电针井穴对血管性痴呆大鼠行为学及海马CA1区CREB表达的影响

目的:探讨电针井穴对血管性痴呆(VD)大鼠学习记忆能力及海马CA1区环磷酸腺苷反应元件结合蛋白(CREB)表达的影响。方法:采用4VO法制备VD大鼠模型。随机分为伪手术组、模型组、药物组、电针组,每组各8只,通过跳台试验检测各组大鼠的学习记忆能力,采用免疫组织化学技术检测各组大鼠海马CA1区CREB阳性神经元表达的变化。结果:模型组大鼠学习记忆能力低于假手术组(P0.01),电针组与药物组学习记忆能力明显优于模型组(P0.01),但不及假手术组(P0.05),电针组和药物组无差异(P0.05);CREB的表达模型组显著低于假手术组(P0.01)。结论:电针井穴可能通过增加VD大鼠海马CA1区CREB的表达,保护神经元,改善大鼠学习记忆能力。     

电针对VD大鼠海马神经细胞PKC mRNA、mGluRs和AMPAR表达的影响

目的 观察电针对血管性痴呆(VD)大鼠海马神经细胞PKC mRNA、mGluRs、AMPAR表达的影响,探讨电针的治疗作用机制.方法 将SD大鼠随机分为假手术组、模型组和电针组,每组10只.模型组和电针组采用重复脑缺血再灌注方法建立VD大鼠模型.将电针组大鼠放入大鼠固定器中,暴露大鼠头部和背部,将电针浅刺入大鼠“百会”、“大椎”穴,每天电针1次,留针20 min,连续治疗10 d.3组大鼠均于造模10d后采用逆转录聚合酶链式反应(RT-PCR)检测海马神经细胞PKC mRNA,免疫组织化学染色技术观察脑组织海马神经细胞mGluRs、AMPAR染色结果.结果 模型组海马PKC mRNA表达较假手术组降低,而与模型组比较,电针组海马PKC mRNA表达显著增加,差异有统计学意义(P＜0.05).海马mGluRs免疫阳性细胞积分光密度在假手术组、模型组和电针组分别为(58.6±3.6)、(36.3±2.5)和(51.5±4.8),与假手术组比较,模型组海马mGluRs免疫阳性细胞积分光密度显著降低,差异有统计学意义(P＜0.01);而与模型组比较,电针组海马mGluRs免疫阳性细胞积分光密度显著增加,差异有统计学意义(P＜0.05);海马AMPAR免疫阳性细胞积分光密度在假手术组、模型组和电针组分别为(66.5±2.8)、(40.1±5.1)和(58.3±4.6),与假手术组比较,模型组海马AMPAR免疫阳性细胞积分光密度显著降低,差异有统计学意义(P＜0.01),而与模型组比较,电针组海马AMPAR免疫阳性细胞积分光密度显著增加,差异有统计学意义(P＜0.05).结论 电针可增加VD大鼠海马PKC mRNA、mGluRs和AMPAR表达.电针大鼠“百会”、“大椎”穴改善大鼠学习记忆能力的机制可能与提高海马mGluRs、AMPAR和PKC mRNA表达有关.     

电针对血管性痴呆大鼠记忆力及海马BDNF、PSD-95蛋白表达的影响

目的:观察电针对血管性痴呆(VD)大鼠记忆力的影响,以及其对大鼠海马组织脑源性神经生长因子(BDNF)与突触后致密蛋白-95(PSD-95)蛋白表达的影响,探讨电针治疗血管性痴呆的可能分子机制。方法:将Wistar大鼠随机分为假手术组、模型组和电针组,每组8只。假手术组暴露双侧颈总动脉,但不结扎;模型组和电针组采用双侧颈总动脉永久性结扎法建立VD大鼠模型。治疗过程中3组大鼠均采用柔软型大鼠固定器固定。电针组选取百会、足三里穴,接通电流,每天1次,每次留针30min,连续治疗14天;模型组与假手术组只给予固定。治疗前后采用新事物识别实验对3组大鼠进行记忆力的检测。治疗结束后采用免疫印迹法检测大鼠海马组织BDNF与PSD-95的蛋白质表达情况,采用Image J图像分析系统对蛋白表达水平进行分析。结果:经过14天的治疗后,电针组大鼠对新物体的探索指数高于治疗前(P0.05),高于模型组大鼠(P0.05)。电针组大鼠海马组织的BDNF、PSD-95的蛋白质表达均高于模型组,差异有显著性意义(P0.05)。结论:电针血管性痴呆模型大鼠的百会穴、足三里穴能有效改善血管性痴呆大鼠的记忆能力,提高大鼠海马组织中PSD-95、BDNF蛋白的表达,电针对记忆力的改善可能与PSD-95、BDNF表达增加相关,有可能是通过影响BDNFGluA1-PSD95信号传导通路而发挥效用。     

电针调控海马头蛋白mRNA的表达对慢性脑低灌注大鼠学习记忆及海马神经发生的影响

目的 通过电针刺激慢性脑低灌注模型大鼠百会穴和大椎穴，观察海马组织头蛋白（Noggin）mRNA的表达，以及电针对慢性脑低灌注模型大鼠学习记忆和海马神经发生的影响。 方法 选取雄性Sprague Dawley(SD)大鼠120只，采用改良永久性结扎双侧颈总动脉法制作慢性脑低灌注模型，将造模成功的104只大鼠分为模型组和电针组，每组52只；再按照治疗时间的不同，将每组大鼠再细分为治疗后第1、2、4、6周四个亚组，每个亚组13只。电针组采用电针刺激大鼠百会穴和大椎穴，电针输出电流1 mA，频率15 Hz连续波，每次20 min，每日1次，治疗7次后休息2 d；模型组不予特殊处理。分别于治疗后第1、2、4、6周，每亚组随机抽取6只大鼠进行BrdU注射，观察神经干细胞增殖及分化情况；利用Morris水迷宫神经行为学检测，观察大鼠空间学习能力和记忆能力的变化情况；采用逆转录-聚合酶链式反应(RT-PCR)检测及BrdU免疫组织化学法，观察海马神经组织Noggin mRNA的表达及海马齿状回神经发生的规律。 结果 电针组大鼠在第2、4、6周的学习记忆能力明显高于同时间点的模型组大鼠（P＜0.05或P＜0.01）；电针组海马组织Noggin mRNA表达均明显高于同时间点模型组大鼠（P＜0.05）；电针组大鼠海马齿状回颗粒下层的BrdU阳性细胞多于同时间点的模型组,且各组的BrdU阳性细胞随着缺血时间的延长均有减少（P＜0.05或P＜0.01）；Pearson相关分析显示，2组大鼠海马Noggin mRNA含量均与BrdU阳性细胞数呈正相关(r=0.561，P=0.000)，且电针组的相关系数大于模型组（P＜0.05）。 结论 电针可通过调控海马Noggin mRNA的表达促进慢性脑低灌注大鼠的海马组织神经发生，从而改善慢性脑低灌注大鼠的空间学习能力和记忆能力。     

电针神庭、百会对大脑中动脉闭塞大鼠学习记忆的影响及机制研究

目的:研究磷酸化的环磷腺苷效应元件结合蛋白(p-c AMP-response element binding protein,p-CREB)、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)在大鼠脑缺血再灌注中的表达,探讨电针神庭、百会对脑缺血再灌注大鼠学习记忆功能的影响及其可能机制。方法:36只雄性SD大鼠,随机分为假手术组、模型组和电针组,每组分配12只。采用大脑中动脉闭塞(middle cerebral artery occlusion,MCAO)法建立局灶性脑缺血再灌注大鼠模型。电针组电针神庭、百会穴干预7d。各组采用Morris水迷宫实验评估大鼠的学习记忆功能;TTC染色观察缺血梗死体积;免疫组化染色检测海马CA1区pCREB,BDNF的表达。结果:与假手术组比较,模型组鼠到达水下平台的潜伏期长些(P0.01),通过平板的次数少些(P0.01)。电针组与模型组比较潜伏期显著短些(P0.05),通过平台的次数显著多些(P0.01)。与假手术组比较,模型组的p-CREB阳性细胞明显减少而BDNF光密度明显增加。与模型组比较,电针组的p-CREB阳性细胞明显增加(P0.01)而BDNF光密度也增加(P0.05),梗死的体积则小些。结论:电针神庭、百会可改善脑缺血再灌注大鼠的学习记忆功能,其作用机制可能与上调缺血侧海马CA1区pCREB,BDNF的表达有关。     

电针对脑缺血再灌注大鼠学习记忆能力及RhoA蛋白表达的影响

目的探讨电针神庭、百会穴对脑缺血再灌注模型大鼠学习记忆能力的影响及其可能机制。方法 45只雄性Sprague-Dawley大鼠随机分为假手术组(n=15)、模型组(n=15)和电针组(n=15)。模型组和电针组均采用左侧大脑中动脉缺血(MCAO)再灌注模型。电针组电针神庭、百会穴共7 d。采用Morris水迷宫测试观察大鼠学习记忆能力;尼氏染色观察大鼠海马神经元形态结构变化;Western blotting法检测大鼠左侧海马Rho A蛋白的表达。结果与模型组相比,电针组学习记忆能力改善(P0.05),海马神经元损伤减少(P0.05),海马组织中Rho A蛋白表达降低(P0.05)。结论电针能够改善脑缺血再灌注大鼠学习记忆能力,其机制可能与抑制Rho A蛋白表达有关。     

电针对脑缺血再灌注大鼠学习记忆能力及MMP-2、MMP-9蛋白表达的影响

目的:探讨电针神庭、百会穴对局灶性脑缺血大鼠学习记忆的影响,及其可能的机制。方法:雄性SD大鼠45只,随机分为假手术组、模型组、电针组,每组15只大鼠。模型组、电针组均采用线栓法制备局灶性脑缺血损伤大鼠模型。电针组电针神庭、百会穴7d。各组在造模后第3天开始采用Morris水迷宫检测学习记忆能力;2,3,5-氯化三苯基四氮唑染色法检测大鼠脑梗死的体积;Western blotting法检测大鼠左侧海马基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)蛋白的表达。结果:同模型组相比,电针组大鼠学习记忆能力改善(P0.05),脑梗死体积明显减少(P0.01),海马组织中MMP-2、MMP-9蛋白表达降低(P0.05)。结论:电针能改善局灶性脑缺血再灌注大鼠学习记忆能力,其机制可能与抑制MMP-2、MMP-9蛋白表达相关。     

跑台训练对阿尔茨海默病模型大鼠记忆能力和突触可塑性的影响

目的:观察8周跑台运动对阿尔茨海默病模型大鼠记忆能力和突触可塑性的影响及内在机制。方法:60只雄性SD大鼠随机分为正常对照组(NC组)、AD模型对照组(AC组)、AD模型训练组(AE组)。通过向大鼠两侧海马区注射Aβ25-35制造AD模型,Morris水迷宫实验检测各组大鼠记忆能力,Golgi法检测海马神经元树突密度;Western blot法检测海马组织中BDNF、SYP、PSD-95、P-Akt、P-CREB的表达。结果:与AC组比较,AE组大鼠逃避潜伏期明显减少,穿越平台区域次数明显增加(P0.01);Golgi染色结果表明,AE组海马神经元侧树突密度明显增加(P0.01);Western blot检测结果表明,与AC组相比,AE组BDNF、SYP、PSD-95、P-Akt表达都明显增强(P0.01),但P-CREB表达无显著性变化(P0.05)。结论:8周跑台训练可增加AD模型大鼠海马组织BDNF、SYP、PSD-95、P-Akt的蛋白表达,可能与海马神经元树突密度增加有关,或许是AD模型大鼠的记忆能力改善和突触可塑性变化的基础。     

电针通过调控NGF/TrkA信号通路改善脑缺血大鼠学习记忆障碍的研究

目的:探讨电针百会、大椎穴促进脑缺血大鼠学习记忆功能的可能机制。方法:将30只雄性SD大鼠随机分为3组,即假手术组,模型组及电针组。采用永久性双侧颈总动脉结扎(permanent bilateral common carotid artery occlusion, BCCAO)模型。电针组造模后第二天开始行百会、大椎穴电针治疗,每天1次,每次20min,共28天。采用Morris水迷宫检测大鼠的学习记忆功能,免疫荧光染色观察海马神经元存活情况,蛋白质印迹法(Western blot,WB)检测海马组织神经生长因子(nerve growth factor,NGF)、酪氨酸蛋白激酶A(tyrosine kinase A,TrkA)及磷酸化酪氨酸激酶A(phosphorylated-tyrosine kinase A,p-TrkA)蛋白的表达情况。结果:模型组大鼠海马神经元标志物NeuN阳性细胞较假手术组显著减少(P0.01),电针组海马神经元标志物NeuN阳性细胞较模型组显著增加(P0.01)。Morris水迷宫结果显示与假手术组相比,模型组大鼠的平均潜伏期明显延长(P0.01),穿过平台次数显著减少(P0.01)。与模型组相比,电针组大鼠的平均潜伏期明显缩短(P0.01),穿过平台次数显著增加(P0.05)。WB结果显示与假手术组相比,模型组大鼠海马组织NGF和p-TrkA蛋白表达量显著下降(P0.01),而电针组大鼠海马组织NGF和p-TrkA蛋白表达量比模型组增加(P0.01),各组间TrkA蛋白表达量没有显著性差异(P0.05)。结论:电针可以改善脑缺血大鼠学习记忆功能障碍,电针发挥作用的机制可能与激活NGF/TrkA信号通路有关。     

丰富环境对缺血缺氧脑损伤新生大鼠海马脑源性神经营养因子表达及细胞凋亡的影响

目的:探讨丰富环境对缺血缺氧脑损伤(HIBD)新生大鼠海马脑源性神经营养因子(BDNF)表达及细胞凋亡的影响。方法:采用随机数字表法将36只7日龄新生大鼠分为假手术组、模型组及丰富环境组,各组又分为术后7d、28d两个亚组(n=6)。采用Rice-Vannucci经典方法建立新生大鼠HIBD模型。模型组及假手术组不予任何干预,丰富环境组予以早期抚触及丰富环境刺激治疗。术后7d、28d采用水迷宫检测方法评估大鼠学习记忆能力,免疫组化法检测大鼠海马CA1区BDNF的表达,TUNEL法检测海马CA1区细胞凋亡。结果:术后7d、28d,与模型组比较,丰富环境组逃避潜伏期均缩短(P0.05),穿越平台次数增多(P0.05),BDNF表达升高(P0.05),TUNEL阳性细胞数降低(P0.05)。结论:丰富环境能改善HIBD新生大鼠学习记忆能力,其机制可能与上调海马区BDNF的表达及抑制细胞凋亡有关。     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation.

OBJECTIVE: Although nausea and vomiting of pregnancy is the most common medical condition during pregnancy, there are many unanswered questions regarding its cause, epidemiologic features and optimal management. The objectives of this study were to ascertain the prevalence of nausea and vomiting in a sample of Canadian women, to characterize the distribution of their severity and to investigate the role of vitamin B6 deficiency in their etiology. DESIGN: Prospective study. SETTING: Antenatal counselling service for pregnant women. PATIENTS: Three cohorts of women: a prospective, population-based cohort of 193 women, to estimate the rate and severity of nausea and vomiting (cohort A); a cohort of 555 women who sought advice for nausea with or without vomiting, to study the correlation between the maximal daily number of episodes of vomiting and maximal weight loss (cohort B); and a prospective cohort of 301 women who reported vomiting, to correlate vitamin supplementation with vomiting (cohort C). INTERVENTIONS: All 3 cohorts were interviewed during the counselling session, and cohort B was followed up prospectively. OUTCOME MEASURES: Frequency of nausea and vomiting, weight loss, maximal number of daily episodes of vomiting, rate of multivitamin supplementation. RESULTS: Overall, 67% of the women in cohort A reported experiencing nausea or vomiting, or both; 22% reported vomiting, and 9% experienced weight loss. In cohort B there was a significant correlation between the maximal number of daily episodes of vomiting and maximal weight loss, although there was wide variation (r2 = 0.25, p < 0.001). There was a highly significant correlation between the number of daily vomiting episodes and mean weight loss (r2 = 0.99). In cohort C, vomiting was significantly associated with lack of supplementation with multivitamins before 6 weeks' gestation (p = 0.002). CONCLUSIONS: The relation between number of daily vomiting episodes and mean weight loss may serve as a clinical tool to assess the severity of nausea and vomiting in pregnancy and the success of anti-emetics and rehydration regimens. Further study is needed to elucidate the biologic basis of the observed association between vomiting and lack of multivitamin supplementation in early pregnancy.     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

骨脂肪瘤及血管脂肪瘤的CT及MRI表现:9例报告并文献复习

目的探讨骨脂肪瘤及血管脂肪瘤的CT及MRI表现。方法收集手术病理证实的9例骨脂肪瘤及血管脂肪瘤的临床及影像学资料,9例术前8例接受CT扫描,3例接受MRI检查。结果9例中骨脂肪瘤6例,骨血管脂肪瘤3例。6例骨脂肪瘤发生于骨内4例,骨旁2例。骨内脂肪瘤跟骨1例,距骨1例,眶骨1例,肱骨1例。骨旁脂肪瘤颅骨1例,股骨1例。骨血管脂肪瘤发生于肋骨1例,颅骨1例,椎骨1例。骨内脂肪瘤CT显示病变骨质呈轻度膨胀性改变,边缘见轻度硬化环,病灶内见脂肪密度及条弧形、结节状钙化,MRI显示病灶T1WI呈高信号,PDWI及T2WI抑脂序列呈低信号。骨旁脂肪瘤CT呈不均匀高密度团块,MRI显示病灶T1WI呈高信号,T1WI及T2WI抑脂序列呈低信号。3例骨血管脂肪瘤CT显示病变骨质呈显著膨胀性改变,骨破坏边缘及内部见多发骨嵴及粗大骨小梁,高密度骨针呈放射状、簇状或不规则排列。结论骨内脂肪瘤及血管脂肪瘤CT及MRI表现均以脂肪成分为主要特征,骨旁脂肪瘤CT以骨化性团块为特征,骨血管脂肪瘤骨质膨胀性改变较骨内脂肪瘤显著,病灶边缘及中心以多发骨嵴及粗大骨小梁为特征。