低氧预处理对大鼠脑缺血再灌注后梗死体积和血脑屏障通透性的影响

目的　探讨低氧预处理对大鼠脑缺血再灌注损伤的保护作用。方法　将SD大鼠分为 3组 ,即假手术组、缺血再灌注组、缺氧预处理 +缺血再灌注组。连续吸入 8%O2 +92 %N2 3h作缺氧预处理 ,12h后再经插线左大脑中动脉栓塞 (MCAO)制作缺血再灌注模型 ,到相应时间点后观察缺氧预处理对MCAO大鼠的行为、脑含水量、血脑屏障通透性和脑梗死体积的影响。结果与缺血再灌注组相比 ,缺氧预处理组大鼠的行为明显改善 ,脑伊文思蓝 (EB)含量、脑含水量 (P <0 0 5 ) ,脑梗死体积缩小。结论　低氧预处理降低缺血再灌注脑组织血脑屏障通透性 ,抑制脑水肿 ,缩小梗死体积 ,对缺血再灌注损伤具有保护作用     

缺血后处理通过水通道蛋白-4对大鼠缺血再灌注损伤的脑保护作用及其机制

目的研究缺血后处理(IP)对大鼠脑缺血再灌注损伤的保护作用,探讨各组大鼠水通道蛋白-4(AQP4)的表达。方法实验分组:48只雄性SD大鼠,随机分为3组(n=16)。假手术组;对照组:行单纯缺血再灌注;缺血后处理组:IP组。采用线栓法阻断大脑中动脉制备大鼠局灶性脑缺血再灌注模型。大鼠脑缺血再灌注后24 h进行神经行为学评分和脑梗死体积测定,干湿重法测定脑水含量。并行免疫组织化学方法检测海马CA_1区细胞凋亡及AQP4表达的变化并行统计学分析。结果与对照组比较,IP组神经行为学评分明显降低,脑梗死体积、脑组织中的水分含量明显减少(P 0. 05)。再灌注24 h后,对照组海马CA_1区AQP4、凋亡细胞24 h表达量明显增加,IP组与对照组之间比较有差异(P 0. 05)。结论 IP组脑神经行为学评分、脑含水量、脑梗死体积均明显降低,提示缺血后处理可通过抑制AQP4的表达减轻缺血再灌注损伤后的脑水肿,起到脑保护作用。     

促红细胞生成素对大鼠局灶性脑缺血再灌注后梗死体积和脑组织水肿的影响

目的 探讨促红细胞生成素(EPO)对大鼠脑缺血再灌注损伤的保护作用。方法 采用阻断大鼠一侧大脑中动脉(MCA)血流2小时,再灌注48小时制成局灶性脑缺血模型。于再灌注开始前,治疗组经腹腔注入EPO(3000 U/Kg);缺血组和假手术组给予生理盐水腹腔注射,48小时后断头取脑。制作 HE切片;以2％氯化-2,3,5三苯基四氮唑(TFC)对脑片进行染色;经图像分析仪计算梗死体积占全脑体积的百分比;同时用干湿重法测定脑组织的含水量。结果 与对照组相比,治疗组海马 CA_1区神经细胞减少(25.7±1.16)％,缺血组减少(31.2±1.49)％;治疗组与缺血组比较有显著性差异(P<0.01)。治疗组脑梗死体积比缺血组明显缩小(P<0.01)。治疗组脑组织含水量比缺血组明显减少(P<0.01)。结论 EPO能够显著降低脑组织含水量,抑制脑水肿,缩小脑梗死体积及减少神经细胞坏死,对脑缺血再灌注损伤有良好的保护作用。     

环孢素A对大鼠脑缺血再灌注后IL-1β表达的影响

目的探讨环孢素A对大鼠脑缺血再灌注损伤后的脑保护作用及其对IL-1β表达的影响.方法将72只大鼠分为假手术组、生理盐水对照组和环孢素A治疗组,参照Zealonga线栓法制备局灶性脑缺血再灌注模型,大鼠脑缺血2 h再灌注22 h和70 h后,分别对各组各时间点大鼠进行脑TTC染色评价脑梗死体积、采用RT-PCR和放免法分别对缺血区皮层IL-1β基因表达和蛋白表达进行测定.结果各时间点环孢素A治疗组与生理盐水对照组相比,环孢素A治疗组脑梗死灶体积比对照组明显减小(P＜0.05);环孢素A可有效降低大鼠局灶性脑缺血再灌后脑组织中IL-1β基因和蛋白的表达(P＜0.01);与上述两组相比,假手术组各项观察指标则无明显异常.结论IL-1β参与脑缺血再灌注损伤,环孢素A对大鼠脑缺血再灌注损伤有明显的保护作用,环孢素A的脑保护机制可能与抑制缺血区内IL-1β的表达有关.     

丹参多酚酸盐对缺血再灌注损伤大鼠脑组织BDNF和GDNF的影响

目的观察丹参多酚酸盐对大鼠局灶性脑缺血再灌注损伤后脑组织内脑源性神经营养因子（BDNF）及胶质源性神经营养因子（GDNF）表达的影响,探讨其神经保护作用的机制。方法线栓法制作大鼠大脑中动脉闭塞再灌注损伤模型,SD大鼠随机分为正常对照组、缺血再灌注组、丹参多酚酸盐低剂量治疗组（10mg／kg）和丹参多酚酸盐高剂量治疗组（30mg／kg）,观察各组大鼠的行为学改变,测定脑梗死体积,ELISA法检测脑组织中BDNF和GDNF的含量。结果与缺血再灌组比较,丹参多酚酸盐可以显著降低大鼠神经损伤行为学评分,减少脑梗死体积,增加脑组织内BDNF和GDNF的含量,且呈剂量依赖性。结论丹参多酚酸盐对脑缺血再灌注损伤有明显的保护作用,其机制与促进脑组织合成BDNF及GDNF有关。     

白藜芦醇对大鼠缺血再灌注损伤后脑组织的保护作用

目的探讨白藜芦醇对大鼠缺血再灌注损伤后脑组织的保护作用及其机制。方法利用线栓法制作大鼠脑缺血再灌注损伤模型。72只SD大鼠按随机数字表法随机平均分为假手术组、对照组、白藜芦醇高剂量组和白藜芦醇低剂量组。缺血2h再灌注24h后,分别测定动物的神经损伤功能评分、脑组织梗死体积,缺血再灌注损伤的脑组织中髓过氧化物酶(MPO)的活性、伊文思兰的含量、肿瘤坏死因子-α(TNF-α)的含量及基质金属蛋白酶-9(MMP-9)的表达水平。结果白藜芦醇治疗组神经功能损伤评分均较对照组明显降低(P<0.05),脑梗死体积明显缩小(P<0.05),MPO的活性、伊文思兰的含量、TNF-α的含量及MMP-9表达水平均也明显低于对照组(P<0.05)。结论白藜芦醇可能通过降低炎症反应和血脑屏障通透性对大鼠脑缺血再灌注损伤的脑组织起神经保护作用;其抗炎作用可能与其降低TNF-α的含量有关,而降低血脑屏障通透性则可能与MMP-9的表达下调有关。     

17-β雌二醇对大鼠脑缺血再灌注后Bcl-2表达的影响

目的 观察雌激素对大鼠局灶性脑缺血-再灌注损伤后bcl-2表达的影响,探讨雌激素在脑缺血-再灌注损伤中 的脑保护作用机制。方法 用线栓法制作脑缺血再灌注损伤模型。缺血2h分别再灌注3h、6h、12h、24h后断头取脑,应用TTC 染色和免疫组化方法,观察脑梗死体积及bcl-2蛋白的表达。结果 ①雌二醇组神经功能评分明显低于手术对照组(P<0.01)。 ②雌二醇组脑梗死体积较手术对照组显著缩小(P<0.01)。③在损伤区皮质,雌二醇组bcl-2表达较手术对照组明显上调(P< 0.01);在纹状体区,元显著性差异(P>0.05)。结论 ①雌二醇能明显减轻脑缺血再灌注损伤所造成的行为障碍,缩小梗塞体 积。②雌二醇脑保护机制可能通过上调皮质抑凋亡基因bcl-2的表达。     

神经节苷脂对大鼠脑缺血再灌注损伤的脑保护作用

目的探讨神经节苷脂对大鼠脑缺血再灌注损伤的脑保护作用。方法采用线栓法制作缺血再灌注大鼠模型,分别用神经节苷脂(治疗组)和生理盐水(对照组)腹腔注射。观察两组大鼠缺血90min、缺血90min再灌注24h的脑梗死面积、神经功能缺损程度、细胞凋亡数、细胞凋亡率。结果治疗组大鼠于相同时间点脑梗死面积较对照组明显减小,仅表现轻度的神经功能缺损,且神经细胞的凋亡数较对照组显著减少(均P<0.01)。结论神经节苷脂能明显减小大鼠实验性脑缺血的脑梗死面积,减轻脑缺血再灌注后神经功能缺损程度,显著减轻缺血区神经元损害,具有显著的脑保护作用。     

脑血疏口服液对大鼠脑缺血再灌注损伤后血脑屏障的影响

目的 探讨脑血疏口服液对大鼠脑缺血再灌注损伤后血脑屏障的影响。方法 将120只SD大鼠随机分为3组:假手术组、对照组,脑血疏组; 采用线栓法建立大鼠左侧大脑中动脉闭塞再灌注模型,缺血2 h后拔出线栓,恢复灌注24 h; 采用Longa FZ 5级评分法进行大鼠神经功能缺损评分; TTC染色计算脑梗死体积百分比; 运用干-湿重法测脑含水率; 通过伊文思蓝( EB)含量反映血脑屏障的损伤程度; 免疫组化检测基质金属蛋白酶-9(MMP-9)的表达水平。结果(1)假手术组大鼠在神经功能缺损评分、脑梗死体积、脑含水率均低于对照组(P<0.01); 脑组织中EB含量和MMP-9表达水平较对照组低(P<0.01);(2)脑血疏组大鼠的神经功能缺损评分较低、脑梗死体积较小,脑水肿程度较轻; EB含量和MMP-9表达水平均较对照组明显减少(P<0.01)。结论 脑血疏口服液对大鼠脑缺血再灌注损伤后血脑屏障具有保护作用,其机制可能是通过抑制MMP-9的表达。     

雌激素对大鼠脑缺血-再灌注损伤的保护作用的研究

目的　研究外源性雌激素替代对大鼠局灶性脑缺血 再灌注损伤的神经保护作用。方法　将12 0只大鼠分为对照组、双侧卵巢切除 (OVX)组、OVX +雌二醇 (E2 )组 (E2 2 0 0 μg/kg ,皮下注射每周 1次 ,连续 4周 )。 4周后用线栓法建立脑缺血再灌注模型 ,在缺血再灌注不同时间观察大鼠脑梗死体积、病理改变、凋亡细胞数及检测血浆雌激素水平。结果　缺血再灌注不同时间均以OVX +E2 组脑梗死体积最小 ,OVX组最大 ,两组比较有显著差异 (均P <0 0 1)。凋亡细胞数OVX组明显多于OVX +E2 组 (P <0 0 5 )。结论　雌激素对缺血 再灌注后脑损伤具有明显的保护作用     

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.