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Deep brain stimulation in the treatment of secondary dystonia

Chinese Medical Journal 2006年第24期119卷 2069-2074页

作者： ZHANG Jian-guo,ZHANG Kai,WANG Zhong-cheng,GE Ming and MA Yu department of Neurosurgery,beijing Tiantan Hospital,Capital University of Medical Sciences functional neurosurgical department,beijing neurosurgical institute,beijing 100050,china department of Neurosurgery Beijing Tiantan Hospital Capital University of Medical Sciences

Background Dystonia is one of the most challenging movement disorders to treat. Medications and surgeries are the two methods to control dystonic symptoms. For patients with dystonia in whom symptoms are inadequately controlled with pharmacologic measures, the use of deep brain stimulation （DBS） can improve symptoms and enhance functional capacity. The best candidate for DBS is believed to be primary generalized dystonia, especially the DYT-1 type. Here, we report 9 cases of secondary dystonia to explore the feasibility, indications and complications of DBS in the treatment of secondary dystonia. Methods From July 2003 to June 2006, nine patients with secondary dystonia underwent surgery at beijing Tiantan Hospital. Among them, 2 were diagnosed as having tardive dystonia, 1 had posttraumatic dystonia, 3 had a history of perinatal anoxia, 1 had neonatal pathologic jaundice, and 2 had no exact contributory history; MRI showed bilateral lentiform nuclei degeneration in one patient. Six patients underwent bilateral subthalamic nucleus （STN）-DBS, two underwent unilateral STN-DBS, the other underwent left STN and fight globus pallidus internus（GPi）-DBS. Results With intraoperative microelectrode recording, the targeted nucleus was accurately localized. Tentative stimulation could decrease muscle tension to the same extent, but twisting was not obviously improved. Follow-up for 3 months to 3 years showed satisfactory results in 3 patients with tardive dystonia and posttraumatic dystonia and that Burke-Fahn-Marsden Dystonia Scale （BFMS） decreased by more than 90%. The improvement of symptoms was progressive along with time. The other 6 patients had slight to moderate improvement. None of them had severe surgery-related complications. One had lead fracture 16 months after surgery and the lead was then evacuated. Conclusions DBS could be an ideal treatment for patients with tardive and posttraumatic dystonia. For patients with perinatal anoxia and diffuse impairment in the ba

关键词： subthalamic nucleus deep brain stimulation secondary dystonia

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A novel arterial pouch model of saccular aneurysm by concomitant elastase and collagenase digestion

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2007年第10期8卷 697-703页

作者： YANG Xin-jian, LI Li, WU Zhong-xue (department of Interventional Neuroradiology, beijing neurosurgical institute, Capital Medical University, beijing 100050, china) department of Interventional Neuroradiology Beijing Neurosurgical Institute Capital Medical University Beijing 100050 China

Background: An ideal aneurysm model of cerebral aneurysm is of great importance for studying the pathogenesis of the lesion and testing new techniques for diagnosis and treatment. Several models have been created in rabbits and are now widely used in experimental studies; however, every model has certain intrinsic limitations. Here we report the development of a novel saccular aneurysm model in rabbits using an arterial pouch that is subject to in vitro pre-digestion with combined elastase and collagenase. Methods: A segment of right common carotid artery (CCA) was dissected out and treated with elastase (60 U/ml, 20 min) followed by type I collagenase (1 mg/ml, 15 min) in vitro. The graft was anastomosed to an arterial arch built with the left CCA and the remaining right CCA, while the other end of the graft was ligated. The dimension and tissue structure of the pouch were analysed immediately, 2 or 8 weeks after operation. Findings: Ten terminal aneurysms were produced. The gross mor-phology of the aneurysm resembles the human cerebral terminal aneurysms. We have observed the following pathological changes: (1) growth of the aneurysm (mean diameter increased from (2.0±0.1) to (3.2±0.3) mm at 2 weeks, P<0.001, n=7~10); (2) thinning of the aneurysmal wall (the mean wall thickness decreased to 44% at 2 weeks), which was accompanied by significant losses of elastic fibres, collagen and the cellular component; and (3) spontaneous rupture (3 out of 9, one aneurysm ruptured 24 h after operation with the other two at 2 and 4 weeks respectively). Conclusion: This rabbit arterial pouch model mimics human cerebral aneurysms in relation to morphology and histology. In particular, this model exhibited an increased tendency of spontaneous rupture.

关键词： Animal model Collagenase Elastase Intracranial aneurysm

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Effect of Rat Schwann Cell Secretion on Proliferation and Differentiation of Human Neural Stem Cells

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Biomedical and Environmental Sciences 2003年第1期16卷 90-94页

作者： YI-HUA AN, HONG WAN, ZE-SHUN ZHANG, HONG-YUN WANG, ZHI-XING GAO, MEI-ZHEN SUN, AND ZHONG-CHENG WANGbeijing neurosurgical institute, beijing 100050, china beijing neurosurgical institute 北京 100050

Objective To investigate the effect of rat Schwann cell secretion on the proliferation and differentiation of human embryonic neural stem cells (NSCs). Methods The samples were divided into three groups. In Group One, NSCs were cultured in DMED/F12 in which Schwann cells had grown for one day. In Group Two, NSCs and Schwann cells were co-cultured. In Group Three, NSCs were cultured in DMEM/F12. The morphology of NSCs was checked and β-tubulin, GalC, hoechst 33342 and GFAP labellings were detected. Results In Group One, all neural spheres were attached to the bottom and differentiated. The majority of them were p-tubulin positive while a few of cells were GFAP or GalC positive. In Group Two, neural spheres remained undifferentiatied and their proliferation was inhibited in places where Schwann cells were robust. In places where there were few Schwann cells, NSCs performed in a similar manner as in Group One. In Group Three, the cell growth state deteriorated day after day. On the 7th day, most NSCs died. Conclusion The secretion of rat Schwann cells has a growth supportive and differentiation-inducing effect on human NSCs.

关键词： Stem cells Schwann cells Nerve growth factors Coculture Immunohistochemistry

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Surgical Management of Intramedullary Spinal Cord Tumors: Surgical Resection and Prognosis

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中国神经肿瘤杂志 2003年第4期1卷 209-214页

作者： Gui-huai Wang Chung-cheng Wangbeijing neurosurgical institute, beijing Tiantan Hospital beijing P. R. china 100050 beijing neurosurgical institute Beijing Tiantan Hospital Beijing P.R.China 100050

BACKGROUND & OBJECTIVE: The majority of intramedullary spinal cord tumors (IMSCT) are low-grade gliomas. Radical resection for IMSCTs remains challenging. Recently, improved neuroimaging and advanced microsurgical technique have made great success in surgical management of the intramedullary spinal cord tumors. METH-ODS & RESULTS: Twenty-nine patients with intramedullary spinal cord tumors were treated by radical resection dur-ing the past 4 years in our institute. The histological results were as follows: 12 ependymomas, 4 astrocytomas, 4 heman-gioblastomas, 4 epidermoids, 1 cavernoma, 2 lipomas, 2 metastatics. A gross -total resection (> 95%) was achieved in 25 surgical procedures. Subtotal resections (80-95% ) were performed in 4 cases. There was no surgical *** comparing the preoperative and 3-month postoperative functional grades, 12 patients were stable 14 improved,and 3 deteriorated. Patients with either no deficit or only mild deficit before surgery were rarely impaired by the proce-dure, reinforcing the importance of early diagnosis and treatment. The major determinant of long-term survival was histologi-cal composition of the tumor. Patients in whom an IMSCT was only partially resected (<80% ) fared significantly worse. CONCLUSIONS: The long-term survival and quality of life for patients with low-grade gliomas treated by radi-cal resection alone is comparable or superior to minimal resection plus radiotherapy. The optimal therapy for patients with high-grade glioma is yet to be determined. For benign lesion, such as hemangioblastoma and cavernoma could be cured by total resection of the tumor. For lipoma and epidermoid, fibrous adhesions to the cord make total removal difficult,and thus, removal is not the goal of surgery. The carbon dioxide laser is particularly useful during surgery for this lesion.

关键词： Intramedullary spinal cord tumors Ependymoma Astrocytoma Surgery

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舒巴坦治疗神经外科重症患者鲍曼不动杆菌感染中国专家共识

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中国现代神经疾病杂志 2024年第6期24卷 407-424页

作者：中华医学会神经外科学分会中国神经外科重症管理协作组石广志赵经纬左玮徐明胡付品不详首都医科大学附属北京天坛医院重症医学科 100070 中国医学科学院北京协和医学院北京协和医院药剂科复旦大学附属华山医院抗生素研究所

多重耐药或广泛耐药鲍曼不动杆菌感染的神经外科重症患者治疗难度大、病死率高。舒巴坦是治疗多重耐药鲍曼不动杆菌感染的有效药物,具有穿透炎性血脑屏障的优势,适用于神经外科重症患者。近年随着鲍曼不动杆菌对舒巴坦的耐药趋势日益严... 详细信息

多重耐药或广泛耐药鲍曼不动杆菌感染的神经外科重症患者治疗难度大、病死率高。舒巴坦是治疗多重耐药鲍曼不动杆菌感染的有效药物,具有穿透炎性血脑屏障的优势,适用于神经外科重症患者。近年随着鲍曼不动杆菌对舒巴坦的耐药趋势日益严峻,舒巴坦治疗多重耐药或广泛耐药鲍曼不动杆菌感染药物剂量、给药途径、联合方案等缺乏规范化标准。中国神经外科重症管理协作组通过梳理相关循证医学证据并经过反复讨论修改后形成《舒巴坦治疗神经外科重症患者鲍曼不动杆菌感染中国专家共识》,涵盖28条共识建议,为舒巴坦在神经外科重症管理中的应用提供科学、可行的临床指导。

关键词：神经外科手术危重病人医疗鲍氏不动杆菌舒巴克坦诊疗指南

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神经重症患者中枢神经系统感染多黏菌素局部应用的中国专家共识(2024年版)

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中华神经医学杂志 2024年第2期23卷 109-118页

作者：中国医师协会神经外科分会神经重症专家委员会中国神经外科重症管理协作组石广志冯光不详首都医科大学附属北京天坛医院重症医学科北京100070 河南省人民医院(郑州大学人民医院)神经外科郑州450003

神经重症患者中枢神经系统感染治疗难度大、病死率高,多重耐药革兰阴性杆菌感染占比逐年升高。多黏菌素是治疗多重耐药革兰阴性杆菌的有效药物,但其血脑屏障通过率低,静脉给药难以达到有效的药物浓度,脑室内或鞘内给药等局部应用的方式... 详细信息

神经重症患者中枢神经系统感染治疗难度大、病死率高,多重耐药革兰阴性杆菌感染占比逐年升高。多黏菌素是治疗多重耐药革兰阴性杆菌的有效药物,但其血脑屏障通过率低,静脉给药难以达到有效的药物浓度,脑室内或鞘内给药等局部应用的方式近年来越来越多地被临床采用,但缺乏相关的规范化操作指引,故本共识专家委员会围绕多黏菌素局部应用治疗中枢神经系统感染的适应证、用法用量、治疗途径等问题进行反复讨论,形成14条共识推荐意见,以期为多黏菌素中枢神经系统局部应用提供科学和切实可行的临床指导。

关键词：神经重症中枢神经系统感染多黏菌素鞘内给药脑室内给药

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Up regulation of aquaporin 1,4 and 9 expressions in brain edema after rat traumatic brain injury

Up regulation of aquaporin 1,4 and 9 expressions in brain ed...

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中国神经科学学会第四次会员代表大会暨第七届全国学术会议

作者： F.YUAN,L.ZHANG,Y.CUI,L.X.XU beijing neurosurgical institute,beijing 100050,china

＜正＞Objective Aquaporins（AQPs） are a family of water-selective channels that provide a major pathway for osmotically driven water transport through cell *** AQP subtypes cloned in mammalian,only AQP 1,4 and 9 were identified in the *** evidence suggests that brain AQPs play important roles for the dynamic regulation of brain water homeostasis and may be correlated with edema formation of the *** purpose of this work is to study the expression of AQP 1,4 and 9 in rat brain and their roles in brain edema after traumatic brain injury（TBI）. Methods The impact-acceleration head injury model of rat was *** rats were divided into control group and TBI groups randomly,and examined at interval times of 1,6,24 h and 7days after TBI respectively（n = 6）.Change of brain water content was assessed by brain wet / dry *** 1,4 and 9 expressions were determined using immunohistochemical staining and were semiquantified as an intensity of staining or numbers of positive staining *** immunostaining was used to assess blood-brain barrier（BBB） *** The brain water content after TBI increased at 6 *** peak at 24 h and returned to normal at 7 *** of IgG began to increase at 1 h and peaked at 6 ***, up expressions of AQP 4 were found both in astrocyte end-feet and cell bodies after *** there were positive cells immunostained with AQP 1 and 9 in edema *** most remarkable changes of the immunostaining of AQP 1,4 and 9 were occurred at 24 h after TBI,which was parallel to brain water content increases but delayed to BBB disturbance. Conclusion The good correlation between alterations in brain water content and AQP 1,4 and 9 immunostaining suggests that changes of these AQPs are involved in the development of brain *** modulation of AQP 1,4 and 9 function may provide a novel therapeutic strategy for the treatment of TBI.

关键词： traumatic brain injury brain edema aquaporin I aquaporin 4 aquaporin 9

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Diagnosis of glioma by multivoxel 1H-MRSI

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Progress in Natural Science:Materials International 2004年第9期 26-29+97页

作者： QUAN Hong 1, LIU Yue 2, BAO Shanglian 1*, LI Shaowu 2, XIE Yaoqin 1, MIAO Binghe 1 and WANG Huiliang 1(1. Research Center for Tumor Diagnosis and Radiotherapeutical Physics and Laboratory of Medical Physics & Engineering, Peking University, beijing 100871, china 2. Neuro Imaging Center, beijing neurosurgical institute, beijing 100050, china) Neuro-Imaging Center Beijing Neurosurgical Institute Beijing 100050 China Research Center for Tumor Diagnosis and Radiotherapeutical Physics and Laboratory of Medical Physics & Engineering Peking University Beijing 100871 China

Glioma is one of the most malignant tumors due to its special construction of the glia cells and its character of infiltration. The usual procedure of the treatment is the surgical resection followed by radiotherapy with or without chemotherapy. This combined treatment needs the precise information on the extent of the tumor's infiltration and tumor grading, and then the determination can be made as to when, where and what kind of treatment should be used. functional imaging modalities display advantages in defining the heterogeneous characters and histological grade. This paper describes how the ratios of Cho/NAA and Lac/NAA measured by magnetic resonance spectroscopy imaging (MRSI) could be used to define the cancer cell distribution in tissues, tumor burden and malignancy, and the results are proved to be consistent with the histological observation.

关键词： segmentation of glioma data analysis of MRSI functional imaging for tumor diagnosis and treatment.

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脊髓血管母细胞瘤的MR影像研究

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实用放射学杂志 2005年第2期21卷 123-125页

作者：陈谦戴建平高培毅北京市神经外科研究所神经放射科北京市神经外科研究所神经放射科北京100050

目的　分析脊髓血管母细胞瘤的MR影像表现。方法　经手术病理证实的脊髓血管母细胞瘤 29例,男 20例,女 9例,所有病例均行MR检查,回顾分析其MR影像表现。结果　12例单发(41. 4% ), 17例多发(58. 6% ),合并颅内血管母细胞瘤 7例。MR平扫... 详细信息

目的　分析脊髓血管母细胞瘤的MR影像表现。方法　经手术病理证实的脊髓血管母细胞瘤 29例,男 20例,女 9例,所有病例均行MR检查,回顾分析其MR影像表现。结果　12例单发(41. 4% ), 17例多发(58. 6% ),合并颅内血管母细胞瘤 7例。MR平扫时肿瘤表现为等T1 等T2 信号 36个,等和低混杂T1 信号、等和高混杂T2 信号 16个,长T1 长T2 信号 1个。小的肿瘤倾向于等T1 等T2 信号。增强扫描后肿瘤显著强化,边界清楚。17例患者中的 21个肿瘤在T2 加权像上可见血管流空信号。27例患者中的 40个肿瘤合并有较长的脊髓空洞或囊肿。结论　脊髓血管母细胞瘤常多发或合并颅内血管母细胞瘤,肿瘤结节边界清楚,强化显著以及肿瘤相关的血管流空信号对该肿瘤的诊断最有意义。

关键词：血管母细胞瘤脊髓肿瘤磁共振成像

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Finite element model on medical image for biomechanical analysis of percutaneous vertebroplasty

Finite element model on medical image for biomechanical anal...

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第八届全国生物力学学术会议

作者： Xiang Chen~1,Haiyun Li~1,Xinjian Yang~2 (1.Biomedical Engineering institute,Capital University of Medical Sciences, 100069 beijing,china 2.beijing neurosurgical institute,beijing 100069,china)

In this paper,a biomechanical analysis method for percutaneous vertebroplasty has been presented. Integrating the anatomical structure from the segmented spine CT image of a patient,a novel three-dimensional geometric model of lumbar functional spinal units(FSUs)has been *** on the geometric model,two kinds of three-dimensional finite element models(FEM)of L1-L2 segments for

关键词： Percutaneous Vertebroplasty Finite element model geometrical model

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