗),观察治疗14天和28天后的疗效.结果:治疗14天后,治疗组的疗效优于对照组(P＜0.01),不同头痛程度疗效上差异显著(P＜0.01),轻度头痛疗效好于中度和重度;治疗28天后,治疗组疗效优于对照组(P＜0.01),但不同头痛程度上的疗效差异无显著性(P＞0.05).治疗组总有效率为90.2%,对照组为73.6%(P＜0.01).

1病历摘要 例1,患者,女,45岁,于10月前因"右基底节脑出血破人脑室,脑室血肿铸型"在我科行右额颞顶开颅血肿清除弃骨瓣减压术,术后8个月因"脑积水"在我科应用Heyer-Schulee中压分流管行V-P分流术,术后10天,右侧骨窗塌陷好,手术切口甲级愈合出院.V-P分流术1个月因上腹部手术切口皮下包块5天再次入院.

掌握颅内病变的定位技术,是神经外科医师手术的基础,也是影响神经外科手术成败的关键因素之一.无论是骨瓣开颅手术,还是立体定向、神经内窥镜、"锁孔" (key hole)技术等,都需依靠颅内结构或病变的精确定位的个性化选择手术方法,以利引导手术入路[1].在传统的神经外科手术中,医师是根据颅内病变的影像学资料,凭借解剖学基础和经验来确定病变的位置及与周围结构的关系,为了避免定位的偏差,常常需要做一个较大的头皮切口和骨窗,并减慢手术操作速度以利寻找病变、避开重要的神经、血管结构,这种操作远远不能达到当代微侵袭神经外科的标准.因此,寻找一种既精确、可靠,又简单、快捷的定位方法,已成为神经外科领域需要探索的课题.随着影像学技术的发展,以及电子计算机、立体定向技术以及神经导航系统的应用,在很大程度上有利于神经外科疾病定位诊断技术水平的迅速提高,成为最重要的诊断与治疗手段,是当代神经外科医师应具备的基本技能之一.

1 病历摘要 患者,男,55岁,因食欲下降、四肢无力、头痛、恶心、呕吐9天入院.入院查体:体温36.5℃,神志清,视乳头水肿,颈软,四肢肌张力正常,肌力4级,肱二、三头肌腱反射、膝腱反射、跟腱反射均活跃.全身淋巴结肿大,腹平软,肝脾未触及.

目的获得具有抗血管生成活性的 angiostatin K(1-3)[AK(1-3)]基因的原核表达蛋白,应用该蛋白治疗裸鼠皮下人脑胶质瘤.方法构建和鉴定 pDH-AK(1-3)载体并在大肠杆菌DH5α内表达,诱导后用 SDS-PAGE分析、经亲和层析纯化后行Western Blot鉴定,以人脐带静脉血管内皮细胞抑制实验和鸡胚绒毛膜尿囊膜实验验证其生物学活性,应用AK (1-3) 蛋白治疗裸鼠皮下人脑胶质瘤.结果获得抑制人脐带静脉血管内皮细胞生长活性的AK(1-3) 原核表达蛋白(Mr为35×103),其蛋白总量占菌体总蛋白的12 %,该纯化表达蛋白5 mg·kg-1·次-1和10 mg·kg-1·次-1组均可抑制裸鼠皮下人脑胶质瘤生长,抑瘤率分别为34.5%和64.6%.结论该实验为应用抗血管生成药物治疗人脑胶质瘤等实体瘤研究奠定了初步基础.