Medicine in the future-with subspecialists in medullary neurology and brain dentistry

The solitary tract nucleus of the medulla with its limited watershed vascular capacity may occasionally be the focus of transient ischemia caused by the increased metabolic demands associated with frequent and intense neuronal stimulation from other organs and other parts of the brain. Case reports have suggested that these ischemic changes may sometimes result in the initiation of intense autonomic discharges, which can occasionally be fatal. Therapeutic interventions for the medulla oblongata are hamperedby its limited accessibility. Systemically administered pharmaceuticals may have some usefulness in future years. Previous experience with vagus nerve stimulation in the treatment of epilepsy suggests that it may have some usefulness in stabilizing medullary autonomic discharges. Computerized electronic stimulation of other cranial nerves may be helpful as well, especially the chorda tympani nerve, and may be most easily accomplished from implanted dental appliances, especially molar modules, transmitting signals via secondary transmitters procedurally placed on cranial nerves. Future technology may enable wireless signaling from the implanted dental appliance to the secondary transmitter placed at the nerve site. By the year 2050 subspecialists in medullary neurology and brain dentistry may use computerized electronic stimulation of cranial nerves to prevent sudden unexpected death and treat "chest pain from the brain".

Melanocortin-4 Receptor Expression in the Rostral Ventromedial Medulla Involved in Modulation of Nociception in Transgenic Mice

The rostral ventromedial medulla （RVM） is a prominent component of the descending modulatory system involved in the control of spinal nociceptive transmission. In the current study, we investigated melanocortin-4 receptor （MC4R） expression in the RVM, where the neurons involved in modulation of nociception reside. Using a line of mice expressing green fluorescent protein （GFP） under the control of the MC4R promoter, we found a large number of GFP-positive neurons in the RVM [nucleus raphe magnus （NRM） and nucleus gigantocellularis pars a （NGCa）]. Fluorescence immunohisto- chemistry revealed that approximately 10% of MC4R-GFP-positive neurons coexpressed tyrosine hydroxylase, indicating that they were catecholaminergic, whereas 50%-75% of those coexpressed tryp- tophan hydroxylase, indicating that they were serotonergic. Our findings support the hypothesis that MC4R signaling in RVM may modulate the activity of serotonergic sympathetic outflow sensitive to nociceptive signals, and that MC4R signaling in RVM may contribute to the descending modulation of nociceptive transmission.

Inhibition of Glial Activation in Rostral Ventromedial Medulla Attenuates Mechanical Allodynia in a Rat Model of Cancer-induced Bone Pain

Descending nociceptive modulation from the supraspinal structures plays an important role in cancer-induced bone pain (CIBP). Rostral ventromedial medulla (RVM) is a critical component of descending nociceptive facilitation circuitry, but so far the mechanisms are poorly known. In this study, we investigated the role of RVM glial activation in the descending nociceptive facilitation circuitry in a CIBP rat model. CIBP rats showed significant activation of microglia and astrocytes, and also up-regulation of phosphorylated p38 mitogen-activated protein kinase (p38 MAPK) and pro-inflammatory mediators released by glial cells (IL-1β, IL-6, TNF-α and brain-derived neurotrophic factor) in the RVM. Stereotaxic microinjection of the glial inhibitors (minocycline and fluorocitrate) into CIBP rats’ RVM could reverse the glial activation and significantly attenuate mechanical allodynia in a time-dependent manner. RVM microinjection of p38 MAPK inhibitor (SB203580) abolished the activation of microglia, reversed the associated up-regulation of proinflammatory mediators and significantly attenuated mechanical allodynia. Taken together, these results suggest that RVM glial activation is involved in the pathogenesis of CIBP. RVM microglial p38 MAPK signaling pathway is activated and leads to the release of downstream pro-inflammatory mediators, which contribute to the descending facilitation of CIBP.

Fos expression incatecholaminergic medullary neu-rons induced by chemical stimulation of stomach projecting to the paraventricular nucleus of hypothalamus in rats

AIM To determine whether medullary catecholaminergic neurons expressing Fos induced by chemical stimulation of the stomach project to the paraventricular nucleus of hypothalamus (PVH) in rats. METHODS A triple labeling method of horseradish peroxidase (HRP) retrograde tracing combined with Fos (ABC method) and tyrosin hydroxylase (TH) (PAP method) immunohistochemical stainings was used in the present study. RESULTS Seven kinds of labeled neurons were found in the nucleus tractus solitarii (NTS), the ventrolateral medulla (VLM) and the reticular formation of the medulla (RF): Fos like immunoreactive (LI) neurons, TH LI neurons and HRP retrogradely single labeled neurons, Fos/HRP, Fos/TH and HRP/TH double labeled neurons, and Fos/HRP/TH triple labeled neurons. CONCLUSION Ascending projections from the NTS, VLM and RF to the PVH might be involved in the transmitting process of the visceral noxious stimulation.

Downregulation of AQP2 and AQP2 mRNA expression in kidney medulla of rats with bile duct ligation

BACKGROUND: Obstructive jaundice is a common disease. Acute renal injury, secondary to obstructive jaundice, is one of the main causes of postoperative multiple system failure. This investigation evaluated renal function and renal aquaporin 2 (AQP2) expression changes in obstructive jaundice. METHODS: Forty male Wistar rats were equally randomized into two groups. Twenty in the obstructive jaundice group were subjected to common bile duct ligation, and then were subdivided into 7- and 14-day obstruction groups, and the other 20 sham-operated rats were also subdivided into 7- and 14-day groups. At the end of each experiment, rats were sacrificed, venous blood was collected from the inferior vena cava, and serum creatinine and urine nitrogen concentrations were measured. At the same time, the medulla of the right kidney was separated and AQP2 expression was assessed. The RT-PCR technique was used to detect AQP2 mRNA expression. RESULTS: Ligation of the common bile duct caused significant rises in serum bilirubin, creatinine clearance and urine nitrogen. AQP2 expression in the medulla decreased mere significantly (38.35 +/- 2.08) in the 7-day ligation group than in the sham-operated group (41.06 +/- 1.04), as did that in the 14-day ligation group, even more than (31.89 +/- 1.57). The expression of AQP2 mRNA also decreased more significantly in the 14-day group (0.5429 +/- 0.1107) than in the 7-day group (0.6071 +/- 0.1328). CONCLUSION: AQP2 expression is inhibited in obstructive jaundice, and so is its gene expression.

GFAP and Fos immunoreactivity in lumbo-sacral spinal cord and medulla oblongata after chronic colonic inflammation in rats

AIM： To investigate the response of astrocytes and neurons in rat lumbo±sacral spinal cord and medulla oblongata induced by chronic colonic inflammation, and the relationship between them. METHODS： Thirty-three male Sprague-Dawley rats were randomly divided into two groups： experimental group （n = 17）, colonic inflammation was induced by intra-luminal administration of trinitrobenzenesulfonic acid （TNBS）; control group （n = 16）, saline was administered intra-luminally. After 3, 7, 14, and 28 d of administration, the lumbo-sacral spinal cord and medulla oblongata were removed and processed for anti-glial fibrillary acidic protein （GFAP）, Fos and GFAP/Fos immunohistochemistry. RESULTS： Activated astrocytes positive for GFAP were mainly distributed in the superficial laminae （laminae Ⅰ-Ⅱ） of dorsal horn, intermediolateral nucleus （laminae Ⅴ）, posterior commissural nucleus （laminae Ⅹ） and anterolateral nucleus （laminae Ⅸ）. Fos-IR （Fos-immunoreactive） neurons were mainly distributed in the deeper laminae of the spinal cord （laminae Ⅲ-Ⅳ, Ⅴ-Ⅵ）. In the medulla oblongata, both GFAP-IR astrocytes and Fos-IR neurons were mainly distributed in the medullary visceral zone （MVZ）. The density of GFAP in the spinal cord of experimental rats was significantly higher after 3, 7, and 14 d of TNBS administration compared with the controls （50.44±16.8, 29.24±6.5, 24.14±5.6, P〈0.05）. The density of GFAP in MVZ was significantly higher after 3 d of TNBS administration （34.34±2.5, P〈0.05）. After 28 d of TNBS administration, the density of GFAP in the spinal cord and MVZ decreased and became comparable to that of the controls （18.04±4.9, 14.64±6.4, P〉0.05）. CONCLUSION： Astrocytes in spinal cord and medulla oblongata can be activated by colonic inflammation. The activated astrocytes are closely related to Fos-IR neurons. With the recovery of colonic inflammation, the activity ofastrocytes in the spinal cord and medulla oblongata is reduced.

Primary clear cell sarcoma of soft tissue in the posterior cervical spine invading the medulla oblongata:A case report

BACKGROUND Clear cell sarcoma(CCS)is a rare and highly malignant soft tissue tumor,usually occurring in the deep soft tissues of the distal tendons and aponeurosis of the extremities,especially the feet and knees.CCS originating in the head and neck is extremely rare.The clinical manifestations of CCS in the head and neck are not typical,and the imaging manifestations have certain characteristics,but the diagnosis still depends on pathological examination and genetic testing.CASE SUMMARY A 33-year-old male patient had paroxysmal headache for more than 4 years,accompanied by nausea and vomiting,which could be relieved after rest.Computed tomography angiography showed a left paraspinal soft tissue mass.Contrast-enhanced imaging showed obvious uneven enhancement with adjacent bone lytic destruction.Magnetic resonance imaging examination showed isosignal on T_(1)-weighted images,slightly high signal on T_(2)-weighted images(T_(2)WI),high signal on Tirm fat suppression sequence,significantly high signal on diffusion weighted imaging,and obvious and uneven enhancement.The lesion invaded the anterior medulla oblongata through the left atlantoaxial foramen and compressed the cervical spinal cord on T_(2)WI.Primary CCS of soft tissue was diagnosed by pathology and genetic examination.CONCLUSION CCS should be considered in the differential diagnosis of soft tissue tumors of the head and neck,and their diagnosis depends on pathological examination and genetic testing.

Motor recovery in a patient with an infarct in the medullary pyramid via the corticospinal tract passing through the small spared area within the infarcted medullary pyramid

The present study reported a 58-year-old male patient who exhibited complete paralysis of the right extremities at stroke onset.Brain MR images showed an infarct in the left medullary pyramid and a small spared area on the medial side of the infarct.He gained the ability to extend the affected fingers against gravity and to dorsiflex the affected ankle without gravity at 3 months after stroke onset.Diffusion tensor imaging results showed that at 6 months after stroke onset,the corticospinal tract of the affected（left） hemisphere descended through the small spared area of the infarcted medullary pyramid.No motor-evoked potential was elicited from the affected（left） hemisphere at 2 weeks after stroke onset; however,motor-evoked potential was elicited at 6 months as shown by transcranial magnetic stimulation results.The motor function of the affected side of this patient appears to have been recovered via the corticospinal tract that passed through the small spared area within the infarcted medullary pyramid.

Postsynaptic responses of the thoracic sympathetic preganglionic neurons to electrical stimulation of the rostral ventrolateral medulla in cats

Objective: To study the characteristics of the postsynaptic potentials in thoracic sympatheticpreganglionic neurons (SPNs) evoked by electrical stimulation of the rostral ventrolateral medulla (RVLM ) incats. Methods: In 11 α--chloralose/urethane anesthetized, artificially ventilated cats, intracellular recordings weremade from T, spinal cord with microelectrodes filled with 3 mol/L KCl. SPNs were identified by antidromicstimulation of the T3 white ramus. Results: Twenty--four SPNs were recorded, the resting membrane potentials ofwhich ranged between -- 45 -- -- 90 mV. The onset latency and threshold of the antidromic action potentialsaveraged (6. 48 + 0. 89) ms and (2. 86 + 0. 37) V respectively. Single pulse (0. 2 ms. 50-- 300 PA) electricalstimulation of RVLM evoked fast excitatory postsynaptic potentials (eEPSPs) with short latencies (4--47 ms) inall the 24 SPNs. In 11 of the SPNs, EPSPs with longer latencies (IEPSPs, 70-- 140 ms) were also recorded. Mostof the eEPSPs and some of the IEPSPs were typical monosynaptic EPSPs as they were of constant onset latency.Conclusion: The results provided direct physiological evidence for that some RVLM sympathoexcitatory neuronsproject monosynaptically to thoracic SPNs. The descending pathways from RVLM may consist of two distinctgroups of fibers, the conduction velocities were calculated to be 5--25 m/s and 0. 78-- 1. 6 m/s respectively.

Electron microscopic radioautographic study on mitochondrial RNA synthesis in adrenal cortical and medullary cells of aging mice

In order to study the aging changes of intramito-chondrial RNA synthesis of mouse adrenal cells, 10 groups of developing and aging mice, each consisting of 3 individuals, total 30, from fetal day 19 to postna-tal newborn at day 1, 3, 9, 14, adult at month 1, 2, 6 and senescent animals at month 12 (year 1) and 24 (year 2) were injected with 3H-uridine, an RNA pre-cursor, sacrificed 1 hr later and the adrenal tissues were fixed and processed for electron microscopic radioautography. On electron microscopic radio-autograms obtained from each animal, the number of mitochondria per cell, the number of labeled mito-chondria with 3H-uridine showing RNA synthesis per cell and the mitochondrial labeling index in each adreno-cortical cells, in 3 zones, as well as in each adreno-medullary cells, 2 types of cells in the medulla, the adrenalin cells and the noradrenalin cells, were calculated and the results in respective aging groups were compared with each others. The results demon-strated that the number of mitochondria in adreno-cortical cells in 3 zones, the zona glomerulosa, fasciculata and reticularis of respective mice at vari-ous ages increased from fetal day 19 to postnatal month 1 reaching the plateau from month 1 to 24 due to development and aging of animals, respectively, while the number of labeled mitochondria per cell and the labeling index of intramitochondrial RNA synthesis incorporating 3H-uridine increased from fetal day 19 to postnatal month 2, reaching the maxima and decreased slightly from month 6 to month 24. On the other hand, the number of mito-chondria per cell in the medulla increased from fetal day 19 to postnatal month 1 reaching the plateau from month 1 to 24, while the number of labeled mi-tochondria per cell and the labeling index of in-tramitochondrial RNA synthesis increased from fetal day 19 to postnatal day 14, reaching the maxima and decreased from month 1 to 24. From the results, it was demonstrated that the activity of intramitochno-drial RNA synthesis in both the cortical and me-dullary cells in developing and aging mice adrenals changed due to aging of individual animals.

Adrenomedullary Function in Cohort of Brazilian Pediatric Patients with Classic Congenital Adrenal Hyperplasia

Congenital Adrenal Hyperplasia is a group of autosomal recessive disorders resulting from deficiency of enzymes essential for the synthesis of cortisol.Disease of the adrenal cortex,but there may be involvement adrenomedullary.Cortisol and epinephrine are directly related to the individual’s stress response.Lower values of epinephrine in children with congenital adrenal hyperplasia could be related to increased clinical complications and hospitalizations rate.We evaluated the serum values of metanephrines and normetanephrines in children and adolescents with classic congenital adrenal hyperplasia and primary hypothyroidism and possible correlations with disease and hospitalizations.Cross-sectional study involved 29 patients(10 simple virilizing and 19 salt-wasting),and control group of 28 patients with primary hypothyroidism(10 overt and 18 subclinical).There were no differences in age(p=0.24)and metanephrine(p=0.34)or normetanephrine values(p=0.85)between groups.Hospitalization rate was higher in the cases than in the controls(51 x 12).We conclude the serum values of metanephrine and normetanephrine in patients with congenital adrenal hyperplasia were within the normal values of reference,with no significant difference of group with primary hypothiroidism.The number of hospitalizations in the case was high in relation to the control,mainly in salt-wasting.

Prognostic analysis of intramedullary ependymomas in medulla oblongata and cervical cord

Objective To analyze factors affecting operative prognosis of intramedullary ependymomas in medulla oblongata and cervical cord. Methods Thirty patients harboring intramedullary ependymomas in medulla oblongata and cervical cord were operated. The preoperative and postoperative status was taken by follow-up and

Identification of Motor Nuclei in the Medulla Oblongata of Carp for Biological Control

Brain-controlled technology is the key technology in biological control,and the corresponding relationship between animal brain nuclei and motor behavior is the core.The purpose of this study was to explore the motor nuclei of the medulla oblongata in carp.The carps were subjected to electrical stimulation and chemical stimulation experiments,respectively,in the water-free state,and the effective chemical stimulation sites were injected with the pontamine sky blue solution.The brain tissue sections were obtained by paraffin tissue section technology and the neutral red staining method.By comparing the positions of the brain nuclei shown in earlier studies,the motor nerve nuclei in the medulla oblongata were identified.The brain electrode was implanted into the motor nucleus of the medulla oblongata,and the underwater control experiment and behavioral tests were carried out with different electrical stimulation parameters.The results showed that the abducens nucleus(NVI)was the motor nucleus that controls the ipsilateral steering,and the facial nucleus(NVII)was the motor nucleus that controls the forward movement.By adjusting the stimulation voltage and the stimulation pulse number,the carp can be stably controlled to achieve a left–right steering motion of 30°–180°and a forward motion of more than 80 cm/s.This study indicated that the quantitative control of the steering and forward behavior of the carp can be achieved by electrical stimulation of the NVI and NVII,which provided a certain experimental basis for the accurate control of the carp robot.

Role of the area postrema of medulla oblongata in the regulation of canine interdigestive migrating motor complex

OBJECTIVE: To determine the effect of the area postrema (AP) of the medulla oblongata on gastrointestinal interdigestive migrating motor complex (MMC) and the plasma motilin level. METHODS: Interdigestive MMC activities of the antrum and duodenum were recorded by strain gauge implanted on the serosa of 8 conscious dogs. A cannula was intubated in femoral vein for motilin injection. The plasma motilin concentration was measured by RIA. We observed: (1) normal interdigestive MMC activity and fluctuations in plasma motilin concentration; (2) the effects of electrically damaging the AP on MMC activity and plasma motilin level; (3) whether intravenous injection of motilin could induce phase III contractions after the AP was destroyed. RESULTS: (1) Typical interdigestive MMC with phase I, II, III, and IV was recorded in normal dogs. Phase III was concurrent with the peak of plasma motilin level. (2) In damaged AP dogs, antroduodenal interdigestive MMC contractions were suppressed; cyclic, phasic and migratory pattern of MMC was disrupted. Plasma motilin concentration was decreased. Intravenous injection of motilin could not induce phase III contractions. CONCLUSIONS: The area postrema might play an important role, which is mediated by motilin, on the regulation of interdigestive MMC.

Morphology of the medullary visceral zone

Since 1990, a series of studies on rats, monkeys and human foetus showed that an arcshaped zone is present in the middle-caudal segment of medulla oblongata, running from the dorsomedial part to the ventrolateral part and passing through the reticular formation. It was named the medullary visceral zone (MVZ). The MVZ has been investigated with various techniques (Golgi method, Nissl method, immunohistochemical method, in situ hybridization method, triple labelling method, neurophysiological method, etc. ), and the morphological features as well as the physiological functions of MVZ have been preliminarily understood. It is proved that the medullary life center is located in MVZ.An introduction and some comments are given on the location of MVZ, its shape and extent, cytoarchitecture, and chemicoarchitecture, afferent and efferent fiber connections and their functions, and its important physiological functions.

内耳三维真实重建反转恢复成像与突发性聋预后

目的分析突发性聋(突聋)患者的内耳三维真实重建反转恢复(three dimensional real inversion recovery,3D Real IR)成像表现,探讨内耳不同信号强度与突聋预后的关系。方法选取2022年9月25日—2023年4月10日郑州大学第五附属医院耳鼻咽喉科住院治疗及门诊治疗的单侧突聋患者60例,按照听力曲线将患者分为低频下降型4例、高频下降型1例、平坦下降型34例和全聋型21例。由于平坦下降型和全聋型治疗方法一致,将平坦下降型和全聋型的55例患者按治疗有效与否分为无效组25例和有效组30例;按治疗前听力分级,分为轻度听力损失组11例、中度听力损失组7例、重度听力损失组16例和极重度听力损失组21例;根据听力下降与否分为患耳组55耳和健耳组55耳。比较患耳和健耳的耳蜗信号强度,并测量延髓信号强度,分别计算耳蜗/延髓(cochlea/medulla ratio,CM)比值,分析耳蜗信号强度与治疗结果之间关系。结果无效组CM比值明显高于治疗有效组,差异有统计学意义(P<0.001);患耳组与健耳组CM比值比较,差异有统计学意义(P<0.05)。轻度、中度、重度和极重度听力损失组患耳CM比值比较(2.57±3.02 vs 1.77±0.87 vs 2.04±1.98 vs 2.51±2.33),差异无统计学意义(F=0.304,P=0.823)。结论内耳3D Real IR可显示突聋患者血-迷路屏障通透性的改变,CM比值可以更精确了解突聋患者内耳受损的程度,CM比值大小与听力损失程度并不一致,可以单独作为一种判断突聋预后的因素。突聋患者CM比值高于1.58提示可能预后不良。

昆虫视叶结构与功能的研究进展

视觉在昆虫飞行、识别寄主和配偶,及寻找产卵位点等行为中起着重要的作用。视叶是昆虫脑内视觉中枢,具有复杂的解剖结构和神经元构成模式,并在接受整合视觉信息方面起重要作用,但具体的视觉神经回路及机制尚未被阐明。本文系统综述了视叶解剖结构类型及神经元构成、及在颜色识别、偏振光检测和运动检测功能等方面的研究进展,提出视叶未来的研究方向,旨在为深入开展基于视觉的昆虫对环境的适应性机制及害虫行为调控提供科学依据。

原发性延髓“心”形出血1例报道

临床上延髓出血是少见的脑出血类型,在文献中多以个案报道形式呈现,而双侧延髓内侧出血更为少见。本文介绍了1例老年男性患者,既往高血压病史多年,平日血压控制不佳,此次以“头晕、头痛伴恶心、呕吐”急性发病,后出现饮水呛咳、吞咽困难、失语、四肢瘫痪等症状。完善头颅CT提示双侧延髓内侧呈“心”形的高密度灶,明确诊断为延髓出血,并考虑此次发病与高血压有关。本文介绍了该患者的诊治经过,并从病因、临床表现、辅助检查、治疗以及结局等方面加以讨论,以期增加临床医师关于此病的诊治经验。

血-迷路屏障通透性与突聋发病机制及预后的关系:在3D real IR的发现

目的分析突聋患者的内耳钆造影MRI三维真实重建反转恢复(three dimensional real inversion recovery,3D real IR)成像上的表现,探讨血-迷路屏障的通透性与突聋发病机制及其预后的关系。方法对41例单侧突聋患者行内耳钆造影MRI,测量患耳和健耳的耳蜗信号强度,并测量延髓信号强度,分别计算出耳蜗/延髓比值(cochlear/medulla ratio,CM ratio),以CM比值作为血-迷路屏障通透性的标志物,分析突聋患者患耳、健耳CM比值的不对称程度与疗效之间的关系。结果41例患者中,33例(80.48%)患耳的CM比值高于健耳,差异有统计学意义(P<0.05);患耳CM比值为健耳的1.5倍以下者18例,治疗有效率为77.78%(14/18);患侧CM比值不高于健侧者8例,治疗有效率为100%;达到健耳的1.5倍至1.75倍之间者7例,治疗有效率为100%(7/7);达到健耳的1.75倍至2.0倍之间者2例,治疗有效率为50%(1/2);达到健耳的2.0倍以上者14例,治疗有效率为14.28%(12/14);差异有统计学意义(P<0.05)。结论内耳3D Real IR可显示突聋患者血-迷路屏障通透性的改变,80.48%的突聋患者患侧耳蜗出现高信号,患耳CM比值达健耳的1.75倍以上者多数预后不良。

RVM致炎细胞因子上调导致5-HT释放参与调控慢性术后疼痛

【目的】探讨延髓头端腹内侧部(RVM)内致炎细胞因子肿瘤坏死因子α(TNFα)和白介素-1β(IL-1β)释放增多导致5-羟色胺(5-HT)向脊髓释放增多在慢性术后疼痛(CPSP)模型中的作用。【方法】按照随机方式将SD大鼠进行如下分组:对照组、皮肤/肌肉切开和牵拉(SMIR)(1d,7d)组、SMIR+RVM内注射TNFα或IL-1β中和性抗体组、SMIR+RVM内注射TNFα或IL-1β组、SMIR+RVM内注射溶剂组,用up-down方法测量大鼠50%机械刺激撤足阈值,免疫组化检测RVM内TNFα或IL-1β表达情况,酶联免疫吸附测定法(ELISA)方法观察RVM及脊髓背角内5-HT含量的变化。【结果】SMIR可引起大鼠机械痛敏,表现为50%机械刺激撤足阈值下降,持续至少3周。SMIR后,RVM内神经元和星形胶质细胞中的TNFα和IL-1β表达上调。TNFα或IL-1β中和抗体(每天一次行SMIR术前30 min给予,共4次))微量注射入RVM可阻断SMIR引起的50%机械刺激撤足阈值下降,并可降低RVM及脊髓背角5-HT的含量。正常动物RVM内注射TNFα和IL-1β也可导致50%机械刺激撤足阈值下降,且引起RVM及脊髓内5-HT含量增加。【结论】RVM中致炎细胞因子增多可能通过引起5-HT释放增多参与调控SMIR后慢性术后疼痛的发生发展。