大鼠孤束核含酪氨酸羟化酶、神经降压素和胆囊收缩素样神经元向伏核的投射—HRP和免疫细胞化学双重标记法的研究

本文应用HRP顺、逆行追踪法结合免疫细胞化学双重标记法,对大鼠孤束核向伏核的投射进行了研究。主要结果如下:1.WGA-HRP注入孤束核尾侧段,在伏核后部的腹、内侧区,出现较密集的标记纤维、终末和标记细胞;将HRP注入伏核后部的腹、内侧区,在孤束核尾侧段(主要在连合核和内侧亚核)出现大量的顺、逆行标记,以同侧为主。2.HRP注射到伏核并结合免疫细胞化学反应,在孤束核尾侧段发现HRP-TH,HRP-NT、HRP-CCK双重标记细胞。HRP-TH的数目最多,其次是HRP-NT双标细胞,HRP-CCK双标细胞最少。     

断指冷冻伤后再植的临床经验

目的 探讨断指冷冻伤后再植术前的复温方式及术后注意事项。方法 对在低温环境下丢弃或保存不当而致指体冷冻伤的9例11指，采取自然复温(22～28℃)和温盐水复温(38～42℃)。对冷冻指体复温后，行再植手术。结果 再植术后完全存活6例，部分成活3例。结论 ①温盐水复温方式值得推荐；②指体冷冻伤不应一概列为断指再植禁忌证；③术后积极处理各种并发症是提高断指再植成活率的重要保证。     

院科两级病案质量评定误差因素的调查研究

2002年某医院出院15448人次，全院科室评定病案质量平均甲级率为96．5％，而该医院病案质量检测办公室随机抽查了5010份病案，甲级率则为89．4％，二者之间存在着7．1％的差距。为了解存在误差的原因，我们对此进行了调查研究，分析了存在问题的原因，提出了对策性的改进措施。     

脑卒中患者日常生活能力的评定

采用Ｂａｒｔｈｅｌ指数对１２０例脑卒中住院患者在发病后５￣６周进行日常生活活动（ＡＤＬ）能力的证实。因脑卒中遗留的功能不全，ＡＤＬ的受损率达６６．７％，肢体的Ｂｒｕｎｎｓｔｒｏｍ功能分级与ＡＤＬ积分高度相关，相关性下肢高于上肢；多元逐步回归分析显示，躯体（偏瘫）和心理（认知障碍和抑郁因素）影响ＡＤＬ的能力。认为ＡＤＬ能力的提高，不仅依赖于肢体功能障碍的改善，提高认知功能，改善情感状况，对于脑卒中患     

Does ageing have an effect on midbrain premotor nuclei for vertical eye movements?

Currently, there is debate in the clinical literature as to whether defects in vertical gaze are a consequence of normal ageing or a component of an underlying neurodegenerative disorder. Although pathological changes have been demonstrated in diseased subjects, no study to date has addressed the question of normal ageing effects. In this retrospective study, we examined 23 neurologically and pathologically normal subjects (age 18-91). Using an unbiased, frame-based sampling method, we quantified neuronal and glial cell densities in 10 young (<50) and 13 aged (>65) subjects in the rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF), the key premotor substrate in the vertical gaze pathway. We found no statistically significant difference in neuronal density, glial cell density, or neuron-to-glial cell ratios between the young and the aged. We conclude, therefore, that neuronal loss, neuronal atrophy, or gliosis in the riMLF are not consequences of normal ageing.     

Vein of Galen and sinus thrombosis with bilateral thalamic infarcts in sickle cell anaemia: CT follow-up and angiographic demonstration

A 2-year-old boy with known sickle cell disease presented in acute coma. CT revealed bilateral thalamic infarcts and incomplete sinus thrombosis. Angiography confirmed thrombosis of the straight sinus and vein of Galen.     

上海社区老年人用药安全及影响因素分析

目的：了解上海社区老年人群的用药安全情况及其影响因素，方法：以整群抽样的方法抽取上海市黄浦区两个居民委员会2985名60岁以上的居民进行问卷调查，了解其疾病和用药情况，用药反应，对安全用药的知识，态度，行为，以及影响其用药行为的因素，结果：被调查中高血压、冠心病、消化系统疾病和呼吸系统疾病的患病率分别为35．93％、10．67％、5．70％和3．71％。抗高血压药，心脑血管病药，消化系统疾病和呼吸系统疾病的患病率分别为35．93％、10．67％、5．70％和3．71％，抗高血压药、心脑血管病药，消化系统药和抗生素的使用率分别为31．72％、16．20％、2．43％和2．11％，过去30天内，51．33％的被调查用过药物，用药不良反应发生率为2．06％，对用药安全的正确知识，态度，行为率分别为71．62％、69．39％及60．67％，影响药物选择的因素中医生占88．19％，结论：老年人的用药安全仍存在问题，有待改进，医生是影响老年人药选择的最主要因素。     

Fear of falling and postural control in Parkinson's disease.

This study investigated the relationship between fear of falling (FOF) and qualitative and quantitative postural control in Parkinson's disease (PD). Fifty-eight nondemented PD patients were studied along with age-matched healthy controls. The degree of FOF was estimated using the Activities-specific Balance Confidence scale. Qualitative postural control was evaluated using a component of the Unified Parkinson Disease Rating Scale. Postural control was quantified, using centre of pressure measures obtained from a force plate, for eight standing balance tests of different challenges. The results showed that FOF was more evident for PD patients when compared with healthy individuals of similar age. Furthermore, FOF was significantly associated with a qualitative estimate of postural control in PD; individuals with PD who had a greater degree of posture impairment reported greater FOF. The results also showed that an estimate of FOF may help to explain quantitative postural instability in PD. FOF, when coupled with a qualitative estimate of postural control, was able to explain a greater amount of variation in quantitative balance performance for five of the eight balance tests. When considered independently, the qualitative measure of postural control, in general, could not well predict quantitative balance performance. The greater degree of FOF and its possible association with altered postural control suggests that FOF should be considered as an important, independent risk factor in the assessment and treatment of postural instability in patients with PD.     

新型饮水对小鼠繁殖及抗氧化酶活性的影响

目的　探讨新型饮水对健康的影响及其保健作用。方法　将矿溶生态水、活化水、纯净水、矿泉水、碱性离子水等 5种新型饮水作为唯一水源分别喂饲亲代及子代小鼠 3个月 ,对照给予天然水。观察它们对小鼠体重、繁殖及抗氧化酶活性的影响。结果　与天然水比较 ,活化水、矿溶生态水促进亲代雄性小鼠体重增长 (P <0 0 5) ;矿溶生态水使子代小鼠、矿泉水和碱性离子水使子代雄性小鼠体重增长缓慢 (P <0 0 5) ;纯净水使新生仔鼠体重减轻 (P <0 0 5) ,活化水、矿溶生态水使小鼠窝产仔数增多 (P <0 0 5) ,5种水对小鼠受孕率、妊娠率、出生存活率无影响 ;矿溶生态水、活化水、纯净水、矿泉水使小鼠肝组织SOD活力升高 (P <0 0 5) ,碱性离子水使肝组织SOD活力降低 (P <0 0 5)。结论　 5种新型饮水对小鼠体重有影响 ,对受孕率、妊娠率、出生存活率无影响 ;矿溶生态水、活化水、纯净水、矿泉水有提高SOD活力作用     

Spatial Learning Deficits in Mice with a Targeted Glucocorticoid Receptor Gene Disruption

Previous studies in rats using the Morris water maze suggested that the processing of spatial information is modulated by corticosteroid hormones through mineralocorticoid and glucocorticoid receptors in the hippocampus. Mineralocorticoid receptors appear to be involved in the modulation of explorative behaviour, while additional activation of glucocorticoid receptors facilitates the storage of information. In the present study we used the water maze task to examine spatial learning and memory in mice homozygous and heterozygous for a targeted disruption of the glucocorticoid receptor gene. Compared with wild-type controls, homozygous and heterozygous mice were impaired in the processing of spatial but not visual information. Homozygous mutants performed variably during training, without specific platform-directed search strategies. The spatial learning disability was partly compensated for by increased motor activity. The deficits were indicative of a dysfunction of glucocorticoid receptors as well as of mineralocorticoid receptors. Although the heterozygous mice performed similarly to wild-type mice with respect to latency to find the platform, their strategy was more similar to that of the homozygous mice. Glucocorticoid receptor-related long-term spatial memory was impaired. The increased behavioural reactivity of the heterozygous mice in the open field points to a more prominent mineralocorticoid receptor-mediated function. The findings indicate that (i) the glucocorticoid receptor is of critical importance for the control of spatial behavioural functions, and (ii) mineralocorticoid receptor-mediated effects on this behaviour require interaction with functional glucocorticoid receptors. Until the development of site-specific, inducible glucocorticoid receptor mutants, glucocorticoid receptor-knockout mice present the only animal model for the study of corticosteroid-mediated effects in the complete absence of a functional receptor.