从血压变异规律看高血压病的中医分型方法

目的 寻找能较好反映高血压病血压变异、昼夜变化规律等特点的中医分型方法.方法 对112例原发性高血压患者按照自拟的八纲辨证标准,及目前常用的高血压病中医分型方法分别进行分型分组,从血压变异、昼夜节律、血压负荷等方面比较几种分型方法特点.结果 自拟的八纲标准分型临床证型诊断覆盖率最高,且血压变异及昼夜变化规律在各型间的差异最为显著.新药标准分型方法的血压负荷值变化最为显著.上海标准分型方法,覆盖率最低,分型太细反致各指标变化规律不明显.结论 研究调整高血压病血压节律的机理及药物作用时采用八纲标准最佳,研究药物降压作用时可考虑采用新药标准分型.     

王法昌运用周期疗法治疗妇科病经验

吾师王法昌主任医师,山东省名中医,临床近50载,学验具丰,尤精于妇科。认为妇人以血为本,妇人较男子气血周期性生物节律变化明显,表现为以月经及排卵的月周期（拟称为经卵周期）变化为主,穿插以子宫孕育受精卵及分娩复旧的年周期（10月妊娠及2月产褥复元约1年,故称为年周期,     

Functional D1 and D5 dopamine receptors are expressed in the suprachiasmatic,supraoptic, and paraventricular nuclei of primates

In rodents, D1 dopamine receptors are expressed in the suprachiasmatic nucleus and are believed to play important roles in regulating circadian rhythms. It is not currently known if the primate circadian system can be influenced by dopaminergic agents, which have broad clinical use. To determine if dopamine receptors can potentially influence primate circadian function, we examined the expression of D1 dopamine receptors in the anterior hypothalamus of ring-tailed macaques (Macaca nemestrema), baboons (Papio sp.), and humans. Because D5 dopamine receptors also stimulate adenylyl cyclase activity, D5 dopamine receptor expression was studied as well. We used [¹²⁵I]SCH 23982, which binds to D1 and D5 dopamine receptors, and labeling of the suprachiasmatic (SCN), supraoptic (SON), and paraventricular (PVN) nuclei was detectable in each species. In situ hybridization studies revealed differential expression of D1 and D5 dopamine receptor mRNA in the hypothalamus. D1 dopamine receptor mRNA was expressed in the SCN, SON, and PVN. By contrast, D5 dopamine receptor mRNA was expressed only in the SON and PVN of baboons and humans. Injection of the D1/D5 dopamine receptor agonist SKF 38393 at night increased the uptake of 2-deoxy-D-[¹⁴C]glucose in the SCN, SON, and PVN of newborn baboons. By contrast, c-fos mRNA expression was induced in the SON and PVN, but not in the SCN. These data show that D1 and D5 dopamine receptors are present in the hypothalamus of primates and show that activation of these receptors acutely influences SCN, SON, and PVN activity. Synapse 26:1–10, 1997. © 1997 Wiley-Liss, Inc.     

Bright Light and LEET Effects on Circadian Rhythms,Sleep and Cognitive Performance

Shift work and jet lag can disrupt circadian rhythms, with detrimental effects on alertness, performance and sleep. This study examined the effects of two interventions to adapt circadian rhythms, sleep and performance to a 10-h phase delay of the work–rest cycle. Bright light was administered from 2200 to 0200 each night to promote phase delay of circadian rhythms. Low energy emission therapy (LEET) was administered for 20 min prior to daytime sleep periods to promote sleep. Twelve subjects received bright light, 12 subjects received LEET, 11 received both interventions and 10 control subjects received only placebo treatments. Bright light accelerated phase delay of the circadian melatonin rhythm after the work–rest schedule shift. Further, subjects who received bright light had greater total sleep time (TST) and improved sleep continuity. LEET treatment produced a trend (p=0.16) for increased TST, but LEET did not affect the melatonin circadian rhythm. After the schedule shift, cognitive performance measures showed few significant differences. Some minor improvements in cognitive performance were produced by light treatments but not by LEET. © 1997 John Wiley & Sons, Ltd.     

Long-Range Respiratory and Theta Oscillation Networks Depend on Spatial Sensory Context

Neural oscillations can couple networks of brain regions, especially at lower frequencies. The nasal respiratory rhythm, which elicits robust olfactory bulb oscillations, has been linked to episodic memory, locomotion, and exploration, along with widespread oscillatory coherence. The piriform cortex is implicated in propagating the olfactory-bulb-driven respiratory rhythm, but this has not been tested explicitly in the context of both hippocampal theta and nasal respiratory rhythm during exploratory behaviors. We investigated systemwide interactions during foraging behavior, which engages respiratory and theta rhythms. Local field potentials from the olfactory bulb, piriform cortex, dentate gyrus, and CA1 of hippocampus, primary visual cortex, and nasal respiration were recorded simultaneously from male rats. We compared interactions among these areas while rats foraged using either visual or olfactory spatial cues. We found high coherence during foraging compared with home cage activity in two frequency bands that matched slow and fast respiratory rates. Piriform cortex and hippocampus maintained strong coupling at theta frequency during periods of slow respiration, whereas other pairs showed coupling only at the fast respiratory frequency. Directional analysis shows that the modality of spatial cues was matched to larger influences in the network by the respective primary sensory area. Respiratory and theta rhythms also coupled to faster oscillations in primary sensory and hippocampal areas. These data provide the first evidence of widespread interactions among nasal respiration, olfactory bulb, piriform cortex, and hippocampus in awake freely moving rats, and support the piriform cortex as an integrator of respiratory and theta activity.SIGNIFICANCE STATEMENT Recent studies have shown widespread interactions between the nasally driven respiratory rhythm and neural oscillations in hippocampus and neocortex. With this study, we address how the respiratory rhythm interacts with ongoing slow brain rhythms across olfactory, hippocampal, and visual systems in freely moving rats. Patterns of network connectivity change with behavioral state, with stronger interactions at fast and slow respiratory frequencies during foraging as compared with home cage activity. Routing of interactions between sensory cortices depends on the modality of spatial cues present during foraging. Functional connectivity and cross-frequency coupling analyses suggest strong bidirectional interactions between olfactory and hippocampal systems related to respiration and point to the piriform cortex as a key area for mediating respiratory and theta rhythms.     

Effects of isradipine on intravenous cocaine‐induced cardiovascular response: a pilot study

We examined the effects of isradipine, a dihydropyridine‐class calcium channel antagonist, and effective antihypertensive medication on the pressor effects of cocaine on cardiac function. Using continuous non‐invasive cardiovascular monitoring of heart rate, blood pressure, electrocardiographic recordings, and peripheral oxygen saturation, six healthy cocaine addicts received the following treatments in blinded, crossover fashion: (a) placebo; (b) intravenous cocaine (0·325 mg/kg iv), and (c) isradipine (10 mg p.o.)+cocaine. While cocaine‐taking was associated with a small increase in blood pressure, this effect was not significantly affected by isradipine. Isradipine pretreatment was, however, associated with a significant reflex rise in heart rate following cocaine. Cocaine administration with or without isradipine produced no clinically significant abnormalities of rhythm or conduction on the electrocardiogram and on peripheral oxygen saturation. While these results should be considered preliminary, they do suggest that this isradipine dose and/or dosing strategy does not have a clinically significant cardioprotective effect during cocaine‐taking. Copyright © 1999 John Wiley & Sons, Ltd.     

Circadian Mechanisms in Alcohol Use Disorder and Tissue Injury

Heavy use of alcohol can lead to addictive behaviors and to eventual alcohol‐related tissue damage. While increased consumption of alcohol has been attributed to various factors including level of alcohol exposure and environmental factors such as stress, data from behavioral scientists and physiological researchers are revealing roles for the circadian rhythm in mediating the development of behaviors associated with alcohol use disorder as well as the tissue damage that drives physiological disease. In this work, we compile recent work on the complex mutually influential relationship that exists between the core circadian rhythm and the pharmacodynamics of alcohol. As we do so, we highlight implications of the relationship between alcohol and common circadian mechanisms of effected organs on alcohol consumption, metabolism, toxicity, and pathology.     

Circadian preference and sleep timing from childhood to adolescence in relation to genetic variants from a genome-wide association study

ObjectiveRecent genome-wide association studies (GWASs) have revealed new genetic variants behind self-reported individual circadian preference, a distinct biological trait that is fairly stable during adulthood. In this study we analyze whether these genetic variants associate with objectively measured sleep timing from childhood to adolescence, over a nine-year period, with self-reported circadian preference during late adolescence.MethodsThe participants (N = 100, 61% girls) came from a community cohort from Finland born in 1998. Sleep midpoint was measured with actigraphy at 8, 12 and 17 years. Circadian preference was self-reported at the age of 17 years. Single nucleotide polymorphisms (SNPs) were extracted at 12 years of age from the Illumina OmniExpress Exome 1.2 bead array data. Weighted polygenic risk scores (PRSs) were calculated based on top SNPs from a recent GWAS for morningness–eveningness in an adult population.ResultsThe PRS for circadian preference towards morningness was associated with earlier sleep midpoint from childhood to adolescence. When the time points were analyzed separately, the association between genetic tendency towards morning preference and earlier sleep midpoint was strongest among the 17-year-olds. Furthermore, the shift towards later sleep rhythm from early to late adolescence was milder for those with a higher PRS for morning preference. PRS for morning preference was also associated with self-reported circadian preference towards morningness in late adolescence.ConclusionOur results suggest that genetic variants found for circadian preference in adults are already associated with objective sleep timing during childhood and adolescence, and predict individual developmental sleep trajectories from childhood onwards.     

Circadian rhythms of hormone secretion and obesity

The adipose tissue homeostasis is profoundly affected by circadian rhythms of corticosteroid secretion and chronic loss of hormonal oscillations is associated with obesity. How adipose tissue differentially responds to pulsatile vs continuous presence of glucocorticoids is poorly defined. To address this question, Bahrami-Nejad et al studied differentiation of pre-adipocytes, containing endogenously tagged CCAAT/enhancer binding protein and peroxisome proliferator-activated receptor (PPAR) γ (key regulators of adipocyte differentiation), in response to corticosteroids that were delivered either in an oscillatory fashion or continuously. The authors show that the bi-stable state of differentiation of pre-adipocytes and adipocytes was regulated by a combination of fast and slow positive feedback networks, that determined unique threshold of PPARγ in these cells. Evidently, pre-adipocytes used the fast feedback loop to reject differentiation cues of oscillating pulses of glucocorticoids and failed to differentiate into fat cells. In contrast, when glucocorticoids were delivered continuously, precursor cells exploited the slow feedback loop to embark on a path of maximal differentiation. This differential differentiation response of pre-adipocytes to pulsatile vs continuous exposure to glucocorticoids was corroborated in vivo. Thus, mice receiving non-oscillating doses of exogenous glucocorticoids, for 21 d, elicited excessive accumulation of visceral and subcutaneous fat. These data shed new light on the mechanisms of obesity caused by putative misalignment of circadian secretion of glucocorticoids or their persistently high levels due to chronic stress or Cushing’s disease.