小脑前下动脉的显微解剖研究

小脑前下动脉(anterior inferior cerebellar arter,AICA)作为桥小脑角区重要的动脉,研究其显微解剖对相关脑血管病具有重要的定位诊断和治疗意义。1材料与方法2005年5月至2006年2月于辽宁医学院解剖教研室选取无明显病变的国人成年尸体头颅标本10例(共20侧),其中男6例,女4例,1     

脑内窥镜下手术治疗桥小脑角病变

桥小脑角区以面神经和听神经为中心 ,其周围结构复杂 ,涉及小脑、脑干、部分颅神经 ,以及小脑下前动脉、小脑下后动脉、迷路动脉、小脑上动脉等重要结构 ,因此 ,开放性手术常会损伤这些结构而导致严重的术后并发症。脑内窥镜的应用既能直接观察病变的范围 ,又能活检以查明病变性质 ,了解局部解剖关系和血供情况 ,还可以根据发现来估计某些病变的手术可能性和患者预后 ,甚至可以在直视下直接手术治疗病变 ,但很少出现严重的术后并发症 ,因而越来越受到人们的重视。目前 ,脑内窥镜在桥小脑角病变手术中的应用主要涉及三叉神经痛、面肌痉挛、听…     

神经内窥镜下桥脑小脑角病变的解剖与治疗

目的探索神经内窥镜下桥脑小脑角区的局部应用解剖及神经内窥镜辅助显微手术的实用性。方法对2具尸头及38例桥脑小脑角病变患者的桥脑小脑角区进行神经内窥镜观察与治疗。结果在神经内窥镜下几乎能观察到桥脑小脑角区全部血管神经结构。38例桥脑小脑角病变患者无术后并发症及死亡。结论桥脑小脑角内窥镜下可分为头、中、尾侧三个层面,每个层面内含知名血管和神经。经乙状窦后人路神经内窥镜辅助显微手术治疗桥脑小脑角病变,可提高手术疗效,降低手术危险性。     

面神经颅内段比邻解剖对听神经瘤切除术中保留面神经的指导意义

听神经瘤主要发生在桥小脑角区,与面神经关系密切,如何在切除肿瘤的同时最大限度地保留面神经的功能是目前该手术的重点,而全面掌握面神经在桥小脑角及内听道内的显微解剖对此有重要意义.我们对18例汉族成人尸头标本共36侧桥小脑角及内听道中的面神经及其毗邻结构进行了显微解剖研究.现报告如下.     

极小小脑梗塞

极小小脑梗塞是发生于小脑供应动脉之间的边缘区小梗塞。梗塞原因多数为大动脉的动脉粥样硬化,少数为高凝状态或微栓塞引起的终末动脉闭塞。梗塞部位在小脑上动脉、小脑后下动脉和小脑前下动脉分支之间的边缘区。皮质梗塞多于白质梗塞。临床表现与大范围小脑梗塞大致相同。     

小脑前下动脉区梗塞

从小脑前下动脉的解剖,小脑前下动脉区梗塞的病因、病理、临床表现以及诊断治疗、预后等方面综述小脑前下动脉区梗塞的研究进展。     

枕下乙状窦后人路微创治疗小脑桥脑角肿瘤8例报告

枕下乙状窦后入路是比较成熟的手术入路，手术显微器械的进步，为微创手术治疗小脑桥脑角肿瘤创造了有利条件。2006年6月-2007年6月，我们采用小骨窗微创手术治疗小脑桥脑角肿瘤8例，效果较好。现报告如下。     

小脑前下动脉区梗塞

从小脑前下动脉的解剖，小脑前下动脉区梗塞的病因、病理、临床表现以及诊断治疗、预后等方面综述小脑前下动脉区梗塞的研究进展。     

全内镜枕下锁孔入路血管减压术治疗面肌痉挛的体会

目的探讨全内镜枕下锁孔入路血管减压术治疗面肌痉挛的临床疗效。 方法回顾性分析宁波市鄞州第二医院神经外科自2019年5月至2020年7月收治的面肌痉挛患者的临床资料。所有患者均于内镜下减压面神经根部（即出脑干区、离脑干区以及移行区）责任血管,术后随访5~19个月,评价其治疗效果。 结果本组患者责任血管分为2类：（1）单一血管组：小脑前下动脉（AICA）共21例（60%）;小脑后下动脉（PICA）共2例（5.7%）;（2）复合血管组：AICA+PICA 4例（11.4%）,PICA+椎动脉（VA）4例（11.4%）,AICA+VA 3例（8.6%）,AICA+PICA+VA 1例（2.9%）。所有患者均未见静脉压迫。术后痊愈者33例,明显缓解者2例。 结论经枕下锁孔入路,内镜下可清晰观察面神经根以及责任血管并实施减压手术,术后效果良好。     

枕下乙状窦后入路手术治疗听神经瘤32例临床分析

听神经瘤是桥小脑角最常见的良性肿瘤,其发病率占桥小脑角肿瘤的80%.我科2003～2006年经枕下乙状窦后入路手术切除听神经瘤32例,术前均经CT及MRI诊断,术后经病理证实.现总结如下.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.