RESUMO
[Abstrict]Objective To explore the key points and clinical value of combined direct and indirect extracranial-in?tracranial (EC-IC) bypass in patients with adult moyamoya disease. Methods Retrospective analysis of combined revas?cularization surgery in 25 adult patients with moyamoya disease. The frontal branch and parietal branch of the superficial temporal artery (STA) were dissected. Combined revascularization surgery consisted of direct (anastomosis between the su?perficial temporal artery and cortical branch of the middle cerebral artery) and indirect (encephalodurogaleosynan-giosis EDAS) surgeries. Clinical status was evaluated using the modified Rankin Scale and NIHSS score at 1 day before, 1 week and 3 months after surgery. Results Thirty lateralities were successfully performed on 25 patients. Postoperative angiogra?phy or CTA and cranial computer tomography perfusion imaging(CTP) were conducted to examine the patency of the di?rect anastomosis and cerebral blood flow in 23 patientswithin 1 weeks after surgery . The results showed that the anasto?motic vascular patency was excellent and the cerebral blood flow increased in parallel to the relief of the patients’s isch?emic symptoms. The median mRS scores were 3 (1,3) before surgery, 2 (1,3) 1 week and 1 (0,3) 1 month after surgery.The median mRS scores were significantly improved (Z=15.14, P<0.01). The median NIHSS scores was 5 (4,8) preopera?tively and 4(2,7) postoperation 1 week and 3(1,4) 3 months. The median NIHSS scores were also significantly improved (Z=11.36, P<0.01). Unfortunately, two patients had complication and left hemiparesis. One patient complicated with con?tralateral hemisphere infarction and the another one complicated with ipsilateral hemispheric hemorrhage after operation. Conclusions Combined revascularization surgery may result in satisfying improvement in clinical, angiographic, and he?modynamic states and prevention of recurrent stroke. The stabilized hemodynamic is the key point in peroperative period for moyamoya patients.
RESUMO
Objective To observe the effects of different modes treadmill training on cognitive func-tion and transforming growth factor β1 ( TGF-β1 ) expression in cerebral cortex of rats. Methods Two months old rats were divided into the control group,piecewise training group and intermittent training group ( n=10 in each group) . The training was performed five times a week for 6 weeks. Learning and memory a-bility of all rats was detected by water maze at 6 weeks after the training. TGF-β1 expression and localization in cerebral cortex was tested by QRT-PCR and immunofluorescence, respectively. Results The platform time in piecewise group ((30±28) s) and intermittent group ((25±23)s) was both significantly shorter than that in control group ((58±50)s). In the space exploration,the time around Ⅳ quadrant platform in piecewise group((23.6±3.9)s) and intermittent group ((24.3±8.9)s) was significantly higher than that in the control group((17.7±2.0)s). The expression of TGF-β1 mRNA in cerebral cortex in intermittent group (0.0067±0.0043)was obviously higher than that in piecewise group (0.0035±0.0006) and control group (0.0041±0.001). TGF-β1 was located in cell membrane and cytoplasm,and the relative optical density of intermittent group (0.0045±0.0017) was significantly higher than that of control group (0.0019±0.0004) and staging group (0.00175±0.00045). Conclusion (1)Learning and memory function both were im-proved after treadmill six weeks with piecewise and intermittent training models. ( 2) The level of TGF-β1 gene and protein was significantly increased after interval training in cortex of rats.
RESUMO
Objective By the designing and clinical application of score table and focus nursing sheet to brain trauma patients,paramedics can observe state of illness individually,optimize the nursing care in a further performance,and ensure the security of brain trauma patients more profitably.Methods To design the score table and focus nursing sheet according to the disease species and symptoms,contrast to the previous nurse observing table in noting time,error rate,exam results and surgeon satisfaction degree.Results By evaluating 130 cases in this test,the score table and focus nursing sheet were superior to the previous nurse observing table.Conclusions With the score table and focus nursing sheet,nurses can observe the illness and note the progress more scientifically and conveniently,the concept of individuation and specialization are worthy of recommending.