颞叶癫大鼠海马轴突导向分子Sema3F及其受体Np2表达的变化

目的 研究颞叶癫(癎)大鼠海马轴突导向分子Sema3F及其受体Np2表达的变化.方法 给SD大鼠腹腔注射匹罗卡品、氯化锂制作颞叶癫(癎)模型.用免疫组化法和原位杂交技术对致(癎)后不同时间点大鼠海马CA1区、CA3区、齿状回的Sema3F mRNA、Np2 mRNA和蛋白表达进行检测,并与正常对照组比较.结果 颞叶癫(癎)大鼠致(癎)后7 d、15 d,海马CA1区、CA3区Sema3F mRNA、Np2 mRNA和蛋白的表达明显低于正常对照组(P＜0.05～0.01), 致(癎)后30 d、60 d表达与正常对照组差异无统计学意义;而齿状回Sema3F mRNA、Np2 mRNA和蛋白的表达与正常对照组的差异无统计学意义.结论 颞叶癫(癎)大鼠海马CA1区、CA3区Sema3F、Np2表达在致(癎)后早期明显下调,而在慢性期恢复正常.     

颞叶癫(癎)大鼠海马轴突导向分子Sema3F及其受体Np2表达的变化

目的研究颞叶癫大鼠海马轴突导向分子Sema3F及其受体Np2表达的变化。方法给SD大鼠腹腔注射匹罗卡品、氯化锂制作颞叶癫模型。用免疫组化法和原位杂交技术对致后不同时间点大鼠海马CA1区、CA3区、齿状回的Sema3F mRNA、Np2 mRNA和蛋白表达进行检测,并与正常对照组比较。结果颞叶癫大鼠致后7d、15d,海马CA1区、CA3区Sema3F mRNA、Np2 mRNA和蛋白的表达明显低于正常对照组(P<0.05~0.01),致后30d、60d表达与正常对照组差异无统计学意义;而齿状回Sema3F mRNA、Np2 mRNA和蛋白的表达与正常对照组的差异无统计学意义。结论颞叶癫大鼠海马CA1区、CA3区Se-ma3F、Np2表达在致后早期明显下调,而在慢性期恢复正常。     

红藻氨酸致颞叶癫(癎)大鼠脑内Semaphorin3A、Semaphorin4C基因表达的研究

目的研究轴索导向分子Semaphorin3A(Sema3A)、4C(Sema4C)对癫大鼠海马苔藓纤维重建的调控作用及对皮层神经元的保护作用。方法大鼠侧脑室内注射红藻氨酸制备颞叶癫模型,原位杂交法检测致痫间后1d,1、2、3、4周大鼠脑内Sema3A/Sema4C mRNA表达。结果致痫间后1周Sema3A、Sema4CmRNA分别在齿状回(DG),CA3区表达明显下降(P<0.01),持续至3、4周时恢复至正常(P>0.05);致痫间后1d Sema3A mRNA在皮层表达明显下降(P<0.01),持续至1、2周后恢复至正常(P>0.05)。结论红藻氨酸致痫间后DG及CA3区神经元分别下调Sema3A/Sema4C mRNA的表达,促进癫大鼠苔藓纤维重建;皮层神经元通过下调Sema3A mRNA的表达来维持自身存活。     

耐药性癫癎患者术后脑组织中Tau蛋白的表达

目的研究Tau蛋白在耐药性癫癎患者脑组织中的表达,探讨其在耐药性癫癎发病机制中的作用。方法采用免疫组化法检测48例耐药性癫癎患者海马及颞叶皮层中Tau蛋白的表达,同步观察海马苔藓纤维芽生,并与对照组进行比较。结果耐药性癫癎组和对照组脑组织中总Tau蛋白表达无明显差异,而磷酸化Tau蛋白在耐药性癫癎患者海马CA3区(0·0450±0·0115)及齿状回内分子层(0·0463±0·0120)表达增多,同步伴有海马苔藓纤维芽生(耐药性癫癎组:3·18±0·35,对照组:0·61±0·19)。结论磷酸化Tau蛋白表达增强可能是耐药性癫癎患者海马突触重建的重要机制,改变磷酸化Tau蛋白的表达有可能改善耐药性癫癎患者的预后。     

法舒地尔对戊四氮点燃大鼠海马丝切蛋白及苔藓纤维出芽的影响

目的 探讨法舒地尔对戊四氮(PTZ)点燃大鼠海马组织中丝切蛋白(cofilin,非磷酸化形式)表达与苔藓纤维出芽程度关系的影响.方法 210只SD雄性大鼠分成戊四氮组、法舒地尔干预组和生理盐水对照组,采用PTZ慢性点燃癫癎模型,应用SABC法检测cofilin表达,用Timm染色检测苔鲜纤维出芽情况.结果 PTZ组大鼠点燃率、病死率与法舒地尔组比较差异无统计学意义.PTZ组和法舒地尔组CA3区苔藓纤维出芽评分差异无统计学意义,与对照组相比差异均有统计学意义(P＜0.05).PTZ组和法舒地尔组海马非磷酸化cofilin表达差异无统计学意义.结论 丝切蛋白可能通过苔藓纤维出芽与癫癎的发生相关.     

神经营养因子-3在颞叶癫(癎)后的表达与海马苔藓纤维发芽的关系

目的 探讨神经营养因子-3(NT-3)在颞叶癫(癎)大鼠海马内表达与苔藓纤维发芽(MFS)的可能关系.方法 大鼠侧脑室注射红藻氨酸(KA)建寺颞叶癫(癎)模型后,侧脑室注射NT-3反义寡核苷酸(ASODN)及正义寡核苷酸(SODN);应用免疫组化法观察海马NT-3表达;应用Timm银染方法,光镜和电镜观察海马MFS,并与空白对照组及脂质体对照组进行比较.结果 致(癎)后大鼠海马齿状回NT-3表达下降;海马苔藓纤维明显粗乱,侧支发芽;齿状回内分子层可见银标记突触末端,主要为轴-树型非对称突触,其中ASODN组海马NT-3蛋白水平降低及MFS程度更明显.结论 KA致痢和NT-3 ASODN均能降低大鼠海马齿状回NT-3表达,增加MFS程度.提示NT-3可能通过对MFS及突触重组作用来影响颞叶癫(癎)的发生和发展.     

匹罗卡品癫(癎)模型中蛋白质netrin-1的表达与苔藓纤维出芽的动态变化

目的:探讨神经诱向因子蛋白质netrin-1在癫(癎)持续状态后海马苔藓纤维出芽(MFS)中的作用.方法:氯化锂-匹罗卡品建立大鼠颞叶癫(癎)(TLE)模型,采用Timm染色和免疫组化的方法分别检测MFS和netrin-1在大鼠海马组织中的表达.结果:TLE组大鼠在模型形成的第2周和第4周,海马齿状回内netrin-1的表达较正常对照组明显增加,并可见到MFS,穿越齿状回颗粒细胞层到达内分子层,并形成一条致密的层状带.结论:癫(癎)状态后在海马齿状回netrin-1的表达上调,证明其可能参与了癫(癎)后MFS过程.     

TRPC6在匹罗卡品致痫大鼠海马苔藓纤维出芽中的作用

目的 观察传统型瞬时受体电位通道6(TRPC6)蛋白在匹罗卡品致痫大鼠海马中的表达变化,探讨其在海马苔藓纤维出芽中的作用.方法 72只SD大鼠随机分为实验组(n=60)和对照组(n=12).实验组采用氯化锂-匹罗卡品腹腔注射法建立颞叶癫痫模型;对照组腹腔注射等量无菌生理盐水.实验组按癫痫持续状态(SE)后1d、7d、15d、30 d和60 d分为5个亚组,每亚组12只大鼠.以上各亚组及对照组再分为2个小组,分别进行Western blot检测TRPC6及突触重建标志蛋白Synaptophysin在海马中的表达和Timm染色观察海马苔藓纤维出芽并评分.结果 实验组TRPC6蛋白表达量在SE后1d达高峰(P＜0.01),其他时间点均显著高于对照组(P＜0.01).Synaptophysin蛋白表达量在SE后7d、15d、30 d和60 d显著增加(7 d:P＜0.05;15 d、30 d、60 d:P＜0.01),30 d达峰值(P＜0.01).实验组大鼠齿状回内分子层在SE后7d出现Timm颗粒,并呈进行性增加.结论 TRPC6可能参与了苔藓纤维出芽这一过程.     

颞叶癫癎大鼠海马TrkB mRNA及其蛋白表达的动态变化

目的探讨颞叶癫瘸发作大鼠海马TrkB mRNA及其蛋白表达的动态变化特征.方法建立匹罗卡品(PILO)颞叶癫癎大鼠模型,应用原位杂交及免疫组织化学方法分别检测致瘸大鼠海马齿状回、CA3区及CAi区TrkB mRNA及其蛋白质表达的变化.结果 PILO致瘸后3～6 h,海马齿状回颗粒细胞层、CA1、CA3区锥体细胞层TrkBmRNA表达显著增高(P＜0.01),稍后TrkB蛋白表达也随之增高.第7～30d,TrkBmRNA及其蛋白在齿状回、CA3区呈现第二次表达增强.结论在癫癎发作早期,TrkB表达增强,提示其可能参与急性癜癎状态的发生;后期表达增强则可能参与了海马的可塑性反应而与慢性自发性发作形成有关.     

Semaphorin-3A与苔藓纤维出芽在毛果芸香碱致痫大鼠中的改变及意义

目的探讨海马Semaphorin-3A(Sema3A)与苔藓纤维出芽(MFS)在癫痫发病机制中的作用。方法通过小剂量多次腹腔注射氯化锂-毛果芸香碱建立癫痫大鼠模型,随机将大鼠分为生理盐水对照组和痫性发作组。痫性发作组分别于药物注射后1、5、7d及3、4周时间点,应用Western blotting法检测大鼠海马Sema3A的表达,同时采用neo-Timm银染观察海马MFS情况。结果生理盐水对照组Sema3A仅有少量表达,痫性发作组1、5d无表达,7d表达明显,3周后亦无表达;痫性发作组1、5d未见MFS,7d可见MFS至齿状回内分子层,3周后明显可见MFS至齿状回分子层。痫性发作组Timm评分与生理盐水对照组比较差异有统计学意义(P<0.05)。结论海马区Sema3A表达变化伴有MFS可能是癫痫发病机制的重要因素之一。     

The neuroendocrinology of stress and the pathophysiology and therapy of depression and anxiety

Clinical and preclinical studies have gathered substantial evidence that stress response alterations play a major role in the development of major depression, panic disorder, and post-traumatic stress disorder. The stress response, the hypothalamic pituitary adrenocortical (HPA) system and its modulation by corticotropin-releasing hormones (CRH),corticosteroids,and their receptors, and the roles of natriuretic peptides and neuroactive steroids are described. We review the role of the HPA system in major depression, panic disorder, and post-traumatic stress disorder and its possible relevance for treatment. Impaired glucocorticoid receptor function in major depression is associated with an excessive release of neurohormones such as CRH, to which a number of signs and symptoms characteristic of depression can be ascribed. In panic disorder, a role of central CRH in panic attacks has been suggested. Atrial natriuretic peptide (ANP) is causally involved in sodium lactate-induced panic attacks. Furthermore, preclinical and clinical data on its anxiolytic activity suggest that nonpeptidergic ANP receptor ligands may be potentially useful in the treatment of anxiety disorders. Post-traumatic stress disorder is characterized by a peripheral hyporesponsive HPA system and elevated CRH concentrations in the CSF. This dissociation is probably related to an increased risk of this disorder. We further review recent data that describe an important role of GABA(A)-receptor modulatory,3 alpha-reduced neuroactive steroids in major depression, anxiety, and its treatment. Antidepressants are effective in both depression and anxiety disorders and have major effects on the HPA system,especially on glucocorticoid and mineralocorticoid receptors. Normalization of HPA system abnormalities is a strong predictor of the clinical course, at least in major depression and panic disorder. Currently,CRH-R1 or glucocorticoid receptor antagonists and ANP receptor agonists are being studied and may provide future treatment options more closely related to the pathophysiology of these disorders.     

Polymorphisms of DRD4 and DRD3 and risk of avoidant and obsessive personality traits and disorders

We investigated whether polymorphisms of the dopamine D4 receptor (DRD4) and polymorphisms of the dopamine D3 receptor (DRD3) were associated with personality disorder symptomatology rather than with personality traits such as novelty seeking. DNA was obtained from 145 depressed patients in a clinical trial. These patients were assessed for the presence of personality disorder symptoms and disorders. The 2-repeat allele of the DRD4 exon III polymorphism was associated with increased rates of avoidant and obsessive personality disorder symptomatology. The T,T genotype of the DRD4 -521 C>T polymorphism was also associated with increased rates of avoidant and obsessive personality disorder symptomatology. The Gly9,Gly9 genotype of the DRD3 Ser9Gly polymorphism was associated with increased rates of obsessive personality disorder symptomatology. None of these three polymorphisms were associated with novelty seeking or other temperament traits on the Temperament and Character Inventory. Our results suggest that genetic polymorphisms of DRD4 and DRD3 may well be associated with personality traits, and that conflicting findings to date may arise from the problem of phenotype definition.     

沙盘游戏疗法在地中海贫血患儿心理干预中的应用

本文目的是对沙盘游戏疗法在地中海贫血患儿心理干预中的应用进行综述,以期为地中海贫血患儿的心理康复提供参考。地中海贫血是以珠蛋白生成障碍为主要特征的遗传性疾病,由于长期输血治疗,患儿存在较多的心理和行为问题。沙盘游戏疗法作为一种有效、实用的儿童心理治疗方法,对提高地中海贫血患儿的康复效果、改善生存质量有重要的临床意义。     

癫痫共病抑郁的机制及临床诊疗

本文目的是探讨癫痫共病抑郁的可能机制及临床诊疗。癫痫是一种常见的、慢性的、致残性的神经疾病,癫痫患者生活质量下降,存在明显的负性情绪,常伴发各种精神疾病。癫痫与抑郁具有共同的神经生物学基础,可能存在共同的发病机制。本文从癫痫共病抑郁的发病机制、临床诊断及治疗方面予以总结归纳。     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Seclusion and restraint and prediction of violence

The authors studied the use of seclusion and restraint on an inpatient unit in a state psychiatric hospital. Of 69 randomly selected inpatients, 51% experienced seclusion or restraint at least once. More psychotic than nonpsychotic patients required seclusion or restraint. However, neither psychosis/nonpsychosis nor voluntary/involuntary admission status predicted the likelihood of violent threats or actions. Patients experiencing seclusion and restraint showed a nonsignificant trend toward longer mean length of stay in the hospital. The frequency of patient behavior leading to seclusion or restraint appeared to be directly related to the stimulation caused by the presence of many staff members and other patients.     

Comparison of trigeminal and spinal modulation of pain and nociception

Modulation of pain and nociception by noxious counterstimulation, also called "diffuse noxious inhibitory controls" or DNIC-like effect, is often used in studies of pain disorders. It can be elicited in the trigeminal and spinal innervation areas, but no study has previously compared effects in both innervation areas. Therefore, we performed a study comparing DNIC-like effects on the nociceptive flexion reflex (NFR) and the nociceptive blink reflex as well as the respective pain sensations. In 50 healthy volunteers, the blink reflex elicited with a concentric electrode and the NFR were recorded before and after immersion of the contralateral hand in cold water. Responses were recorded as the subjective pain sensation and the reflex size. The cold water immersion of the contralateral hand elicited a reduction of both subjective pain sensation and reflex amplitude following the stimulation of both reflexes. However, there were no strong correlations between the individual reductions of both subjective pain sensation and reflex amplitude for both reflexes, and neither when results of the two reflexes were compared with each other. The dissociation between DNIC-like effects on pain and on nociception, which had been found previously already for the NFR, implies that both effects need to be studied separately.