急诊科开展神经内镜治疗高血压脑出血的临床研究

目的探讨急诊科开展神经内镜手术治疗高血压脑出血的临床价值。方法1999年7月至2003年12月我院急诊科开展神经内镜手术治疗自发性脑出血101例。对其时效性、疗效、并发症等方面进行分析。结果从入院到手术间隔时间为(68.6±38.3)min。出血部位在基底节51例,脑叶27例,丘脑9例,血肿破入脑室14例。出血量20~130ml,平均(53.3±36.8)ml。手术时机为发病7h以内36例,7~72h43例,超过72h22例。手术时机越早,其疗效越好,并发症越少(P<0.001)。同时血肿量越大,疗效越差(P<0.001)。结论急诊科应用神经内镜治疗高血压脑出血具时效性、整体性和微创性统一,扩大了手术指征,值得进一步研究和推广应用。     

Identification of antiviral-relevant genes in the cultured fish cells induced by UV-inactivated virus

UV-inactivated grass carp hemorrhage virus (GCHV) can induce high titer of interferon in cultured CAB (Crucian carp (Carassius auratus L.) blastulae )cells,and thus defend host cells against the virus invasion ,The mechanism is proposed that an antiviral state should be established in the host cells by activating expression of a set of antiviral-relevant genes,In this study ,suppressive subtractive hybridization is applied to constructing a subtracted ,cDNA library with mRNAs isolated from UV-inactivated GCHV infected and mock-infected CAB cells,272 differential cDNA fragments are identified by both PCR and dot blot from the subtractive cDNA library .Sequencing analysis reveals 69 genes,including 46 known gene homlologues,and 23 unknown putative genes,The known genes include the gemes involved in interferon signaling pathways,such as Stat1 and Jak1,the antiviral gences,such as Mx and Vipering,and a set of interferon-stimulated genes observed in mammalian cells. Most of the unknow putative genes contain AU-rich element in their sequences,Differential expressions of these genes are further confirmed by virtual Northern blot and RT-PCR,The data imply that UV-inactivated GCHV is not only able to induce production of interferon in the infected CAB cells,but also leads to the expression of a series of antiviral-relevant genes or immune-releveant genes,and therefore reveals that the signaling pathway of interferon system and antiviral mechanism in fish are similar to those in mammals.     

辽宁大学职工病死调查及分析

本校教职工九年共死亡１０８人，在职工人数２５１２人没有大幅度增加的情况下、死亡率逐年增加，甚至成倍增加。从年龄段分析６１￣７１岁死亡率是高，其次是５１￣６０岁，男比女高，疾病种类占首位的是恶性肿瘤，以下顺序是脑溢血，心肌梗死，肺心病。上述情况与生活环境、不良饮食习惯、烟酒嗜好、环境污染等因素危害身体健康有关。它提醒人们认清损害身体的诸因素，提高防病意识，加强自身保健能力。     

Short cerebral ischemia and subsequent reperfusion and treatment with stobadine

Lipid peroxidation and activities of antioxidative enzymes were studied in the brain cortex after short (15 min) cerebral ischemia and reperfusion (10 min) in rats. Conjugated dienes (CD) and thiobarbituric acid-reactive substances (TBARS) were significantly elevated in the group of rats with ischemia followed by reperfusion in comparison to the ischemic animals. Superoxide dismutase (SOD) activity significantly increased in the group of animals with ischemia and reperfusion. No significant changes in the activities of glutathione peroxidase (GP) were observed. Stobadine administered before ischemia or before reperfusion decreased the level of TBARS. Stobadine probably prevents malondialdehyde (MDA) formation from hydroperoxide or might elevate the activity of aldehyde dehydrogenase. In contradiction to the findings after long-lasting (4 h) ischemia and subsequent reperfusion¹, no decrease in the concentration of CD or in the activity of SOD or GP was found.     

年轻人脑梗死临床研究

目的：研究年轻人脑梗死的病因及危险因素，方法：对31例年轻人脑梗死的病因及危险因素进行分析总结，结果：年轻人脑梗死主要病因为早发性脑动脉硬化，心源性脑栓塞是常见病因，脑动脉炎、酒精中毒等较常见，女性患者与偏头痛、吸烟、口服避孕药密切相关，结论年轻人脑梗死病因复杂，危险因素多样，加强多学科深入合作，加强对高危人群的筛查，早发现、早预防。     

Reduced cell death by inosine pretreatment after photochemically-induced cerebral ischemia in adult rats

Protective effect of inosine against cell death after photochemically induced focal cerebral ischemia was investigated in adult rats. Intraperitoneal injection of inosine was started 24 h before operation and continued till the animals were sacrificed. The TUNEL method and Nissl staining were used to identify apoptosis and necrosis, respectively. TUNEL-positive cells were located in the transitional zone between the necrotic core and normal cortex. The mean maximum area of the necrotic cores and mean number of TUNEL-positive cells 24 h after operation were reduced significantly in the inosine-treated rats when compared with those in the saline-treated control animals. We suggest that inosine can significantly reduce both necrosis and apoptosis following cerebral ischemia induced by photothrombosis in adult rats.     

侧脑室前角引流治疗高血压丘脑出血破入脑室临床分析

目的探讨侧脑室前角引流治疗高血压丘脑出血破入脑室的临床疗效及预后。方法采用单或双侧脑室前角引流治疗34例高血压丘脑出血破入脑室,术后CT动态观察血肿量,第1、7、14、30天进行NIHSS评分,第3个月采用改良Rankin量表（mRS）评价预后。结果术后第7天NIHSS评分及第14天血肿量与治疗前比较差异有显著性意义（P〈0．01）,3个月mRS分级：0～3级22例,4．5级6例,死亡6例。结论侧脑室前角引流治疗高血压丘脑出血破入脑室疗效确切,可明显改善患者的日常生活能力,提高生存质量,降低病死率和致残率。     

大鼠蛛网膜下腔出血模型的制作及护理

目的制备可靠的大鼠蛛网膜下腔出血(SAH)后迟发性脑血管痉挛模型,探索模型鼠的护理经验,为蛛网膜下腔出血的治疗研究提供实验依据。方法48只健康成年Sprague-Dawley(SD)大鼠随机分为6组:对照组3组(n=8)及蛛网膜下腔出血手术3组(n=8)。采用枕大池二次注自体颅内血的方法建立SAH模型,假手术组只手术不注射,在首次手术注血后3、57、d,每组各灌注处死大鼠,取其基底动脉比较基底动脉的内口径周长和血管壁厚度。结果假手术对照组与SAH组的基底动脉的内口径周长和血管壁厚度在手术后3、57、d均有显著性差异(P<0.05),脑血管痉挛在第7 d达到高峰。术后进行了严格的护理。结论大鼠枕大池二次注自体颅内血法是可靠的SAH后迟发性脑血管痉挛模型制作方法,有效的护理对模型的成功制作极为重要。     

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．     

实验性脑梗塞(MCAO)模型大鼠热休克蛋白基因表达的动态观察

采用分子杂交技术观察了实验性脑梗塞大鼠缺血区皮质、纹状体、海马的HSP70mRNA转录水平的动态变化 ,从基因水平探讨了急性脑缺血发生发展的病理规律及机制。结果提示 :皮质、纹状体HSP70mRNA在大脑中动脉梗塞后 1h、3h、6h、2 4h和 4 8h显著表达 ,海马仅 2 4h和 4 8h显著表达 ,表明HSP70mRNA表达与脑梗塞关系非常密切。如果能针对性改变这些基因的表达 ,以提高机体对损伤的耐受能力 ,那么对脑缺血损伤的修复及预后无疑具有重要的意义