隐性腕背腱鞘囊肿的超声诊断与治疗

目的初步探讨隐性腕背腱鞘囊肿超声诊断的准确性及手术疗效。方法对慢性腕关节背侧疼痛的患者,应用超声检查诊断出隐性腕背腱鞘囊肿7例,对其中5例采取手术治疗,2例保守治疗。结果5例手术患者中,其中4例术中发现舟月间隙有腱鞘囊肿,与术前超声诊断相符,1例未发现肿块。4例行囊肿切除,1例行腱鞘松解术;术后随访2～6个月,术后腕背疼痛症状完全消失,关节活动正常,握力较术前明显改善。2例保守治疗患者,经6～12个月的随访,腕背症状无明显缓解。结论隐性腕背腱鞘囊肿手术疗效可靠,超声诊断作为一种简便、无创的检查方法,对慢性腕关节背侧疼痛的临床诊断提供了新的检测手段。     

尺神经腕背支营养血管逆行皮瓣的临床应用

目的探讨应用尺神经腕背支营养血管逆行皮瓣修复小指皮肤缺损的临床效果及手术操作要点。方法以尺神经腕背支营养血管远端为蒂,选择小指尺侧分支为皮瓣轴心血管,将皮瓣向小指远端转移,修复小指掌背侧皮肤缺损8例。结果8例全部成活,其中1例因创面止血不彻底,皮瓣受压导致远端部分坏死,经换药后痊愈。结论尺神经腕背支走向较恒定,本组未发现变异。沿皮神经干有纵行的皮神经旁血管网及皮神经干内血管网,此皮瓣血供可靠的,皮瓣切取容易,对供区影响小,是修复小指皮肤缺损的理想方法。     

小鼠背根神经节中三个不同的钙激活氯离子通道基因家族的表达(英文)

目的在背根神经节(dorsal root ganglion,DRG)中等大小感觉神经元中可以观察到钙激活氯离子流(I_(Cl(Ca)))。在坐骨神经损伤模型中,在大多数大中神经元上诱导出类似的氯离子流。本文旨在探讨引起这个离子流的分子基础。方法使用常规的定量RT-PCR方法检测在DRG中三个基因家族的表达,这三个基因家族都具有诱导I_(Cl(Ca))的特点。结果在成年小鼠的DRG中,分别显示了在正常状态和坐骨神经损伤3天后CLCA,Bestrophin和Tweety基因家族成员的转录产物。结论mBestl和Tweety2可能在损伤诱导的DRG神经元I_(Cl(Ca))中发挥作用。     

KN-93抑制脊髓背角C-纤维诱发电位LTP的诱导和早期维持

[目的]探讨钙-钙调蛋白依赖性蛋白激酶Ⅱ(CaMKⅡ)在脊髓背角C-纤维诱发电位长时程增强(LTP)的诱导和维持中的作用。[方法]用钨丝微电极在脊髓腰膨大部背角浅层神经元细胞外记录C-纤维诱发电位,强直刺激坐骨神经诱导背角C-纤维诱发电位的LTP。在LTP诱导前后,在暴露的脊髓表面局部给予CaMKⅡ的选择性抑制剂KN-93,观察C-纤维诱发电位的变化。[结果]50μmol/L的KN-93不影响脊髓背角C-纤维诱发电位的幅度,但可完全阻断脊髓背角LTP的诱导(n=6)。KN-93呈时间依赖性翻转脊髓背角LTP。在LTP诱导后30min,50μmol/L的KN-93对LTP的早期表达无影响(n=4),而100μmol/L的KN-93在用药后,LTP逐渐降低,于3h降至对照水平(n=6);在LTP诱导后1h脊髓局部给予100μmol/L的KN-93,7例动物中有5例LTP被抑制;但同样浓度的KN-93,在LTP诱导后3h,不能翻转业已建立的LTP(n=5),且增加KN-93的浓度至200μmol/L也不能抑制脊髓背角LTP。[结论]CaMKⅡ参与脊髓背角C纤维诱发电位LTP的诱导和早期维持,但KN-93对晚期LTP无抑制作用。     

Morphology and distribution of serotoninergic and oculomotor internuclear neurons in the cat midbrain

Serotoninergic fibers have been reported in both the abducens and facial nuclei of the cat. Furthermore, serotoninergic dorsal raphe and oculomotor internuclear neurons occupy similar locations in the periaqueductal gray overlying the oculomotor and trochlear motor nuclei. To resolve the issue of whether these two populations of neurons overlap, serotoninergic fibers were assayed in the abducens and facial nucleus; then the morphologies and distributions of identified serotoninergic neurons and oculomotor internuclear neurons were determined. Both the abducens and facial nuclei contained varicosities labelled with antibody to serotonin, but a much higher density of immunoreactive fibers was present in the latter, especially in its medial aspect. Distinct synaptic profiles labelled with antibodies to serotonin were observed in both nuclei. In both cases, terminal profiles contained numerous small, predominantly spheroidal, synaptic vesicles as well as a few, large, dense-core vesicles. These profiles made synaptic contacts onto dendritic and, in the facial nucleus, somatic profiles that occasionally displayed asymmetric, postsynaptic, membrane densifications. Following injection of horseradish peroxidase into either the abducens or facial nuclei, double-label immunohistochemical techniques demonstrated that the serotoninergic and oculomotor internuclear neurons form two distinct cell populations. The immunoreactive serotoninergic cells were distributed within the dorsal raphe nucleus, predominantly caudal to the retrogradely labelled oculomotor internuclear neurons. The latter were located in the oculomotor nucleus along its dorsal border and in the adjacent supraoculomotor area. Intracellular injection of horseradish peroxidase revealed that oculomotor internuclear neurons have multipolar somata with up to ten long, tapering dendrites that bifurcate approximately five times. Their dendritic fields were generally contained within the nucleus and adjacent supraoculomotor area. In contrast, putative serotoninergic neurons were often spindle-shaped and exhibited far fewer primary dendrites. Many of these long, narrow, sparsely branched dendrites crossed the midline and extended to the surface of the cerebral aqueduct. In the vicinity of the aqueduct they branched repeatedly to form a dendritic thicket. The axons of the intracellularly stained serotoninergic neurons emerged either from the somata or the end of a process with dendritic morphology, and in some cases they produced axon collaterals within the periaqueductal gray. Thus the oculomotor internuclear and serotoninergic populations differ in both distribution and morphology.(ABSTRACT TRUNCATED AT 400 WORDS)     

家兔肝的神经支配

本实验共用家兔17只,将20%的HRP溶液100μl,经肝门多点注入,其中10只家兔出现标记细胞.两侧T_(2-12)背根节内共270个,左侧占51.11±3.04%,右侧为48.89±3.04%,左、右侧差异无显著性(P>0.05).在T_(5-8)背根节内的标记细胞较多,占总数的59.26±2.99%,中、小型细胞共占94.53±1.60%.两侧结状神经节内的标记细胞共143个.左侧占53.15±4.17%,右侧占46.85±4.17%.两侧差异无显著性.中、小型细胞共占93.01±2.13%.两侧腹腔神经节内的标记细胞较多,计数其中2例,共582个,左侧占59.79±2.03%,右侧为40.21±2.03%.在迷走神经背核内仅发现2个标记细胞.     

Aminergic and cholinergic afferents to REM sleep induction regions of the pontine reticular formation in the rat

Microinjection of cholinergic agonists in a dorsolateral part of the mesopontine tegmentum has been shown to induce a rapid eye movement (REM) sleep-like state. Physiological evidence indicates that not only acetylcholine but also various amine transmitters, including those implicated in behavioral state regulation, affect neuronal activity in this region of the pontine reticular formation. In the present study, sources of select aminergic and cholinergic inputs to this REM sleep induction zone were identified and quantitatively analyzed by using fluorescence retrograde tracing combined with immunofluorescence in the rat. In addition to previously demonstrated cholinergic projections from the pedunculopontine and laterodorsal tegmental nuclei, the REM sleep induction zone received various aminergic inputs that originated in widely distributed regions of the brainstem and hypothalamus. Serotoninergic afferents represented a mean of 44% of all aminergic/cholinergic source neurons projecting to the REM sleep induction zone, which was comparable to the mean percentage of 39% represented by cholinergic afferent neurons. The serotoninergic afferents originated from the raphe nuclei at all brainstem levels, with heavier projections from the pontine than from the medullary raphe nuclei. Unexpectedly, an additional major serotoninergic input was provided by serotoninergic neurons in the nucleus prosupralemniscus (B9). Noradrenergic afferent neurons represented a mean of 14% of all aminergic/cholinergic source neurons, which was only about one-third of the mean percentage of either cholinergic or serotoninergic source neurons. These noradrenergic projection neurons were located not only in the locus ceruleus (8%) but also in the lateral tegmentum, including the A5 (4%) and A7 (2%) cell groups. Histaminergic neurons in the tuberomammillary hypothalamic nucleus represented a minor group of afferent neurons (3%), and a still smaller input came from adrenegic C1 neurons. The pattern of these transmitter-specific afferent connections appeared to be similar regardless of the longitudinal level within the REM sleep induction zone. The present results are consistent with previous behavioral and physiological evidence for a role of the pontine REM sleep induction zone in triggering REM sleep. The regulation of REM sleep induction would be best understood in terms of a state-dependent interplay of cholinergic, serotoninergic, and other inputs all acting convergently upon neurons in the REM sleep-inducing region of the pontine reticular formation.     

中指近节背侧岛状皮瓣

介绍中指近节背侧岛状皮瓣的应用解剖,该皮瓣的营养动脉为第2掌背动脉,位置表浅,解剖容易,安全可靠。自1990年11月以来,应用该皮瓣修复手部软组织缺损共6例,均获成功。     

Development of the rat thalamus: II. Time and site of origin and settling pattern of neurons derived from the anterior lobule of the thalamic neuroepithelium

Short-survival, sequential, and long-survival thymidine radiograms of rat embryos, fetuses, and young pups were analyzed in order to examine the time of origin, settling pattern, and neuroepithelial site of origin of the anterior thalamic nuclei--the lateral dorsal (lateral anterior), anterodorsal, anteroventral and anteromedial nuclei--and of two rostral midline structures--the anterior paraventricular and paratenial nuclei. The neurons of the lateral dorsal nucleus are generated over a 3-day period between days E14-E16 and their settling pattern displays a combined lateral-to-medial and dorsal-to-ventral neurogenetic gradient. The bulk of the neurons of the anteroventral nucleus are generated over a 3-day period between days E15-E17 and settle with an oblique lateral-to-medial and ventral-to-dorsal neurogenetic gradient. The bulk of the neurons of the anteromedial nucleus are generated over a 2-day period between days E16-E17 and show the same settling pattern as the anteroventral nucleus. The neurons of the anterodorsal nucleus are generated over a 3-day period between days E15-E17 and show a lateral-to-medial neurogenetic gradient. The bulk of the neurons of the central part and lateral part of the paraventricular nucleus are generated over a 2-day period (E16-E17 and E17-E18, respectively) and each part displays a ventral-to-dorsal neurogenetic gradient. Finally, the bulk of the neurons of the paratenial nucleus are generated over a 4-day period between days E15-E18 and settle with a lateral-to-medial neurogenetic gradient. Observations are presented that the anterior thalamic nuclei, constituting the distinct "limbic thalamus," derive from a discrete neuroepithelial source. This is the crescent-shaped germinal matrix lining the diencephalic (medial) wall of the hitherto unrecognized anterior transitional promontory, which we call the anterior thalamic neuroepithelial lobule. On day E16 three migratory streams leave the anterior neuroepithelial lobule and, on the basis of their labeling pattern in relation to the neurogenetic gradients of the anterior thalamic nuclei, they are identified, from dorsal to ventral, as the putative migratory streams of the anterodorsal, anteroventral, and lateral dorsal nuclei. On day E17 the putative migratory stream of the anteromedial nucleus appears to leave the same neuroepithelial region that on the previous days was the source of the anteroventral nucleus. Dorsally, two neuroepithelial patches persist after day E17 and these are identified as the putative cell lines of the anterior paraventricular and paratenial nuclei.