ObjectiveTo observe the changes of microstructure of rats'sciatic nerves with non-freezing cold injury after treated with dexamethasone. MethodsTwelve male Wistar rats were randomly divided into cooling group and treating group.Unilateral sciatic nerves of the rats in the cooling group received cooling treatment with 3-5℃ for 2 hours;while unilateral sciatic nerves of the rats in the treating group received cooling treatment with 3-5℃ for 2 hours and underwent the celiac injection with dexamethasone in addition.The other sciatic nerves were exposed,as the control.The bilateral sciatic nerves of rats in each group were harvested after 24 hours.The microstructure of nerves was examined under the light microscope and electron microscope. ResultsLight microscopic examination revealed extensive myelinated fibre degeneration in form of giant empty axons or shrunken dark axons on the first day after cooled.And the endoneurial capillary lumen was narrowed because of swollen endothelial cells.After the treatment,myelinated fibre degeneration was still similar to that before the treatment,but the endoneurial capillary lumen and endothelial cells were normal.By electron microscopy,sciatic nerves showed extensive myelinated fiber degeneration,and swollen endothelial cells.But unmyelinated fibers and tight junction were preserved on the first days after cooled.Aggregated red cells and platelet thrombus were not found.After the treatment,myelinated fibre degeneration was still similar to that before the treatment.Unmyelinated fibers and tight junction were preserved.The endoneurial capillary lumen and endothelial cells were normal. ConclusionAfter the treatment,the damage of endoneurial capillary had improved,but myelinated fiber degeneration was similar to that before the treatment.It suggested that dexamethasone may only improve the vascular system in non-freezing cold injury of sciatic nerve.
目的:调查分析神经外科护士工作压力因素,采取相应对策以减轻压力,积极应对工作。方法:采用问卷调查法,对在神经外科工作的护士工作压力程度,工作压力源,压力源前五位,与其它科室护士进行比较,并通过统计学方法进行分析。结果:神经外科护士工作压力程度以重度压力为主。排序前5位的压力源为:工作量大,担心工作出差错,社会地位低,上班护士数量少,护理的患者病情过重。结论:正确分析神经外科护士工作压力因素,采取有效的对策,对于提高护理质量,保障护理安全,具有十分重要的意义。
ObjectiveTo observe changes in peripapillary blood flow before and after combined treatment with anti-vascular endothelial growth factor (VEGF) drugs and Dexamethasone intravitreal implant (DEX) in patients with central retinal vein occlusion (CRVO). MethodsA prospective clinical study. Thirty-three eyes of 33 patients with newly diagnosed non-ischemic CRVO and macular edema (ME) were enrolled from Shanxi Eye Hospital between April 2023 and April 2024. All patients underwent best-corrected visual acuity (BCVA) and swept-source optical coherence tomography angiography (SS-OCTA) examinations. The treatment regimen consisted of three intravitreal injections of ranibizumab and one DEX implant. SS-OCTA was used to scan a 3 mm×3 mm area centered on the optic disc to measure peripapillary retinal nerve fiber layer (RNFL) thickness and blood flow density in the superficial vascular complex (SVC), deep vascular complex (DVC), and radial peripapillary capillaries (RPC). Changes in SVC, DVC, and RPC blood flow density and RNFL thickness were evaluated at 3 and 6 months post-treatment. Shapiro-Wilk test was used to assess normality, and Spearman's rank correlation coefficient was applied for correlation analysis. ResultsCompared with before treatment, the blood flow density changes of SVC and RPC showed a downward trend at 3 and 6 months after treatment. Among them, the difference was statistically significant at 6 months after treatment (Z=−2.592, −2.070, P=0.012, 0.042), while there was no statistically significant difference at 3 months after treatment (P＞0.05). The blood flow density of DVC showed an upward trend at 3 and 6 months after treatment, but the differences were not statistically significant (P＞0.05). The results of the correlation analysis showed that the thickness of RNFL was negatively correlated with the blood flow density of DVC (r=−0.768, P＜0.001). It was positively correlated with the blood flow densities of SVC and RPC (r=0.288, 0.398; P=0.040, 0.004). ConclusionAnti-VEGF drugs combined with DEX treatment can significantly improve the perioptic disc blood flow distribution in eyes with CRVO, manifested as a decrease in blood flow density of SVC and RPC, while a compensatory increase in blood flow of DVC. The thickness variation of RNFL is closely related to the blood flow density of different vascular layers.