链脲佐菌素糖尿病大鼠痛阈的变化

链脲佐菌素糖尿病大鼠痛阈的变化张巧俊，赵英贤，刘健糖尿病性神经病通常伴有对痛刺激的敏感性升高、感觉异常和其它的神经功能障碍［１］。本实验采用行为学方法，对大鼠腹腔注射链脲佐菌素（ＳＴＺ）后，对非伤害性温度刺激（１０～４２℃）、伤害性温度刺激（甩尾反射...     

嘌呤核苷酸补偿对海洛因依赖大鼠痛阈的影响

目的 探讨嘌呤核苷酸补偿对海洛因依赖大鼠痛阈的影响.方法 将50只雄性Wistar大鼠随机分为对照组、海洛因组和海洛因+AMP+GMP组、海洛因+AMP组、海洛因+GMP组.于实验1、3、5、7 d用电子压痛仪检测大鼠尾压痛阈值,2、4、6、8 d进行热甩尾实验检测大鼠抗热痛觉过敏能力.结果 与对照组相比,第1天海洛因组及海洛因补偿嘌呤核苷酸组压痛阈值有所增加,但差异不显著(P＞0.05);第3天起海洛因+嘌呤核苷酸组压痛阈值明显高于海洛因组(P＜0.05).第2天起海洛因组热甩尾潜伏期延长(P＜0.05);第4天起海洛因+嘌呤核苷酸组热甩尾潜伏期时间长于海洛因组(P＜0.05).结论 嘌呤核苷酸补偿能够明显增强海洛因的镇痛作用.     

实验性血压变化对基础痛阈的影响

目的 :观察左侧肾动脉结扎大鼠血压变化对热痛阈和机械痛阈影响的时程。方法 :将 16只动物分为 3组 :假手术组、肾动脉结扎组和肾动脉结扎 +肌注利血平组 ,每天在一定时间检测动脉收缩压 （BP）、热刺激缩足反应潜伏期 （PWTL ）和机械刺激缩足反应阈值 （PWMT） ,并作定量分析。结果 :1假手术组 BP,PWTL和 PWMT均未发生明显变化 （P>0 .0 5 ）。 2肾动脉结扎组大鼠血压在术后第 1天开始升高 ,第 3天达峰值 ,并维持在高血压水平 （112± 6 vs 16 0± 8m m Hg） ,平行观察显示 PWTL和 PWMT均随动脉收缩压升高而降低 ,提示发生了热和机械痛敏现象。 3利血平降压治疗后动脉收缩压虽然降至正常范围 ,但热痛敏和机械痛敏却未被翻转。结论 :持续实验性高血压可能对伤害性反射的神经通路具有不可逆的调节作用     

去势大鼠痛阈及其PAG降钙素受体表达的变化

目的观察双侧卵巢切除（去势）不同时间（4、8、12周）大鼠痛阈的变化及中脑导水管周围灰质（PAG）中降钙素受体（CT-R）的表达。方法 48只雌性SD大鼠被平均随机分配成6组：正常组、假手术组和去势4、8、12周组（OVX1、OVX2、OVX3）及慢性神经压迫性损伤（CCI）组。通过腹正中路径切除双侧卵巢,采用慢性压迫性损伤的方法制备神经性疼痛的大鼠模型,热板实验评估热痛阈（TWL）,von Frey纤丝测定机械痛阈（MNT）。免疫组织化学法检测CT-R的表达。结果 CCI组TWL和MNT低于其他各组（P〈0.05）,CCI组PAG中CT-R表达较其他组增高（P〈0.05）,其余各组间TWL、MNT以及CT-R表达均无显著性差异。结论去势12周内大鼠痛阈及PAG中CT-R表达均无明显改变,疼痛可以上调PAG中CT-R的表达。     

椎间孔内注射不同浓度阿霉素对大鼠痛阈和背根神经节结构的影响

目的进一步探讨阿霉素（ADM）椎旁阻滞的机制及适宜浓度。方法将80只Wister大鼠随机分为ADM1。3组及对照组各20只,分别于右侧L4、L5椎间孔注射0．33％、0．5％、1％的ADM和生理盐水溶液10μl,术后第1、2、4、8周分别测量各组痛阈（热痛和电击痛阈）;术后第2、4周每组随机选取2只大鼠进行背根神经节（DRG）组织学观察。结果ADM3组术后1—8周热痛及电击痛阈值均明显高于对照组（P〈0．05）,ADM1组和ADM2组术后1周热痛和电击痛阈值显著低于对照组、2—8周显著高于对照组（P均〈0．05）;ADM1组DRG以小神经元破坏为主,而ADM2组和ADM3组DRG大、小神经元均有破坏。结论椎间孔内注射上述三种浓度ADM均可明显提高大鼠痛阈,可能机制为破坏DRG细胞;ADM浓度为0．33％时可仅提高痛阈而不产生其他感觉障碍。     

术前疼痛敏感度与术后硬膜外自控镇痛药物用量的相关性研究

目的探讨术前疼痛敏感与术与硬膜外自控镇痛药物用量的关系。方法60例在硬膜外麻醉下择期行经腹全子宫切除术或子宫肌瘤剔除术患者,术前采用电刺激痛阈测试仪测量痛阈、耐痛阈,采用状态-特质焦虑问卷（STAI）测量焦虑评分。术后硬膜外自控镇痛药物为0.75%布比卡因30 ml＋氟哌利多5 mg＋生理盐水稀释至150 ml。记录术后24 h布比卡因消耗量及术后4、81、22、4 h的视觉模拟（VAS）评分2、4 h按压总次数（D1）与实际进药次数（D2）比值（D1/D2）、Ramsay镇静评分、生命体征、不良反应发生情况。对术前焦虑评分、痛阈和耐痛阈与布比卡因消耗量的相关性行Pearson相关分析;对耐痛阈与布比卡因用量的关系行Stepwise多重线性回归分析,求出回归方程。结果布比卡因消耗量与耐痛阈呈负相关（r=-0.53,P〈0.01）。布比卡因消耗量=198.35-22.21×耐痛阈。布比卡因消耗量与痛阈、焦虑评分相关性无统计学意义（P〉0.05）。结论耐痛阈能有效预测术后硬膜外自控镇痛药消耗量。     

脊髓内催产素在痛行为调节中的作用

以钾离子透入法引起大鼠甩尾反应的电流强度为痛行为反应的指标,观察向脊髓蛛网膜下腔内注入催产素（OT）、抗OT血清（AOTS）对大鼠痛阈的影响.结果脊髓蛛网膜下腔内注射OT后,大鼠痛阈明显增加;注射AOTS后痛阈虽有一定程度降低,但无统计学意义.认为脊髓内OT在痛行为调节的复杂过程中发挥着一定的作用.     

电针及人参对慢性心肌梗死大鼠室颤阈（VFT）的影响

目的：探讨中药人参及针刺对心肌梗死诱发心律失常的良性调整作用,方法：采用结扎大鼠左冠状动脉前降支的慢性心肌梗死模型,用室颤阈（VFT）为观察指标,共选用SD纯种成年大鼠90只,体重200－250g,雌雄不限,随机分为正常组,假手术组,假手术电针组,结扎组,结扎＋电针组,结扎＋人参治疗组,电针组取“内关”“灵道”穴每天电针30分钟治疗2周,人参组以及人参水煎剂每日一次（1g/ml)喂养2周,结果：电针治疗组及人参治疗组慢性心梗大鼠室颤阈均显著高于未治疗组,并能改变缺血心肌对异丙肾上腺素的致颤敏感性,结论：电针及人参治疗能提高缺血心肌的室颤阈,降低其易颤性,及其对致颤药敏感性。     

老年急性单纯性创伤性脑损伤与ATC发生的相关性

目的 探究老年急性单纯性创伤性脑损伤(TBI)与急性创伤性凝血(ATC)发生的相关性.方法 选取73例创伤性脑出血患者,并采集其一般资料,分为单纯性颅脑损伤(iTBI)组16例、含TBI的多发伤(TBI+)组31例及非TBI的多发伤(NTBI)组26例,主要依据简明损伤评分(AIS)不同进行分组.采用多因素Logist...     

丙泊酚诱导七氟醚维持麻醉期间机体应激反应与BIS值的相关性

目的探讨脑电双频指数(BIS)判断麻醉期间应激反应强度的价值。方法 ASA分级Ⅰ或Ⅱ级丙泊酚诱导七氟醚维持麻醉行上腹部手术患者30例,记录气管插管前1min,插管后3 min,切皮前1 min,切皮后3、10min,探查后10 min时应激指标(包括血清皮质醇、血糖浓度,MAP、HR)和BIS,分析应激指标与BIS的相关性。结果应激反应指标与BIS均无明显相关性,P>0.05。结论丙泊酚诱导七氟醚维持麻醉期间BIS不能反映应激反应强度。     

Assessment of pain threshold in haemophilic patients

Many patients with haemophilia (PWH) live with persistent end‐stage arthritis, as a result of multiple joint haemarthrosis, and experience daily pain. For these people, pain becomes a central aspect of life. The aim of this study was to use mechanical pain thresholds (MPT) to characterize pain perception in different PWH groups. The groups tested were characterized by age, previous bleeding into joints, Hemophilia Joint Health Score (HJHS) and PAIN perception score in the HJHS scoring. A total of 23 PWH (haemophilia A) were included in this study (10 children, 13 adults). A total of 12 PWH suffered from repeated bleeding into some of the tested joints. Data were compared to those collected from 15 age‐matched control subjects. The most significant differences in MPTs were found when the PWH were compared to the controls, based on the differences in PAIN score (PAIN score 1 and 2) in all the tested joints, except for the right knee. Similarly, the difference in MPT in ankle joints was confirmed when PWH with and without bleeding were compared to controls. Summarizing the outcomes, we can emphasize the potential usefulness of MPT as an objective tool in evaluating the pain of PWH.     

胸腔镜肺癌根治术对患者疼痛应激及代谢反应的影响观察

目的观察研究胸腔镜肺癌根治术对患者疼痛应激及代谢反应的影响。方法选取2011年11月~2013年12月本院收治的78例肺癌患者为研究对象,将其随机分为对照组(开胸根治术组)39例和观察组(胸腔镜根治术组)39例,然后将两组患者手术前和手术后1 d、3 d与5 d的血清疼痛应激、蛋白代谢及其他代谢指标水平进行比较。结果观察组手术后1 d、3 d与5 d的血清蛋白代谢指标均高于对照组,而疼痛应激及其他代谢指标水平则均低于对照组,P均0.05。结论胸腔镜肺癌根治术患者的疼痛应激程度相对较小,其手术对患者代谢反应的不良影响也相对更小。     

Eating disorders and chronic post traumatic stress disorder: issues of psychopathology and comorbidity

This article reviews in both directions the recent literature on the relationship between Eating Disorders (ED) and chronic Post Traumatic Stress Disorder (PTSD) to shed some light on an area of comorbidity for too long overlooked. PTSD may be the commonest anxiety disorder in ED but it seems to be independent from ED. Clinicians should be aware that PTSD might represent more than just an occasional occurrence in ED clinical work and should know how to approach it. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association.     

Pharmacological pain management in the elderly patient

With the increasing number of elderly patients the issue of pain management for older people is of increasing relevance. The alterations with aging of the neurobiology of pain have impacts of pain threshold, tolerance and treatment. In this review the available evidence from animal and human experimentation is discussed to highlight the differences between young and older subjects along with consideration of how these changes have practical effect on drug treatment of pain. Cognitive impairment, physical disability and social isolation can also impact on the accessibility of treatment and have to be considered along with the biological changes with ageing. Conventional pain therapies, while verified in younger adults cannot be automatically applied to the elderly without consideration of all these factors and in no other group of patients is a holistic approach to treatment more important.     

Elevated pain threshold in patients with effort-induced angina pectoris and asymptomatic myocardial ischemia during exercise test

The purpose of the present study was to analyze the prevalence of asymptomatic (silent) myocardial ischemia during exercise testing among patients with effort-induced angina pectoris, and further, to compare the pain threshold of patients with symptomatic and asymptomatic myocardial ischemia. A group of 26 patients comprised the study. In half of the patients myocardial ischemia during the exercise testing was silent and in one half it was symptomatic. Asymptomatic myocardial ischemia was defined as an asymptomatic ST-segment depression greater than or equal to 0.1 mV, lasting longer than 60 s during an exercise test. In patients with asymptomatic ischemia the pain thresholds both on toe and finger were significantly higher than in patients with symptomatic ischemia: mean values were 10.1 versus 4.9 mA on the toes, p less than 0.025, and 8.4 versus 2.5 mA on the fingers, p less than 0.01. We conclude that asymptomatic myocardial ischemia during exercise test is seen often in patients with angina pectoris and that this may be due to an increased pain threshold.     

Post‐traumatic stress disorder,social support and cognitive status in community‐based older veterans

Objective: The present study investigated the relationships between structural and qualitative aspects of social support, combat‐related post‐traumatic stress disorder (PTSD) and cognitive status in a New Zealand veterans sample. Methods: A random sample of 232 New Zealand veterans completed a self‐report questionnaire and participated in a face‐to‐face interview. Results: Regression analysis showed that when controlling for age, income, education, depression and general health, PTSD scores had a negative relationship with cognitive status. Those who reported having private, restricted social networks had poorer cognitive functioning. These relationships were independent of each other. Conclusions: The findings suggest that while social support might be a potential target for interventions in at‐risk older adults, health professionals need to be aware of the concomitant possible influence of past trauma when dealing with this specific population.