Synaptic reorganization in the medial amygdaloid nucleus after lesion of the accessory olfactory bulb of adult rat. II. New synapse formation in the medial amygdaloid nucleus by fibers from the bed nucleus of the stria terminalis

The rearrangement of terminations from the bed nucleus of stria terminalis (BST) was examined in the medial amygdaloid nucleus (MAN) at 2 months following the lesion of the accessory olfactory bulb (AOB) using an electron microscopy and degeneration study. At 2 days following a BST lesion, the number of degenerating synapses was 0.7 ± 0.1 (mean±S.E.M.) per unit area (2500 μm² in the molecular layer, and 3/0 ± 0.3 in the cellular part. At 2 months after an AOB lesion, the degenerating synapses from the AOB had completely disappeared from the MAN. The BST was then lesioned at 2 months after the AOB lesion and, 2 days following this BST lesion, the degenerating synapses were counted in MAN. The numbers observed were 3.3 ± 0.6 per unit area in the molecular layer and 4.5 ± 0.4 in the cellular part. Therefore, the number of these degenerating synapses increased significantly within the molecular layer, though, in the cellular part the number of synapses was not significantly elevated over control. No differences in postsynaptic profiles (ratio of synapses on dendritic spine to dendritic shaft) were observed after the AOB lesion. These results indicate that the BST fibers formed new synapses in the molecular layer following the denervation of AOB fibers. The possibility of new synapse formation by other afferent fibers in addition to the AOB fibers is discussed as is the relationship between lesion induced synaptic reorganization and functional recovery after injury.     

图表比较教学法在微生物学教学中的应用

图表比较教学法作为微生物学教学的直观教学手段在本科教学中占有十分重要的地位，是形象思维和抽象思维两种思维方式的协调统一。有利于反映各知识层面的内在联系，可使学生加深对知识的理解，增强分析和综合问题的能力，以利于提高教学质量。     

Effects of simplifying choice tasks on estimates of taste heterogeneity in stated-choice surveys

Researchers usually employ orthogonal arrays or D-optimal designs with little or no attribute overlap in stated-choice surveys. The challenge is to balance statistical efficiency and respondent burden to minimize the overall error in the survey responses. This study examined whether simplifying the choice task, by using a design with more overlap, provides advantages over standard minimum-overlap methods. We administered two designs for eliciting HIV test preferences to split samples. Surveys were undertaken at four HIV testing locations in San Francisco, California. Personal characteristics had different effects on willingness to pay for the two treatments, and gains in statistical efficiency in the minimal-overlap version more than compensated for possible imprecision from increased measurement error.     

应重视口腔颌面部恶性肿瘤的综合序列治疗

口腔颌面部恶性肿瘤约占全身恶性肿瘤的3％，虽然所占比例不高，但l大l其解剖部位特殊．涉及美观和重要的生理功能，冈此对患者机体和心理的影响不容忽视。早期（Ⅰ、Ⅱ期）口腔颌面部恶性肿瘤无论采用手术和（或）放射治疗，均能取得良好效果。但遗憾的是，大多数患者就诊时，已属局部一区域晚期（Ⅲ、Ⅳ期）。由于受到局部解剖和维持功能的限制，单纯通过扩大手术切除范围和改进现有手术技术，除能改善患者生存质量外，已无法提高此类患者的生存率，延长其生存时间。     

颈椎管哑铃形肿瘤的显微外科治疗

目的探讨不同入路显微手术切除颈椎管哑铃形肿瘤的手术方法,总结其主要优点和术后并发症情况。方法2004年5月至2006年7月共收治16例颈椎管哑铃形肿瘤,其中5例肿瘤最大径超过5cm。5例巨大肿瘤中4例位于上颈段,采用侧方改良的极外侧入路（后外侧肌间入路）, 1例外院手术复发的巨大肿瘤位于中颈段,采用分次后正中和前路联合切除并行后方和前方内固定加前方植骨融合;1例肿瘤椎管外部分向前方生长,采用颈前入路切除后行前方植骨融合加内固定,其余10例采用后正中入路,其中1例超过中线的肿瘤采用全椎板切除加椎管成形,7例半椎板切除, 1例复发肿瘤原路切除,1例未切除椎板切除肿瘤。结果手术全切肿瘤14例,次全切2例。所有病例术后症状均有明显改善,其中2例巨大肿瘤患者术后出现低氧血症,重新气管插管后逐渐恢复, 1例巨大肿瘤患者术后脑脊液漏皮下积液,经穿刺置管引流数日后恢复正常。其中12例随访9-18个月,无一例复发或出现脊柱不稳定的情况。结论对于颈椎管哑铃形肿瘤,应尽可能采用创伤小的手术方式,在切除肿瘤的同时,减少棘突、韧带、椎板以及小关节的破坏,减小创伤和对脊柱稳定性的破坏,预防脊柱后凸和侧凸畸形的发生。极外侧入路适用于微创切除体积较大的高颈段椎管哑铃形肿瘤,较小的肿瘤可以采用后正中入路半椎板开窗手术,对骨质破坏严重者需在切除肿瘤后行内固定手术。     

腓肠神经内侧头肌支切断术瘦小腿

目的探讨一种以腓肠神经内侧头肌支切断来改善小腿外形的新方法。方法在腘窝处切开,暴露腓肠神经内侧头肌支,并切断,使局部肌肉失神经萎缩,而缩小小腿的容积。结果本组4例,术后小腿周径平均缩小3.6±0.8cm,小腿外形满意。结论本方法为一简单、安全而有效的技术,能达到缩小小腿部的目的。     

内眦赘皮与重睑成形同期手术的一种新方法

目的 探索适合同时行重睑成形术和内眦赘皮矫正术的新方法。方法 根据内眦赘皮深部眼轮匝肌结构上的异常特点，遵循内眦赘皮的上睑（倒向性内眦赘皮除外）内侧睑缘处皮肤短缺和尽量减少局部皮肤瘢痕的原则，设计适合同时行重睑成形术的新内眦赘皮矫正术（反Stallard法）。结果 临床应用86例，进行了为期6个月以上的随访，结果所有患者的重睑为稳定性平行型重睑，内眦已完全或大部分开大，手术效果满意。结论 此内眦赘皮矫正术能够充分矫正内眦部结构上的异常，而且适合与重睑成形术同期施行，是一种效果稳定，结果满意的术式。     

颈椎病伴椎管狭窄患者再手术问题探讨

目的：探讨颈椎病伴椎管狭窄患者再手术的原因、手术方式及其相关问题。方法：我院2002年7月～2003年12月对40例颈椎病伴椎管狭窄术后疗效不佳或症状复发的患者进行了后路多节段（5个或以上）减压手术。根据其手术治疗方式及影像学资料分析再手术原因，并进行术后疗效评价。结果：经前路手术者再手术的主要原因为：（1）伴有多节段颈椎管狭窄因素时，只选择部分压迫重的节段行减压融合15例；（2）经前路多节段（≥3个节段）减压融合后，相邻节段继续退变，出现新的脊髓压迫表现及椎间不稳定9例；（3）伴有OPLL时，行部分节段前路减压融合后，病变呈进展表现，产生或加重对脊髓的压迫8例。经后路手术者再手术的原因为：（1）后路减压节段不够5例（包括1例前后路联合手术者）；（2）后路减压不充分3例。再手术后随访1．3～2．7年，平均2．1年，所有患者脊髓功能获得一定的提高，JOA评分改善率为51．3％。结论：颈椎病伴椎管狭窄病例再手术的主要原因为椎管狭窄因素仍然存在，经后路多节段（5个或以上）减压手术治疗可彻底去除颈椎管狭窄因素，有效解除脊髓前、后方所受的压迫，可获得较满意的临床疗效。     

经一侧半椎板入路显微手术切除椎管内神经鞘瘤

目的探讨经一侧半椎板入路在椎管内神经鞘瘤显微切除术中的应用。方法我们从1999年6月至2006年6月经一侧半椎板显微切除38例椎管内神经鞘瘤。其中肿瘤位于颈段13例，胸段19例，腰段6例。结果所有肿瘤均被全切除，病人术后2周即可下床活动，随访期内（2-48个月）患者的症状和体征均有明显改善，无手术并发症和脊柱畸形。结论经一侧半椎板入路能够最大程度保留脊柱后部的肌肉、韧带和骨结构，有利于脊柱的稳定性，具有手术创伤小、安全、卧床时间短等优点，值得进一步推广应用。