大鼠发育过程中视皮层神经元电生理与形态 学特性的相关性——细胞内染色研究

目的研究大鼠不同发育阶段视皮层神经元电生理学与形态学特性的关系, 观察电生理特性和形态变化的同步化程度,认识正常视觉发育的细胞内机制。 方法应用脑片膜片钳全细胞记录技术和细胞内标记相结合的方法, 获得4～28 d Sprague-Dawleg(SD) 大鼠视皮层神经元的细胞内微电极记录,再进行细胞内标记和组织学染色。 结果成功标记23例细胞,其中锥体细胞与非锥体细胞在电生理特性上差异有显著性。不同发育阶段视皮层神经元形态学上的成熟度不同。 结论①视觉发育过程中,视皮层锥体细胞和非锥体细胞的电生理学特性反映其参与不同的视皮层神经元回路的整合功能。②视觉发育可塑性关键期内,视皮层神经元形态和电生理特性变化的同步化程度大于视皮层下结构。(中华眼底病杂志,2001,17:289-292)     

Computer-assisted navigational surgery improves outcomes in orbital reconstructive surgery

ABSTRACT: Orbital reconstruction is a difficult procedure, success of which is dependent on the surgeon's experience. The lack of objective methods requires a fair amount of estimation is its execution. This study evaluates the efficacy of Kolibri (BrainLab, Munich, Germany), an intraoperative navigation device, in improving outcomes.From 2004 to 2009, 58 patients with orbital trauma who underwent surgery at the National University Hospital, Singapore, were included in this prospective matched control trial. Twenty-nine consecutive patients underwent surgery with Kolibri. The control group underwent surgery without the device. Both groups were matched for age, sex, orbital wall fracture, preoperative ophthalmologic features, etiology and severity of trauma, surgical approach, and types of implant used. The postoperative follow-up was at 1, 3, 6, and 12 months. For subjective assessment, the postoperative ophthalmologic features, including diplopia, infraorbital hypoesthesia, ophthalmoplegia, and enophthalmos, were compared. At 1, 3, 6, and 12 months, respectively, there were fewer patients with postoperative ophthalmologic complications in the study group (italicized; n = 29) compared with the control group (n = 29; P < 0.05): 12/29 (41%) versus 21/29 (72%), 8/29 (28%) versus 19/29 (66%), 5/29 (17%) versus 15/29 (52%), and 2/29 (7%) versus 12/29 (41%).For objective assessment, using the Kolibri workstation, operative plans were created and fused with postoperative computed tomographic scans. Vertical distances between the actual reconstructed and planned orbital floors were measured. On average, the vertical distance measured from the boundaries of floor defects for patients in the study group was 3.24 mm (95% confidence interval, 1.56-4.91) lower than the control group (P = 0.001).In conclusion, navigation minimizes postoperative complications, reduces the need for repeat procedures, and helps surgeons with planning, execution, and postoperative assessment.