依达拉奉调控PI3K/Akt信号通路抑制七氟烷致海马神经元凋亡

目的探讨依达拉奉对七氟烷致海马神经元凋亡及对PI3K/Akt信号通路影响。方法将80只成年昆明小鼠随机分为正常组、七氟烷组、七氟烷+依达拉奉组及LY294002+七氟烷+依达拉奉组,每组20只。正常组:小鼠不做处理;七氟烷组:小鼠每天给予1h吸入1.5%七氟烷;七氟烷+依达拉奉组:小鼠每天尾静脉注射依达拉奉3 mg·kg~(-1)后,给予1h吸入1.5%七氟烷;LY294002+七氟烷+依达拉奉组:小鼠每天尾静脉注射依达拉奉3 mg · kg~(-1)和LY294002 0.3 mg · kg~(-1)给予1h吸入1.5%七氟烷。总共麻醉14 d。麻醉结束后,采用TUNEL法检测海马神经元凋亡的情况,采用Y迷宫检测各组小鼠学习记忆能力,Western blotting检测海马神经元细胞中磷脂酰肌醇激酶(PI3K)、磷酸化蛋白激酶B (p-AKT)、B淋巴细胞瘤-2基因(Bcl-2)和Bcl-2相关X蛋白(Bax)蛋白表达。结果与正常组相比,七氟烷组小鼠海马神经元凋亡率升高(P0.05),学习、记忆能力下降(P0.05),PI3K、p-Akt和Bcl-2的蛋白表达下降(P0.05),Bax蛋白表达升高(P0.05)。与七氟烷组相比,七氟烷+依达拉奉组小鼠海马神经元凋亡率降低(P0.05),学习、记忆能力上升(P0.05),PI3K、p-Akt和Bcl-2的蛋白表达升高(P0.05),Bax蛋白表达下降(P0.05)。PI3K抑制剂LY294002与依达拉奉联合注射后,逆转了依达拉奉的上述作用。结论依达拉奉通过激活PI3K/Akt信号通路抑制七氟烷致海马神经元凋亡。     

丁苯酞联合依达拉奉治疗急性缺血性脑卒中对细胞凋亡的影响

目的探讨丁苯酞注射液联合依达拉奉对急性缺血性脑卒中的临床疗效及对细胞凋亡的影响。方法选择急性脑梗死患者136例,随机分为联合用药组和依达拉奉组,每组68例。依达拉奉组给予依达拉奉注射液治疗,联合用药组在依达拉奉组治疗的基础上加用丁苯酞,共治疗14 d。比较治疗前后NIHSS、ADL评分,测定细胞脂质过氧化水平及抗氧化酶活性及血清Bax、Bcl-2含量。结果联合用药组治疗后NIHSS评分低于依达拉奉组,ADL评分高于依达拉奉组,丙二醛(MDA)、超氧化物歧化酶(SOD)水平低于依达拉奉组(P0.05);联合用药组治疗后血清Bax含量低于依达拉奉组,血清Bcl-2含量高于依达拉奉组(P0.05)。结论丁苯酞注射液联合依达拉奉治疗急性缺血性脑卒中,可减轻缺血再灌注过程中氧化应激反应及细胞凋亡,从而减轻脑缺血再灌注(I/R)所引起的脑损伤。     

氢气预处理对乳鼠海马神经元细胞缺氧/复氧损伤后细胞活力的影响

目的探讨氢气对乳鼠海马神经元细胞缺氧/复氧损伤后细胞活力的影响。方法原代培养的SD乳鼠海马神经元细胞,随机分成对照组,缺氧/复氧组和氢气预处理组。对照组常规培养;缺氧/复氧组在100%N2中培养15min后复氧30min;氢气预处理组在2%H2+98%N2中培养15min后复氧30min。采用MTT法检测乳鼠海马神经元细胞活力。结果氢气预处理能够增强细胞活力(P<0.05)。结论氢气预处理对海马神经元细胞缺氧/复氧损伤具有保护作用,可能与提高细胞活力有关。     

依达拉奉治疗高血压急性脑出血的临床疗效观察

脑出血(ICH)后脑损伤病理过程中,脑水肿是脑出血后神经元受第二次打击的中心环节,也是脑出血后继发性脑损伤的主要标志.自由基损伤是主要的机制之一.依达拉奉是一种强效的羟自由基清除剂,可抑制脂质过氧化反应引起的神经细胞损伤,提高缺血神经元的生存能力,为观察依达拉奉对急性脑出血的疗效,设立了治疗组和对照组. 1 对象与方法     

依达拉奉后处理对氧糖剥夺SK-N-SH细胞的抗凋亡作用及对Bcl-2与Bax表达的影响

目的观察依达拉奉后处理(EPC)对氧糖剥夺损伤SK-N-SH细胞的抗凋亡作用及对Bcl-2与Bax表达的影响,探讨其可能的机制。方法细胞分为正常对照组、氧糖剥夺组(OGD组)、依达拉奉后处理组(EPC组)。正常对照组DMEM高糖培养液中正常培养;OGD组的SK-N-SH细胞换用无糖DMEM培养液并置入自制缺氧罐处理4 h,再换成DMEM高糖培养液继续培养20 h;EPC组的SK-N-SH细胞先氧糖剥夺4 h,然后用含终浓度1μmol/L依达拉奉的DMEM高糖培养液作为后处理4 h后,再换成DMEM高糖培养基继续培养16 h。四甲基偶氮唑蓝(MTT)法检测细胞存活率,Hoechst33258染色检测细胞凋亡,Western blot检测Bcl-2与Bax蛋白的表达。结果 OGD组存活率比正常组明显下降(P<0.01),EPC组细胞存活率比OGD组显著增加(P<0.05);OGD组细胞凋亡率较正常组显著增高(P<0.01),而EPC组细胞凋亡率显著低于OGD组(P<0.05);与OGD组比较,EPC组Bcl-2表达显著增高(P<0.05),而Bax的表达明显降低(P<0.05)。结论依达拉奉后处理对氧糖剥夺SK-N-SH细胞有抗凋亡作用,可能与其使Bcl-2过表达和抑制Bax表达有关。     

人重组白细胞介素-6可减少缺氧-复氧后大鼠海马培养神经元的DNA损伤

用原位末端标记（ＴＵＮＥＬ）法观察人重组白细胞介素－６（ｒｈＩＬ－６）对缺氧－复氧后大鼠海马培养神经元的ＤＮＡ损伤的影响。结果显示,海马神经元缺氧－复氧后ＤＮＡ损伤神经元百分率明显增高,经ｒｈＩＬ－６ 预处理的海马神经元缺氧－复氧后ＤＮＡ损伤神经元百分率明显低于对照组。本结果表明,缺氧－复氧能使体外培养海马神经元发生ＤＮＡ损伤,ｒｈＩＬ－６ 可减少缺氧－复氧后海马神经元的ＤＮＡ损伤。提示ｒｈＩＬ－６ 对海马神经元缺氧－复氧损伤可能具有一定保护作用。     

依达拉奉对海人酸致颞叶癫痫大鼠海马神经元的保护作用

目的本实验观察依达拉奉对海人酸致痫大鼠海马神经元损伤的保护作用。方法选用成年健康雄性Wistar大鼠18只,体重260±20g。实验动物随机分为3组,①sham组(n=6):右侧海马CA3区注入等量的生理盐水;②KA模型组(n=6):右侧海马CA3区注入KA 4μg.kg-1(4μg/μl);③依达拉奉组(n=6):右侧海马CA3区注入KA 4μg.kg-1(4μg/μl)后,即刻给予依达拉奉10mg.kg-1.d-1腹腔注射。于大鼠注药或假手术后立即观察各组大鼠的行为学表现,于7d断头取脑,石蜡切片进行硫堇染色,于光学显微镜下观察注药对侧(左侧)海马CA1、CA3区及CA4门区组织形态学特征,并对其进行组织学分级。结果 Sham组大鼠注射对侧海马CA1、CA3和CA4门区无明显组织损伤,组织学分级多为0～1级,ND值为198±20.62和212±30.14;模型组KA致痫大鼠可见明显的组织损伤,组织学分级多为2～3级,ND值为79±13.72和90±14.98,与sham组相比,组织学分级显著升高(p<0.05),ND值显著降低(p<0.01)。依达拉奉组大鼠海马CA1区可见少量、散在性神经元坏死,组织学分级多1～2级,ND值为101±16.85和135±12.17。与模型组相比,组织学分级降低(p<0.05),ND值显著升高(p<0.05)。结论依达拉奉能够减轻KA致痫大鼠海马神经元的损伤,对神经元具有保护作用。     

依达拉奉对糖尿病脑缺血再灌注大鼠细胞凋亡及缺氧诱导因子表达的影响

目的 探讨依达拉奉对糖尿病急性脑缺血再灌注大鼠细胞凋亡及缺氧诱导因子表达的影响.方法 选取健康雄性SD大鼠70只,采用腹腔内一次性注入新鲜配制的1%链尿佐菌素(STZ)及线栓法建立糖尿病大鼠大脑中动脉闭塞再灌注模型.随机分成依达拉奉干预脑缺血再灌注组(干预组)30只、非依达拉奉干预脑缺血再灌注组(非干预组)30只、假手术组5只和正常组5只.前两组又分为缺血2h再灌注1h、6h、12h、24h、48h、72h亚组,每亚组5只.用TUNEL法检测细胞凋亡的变化,用免疫组化法检测缺氧诱导因子(HIF-1α)的表达水平.结果 依达拉奉干预组各个时间点脑皮质区凋亡细胞数及缺氧诱导因子表达量均低于非依达拉奉干预组(P<0.05).结论 依达拉奉可明显减少糖尿病急性脑缺血再灌注大鼠脑神经细胞凋亡数,同时可减少缺氧诱导因子的表达.在糖尿病脑缺血再灌注过程中具有明显神经保护作用.     

低氧预适应小鼠脑匀浆液提取液对大鼠鼠胚海马神经元缺氧复氧后神经细胞的影响

目的 探讨低氧预适应小鼠脑匀浆液提取液对大鼠鼠胚海马神经元缺氧复氧后神经细胞活性和凋亡的影响. 方法在96孔培养板中将大鼠鼠胚海马神经细胞原代培养至8 d,将培养细胞按照处理的不同分为以下5组:(1)正常对照组(仅加入PBS)、(2)H<,4>R<,48>组(缺氧4 h/复氧48h后加PBS)、(3)H0组(缺氧4 h/复氧48 h前加正常小鼠脑匀浆提取液)、(4)H1组(缺氧4h/复氧48h前加急性低氧对照小鼠脑匀浆提取液)、(5)H4组(缺氧4 h/复氧48 h前加低氧预适应小鼠脑匀浆提取液),分别用酶标仪和流式细胞仪测定神经细胞活性和凋亡情况.结果 正常对照组细胞活性明显高于H<,4>R<,48>组,H0、H1和H4组分别与H<,4>R<,48>组相比,细胞活性明显增加,且H4组细胞活性又明显高于H0、H1组;正常对照组仅有极少量的凋亡细胞,而H<,4>R<,48>组凋亡细胞显著增多,H0、H1和H4组分别与H<,4>R<,48>组相比凋亡细胞明显减少,且H4组又分别明显少于H0、H1组.结论低氧预适应小鼠脑匀浆液提取液可能通过增加大鼠鼠胚海马神经元缺氧复氧后神经细胞活性和减少神经细胞凋亡起到抗缺氧性损伤作用.     

依达拉奉对海人酸致痫大鼠海马神经元抗氧化应激能力的影响

目的本实验观察依达拉奉对海人酸(KA)致痫大鼠海马神经元抗氧化应激能力的影响。方法选用成年健康雄性Wistar大鼠66只,体质量240±20g,实验动物随机分为3组:1假手术组(n=6)右侧海马CA3区注入等量的生理盐水;2KA模型组(n=30):右侧海马CA3区注入KA 4μg·kg-1(4μg·μl-1)。3依达拉奉组(n=30):右侧海马CA3区注入KA 4μg·kg-1(4μg·μl-1)后,即刻给予依达拉奉10mg.kg-1.d-1腹腔注射。模型组和依达拉奉组均设定5个时间点,分别为5min、6h、24h、72h、7d,每个时间点6只大鼠,于预订的时间点断头取脑,分离左侧海马,检测脑组织中超氧化歧化酶(SOD)、丙二醛(MDA)含量。结果假手术组各个时间点SOD活性及MDA含量均无明显变化(P>0.05);模型组于KA注射后6h可见SOD活性下降,MDA开始升高,于3d SOD活性降至最低(P<0.01),MDA升至最高(P<0.01),随后SOD活性开始回升,MDA开始下降,于7d时SOD活性恢复至基线水平;依达拉奉组于6⁷2h时间段内SOD活性明显高于模型组(P<0.01或P<0.05),MDA含量明显低于模型组(P<0.01或P<0.05)。结论依达拉奉有效地升高KA致痫大鼠海马神经元的SOD活性并降低MDA生成,从而提高机体的抗氧化应激能力,减轻神经元的损伤,对神经元具有保护作用。     

Brazilian consensus on public policies on alcohol

This is the summary of a meeting where a group of experts, representing several health organizations and academic departments from different parts of Brazil, created a consensus about the main alcohol policies which should be implemented by different levels of the Brazilian government. The World Health Organization has been suggesting for 30 years the actions that should be implemented for the public good. Two important conclusions were reached: 1) The research establishes beyond doubt that public health measures of proven effectiveness are available to serve the public good by reducing the widespread costs and pain related to alcohol use; 2) To that end, it is appropriate to deploy responses that influence both the total amount of alcohol consumed by a population and the high-risk contexts and drinking behaviours that are so often associated with alcohol-related problems. To conceive of these intrinsically complementary approaches as contractory alternatives would be a mistake. The objectives of the consensus are: 1) To make the scientific evidences more available to the Brazilian policy makers; 2) To facilitate the evaluation of the available strategies according their effectivity, scientific support, cost and cultural adaptability; 3) To make the Brazilian health professionals familiar with the priorities of alcohol policies.     

应重视脑卒中的综合预防

脑卒中高居人口死亡原因的第 2位 ,每年新发患者 >15 0万例 ,现有幸存者 >6 0 0万例 ,其中 75 %丧失劳动力 ,4 0 %中度致残 ,是老年人致残和认知障碍的主要原因 ,年直接或间接经济损失高达数百亿元。高血压、心脏病、房颤、糖尿病、高脂血症、无症状颈动脉狭窄以及不良生活方式 ,包括吸烟、酗酒等均为脑卒中的危险因素 ,应针对危险因素予以控制 ,并长期有效坚持 ,大部分脑卒中是可以预防的。1.高血压 :我国高血压超过 1亿人口 ,是脑卒中最常见的可控危险因素。 14项随机对照研究结果表明 ,舒张压降低 5～ 6ｍｍＨｇ可以减少脑卒中发生率的 4…     

Clinical and experimental studies on the action of ethamsylate on haemostasis and on platelet functions

In a series of tests,the action of ethamsylate on haemostasis and on platelet functions was examined. After oral administration of the drug,a highly significant diminution of the bleeding time and of the blood loss from a standard wound was observed. This effect was demonstrated in healthy individuals and in patients suffering from platelet dysfunctions,and there was a distinct dose relation. There was also an increase of platelet adhesion,of PF 3 availability and of PF 4 release. The action of prostacyclin on the epinephrine induced platelet aggregation could be inhibited by ethamsylate. This offers a possible explanation for some of the effects on hemostasis. In addition,an action of ethamsylate on the platelet membrane was assumed since an in vitro increase of functions of the platelet membrane like PF 3 availability would not be explainable by a possible inhibition of prostacyclin.     

Certain predictions on the effectiveness of l-DOPA on parkinsonism

Summary Sixty nine patients with Parkinson's disease were treated with L-DOPA for more than a year. L-DOPA produced remarkable improvement in akinetic patients, moderate improvement in rigidity and slight improvement in tremor. The degree of improvement in akinesia, rigidity and tremor tended to be reversely related to the severity of the disease. Rigidity and akinesia improved better in young patients, but there was no correlation between age and the response of tremor to the treatment. Except for rigidity there was no correlation between the improvement and the duration of the disease.

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Zusammenfassung 69 Parkinsonpatienten wurden während mehr als 1 Jahr mit L-DOPA behandelt. Es wurde dadurch bei akinetischen Patienten eine beachtliche, bei Patienten mit Rigor eine mäßige und bei Patienten mit Tremor eine geringfügige Besserung erreicht. Das Ausmaß der Besserung war in allen drei Formen um so geringer, je ausgeprägter die Symptome bei Behandlungsbeginn waren. Rigor und Akinesie sprachen bei jungen Patienten besser auf die Therapie an, aber es bestand keine Korrelation zwischen dem Alter der Patienten und der Beeinflußbarkeit des Tremors durch die L-DOPA-Therapie. Außer für den Rigor bestand keine Korrelation zwischen dem Ausmaß der Besserung und der Dauer der Erkrankung vor Behandlungsbeginn.

     

不同病房模式对精神分裂症病情影响的研究

目的探讨不同病房模式对首发精神分裂症患者病情的影响及康复情况。方法开放式病房的患者为研究组68例,同时选择住封闭式病房患者为对照组130例,对两组患者的临床资料进行比较分析。结果对照组患者入院时焦虑抑郁及敌对猜疑出现明显变化（P＜0.05）;研究组患者在第1周时焦虑抑郁已经开始改善,第2周时病情、阳性症状、一般精神病理、敌对猜疑、激活性也出现明显变化（P＜0.05）;第4周时研究组病情及各因子、认知功能及自知力显著改善,与对照组比较存在统计学差异（P＜0.05）。结论开放式病房模式可以减少患者的负性影响,更快改善患者的认知功能,有利于患者自知力的恢复,使患者的病情达到更全面的康复。     

Efficacy of milnacipran on poststroke depression on inpatient rehabilitation

Post-stroke depression (PSD) has a negative impact on rehabilitation following stroke. No satisfactory antidepressant treatment for PSD has yet been developed. The present study examined the effect of milnacipran, a serotonin and norepinephrine reuptake inhibitor, on PSD patients. Eleven PSD patients taking milnacipran in a rehabilitation hospital were compared to age-matched, sex-matched, and severity of depression at admission-matched PSD patients hospitalized during 2001 who did not take any antidepressant as historical control. Severity of depression was measured using self-rating depression scale for depression (SDS) assessed at admission and discharge after 3 months inpatient rehabilitation. Activities of daily living (ADL) and quality of life (QOL) were measured, respectively, by the functional independence measure (FIM) and a self-completed questionnaire for QOL (QUIK) as outcomes of rehabilitation. For the SDS score, the group taking milnacipran showed significant improvement compared to the control group in our study. FIM was improved in both groups. In the end QUIK did not change significantly in either group. We found no major side-effects of milnacipran among the patients. These results suggest that milnacipran is a safe and effective treatment for PSD for inpatients undergoing rehabilitation.