原发性视神经萎缩的视网膜电图明视负向反应研究

目的:研究原发性视神经萎缩的视网膜电图(ERG)明视负向反应(PhNR)变化特点,并进行PhNR与视网膜神经纤维层厚度(RNFLT)、视野平均缺损值(MD)、杯盘比(C/D)的相关性研究,探索PhNR在原发性视神经萎缩的诊断及视神经节细胞功能评价中的作用。方法:选取正常健康者20例20只眼和原发性视神经萎缩的患者18例20只眼。分别对两组进行ERG、视野、眼底照相和OCT检查,比较两组视网膜电图PhNR振幅,并将原发性视神经萎缩组的PhNR振幅分别与MD、C/D和RNFLT进行相关性分析。结果:原发性视神经萎缩组和对照组的ERG中暗视反应、最大反应、30Hz震荡电位的振幅差异无显著性意义,视神经萎缩组明视反应a波和b波振幅差异也没有显著性意义,但原发性视神经萎缩组的PhNR振幅比对照组明显下降(P<0.01),而且PhNR的振幅与视神经损伤情况如RNFLT(r=0.665)、MD(r=0.564)、杯盘比(r=0.686)等相关(均为P<0.01)。结论:原发性视神经萎缩眼视网膜电图PhNR振幅明显下降甚至消失,PhNR可用于原发性视神经萎缩的诊断和神经节细胞及其轴突功能的评价。     

电刺激迷走神经对严重烫伤大鼠的治疗作用

目的:观察电刺激迷走神经对严重烫伤大鼠平均动脉压(MAP)、心率、存活时间及存活率的影响。方法:取24只健康成年SD雄性大鼠(200-240 g),30%TBSAⅢ度烫伤,随机分为假伤组(Sham组)、烫伤组(Scald组)、迷走神经切断组(VGX组)、迷走神经电刺激组(STM组)。各组大鼠右颈总动脉置管后通过压力传导系统与心电监护仪相连,以连续监测MAP和心率变化,并记录生存状况。结果:STM组血压、心率下降趋势平缓,各时间点血压和心率明显高于Scald组和VGX组,生存时间延长,存活率高。结论:电刺激迷走神经对严重烫伤大鼠具有治疗作用。     

大鼠睾丸移植模型的建立及植睾损伤机制的研究

目的：探讨影响植睾生精细胞发育的内在因素及胶质细胞源性神经营养因子（GDNF）mRNA在植睾丸组织中的表达。方法：应用Cuff管技术建立大鼠原位异体睾丸移植模型，并将实验动物分为6组，在光镜和电镜下分别观察移植物的形态学和超微结构变化，应用放免法和RT—PCR技术检测实验各组T、FSH、LH水平和GDNFmRNA的表达量。结果：术后7d，同种移植组植睾组织在光镜下可见间质内大量淋巴细胞浸润，曲细精管内生精细胞层次紊乱，支持细胞数目减少并出现萎缩，电镜下可见支持细胞之间构成的紧密连接出现断裂；血清T值下降而FSH、LH值反馈性升高，GDNFmRNA的表达量较正常对照组减少。术后14d，同种移植组植睾损害进一步加剧，且GDNFmRNA的表达量明显下降。结论：同种移植植睾组织中支持细胞数目的减少和萎缩及其胞突构成的紧密连接出现断裂可能是植睾生精功能不良的主要原因；GDNFmRNA表达水平可作为睾丸生精功能状态指标之一。     

电针夹脊穴治疗神经根型颈椎病疗效观察

目的:观察对比电针夹脊穴与电针循经取穴治疗神经根型颈椎病的临床疗效,并探讨电针夹脊穴的作用机理.方法:120例神经根颈椎病患者,随机分为两个治疗组,60例采用电针夹脊穴治疗,60例采用电针循经取穴治疗.进行疗效对比分析.结果:电针夹脊穴治疗相对循经取穴治疗来说,有更好的治疗效果和简单的取穴方法.结论:电针夹脊穴治疗神经根型颈椎病疗效确切,安全可靠,操作简单,便于临床推广应用.     

针刀三步神经定位治疗神经根型颈椎病的临床研究

目的:以三步神经定位法对神经根型颈椎病的病灶进行定位诊断,观察在此指导下针刀治疗本病的临床疗效.方法:先以临床症状定位、触诊定位以及影像学定位的三步神经定位方法对神经根型颈椎病的病灶进行精确定位,在此基础上针刀常规治疗,同时与针刺组进行了临床对照.结果:针刀组76例中痊愈64例,好转11例,痊愈率与针灸组比较,X2=34.78,P＜0.01;有效率与针灸组比较,X2=13.17,P＜0.01.结论:结合三步神经定位法能使针刀微创治疗更加精确、疗效迅速,临床上具有推广意义.     

腹外斜肌的神经入肌点定位与肌内神经分布研究

目的　对人腹外斜肌的神经入肌点定位和肌内神经染色观察，为其临床应用提供形态学资料。 方法　成尸11具定位神经入肌点和5具行Sihler’s 肌内神经染色。 结果　腹外斜肌受下8对肋间神经外侧肌支支配，各个肌齿的神经入肌点距离相应肌齿起端中点(1.54±0.33)cm，位于锁骨中线与第5肋下缘的交界处至腋后线与第11肋下缘交界处的连线上。Sihler’s染色显示支配腹外斜肌的肋间神经外侧肌支入肌后分出小分支分布到各肌齿的起端1/3，然后约在各肌齿的近、中1/3交界处分出2支二级神经分支，即上支与下支，它们分出小分支分布到各肌齿的中间1/3，相邻两个肌齿的上支与下支在各肌齿中远部形成“U”形吻合，从“U”形吻合弓上分出小分支分布到各肌齿的止端1/3。在腹外斜肌上半部，各肌齿的神经分支分布到相应的肌齿，但在腹外斜肌下半部，上一肌齿的远侧下份是由下一肌齿的神经分支(上支)分布。 结论　①为临床上腹壁局部麻醉和术后切口疼痛的神经阻滞提供指导意义；②腹外斜肌中远部从上至下形成“波浪形”的神经分支密集区；③腹部手术切口建议不要超过四个肌齿。     

Neurophysiological adaptations to spaceflight and simulated microgravity

Changes in physiological functions after spaceflight and simulated spaceflight involve several mechanisms. Microgravity is one of them and it can be partially reproduced with models, such as head down bed rest (HDBR). Yet, only a few studies have investigated in detail the complexity of neurophysiological systems and their integration to maintain homeostasis. Central nervous system changes have been studied both in their structural and functional component with advanced techniques, such as functional magnetic resonance (fMRI), showing the main involvement of the cerebellum, cortical sensorimotor, and somatosensory areas, as well as vestibular-related pathways. Analysis of electroencephalography (EEG) led to contrasting results, mainly due to the different factors affecting brain activity. The study of corticospinal excitability may enable a deeper understanding of countermeasures' effect, since greater excitability has been shown being correlated with better preservation of functions. Less is known about somatosensory evoked potentials and peripheral nerve function, yet they may be involved in a homeostatic mechanism fundamental to thermoregulation. Extending the knowledge of such alterations during simulated microgravity may be useful not only for space exploration, but for its application in clinical conditions and for life on Earth, as well.     

Changes in the connective tissue sheath of Wistar rat nerve with aging

The alterations due to aging in the peripheral nerves can affect the physiology of these structures. Thus, the purpose of the present study was to describe the activity of the MMP-2 and MMP-9, as well as the structure and composition of the extracellular matrix of the rat sciatic nerve during maturation and aging. Our results have shown that the extracellular matrix of the sciatic nerve of 30-, 180- and 730-day-old Wistar rats present ultrastructural, morphometrical and biochemical changes during aging. The perineurium was the structure most affected by age, as evidenced by a decrease in thickness and in collagen fibril content. Cytochemical analysis detected proteoglycans in the basal membrane of Schwann cells and around perineural cells, as well as on the collagen fibrils of the perineurium and endoneurium at all ages. Biochemical analyses showed that the quantity of non-collagenous proteins was higher in 730-day-old animals compared to other ages, while the uronic acid content was higher in 30-day-old animals. Morphometrical analysis detected greater numbers of myelinated fibers and increased myelin thickness in 180-day-old animals. Zymography analysis detected greater amounts and activity of MMP-2 and MMP-9 in 180- and 730-day-old animals compared to younger rats. In conclusion, our results showed changes in the structural organization and composition of extracellular matrix of the sciatic nerve during aging, such as increase in the non-collagenous protein content and higher MMP-2 and MMP-9 activity, decrease in uronic acid concentration and in collagen fibril content in the perineurium, as well as degeneration of nerve fibers.