叶酸与神经管畸形的相关性研究

目的探讨本地区神经管缺陷疾病与孕妇血清叶酸水平的关系。方法产前筛查孕26周至孕40周的孕妇,进行系统超声检查及血清叶酸水平检验。结果 105例NTDs孕妇血清中叶酸水平低于同期正常组,差异有统计学意义。结论孕妇低水平叶酸是妊娠NTDs的危险因素,指导孕妇合理服用叶酸对NTDs的发生有预防作用。     

四维彩超在胎儿神经管畸形孕早期诊断的临床研究

目的探讨孕早期四维超声对胎儿先天性神经管畸形的临床诊断价值。方法选择我院应用实时四维彩色超声进行产前检查的1 527例孕11~14周孕妇的临床资料进行分析。结果四维彩超在早期孕检发现,131例胎儿先天性神经管畸形,检出率8.58%。35岁高龄孕妇神经管畸形发生率占22.76%,与正常孕妇相比差异有统计学意义(P0.05);不同孕周确诊胎儿神经管畸形相比,11~14周组与28~37周组相比差异无统计学意义(P0.05),28~37周组与37周以上组差异有统计学意义(P0.01),11~14周组与37周以上组相比差异有统计学意义(P0.01)。结论四维彩超图像立体、直观,为诊断提供了更丰富的信息,高龄孕妇早期筛查可提高对胎儿先天性神经管畸形的早期诊断率,降低围生儿死亡和畸形儿的发生,具有重要临床应用价值。     

早发型重度子痫前期再次妊娠血压正常时的围生儿结局

目的探讨早发型重度子痫前期再次妊娠血压正常时的围生儿结局。方法对首次妊娠为重度子痫前期,根据首次发病孕周分为早发型重度子痫前期(孕周<34周)A组87例,晚发型重度子痫前期B组(孕周>34周)90例,而第二次妊娠血压均正常,观察围生儿结局。结果 A组新生儿小于育龄儿(SGA)发生率明显高于B组(14.9%vs 7.8%),差异具有统计学意义(P<0.01);A组早产率、胎儿宫内生长受限、剖宫产率明显高于B组,差异具有统计学意义(P<0.01)。结论早发型重度子痫前期再次妊娠时即使血压正常,也可能导致不良的妊娠结局,仍需密切观察减少SGA和早产儿的发生率,提高新生儿预后。     

叶酸维生素B12对高龄老人缺血性脑卒中合并高血压的影响

目的：探讨高龄老人缺血性脑卒中患者维生素B12、血清叶酸与血Hcy的相关性。方法测定各组高龄老人血清H cy水平,将90例缺血性脑卒中伴高血压的高龄患者按双盲标准随机分成A、B 2组,A组45例采用常规临床治疗并同时增加叶酸治疗,剂量5 mg ,3次／d ,维生素B12500μg ,3次／d。B组45例采用常规临床治疗但未增加叶酸治疗,并分别在患者入院后及接受治疗8周后测量血清 Hcy 水平。结果缺血性脑卒中组血清 Hcy水平高于对照组,差异有统计学意义（ P＜0.05）,缺血性脑卒中伴高血压患者A 组经叶酸治疗8周后血浆 Hcy水平下降,与入院时血浆 Hcy水平相比,差异有统计学意义（P＜0.01）,并同时低于B组同期水平,差异有统计学意义（P ＜0.01）,但仍高于对照组（P＜0.01）;而缺血性脑卒中伴高血压B组治疗前后血浆Hcy水平差异无统计学意义（P＞0.05）。缺血性脑卒中组高龄患者Hcy水平变化与血压高低呈正相关性（P＜0.05）。结论高Hcy血症是老年缺血性脑卒中的常见高危因素,常规检查血 Hcy血清水平,并及时给予维生素B12及叶酸治疗,能够有效降低 Hcy水平,有效调节血压,从而降低缺血性卒中的再发风险。     

综合护理干预对癫痫女性妊娠结局及生活质量的影响

目的浅析综合护理干预对癫痫女性妊娠结局及生活质量的影响。方法选取2015-02—2016-03来我院产前咨询及孕期产检并分娩患有癫痫的100例孕妇,随机数字表法分为实验组(50例)和对照组(50例),2组患者分别接受综合护理和常规护理,比较护理前后2组妊娠结局及生活质量的变化。结果护理前2组癫痫患者的妊娠结局及生活质量评分差异无统计学意义(P0.05)。经相应护理后实验组产妇剖宫产率、产后出血率及胎盘早剥率均明显低于对照组;同时,新生儿窒息率、胎儿窘迫率也均显著低于对照组;且护理后,实验组生活质量各指标评分均明显高于对照组,差异具有统计学意义(P0.05)。结论综合护理干预可显著改善生育期癫痫女性的妊娠结局和生活质量。     

强化心理干预对妊娠期糖尿病孕妇不良情绪及妊娠结局的影响

目的探讨强化心理干预应用于妊娠期糖尿病孕妇对其焦虑、抑郁不良情绪及妊娠结局的影响。方法选择2014年9月~2015年12月期间我院收治的妊娠期糖尿病孕妇98例,将实施强化心理干预护理的49例归为研究组,将实施常规护理的49例为对照组,比较两组孕妇不良情绪和妊娠结局的各项指标。结果护理前两组孕妇的不良情绪评估及血糖水平,组间无明显差异(P0.05);护理干预后两组孕妇的焦虑,抑郁情绪和血糖水平均较护理前明显改善,研究组改善情况明显优于对照组(P0.01);研究组孕妇治疗依从性高于对照组(P0.01);研究组剖宫产率、产后出血发生率和新生儿窒息发生率低于对照组(P0.05)。结论对妊娠期糖尿病孕妇实施强化心理干预能明显改善其焦虑、抑郁的不良情绪,提高治疗依从性,从而更好的控制血糖水平,降低不良妊娠结局的发生。     

早发型重度子痫前期的期待治疗与围生结局的相关性

目的探讨早发型重度子痫前期的期待治疗与围生结局的相关性。方法选取我院于2013-04-2015-02收治的早发型重度子痫前期患者96例进行统计分析,根据孕周随机分为3组,A组孕周24~28周,B组孕周28~31周,C组孕周32~33周,探讨3组患者期待治疗与孕产妇及围生儿并发症的关系,进行临床对照性分析。结果 3组期待治疗时间、终止妊娠时间比较差异有统计学意义(P0.05);A组并发症发生率48.4%,B组为12.5%,C组为18.2%,A组并发症发生率明显大于B组、C组,差异具有统计学意义(P0.05);3组新生儿呼吸窘迫综合征、胎死宫内、新生儿窒息、死亡等并发症发生率存在明显差异,A组明显大于B组、C组,B组明显大于C组,差异均有统计学意义(P0.05)。结论早发型重度子痫前期的期待治疗与围生结局的相关性高,应用效果好,值得在临床实践中推广。     

慢性高血压并发子痫前期患者对母婴高危因素结局的影响

目的探讨妊娠合并慢性高血压患者母婴不良预后的高危因素。方法对2011-06—2013-06我院分娩的慢性高血压妊娠患者190例,根据病情分为慢性高血压并发子痫前期组(A组)68例,妊娠合并慢性高血压组(B组)122例,对2组患者母婴结局进行分析,找出影响不良预后的高危因素。结果 (1)2组间胎盘早剥、肺水肿、视网膜病差异具有统计学意义(P0.05)。(2)2组早产与胎儿生长受限发生率差异具有统计学意义(P0.05)。新生儿转重症监护或围生儿病死率间差异具有统计学意义(P0.05)。(3)2组出血病例间差异无统计学意义(P0.05)。结论慢性高血压并发子痫前期组母婴病死率和围产儿病死率明显高于妊娠合并慢性高血压组,病情严重,围产结局不良。     

心理护理对妊娠高血压综合征孕妇母婴结局的影响

目的探讨心理护理对妊娠高血压综合征孕妇母婴结局的影响。方法以我院2013-03—2014-12就诊的100例妊娠高血压综合征孕妇为研究对象,随机双盲法将其分为2组各50例,对照组采取对症治疗及常规护理,观察组在对照组基础上给予心理护理干预,比较2组并发症发生率、新生儿结局。结果观察组胎盘早剥、HELLP综合征、剖宫产率分别为2.0%、4.0%、52.0%,对照组为16.0%、16.0%、76.0%,差异有统计学意义(P0.05)。观察组新生儿窒息发生率6.0%,胎儿早产率12.0%,与对照组的20.0%、28.0%比较差异有统计学意义(P0.05)。结论给予妊娠高血压综合征心理护理干预能明显降低剖宫产率,改善母婴结局,值得临床推广。     

奥氮平与帕利哌酮对首发精神分裂症患者血清叶酸、同型半胱氨酸和脑源性神经营养因子水平的影响

目的探析奥氮平与帕利哌酮对首次发病精神分裂症患者血清叶酸、同型半胱氨酸和脑源性神经营养因子水平的影响。方法选取我院2016年9月～2017年9月收治的100例首次发病精神分裂症患者为观察组,另选同期100例健康体检者为对照组,对两组血清叶酸、同型半胱氨酸和脑源性神经营养因子进行对比,随后采用掷硬币法将观察组分为接受帕利哌酮治疗的帕利哌酮组及接受奥氮平治疗的奥氮平组两个亚组各50例,对两亚组治疗前后指标变化进行对比。结果观察组血清叶酸、脑源性神经营养因子低于对照组,同型半胱氨酸高于对照组,差异有统计学意义(P0.05);观察组内两亚组治疗前血清叶酸、同型半胱氨酸和脑源性神经营养因子水平无明显差异,治疗2周、治疗4周、治疗6周、治疗8周各指标数值相比较,奥氮平组血清叶酸、脑源性神经营养因子水平低于帕利哌酮组,而同型半胱氨酸高于帕利哌酮组但组间差异无统计学意义(P0.05);疗程结束后两组患者不良反应发生率比较,奥氮平组略高于帕利哌酮组但差异无统计学意义(P0.05)。结论相较于临床常规用药的帕利哌酮,奥氮平对首次发病精神分裂症患者血清叶酸、同型半胱氨酸和脑源性神经营养因子水平的影响略逊于后者但差异并不明显,在患者存在帕利哌酮用药禁忌时可选取奥氮平予以替代治疗。     

Development of the projection from the nucleus of the brachium of the inferior colliculus to the superior colliculus in the ferret

Neurons in the deeper layers of the superior colliculus (SC) have spatially tuned receptive fields that are arranged to form a map of auditory space. The spatial tuning of these neurons emerges gradually in an experience-dependent manner after the onset of hearing, but the relative contributions of peripheral and central factors in this process of maturation are unknown. We have studied the postnatal development of the projection to the ferret SC from the nucleus of the brachium of the inferior colliculus (nBIC), its main source of auditory input, to determine whether the emergence of auditory map topography can be attributed to anatomical rewiring of this projection. The pattern of retrograde labeling produced by injections of fluorescent microspheres in the SC on postnatal day (P) 0 and just after the age of hearing onset (P29), showed that the nBIC-SC projection is topographically organized in the rostrocaudal axis, along which sound azimuth is represented, from birth. Injections of biotinylated dextran amine-fluorescein into the nBIC at different ages (P30, 60, and 90) labeled axons with numerous terminals and en passant boutons throughout the deeper layers of the SC. This labeling covered the entire mediolateral extent of the SC, but, in keeping with the pattern of retrograde labeling following microsphere injections in the SC, was more restricted rostrocaudally. No systematic changes were observed with age. The stability of the nBIC-SC projection over this period suggests that developmental changes in auditory spatial tuning involve other processes, rather than a gross refinement of the projection from the nBIC.     

The organization of the connections between the cortex and the claustrum in the monkey

The distribution of labelled cells and of extracellular granules in the claustrum has been studied after injections of horseradish peroxidase in several areas of the neocortex. The frontal and parietal lobes are related to the anterior and posterior halves respectively of the claustrum, and the occipital and temporal cortex to the posterior and inferior margins. Parts of the claustrum related to areas of the cortex in the frontal lobe overlap considerably in the antero-posterior dimension with parts related to widely separated but interconnected areas of the parieto-temporal cortex. Areas of cortex within one lobe which are interconnected are related to parts of the claustrum which overlap in the dorsoventral dimension.     

Sexual pheromones and the evolution of the reward system of the brain: the chemosensory function of the amygdala

The amygdala of all tetrapod vertebrates receives direct projections from the main and accessory olfactory bulbs, and the strong similarities in the organization of these projections suggest that they have undergone a very conservative evolution. However, current ideas about the function of the amygdala do not pay sufficient attention to its chemosensory role, but only view it as the core of the emotional brain. In this study, we propose that both roles of the amygdala are intimately linked since the amygdala is actually involved in mediating emotional responses to chemical signals. The amygdala is the only structure in the brain receiving pheromonal information directly from the accessory olfactory bulbs and we have shown in mice that males emit sexual pheromones that are innately attractive for females. In fact, sexual pheromones can be used as unconditioned stimuli to induce a conditioned attraction to previously neutral odorants as well as a conditioned place preference. Therefore, sexual pheromones should be regarded as natural reinforcers. Behavioural and pharmacological studies (reviewed here) have shown that the females' innate preference for sexual pheromones is not affected by lesions of the dopaminergic cells of the ventral tegmental area, and that the systemic administration of dopamine antagonists do not alter neither the attraction nor the reinforcing effects of these pheromones. Anatomical studies have shown that the vomeronasal amygdala gives rise to important projections to the olfactory tubercle and the islands of Calleja, suggesting that these amygdalo-striatal pathways might be involved in the reinforcing value of sexual pheromones.     

Evidence for the collateral innervation of the esophagus and the heart from neurons in the compact formation of the nucleus ambiguus of the rat

We investigated whether the heart receives collateral projections from the neurons which innervate the esophagus with a retrograde double-labeling method using two fluorescent tracers. Following injections of True Blue (TB) into the esophagus and Diamidino Yellow (DY) into the heart, about 21.9% of the labeled esophageal motoneurons in the compact formation of the nucleus ambiguus (AmC) were retrogradely double labeled. No single-labeled cardiac motoneurons were found in the AmC. The present results provide anatomical substrates for the esophagocardiac reflex.     

A projection to the striatum from the medial subdivision of the posterior group of the thalamus in the cat

Injections of wheat germ agglutinin-conjugated horseradish peroxidase in the lateral part of the caudate nucleus or the putamen of the cat result in retrograde thalamic cell-labeling in the rostral extension of the medial subdivision of the posterior group (POM). Autoradiography after [³H]amino acid injection of POM reveals a dense and discontinuous distribution of axons in the lateral half of the caudate and putamen concentrated at their middle rostrocaudal levels. This newly discovered thalamostriatal projection of POM may account for somatosensory activity observed in striatal cells.     

Role of the paraventricular nucleus in the projection from the nucleus of the solitary tract to the olfactory bulb

Electrophysiological experiments were performed on anesthetized rats to determine the effects of lesions of the paraventricular nucleus on the amplitude of evoked potentials recorded in the periglomerular layer of the olfactory bulb after nucleus of the solitary tract electrical stimulation. Lesions of the paraventricular nucleus enhance the amplitude of both the positive and negative components of the evoked potential in the olfactory bulb. The pathway from the paraventricular nucleus to the olfactory bulb seems to exert a suppressive influence over the projection from the nucleus of the solitary tract to the olfactory bulb under these conditions.     

Projections from the five divisions of the orbital cortex to the thalamus in the rat

The orbital cortex (ORB) of the rat consists of five divisions: the medial (MO), ventral (VO), ventrolateral (VLO), lateral (LO), and dorsolateral (DLO) orbital cortices. No previous report has comprehensively examined and compared projections from each division of the ORB to the thalamus. Using the anterograde anatomical tracer, Phaseolus vulgaris leucoagglutinin, we describe the efferent projections from the five divisions of the ORB to the thalamus in the rat. We demonstrated that, with some overlap, each division of the ORB distributed in a distinct (and unique) manner to nuclei of the thalamus. Overall, ORB projected to a relatively restricted number of sites in the thalamus, and strikingly distributed entirely to structures of the medial/midline thalamus, while completely avoiding lateral regions or principal nuclei of the thalamus. The main termination sites in the thalamus were the paratenial nucleus (PT) and nucleus reuniens (RE) of the midline thalamus, the medial (MDm) and central (MDc) divisions of the mediodorsal nucleus, the intermediodorsal nucleus, the central lateral, paracentral, and central medial nuclei of the rostral intralaminar complex and the submedial nucleus (SM). With some exceptions, medial divisions of the ORB (MO, VO) mainly targeted “limbic-associated” nuclei such as PT, RE, and MDm, whereas lateral division (VLO, LO, DLO) primarily distributed to “sensorimotor-associated” nuclei including MDc, SM, and the rostral intralaminar complex. As discussed herein, the medial/midline thalamus may represent an important link (or bridge) between the orbital cortex and the hippocampus and between the ORB and medial prefrontal cortex. In summary, the present results demonstrate that each division of the orbital cortex projects in a distinct manner to nuclei of the thalamus which suggests unique functions for each division of the orbital cortex.     

On the development of the stratification of the inner plexiform layer in the chick retina

This study investigated the development of the subdivision of the chick inner plexiform layer (IPL). The approach included an immunohistological analysis of the temporal and spatial expressions of choline acetyltransferase, of the neural-glial-related and neural-glial cell adhesion molecules (NrCAM and NgCAM, respectively) and axonin-1, and of inwardly rectifying potassium (Kir) channels in 5- to 19-day-old (E5-E19) embryos. Ultrastructural investigations evaluated whether synaptogenesis accompanies the onset of differentiation of the IPL. We found that the differentiation of the IPL started at E9. Distinct cholinergic strata appeared, NrCAM immunoreactivity showed a poorly defined stratification, and Kir3.2 was expressed in the IPL and in the inner nuclear layer. From E10 until late E14, NgCAM- and axonin-1-immunoreactive strata emerged in an alternating sequence from the outer to the inner IPL. During this period, the NrCAM pattern sharpened, and eventually five bands of weaker and stronger immunoreactivity were found. Conventional synapses formed at the beginning of E9, and stratification of the IPL also began on the same day at the same location. Synaptogenesis and stratification followed a gradient from the central to the peripheral retina. The topographic course of differentiation of the IPL generally corresponded to the course of maturation of ganglion and amacrine cells. Synaptogenesis and the expression of G-protein-gated Kir3.2 channels accompanied the onset of stratification. These events coincide with the occurrence of robust and rhythmic spontaneous neuronal activity. The subsequent differentiation of the IPL seemed to be orchestrated by several mechanisms.     

Origins of the sympathetic innervation of the cervical end of the uterus in the rat

A retrograde neuronal tracer (Fast Blue) was injected in the cervical end of the uterine horn of virgin rats. The majority of the retrogradely labeled post-ganglionic sympathetic neurons were found in the sympathetic chain (74%). The superior mesenteric ganglia, inferior mesenteric ganglia and suprarenal ganglia accounted for 22, 3 and <1%, respectively. The distribution of neurons in the sympathetic chain labeled from the uterus resembles that described for other pelvic organs.