银丹心脑通软胶囊对血管性痴呆大鼠学习记忆能力及皮层反应性氮中介物含量的影响

目的 探讨银丹心脑通软胶囊对血管性痴呆(VD)大鼠学习记忆能力及大脑皮层反应性氮中介物含量的影响. 方法 将SD大鼠按随机数字表法分为假手术组、VD组、银丹心脑通软胶囊治疗组,后两组采用永久性结扎双侧颈总动脉方法制备VD模型,银丹心脑通软胶囊治疗组于手术后即刻给予银丹心脑通软胶囊60 mg/(kg·d)灌胃,连续给药4周.4周后采用Morris水迷宫试验观察各组大鼠学习记忆能力的改变,采用比色法检测大鼠大脑皮层一氧化氮(NO)、诱导型一氧化氮合酶(iNOS)含量的变化. 结果 VD组与银丹心脑通软胶囊治疗组、假手术组比较,逃避潜伏期明显延长,原平台所在象限的搜索时间明显缩短,差异有统计学意义(P＜0.05).银丹心脑通软胶囊治疗组较VD组逃避潜伏期明显缩短、原平台所在象限的搜索时间明显延长,差异有统计学意义(P＜0.05).银丹心脑通软胶囊治疗组与VD组相比,大脑皮层NO和iNOS含量明显下降,差异有统计学意义(P＜0.05). 结论 银丹心脑通软胶囊能降低VD大鼠皮层NO、iNOS含量,对学习记忆能力有明显的提高作用.     

银丹心脑通软胶囊对血管性痴呆大鼠行为学及海马组织乙酰胆碱酯酶的影响

目的 观察银丹心脑通软胶囊对血管性痴呆大鼠学习记忆及海马组织乙酰胆碱酯酶活性的影响,探讨银丹心脑通软胶囊治疗血管性痴呆的作用机制. 方法 采用反复夹闭双侧颈总动脉再灌注、同时腹膜腔内注射硝普钠方法制作拟血管性痴呆大鼠模型.将造模成功的20只大鼠按随机数字表法分为血管性痴呆组及银丹心脑通软胶囊治疗组(各10只),另以条件匹配的10只大鼠为假手术组.于造模结束大鼠苏醒后30min以及处死前测定大鼠神经功能评分,采用跳台实验检测大鼠学习记忆能力,采用放射免疫法检测海马组织乙酰胆碱酯酶活性. 结果 大鼠处死前,与假手术组比较,血管性痴呆组和银丹心脑通软胶囊治疗组大鼠神经功能评分仍明显增高,差异有统计学意义(P＜0.05);银丹心脑通软胶囊治疗组大鼠神经功能评分明显低于血管性痴呆模型组,差异有统计学意义(P＜0.05).与血管性痴呆组比较,银丹心脑通软胶囊治疗组大鼠反应时间明显缩短,潜伏时间明显延长,错误次数明显减少,差异均有统计学意义(P＜0.05).银丹心脑通软胶囊治疗组海马组织AChE活性明显低于血管性痴呆组,差异有统计学意义(P＜0.05). 结论 银丹心脑通软胶囊能增强血管性痴呆模型动物的学习记忆功能,其作用机制可能与抑制乙酰胆碱酯酶活性有关.     

银丹心脑通对脑缺血再灌注大鼠海马区神经细胞凋亡及Caspase-3表达的影响

目的 明确银丹心脑通对脑缺血再灌注时神经细胞凋亡的保护作用,探索其治疗缺血性脑卒中的分子作用机制. 方法 将40只SD雄性大鼠按随机数字表法分为假手术组、模型组、阳性对照组(尼莫地平组)、银丹心脑通组.尼莫地平组及银丹心脑通组预先连续灌胃给药7d,假手术组和模型组每日灌服相当量的蒸馏水,第8大制备大鼠大脑中动脉阻塞模型.脑缺血再灌注24 h后应用TUNEL法检测各组大鼠海马CA1区凋亡阳性神经细胞数,应用免疫组化染色测定各组大鼠脑组织中天冬氨酸特异性半胱氨酸蛋白酶-3(Caspase-3)的表达. 结果 模型组大鼠均能见到较多的凋亡阳性细胞数及Caspase-3阳性细胞数,与假手术组比较差异有统计学意义(P＜0.05);与模型组比较,银丹心脑通组、尼莫地平组能明显减小凋亡阳性细胞数及Caspase-3阳性细胞数,差异有统计学意义(P＜0.05);银丹心脑通组与尼莫地平组在凋亡阳性神经细胞数及Caspase-3阳性细胞数上比较差异无统计学意义(P＞0.05). 结论 银丹心脑通对脑缺血再灌注损伤有一定保护作用,能够减少脑缺血再灌注大鼠神经细胞的凋亡,其作用机制可能与减少脑组织中Caspase-3的表达有关.     

银丹心脑通软胶囊对血管性痴呆模型大鼠行为学及脑组织自由基代谢的影响

目的 研究银丹心脑通(YDXNT)软胶囊对血管性痴呆(VD)模型大鼠学习记忆能力及超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量的影响. 方法 30只SD大鼠按照随机数字表法分成3组:假损伤组、VD模型组、YDXNT治疗组.后2组采用血管闭塞法复制VD模型,假损伤组除不结扎双侧颈总动脉外,其余处理与VD模型组、YDXNT治疗组相同.大鼠术后当天清醒后开始灌胃给药,YDXNT治疗组参照人的给药剂量,每只每次灌服lrnL液体(预先取YDXNT胶囊9粒去除胶囊溶解于360 mL生理盐水中配成液体备用),3次/d,连续注射4周.假损伤组与VD模型组均灌胃等体积生理盐水.Morris水迷宫检测大鼠学习记忆能力,放射免疫方法检测海马组织SOD活性与MDA含量. 结果 YDXNT治疗组大鼠找到平台的时间较VD模型组明显缩短,找到平台的游泳距离较VD模型组明显减少,差异均有统计学意义(P＜0.05).与VD模型组大鼠比较,YDXNT治疗组大鼠SOD活性明显升高,MDA含量明显降低,差异均有统计学意义(P＜0.05). 结论 YDXNT胶囊可增加脑组织氧自由基代谢能力,改善VD大鼠学习记忆能力.     

雌激素对血管性痴呆大鼠认知功能、海马Bcl-2、Bax蛋白表达及神经元凋亡的影响

目的 探讨雌激素对血管性痴呆(VD)大鼠认知功能、海马Bcl-2、Bax蛋白表达和神经元凋亡的影响.方法 60只雄性大鼠随机分为假手术组、VD组和雌激素组,每组20只.采用双侧颈总动脉结扎法制备VD大鼠模型;雌激素组腹腔注射17-β雌二醇(花生油溶解)200 μg/kg,同时假手术组和VD组腹腔注射等量的花生油,均为隔日1次,共30次.60 d后,Y-型迷宫试验检测大鼠学习记忆能力;HE染色观察大鼠海马神经元形态;免疫组化染色检测海马Bcl-2、Bax蛋白的表达,原位缺口末断标记(TUNEL)法检测神经元凋亡程度.结果 与假手术组相比,VD组及雌激素组认知能力明显下降, 海马CA1区Bcl-2、Bax蛋白表达增加,TUNEL 阳性细胞数明显增多(均P<0.001);与VD组比较,雌激素组认知能力改善,海马CA1区Bcl-2蛋白表达明显增加,Bax蛋白的表达明显减少,TUNEL 阳性细胞明显减少 (均P<0.001).结论 17-β雌二醇可调节Bcl-2、Bax蛋白表达而抑制神经元凋亡,有助于改善VD大鼠的认知能力.     

银丹心脑通软胶囊对腔隙性脑梗死患者血液流变学及血脂的影响

目的 探讨腔隙性脑梗死患者血液流变学和血脂指标的变化及银丹心脑通软胶囊对其的影响. 方法 检测62例腔隙性脑梗死患者血液流变学和血脂指标,并与50例健康老年人进行比较:62例腔隙性脑梗死患者中50例于银丹心脑通软胶囊治疗45 d后再次检测血液流变学和血脂指标,观察银丹心脑通软胶囊的治疗作用. 结果腔隙性脑梗死患者血液流变学指标均较健康老年人高,比较差异有统计学意义(P＜0.05);血三酰甘油、总胆固醇、低密度脂蛋白胆固醇均较健康老年人高,比较差异有统计学意义(P＜0.05).经银丹心脑通软胶囊治疗后,腔隙性脑梗死患者血液流变学和血脂指标均较治疗前有明显改善,比较差异有统计学意义(P＜0.05). 结论 腔隙性脑梗死患者存在血液流变学和血脂指标的明显异常,银丹心脑通软胶囊可改善老年腔隙性脑梗死患者的血液流变学及血脂异常.     

α-细辛醚对KA癫痫大鼠海马组织中Bax、Bcl-2的影响

目的 探讨不同浓度的α-细辛醚对KA癫痫大鼠海马组织中细胞凋亡调节基因Bax、Bcl-2的mRNA及其蛋白表达的影响.方法 红藻氨酸(kainic acid,KA)侧脑室注入SD大鼠制备癫痫模型,随机分为模型对照组(KA组)、α-细辛醚低浓度组(6mg/kg)、中浓度组(12mg/kg)和高浓度组(24mg/kg),另设假手术组为正常对照组,每组10只.α-细辛醚组经腹腔注射连续给药10d后检测大鼠海马组织中Bax、Bcl-2的mRNA及其蛋白的表达.结果 α-细辛醚用药后,大鼠表现为明显的镇静、抗惊厥作用;与正常对照组相比,KA组、α-细辛醚低、中浓度组大鼠海马区Bax的mRNA及蛋白表达升高,差异有统计学意义(P均＜0.05),α-细辛醚高浓度组Bax的mRNA及蛋白表达下降(P＜0.05);与正常对照组相比,Bcl-2的mRNA及蛋白表达KA组显著降低,α-田辛醚中、高浓度组升高(P均＜0.05),低浓度组与对照组相比差异不明显(P＞0.05).结论 KA诱导的SD癫痫大鼠神经元存在Bax、Bcl-2的异常表达,α-细辛醚可能通过降低Bax和提升Bcl-2基因的表达从而减少SD癫痫大鼠神经元凋亡.     

促红细胞生成素对血管性痴呆模型大鼠认知功能、脑保护作用及海马α-微管蛋白表达的影响

目的 研究促红细胞生成素(Epo)对血管性痴呆(VD)模型大鼠认知功能、脑保护作用和海马α-微管蛋白(tubulin)表达的影响.方法 用"两血管阻断 硝普钠降压"法建立大鼠VD模型,并给予Epo腹腔注射治疗,采用Morris水迷宫试验检测大鼠的认知功能,Nissle染色、α-tubulin免疫组化染色观察细胞形态和Western blot法检测海马α-tubulin表达水平.并与VD大鼠及假手术组大鼠比较.结果 与VD组比较,Epo组大鼠水迷宫试验逃避潜伏期明显缩短(除试验第1 d)(均P＜0.05);海马神经元形态规则,尼氏小体数量多,α-tubulin阳性轴突数多,α-tubulin含量显著升高(P＜0.05).而Epo组与假手术组水迷宫试验逃避潜伏期及海马α-tubulin含量差异无统计学意义.结论 Epo可改善VD大鼠的认知功能,减轻缺血性脑损害,促进海马α-tubulin的表达.     

盐酸美金刚对血管性痴呆大鼠海马CA1区BDNF及ERK表达的影响

目的 探讨盐酸美金刚对血管性痴呆大鼠海马神经元脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)及细胞外信号调节激酶(ERK)表达的影响.方法 健康雄性Wistar大鼠48只随机分为假手术组、模型组、盐酸美金刚组各16只,采用结扎双侧颈总动脉方法制备动物模型,用盐酸美金刚溶液灌胃,Y-型迷宫测试学习记忆能力,HE染色观察大鼠海马神经元的形态学变化,兔疫组化染色检测BDNF及ERK的表达变化.结果 盐酸美金刚组大鼠的学习记忆成绩优于模型组,但不及假手术组,差异均有统计学意义(P＜0.01);BDNF表达较模型组与假手术组均明显增高(P＜0.01) ; ERK表达较模型组明显增高,却低于假手术组,差异均有统计学意义(P＜0.01).结论 盐酸美金刚有可能通过增加VD大鼠脑内BDNF含量,保护海马神经元,增加ERK含量,改善学习记忆能力.     

胰岛素样生长因子-1对痴呆模型大鼠额叶、海马Caspase-3P20活性片段及Bcl-2蛋白表达的影响

目的 探讨胰岛素样生长因子-1(IGF-1)对痴呆模型大鼠额叶、海马caspase-3 P20活性片段及Bcl-2蛋白表达的影响.方法 本研究采用切断成年Wistar大鼠双侧穹隆海马伞,建立隔-海马胆碱能系统损害的痴呆模型.分为正常对照组、假手术组、痴呆组、小剂量胰岛素样生长因子-1(IGF-1)组、大剂量IGF-1组.痴呆模型制备1d后开始侧脑室给药,连续21d.正常对照组不给予任何处置.利用免疫组织化学染色结合图像分析方法观察各组大鼠额叶、海马胆碱能神经元caspase-3 P20活性片段、Bcl-2蛋白的表达,并进行光密度值(IOD)测定.结果 小剂量IGF-1组和大剂量IGF-l组与痴呆组相比,caspase-3 P20阳性神经元IOD值明显降低,具有显著差异(P＜0.001).小剂量IGF-1组与大剂量IGF-1组比较,caspase-3 P20阳性神经元IOD值明显降低,具有显著性差异(P＜0.05或P＜0.01).小剂量IGF-1组和大剂量ICF-1组与痴呆组相比,额叶、海马Bcl-2阳性神经元明显增多,IOD值明显增加,具有显著差异(P＜0.001).小剂量IGF-1组与大剂量IGF-1组比较,Bcl-2阳性细胞增多,IOD值明显增高,差异显著(P＜0.05或P＜0.01).结论 ICF-1能够通过抑制caspase-3的活化并增加Bcl-2的表达量,减少细胞凋亡.     

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.     

Cultural Identity and Experiences of Prejudice and Discrimination of Afghan and Iranian Immigrant Youth

In culturally diverse and immigrant receiving societies, immigrant youth can be subject to prejudice and discrimination. Such experiences can impact on immigrant youth’s cultural identity and influence their psychosocial outcomes. This paper presents findings of a study that examined cultural identity and experiences of prejudice and discrimination among Afghan (N = 9) and Iranian (N = 17) immigrant youth in Canada. The study had a prospective, comparative, longitudinal qualitative design. Data was gathered through focus groups, interviews, journals and field logs. Four main themes emerged on participants’ experiences of prejudice and discrimination: (a) societal factors influencing prejudice; (b) personal experiences of discrimination; (c) fear of disclosure and silenced cultural identity; and (d) resiliency and strength of cultural identity. Drawing from Rosenberg’s (Conceiving the self, Basic Books, New York, 1979) self-concept framework and Romero and Roberts (J. Adolesc., 21:641–656, 1998) distinction between prejudice and discrimination, results indicated that youth’s extant and presenting cultural identity were affected. Inclusive policies and practices are needed to promote youth integration in multicultural and immigrant receiving settings.

发作性睡病与异态睡眠的诊治

本文目的是探讨发作性睡病与异态睡眠的诊断与治疗.发作性睡病被漏诊和误诊的几率较高,危害较大,共患异态睡眠比例高.文章从发作性睡病临床特征、REM睡眠的作用、发作性睡病与异态睡眠(睡眠瘫痪、睡眠幻觉、快眼动睡眠期行为障碍)共病特征及治疗这四个方面进行了讨论.     

Effects of Agonists and Antagonists of Cholecystokinin on Contractile and Myoelectric Activity of Isolated Muscle of Colon and Ileum in the Dog and Guinea Pig

This study evaluates the effects of agonists and antagonists of cholecystokinin (CCK) on contractile and myoelectrical activity in isolated longitudinal muscle strips from colon or ileum of guinea pigs or beagle dogs. Caerulein and CCK-8 caused a dose-dependent increase of contractile and myoelectrical spike activity in both species with maximal effects seen between 10⁻⁸ and 3 × 10⁻⁸ M. The dose responses were identical for both CCK agonists and species. The dose-related effects of CCK compounds on colonic muscle were slightly shifted to the right when compared to ileum in both species. All antagonists, the proglumide-derivatives CR1409, CR1392, and CR1505, as well as the nonpeptide substances asperlicin and L-364,718, caused a parallel rightward shift of CCK's dose-dependent motor activity response, indicating the competitive nature of inhibition. The antagonists displayed a rank order of potency in antagonizing CCK's action on intestinal motility similar to their ability to antagonize CCK's action on pancreas and gallbladder. L-364,718 was the most potent antagonist, followed by CR1409, CR1505, CR1392, asperlicin, and proglumide. The antagonists did not affect contractile or myoelectrical responses to acetylcholine, histamine, motilin, or substance P. Thus compounds that have been described as CCK antagonists for pancreas and gallbladder also act as specific and competitive antagonists of CCK's action on contractile and myoelectrical activity of Heal and colonie muscle.     

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.     

小胶质细胞和少突胶质细胞前体的培养和鉴定

目的 探讨新生大鼠脑组织小胶质细胞(MG)和少突胶质细胞(OL)前体的分离和体外培养方法 . 方法 取新生2 d SD大鼠脑组织,体外原代培养混合胶质细胞7 d后,分别采用"改良振荡伴差速贴壁"法和"营养缺失伴振荡"法纯化培养MG和OL前体,并分别应用免疫荧光染色异凝集素-B4(IB4)和OL前体标记物(O4)进行鉴定.结果 混合胶质细胞培养7 d后呈明显三层增长,其中MG位于上层,星型胶质细胞位于底层,两者之间为2型少突星型(O2A)祖细胞.纯化培养后OL前体胞体呈小圆形,有双极或三极突起,MG则以阿米巴形、圆形居多,或边缘呈毛刺状.免疫荧光染色IB4显示绿色荧光,MG纯度达到90%以上.免疫荧光染色O4显示棕黄色荧光,OL前体纯度达到95%以上. 结论 采用"改良振荡伴差速贴壁"法以及"营养缺失伴振荡"法分别成功获取大量纯度高、活力好的MG和OL前体.     

Review and meta-analysis of the phenomenology and clinical characteristics of mania in children and adolescents

OBJECTIVE: Using predetermined criteria for study quality and methods, a literature review and meta-analysis of seven reports about pediatric bipolar disorder (BPD) was conducted to determine if there is a consistent picture of the phenomenology and clinical characteristics of BPD in children and adolescents. METHODS: Searches were conducted in MedLine and PsycINFO using the terms mania, BPD, children and adolescents, and was limited to published articles in peer-reviewed journals. Seven reports were selected that met the following criteria: a systematic method for the elicitation and reporting of symptoms and clinical characteristics of subjects; subjects were interviewed by a trained researcher or clinician; ages 5-18 years; use of a diagnostic system, either DSM or RDC for categorization; a consensus method for the establishment of the diagnosis of BPD. RESULTS: Most DSM-IV symptoms of mania were common in the children and adolescents with BPD with the most common symptoms being increased energy, distractibility, and pressured speech. On average, four of five bipolar cases also showed threshold levels of irritable mood and grandiosity, and more than 70% of all cases showed elated/euphoric mood, decreased need for sleep, or racing thoughts. Roughly 69% of cases also showed poor judgment, whereas only half of bipolar cases demonstrated flight of ideas, and slightly more than one-third showed hypersexuality or psychotic features. CONCLUSIONS: The clinical picture that emerges is that of children or adolescents with periods of increased energy (mania or hypomania), accompanied by distractibility, pressured speech, irritability, grandiosity, racing thoughts, decreased need for sleep and euphoria/elation.