Vitamin B complex and vitamin B12 levels after peripheral nerve injury

The aim of the present study was to evaluate whether tissue levels of vitamin B complex and vitamin B12 were altered after crush-induced peripheral nerve injury in an experimental rat model. A total of 80 male Wistar rats were randomized into one control（n = 8） and six study groups（1, 6, 12, 24 hours, 3, and 7 days after experimental nerve injury; n = 12 for each group）. Crush-induced peripheral nerve injury was performed on the sciatic nerves of rats in six study groups. Tissue samples from the sites of peripheral nerve injury were obtained at 1, 6, 12, 24 hours, 3 and 7 days after experimental nerve injury. Enzyme-linked immunosorbent assay results showed that tissue levels of vitamin B complex and vitamin B12 in the injured sciatic nerve were significantly greater at 1 and 12 hours after experimental nerve injury, while they were significantly lower at 7 days than in control group. Tissue level of vitamin B_（12） in the injured sciatic nerve was significantly lower at 1, 6, 12 and 24 hours than in the control group. These results suggest that tissue levels of vitamin B complex and vitamin B12 vary with progression of crush-induced peripheral nerve injury, and supplementation of these vitamins in the acute period may be beneficial for acceleration of nerve regeneration.

Loss of Aβ-nerve endings associated with the Merkel cell-neurite complex in the lesional oral mucosa epithelium of lichen planus and hyperkeratosis

The Merkel cell-neurite complex initiates the perception of touch and mediates Ap slowly adapting type I responses. Lichen planus is a chronic inflammatory autoimmune disease with T-cell-mediated inflammation, whereas hyperkeratosis is characterized with or without epithelial dysplasia in the oral mucosa. To determine the effects of lichen planus and hyperkeratosis on the Merkel cell-neurite complex, healthy oral mucosal epithelium and lesional oral mucosal epithelium of lichen planus and hyperkeratosis patients were stained by immunohistochemistry （the avidin-biotin-peroxidase complex and double immunofluorescence methods）using pan cytokeratin, cytokeratin 20 （K20, a Merkel cell marker）, and neurofilament 200 （NF200, a myelinated Aβ- and Aδ-nerve fibre marker） antibodies. N F200-immunoreactive （ir） nerve fibres in healthy tissues and in the lesional oral mucosa epithelium of lichen planus and hyperkeratosis were counted and statistically analysed. In the healthy oral mucosa, K20-positive Merkel cells with and without close association to the intraepithelial NF200-ir nerve fibres were detected. In the lesional oral mucosa of lichen planus and hyperkeratosis patients, extremely rare NF200-ir nerve fibres were detected only in the lamina propria. Compared with healthy tissues, lichen planus and hyperkeratosis tissues had significantly decreased numbers of NF200-ir nerve fibres in the oral mucosal epithelium. Lichen planus and hyperkeratosis were associated with the absence of Aβ-nerve endings in the oral mucosal epithelium. Thus, we conclude that mechanosensation mediated by the Merkel cell-neurite complex in the oral mucosal epithelium is impaired in lichen planus and hvperkeratosis.

Neuronal changes resulting in up-regulation of alpha-1 adrenoceptors after peripheral nerve injury

Under normal conditions, the sympathetic neurotransmitter noradrenaline inhibits the production and release of pro-inflammatory cytokines. However, after peripheral nerve and tissue injury, pro-inflammatory cytokines appear to induce the expression of the alphalA-adreno- ceptor subtype on immune cells and perhaps also on other cells in the injured tissue. In turn, noradrenaline may act on up-regulated alphal-adrenoceptors to increase the production of the pro-inflammatory cytokine interleukin-6. In addition, the release of inflammatory mediators and nerve growth factor from keratinocytes and other cells may augment the expression of alphal-adrenoceptors on peripheral nerve fibers. Consequently, nociceptive afferents acquire an abnormal excitability to adrenergic agents, and inflammatory processes build. These mechanisms could contribute to the development of sympathetically maintained pain in conditions such as post-herpetic neuralgia, cutaneous neuromas, amputation stump pain and complex regional pain syndrome.

Evaluation of peripapillary retinal nerve fiber layer, macula and ganglion cell thickness in amblyopia using spectral optical coherence tomography

AIM:To investigate peripapillary retinal nerve fiber layer (RNFL), macula and ganglion cell layer thicknesses (GCC) in amblyopic eyes with spectral domain optical coherence tomography (SD-OCT). METHODS:Thirty six patients with a history of unilateral amblyopia and thirty two children who had emmetropia without amblyopia were included in this study. In this institutional study, 36 eyes of 36 patients with amblyopia (AE), 36 fellow eyes without amblyopia (FE), and 32 eyes of 32 normal subjects (NE) were included. RNFL, GCC and macular thickness measurements were performed with RS-3000 OCT Retina Scan (Nidek Inc CA. USA). RESULTS:The mean global thicknesses of the RNFL were 113.22 ±21.47, 111.57 ±18.25, 109.96 ±11.31μm in the AE, FE, and NE, respectively. There was no statistically significant difference for mean global RNFL thickness among the eyes (P =0.13). The mean thicknesses of the macula were 258.25±18.31, 258.75±19.54, 248.62±10.57μm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of macula among the eyes (P =0.06). The GCC was investigated into two parts:superior and inferior. The mean thicknesses of superior GCC were 102.57 ±13.32, 103.32 ±10.64, 100.52 ± 5.88μm in the AE, FE, and NE, respectively. The mean thicknesses of inferior GCC were 103.82 ±12.60, 107.82 ± 12.33, 105.86±10.79μm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of superior and inferior GCC between the eyes (P =0.63, P =0.46). ·CONCLUSION:The macular thicknesses of AE and FE were greater than the NE, although it was not statistically significant. Amblyopia does not seem to have a profound effect on the RNFL, macula and GCC.

TRH microinjection into DVC enhances motility of rabbits gallbladder via vagus nerve

AIM To investigate the effects of TRH in DVC on motility of the gallbladder in rabbits. METHODS After fasted for 15h - 18h , rabbits were anesthetized with urethane (1 0g/kg) . Gallbladder pressure (GP) was measured by a frog bladder perfused with normal saline. RESULTS After microinjection of TRH (8 8nmol, 1μl ) into DVC, GP was raised and the frequency of phasic contraction of gallbladder (FPCGB) increased. All the doses of TRH (0 13, 0 25, 0 50, 0 80, 1 30nmol , 1μl ) injected into DVC could excite the motility of gallblader. As the dose of TRH was enlarged, the amplitude and duration of the reaction increased. Effects of TRH in DVC on motility of the gallbladder could be completely abolished by atropine ( 0 2mg/g , i.v.) or vagotomy, but could not be inhibited by phentolamine iv (1 5mg/g) or propranolol iv (1.5mg/g) or by transecting the spinal cord. CONCLUSION Thyrotropin releasing hormone in DVC can excite motility of gallbladder. This effect was mediated by vagus nerves and peripheral M receptor. Its physiological significance may be related to maintaining the phasic contraction of gallbladder in interdigestive period.

Neurotoxicity of prenatal alcohol exposure on medullary pre-B?tzinger complex neurons in neonatal rats

Prenatal alcohol exposure disrupts the development of normal fetal respiratory function, but whether it perturbs respiratory rhythmical discharge activity is unclear. Furthermore, it is unknown whether the 5-hydroxytryptamine 2A receptor（5-HT2AR） is involved in the effects of prenatal alcohol exposure. In the present study, pregnant female rats received drinking water containing alcohol at concentrations of 0%, 1%, 2%, 4%, 8% or 10%（v/v） throughout the gestation period. Slices of the medulla from 2-day-old neonatal rats were obtained to record respiratory rhythmical discharge activity. 5-HT2 AR protein and m RNA levels in the pre-B？tzinger complex of the respiratory center were measured by western blot analysis and quantitative RT-PCR, respectively. Compared with the 0% alcohol group, respiratory rhythmical discharge activity in medullary slices in the 4%, 8% and 10% alcohol groups was decreased, and the reduction was greatest in the 8% alcohol group. Respiratory rhythmical discharge activity in the 10% alcohol group was irregular. Thus, 8% was the most effective alcohol concentration at attenuating respiratory rhythmical discharge activity. These findings suggest that prenatal alcohol exposure attenuates respiratory rhythmical discharge activity in neonatal rats by downregulating 5-HT2 AR protein and m RNA levels.

Chitosan/PLGA-based tissue engineered nerve grafts with SKP-SC-EVs enhance sciatic nerve regeneration in dogs through miR-30b-5p-mediated regulation of axon growth

Extracellular vesicles from skin-derived precursor Schwann cells(SKP-SC-EVs)promote neurite outgrowth in culture and enhance peripheral nerve regeneration in rats.This study aimed at expanding the application of SKPSC-EVs in nerve grafting by creating a chitosan/PLGA-based,SKP-SC-EVs-containing tissue engineered nerve graft(TENG)to bridge a 40-mm long sciatic nerve defect in dogs.SKP-SC-EVs contained in TENGs significantly accelerated the recovery of hind limb motor and electrophysiological functions,supported the outgrowth and myelination of regenerated axons,and alleviated the denervation-induced atrophy of target muscles in dogs.To clarify the underlying molecular mechanism,we observed that SKP-SC-EVs were rich in a variety of miRNAs linked to the axon growth of neurons,and miR-30b-5p was the most important among others.We further noted that miR-30b-5p contained within SKP-SC-EVs exerted nerve regeneration-promoting effects by targeting the Sin3a/HDAC complex and activating the phosphorylation of ERK,STAT3 or CREB.Our findings suggested that SKP-SC-EVs-incorporating TENGs represent a novel type of bioactive material with potential application for peripheral nerve repair in the clinic.

Development of BINOL-Si complexes with large stokes shifts and their application as chemodosimeters for nerve agent

Three fluorescent BINOL-Si complexes(FS1,FS2 and FS3)were rationally designed and synthesized to detect diethyl chlorophosphate(DCP),a mimic of lethal nerve agents.These three fluorescent probes showed green,yellow and orange fluorescence,respectively.Moreover,the series of fluorescent probes has the characteristics of fast response time(4 s),low detection limit(0.0097 mmol/L),high sensitivity and naked eye detection.More important,a fiber optic sensor capable of detecting DCP vapor in real time was also prepared for the first time,the lowest detection limits(down to 4.4 ppb)were all lower than that of the IDLH(immediately dangerous to life or health)concentration of Sarin(7.0 ppb).

妇科恶性肿瘤术后继发Ⅲ期下肢淋巴水肿的护理

总结采用腰交感神经阻滞术和综合消肿治疗对4例妇科恶性肿瘤术后继发Ⅲ期下肢淋巴水肿患者进行治疗的护理经验,包括腰交感神经阻滞术的护理、个性化皮肤护理、改良的徒手淋巴引流、多层绷带加压包扎、患肢功能锻炼、饮食管理等。经过腰交感神经阻滞术和综合消肿治疗后,出院时患者患肢各部分周径减少,体重下降,皮肤变软,肢体功能受限得到缓解,水肿症状得到了有效控制。

复杂岩性裂缝—孔隙型储层孔隙度计算方法研究

酒泉盆地青西坳陷青南凹陷柳沟庄—窟窿山构造下沟组储层岩性主要为低孔、低渗砂砾岩类和泥云岩类,岩石矿物成分复杂、泥质含量高、黄铁矿富集、裂缝类型及组合形式复杂,属典型复杂岩性裂缝—孔隙型储层。在这类复杂岩性裂缝—孔隙型储层中,自然伽马等测井曲线不能很好指示地层中的泥质含量,常规测井资料难以准确识别地层的岩石矿物成分,单条测井曲线与岩心孔隙度之间的关联度低,采用常规的孔隙度测井计算方法存在明显的缺陷,孔隙度计算精度远远不能满足储层评价和储量计算要求。文章利用岩心分析数据和测井信息等资料,采用3层BP神经网络进行学习训练,得到砂砾岩岩类和泥云岩岩类的孔隙度计算模型。利用该模型计算储层孔隙度,其结果与岩心分析孔隙度比较,平均误差小于1.5%,能满足储量计算要求。在实际应用中见到良好效果,孔隙度计算精度明显得到提高。

镜像疗法治疗高位脊髓损伤后上肢Ⅱ型复杂性局部疼痛综合征的有效性:自身交叉对照研究

背景:镜像疗法最早用于截肢术后患肢痛的治疗,研究显示该疗法对其他损伤引起的复杂性局部疼痛综合征有效,但针对高位脊髓损伤后3年余的上肢复杂性局部疼痛综合征患者还未见报道。目的:探讨镜像疗法对高位脊髓损伤后上肢Ⅱ型复杂性局部疼痛综合征患者疼痛缓解的有效性。方法:采用自身交叉对照的试验设计分别应用经皮电神经刺激、镜像盒对该高位脊髓损伤后上肢Ⅱ型复杂性局部疼痛综合征的患者进行为期2周和3周的疼痛治疗,2种干预手段之间的洗脱期为1周,随访时间为1个月。结果与结论:前2周的经皮电神经刺激治疗患者疼痛没有实质性缓解,甚至一度加重,而洗脱期(第3周)后经过3周的镜像治疗,患者的疼痛感受明显减轻;其汉密尔顿焦虑量表、汉密尔顿抑郁量表、世界卫生组织生活质量量表评分也较治疗前明显改善。表明镜像疗法作为复杂性局部疼痛综合征综合治疗的补充,可能是一种有效地减轻Ⅱ型复杂性局部疼痛综合征疼痛的康复手段,但仍需进一步研究来确证其疗效。

猴失神经手指神经植入后感觉终器的溃变与再生

目的：观察猴失神经手指感觉神经植入后感觉终器溃变与再生情况．方法：用猴手失神经模型，神经植入后在第１，３，５，８，１２ｍｏ分别取材进行电镜观察．结果：游离神经末梢其再生过程是：神经植入３ｍｏ真皮层出现新生的神经轴突．５ｍｏ时有髓和无髓纤维的数量明显增加．髓鞘增厚结构更加清晰．８ｍｏ～１２ｍｏ再生轴突逐渐成熟达正常水平．Ｍｅｒｋｅｌ细胞①感觉神经的植入能延迟Ｍｅｒｋｅｌ细胞溃变的发生．②感觉神经的植入使Ｍｅｒｋｅｌ细胞可以再生．③再生过程是：神经植入５ｍｏＭｅｒｋｅｌ细胞周围出现游离神经末梢，８ｍｏ时大部分Ｍｅｒｋｅｌ细胞获得神经支配．Ｍｅｉｓｓｎｅｒ小体失神经后逐渐萎缩被胶原纤维所代替．神经植入后３ｍｏ时小体周围开始出现无髓神经纤维并且开始向小体内部生长．５ｍｏ时已有部分小体获得神经支配，８ｍｏ时大部分小体获得神经支配，且小体尾端开始有幼稚的有髓神经纤维出现，１２ｍｏ未发现失神经支配的小体．环层小体、Ｒｕｆｆｉｎｉ小体、Ｋｒａｕｓｅ小体在神经植入后均可以获得神经再支配．结论：感觉神经植入后可以再生出５种感觉小体．神经植入后可延缓小体溃变，并最终使小体获得神经再支配．新生血管在神经再生中起重要作用．

颈椎旁注射脉络宁复合液配合仰卧位手法牵引治疗神经根型颈椎病临床观察

目的观察颈椎旁注射脉络宁复合液配合仰卧位手法牵引治疗神经根型颈椎病的临床疗效。方法将120例神经根型颈椎病患者按照随机方法分为中药组60例和激素组60例。两组患者分别采用脉络宁复合液和复方倍他米松注射液颈椎旁注射配合仰卧位手法牵引治疗,每周治疗1次,4次为1个疗程。观察两组患者治疗后临床疗效及疼痛情况,疼痛程度采用视觉模拟评分(VAS评分)评定。结果两组患者治疗后VAS评分与治疗前比较均有明显降低(P<0.05),且中药组患者治疗后VAS评分与激素组治疗后比较,降低更加明显(P<0.05)。中药组治愈率和总有效率与激素组比较,差异有统计学意义(P<0.05)。结论颈椎旁注射脉络宁复合液配合仰卧位手法牵引治疗神经根型颈椎病,充分发挥了中西医结合方法的优势,同时避免了使用激素的副作用,具有操作简单,见效快,效果好,副作用少等优点,为治疗神经根型颈椎病的有效方法之一。

3D-OCT对早期原发性青光眼黄斑区视网膜神经节细胞复合体及神经纤维层结构变化的评估

背景 视网膜神经纤维层（RNFL）变薄被认为是能够检测到的青光眼最早期的改变,3D-OCT对黄斑区神经节细胞复合体（mGCC）厚度的检测使得检测黄斑区节细胞的改变成为可能,为更早发现和诊断青光眼提供思路. 目的 利用3D-OCT检查系统检测早期原发性青光眼mGCC厚度及视盘周围RNFL厚度的变化,评估早期原发性青光眼视神经损害的解剖基础. 方法 对2010年12月至2012年12月在中日友好医院眼科就诊的一眼为中晚期而对侧眼为早期的原发性青光眼的10例患者采集的3D-OCT扫描图像进行回顾性分析.所有患者均符合1987年中国青光眼学组推荐的诊断标准,临床检查资料完整.患者均接受常规眼科检查和眼底3D-OCT检查,分别采用3D-macular模式、3D-macular Wide模式和3D-disc模式对原发性青光眼黄斑区、后极部和视盘进行扫描,利用检查系统自带软件对黄斑6 mm×6 mm区域的扫描结果进行分析,由黄斑中心凹向外各方向等距离分成100个小格区,每个格区面积为0.6 mm×0.6 mm,按照mGCC的变薄程度由重到轻依次以红色、黄色和灰色标记,以每个小格中的数字与其正常值比较得到与颜色匹配的、mGCC变薄程度发生的概率值（依次为P＜1％、P＜5％、P≥5％）表示.然后分析视盘旁RNFL厚度和不同部位的厚度曲线改变,并评估视盘生理凹陷的改变. 结果 10例患者患早期青光眼的眼和对侧眼视细胞层和双极细胞层厚度均未发生改变,而患中晚期青光眼的一侧眼视盘周围RNFL厚度概率图呈红色,即视盘周围RNFL层厚度明显变薄,mGCC厚度概率和黄斑区RNFL厚度概率图呈红色,即mGCC和黄斑区RNFL层厚度明显变薄;而患早期青光眼的一侧眼视野均正常,mGCC厚度概率图和黄斑区RNFL区呈黄色,即mGCC和黄斑区RNFL厚度轻微变薄;视盘周围RNFL厚度概率图呈绿色或黄色,即视盘周围RNFL厚度正常或轻微变薄.结论 原发性青光眼mGCC层厚度变薄早于视盘周围RNFL的变薄,提示青光眼视神经结构的损害始于RGCs的细胞体并早于轴突的损伤或丢失.

频域-OCT观测原发性闭角型青光眼患者视盘形态、视网膜神经纤维层及神经节细胞复合体的临床意义

目的应用频域-OCT观测原发性闭角型青光眼(primary angle closed glaucoma,PACG)患者视盘形态、视网膜神经纤维层(retinal nerve fiber layer,RNFL)及黄斑区神经节细胞复合体(ganglion cell complex,GCC),分析其与视野平均缺损(mean deviation,MD)的相关性。方法选取35例60眼PACG患者,根据视野损害程度分为早期及中晚期2组,与33例正常人进行频域-OCT对比检查。测量视盘形态学参数、整体平均RNFL厚度(RNFL-Avg)、上方平均RNFL厚度(RNFL-Sup)、下方平均RNFL厚度(RNFL-Inf)、整体平均GCC的厚度(GCC-Avg)、上方平均GCC厚度(GCC-Sup)、下方平均GCC厚度(GCC-Inf),并分析青光眼患者组视野MD与RNFL、GCC的相关性。结果视盘各形态学参数在各期PACG组与正常对照组间的差异具有统计学意义(视盘面积F=14.29、P=0.000;视杯面积F=11.31、P=0.000;盘沿面积F=6.27、P=0.002;盘沿容积F=10.41、P=0.000;视神经盘容积F=3.53、P=0.034;视杯容积F=10.99、P=0.000;杯盘比F=8.64、P=0.000;杯盘纵比F=3.14、P=0.048;杯盘横比F=4.20、P=0.012)。其中视盘面积差异表现为两个PACG组均较正常对照组大,而两个PACG组间差异无统计学意义;其他各参数表现为:中晚期PACG组的视杯面积、视杯容积、杯盘比均比正常对照组显著增大;而盘沿面积、盘沿容积和视神经盘容积均比正常对照组显著减小。增大及缩小的程度与正常对照组比较,差异均具有统计学意义,变化符合PACG神经损害的特点;而早期PACG组在上述参数中与正常对照组之间的差异均无统计学意义(均为P>0.05)。对RNFL及GCC的分析中,PACG组与正常对照组间的差异具有统计学意义(RNFL-Avg F=9.79、P=0.000;RNFL-Sup F=6.48、P=0.002;RNFL-Inf F=7.54、P=0.001;GCC-Avg F=6.62、P=0.002;GCC-Sup F=5.69、P=0.005;GCC-Inf F=6.45、P=0.003)。组间两两比较发现:中晚期PACG组上述各参数与正常对照组的差异具有统计学意义(均为P<0.05);而早期PACG组各参数与正常对照组间的差异无统计学意义(均为P>0.05)。中晚期PACG组RNFL和GCC均与MD呈明显的正相关(r=0.689 5,P=0.001;r=0.527 1,P=0.010);早期PACG组RNFL及GCC与MD无相关性(r=-0.208 4、P=0.244;r=0.200 1、P=0.281)。结论频域-OCT是一种比较敏感的能够观察到视网膜结构改变的检查方法,但其对于早期青光眼的诊断仍具有局限性。

下颌神经切断术后Ⅰ型囊泡膜谷氨酸转运体在大鼠三叉神经复合体中表达的变化

目的观察下颌神经切断术后不同存活时间I型囊泡膜谷氨酸转运体(VGluT1)样免疫阳性物质在大鼠三叉神经复合体中表达水平的变化。方法免疫细胞化学和图像分析技术。结果正常大鼠三叉神经复合体内可观察到大量的VGluT1样免疫阳性物质,且主要分布于终末内。切断一侧下颌神经后,手术侧与对照侧相比,术后存活1周组的Vp背侧部内VGluT1样阳性物质的表达有所下降(P<0.05);术后存活2周组的Vp背侧部、Vc背侧部、Vi背侧部,以及Vsup和Vmo内VGluT1样阳性物质的表达明显下降(P<0.01),且与术后存活1周组手术侧比较其下降有显著差异(P<0.05);术后存活3周组上述部位内VGIuT1样阳性物质表达的下降更加明显(P<0.01),且与前两组手术侧相比均有显著差异(P<0.01或P<0.05);其中在Vmo内的表达几乎完全消失。结论切断初级传入神经元的周围突可以导致其中枢突终末内VGluT1的表达水平下降;三叉神经复合体内部分VGIuT1样阳性终末来源于外周。

运脾中药复方制剂降低厌食大鼠下丘脑腹内侧区神经元的兴奋性

目的证实运脾中药复方儿宝颗粒降低厌食大鼠下丘脑腹内侧核(VMN)神经元对外周传入信号的敏感性.方法用特制饲料喂养大鼠1wk制备厌食模型,再用运脾复方灌胃治疗3wk,然后用细胞外记录法,记录大鼠VMN神经元的自发放电,观察其对电刺激胃迷走神经、静脉注射八肽胆囊收缩素(CCK-8)的反应,比较对照组、模型组和治疗组3组间的差异.结果模型组大鼠VMN神经元对胃迷走神经刺激的兴奋性反应时程延长(P<0.05),刺激强度降低(P<0.05),这些迷走兴奋的VMN神经元对静脉注射CCK的敏感率也增加(P<0.05);而治疗组大鼠VMN对胃迷走神经刺激和静脉注射CCK的反应与正常组无显著差异.结论运脾复方儿宝颗粒能够降低VMN神经元对外周传入的摄食负反馈信号的敏感性,从而达到促进食欲的目的.

神经节细胞复合体厚度检测在原发性开角型青光眼中的诊断价值

背景青光眼以损害视网膜神经节细胞（RGCs）继而出现视野缺损为特征，高分辨率频域OCT（SD-OCT）可以准确可靠地定量分析黄斑区视网膜神经节细胞复合体（GCC）厚度。目的探讨黄斑区GCC厚度对原发性开角型青光眼（POAG）的诊断意义。方法采用前瞻性诊断试验研究设计。于2015年11月至2016年4月在北京同仁医院连续纳入POAG患者70例和30名健康志愿者，应用RTVue SD—OCT对70例POAG患者和30名正常对照者进行黄斑区GCC厚度和视盘周围视网膜神经纤维层（RNFL）厚度检测，并行Humphrey视野检查，均纳入受检者的右眼进行统计。根据视野检查的平均缺损（MD）值将POAG分为早期、进展期和晚期，对各组受检眼平均GCC、上方GCC和下方GCC、平均RNFL、上方RNFL、下方RNFL、局部丢失体积（FLV）和整体丢失体积（GLV）进行比较；评估POAG患者GCC厚度、RNFL厚度与视野MD值的关系，采用曲线下面积（AUC）和受试者工作特征ROC曲线评价GCC厚度和RNFL厚度对POAG的诊断效率。结果与正常对照组比较，早期POAG组、进展期POAG组和晚期POAG组的平均GCC、上方GCC、下方GCC、平均RNFL、上方RNFL和下方RNFL均明显降低，FLV和GLV均明显升高，各组间总体比较差异均有统计学意义（均P〈0．001）；与早期POAG组比较，进展期POAG组和晚期POAG组受检眼平均GCC值和平均RNFL厚度值均明显下降，GLV值明显增加，差异均有统计学意义（均P〈0.05）；晚期POAG组受检眼上方RNFL厚度值明显低于早期POAG组，差异有统计学意义（P=0．003）；晚期POAG组受检眼上方GCC值明显低于早期POAG组和进展期POAG组，差异均有统计学意义（均P〈0.001）；与早期POAG组比较，进展期POAG组和晚期POAG组受检眼下方GCC和下方RNFL厚度值明显下降，FLV明显增加，差异均有统计学意义（均P≤0．01）。POAG患者平均GCC、上方GCC和下方GCC、平均RNFL、上方RNFL和下方RNFL与MD值均呈线性正相关（r=0．624、0．583、0．601、0．571、0．447、0．537，均P〈0.001）；POAG患者平均GCC与平均RNFL、上方GCC与上方RNFL以及下方GCC与下方RNFL均呈线性正相关（r=0．648、0．630、0．602，均P〈0.001）。平均GCC、上方GCC、下方GCC、FLV、GLV、平均RNFL、上方RNFL和下方RNFL的AUC值分别为0．965、0．924、0．979、0．985、0．980、0．990、0．979和0．992（均P〈0．001）。GCC参数中FLV与下方RNFL的AUC值比较，差异无统计学意义（P〉0．05）。结论POAG患者下方GCC厚度更容易受到损伤，GCC参数中FLV和GLV是诊断POAG的敏感指标，GCC厚度可以作为诊断和判断POAG病情进展的有效指标。

脉冲射频V_1与C_(2-3)后内侧支治疗额面部带状疱疹后神经痛

目的:评价第五对脑神经即三叉神经第一支(V1)联合颈2-3(C2-3)后内侧支脉冲射频治疗额面部带状疱疹后神经痛的疗效。方法:30名额面部带状疱疹后神经痛患者随机分为V1脉冲射频组(V组,n=15)和C2-3后内侧支联合V1脉冲射频组(C组,n=15)。比较两组治疗前、治疗后第1、7、14天、1、3、6个月的视觉模拟评分(visual analogue scale,VAS)及治疗的副作用;比较两组治疗前及治疗后第1、7、14天及1个月的曲马多日用量;比较两组治疗前、治疗后第1、3、6个月的匹兹堡睡眠质量指数(pittsburgh sleep quality index,PSQI)。结果:与治疗前比较,两组患者治疗后VAS值、曲马多日用量及PSQI评分均显著下降(P<0.05)。治疗后第1天,C组VAS值及曲马多日用量均明显低于V组(P<0.05);但随后各时点两组VAS值、曲马多日用量及PSQI评分差异均无统计学意义。两组患者均无明显不良反应。结论:对于额面部带状疱疹后神经痛患者,联合C2-3后内侧支脉冲射频可增强即时V1的射频镇痛效果,但远期疗效无区别。