MAGE-3-HSP70融合基因真核表达载体的构建与鉴定

背景：疫苗诱导的抗肿瘤CD8+T细胞反应被认为在增加机体对肿瘤抵抗力方面起重要作用。研究发现,抗原递呈细胞摄取热休克蛋白70与肿瘤相关抗原的融合蛋白,并在MHC I类分子上处理提呈有此热休克蛋白为伴侣的肽后,会启动CD8+细胞毒性T淋巴细胞反应。 目的：构建黑色素瘤抗原3(MAGE-3)、人热休克蛋白70(HSP70)融合基因的真核表达载体。 设计、时间及地点：单一样本观察,于2008-06/12在国家卫生部纳米生物技术重点实验室完成。 材料：pcDNA3.1(-) Vector为BD公司产品,pINCY /MAGE-3,pOTB7/HSP70为Open Biosystems公司产品,DH5α由纳米生物技术重点实验室保存。 方法：设计含Xho Ⅰ酶切位点MAGE-3引物及含Kpn Ⅰ酶切位点人热休克蛋白70引物,以pINCY/MAGE-3 和pOTB7/HSP70为模板扩增黑色素瘤抗原3和人热休克蛋白70基因片段,以基因片段为模板,采用MAGE-3上游引物(含Xho Ⅰ酶切位点)及人热休克蛋白70下游引物(含Kpn Ⅰ酶切位点),PCR扩增MAGE-3-HSP70融合基因片段,KpnⅠ和Xho Ⅰ双酶切并连接至pcDNA3.1(-),转化感受态大肠杆菌DH5α,获得阳性克隆进行双酶切和测序鉴定。 主要观察指标：真核表达载体pcDNA3.1(-)/MAGE-3-HSP70的鉴定。 结果：测序结果显示黑色素瘤抗原3与Gene Bank上公布的序列完全一致, 人热休克蛋白70有3处同义突变。 结论：成功构建MAGE-3-HSP70融合基因真核表达载体。     

壳聚糖季铵盐作为基因递送载体的初步研究**

背景：非病毒载体因其安全性好而在基因治疗领域赢得了广泛的关注,各种各样的非病毒载体处在不断的研究中,壳聚糖季铵盐作为一种新的生物材料,同样也具有作为基因递送载体的潜质。 目的：考察壳聚糖季铵盐体外基因转染活性,寻求一种新的非病毒基因载体递送系统。 设计、时间及单位：对比观察实验,于2008-04/12在浙江省医学科学院生物工程所完成。 材料：质粒pcDNA3.1-EGFP为浙江省医学科学院生物工程实验室保存。以3-氯-2-羟丙基三甲基氯化铵作为改性剂制备壳聚糖季铵盐,用复凝聚法制备载基因纳米粒。 方法：凝胶阻滞实验分析壳聚糖季铵盐包裹质粒的能力,DNase I的保护实验分析载基因纳米粒的抵抗核酸酶降解的能力,体外基因转染实验评价纳米粒的体外转染活性,用倒置荧光显微镜观察和流式细胞仪测定转染结果。通过考察转染液中有无牛血清和递送不同剂量的基因对转染效率的影响,寻求本递送系统较好的转染条件。另外,用MTT法测定壳聚糖季铵盐的细胞毒性。 主要观察指标：壳聚糖季铵盐和pcDNA 3.1-EGFP以何种比例结合形成的纳米粒、转染液中有无牛血清,质粒的量为多少时对人胚肾T细胞的转染效率是最高的;不同浓度的壳聚糖季铵盐对细胞生长的影响。 结果：壳聚糖季铵盐纳米粒能转入人胚肾T细胞,虽然转染效率略逊于聚乙烯亚胺,但是细胞毒性明显小于聚乙烯亚胺。壳聚糖季铵盐纳米粒转染细胞72 h后效率较高,经综合分析,当pcDNA质量为2 μg,壳聚糖季铵盐和pcDNA以质量比为5结合形成的纳米粒,在无血清条件下对人胚肾T细胞进行转染,转染效率是最高的。 结论：壳聚糖季铵盐纳米粒能将基因递送到细胞内,并且报告基因能在细胞内表达。因此,壳聚糖季铵盐用做基因递送的载体系统值得进一步的研究。     

叶酸-壳聚糖介导survivin shRNA基因纳米载体的制备***★

背景：叶酸-壳聚糖纳米粒是一种新型的高靶向纳米载体，可进一步提高药物的靶向性，并进一步实现缓释和控释给药。 目的：探讨叶酸-壳聚糖纳米粒作为survivin shRNA重组质粒载体传递系统的可行性以及对大肠癌细胞(SW480)的转染效率。 设计、时间及地点：对比观察实验，于2008-06/2009-01在中南大学卫生部纳米生物技术重点实验室完成。 材料：壳聚糖(脱乙酰度>90%)由上海伯奥生物科技有限公司提供，叶酸由国药集团化学试剂有限公司提供，survivin shRNA重组质粒由上海吉凯基因化学技术有限公司提供。 方法：首先制备粒径均匀的叶酸偶联壳聚糖纳米粒，然后将20 mg/L survivin shRNA重组质粒和10 mg/L 叶酸-壳聚糖混合制备基因纳米复合物，同时以阳离子脂质体基因复合物作为对照，将上述两者转染大肠癌细胞。 主要观察指标：基因纳米复合物的理化性质及转染效率；Western blotting检测转染后肿瘤细胞中survivin蛋白的表达。 结果：成功制备叶酸-壳聚糖介导的survivin shRNA重组质粒基因纳米复合物。该基因纳米复合物转染大肠癌细胞的效果强于阳离子脂质体基因复合物。且转染后大肠癌细胞中survivin蛋白的表达显著低于阳离子脂质体基因复合物。 结论：叶酸-壳聚糖纳米粒作为载体系统能将survivin shRNA重组质粒高效递送到大肠癌细胞，从而诱导人大肠癌细胞的凋亡。     

聚氰基丙烯酸正丁酯纳米颗粒的表面修饰和转染研究

目的：比较不同物质修饰的聚氰基丙烯酸正丁酯纳米颗粒的物理化学性质,并考察它们体外基因转染活性,以寻求一种新的非病毒基因载体递送系统。方法：用乳化聚合法制备不同物质修饰的聚氰基丙烯酸正丁酯纳米粒,透射电镜观察表面修饰对纳米粒粒径大小、粒子形态的影响;利用体外转染实验考察表面修饰对纳米粒转染活性的影响;用倒置荧光显微镜观察并用流式细胞仪测定转染结果。结果：经壳聚糖表面修饰的聚氰基丙烯酸正丁酯纳米粒带有很强的正电荷,能够转染人肝癌细胞HepG2细胞,并且转染效率高于葡聚糖和mPEG-NH2修饰的纳米粒,也能防止DNase I酶的降解。结论：壳聚糖修饰的聚氰基丙烯酸正丁酯纳米颗粒能有效地将基因递送到细胞内,并且报告基因能在细胞内表达。因此,壳聚糖修饰的聚氰基丙烯酸正丁酯纳米粒用做基因递送的载体系统值得进一步的研究。     

壳聚糖氧化铁纳米颗粒包裹MDR1 shRNA与对胶质瘤细胞转染的影响

目的探讨多药耐药基因短发卡RNA（MDRl shRNA）与壳聚糖氧化铁（Fe304）纳米颗粒对胶质瘤细胞系转染的影响。方法设计并合成针对MDRl的shRNA序列与pSIREN—RetroQ质粒载体连接,提取质粒,制备壳聚糖纳米颗粒并包裹制备的质粒,测定包封率及粒径分布。培养人类胶质母细胞瘤BT325共转染,测定转染效率。结果质粒pSIREN—RetroQ—RNAi经双酶切后测序验证,与实验设计的shRNA长度相符。壳聚糖一铁纳米粒子的粒径为100～300mm。分布较均匀．包裹质粒DNA包封率为97％-99％。壳聚糖Fe304纳米粒子包裹质粒经PI试剂转染BT325细胞,在共转染24h开始表达,荧光显微镜下呈绿色荧光,48h表达最强。转染效率为70％-80％（P〈0．05）。结论MDRlshRNA表达质粒与壳聚糖Fe3O4纳米粒子结合,可提高胶质瘤细胞系BT325转染效率,转染后细胞可以正常生长,可以为进一步的靶向基因检测及治疗提供有意义的思路。     

负载两性霉素B壳聚糖-聚乳酸纳米粒的制备及其释药性能*☆

背景：两性霉素B为治疗深部真菌感染的首选药物,但该药无法通过血脑屏障而对隐球菌性脑膜炎的治疗效果甚微。利用纳米粒子作为药物载体的优势,通过相分离透析技术制备负载两性霉素B的壳聚糖-聚乳酸纳米粒子,有望克服两性霉素B的不足。 目的：对负载两性霉素B的壳聚糖-聚乳酸纳米粒进行表征,分析其体外药物释放能力。 设计、时间及地点：重复测量设计,于 2008-11/2009-04 在国家纳米科学中心纳米医学与生物实验室完成。 材料：壳聚糖,平均相对分子质量为3.4×105,脱乙酰度为93%,为上海卡伯工贸有限公司产品。两性霉素B为Sigma公司产品。 方法：在二甲基亚砜溶液中,在三乙胺存在下,通过壳聚糖和D,L-丙交酯的开环聚合反应能够生成壳聚糖-聚乳酸共聚物。该共聚物由亲水壳聚糖段和疏水聚乳酸段组成,在水中能够组装形成纳米粒子。两性霉素B通过相分离透析技术包载于纳米粒子中。 主要观察指标：激光粒度分析仪测定纳米颗粒的粒径大小、粒径分布,环境扫描电镜观察纳米颗粒的外观形态,紫外光谱分析负载两性霉素B的壳聚糖-聚乳酸纳米粒的包封率、载药量和释药性能。 结果：壳聚糖-聚乳酸纳米粒和负载两性霉素B的壳聚糖-聚乳酸纳米粒,其粒径分别为114 nm和153 nm(当丙交酯与壳聚糖摩尔比为11∶1时)。纳米粒子粒径分布较窄,呈球形。共聚物中丙交酯与壳聚糖摩尔比影响药物的包封率和载药量,随着丙交酯与壳聚糖摩尔比从11∶1到20∶1,包封率从(62.3±3.5)%增加到(90.7±2.8)%,载药量从(7.8±1.2)%增加到(12.3±1.4)%。随着聚乳酸段质量比增加,纳米粒子尺寸、包封率和载药量增加,而药物释放降低。 结论：开环聚合制备壳聚糖-聚乳酸共聚物及用相分离透析方法制备负载两性霉素B纳米粒简便可靠,负载两性霉素B后纳米粒径明显变大,且纳米粒对两性霉素B有很高的包封率,体外释药具有明显的缓释作用。 关键词：两性霉素B;壳聚糖;聚乳酸;纳米粒子;包封率;体外释放     

负载紫杉醇壳聚糖纳米粒的制备、表征与释药性能

背景：紫杉醇是一种天然抗肿瘤药物,但其水溶性极低。壳聚糖经接枝改性，生成的共聚物可在液相中生成纳米粒，可用于药物的缓释和控释。 目的：对制备的负载紫杉醇的壳聚糖纳米粒进行表征，分析其体外药物释放能力。 设计、时间及地点：重复测量设计，于2008-01/07在华北煤炭医学院医学系实验室完成。 材料：壳聚糖，平均相对分子质量为2.0×105，脱乙酰度为92%，为浙江省玉环海洋生物化学有限公司产品。紫杉醇，批号082329802，为中国药品生物制品检定所产品。 方法：采用引发接枝效率高、引发反应条件温和的二羟基二过碘酸合镍钾为引发剂，在壳聚糖上接枝醋酸乙烯酯，该聚合物在水溶液中直接生成具有疏水核心、亲水表面的纳米粒，即壳聚糖纳米粒，再利用超声振荡技术将0.5~5.0 mg紫杉醇与上述纳米粒混合制成负载紫杉醇的壳聚糖纳米粒。 主要观察指标：激光粒度分析仪测定纳米颗粒的粒径大小、粒径分布及Zeta电位，透射电镜观察纳米颗粒的外观形态，高效液相色谱法分析负载紫杉醇的壳聚糖纳米粒的包封率、载药量和释药性能。 结果：壳聚糖纳米粒和负载紫杉醇的壳聚糖纳米粒，其粒径分别为196.2 nm和320.8 nm，粒径分布较窄，纳米粒表面均带正电荷，Zeta电位比较差异无显著性意义（F=0.818，F=3.38，P均>0.05）。稳定的纳米粒呈球形，粒径均匀。紫杉醇的加入量可影响纳米粒的包封率，紫杉醇的加入量为纳米粒的量2%时，达到最大包封率93.6%。体外模拟释药结果表明药物释放曲线分为两个阶段，突释阶段微球释药量在24 h内达48.3%，缓释阶段微球释药持续时间长，在175 h时释药量达75.9%，载药纳米粒的药物释放速率持续稳定。 结论：接枝共聚法制备壳聚糖纳米粒简便可靠，负载紫杉醇后纳米粒径明显变大，表面带有正电荷，且纳米粒对紫杉醇有很高的包封率，体外释药具有明显的缓释作用。     

纳米粒包裹氨基吡啶亚乙基双磷酸甜菜碱对巨噬细胞的选择性清除作用

背景：氨基吡啶亚乙基双磷酸甜菜碱（2-(2-aminopyrimidinio) ethylidene-1,1-bisphosphonic acid betaine,ISA）是一种新近人工合成的效力极强的双磷酸酯,将其用纳米粒包裹后通过巨噬细胞的吞噬作用而导入细胞,可以达到选择性清除巨噬细胞的目的。 目的：拟验证纳米粒包裹ISA对单核/巨噬细胞选择性的清除作用。 设计、时间及地点：分组设计、对比观察,于2003/2007分别在以色列希伯莱大学和解放军总医院实验室完成。 材料：ISA由以色列希伯莱大学药学院合成;聚乳酸/乙醇酸共聚物 (50∶50),相对分子质量123 400;聚乙烯醇,相对分子质量30 000~70 000。 方法：采用双相乳化系统和溶剂蒸发技术制备纳米粒包裹的ISA,另以ISA溶液和等量不含ISA的纳米粒为对照。 主要观察指标：①纳米粒形态、大小及纳米粒中ISA含量。②纳米粒中ISA体外释放率。③ISA对培养巨噬细胞、平滑肌细胞增殖的影响。④激光扫描共聚焦显微镜观察培养细胞对荧光标记纳米粒吞噬作用。 结果：所制备的纳米粒直径500 nm,表面呈负电荷（-40 mV）,ISA包裹率高（17.6%~19.0%）,扫描电镜检查见其大小均匀。体外实验证实,ISA在纳米粒包裹后对巨噬细胞、平滑肌细胞增殖抑制作用明显增加,并且对巨噬细胞增殖的抑制作用尤为明显。激光扫描共聚焦显微镜观察发现荧光标记的纳米粒分别与巨噬细胞、平滑肌细胞孵育后,纳米粒可快速进入巨噬细胞内,且包裹ISA的纳米粒对巨噬细胞有明显损伤作用,而平滑肌细胞内无纳米粒。 结论：ISA经纳米粒包裹后可选择性清除单核/巨噬细胞,而对非吞噬细胞影响较小。     

两亲性壳聚糖衍生物负载及缓释醋酸曲安奈德的性能

背景：醋酸曲安奈德是一种长效肾上腺糖皮质激素，具有较强的抗炎作用。近年来在眼内疾病的治疗中取得了较好的效果，但同时带来一些不良反应，且需多次注射，以防止疾病复发。壳聚糖经接枝改性，生成的共聚物可在水溶液中生成纳米粒，用于药物的缓释载体，延长药物作用时间，降低不良反应，提高生物利用度。 目的：合成含脱氧胆酸基团的两亲性壳聚糖衍生物作为醋酸曲安奈德的载体材料，制备具有缓释功能的载药纳米胶束，研究其负载和缓释醋酸曲安奈德的性能。 方法：通过酰胺化反应在壳聚糖上偶联脱氧胆酸基团，合成两亲性壳聚糖衍生物。透射电镜观察纳米粒的外观形态和粒径，Zeta电位分析仪测定纳米粒的Zeta电位，体外释放实验检测负载醋酸曲安奈德的壳聚糖-脱氧胆酸纳米粒的包封率、载药量和体外释药性能。 结果与结论：合成出含脱氧胆酸基团的两亲性壳聚糖衍生物，它能与醋酸曲安奈德形成载药纳米胶束，载药量可高达82%。随着载药量的增加，载药纳米胶束的粒径逐渐增大，而Zeta电位则呈下降的趋势。体外释放的结果表明载药纳米胶束能起到72 h缓释醋酸曲安奈德的作用。提示以两亲性壳聚糖衍生物为载体的载药纳米胶束显示出较好的缓释醋酸曲安奈德性能，将有希望提高醋酸曲安奈德的治疗效果。 关键词：醋酸曲安奈德；两亲性壳聚糖衍生物；脱氧胆酸；纳米胶束；体外药物释放 doi:10.3969/j.issn.1673-8225.2010.29.013     

阳离子脂质体转染Hela细胞的实验

背景：基因载体是基因治疗中重要的影响因素,阳离子脂质体细胞毒性低,转染效率高,是一种很有前景的基因转染载体。 目的：评价两种阳离子脂质体介导基因转染宫颈癌细胞的转染效果,优化它们对宫颈癌细胞的转染条件。 设计、时间及地点：以Hela细胞为观察对象,分组设计。实验于2008-03/06在大连民族学院生命科学学院国家民委－教育部重点实验室完成。 材料：质粒pGFP-N2购自Clontech公司,Hela细胞由大连民族学院的实验室保存。 方法：首先采用DNA延滞实验考察阳离子脂质体与DNA的结合能力,然后用进行细胞转染实验研究脂质体的转染效率,最后通过四甲基偶氮唑盐法考察脂质体对细胞的毒性。 主要观察指标：采用DNA延滞实验观察阳离子脂质体Lipofectamine 2000和DOTAP与DNA的结合能力,以报告基因（绿色荧光蛋白基因pGFP-N2）,分析阳离子脂质体Lipofectamine 2000和DOTAP转染Hela细胞转染效率和细胞毒性。 结果：Lipofectamine 2000和DOTAP与DNA均有很强的结合力;以绿色荧光蛋白基因为报告基因,Lipofectamine 2000转染率较高;当Lipofectamine 2000与DNA质量比为3∶1时,转染效率最高,约72%,是DOTAP转染细胞最高活性的2.5倍;在最佳转染剂量时,2种试剂的细胞存活率均在75%以上,Lipofectamine 2000的毒性相对较小。 结论：对Hela细胞而言,Lipofectamine 2000较DOTAP具有更高的转染效率和较低的细胞毒性。     

Epilepsy and anomalies of neuronal migration: MRI and clinical aspects

Neuronal migration disorders are the result of disturbed brain development. In such disorders, neurons are abnormally located. In diagnosing these conditions, magnetic resonance imaging is superior to any other imaging technique. This enables us to improve our knowledge of the clinical correlates of neuronal migration. With reference to migrational disorder, a retrospective study of all 303 patients with epileptic seizures referred for magnetic resonance imaging during a 3-year period was performed, 13 patients (aged 12-41, mean age 27) were identified. They represent 4.3% of the entire study group. Of the patients with known epilepsy, 6.7% and of the mentally retarded, 13.7% had migrational disorders. Four patients had schizencephaly as the dominant finding, one was classified as hemimegalencephaly, 2 had isolated heterotopias, and 6 had localized pachy- and/or poly-microgyria. The clinical pictures are complex. Ectopias of grey matter are recognised foci of epilepsy, but from an epileptological and a clinical viewpoint little attention has been given to these disorders. The present study shows that malmigration is not rare in epilepsy patients, especially not in the mentally retarded.     

Hepatic Considerations in the Use of Antiepileptic Drugs

Summary: Virtually all of the major antiepileptic drugs (AEDs) can cause hepatotoxicity, although fatal hepatic reactions are rare. The mechanisms, incidences, and risk profiles for such reactions differ from drug to drug. With carbamazepine and phenytoin, hepatotoxicity may be due to drug hypersensitivity. Although the profiles of patients at risk have not been well-defined for these two antiepileptic drugs, it would appear from reports in the literature that older adolescents and adults are at higher risk than children of developing serious or fatal hepatotoxicity. Once hepatotoxicity develops, mortality rates are 10–38% with phenytoin and 25% for carbamazepine. The risk profile for valproate fatal hepatotoxicity has been more clearly defined. Those at primary risk of fatal hepatic dysfunction are children under the age of 2 years who are receiving multiple anticonvulsants and also have significant medical problems in addition to severe epilepsy. The risk is considerably lower for patients over the age of 2 years on valproate monotherapy. In contrast to the risk profile with other AEDs, adults receiving valproate as monotherapy have the lowest risk of hepatotoxicity. Fatal hepatic dysfunction coincident with valproate may be the result of aberrant drug metabolism. Concomitant use of AEDs that induce microsomal P450 enzymes (e.g., phenytoin and phenobarbital) may enhance the production of a toxic metabolite, and hence the greater risk of hepatotoxicity with polypharmacy.     

Vascular Malformations and Epilepsy: Clinical Considerations and Basic Mechanisms

Summary: Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to provoke epilepsy determine treatment strategies. Investigations have probed the mechanisms of epileptogenesis associated with these lesions. Electrophysiologic changes are associated with epileptogenic cortex adjacent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial physiology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology.     

Classification of methods in transcranial Electrical Stimulation (tES) and evolving strategy from historical approaches to contemporary innovations

Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.     

Carbamazepine Efficacy and Utilization in Children

Summary: Carbamazepine is effective for preventing partial and generalized tonic-clonic seizures in children. Although absence epilepsies are more common in children than adults, an estimated 80% of children with epilepsy have seizure types or epilepsies that are potentially responsive to carbamazepine. The differential diagnosis of ictal staring is an especially important issue in children because absence and atypical absence seizures are more prevalent in children than adults. Age-related pharmacokinetic differences and drug interactions are major considerations in children. On average, children have higher clearance rates of carbamazepine, shorter half-lives, and higher ratios of carbamazepine-10, 11-epoxide to carbamazepine than adults. In addition, children with severe epilepsy are more likely to require multiple-drug therapy, which can lead to complex drug interactions. When carbamazepine is administered along with valproate, drug protein binding interactions can cause intermittent side effects.     

Neonatal Seizures: Problems in Diagnosis and Classification

Summary: The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo-graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction.     

Valproate Monotherapy in the Management of Generalized and Partial Seizures

Summary: For decades, therapeutic tradition has promoted the concept of polypharmacy in the management of epilepsy. In recent years, however, studies have shown that, for most patients, monotherapy can provide comparable or better seizure control than administration of multiple anticonvulsants, while diminishing the potential for adverse reactions, drug interactions, and poor compliance. Valproate is an important monotherapeutic agent that is highly effective in the control of idiopathic primary and secondarily generalized epilepsies, and partial seizures that do not generalize. Comparative studies have found that valproate is at least as effective as phenytoin and carbamazepine in the treatment of generalized and partial seizures. Given the similar efficacy, other factors such as pharmacokinetics and side effects may therefore determine anticonvulsant selection for monotherapy.     

Un nouveau cadre conceptuel de travail pour la psychiatrie

In an attempt to place psychiatric thinking and the training of future psychiatrists more centrally into the context of modern biology, the author outlines the beginnings of a new intellectual framework for psychiatry that derives from current biological thinking about the relationship of mind to brain. The purpose of this framework is twofold. First, it is designed to emphasize that the professional requirements for future psychiatrists will demand a greater knowledge of the structure and functioning of the brain than is currently available in most training programs. Second, it is designed to illustrate that the unique domain which psychiatry occupies within academic medicine, the analysis of the interaction between social and biological determinants of behavior, can best be studied by also having a full understanding of the biological components of behavior.