亚低温减少大鼠短暂性全脑缺血后皮质iNOS诱导的神经元凋亡

为研究亚低温对大鼠脑缺血再灌注后皮质iNOS表达、NO产生及神经元凋亡的影响及探讨亚低温的神经保护机制,用大鼠短暂全脑缺血模型,采用Nissl染色观察存活神经元、免疫组化法检测iNOS、硝酸还原酶法检测NOx-水平和TUNEL染色结合电子显微镜观察检测凋亡神经元。结果显示:常温缺血组额叶皮质iNOS表达、NOx-水平增高,出现凋亡神经元;低温缺血组iNOS表达、NOx-水平明显低于常温缺血组,未检测到凋亡神经元。上述结果提示,脑缺血后iNOS来源的NO参与了神经元的凋亡过程,亚低温可减少大鼠短暂性全脑缺血后iNOS诱导的神经元凋亡。     

浅低温和中低温体外循环在婴幼儿心脏外科的比较

目的　比较浅低温体外循环和中低温体外循环在婴幼儿心脏外科的应用。方法　分析 1 1 8例 3岁以下心脏手术患者 ,其中 46例 (组 1 )在中低温体外循环下手术 ,72例 (组 2 )在浅低温体外循环下进行手术。比较两组患者的转流时间、术后低心排发生率、术后机械通气时间以及动脉血气等围手术期资料。结果　浅低温组患者的平均转流时间较中低温组短 (P <0 .0 5 ) ,术后低心排的发生率也较中低温组低 (P <0 .0 5 ) ;浅低温组患者术后的失血量和输血量均较中低温组少 (P <0 .0 5 ) ,并且术后机械通气时间也较中低温组短 (P <0 .0 5 ) ,而氧合指数高于中低温组 ;浅低温组术后肌酸磷酸激酶同工酶 (CK MB)浓度明显低于中低温组 (P <0 .0 1 ) ,另外浅低温组术后代谢性酸中毒的发生率也较低。两组患者术后的心率和收缩压相似 ,而浅低温组术后舒张压却低于中低温组。结论　浅低温体外循环技术在婴幼儿心肌保护、改善术后呼吸功能及维持酸碱平衡等方面均优于中低温体外循环技术。表明浅低温体外循环可作为一项安全、有效的技术应用于婴幼儿心脏外科。     

新生儿缺氧缺血性脑损伤亚低温干预大鼠模型的建立

为探讨不同疗程亚低温对新生儿脑损伤的保护作用,建立新生儿缺血缺氧性脑损伤亚 温干预大鼠模型,先在７日龄清洁级ＳＤ大鼠上以右颈总动脉结扎术和吸入低氧浓度气体法制备缺血缺氧性脑损伤（ＨＩＢＤ）模型,再将其随机分为室温恢复组（ＲｏＴ组,ｎ＝４４）和３种疗程（２４ｈ,４８ｈ,７２ｈ）的亚低温干预组（Ｈｙ２４组,ｎ＝２６,Ｈｙ４８组,ｎ＝１４,Ｈｙ７２组,ｎ＝２０）。亚低温干预期间采用配方奶喂养,并监测脑温     

Effects of adenosine 3′, 5′-cyclic monophosphate on thermoregulation in both rats and rabbits

Summary The effects of intraventricular administration of dibutyryl adenosine 3, 5-cyclic monophosphate (db cyclic AMP) on the thermoregulatory responses of unanesthetized rats and rabbits to different ambient temperatures (T_a) were assessed. Administration of db cyclic AMP (10–60 mM) produced dose-dependent hypothermia in both rats and rabbits at T_a 2–22 °C. The hypothermia in response to db cyclic AMP was due to decreased metabolic heat production and cutaneous vasodilatation. There was no change in respiratory evaporative heat loss. In contrast, in the heat (30–32 °C), db cyclic AMP administration produced dose-dependent hyperthermia in these animals. The hyperthermia was due to increased metabolism (due to muscular shivering) and decreased heat losses. The reduction in heat losses was shown by a decrease in both cutaneous circulation and respiratory evaporative heat loss. The data demonstrate that the thermoregulatory responses induced by central administration of db cyclic AMP are T_a-dependent.     

张家维教授针灸治疗小儿多动症380例临床研究

目的　探讨针灸治疗小儿多动症的临床疗效、对异常脑电图的改变情况、疗效与证型的关系、疗效与年龄的关系等。方法　将 5 92例患者分为针灸组及中药组。结果　针灸组总有效率为 84 .4 % ,中药组为 78.77% ,前者疗效优于后者 (P<0 .0 5 ) ;针灸组对异常脑电图的改变率优于中药组 (P<0 .0 5 ) ;针灸组中肝肾不足型、肝郁气滞型两型间的疗效有显著性差异(P<0 .0 1) ;肝郁气滞型较佳。疗效与年龄之间有非常显著性关系 (P<0 .0 1) ,年龄小者针刺疗效较佳。结论　针灸治疗小儿多动症可取得较好疗效 ,其总有效率及对异常脑电图的改善优于内服中药 ,肝郁气滞型及年龄小者疗效较好     

亚低温对颅内巨大动脉瘤夹闭术瞬间阻断及缺血再灌注期的脑保护作用

目的：研究亚低温对颅内巨大动脉瘤夹闭术瞬间阻断其供血动脉时缺血再灌注期的脑保护作用。方法：对颅内巨大动脉瘤行夹闭术27例，13例于动脉瘤夹闭瞬间阻断及缺血再灌注期行亚低温处理。直肠温度（RT）控制在31．0℃～36．0℃，脑组织温度（BT）为32．0℃～35．0℃。同时，监测患者的生命体征、BT和失血量。常温组14例，RT控制在36．0℃～37．2℃。2组患者均于术后3个月时根据GOS评估法判定疗效。结果：术中2组生命体征差异无统计学意义。亚低温组与常温组相比．手术完成比较顺利，无严重并发症，病死率较低，运动神经功能良好率较高，预后显著改善。结论：亚低温可明显降低颅内巨大动脉瘤夹闭术患者的病死率，提高患者生命质量，对脑缺血及再灌注性损伤具有良好的脑保护作用。     

Depression of long term potentiation in gerbil hippocampus following postischemic hypothermia

To investigate the mechanism of chronic cell death following postischemic hypothermia, the change of N-methyl- -aspartate receptor (NMDAR) were examined by immunohistochemistry of NMDAR1 and long-term potentiation (LTP) in the CA1 subfield of the gerbil hippocampus. At 1 week following postischemic hypothermia (32°C×4 h), all CA1 neurons survived; however, immunoreactivity of NMDAR1 increased in neuronal perikarya whereas decreased in dendrites in the CA1 neurons. The abnormality was still observed in remaining CA1 neurons at 1 month after hypothermia. LTP was also significantly depressed at 1 week after hypothermia. These results suggest that some abnormalities in the glutamate receptor may be caused by ischemia; such abnormality would persist in spite of hypothermia treatment, resulting in the depression of LTP.     

An assessment of the thermal safety of microwave warming of crystalloid fluids

We performed an in vitro study to determine the thermal safety of a domestic microwave to warm intravenous crystalloid solutions. Five-hundred-millilitre bags of crystalloid, randomly allocated to groups which differed in power setting, timer setting and whether or not agitation was performed after warming, were heated in a microwave oven to a calculated temperature of 39 degrees C. Timer accuracy was checked by stopwatch. Bag temperature was measured using an infrared tympanic temperature probe and fluid temperature was measured with an in-line thermocouple. Mean times measured by stopwatch were higher than set. No in-line temperatures reached 40 degrees C. Wider overall ranges and a higher mean were found with the tympanic probe compared with in-line temperature measurement. There were significant differences between the in-line temperatures of shaken and unshaken bags at each power setting, but not when groups were added together. There was no change in colour or odour of bags or fluid. One bag developed a pinhole leak when the packaging was removed.     

老年人轻度认知功能损伤危险因素的病例对照研究

目的 探讨轻度认知功能损伤（MCI）的可能危险因素.方法 采用病例对照研究,分析MCI以及年龄、性别和职业相匹配的认知功能正常老年人各97例和143例.结果 单因素分析显示,冠心病、脑卒中和贫血病史以及受教育程度在两组之间差异有统计学意义;多因素分析去除了年龄的影响后,证实冠心病、脑卒中和贫血病史以及受教育程度与MCI显著相关,OR值（95%CI）分别为2.21（1.18～4.14）、2.18（1.20～3.98）、4.63（1.79～11.97）和0.75（0.58～0.97）.结论 冠心病、脑卒中和贫血病史可能是MCI的独立危险因素,高教育水平是MCI的保护因素.