吗啡对大鼠海马锥体神经元L-型Ca2+通道电流的影响

目的观察吗啡对大鼠海马锥体神经元L-型Ca^2＋通道电流的影响。方法成年SD大鼠,体重230～270 g,麻醉后快速断头取脑,急性分离海马锥体神经元,12个海马（椎体神经元）随机分为2组（n=6）,吗啡组应用细胞贴附式膜片钳技术记录依次加入不同浓度吗啡[0（未加吗啡）、10^-8、10^-7、10^-6、10^-5mol/L]后海马锥体神经元L-型Ca^2＋通道电流及电导;纳洛酮组加入10^-5mol/L纳洛酮后30min,再依次加入上述不同浓度吗啡,记录此通道电流及电导。结果与未加吗啡比较,吗啡组10^-6、10^-5mol/L吗啡可抑制海马神经元L-型Ca^2＋通道电流,10^-5 mol/L的抑制作用更明显（P＜0．01）;预先加入纳洛酮可阻断吗啡对该通道电流的抑制作用（P＜0．01）;但L-型Ca^2＋通道电导无变化。结论通过作用于μ片受体,10^-6、10^-5 mol/L吗啡可抑制大鼠海马锥体神经元L-型Ca^2＋通道电流,10^-5mol/L的抑制作用更强。     

异丙酚对肿瘤坏死因子-α诱导小鼠脊髓神经元凋亡的影响

目的研究异丙酚对肿瘤坏死因子-α（TNF-α）诱导小鼠脊髓神经元凋亡的影响。方法脊髓神经元取自孕14d胎龄小鼠的胎鼠，于含B27的神经细胞培养基中培养7d后，随机分为6组：对照组（Con组）；50μmol／L异丙酚组（P50组）；TNF-α组（TNF-α组）；25μmol／L异丙酚＋TNF-α组（P25＋TNF-α组）；50μmol／L异丙酚＋TNF-α组（P50＋TNF-α组）；100μmol／L异丙酚＋TNF-α组（P100＋TNF-α组），各组中加入相应终浓度的异丙酚孵育30min，再加入TNF-α至终末浓度为2000U／ml，培养24h后，采用碘化丙锭／Hoechst 33342双染法检测细胞凋亡，计算细胞凋亡率，采用免疫细胞化学方法测定Bcl-2表达。结果与Con组比较，TNF-α组神经元凋亡率升高，Bcl-2表达降低（P〈0．01），不同浓度异丙酚预先给药可减弱TNF-α诱导的上述改变（P〈0．05）。结论异丙酚可抑制TNF-α诱导小鼠脊髓神经元的凋亡，其机制与上调Bcl-2表达有关。     

异丙酚对大鼠海马神经元NMDA受体通道电流的影响

目的 研究异丙酚对大鼠海马神经元N-甲基-D-天冬氨酸（NMDA）受体通道电流的影响。方法 体外培养新生Wistar大鼠海马神经元8—12d，采用全细胞膜片钳技术和压力喷射给药方式，钳制电压为-80mV，记录3、48μg∥ml异丙酚对100μmol／LNMDA诱发NMDA受体通道电流的影响；然后用7-氨基丁酸（GABA）受体拮抗剂荷包牡丹碱100μmol／L阻断GABA．受体，观察3、48μg／ml异丙酚对NMDA受体通道电流的影响。结果 3、48μg／ml异丙酚抑制自发兴奋性突触后电流并直接激动GABA．受体，使Cl．内流，产生外向超极化的GABA电流，从而间接抑制NMDA受体通道电流。用荷包牡丹碱100μmol／L阻断GABA．受体后，3、48μg∥ml异丙酚仍可抑制100μmol／LNMDA诱发的NMDA受体通道电流（P〈0．05）。结论 异丙酚通过激活GABA．受体影响NMDA受体通道电流，对NMDA受体通道也有直接抑制作用。     

异丙酚对大鼠海马神经细胞内游离钙和钙调蛋白活性的影响

目的观察一次性注射异丙酚对Wistar＇s大鼠海马神经细胞内游离钙（[Ca^2＋]i）和钙调蛋白（calmodulin，CaM）相对活性的影响。方法40只Wistar＇s大鼠随机分为5组，即对照组、诱导期组、麻醉期组、恢复期组、清醒期组。对照组腹腔注射生理盐水10ml／kg，其余各组注射异丙酚100mg／kg．在不同麻醉时期断头取脑，用流式细胞术测定海马神经细胞内[Ca^2＋]i和CaM相对活性。结果①麻醉诱导后海马神经细胞内[Ca^2＋]i与对照组比较升高有统计学意义（P〈0．01）．②CaM平均荧光强度诱导期与对照组及恢复期比较升高有统计学意义（P〈0．05），恢复期其活性接近对照组水平（P〉0．05）。结论Wistarg大鼠腹腔注射异丙酚100mg／kg即刻可明显影响其海马神经细胞内[Ca^2＋]i和CaM相对活性。CaM作为信号分子在异丙酚全麻作用的分子学机制中发挥了一定作用。     

异丙酚对大鼠海马CA1区神经元兴奋性突触传递的影响

目的 研究异丙酚对大鼠海马CA1区神经元兴奋性突触后电流（EPSC）和自发性兴奋性突触后电流（sEPSC）的影响。方法 Wistar大鼠断头后分离海马脑组织，制成400μm厚度的海马脑片，脑片随机分为5组（n=10）。脂肪乳剂Ⅰ组、异丙酚Ⅰ组、SR95531＋异丙酚组：记录EPSC10min（基础值）后分别加入10％脂肪乳剂90μl,1％异丙酚90μl（相当于100μmol／L）、10μmol／LSR95531＋100μmol/L异丙酚，继续记录EPSC40min，分析EPSC幅值的变化。脂肪乳剂Ⅱ组、异丙酚Ⅱ组：细胞破膜后稳定10．15min，分别加入10％脂肪乳剂90出和1％异丙酚90出，记录sEPSC40min，分析sEPSC频率、幅值和半衰期的变化。膜钳制电压均为-70mV。结果 与基础值比较，给药后脂肪乳剂Ⅰ组和SR95531＋异丙酚组EPSC幅值差异无统计学意义，异丙酚Ⅰ组EPSC幅值降低；给药后异丙酚Ⅰ组EPSC幅值比脂肪乳剂Ⅰ组降低（P〈0．05）。与脂肪乳剂Ⅱ组比较，异丙酚Ⅱ组sEPSC的频率、幅值降低、半衰期缩短（P〈0．05）。结论 异丙酚主要通过增强大鼠海马CA1区神经元突触前膜和突触后膜的GABA．受体活性，产生突触前抑制和突触后抑制，从而抑制兴奋性突触传递。     

异丙酚或依托咪酯对戊四唑诱发大鼠海马CA1区神经元动作电位和突触传递的影响

目的探讨异丙酚或依托咪酯对戊四唑诱发大鼠海马CA1区神经元动作电位（APs）和突触传递的影响。方法断头法分离60只Wistar大鼠海马，切片机切出400μm厚度的海马脑片，随机分为4组：戊四唑组（P组）、戊四唑＋脂肪乳剂组（PI组）、戊四唑＋异丙酚组（PP组）、戊四唑＋依托眯酯组（PE组）。全细胞电流钳记录海马CA1区锥体神经元APs发放频率，全细胞电压钳记录电刺激Schaeffer侧支，联合纤维诱发的CA1区锥体神经元兴奋性突触后电流（EPSCs）的幅值。结果与基础值比较，加入戊四唑后4组大鼠海马CA1区神经元APs发放频率增加，EPSCs幅值下降（P〈0．05）；与加入戊四唑后比较，加入异丙酚或依托咪酯后APs发放频率减少。EPSCs幅值回升（P〈0．05）。与P组及PI组比较．PP组加入异丙酚、PE组加入依托咪酯后APs发放频率减少，EPSCs幅值回升（P〈0．05）；P组与PI组比较、PP组与PE组比较差异均无统计学意义（P〉0．05）。结论异丙酚、依托咪酯可拮抗戊四唑诱发大鼠海马CA1区神经元动作电位的发放和突触传递。     

二氮嗪预处理对缺氧复氧后大鼠海马神经元凋亡的影响

目的研究线粒体内膜ATP敏感性钾通道（Mito-KAw）特异性开放剂二氮嗪预处理对缺氧复氧后大鼠海马神经元凋亡的影响。方法取离体培养的大鼠海马神经元，随机分为4组：对照组（A组）、二氮嗪30μmol／L组（B组）、二氮嗪1（30μmol／L组（C组）、二氮嗪100μmol／L＋Mito-KATP特异性阻断剂5．羟葵酸100μmol／L组（D组），各组神经元每天给予相应药物预处理1h，连续3d，继而缺氧4h复氧24h，观察神经元的活力、凋亡率、Bax和Bd．2蛋白的表达水平。结果与其它3组比较，C组海马神经元活力增强，凋亡率降低，Bcl．2蛋白表达水平升高，Bax蛋白表达水平下降（P〈0．01）。结论100μmol／L二氮嗪预处理通过改善Bcl-2与Bax蛋白表达的失衡，降低神经元的凋亡，对大鼠海马缺氧复氧神经元产生了保护效应。     

异丙酚对小鼠海马脑片细胞外信号调节激酶ERK1/2磷酸化水平的影响

目的 观察异丙酚对小鼠海马脑片细胞外信号调节激酶ERK1／2磷酸化水平的影响。方法BALB／C小鼠，体重18～22g，雌雄不拘，迅速断头取脑，取海马用震动切片机切成450μm厚的脑片。量效实验随机将脑片分为空白对照组（C组）及不同浓度异丙酚组[10^-4mmol／L（P1组）、10^-5mmol／L（P2组）、10^-6mmol／L（P3组）、10^-7mmol／L（P4组）、10^-8mmol／L（P5组）、10^-8mmol／L（P6组）]；分别以不同浓度的异丙酚36℃恒温孵育海马脑片1h。时效实验应用5μmol／L异丙酚孵育脑片，分别于孵育即刻、1、2、5、7、9、12、15、30、60min取出脑片；取5μmol／L异丙酚孵育5min后的部分脑片，以人工脑脊液洗出异丙酚，分别于洗出2、4、7、10、25min取出脑片。应用SDS-PAGE和Westem blot生化技术及Gel Doc凝胶成像系统半定量检测小鼠海马p-ERKI／2水平。结果 异丙酚能降低ERK1／2磷酸化水平，降低呈时间、浓度依赖性（P〈0．05）。随异丙酚孵育5min后洗出时间延长，ERK1／2的磷酸化水平逐渐恢复，但洗出25min时仍明显低于药物处理前水平（P〈0．01）。结论 异丙酚能显著地抑制小鼠海马脑片细胞外信号调节激酶ERK1／2磷酸化水平。     

异丙酚对心肌缺血再灌注损伤大鼠离体心脏脂质代谢的影响

目的观察异丙酚对心肌缺血再灌注损伤大鼠离体心脏脂质代谢的影响。方法雄性Wistar大鼠68只，体重350～450g，随机分为2组（n=34）：正常对照组（C组）和心肌缺血再灌注组（I／R组）。I／R组阻断左冠状动脉前降支，缺血30min，再灌注2h制备心肌缺血再灌注模型，取心脏在Langendorff灌注模型上用Krebs-Hemseleit（KBH）缓冲液灌注，将用放射性物质标记的（TAG）0．4mol/L加入循环回路中。分别用含不同浓度异丙酚[0（生理盐水）、0．1、1．0、5．0、10．0、500μmol／L]的灌注液进行灌注，监测平均动脉压、心率、主动脉流量（AFR）、冠状动脉血流（CFR），计算Hvdraulic work反映心肌作功情况。测定灌注液中TAG浓度，计算脂肪酸（FFA）氧化率，并测定心肌脂蛋白酶（LPL）活性。结果心肌缺血再灌可导致Hydraulic work降低，FFA氧化率和心肌LPL活性升高；与C组异丙酚浓度为0时比较，C组异丙酚浓度为10．0、50．0μmol／L时Hydraulic work降低，异丙酚浓度为5．0～50．0μmol／L时灌注液中TAG浓度升高，I／R组异丙酚浓度为10．0、50．0μmol／L时Hydraulic work降低，异丙酚浓度为5．0—50．0μmol／L时灌注液中TAG浓度升高，异丙酚浓度为10．0～50．0μmol／L时FFA氧化率和心肌LPL活性降低（P〈0．05）；与I／R组异丙酚浓度为0时比较，I／R组异丙酚浓度为0．1～10．0μmol／L时Hydraulic work升高，异丙酚浓度为5．0～50．0μmol／L时灌注液中TAG浓度升高，FFA氧化率及心肌LPL活性降低（P〈0．05）。结论异丙酚可减轻心肌缺血再灌注损伤大鼠心脏功能的降低，其机制与改善心肌脂质代谢有关。     

硫化氢对大鼠海马神经元氧-糖缺失/恢复损伤的影响

目的研究硫化氢（H2S）对大鼠海马神经元氧-糖缺失/恢复损伤的影响。方法新生（24～48h内）Wistar大鼠断头,迅速取出海马,应用0．125%胰酶消化,海马神经元在96孔和6孔培养板上培养10d后随机分为5组：正常培养组（Ⅰ组）、氧-糖缺失/恢复组（Ⅱ组）、氧-糖缺失/恢复＋50μmol/L NaHS组（Ⅲ组）、氧-糖缺失/恢复＋100μmol/L NaHS组（Ⅳ组）和氧-糖缺失/恢复＋200μmol/L NaHS组（Ⅴ组）。Ⅱ组神经元进行氧-糖缺失45min后换回原来的培养液,然后放回原培养箱培养24 h,Ⅲ组、Ⅳ组和Ⅴ组在氧-糖缺失时加入NaHS,使其终浓度分别为50、100、200μmol/L,余处理同Ⅱ组,Ⅰ组按正常培养方法培养。检测96孔培养板神经元活力。鉴定6孔培养板的神经元纯度并进行细胞色素C水平、还原型谷胱甘肽（GSH）、丙二醛（MDA）浓度和神经元凋亡的检测。结果与Ⅰ组比较,Ⅱ组MDA浓度、细胞色素C水平和神经元凋亡率升高,GSH浓度和神经元活力降低（P＜0．05）；与Ⅱ组比较,Ⅲ组、Ⅳ组和Ⅴ组MDA浓度、细胞色素C水平和神经元凋亡率降低,GSH浓度和神经元活力升高（P＜0．05）；与Ⅲ组比较,Ⅳ组和Ⅴ组MDA浓度、细胞色素C水平和神经元凋亡率降低,GSH浓度和神经元活力升高（P＜0．05）；与Ⅳ组比较,Ⅴ组MDA浓度、细胞色素C水平和神经元凋亡率降低,GSH浓度和神经元活力升高（P＜0．05）。结论外源性H2S可减轻大鼠海马神经元氧-糖缺失/恢复损伤,其机制可能与其提高机体的抗氧化能力、减少神经元的凋亡有关。     

2015年乳腺癌辅助化疗进展

【摘要】〓乳腺癌是危害我国女性健康的头号杀手,尽管近年来辅助化疗的研究进展突飞猛进,但临床中仍有不少问题未能明确,如辅助化疗的合适人群、化疗的开始时间、蒽环及紫杉类的地位和用法、强化维持治疗的作用、疗效及预后的生物标志物等。本文结合乳腺癌辅助化疗在临床上的常见问题和2015年各大乳腺癌会议阐述乳腺癌辅助化疗的最新进展。     

Alterations in T-Cell Subset Frequency in Peripheral Blood in Obesity

Background: Obesity affects the regulation of immune and inflammatory responses. This study characterizes differences in peripheral blood lymphocyte phenotype in obese humans. Methods: Frequencies of lymphocyte subsets among peripheral blood mononuclear cells were compared between 10 obese (BMI ≥35) and 10 lean subjects, as determined by antibodies directed against cluster differentiation (CD) markers. Results: Obese patients demonstrated an increased frequency of CD3+CD4+ T-cells (mean difference 12%, P=0.004), a decreased frequency of CD3+CD8+ T-cells (mean difference 9.4%, P=0.016) and an increased frequency of CD3+CD8+CD95+ T-cells (mean difference 13.3%, P=0.032). No other differences among T-cell or monocyte subsets were noted. Conclusions: Obesity is associated with alterations in frequencies of peripheral CD4+ and CD8+ T-cells and aberrations in the expression of CD95 among CD8+ T-cells. These data suggest both CD4+ and CD8+ T-cell compartments, as well as the regulation of CD95 expression on CD8+ T-cells, as targets for further study into obesity's effects on the immune system.     

西宁地区烧伤病人动脉血气分析观察

对高海拔地区的27例烧伤病人动脉血气变化进行了分析和观察。结果证明:无论是存活病人还是死亡病人伤后均存在有低氧血症问题。并且在死亡病人和烧伤合并吸入性损伤病人其低氧血症的发生早于单纯烧伤病人。提示:吸入性损伤病人应立即行气管切开术以保障氧气供给,单纯烧伤病人可常规吸氧以维持正常血 PaO_2,ARDS 均发生在合并吸入性损伤的病人,高频喷射通气技术对纠正低氧血症有一定效果。     

Controversies in Fistula in Ano

Managing a complex fistula in ano can be a daunting task for most surgeons; largely due to the two major dreaded complications—recurrence & fecal incontinence. It is important to understand the anatomy of the anal sphincters & the aetiopathological process of the disease to provide better patient care. There are quite a few controversies associated with fistula in ano & its management, which compound the difficulty in treating fistula in ano. This article attempts to clear some of those major controversies.     

β-半乳糖苷酶在体内外成骨细胞中的表达

目的 研究β—半乳糖苷酶(β—gal)在成骨细胞中的表达状况，为阐明MorquioB综合征的发病机制提供依据。方法 裸鼠各器官和骨组织标本行X-gal染色检测。抽取羊和人骨髓行骨髓基质细胞(BMSCs)培养，分为4组：I：Adv-hBMP-2转染组；Ⅱ：Adv—β—gal转染组；Ⅲ：未转染组；Ⅳ：地塞米松诱导组。分别行X-gal染色和RT-PCR检测β—gal的表达。结果 裸鼠骺板两侧、骨膜内面及松质骨的成骨细胞和破骨细胞可见多量β—gal的表达。未转染BMSCs组有少量β—gal的表达，其他3组细胞的β—gal表达增高。结论成骨细胞和破骨细胞可表达多量β—gal，该两种细胞的β—gal缺乏可能是MorquioB综合征骨骼异常的直接原因。     

Smoking-Attributable mortality in Spain in 2016

IntroductionSmoking-attributable mortality (SAM) is a valuable indicator that can be used to characterize the course and health burden of the smoking epidemic. The aim of this paper was to estimate SAM in Spain in 2016 in the population aged 35 and over, using the best available evidence.MethodsA smoking prevalence-dependent analysis based on the estimation of population-attributable fractions was performed. Smoking prevalence (never, former, and current smokers) was calculated from a combination of the Spanish Health Survey (2016) and the European Health Survey (2014); the relative risk of death among current and former smokers was taken from the follow-up of various cohorts; and mortality rates were obtained from National Center for Statistics data. SAM estimates are presented globally, and by sex, age groups, and major disease categories: cancer, cardiometabolic diseases and respiratory diseases.ResultsIn 2016, 56,124 deaths were attributed to tobacco consumption, 84% in men (47,000), and 50% in the population aged over 74 (27,795). Overall, 50% of SAM was due to cancer (28,281), 65% of which was lung cancer. One in 4 attributable deaths (13,849) occurred before the age of 65.ConclusionsOne in 7 deaths in Spain in 2016 were attributable to smoking. This estimation of SAM clearly highlights the great impact of smoking on mortality in Spain, mainly due to lung cancer and chronic obstructive pulmonary disease.     

MicroRNAs in hepatic pathophysiology in diabetes

MicroRNAs(miRNAs or miRs) are small approximately 22 nucleotide RNA species that are believed to regulate diverse metabolic and physiological processes.In the recent past,several reports have surfaced that demonstrate the role of miRNAs in various biological processes and numerous disease states.For a disease as complex as diabetes,the emergence of miRNAs as key regulators leading to the disease phenotype has added a novel dimension to the area of diabetes research.On the other hand,the liver,a metabolic hub,contributes in a major way towards maintaining normal glucose levels in the body as it can both stimulate and inhibit hepatic glucose output.This equilibrium is frequently disturbed in diabetes and hence,the liver assumes special significance considering the correlation between altered hepatic physiology and diabetes.While the understanding of the mechanisms behind this altered hepatic behavior is not yet completely understood,recent reports on the status and role of miRNAs in the diabetic liver have further added to the complexities of the knowledge of hepatic pathophysiology in diabetes.Here,we bring together the various miRNAs that play a role in the altered hepatic behavior during diabetes.     

Fluid-phase transcytosis in the primate epididymis in vitro and in vivo

Ligated tubules from the corpus epididymidis of men and monkeys were incubated in medium containing horseradish peroxidase (HRP) as a marker for fluid-phase endocytosis. HRP was localized by light and electron microscopy after 0, 15, 30 and 60 min of incubation. Movement between the cells was prevented by tight junctions, but bypass of this barrier was apparently achieved by an intracellular vesicular mechanism leading to a time-dependent appearance of HRP in the lumen. Uptake of HRP into basal cells and capture by the lysosomal apparatus of principal cells were also observed. HRP-filled vesicles also appeared in the basal, mid and apical cytoplasm of epithelial cells in the caput 1 h after injection of the tracer into the epididymal circulation of the monkey, suggesting that this pathway also operates in vivo.