脑缺血/再灌注对大鼠脑内花生四烯酸乙醇胺浓度的影响及其机理初步研究

目的：脑缺血再灌注对脑组织中大麻内源性配体花生四烯酸乙醇胺（AEA）含量变化的影响。方法：用高效液相色谱法分别测定脑缺血、再灌注与对照组脑组织中AEA的浓度含量。结果：脑缺血及再灌注大鼠脑内AEA明显改变,浓度高于对照组,脑内AEA浓度在3小时缺血后显著增加,差异具有统计学意义。结论：脑缺血/再灌注导致脑组织中AEA浓度明显升高,AEA可能在脑缺血早期发挥了保护作用。     

早期降眼压药物对高度近视术后屈光回退影响的研究

目的：探讨早期应用降眼压药物噻吗洛尔对高度近视术后屈光回退的影响。方法：将高度近视患者41例（81眼）LASIK手术后分为两组：常规组和噻吗洛尔组,分别于术前和术后1m、3m、6m、12m检查裸眼视力、屈光度、角膜前表面曲率等指标,比较分析并计算屈光回退率。结果：两组术后随着时间的推移,屈光回退率及角膜前表面曲率值均有增加,但用药组回退率及曲率增加值在术后1m、3m、6m、12m分别低于常规组,差异有统计学意义（P〈0.05）。结论：早期应用降眼压药物能够较好的降低高度近视术后屈光回退,稳定手术效果。     

幕上高血压脑出血手术疗效的临床分析

目的：探讨分析幕上高血压脑出血的手术时机、手术方式以及术中的注意事项。方法：通过对我科自2004年3月至2010年12月收治的208例幕上高血压脑出血病例采取不同的手术方式的治疗，然后根据患者术后1年的恢复情况的分析，探讨患者预后与手术方式、手术时机、术中注意事项的关系。结果：本组共208例患者，术后1年左右随访病人能自行下床行走者87例，需搀扶或拄拐行走者59例，不能行走者42例，死亡20例。结论：幕上高血压脑出血患者的预后除与脑出血的部位，出血的量有关外，还与手术方式、手术时机、术中注意事项密切相关。临床上可针对不同的病例采取不同的手术方式，把握好手术时机，严格注意术中操作，以改善患者的预后，提高患者的生存质量。     

股静脉穿刺置管术在烧伤救治中的应用及并发症的预防

1．1资料本组430例病例中,男312例,女118例;成人378例,小儿52例：年龄最大者80岁,最小者1岁;用于烧伤早期抗休克292例,术中快速补液88例,肠道外营养20例,血液透析20例：置管时间多为7-10天。     

口腔癌术后化疗早期血小板升高相关因素研究

目的：探讨口腔癌患者术后化疗早期血小板升高的意义。方法：查阅2008年1月至2011年1月在我院行术后化疗的86例口腔癌患者病历资料,统计化疗前及化疗第一至四周期PLT数,探寻血小板数（Platdets,PLT）的变化规律;选取2011年8月至2012年7月在我院行术后化疗46例口腔癌患者,20例健康人作为对照组,晨起空腹采血,检测血液常规,分离血清,ELISA法检测血清中Fit-3配体（Flt-3 ligand,FL）及血小板生成素（Thrombopoietin,TPO）含量。结果：①2008年1月至2011年1月86例口腔癌患者有27例化疗期间出现PLT先升高再降低的现象,且升高较化疗前具有显著性（P〈0．05）。②2011年8月至2012年7月46例口腔癌患者化疗前PLT各参数与对照组均无明显差异（P〉0．05）,而化疗后与化疔前相比,PLT、血小板压积（Platecrit,PCT）明显升高（P〈0．05）,血小板平均体积（MeanPlateletVolume,MPV）、血小板分布宽度（Platelet distribution width,PDW）则明显降低（P〈0．05）;化疗前血清中FL、TPO与对照组无明显差异（P〉0．05）,化疗后与化疗前相比,FL明显降低（P〈0．05）,TPO差异不具有显著性（P〉0．05）。结论：术后11．5个月行化疗时,骨髓造血功能已基本恢复正常,而化疗后骨髓造血功能确实受到一定的抑制;化疗早期血小板升高是由于外周血中血小板破坏减少,而非骨髓生成血小板增多所致;化疗早期血小板升高不能代表肿瘤治疗无效,或者癌细胞发生转移。     

药物合并紫外线局部照射治疗糖尿病足部烫伤疗效观察

48例糖尿病病人均符合1985年WHO确定的糖尿病诊断标准,有明确烫伤史。符合全国第3次周围血管病会议所确定的诊断标准及Wagner分级标准。0级：皮肤无开放性病灶;1级：肢端皮肤有开放性病灶;2级：感染病灶已侵犯深部肌肉组织;3级：肌腱韧带组织破坏;4级：骨质缺损,部分趾、足坏疽：5级：足的大部或全部坏疽。所有病例均为1-4级。48例中男28例,女20例,平均年龄63岁,平均糖尿病史10年,入院时的平均空腹血糖12．6mmol/l,其中干性坏疽4例．湿性坏疽4例,混合性坏疽12例,坏疽部位分别为足底部和指趾。以上48例病人随机分为一般治疗组和紫外线治疗组两组,每组24人。     

早期膜性肾病的超微结构观察

目的：探讨早期膜性肾病(mernhmnous nephmpathy,MN)的超微病理变化类型及其诊断意义。方法：收集我院肾脏疾病研究所近一年来的肾活检病例,对免疫荧光或电镜检查提示为早期MN的病例,进行其超微病理形态的分析。结果：48例具有早期MN的指征,经电镜检查后得出最终诊断     

单克隆免疫球蛋白轻链相关性肾病的超微结构及免疫电镜研究

目的：探讨电镜及免疫电镜方法在单克隆免疫球蛋白轻链相关性肾病包括轻链沉积病(Light chain deposition disease,LCDD)和轻链型淀粉样变(amyloidosis,AL)诊断中的作用。方法：对我院1994．1～2002．12间接受的肾活检病例进行系统的电镜观察,对疑为LCDD及早期AL的病例进行轻链(κ、λ)的免疫电镜标记。结果：7例符合LCDD的诊断,45例符合AL的诊断。LCDD肾活检组织电镜下可见肾小管基底膜(TBM)外侧、肾小球基底膜(GBM)内侧、鲍曼囊外侧及小血管壁基底膜外侧的点状、颗粒状电子致密物质沉积,其中2例早期病例表现颗粒状物质节段性分布;免疫电镜标记,颗粒状物质被单种轻链标记,其中,κ轻链5例,λ轻链2例。AL肾活检组织电镜下可见肾小球系膜区、GBM及小动脉壁基底膜上的细纤维物质呈团片状或束状分布,其中15例早期病例表现系膜区或,及GBM的细纤维呈节段性分布;15例早期AL的免疫电镜标记结果,细纤维被单种轻链标记,其中,κ轻链4例,λ轻链11例。结论：肾脏LCDD及早期AL的诊断需依赖于电镜检查,免疫电镜检查对肾脏早期LCDD及早期AL的确诊具有不可替代的作用。     

激光治疗变态反应性鼻炎

变态反应性鼻炎分季节性和常年性。前者病因以花粉为主,后者以空气中尘埃为首。其症状均为鼻塞、鼻痒、打喷嚏,流清水样鼻涕。治疗以抗过敏药和脱敏疗法为主,疗效均不持久。有些顽固病例可用电凝或冷冻鼻甲和鼻甲部分切除来治疗。术中易引起疼痛和出血,患者难以接受。而激光治疗简便易行。我院从1987年至今共治疗63例,取得较好疗效,报导如下。     

低功率激光综合治疗外阴肿瘤63例

自1985年7月至1989年4月,我院以低功率激光综合治疗外阴肿瘤共63例,取得了满意的疗效。临床将63例分成四组,具体情况如下: A组:使用3W的便携式CO_2激光器治疗外阴尖锐湿疣12例,全部治愈。创面一般在两周内痊愈,未发生感染、出血或其它并发症。 B组:使用3～5W的便携式CO_2激光和10WYAG激光器治疗外阴各种肿瘤共21例,其中8例外阴     

CT扫描和选区激光烧结技术在颌骨修复中的应用

目的：探讨根据不同的患者,不同的设计方案,生成个性化的缺损模型、修复体模型,建立颅骨上颌骨及牙列三维仿真,为上颌骨的修复提供标准数学模型和实体模型。方法：选择一具颅骨标本作为建模素材,通过螺旋CT扫描技术及三维影像技术完成初步重建,建立上颌骨及牙列的三维有限元模型,在此基础上运用快速原形技术得到修复体进行颌面修复。结果：获得了形态细致逼真的上颌骨及牙列三维重建生物力学模型和修复体,修复后形态与功能得以很好重建。结论：综合运用CT扫描、三维建模、快速成型等技术可以获得不同个体的上颌骨及牙列三维仿真模型和逼真的修复体,为临床探索上颌骨及牙列的修复设计了一套完整思路。     

Development of an integrated hardware and software platform for the rapid detection of cerebral aneurysm rupture

A cerebral aneurysm is defined as a weakened portion of an artery in the brain. Rupture of a cerebral aneurysm leads to subarachnoid hemorrhage (SAH). A significant number of patients with SAH are initially misdiagnosed and subjected to the risks associated with aneurysm re-rupture. Traditional detection methods recommended by physicians include computed tomography (CT) scan, lumbar puncture and angiography. Unfortunately, the CT scan is ineffective after 12 h, and angiography is best suited for those cases of finding the aneurysm before surgery. Physicians may therefore rely on lumbar puncture to develop a quick and objective evaluation by assessing xanthochromia. Bilirubin in the cerebrospinal fluid, resulting from the chemical decomposition of whole blood, is an indicator of hemorrhage. This metabolite can be detected after lumbar puncture, by differentiating its optical signature in the spinal fluid. In cases of traumatic spinal tap, bilirubin needs to be distinguished from whole blood. We introduce a diagnostic system based on visible spectroscopy to quickly and objectively assess low blood-volume SAH. The system integrates innovative hardware and a powerful software interface. We explore an algorithm that accounts for the noise and distortion from blood in the cerebrospinal fluid. We introduce a portable, user-friendly hardware platform composed of specific components designed for their sensitivity and specificity.     

In vivo measurement of the brain and skull resistivities using an EIT-based method and realistic models for the head

In vivo measurements of equivalent resistivities of skull (rho(skull)) and brain (rho(brain)) are performed for six subjects using an electric impedance tomography (EIT)-based method and realistic models for the head. The classical boundary element method (BEM) formulation for EIT is very time consuming. However, the application of the Sherman-Morrison formula reduces the computation time by a factor of 5. Using an optimal point distribution in the BEM model to optimize its accuracy, decreasing systematic errors of numerical origin, is important because cost functions are shallow. Results demonstrate that rho(skull)/rho(brain) is more likely to be within 20 and 50 rather than equal to the commonly accepted value of 80. The variation in rho(brain)(average = 301 omega x cm, SD = 13%) and rho(skull)(average = 12230 omega x cm, SD = 18%) is decreased by half, when compared with the results using the sphere model, showing that the correction for geometry errors is essential to obtain realistic estimations. However, a factor of 2.4 may still exist between values of rho(skull)/rho(brain) corresponding to different subjects. Earlier results show the necessity of calibrating rho(brain) and rho(skull) by measuring them in vivo for each subject, in order to decrease errors associated with the electroencephalogram inverse problem. We show that the proposed method is suited to this goal.     

儿童支原体肺炎的X线诊断分析及临床特征

目的:探讨小儿支原体肺炎的胸部X线表现及临床特征,提高对本病的认识.方法:搜集经临床和实验室检查证实的小儿支原体肺炎63例胸部X线资料及临床特点进行回顾性分析.结果:X线:①小斑片或扇形浸润型23例(37%);②间质浸润19例(30%);③肺门阴影增浓11例(17%);④节段或叶型实质浸润10例(16%),合并-侧少量...     

Patterns of thermal deposition in the skull during transcranial focused ultrasound surgery

The induction of temperature elevation by focused ultrasound is a noninvasive surgical technique for destroying tissue. This technique has been used clinically in soft tissues such as liver, prostate and breast. It has long been desired to extend this technique to noninvasive treatment of brain tumors. Although the skull was once thought to be an unsurpassable barrier to focused ultrasound treatment, it has been shown that the distortion caused by the skull can be corrected to produce a useful intracranial focus. However, the attenuation experienced by the ultrasound in passing through cranial bone is large, and consequently the skull is subject to the deposition of acoustic energy as heat. The nature and extent of this heating process has been difficult to characterize empirically. It is practically difficult to implant a sufficient number of thermocouples to obtain detailed temperature data directly, and bone is an unsuitable medium in which to perform noninvasive thermometry using proton chemical shift magnetic resonance imaging. Furthermore, skull specimens used experimentally lack active blood perfusion of the skull and the overlying scalp. This paper describes the use of large-scale acoustic and thermal simulations to calculate the distribution of temperature within the skull and brain that can be expected to occur during therapeutically useful focused ultrasound sonications of the brain. The results demonstrate that standing waves may be formed within the skull during transcranial sonication leading to nonuniform skull heating. However, the results also show that these effects can be sufficiently controlled to allow therapeutic ultrasound to be focused in the cranial base region of the brain without causing thermal damage to the scalp, skull or outer surface of the brain.     

大直径球头-骨水泥型人工髋关节置换治疗帕金森患者股骨颈骨折12例

目的：探讨采用大直径球头-骨水泥型人工髋关节置换的方法,治疗老年帕金森患者股骨颈骨折的临床疗效。方法：回顾性病例分析2007年1月至2010年10月收治的帕金森患者合并股骨颈骨折12例,男3例,女9例,年龄65岁至87岁,平均年龄76.17岁。假体类型：人工全髋关节假体2例,人工双极股骨头10例。置换后3个月随访,进行围置换期并发症、影像学、髋关节功能评分（Harris评分）等方法评价手术效果。结果：所有患者均安全度过围置换期,置换术后3周出现脱位1例,无深部感染及深静脉血栓形成,无围手术期死亡病例;骨盆平片上出现髋臼侧透亮线1例,无骨溶解、松动及股骨柄下沉;Harris评分：90分至100分3例,80分至89分5例,70分至79分3例,〈70分1例。结论：大直径球头-骨水泥型人工髋关节置换治疗老年帕金森患者股骨颈骨折可有效改善关节功能,减少并发症,降低脱位率,提高患者生活质量。     

Correlation between skull thickness asymmetry and scalp potentialestimated by a numerical model of the head

The contribution of asymmetric skull thickness to the scalp potential amplitude was investigated numerically. The model consisted of four conductive layers representing the scalp, the skull, the cerebrospinal fluid, and the cortex with a current dipole in the occipital region. The potential created by the dipole was calculated assuming quasistatic formulation and linear media. The governing equation was discretized by the finite volume method to ensure the conservation of fluxes even in regions with abrupt changes of the conductivity. The large set of the algebraic equations for the electric potential was solved iteratively by the successive overrelaxation method. The model confirmed previous experimental studies suggesting that the potential amplitude is 60% smaller on the side with the thicker bone if the asymmetry of the skull thickness exceeds 40%. The model developed suggests that skull thickness asymmetry can create nonnegligible asymmetries in the potential measured on the scalp above homotopic points of the two hemispheres     

A system for video-based navigation for endoscopic endonasal skull base surgery

Surgeries of the skull base require accuracy to safely navigate the critical anatomy. This is particularly the case for endoscopic endonasal skull base surgery (ESBS) where the surgeons work within millimeters of neurovascular structures at the skull base. Today's navigation systems provide approximately 2 mm accuracy. Accuracy is limited by the indirect relationship of the navigation system, the image and the patient. We propose a method to directly track the position of the endoscope using video data acquired from the endoscope camera. Our method first tracks image feature points in the video and reconstructs the image feature points to produce 3D points, and then registers the reconstructed point cloud to a surface segmented from preoperative computed tomography (CT) data. After the initial registration, the system tracks image features and maintains the 2D-3D correspondence of image features and 3D locations. These data are then used to update the current camera pose. We present a method for validation of our system, which achieves submillimeter (0.70 mm mean) target registration error (TRE) results.     

Optimal Protection in Direct Closed Head Impact

The direct closed head impact problem was idealized as a fluid-filled cylinder attached to a spring-dashpot element striking a rigid wall. The rigid cylinder represents the skull, the fluid denotes the brain and the cerebrospinal fluid (CSF) and the lumped spring-dashpot element simulates the composite elastic and dissipative properties of the helmet, hair, skin, skull and the real wall. This paper concerns the inverse problem, i.e., what material and inertial properties should the helmet or padding have to afford optimal protection in a direct closed head impact? The answer was found in terms of 4 dimensionless ratios: (1) the brain to skull mass, (2) the skull to closed brain stiffness, (3) the damping factor of the skull, and (4) the impact speed of the cylinder to the brain wave speed. The solution to the problem was achieved through hybrid computation using as the Index of Performance the time averaged pressure at contrecoup beyond the cavitation pressure of the fluid. Given a set of impact and system parameters, the optimal choice consists of making the value of the stiffness ratio as small as possible and still completely compressing the spring. Then, for a given mass ratio, the optimum damping ratio is found from a simple graph.     

老年骨折患者便秘的预防及护理

目的:探讨老年骨折患者便秘的预防措施,减少便秘的发生.方法:将45例老年骨折患者随机分为对照组23例和实验组22例.对照组实施骨科常规护理,实验组除实施骨科常规护理外,加强健康教育、心理护理、饮食护理、指导患者适当的运动及适当的辅助用药.结果:实验组便秘的发生率远远低于对照组(P<0.05).结论:恰当的健康教育、心理...