低频脉冲电刺激治疗产褥期乳腺炎55例疗效观察

目的探讨低频脉冲电刺激对产褥期妇女急性乳腺炎的疗效。方法选择产褥期乳腺炎患者110例,随机分为综合治疗组和对照组,各55例。对照组采用常规疗法,综合治疗组在常规疗法基础上采用低频脉冲电刺激,比较两组患者的治疗效果。结果两组患者疗效间差异有显著性意义(P<0·05);两组患者平均治疗天数间差异亦有显著性意义(P<0·01)。结论运用低频脉冲电刺激治疗产褥期乳腺炎效果明显,值得在临床推广。     

Target-dependent axonal sprouting following vagal-hypoglossal nerve anastomosis in cats

Purpose: To investigate the relationships between the axonal sprouting and target neurotization by central neurons after nerve heterocon-nection. Methods: Unilateral (right) vagal-hypoglossal nerve anastomosis (VHA) was performed in adult cats. Following 3-315 days postoperation (dpo), quantitative analyses and ultrastructural changes in the proximal portion of the vagal-hypoglossal heteroconnected nerve as well as the time course of neuronal regeneration were studied. Along with this, horseradish peroxidase (HRP) retrograde tracing technique was used to label the neurons of dorsal motor vagal nucleus (DMV) and nucleus ambiguus (NA) to ascertain if target neurotization was established. Results: The contralateral (left) intact vagus nerve proximal to the level of ansa cervicalis showed an average of 33 +/- 1 myelinated and 74 +/- 4 unmyelinated axons in 727 &mgr;m(2) sectional area of the nerve. In the heteroconnected nerve at the corresponding level just proximal to the anastomosis site, there was a marked increase in the number of small axons sprouting from the unmyelinated nerve fibers between 18 and 25 dpo. The number of these axonal sprouts appeared to decline at 32 dpo but its increase of 131 % was sustained until the late regeneration stage at 315 dpo when compared with the contralateral nerve serving as a control. The mean number of myelinated axons per area unit (727 &mgr;m(2)) was reduced to 18 at 3 dpo but was immediately restored to the normal range at 7 dpo. The retrograde labelling of neurons in both the DMV and NA was first detected at 22 dpo and was progressively increased peaking by about 67 dpo. Conclusions: We conclude that compared with the unmyelinated axons, the myelinated axons may acquire a superior interaction with the new target. Furthermore, the postoperative neurotization of tongue muscles may initiate and facilitate the retraction of the redundant axonal sprouts.     

Timing of ketogenic diet initiation in an experimental epilepsy model

Following kainic acid (KA)-induced status epilepticus (SE), the ketogenic diet (KD) retards the development of epileptogenesis, with fewer spontaneous recurrent seizures (SRS) and less mossy fiber sprouting than rats on a normal diet. In this study, we investigated whether there is a critical period for initiation of the KD, in terms of the diet's effectiveness in reducing SRS. In addition, we investigated whether early treatment with the KD prevents the deficits in spatial learning and memory that ordinarily follow KA-induced SE. Young rats (P30) underwent KA-induced SE, followed by assignment to one of three treatment groups: control diet ('KA'), KD begun 2 days after SE ('KD2'), and KD begun fourteen days after SE ('KD14'). For 12 weeks following SE, rats were monitored by closed circuit video recording (12 h/wk) to detect SRS. KD2 rats had significantly fewer SRS than rats in the control or KD14 groups. On water maze testing to assess spatial learning and memory, KD2 rats had significantly poorer acquisition of place learning than control (KA alone) or KD14 rats. KD2 rats also failed to gain weight well. There was no difference between groups on routine histologic examination of the hippocampus. In summary, P30 rats placed on the KD 2 days after SE were relatively protected from recurrent seizures, but showed behavioral and physical impairment. Rats placed on the KD 14 days after KA-induced SE did not differ from controls with regard to spontaneous seizure rate.     

DNA damage and activated caspase-3 expression in neurons and astrocytes: evidence for apoptosis in frontotemporal dementia

Frontotemporal dementia (FTD) is a neurodegenerative disease which affects mainly the frontal and anterior temporal cortex. It is associated with neuronal loss, gliosis, and microvacuolation of lamina I to III in these brain regions. In previous studies we have described neurons with DNA damage in the absence of tangle formation and suggested this may result in tangle-independent mechanisms of neurodegeneration in the AD brain. In the present study, we sought to examine DNA fragmentation and activated caspase-3 expression in FTD brain where tangle formation is largely absent. The results demonstrate that numerous nuclei were TdT positive in all FTD brains examined. Activated caspase-3 immunoreactivity was detected in both neurons and astrocytes and was elevated in FTD cases as compared to control cases. A subset of activated caspase-3-positive cells were also TdT positive. In addition, the cell bodies of a subset of astrocytes showed enlarged, irregular shapes, and vacuolation and their processes appeared fragmented. These degenerating astrocytes were positive for activated caspase-3 and colocalized with robust TdT-labeled nuclei. These findings suggest that a subset of astrocytes exhibit degeneration and that DNA damage and activated caspase-3 may contribute to neuronal cell death and astrocyte degeneration in the FTD brain. Our results suggest that apoptosis may be a mechanism of neuronal cell death in FTD as well as in AD (228).     

经血管内途径栓塞治疗颈动脉海绵窦瘘(附216例报告)

目的　探讨颈动脉海绵窦瘘 (CCF)的治疗方法选择、栓塞技术要点及随访意义。方法　对 2 16例CCF病人共行 2 2 0次栓塞 ,其中 ,经股动脉入路 2 0 2例 ,经股静脉入路 9例 ,经眼上静脉入路 5例 ;以球囊栓塞瘘口 188例 ,以微弹簧圈栓塞 2 3例 ,球囊并用弹簧圈 5例。术后 6～ 10 8个月随访 110例 ,其中行影像学复查 3 5例。结果　 2 12例 1次栓塞成功 ,4例于第一次栓塞后球囊泄漏复发 ,经再次栓塞治愈 ,总治愈率 10 0 %。颈内动脉通畅率 94 4% (2 0 4/2 16) ,无并发症及死亡 ,随访显示疗效可靠。结论　CCF一般经股动脉入路用可脱性球囊栓塞瘘口 ,栓塞时球囊应稳步前进 ,一旦扩充 ,决不轻易后拉。小瘘口CCF选择微弹簧圈栓塞 ;若颈内动脉结扎或闭塞 ,可经静脉入路栓塞瘘口。正确选择栓塞途径及栓塞材料是手术成功的关键。     

颅内肿瘤的立体定向放射治疗(附79例报告)

目的　探讨立体定向放射治疗颅内肿瘤的方法和疗效。方法　对 79例胶质瘤等 6种颅内肿瘤采用 5～ 10个非共面弧共治疗 3～ 10次 ,3～ 10Gy/次 ,3次 /周 ,总剂量 2 0～ 5 0Gy。术后随访 6～ 2 4个月 ,以CT/MR示肿瘤平均直径变化为主的指标评定疗效。结果　立体定向放射治疗 (SRT)组 79例 ,有效 6 6例 (83 5 % ) ,立体定向放射外科 (SRS)组 73例 ,有效 6 3例 (86 3% ) ,两组比较无显著差异 (P >0 0 5 ) ;术后放疗 (S RT)组 5 7例 ,有效 36例 (6 3 2 % ) ,与SRT组比较有显著差异 (P <0 0 1) ;SRT组无效 13例 (16 5 % ) ,出现并发症 4例 (5 % ) ;SRS对照组并发症 2 1例 (2 8 8% )与SRT组有显著差异 (P<0 0 1) ;S RT组并发症 6例 (10 5 % ) ,与SRT组比较无显著差异 (P >0 0 5 )。结论　SRT可治疗体积较大和位于重要器官的肿瘤。它与外放疗比较 ,可缩短治疗时间 ,提高个别颅内肿瘤的疗效 ;与SRS比较 ,可减少并发症发生率 ;与S RT比较可提高治疗效果     

磁共振弥散/灌注加权成像确认局灶脑缺血半暗带的实验研究

目的　探讨超急性期确认局灶脑缺血半暗带的范围和演变规律。方法　用易卒中型肾血管性高血压大鼠(RHRSP)行左侧腔内线栓MCAO术 ,分别在闭塞 12h内的不同时间点及再灌注 48h后行T2 加权成像 (T2 WI)、磁共振弥散加权成像 (DWI)和磁共振灌注加权成像 (PWI)。将大鼠处死后行TTC染色 ,比较在闭塞不同的时间点上在两次T2 WI和DWI上病灶的演变和TTC染色上梗死灶的改变。结果　DWI在闭塞 30min时显示出确切的病灶 ,而T2 WI要在 3h以后才能显示出病灶 ;自 30min至 6h ,DWI所显示的病灶持续扩大 ,可逆性部分占首次DWI上病灶的百分比 (%RP)逐渐缩小 ,最终为负数 ;PWI在MCAO闭塞的即刻即在时间 信号强度曲线上表现为最大下降幅度的减小 ,复通后上升 5 0 %以上 ;半暗带部分水的表面弥散系数值 (ADC)为 (0 5 6± 0 0 2 )× 10 -5cm2 /s。结论　DWI能在超急性期 (3h以内 )显示出缺血病灶 ,根据梗死中心和梗死周边的ADC值的不同可以分辨出可逆性和不可逆性损伤的缺血组织 ;本模型的缺血半暗带存在的时间为6h。     

The HSV 1 genome in quiescently infected NGF differentiated PC12 cells can not be stimulated by HSV superinfection

This study reports that quiescent herpes simplex virus (HSV) type 1 genomes, persisting in long-term infected nerve growth factor (NGF) differentiated PC12 cells, were not stimulated by superinfection with a HSV-1. We have previously shown that HSV-1 can establish long term, quiescent infections in NGF differentiated PC12 cells. To determine if virion associated factors or virus induced gene products could trans-activate the quiescent viral genomes, long term infected PC12 cell cultures were superinfected at a high moi (moi of 20) with a recombinant HSV 17alpha47/lacZ that contains the lacZ gene within the alpha 47 locus. Progeny virus and gene expression from the resident 'quiescent' viral genomes were not detected following superinfection with recombinant 17alpha47/lacZ. The failure to stimulate the quiescent genome appears to be related to the inability of the super infecting virus to induce any gene expression from its own genome following entry into the long term NGF treated PC12 cells. Interestingly, both primary and superinfecting viruses could be stimulated from the quiescently infected cultures following cocultivation with inducer cells. These data suggest that (i) HSV genomes in quiescently infected PC12 cells are unable to be stimulated by incoming virion associated factors and (ii) NGF differentiated PC12 cells maintained in tissue culture for longer than 3 weeks became completely refractory to viral gene expression. The possibilities that these results are reflective of populations of neural cells, in vivo in mouse central nervous system, which are completely refractory to virus gene expression, yet accommodating to the maintenance of viral genomes and thus favor 'latency', are discussed.