氯胺酮对吗啡耐受小鼠脊髓星形胶质细胞的影响

目的 观察氯胺酮对吗啡耐受过程中脊髓星形胶质细胞的影响。方法 昆明种小鼠30只,随机分为5组(n=6):A组(对照组):皮下注射生理盐水(10 ml·kg-1)30 min后腹腔注射生理盐水(10 ml·kg-1);B组(慢性吗啡耐受模型组):皮下注射吗啡(10 mg·kg-1)30 min后腹腔注射生理盐水(10 ml·kg-1);C、D、E三组:吗啡用药均同B组,吗啡注射30 min后分别腹腔注射5、10、20 mg·kg-1氯胺酮。各组给药,每日重复2次,连续9 d采用免疫组织化学方法测定脊髓星形胶质细胞胶质纤维酸性蛋白(GFAP)免疫反应阳性产物在吗啡耐受过程中的变化。结果 B组GFAP免疫反应阳性产物染色较A组深,其阳性产物表达相对面积(6.35±0.35)与A组(3.39±0.24)相比增加了88％(P<0.01)。D组、E组第9天GFAP免疫反应阳性产物面积分别比B组降低34％和45％(P<0.01).结论 吗啡耐受的机制可能涉及星形胶质细胞的激活,氯胺酮可能通过抑制星形胶质细胞激活而具有部分抗吗啡耐受作用。     

丙戊茶碱对吗啡耐受大鼠脊髓星型胶质细胞的影响

目的 观察脊髓星型胶质细胞(AST)在吗啡耐受过程中的变化。方法 建立慢性吗啡耐受大鼠模型，用丙戊茶碱(propentofylline)进行干预，用免疫组织化学方法测定脊髓后角AST活性在吗啡耐受过程中的变化，用热辐射抬足法测定痛阈。结果 吗啡耐受形成过程中胶质纤维酸性蛋白(GFAP)免疫反应呈强阳性，丙戊茶碱有部分抗吗啡耐受作用，并且可以使吗啡耐受过程中GFAP免疫反应阳性产物减少。结论 吗啡耐受的机制可能涉及脊髓AST的激活，丙戊茶碱可能通过抑制脊髓AST激活而具有部分抗吗啡耐受作用。     

骨癌痛大鼠吗啡耐受后脊髓胶质细胞及炎性细胞因子的变化

目的 评价骨癌痛大鼠吗啡耐受后脊髓胶质细胞及炎性细胞因子的变化.方法 雌性SD大鼠,体重180～220 g,采用MADB-106鼠源性乳腺癌细胞注入大鼠左侧胫骨建立骨癌痛模型.14d后,选择一般状况良好、体重无减轻、进食好、活动正常、热痛阈<18.5 s、机械痛阈<27.8 g的大鼠16只,随机分为2组:对照组(n=7)注射等容量生理盐水;吗啡耐受组(n=9)皮下注射吗啡3次/d,连续5 d,每天单次注射剂量按10、20、40、50、60 mg/kg递增.于造模前和造模后10 d开始隔日1次测定热痛阈和机械痛阈;造模后19 d皮下注射吗啡3 mg/ks,30 min后测定热痛阈和机械痛阈.随后处死动物,取腰段脊髓,采用RT-PCR法测定脊髓白细胞介素-1β(IL-1β)mRNA和肿瘤坏死因子α(TNF-α)mRNA的表达;采用ELISA法测定脊髓IL-1β和TNF-α的含量;采用免疫组化法测定脊髓星形胶质细胞和小胶质细胞的活力.结果 与造模前比较.对照组造模后14、16、18 d时热痛阈和机械痛阈降低(P<0.05);与对照组比较,吗啡耐受组造模后14、16、18 d时热痛阈和机械痛阈升高,造模后19 d时热痛阈和机械痛阈降低,左侧脊髓IL-1β mRNA和TNF-αmRNA表达升高,脊髓IL-1β和TNF-α的含量增加,脊髓星形胶质细胞和小胶质细胞的活力增强(P<0.05).结论 骨癌痛大鼠连续递增剂量腹腔注射吗啡可引起脊髓星形胶质细胞和小胶质细胞进一步活化,IL-1β和TNF-α释放增加,从而发生吗啡耐受.     

胶质细胞活化对慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)大鼠脊髓背角P物质的影响

目的探讨胶质细胞活化对慢性前列腺炎/慢性盆腔疼痛综合征（chronic prostatitis/chronic pelvic pain syndromes,CP/CPPS）大鼠脊髓背角P物质的影响。方法完全福氏佐剂和3%角叉菜胶前列腺内注射造成CP/CPPS模型,脊髓插管给药胶质细胞活化抑制剂Propentofylline干扰CP/CPPS模型大鼠,免疫组织化学方法观察正常组、疼痛模型组、药物干扰组脊髓节段（L6和S1）背角的胶质细胞的活化和P物质的定性定位,并用放射免疫的方法观察三组脊髓背角P物质的变化。结果脊髓背角胶质细胞活化阳性细胞数疼痛组明显增加,药物干扰组明显减少;P物质主要表达于脊髓背角且疼痛模型组明显增多,药物干扰组明显减少。结论胶质细胞活化是CP/CPPS大鼠脊髓背角P物质变化的重要原因,胶质细胞活化抑制剂的应用将是治疗CP/CPPS的新亮点。     

嗅鞘细胞移植调节星形细胞活性促进急性脊髓损伤大鼠神经功能恢复

[目的]探讨嗅鞘细胞(OECs)对急性脊髓损伤大鼠星形胶质细胞(AST)激活的影响。[方法]乳鼠嗅球制备嗅鞘细胞,制备急性脊髓损伤模型,随机分为3组,空白组:T_(9-11)椎板去除;对照组:T_(10)脊髓损伤,DMEM/F_(12)移植;实验组:T_(10)脊髓损伤,OEC移植。行BBB评分和体感诱发电位检测评价神经功能,Western Blot检测GFAP、CSPG、bFGF表达变化,观察脊髓损伤后星形胶质细胞激活情况及OEC移植对其影响。[结果](1)脊髓损伤后GFAP阳性细胞数目增加,实验组少于对照组,尼氏染色及NF-200阳性细胞数目实验组多于对照组,差异有统计学意义;(2)Western Blot:脊髓损伤后GFAP、CSPG表达增加,bFGF表达下降,OEC干预后,GFAP、CSPG表达较对照组下降。bFGF表达增加;(3)神经功能:脊髓损伤BBB评分及SEP显示治疗组大鼠神经功能得到改善。[结论]嗅鞘细胞移植可抑制星形胶质细胞增殖,调节因子分泌,促进大鼠脊髓损伤恢复。     

吗啡急性处理对脂多糖刺激后离体星形胶质细胞活性的影响

目的　观察不同浓度吗啡急性处理对脂多糖刺激后乳鼠离体星形胶质细胞活性的影响。方法　体外培养星形胶质细胞于融合状态 ,随机分为八组 :对照组 (L0 M0 组 )、0 5 μmol/L吗啡组 (L0 M0 5组 )、1 0 μmol/L吗啡组 (L0 M1 0 组 )、2 0 μmol/L吗啡组 (L0 M2 0 组 )、1 0 μg/ml脂多糖组(L1M0 组 )、1 0 μg/L脂多糖 +0 5 μmol/L吗啡组 (L1M0 5组 )、1 0 μg/ml脂多糖 +1 0 μmol/L吗啡组 (L1M1 0 组 )、1 0 μg/L脂多糖 +2 0 μmol/L吗啡组 (L1M2 0 )。在相应组中加入相应终浓度的吗啡和脂多糖 ,继续培养 2 4h。采用神经胶质纤维酸性蛋白 (GFAP)免疫组化方法分别检测星形胶质细胞免疫活性。结果　L0 M0 5、L0 M1 0 、L0 M2 0 组对正常星形胶质细胞形态均无影响 ;L1M0 组的星形胶质细胞GFAP免疫反应阳性细胞平均光密度 (AOD)明显高于L0 M0 组 (P <0 0 1) ;L1M1 0 和L1M2 0组GFAP阳性产物AOD值比L1M0 组均明显降低 (P <0 0 1)。结论　吗啡的急性镇痛机制可能与其抑制星形胶质细胞激活有关     

脊髓胶质细胞活化与病理性疼痛调节

背景 研究表明脊髓胶质细胞(星形胶质细胞和小胶质细胞)在各种病理性疼痛模型中活化,并且活化的胶质细胞在各种病理性疼痛的发生和发展中具有重要作用.目的 探讨脊髓胶质细胞在病理性疼痛调节中的作用.内容 从脊髓胶质细胞活化参与病理性疼痛调节的生理基础,脊髓胶质细胞活化及其检测,脊髓胶质细胞活化与病理性疼痛和脊髓胶质细胞参与病...     

星形胶质细胞活化对慢性前列腺炎大鼠模型脊髓背角P物质的影响

目的:探讨星形胶质细胞活化对慢性前列腺炎模型大鼠脊髓背角P物质的影响。方法:SD雄性大鼠60只随机分为正常组(n=20)、疼痛组(n=20)、干扰组(n=20),完全福氏佐剂和3%角叉菜胶前列腺内注射造成慢性前列腺炎疼痛模型,脊髓插管给药胶质细胞活化抑制剂干扰慢性前列腺炎疼痛模型大鼠,免疫荧光法观察正常组、疼痛组、干扰组脊髓节段(L6和S1)背角星形胶质细胞的活化和P物质的分布,并用放射免疫法观察3组脊髓背角P物质的变化。结果:与正常组比较,脊髓背角星形胶质细胞活化阳性细胞数疼痛组明显增加(P<0.01),而干扰组较疼痛组明显减少(P<0.01),P物质主要表达于脊髓背角且疼痛组明显增多(P<0.01),干扰组明显减少(P<0.01)。结论:星形胶质细胞活化是慢性前列腺炎疼痛大鼠脊髓背角P物质变化的重要原因之一。     

星型胶质细胞和小胶质细胞在1型糖尿病小鼠外周神经病变中的作用

目的 观察星形胶质细胞和小胶质细胞标志物在1型糖尿病外周神经病变小鼠脊髓中的表达变化。
方法 SPF级健康雄性C57BL/6小鼠30只,6周龄,体重18~22 g,采用随机数字表法分为两组：对照组（C组）和糖尿病组（DM组）。DM组采用链脲佐菌素（STZ）（100 mg/kg,连续2 d腹腔注射）制备1型糖尿病小鼠模型,C组给予同等剂量柠檬酸钠缓冲液连续2 d。记录两组小鼠造模前、造模后1、2、4、6、8、10周的体重、随机血糖、机械缩足反应阈（MWT）、热缩足潜伏期（TWL）。生化检测分别选取C组和DM组1周、10周的脊髓。采用Western blot法测定L4—L6脊髓脂肪酸结合蛋白7（FABP7）、星形胶质细胞特异性标记物胶质纤维酸性蛋白（GFAP）、小胶质细胞标记物（CD11b、iba1）表达量,Elisa法测定小鼠脊髓组织中肿瘤坏死因子α（TNF-α）、IL-10浓度,免疫组化法测定足底表皮神经纤维密度（IENFD）。
结果 与C组比较,DM组造模后2、4、6、8、10周体重、MWT明显降低（P＜0.05或P＜0.01）,造模后1、2、4、6、8、10周血糖明显升高（P＜0.01）,造模后4、6、8、10周TWL明显延长（P＜0.05或P＜0.01）;造模后1周FABP7和GFAP表达量明显升高（P＜0.05）;造模后10周FABP7、CD11b、iba1表达量明显升高（P＜0.05）;造模后10周脊髓组织中IL-10、TNF-α浓度明显升高（P＜0.05）;造模后10周IENFD明显降低（P＜0.05）。
结论 糖尿病模型小鼠造模后1周脊髓中星形胶质细胞活化但小胶质细胞无明显改变,而造模后10周星形胶质细胞已恢复正常但小胶质细胞活化,1型糖尿病外周神经病变中星型胶质细胞较小胶质细胞更早的激活。     

脊髓胶质细胞活化与病理性疼痛调节

背景 研究表明脊髓胶质细胞(星形胶质细胞和小胶质细胞)在各种病理性疼痛模型中活化,并且活化的胶质细胞在各种病理性疼痛的发生和发展中具有重要作用.目的 探讨脊髓胶质细胞在病理性疼痛调节中的作用.内容 从脊髓胶质细胞活化参与病理性疼痛调节的生理基础,脊髓胶质细胞活化及其检测,脊髓胶质细胞活化与病理性疼痛和脊髓胶质细胞参与病理性疼痛的调节机制等几方面就与此有关的研究进展进行了综述.趋向 胶质细胞将继续引起疼痛研究者的关注,因为它为临床病理性疼痛的治疗提供了新的靶点.     

胸腰椎骨折椎弓根内固定断裂与植骨融合方式的相关性分析

[目的]探讨胸腰椎骨折椎弓根螺钉内固定系统内固定术后,椎弓根螺钉断裂与植骨融合方式之间的关系,以探讨胸腰椎骨折植骨融合的最佳方式。[方法]回顾性研究1995年5月~2005年12月本院脊柱外科收治的胸腰椎骨折病人197例,其中A组单纯内固定(不植骨)患者14例,B组“H”形椎板植骨21例,C组横突间植骨67例,D组椎间、椎内联合横突间植骨95例。[结果]术后随访6~32个月,内固定断裂12例,其中A组4例,B组3例,C组5例,D组0例,4组中D组内固定断裂率显著低于其他3组(P<0.05)。[结论]椎间、椎体内联合横突间植骨重建脊柱三柱的稳定性,符合人体生物力学原理,能有效降低内固定断裂的发生。     

On the measurement of the functional properties of the CFTR

A number of methods are currently employed to assess the functional properties of CFTR channels and their response to pharmacological potentiators, correction of the defective CFTR trafficking, and vectorial introduction of new proteins. Here we review the most common methods used to assess CFTR channel function. The suitability of each technique to various experimental conditions is discussed.     

Preservation of the pylorus and resection of the head of the pancreas

The historical evolution of the pylorus-preservation resection of the head of the pancreas is traced from the first resections early in this century to relative standardization of the operation, to a lowering of the operative mortality, and to an interest in improving nutritional status after resection. There are many theoretical advantages for the function of the upper gastrointestinal tract after pylorus and gastric preservation, such as maintenance of gastric capacitance and equilibration of osmotic pressure in gastric digestants, foodstuff digestion and absorption, and bowel motility. After the pylorus-preserving resection, gastric emptying is normal, pyloric function to prevent duodenal reflux is often normal, and gastric acids and serum levels of duodenal hormones are at normal levels, whereas after standard pancreatoduodenectomy, all of these are often abnormal. No prospective blinded studies have been published comparing nutritional values after the two operative procedures, but evidence is presented of a satisfactory result with regard to gastric capacitance, body weight gain, and lack of postgastrectomy symptoms. An undoubted advantage of the pylorus-preserving feature is a simplification of the operation. These gains are achieved without increase in operative mortality, without increase in the incidence of jejunal ulcer, and without theoretical or actual decrease in value of the procedure as a cancer operation, except in patients with duodenal carcinoma proximal to the ampulla of Vater.     

下颌全牙弓后移量及最后界的测量

目的：研究下颌牙弓的有效后移量及找寻下颌牙弓移动的后界。方法：选取涉及拔除下颌第三磨牙或下颌第三磨牙缺失的病例18例（男6例,女12例）。采用种植支抗牵引下牙弓向远中,治疗完成时所有病例均明确到达下颌牙弓后界,即下颌第二磨牙远中到达下颌升支前缘软组织交界处。应用治疗前后的曲断片测量下颌第二磨牙远中到升支前缘的距离。结果：下颌第二磨牙后移量为（3.49±1.21）mm;治疗后磨牙后间隙的长度为（4.43±0.97）mm。结论：下颌牙弓可确定性地实现整体后移;最大后移量由磨牙后间隙的长度决定;其最后界止于下颌第二磨牙远中与下颌升支前缘软组织交界处。     

The Measurement of the Inclination Angle of the Hamate and Analysis of the Inclination Angle for the Rotation Deformity of the Little Finger in the Fixation of the Carpometacarpal Joint

ObjectiveComplex base fractures of the fifth metacarpal bone and dislocation of the fifth carpometacarpal joint are more prone to internal rotation deformity of the little finger sequence after fixation with a transarticular plate. In the past, we have neglected that there is actually a certain angle of external rotation in the hamate surface of transarticular fixation. This study measured the inclination angle of the hamate surface relative to the fifth metacarpal surface for clinical reference.MethodsIn a prospective single‐center study, we investigated the tilt angle of 60 normal hamates. The study included thin‐layer computed tomography (CT) data from 60 patients from the orthopaedic clinic and inpatient unit from January 2017 to March 2020, including 34 men and 26 women who were 15~59 years old, average 35 years old. The CT data of 60 cases in Dicom format of the hand was input into Mimics and 3‐Matics software for three‐dimensional (3D) reconstruction and measuring the angle α between hamate surface and the fifth metacarpal surface. According to the possible placement of the transarticular plate on the fifth metacarpal surface, we measured the angle β between the hamate surface 1 and the fifth metacarpal surface and the angle γ between the hamate surface 2 and the fifth metacarpal surface.ResultsThe average angle between the hamate surface and the fifth metacarpal surface was 11.66°. The hamate surfaces 1 and 2 have an external rotation angle of 7.30° and 7.51° on average with respect to the fifth metacarpal surface, respectively. There is no statistically significant difference in the angles between the two groups (P > 0.05).ConclusionsThe horizontal angle of the dorsal side of the hamate is different from the back of the fifth metacarpal surface, and the hamate has a certain external rotation angle with respect to the fifth metacarpal surface. No matter how the transarticular plate is placed, the plate always has a certain external rotation angle relative to the fifth metacarpal surface. When the fixation is across the fifth carpometacarpal joint, if the plate does not twist and shape, it will inevitably cause internal rotation of the fifth metacarpal, resulting in internal rotation deformity of the little finger sequence.     

静脉输注甘露醇开放血脑屏障对抗生素透过血脑屏障的影响

目的　通过快速静脉输注甘露醇可逆性开放血脑屏障 (BBB) ,探知此方法能否增加抗生素透过BBB的量 ,在何时达到最高峰 ,其通透量增加后临床上有无不良反应。方法　采用自身配伍设计 ,共 6个样本组。对照组仅使用抗生素 ;其余 5组分别在使用甘露醇前 60、3 0min ,同时使用甘露醇后 3 0、60min使用抗生素 ,各组皆取使用抗生素后 1h的脑脊液测其抗生素浓度。抗生素选用头孢三嗪。结果　测量值经过q检验 ,经 2 0 %甘露醇处理前后的CSF中的头孢三嗪浓度差异有非常显著性。全组患者经临床观察未出现神经系统的不良反应。结论　经静脉快速输注2 0 %甘露醇后可以使透过BBB的水溶性抗生素的量增加 ,两者使用的顺序是在抗生素使用 3 0min内即给予甘露醇快速滴注。该方法不会增加低神经毒性抗生素在中枢神经系统的不良反应。     

Preservation of the pylorus in resection of the head of the pancreas

Whipple's pancreatoduodenectomy was the standard operation for diseases of the head of the pancreas for more than 40 years, but the results were vitiated in part by poor gastrointestinal function and malnutrition. Reintroduced in 1978, pylorus-preserving proximal pancreatoduodenectomy (PPPP) has had an increasing impact on pancreatic surgery as its benefits have been recognized: improved nutritional status, decreased incidence of postgastrectomy syndromes, and a technically easier operation. Postoperative mortality rates and 5-year survival rates are comparable with those of the classic Whipple procedure. PPPP is indicated for most patients with chronic pancreatitis of the pancreatic head. It is also appropriate for patients with periampullary cancer and for those with pancreatic cancer arising from the lower part of ‘the head and the uncinate process. More than 650 patients have now undergone PPPP: 31% for chronic pancreatitis and 66% for periampullary and pancreatic cancers. We assess the indications for PPPP, outline the operation, and review the results.