简介:目的分析多脑叶离断手术治疗顽固性癫痫的预后及神经功能障碍.方法回顾性分析本院收治的8例多脑叶离断病人临床资料,所有患者均为广泛半球病变,且保留一定的肢体感觉运动等中央区功能,手术方式均为保留中央区的多脑叶离断.随访内容包括发作症状,术后肢体肌力肌张力.结果至随访结束,按Engel分级:Ⅰ级4例,Ⅱ级3例,Ⅲ级l例.肢体功能障碍轻微.结论多脑叶离断手术可很好的控制半球病变引起的顽固性癫痫发作,是不适合半球切除或功能半球切除术病例的一个不错选择.
简介:目的介绍一种新的治疗半球性病变引起的难治性癫痫的手术方法,并就该手术方法和适应证进了讨论。方法应用新的大脑半球多脑叶离断术,分步骤离断额叶,颞叶和顶忱叶与丘脑、基底节的联系,通过侧肭室额钔和枕角离断胼胝体前后部,只保留中央前后回皮层及其与丘脑、基底节和内囊的联系,治疗一例半球性病变引发的成年难治性癫痫患者。该患者右侧大脑半球广泛病变,但是中央前后回的运动感觉功能存在。结果手术后病人没有任何加重对侧肢体功能障碍的并发症,癫痫得到有效控制,随访半年EngelⅡ级。结论多脑叶离断术,可以有效治疗严重的半球病变所致的难治性癞痫。尤其适合那些运动、感觉和语言功能存在或尚未转移的难治性癫痫。
简介:目的分析颞顶枕离断术对药物难治性单侧头后部多脑叶癫癇病人认知功能的影响。方法回顾性分析33例单侧头后部多脑叶癫癇病人的临床资料,其中18例行右侧颞顶枕离断术(右侧组),15例行左侧颞顶枕离断术(左侧组)。术前及术后1年两组行详细的神经心理学评估包括智商、记忆商和语言功能等,并进行统计分析。结果随访33例,平均47.5个月,Engel分级:Ⅰ级21例,Ⅱ级6例,Ⅲ级3例,Ⅳ级3例。与术前比较,左侧组术后1年操作智商(PIQ)平均值增加,但是汉语命名测验(CNT)、听觉言语学习测验(AVLT)平均值减少(均P<0.05);右侧组术后1年言语智商(VIQ)平均值增加,视觉记忆能力(VM)平均值减少(均P<0.05);其余均无统计学意义(P>0.05)。结论对于致灶广泛分布于一侧颞顶枕叶的癫癇病人,颞顶枕离断术是一种安全有效的治疗方法。
简介:Theirretrievablefateofneuronsdominatedtheneurosciencerhetoricforthefirsthalfofthiscentury,apositionthatwasfiercelycontestedandrecentlydebunkedbyextensivestudiescarriedoutinthefieldofneuroregenerationresearch.Theturningpointcameintheyear1928,whenRamonY.Cajal’s(Lobato,2008)worksuggestedthattheregenerativecapacityof
简介:BACKGROUND:Previousresearchhasrevealedthatsomatostatincaninduceepilepsy,andthatthelevelsofneuropeptideYmayincreaseandbecomemoreactiveinbrainareaswithepilepticseizures.OBJECTIVE:ToobservetheeffectofGanodermalucidumsporepowderontheneuropeptideYandsomatostatincontentinthecerebralcortexandhippocampalregionsofseizureratsinducedbypentylenetetrazol(PTZ).Furthermore,toverifyanyeffectofGanodermalucidumsporepowderoninhibitionofepilepticseizures.DESIGN,TIMEANDSETTING:ArandomizedgroupanimalstudywasperformedinAugust2007intheSchoolofBasicMedicalSciences,JiamusiUniversity(Jiamusi,Heilongjiang,China).MATERIALS:Thirtyhealthy,male,Wistarrats,aged12weeksandweighing180–220g,weretakenastheexperimentalanimals.PTZ(SigmaCompany,UnitedStates)wasusedtoinduceepilepsy.Ganodermalucidumspores(Leyss,exFrvariety)werepurchasedfromJiamusiCityWildGrowingCaseoftheGanodermaLucidum(China).Rabbitanti-somatostatinantibodiesandsecondaryantibodieswerepurchasedfromWuhanBosterCompany(China).NeuropeptideYradioimmunoassaykitwaspurchasedfromBeijingFuruiBiotechnologyCompany(China).METHODS:Thirtyratswererandomlydividedintothreegroups:acontrolgroup,anepilepsymodelgroupandaGanodermalucidumspore-treatedgroup.Eachgroupcontained10animals.RatsintheepilepsymodelgroupweretreatedwithintraperitonealinjectionsofPTZandgastricperfusionofphysiologicsaline.IntheGanodermalucidumspore-treatedgroup,intraperitonealinjectionofPTZandgastricperfusionofGanodermalucidumsporepowderwereadministered.Theblankcontrolgroupwasonlyadministeredwiththephysiologicalsalinebyintraperitonealinjectionandgastricperfusion.MAINOUTCOMEMEASURES:ImmunohistochemicalstainingandradioimmunoassaymethodswereusedtoobservethechangesofsomatostatinandneuropeptideYcontentinbraintissueofepilepticrats,aswellasthemorphologyofneurons
简介:ThisstudysoughttoidentifydifferentiallyexpressedproteinsinSH-SY5Ycellstreatedwithvalproicacid,usingtwo-dimensionaldifferencegelelectrophoresisanalysis.Threeproteinswereunambi-guouslyidentified:theeukaryotictranslationinitiationfactor4Aisoform1andATP6V1B2proteinweredownregulated,whiletheheterogeneousnuclearribonucleoproteinKwasupregulated.Moreover,allthreeproteinsareassociatedwithalteredexpressionduetooxidativestress.Ma-trix-assistedlaserdesorption/ionization-timeofflightmassspectrometryandproteinimmunoblottingassayconfirmedthedifferentialexpressionofeukaryotictranslationinitiationfactor4Aisoform1.Theresultsindicatethatvalproicacidexertsanantioxidationeffectbyregulatingtheexpressionofeukaryotictranslationinitiationfactor4Aisoform1.
简介:Freeradicalsinducedbytraumaticbraininjuryhavedeleteriouseffectsonthefunctionandantioxidantvitaminlevelsofseveralorgansystemsincludingthebrain.Melatoninpossessesantioxidanteffectonthebrainbymaintainingantioxidantenzymeandvitaminlevels.Weinvestigatedtheeffectsofmelatoninonantioxidantabilityinthecerebralcortexandbloodoftraumaticbraininjuryrats.Resultsshowedthatthecerebralcortexβ-carotene,vitaminC,vitaminE,reducedglutathione,anderythrocytereducedglutathionelevels,andplasmavitaminClevelweredecreasedbytraumaticbraininjurywhereastheywereincreasedfollowingmelatonintreatment.Inconclusion,melatoninseemstohaveprotectiveeffectsontraumaticbraininjury-inducedcerebralcortexandbloodtoxicitybyinhibitingfreeradicalformationandsupportingantioxidantvitaminredoxsystem.
简介:目的研究颌内动脉第二段与大脑中动脉第二段(M2)近端之间移植搭桥术的方法.方法10个灌注好的尸头,共20侧.行额颞瓣开颅,游离颞浅动脉主干及其两个分枝,测量其外径;于颧弓下、下颌切迹上、颞下窝内,游离颌内动脉第二段,把其远端离断并测量其长度和外周直径作为吻合口的近端;然后打开侧裂池,分离出M2分枝的近端并予以测量其外周直径,作为吻合口的远端;用4.0mm的磨钻在颅中窝底圆孔外3.0~4.0cm处磨出一骨孔,再测量颌内动脉断端经骨孔到M2近端的距离;最后以颈部胸锁乳突肌前为切口,游离出颈总动脉、颈外动脉和颈内动脉,分别测量分叉部颈外动脉和颈内动脉的外周直径和经耳前皮下到M2近端的距离.结果颌内动脉第二段断端的直径(2.5±0.3)mm,大于颞浅动脉分叉部的直径(1.6±0.3)mm;颞下窝内颌内动脉第二段的长度(断端到下颌支)为:(17.8±0.3)mm;颈外动脉起始段到M2起始段距离(162.4±1.8)mm,颈内动脉起始段到M2起始段距离(171.1±1.7)mm,颌内动脉断端到M2起始段的距离(62.6±1.4)mm,较上述两者行程短,而且直.结论颌内动脉第二段与大脑中动脉M2近段之间移植搭桥术是一种可选择的颅外-颅内血管移植搭桥术方法.
简介:Mitochondriaplayanimportantroleinneuronalapoptosiscausedbycerebralischemia,andtheroleismediatedbytheexpressionofmitochondrialproteins.Thisstudyinvestigatedtheinvolvementofmitochondrialproteinsinhippocampalcellapoptosisaftertransientcerebralischemia-reperfusioninjuryinagedratsusingacomparativeproteomicsstrategy.Ourexperimentalresultsshowthattheagedratbrainissensitivetoischemia-reperfusioninjuryandthattransientischemialedtocellapoptosisinthehippocampusandchangesinmemoryandcognitionofagedrats.Differentialproteomicsanalysissuggestedthatthisphenomenonmaybemediatedbymitochondrialproteinsassociatedwithenergymetabolismandapoptosisinagedrats.Thisstudyprovidespotentialdrugtargetsforthetreatmentoftransientcerebralischemia-reperfusioninjury.
简介:BACKGROUND:ItisknownthatacupuncturetherapycandecreaseplasmaneuropeptideY(NPY)levelsinpatientswithcerebralinfarction,butdifferenttypesofacupuncturetherapyusedinvariousstagesofcerebralinfarctionhavenotbeenevaluated.OBJECTIVE:Toexploretheeffectofacupuncturetherapyonresuscitation(XingnaoKaiqiao)andplasmaNPYlevelsinpatientswithveryearlystageacutecerebralinfarction.DESIGN,TIMEANDSETTING:Thiscase-controlledstudywasperformedattheAffiliatedHospitaloftheMedicalCollegeoftheChinesePeople'sArmedPoliceForcebetweenSeptember2004andOctober2005.PARTICIPANTS:Sixtypatientswithacutecerebralinfarctionof≤6hourswereusedinthisstudy.Patientswererandomlydividedintoanacupuncturetherapygroup(n=30)andaroutinetreatmentgroup(n=30).Another30healthysubjectswereusedasthecontrolgroup.METHODS:TheacupuncturetherapyofXingnaoKaiqiaousedintheacupuncturetherapygroupwasbasedonroutinewesternmedicaltreatmentandwasperformedatbilateralNeiguan(PC6)usingthetwirling,reinforcing-reducingmethod,Renzhong(DU26)usingheavybird-peckingneedling,Sanyinjiao(SP6)usingreinforcingandreducingbyliftingandthrustingtheneedle,Jiquan(HT1),Weizhong(BL40)andChize(LU5)usingreinforcingandreducingbyliftingandthrustingtheneedle.Theacupuncturelastedfor14days.Patientsintheroutinetreatmentgroupunderwentroutinemedicaltreatmentandnointerventionwasgiventosubjectsinthecontrolgroup.MAINOUTCOMEMEASURES:A4mLvenousbloodsamplewasobtainedatdifferenttimepoints,i.e.,immediatelyafterhospitalization,thenextmorning,7and14daysaftertreatment,tomeasureplasmaNPYlevelspre-andpost-treatmentusingtheradio-immunitymethod.RESULTS:TheplasmaNPYlevelsweresignificantlyhigherinboththeroutinetreatmentgroupandtheacupuncturetherapygroupthaninthecontrolgrouppre-andpost-treatment(P<0.01).Inparticular,theplasmaNPYlevelsinboththeacupuncturetherapygroupa
简介:目的观察并比较脑瘫患者实施选择性脊神经后根切断术(SPR)和神经根部分切断并逆行交叉吻合术(SPA)的疗效。方法广东省第二人民医院和解放军第88医院全军骨科中心自1998年1月至2008年1月共手术治疗96例脑瘫患者,其中47例患者行双侧L3~S1SPR,49例患者行SPA。术后2周、1年测定患者下肢肌张力以及运动功能改善情况。结果术后2周行2种术式的患者肌张力、运动功能的改善差异均无统计学意义(P〉0.05);术后1年行2种术式的患者肌张力的改善差异无统计学意义(p〉0.05),但实施SPA患者运动功能改善优于SPR患者,差异有统计学意义(P〈0.05)。结论实施SPA患者运动功能的改善较好,短期内治疗效果不明显,而长期随访疗效显著。