血清电解质、CKBB及血乳酸水平与新生儿缺氧缺血性脑病严重程度的相关性分析

分析血清电解质、肌酸激酶同工酶(CKBB)及血乳酸水平与新生儿缺氧缺血性脑病严重程度的相关性。80例缺氧缺血性脑病患儿中轻度患儿27例、中度患儿26例、重度患儿27例。以本院同期健康的足月新生儿60例为对照组。结果显示与对照组新生儿比较,观察组新生儿氯离子及钙离子水平明显降低(P<0.05),CKBB和血乳酸水平明显升高(P<0.05);重度患儿的氯离子及钙离子水平明显低于中度患儿和轻度患儿(P<0.05),CKBB和血乳酸水平明显高于中度患儿和轻度患儿(P<0.05);血清中氯离子和钙离子与缺氧缺血性脑病严重程度呈现负相关性(P<0.05),但CKBB和血乳酸与缺氧缺血性脑病严重程度呈明显的正相关性(P<0.05)。结果说明血清氯离子和钙离子、CKBB及血乳酸水平与新生儿缺氧缺血性脑病严重程度呈明显的相关性。     

Creatine transporter expression after antidepressant therapy in rats bred for learned helplessness

In cells and tissues with a high demand of energy such as neurons the major pool of energy is supplied by phosphocreatine. The necessary supply with creatine is directly related to the expression level of the creatine transporter (CRT). To study possible interactions between this transporter and depressive like behavior we have used a congenitally learned helplessness (cLH) model. Because uptake via CRT is the only means to supply neurons with creatine, we hypothesized a rise in CRT expression following antidepressive treatment strategies. The hippocampus of the cLH animals exhibited a significantly lower CRT expression as compared to wild type (WT) animals. Treatment with escitalopram and ECS induced an elevation of CRT levels in the hippocampus and the prefrontal cortex. In WT animals there was no treatment effect. In summary, our data presented here suggest an association between depressive behavior and cellular energy metabolism in defined brain areas.     

Decreased frontal lobe function in people with Internet addiction disorder

In our previous studies, we showed that frontal lobe and brainstem functions were abnormal in online game addicts. In this study, 14 students with Internet addiction disorder and 14 matched healthy controls underwent proton-magnetic resonance spectroscopy to measure cerebral function. Results demonstrated that the ratio of N-acetylaspartate to creatine decreased, but the ratio of cho- line-containing compounds to creatine increased in the bilateral frontal lobe white matter in people with Internet addiction disorder. However, these ratios were mostly unaltered in the brainstem, suggesting that frontal lobe function decreases in people with Internet addiction disorder.     

Hyperbaric oxygen therapy improves cognitive functioning after brain injury

Hyperbaric oxygen therapy has been widely applied and recognized in the treatment of brain injury; however, the correlation between the protective effect of hyperbaric oxygen therapy and changes of metabolites in the brain remains unclear. To investigate the effect and potential mechanism of hy- perbaric oxygen therapy on cognitive functioning in rats, we established traumatic brain injury models using Feeney＇s free falling method. We treated rat models with hyperbaric oxygen therapy at 0.2 MPa for 60 minutes per day. The Morris water maze test for spatial navigation showed that the average escape latency was significantly prolonged and cognitive function decreased in rats with brain injury. After treatment with hyperbaric oxygen therapy for 1 and 2 weeks, the rats＇ spatial learning and memory abilities were improved. Hydrogen proton magnetic resonance spectroscopy analysis showed that the N-acetylaspartate/creatine ratio in the hippocampal CA3 region was sig- nificantly increased at 1 week, and the N-acetylaspartate/choline ratio was significantly increased at 2 weeks after hyperbaric oxygen therapy. Nissl staining and immunohistochemical staining showed that the number of nerve cells and Nissl bodies in the hippocampal CA3 region was significantly increased, and glial fibrillary acidic protein positive cells were decreased after a 2-week hyperbaric oxygen therapy treatment. Our findings indicate that hyperbaric oxygen therapy significantly im- proves cognitive functioning in rats with traumatic brain injury, and the potential mechanism is me- diated by metabolic changes and nerve cell restoration in the hippocampal CA3 region.     

急诊经皮冠状动脉介入治疗前强化阿托伐他汀对急性心肌梗死患者的中期疗效观察

目的探讨急性ST段抬高心肌梗死(STEMI)患者术前强化阿托伐他汀治疗的中期临床疗效。方法对拟行急诊PCI治疗的102例STEMI患者随机分为A组32例,B组32例,C组38例。观察术后90 min内ST段回落、术后24、72 h高敏C反应蛋白(hs-CRP)、术后肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)峰值及术后6个月主要不良心血管事件。结果 3组患者入院和术后24 h hs-CRP比较,差异无统计学意义(P>0.05)。与A组比较,B组、C组术后72 h hs CRP明显升高(P<0.05)。术前3组CK与CK-MB比较,差异无统计学意义(P>0.05)。与A纽比较,B组、C组术后CK、CK-MB明显升高,ST段回落均值及发生率明显降低(P<0.05)。A组、B组、C组术后6个月主要心血管不良事件发生率分别为9.4%、9.4%和10.5%,差异无统计学意义(P>0.05)。结论急诊PCI术前强化阿托伐他汀治疗可抑制STEMI患者炎性反应,减轻心肌梗死范围。     

经肌间隙入路或后正中入路行腰椎融合术的效果及其对椎旁肌损伤的影响

【摘要】 目的：比较经后正中入路与经肌间隙入路行腰椎融合术的效果及其对椎旁肌损伤的影响程度。方法：选择2010年6月～2011年8月收治的行单节段腰椎融合术患者40例,根据手术入路不同分为肌间隙入路组（A组）和后正中入路组（B组）,每组20例。测量两组患者术前、术后24h外周血中肌酸磷酸激酶（CK）浓度,在肌肉暴露后即刻、术后（松开牵开器后）提取肌肉标本,测定组织内CK浓度,记录术中肌肉牵拉时长、手术时间、手术出血量、术后引流量,采用视觉模拟评分（VAS）评价术前、术后1个月及术后6个月腰痛及腿痛评分。术后进行1年以上的随访,观测椎间隙植骨融合情况。结果：两组患者全部完成术后1个月、6个月的定期随访,随访时间为14～25个月,平均18个月。末次随访时所有患者均达到骨性融合。A组与B组比较,术中出血量、术后引流量少（P<0.01）, 患者手术时间、术中肌肉牵拉时间无明显差异（P>0.05）。两组患者椎旁肌及外周血CK水平术前无明显差异（P>0.05）;术前与术后比较,均有显著性差异（P<0.01）;术后A组椎旁肌组织内CK降低幅度小于B组（P<0.05）, 术后外周血CK升高幅度A组与B组比较无明显差异（P>0.05）。两组患者腰痛及腿痛VAS评分术后1个月、6个月较术前比较均有显著性差异（P<0.01）,A组腰痛VAS评分术后1个月、6个月较术前缓解程度大于B组（P<0.01）,腿痛VAS评分术后1个月、6个月较术前缓解程度与B组比较无明显差异（P>0.05）。结论：经肌间隙入路行腰椎融合术有着对椎旁肌损伤小、术中及术后出血少、术后恢复快的优点,较经后正中入路手术有着明显的优势。     

Predictive markers of asymptomatic atherosclerosis in end-stage renal disease patients

Objective: Uremia is associated with accelerated atherosclerosis and increased cardiovascular mortality in patients with end-stage renal disease (ESRD). Cardiac injury markers, such as myoglobin, creatine kinase-MB (CK-MB), or troponins, frequently used to recognize acute coronary events, may be falsely elevated in this patient group. In this study, our aim was to (i) test serum levels of myoglobin, CK-MB, and troponin I (cTnI) in ESRD patients without coronary artery disease (CAD) and compare the results with healthy controls and (ii) to investigate the association between these markers and carotid artery intima–media thickness (CA–IMT), high-sensitive C-reactive protein (hs-CRP), and serum uric acid (SUA) levels in ESRD patients. Materials and methods: Fifty-two ESRD patients (25 hemodialysis and 27 peritoneal dialysis) and 17 healthy controls were included in the study. Serum levels of myoglobin, CK-MB, and cTnI were measured and ultrasonographic CA–IMT was determined in all participants. SUA and hs-CRP levels were only measured in the ESRD group. Results: Serum myoglobin, CK-MB levels, and the mean CA–IMT were significantly higher in ESRD group (p < 0.01), whereas cTnI levels were not different compared to healthy controls (p = 0.70). There was also a positive correlation between CA–IMT and cTnI levels (p = 0.003, r = 0.35) and CA–IMT and hs-CRP (p = 0.03, r = 0.30) or SUA levels (p = 0.003, r = 0.43). Conclusion: cTnI may serve as a more sensitive marker in detecting cardiovascular events in patients with renal failure. Besides the traditional risk factors of atherosclerosis, cTnI, hs-CRP, and SUA may have a predictive role in recognizing premature atherosclerosis in ESRD patients.     

Prevention and Treatment Of Heterotopic Ossification After Spinal Cord Injury

Abstract

Background/Objectives: Heterotopic ossification (HO) is a frequent, irreversible complication afterspinal cord injury (SCI). The objective of this article is to explain the etiology of HO; present new advances in prevention, diagnosis, and management of this complication; and provide a suggested algorithm for clinical management.

Etiology: Although still hypothetical, trauma and overexpression of bone morphogenic protein(s) in traumatized soft tissue appear to play important roles as initiating factors of HO.

Prevention: Preventive use of nonsteroidal antiinflammatory agents (NSAIDs) reduces the incidence of HO by a magnitude of 2 to 3.

Management: Early determination of serum creatine phosphokinase may have a diagnostic value in predicting the onset and severity of HO, and an NSAID may be added to etidronate therapy in the initial inflammatory phase of HO formation until C-reactive protein Ieveis return to normal range. Surgery is indicated in a subset of patients, and a regimenthat includes radiation therapy may prevent postoperative recurrence.

Conclusion: Significant progress has been made in the early prevention and management of HO. Further studies are needed to elucidate the etiology.