兴奋性氨基酸、Ca~(2+)和乳酸在短暂性脑缺血后海马DND发生机制中的作用(摘要)

短暂性脑缺血后海马 CA_1区产生迟发性神经元坏死(DND),但是对海马 CA_1区DND 发生机制仍有争议。本实验目的是为了阐明兴奋性氨基酸、Ca~(2+)和乳酸在短暂性脑缺血后海马 DND 发生机制中的作用。首先,通     

沙土鼠短暂性脑缺血后海马迟发性神经元死亡发生机制的探讨(摘要)

本实验通过结扎沙土鼠双侧颈总动脉20分钟再灌流2天或7天造成海马迟发性神经元死亡(DND)模型,检测背侧海马 Ca~(++)及脂质过氧化物含量的变化,并用海马 CA_1区神经元密度作为指标,观察     

兴奋性氨基酸在短暂性脑缺血后海马DND发生机制中的作用

本实验首先通过结扎沙土鼠双侧颈总动脉10分钟再灌流7天,造成海马DND模型,以计数海马CA_1区神经元密度作为指标,观察谷氨酸钠和氯胺酮对海马DND的影响;用氨基酸自动分析技术测定脑缺血10分钟时背侧海马氨基酸含量。结果示谷氨酸钠加重海马DND损伤;氯胺酮对海马DND有明显保护作用;短暂性脑缺血10分钟时兴奋性氨基酸含量升高。此结果均直接或间接说明兴奋性氨基酸在海马DND发生机制中起着重要作用。     

大鼠脑缺血再灌注后Caspase-3的表达及纳洛酮的影响

目的:探讨Caspase-3在缺血再灌注大鼠海马神经元中的表达及纳洛酮的影响。方法:用插线法制作大鼠大脑中动脉闭塞(middlecerebralarteryocclusion,MCAO)局灶性脑缺血再灌注模型,左侧MCAO1h,再灌注23h后处死,对照组给予生理盐水,纳洛酮组给予纳洛酮,海马区Caspase-3的表达通过免疫组化来测定;缺血侧海马区凋亡细胞数采用TUNEL法测定。结果:对照组、纳洛酮组、假手术组缺血侧海马区平均密度值分别为0.130±0.012、0.062±0.004、0.053±0.006。对照组大鼠缺血侧海马区Caspase-3的表达较假手术组显著增强(P<0.01),给予纳洛酮处理后,Caspase-3的表达减弱(P<0.01)。对照组缺血侧海马区许多神经元有凋亡现象,纳洛酮组凋亡神经元减少,假手术组偶见凋亡神经元。结论:短暂的脑缺血可导致海马区Caspase-3的表达增加,凋亡神经元增多。海马区Caspase-3的激活与神经元的凋亡相关,纳洛酮可抑制海马区Caspase-3的表达,减少神经元的凋亡。     

白松片对抑郁模型大鼠海马神经元睫状神经生长因子及其mRNA表达水平的影响

目的观测白松片对抑郁模型大鼠海马睫状神经生长因子(CNTF)及其mRNA表达水平的影响,探讨白松片的抗抑郁作用的机制。方法将大鼠随机分为正常组、模型组、白松片组、氟西汀组,采用连续21d慢性轻度不可预见性应激配合孤养复制抑郁模型。运用免疫组化和原位杂交方法探讨白松片对抑郁模型大鼠海马神经元细胞CNTF、CNTFmRNA表达的影响。结果白松片组大鼠海马神经元CNTF免疫反应阳性细胞数目增多,神经元平均灰度值降低,其中CA1区(105.14±7.21),CA3区(104.47±6.05),DG区(108.18±7.56);CNTFmRNA杂交阳性信号增加,神经元平均灰度值降低,其中CA1区(182.14±12.68),CA3区(176.82±11.12),DG区(175.98±12.15)。与模型组比较,差异有显著性(P<0.05或P<0.01)。结论白松片增加抑郁模型大鼠海马CNTF、CNTFmRNA的表达,可能是其抗抑郁作用的分子机制之一。     

谷氨酸转运体抑制剂DHK抑制脑缺血预处理的保护作用

目的:观察谷氨酸转运体GLT1抑制剂二氢卡因酸盐(DHK) 对脑缺血预处理(CIP)诱导脑缺血耐受的影响.方法:采用四血管闭塞法制作大鼠全脑缺血模型,右侧脑室注射DHK.脑组织切片硫堇染色法观察海马CA1区锥体神经元迟发性死亡(DND)程度,确定组织学分级.结果:假手术组和CIP组海马CA1区未见明显的DND;损伤性缺血组海马CA1区有明显的DND;CIP 损伤性缺血组海马CA1区DND不明显; DHK CIP 损伤性缺血组中,DHK阻断了CIP对海马CA1区锥体神经元的保护作用.定量分析发现,DHK CIP 损伤性缺血组较CIP 损伤性缺血组的保护效应明显降低.结论:DHK可抑制CIP诱导的脑缺血耐受.     

益气通络方对大鼠短暂性脑缺血后海马DND的保护作用

目的 :探讨益气通络方对大鼠短暂性脑缺血后海马迟发性神经元死亡 (DND)的保护作用及其机制。方法 :用Pulsinelli四血管闭塞法制作全脑缺血模型。实验动物随机分为假手术对照组、脑缺血加生理盐水组和脑缺血加益气通络方组。缺血再灌 3天后进行HE染色、TUNEL染色。结果 :①HE染色 ,光镜下观察CA1区组织病理学变化 ,并用显微测微尺测量CA1区存活锥体细胞密度 (存活锥体细胞的个数 /mm) ,表明益气通络口服液组 ( 1 1 4 .5± 1 9.0 )与生理盐水组 ( 1 0 .5± 3.0 )比较 ,P <0 .0 1。②TUNEL染色 ,光镜下假手术组未见阳性结果 ,缺血再灌流加生理盐水组CA1区大部分锥体神经元发生凋亡 ( 1 2 4 .0± 1 1 .5) ,益气通络方组CA1区凋亡的锥体神经元明显减少 ( 2 4 .5± 3.0 ) ,存活细胞增多。结论 :益气通络方能够显著降低大鼠短暂性脑缺血后海马迟发性神经元死亡 ,抑制细胞凋亡可能是其临床疗效的机制之一。     

红藻氨酸致痫大鼠海马区神经元凋亡的动态变化

目的探讨红藻氨酸(kainicacid,KA)诱导的大鼠癫痫状态海马神经元的形态学变化、凋亡情况及抗痫药物的神经保护作用。方法90只Wistar大鼠随机分为对照组、KA组和卡马西平(CBZ)组,后两组再按癫痫发作后1h、4h、12h、24h、48h和72h不同时点分为6个亚组。KA注射后,观察大鼠癫痫发作后的行为学变化;采用HE染色法观察大鼠癫痫状态海马CA1、CA3区神经元形态学改变;采用原位细胞凋亡检测法观察癫痫状态海马CA1、CA3区神经元凋亡情况。结果KA注射后,大鼠出现严重的惊厥;在癫痫发作后12h,海马CA1区、CA3区开始出现凋亡细胞[CA1区:KA组(6.53±1.36)个,CBZ组(5.85±1.68)个;CA3区:KA组(9.58±1.63)个,CBZ组(7.36±1.27)个],48h凋亡细胞达到峰值(P<0.01)[CA1区:KA组(42.263±3.28)个,CBZ组(35.39±2.36)个;CA3区:KA组(57.64±12.76)个,CBZ组(38.37±13.65)个]。经CBZ干预后凋亡细胞明显减少(P<0.05)。结论癫痫发作后的迟发性神经元死亡很可能是由凋亡引起的,CBZ可抑制癫痫状态海马神经元凋亡。     

海洛因慢性处理对大鼠脑内一氧化氮合酶阳性神经元数量和形态的影响

目的观察不同浓度海洛因处理对大鼠伏隔核(NAc)、中央灰质背侧(CGd)一氧化氮合酶(NOS)阳性神经元数量和形态的影响。方法将32只SD大鼠随机分成4组,海洛因慢性处理后,采用还原型辅酶Ⅱ-黄递酶(NADPH-d)组织化学方法染色,观察不同浓度海洛因处理对大鼠NAc、CGd区NOS阳性神经元表达的影响。结果0.25mg·kg-1、1.0mg·kg-1海洛因慢性处理组NAc区(38.2±3.8)(36.8±1.9)、CGd区(65.3±1.3)(61.8±1.8)和0.05mg·kg-1海洛因慢性处理组NAC区(44.3±1.4)NOS阳性神经元细胞数较对照组NAc区(29.8±1.9)、CGd区(52.4±2.7)明显增多(P<0.05);0.05mg·kg-1海洛因慢性处理组CGd区(33.9±1.3)和1.0mg·kg-1海洛因慢性处理组CGd区(32.1±1.1)、NAc区(31.0±1.6)NOS阳性神经元胞体面积较对照组(40.8±0.8)有明显缩小(P<0.05);0.05mg·kg-1、1.0mg·kg-1组大鼠CGd区(49.2±2.1)(43.5±1.4)NOS阳性神经元轴突长度较对照组(58.2±3.6)明显变短(P<0.05),而三个处理组NAc区NOS阳性神经元轴突长度差异无显著性(P>0.05)。结论海洛因慢性处理能够引起CGd、NAc区NOS阳性神经元数量增多、胞体缩小、轴突长度变短,提示海洛因慢性处理对NOS阳性神经元有损伤作用,NOS参与了海洛因的依赖过程。     

硫酸镁减轻缺血再灌注性兔脑损伤作用的实验研究

目的 :探讨硫酸镁对缺血再灌注兔脑损伤的作用。方法 :15只兔随机均分至 :对照组、缺血组和缺血+硫酸镁处理组。阻断兔脑血管 6分钟 ,诱导全脑缺血。缺血再灌注 3天后 ,分别用HE染色和TUNEL染色 ,检测海马CA1 区神经元密度和凋亡神经元密度。结果 :缺血 +硫酸镁处理组海马CA1 区正常神经元密度为 140 .5 2±16 .2 3个 mm ,显著高于缺血组 (P <0 .0 1) ;缺血神经元密度为 2 4.18± 3 .16个 mm ,显著低于缺血组 (P <0 .0 1) ;凋亡神经元密度为 18.40± 8.0 8个 mm ,显著低于缺血组 (P <0 .0 1)。结论 :硫酸镁具有减轻兔缺血再灌注性全脑损伤的作用 ,其作用机制可能同抑制缺血后神经元凋亡有关     

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…     

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.     

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.     

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.     

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.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…