辐照灭菌冷冻干燥羊膜修复碱烧伤

背景：经辐照灭菌的冷冻干燥羊膜便于保存和使用,但羊膜经这种方式处理后其活性是否会降低、其临床疗效是否会受到影响至今仍鲜有报道。目的：观察辐照灭菌后的冷冻干燥羊膜对兔角膜碱烧伤的修复作用。方法：取健康成年白兔9只,均用1mol/L氢氧化钠烧伤角膜后,左侧眼设为羊膜组植入辐照灭菌后的冷冻干燥的羊膜,右侧眼设为对照组不植入羊膜。植入后30d内裂隙灯显微镜每日观察角膜透明度、角膜新生血管及角膜上皮修复情况。结果与结论：羊膜植入后30d,羊膜组角膜透明度、新生血管及角膜上皮修复情况明显优于对照组（P〈0.05）,角膜上皮愈合好,基质纤维排列更为整齐,炎细胞浸润程度轻,新生血管更少。结果证实,兔角膜碱烧伤后植入辐照灭菌后的冷冻干燥羊膜可减轻角膜炎性反应,促进角膜上皮修复,减少角膜新生血管形成。     

辐照灭菌冷冻干燥羊膜修复碱烧伤

背景：经辐照灭菌的冷冻干燥羊膜便于保存和使用,但羊膜经这种方式处理后其活性是否会降低、其临床疗效是否会受到影响至今仍鲜有报道。 目的：观察辐照灭菌后的冷冻干燥羊膜对兔角膜碱烧伤的修复作用。 方法：取健康成年白兔9只,均用1 mol/L 氢氧化钠烧伤角膜后,左侧眼设为羊膜组植入辐照灭菌后的冷冻干燥的羊膜,右侧眼设为对照组不植入羊膜。植入后30 d内裂隙灯显微镜每日观察角膜透明度、角膜新生血管及角膜上皮修复情况。 结果与结论：羊膜植入后30 d,羊膜组角膜透明度、新生血管及角膜上皮修复情况明显优于对照组(P < 0.05),角膜上皮愈合好,基质纤维排列更为整齐,炎细胞浸润程度轻,新生血管更少。结果证实,兔角膜碱烧伤后植入辐照灭菌后的冷冻干燥羊膜可减轻角膜炎性反应,促进角膜上皮修复,减少角膜新生血管形成。     

多囊卵巢综合征骨骼肌胰岛素抵抗大鼠模型的建立

背景：研究表明胰岛素抵抗在多囊卵巢综合征的发生与发展过程中起重要作用,建立理想的多囊卵巢综合征骨骼肌胰岛素抵抗动物模型是研究该疾病的基础。 目的：探讨建立较为理想的多囊卵巢综合征骨骼肌胰岛素抵抗大鼠模型的方法。 方法：将八九周龄SD雌性大鼠随机分为模型组和对照组。模型组给予胰岛素联合人绒毛膜促性腺激素皮下注射,并以高脂饲料和50 g/L葡萄糖水喂养,对照组皮下注射生理盐水,常规饮食喂养。 结果与结论：造模6周后,模型组大鼠卵巢体积明显增大,且呈多囊性改变;血清睾酮、黄体生成素、空腹血糖和胰岛素水平高于对照组;骨骼肌组织中葡萄糖转运蛋白4表达明显低于对照组,且其葡萄糖转运蛋白4阳性颗粒靠近骨骼肌细胞膜边缘者较少。可见胰岛素联合人绒毛膜促性腺激素皮下注射,并饲以高脂饲料和50 g/L葡萄糖水是建立多囊卵巢综合征骨骼肌胰岛素抵抗大鼠模型较为理想的方法。     

The neural correlates of intertemporal decision-making: contributions of subjective value, stimulus type, and trait impulsivity

Making choices between payoffs available at different points in time reliably engages a decision-making brain circuit that includes medial prefrontal cortex (mPFC), posterior cingulate cortex (PCC), and ventral striatum (VS). Previous neuroimaging studies produced differing accounts of the functions of these regions, including that these regions: (1) are sensitive to the value of rewards discounted by a function of delay ('subjective value'); (2) are differentially sensitive to the availability of an immediate reward; and (3) are implicated in impulsive decision-making. In this event-related fMRI study of 20 volunteers, these hypotheses were investigated simultaneously using a delay discounting task in which magnitude of rewards and stimulus type, i.e., the presence or absence of an immediate option, were independently varied, and in which participants' trait impulsivity was assessed with the Barratt Impulsiveness Scale. Results showed that mPFC, PCC, and VS are sensitive to the subjective value of rewards, whereas mPFC and PCC, but not VS, are sensitive to the presence of an immediate reward in the choice option. Moderation by individual differences in trait impulsivity was specific to the mPFC. Conjunction analysis showed significant overlap in mPFC and PCC for the main effects of subjective value and stimulus type, indicating these regions may serve multiple distinct roles during intertemporal decision-making. These findings significantly advance our understanding of the specificity and overlap of functions subserved by different regions involved in intertemporal decision-making, and help to reconcile conflicting accounts in the literature.     

Bilateral Rasmussen encephalitis

Rasmussen encephalitis (RE) is a rare, chronic, inflammatory neurological disorder that usually affects one hemisphere of the brain. RE is characterized by frequent and severe seizures, progressive neurological dysfunction, and unilateral brain atrophy. This article documents a case of RE with bilateral involvement occurring at the age of 2. The patient's seizures consisted of focal motor seizures (epilepsia partialis continua in the fingers on the right hand); tonic convulsions of the right arm and head turning to the right with impairment of consciousness; and secondarily generalized tonic-clonic seizures. Antiepileptic drugs did not effectively control the seizures. The pathology of the left frontoparietal lobe biopsy of the abnormal MRI signal showed typical neuronal loss, abundant lymphocytic infiltration into the perivascular space, and numerous microglial nodules. Bipolar electrocoagulation on functional cortexes, which failed to alter the course of the illness, was followed by high-dose prednisone (about 2 weeks worth), without improvement. Both functional hemispherectomies and anatomical hemispherectomies failed to halt the course of the illness, and contralateral seizures developed and became apparent after the operation, suggesting bilateral RE.     

Treatment of drug-resistant epilepsy with vagus nerve stimulation — review of 45 cases

Background  Vagus nerve stimulation (VNS) is an alternative treatment for drug-resistant epilepsy (DRE). The study aimed to explore the potential factors of prognosis, safety and effect of VNS treatment in patients with DRE.

Methods  We retrospectively examined 45 cases of DRE that received VNS treatment in our center from June 2004 to June 2010 and analyzed the parameters (age of patient receiving VNS, seizure frequency before and after VNS as well as treatment duration) by Student’s t test, Fisher’s exact and Mann-Whitney U tests, and multivariate Logistic regression.

Results  The overall response rate was 64% (29/45), 67% (6/9) for adults and 64% (23/36) for children, with no significant difference (P=0.28). Twenty-two cases had been in VNS therapy for over 1 year with a treatment efficacy of 73% (16/22), whereas 23 cases had been in VNS therapy no more than 1 year with a treatment effecacy of 57% (13/23), and has statistically significant difference (P=0.03). The main side effect included hoarseness of voice and cough. One patient’s device was removed due to infection. One patient’s VNS was half-way terminated due to seizure aggravation. One patient died due to status epilepticus.

Conclusions  VNS is a safe and effective treatment for DRE. Duration of VNS therapy may be a crucial factor on prognosis.

     

巩膜外环扎术治疗硅油填充眼早期视网膜脱离疗效观察

目的:观察巩膜外环扎术治疗硅油填充眼早期视网膜脱离的临床效果。方法:本研究为回顾性病例研究,对26例26眼行硅油填充术后早期(<15d)出现视网膜脱离的患者行巩膜外环扎及局部加压术。术后随访6～18mo,观察患者视网膜复位、视力及眼压情况。结果:患者26例26眼均存在下方视网膜脱离;22例22眼术后视网膜解剖复位,4例4眼再次行硅油注入术;术后视力提高者22例22眼,视力不变者3例3眼,视力下降者1例1眼;环扎术后早期存在眼压升高现象,观察至3mo眼压恢复正常。结论:巩膜外环扎术是治疗硅油填充眼早期视网膜脱离的有效手段。