单唾液酸四己糖神经节苷脂对青光眼术后视神经的保护作用

目的观察单唾液酸四己糖神经节苷脂对青光眼术后视神经的保护作用。方法选取2013-01—2015-03在我院诊治的96例青光眼患者,按随机数字表法分为对照组和观察组各48例,对照组术后给予甲钴胺治疗,观察组在对照组基础上加用GM1治疗,观察2组治疗后的视神经保护效果。结果 2组治疗后的视力恢复总有效率比较,观察组明显高于对照组(P0.05),且眼压及MS、MD指数均较对照组明显改善(P0.05)。结论单唾液酸四己糖神经节苷脂对青光眼术后视神经有显著的保护作用。     

多发性硬化与视神经脊髓炎谱系疾病的OCT评价

目的利用OCT检测MS与NMOSD患者黄斑区神经节细胞复合体(ganglion cell complex,GCC)和视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度,对其所致的视神经及轴突损伤进行分析。方法采用回顾性对照研究方法。收集河南科技大学第一附属医院治疗的MS患者30例为MS组,NMOSD患者32例为NMOSD组,同期健康受试者30例为对照组。采用OCT检测GCC(上、下象限和平均)和RNFL(鼻、颞、上、下4个象限及平均)的厚度,并进行比较分析。结果 NMOSD组和MS组GCC厚度(上、下象限和平均)及RNFL(4个象限和平均)厚度均显著低于对照组(P0.05)。NMOSD组上、下象限及平均GCC厚度低于MS组(P0.05)。NMOSD组上方RNFL厚度低于MS组(P0.05),但鼻、颞及下方象限RNFL厚度与MS组差异无统计学意义(P0.05)。结论 MS和NMOSD患者均存在明显的视神经及轴突损伤,但NMOSD患者损伤更为明显。     

甲钴胺联合神经生长因子治疗周围神经损伤的技术创新与应用

目的探讨甲钴胺联合鼠神经生长因子(NGF)在周围神经损伤中的疗效。方法 186例住院治疗的周围神经损伤患者,将随机分为甲钴胺联合NGF组(治疗组)93例,单纯甲钴胺组(对照组)93例,治疗组采用甲钴胺联合NGF治疗,对照组采用单纯的甲钴胺治疗,2组分别于治疗后1个月、3个月、6个月比较患者疼痛情况、麻木症状改善程度及神经电生理变化的改善程度。结果治疗组患者的疼痛、感觉麻木症状较对照组显著减轻,差异有统计学意义(P0.05);恢复神经的感觉和运动电位的潜伏期均较对照组明显缩短,差异有统计学意义(P0.05);波幅均较对照组显著增高,差异有统计学意义(P0.05)。结论甲钴胺联合NGF在周围神经损伤中具有的较好治疗效果,值得临床推广应用。     

RNFL厚度检测在不同类型特发性视神经炎鉴别诊断中的应用

目的探讨视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度检测在不同类型特发性视神经炎(ION)鉴别诊断中的应用。方法回顾性收集2012-09—2017-09复旦大学附属华山医院神经内科和眼科收治的不同类型ION患者83例,其中首发症状仅为视神经炎的多发性硬化(MS-ON)患者18例,视神经脊髓炎谱系病(NMOSD-ON)患者45例,其他脱髓鞘相关性视神经炎(O-ION)20例,另收集19名健康志愿者作为对照(HC组)。采用光学相干断层成像术(OCT)检测并比较各组眼RNFL厚度的差异,同时比较AQP4-IgG阳性和阴性NMOSD-ON患者受累眼RNFL厚度的差异。结果 MS-ON、NMOSD-ON和O-ION的平均RNFL厚度及各象限RNFL厚度均较HC组显著变薄(P0.01),且NMOSD-ON患者鼻侧象限RNFL厚度较MS-ON和O-ION组变薄(P0.05)。AQP4-IgG阳性NMOSD-ON患者下侧象限RNFL厚度较AQP4-IgG阴性者薄(P0.05)。MS-ON无视神经炎表现的眼(非受累眼)平均及各象限RNFL厚度与HC组比较差异无统计学意义(P0.05)。结论 NMOSD-ON鼻侧RNFL厚度较MS-ON和O-ION显著变薄,可能有助于不同类型ION的鉴别。     

鼠神经生长因子联合甲钴胺治疗合并足下垂的腰椎间盘突出症

目的 探讨鼠神经生长因子(mNGF)在合并足下垂的腰椎间盘突出症患者中的应用价值. 方法 对复旦大学附属中山医院骨科自2008年1月至2011年6月进行手术治疗的76例合并足下垂的腰椎间盘突出症患者的临床资料进行回顾性分析,其按照术后处理方法不同分为2组:联合组36例(应用mNGF联合甲钴胺治疗)、单纯组40例(单纯应用甲钴胺治疗).分析患者治疗后一般情况,比较2组治疗后1周、4周、12周、12个月时视觉模拟评分(VAS)和神经功能(感觉功能和肌力)恢复情况. 结果 患者获得12～54个月(平均24.8个月)随访,无一例死亡,均无创口感染,平均8个月时植骨融合.治疗后1周、4周、12周及12个月时2组VAS评分均明显低于治疗前,且各时间点联合组VAS评分亦明显低于单纯组,差异有统计学意义(P＜0.05).治疗后1周、4周、12周及12个月时联合组感觉功能改善有效率均明显优于单纯组,差异有统计学意义(P＜0.05);除1周外其余时间点联合组肌力改善有效率均明显优于单纯组,差异有统计学意义(P＜0.05). 结论 mNGF与甲钴胺联合使用能促进合并足下垂的腰椎间盘突出症患者的神经功能恢复.     

丹红甲钴铵与胰激肽原酶联合治疗糖尿病周围神经病变患者的临床疗效

目的观察丹红注射液联合甲钴胺液注射液及注射用胰激肽原酶治疗糖尿病性周围神经病变患者的临床治疗效。方法选取我院神经内科收治的120例糖尿病性周围神经病变患者为研究对象,随机分为2组。对照组采用丹红注射液+甲钴胺注射液+VitB1注射液+降糖等药物治疗;观察组使用丹红注射液+甲钴胺注射液+注射用胰激肽原酶进行治疗。治疗1个月后对比2组治疗前后的临床疗效、生化指标、周围神经传导速度(MCV、SCV)改变、动作电位波幅变化情况等的差异。结果治疗1个月后,观察组自觉麻木、疼痛或感觉异常症状均明显少于对照组;观察组空腹血糖、餐后2h血糖和糖化血红蛋白显著低于对照组;观察组动作电位平均波幅明显高于对照组,差异有统计学意义(P0.05)。结论丹红注射液+甲钴胺注射液+注射用胰激肽原酶治疗糖尿病性周围神经病变比丹红注射液+甲钴胺注射液+VitB1注射液+降糖等药物有较好的疗效。     

丹栀逍遥散联合艾司西酞普兰片治疗缺血性脑卒中后抑郁症对患者总体康复的影响

目的探讨丹栀逍遥散联合艾司西酞普兰片治疗缺血性脑卒中后抑郁症对患者总体康复水平的影响。方法将68例缺血性脑卒中后抑郁症患者按入院顺序随机分为观察组和对照组。对照组予以艾司西酞普兰片口服,初始剂量5mg/d,连服3d,3d后改为10mg/d口服;观察组在此基础上加用丹栀逍遥散加减治疗,水煎服,3次/d,100mL/次,2组疗程均为8周。观察2组患者的HAMD评分、Hcy水平、血脂水平及不良反应。结果治疗后4周及治疗后6周,2组HAMD评分比较差异有统计学意义(P0.05),观察组较对照组HAMA评分减少显著;观察组治疗后Hcy水平较治疗前显著下降,差异有统计学意义(P0.05),对照组治疗后Hcy无显著变化。对照组治疗后血脂水平较治疗前无明显变化,观察组治疗后TC、TG较治疗前下降(P0.05);观察组治疗后H-DLC较治疗前增高(P0.05)。2组不良反应差异无统计学意义。结论丹栀逍遥散联合艾司西酞普兰片治疗缺血性脑卒中后抑郁症对患者总体康复水平有积极的影响。     

鼠神经生长因子联合依帕司他及甲钴胺治疗糖尿病周围神经病变的临床观察

目的观察鼠神经生长因子联合依帕司他及甲钴胺治疗糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的疗效。方法选取160例DPN患者,随机分为A、B、C、D 4组,A组患者(对照组)仅给予甲钴胺治疗,B组患者给予甲钴胺+依帕司他治疗,C组患者给予甲钴胺+鼠神经生长因子治疗,D组患者给予鼠神经生长因子+依帕司他+甲钴胺治疗,疗程均为4 w,比较4组患者临床症状、神经传导速度、感觉定量检测变化情况及治疗有效率差异。结果 4组患者治疗后神经症状评分均下降(P0.05),神经传导速度均增加(P0.05),4个不同部位的温度觉阈值、振动觉阈值平均值均较治疗前明显改善(P0.05);D组患者的神经症状评分下降程度、神经传导速度增加程度、温度觉阈值、振动觉阈值改善程度、治疗有效率均明显优于A组、B组、C组(P0.05),B组、C组患者的神经症状评分下降程度、神经传导速度增加程度、温度觉阈值、振动觉阈值改善程度、治疗有效率均明显优于A组(P0.05),B组患者与C组患者比较,差异无统计学意义(P0.05)。结论鼠神经生长因子联合依帕司他及甲钴胺治疗DPN临床疗效显著。     

脉络宁口服液联合甲钴胺片治疗老年糖尿病周围神经病变的疗效

目的观察脉络宁口服液联合甲钴胺片治疗老年糖尿病周围神经病变(DPN)的疗效。方法将49例DPN患者随机分为治疗组(n=24)和对照组(n=25)。两组患者均采用甲钴胺片治疗,治疗组加用脉络宁口服液,两组均治疗3个月。比较两组患者的多伦多临床评分系统(TCSS)评分、中医症状量化评分。根据中医症状量化评分标准判断患者疗效。结果两组患者治疗后TCSS评分均明显低于治疗前(均P0.05)。治疗组患者治疗后的TCSS评分明显低于对照组(P0.05)。治疗组治疗后中医症状量化评分明显低于治疗前(P0.05)。治疗组治疗后中医症状量化评分明显低于对照组(P0.05)。治疗组患者总有效率(88%)明显高于对照组(50%)(χ~2=6.631,P=0.01)。结论脉络宁口服液联合甲钴胺片对DPN治疗安全有效。     

复方丹参注射液联合甲钴胺治疗缺血性视神经病变的疗效

目的评价复方丹参注射液联合甲钴胺治疗缺血性视神经病变的临床疗效。方法按照随机数字法将70例缺血性视神经病变患者随机分为对照组和观察组,每组35例,对照组给予复方丹参注射液颞浅动脉旁注射,同时联合维生素B120.5mg肌内注射,1次/d;观察组给予复方丹参注射液颞浅动脉旁注射,同时联合甲钴胺0.5mg肌内注射,1次/d。治疗14d(1个疗程)后,观察2组视力及视野的变化及临床疗效。结果 2组治疗后视力及视野情况均得到明显改善,观察组视力及视野总有效率分别为94.11%、92.16%,明显高于对照组的79.17%、75.00%,差异有统计学意义(P0.05)。结论复方丹参注射液联合甲钴胺治疗缺血性视神经病变较单一治疗起效快,可明显改善患者的视力水平和视野损伤情况,安全有效,值得临床进一步推广。     

帕罗西汀联合丹栀逍遥丸治疗合并睡眠障碍的女性围绝经期抑郁症患者的疗效

目的：观察帕罗西汀联合丹栀逍遥丸对合并睡眠障碍的女性围绝经期抑郁症患者的治疗效果。方法行开放对照研究,单日就诊符合标准的患者为观察组（29例）,应用帕罗西汀联合丹栀逍遥丸治疗,双日为对照组（31例）,单用帕罗西汀治疗。4周后,通过检测治疗前后血浆雌二醇（E2）、促卵泡生成素（FSH）和促黄体生成素（LH）水平,采用改良的 Kupperman 评分量表、匹兹堡睡眠质量指数（PSQI）和汉密尔顿抑郁量表（HAMD）的评分变化评价临床疗效。结果对照组1例中途前往外地退出观察。治疗前两组性激素水平、躯体症状程度、PSQI 和 HAMD 的评分差异无统计学意义。治疗后两组患者血浆 E2水平均较治疗前增加,差异均有统计学意义（P ＜0．05）。观察组躯体症状明显减轻（Z ＝3．95,P ＜0．05）,而对照组变化不明显。治疗后两组 PSQI 和 HAMD 评分均有显著下降（P ＜0．01）,且观察组较对照组下降更显著,疗程末观察组的疗效优于对照组（P ＜0．05）。结论帕罗西汀能有效缓解女性围绝经期的抑郁症状及改善睡眠质量,联合丹栀逍遥丸治疗,疗效更佳。     

中西医结合治疗老年脑卒中后抑郁的效果

目的分析中西医结合治疗老年脑卒中后抑郁及改善神经功能的效果。方法选取113例老年脑卒中后抑郁患者,分为对照组56例及观察组57例,对照组应用盐酸帕罗西汀治疗,观察组应用盐酸帕罗西汀联合疏肝消郁散治疗,观察2组治疗后疗效及神经功能、抑郁情绪改善效果。结果观察组治疗后总有效率(92.98%),显著高于对照组的(78.57%,P0.05);观察组NIHSS评分及SDS评分优于对照组(P0.05)。结论在常规西医治疗基础上,联合应用疏肝消郁散治疗老年脑卒中后抑郁效果确切,能够有效改善患者神经功能,值得临床推广应用。     

中西医结合治疗糖尿病足坏疽合并下肢神经病变的效果观察

目的观察中西医结合治疗糖尿病足坏疽合并下肢神经病变的临床效果。方法选择我院收治的80例糖尿病足坏疽合并下肢神经病变患者,采用随机数表法分为2组各40例,对照组采用常规西医治疗,观察组在对照组基础上进行中西医结合治疗,对比2组治疗效果。结果观察组和对照组的治疗有效率分别为95.0%、77.5%,2组比较差异有统计学意义(P0.05),治疗前2组糖尿病足Wagner分级改善情况及临床症状无明显差异(P0.05),治疗后观察组糖尿病足Wagner分级及临床症状改善情况优于对照组(P0.05)。结论对于糖尿病足坏疽合并下肢神经病变患者应用中西医结合治疗具有更好的效果,可有效改善患者的临床症状,值得临床推广。     

Retinal nerve fiber layer thickness is unaffected in migraine patients

OBJECTIVES: To search for possible structural effects of migraine on the retina. MATERIALS AND METHODS: The study group included 39 consecutive migraine patients, 15 with visual aura and 24 without aura, and 25 healthy subjects as the control group. Scanning laser polarimetry was used to measure and compare retinal nerve fiber layer (RNFL) thickness between migraine and control groups. RESULTS: The mean age of the patients and the control group were 35.64 +/- 8.3 and 35.96 +/- 9.14 years, respectively (P = 0.92) and the mean duration of migraine in patients with aura and without aura as 4.4 +/- 2.9 and 5.3 +/- 4.3 years, respectively (P = 0.68). Parameters related to RNFL thickness were found to be similar (P > 0.001) in migraine and control subjects. After examining the whole patient group migraine patients with and without aura were compared to each other and the control group individually for RNFL thickness parameters. Briefly no statistical difference was found for any of the test parameters between migraine patients with aura, without aura and controls (P > 0.001). CONCLUSION: Retinal nerve fiber layer thickness was found to be unaffected in migraine patients.     

Analysis of the retinal nerve fiber and ganglion cell – Inner plexiform layer by optical coherence tomography in Parkinson’s patients

AimTo measure and evaluate the thickness of the retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) in patients with Parkinson’s disease using optical coherence tomography (OCT).Methods58 eyes of 30 patients with Parkinson’s disease and 60 eyes of 30 healthy individuals were enrolled to this study according to defined criteria. RNFL thickness, central macular thickness (CMT) and ganglion cell-inner plexiform layer (GC-IPL) thickness were measured in these groups. The Parkinson’s patient group was also subjected to Unified Parkinson’s Disease Rating Scale (UPDRS) and Mini Mental Status Exam (MMSE).ResultsNo difference was found between the two groups with respect to age, sex and the best corrected visual acuity (BCVA). Mean, superior, and inferior quadrant RNFL values in the Parkinson’s patients were found statistically significantly lower than those in the control group (P < 0.001, P < 0.049, P < 0.001, respectively). While CMT was statistically similar between the groups, GC-IPL thickness was statistically significantly lower in Parkinson’s patients (p = 0.028). There was no significant correlation between the duration of Parkinson’s disease and RNFL thickness. While there was not any correlation between UPDRS total and motor scores and superior and temporal quadrant RNFL thicknesses, a significant negative correlation was established between RNFL nasal, inferior quadrant and RNFL mean thicknesses (P = 0.022; P = 0.035; P = 0.002, respectively). A significant positive correlation was found between MMSE and nasal and mean RNFL thicknesses (P = 0.046; P = 0.019, respectively).ConclusionRNFL and GC-IPL thicknesses were found lower in Parkinson’s patients. These parameters may be useful to evaluate neurodegeneration and to monitorize neuroprotective therapies.     

尼莫地平对大鼠面神经损伤的保护作用及GDNF表达的影响

目的 探讨尼莫地平对大鼠面神经损伤的保护作用及对胶质细胞源性神经生长因子(GDNF)表达的影响.方法 96只大鼠按随机数字表法分为假手术组、单纯损伤组、尼莫地平预处理组、尼莫地平后处理组,后三组建立大鼠面神经电损伤模型.应用HE染色、Western blotting等方法,观察大鼠面神经损伤后不同时期(1、3、6月)GDNF的动态表达变化及尼莫地平不同给药时间对其表达的影响.结果 与单纯损伤组相比,尼莫地平预处理组大鼠面神经损伤程度减轻,GDNF表达升高,持续时间延长;尼莫地平预处理组GDNF表达和尼莫地平后处理组间比较差异有统计学意义(P＜0.05);尼莫地平后处理组GDNF表达在3月、6月时与单纯损伤组比较差异无统计学意义(P＞0.05).结论 预防性应用尼莫地平可以保护面神经,其机制可能是通过调节GDNF的表达而实现的.

Abstract：

Objective To study the protective function of nimodipine on facial nerve injury and its effect on the expression of glial cell line-derived neurotrophic factor (GDNF). Methods Ninety-six SD rats were randomly divided into sham-operated group, facial nerve injury group, nimodipine pretreatment group, and nimodipine post-treatment group. Rat models of facial nerve injury in thc later 3groups were established. The dynamic changes of expression of GDNF were observed by HE staining and Western blotting in different treatment groups and at different time points (1, 3 and 6 months after the injury). Restdts Compared with the facial nerve injury group, the nimodipine pretreatment and post-treatment groups had significantly less severe nerve damage and significantly up-rcgulated expression of GDNF (P＜0.05). The expression of GDNF in the nimodipine pretreatment group was statistically higher than that in the nimodipine post-treatment group (P＜0.05). However, the expression of GDNF in the nimodipine post-treatment group was not statistically different from that in the facial nerve injury group 3 and 6 months after the injury (P＞0.05). Conclusion Nimodipine has significant facial nerve protective effect, and one of the mechanisms of nimodipine to protect the facial nerve is to regulate the GDNF expression.     

Retinal nerve fiber layer analysis in idiopathic intracranial hypertension

BACKGROUND: The chronic nature of idiopathic intracranial hypertension (IIH) represents a risk factor for progressive optic nerve damage and structural abnormalities of the retina. AIM: We measured the retinal nerve fiber layer (RNFL) thickness in patients followed with the diagnosis of IIH who had no or mild visual impairment to search for possible structural alterations in the retina for diagnostic and prognostic purposes. SETTINGS AND DESIGN: Case-control prospective study. MATERIALS AND METHODS: The study group consisted of 12 women followed and treated with the diagnosis of IIH in our clinic. The selection criteria were the, normal optic nerve, normal visual fields or mild visual field defects (Grade 1-3) by Humphrey perimeter. Randomly assigned, age-matched 12 healthy women were taken as the control group. Retinal nerve fiber layer thickness was evaluated with scanning laser polarimetry and both eyes were studied for each case in both groups. STATISTICAL ANALYSIS USED: Mann-Whitney U test. RESULTS: The mean ages of the patient and the control groups were 34.58+/-4.2 and 34.42+/-5.7 years respectively (P=0.87). The mean duration of disease was 5.5+/-3 years. Some parameters related to RNFL thickness were found to differ significantly between patients with IIH and control subjects. Namely superior ratio (P=0.007), inferior ratio (P=0.039), superior-nasal ratio (P=0.025), maximum modulation (P=0.01) and symmetry (P=0.006) were lower in the patient group than controls. CONCLUSION: Scanning laser polarimetry might be a good adjunct for determining possible structural affects of IIH on the retina in patients with no or mild visual impairment.     

Effects of different nerve autografts on greater auricular nerve deficit in rabbits

BACKGROUND: Autograft is commonly used to repair nerve deficit. Usually, the choice of donor nerves is based on their similarities in form and structures to the injured nerves. For the reason, the cutaneous antebrachii lateralis nerve is currently considered the most suited for digital nerve repair. OBJECTIVE: To compare early nerve regeneration after transplantation of three different autografts: the greater auricular nerve (GAN), the saphenous nerve (SN) and the lateral femoral cutaneous nerve (LFCN). DESIGN: Observational contrast study. SETTING: Department of Plastic Surgery and Burns, Tangdu Hospital, Fourth Military Medical University of Chinese PLA. MATERIALS: A total of 42 New Zealand rabbits, of both genders, 12–14 months old and weighing 2.0–2.5 kg, were used in this study. In addition, Moller-spetra 900 operating microscope (Germany), Olympus BX 51 microscope, DP 70 image collecting System (Japan), BL-420E+ Biologic function testing System (China), JEM-100 electron microscope (Japan), Reichet-JunG820 Cryostat (Swiss), and Libror-AEG-120 precision analytical Balance (Japan) were also used in this study. METHODS: The experiment was carried out in the Department of Plastic Surgery and Burns, Tangdu Hospital, Fourth Military Medical University of Chinese PLA from April to November 2005. After anaesthesia, the GAN were dissected bilaterally and a 1.2 cm deficit was made in each nerve. The animals were randomly divided into three groups, including GAN group, SN group and LFCN group with 14 in each group. ① Nerve pinch test: At 1, 2, and 4 weeks after operation, three animals in each group were tested. The nerve grafts, along with the proximal and distal GAN segments were exposed and pinched with microsurgical forceps in distal-proximal orientations. The distance between the proximal anastomosis site and the most distal point, where the pinch evoked an ear contraction response, was measured as distance of nerve regeneration. ② Computer image analysis: At 4 and 12 weeks, 2 μm sections were prepared, each stained with either HE or methylene blue to assess axon number and density, cross-section area, and myelin sheath thickness. ③ Electrophysidogical tests: At 12 weeks, the bilateral GAN along with the nerve grafts of 4 animals in each group were exposed. Points A, B and C were marked on each specimen: point A: at the proximal GAN segment, 7 cm from the proximal anastomosis; point B: 0.5 cm from the proximal anastomosis; point C: at the distal GAN segment, 0.5 cm from the distal anastomosis. The whole nerve including nerve graft and proximal and distal GAN segments, as a block, was harvested and immersed in Ren's solution for several minutes until its excitability was stabilized. The specimen was then placed on the electrodes of the shield box to examine the action potential and conduction velocity on segment AB and AC with BL-420E+biologic function testing system. AC/AB would be the recovery rate of action potential on segment AC. ④ Horseradish peroxidase (HRP) fascicle: At 12 weeks, at the site on the distal segment of GAN 1.0 cm from the distal anastomosis of nerve graft, the GAN was crushed by a pair of haemostatic forceps and HRP water solution was injected into the nerve. Two rabbits in GAN group, SN group and LFCN group, after having survived for 24 hours, 36 hours and 48 hours were selected. The C2 ganglion was exposed and the distance from C2 ganglion to HRP injection site was taken as the axoplasmic transport distance, from which the axoplasmic transport velocity and the mean density of the labeled C2 ganglion cells were calculated. MAIN OUTCOME MEASURES: ① The greatest distance of nerve regeneration; ② the axon number and density, cross-section area, and myelin sheath thickness; ③ the action potential and conduction velocity; ④ the axoplasmic transport velocity and the mean density of the labeled C2 ganglion cells. RESULTS: All 42 experimental rabbits were involved in the final analysis. ① The greatest distance of nerve regeneration: At 4 weeks after operation, the greatest distance of nerve regeneration was longer in the SN group than that in the GAN group and the LFCN group [(45.17±2.48), (41.83±2.32), (34.83±2.64) mm, P < 0.05], while the greatest distance of nerve regeneration was longer in the GAN group than that in the LFCN group (P < 0.05). ② The axon number and density, cross-section area, and myelin sheath thickness: The number of nerve fascicle was the greatest in the GAN group, and the cross-section area was the most; however, ratio between nerve fascicle and cross-section area, and the axon density were lower than those in other two groups (P < 0.05–0.01). In contrast, the axon density was the greatest in the SN group. At 4 weeks after operation, axon density was the most in the SN group, and then the GAN group and the LFCN group. There were significant differences among the three groups (P < 0.05–0.01). At 12 weeks after operation, density of myelinated fiber and axon section area were higher in the SN group than those in other two groups (P < 0.05–0.01). ③ The action potential and conduction velocity: At 12 weeks after operation, the maximal action potential, the recovery rate of action potential and the nerve conduction velocity were the highest in the SN group. HRP-labeled neurons early occurred in C2 ganglion, and the action potential and the recovery rate of action potential were increased (P > 0.05). At 12 weeks after operation, even though the maximal action potential, the recovery rate of action potential and the nerve conduction velocity on segment AB remained similar in different groups, on segment AC, the action potential, the recovery rate of action potential and nerve conduction velocity were greater in the SN group than those in other groups. ④ The axoplasmic transport velocity and the mean density of the labeled C2 ganglion cells: After HRP injection in the SN group, the positive labeled cells in C2 ganglion firstly appeared at 24 hours, and in other two groups, they did not appeared until 36 hours. The density of labeled cells was the greatest in the SN group and the lowest in the LFCN group. The axoplasmic transport velocity in the SN group was also significantly faster than in the GAN group and the LFCN group (P < 0.05–0.01). Otherwise, the axoplasmic transport velocity was faster in the SN group than that in the GAN group and the LFCN group. CONCLUSION: The donor nerve with greater axon number and density can achieve much better effects during early regeneration.     

GDx-VCC检测视网膜神经纤维层在青光眼早期诊断中的价值

目的比较正常人和不同程度青光眼患者GDx参数的不同,评价GDx检测RNFL各参数的敏感性、特异性,确定GDx参数早期诊断青光眼的能力和最有价值指标。方法应用GDx-VCC分别对40例（80只眼）正常人、80例（130只眼）早期青光眼和70例（90只眼）中晚期青光眼患者的RNFL进行检测。分别比较其RNFL参数的不同。绘制GDx参数ROC曲线,确定对早期青光眼诊断最有意义的GDx参数。结果早期青光眼RNFL较正常人明显变薄,中晚期青光眼RNFL较早期青光眼明显变薄,各参数均有统计学极显著性差异（P〈0.001）。所有参数ROC曲线下面积均〉0.7,具有良好地区分正常人和早期青光眼的能力。NFI和IA的ROC曲线下面积为0.81,区分能力更强。结论GDx-VCC可为临床上提供定量检测RNFL厚度的参数,并有良好地区分正常人和早期青光眼的能力,有助于临床上青光眼的早期诊断。