Regional activation in the rat brain during visceral stimulation detected by c-fos expression and fMRI

AIM: The aim of the study was to determine and compare the areas of brain activated in response to colorectal distention (CRD) using functional magnetic resonance imaging (fMRI) and c-fos protein expression. METHODS: For fMRI study (3.0 T magnet), anaesthetized rats underwent phasic CRD, synchronized with fMRI acquisition. Stimulation consisted of eight cycles of balloon deflation (90 s) and inflation (30 s), at 40, 60 or 80 mmHg of pressure. For c-fos study two sets of experiments were performed on anaesthetized rats: comparing (A) brain activation in rats with the inserted colorectal balloon (n = 5), to the rats without the balloon (n = 5); and (B) rats with inserted balloon (n = 10), to the rats with inserted and distended balloon (n = 10). The pressure of 80 mmHg was applied for 2 h of 30 s inflation and 90 s deflation, alternating cycles. RESULTS: Functional MRI revealed significant activation in the amygdala, hypothalamus, thalamus, cerebellum and hippocampus. Significant increase in c-fos expression was observed in amygdala and thalamus in the first set of experiments, and hypothalamus and parabrachial nuclei in the second. CONCLUSION: The two methods are not interchangeable but appeared to be complementary: fMRI was more sensitive, whereas c-fos had much greater resolution.     

神经外科患者并发下呼吸道感染的常见菌群分布及耐药性分析

神经外科患者大多原发病重,抵抗力低下,加之气管切开和(或)机械通气的应用,下呼吸道感染成为神经外科医院感染患者最常见的并发症之一,严重影响患者的预后.随着广谱抗菌药物的广泛应用,感染菌株的耐药率不断上升,给临床治疗带来了极大困难.因此,掌握神经外科患者下呼吸道感染常见病原菌分布及其对抗菌药物的敏感性及耐药性,对患者的治疗和预防医院感染具有重要意义.本研究对湖南省郴州市第一人民医院神经外科住院患者发生下呼吸道感染时送检的痰液样本中进行调查,通过了解神经外科住院患者发生下呼吸道感染时痰液中菌群的耐药趋势,为临床提供诊治依据.     

现代军校教学督导机制研究及对策

本研究从军队院校教学督导机制构建为出发点,深入分析了当前军队院校教学督导存在的机制不健全、职能发挥局限、专职人员缺乏、信息化程度滞后等问题,调研了国内外教学督导现状,并提出了构建综合督导体系、实现职能转变、推进模式创新、拓展督导内涵、优化队伍结构、开展专业培养、加强信息化条件建设等方面的建议及对策,对军队院校深化教学督导改革具有较好的指导意义和作用。     

Development of gastric slow waves and effects of feeding in pre-term and full-term infants

The aims of this study were to investigate the difference in developmental process of gastric slow waves and the effects of feeding in pre-term and full-term infants. Twenty-six pre-term and 31 full-term infants were enrolled in the study. Gastric myoelectrical activity was recorded using electrogastrography (EGG) from birth to month 6. An increase in the % of 2-4 cpm slow waves was noted in both pre-term (P < 0.01) and full-term infants (P < 0.04) from birth to month 4. The pre-term infants showed a reduced dominant EGG power at certain points of the study. (3) Breast or formula feeding resulted in no difference in the EGG in the full-term infants and showed a difference in the postprandial dominant power of the EGG in the pre-term infants only at month 2 after birth (P < 0.05) but not at other times. The gastric slow wave in pre-term infants is of a significantly reduced amplitude but similar rhythmicity. The method of feeding has no effects on the EGG in full-term infants and minimal effects (may be of non-clinical significance) on the EGG in pre-term infants as the difference was noted only at one time point during the 6-month follow-up study.     

Tachygastria induced by gastric electrical stimulation is mediated via α- and β-adrenergic pathway and inhibits antral motility in dogs

BACKGROUND: It is known that tachygastria is associated with gastric hypomotility and retrograde gastric electrical stimulation (RGES) delays gastric emptying and is proposed for treating obesity. The aim was to investigate the effects and mechanisms of RGES on postprandial antral contraction in dogs. METHODS: Seven dogs were implanted with a gastric cannula and three pairs of gastric serosal electrodes. Antral contractions and gastric myoelectrical activity were recorded immediately after a solid meal, with or without RGES, or with GES on the corpus, or with RGES under administration of propranolol. The stimulus was composed of long pulses with a tachygastrial frequency. RESULTS: (i) GES at the tachygastrial frequency impaired gastric myoelectrical activity and induced tachygastria (anovaP<0.05). (ii) GES at the tachygastrial frequency suppressed antral contractions (anovaP<0.01) and the effect was stronger with retrograde stimulation than forward stimulation (P<0.05). (iii) GES-induced tachygastria was correlated with antral hypomotility (r=-0.60, P=0.01). (iv) Propranolol and phentolamine abolished GES-induced tachygastria and antral hypomotility. CONCLUSIONS: Long-pulse RGES at a tachygastrial frequency suppresses postprandial antral contractions, which is attributed to an induction of tachygastria via the alpha- and beta-adrenergic pathway.     

5-Hydroxytryptamine selectively activates the vagal nodose C-fibre subtype in the guinea-pig oesophagus

Abstract  The afferent neurons innervating the oesophagus originate from two embryonic sources: neurons located in vagal nodose ganglia originate from embryonic placodes and neurons located in vagal jugular and spinal dorsal root ganglia (DRG) originate from the neural crest. Here, we address the hypothesis that 5-hydroxytryptamine (5-HT) differentially stimulates afferent nerve subtypes in the oesophagus. Extracellular recordings of single unit activity originating from nerve terminals were made in the isolated innervated guinea-pig oesophagus. Whole cell patch clamp recordings (35 °C) were made from the primary afferent neurons retrogradely labelled from the oesophagus. 5-Hydroxytryptamine (10  μ mol L⁻¹) activated vagal nodose C-fibres (70%) in the oesophagus but failed to activate overtly vagal jugular nerve fibres and oesophagus-specific spinal DRG neurons. The response to 5-HT in nodose C-fibre nerve terminals was mimicked by the selective 5-HT₃ receptor agonist 2-methyl-5-HT (10  μ mol L⁻¹) and nearly abolished by the 5-HT₃ receptor antagonists ondansetron (10  μ mol L⁻¹) and Y-25130 (10  μ mol L⁻¹). In patch clamp studies, 2-methyl-5-HT (10  μ mol L⁻¹) activated a proportion of isolated oesophagus-specific nodose capsaicin-sensitive neurons (putative cell bodies of nodose C-fibres). We conclude that the responsiveness to 5-HT discriminates placode-derived (vagal nodose) C-fibres from the neural crest-derived (vagal jugular and spinal DRG) afferent nerves in the oesophagus. The response to 5-HT in nodose C-fibres is mediated by the 5-HT₃ receptor in their neuronal membrane.     

团队式自主学习在《医学伦理学》教中的应用

目的 论证在医学伦理学教学中采用团队式自主学习的实用性。 方法 将临床医学五年制本科大三学生186人随机分成A组/实验组（96人）和B组/对照组（90人）,分别采用团队式自主学习和传统学习方式学习,并从批判性思维能力、课终评价等方面对教学效果进行比较。数据均采用SPSS15.0进行统计分析,采用t检验。结果 批判性思维能力方面,两组学生课题开始前CCTDI量表得分：实验组（271.10±19.77）、对照组（272.54±23.44）;课程结束后测试得分：实验组（285.93±21.37）、对照组（280.87±19.24）。课终评价方面,期末成绩得分[（79.86±12.37）vs.（77.24±9.17）分];临床案例分析得分[（81.07±7.43）vs.（75.23±10.74）];自主实践得分[（7.598±1.231）vs.（7.019±0.997）],实验组均高于对照组。结论 团队式自主学习对提高学生创新思维能力、激发学习主动性、提高学习效果具有积极作用。     

既往经皮冠状动脉介入对冠状动脉旁路移植术效果的影响

随着经皮冠状动脉介入（percutaneous coronary intervention，PCI）治疗的发展，接受PCI治疗的冠心病患者不断增加。由于支架内再狭窄、未处理节段冠状动脉粥样硬化进展，既往接受PCI治疗行冠状动脉旁路移植术（coronary artery bypass grafting，CABG）的患者亦不断增加。既往PCI对CABG手术效果是否存在影响仍有争议，本文对此作一综述。     

Assessment of gastric volume changes with sonometry compared with barostat

AIM: The aim was to investigate the validity of sonometry on the assessment of gastric volumes in comparison with gastric barostat. METHOD: Six dogs were implanted with gastric serosal electrodes, sonometric sensors, and a gastric cannula. Experiments were performed to assess sensor distance when an intragastric balloon was inflated with different volumes, after a meal with or without a balloon, and with gastric electrical stimulation. RESULTS: (i) The distance measured using sonometry was reproducible and stable, and there was a correlation between sensor distance and the gastric volume measured with barostat. (ii) Simultaneous recordings by sonometry and barostat showed a similar postprandial response, while the postprandial increase of the sensor distance was much smaller without the balloon (3.2+/-0.2 mm vs 9.7+/-1.5 mm, P<0.02). (iii) The sensor distance was increased with gastric electrical stimulation. CONCLUSIONS: Sonometry is able to detect gastric volume changes as validated by gastric perturbations with distensions, food ingestion and electrical stimulation. The postprandial increase in gastric volume measured by sonometry with barostat balloon is greater because of the presence of the intragastric balloon.     

超声对少见部位异位妊娠的诊断及鉴别诊断

目的探讨输卵管间质部、宫角、宫颈及子宫瘢痕处异位妊娠病灶的超声图像特征。方法采用常规腹部超声及经阴道超声对94例临床疑诊为异位妊娠的患者进行检查,并与手术后病理诊断结果进行对照分析。结果病理诊断证实94例异位妊娠患者中输卵管间质部妊娠33例,宫角妊娠24例,宫颈妊娠12例,子宫瘢痕处妊娠25例。术前常规超声及经阴道超声诊断异位妊娠与病理诊断符合87例(92.6%,87/94),误诊7例(7.4%,7/94)。其中诊断输卵管间质部妊娠30例(30/33,3例宫角妊娠误诊为输卵管间质部妊娠),诊断宫角妊娠20例(20/24,4例输卵管间质部妊娠误诊为宫角妊娠),诊断宫颈妊娠12例(12/12),诊断子宫瘢痕处妊娠25例(25/25)。结论超声检查在少见部位异位妊娠诊断与鉴别诊断中有重要作用。