诱导排尿反射对急性酒精性意识障碍患者催醒作用的研究

为了观察以呋塞米注射液诱导排尿反射对急性酒精性意识障碍患者促醒的作用,将30例急性重度酒精中毒患者纳入观察,随机分为2组,每组15例.两组患者均予补液,营养支持,纠正水电解质、酸碱平衡等对症处理.对照组予注射用纳洛酮2mg,加入5％葡萄糖溶液中静滴,纳洛酮日总用量不超过4.0mg.观察组在对照组基础上,加用呋塞米注射液20mg静脉推注,1次/日.对照组治疗后平均苏醒时间为1.85h±0.26h,观察组治疗后平均苏醒时间为1.28h±0.22h,经t检验,t=6.481 7,P＜0.01,提示观察组疗效优于对照组.笔者认为,以呋塞米注射液诱导排尿反射对急性酒精性意识障碍患者有较好的促醒作用,不仅与促进酒精代谢有关,兴奋觉醒中枢亦是其可能的机制.     

Modality-repetition and attentional effects on reflex blinking in infants and adults

The ability of a brief prepulse to inhibit reflexively elicited startle is a robust phenomenon in adults of several species but is weak or absent in infants. The possibility that afferent processing of the prepulse is inadequate in infants was tested by assessing the integrity of two other types of reflex modulation that occur in modality-specific paths, that is, attenuation by repetition of same-modality stimuli and enhancement by modality-selective attention. The reflex, measured by electromyographic activity of the muscle controlling blink, was elicited by intense light flashes or noise bursts preceded by brief acoustic or visual prepulses and delivered during attention-directing acoustic or visual foregrounds that evoked cardiac deceleration. Modality-repetition effects were evidenced by smaller peak blink magnitude and longer latency of blinking to same than to different modality pairs and did not differ as a function of age (4-month-old infants or college students). Attention effects were also seen in both infants and adults and, in accord with previous findings, were evident in magnitude for infants and latency for adults. Thus, immaturity in paths mediating these effects could not explain delayed development of prepulse inhibition. Other possibilities include delayed maturation of extrinsic inhibition or of transient-processing systems.     

Self-motion perception and vestibulo-ocular reflex during whole body yaw rotation in standing subjects: the role of head position and neck proprioception

Self-motion perception and vestibulo-ocular reflex (VOR) were studied during whole body yaw rotation in the dark at different static head positions. Rotations consisted of four cycles of symmetric sinusoidal and asymmetric oscillations. Self-motion perception was evaluated by measuring the ability of subjects to manually track a static remembered target. VOR was recorded separately and the slow phase eye position (SPEP) was computed. Three different head static yaw deviations (active and passive) relative to the trunk (0°, 45° to right and 45° to left) were examined. Active head deviations had a significant effect during asymmetric oscillation: the movement perception was enhanced when the head was kept turned toward the side of body rotation and decreased in the opposite direction. Conversely, passive head deviations had no effect on movement perception. Further, vibration (100 Hz) of the neck muscles splenius capitis and sternocleidomastoideus remarkably influenced perceived rotation during asymmetric oscillation. On the other hand, SPEP of VOR was modulated by active head deviation, but was not influenced by neck muscle vibration. Through its effects on motion perception and reflex gain, head position improved gaze stability and enhanced self-motion perception in the direction of the head deviation.