国产降纤酶对大鼠缺血/再灌注脑损伤的保护作用

目的观察3种国产降纤酶对大鼠缺血/再灌注脑损伤的保护作用。方法采用线栓法大鼠局灶性脑缺血/再灌注模型,观察3种国产降纤酶对缺血/再灌注不同时程动物脑梗死体积、血流量、神经功能缺损评分及梗死灶内肉眼出血率的影响。结果持续缺血3h,降纤酶治疗的各组动物脑梗死体积明显小于生理盐水对照组(P<0.05);缺血3h再灌注3h和72h,降纤酶治疗的各组动物脑梗死体积与生理盐水组相比无明显变化,但缺血3h再灌注6h和24h,降纤酶治疗的各组动物脑梗死体积比生理盐水组明显减少(P<0.05)。缺血3h再灌注6h、24h和72h,降纤酶治疗组动物脑血流量比生理盐水组明显增加(P<0.05)。但治疗组动物行为学评分较生理盐水组无相应改善,梗死灶内有肉眼出血的动物较生理盐水组多,但无统计意义。结论国产降纤酶能明显减小缺血/再灌注脑损伤动物的梗死体积和增加脑血流量,改善损伤后的低灌注状态,对脑组织有一定保护作用。     

大鼠脑缺血再灌注后梗死体积的动态变化

目的观察大鼠大脑中动脉缺血再灌注后梗死灶体积的变化规律。方法线栓法制作大鼠局灶性脑缺血再灌注模型,观察脑缺血2h再灌注3h、24h、3d、7d、14d及21d后的神经功能缺损评分及2％氯化三苯基四氮唑(TTC)标记的梗死体积。结果缺血2h再灌注3h组已经出现较明显的梗死灶(梗死体积占前脑体积14．4％),再灌注24h组梗死体积最大(24．3％),显著大于再灌注3h、7d、14d、21d组(P<0．05)。再灌注3d组梗死灶仍较大 (23．8％),再灌注7d组梗死体积缩小(5．0％),再灌注14d组梗死灶进一步缩小(1．2％),再灌注21d组梗死灶基本消失(0．2％)。大鼠神经功能缺损评分与梗死体积之间呈显著相关(r=0．61,P<0．01)。结论脑缺血再灌注后梗死体积于24h达最大,21d时基本消失。脑缺血再灌注后神经功能缺损评分与梗死体积之间显著相关。     

高血糖及胰岛素干预对大鼠脑缺血再灌注损伤的影响

目的探讨高血糖及胰岛素干预对大鼠脑缺血再灌注损伤的影响。方法将健康成年雄性SD大鼠160只随机分为假手术组、正常血糖组、高血糖组及胰岛素干预组，每组40只。高血糖组及胰岛素干预组采用STZ法诱导高血糖模型，以线栓法制作大脑中动脉缺血．再灌注模型，再灌注时间分别为1h、6h、12h和24h。大鼠清醒后行神经功能缺损程度评分（NSS）、TTC染色法计算梗死体积、HE染色和原位末端标记法（TUNEL）定量观察梗死周边区域凋亡神经元数目。结果与正常血糖组大鼠比较，再灌注同时间点高血糖组大鼠NSS显著增高（均P〈0．01）、梗死体积明显扩大（均P〈0．01）以及梗死周边区凋亡神经元数目明显增多（P〈0．01）；与高血糖组比较，胰岛素干预可明显控制血糖、减轻神经功能损害（12hP〈0．05，24hP〈0．01）、缩小梗死体积（均P〈0．01）、减少神经元凋亡数（P〈0．05—0．01），再灌注24h甚至可达正常血糖组水平。结论血糖水平升高可加重缺血再灌注性脑损害，可能与其诱导神经元凋亡有关，而胰岛素可能通过阻止神经元凋亡实现神经保护作用。     

三七三醇皂苷对脑缺血再灌注大鼠的保护作用

目的 通过对局灶性脑缺血大鼠不同再灌注时段的动态观察．探讨三七三醇皂苷(PTS)对大鼠局灶性脑缺血／再灌注动物模型的神经行为学和脑梗死体积的保护作用。方法 采用改良的线栓法制备大脑中动脉阻塞(MACO)2h、再灌注不同时间段(3h、6h、12h、24h、48h、72h、7d)的大鼠短暂局灶性脑缺血模型。动物随机分假手术组、生理盐水对照组、三七三醇皂苷(PTS)组。用Zea Longa5分制评分和TTC染色法评价神经行为学和脑梗死体积。结果 神经行为学评分除72h组有明显改善外．其余各组与生理盐水对照组比较无显著性差异。脑梗死体积除再灌注3h、6h外．其余各组与生理盐水组比较差异均有显著性意义。结论 三七三醇皂苷对大鼠局灶性脑缺血及再灌注损伤有一定的保护作用。     

亚低温对大鼠脑缺血再灌注后炎性反应的影响

目的：观察亚低温的不同时程对大鼠脑缺血再灌注后炎性反应的影响。方法：24只SD大鼠随机分为4组：常温组，亚低温1／2h组，亚低温1h组和亚低温3h组。每组各6只大鼠。参照Zea Longa的方法建立脑缺血再灌注动物模型，于再灌注24h断头取脑，行HE染色，观察脑组织中自细胞浸润及神经细胞的变化情况。结果：常温组在缺血梗死灶周围区可见白细胞浸润明显及深染受损的神经元；随亚低温时间的延长，白细胞浸润逐渐减少，神经元亦表现为淡染的轻度损伤。结论：亚低温可抑制脑缺血再灌注后的白细胞浸润，具有神经保护作用。     

雷帕霉素对大鼠脑缺血再灌注后神经元损害的保护作用

目的 观察雷帕霉素对大鼠脑缺血再灌注后神经元损害的保护作用。方法 52 只雄性 SD 大鼠随机分为对照组和实验组（雷帕霉素干预）各24 只,另4 只为假手术组。采用Longa 线栓法制备 大鼠局灶性脑缺血再灌注模型,缺血3 h 后,于再灌注4 h、6 h、12 h、24 h、72 h、7 d 进行各指标观察;其 中实验组在构建脑梗模型之前进行腹腔注射雷帕霉素（ 1 mg/kg）,假手术组不插线,其余过程同对照组。 采用TTC 染色法观察脑组织变化;免疫组织化学（免疫荧光法）检测Bcl-2、Caspase-3 及自噬相关蛋白 LC-3 的变化。结果 TTC 染色假手术组未见缺血表现,缺血3 h 后可见病灶侧脑组织苍白,实验组病灶 小于对照组。实验组大鼠灌注6、12、24 h 时神经功能缺损评分均明显低于对照组（P＜ 0.05）。Caspase-3 的表达：再灌注4 h表达显著增高, 至24 h左右达高峰, 实验组再灌注6 h、24 h、7 d表达明显低于对照组, 差异有统计学意义（P＜ 0. 05）;Bcl-2 的表达：再灌注4 h 增多,24 h 达高峰,实验组再灌注4、6、12、24 h 表达明显高于对照组（P＜ 0.05）;实验组LC-3 表达明显高于对照组。结论 雷帕霉素能促进LC-3 表达, 抑制细胞凋亡;抑制Caspase-3 的表达,增加Bcl-2 的表达从而减轻缺血所致的损伤,对大鼠缺血后神经 功能的恢复有确切的疗效。     

流式细胞术检测局灶性脑缺血再灌注bcl—xl、bax蛋白表达

目的 探讨应用流式细胞术检测bcl-xl和bax在局灶性脑缺血再灌注中的表达及作用。方法 45只健康雄性Wistar大鼠随分为正常对照组，假手术组、缺血3h组和缺血3h再灌注组；缺血再灌注组又分为缺血再灌注3h,6h,12h,24h,48h和72h等6个亚组。采用线栓法复制大脑中动脉脑缺血再灌注模型，应用流式细胞术检测bcl-xl和bax蛋白表达。结果 缺血3h再灌注各亚组，随再灌注时间的延长，半影区bax表达逐渐增强，于再灌注24h和48h达高峰（均P＜0．01）;bcl-xl表达在早期增强后随即呈下降趋势，bcl－xl/bax比值呈动态变化。再灌注中心区，在缺血再灌注早期bcl-xl和bax表达均增强（P＜0．05或P＜0．01），随着再灌注时间的延长，二者的表达及bcl-xl/bax比值逐渐减弱。结论 bcl-xl表达增强有利于促进神经细胞存活，而bcl-xl与bax比值的转变则促进神经细胞凋亡。     

大鼠局灶性脑缺血再灌注中1-磷酸鞘氨醇受体1的表达变化

目的 观察大鼠局灶性脑缺血再灌注模型1-磷酸鞘氨醇受体1(S1P1)的变化,探索S1P1在脑缺血再灌注损伤中的作用.方法 雄性Wistar大鼠,随机分成假手术组、缺血2h再灌注3h组、6h组、12h组、24h组、24h+安慰剂组和24h+FTY720组.应用"线栓法"实现大鼠右侧大脑中动脉闭塞,2h后拔出线栓进行再灌注,并在相应时间点处死大鼠.再灌注24h+安慰剂组和再灌注24h+FTY720组大鼠于再灌注前10min经尾静脉注入安慰剂或S1P受体激动剂FTY720[1mg/(kg·体重)].利用免疫组化方法观察S1P1蛋白表达水平的变化,对再灌注24h+安慰剂组和再灌注24h+FTY720组大鼠进行神经功能评分、梗死体积测定和TUNEL阳性细胞计数.结果 与假手术组相比,缺血再灌注组大鼠梗死灶周围区皮质S1P1的蛋白表达水平明显升高(P<0.05),开始于再灌注后3h,12h达到高峰,24h开始下降.FTY720显著缩小梗死体积,改善神经功能评分,减少TUNEL阳性细胞数量.结论 S1P1在脑缺血再灌注过程中激活,减轻缺血再灌注损伤,发挥脑保护作用.     

重组人促红细胞生成素对大鼠局灶性脑缺血再灌注损伤的保护作用

目的 探讨重组人促红细胞生成素(EPO)对大鼠局灶性脑缺血再灌注损伤所致炎性反应的保护机制。方法采用线拴法制备大鼠局灶性大脑中动脉缺血再灌注模型,应用TTC染色法、干湿重法、常规HE染色法观察EPO治疗前后再灌注24h脑梗死体积、脑组织含水量以及组织学变化,应用RT- PCR方法检测EPO治疗前后再灌注lh、3h、6h、12 h、24h、72 h缺血侧脑皮质IL-1β、TNF-α基因表达的变化。结果与假手术组相比,EPO可显著缩小缺血再灌注24h所致的脑梗死体积(P＜0.01),降低梗死侧脑组织含水量(P＜0.01),减轻病理学变化。缺血再灌注各时相点缺血侧皮层IL -lβ mRNA和TNF -α mRNA表达均显著上调(P＜0.01),12 h达高峰。EPO治疗后lh、3h、6h缺血侧皮层IL - 13 mRNA表达显著下降,与病理组相应时间点相比,分别降低了63％、55％和84％(P＜0.01)。EPO治疗后lh、3h、6h缺血侧皮层TNF -α mRNA表达亦显著下降,与病理组相应时间点相比,分别降低了75％、76％和95％（P＜0.01）。结论EPO可能通过抑制IL - 1β、TNF-α的基因表达,降低缺血再灌注的炎性反应损伤而改善脑组织的结构和功能。     

丁苯酞预处理对脑缺血再灌注大鼠CHOP及Caspase-3的影响

目的观察丁苯酞预处理对脑缺血再灌注大鼠的保护作用。方法 72只健康SD大鼠随机分为假手术组、缺血再灌注组及丁苯酞预处理组,每组按再灌注6h、12h、24h分3个亚组各8只。采用Zea Longa法制备大鼠脑缺血再灌注模型,假手术组不插入线栓,丁苯酞预处理组给予丁苯酞50mg/(kg·d)灌胃,共5d,其他2组给予等量生理盐水替代。免疫组化法分别检测脑组织CHOP及Caspase-3的动态表达。结果与假手术组比较,缺血再灌注组的CHOP、Caspase-3在6h升高,24h达峰(P0.01);丁苯酞预处理组24hCHOP、Caspase-3阳性表达低于缺血再灌注组(P0.05)。结论丁苯酞预处理可下调CHOP、Caspase-3的表达,抑制IRE1介导的内质网应激及其后的凋亡信号通路,有效减少神经细胞凋亡。     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

Abstract

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Presence and severity of anorexia and bulimia among male and female Omani and non-Omani adolescents

OBJECTIVE: The population of Oman is a heterogeneous mix of nationalities providing a natural setting for studying the cross-cultural differences in the presence and severity of eating disorders as well as an opportunity for evaluating the performance of measurement instruments for these disorders. METHOD: Disordered eating screening instruments (the Eating Attitude Test and the Bulimic Investigatory Test) were administered to Omani teenagers, non-Omani teenagers, and Omani adults. RESULTS: On the Eating Attitude Test, 33% of Omani teenagers (29.4% females and 36.4% males) and 9% of non-Omani teenagers (7.5% of males and 10.6% females) showed a propensity for anorexic-like behavior. On the Bulimic Investigatory Test, 12.3% of Omani teenagers showed a propensity for binge eating or bulimia (13.7% females and 10.9% males). Among the non-Omani teenagers, 18.4% showed a tendency toward bulimia, with females showing a slightly greater tendency than males. In contrast, barely 2% of Omani adults showed either a presence of or a severity of disorderly behavior with food. CONCLUSION: Omani teenagers scored significantly higher than other ethnic groups and Omani adults. This finding is discussed in the light of emerging evidence from many parts of the world suggesting that cultural transition, compounded by demographic constraints, plays a significant role in abnormal eating attitudes.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Spatial attention and conscious perception: interactions and dissociations between and within endogenous and exogenous processes

A current controversy exists about the relationship between spatial attention and conscious perception. While some authors propose that these phenomena are intimately related (Bartolomeo, 2008, Chun and Marois, 2002, O’Regan and Noë, 2001, Posner, 1994), others report dissociations between them (Kentridge et al., 1999, Koch and Tsuchiya, 2007, Wyart and Tallon-Baudry, 2008). However, spatial attention is not a unitary mechanism, and it is possible that not all forms of attention dissociate from conscious perception. In the present study we used a paradigm in which endogenous and exogenous forms of attention are orthogonally manipulated in order to investigate their relation with conscious perception within the same design. By analyzing two different cue-related components, our results demonstrated that while endogenous attention was electrophysiologically dissociated from conscious perception, exogenous attention was not, consistent with the hypothesis that exogenous attention is an important antecedent of our conscious experience. Our results support previous claims of dissociations between some forms of spatial attention and conscious perception, but also highlight the importance of exogenous orienting on the selection of information for conscious access.     

Serious emotional and behavioral problems and mental health contacts in American and British children and adolescents

OBJECTIVE: To compare prevalence of serious emotional and behavioral problems and mental health contacts for these problems among American and British children and adolescents. METHOD: Data on children and adolescents ages 5 to 16 years were drawn from the 2004 U.S. National Health Interview Survey (response rate = 79.4%) and the 2004 survey of Mental Health of Children and Young People in Great Britain (response rate = 76.0%). Emotional problems, hyperactivity/inattention, and conduct problems were assessed using the parent version of the Strengths and Difficulties Questionnaire (SDQ). Psychometric properties of SDQ scales were compared across countries. RESULTS: The SDQ has similar psychometric properties across countries. More British than American children met the criteria for emotional and conduct problems, but not hyperactivity/inattention. Prevalence was higher for all problems in 5- to 8-year-old British boys and for emotional problems in 13- to 16-year-old British girls. American children with serious emotional and behavioral problems had a higher prevalence of mental health contacts overall and with mental health providers but not with general medical providers. CONCLUSIONS: British children have a higher prevalence of parent-reported serious emotional and behavioral problems than American children. However, British children with these problems are less likely than American children to receive mental health care.