股骨近端解剖型钢板在股骨转子间骨折中应用

目的:报告股骨近端解剖型钢板治疗股骨转子间骨折的疗效。方法:应用股骨近端解剖钢板治疗19例股骨转子间骨折,评价治疗结果。结果:19例病人中4个月全部骨性愈合,髋关节屈伸活动恢复95%以上,旋转活动恢复85%,2例轻度髋内翻。结论:股骨近端解剖型钢板治疗转子间骨折具有手术简单,有效,符合生物力学要求,效果满意。     

中国汉族人与美国高加索白人膝关节几何形态的比较

背景:有研究显示中国人膝关节胫骨近端前后径和横径均小于美国高加索人,所以在膝关节形态学方面存在一定差异,因此常发生进口假体系统应用于国人后出现匹配度不高的现象。目的:测量中国人和美国人股骨远端、胫骨近端的几何形态学参数,比较其差异。方法:选择北京清华长庚医院骨科拟行前交叉韧带重建的中国汉族患者50例,以及美国匹兹堡大学运动医学中心拟行前交叉韧带重建的高加索白人后裔患者40例,对90例受试者膝关节进行CT扫描,使用AW Volume Share 5软件进行三维重建,利用Geomagic软件对胫骨近端和股骨远端的各项参数进行测量。结果与结论:①股骨近端测量参数中,中国人的外侧胫骨平台内外径小于美国人(P=0.027),外侧胫骨平台后倾角大于美国人(P<0.05);两组间胫骨平台内外径、内侧胫骨平台外径、内侧胫骨平台前后径、外侧胫骨平台前后径与内侧胫骨平台后倾角比较差异均无显著性意义(P>0.05);②股骨远端测量参数中,中国人的股骨远端横径、外侧髁内外径、内侧髁前后径、外侧髁前后径及髁间窝高度均小于美国人(P<0.05),股骨外翻角大于美国人(P<0.05);两组间内侧髁内外径、髁间窝宽度及滑车沟宽度比较差异无显著性意义(P>0.05);③结果表明,中国人与美国人在膝关节形态学的多个参数存在差异,有必要针对中国人设计更为个体化的膝关节假体。     

Mouse killing and hyperreactivity following lesions of the medial hypothalamus, the lateral septum, the bed nucleus of the stria terminalis, or the region ventral to the anterior septum

Electrolytic lesions in the medial hypothalamus, the lateral septum, or the region ventral to the anterior septum induced home cage mouse killing in 85 to 100% of rats when tested 2 days postoperatively and in 50 to 70% when tested at 21 days. When tested in a novel and larger test chamber, 100% of the rats with medial hypothalamic lesions killed mice at 2 days postoperatively but only 30% killed at 21 days postoperatively. Ten to thirty percent of animals with lesions of the lateral septum or of the region ventral to the anterior septum killed at any time in the novel environment. Lesions of the stria terminalis produced a slight increase in mouse killing in both the home cage and the novel environment. A high level of reactivity was produced by lesions of the medial hypothalamus, the lateral septum or the region ventral to the anterior septum but only that caused by the medial hypothalamic lesions was sustained over the 21 day test period. These results support previous evidence that the lateral septum, the region ventral to the anterior septum, and the medial hypothalamus are each important areas modulating mouse killing.     

Effects of intracerebroventricular injections of 2-deoxy-D-glucose,d-glucose and xylose on operant feeding in pigs

The effects, on operant feeding, of injection into the lateral cerebral ventricle of 50 μmoles CaCl₂, 4 mmoles D-glucose, 2-deoxy-D-glucose (2DG) or xylose, or NaCl, have been studied in five pigs. All the sugars and CaCl₂ were given in 1 ml of normal saline. Each of the sugar solutions produced transient drinking. Only CaCl₂ and 2DG significantly increased food intake during the hour following injection. The results show that the mechanism by which the pig responds to intracerebroventricular 2DG is similar to that of the rat and different from that of the sheep.     

股骨远端骨折两种固定方法对比研究

目的 对比应用逆行交锁髓内钉(GSH)和动力髁螺钉(DCS)内固定治疗股骨远端骨折的效果.方法 采用回顾性研究方法对我院自2000年8月～2004年10月治疗的54例股骨远端骨折病例进行对照研究,按A0分类:A1型17例,A2型14例,A3型11例,B1型2例,C1型6例,C2型3例,C3型1例.其中,DCS内固定30例,GSH固定24例.分组统计手术时间,出血量,骨折愈合时间,并发症,膝关节功能.结果 所有病例经5月～2年随访,平均9个月;骨折愈合时间为4.6月(4～9月).DCS固定组平均手术时间1.5小时(1～2.5小时).出血量105 ml(50～200 ml),骨折愈合时间平均4.7月(4～8月),并发症发生5例(发生率16.7%),根据Kolmert膝关节功能评分,优20例,良6例,可4例,优良率为86.6%.GSH固定组手术时间1.8小时(1.5～3.5小时).术中出血量平均120 ml(100～250 ml),平均骨折愈合时间5.1个月(4.5～9个月),并发症发生5例(发生率28%),根据Kolmert膝关节功能评分标准,优15例,良7例,可2例,优良率为91.7%.两组比较,结果无显著差异(P＞0.05) 结论 逆行带锁髓内钉(GSH)及动力髁螺钉(DCS)均是治疗股骨远端骨折的较好方法,但各有其最佳适应症.选择好适应症以及术者技术熟练有利于骨折愈合及关节功能恢复.     

Degeneration and electron microscope analysis of the synaptic glomeruli in the lateral geniculate body

Summary Optic fibers of retinal origin terminate in the lateral geniculate body exclusively in the so called glomerular synapses. They can be recognized on the basis of their unusually large irregular mitochondria having very few cristae. In the cat the structure of the optic terminal profiles is rather dense. The majority of terminals in most glomeruli originate from axons of other source. Relatively large axon terminal profiles of unusually light structure cannot be brought to degeneration by any interference with extraneous pathways. From Golgi information it becomes obvious that they originate from local Golgi 2nd type neurons. Small rather dense axonal profiles of the glomeruli can occasionally be traced back by degeneration to the occipital cortex (parastriate), although most of the descending cortical afferents of the lateral geniculate body terminate outside the glomeruli on more proximal parts of the dendrites. — Axo-axonic synapses are very frequent. If an optic terminal is involved, it appears that by structural standards it is presynaptic to the non optic. As judged, however, from the numerous axoaxonic contacts persisting after enucleation, many of the contacts are established between non optic axon terminals. — The progress of secondary degeneration and particularly the removal from the glomeruli of degeneration fragments is unexpectedly rapid. — The possible functional significance of these findings, especially also with regards to presynaptic inhibition, is discussed.     

Effects of 5-hydroxytryptamine on the firing rates of neurons of the lateral vestibular nucleus in the rat

Summary 5-hydroxytryptamine (5-HT) was delivered microiontophoretically (20–80 nA) to cells of the lateral vestibular nucleus of anaesthetized rats to test its influence on the spontaneous activity of single neurons. 5-HT increased the rate of firing of 94% of the units tested. The enhancement persisted for up to 700 s after the end of the 5-HT ejection and the maximum magnitude of the excitation (10–3400%) showed a hyperbolic correlation (=0.86) with background firing. In 43% of units the enhancement was preceded by a short-lasting (less than 105 s) depression of the neuronal firing rate, the magnitude of which was unrelated to the background mean firing rate. Both components of the 5-HT response were dose-dependent. Only the excitatory responses were antagonized by metergoline, methysergide and ketanserin. The putative 5-HT agonist, 5-methoxy-N,N-dimethyltryptamine, applied microiontophoretically, depressed the background firing rate and was not antagonized by methysergide. These results demonstrate that 5-HT modifies the responsiveness of vestibular neurons and suggest that at least two mechanisms and maybe two types of receptors are activated by 5-HT in this nucleus.     

The control of retinogeniculate transmission in the mammalian lateral geniculate nucleus

Summary In the mammalian visual system, the lateral geniculate nucleus is commonly thought to act merely as a relay for the transmission of visual information from the retina to the visual cortex, a relay without significant elaboration in receptive field properties or signal strength. However, many morphological and electrophysiological observations are at odds with this view. Only 10–20% of the synapses found on geniculate relay neurons are retinal in origin. Roughly half of all synapses derive from cells in layer VI of visual cortex; roughly one third are inhibitory and GABAergic, derived either from interneurons or from cells of the nearby perigeniculate nucleus. Most of the remaining synapses probably derive from cholinergic, noradrenergic, and serotonergic sites within the brainstem reticular formation. Moreover, recent biophysical studies have revealed several ionic currents present in virtually all thalamic neurons. One is a Ca²⁺-dependent K⁺ current underlying the afterhyperpolarization (or the I_AHP), which may last up to 100–200 ms following an action potential. Activation of the I_AHP leads to spike frequency adaptation in response to a sustained, suprathreshold input. Intracellular recordings from other neuronal preparations have shown that the I_AHP can be blocked by noradrenalin or acetylcholine, leading to an increased cellular excitability. Another ionic current results from a voltage- and time-dependent Ca²⁺ conductance that produces a low threshold spike. Activation of this conductance transforms a geniculate neuron from a state of faithful relay of information to one of bursting behavior that bears little relationship to the activity of its retinal afférents. We propose that state-dependent gating of geniculate relay cells, which may represent part of the neuronal substrate involved in certain forms of selective visual attention, can be effected through at least three different mechanisms: (1) conventional GABAergic inhibition, which is largely controlled via brainstem and cortical afferents through interneurons and perigeniculate cells; (2) the I_AHP, which is controlled via noradrenergic and cholinergic afferents from the brainstem reticular formation; and (3) the low threshold spike, which may be controlled by GABAergic inputs, cholinergic inputs, and/or the corticogeniculate input, although other possibilities also exist. Furthermore, it seems likely that gating functions involving the corticogeniculate pathway are suited to attentional processes within the visual domain (e.g., saccadic suppression), whereas brain-stem inputs seem more likely to have more global effects that switch attention between sensory systems. In any case, it is now abundantly clear that geniculate circuitry and the intrinsic electrophysiological properties of geniculate neurons are no longer compatible with the notion that the lateral geniculate nucleus serves as a simple relay.     

Neocortical and hippocampal EEG in normal and lateral hypothalamic-damaged rats

Cortical and hippocampal EEG were correlated with behavior in rats before and after bilateral hypothalamic (LH) damage. In Stage 1 of recovery (aphagia and adipsia), the neocortex showed continuous large amplitude slow activity. It did not desynchronize during spontaneous acts such as grooming as well as during tail pinch-induced struggling or orienting, even though a slow form of hippocampal theta accompanied these acts. However, during Stage 2 (anorexia), the neocortical EEG did desynchronize when such theta appeared. Therefore, as behavioral recovery progresses after LH damage, there appears to be a concomitant recovery of cortical participation in such behavior. Early in recovery, LH rats, unlike normals, showed slow (3–4.5 Hz) atropine-sensitive hippocampal theta during automatisms such as grooming as well as during immobility. Thus, LH damage, while temporarily abolishing fast. noncholinergic theta, appears to release slow cholinergic theta. Later in recovery, faster atropine-resistant (noncholinergic) theta becomes functional again.     

Histamine excites rat lateral vestibular nuclear neurons through activation of post-synaptic H2 receptors

Through whole-cell patch recordings in brainstem slices, the effects of histamine on neuronal activity of the lateral vestibular nucleus (LVN) were investigated. Bath application of histamine elicited a concentration-dependent excitation of both spontaneous firing (n = 19) and silent (n = 7) LVN neurons. Moreover, histamine induced a stable inward current in the LVN neurons (n = 5) and the histamine-induced depolarization of membrane potential persisted in the presence of tetrodotoxin (n = 4), indicating a direct post-synaptic effect of the histamine on the LVN neurons. Selective histamine H2 receptor antagonist ranitidine effectively blocked the histamine-evoked excitatory responses on the LVN neurons (n = 4), but selective histamine H1 receptor antagonist triprolidine did not (n = 4). In addition, selective histamine H2 receptor agonist dimaprit (n = 3) rather than 2-pyridylethylamine (n = 4), a selective histamine H1 receptor agonist, mimicked the excitatory action of histamine on LVN neurons. The results demonstrate that histamine excites the LVN neurons via post-synaptic histamine H2 receptors and suggest that the central histaminergic projection arising from the hypothalamus may modulate LVN neurons activity and actively influence the vestibular reflexes and functions.