深部脑电图在七氟醚麻醉条件下的(痫)样放电波幅变异

目的:比较七氟醚在不同麻醉深度下对颞叶癫(痫)手术术中深部电极描记的EEG的影响.方法:颞叶癫(痫)行射频热凝毁损手术患者68例,在七氟醚吸入麻醉,最小肺泡浓度(MAC) =0.6时监测额叶皮质EEG和颞叶深部EEG,再加深麻醉至MAC=1.2时再监测.EEG数据应用快速傅里叶处理(FFT),计算额叶背景平均波幅,测量10个颞叶内侧棘波的波幅,取平均值后确定为该患者的棘波波幅,对MAC=0.6和MAC=1.2两组进行统计.结果:MAC=0.6时颞叶内侧棘波放电波幅平均为(426.2±63.1)μV,额叶10～12 Hz(80.3±16.4)μV背景波幅显著；MAC=1.2时颞叶内侧棘波放电波幅平均为(171.2±32.6)μV,额叶10～12 Hz(550.3±126.8)μV背景波幅显著,两组间的(痫)样放电波幅和额叶背景波幅比较差异均有统计学意义(P＜0.05).MAC≤1.2时,七氟醚吸入麻醉影响背景节律和(痫)样放电的波幅,对频率和波形无明显影响.结论:七氟醚麻醉对深部电极EEG的影响呈剂量依赖性,麻醉过深则可能导致(痫)样放电鉴别困难.     

帕金森病大鼠苍白球神经元簇发放电及峰峰间期序列的研究

目的 观察帕金森病大鼠模型苍白球神经元的电活动.方法 30只大鼠注射6-羟基多巴胺(6-hydroxydopamine, 6-OHDA)建立PD模型,并通过跑步机测试、注射阿朴吗啡诱发旋转和免疫组化检测黑质对模型进行评价;10只大鼠注射含0.2%抗坏血酸的人工脑脊液建立对照组.在立体定向仪引导下记录大鼠在PD病理及正常生理状态下GP神经元的自发放电活动.结果 模型组大鼠中有13只行为学及病理学检测结果符合PD模型标准.电生理记录显示对照组大鼠GP神经元放电频率为(6.04±2.12)Hz,模型组大鼠GP神经元放电频率为(21.10±3.21)Hz(P=0.001).模型组GP神经元簇发放电模式的比例术后4周为59%,术后8周为61%,而对照组GP神经元簇发放电模式的比例在术后4周和8周均为11%.模型组大鼠神经元放电的峰峰间期散点图在100ms以下有一分布密集条带.结论 PD模型大鼠GP神经元较生理状态下放电频率明显增加,簇状放电模式比例增大,ISI序列发生明显变化.     

兔正中神经F波对脊髓压迫损伤的评估

目的探讨正中神经F波对兔急性椎管狭窄导致脊髓压迫损伤的评估作用及对运动功能的预测价值。方法20只新西兰大白兔用随机分组法分实验组(n=15)和对照组(n=5),实验组分为A、B和C三个亚组(n=5),分别在C6-C7椎板间隙向尾端方向植入直径为1.0 mm、1.5 mm和2.0 mm的实心硅胶柱,分别记录术前和术后波形平稳后的F波,麻醉前和术后2 d进行运动功能评分。对照组用于排除麻醉和手术对F波的影响。结果A、B和C组F波波幅和潜伏期均对椎管狭窄脊髓压迫损伤敏感,分别经过(0.36±0.17)min、(0.36±0.22)min和(0.32±0.13)min波变平稳;A、B和C组术后波形平稳后波幅与基线波幅百分比(71.93%±6.90%)、(34.74%±6.05%)和(8.32%±4.25%)经配对t检验,与本组术前基线波幅与基线波幅百分比(100.00%±0.00%)、(100.00%±0.00%)和(100.00%±0.00%)比较,差异有统计学意义(均P<0.05);A、B和C组手术后波形平稳后潜伏期(9.48±1.31)ms、(12.04±0.48)ms和(10.55±0.21)ms经配对t检验,与术前(8.48±0.76)ms、(9.08±0.91)ms和(8.45±0.71)ms比较,差异有统计学意义(均P<0.05);各组F波术后早期的波幅变化和术后2 d前肢运动功能评分经Spearman相关性分析呈显著性正相关(r=0.960,P<0.05)。结论兔正中神经F波对发现椎管狭窄引起的脊髓损伤非常敏感;早期F波的波幅变化可以预测脊髓损伤后的肢体运动功能。     

实验性恒河猴脊髓半横切损伤模型的建立

目的通过脊髓半侧横切的方法建立灵长类恒河猴脊髓半横切损伤动物模型,用于神经再生的研究。方法 5只成年恒河猴称重麻醉后,颈部后正中切口显露C3-5脊髓,于C4用虹膜刀切开脊髓左半侧0．5cm,通过体感诱发电位(somatosensory evoked potential SSEP)监测,确保波形改变并观察恒河猴术后24h、7d肢体运动功能和SSEP变化。结果术后24h、7d同侧肢体瘫痪,肢体运动评分由术前的5分降到1分,SSEP显示术前潜伏期(15．88±2．53)毫秒,术后24h(22．26±4．12)毫秒;7d(23．12±3．92)毫秒延长明显(P<0．01),波幅术前(11．92±5．48)μV,术后24h(5．34±3．04) μV,7d(5．78±2．98)μV,降低明显(P<0．01)。结论恒河猴麻醉后用虹膜刀脊髓半横切能损伤皮质脊髓束,引起肢体瘫痪,结果稳定可靠,操作较为简便,可建立脊髓半侧横切损伤动物模型,重复性较好,为脊髓损伤的神经修复实验研究提供了模型基础。     

神经肽Y对海马神经元“癫痫样”动作电位的影响

目的探讨神经肽Y(neuropeptide Y,NPY)对海马神经元"癫痫样"动作电位的影响。方法用无镁细胞外液处理原代培养12 d的海马神经元3 h,诱导海马神经元癫痫样放电,建立海马神经元癫痫样放电模型;用全细胞膜片钳电流钳模式检测神经元动作电位,分别给予0.1μmol/L和1μmol/L NPY各1μL,给药时间10 s,观察其对神经元动作电位频率及波幅的影响。结果无镁细胞外液处理神经元3 h,可以形成稳定的海马神经元癫痫样放电模型,频率16～23 Hz,波幅75～96 mV。模型组神经元动作电位频率为(18.00±2.32)Hz,而0.1μmol/L和1μmol/L NPY组分别为(4.75±1.04)Hz和(1.50±0.75)Hz。与模型组相比较,两种浓度NPY组均降低了动作电位发放的频率(P<0.05)。模型组神经元动作电位波幅为(82.25±5.17)mV,而0.1μmol/L和1μmol/L NPY组分别为(49.75±2.49)mV和(40.00±2.20)mV。与模型组相比较,两种浓度NPY组均降低了动作电位发放的波幅(P<0.05)。两种浓度NPY之间相比较,也有统计学差异(P<0.05)。1μmol/LNPY明显抑制了动作电位发放的频率和波幅。结论 NPY能够抑制无镁细胞外液诱发的神经元癫痫样电活动,为应用NPY抑制癫痫发作提供了细胞电生理学证据。     

经颅电刺激运动诱发电位监测麻醉方法的建立

目的 对比相同麻醉深度下丙泊酚、七氟醚分别复合瑞芬太尼维持麻醉对经颅电刺激运动诱发电位(TES-MEPs)波幅和潜伏期的影响,以建立术中MEP监测时的适宜麻醉方法.方法 36例脊髓脊柱神经外科手术患者随机分为两组:丙泊酚麻醉组和七氟醚麻醉组,每组18例.对比麻醉诱导后30 min、60 min、90 min和120 min MEP的波幅和潜伏期.结果 两组病例麻醉期间血流动力学均维持稳定,组间脑电双频指数、呼气末二氧化碳分压和体温的差异均无统计学意义.丙泊酚组MEP所需阈刺激强度显著低于七氟醚组[(172±23)V:(217±42)V,P＜0.05].丙泊酚组各时间点上肢MEP波幅显著高于七氟醚组(P＜0.05),潜伏期显著短于七氟醚组(P＜0.05).两组内各时间点上肢MEP波幅和潜伏期差异无统计学意义.结论 在相同麻醉深度下,丙泊酚复合瑞芬太尼全凭静脉麻醉对MEP波幅的抑制作用显著优于七氟醚复合瑞芬太尼静吸复合麻醉方案,是用于脊髓脊柱手术TES-MEPs监测的适宜麻醉方法.     

惊恐障碍患者事件相关电位P300及催眠状态脑电图初步研究

目的探讨惊恐障碍(PD)患者催眠状态前后的事件相关电位P300及脑电图(EEG)的变化。方法记录29例PD患者催眠前和进入催眠状态后的P300和EEG,进行自身对照研究。结果患者进入催眠状态后,P300波幅下降[催眠前后的靶波幅P3分别为(6.5±2.1)μV和(3.1±1.9)μV;催眠前后的非靶波幅P2分别为(4.2±2.1)μV和(2.0±1.7)μV,P均0.05]。EEG背景节律α波频率,在催眠前为(10.3±0.8)Hz,催眠后为(8.9±0.9)Hz(P0.05)。结论 PD患者催眠状态下的P300和EEG变化特点有助于临床判断。     

大鼠头端延髓腹外侧区前交感神经元的电生理研究

采用细胞外记录方法,研究氨基甲酸乙酯麻醉大鼠头端延髓腹外侧区(RVLM)前交感神经元的电生理特性.观察到125个RVLM神经元中有24个的自发放电被电刺激主动脉神经(ADN)和静脉注射苯肾上腺素后抑制,同时其放电具有心性节律,以上24个中有18个单位(75%)能被脊髓(T2)侧索电刺激逆行激活.提示RVLM前交感神经元具有压力敏感性和对脊髓的投射等特点,在压力感受器反射等交感心血管活动调节中具有十分重要的作用.     

吗啡成瘾对大鼠伏隔核神经元自发放电的影响

目的 研究吗啡成瘾对大鼠伏隔核电生理的影响及静脉吗啡注射对吗啡成瘾大鼠伏隔核神经元自发放电的影响探讨伏隔核在吗啡成瘾过程中的作用.方法 通过连续14日递增腹腔吗啡注射,建立急性大鼠吗啡成瘾模型,通过玻璃微电极记录吗啡依赖大鼠伏隔核单细胞细胞外放电,观察吗啡成瘾及静脉注射吗啡对大鼠伏隔核神经元放电的影响.结果 与生理盐水组相比,吗啡依赖组大鼠伏隔核神经元单位自发放电的频率分布组间差异显著(P<0.05),放电形式无明显差异.吗啡依赖大鼠伏隔核神经元放电频率静脉注射吗啡前为14.40±4.92Hz,静脉注射吗啡后降为4.10±2.65Hz.结论 吗啡成瘾对大鼠伏隔核神经元自发放电有影响,吗啡可以显著抑制吗啡成瘾大鼠的伏隔核神经元放电,伏隔核在吗啡成瘾过程具有重要作用.     

电磁刺激对脊髓神经干细胞增殖与分化作用研究

目的探讨电磁刺激对大鼠脊髓神经干细胞(NSCs)向功能性神经元增殖分化的作用及可能的机制。方法体外分离培养妊娠第14天(E14 d)的Wistar大鼠脊髓NSCs,无血清培养14 d后,分为对照组和电磁刺激组。电磁刺激组置于脉冲强磁场条件下用促增殖参数(0.1 Hz、4T、8次)进行干预,每次脉冲放电20 ms。对照组不做干预处理。干预后第1天,10%胎牛血清诱导贴壁分化;诱导贴壁后第7天,蛋白免疫印迹法(Western Blot)检测β-catenin蛋白表达情况;NCSs分化后第14天,免疫荧光染色检测神经元MAP2表达情况,红外可视膜片钳技术记录神经元自发放电情况。结果干预后,免疫荧光染色显示电磁刺激组MAP2阳性细胞数45.4%±3.1%,较对照组38.3%±6.0%明显增多(P0.05)。Western Blot检测结果显示干预后第7天,电磁刺激组神经干细胞β-catenin蛋白量较对照组增高。膜片钳实验结果显示,诱导后第14天,可以记录到神经元自发放电,是有生理功能的。结论强电磁刺激能够促进大鼠脊髓神经干细胞增殖分化为功能性神经元。     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

Release of endogenous catecholamines from slices of hypothalamus of rats

The release of endogenous catecholamines from superfused slices of rat hypothalamus was studied under basal conditions and during release evoked by 40 mM K⁺. Catecholamines in superfusates, and in extracts of the tissue after stimulation, were isolated by column chromatography and quantitated by liquid chromatography with electrochemical detection. Norepinephrine (NE) was not consistently demonstrable in superfusate collected under basal conditions, but 40 mM K⁺ caused the release of from 2 to 4 ng/g of tissue per min. The addition of cocaine to the superfusate caused increases in basal and evoked release of NE. Epinephrine (E) could be measured in superfusates of slices from male but not female rats and then only when cocaine was added to the superfusate. Accordingly, the concentration of E in hypothalamus was greater in male rats than in female rats. Dopamine (DA) was not consistently measurable in the spontaneous overflow from slices either in the presence or absence of cocaine. K⁺-evoked release of DA could be demonstrated in slices from female rats. The addition of cocaine increased the evoked release of DA from slices from both sexes. Corticosterone, added to cocaine, had no effects on the efflux of any of the catecholamines. The experiments suggest that neuronal reuptake of all catecholamines is very efficient in the hypothalamus both under basal conditions and during evoked release.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。