家兔面神经撞击伤后生长相关蛋白的变化及丙酸睾丸酮治疗的影响

目的：研究面神经撞击伤后面神经核内生长相关蛋白（ＧＡＰ－４３）的变化及丙酸睾丸酮（ＴＰ）治疗的影响．方法：利用ＢＩＭ－Ⅱ型生物撞击机致家兔右侧面神经干损伤，ＳＰ免疫组化染色法观察损伤后１、３、７、１４和２１天伤侧面神经核内ＧＡＰ－４３的改变，电镜观察面神经干超微结构变化，以及ＴＰ对这些改变的影响．结果：面神经损伤第１天，伤侧面神经核内ＧＡＰ－４３样免疫反应性神经元（ＧＬＩＮ）开始增多，第１４天达到高峰，第２１天逐渐下降．ＴＰ治疗组各时相点ＧＬＩＮ的增多明显高于对照组．与对照组相比，伤后第２１天ＴＰ组面神经干电镜观察可见较多的新生髓鞘．结论：ＴＰ治疗能促进伤后面神经核内ＧＬＩＮ的合成，提示有助于面神经损伤后的修复与再生     

高压氧对提高严重烧伤患者血浆纤维连结蛋白含量的作用(论著)

目的：通过观察高压氧（ＨＢＯ）治疗对严重烧伤患者血浆纤维连结蛋白（ｆｉｂｒｏｎｅｃｔｉｎ，Ｆｎ）含量的影响，探讨ＨＢＯ在烧伤治疗中的价值。方法：４２例严重烧伤患者（烧伤总面积大于３０％或３度烧伤面积大于１０％），随机分为ＨＢＯ治疗组（ＨＢＯ组）和非ＨＢＯ治疗组（ｎｏｎ－ＨＢＯ组），于伤后８小时和１、２、３、５、７、１０、１４、１７、２１天１０个时相点抽静脉血，用火箭免疫电泳法测定其血浆Ｆｎ含量。结果：ｎｏｎ－ＨＢＯ组患者伤后各时相点血浆Ｆｎ含量均显著低于正常对照组（Ｐ＜０．０５或Ｐ＜０．０１）；而ＨＢＯ组除伤后８小时及１天外，其余各时相点血浆Ｆｎ含量正常，与ｎｏｎ－ＨＢＯ组比，伤后１０个时相点血浆Ｆｎ含量均显著增高（Ｐ＜０．０５或Ｐ＜０．０１）。结论：ＨＢＯ可明显提高严重烧伤患者血浆Ｆｎ水平，故对烧伤治疗有一定价值。     

Hypertonic Saline Mannitol to Reverse Hemorrhagic Shock in Rabbits

ＨＹＰＥＲＴＯＮＩＣＳＡＬＩＮＥＭＡＮＮＩＴＯＬＴＯＲＥＶＥＲＳＥＨＥＭＯＲＲＨＡＧＩＣＳＨＯＣＫＩＮＲＡＢＢＩＴＳＬＵＯＸｕｅ－ｈｏｎｇ（罗学宏），ＨＵＡＮＧＺｈｉ－ｊｕｎ（黄志军），ＮＩＮＧＹａｎｇ－ｇｅｎ（宁阳根），ＴＡＮＧＡｉ－ｇｕｏ（汤爱国...     

A Comparison in Healing of Skull Defect Repaired with Four Different Kinds of Graft Materials in Rabbits

ＡＣＯＭＰＡＲＩＳＯＮＩＮＨＥＡＬＩＮＧＯＦＳＫＵＬＬＤＥＦＥＣＴＲＥＰＡＩＲＥＤＷＩＴＨＦＯＵＲＤＩＦＦＥＲＥＮＴＫＩＮＤＳＯＦＧＲＡＦＴＭＡＴＥＲＩＡＬＳＩＮＲＡＢ┐ＢＩＴＳＤＩＮＧＺｈｅｎ－ｑｉ（丁真奇）１，ＴＡＮＦｕ－ｓｈｅｎｇ（谭富生）２，...     

INTERRELATIVITY AMONG STRESS，STRESS─GENERATED PO─TENTIAL AND FRACTURE HEALING OF THE TIBIAE IN RABBIT

ＩＮＴＥＲＲＥＬＡＴＩＶＩＴＹＡＭＯＮＧＳＴＲＥＳＳ，ＳＴＲＥＳＳ┐ＧＥＮＥＲＡＴＥＤＰＯ┐ＴＥＮＴＩＡＬＡＮＤＦＲＡＣＴＵＲＥＨＥＡＬＩＮＧＯＦＴＨＥＴＩＢＩＡＥＩＮＲＡＢＢＩＴＳＬＩＪｉａｎ－ｆｕ（李建福），ＬＩＱｉ－ｈｏｎｇ（李起鸿）Ｄｅｐａｒ...     

豚鼠面神经损伤及修过程中面神经纤维EGF含量的变化

应用放射免疫技术，观察豚鼠面神经损伤后１－１０ｄ、６０ｄ，其远、近端神经纤维内ＥＧＦ含量的变化。结果表明：面神经损伤后，ＥＧＦ含量从损伤后第１ｄ开始增高，第５ｄ天达到高峰，然后徐缓下降，第１０ｄ仍较高，第６０ｄ基本恢复正常。面神经损伤后其远端在第１～１０ｄ，其近端在第３～７ｄ，与正常面神经颊支ＥＧＦ含量比较差异有显著意义（Ｐ＜０．０５），第６０ｄ正常面神经颊支比较差异无显著意义（Ｐ＞０．０５）。提示神经损伤的早期，ＥＧＦ开始发挥促损伤神经再生的作用。     

21d头低位卧床中几种体液调节激素的变化

目的观察卧床模拟失重所致血浆肾素活性（ＰＲＡ）、醛固酮（Ａｌｄ）及前列腺素（ＰＧＩ２）的变化和ＬＢＮＰ对抗措施对上述激素的影响。方法１２名健康男性志愿者进行了２１ｄＨＤＴ－６°卧床实验。被试者年龄２３．７±５．０岁,随机等分为对照组（ＣＯＮ）和下体负压（ＬＢＮＰ）组。ＬＢＮＰ组在卧床最后一周进行下体负压锻炼（－３０ｍｍＨｇ,１ｈ／ｄ）。卧床前、卧床第２、４、１１天及卧床结束日清晨分别抽取肘静脉血。结果与卧床前相比,Ａｌｄ在第２天显著下降（ＣＯＮ－３０％,Ｐ＜０．０５;ＬＢＮＰ－３８％,Ｐ＜０．０１）,在第１１天显著上升（ＣＯＮ＋３０％,Ｐ＜０．０５;ＬＢＮＰ＋４８％,Ｐ＜０．０１）。ＰＲＡ在第４天达到峰值（Ｐ＜０．０５）,第２２天回落到低于对照水平。ＰＧＩ２在ＨＤＴ过程中均高于对照水平。对照组在第２２天增加＋２６０％（Ｐ＜０．０１）,ＬＢＮＰ组在第１１天,第２２天分别升高１４９％,１０２％（Ｐ＜０．０５）。采用ＬＢＮＰ对抗措施后,ＰＲＡ,Ａｌｄ在两组间无明显差别,ＰＧＩ２在ＬＢＮＰ组未进一步升高。结论２１ｄ头低位卧床导致ＰＲＡ、Ａｌｄ的一过性升高及ＰＧＩ２持续性升高。     

高压氧对实验性腹膜粘连的防治作用(论著)

目的：探讨高压氧（ＨＢＯ）对实验性腹膜粘连的防治作用。方法：３６只Ｗｉｓｔａｒ大鼠采用创伤法复制实验性腹膜粘连动物模型，随机分为ＨＢＯ－Ａ组、ＨＢＯ－Ｂ组、ＨＢＯ－Ｃ组和对照组。ＨＢＯ－Ａ组和ＨＢＯ－Ｂ组于创伤后立即行ＨＢＯ治疗，分别治疗１０天和５天。ＨＢＯ－Ｃ组推迟５天才治疗，只治疗５天。创伤后１０天解剖所有大鼠，观察局部肠管色泽，并按腹膜粘连程度按级评分。结果：ＨＢＯ－Ａ组和ＨＢＯ－Ｂ组的腹膜粘连积分分别为１．２５±０．８９和１．６３±０．９２，显著低于对照组３．０８±０．７９（Ｐ＜０．０１），而ＨＢＯ－Ｃ组的腹膜粘连积分为２．８８±０．８３，与对照组相比无统计学差异（Ｐ＞０．０５）。结论：术后及时行ＨＢＯ治疗能防治实验性腹膜粘连。     

CLINICAL AND EXPERIMENTAL STUDIES ON RENAL INJURIES AFTER EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY

ＣＬＩＮＩＣＡＬＡＮＤＥＸＰＥＲＩＭＥＮＴＡＬＳＴＵＤＩＥＳＯＮＲＥＮＡＬＩＮＪＵＲＩＥＳＡＦＴＥＲＥＸＴＲＡＣＯＲＰＯＲＥＡＬＳＨＯＣＫＷＡＶＥＬＩＴＨＯＴＲＩＰＳＹＦＡＮＧＹｕ－ｈｕａ（方玉华），ＪＩＡＮＧＪｕｎ（江军），ＤＵＷｅｉ－ｇｕｏ（都卫...     

高压氧对MPTP引起的小鼠帕金森综合征行为、超微结构和生化改变的影响(论著)

目的：探讨高压氧（ＨＢＯ）对帕金森病可能的治疗作用。方法：对用１－甲基－４－苯基－１，２，３，６－四氢吡啶（ＭＰＴＰ）制备的Ｃ５７ＢＬ小鼠帕金森综合征模型分别在注射ＭＰＴＰ后７天、１天和１小时内开始用ＨＢＯ处理，每日１次，共７次。按不同的ＨＢＯ处理方式分组，从行为、病理改变和黑质纹状体区多巴胺（ＤＡ），３，４－二羟苯乙酸（ＤＯＰＡＣ）和高香草酸（ＨＶＡ）的含量测定等几方面与对照组进行比较。结果：ＨＢＯ处理可部分恢复ＭＰＴＰ引起的小鼠黑质纹状体区ＤＡ、ＤＯＰＡＣ和ＨＶＡ的耗竭，电镜下观察轴索肿胀和神经细胞缺血性改变也明显轻于未用ＨＢＯ处理的模型组，而行为改变及黑质区神经细胞脱失则不明显。结论：ＨＢＯ处理对小鼠帕金森综合征有明显效果。     

MRI of the facial nerve in idiopathic facial palsy

The purpose of this prospective study was to define the enhancement pattern of the facial nerve in idiopathic facial paralysis (Bell's palsy) on magnetic resonance (MR) imaging with routine doses of gadolinium-DTPA (0.1 mmol/kg). Using 0.5T imager, 24 patients were examined with a mean interval time of 13.7 days between the onset of symptoms and the MR examination. Contralateral asymptomatic facial nerves constituted the control group and five of the normal facial nerves (20.8%) showed enhancement confined to the geniculate ganglion. Hence, contrast enhancement limited to the geniculate ganglion in the abnormal facial nerve (3 of 24) was referred to as equivocal. Not encountered in any of the normal facial nerves, enhancement of other segments alone or associated with geniculate ganglion enhancement was considered to be abnormal and noted in 70.8% of the symptomatic facial nerves. The most frequently enhancing segments were the geniculate ganglion and the distal intracanalicular segment. Correspondence to: I. Saatçi     

选择性面神经减压术治疗外伤性周围性面瘫

目的：探讨选择性面神经减压术治疗外伤性周围性面瘫的方法和临床意义。方法：回顾性分析1990-2001年间采用连续性面神经减压术治疗外伤性周围性面瘫103例的临床特点及治疗方法。结果：103例患者中术后随访93例，依据House-Brackmann面神经功能恢复评分标准评定，Ⅰ级恢复71例，Ⅱ级恢复14例，Ⅲ级恢复5例，Ⅳ级恢复2例，Ⅴ级恢复1例，其中Ⅰ－Ⅱ级恢复者占随访人数的91.4%。结论：选择性面神经减压术治疗外伤性周围性面瘫是一种更为简便、有效的手术方法。     

Preoperative facial muscle imaging predicts final facial function after facial nerve grafting

BACKGROUND AND PURPOSE: Our goal was to determine whether preoperative MR imaging of facial muscles predicts facial function after facial nerve grafting. METHODS: A retrospective review of all patients undergoing facial nerve grafting between 1997 and 2001 revealed 26 patients. Twelve of the patients had adequate preoperative MR images available for review and had undergone clinical follow-up for at least 12 months. Eight had malignant parotid tumors, and four had benign skull base or parotid tumors. Preoperative facial muscle MR imaging appearance was categorized as symmetrical or asymmetrical. The asymmetrical images were further classified into mild or pronounced asymmetry. Preoperative facial function was classified by using the House-Brackmann scale. Postoperative function was graded with the May scale. RESULTS: Four patients had symmetrical facial muscles shown by preoperative MR imaging, three had mild asymmetry, and five had pronounced asymmetry. No or mild asymmetry had an 86% positive predictive value for good to excellent functional outcome. Eighty percent of patients with pronounced asymmetry experienced poor functional outcomes. Six of eight patients with malignant and perineural tumors at surgery had asymmetrical facial muscles revealed by preoperative MR imaging studies. CONCLUSION: Symmetrical or mildly asymmetrical facial muscles are predictive of good facial function after nerve grafting. Pronounced asymmetry of facial muscles on MR images is predictive of poor facial function after grafting. Asymmetric facial muscles on preoperative MR images are associated with perineural tumor spread in patients with malignant disease.     

Magnetic resonance imaging of the intratemporal facial nerve in idiopathic peripheral facial palsy

The aim of this study was to investigate the prevalence of facial nerve involvement with gadolinium-enhanced magnetic resonance imaging (Gd-MRI) in patients with idiopathic peripheral facial palsy (IPFP), and to discuss the localization and the pattern of enhancement. A total of 13 patients (9 female, 4 male) with IFPF were included in this study. Topographic tests and electromyography (EMG) were performed, and MRI was taken. Ten subjects whose cranial MRIs were taken for nonorganic pathology served as the control group. Twelve of 13 paralytic facial nerves had enhancement on postcontrast images. Two facial nerves of the control group demonstrated enhancement. We found a correlation between the enhancement of the facial nerve and the time for recovery. The average time from the onset of facial palsy to the recovery in patients with enhancement was 14 weeks, whereas it was 6 weeks in patient with no enhancement. Finally, all patients had complete recovery of the facial nerve function. We concluded that contrast enhancement of the paralytic facial nerve can be a radiological sign of a neural inflammation and may indicate a prolonged recovery.     

氨基胍对大鼠创伤必性面瘫恢复及面神经核一氧化氮合酶表达的影响

目的 研究诱导型一氧化氮合酶抑制剂氨基胍对大鼠创伤性面瘫恢复的影响及面神经核内一氧化氮合酶表达的变化。方法 通过大鼠面瘫前后 膜内小剂量给予氨基胍，在伤后各个时间点上观察面瘫的恢复，并采用兔抗大鼠NOS抗血清免疫组织化学ABC对面神经核内NOS阳性神经元的变化进行研究。结果 氨基胍在创伤性面瘫恢复的早、中期有促进恢复的作用，其面神经核同诱导型一氧化氮合酶的免疫反应性明显受到抑制。结论 氨基胍慢性干预明显抑制面神经核内诱导型一氧化氮合酶的表达，并促进创伤性面瘫的早、中期恢复。     

MR imaging for evaluation of severe facial nerve damage in patients with facial nerve palsy

PURPOSE: To evaluate the usefulness of MR imaging for the detection of severe facial nerve damage in patients with facial nerve palsy. MATERIALS AND METHODS: We retrospectively reviewed 26 consecutive patients with facial nerve palsy (13 non-responders and 13 responders). T1-weighted, T2-weighted, and postcontrast T1-weighted images were obtained in all patients. FLAIR images were also obtained in 3 non-responders. RESULTS: The geniculate ganglion, labyrinthine segment, and tympanic segment or mastoid segment showed high signal intensity on T2-weighted images in 9 of 13 non-responders, whereas high signal intensity of the nerve was only seen in 1 of 13 responders. FLAIR imaging revealed high signal intensity lesions of the distal intrameatal segment in 2 non-responders. Contrast enhancement of the facial nerve showed a similar pattern in non-responders and responders. High signal intensity lesions on T2-weighted or FLAIR images showed enhancement on postcontrast T1-weighted images. CONCLUSION: These results suggest that a high signal intensity area on T2-weighted images is a marker of severe facial nerve damage. FLAIR imaging is useful for identification of T2-prolongation in the distal intrameatal segment.     

Study of facial neuralgia

So-called idiopathic, essential trigeminal neuralgia is characterised by typical severe pain in the territory of the trigeminal nerve or one of its divisions. This entity remains a diagnosis of exclusion after investigation by computerized tomography and/or magnetic resonance imaging of the path of the trigeminal nerve and its branches, to exclude any neoplastic, inflammatory, infectious or vascular process. Nevertheless, surgical exploration and now medical imaging have revealed in a large number of cases of "idiopathic" essential trigeminal neuralgia, compression of the trigeminal nerve as it emerges from the brainstem by a vascular loop.     

氨基胍对大鼠创伤性面瘫恢复及面神经核IL-6表达的影响

 目的研究诱导型一氧化氮合酶抑制剂氨基胍对大鼠创伤性面瘫恢复的影响及面神经核内IL-6表达的变化.方法通过大鼠面瘫前后腹膜内小剂量给予氨基胍,在伤后各个时间点上观察面瘫的恢复情况,并采用免疫组织化学ABC法对面神经核内IL-6阳性神经元的变化进行研究.结果氨基胍在创伤性面瘫的轻、中度恢复上有促进作用,其面神经核内IL-6免疫反应性明显比对照组增强.结论氨基胍慢性干预明显促进面神经核内IL-6的表达,并促进创伤性面瘫的轻、中度恢复.     

Computed tomographic analysis of the intratemporal facial nerve and facial nerve neuromas

High-resolution computed tomography (HRCT) has replaced multidirectional tomography in the detailed analysis of the temporal bone because of its excellent resolution of fine bony detail. Small soft-tissue masses not discernible on plain tomograms are easily seen using HRCT. Unsuspected early disease which has not caused recognizable bone erosion in also demonstrable by HRCT. Last but not least, the amount of radiation received by a patient as a result of HRCT is considerably less. We illustrate the normal course of the facial nerve through the temporal bone, its anatomical relationship to various adjacent structures, and the numerous branches given off during its course through the temporal bone. The clinical features of facial nerve neuromas (schwannomas) depend on their location and include facial nerve weakness or paralysis, otalgia or facial pain, hearing loss or imbalance, and loss of taste sensation. HRCT allows the identification of a soft-tissue mass along the course of the facial nerve, with its bony canal usually enlarged by the mass. Pressure erosion of the underlying bone is often noted and erosion of the ossicles may be demonstrated in the case of middle ear involvement. The importance of both clinical and radiological correlation cannot be overemphasized in the discovery of these tumors.