机械性脑白质损伤后皮层神经元凋亡的证据及其分布特征

目的 探讨细胞凋在机构性脑白质损伤后皮层神经细胞病理变化中的作用及其分布特征。方法 雄性健康SD36只随机分为假手术组（12只）和模型组（24只），用模型组动物制作大脑皮层下横切模型。于致伤后不同时间片锴动物，用TUNEL原位末端标记和常规病理组织学方法观察损伤区及相应皮层神经细胞变化的性质和规律。结果 致伤后横切处出血，损伤组织内神经元再现坏死改变，胶质细胞增多。大脑皮层Ⅱ-Ⅴ层神经细胞多出现切缩改变。伤后12d后，相应皮层内即再现散在早期凋亡神经元，随后逐渐增多，7d后又趋减少，伤后19d皮层内仍可检出凋亡神经元。在损伤区凋亡神经元少见，可见部分胶质细胞凋亡。结论 脑白质损害时，损伤相应部位皮层神经元主要表现为凋亡。在损伤区，神经元和胶质细胞主要表现为坏死。层内凋亡神经元主要分布于第Ⅱ-Ⅴ层，其时间分布呈一单峰状曲线，凋亡峰出现在伤后第7d前后至少持续19d。     

硫酸镁对大鼠创伤性脑损伤后神经细胞凋亡的影响

目的:观察创伤性颅脑损伤(TBI)后大鼠神经细胞凋亡现象.应用硫酸镁观察其对损伤后大鼠神经细胞凋亡的影响.方法:采用Feeney损伤模型,运用原位末端标记(Tunel)技术,观察中度脑损伤后2h～5d伤侧大脑皮层、海马神经细胞凋亡情况,结果:1.Tunel染色:伤侧大脑半球广泛存在细胞凋亡,以受伤区周缘为甚,伤后2h即可见凋亡细胞,2～3d达高峰,5d时减少.2硫酸镁治疗后8h～3d,伤侧皮层、海马区细胞凋亡数与损伤组比较明显减少(P＜0.05).结论:TBI后,神经元发生变性、坏死的同时,存在凋亡现象.硫酸镁能阻滞TBI后神经细胞的凋亡,具有脑保护作用.     

大鼠创伤性脑损伤后神经元的凋亡及NOS、NGF-R、bcl-2、ChAT阳性神经元的变化

目的 :探讨脑损伤后不同时相皮质、海马、隔区神经元凋亡及NOS、NGF -R、bcl-2、ChAT阳性神经元数量的变化。方法 :采用大鼠自由落体脑损伤模型 ,伤后不同时间取脑片作Nissl染色 ,TUNEL染色 ,NADPH -d组化和NGF -R、bcl-2、ChAT免疫组化染色。结果 :Nissl染色可见损伤侧海马CA2、CA3区锥体细胞层细胞稀疏、排列紊乱。损伤区周围皮质凋亡细胞于伤后 1天已十分明显 ,伤后 3天达到高峰 ;损伤侧海马伤后 1天CA1区即出现凋亡细胞 ,伤后 5天达到高峰 ,主要见于CA3区及齿状回 (DG ) ;损伤侧隔区于伤后 4天开始出现凋亡细胞 ,7天时达高峰。损伤区周围皮质NOS阳性神经元数量伤后 1天即有大量增加 ;损伤侧海马伤后 1天NOS阳性神经元数量开始增加 ,伤后 4天达高峰 ,正常侧海马NOS阳性神经元数量也有增加 ;损伤侧隔区NOS阳性神经元数量于伤后 4天有明显增加增加的NOS细胞以iNOS为主。损伤侧海马NGF -R阳性神经元于伤后 1天开始增加 ,伤后 5天达高峰。损伤侧海马伤后 1天bcl-2阳性神经元数量即下降 ,伤后 3天下降至最低点。损伤侧隔区ChAT阳性神经元于伤后 4天开始减少 ,7天时减至最低点。结论 :大鼠创伤性脑损伤后损伤区周围皮质和损伤侧海马、隔区神经元凋亡数量的变化与伤后时程有关。伤后神经元iNOS、NGF -R的表?     

全脑缺血再灌注后神经元凋亡的时相和分布特征

目的探讨大鼠全脑缺血再灌注后神经元凋亡的时相和分布特征,为神经元损伤的早期干预和继发性脑损害的防治提供实验依据.方法建立大鼠全脑缺血模型,采用TTC染色、原位细胞凋亡检测(原位末端标记法,TUNEL)及AO/EB荧光比色法观察脑缺血再灌后海马、皮层凋亡发生的数量和分布,用荧光指示剂Fura-2 AM标记,检测脑海马细胞内游离钙的浓度.结果 TUNEL显示再灌注3 h海马部位即出现散在凋亡细胞,并向皮层区域扩展,24～48 h达高峰;坏死细胞迟于凋亡出现,弥散分布于凋亡细胞周围,再灌注48 h后坏死细胞增多,72 h最多.AO/EB法显示海马、额叶和顶叶凋亡细胞总数分布在再灌注后24 h和72 h达高峰,并显著高于对照组(P＜0.05).TTC染色证实全脑缺血再灌注后不出现梗死灶,而是在海马及大脑皮层有弥散性坏死.胞内[Ca2 ]i各时间点与对照相比匀显著升高(P＜0.01).结论全脑缺血再灌后受累神经元经历了由凋亡到死亡的过程,对缺血敏感的海马神经元首先受损,并向顶叶和额叶皮层扩展,细胞质内[Ca2 ]i增加是主要原因.利用凋亡时间窗进行早期干预可能有益于保护和挽救凋亡前期神经元,减小继发性损害的严重程度.     

实验性大鼠脊髓损伤神经细胞凋亡的研究

目的 探讨脊髓损伤（SCI）后神经细胞凋亡时间和空间的分布规律。方法 制作大鼠程控电磁吸铁棒下落打击脊髓损伤模型,且末端脱氧核苷酸转移酶介导生物素标记（TUNEL）技术检测细胞凋亡。结果 脊髓损伤后1～2d灰质区TUNEL阳性细胞数最多,随着时间的延长,TUNEL阳性细胞逐渐减少。白质区伤后1d TUNEL阳性细胞数量多,至伤后2d明显减少,伤后7d白质区又出现高峰,至30d白质和灰质区仅见少量散在的TUNEL阳性细胞。结论 脊髓损伤后存在神经细胞的凋亡,白质区和灰质区细胞凋亡演变过程不同。     

富含鱼油饮食对轻型颅脑爆炸冲击伤大鼠的神经保护作用研究

目的 研究轻型颅脑爆炸冲击伤后大鼠不同时间脑组织星形胶质细胞、小胶质细胞和神经元损伤反应的病理改变和过程。同时探讨富含鱼油饮食对轻型颅脑爆炸冲击伤大鼠的神经保护作用。方法 收集54只刚断乳SD大鼠,随机均分为对照组、模型组、治疗组,模型组及治疗组大鼠分别在喂养普通饲料和富含鱼油的饲料33 d后建立由冲击波诱导的轻型颅脑爆炸冲击损伤模型,对照组大鼠在喂养普通饲料33 d后不建立爆炸冲击波损伤模型。结果 与对照组相比,模型组和治疗组的大鼠体质量在致伤后出现一定程度的减轻,随后恢复至致伤前水平;轻型爆炸伤后6 h、24 h、3 d,模型组和治疗组大鼠大脑海马区GFAP阳性染色星形胶质细胞数量及海马区锥体细胞数量均减少。反之,模型组和治疗组大鼠脑组织中海马区的激活态小胶质细胞和皮层区域凋亡神经元数量均增加,且具有时间依赖性。此外,与模型组相比,治疗组可增加伤后星形胶质细胞和海马区锥体细胞数量,并降低激活态小胶质细胞和皮层区域凋亡神经元数量。结论 富含鱼油饮食可通过减轻颅脑爆炸伤后神经细胞损伤,抑制神经炎性反应等方面发挥其神经保护作用。     

外源性NGF对液压脑损伤大鼠神经细胞凋亡的影响

目的　研究脑创伤后外源性NGF对神经细胞凋亡的影响及其意义。方法　建立大鼠流体脑创伤模型 ,采用免疫细胞化学、电镜及图像分析等方法 ,观察脑创伤后单纯致伤组和NGF处理组神经细胞凋亡的变化。结果　正常及对照组的皮层及海马区域偶见TUNEL染色阳性的细胞。电镜超微结构观察凋亡细胞的染色阳性信号在胞核内 ;脑创伤后 12h即见大量凋亡细胞 ,并随时间延长而逐渐增多 ,主要分布在伤侧皮层、海马等区域。单纯致伤组在伤后 3d即出现凋亡高峰 ,为 (6 1.4± 3.7)个 /mm2 ,明显高于对照组 (P <0 .0 1)。NGF处理组在伤后第 7天达凋亡高峰 ,为 (2 4 .9± 2 .5 )个 /mm2 ,明显高于对照组 (P <0 .0 1) ,并显著低于单纯致伤组 (P <0 .0 1)。结论　外源性NGF能够明显减轻脑创伤后神经细胞的凋亡 ,可能与NGF对脑创伤后神经细胞的保护作用有关     

体外培养皮层神经元缺糖氧后氧化-抗氧化状态的变化

目的:观察皮层神经元缺糖氧复氧后氧化-抗氧化分子的变化,并探讨其对凋亡的影响.方法:建立体外培养皮层神经元缺糖氧复氧损伤模型,实验分为正常对照组,缺糖氧复氧不同时间组(3、6、12及24 h组),检测各组细胞上清液乳酸脱氢酶(LDH)、一氧化氮(NO)含量及一氧化氮合酶(NOS)活性;观察神经元谷胱甘肽(GSH)含量及谷胱甘肽过氧化物酶(GPx)活性变化:Hochest33258核染色观察皮层神经元凋亡情况.结果:与正常对照组相比,缺糖氧复氧后神经元LDH释放量及NO含量明显增多、GPx活性持续下降(P<0.05);于缺糖氧复氧3 h及6 h时,NOS活性增高、GSH含量减少(P<0.05),而于24 h时二者变化无显著差异(P>0.05);神经元于缺糖氧复氧3 h时出现凋亡,且随复氧时间的延长,凋亡持续增多(P<0.05).结论:随着缺糖氧复氧时间的持续,氧化及抗氧化平衡的破坏,可能是致体外培养皮层神经元凋亡的原因之一.     

癫痫大鼠海马中表达生长抑素的中间神经元轴突出芽的研究

目的:探讨表达生长抑素(somatostatin,SS)的树突型中间神经元的轴突出芽.方法:6～8周龄健康雄性SD大鼠随机分为实验组(腹腔注射氯化锂+匹罗卡品)和对照组(腹腔注射氯化锂+生理盐水),注药后于1,7,15,30,60d5个时间点又随机分为5个亚组(A1 ～5亚组,B1 ～5亚组).免疫组织化学方法检测各组海马不同区域不同时间点SS中间神经元的表达及其轴突出芽情况,结合神经元特异性核抗原(neuronal nuclei-NeuN)的免疫组织化学及其与SS的免疫荧光双标记,观察SS中间神经元的数目及其轴突出芽的动态变化.结果:癫痫持续状态(status epilepticus,SE)后60d时CA1区SS神经元数目超过对照组(P＜0.01),60d时海马CA1区全层均可见大量增多的SS阳性纤维;SE后60 d CA1区的起始部位始层和辐状层NeuN阳性神经元数目超过正常;SE后15 d时与NeuN双标记的SS中间神经元在CA1区始层逐渐增多,60d时CA1始层及辐状层可见增多的双标记SS中间神经元.结论:SE后60 d CA1区全层大量增多的SS阳性纤维来自于CA1区始层及辐状层增多的SS阳性中间神经元,这种病理性轴突出芽可能在颞叶癫痫的发生和慢性期自发发作中发挥重要作用.     

亚低温抗脑缺血后神经细胞凋亡的信号传导途径

脑缺血后神经元坏死和凋亡并存,神经细胞坏死多发生在伤后即刻及之后数分钟至1 d内发生于损伤灶的中心部位.脑缺血所致的神经细胞凋亡则主要出现在伤灶四周的缺血、缺氧区及半影区内迟发型神经细胞死亡和对缺血缺氧敏感的海马、齿状回和大脑皮质的神经细胞[1].     

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.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

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.