Morphine Preconditions Purkinje Cells against Cell Death under In Vitro Simulated Ischemia-Reperfusion Conditions

Background: Morphine pretreatment via activation of [delta]1-opioid receptors induces cardioprotection. In this study, the authors determined whether morphine preconditioning induces ischemic tolerance in neurons.

Methods: Cerebellar brain slices from adult Sprague-Dawley rats were incubated with morphine at 0.1-10 [mu]m in the presence or absence of various antagonists for 30 min. They were then kept in morphine- and antagonist-free buffer for 30 min before they were subjected to simulated ischemia (oxygen-glucose deprivation) for 20 min. After being recovered in oxygenated artificial cerebrospinal fluid for 5 h, they were fixed for morphologic examination to determine the percentage of undamaged Purkinje cells.

Results: The survival rate of Purkinje cells was significantly higher in slices preconditioned with morphine (>= 0.3 [mu]m) before the oxygen-glucose deprivation (57 +/- 4% at 0.3 [mu]m morphine) than that of the oxygen-glucose deprivation alone (39 +/- 3%, P < 0.05). This morphine preconditioning-induced neuroprotection was abolished by naloxone, a non-type-selective opioid receptor antagonist, by naltrindole, a selective [delta]-opioid receptor antagonist, or by 7-benzylidenenaltrexone, a selective [delta]1-opioid receptor antagonist. However, the effects were not blocked by the [mu]-, [kappa]-, or [delta]2-opioid receptor antagonists, [beta]-funaltrexamine, nor-binaltorphimine, or naltriben, respectively. Morphine preconditioning-induced neuroprotection was partially blocked by the selective mitochondrial adenosine triphosphate-sensitive potassium channel antagonist, 5-hydroxydecanoate, or the mitochondrial electron transport inhibitor, myxothiazol. None of the inhibitors used in this study alone affected the simulated ischemia-induced neuronal death.     

Isoflurane Preconditions Hippocampal Neurons against Oxygen-Glucose Deprivation: Role of Intracellular Ca2+ and Mitogen-activated Protein Kinase Signaling

Background: Isoflurane preconditions neurons to improve tolerance of subsequent ischemia in both intact animal models and in in vitro preparations. The mechanisms for this protection remain largely undefined. Because isoflurane increases intracellular Ca2+ concentrations and Ca2+ is involved in many processes related to preconditioning, the authors hypothesized that isoflurane preconditions neurons via Ca2+-dependent processes involving the Ca2+- binding protein calmodulin and the mitogen-activated protein kinase-ERK pathway.

Methods: The authors used a preconditioning model in which organotypic cultures of rat hippocampus were exposed to 0.5-1.5% isoflurane for a 2-h period 24 h before an ischemia-like injury of oxygen-glucose deprivation. Survival of CA1, CA3, and dentate neurons was assessed 48 later, along with interval measurements of intracellular Ca2+ concentration (fura-2 fluorescence microscopy in CA1 neurons), mitogen-activated protein kinase p42/44, and the survival associated proteins Akt and GSK-3[beta] (in situ immunostaining and Western blots).

Results: Preconditioning with 0.5-1.5% isoflurane decreased neuron death in CA1 and CA3 regions of hippocampal slice cultures after oxygen-glucose deprivation. The preconditioning period was associated with an increase in basal intracellular Ca2+ concentration of 7-15%, which involved Ca2+ release from inositol triphosphate-sensitive stores in the endoplasmic reticulum, and transient phosphorylation of mitogen-activated protein kinase p42/44 and the survival-associated proteins Akt and GSK-3[beta]. Preconditioning protection was eliminated by the mitogen-activated extracellular kinase inhibitor U0126, which prevented phosphorylation of p44 during preconditioning, and by calmidazolium, which antagonizes the effects of Ca2+-bound calmodulin.     

Parkinson''''s Disease and Smoking: An Integral Part of PD''''s Etiological Study

INTRODUCTION Parkinson抯 disease (PD), a debilitating neurodegenerative disorder, is featured with bradykinesia, resting, muscular rigidity, gait disturbances, and postural reflex impairment[1]. PD is rare before age of 50 years, but it increases dramatically with older ages, with peak onset occurring during the age of 70-85 years. In the United States, prevalence of PD in all age groups is approximately 150 per 100 000 and is roughly 30 per 100 000 at age of less than 50 years and 800 …     

脊髓纵裂手术治疗的疗效

[目的]探讨脊髓纵裂手术治疗效果.[方法]对1978年5月～2006年1月收治的有完整资料的121例单管型及双管型脊髓纵裂手术及非手术治疗的病例进行回顾性分析,并通过临床神经功能评分及胫后神经皮层体感诱发电位(PTNCSEP)P40波峰监测,评价其手术治疗的疗效.[结果]双管型脊髓纵裂通过手术后观察和6个月～15年(平均2年6个月)的随访发现,临床神经功能评分及PrNCSEP术后有明显改变,尤其是疼痛为主诉的患者恢复最为明显,手术的总有效率可达86%;单管型脊髓纵裂手术前后无明显变化.[结论]双管型脊髓纵裂脊髓损害重,且呈进行性加重,精细的手术治疗可以使大多数患者症状缓解,终止神经进行性损伤,确诊后应尽早手术;单管型脊髓纵裂脊髓损害轻,不需手术探查.     

5％咪喹莫特乳膏治疗14例非侵袭性基底细胞癌

Sexton等和Milroy等根据镜下表现。将基底细胞癌（BCC）分为结节型、浅表型、微结节型、浸润型、硬斑病型、混合型，在生物学行为上将前两型归为非侵袭性BCC，后四型归为侵袭性BCC。2003年我们从门诊患者中选择14例非侵袭性BCC，单独用5％咪喹莫特乳膏治疗，治疗结果报道如下。     

青少年初始血压高者在高血压发生中的预测意义

为探讨初始血压偏高者在高血压发生中的预测意义，对汉中农村４６２３名年龄６～１５岁青少年血压，经过８年随访（末次随访率为８２．０７％）证明，基线调查收缩压百分位与８年后的收缩压相关系数，男为０．３３，女为０．２８，舒张压均为０．２０；基线调查收缩压在第７５百分位（Ｐ７５）以上者，８年后血压≥１８．７／１２．０ｋＰａ（１４０／９０ｍｍＨｇ）的机率是＜Ｐ５０以下的３．９１倍，初始血压百分位愈高相对危险性愈大；如同时初始收缩压≥Ｐ７５、体重指数≥Ｐ９０，并有高血压病家族史者，发生高血压的机率为２７．６％，是收缩压＜Ｐ７５、体重指数＜Ｐ９０和无高血压家族史者的６．５７倍。我们认为，青少年初始血压高者是成年高血压的易感人群，特别当伴有肥胖或超重及高血压家族史者，预测意义更大。     

肛周皮角1例

患者男，52岁，因肛周赘生物，不痛不痒半年余，于2004年11月8日至我科门诊就诊。半年前，患者无意中发现肛周存一米粒大赘生物，不痛不痒。后赘生物逐渐增大，无出血现象。1987年接受过混合痔根除术，术后无复发。     

5-氟脲嘧啶灌洗并持续负压引流治疗耳廓假性囊肿

介绍一种治疗耳廓假性囊肿的方法,以负压吸引器代替加压外固定,以5-氟脲嘧啶(5-fluorouracil,5-FU)做为刺激软骨层粘连药物,不易复发.     

境外医院领导体制概述

介绍了境外部分国家和地区的医院类型、政府在医院管理中的职能和有关医院领导体制的基本情况,侧重介绍了医院最高领导机构和决策者的组成和特征。指出:要转变政府职能,强调医院的自主经营和自主管理,医院的发展需要有一支高效率、高管理水平的医院领导队伍。     

脊髓纵裂分型治疗的疗效分析

目的探讨脊髓纵裂分型治疗的疗效。方法对1978年5月至2006年11月收洽的有完整资料的121例单管型及双管型脊髓纵裂患者的病历资料进行回顾性分析，并通过临床神经功能评分及胫后神经皮层体感诱发电位（FTNCSEP）P40波峰监测，评价其手术及非手术治疗的疗效。结果所有患者均得到随访，随访时间6个月～15年，平均2年6个月。96例双管型患者中手术治疗86例，术后观察和随访发现24例痊愈、22例有明显改善、28例有一定改善、12例无明确效果，临床神经功能评分及PTNCSEP术后有明显改变，尤其是以疼痛为主诉的患者恢复最为明显，手术总有效率为86％；10例双管型患者未行手术治疗，随访发现临床症状无明显改善且有加重趋势。单管型患者25例，手术治疗16例，术前、术后临床神经功能评分及胛NCSEP无明显变化；未手术治疗的9例，随访时上述指标亦无明显变化。结论双管型脊髓纵裂患者脊髓损害重且呈进行性加重，精细的手术治疗可以使大多数患者症状得到缓解，终止神经进行性损伤，确诊后应尽早手术。单管型脊髓纵裂患者脊髓损害轻，无须手术探查。