Correlation between regional myasthenic weakness and mental aspects of quality of life

Here we report how the different types of regional muscle involvement, i.e. bulbar, ocular or generalized, in patients with myasthenia gravis (MG) influence the mental aspects of quality of life. Clinical examination according to Osserman was performed in 48 MG patients (45 women, three men; mean age 54, SD 12 years). Each patient was at the time for clinical evaluation asked to fill out the disease-specific Myasthenia Gravis Questionnaire (MGQ) and the Short-Form 36-item questionnaire for health survey (SF-36) as patient-oriented tools. We related the regional domains (generalized domain, bulbar domain and ocular domain) of the MGQ and the clinical findings, respectively, with mental quality of life as assessed by SF-36. Bulbar and generalized involvement results in impairment of mental aspects of quality of life, whereas ocular involvement does not.     

埃索美拉唑三联与奥美拉唑三联疗法治疗Hp阳性十二指肠溃疡对比研究

目的比较埃索美拉唑三联与奥美拉唑三联疗法治疗幽门螺杆菌（Hp）阳性十二指肠球部溃疡的临床疗效。方法将104例经内镜诊断并检测证实Hp阳性的十二指肠球部溃疡患者随机分为两组。埃索美拉唑组（52例）：埃索美托唑20mg＋阿莫西林1g＋克托霉素500mg，每日2次，共7d；奥美拉唑组（52例）：奥美拉唑20mg＋阿莫西林1g＋克拉霉素500mg，每日2次，共7d。疗程结束4周后复查胃镜并检测Hp，观察腹痛缓解率、溃疡愈合率、Hp根除率及用药后的不良反应等。结果埃索美拉唑组第1天和第2天腹痛缓解率分别为34．6％和59、6％，高于奥美托唑组的17.3％和38．5％（P〈0．05）。埃索美托唑组和奥美拉唑组溃疡愈合率分别为92.3％和88．5％，Hp根除率分别为88．5％和82．7％，差异无显著性（P〉0．05）。两组用药后不良反应少，有较好的安全性。结论埃索美拉唑三联疗法治疗Hp阳性的十二指肠溃疡安全有效．腹痛缓解速度优于奥美拉唑三联疗法。     

The bilateral bulbar projections of the primary olfactory neurons in the frog

Summary Whether or not the frog olfactory neuroreceptor cells project bilaterally to the olfactory bulb is still a debated question. We therefore decided to ascertain whether bilateral projections of the primary olfactory input exist and if so to investigate their extent. Reproducible extracellular bilateral bulbar potentials were recorded in the frog following electrical stimulation of dorsal or ventral olfactory nerve bundles. The general features of the contralateral evoked responses were very similar to those of the ipsilateral response. The contralateral response disappeared after transection of the rostral part of the olfactory interbulbar adhesion but not following transection of the habenular or anterior commissures. Horseradish peroxidase labelling showed that the fiber terminations of the olfactory nerve bundle was not restricted to the ipsilateral olfactory bulb but included the medial aspects of the contralateral bulb. The intertelencephalic sections increased the magnitude of the ipsilateral evoked responses. Olfactory bulb isopotential maps revealed a rough topographical correspondence between the olfactory neuroepithelium and bulb along the medio-lateral axis as well as along the dorso-ventral axis. In addition, a projection of the medial and central part of the olfactory sac to the medial part of the contralateral olfactory bulb through the interbulbar adhesion was confirmed. These findings suggest first, that the fibers from the neuro-receptors located in either the ventral or the dorsal olfactory mucosae project to both olfactory bulbs, and second, that the left and right bulbs exert a constant inhibition on each other via the habenular commissure.Abbreviations AON anterior olfactory nucleus - ax olfactory neuroreceptor axon - BA bulbar adhesion - D_I latero-dorsal olfactory nerve bundle - D_II centro-dorsal olfactory nerve bundle - D_III mediodorsal olfactory nerve bundle - EPL external plexiform layer - GL glomerular layer - gl glomerulus - GRL granular cell layer - MOB main olfactory bulb - m mitral cell - MBL mitral cell body layer - ON olfactory nerve - V lateral ventricule - V_I latero-ventral ol-factory nerve bundle - V_II centro-ventral olfactory nerve bundle - V_III medio-ventral olfactory nerve bundle - VN vomero-nasal nerve     

32例再生障碍性贫血的微循环及血液粘度

对３２例再障患者的甲襞、球结膜微循环及血粘度进行观察，结果表明：再障组均有不同程度的微循环异常改变（１００％），与正常对照组比较差异显著（Ｐ＜０．０１）；再障组全血粘度、全血还原粘度明显低于正常对照组（Ｐ＜０．０１），再障患者的Ｈｂ与全血粘度及血浆比粘度呈正相关。     

Specialized neuroglial arrangement may explain the capacity of vomeronasal axons to reinnervate central neurons

The neurosensory cells of the primary olfactory and vomeronasal projections are in a state of continuous replacement throughout adult life. Since their axons form synaptic terminals with neurons in the olfactory and accessory olfactory bulbs, this system is an apparent exception to the rule that peripheral axons cannot grow into the central nervous system of adult mammals. Electron microscopy of sections (especially in a plane tangential to the surface of the accessory olfactory bulb) shows a unique glial arrangement. By virtue of their greater electron density and "secretory-type" organelle content (Golgi apparatus and dense-core vesicles) the glial cells of the superficial layers of the accessory olfactory bulb are distinguished both from the glia of the vomeronasal nerves and from the astrocytes of the deeper bulbar layers. The synapses between the vomeronasal axons and the postsynaptic elements are formed in glomeruli which are encapsulated by an inner layer of glial cytoplasm derived from the superficial glia, and an outer layer derived from the astrocytes. The principle of the organization is that the superficial glial processes are reflected off the axons before they reach the synaptic terminal zone. Conversely, for the postsynaptic elements, the astrocytic processes are reflected off the dendrites of the accessory olfactory bulb neurons before they enter the core of the glomeruli. In effect, the synapses are formed in a "no-man's-land" between the two glial cell types. This peculiar glial arrangement may be important for the unique regenerative capacity of this system.     

Brain death

Summary Following the research of Giessen Neurosurgery on primary and secondary lesions of the hypothalamo-pituitary system and the brainstem over a period of more than 30 years, cerebral failure and death does not represent a uniform syndrome but consists of several, well characterized syndromes of irreversible hypothalamo-pituitary, mesencephalic and bulbar failure. The specific syndromes are described in detail. The diagnosis is based on establishing complete irreversible damage of specific vital basal functions such as hypothalamo-pituitary transmission, water-and electrolyte metabolism, temperature regulation, circulation and respiration. The common feature of all types is the irreversible break-down of the complex central neurogenous and/or neurohumoral regulatory system. The permanent and irreversible loss of central regulation and modulation means at the same time the complete cessation of the specific human cortical function, the death of the whole brain. Only in bulbar failure with primary irreversible cessation of respiration artificial respiration can maintain the autonomous functions of the heart for a limited time. It is indicated when organ explantation is to be considered. Complete and irreversible isolated loss of cortical function abolishes the normal human life, but does not mean death of the remaining vegetating human being.Presented at the meeting of the Working Group of the Pontificia Academia Scientiarum on The artificial prolongation of life and the exact determination of the moment of death, Vatican City, October 19–21, 1985.Dedicated to Prof. Dr. Jean Brihaye at the occasion of his 65th anniversary.     

胬肉切除联合球结膜瓣转位术的疗效

目的:探讨胬肉切除联合球结膜瓣转位术技巧及其疗效分析。方法:胬肉切除联合球结膜瓣转位术操作要点:术眼在表麻和浸润麻醉下,彻底切除胬肉及受累及的球筋膜组织。于上方球结膜下注入20g/L利多卡因使球结膜与结膜下组织分离,并作一条与角膜缘平行的带蒂球结膜瓣,将其转位覆盖在巩膜裸露区,并予缝合固定。术后用氯霉素地塞米松眼液滴眼,6～7d拆线。采用此术式治疗翼状胬肉患者379例(386眼),其中原发性翼状胬肉患者373例(380眼),复发性翼状胬肉患者6例(6眼)。结果:手术治愈373例(380眼),治愈率为98.4%;复发6例(6眼),复发率为1.6%。术后复发者经再次作手术,全部治愈。结论:胬肉切除联合球结膜瓣转位术治疗翼状胬肉效果显著,此术式值得推广应用。     

穴位埋线治疗卒中后假性球麻痹吞咽障碍的临床研究

目的：观察穴位埋线治疗卒中后假性球麻痹吞咽障碍的临床疗效。方法：将符合研究标准的90例合并吞咽障碍的假性球麻痹患者随机分为治疗组（45例）和对照组（45例）,两组均给予常规的脑血管病治疗、吞咽训练和吞咽电刺激治疗．治疗组在此基础上给予穴位埋线治疗,对照组给予电针治疗,治疗1个疗程后评价其,艋床疗效。结果：两组总有效率均为97．78％．两组的总有效率差异无统计学意义（P〉0．05）。结论：穴位埋线和电针治疗卒中后假性球麻痹的临床疗效相当,但穴位埋线只需每2周治疗1次,患者更易于接受。     

丹龙醒脑片对血瘀证犬血液流变性和球结膜微循环的影响

目的观察丹龙醒脑片时血瘀证犬血液流变性和球结膜微循环的影响,以探讨其活血化瘀功效。方法从后肢大隐静脉注射高分子右旋糖苷复制血瘀证犬模型,观察其血液流变性和球结膜微循环改变以及丹龙醒脑片对该模型的影响。结果造模后,模型组全血粘度、全血还原粘度和血浆粘度显著升高,血沉和血沉方程K值升高,红细胞聚集指数和红细胞变形指数明显升高;球结膜微循环形态积分和流态积分明显增高(P<0.01-0.05)。与模型组相比,丹龙醒脑片大中剂量组全血粘度、全血还原粘度,血浆粘度、血沉方程K值、红细胞聚集指数、红细胞变形指数显著降低,球结膜微循环形态积分和流态积分亦显著降低(P<0.01-0.05)。结论丹龙醒脑片能改善高分子右旋糖苷所致血瘀证犬模型血液流变性,改善微循环障碍。这可能是其活血化瘀作用的机制之一。     

正常人与Sjogren''s Syndrome患者球结膜免疫细胞的研究

目的 研究正常人与干燥综合征(Sjogren’s Syndrome,SS)患者球结膜HLA-DR+细胞、朗格罕斯细胞(LC)、T淋巴细胞亚群的变化特征。方法 采用链菌素-过氧化物酶法检测正常人与SS患者球结膜组织。结果 (1)SS患者球结膜大量T淋巴细胞浸润,抑制性T淋巴细胞(CD~(+8))较辅助性T淋巴细胞(CD~(+4))为多。CD~(+4)/CD~(+8)比值升高。(2)SS球结膜中LC数量减少,且鳞状上皮化生明显。(3)SS球结膜中HLA-DR~+细胞较正常人明显增加。结论 SS患者球结膜有显著的病理改变和免疫细胞异常。