黑质致密部神经元对去甲肾上腺素的敏感性与其放电型式的关系

目的　研究黑质致密部 (SNc)神经元的放电型式与其对去甲肾上腺素 (NE)敏感性的关系 ,探讨“非周期敏感”现象的普遍性 .方法　在幼鼠的脑片胞外记录 SNc神经元的自发放电 .比较周期与非周期放电神经元对 NE反应的敏感性 ,对非周期放电神经元的放电进行非线性动力学分析 .结果　 NE对 18个周期及 12个非周期放电神经元呈现兴奋作用 ,对 16个周期及 12个非周期放电神经元呈现抑制作用 .无论兴奋或抑制作用 ,非周期放电神经元对不同浓度 NE的反应程度均比周期放电神经元大 (P<0 .0 1) ;NE的兴奋及抑制作用可分别被酚妥拉明 (2 0μmol· L- 1 )及舒必利 (1μmol· L- 1 )阻断 ;在非周期放电神经元的放电序列中测出非稳定周期轨道 .结论　 SNc的非周期放电神经元比周期放电神经元对 NE更敏感 ,这种敏感性可能与非周期放电的混沌特性有关 .     

辣椒素通过钙信号抑制感觉神经元的电压门控性钙离子通道

目的 研究辣椒素对大鼠背根神经节神经元的电压门控性钙离子通道的抑制效应及其信号机制.方法 在急性分离的大鼠背根神经节(DRG)神经元上,应用全细胞膜片钳技术记录电压激活性钙离子通道电流以及辣椒素诱导的电流,应用钙离子成像技术检测Ca2+浓度的变化.结果 辣椒素能够抑制大鼠DRG神经元的电压激活性钙离子通道电流.细胞外钾离子浓度显著升高引起细胞去极化并打开膜上电压门控性钙离子通道引起胞外Ca2+内流,辣椒素只在引起胞内Ca2+浓度显著升高的情况下才能抑制高钾诱导的电压门控性Ca2+内流.用咖啡因耗竭细胞内Ryanodine敏感性钙库以后,辣椒素引发的胞内钙浓度升高的效应被显著抑制,说明辣椒素可诱导胞内Ryanodine敏感性钙库释放Ca2+.结论 在辣椒素敏感性的大鼠DRG神经元中,辣椒索通过胞内钙信号抑制电压门控性钙离子通道.Ca2+信号部分来源于Ryanodine敏感性钙库.     

混沌和周期的交感神经刺激对大鼠受损背根节神经元放电的影响

目的研究受损背根节(DRG)神经元对不同时间序列的交感神经刺激反应。方法采用单纤维记录神经元自发放电的方法,在DRG慢性压迫模型上,电刺激腰交感神经干,比较受损DRG神经元对周期和混沌的交感神经刺激的反应。结果慢性压迫DRG中存在交感-感觉耦联现象。受损DRG神经元对交感神经刺激的反应随刺激频率(在5~20 Hz范围内)的增加而增大(P<0.01)。将刺激平均频率和刺激强度相同而刺激时间序列不同的交感神经刺激引起受损DRG神经元的反应进行比较发现,混沌的交感神经刺激引起的反应比周期的交感神经刺激引起的反应大(P<0.01)。结论除刺激频率外,交感神经刺激的时间序列是影响受损DRG神经元反应的重要因素,混沌刺激引起的效应比周期刺激效应强,突触前神经元的混沌放电比周期放电可引起更大的突触后效应,神经元的混沌放电可能是神经传递信息的一种有效形式。     

马桑内酯对大鼠海马锥体神经细胞内钙稳态的影响

目的　了解钙离子及钙通道在癫痫发病中的作用 ,探讨马桑内酯 (coriaria lactone,CL)调节神经细胞内钙稳态的机理。方法　利用激光扫描共聚焦显微镜和细胞培养技术 ,观察致痫剂 CL 对 Wistar乳鼠海马单个锥体神经细胞内游离钙离子 (Ca2 +)浓度的影晌。结果　经致痫剂 CL 作用后 ,锥体神经细胞内 Ca2 +浓度高于正常对照组 (P<0 .0 1) ,但其升高不呈剂量依赖性 (P>0 .0 5 ) ;经钙通道阻滞剂尼莫地平处理后 ,CL 虽然仍能引起神经元胞内 Ca2 +浓度升高 (P<0 .0 1) ,但与单纯使用 CL 组相比仍有明显差异 (P<0 .0 0 1)。结论　 L-型钙通道开放在痫性放电的发生、发展上起了重要作用 ,促进钙通道开放可能是马桑内酯致痫的重要途径之一。     

PKA参与ATP对大鼠背根神经节神经元电压门控性钙通道的抑制

目的 探讨ATP对大鼠背根神经节(DRG)神经元的电压门控性钙通道(VGCC)的抑制效应及其信号转导途径.方法 在急性分离的大鼠DRG神经元上应用全细胞膜片钳技术记录ATP诱导的电流以及VGCC电流;应用钙离子成像技术检测胞内Ca2+浓度([Ca2+]i)的变化.结果 ATP能够可逆性地抑制DRG神经元的VGCC电流和VGCC介导的[Ca2+]i升高.用PKA抑制剂H-89预处理DRG神经元,ATP对VGCC电流及其介导的[Ca2+]i升高的抑制被反转;而用PKC抑制剂bisindolylmaleimide(Bis)预处理DRG神经元,ATP对VGCC介导的[Ca2+]i升高的抑制效应则无影响.结论 在大鼠DRG神经元中,PKA参与了ATP对该神经元VGCC的抑制.     

A型肉毒毒素对大鼠受损背根节神经元放电和交感-感觉耦联的影响

目的 研究A型肉毒毒素(BTXA)对慢性压迫背根节(DRG)神经元(慢性神经痛模型)的自发放电和交感-感觉耦联的影响.方法 采用单纤维记录神经元自发放电的方法,在受损DRG上加BTXA,观察BTXA对DRG神经元自发放电的影响.电刺激腰交感神经干,观察交感刺激对受损DRG神经元放电的调节作用,静脉注射BTXA后,再观察交感刺激对受损DRG神经元放电的影响.结果 慢性压迫DRG神经元有丰富的自发放电,47个受损DRG神经元放电对无钙人工脑脊液有显著的兴奋反应,但BTXA对这些神经元的自发放电无影响.64%的受损DRG神经元对腰交感神经干电刺激有反应,交感刺激对受损DRG的这种作用可被静脉注射BTXA所阻断.结论 BTXA对慢性压迫DRG神经元的自发放电无影响.在慢性压迫DRG神经元上存在交感-感觉耦联现象,BTXA可以阻断这种交感-感觉耦联现象.     

风湿性心脏病心房纤颤和非心房纤颤患者心房肌细胞内钙离子浓度变化

目的　观察风湿性心脏病 (RHD)心房纤颤 (AF)患者心房肌细胞内是否存在 Ca2 + 超载 .方法　急性分离 RHD伴 AF和非 AF患者的心房肌细胞 ,用 Fluo- 3作为钙指示剂 ,用共聚焦显微镜测定细胞内 Ca2 +浓度 .结果　 AF组心房肌细胞内 Ca2 +浓度明显高于非 AF组心房肌细胞内 Ca2 +浓度(5 17± 98) nmol· L- 1 vs(2 6 2± 6 5 ) nmol· L- 1 ,两组间差异显著 (P<0 .0 1) .结论　 RHD伴 AF患者心房肌细胞内存在Ca2 +超载     

不同糖浓度中大鼠DRG神经元相关蛋白表达及Ca2+浓度的测定

目的观察高糖对背根神经节(DRG)中瞬时感受器电位香草酸受体4(TRPV4)和蛋白激酶Cε(PKCε)的表达以及细胞内Ca2+浓度的影响,探讨其在糖尿病大鼠神经病理性疼痛形成中的作用机制。方法培养的新生大鼠DRG神经元分成正常对照组(C组)、中糖组(M组)和高糖组(H组)。48 h后通过蛋白质免疫印迹法测定DRG神经元TRPV4和PKCε的表达水平,并通过共聚焦显微镜测定DRG神经元[Ca2+]i的水平。结果 TRPV4、PKCε蛋白的表达上调且呈浓度依赖性。C组、M组、H组TRPV4蛋白分别为0.33±0.05、3.20±0.40和7.69±0.60;PKCε蛋白分别为0.88±0.04、1.08±0.08和1.97±0.35。在TRPV4激动剂4α-PDD的作用下,与C组比较,H组[Ca2+]i显著升高(P<0.05),且呈浓度依赖。结论高糖可以上调DRG神经元中TRPV4、PKCε蛋白的表达,增加神经元内Ca2+浓度。TRPV4、PKCε对DRG神经元内Ca2+起到了协同调控的作用。     

乙酰胆碱对大鼠慢性压迫背根节神经元放电的影响

目的研究乙酰胆碱(ACh)对大鼠慢性压迫背根节(DRG)神经元放电的影响。方法采用单纤维记录神经元自发放电的方法,在DRG慢性压迫模型上观察ACh对受损DRG神经元自发放电的影响。结果受损DRG神经元有丰富的自发放电,77.9%有自发放电的受损DRG神经元对ACh有反应,其中反应类型有单纯兴奋和先兴奋后抑制两种形式,而且反应的幅度随ACh浓度的延长而逐渐增大。结论在慢性压迫DRG神经元有大量的自发放电,ACh可明显影响受损DRG神经元的自发放电。     

大鼠肠肌间神经元胃动素受体的表达及胃动素引起神经元内钙信号的机制

目的观察大鼠肠肌间神经元胃动素受体(MTLR)的表达,并探讨胃动素引起神经元内钙信号的机制。方法采用免疫荧光双标技术观察大鼠肠肌间神经元MTLR的表达;应用激光共聚焦显微镜技术检测不同药物处理组胃动素引起的单个神经元内Ca2+荧光强度的变化。结果大鼠肠肌间神经元呈MTLR免疫反应阳性表达;在Hank's液中,10-6mol/L胃动素可引起神经元内Ca2+浓度的显著升高,其峰高(峰值减去静息值)为30.6±3.7,荧光强度相对变化百分比为(100.8±18.4)%。在D-Hank's液(去除细胞外Ca2+)中或用L型钙离子通道阻断剂维拉帕米预处理细胞后,胃动素可轻度升高胞内Ca2+浓度。与单独应用胃动素组相比差异有统计学意义(P<0.05)。当分别用G蛋白拮抗剂NEM和PLC抑制剂Compound48/80预处理细胞后再加入胃动素,胞内Ca2+浓度升高的程度明显降低,与单独应用胃动素组相比差异有统计学意义(P<0.05)。当用PKC抑制剂D-鞘氨醇预处理细胞后,再加入胃动素,其峰高和荧光强度相对变化百分比同单独应用胃动素组相比差异无统计学意义(P>0.05)。结论大鼠肠肌间神经元能自身表达MTLR。胃动素可明显升高神经元内Ca2+浓度,胞内Ca2+浓度的升高既源于外钙的内流又源于内钙的释放。外钙的内流主要通过L型Ca2+通道,G蛋白偶联型MTLR-PLC-IP3途径参与细胞内钙的释放。     

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.     

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…     

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.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.