刺激光频率及光强对SD大鼠明适应视网膜电图的影响

目的: 探索明适应状态下分离视锥系统反映的相关参数(刺激光频率、刺激光强度),为SD大鼠明适应视网膜电图的b波测定提供参考. 方法: 采用RETI-scan系统使用8种不同频率(0.1, 0.5, 5.0, 10.0, 15.0, 20.0, 25.0, 30.0 Hz)及7种不同光强(0.11, 0.35, 1.10, 3.50, 11.00, 35.00, 110.00 cd*s*m-2)检查SD大鼠明适应ERG. 背景光强37.00 cd*s*m-2,明适应时间为10 min. 结果:SD大鼠明适应ERG,低频时(0.1, 0.5, 5.0 Hz)波形中含有视杆系统成分,高频时(25.0, 30.0 Hz)波形不稳定. 不同光强下潜伏期改变不大,幅值先升高后降低,在3.50 cd*s*m-2时达到最高值. 结论: 在大鼠明适应闪光ERG检查中,应用15.0～20.0 Hz,3.50 cd*s*m-2的刺激光可以很好地分离出视锥系统功能.     

暗适应及明适应状态下正常SD大鼠视觉诱发电位的比较

目的 :探索明暗适应条件下正常SD大鼠视觉诱发电位 (visualevokedpotential,VEP)的区别 .方法 :大鼠都给予1 2h以上的暗适应 ,一组即时开始记录 ,另一组在 37cd·m-2的背景光下明适应 1 0min后再进行记录VEP .刺激光强为0 .0 1 1 ,0 .0 35 ,0 .1 1 ,0 .35 ,1 .1 ,3.5 ,1 1 ,35和 1 1 0cd·s·m-2 ,叠加 1 0 0次 ,不同光强间间隔 1～ 4min ,随光强增加而延长间隔时间 .结果 :正常SD大鼠在暗适应及明适应状态下均能记录出满意的波形 ,明适应时N1 波的潜伏期较暗适应时为长 .3.5cd·s·m-2 以上光强 ,两种适应状态下 ,可在 1 0ms左右见到一正向波 ,同时P1 及N1 波上叠加有小的子波 .结论 :视锥和视杆系统的视传导通路结构的可能差异导致了暗适应比明适应条件下潜伏期为短 ,高光强时出现的 1 0ms左右的正向波及P1 和N1 上的子波可能与机器设置、记录参数、以及其他皮质中枢的活动等有关 .     

低频刺激抑制GABA介导背根神经节神经元膜去极化反应

目的:探讨低频率电刺激对GABA介导的背根神经节神经元膜电位去极化反应的影响.方法:新鲜分离的大鼠DRG坐骨神经干标本,通过细胞内微电极记录技术,应用波宽5 ms,强度2 V,频率分别为2 Hz和10 Hz的脉冲波作用于大鼠坐骨神经远端,观察刺激前后GABA(3×10-4mol/L)介导的DRG神经元膜电位去极化反应幅值的变化.结果:低频电刺激(2 Hz、10 Hz)对GABA介导的DRG神经元膜电位去极化反应均有抑制作用,10 Hz时抑制作用达到最大,反应幅值从17.00±3.39mV降至12.00±2.45mV(P<0.05).刺激频率增加,电刺激对GABA介导DRG神经元膜去极化反应抑制作用持续时间也逐渐延长,10 Hz时作用持续时间达到最长(>72 min).结论:电刺激可抑制DRG神经元膜GABA去极化反应,从而易化伤害性信息的传入,导致疼痛.     

实验性糖尿病大鼠早期视网膜电图的变化

目的: 观察实验性糖尿病早期对大鼠视网膜电图的影响. 方法: 链脲佐菌素诱导的糖尿病组大鼠和日龄相匹配的对照组正常大鼠,采用国际临床视觉电生理学会推荐的标准化方案,在糖尿病早期阶段(5 wk内)对其进行杆细胞反应、最大反应、振荡电位、明适应视网膜电图和20 Hz闪烁反应5个项目的检查. 结果: 在诱导糖尿病前和建模后1 wk时,糖尿病组大鼠与对照组相比未发现视网膜电图的异常;在建模后2 wk和5 wk时,糖尿病组杆细胞反应b波、最大反应 b波、振荡电位O2波和明适应视网膜电图b波的潜伏期都比对照组相应各波的潜伏期显著延长;两组大鼠各波的幅值始终未发现显著改变. 结论: 糖尿病大鼠在早期阶段杆细胞反应b波、最大反应b波、振荡电位O2波和明适应视网膜电图b波的潜伏期显著延长,这有可能成为监测糖尿病视网膜病变早期发展的指标.     

吗啡对新生期大鼠脊髓背角长时程增强的作用

目的:评价吗啡对电刺激坐骨神经诱发新生期大鼠脊髓背角浅层长时程增强(LTP)的影响。方法:雄性SD大鼠20只,日龄18-21d,体重60-65g,随机分为对照组、吗啡组(M组)、纳洛酮组(N组),纳洛酮+吗啡组(MN组),每组8例。麻醉下分离左侧坐骨神经,记录电极插于左侧T13-L1脊髓背角浅层,刺激电极刺激左侧坐骨神经,给予4V、0.5ms、1/60Hz单个方波电刺激30min以诱发场电位,抽取生理盐水10μl、吗啡10μl(15μg/μl)、纳洛酮10μl(2.5μg/μl)、纳洛酮(2.5μg/μl)和吗啡(15μg/μl)各5μl的混合液,在脊髓上方3mm,经2min内缓慢滴注,给药后5min时,给予4串条件电刺激(8V、0.5ms、100Hz、串长1s、串间隔10s)后,再给予单个方波电刺激120min以上,记录强直刺激前30min、条件电刺激后0-30,35-60,65-120min时段平均场电位幅值及潜伏期。结果:与强直刺激前30min比较,C组和N组A类特征的波在强直刺激后各时段平均场电位幅值升高,潜伏期缩短,M组A类特征的波在强直刺激后各时段平均场电位幅值降低,潜伏期延长,MN组A类特征的波在强直刺激后0-30min平均场电位幅值升高,潜伏期缩短,35-120min时段平均场电位幅值降低,潜伏期延长,以上P<0.05或0.01,C类特征的波在刺激前后变化不明显。结论:吗啡可抑制电刺激新生期大鼠坐骨神经诱发脊髓背角以A类特征波的突触LTP,可能是其所处神经发育阶段决定的。     

不同麻醉药物对大鼠视觉电生理的影响

目的 :比较各种麻醉药物对视觉电生理的影响 ,为今后的视觉电生理实验提供依据 .方法 :采用RETI scan系统和银 氯化银角膜电极以及不锈钢针状电极对乌拉坦、戊巴比妥、氯胺酮、84 6合剂 4种麻醉药物作用下的大鼠进行暗适应视网膜电图、振荡电位、明适应视网膜电图和 2 0Hz闪烁反应记录 .结果 :暗适应视网膜电图中光强为 3.5cd·s·m-2 时 ,b波的潜伏期 ,乌拉坦组最长 ,氯胺酮最短 .振荡电位O2 波幅值 ,84 6组最高 ,戊巴比妥组最低 .明适应视网膜电图和 2 0Hz闪烁反应氯胺酮组大鼠b波幅值最高 .闪光视觉诱发电位乌拉坦组大鼠P10 0潜伏期普遍较长 ,氯胺酮组大鼠普遍较短 .结论 :由于各种麻醉药物的作用部位以及药物机制不同 ,对ERG和VEP产生不同的影响 ,因此在观察视觉电生理实验结果时要把麻醉药物的影响因素考虑在内     

兔内听动脉阻断与听觉改变的关系

目的 探讨实验性内听动脉阻断与术后听力改变的关系及术中听觉监控的方法。方法 实验兔乙状窦后进路暴露小脑桥脑角，下压小脑暴露内听道及第Ⅷ神经复合体，分辨出内听动脉，予阻断不同时间，分别行蜗神经直接复合动作电位(DCAP)和畸变产物耳声发射记录(DPOAE)。结果对照组DCAPN1波潜伏期值无明显改变。内耳血供阻断10s和30s组在压迫开始后3min，DCAPN1波潜伏期值均恢复为初始值。内耳血供阻断1min组在压迫开始后3h，DCAPN1波潜伏期值未恢复为初始值假手术组DPOAE幅值无明显改变，内耳血供阻断10s、30s对DPOAE幅值无影响，内耳血供阻断1min使得DPOAE幅值下降结论兔内耳血供阻断1min可能造成兔听觉不可逆损伤。DCAP、DPOAE能有效、持续地监控内耳血供阻断，是耳神经外科手术中实用的听觉监测手段。     

兔内听动脉阻断与听觉改变的关系

目的探讨实验性内听动脉阻断与术后听力改变的关系及术中听觉监控的方法.方法实验兔乙状窦后进路暴露小脑桥脑角,下压小脑暴露内听道及第Ⅷ神经复合体,分辨出内听动脉,予阻断不同时间,分别行蜗神经直接复合动作电位(DCAP)和畸变产物耳声发射记录(DPOAE).结果对照组DCAP N1波潜伏期值无明显改变.内耳血供阻断10 s和30 s 组在压迫开始后3 min, DCAP N1波潜伏期值均恢复为初始值.内耳血供阻断1 min组在压迫开始后3 h, DCAP N1波潜伏期值未恢复为初始值.假手术组DPOAE幅值无明显改变.内耳血供阻断10 s、30 s对DPOAE幅值无影响,内耳血供阻断1 min使得DPOAE幅值下降.结论兔内耳血供阻断1 min可能造成兔听觉不可逆损伤.DCAP、DPOAE能有效、持续地监控内耳血供阻断,是耳神经外科手术中实用的听觉监测手段.     

原发性青光眼彩色图形翻转视觉诱发电位的研究

目的 通过对双眼处于不同青光眼阶段的青光眼患者自身对比,探讨彩色图形视觉诱发电位(CPR-VEP)在不同时问频率(TF)对原发性青光眼(PG)诊断的敏感性,评价CPR-VEP在青光眼诊断中的价值,寻找最佳时间频率参数及色彩参数.方法 采用法国Metro Vision公司生产的Vision Monitor视觉电生理仪记录CPK-VEP.对17例(34眼)左右眼青光眼程度明显不对称的原发性青光眼患者(一眼为早期,另眼为中晚期)在不同时间频率(1、2、4、8、16和32 Hz)及不同色彩刺激(黑/白,红/绿,蓝/黄)下记录双眼VEP的变化,比较双眼P100波波幅值及潜伏期值.采用配对c检验进行比较.结果 黑/白刺激下VEP P100潜伏期青光眼中晚期组较早期组延长,差异在1、2、4及8 Hz处有意义,8 Hz潜伏期延长最多;红/绿刺激下CPR-VEP P100潜伏期值差异在1 Hz及2Hz处有意义;蓝/黄刺激下CPK-VEP P100波幅值差异在2 Hz及8 Hz处有意义.在8 Hz波幅值差异最大;CPR-VEP P100潜伏期值差异在32 Hz处有意义.结论 CPR-VEP P100的波幅变化能客观反映青光眼患者的视功能损害,8 Hz时间频率蓝/黄刺激下P100波幅及黑/白刺激下P100潜伏期改变具有较大价值.     

链脲霉素诱导糖尿病大鼠的早期视觉电生理改变

目的　观察糖尿病大鼠病程早期的视网膜电图变化 .方法　按照国际临床视觉电生理学会的标准化方案 ,采用 REPIport系统和银 -氯化银角膜电极以及不锈钢针状电极对链脲霉素诱导的糖尿病大鼠模型进行 2 wk的暗适应视网膜电图 (scot- ERG)、振荡电位 (OPs)、明适应视网膜电图(phot- ERG)和 30 Hz闪烁反应记录 (30 Hz flicker) .结果　大鼠 scot- ERG的 a波和 b波和 OPs的 O2 波的潜伏期 ,在 1wk时 [a波 (2 7.2± 1.9) ms,b波 (72± 6 ) ms,O2 波 (38± 4 )ms],与未打药时相比 [a波 (2 4 .1± 1.2 ) ms,b波 (6 4 .6±2 .9) m s,O2 波 (34.1± 1.6 ) ms],显著延长 ,2 wk时潜伏期继续增加 [a波 (2 8.4± 1.9) ms,b波 (76± 10 ) ms,O2 波 (41± 6 ) ms],幅值一直没有显著改变 .结论　视觉电生理学检查特别是 scot- ERG和 OPs波是早期诊断糖尿病视网膜病的可靠手段     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.