用磨牙作支柱拉尖牙向远中支柱情况的早期观察

选择６２例拔除第一双尖牙的样本，分为平弓丝组、带“Ｕ”型阻滞曲组、固定舌弓组，采用方丝弓细丝弓技术，以磨牙作支抗拉尖牙向远中移动，对支抗磨牙进行观察。为期４周的观察发现，平弓丝组、带“Ｕ”型阻滞曲组的支抗磨牙均有近中舌向扭转，第二双尖牙中央窝间距亦比治疗前减少；而固定舌弓组支抗磨牙未见有近中舌向扭转。作者认为：以磨牙为支抗移动尖牙时，应注意支抗控制。本文对力的使用及支抗失控的预防、处理问题进行了讨论。     

Chromatic pattern-reversal electroretinograms (ChPERGs) are spared in multiple system atrophy compared with Parkinson’s disease

Abstract Idiopathic Parkinson’s disease (IPD) patients have abnormal visual evoked potentials (VEPs) and pattern electroretinograms (PERGs), attributed to dopaminergic transmission deficiency in visual pathway, probably the retina. VEP abnormalities are not reported in multiple system atrophy (MSA). The aim of this study was to investigate and compare chromatic (Ch) red-green (R-G) and blue-yellow (B-Y), and luminance yellow-black (Y-Bk) PERGs in patients with MSA and IPD. We investigated 6 MSA patients (mean age: 62±7.4 years) not undergoing any pharmacological treatment, as well as 12 early IPD patients (mean age: 60.1±8.3 years) and 12 age-matched normal observers. ChPERGs were recorded monocularly in response to full-field equiluminant R-G, B-Y and Y-Bk horizontal gratings. In MSA only responses to R-G stimuli showed minimal insignificant changes (slight but not significant amplitude reduction without any significant latency delay); no significant abnormality was detected for B-Y and luminance Y-Bk stimuli. By contrast, in IPD all responses were reduced in amplitude and delayed in latency, above all for B-Y stimuli. Present data indicate that both chromatic and achromatic PERGs are virtually unaffected in MSA, whereas in early IPD they are clearly impaired, suggesting different pathogenic retinal mechanisms and a useful simple tool for distinguishing MSA from IPD.     

Tetrabenazine therapy of pediatric hyperkinetic movement disorders.

Tetrabenazine (TBZ), a presynaptic dopamine depletor and postsynaptic dopamine receptor blocker, is widely used for the treatment of hyperkinetic movement disorders in adults. However, reports of its use in children are limited. We review the efficacy and tolerability of TBZ therapy in 31 children with hyperkinetic movement disorders refractory to other medications. TBZ was effective in reducing the severity of movement disorders resistant to treatment with other medicines. When compared to adult patients, pediatric patients required higher doses. Side effects were similar to the adult population; however, children had a lower incidence of drug-induced Parkinsonism.     

自拟白术桃花汤治疗习惯性便秘临床观察

目的　观察白术桃花汤治疗习惯性便秘的疗效。方法　自拟白术桃花汤 (白术 30g ,桃花 12g ,生地黄 30g ,枳实 10g) ,每日服 1剂 ,7d为 1个疗程。对照组服用果导片作对比观察。结果　白术桃花汤治疗习惯性便秘 117例 ,治愈 10 6例 ,好转 4例 ,总有效率 94 .0 2 %;果导片治疗 6 6例 ,治愈18例 ,好转 30例 ,总有效率 72 .73%。两组总有效率比较 ,经统计学处理P <0 0 1,差异有非常显著性意义。结论　白术桃花汤功能为补气除湿 ,增液行气 ,通调大便 ,治疗习惯性便秘疗效满意。     

Effects of nicotine on hippocampal and cingulate activity during smooth pursuit eye movement in schizophrenia.

BACKGROUND: Abnormal smooth pursuit eye movement (SPEM) in schizophrenic patients is a well known phenomenon, but the neurophysiological mechanisms underlying the deficit are unknown. Nicotine temporarily improves SPEM and has been associated with reduced hippocampal hemodynamic activity in schizophrenics. Nicotine's effect on brain activity in control subjects performing SPEM has not been studied. The purpose of this work was to determine if nicotine differentially affects brain activity in schizophrenic and control subjects during pursuit eye tracking. METHODS: 16 subjects with schizophrenia and 16 control subjects underwent functional MR imaging during SPEM after receiving placebo or nicotine gum. Four brain regions were analyzed for main effects of group, drug, and interactions: hippocampus, cingulate gyrus, frontal eye fields, and area MT. RESULTS: Nicotine reduced hippocampal activity in both groups, but the effect was greater in control subjects. A group by drug interaction was observed in the anterior cingulate gyrus, where nicotine decreased activity in control subjects and increased activity in schizophrenic subjects. There were no significant effects of group, drug, or interactions in frontal eye fields or area MT. CONCLUSIONS: Nicotine may improve SPEM performance in people with schizophrenia through cholinergic stimulation of the hippocampus and cingulate gyrus. Potential mechanisms include improved inhibitory function and attention.     

Movement disorders after intervertebral disc surgery: Coincidence or causal relationship?

It is well known that brain injury or central traumatic lesions may result in the subsequent appearance of movement disorders such as dystonia or tremor. The concept that peripheral lesions to neural structures may be involved in the pathogenesis of movement disorders has been discussed controversely but has gained more widespread acceptance only recently. Here, we report on 6 patients who developed movement disorders after spinal disc surgery. The movement disorders became manifest with a delay of 1 day to 12 months after surgery. Of the six patients, 4 underwent cervical disc surgery, and 2 patients were operated on for lumbar disc herniation; 2 patients presented with paroxysmal kinesigenic segmental dystonia, 1 patient with focal dystonia, 2 with unilateral tremor, and 1 with bilateral tremor. The appearance of the movement disorder was associated with persistent dermatomal or segmental pain. In all patients, the anatomic distribution of the movement disorder was related to the nerve root or spinal segment of the corresponding disc level and the manifestation was in close temporal relation to the surgery. We conclude that spinal disc surgery may be another, thus far neglected, cause for movement disorders. The postoperative pain syndrome in all patients should be considered as an important factor of pathogenesis. Overall, movement disorders associated with disc surgery appear to be rare, yet they may cause significant discomfort to the affected individual.     

The relations among putative biorisk markers in schizotypal adolescents: minor physical anomalies, movement abnormalities, and salivary cortisol.

BACKGROUND: Evidence suggests that prenatal insult may play a role in the etiology of psychotic disorders. Minor physical anomalies (MPA) are an indicator of abnormal fetal development and are elevated in individuals at genetic and behavioral risk for psychosis. Yet, there has been little empirical research on the relationships between MPAs and other neurobiological risk indicators. We hypothesized that the frequency of MPAs (an external marker of prenatal central nervous system [CNS] disruption) would be associated with two other biomarkers suggestive of disruptions in fetal neurodevelopment: movement abnormalities (an indicator of striatal abnormalities) and heightened cortisol secretion (an indicator of hypothalamic-pituitary-adrenal [HPA]/hippocampal function). METHODS: Participants with schizotypal personality disorder (SPD; n = 39) and both normal (n = 47) and other personality disorders (n = 28) control subjects were administered structured diagnostic interviews and assessed for MPAs, movement abnormalities, and salivary cortisol. RESULTS: Schizotypal personality disorder participants showed significantly greater MPAs and movement abnormalities and higher cortisol than both the normal and other personality disorders groups. Hierarchical linear regression analyses revealed that higher rates of MPAs were linked with greater movement abnormalities and salivary cortisol. CONCLUSIONS: The findings suggest that MPAs serve as a marker of neurodevelopmental abnormalities that affect striatal and hippocampal regions.     

舟月骨间韧带在腕尺桡偏时舟月骨三维运动中的作用

目的 观察在腕关节尺桡偏运动时,舟月骨间韧带(scapholunate interosseous ligament,SLIL)及其各亚区分级切断后对舟骨与月骨三维运动的影响,从亚区水平对SLIL在舟月骨三维运动中的作用进行研究.方法 取12例新鲜冰冻成人上肢标本(左、右侧各6例),共分为正常对照组、断SLIL近侧组、断SLIL近+背侧组、断SLIL近+掌侧组、SLIL全断组(每组6例).采用三维激光扫描及图像重建技术,测定在腕关节尺桡偏时舟骨与月骨的三维运动数据,并进行统计学处理.结果 在正常腕关节做尺桡偏运动时,舟、月骨同时也做尺桡偏运动,但还伴有明显的屈伸方向上的运动;与此同时,舟、月骨还做一定的旋前、旋后活动.在切断近+掌和近+背侧亚区组,舟月骨的活动受到影响.全切断SLIL会导致舟骨掌屈度增加,月骨掌屈活动减弱.结论 采用三维激光扫描及图像重建技术可准确测定腕舟月骨的三维活动度,从SLIL亚区水平上进行的研究表明,部分或全部切断SLIL后会对舟月骨的掌屈程度产生明显影响,但SLIL近侧亚区在控制舟、月骨的活动上不起主要作用.     

“Recumbent” gait: Relationship to the phenotype of “astasia‐abasia”?

Psychogenic gait disorders can present in many different ways. Among patients with a pure psychogenic gait disorder, buckling of the knee is the most common feature, followed by astasia-abasia. Here, we describe one such patient with a very unusual gait disturbance that might be regarded as a variant of astasia-abasia. The patient characteristics are described and discussed in a historical context.