GluRs介导的神经突触内级联反应对视神经元可塑性调节机制的研究进展Research progress in regulatory mechanism of synaptic cascade response based on GluRs in plasticity of optic neurons

谷氨酸（Glu）是视觉传导通路上神经元轴突末梢主要的兴奋类神经递质,借助不同亚型的谷氨酸受体（GluRs）广泛参与视神经元的生长、发育、分化和成熟等过程,在视觉信号传递和维持正常视功能方面具有至关重要的作用。在视功能可塑性调控机制中,突触后膜上的离子型谷氨酸受体（iGluRs）被激活,产生兴奋性突触后电位（EPSC）以提升视神经元的突触传递效率。代谢型谷氨酸受体（mGluRs）通过与不同类型的G蛋白偶联而激活神经突触内的级联反应过程,借助细胞内离子水平改变、信号通路增强和特定基因的转录表达途径,发挥对突触结构和功能重塑的间接调控作用。上述不同亚型的GluRs共同参与调节了视觉信号传递的长时程增强（LTP）和长时程抑制（LTD）过程。现结合近年来国内外相关研究进展,从大脑视皮层神经元突触膜上不同亚型的GluRs入手,阐述视觉剥夺后基于不同亚型GluRs介导的视觉可塑性级联反应机制,以期为今后弱视中枢发病机制的研究和有效的靶点治疗药物的开发指明新的方向。     

谷氨酸NMDA受体激活双重作用的教学体会（摘要）

为了培养研究生在文献中抓住有用信息并进行分析的能力,我们以NMDA受体激活在LTP和LTD以及NMDA 受体激活引起神经毒性和神经保护相反作用为例进行探讨.我们收集相关资料,根据研究发展线索进行分析,如NMDA受体激活引起LTP和LTD首先是通过高频电刺激引起LTP、低频电刺激引起LTD观察到的现象,随后发现是由同样的NMDA、AMPA受体引起的,进一步研究表明,不同的NMDA受体亚单位是确定极性的关键因素,含NR2B亚单位的NMDA受体引起LTD,含NR2A亚单位的NMDA受体引起LTP,分析细胞内信息传递过程,发现CaMKII介导了增强过程而钙调神经磷酸酶介导了抑制过程;又如激活NMDA受体引起神经毒性和神经保护相反作用现象是通过给予不同剂量的谷氨酸和NMDA观察到的,因为这有重要的临床意义,激起众多学者探讨其机制.     

谷氨酸影响培养的海马神经元内钙变化机制

目的:研究谷氨酸对培养的大鼠海马神经元内钙信号的影响及作用机制。方法:用显微荧光测量技术监测神经元内钙信号的动态变化和谷氨酸对其的影响;阻断NMDA、AMPA受体后,观察谷氨酸对神经元内钙信号影响的变化。结果:谷氨酸使神经元内游离钙浓度明显升高,NMDA和AMPA受体拮抗剂、胞外钙离子浓度的降低均可不同程度地降低胞内游离钙离子升高幅度。结论:谷氨酸通过多种途径影响大鼠海马神经元内钙信号,激活NMDA和AMPA受体是其中的重要机制之一。     

竞争性α-氨基-3-羟基-5-甲基-4-异唑恶唑丙酸受体拮抗剂研究进展

α-氨基-3-羟基-5-甲基-4-异唑恶唑丙酸（AMPA）受体是游离型谷氨酸受体,广泛分布于中枢神经系统,介导快速兴奋性突触传递。越来越多的证据表明,其在突触可塑性及中枢敏化中发挥重要作用,并且与神经系统疾病关系密切。过度刺激AMPA受体产生兴奋性毒性会导致神经元损伤,引发癫痫、肌萎缩侧索硬化和帕金森病等一系列神经系统疾病的发生。竞争性AMPA受体拮抗剂能够有效下调AMPA受体活性,对预防和治疗神经系统疾病意义重大。本文对竞争性AMPA受体拮抗剂的研究进展进行综述。     

缺血损伤后突触后膜GluR2含量变化及机制

目的探讨缺血损伤后突触后膜谷氨酸受体2(glutamate receptor 2, GluR2)含量变化、机制及其在神经元延迟性死亡中的作用.方法采用PI染色、比色分析和双重免疫荧光技术定量观察神经元死亡、膜表面及突触GluR2含量变化及途径.结果缺血损伤神经元死亡数量明显增加;膜表面GluR2总量、含GluR2的突触数目以及突触部位GluR2含量都明显降低(P<0.05),而胞内GluR2含量则显著增加,采用高渗糖预处理阻断内吞过程可显著抑制膜表面GluR2的降低过程.结论缺氧损伤后膜GluR2内吞过程增强,导致了膜表面GluR2含量降低,缺乏GluR2的AMPA受体增加,进而介导了Ca2 的快速内流,引起神经元延迟性死亡.     

Baclofen抑制DRG分离细胞NMDA-激活电流

我室及其它学者的研究证明：背根神经节(DRG)神经元细胞膜不仅存在有兴奋性氨基酸谷氨酸(Glu)亚型(NMDA，KA，QA／AMPA)受体，也存在有抑制性氨基酸GABAA及GABAB受体，而且发现在部分细胞这些受体可以共存。Morrisett et al(1991)曾报导GABAB受体激活对大鼠海马突触传递的NMDA成份具有抑制效应。本文研究的目的系探讨大鼠DRG神经元膜GABAB受体激活对NMDA受体介导的反应的调制作用。     

钙离子介导NMDA受体与AMPA受体的相互抑制

目的观察NMDA受体与AMPA受体之间的相互抑制作用及其作用机制.方法采用全细胞膜片钳技术记录培养大鼠海马神经元谷氨酸受体电流.结果在培养大鼠海马神经元上记录到10^-4mol/L NMDA和10^-4mol/L AMPA分别诱导的内向阳离子电流,同时施加NMDA和AMPA所诱导的钙电流幅度明显小于分别施加两者之和;而诱导的钡电流则无此现象.结论NMDA受体与AMPA受体存在相互抑制作用,该抑制作用可能通过内流的Ca^2＋介导.     

NMDA受体NR1亚单位与学习记忆

谷氨酸（Glu）是脊椎动物中枢神经系统中的主要兴奋性神经递质，其受体可分为代谢型和离子型两大类。离子型受体由三种组成：AMPA受体（α-amino-3-hydroxy-5-methyl-4-isoxazoepionate receptor，AMPAR），KA受体（kanieacid，KAR）及NMDA受体（N-methyl-D-Aspartic acid receptor，NMDAR）。其中NMDA受体被认为是突触可塑性及皮质和海马神经元长时程增强效应（Long-term potentiation，LTP）的主要调控者，     

NMDA受体与神经退行性疾病的关系

兴奋性氨基酸受体是哺乳动物中枢神经系统中主要的兴奋性神经递质受体,它是介导谷氨酸(Glu)及其他相关内源性酸性氨基酸兴奋作用的跨膜蛋白.谷氨酸受体可分为离子型和代谢型两类.离子型受体可进一步分为N-甲基-D-天冬氨酸(NMDA)受体和非NMDA受体(AMPA和KA受体).NMDA受体可调节神经元的存活,树突、轴突结构发育和突触可塑性,神经元回路的形成以及学习记忆活动,对生物发育过程极为重要.NMDA受体活性调节的失衡可能是神经退行性疾病及癫痫、缺血性脑损伤等许多中枢神经系统疾病发病的基础.文章重点就NMDA受体与神经退行性疾病的关系进行综述.     

NMDA受体与神经退行性疾病的关系

兴奋性氨基酸受体是哺乳动物中枢神经系统中主要的兴奋性神经递质受体,它是介导谷氨酸(Glu)及其他相关内源性酸性氨基酸兴奋作用的跨膜蛋白.谷氨酸受体可分为离子型和代谢型两类.离子型受体可进一步分为N-甲基-D-天冬氨酸(NMDA)受体和非NMDA受体(AMPA和KA受体).NMDA受体可调节神经元的存活,树突、轴突结构发育和突触可塑性,神经元回路的形成以及学习记忆活动,对生物发育过程极为重要.NMDA受体活性调节的失衡可能是神经退行性疾病及癫痫、缺血性脑损伤等许多中枢神经系统疾病发病的基础.文章重点就NMDA受体与神经退行性疾病的关系进行综述.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.