Reaktionsmuster verschiedener Mittel-und Zwischenhirnzentren von Rana temporaria L. nach Unterbrechung der Nervenbahnen des Pinealkomplexes

Zusammenfassung Der Einfluß des lichtempfindlichen Pinealkomplexes (Stirnorgan und Epiphysis cerebri) von Rana temporaria auf dorsale diencephale und mesencephale Hirnzentren breitet sich über ein größeres Gebiet aus als man bisher angenommen hat. Nach operativer Unterbrechung des Nervus- und Tractus pinealis wurde mit Punktzählverfahren die Dichte der Zell- und Zellkernvolumina sowie der Kapillaroberfläche im dorsalen Thalamus, mesencephalen (postthalamischen) zentralen Grau, Ganglion habenulae, Tectum opticum, in der Area praetectalis und im Subcommissuralorgan (Sco) bestimmt. Die morphometrischen Meßergebnisse lassen sich wie folgt interpretieren: 1. Der Pinealkomplex wirkt auf das Sco, das zentrale Grau und die Area praetectalis ein (vgl. Paul u. Mitarb., 1971); das Sco wird in erster Linie über das Stirnorgan beeinflußt. 2. Weitere Kerngebiete des Zwischenhirns (Ganglion habenulae und dorsaler Thalamus) gehören funktionell zu dem vom Pinealkomplex kontrollierten System. 3. Die von Kemali und Braitenberg (1970) beschriebene Asymmetrie der Ganglia habenularum zeigt sich auch im funktionellen Zusammenspiel dieser Kerngebiete mit dem Pinealkomplex, dem dorsalen Thalamus und dem dorsalen Abschnitt des zentralen Graus. Die in Stirnorgan und Epiphysis cerebri transformierten Lichtreize werden in Hirnabschnitte weitergeleitet, die olfaktorische und retinale Signalmuster verarbeiten. Über die biologische Bedeutung der nervösen Beziehungen des Stirnorgans zum sekretorischen Sco können noch keine Angaben gemacht werden.

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Study of mesencephalic and diencephalic centers after transection of the centripetal nervous pathways of the pineal complex in Rana temporaria L.

Summary Nervous influences of the pineal complex of the frog, Rana temporaria, exerted upon mesencephalic and diencephalic centers were investigated using morphometric methods after the transection of the nervus or the tractus pinealis. Densities of the cell- and nuclear volumes and of the capillaries were measured by a point-counting method in the dorsal thalamus, the mesencephalic (postthalamic) central gray, the habenular ganglion, the optic tectum, the pretectal area, and the subcommissural organ (sco). The morphometric measurements showed: 1. A functional influence of the pineal complex on the sco, the central gray, and the pretectal area (see Paul et al., 1971); the frontal organ seems to be primarily related to the sco. 2. The habenular ganglia and the dorsal thalamus belong to a system which is controlled by the pineal complex. 3. The morphological asymmetry of the habenular ganglia (Kemali and Braitenberg, 1970) has an influence on the functional interactions between the pineal complex, the dorsal thalamus, and the central gray. The impulses arising in the light-sensitive pineal complex of the frog are conducted to brain regions which are known to integrate olfactory and retinal sensory inputs. The functional significance of the nervous connexion of the frontal organ with the secretory sco is still open to discussion.

Mit Unterstützung durch die Deutsche Forschungsgemeinschaft (Arbeitskreis Prof. Dr. A. Oksche).     

病毒性肝炎肝硬化并脾功能亢进的治疗进展

病毒性肝炎肝硬化合并脾功能亢进是临床上常见的肝脏疾病,其产生的脾脏肿大占位效应和血细胞过度消耗及伴随骨髓移植等临床综合症状,严重影响了针对病毒性肝炎肝硬化的抗病毒治疗。目前通过非手术治疗难以控制脾脏肿大,且无特异性药物有效遏制,极易造成重度贫血和血小板减少症导致的出血现象,此时外科和介入治疗手段则为首选方式,一般包括脾脏切除、脾脏部分切除、介入治疗(目前以脾动脉栓塞为主)等,其中又以脾脏切除术疗效最直接和确切。然而脾切除对人体免疫功能的损害使人们认识到保脾的重要性,但如何最大限度的保留脾组织和脾功能,至今争议仍然存在。因此,本文综述了肝硬化脾功能亢进的发病原因及机制,脾亢的诊断标准以及脾功能亢进的外科和介入治疗方法,为脾功能亢进的研究提供一定的理论基础。     

限制性输液与充分液体复苏在感染性休克患者围手术期麻醉中的应用研究

目的:探究限制性输液与充分液体复苏在感染性休克患者围手术期麻醉中的应用,从而为患者治疗提供相关科学依据。方法:回顾性分析2007年2月至2015年6月期间因感染性休克入院接受治疗的82例患者的临床资料,按输液方式的不同分为研究组(限制性输液)与对照组(充分液体复苏)各41例,观察两组患者转归情况,记录患者心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)、动脉血氧分压(PaO_2)、出血量、总输液量、尿量、术后机械通气时间及ICU住院时间。结果:术后研究组患者出现弥散性血管内凝血(DIC)5例、成人呼吸窘迫综合征(ARDS)3例,2例病情控制不佳者转为多器官功能障碍综合征(MODS),1例死亡,总发生率为26.83%;对照组患者出现DIC 8例,ARDS 7例,MODS 5例,最终出现3例死亡,总发生率为56.10%,两组患者术后转归状况比较,差异有统计学意义(P0.05);研究组患者MAP、CVP、HR、出血量、总输液量及尿量等指标低于对照组,差异有统计学意义(P0.05),研究组患者PaO_2显著高于对照组,差异有统计学意义(P0.05);研究组患者术后机械通气时间及ICU住院时间比对照组短,差异有统计学意义(P0.05)。结论:限制性输液较充分液体复苏能够显著改善感染性休克患者组织血流灌流状况,术中出血量少、术后并发症少,效果更显著,更适合在围手术期麻醉中使用。     

手术切除与介入栓塞治疗肝癌术后复发患者的临床对比研究

目的:比较手术切除与介入栓塞治疗肝癌术后复发患者的临床疗效。方法:选择2010年6月到2011年6月本院收治的92例肝癌手术切除术后复发患者,按随机数字表法分为手术切除组和介入栓塞组,各46例。手术切除组患者给予再次切除治疗,介入栓塞组患者给予介入栓塞治疗。记录并比较两组患者治疗后1年、3年及5年的生存率。检测并比较两组患者治疗前后血清肝纤维化指标,包括血清透明质酸(HA)、层黏蛋白(LN)、人Ⅲ型前胶原(HPC-Ⅲ)及IV型胶原(IV-C)水平。检测并比较两组患者治疗前后血清白细胞(WBC)、甲胎蛋白(AFP)及癌胚抗原(CEA)水平。结果:手术切除组患者治疗后1年、3年、5年的生存率均明显高于介入栓塞组,差异均具有统计学意义(P0.05)。治疗后,介入栓塞组血清HA、LN、HPC-Ⅲ及IV-C明显高于治疗前,且均明显高于手术切除组,差异均具有统计学意义(P0.05)。两组患者治疗后血清WBC、AFP及CEA水平均明显低于治疗前,且手术切除组患者血清WBC明显高于介入栓塞组,而血清AFP、CEA水平明显低于介入栓塞组,差异均具有统计学意义(P0.05)。结论:手术切除治疗肝癌术后复发能够明显提高患者生存率,降低肝纤维化程度,改善血清AFP及CEA水平,值得在临床上推广应用。     

Donepezil plus estradiol treatment enhances learning and delay-dependent memory performance by young ovariectomized rats with partial loss of septal cholinergic neurons

Effects of estrogen therapy on cognitive performance appear to diminish with age and time following the loss of ovarian function. We hypothesize that this is due to a reduction in basal forebrain cholinergic function and that treatment with a cholinergic enhancer can reverse the effect. This study tested whether combining the cholinesterase inhibitor donepezil with estradiol treatment can enhance/restore estradiol effects on cognitive performance in young ovariectomized rats with selective lesions of septal cholinergic neurons. 192IgG-saporin was injected directly into the medial septum to produce selective cholinergic lesions. Rats were then treated with donepezil (Don, daily injections of 3 mg/kg/day, i.p.) or vehicle, and then with 17β-estradiol (E2, administered by silastic capsule implanted s.c.) or an empty capsule. Rats were trained on a delayed matching-to-position (DMP) T-maze task which previous studies have shown is sensitive to ovariectomy and estrogen replacement. Results show that neither estradiol nor donepezil alone significantly enhanced acquisition of the DMP task in rats with cholinergic lesions. Combination therapy was effective, however, depending on the severity of the lesion. Don + E2 significantly enhanced acquisition of the task in rats with partial lesions (< 50% loss of cholinergic neurons), but not in rats with severe lesions. This effect was due largely to a reduction in perseverative behavior. Don + E2 also improved working memory in rats with partial lesions, as evidenced by significantly better performance than controls during increased intertrial delays. These findings suggest that even partial loss of septal cholinergic neurons can reduce effects of estrogen therapy on cognitive performance, and demonstrate that combining a cholinesterase inhibitor with estrogen therapy can help to restore beneficial effects on performance. We propose that combination therapy may have similar beneficial effects in women, particularly in older women who have not used estrogen therapy for many years and are beginning to show signs of cognitive impairment or early Alzheimer's disease.     

手术室护士对外科手消毒相关知识的认知状况调查分析

目的:了解手术室护士对外科手消毒相关知识的认知状况,为手术室管理者提供护士掌握外科手消毒知识的整体水平,以全面提高外科手消毒的效果。方法:自行设计的问卷对哈尔滨市8家三级甲等综合性医院手术室护士进外科手消毒相关知识的认知调查。结果:目前手术室护士掌握外科手消毒相关知识的状况不容乐观,共20个被调查问题,回答正确率平均为49.85%;工作年限、第一学历、职称、学习过《医务人员手卫生规范》、消毒重要性的认识对答题结果的影响具有统计学意义(P0.05),表现为工作年限时间越长、第一学历越低、职称越高、学习过《医务人员手卫生规范》的、认为外科手术消毒重要的护士理论知识掌握情况越好。结论:被调查者自主学习较差,手术室管理者应当注重和加强手术室护士的外科手消毒专题学习培训与考核,理论与实践相结合,不断探索长期、可持续的培训教育模式,管理者制定与临床工作相结合并且适合不同学历背景和年资护士的培训方式和学习计划。充分调动护士的自我管理意识,建立外科手消毒"品管圈",分析和解决问题,使手术室的护理质量在持续的改进中得到不断提高。     

广西桉树人工林叶面积指数的估测及其校正

叶面积指数(Leaf area index, LAI)是森林生态系统重要的结构参数,通过遥感技术可反演区域LAI,但其可靠性需要地面准确的实测数据进行验证。选取广西国有高峰林场不同林龄的桉树(Eucalyptus robusta)人工林为对象,以异速生长法(Allometry)为对照,综合利用植物冠层分析仪法(LAI-2200)、跟踪辐射和冠层结构分析仪法(TRAC)、半球摄影法(DHP)以及地基激光雷达法(TLS)等间接法估测样地的LAI,并考虑木质成分以及聚集效应影响,进行相应的校正处理,为地面快速、准确测量桉树人工林LAI提供参考。结果表明：桉树人工林的比叶面积为125.37±13.38 cm~2/g,通过Allometry获得的LAI变化范围在1.65—3.84,平均为2.73,不同林龄间的差异均显著(P<0.05),随着林龄的增加呈现先增加后减少的趋势。在未校正情况下,LAI-2200、TRAC、DHP、TLS估算的LAI存在显著差异(P<0.05)。与对照相比,LAI-2200在幼龄林和过熟林中估算误差最小,TRAC在成熟林中估算误差最小。相对于完全去除法,利用...     

胃肠外科术后ERAS及大承气冲剂对患者手术应激影响

摘要 目的：探讨胃肠外科术后加速康复外科(enhanced recovery after surgery,ERAS)及大承气冲剂对患者手术应激影响。方法：选取我院近3年所收治的80例胃肠外科手术患者,将其随机分为研究组和对照组,每组患者40例,两组患者围手术期分别采取ERAS及大承气冲剂、传统处理方法及常规西医治疗结合安慰剂,对比围手术期不同处理方式对患者手术应激影响。结果：两组患者手术前心理（汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)）、生理（C反应蛋白(CRP)、肾上腺素、皮质醇）应激指标对比无统计学差异（P＞0.05）,手术后7 d,研究组患者各项应激指标均明显低于对照组（P＜0.05）;研究组患者术后首次排气时间、术后首次排便时间、术后首次下床活动时间、平均住院时间均明显短于对照组（P＜0.05）;两组患者手术前各营养状态对比均无统计学差异（P＞0.05）,对比指标发现,各营养指标均应激降低后,逐渐恢复,研究组患者术后3 d降低程度明显低于对照组（P＜0.05）,在手术后7 d逐渐恢复术前水平。结论：胃肠外科术后ERAS及大承气冲剂更有利于患者术后胃肠功能恢复,术后应激反应更轻,促使患者机体营养状态稳定,可缩短患者的住院时间,促使患者术后康复,值得临床上推广应用。     

外科手术在高血压脑出血治疗中的应用

高血压脑出血是当今社会一种发病率及死亡率都非常高的神经科疾病,对于它的治疗,则是神经内外科的重点难点。目前治疗高血压脑出血的方法分为内科保守治疗和外科手术治疗两种,作者阅读了大量国内外临床相关文献,综述了高血压脑出血相关内外科治疗的方法,以及具体应用,望能为其相关研究提供有益的思路。     

Finite element simulation of spinal deformities correction by in situ contouring technique

Biomechanical models have been proposed in order to simulate the surgical correction of spinal deformities. With these models, different surgical correction techniques have been examined: distraction and rod rotation. The purpose of this study was to simulate another surgical correction technique: the in situ contouring technique. In this way, a comprehensive three-dimensional Finite Element (FE) model with patient-specific geometry and patient-specific mechanical properties was used. The simulation of the surgery took into account elasto–plastic behavior of the rod and multiple moments loading and unloading representing the surgical maneuvers. The simulations of two clinical cases of hyperkyphosis and scoliosis were coherent with the surgeon's experience. Moreover, the results of simulation were compared to post-operative 3D measurements. The mean differences were under 5° for vertebral rotations and 5 mm for spinal lines. These simulations open the way for future predictive tools for surgical planning.