经皮穿刺牛角扩张气管造口术在ICU中的应用

导丝牛角型扩张法（GWCH）是经皮扩张气管切开技术（PDT）的一种改良方法。目前研究发现，与导丝扩张钳法（GWDF）和导丝螺旋扩张法（GWDS）相比，此种方法在手术操作技巧和应对并发症等方面更有优势。在重症监护室（ICU），研究推广经皮穿刺牛角扩张气管造口术可为危重患者提供更安全的气道开放微创技术。     

内脏高敏感状态下食管酸灌注诱导的鼠脊髓背角c-Fos基因表达的研究

目的 观察在内脏高敏感状态下,食管酸灌注诱导的大鼠脊髓背角Fos 蛋白表达的表达,初步探索食管内脏感觉过敏在脊髓水平敏感化的分子机制.方法 采用腹腔注射鸡卵清蛋白基础致敏联合食管酸灌注的方法,建立内脏高敏感性-食管化学刺激大鼠模型;采用免疫组织化学方法和显微图像分析技术研究,在生理条件、内脏高敏感状态下进行食管酸灌注时Fos蛋白激活模式的差异.结果 模型组大鼠双侧脊髓背角内有大量的Fos样免疫反应 (FLI) 阳性神经元,集中分布于背角Ⅰ～Ⅱ、Ⅴ～Ⅶ层,其FLI阳性神经元数量和平均光密度值较单纯食管酸灌注组和单纯,OVA(ovalbumin)致敏组明显增加,差异有统计学意义(P＜0.05).单纯酸灌注组和单纯OVA致敏组在背角Ⅰ～Ⅱ、Ⅴ～Ⅵ、Ⅹ层的FLI阳性神经元数量均较生理盐水对照组显著增加,差异有统计学意义(P＜0.01).单纯酸灌注组在背角Ⅰ～Ⅱ层和Ⅲ～Ⅳ层FLI阳性细胞数较单纯OVA致敏组显著增加,差异有统计学意义(P＜0.05).结论 腹腔注射鸡卵清蛋白基础致敏,对食管酸灌注诱导的脊髓背角内Fos蛋白表达有活化作用,c-Fos过度表达的阳性神经元的兴奋性增加和神经可塑性改变,促进了内脏高敏感性在脊髓水平敏感化的形成和维持.     

采用牛角型扩张器经皮一步扩张法气管切开术的临床应用体会

目的：探讨经皮牛角型扩张器一步法气管切开术的临床应用方法及效果。方法：分析采用经皮牛角型扩张器一步法气管切开术的18例患者的手术时间,观察术中患者呼吸频率、心率、血压及血氧饱和度,出血量及并发症。结果：采用经皮导丝牛角型扩张器一步法气管切开术能一次性顺利扩张造瘘口,气管套管经插入器插入造瘘口顺畅,瘘口与气管切开套管匹配,平均手术时间（6±1.5）min,其中扩张造瘘口时间平均（20±5.5）s,插入气管套管时间平均（12±3）s出血少。术中呼吸频率、心率、血压、血氧饱和度无明显波动,术后出现1例纵隔皮下气肿。结论：经皮牛角型扩张器一步法气管切开术操作安全、简单、快速,值得临床应用推广。     

电针对糖尿病神经痛模型大鼠脊髓背角p-ERK和p-CREB的影响

目的 观察电针对糖尿病神经痛大鼠脊髓背角磷酸化细胞外信号调节蛋白激酶（p-ERK1/2）和磷酸化环磷酸腺苷反应元件结合蛋白（p-CREB）表达的影响。 方法 从30只健康雄性SD大鼠中随机选择8只作为正常组,其余22只采用单次大剂量腹腔注射链脲佐菌素法建立糖尿病神经痛模型,共16只大鼠造模成功,将其分为模型组和电针组,每组8只。电针组于链脲佐菌素注射后15 d开始电针干预,每日1次,每次30 min,干预1周,穴位选择双侧“后三里”和“昆仑”穴。链脲佐菌素注射前、注射后7 d、14 d、21 d,观察并记录大鼠的体重、空腹血糖、热痛阈变化,采用免疫印迹法检测大鼠脊髓背角p-ERK1/2和p-CREB表达,采用免疫荧光法检测p-CREB阳性细胞数与神经元共表达情况。 结果 链脲佐菌素注射后7 d、14 d、21 d,与正常组比较,模型组大鼠体重下降（P<0.05）、空腹血糖升高（P<0.015）。链脲佐菌素注射后7 d,与正常组比较,模型组大鼠热痛阈无显著变化;链脲佐菌素注射后14 d、21 d,模型组大鼠热痛阈下降（P<0.05）。与模型组比较,链脲佐菌素注射后21 d,电针组大鼠热痛阈显著升高（P<0.05）。免疫印迹结果显示,与正常组比较,模型组大鼠脊髓背角p-ERK1/2和p-CREB蛋白表达显著升高（P<0.05）;与模型组比较,电针组大鼠脊髓背角p-ERK1/2和p-CREB蛋白表达显著降低（P<0.05）。免疫荧光结果显示,与正常组比较,模型组大鼠脊髓背角p-CREB阳性细胞数升高（P<0.05）;与模型组比较,电针组大鼠脊髓背角p-CREB阳性细胞数降低（P<0.05）;糖尿病神经痛模型大鼠脊髓背角p-CREB与神经元存在共表达。 结论 电针可有效缓解糖尿病神经痛,其机制可能与抑制大鼠脊髓背角p-ERK1/2和p-CREB的蛋白表达有关。     

Substitutes for endangered medicinal animal horns and shells exposed by antithrombotic and anticoagulation effects

Aim of the study

Cornu Saigae Tataricae (antelope horn), Manis Squama (pangolin scale), Cornu Cervi Pantotrichum (velvet antler) and Cornu Bovis grunniens (yak horn) are valuable medicinal animal horns and shells (MAHS). As the major source of biological agents and ethnodrugs, MAHS show pretty good bioactivities. However, with the increased demand for MAHS, some of the medicinal resources are endangered, and there has been a concomitant increase in the prevalence of adulterated or impostor MAHS. It is of great significance to exploit the substitutes for endangered medicinal animal resources. This study is going to provide a new mode for the exploitation of the substitutes of MAHS.

Materials and methods

Plasma recalcification time, thrombin time and thrombin consumption were recorded to evaluate the anticoagulation effect of MAHS. Dissolution rate of thrombus in vitro and whole blood-gore were observed to appraise the antithrombotic effect of MAHS.

Results

All the MAHS involved in this study except Cornu Procaprae Gutturosae (argali horn), Cornu Saigae Tataricae and Cornu Bovis (cattle horn) could not only prolong recalcification time (P < 0.01) and thrombin time (P < 0.01), but also dissolve the thrombus in vitro (P < 0.01) and whole blood-gore (P < 0.01). The bioactivities among MAHS differed greatly from each other.

Conclusions

The results indicate that Cornu Caprae Hircus (goat horn), Cornu Bubali (water buffalo horn) and Trionycis Carapax (turtle shell) are rational to be explored as the substitutes of Cornu Saigae Tataricae, Cornu Bovis grunniens and Manis Squama, respectively. On the contrary, velvet antler is not suitable to be substituted by Cornu Cervi (deerhorn). We presume that the bioactive evaluation methods are effective means of seeking substitutive resources of endangered medicinal animals with the advantages of close correlation to drug action, low dosage, and high sensitiveness.     

A new animal model of allodynia

A new rat model of allodynia is developed in which penicillin, an inhibitor of GABAergic inhibition, is applied to the dorsal surface of lumbosacral segments of the spinal cord. Correlation is found between abnormal pain reactions in rats with allodynia and alterations of evoked potentials in their dorsal horns. Stimulation of the sciatic nerve decreases threshold and increases amplitude and duration of evoked potentials. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 122, No. 9, pp. 258–261, September, 1996     

The relationship between enlargement of the temporal horns of the lateral ventricles and dementia in aging patients with Down syndrome

Summary Head CT studies of patients with Alzheimer's disease (AD) show global atrophic changes. Tissue loss is especially prominent in the temporal lobes, with widening of the temporal horns of the lateral ventricles and, usually, widening of the temporal sulci. Some recent studies have found a familial form of AD to be mapped to chromosome 21. Down syndrome (DS) results from the inheritance of three chromosomes 21, and it has been shown that after the age of 35 the brains of patients with DS commonly show neuropathological changes similar to those in patients with AD. CT studies of 25 patients with DS (ages 29–64 years) were examined for tissue loss in the temporal regions, and this was compared to the findings commonly seen in patients with AD. The widths of CSF spaces varied considerably in patients with DS, but after the age of 50 most of them showed significant widening of the temporal horns. In some patients the horns were large enough to suggest obstructive hydrocephalus. Because of a new trend toward deinstitutionalization of patients with DS, radiologists will be seeing more studies on these patients and should familiarize themselves with the unique ways in which they manifest the aging process.     

Magnetic resonance imaging findings in schizophrenia and atypical psychoses

The differences among MRI findings were studied in schizophrenic psychoses. The schizophrenics and atypical psychotics had significant reductions in bilateral hippocampal volumes compared to controls, but the two patient groups did not differ from each other. As for ventricle volume, the schizophrenics showed significantly larger temporal horns and third ventricle than normal controls, whereas atypical psychotics did not. Moreover, the left temporal horn in the schizophrenics was significantly larger than that seen in the atypical psychotics. By cluster analysis, schizophrenics and atypical psychotics were found to have a tendency to be distributed in different groups. These results might be considered to support the classification of schizophrenic psychoses into schizophrenia and atypical psychoses.     

山羊角替代羚羊角的实验研究

目的 通过抗惊厥和解热实验,研究山羊角对羚羊角的替代比例范围,为山羊角替代羚羊角的应用提供依据.方法 采用戊四唑致小鼠惊厥实验,观察两者对惊厥时间和死亡率的影响,并分别作量效关系图;采用干酵母致大鼠发热实验,比较两者对大鼠温度升高的抑制作用,并分别作量效关系图.结果 羚羊角能延长小鼠惊厥的潜伏期,降低死亡率;羚羊角和山羊角能不同程度地抑制大鼠体温的升高.两模型的替代比例分别为6.0:1与7.2:1.结论 山羊角替代羚羊角的比例范围为(6.0:1～7.2:1).