胸腰椎骨折伴脊髓损伤前后路手术适应证的选择

目的 通过107例胸腰椎骨折伴脊髓损伤病例的治疗,探讨前、后路手术适应证的选择。方法 31例经前路减压植骨,采用Z-Plate等内固定。76例经后路采用短节段椎弓根钉内固定。结果 两组均获得了满意的疗效。结论 选择前或后路手术,应综合考虑脊髓损伤程度、手术时机与技巧、骨折的部位、骨折类型和影像结果等,才能确实做到减压、恢复脊柱序列和坚强固定的目的。     

大鼠中枢和外周神经损伤后胞体分布区神经组织的红外光谱分析

目的：观察外周和中枢神经损伤后胞体分布区神经组织总蛋白和核酸的变化规律。方法：应用傅里叶红外光谱(FTIR)检测方法，分析大鼠脊髓和坐骨神经损伤后相应的神经元胞体分布区神经组织中归属为核酸和蛋白质的谱带吸收强度的变化。结果：伤后早期，外周和中枢神经损伤后其相应胞体部位神经组织RNA，DNA和蛋白质的含量均增加；1周后，外周和中枢神经元胞体分布区RNA，DNA和蛋白质含量均变化规律不同：外周神经元胞体RNA和DNA的含量仍较高，而中枢神经伤侧和对照侧胞体RNA和DNA的含量接近，中枢和外周神经元胞体蛋白含量变化相反。结论：外周和中枢神经损伤后再生过程中其胞体反应性不同，这一差异可能与外周和中枢神经损伤后再生差异有关。     

42.3GHz毫米波电场治疗大鼠脊髓损伤的实验研究

研究毫米波对损伤脊髓修复的生物效应。方法采用频率４２．３ＧＨｚ，波长７．１ｍｍ，同功率密度２ｍＷ／ｃｍ＾２，７ｍＷ／ｃｍ＾２，２０ｍＷ／ｃｍ＾２的毫米波治疗大鼠损伤脊髓，３０ｍｉｎ，２次／ｄ＊２０，观察组织学及皮层体感诱发电位、运动诱发电位变化。     

Organization of amygdaloid projections to the mediodorsal thalamus and prefrontal cortex: a fluorescence retrograde transport study in the rat

Previous studies have shown that the amygdala projects to both the mediodorsal thalamic nucleus (MD) and its cortical projection area, the prefrontal cortex (PFC). In this investigation rats received injections of different fluorescent retrograde tracers (true blue and diamidino yellow) into MD and either the lateral, polar, or medial PFC in order to examine the relationship of amygdaloid neurons with cortical and/or thalamic projections. PFC injections labeled neurons in the basolateral (BL), basomedial (BM), ventral endopiriform (EnV), and rostral lateral nuclei as well as the periamygdaloid cortex (PAC) and the medial part of the amygdalohippocampal area (AHA). In BL, which contained the great majority of neurons projecting to PFC, most labeled cells were concentrated in particular parts of the nucleus and were topographically organized. The overwhelming majority of labeled neurons in BL were large pyramidal or piriform cells that correspond to class I neurons described in Golgi studies. Occasional small neurons with thin dendrites were also observed; these cells may be class II neurons. MD injections labeled numerous cells in the anterior division of the cortical nucleus, medial nucleus, and caudomedial part of the central nucleus. Moderate numbers of labeled cells were found in caudal portions of BM and PAC, whereas scattered cells were observed throughout the rest of the amygdala with the exception of the lateral nucleus. In BL and AHA many MD-projecting neurons were observed along nuclear boundaries and in the adjacent white matter. Neurons in BL, BM, and AHA usually had large elongated or irregular somata and two to four primary dendrites that branched sparingly. Other cells had smaller ovoid somata. The morphology and distribution of MD-projection cells in the basolateral amygdala indicate that they are primarily large class II neurons. Double-labeled amygdaloid neurons, labeled by both cortical and thalamic injections, were observed only in a small number of animals. Control experiments suggest that most of the double-labeled cells in these cases were artifacts caused by spread of the thalamic injectate into the third ventricle with subsequent uptake by fibers in the anterior commissure. Thus the findings of this study suggest that different neuronal populations in the amygdala project to the two poles of the MD-PFC system. In the basolateral amygdala class I neurons are the predominant cell type involved in PFC projections, whereas a subpopulation of class II neurons, hitherto thought to be primarily local-circuit neurons, project to MD.     

鞘内注射吗啡对大鼠中脑导水管周围灰质、海马和脊髓μ阿片受体mRNA表达的影响

目的研究鞘内注射吗啡对大鼠中脑导水管周围灰质（PAG）、海马和脊髓μ阿片受体（MOR）mRNA表达的影响,探讨大鼠鞘内注射吗啡免疫功能抑制的机制。方法清洁级成年雄性SD大鼠,鞘内置管成功的16只大鼠随机分为2组（n=8）：生理盐水组（NS组）和吗啡组（M组）。M组鞘内持续输注吗啡10μg/h 7 d（生理盐水稀释）,NS组给予等体积的生理盐水。输注7 d后断头处死大鼠,取出大鼠PAG、海马和脊髓标本,采用巢式RT-PCR测定MOR mRNA的表达。结果与NS组比较,M组PAG和海马MOR mRNA表达下调（P〈0.05或0.01）,脊髓MOR mRNA表达无统计学意义（P〉0.05）。结论大鼠PAG和海马MOR表达下调可能是鞘内注射吗啡导致免疫功能抑制的机制之一。     

大鼠神经系统发育过程中神经元特异性烯醇酶的出现和意义

用自行提纯的人脑和牛脑神经元特异性烯醇酶(NSE)分别免疫家兔,制备兔抗人和抗牛NSE血清(抗NSEh和抗NSEb)。以PAP免疫组织化学染色,系统观察3O只发育出SD大鼠的脑、脊髓与脊神经节。发现NSE最先出现于胚胎15d的脊神经节神经元,随后相继出现于三叉神经节、脊髓、嗅皮质、海马、扣带回和外侧皮质神经元。表明NSE先后出现于周围神经和中枢神经系统,由脊髓向大脑、原始皮质及新皮质发展的顺序,与神经系统发育过程中的头向发展规律相一致。     

双侧声带麻痹及固定的治疗：附12例报告

文中总结了１２例双侧声带麻痹或固定的治疗。气道通畅型２例，行病因治疗。气道阻塞型１０例，８例作了气管切开术，声带外移术３例，２例呼吸发音功能恢复较好，１例失败者行一侧声带切除＋喉扩张术。另外２例行Ｔ型管扩张术，均顺利拔管。药物治疗共５例。并讨论各种手术治疗现状。     

Direct evidence for the link between monoaminergic descending pathways and motor activity:: II. A study with microdialysis probes implanted in the ventral horn of the spinal cord

In order to define precisely the relation between descending monoaminergic systems and the motor system, we measured in the ventral horn of spinal cord of adult rats the variations of extracellular concentrations of 5-HT, 5-HIAA, DA and MHPG. Measurements were performed during rest, endurance running on a treadmill, and a post-exercise period, with microdialysis probes implanted permanently for 45 days. We found a slight decrease in both 5-HT and 5-HIAA during locomotion with a more marked decrease during the post-exercise period compared to the mean of rest values. In contrast, the concentration of DA and MHPG increased slightly during the exercise and decreased thereafter. These results, when compared with those of a previous study, which measured monoamines in the spinal cord white matter [C. Gerin, D. Bécquet, A. Privat, Direct evidence for the link between monoaminergic descending pathways and motor activity: I. A study with microdialysis probes implanted in the ventral funiculus of the spinal cord, Brain Res. 704 (1995) 191–201], highlight the complex regulation of the release of monoamines that occurs in the ventral horn.     

Crossed inhibition of the soleus H reflex during passive pedalling movement

We hypothesized that sensory input from the moving leg induces presynaptic inhibition of the soleus H reflex pathway in the contralateral stationary leg. The results showed a crossed inhibition during passive pedalling movement of the leg, which was not removed by low levels of tonic contraction of soleus in the stationary leg. The inhibition was correlated exponentially to the rate of the movement (R²=0.934, P<0.05) and was not dependent on the quadrants through which the moving leg was passing. Static flexion of the stationary leg caused ipsilateral inhibition of the reflexes (t=5.590, P<0.05), independent of the orientations of the other leg. We concluded that sensory inflow from the moving leg induces presynaptic inhibition in the stationary leg, that a complex transformation of the sensory input in the spinal cord or brain underlies the tonic crossed inhibition and phasic ipsilateral inhibition, and that descending motor commands exert a powerful control over these sensorimotor modulatory mechanisms.     

Desensitization of AMPA Receptors Limits the Amplitude of EPSPs and the Excitability of Motoneurons of the Rat Isolated Spinal Cord

Intracellular recording was used to study the effect of cyclothiazide, a selective blocker of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA) receptor desensitization, on lumbar motoneurons of the rat isolated spinal cord. Cyclothiazide (25 μM) enhanced the responses to AMPA in a tetrodotoxin-insensitive fashion, without affecting those produced by N -methyl-D-aspartate or γ-aminobutyric acid. Excitatory postsynaptic potentials (EPSPs) evoked by dorsal root stimulation were strongly potentiated in amplitude while paired-pulse depression (produced by applying pairs of pulses at 2 s interval) of the EPSP was decreased. In the presence of cyclothiazide the frequency of spontaneous synaptic events was greatly increased and network-driven bursting activity developed with eventual loss of electrical excitability. The present results suggest that pharmacological block of AMPA receptor desensitization led to strong excitation of motoneurons and indicate a physiological role of desensitization in protecting these nerve cells from overactivity.