中岩斜区的应用解剖

目的研究中岩斜区神经血管间的关系及其分布和走行特点、血管穿支的分布特点等,为中岩斜区的手术提供显微解剖学基础。方法用15例血管经彩色乳胶灌注的成人尸体头颅,在镜下从不同方向研究中岩斜区神经血管的走行分布特点、神经和血管间及其与周围结构间的显微解剖关系。结果磨除三叉神经节外下方颞骨岩部尖的骨质后,三叉神经可向下、向外移动。小脑前下动脉的走行可分为,桥脑前段、桥脑外侧段、小脑外侧间裂段和皮质段。当一侧的小脑后下动脉缺如时则为同侧的小脑前下动脉所替代,小脑前下动脉在四段中均有穿支供应桥脑或延髓,小脑前下动脉可与Ⅴ、Ⅵ、Ⅶ、Ⅷ相接触,其中与Ⅶ、Ⅷ的关系最为复杂。基底动脉（BA）的走行变异很大,高位的BA头端在本组占33．3%。其全程发出桥支,供应桥脑的腹侧或外侧。结论（1）中岩斜区神经血管结构众多而复杂,全面而系统地掌握中岩斜区的显微解剖是策划中岩斜区手术入路、减少术中并发症的重要前提和保证。（2）小脑前下动脉在中岩斜区有较多的穿支供应脑干和颅神经,手术中要尽量避免损伤。     

下岩斜区的应用解剖

目的研究下岩斜区神经血管间的关系及其分布和走行特点、血管穿支的分布特点等,为下岩斜区的手术提供显微解剖学基础。方法用15例血管经彩色乳胶灌注的成人尸体头颅,在镜下从不同方向研究下岩斜区神经血管的走行分布特点、神经和血管间及其与周围结构间的显微解剖关系。结果舌咽神经通常以单干起源,迷走神经常由较多大小不等的神经根构成,舌下神经以两束者多见。小脑后下动脉（PICA）的走行可分为五段,延髓前段、延髓外侧段、扁桃体延髓段、扁桃体远段和皮质段;PICA的起源和走行变异最大,PICA的穿支主要发自第二、第三和第四段,供应延髓和第四脑室,PICA与Ⅸ、Ⅹ、Ⅺ最为密切。椎动脉一般从后壁发出穿支供应延髓的腹侧,并发出脊髓前动脉。结论（1）下岩斜区神经血管结构众多而复杂,全面而系统地掌握下岩斜区的显微解剖是策划下岩斜区手术入路、减少术中并发症的重要前提和保证。（2）PICA的扁桃体远段穿支变异有以下特点：当两侧PICA管径相近时,两侧都发出较多的穿支供应第四脑室的脉络丛及延髓帆;当一侧PICA缺如,而由同侧的小脑前下动脉代替供血时,对侧的PICA在此段发出多个穿支供应第四脑室脉络丛和延髓帆;当两侧的PICA均缺如时第四脑室脉络丛和延髓帆主要由管径较粗的一侧血管发出穿支供应。     

面神经微血管束显微解剖与临床应用研究

目的 研究桥小脑角区(CPA)面神经微血管束的显微解剖,总结面神经微血管减压术(MVD)手术资料.方法 显微解剖成人尸头标本10例20侧(男性6例,女性4例),模拟枕下乙状窦后锁孔入路手术操作过程,对CPA区面神经及其毗邻神经血管等结构进行观察和测量;回顾性分析400例面神经MVD手术资料.研究面神经微血管束的组成与变异,并将解剖标本与手术资料进行对比分析.结果 尸头解剖:面神经桥小脑池段与毗邻血管发生压迫或接触9侧( 9/20),其中:小脑前下动脉(AICA)5侧,小脑后下动脉(PICA)2侧,椎动脉1侧,多支血管1侧;手术资料:半侧面肌痉挛(HFS)的责任血管绝大多数位于桥脑延髓沟,其中AICA 265例(66.25％);PICA 69例(17.25％);椎-基底动脉11例(2.75％);多支血管45例(11.25％).结论 对桥小脑角区面神经微血管束,尤其是桥脑延髓沟段显微解剖结构的深入认识,是术中进行充分探查并明确责任血管,保证面神经MVD手术成功的关键.     

小脑延髓裂入路的显微解剖学研究

目的本研究是为了探讨是否可以通过解剖小脑延髓裂,不切开小脑蚓部,即可以到达第四脑室和脑干侧方,获得必要的手术空间以及沿途组织结构间关系,以指导第四脑室肿瘤手术入路.方法应用显微外科解剖学技术,对经甲醛固定、血管内灌注彩色乳胶的5例成人尸头标本,按手术入路逐层解剖.观察小脑延髓裂、下髓帆和脉络膜的组成、分布与菱形窝的关系;观察小脑后下动脉及其分支的走行与分布.结果经小脑延髓裂入路,可通过脉络膜、下髓帆及蚓小结到达菱形窝的任何部位,通过外侧隐窝到达脑桥和延髓的背外侧.小脑后下动脉的扁桃体延髓段和膜髓帆扁桃体段是该入路涉及的重要血管.结论第四脑室肿瘤手术时,充分解剖小脑延髓裂,即可以在不需切开小脑蚓部的情况下获得足够手术空间,经此入路通过正常的解剖间隙可到达第四脑室甚至脑干的侧方,可减少对组织的损伤,提高手术疗效.     

小脑上动脉及其变异的显微解剖研究

目的 观察小脑上动脉(SCA)的显微解剖特点及其变异特征,明确小脑上动脉与相邻颅骨、神经的比邻关系与供血范围,为临床该区域的小脑肿瘤外科手术、微血管减压术及介入手术等提供解剖学依据.方法 利用40例80侧甲醛固定的硬脑膜完整的成人脑标本,对SCA进行显微解剖,观察、测量、统计血管的数目、走行、分支情况及其与周围神经的关系.结果 SCA管径在0.4～2.5(1.36±0.37) mm.5.9％的SCA发自同侧大脑后动脉(PCA),其中1例发自大脑后动脉交通后段(P2段).SCA形成尾袢63支,其中与三叉神经接触的21支,占33.3％.结论 小脑上动脉存在较大变异,与周围的三叉神经关系密切,熟悉颅底血管的显微外科解剖,重视血管的复杂变异,会提高手术的安全性和可靠性.     

经锁孔枕下乙状窦后经内听道上人路研究岩斜区的显微解剖

目的 通过锁孔枕下乙状窦后经内听道上入路对岩斜区结构进行显微解剖.方法 用成人湿性头颅标本10例,20侧,模拟锁孔枕下乙状窦后经内听道上人路对岩斜区进行显微解剖观察.结果 该入路可以清楚暴露颞骨岩部、三叉神经、面听神经、部分后组颅神经、脑桥外侧面、岩静脉、椎动脉、小脑前下动脉、小脑后下动脉.磨除部分岩骨可以扩大内听道的暴露,切开小脑幕缘可以暴露部分滑车神经.结论 锁孔枕下乙状窦后经内听道上入路,充分利用了有效的骨窗,减少无效脑暴露;同时,手术创伤小、并发症少.对于主体位于后颅窝的岩斜区肿瘤显微切除是一种有效、安全、便捷的微创手术方法 .     

桥小脑角区三叉神经与周围动脉关系的显微外科解剖研究

目的模拟桥脑小脑角入路显微解剖的方法,观察三叉神经与周围动脉的解剖关系.方法采用20个经福尔马林固定,灌注蛛红明胶的成人尸头,在手术显微镜下解剖观察并测量有关数据.结果两侧三叉神经受血管压迫或血管接触的机率相同(P＞0.05),但以小脑上动脉为主.三叉神经与矢状面成角12°±3°,与冠状面成角75°±5°,与水平面成角9°±3°.结论本研究为临床开展微血管减压术治疗三叉神经痛或其它桥脑小脑角手术提供了一定的解剖依据.     

神经内镜下乙状窦后入路桥小脑角区神经血管复合体的解剖学研究

目的探讨经乙状窦后锁孔入路观察桥小脑角区的三叉神经血管复合体的内镜解剖学特征,为临床手术提供解剖学依据。方法取15具30侧经福尔马林固定成人头颅标本,模拟枕下乙状窦后入路,按三叉血管神经复合体观察神经内镜下所显露的解剖结构。结果小脑上动脉和岩上静脉经常压迫三叉神经出入脑干区;调整内镜角度,可清晰显示三叉神经和和小脑上动脉、岩上静脉的关系。结论结合神经内镜有助于更全面的了解桥小脑角区三叉神经血管复合体的解剖结构之间的关系,能最大程度减低损伤,更好的保护正常结构。     

基底动脉尖综合征

基底动脉尖(TOB)综合征:是指基底动脉顶端血液循环障碍引起的一组临床综合征,由于其发病症状多样,特异性不突出,且临床预后多不良,及早发现及早期干预,对病情估计及提高就治率有积极的临床意义. 1 局部解剖 基底动脉尖(TOB)是基底动脉顶端2cm范围内的五条血管即2条大脑后动脉、两条小脑上动脉以及基底动脉顶端,形成一个"干"字.大脑后动脉是基底动脉的终末支,绕过大脑脚跨过小脑幕切迹,最后达距状裂,供应枕叶内侧面和颞叶的底面,还发出许多小支,供应丘脑的内测部、大脑脚的内侧部及外侧膝状体.     

腘外侧皮动脉蒂小腿后侧游离皮瓣的解剖及临床应用

对腘外侧皮动脉及其伴行静脉、神经的外径、走行和毗邻关系进行了显微解剖观察。发现腘外侧皮动脉解剖恒定,降支长,血流灌注范围广。以它作为供血的小腿后侧皮瓣其血管蒂长,并带有腓肠外侧皮神经可供吻合。临床上应用此瓣治疗了5例,效果满意。该皮瓣的游离移植适用于修复肢体中小面积的软组织缺损。供区隐蔽,损伤小。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.