Brainstem mediates diazepam enhancement of palatability and feeding: microinjections into fourth ventricle versus lateral ventricle

The hypothesis that benzodiazepine-induced hyperphagia is due to a specific enhancement of the palatability of foods has been supported by previous ‘taste reactivity’ studies of affective (hedonic and aversive) reactions to taste palatability. Diazepam and chlordiazepoxide enhance hedonic reactions of rats (rhythmic tongue protrusions, etc.) to sweet tastes in a receptor-specific fashion. A role for brainstem circuits has been indicated by a previous demonstration of the persistence of the taste reactivity enhancement by diazepam after midbrain decerebration. The present study examined whether benzodiazepine brainstem receptors are the chief substrates for palatability enhancement even in intact brains. We compared the effectiveness of benzodiazepine microinjections to elicit feeding and enhance hedonic reactions when delivered into either the lateral ventricle (forebrain) or the fourth ventricle (brainstem) of rats. The results show diazepam is reliably more effective at eliciting feeding and enhancing positive hedonic reactions to oral sucrose when microinjections are made in the fourth ventricle than in the lateral ventricle. We conclude that brainstem neural systems containing benzodiazepine-GABA receptors are likely to be the chief substrates for benzodiazepine-induced palatability enhancement.     

700例高血压病临床分析

目的：通过对700例高血压病患者的临床分析，探讨高血压病的常见并发症及主要死亡原因。方法：对搜集诊治的700例高血压病患者的病例，从发病年龄、病程、并发症、死亡原因等方面进行回顾性分析。结果：30－59岁是高血压病的多发年龄；并发症以脑血管疾病和心血管疾病居多；死亡原因以脑梗塞、脑出血、心肌梗塞为多。结论：在高血压病的多发年龄之季，应采取有效的防治措施，以控制高血压及其并发症的发病率。减少死亡率。     

风心病并发脑栓塞病人的瓣膜替换术

报告６４例风心病并发脑栓塞病人的瓣膜替换术。术前心功能Ｉ级１０例、ＩＩ级３８例、ＩＶ级１６例。伴房颤者５４例。脑栓塞史半年以上者４４例，６个月以内２０例，其中２个月以内者１４例。３４例有程度不同的脑栓塞后遗症。行二尖瓣替换术４７例、双瓣膜替换术１７例，同期行三尖瓣环环缩或成形术４３例。术中证实有左房血栓２５例（３９％）。手术死亡率６．２５％。术后并发颅内出血和栓塞各１例。结果表明风心病并发脑栓塞病人的手术效果良好。作者指出，脑栓塞２个月以上者应尽早手术，２个月以内者则应根据脑栓塞程度、恢复情况及有无左房血栓，选择手术时机。并介绍了围术期的处理经验。     

The somatotopic localisation of the descending cortical tract in the cerebral peduncle: a study using MRI of changes following Wallerian degeneration in the cerebral peduncle after a supratentorial vascular lesion

We studied the effects of Wallerian degeneration in the cerebral peduncle shown by magnetic resonance imaging (MRI) following a supratentorial vascular lesion, to identify the somatotopic localisation of the descending cortical tracts. Patients with a lesion involving a large area of a cerebral hemisphere had an area of abnormal signal intensity in the whole cerebral peduncle, suggesting Wallerian degeneration of all the whole descending cortical tracts. With a small lesion confined to the precentral gyrus, corona radiata, or posterior limb of the internal capsule there was an abnormal signal at the centre of the peduncle, suggesting degeneration of the precentrospinal tract. Those with a small lesion confined to the paracentral gyrus had an abnormal area slightly lateral to the centre of the peduncle, suggesting degeneration of the parietospinal tract. Patients with a lesion of the parietal or temporal lobes, not including the paracentral or precentral gyri, corona radiata, or the posterior limb of the internal capsule, had an abnormal area laterally in the peduncle, suggesting degeneration of the parietopontine or temporopontine tract.     

彩色多普勒和磁共振对健康人颅内动脉影像学的比较研究

目的通过彩色多普勒和磁共振血管成像对健康人颅内动脉的检测,初步确定其操作规范及衡量标准。方法正常人200例,按照检查方法分为彩色多普勒血流显像(ColourDopplerFlowImaging,CDFI)组及磁共振血管成像(MagneticReso-nanceAngiography,MRA)组。CDFI组观察大脑中动脉(MiddleCerebralArtery,MCA)、椎动脉(VertebralArtery,VA)各段的血流动力学改变和相应点的血流束内径。MRA组检测相应血管对应部位的血管内径。结果同一条血管不同位置的血流速率有差异(P<0.05);同名血管相应位置的血流速率左侧略高于右侧,女组高于男组,但无统计学意义(P>0.05)。按年龄分组,相邻组间无显著性差异,相隔组间有显著性差异。CDFI所测血流束内径较MRA所测血管内径值偏高,且P<0.05,差异有显著性。结论a)应用CDFI能显示MCA,VA走行,可检测血管的血流动力学的改变。b)要提高临床脑血管疾病诊断的准确性,必须有规范的临床操作和可靠的检测指标。c)对血管内径的测量MRA更佳。     

HIPDM single photon emission computed tomography brain imaging in partial onset secondarily generalized tonic-clonic seizures

HIPDM-Single photon emission computed tomography brain imaging was performed during interictal and ictal stages in three patients with complex partial seizures and secondarily generalized tonic-clonic seizures. In all three patients, interictal studies demonstrated decreased regional cerebral perfusion (rCP) and ictal studies showed increased rCP in the epileptogenic region. The demonstration of focal hyperperfusion by SPECT performed during secondarily generalized tonic-clonic seizures suggests that rCP in the epileptic focus remains higher than in other cerebral regions during immediate postictal stages, even in secondarily generalized seizures.     

有效控制与控制不佳的MRI阴性的GTCS病人发作间期SPECT对照研究

目的:利用单光子发射计算机断层摄影(SPECT)半定量分析有效控制与控制不良的MRI阴性的全面性强直阵挛发作癫(GTCS)病人的局部脑血流差异,探讨脑血流灌注与其预后的关系.材料和方法:对29例有效控制的和12例控制不佳的MRI阴性的GTCS病人进行发作间期99mTc-ECD-SPECT脑血灌流显像,10例年龄匹配的健康人作对照,用感兴趣区(ROI)的不对称指数(%AI)进行半定量分析.将SPECT分析结果与病人的临床表现与EEG相比较.结果:①控制不佳组与有效控制组在丘脑和基底节区的%AI存在显著性差异(P<0.05);②控制不佳组SPECT脑显像的异常率(83.3%,10/12)明显高于有效控制组的异常率(17.2%,5/29),两组具有显著性差异(P<0.01);而两组病人的EEG异常率分别为58.3%、44.8%(7/12、13/29),无显著性差异(P>0.05).结论:控制不佳的MRI阴性的GTCS病人往往存在发作间期的低血流灌注脑区,提示癫的难治性;而控制良好的病人多无明显异常发现,可能预后较好.     

脑梗死后抑郁与负性生活事件相关性研究

目的　探讨脑梗死后抑郁与负性生活事件的关系。方法　将脑梗死患者按是否受负性生活事件影响分为 A(n=75 )、B(n=73)两组。采用抑郁自评量表 (SDS)及 Hamilton抑郁量表筛查 ,对两组进行比较分析 ,并观察其治疗效果。结果　A、B两组脑梗死后抑郁的发生率分别为 5 6 %、38.4 % ,两者比较差异显著 (P<0 .0 5 ) ;百忧解可显著改善或治愈脑梗死后抑郁 ,总有效率 6 1.7%。结论　脑梗死后抑郁发生与负性生活事件相关。百忧解治疗有效     

牛黄栀子配伍对大鼠局灶性脑缺血再灌注不同时段神经生长因子（NGF）含量的影响

目的:通过检测牛黄、栀子配伍对大鼠局灶性脑缺血再灌注不同时段神经生长因子(NGF)含量的影响,探讨治疗缺血性中风在该作用环节不同时段的作用特点,研究其配伍阻抑脑缺血级联反应的时序特征。方法:用线栓法建立大鼠大脑中动脉缺血再灌注模型,观察牛黄、栀子及二者配伍对缺血再灌注24小时和72小时两个时段大鼠脑组织NGF含量的影,响。结果:缺血再灌注损伤可明显抑制脑组织NGF的表达,从而削弱了机体的自身保护机制;再灌注24小时,牛黄、栀子均可促进NGF的表达,而二者配伍后作用明显降低:再灌注72小时,牛黄的作用不显著,栀子可明显增强NGF的表达,二者配伍与栀子的作用相当,未显示出明显的配伍效应。结论:中药配伍的作用不是简单的效应累加,而是依据作用环节及作用时间的不同表现为不同的时空特征。     

不同海拔高度严重烧伤延迟复苏大鼠脑组织中能量负荷的变化及其意义

目的：探讨不同海拔高度严重烧伤延迟复苏大鼠脑组织能量负荷变化及其意义。方法：以120只雄性Wistar大鼠建立高原（海拔3800m）实验模型（TBSA30％，Ⅲ度），随机分为延迟、即时复苏组和正常对照组，分别于伤后1、6、12、24、72h及7d取材。兰州地区取相等数量动物重复实验。应用高效液相色谱法检测脑组织中AMP、ADP、ATP的含量，并计算能量负荷。结果：能量负荷在高原正常对照组与兰州地区正常对照组差异显著（P〈0．01）。高原烧伤后脑组织能量负荷与对照组相比均降低，即时复苏组伤后早期即出现显著变化（P〈0．01），伤后72h开始恢复，伤后7d差异无显著，延迟复苏组伤后7d仍星显著差异（P〈0．01）。与即时复苏组比较伤后6～24h无显著差异，伤后72h～7d呈显著性差异（P〈0．01）。高原地区各时相点与兰州地区比较，EC值均降低，除即时复苏组6h外，具有统计学意义。结论：不同海拔高度严重烧伤延迟复苏大鼠脑组织能量负荷的改变一定程度上反映了脑损伤的严重程度。