Adult Retinofugal Axons Regenerating Through Peripheral Nerve Grafts Can Restore the Light-induced Pupilloconstriction Reflex

To investigate the ability of mature regenerating retinal axons to form functional connections within central targets, severed axons were guided into the primary visual centres which subserve the pupillary constriction reflex in response to light. The ocular stump of the transected optic nerve of adult rats was connected by means of an autologous peripheral nerve graft with the pretectal region which contains the relay nucleus of pupillary constriction, the olivary pretectal nucleus. This nucleus is efferently connected with preganglionic neurons in the oculomotor nuclear complex which innervates parasympathetically the muscle constrictors of the iris. Six to sixteen weeks after optic nerve transection and peripheral nerve transplantation, brisk responses were observed in the pupils upon illumination of the transplanted eye. Recovery of the pupil responses indicated that retinal neurons used the peripheral nerve 'bridge' to access the pretectum, in which they established synaptic contacts in sufficient density and with appropriate specificity to reconstitute the function of the traumatically interrupted neuronal circuitry.     

Effects of intravenously administered lidocaine on pulmonary vagal afferents and phrenic nerve activity in cats

The ability of lidocaine to suppress activity of single vagal afferent fiber and that of phrenic nerve was studied in 20 cats anesthetized with pentobarbital. Slowly adapting stretch receptors (SAR, n = 16) and rapidly adapting stretch receptors (RAR, n = 7) were identified by their discharge pattern to pulmonary inflation. Intravenous lidocaine (1mg·kg^–1 or 2mg·kg^–1) produced a suppression of SAR activity but not of RAR activity. Suppression of phrenic nerve activity lasted much longer than that of SAR. These findings indicate that iv lidocaine acts more dominantly on CNS than on peripherals. We conclude that iv lidocaine prevents cough and hemodynamic changes caused by airway manipulation mainly through its action on CNS and not on peripherals (peripheral nerves or their receptor).(Aoki M, Harada Y, Namiki A, et al.: Effects of intravenously administered lidocaine of pulmonary vagal afferents and phrenic nerve activity in cats. J Anesth 6: 395–400, 1992)     

针灸治疗胆汁返流性胃炎近况

系统回顾及总结了近几年来有关针灸治疗胆汁返流性胃炎(BRG)的文献，认为针灸防治BRG具有肯定的临床疗效和优势，并为进一步探索提供思路。     

Reflex sympathetic dystrophy in childhood: A case report

A case report is presented of a 15-year-old girl with reflex sympathetic dystrophy (RSD). She was referred to hospital because of left upper limb pain. Her left upper limb was cold, edematous and blue with a limited active range of movement. The serum concentration of noradrenaline was lower on the painful side than on the healthy side, and neurotropin, which has an antinociceptive effect to hyperalgesia, was clearly effective. Early diagnosis and management is essential in the treatment of RSD and administration of neurotropin is a useful and non-invasive treatment without severe adverse effects.     

Reflex sympathetic dystrophy in a 12-year-old twin with comorbid conversion disorder in both twins

A case of reflex sympathetic dystrophy is presented in a 12-year-old girl with comorbid conversion disorder. Her identical twin also had a conversion disorder. This is the first reported case of coexistence of reflex sympathetic dystrophy and conversion disorder. It is important for clinicians to be aware that these conditions may coexist since the presentation of symptoms differ, even though there are shared features of treatment.     

Spatial encoding properties of subnucleus reticularis dorsalis neurons in the rat medulla

Denervation of the synergists of the medial gastrocnemius (MG) muscle in the cat hind leg results in a progressive increase in the magnitude of burst activity in the MG muscle during walking. The increase in burst magnitude is associated with an increase in the slope of the relationship between the magnitude of individual MG bursts and the amplitude of ankle flexion during stance. This finding is consistent with the hypothesis that the increase in MG burst magnitude is due to an increase in gain of reflex pathways reinforcing the activation of MG. The increase in slope is use-dependent since it was not observed when the leg was released from a cast that immobilized the leg for 6 days.     

Chronic cerebral hypoperfusion: loss of pupillary reflex, visual impairment and retinal neurodegeneration

Adult rats underwent permanent bilateral occlusion of the common carotid arteries (2VO) to determine the effect of chronic cerebral ischemia on vision and retina. They were monitored post-surgically for the presence of the pupillary reflex to light. Some rats were tested for 6 months post-surgically on a radial arm maze task and then tested in another water-escape task which explicitly tested visual function. Another group of rats were tested post-surgically for 3 months on a task which simultaneously assessed visual and tactile discrimination ability. The thicknesses of the retinal sub-layers were then measured for some rats. Fourteen of the 25 rats that underwent 2VO lost the pupillary reflex. This seemed to occur within 5 days. Rats that lost the pupillary reflex but not rats whose reflex was intact, were impaired on all visually guided mazes. Tactile discrimination ability was unaffected. Only rats that lost the pupillary reflex showed reduced thickness of the retinal outer nuclear and plexiform layers, reduced cell density in the retinal ganglion cell layer and astrocytosis and degeneration of the optic tract. We conclude that 2VO can eliminate the pupillary reflex. Photoreceptors and retinal ganglion cells degenerate, but it is unclear if these are the cause(s) or result(s) of the loss of the pupillary reflex. These effects are accompanied by impairment of visually guided behavior. The possibility that visual system damage may also occur in acute ischemia merits further investigation.     

Evidence of Normal Cerebellar Control of the Vestibulo-Ocular Reflex (VOR) in Children with High-Functioning Autism

The effect of tilt-suppression on post-rotatory vestibular nystagmus was investigated to assess the function of the caudal cerebellar vermis (lobules IX and X, or nodulus and uvula) in 13 school-age children with high-functioning autism (HFA) and 10 normal controls. Tilt-suppression of the vestibulo-ocular reflex (VOR) refers to the decreasing of the duration of post-rotatory vestibular nystagmus that occurs when the head is moved out of the plane in which it was located during the previous sustained constant-velocity rotation. The participant is rotated in a vestibular chair with the head upright and then the head is tilted forward just after the chair stops rotating. Such tilt-suppression is impaired with lesions of the cerebellar nodulus and portions of the uvula. Results show that children with HFA have normal post-rotatory nystasmus with the head upright and normal attenuation of post-rotatory nystagmus induced by head tilt. These behavioral findings suggest that lobules IX and X of the cerebellum are spared in high-functioning autism.     

周围性面瘫电生理检查与预后相关分析

目的 评价面神经电图（ENoG）、F波和瞬目反射（BR）等电生理检查在早期周围性面瘫预后判断中的价值及相关性.方法 对发病3周内行ENoG、F波和BR检测的31例周围性面瘫患者的恢复情况进行随访,时间6个月～2年,分别以F波、BR异常与否以及ENoG是否≥90％作为诊断界值,比较3种诊断方法判断预后的准确度以及三者间的相关性.结果 3种方法均能准确判断周围性面瘫的预后,ENoG≥ 90％、F波和BR异常均预示预后差.Pearson相关性分析显示,F波和BR结果之间（r=0.674,P＜0.01）、ENoG与BR间（r =0.445,P＜ 0.05）具有一定的相关性,ENoG与F波的无相关性（r=0.251,P＞0.05）.结论 结合多项适当的电生理检查全面综合分析,对周围性面瘫早期预后判断起重要作用.     

膝腱反射检查对前交叉韧带断裂和重建后本体感觉功能的评价

目的探讨膝腱反射检查对前交叉韧带断裂和重建后本体感觉功能的评价和意义。方法对20例单纯前交叉韧带断裂,采用关节镜下自体四股半腱肌-股薄肌肌腱重建。常规方法检查膝腱反射,双极表面电极电刺激髌韧带并记录股内侧肌肌电图。观察前交叉韧带断裂和重建后膝腱反射和肌电图的客观改变,结合临床"打软腿"的主观症状,研究主、客观相互关系。结果3项指标手术前后两样本率比较,差异有统计学意义(PKJ=0.004,PEMG=0.022,PS=0.000);3项指标手术前后改变率之间两两比较,差异无统计学意义(PKJ-EMG=0.495,PKJ-S=0.476,PEMG-S=0.163)。结论提出"前交叉韧带-膝腱反射弧"的观点,将膝腱反射检查作为前交叉韧带断裂和重建后的常规查体,借此评价膝关节本体感觉功能,以指导本体感觉的康复锻炼。