角膜损伤后神经再生的实验研究

应用神经组织化学技术观察了兔角膜NA能神经及AchE阳性神经在角膜损伤后的再生,证实术后1月,两种神经均有再生轴突进入植片;术后3月可见交界区和植床内神经密度明显增加;同时,对术后两种神经再生的功能意义进行了讨论。     

Features of pediatric head injury in Hong Kong

Head injury in children causes special concern in most communities. From 1989 to 1994, 2,785 children younger than 16 years old were admitted to our neurosurgical service because of head injury. Fall from a height was the major cause of head injury leading to admission in infants and children in preschool age groups, whereas traffic-related or bicycle-related accidents were more likely to be the cause of head injury for those aged 11–15 years. In all age groups there was a male preponderance. The overall mortality was 0.6%. Traffic-ralated accidents caused more severe injury and accounted for 67% of all fatalities. For patients under 6 years old, about 40% of head injuries occurred at home. Preventive measures for pediatric head injury in Hong Kong are suggested.     

Auditory and vestibular system findings in patients with vertebrobasilar dolichoectasia

Impairment of the auditory-vestibular system has been reported in patients with vertebrobasilar dolichoectasia (VBD), but little is known about the underlying cause of the symptoms. Auditory testing (pure tone audiometry, auditory brain stem response and stapedius reflex) and vestibular tests (assessment of nystagmus, eye tracking tests, caloric test and rotational test) were performed in 23 patients with auditory-vestibular symptoms and/or cranial nerve impairment associated with VBD. Specific evidence of auditory and/or vestibular system impairment was observed in 19 cases (83%). Among patients with abnormal test findings, 47% had evidence suggesting peripheral impairment, 16% evidence suggesting central dysfunction, and 37% evidence suggesting both peripheral and central dysfunction. Although compression of the vestibulocochlear nerve plays an important role in the genesis of the auditory-vestibular dysfunction in patients with VBD, mechanism such as brain stem-cerebellar ischemia and impaired blood supply to the vestibular labyrinth may be just as important.     

A comparison of glue and a tube as an anastomotic agent to repair the divided buccal branch of the rat facial nerve

The best anastomotic agent to join nerve ends is controversial. This paper describes a controlled trial between a collagen tube wrap and a tissue glue to anastomose the rat facial nerve. There was no difference in the results using photographic, histological and electrophysiological techniques.     

电针对沙鼠急性脑缺血再灌注后神经原损伤的保护作用

本实验利用沙鼠急性脑缺血再灌注模型，研究电针对脑缺血及再灌注各期脑电活动的影响及组织病理学的改变。结果表明：缺血１０ｍｌｎ，脑电幅度受到严重抑制，甚至变平坦，总功率大大下降，再灌注后总功率难以恢复，在１２０ｍｉｎ时仅恢复到缺血前的２７．３９±１１．３１％，以后即不再进一步恢复，电针组动物缺血１０ｍｉｎ再灌注后，脑电的恢复明显比对照组快，１２０ｍｉｎ时恢复至缺血前的７１．４５±１６．４６％（Ｐ＜０．０１），２４０ｍｉｎ时继续恢复至缺血前的７５．２７±１８．４３％。同时电针能明显减轻缺血１０ｍｉｎ后再灌注２４小时的神经原缺血性损伤。结果提示：电针对急性脑缺血引起的神经原损伤具有保护作用，并能促进脑功能的恢复。     

Cyclosporine overcomes cold preservation/reperfusion injury of liver graft: Chemokine release and liver ultrastructure

There is a growing body of evidence that the cytokine, tumor necrosis factor-α (TNF-ga), plays an important role in the development of hepatic ischemia/reperfusion injury. We found that the immunosuppressants, cyclosporine-A (CsA), azathioprine, and FK506, have protective effects on such injury. The purpose of the present study was to elucidate mechanisms involved in these beneficial effects of the immunosuppressant, CsA, on liver injury following cold preservation and transplantation, with special reference to the suppression of TNF-α release. Rat livers were stored in Euro-Collins solution (EC) at 4°C for 6h and orthotopically transplanted. The animals allotted to two groups: group A (untreated controls) and group B (CsA pretreatment of recipients). CsA (10 mg/kg, p.o.) was given for 3 consecutive days preoperatively. CsA pretreatment of the recipients significantly improved the 2-week survival rate (0/6 for group A, 3/6 for group B;P<0.05) and this was associated with a significant decrease in serum TNF-α levels 2h posttransplantation (group A, 69.8±15.7 pg/ml; group B, 22.8±6.8; mean±SEM;n=12 each;P<0.05) and amelioration of sinusoidal endothelial injury, assessed by electron microscopy. Plasma endotoxin levels following reperfusion of the grafts were not altered by the CsA therapy. Morphologically, CsA pretreatment of the recipients did not alter activation of Kupffer cells. CsA pretreatment of the recipient aids in preventing cold preservation/reperfusion injury of the liver graft, possibly by modulating effects of TNF-α.     

Short-term lack of cerebral perfusion with good outcome. Advantages of early intracranial pressure monitoring

A 21-year-old man was injured by a tailboard of a truck. He suffered a severe head injury with bilateral depressed skull fractures necessitating surgical decompression. On admission to the hospital the patient showed bending to pain stimuli (Glasgow Coma Score 5). Anisocoria was noticed from the beginning. Initial intracranial pressure (ICP), measured 3 hours after injury, was 30 mm Hg, and the cerebral perfusion pressure (CPP) was 70 mm Hg. During surgical elevation of the skull fracture on the right side an unexplainable rise of ICP to values of 100 mm Hg occurred, which corresponded to the mean arterial blood pressure (MAP). At the same time both pupils were dilated and fixed indicating a lack of cerebral perfusion. Due to immediate trephination of the opposite side, the ICP was lowered to values below 20 mm Hg, and sufficient cerebral perfusion (above 50 mm Hg) was regained. The patient showed a good recovery and was transferred to a rehabilitation center 5 weeks after injury.This case report emphasizes the importance of early and continuous intracranial pressure monitoring for adequate therapy in neurosurgical emergencies.     

川芎嗪对脑外伤患者血栓素、前列腺环素及颅内压的影响

28例重度脑外伤患者分为川药嗪治疗组和一般治疗对照组,两组病人均于用药前和用药后3小时测定血浆和脑室内脑脊液(VCSF)中血栓素代谢产物(TXB_2)前列腺环素代谢产物6—酮—PGF_(la)(6KP)和颅内压。结果表明:两组治疗前血浆、VCSF中TXB_2及T/K均明显高于正常献血员对照组,川芎嗪能降低脑外伤患者血浆、VCSF中TXB_2及T/K值,对颅内压则无明显影响。提示川芎嗪能抑制脑外伤对血小板的激活、纠正循环血中TXA_2—PGI_2平衡失调,从而改善脑微循环。     

Mandibular fracture not shown by axial computed tomography: Benefit of computed reformation

A 36-year-old man was brought to the emergency department after being assaulted. A mandible series showed a nondisplaced fracture through the angle of the mandible extending through the left third molar tooth. Axial slices from a nonhelical computed tomographic (CT) examination of the head as well as a helical CT examination of the mandible failed to demonstrate the fracture. The fracture was well shown, however, on sagittal CT reformations. Although CT is generally regarded as more sensitive than plain radiography for the detection of fractures, fractures may be overlooked by CT if examination in only one plane is performed.