Poststroke DNA immunization against neurite growth inhibitors is beneficial to the recovery from local cerebral ischemia in rats

BACKGROUND： Inhibitory signals, i.e. neurite growth inhibitors （NGIs）, presenting on central nervous system （CNS） myelin have been shown to play a crucial role in inhibiting lesioned axonal sprouting and leading to less functional recovery. Vaccines targeting NGIs may provide multifactorial protection against brain insults by overcoming the inhibitory effects of these NGIs and boosting the body＇s immune repair mechanisms. OBJECTIVE： To evaluate the effect of poststroke DNA immunization against NGIs on the rehabilitation for sensorimotor function of rat models of local cerebral ischemia. DESIGN： Completely randomized grouping design, and controlled experiment. SETTING： Brain Injury Research Laboratory, Department of Neurosurgery, National Neuroscience Institute, Singapore. MATERIALS： Sixty adult male Sprague-Dawley rats ranging in age from 45 to 120 days and in weight from 180 to 250 grams were provided by Animal Center of Department of Anatomy, Faculty of Medicine, National University of Singapore. pcDNA3.1（＋）-neurite growth inhibitors （pcDNA-NGIs） a gift was provided by Dr. Xiao from Department of Clinical Research, Singapore General Hospital, Singapore. METHODS： The experiment was carried out at Brain Injury Research Laboratory, Department of Neurosurgery, National Neuroscience Institute, Singapore from August 2003 to April 2005. （1）The involved rats were randomized into 3 groups： pcDNA-NGIs group （group A）, pcDNA3.1 （＋） group （group B） and model group （group C）, with 20 rats in each group. Left focal cerebral ischemia （FCI） was permanently induced through middle cerebral artery occlusion （MCAO） with the assistance of an operating microscope. Successful MCAO was determined by a 20% decrease to baseline in the ipsilateral cerebral blood flow. 100 μg of pcDNA-NGIs eluted in phosphate-buffered saline （PBS） was intramuscularly injected into the tibial muscle once a week after MCAO for 6 weeks in group A. As control, pcDNA3.1 （＋） was also administrated in the same way in group B and nothing was administrated in group C. （2） The modified neurological severity score （mNSS）, a composite of motor, sensory, reflex and balance tests, was used to test the sensorimotor deficit. The mNSS was graded on a scale of 0 - 18, i.e. normal score was 0, maximal deficit score was 18, and 1 point was warded for the inability to perform the tasks or the lack of a tested reflex. （3） The newly generated axons of corticorubral projection were traced by stereotaxic guided injection of 100 g/L biotinylated dextran amine. Rats were sacrificed two weeks after tracing, and cryostat coronal sections of midbrains （30μm） were reacted to BDA according to the manufacturer＇s instruction by the free-floating method. Images were captured on a DM RXA2 LEICA Microscope with a Spot Digital Camera system （Germany）, and the numbers of labeled axons on the denervated side in four standard coronal sections including the red nucleus were manually quantified. MAIN OUTCOME MEASURES： （1） The number of newly generated axons of corticorubral projection. （2）The improvement in sensorimotor deficit. RESULTS： All the involved 60 rats entered the stage of final analysis. （1） The number of newly generated axons of corticorubral projection of rats： Only ipsilateral axons of CRP were noted with little evidence of fibers crossing to the contralateral red nucleus in rats of groups B and C. More BDA-positive fibers crossing the midline and terminating in the contralateral red nucleus in appropriate target areas mirroring the non-differentiated red nucleus were found in rats of group A. Quantitative analysis showed that BDA-labeled axons in the denervated side of rats in group A were more than those in group B （P 〈 0.05）. （2） Improvement in sensorimotor deficit of rats： At 2 weeks after immunization, significant improvement in sensorimotor deficit was found in rats of group A. There were significant differences of improvement in sensorimotor deficit of rats between group A and group B or group C at 12 and 14 weeks after immunization （P 〈 0.05）. CONCLUSION： （1） Poststroke DNA immunization against NGIs leads to increased sensorimotor recovery following FCI and compensatory newly growth of axons from corticorubral projection.     

中医药治疗宫环出血临床疗效的Meta分析

目的:观察中医药治疗宫环出血的临床疗效。方法:应用Meta分析方法的随机效应模型,对国内1989~2006年采用中医药治疗宫环出血,并以西医治疗作对照的研究文献进行定量合并分析。结果:对中医治疗组与西医对照组临床有效率进行分析后表明,在临床疗效方面,中医治疗组427例患者中376例临床治疗有效,西医对照组347例患者中217例临床治疗有效。中医治疗组稳定率总优势比(OR)=4.65,95%置信区间(CL)为(3.20~6.75)。两者间差异有统计学意义(P<0.05)。结论:据目前掌握的资料证明中医药治疗宫环出血的临床疗效确切。     

中西医结合医院单病种的质量管理及其作用

针对中西医结合医院单病种质量评定没有现成的、规范的标准的现状,就中西医结合单病种的质量管理方法及其在中西医结合医院建设中的作用进行了论述。     

中医五色理论在现代色彩心理学及疗法中的佐证初探

[目的]探讨中医五色理论在现代色彩心理学及色彩疗法方面的证据。[方法]以中医五脏生理功能为线索,结合现代色彩心理学及色彩疗法,对中医五色理论在视觉刺激方面的应用加以探讨。[结果]现代色彩心理学理论以及色彩疗法,在很大程度上为中医五色理论在视觉刺激方面的应用提供了有力的证据。[结论]对根据中医理论辨证施以中医色彩疗法的探讨与研究具有相当的可行性与必要性。     

从脾论治磺脲类降糖药继发性失效

对 64例 2型糖尿病继发磺脲类降糖药失效患者 ,在继续口服磺脲类药的基础上加用健脾中药 ,结果显效 1 5例 ,有效 3 6例 ,无效 1 3例 ,总有效率 85 .2 4% ;治疗前后血糖明显下降 ,有显著性差异 ( P<0 .0 0 1 )     

晚期肺癌的中医证候研究

目的　探讨晚期肺癌的主要中医证候。方法　采用回顾性与前瞻性相结合的方法进行临床观察。结果　经 χ2 检验 ,不同中医证候的晚期肺癌组之间有显著性差异 (P <0 0 1) ,而血瘀证、气虚证、痰证、阴虚证最为多见 ;晚期非小细胞肺癌与晚期小细胞肺癌的中医证型没有显著性差异。结论　晚期肺癌的中医证候以血瘀证、气虚证、痰证、阴虚证为主 ;晚期非小细胞肺癌与小细胞肺癌的中医证候无明显差异。     

Strategies for understanding. A case study of occupational therapists' communication behaviour

This study focuses on the communication strategies of occupational therapists. Many recent studies in occupational therapy emphasize the importance of having a client-oriented perspective; the needs and wishes of the patient should form the basis for treatment. Such a perspective brings to the fore the capacity of the therapist to enter into the life-world of the patient. Communication, dialogue between patient and therapist, is the basic source of such knowledge. In this paper, understanding verbal acts is seen as fundamentally problematic. The purpose is to analyse what strategies and tactics occupational therapists use to create a basis for their interpretation of patients' messages. What kinds of questions and other forms of verbal behaviour are utilized to check and verify these interpretations? A case-study of communication behaviour during five meetings between patients and therapists in the homes of the patients was undertaken. Seven types of tactics were observed and categorized as belonging to two different strategic dimensions: active-passive and abstract-concrete. Although active strategies were predominant, only one therapist consistently used a combination of ‘asking open questions’ and ‘verifying’ interpretations, the two most active tactics. Most therapists also asked the patients to concretely ‘show in action’ what they meant, but to a varying degree. A consistent use of active-concrete strategies is arguably an ideal way of seeking knowledge and understanding. Empirically, therapists differ in how closely they fit this ideal. This may be a result of training and experience, but also of degree of empathy. This study points to the importance of carefully developing communication strategies in order to fully understand the problems of the patients. Copyright © 1997 Whurr Publishers Ltd.     

急性白血病肺部感染病机分析

对54例急性白血病并肺部感染患者临床观察分析发现,急性白血病合并肺部感染的病机与一般肺部感染有本质的不同。本病的发生以气血亏虚严重、精血化生衰竭为主要原因。故应以益气、养阴、补血为治疗大法。对化疗期间病人要注意调理脾胃,顾护胃气,以后天养先天。造血功能抑制的患者,切忌一味攻伐,折伤正气。     

机体阴阳交感现象的熵变分析

借用非平衡热力学理论,分析自然界水火运动的规律,得出结论——阴阳交感过程是熵减少过程,阴阳反作过程是熵增加过程;机体的许多阴阳变化也遵循同一规律。并在此基础上论证了新陈代谢过程是机体从外界输入负熵以抵消体内正熵产生的过程,从而推知阴阳交感现象发生的原因是新陈代谢。     

超声观察银屑病中医分型的血管变化研究

目的　探讨银屑病中医分型皮损处与正常皮肤处血管血流的变化情况。方法　将 3 0例寻常型斑片状银屑病按中医辨证分型 ,超声观察患者正常皮肤处及皮损处浅层动脉血管、静脉血管血流情况。结果　“血热型”皮损处及正常皮肤处动脉血管增大、扩张、血流加快 ;“血瘀型”及“血燥型”未发现异常。结论　银屑病动脉血管及静脉血管增大、扩张、血流加快与中医分型“血热型”密切相关 ,这些将有助于临床根据中医分型进行辨证施治