Efferents from the supracommissural ventral telencephalon in the hime salmon (landlocked red salmon, Oncorhynchus nerka): An anterograde degeneration study

Efferents from the area ventralis telencephali pars supracommissuralis (Vs) of hime salmon (landlocked red salmon, Oncorhynchus nerka) were studied using anterograde degeneration methods. It was found that Vs sends intratelencephalic fibers bilaterally to the internal cell layer of the olfactory bulb and wide areas of telencephalon, while it sends extratelencephalic fibers bilaterally to habenulae, inferior lobes and midbrain tegmenti through medial and lateral forebrain bundles and lateral preoptic area. A possibility was pointed out that some of these extratelencephalic projections are involved in the pathway controlling the sexual behavior which are suggested from behavioral experiments.     

Degeneration in the cochlear nerve of the rat following cochlear lesions

Left unilateral cochlear lesions were performed on 26 albino rats at 1.5 months of age. After survival times ranging from 1 h to 6 months, the animals were perfused via the aorta with mixed aldehydes. Blocks including the cochlear nerves were removed, embedded in Araldite, sectioned in a plane transverse to the longitudinal axis of the nerve, and analyzed in the light microscope. Degenerating fiber profiles were grouped into 4 categories, and their relative frequencies were counted, as were numbers of normal fibers and glial cell nuclei. The cross-sectional areas of the nerves were measured. Lesion extent was evaluated by means of sections through operated cochleas from short and long survival times, and right cochlear nerves from 11 of the animals were used as controls. In the left nerves, segmental swelling of fibers occurred as early as 16 h survival, followed by collapse of fibers and breakdown of myelin sheaths. Starting at 36 h survival, increased numbers of glial cells were seen in the nerve. At longer survival times there were decreases in the cross-sectional area of the nerve and in the packing density of degenerating fiber profiles. At the longest survival times, a substantial amount of debris remained which resembled that seen in early stages. Finally, there was evidence of continued loss of nerve fibers occurring over a period of weeks to months.     

Lesion of the rat entorhinal cortex leads to a rapid microglial reaction in the dentate gyrus

Summary Stereotaxic lesioning of the entorhinal cortex leads to an anterograde axonal degeneration in the molecular layer of the dentate gyrus. As revealed by immunocytochemical and histochemical methods, lesion of the entorhinal cortex induced a proliferation of microglia and an increased expression of established microglial activation markers within the deafferented zone. Reactive microglial cells were detected as early as 24 h after the lesion. The microglial reaction showed a maximum around day 3 post-lesion and disappeared by day 8 post-lesion. Reactive microglia were strongly positive for the B₄-isolectin from Griffonia simplicifolia (GSI-B₄), expressed high levels of CR3 complement receptor and 5-nucleotidase, but lacked CD4 and MHC class I and II antigens. In addition, microglial cells were identified using MUC 102, a new monoclonal antibody against rat microglia. At the ultrastructural level, reactive microglial cells were consistently seen to phagocytose degenerating terminals. Our data suggest that (1) axonal degeneration represents a sufficient stimulus for inducing microglial activation and proliferation in the deafferented dentate gyrus; (2) these activated microglial cells are characterized by immunophenotypes different from those observed in other types of CNS injury; (3) the early microglial reaction precedes the well-documented astrocyte reaction in the dentate gyrus; and (4) the timed interaction of microglia and astrocytes could be important for regulating regenerative sprouting processes in the mature CNS.     

儿童专科医院静脉治疗疑难会诊平台的构建及应用

目的 探讨儿童专科医院静脉治疗穿刺疑难会诊平台的构建及应用效果。 方法 建立以首席+护理骨干组成的静脉治疗小组,并依托医院疑难会诊平台开展院内外儿童疑难静脉治疗会诊。 结果 改进后,静脉治疗专科护士由8人增加至33人,院内外会诊例次增加,患儿家属对会诊满意度显著提升。 结论 儿童专科医院静脉治疗疑难会诊平台的构建及应用,有利于提高儿童静脉穿刺疑难会诊质量和效率,满足患儿个性化需求,提升患儿家属的满意度。     

化疗期锁骨下中心静脉置管并发症的早期干预

目的 探讨肿瘤患者锁骨下中心静脉置管并发症的原因及防护措施。方法 总结2002年9月-2006年10月间为肿瘤内科患者行锁骨下中心静脉置管术320例，观察和记录各种并发症的发生，分析其原因及护理注意事项。结果 出现并发症36例，发生率为11．2％，其中气胸4例，误伤动脉3例，臂丛神经损伤2例，感染8例，导管脱落4例，导管堵塞12例，静脉血栓3例。经密切观察，及时发现，加强护理，均顺利恢复并完成治疗。结论 熟练掌握锁骨下中心静脉置管操作技能，严格把握禁忌证，建立持续监测系统，促进质量改善，实施全面的健康教育，可以大大降低中心静脉置管患者并发症的发生率。     

应用 PDCA 管理法持续改进儿科护士静脉穿刺技术的探讨

目的：探讨应用 PDCA 管理法持续改进儿科护士静脉穿刺技术的方法和效果。方法应用 PDCA 管理法进行儿科护士静脉穿刺技术的现状调查、原因分析、改进对策研讨并组织有效实施和效果评价，通过6个月的整改，比较改进前后一次性穿刺成功率、患者满意度、发生护患争议和转院事件例次情况。结果改进后一次性穿刺成功率、患者满意度均提高，因穿刺发生护患争议和因穿刺技术因素导致转院事件例次减少，两组比较，差异具有统计学意义（ P 〈0.05）。结论 PDCA 管理法用于儿科护士穿刺技术质量持续改进中，能有效的提高儿科护士一次性穿刺成功率，提高患者满意度。     

Anterograde tracing of retinal afferents to the tree shrew hypothalamus and raphe

The anterograde neuronal transport of Cholera toxin B subunit (CTB) was used in this study to label the termination of retinal afferents in the hypothalamus of the tree shrew Tupaia belangeri. Upon pressure-injection of the substance into the vitrous body of one eye, a major projection of the retinohypothalamic tract (RHT) was found to the hypothalamic suprachiasmatic nuclei (SCN). Although the innervation pattern was bilateral, the ipsilateral SCN received a somewhat stronger projection. Labeling was also found in the supraoptic nucleus and its perinuclear zone, respectively, mainly ipsilaterally as well as in the bilateral para- and periventricular hypothalamic regions without lateral predominance. In the raphe region, scattered fibers and terminals were seen in the dorsal and median raphe nuclei. CTB-immunoreactive structures were observed neither in the locus ceruleus nor in vagal nuclei. Our results, partly in contradiction to earlier studies using different tracing techniques in another tree shrew species (Tupaia glis), reveal that hypothalamic nuclei, in particular the SCN, are contacted by retino-afferent fibers which are thought to mediate the effects of light to the endogenous ‘clock’ and to parts of the neuroendocrine system.     

手背皮神经分布与静脉穿刺疼痛程度的相关性研究

背景静脉穿刺是临床治疗最常用的方法之一.手背静脉又是最常选用的静脉穿刺部位.但这种治疗方法是一种有创伤性的操作,它给患者带来一定的痛苦.目前还较少有人从手背静脉与手背皮神经分布、走向规律与穿刺部位疼痛性关系进行研究.目的探讨手背静脉穿刺疼痛程度最低的最佳部位,减轻患者疼痛.设计随机对照的前瞻性研究.地点和对象资料收集于广州医学院荔湾医院,所选取的对象有12例24侧成人防腐标本和在本院住院及门诊静脉穿刺的3 011例次患者.方法首先对24侧成人手背标本进行解剖、观察,找出手背静脉与皮神经分布规律,进行分区.以随机方式对本院2000-08/2001-02就诊留医患者2 980例按不同分区部位进行静脉穿刺.采用双盲法对穿刺患者进行疼痛评分(简化Megill疼痛评分法).分组进行相互对照,方差分析法对数据进行分析.主要观察指标解剖观测结果及静脉穿刺疼痛评分结果.结果手背解剖研究发现桡骨茎突、尺骨茎突及第三掌骨头所形成的三角形区域内神经与静脉呈交叉关系,神经分布稀疏(可称为乏神经区),此区域内静脉穿刺疼痛分值明显低于其他区域(P＜0.01).结论乏神经区内神经分布稀疏,是减少手背静脉穿刺疼痛的最佳部位.