心房肽mRNA在大鼠脑室脉络丛的表达

目的 :研究大鼠脑室脉络丛细胞内是否存在ANPmRNA的基因表达。方法 :原位杂交技术。结果 :脉络丛细胞及侧脑室和第三脑室室管膜上皮细胞内呈现ANP阳性反应产物。结论 :证明在脑室脉络丛细胞及室管膜上皮细胞内存在ANPmRNA的表达。本实验结果为脉络丛产生分泌ANP提供了形态学依据 ;为脉络丛产生的ANP可能发挥的生理作用提供了理论基础     

大鼠回肠肌间神经丛内一种特殊类型的神经元

实验用乙酰胆碱酯酶和一氧化氮合成酶组织化学方法,对１０只大鼠回肠肌间神经丛进行研究。发现肌间神经丛的一些神经元,沿毛细血管周围分布,有的甚至与毛细血管壁相紧贴,将其称为毛细血管周神经元。这些神经元胞体呈梭形,梨形或多角形,均呈一氧化氮合成酶阳性反应,而乙酰胆碱酯酶反应阴性。这种神经元类似于中枢神经系统的接触脑脊液神经元,它们可能具有神经分泌或感受血液中某些化学成分成分变化之功能。     

Continuous blockade of the lumbar plexus after knee surgery: a comparison of the plasma concentrations and analgesic effect of bupivacaine 0.250% and 0.125%

In 20 patients a continuous block of the lumbar plexus was administered after knee-joint surgery, and the analgesic effect of two different concentrations of bupivacaine was compared. The same volume of bupivacaine was given to both groups of patients: a bolus dose of 0.4 ml/kg, 0.5% or 0.25%, followed by infusion of 0.14 ml/kg/h, 0.25% or 0.125%, respectively, via a catheter placed in the neurovascular fascial sheath of the femoral nerve according to the "3-in-1 block" technique. The median morphine consumption during the first 16 h postoperatively was 6.0 mg when bupivacaine 0.5/0.25% was used and 9.5 mg when 0.25/0.125% was used. This difference is not significant. The visual analogue pain scores were also similar in the two groups (P greater than 0.05). All plasma concentrations were below 4 micrograms/ml, the highest concentration measured being 3.6 micrograms/ml. It is concluded that when used for a continuous block of the lumbar plexus after knee-joint surgery, bupivacaine in a concentration of 0.125% offers the same pain relief as a concentration of 0.25%, and the risk of toxic reactions is reduced.     

Differential effects of calcium channel antagonists (ω-conotoxin GVIA,nifedipine, verapamil) on the electrically-evoked release of [3H]acetylcholine from the myenteric plexus,phrenic nerve and neocortex of rats

Summary Electrically-evoked release of [³H]acetylcholine from autonomic neurons (myenteric plexus), motoneurons (phrenic nerve) and the central nevous system (neocortex) was investigated in the presence and absence of the calcium channel antagonists -conotoxin GVIA, nifedipine and verapamil, whereby the same species (rat) was used in all experiments. Release of [³H]acetylcholine was measured after incubation of the tissue with [³H]choline.-Conotoxin GVIA markedly reduced (70%) the evoked release of [³H]acetylcholine from the myenteric plexus of the small intestine (IC₅₀: 0.7 nmol/l) with a similar potency at 3 and 10 Hz stimulation. An increase in the extracellular calcium concentration attenuated the inhibitory effect of -conotoxin GVIA. Release of [³H]acetylcholine from the rat neocortex was also inhibited (90%) by -conotoxin GVIA, but the potency was 19-fold lower (IC₅₀: 13 nmol/l). However, the release of [³H]acetylcholine from the phrenic nerve was not reduced by -conotoxin GVIA (100 nmol/l) at 1.8 mmol/l calcium (normal concentration), whereas -conotoxin GVIA inhibited evoked [³H]acetylcholine release by 47% at 0.9 mmol/l calcium. Neither nifedipine (0.1 and 1 mol/l) nor verapamil (0.1, 1 and 10 mol/l) modified the evoked release of [3H]acetylcholine from the myenteric plexus and the phrenic nerve.Acetylcholine release from different neurons appears to be regulated by different types of calcium channels. N-type channels play the dominant role in regulating acetylcholine release from both the myenteric plexus and the neocortex, whereas acetylcholine release from motor nerves is regulated by calcium channel(s) not yet characterized. Send offprint requests to I. Wessler at the above address     

神经移植端侧缝合颈5/7神经根与上干桥接治疗产瘫

目的：探讨一种不影响残存神经自行恢复的产瘫臂丛神经修复新方法。方法：将上干损伤部位行松解,不切除神经瘤,将其近端的颈5或颈7神经根和神经瘤远端的臂丛上干的神经束膜切开窗口,取颈丛皮支或前臂外侧皮神经前成多段（一般每段长约2．0－2．5cm）,两端分别与颈5神经根和上干的神经束膜行端侧缝合,结果：8例患儿经术后1－11年（平均3年）的随访,4例的三角肌和肱二头肌骨力达4级和4^-级,4例达3例。3例后期进行了肩关节松解和旋前圆肌肌腱切断,结论：该方法既提供了可使损伤近端颈5神经根的新生纤维生长至上干的神经通道,又未阻断神经瘤内残存神经纤维的自行恢复,是治疗产瘫特别是Tassin2型的新术式。     

改良的颈神经丛阻滞麻醉的临床观察

目的：探讨甲状腺大部切除手术应用改良的颈神经丛阻滞麻醉效果。方法：全部病例均采用一点法深浅颈神经丛阻滞。将全部病例随机分为A、B两组（每组30例）,深丛均为0.25%布比卡因液或1.14%利多卡因和0.14%地卡因混合液,每侧各约5-6ml。A组为与深丛相同浓度的局麻药液,每侧约8-10ml,B组为与A组所用药同等剂量,但其浓度为A组的2/3（即加入1/3容量的生理盐水）,使浅丛容量较A组增加1/3,约为11-13.5ml。结果：两组病人经过顺利,均无并发症。阻滞效果均较好,但A组病人在手术进行到牵拉甲状腺上极时,有12例病人牵拉痛较明显。结论：低浓度高容量法颈丛阻滞,效果可靠、安全、并发症少,是甲状腺大部切除较理想的麻醉方法。     

咽丛神经切断术在发音重建中的作用

目的　为解除咽缩肌的痉挛 ,提高喉全切除术后用发音管发音重建的成功率。方法　在一侧舌骨大角后内侧咽缩肌的后表面 6 5mm左右 ,可找到咽丛神经支配咽下缩肌的主支或分支 ,将其切断。结果　 16例中 15例咽丛神经切断术后发音重建成功 ,成功率为 93 8%。结论　咽丛神经切断术取代咽缩肌切断术是可行的。咽丛神经切断术能提高Blom Singer发音管发音重建的成功率 ,值得推广应用。     

Effects of probenecid and brilliant blue G on rat enteric glial cells following intestinal ischemia and reperfusion

The P2X7 receptor participates in several intracellular events and acts with the pannexin-1 channel. This study examined the effects of probenecid (PB) and brilliant blue G (BBG), which are antagonists of the pannexin-1 channel and P2X7 receptor, respectively, on rat ileum enteric glial cells after on ischemia and reperfusion. The ileal vessels were occluded for 45 min with nontraumatic vascular tweezers, and reperfusion was performed for periods of 24 h and 14 and 28 days. After ischemia (IR groups), the animals were treated with BBG (BG group) or PB (PB group). The double-labeling results demonstrated the following: the P2X7 receptor was present in enteric glial cells (S100β) and enteric neurons positive for HuC/D; enteric glial cells exhibited different phenotypes; some enteric glial cells were immunoreactive to only S100β or GFAP; and the pannexin-1 channel was present in enteric glial cells (GFAP). Density (in cells/cm²) analyses showed that the IR group exhibited a decrease in the number of cells immunoreactive for the P2X7 receptor, pannexin-1, and HuC/D and that treatment with BBG or PB resulted in the recovery of the numbers of these cells. The number of glial cells (S100β and GFAP) was higher in the IR group, and the treatments decreased the number of these cells to the normal value. However, the PB group did not exhibit recovery of S100β-positive glia. The cell profile area (μm²) of S100β-positive enteric glial cells decreased to the normal value after BBG treatment, whereas no recovery was observed in the PB group. The ileum contractile activity was decreased in the IR group and returned to baseline in the BG and PB groups. BBG and PB can effectively induce the recovery of neurons and glia cells and are thus potential therapeutic agents in the treatment of gastrointestinal tract diseases.     

Posterior approach to the lumbar plexus combined with a sciatic nerve block using lidocaine

A combination of lumbar plexus block, by a posterior technique, and sciatic nerve block can be a useful technique for outpatient anaesthesia. The purpose of this study was to examine the clinical characteristics of these blocks using lidocaine and to measure the serum lidocaine concentrations. Forty-five patients, undergoing lower extremity surgery, were studied. Sciatic nerve and lumbar plexus blocks were made with lidocaine, 680 mg with adrenaline 0.3 mg. For each patient the following data were collected: weight, age, sex, site of surgery, time to perform each block, needle depth, speed of onset of the sensory and motor blocks in the territories of the sciatic, femoral, obturator and lateral cutaneous (sensory) nerves and postoperative analgesic requirements. Lidocaine serum concentrations were measured in ten of these patients at 0, 2, 5, 10, 30, 60, 90 and 120 min after the second block. Analgesia was complete in 88% (40/45) of the patients. The remaining five patients needed analgesics (fentanyl 150 μg or less). Despite the high dose of lidocaine, the serum concentrations were within safe limits (mean ± SD) (C_MAX = 3.66 ± 2.21 μg · ml^?1). Only one patient had a serum concentration > 5 μg · ml^?1 (C_MAX = 9.54 μg · ml^?1). This was associated with a contra-lateral extension of the block. We conclude that this combination of blocks is a valuable alternative for unilateral lower extremity anaesthesia. However, clinicians must be aware of the implications of a contra-lateral extension of the block.