星状神经节阻滞对脑卒中吞咽障碍康复的影响

目的观察星状神经节阻滞对脑卒中患者吞咽障碍的康复作用。方法脑卒中合并假性球麻痹患者100例,随机分为两组各50例,两组均给予常规康复治疗,阻滞组加用星状神经节阻滞。结果治疗前两组意识状态和吞咽功能评分相近,治疗20d后吞咽功能评分两组与治疗前比较均有明显提高,对照组治疗后评分5．15±0．35（P〈0．05）;阻滞组提高更明显,评分5．92±0．52（P〈0．05）。结论星状神经节阻滞治疗可明显提高脑卒中并发假性球麻痹患者的吞咽功能,改善其生活质量。     

0．5％与1％利多卡因用于星状神经节阻滞的临床对比观察

目的比较0．5％及1％利多卡因行星状神经节阻滞的效果及不良反应,对SGB用药的浓度选择进行评价。方法需要行星状神经节阻滞的患者54例随机分成A、B两组,每组27例,A组用0．5％利多卡因,B组用I％利多卡因分别行星状神经节阻滞,观察两组霍纳征出现率、持续时间及不良反应,对观察结果进行比较。结果霍纳征出现率A组为90．8Yoo（369／406例次）,B组为91．6％（351／383例次）;持续时间A组为（34．5±5．0）rain,B组为（37．0±5．O）min,两组无统计学差异;0．5％利多卡因出现喉返神经阻滞仅为1％。臂丛神经阻滞为2．9％,少于1％利多卡因。结论0．5％利多卡因的霍纳征出现率与持续时间与1％利多卡因相当,副作用较少、安全性较高,星状神经节阻滞治疗以0．5％利多卡因为好。     

A Ganglion Cyst in the Second Lumbar Intervertebral Foramen

Ganglion cysts usually arise from the tendon sheaths and tissues around the joints. It is usually associated with degenerative arthritic changes in older people. Ganglion cyst in the spine is rare and there is no previous report on case that located in the intervertebral foramen and compressed dorsal root ganglion associated severe radiculopathy. A 29-year-old woman presented with severe left thigh pain and dysesthesia for a month. Magnetic resonance imaging revealed a dumbbell like mass in the intervertebral foramen between second and third lumbar vertebrae on the left side. The lesion was removed after exposure of the L2-L3 intervertebral foramen. The histological examination showed fragmented cystic wall-like structure composed of fibromyxoid tissue but there was no lining epithelium. A ganglion cyst may compromise lumbar dorsal root ganglion when it located in the intervertebral foramen. Although it is very rare location, ganglion cyst should be included in the differential diagnosis for intervertebral foraminal mass lesions.     

Inner retinal circadian clocks and non-visual photoreceptors: Novel players in the circadian system

Daily and annual changes in ambient illumination serve as specific stimuli that associate light with time and regulate the physiology of the organism through the eye. The eye acts as a dual sense organ linking light and vision, and detecting light that provides specific stimuli for non-classical photoreceptors located in the inner retina. These photoreceptors convey information to the master circadian pacemaker, the hypothalamic suprachiasmatic nuclei (SCN). Responsible for sensing the light that regulates several non-visual functions (i.e. behavior, pupil reflex, sleep, and pineal melatonin production), the retina plays a key role in the temporal symphony orchestra playing the musical score of life: it is intrinsically rhythmic in its physiological and metabolic activities. We discuss here recent evidence in support of the hypothesis that retinal oscillators distributed over different cell populations may act as clocks, inducing changes in the visual and circadian system according to the time of the day. Significant progress has recently been made in identifying photoreceptors/photopigments localized in retinal ganglion cells (RGCs) that set circadian rhythms and modulate non-visual functions. Autonomous retinal and brain oscillators could have a more complex organization than previously recognized, involving a network of “RGC clock/SCN clock cross-talk”. The convergence of oscillatory and photoreceptive capacities of retinal cells could deeply impact on the circadian system, which in turn may be severely impaired in different retinal pathologies. The aim of this review is to discuss the state of the art on inner retinal cell involvement in the light and temporal regulation of health and disease.     

The development of Kv4.2 expression in the retina

Throughout the brain, the potassium channel Kv4.2 regulates signal propagation in dendrites and action potential properties in subtypes of neurons. In adult rodents Kv4.2 is expressed predominantly in two bands in the inner plexiform layer (IPL) and in retinal ganglion cell (RGC) somas (Klumpp et al. [15]; Pinto and Klumpp [20]), suggesting a role regulating the activity of specific subtypes of RGCs. To understand the role of Kv4.2 in the regulation of the activity of RGCs during development we determined the developmental expression pattern of Kv4.2 immunoreactivity (Kv4.2-IR). At P4-6 Kv4.2-IR appeared diffusely throughout the IPL in cross-sectioned retinas. From postantal day 10 (P10) through adult there was an additional pair of brighter Kv4.2-IR bands between the ChAT bands that had a reticular pattern in flat-mounted retinas. Kv4.2-IR was not present in somas at P4–6, but appeared in ganglion cell layer (GCL) somas beginning at P10. The fraction of somas expressing Kv4.2 in the GCL was about 8% at P10–11, decreased to 5% at P20–21, then increased to 9% in adult retinas. The restriction of Kv4.2 expression to less than 10% of the GCL somas and the specificity of expression in the IPL suggest that Kv4.2 regulates activity in one or a few functional subtypes of RGCs. The pattern of Kv4.2-IR through postnatal development indicates that Kv4.2-mediated currents are important for development in a subset of RGCs, especially around P10 as the bipolar cells mature.     

GRP78/BiP在强噪声诱导下豚鼠耳蜗螺旋神经节细胞损伤过程中的动态观察

目的 观察分子伴侣葡萄糖调节蛋白78 (GRP78/BiP)在豚鼠强噪声暴露后不同时期的耳蜗螺旋神经节细胞中的表达情况,探讨GRP78/BiP在强噪声暴露后豚鼠耳蜗螺旋神经节细胞损伤中的作用.方法 选用健康雄性白色豚鼠25只,随机分为5组,将实验组动物暴露于120 dB SPL、4 kHz窄带噪声环境4h.分别对健康对照组及噪声刺激后3h、ld、4d、14d组豚鼠处死前测试听性脑干反应(auditory brainstem response,ABR).用免疫组化及Western Blot方法检测GRP78/BiP的表达及在耳蜗螺旋神经节细胞的分布情况.结果 实验组耳蜗螺旋神经节细胞的GRP78/BiP蛋白明显高于健康对照组(P＜0.01),且在3h、1d、4d、14d均维持在比较高的水平.结论 强噪声暴露后GRP78/BiP的表达可引导蛋白质正确折叠,降低细胞损伤,是听觉系统的一种自身防御机制.     

霍乱毒素对受损视网膜环磷酸腺苷和节细胞存活及凋亡的影响

目的 研究霍乱毒素(CTx)对视网膜cAMP水平及视网膜节细胞存活及凋亡的影响。方法 视神经远端(颅内)切断,玻璃体内注射CTx,采用荧光逆行示踪技术及原位末端标记(TUNEL)技术显示存活的视网膜节细胞及节细胞层凋亡的细胞,Brown放射免疫法测定各时间点视网膜cAMP的水平。结果 远端切断视神经后各时间点cAMP水平均低于玻璃体内注射霍乱毒素组。视神经远端切断后视网膜节细胞平均密度明显下降,玻璃体内注射霍乱毒素后,节细胞平均密度明显提高,细胞凋亡数也明显少于单纯视神经切断组。结论 表明霍乱毒素可提高成年金黄地鼠视网膜cAMP水平并具有促受损视网膜节细胞存活及抗凋亡作用。