Parietal Infiltration for Postoperative Analgesia

The parietal component of pain occupies an important place in the management of postoperative analgesia. Parietal infiltration is a technique that fits into a concept of multimodal analgesia using several analgesic products simultaneously. This simple and reliable technique makes it possible to reduce the use of opioids and therefore their adverse effects;without increasing the risk of infection. It reduces the length of hospitalization.

Spectral Analysis and Validation of Parietal Signals for Different Arm Movements

Brain signal analysis plays a significant role in attaining data related to motor activities.The parietal region of the brain plays a vital role in muscular movements.This approach aims to demonstrate a unique technique to identify an ideal region of the human brain that generates signals responsible for muscular movements;perform statistical analysis to provide an absolute characterization of the signal and validate the obtained results using a prototype arm.This can enhance the practical implementation of these frequency extractions for future neuro-prosthetic applications and the characterization of neurological diseases like Parkinson’s disease(PD).To play out this handling method,electroencepha-logram(EEG)signals are gained while the subject is performing different wrist and elbow movements.Then,the frontal brain signals and just the parietal signals are separated from the obtained EEG signal by utilizing a band pass filter.Then,feature extraction is carried out using Fast Fourier Transform(FFT).Subse-quently,the extraction process is done by Daubechies(db4)and Haar wavelet(db1)in MATLAB and classified using the Levenberg-Marquardt Algorithm.The results of the frequency changes that occurred during various wrist move-ments in the parietal region are compared with the frequency changes that occurred in frontal EEG signals.This proposed algorithm also uses the deep learn-ing pattern analysis network to evaluate the matching sequence for each action that takes place.Maximum accuracy of 97.2%and maximum error range of 0.6684%are achieved during the analysis.Results of this research confirm that the Levenberg-Marquardt algorithm,along with the newly developed deep learn-ing hybrid PatternNet,provides a more accurate range of frequency changes than any other classifier used in previous works of literature.Based on the analysis,the peak-to-peak value is used to define the threshold for the prototype arm,which performs all the intended degrees of freedom(DOF),verifying the results.These results would aid the specialists in their decision-making by facilitating the ana-lysis and interpretation of brain signals in the field of neuroscience,specifically in tremor analysis in PD.

Role of Injury of Gastric Parietal Vessels by Immunocomplexes in the Mechanism of Gastric Mucosal Lesion in Portal Hypertension with Cirrhosis

The present experiment employed the immunohistochemical technique and morphological observation to investigate the expression and distribution of C3, C4, IgG, IgE and 5-HT in portal hypertensive pigs with pathological change of gastric mucosa and gastric parietal vessels. The wall of gastric mucosal microvessels in portal hypertensive pigs had a positive or strong positive reaction of C3,C4, IgG, IgE and 5-HT with obvious injury of gastric mucosa normal pigs imparted negative or feeble positive reaction, suggesting that during portal hypertension, the gastric mucosal micr0-vessels has deposit of immunocomplexes resulting in the injury of the micro-vessels. It might be a factor inv01ved in the pathogenesis of the gastric mucosal lesion during portal hypertension with cirrhosis.

A focus on parietal cells as a renewing cell population

The fact that the acidsecreting parietal cells undergo continuous renewal has been ignored by many gastroenterologists and cell biologists. In the past, it was thought that these cells were static. However, by using 3Hthymidine radioautography in combination with electron microscopy, it was possible to demonstrate that parietal cells belong to a continuously renewing epithelial cell lineage. In the gastric glands, stem cells anchored in the isthmus region are responsible for the production of parietal cells. The stem cells give rise to three main progenitors: prepit, preneck and preparietal cells. Parietal cells develop either directly from the noncycling preparietal cells or less commonly via differentiation of the cycling prepit and preneck cell progenitors. The formation of a parietal cell is a sequential process which involves diminishment of glycocalyx, production of cytoplasmic tubulovesicles, an increase in number and length of microvilli, an increase in number and size of mitochondria, and fi nally, expansion and invagination of the apical membrane with the formation of an intracellular canalicular system. Little is known about the genetic counterparts of these morphological events. However, the time dimension of parietal cell production and the consequences of its alteration on the biological features of the gastric gland are well documented. The production of a new parietal cell takes about 2 d. However, mature parietal cells have a long lifespan during which they migrate bidirectionally while their functional activity for acid secretion gradually diminishes. Following an average lifespan of about 54 d, in mice, old parietal cells undergo degeneration and elimination. Various approaches for genetic alteration of the development of parietal cells have provided evidence in support of their role as governors of the stem/progenitor cell proliferation and differentiation programs. Revealing the dynamic features and the various roles of parietal cells would help in a better understanding of the biological features of the gastric glands and would hopefully help in providing a basis for the development of new strategies for prevention, early detection and/or therapy of various gastric disorders in which parietal cells are involved, such as atrophic gastritis, peptic ulcer disease and gastric cancer.

Effects of different acupuncture manipulations on protein expression in the parietal cortex of spontaneously hypertensive rats

Objective: To analyze the effects of twirling reinforcing and reducing manipulations on protein expression in parietal cortex of spontaneously hypertensive rats(SHRs), and elucidate the main mechanisms and differences between two manipulations in hypertension treatment.Methods: Rats were randomly divided into the control, model, twirling reinforcing manipulation(TRFM),and twirling reducing manipulation(TRDM) groups. The control and model groups received catch and fixation stimulations once a day for 14 days. The TRFM and TRDM groups were intervened once a day for 20 min for 14 days. On days 0, 2, 6, 10, and 14 after acupuncture, rat systolic blood pressures(SBPs) were measured. Differential protein(DP) expression in the rat parietal cortices was detected. Thereafter, GO functional significance and KEGG pathway enrichment analyses were performed.Results: Compared with the model group, SBP of rats in the TRDM and TRFM groups decreased on days 6 and 10 of acupuncture, respectively(P=.009;P <.001). Moreover, SBP of the TRDM group was significantly lower than that of the TRFM group on days 10 and 14 of acupuncture(P=.015;P=.013).Compared with control group, 601 and 1040 DPs were up-and downregulated, respectively, in the model group. Compared with model group, 44 and 28 up-and downregulated DPs were expressed, respectively,in the TRFM group. Compared with model group, expression of 616 and 427 up-and downregulated DPs,respectively, was found in the TRDM group. After combining the results of GO and KEGG enrichment analyses, five and one pathways were found to be related to the central antihypertensive mechanism of the parietal cortex during twirling reducing and reinforcing manipulations, respectively.Conclusion: TRDM showed a more effective antihypertensive effect on SHRs than TRFM;this antihypertensive effect was related to the regulation of different proteins and their biological functions.

Dynamic functional and ultrastructural changes of gastric parietal cells induced by water immersion-restraint stress in rats

AIM： To investigate the dynamic functional and ultrastructural changes of gastric parietal cells induced by water immersion-restraint stress （WRS） in rats.METHODS： WRS model of Sprague-Dawley （SD） rats was established. Fifty-six male SD rats were randomly divided into control group, stress group and post-stress group. The stress group was divided into 1, 2 and 4 h stress subgroups. The post-stress group was divided into 24, 48 and 72 h subgroups. The pH value of gastric juice, ulcer index （UI） of gastric mucosa and H^＋, K^＋- ATPase activity of gastric parietal cells were measured. Ultrastructural change of parietal cells was observed under transmission electron microscope （TEM）.RESULTS： The pH value of gastric juice decreased time-dependently in stress group and increased in post-stress group. The H^＋, K^＋-ATPase activity of gastric parietal cells and the UI of gastric mucosa increased time-dependently in stress group and decreased in poststress group. Compared to control group, the pH value decreased remarkably （P = 0.0001）, the UI and H^＋, K^＋- ATPase activity increased significantly （P = 0.0001, P = 0.0174） in 4 h stress subgroup. UI was positively related with stress time （r = 0.9876, P 〈 0.01） but negatively with pH value （r = -0.8724, P 〈 0.05）. The parietal cells became active in stress group, especially in 4 h stress subgroup, in which plenty of intracellular canalicular and mitochondria were observed under TEM. In post-stress group, the parietal cells recovered to resting state.CONCOUSION： The acid secretion of parietal cells is consistent with their ultrastructural changes during the development and healing of stress ulcer induced by WRS and the degree of gastric mucosal lesions, suggesting gastric acid play an important role in the development of stress ulcer and is closely related with the recovery of gastric mucosal lesions induced by WRS.

Effects of basic fibroblast growth factor on hippocampal and parietal cortical neuronal cAMP-response element-binding protein expression in a rat model of focal cerebral ischemia/reperfusion

BACKGROUND： cAMP-response element binding protein （CREB） is a key modulator of various signaling pathways. CREB activation initiates a series of intracellular signaling pathways that promote neuronal survival. OBJECTIVE： To investigate the regulatory effects of basic fibroblast growth factor （bFGF） on cerebral neuronal CREB expression following ischemia/reperfusion injury. DESIGN, TIME AND SETTING： An immunohistochemical detection experiment was performed at the Department of Anatomy, Shenyang Medical College, between October 2006 and April 2008. MATERIALS： A total of 60 healthy, adult, Wistar rats were randomly divided into three groups： sham-operated （n =12）, ischemia/reperfusion （n = 24）, and bFGF-treated （n = 24）. Rabbit anti-rat CREB （1： 100） and biotin labeled goat anti-rabbit IgG were purchased from the Wuhan Boster Company, China. MetaMorph-evolution MP5.0-BX51 microscopy imaging system was provided by China Medical University, China. METHODS： Rat models of cerebral ischemia/reperfusion injury were developed using the suture method for right middle cerebral artery occlusion. Two-hour ischemia was followed by reperfusion. Rats from the bFGF-treated and ischemia/reperfusion groups were intraperitoneally administered endogenous bFGF （500 IU/mL, 2 000 IU/kg） or an equal amount of physiological saline. Rats from the sham-operated group underwent a similar surgical procedure, without induction of ischemia/reperfusion injury and drug administration. MAIN OUTCOME MEASURES： After 48-hour reperfusion, hippocampal and parietal cortical neuronal CREB expression was detected by immunohistochemistry, and the absorbance of hippocampal CREB-positive products was determined using MetaMorph-evolutionMP5.0-BX51 microscopy imaging system. RESULTS： The sham-operated group exhibited noticeable CREB expression in hippocampal and parietal cortical neurons. In the ischemia/reperfusion group, the CREB expression was discrete and neurons were poorly arranged. The bFGF-treated group exhibited increased CREB expression and better neuronal arrangement compared with the ischemia/reperfusion group. The mean absorbance of CREB-immunoreactive products in the hippocampus and parietal cortex was significantly higher in the ischemia/reperfusion group than in the sham-operated group （P 〈 0.05）, and significantly higher in the bFGF-treated group than in the ischemia/reperfusion group （P 〈 0.05）. CONCLUSION： bFGF significantly upregulates CREB expression in hippocampal and parietal cortical neurons following ischemia/reperfusion injury.

Caval replacement with parietal peritoneum tube graft for septic thrombophlebitis after hepatectomy: A case report

BACKGROUND Caval vein thrombosis after hepatectomy is rare, although it increases mortality and morbidity. The evolution of this thrombosis into a septic thrombophlebitis responsible for persistent septicaemia after a hepatectomy has not been reported to date in the literature. We here report the management of a 54-year-old woman operated for a peripheral cholangiocarcinoma who developed a suppurated thrombophlebitis of the vena cava following a hepatectomy.CASE SUMMARY This patient was operated by left lobectomy extended to segment V with bile duct resection and Roux-en-Y hepaticojejunostomy. After the surgery, she developed Streptococcus anginosus, Escherichia coli, and Enterococcus faecium bacteraemias, as well as Candida albicans fungemia. A computed tomography scan revealed a bilioma which was percutaneously drained. Despite adequate antibiotic therapy,the patient's condition remained septic. A diagnosis of septic thrombophlebitis of the vena cava was made on post-operative day 25. The patient was then operated again for a surgical thrombectomy and complete caval reconstruction with a parietal peritoneum tube graft. Use of the peritoneum as a vascular graft is an inexpensive technique, it is readily and rapidly available, and it allows caval replacement in a septic area. Septic thrombophlebitis of the vena cava after hepatectomy has not been described previously and it warrants being added to the spectrum of potential complications of this procedure.CONCLUSION Septic thrombophlebitis of the vena cava was successfully treated with antibiotic and anticoagulation treatments, prompt surgical thrombectomy and caval reconstruction.

Cortical infarction of the right parietal lobe and neurogenic heart disease A report of three cases

Three male patients were diagnosed with new cortical infarctions of the right parietal lobe on the basis of head magnetic resonance imaging; high-intensity signals indicating lesions in the right parietal lobe were noted on diffusion-weighted images at admission. Two of them presented with left hand weakness, and one exhibited left upper limb weakness. Treatment for improving blood supply to the brain was administered. One patient died suddenly because of ventricular fibrillation 3 days after admission. The other two patients had increased troponin levels and abnormal electrocardiograms, and were diagnosed with acute myocardial infarction half a month after admission. When lesions exist in field 7 of the parietal cortex （resulting in paralysis of the contralateral hand）, the sympathetic center of the posterior lateral nucleus of the hypothalamus demonstrates compensatory excitement, which easily causes tachyarrhythmia and sudden death. Our experimental findings indicate that close electrocardiograph monitoring and cerebral infarction treatment should be standard procedures to predict and help prevent heart disease in patients with cerebral infarction in the right parietal lobe and left upper limb weakness as the main complaint.

Immunohistochemical Analysis of the Acid Secretion Potency in Gastric Parietal Cells

Gastric parietal cells are important in acid secretion, but it is unclear which cells throughout the gastric gland have the highest secretion potency. Here, we used immunohistochemical methods with anti-H+, K+-ATPase, phosphoryl ezrin and CD44 antibodies to study the distribution of gastric acid secretion activity. Stomach tissues from freely fed and starved rats were cryofixed for light microscopy or fixed by high-pressure freezing for electron microscopy. Parietal cells from freely fed animals corresponded to the active secretion phase and to the inactive resting phase from starved rats. Anti-H+, K+-ATPase and anti-phosphoryl ezrin labeling were observed on the membrane of the intracellular canaliculi and the tubulovesicle from freely fed rats, while cells from starved animals showed weak labeling with anti-phosphoryl ezrin antibody staining. Morphometrical analysis at the electron microscopic level was performed on active and inactive acid secretory phases between the upper and base regions of the gland. H+, K+-ATPase and CD44 were distributed on both sites of the microvillous and tubulovesicle membrane in the same cells, but phosphoryl ezrin localized predominantly on the microvillous membrane in active cells of the glandular neck and upper base. Therefore, the highest secreting potency appeared to be in cells of the glandular neck and upper base.

NUMERICAL SIMULATIONS OF THE VORTEX-SHEDDING IN FLOWS AROUND RECTANGULAR CYLINDERS

Flows around rectangular cylinders with a series of width-to-height ratios are calculated by means of the Improved Finite Analytic Method (IFAM) and the formation, development and shedding of vortices from the cylinders are simulated successfully. According to these results of time-dependent processes the physical phenomena in the flows are investigated in detail, and the discontinuity of Strouhal number is explained in the case of the width-to-height ratio equal to 3.0. The numer- ical solutions here show good agreement with the experimental results. In addition, based on several hundreds of the calculated flow patterns a moving picture is made by the computer image processing technology and recorded on a video tape, and then the vivid pictures of the physical process of vortex-shedding can be replayed later and analysed in detail.

3D Effects on Vortex-Shedding Flow and Hydrodynamic Coefficients of A Vertically Oscillating Cylinder with A Bottom-Attached Disk

Vortex-shedding flow induced by the vertical oscillation of a cylinder with bottom-attached disks of different diameter ratio Dd/Dc and thickness ratio td/Dc is studied by a 3D （three-dimensional） numerical model developed in this paper, and compared with the results obtained through 2D （two-dimensional） numerical model. The high-order upwind scheme is applied to stabilize the computation, and convergence is accelerated by the multi-grid method. Qualitative and quantitative analyses of the differences between the 2D and 3D simulation results reveal the 3D effect on the flow field characteristics and hydrodynamic coefficients of the vertically oscillating cylinder with a bottom-attached disk. The 3D effect on the fluid field is mainly reflected in the significance of three vortex-shedding patterns： ωx has a greater effect on the flow fields around the sharp edges relative to the vortices generated in the 2D simulation. In the slice along the axial orientation, the vortex effect of ωy along the radial axis is smaller than that of ωx along the circumferential direction, indicating the radial effect on the velocity more pronounced than the circumferential effect around the sharp edges of the disk. The rotational interaction ωz of the fluid in the horizontal plane during the heave motion is insignificant. Based on the 2D and 3D simulation results, the turning points that separate the increasing regimes of the added mass coefficient and damping ratio are identified. The dependence of the turning point on the diameter ratio Dd/Dc and thickness ratio td/Dc are discussed in detail.

AB014.Impaired anti-saccade production in posterior parietal cortex damaged patients

Background:Performing an anti-saccade relies on two mechanisms:(I)inhibiting an automatic saccade to a target,and(II)generating,instead,a voluntary saccade to a location other than this visual target.It remains unclear where and how these two processes are implemented to ensure the production of correct anti-saccades.Previous research in optic ataxia has implicated the posterior parietal cortex(PPC)in anti-pointing,implying a possible role of the PPC in anti-saccade production.Methods:Here,we tested how three patients with unilateral or bilateral damage to the PPC,as well as six neurologically intact controls,perform different types of anti-saccade:classic anti-saccades(180°rotation)or mirror saccades(90°rotation)across and within hemi-fields.Results:We showed that PPC damaged patients were impaired in anti-saccade production for their contralesional visual fields.This was reflected in a longer period of erroneous pro-saccades,longer latencies associated with correct anti-saccades to the contralesional visual field and more imprecise anti-saccades.Conclusions:Our results thus suggest that PPC damage results in delayed and prolonged competing saccade planning processes between two locations(i.e.,visual target and saccade goal location).Taken together,our results provide evidence for a crucial role of the PPC in parallel mechanisms underlying anti-saccade performance.

Case Report of a Septum Pellucidum Cavernoma Surgically Resected via Inferior Parietal Approach and Short Literature Review

Background and Importance: Cavernomas of the septum pellucidum represent an extremely rare subtype of CNS cavernous angiomas which are a rare subtype of CNS tumors. Intraventricular cavernomas of the body of the lateral ventricle are usually treated by the transcallosal approach. Clinical Presentation: We present a case of a fifty-eight year old man with a septum pellucidum cavernoma successfully treated operatively by means of the inferior parietal transcortical transventricular approach. This unusual and scarcely documented tumor was situated at the posterior third of the septum pellucidum. The patient had a good recovery with no focal deficit. Conclusion: Septum pellucidum cavernomas are extremely rare lesions. Inferior parietal transcortical approach is a safe alternative to the commonly used transcallosal approach for lesions of the posterior half of the septum pellucidum.

Congenital Left Mesenteric-Parietal Hernia Associated to a Small Bowel Volvulus: About a Case

Introduction: The left mesenterico-parietal hernia or left paraduodenal hernia is an anomaly of intestinal rotation which may be responsible for intestinal obstruction. It is rare. Observation: A 5-year-old boy was admitted for abdominal pain with episodes of vomiting and cessation of matters and gases. After clinical and paraclinical investigations, the diagnosis of occlusion was accepted and the child was operated. Exploration revealed a mesenterico-parietal hernia with a retrocolic sac measuring 11 cm of collar and a deep of 18 cm containing a twisted bowel. After reduction of the content, we untwisted the small intestine and released adhesions. The hernial sac was partially resected and the defect was closed. Operating outcomes were simple. Conclusion: The mesenterico-parietal hernia is a cause of organic intestinal obstruction. Although of congenital origin, it can have a late clinical manifestation. It should be considered in case of episodes of repetitive abdominal pain and vomiting to avoid complications.

社会交互情境中的主动控制感

主动控制感是人与环境交互过程中产生的控制自身动作并控制外界事物的体验,它既存在于个人情境中,也能产生于社会交互情境下。本文围绕社会交互情境中的主动控制感,首先依据行动主体目标、社会层级等区分了竞争、合作和层级式社会交互情境,分别阐述了各种社会交互情境对主动控制感的影响,并总结了以额-顶网络为主的脑机制;随后,探讨了社会交互情境中主动控制感和责任感的关系;最后从社会交互情境之间的主动控制感比较、多人互动情境中的主动控制感以及社会交互情境影响主动控制感的神经机制等方面对未来研究进行了展望。

立体定向额叶与枕顶叶入路治疗高血压脑出血疗效及术后再出血研究

目的比较立体定向下额叶入路与枕顶叶入路治疗高血压脑出血(hypertensive intracerebral hemorrhage,HICH)的疗效,并分析术后再出血危险因素。方法选取190例接受血肿清除术治疗的HICH患者作为研究对象,按不同手术入路分为对照组(92例)与研究组(98例)。对照组患者应用立体定向辅助下枕顶叶入路治疗,研究组患者应用立体定向辅助下额叶入路治疗。对比两组临床相关指标、术后并发症、日常生活能力量表(activity of daily living scale,ADL)分级情况。应用多因素Logistics回归分析,探究HICH术后再出血的危险因素。结果两组性别、年龄、发病部位比较,差异无统计学意义(P>0.05)。与对照组比较,研究组患者术后血肿排空率较高,术中出血量较少,手术时间、住院时间、ICU入住时间较短,术后并发症发生率较低,术后ADL分级Ⅰ级、Ⅱ级占比较高,Ⅲ级、Ⅳ级占比较低(P<0.05)。单因素分析显示:HICH患者术后再出血与性别、年龄、并发基础病、使用镇痛镇静药物无关(P>0.05)。单因素分析与多因素Logistics回归分析显示:收缩压>160mmHg、舒张压>90mmHg、术前血肿量≥30ml、术前格拉斯哥昏迷评分(Glasgow coma scale,GCS)<10分、手术方式为枕顶叶入路是HICH患者术后再出血的危险因素(均P<0.05)。结论HICH患者采用立体定向辅助下额叶入路行血肿清除术后,临床相关症状改善较明显,且并发症发生率较低。收缩压、舒张压、术前血肿量、术前GCS评分、手术方式均为影响HICH患者术后再出血的因素。

右侧顶叶低频重复经颅磁刺激治疗焦虑失眠的随机对照研究

目的探讨右侧顶叶低频重复经颅磁刺激(rTMS)对焦虑失眠患者的治疗效果及其机制。方法随机将60例焦虑失眠患者分为研究组和对照组,研究组采用1 Hz rTMS刺激右侧顶叶皮层,每次2000脉冲,共20次治疗,对照组采用与研究组相同的刺激设备、参数及次数,但将刺激线圈旋转90度,使其垂直于患者头皮,保证磁刺激不能实际作用于大脑的同时又有刺激声音输出。比较治疗前后两组的汉密尔顿焦虑量表(HAMA)评分和匹兹堡睡眠质量指数(PSQI)评分的变化以及事件相关电位失匹配负波(MMN)、P300的潜伏期及波幅的变化,分析治疗前后各项指标及其变化值之间的相关性。结果研究组治疗后HAMA、PSQI评分均较治疗前降低(P<0.05)。研究组治疗后MMN和P300的潜伏期较治疗前缩短,波幅增高(P<0.05)。研究组治疗前后HAMA评分的差值与PSQI评分的差值呈正相关(P<0.01)。研究组治疗前后P300波幅差值与HAMA评分差值呈正相关(P<0.05)。结论右侧顶叶低频rTMS对焦虑失眠患者有确切疗效,可改善患者的焦虑状态、睡眠质量及认知功能,P300的波幅变化可作为焦虑症状改善的生物学指标。

实地导航训练提高大脑功能连接模式稳定性

空间导航主要依赖于两种空间表征:自我中心参照表征与环境中心参照表征。然而,个体在现实环境中的空间导航能力提升与这两种空间表征存在何种关联仍未可知。为此,本研究结合行为测量与功能核磁共振技术(fMRI),对非熟悉环境实地空间导航训练前后个体空间导航能力和大脑全局性功能连接模式的改变进行分析,系统考察个体实地空间导航能力提高的内在神经机制。研究结果发现,训练组被试在训练后进行空间导航任务时,自我中心参照表征的核心脑区——顶上小叶(SPL)的神经活动显著增强。更为重要地,训练显著提高了以SPL为核心的全脑功能连接模式的稳定性,且与个体导航任务表现的提高呈正相关。上述结果表明,实地空间导航能力的提高与自我中心参照表征的增强存在密切关联,并进一步表现为SPL与全脑其他区域的信息交互通路的固化。