Objective To investigate the feasibil ity of building the 3D reconstruction of short segment common peroneal nerve functional fascicles based on serial histological sections and computer technology. Methods Five cm of the common peroneal nerve in the popl iteal fossa, donated by an adult, was made into the serial transverse freezing sections(n=200) at an interval of 0.25 mm and 10 μm in thickness per section. Acetylchol inesterase staining was adopted and the nerve fascicles were observed by microscope. 2D panorama images were acquired by high-resolution digital camera under microscope (× 100) and mosaic software. Different functional fascicles were distinguished and marked on each section. The topographic database was matched by image processing software. The 3D microstructure of the fascicular groups of 5 cm common peroneal nerve was reconstructed using Amira 3.1 3D reconstruction software. Results Based on microanatomy and the results of acetylchol inesterase staining, this segmented common peroneal nerve functional fascicles was divided into sensory tract, motor tract, mixed tract and motor-predominating mixed tract. The cross merging was not evident in the nerve fascicles between deep peroneal nerve and superficial peroneal nerve, but existed within the functional fascicles of the deep peroneal nerve and the superficial peroneal nerve. The results of 3D reconstruction reflected the 3D structure of peripheral nerve and its interior functional fascicles factually, which displayed solely or in combination at arbitrary angles. Conclusion Based on serial histological sections and computer technology, the 3D microstructure of short-segment peripheral nerve functional fascicles can be reconstructed satisfactorily, indicating the feasibil ity of building 3D reconstruction of long-segmental peripheral nerve functional fascicles.
Objective To observe the plastic changes of sensory nerve in terms of structure and function when targetorgan changed through making the rat model of nerve regeneration by anastomosing the proximal end of sensory nerve and the distal end of motor nerve. Methods Thirty adult SD rats (male or female), weighing 200-250 g, were randomized into three groups (n=10 per group). The left upper l imb of the each rat was used as the experimental side, while the right upper l imb as the control side. In group A, the medial antebrachial cutaneous nerve was cut 5 mm away from its origin and its proximal end was anastomozed end-to-end to the distal end of musculocutaneous nerve. In group B, the musculocutaneous nerve was cut 5 mm away from its nerve entry point and the proximal end of medial antebrachial cutaneous nerve were anastomozed end-to-end to the distal end of musculocutaneous nerve. In group C, medial antebrachial cutaneous nerve and musculocutaneous nerve were cut, without further anastomosis. Twenty-four weeks after operation, the general condition and the motion of the elbow joint of rats, the wet weight and muscle fiber cross-section area of the biceps brachii as well as the latent period and the ampl itude of the evoked potential were observed and the acetylchol inesterase (AchE) staining of nerve of proximal end of anastomosis was conducted. Results All the rats survived for 24 weeks with good general condition and without wound infection. The rats in groups A, B and C were lost the active flexion of left elbow joint after operation. The rats in groups A and B got recovered to some degree at 24 weeks. The behavioral evaluation showed that there were 7 l imbs in group A and 5 l imbs in group B scoredas 4-5 points, there was a significant difference when compared with group C (P lt; 0.05), but there was no significant difference between group A and group B (P gt; 0.05). Group A and group B were superior to group C in terms of the wet weight and the muscle fiber cross-section area of the biceps brachii (P lt; 0.05), but no significant difference between group A and group B was detected (P gt; 0.05). The evoked potential of the biceps brachii and motor nerve fibers in proximal end of anastomosis could be detected in both group A and group B. But there was no significant difference between group A and group B with respects of function recovery of elbow joint, the latent period and the ampl itude of the evoked potential of the biceps brachii and the quantity of motor nerve fiber in proximal end of anastomosis (P gt; 0.05). Conclusion The change of target organ leads to the sensory nerve plasticity structurally and functionally, which may provide a new approach for peripheral nerve repair.
In order to explore the histochemical changes in retina after intravitreal injection of gentamycin,a histochemical quantitative analysis of cytochrome oxidase(CYO)and acetylcholinesterase(ACHE)was performed with a computerized image analysis system and was compared with that of morphological study.The results showed that CYO decreased significantly in 100mu;g dosage group.With increasing intravitreal gentamycin dosage or observed days,CYO decreased gradually in all rabbits.In 100~500mu;g dosage groups,ACHE changed mildly at 3 days of injection.It decreased significantly at 7 days.However,it was destroyed completely in 1000~3000mu;g dosage groups at 3 days. （Chin J Ocul Fundus Dis,1994,10:232-235）
Objective To formulate an optimal treatment for patients with acute organophosphorus pesticide poisoning through the evidence-based approach. Methods Based on the clinical questions raised from a real-life patient of acute organophosphorus pesticide poisoning (OP poisoning) in Emergency ICU (EICU), we searched ACP journal club (1991-April, 2006), The Cochrane Library (Issue 1, 2006), MEDLINE (1966-May 2006) and Chinese Biological Medical Database(1978-May 2006) for systematic reviews , clinical randomized controlled trials, cohort and case-control studies using the keywords of “organophosphorus compounds, poisoning, insecticides, oximes, cholinesterase reactivators, and intermediate syndrome”. The quality of the included studies was assessed. Results One Cochrane systematic review and one meta-analysis were included. These two studies concluded that there was no clear evidence on the benefits of oximes for acute organophosphorus pesticide poisoning. Based on the current evidence, integrated with clinical expertise and the patients’ values, the oximes were not used for this patient, only low-dose atropine was administered with other supportive therapies. After one week of treatment, the patient was discharged since her vital signs were stable and clinical symptoms were relieved. Conclusions The appropriate management for acute organophosphorus pesticide poisoning has been formulated with the approach of evidence-based medicine. Large-scale, methodologically-sound trials are required.
【摘要】 目的 探讨脓毒血症患者胆碱酯酶水平与患者病情及预后的关系。 方法 2007年6月-2009年6月，将89例脓毒血症患者设定为脓毒血症组，进行血清胆碱酯酶测定及APACHEⅡ评分；另择82例健康人为正常组，测定血清胆碱酯酶值，比较两者之间差异；89例脓毒症患者按病况再分为存活组及死亡组，比较两者之间血清胆碱酯酶及APACHEⅡ评分差异。 结果 治疗前脓毒血症组胆碱酯酶水平明显低于正常组，有统计学意义（Plt;0.01）；脓毒血症组APACHEⅡ评分与血清胆碱酯酶呈负相关；死亡组APACHEⅡ评分明显高于存活组，而血清胆碱酶低于存活组（Plt;0.01）。 结论 胆碱酯酶同APACHEⅡ评分呈负相关，能明显反映脓毒症患者病情严重程度及预后。【Abstract】 Objective To explore the relationship between the level of cholinesterase and the patients condition and the prognosis in the patients with sepsis. Methods From June 2007 to June 2009, 89 patients with sepsis were selected as the sepsis group, whose cholinesterase level was assayed and evaluated by APACHE Ⅱ score. Another 82 healthy people were as the control whose cholinesterase level was assayed and compared with that in the sepsis group. The patients in the sepsis group were subdivided into survival and death group; the level of cholinesterase and the result of APACHE Ⅱ score were compared between the two groups. Results The level of cholinesterase in sepsis group was significantly lower than that in the control group before treatment, and the difference was significant (Plt;0.01); the APACHE Ⅱ score negatively correlated with the serum cholinesterase in sepsis group. The APACHE Ⅱ score in the death group was significantly higher than that in the survival group, but the level of cholinesterase was obviously lower in the death group than that in the survival group (Plt;0.01). Conclusion The serumal cholinesterase negatively correlates with the APACHE Ⅱ score, which could obviously reflect the patients condition and the prognosis of sepsis.