The relationship between the neuromyelitis optica astrocyte damage and the patients with functional defect / 实用医学杂志

Objective To explore the relationship between the damage of neuromyelitis optica (NMO) astrocytes (AS) and the onset of NMO, and investigate the relevance of AS damage with the severity of the patients with functional defect. Methods The levels of aquaprin4-antibody (AQP4 -Ab), glial fibrillary acidic protein (GFAP), apolipoprotein(ApoE),interleukins-6(IL-6), interleukins-10(IL-10), tumor necrosis factor-α(TNF-α) in cerebrospinal fluid (CSF ) and serum of 30 acute NMO patients were tested by means of ELISA. The results were later compared with control group. And analysis of the relevance of the various index of the levels in CSF with the CSF AQP4-Ab level, the acute phase expanded disability status scale(EDSS) score of the NMO group were made. Results (1)The NMO group in CSF and serum AQP4-Ab, GFAP, IL-6 levels were higher than the control group (P < 0.05), and ApoE, IL-10 levels were lower than the control group (P < 0.05). (2)The CSF GFAP, ApoE, IL-6 in NMO group is higher than the serum (P < 0.05), and CSF AQP4-Ab, IL-10 levels were lower than the serum ( P < 0 . 05 ) . ( 3 ) The CSF GFAP , IL-6 levels and the CSF AQP4-Ab level were positively correlated (r=0.749, r=0.526, P<0.05), and the CSF ApoE, IL-10 levels were negatively correlated with CSF AQP4-Ab level(r = -0.571, r = -0.676, P < 0.05). (4)The CSF AQP4-Ab, GFAP, IL-6 levels and the acute phase EDSS score were positively correlated (P < 0.05), the CSF ApoE, IL-10 levels were negatively correlated with the acute phase EDSS score (P < 0.05). Conclusion The AS damage exists in the NMO and the damage severity may correlate with patient function defect. AQP4-Ab, GFAP, IL-6 may play important roles in the onset of NMO and the disease aggravating. The decrease of the ApoE and IL-10 may exacerbate NMO damage.

Early Hematoma Growth in Patients with Intracerebral Hemorrhage / 国际脑血管病杂志

Objective:To explore the incidenee of early hematoma growth in patients with intracerebral hemorrhage,and the correlation between early hematoma growth and early neurological deterioration.Methods:The evaluation of nervous system and CT scan in patients with intracerebral hemorrhage within 3 hours after the omet of symptoms were performed respectively at baseline,and 1,2,3,and 20 hours after the baseline.Results:In 106 patients,CT scan shelwed that the volume of intraparenehymal hemorrhage inereased significantly in 26% of patients at baseline and within 1 hour.CT scan showed that the bleeding volume increased in 12% of patients at 1,2,3,and 20 hours.By measuring baseline,1-hour Glasgow Coma Scale (GCS)score,and the changes of the National Institutes of Health Stroke Scale(NIHSS),it had found that the baseline status and the increased bleeding volume within 1 hour vdgre closely correlated with the clinical neurological deterioration.Conclusions:The early bleeding volume often inereases significantly in patiems with intracerebral hemorrhage,which is complicated with neurological deterioration.In order to determine whether these therapeutic measures improve the natural course of this early hematoma growth and decrease its occurrence,it is necessary to make a randomized clinical trial.

The Assessment of the Dysphagia Following Stroke / 医学研究杂志

Objective To reduce the rate of dysphagia and inhalation pneumonia by changing the food dense and evaluate the swallow function by videofluoroscopy(VF) and fiberoptic endoscopic examination of swallowing(FEES). Methods The videofluoroscopy and fiberoptic endoscopic examination of swallowing were used in 50 healthy volunteer and 35 dysphagia person. Results Aspiration was find in 14% volunteer and penetration was find in 36% volunteer. The positive rate of videofluoroscopy was higher than of fiberoptic endoscopic examination of swallowing in the two indicators. The delay of the thin barium passed the pharynx was the danger factor of aspiration. Videofluoroscopy was more sensitive in diagnosis of penetration. The time that watery barium and pudding barium flowed from pharynx to epiqlottis is longer in patients than that in volunteer. Conclusion The videofluoroscopy and fiberoptic endoscopic examination could be predicted to some extend by some clinical swallowing abnormalities, which could increase the accuracy of clinical evaluation . The viscosity changing can decrease the rate of dysphagia and inhalation pneumonia.

Stereotactic conformal radiotherapy for extracranial tumors / 中国微创外科杂志

Objective To explore the curative effect of stereotactic conformal radiotherapy (SCR) for extracranial tumors. Methods Eighty-six patients with extracranial tumors underwent SCR from May 1997 to August 2002. The clinical target volume (CTV) of tumors ranged from 0.2 cm3 to 232 cm3, with a mean of 27.6 cm3. The prescribed dose to the planning target volume (PTV) was 3～12 Gy (mean,5.3 Gy),which were prescribed in 1～10 fractions. Results No patient died during the treatment. Karnofsky performance scores (KPS) ranged 10～90 (mean,60) and 20～100 (mean,82) before and after the treatment. Follow-up for 1～5 years showed complete remittence (CR) in 25 cases, partial remittence (PR) in 49 cases, no change in 9 cases, and progressed in 3 cases. Conclusions SCR is an effective method in the management of extracranial tumors.

Stereotactic radiotherapy for lung carcinoma / 中国微创外科杂志

Objective To discuss the clinical effects of stereotactic radiotherapy in the management of lung cancer. Methods Included in this study there were 27 patients with lung cancer. After the lesions were localized by CT scans with 2 mm slice thickness, the images were reconstructed and clinical tumor volume (CTV), planning tumor volume (PTV) and dose-volume histograms of the involved lung were calculated. By using Leibinger stereotactic radiotherapy planning system and Varian Clinic 600C, a series of 5～8 fractions of radiotherapy were carried out once daily with 5～7 Gy per fraction. Results None of the 27 patients died during the treatment. General conditions of the patients were assessed by means of Karnofsky performance status (KPS). Preoperative KPS scores were 20～80 (mean 59), while postoperative KPS scores were 20～100 (mean 87). Follow-up information revealed 4 cases of complete remission, 17 cases of patial remission, 2 cases of no change and 4 progressed, with control rate being 85%. Conclusions Stereotactic radiotherapy provides excellent short-term curative effects in the treatment of lung carcinoma.

The therapeutic effect of 3D-conformal radiotherapy on metastatic hepatic cancer / 中国微创外科杂志

Ojective To evaluate the therapeutic effect of conformal radiotherapy on metastatic hepatic cancer. Methods 10 cases of metastatic hepatic cancer (1 to 5 metastatic focus respectively) were treated with stereotactic radiotherapy from Septermber 1997 to April 2000. The clinical target volume(CTV) of tumor ranged from 0.6cm 3 to 232cm 3 (the mean 41.9cm 3), peripheral irradiation doses of planning target volume (PTV) ranged from 3.96Gy to 7.00Gy(the mean 5.26Gy)each time, cential irradiation doses of PTV were 6.3Gy～10.88Gy (the mean 7.89Gy) each time, once a day for 5～8 times totally. Results No patient died during therapy. KPS of patients normal condition were 20～90(54?25.90) before treatment and 30～100 (74?23.90) after treatment. Effect of entity tumor were as follows completely relaxed (CR) in two cases, partly relaxed (PR) in four cases, no change (NC) in three cases, progressed (PD) in one case. During follow-up period tasting 2 to 28 months 90% of the tumors were controlled (no progressive disease). 60% fo the tumors decreased in size or disappeared. Conclusions Stereotactic radiotherapy has better therapeutic effects on cases of metastatic hepatic cancer.