近年来,三维数字减影血管造影(3D-DSA)技术在颅内动脉瘤的诊断和治疗,尤其是在介入治疗方面的作用,越来越被广泛认可[1-2].笔者对我院2009 年1月～2010 年6月间收治的68例疑为颅内动脉瘤的患者,在常规2D-DSA检查基础上行3D-DSA SSD检查.对22例确诊颅内动脉瘤的患者在3D-DSA遮盖表面显示(SSD)影像引导下,采用神经介入治疗,取得了良好疗效.现报告如下.

数字减影全脑血管造影术（Digital SubtractionAngiography,DSA）,是目前临床诊断颅内动脉瘤的金标准。近年来,三维DSA（3D DSA）检查越来越多的应用于颅内动脉瘤的诊断[1,2]。本文对38名疑为颅内动脉瘤的患者同时应用3D DSA遮盖表面显示技

正>1病例报告患者男,28岁。无任何不适症状。体检时行头部CT检查,疑为颅内占位病变。入院后影像学检查:头部MR平扫及增强片显示:右侧额叶占位病变,增强后未见明显强化（图1）。

目的探讨银杏、川芎制剂是否可以使骨髓基质细胞(MSCs)治疗局灶性脑缺血最佳时间窗延后。方法SD大鼠随机分为对照组、MSCs组、MSCs+中药组,每组10只。采用线栓法制备大鼠缺血再灌注模型。MSCs组尾静脉注入MSCs;MSCs+中药组静脉注入银杏、川芎制剂,48h注入MSCs;对照组注入PBS。应用姿势反射实验和肢体不对称应用实验进行神经功能障碍评价,脑组织双免疫荧光组化检测。结果MSCs组、MSCs+中药组神经功能障碍程度明显好于对照组(P<0.05),两治疗组之间无显著差异(P>0.05)。免疫组化显示,MSCs组、MSCs+中药组在梗死灶部位BDNF及GFAP表达显著。结论银杏、川芎制剂可使MSCs治疗时间窗延后,促进MSCs在脑病灶内分布、分化。

Objective:To investigate the role of CTA in the diagnosis of cerebral ischemia disease.Methods:Cerebral ischemia patients were examined with CTA,And the results were compared with DSA.Results:All 198 arteries were inspected,Conincidence of results inspected with DSA and CTA in 195 arterys,discrepancy of diagnosis in 3 arterys.Conclusion:In the diagnosis of cerebral ischemia disease,CTA had high accuracy and repeatability.Make the best of various kinds analysis diagnostic methods,the CTA may substitute to the DSA completely.

1995年11月,我们收治一位少突胶质细胞瘤患者,术后至该患于2007年3月病逝,追踪观察11年4个月,报告如下.

目的探讨经胼胝体-侧脑室手术入路治疗重型原发性脑室出血的临床价值。方法回顾分析显微镜下经胼胝体-侧脑室手术入路治疗14例重型原发性脑室出血的临床资料。结果14例患者存活11例;其中恢复正常生活6例,轻偏瘫1例,记忆力下降2例,植物生存2例;死亡3例。随访3个月GOS预后分级Ⅰ级3例,Ⅱ级2例,无Ⅲ级病例,Ⅳ级3例,Ⅴ级6例。结论早期显微镜下经胼胝体-侧脑室手术入路治疗重型原发性脑室出血可明显改善患者的预后、降低病死率,具有较好的临床价值。

ObjectiveTo characterize the releasing pattern of soluble adhesion molecules in patients with multi-infarct dementia. MethodsThe levels of serum soluble adhesion molecules and superoxide dismutase of 82 patients with multi-infarct dementia were serially measured with ELISA, radio immunoassay, and were compared with 23 normal controls. ResultsThe levels of serum soluble adhesion molecules in patients with multi-infarct dementia [sICAM-1:CDR 0.5-1 361.1083.90 ng/ml CDR2 393.3758.02 ng/ml CDR3 618.8749.27 ng/ml] were higher than those in normal controls(P0.01); The levels of serum superoxide dismutase in patients [SOD:407.32163.02 ng/ml] were lower than those in normal controls(P0.05). The levels of serum sICAM-1 was positively correlated with the degree of multi-infarct dementia(r=0.6594 P0.05). ConclusionThese findings suggests that soluble adhesion molecules are closely related to the development of multi-infarct dementia. Further study is needed on the charge of serum soluble adhesion molecules during the treatment of multi-infarct dementia.

外伤性颈内动脉海绵窦瘘(TCCF)的治疗是神经外科较棘手的问题,其治疗经历了多种方法的探索.近年来可脱性球囊栓塞被认为是治疗TCCF的首选方法[1].但尚无学者对该方法的技术问题进行专门的阐述.我们通过近年来治疗的TCCF28例患者的回顾性分析,结合文献对用可脱性球囊栓塞TCCF的技术相关问题进行讨论.

Objective To observe the antihepatofibrosis function of oxymatrine and to discuss the mechanism.Methods This experiment is based on the model of kunming mouse hepatic fibrosis (CCl_4),and normal group,model group,oxymatrine prevent group and therapy group were set up.After that,ALT,ALB,Tbil,HA,LN,PC-Ⅲ,IV-CL were measured separately,simultaneously hepatic tissue pathology and immunohistochemistry dyeing were used.Results Oxymatrine prevention group and therapy group were more distinct than those of model group on hepatic function,the indexs of hepatic fibrosis,pathology changes and the result of immunohistochemistry dyeing(P0.05).And compared with therapy group,prevention group had markedly difference(P0.05) in those indexes.Conclusion Oxymatrine can restrain the production of collagen,decrease the expression of CTGF and inhibit the abnormal hyperplasia of hepatic extracellular matrix,so it has the function of antihepaticfibrosis.

目的了解多梗死性痴呆患者血清可溶性黏附分子的变化及临床意义.方法采用酶联免疫法和DTNB直接法测定了82例多梗死性痴呆患者血清可溶性血管细胞黏附分子-1(sVCAM-1)水平和血GSH-Px活力,并与23例健康人对照比较.结果多梗死性痴呆患者血清黏附分子水平[sVCAM-1:轻度痴呆(993.62±108.92)ng/ml,中度痴呆(1190.32±43.95)ng/ml,重度痴呆(1625.22±220.90)ng/ml]明显高于健康对照组(P<0.01);GSH-Px活力(73.98±22.32 U·ml-1·min-1)明显低于健康对照组.sVCAM-1水平与痴呆程度呈正相关(r＝0.6975,P<0.05).结论可溶性黏附分子与多梗死性痴呆密切相关,可溶性黏附分子可作为多梗死性痴呆治疗时的主要监测指标之一.

我院2003-09～2004-09收治脑出血及颅脑外伤术后患者41例,均常规腰穿释放脑脊液,效果较好,总结如下.