大鼠脊髓T3节段全横断后损伤节段神经元超微结构的观察

目的：观察大鼠脊髓T3节段全横断后损伤节段神经元超微结构的变化。方法：48只大鼠随机分为假手术组和脊髓T3完全横断损伤1d组、2d组、7d组、14d组、21d组,每组8只。各组大鼠BBB运动功能评分后取损伤节段脊髓,透射电镜观察脊髓神经元超微结构的变化。结果：脊髓损伤（SCI）各组大鼠的BBB评分明显低于假手术组（P ＜0.01）;随着损伤时间的延长,SCI各组大鼠的BBB评分逐渐升高（P ＜0.01）。电镜下观察,大鼠脊髓神经元在损伤后2d病理变化最为严重,表现为神经元明显肿胀,线粒体等细胞器严重受损,核固缩,染色质凝集;损伤后7d时,脊髓神经元的病理变化有所减轻;损伤后21d,脊髓神经元的病理变化明显减轻,甚至接近正常。结论：大鼠脊髓损伤后2d脊髓神经元的病理变化最为严重,后逐渐减轻。     

川芎嗪对大鼠急性脊髓损伤后巨噬细胞移动抑制因子表达的影响

目的:观察川芎嗪(tetramethylpyrazine, TMP) 对大鼠急性脊髓损伤模型损伤段巨噬细胞移动抑制因子(macrophage migration inhibitory factor, MIF) 表达的影响。方法:SD 大鼠110 只, 随机分为假手术组, 对照组和实验组。应用改良Allen 氏打击法建立大鼠急性脊髓损伤模型。应用改良Rivlin 斜板实验、联合行为评分(combinebehavior score, CBS) 和BBB(Basso, Beattie, Bresnahan, BBB) 评分对术前和术后1, 3, 5, 7, 14, 21 d 大鼠脊髓功能进行行为学评分。在建模后1, 3, 6, 12 h 及1, 3, 5, 7, 14, 21 d 获取损伤段脊髓标本, HE 染色观察其组织病理变化;免疫组织化学染色检测MIF 表达。结果:术后7, 14, 21 d 实验组斜板临界角度数均较对照组高(P<0.05);术后5, 7, 14, 21 d 实验组BBB 评分值均较对照组高(P<0.05);, 而术后5, 7, 14, 21 d 实验组CBS 评分值均较对照组低(P<0.05), 术后12 h 及1, 3, 5, 7 d, 实验组MIF 阳性细胞表达数较对照组低(P<0.05)。且随着时间推移, 改良Rivlin 斜板实验临界角度和BBB 评分与MIF 阳性细胞表达数呈负相关, CBS 评分与MIF阳性细胞表达数呈正相关。结论:TMP 对大鼠急性继发性损伤的脊髓有保护和促进其功能恢复的作用, 这种作用在损伤后1~2 周最为显著;TMP 能够抑制大鼠急性继发性损伤后脊髓组织中MIF 的表达。     

脊髓损伤模型大鼠神经行为与脊髓病理变化的相关性

目的 观察电控打击脊髓损伤(spinal cord injury,SCI)模型大鼠神经行为及脊髓病理变化.方法 采用自行研制的电控大鼠脊髓损伤打击器建立大鼠脊髓损伤模型,观察脊髓损伤后Basso Beattie Bresnahan (BBB)评分、免疫组化及病理变化特点.结果 SCI后3 d BBB评分(1.0±0.7)开始增加,7d时显著明显增加至(4.2±1.3)分,28 d时BBB评分达(7.2±1.3)分.HE染色可观察到SCI后脊髓灰、白质组织结构不完整,大量神经元变性坏死、细胞肿胀、胶质细胞增生.免疫组化显示SCI伤后2h神经元特异性烯醇化酶(NSE)阳性细胞灰度值、神经丝蛋白-200(NF200)阳性轴突灰度值减少,24 h最低,3d开始恢复,28 d仍未恢复正常(P＜0.05);SCI伤后3d胶质纤维酸性蛋白(GFAP)阳性细胞数量增多,14 d达到高峰,28 d有所回落(P＜0.05).NSE、NF200、GFAP的变化与BBB评分呈显著相关(r=0.856,0.856,0.795,均P＜0.01).结论 电控打击脊髓损伤模型大鼠NSE、NF、GFAP的变化反映了脊髓损伤的病理变化,与脊髓损伤后的神经行为密切相关.     

三七总皂甙对大鼠脊髓损伤后神经功能恢复作用的研究

目的探讨三七总皂甙对大鼠脊髓半横断损伤后组织结构及运动功能恢复的作用。方法参考Ram—berg和Borgens法建立大鼠半横断型脊髓损伤模型，45只Sprague—Dawley大鼠均接受T10节段的脊髓损伤，然后被随机分为三七总皂甙、甲基强的松龙和空白对照组，所有大鼠分别在脊髓损伤后第1、3、7、14和21天接受斜板试验和BBB运动功能评分，观察大鼠后肢运动功能的恢复情况。第22天将所有实验大鼠处死后取出脊髓损伤标本，进行组织学检查。结果45只实验鼠中符合设计要求的共40只，其中三七总皂甙（Panax notoginseng saponins，PNS）组13只，空白对照组14只，甲基强的松龙（Methylprednisolone，MP）组13只。三七总皂甙组大鼠的BBB评分及斜板测定均优于对照组，两者之间的差异有统计学意义（P〈0．05）。电镜下三七总皂甙组大鼠脊髓损伤部位可见神经元核周体和神经纤维修复再生。对照组大鼠脊髓损伤区神经元胞体和轴突的超微结构发生明显的变性。结论三七总皂甙可以改善脊髓损伤区的组织结构并促进大鼠脊髓损伤后运动功能的恢复．     

胚胎脊髓移植联合应用bFGF对脊髓损伤后神经再生的影响

目的：探讨胚胎脊髓（fetal spinal cord, FSC）移植联合外源性碱性成纤维细胞生长因子（basic fibroblast growth factor, bFGF）的应用对脊髓损伤后脊髓神经再生的影响.方法：采用大鼠胸段（T8～T11）脊髓左侧半横切损伤模型.移植供体为同种异体妊娠14 d的孕鼠,将实验动物分为3组：A组为损伤＋FSC移植组;B组为损伤＋FSC移植＋bFGF组;C组为单纯损伤组.术后1～8周每周行综合行为评分（combined behavioral score, CBS）评定大鼠功能,并取术后8周损伤区脊髓组织0.5 cm作嗜银染色及NF200免疫组织化学检查,分别标记轴突和胶质细胞,进行定量分析,观察神经纤维再生情况.结果：胚胎脊髓移植和外源性bFGF可以防止成鼠脊髓损伤后神经元的萎缩,图像分析发现其作用A、B组优于C组,可以较好的恢复神经元形态.CBS评分提示大鼠神经功能的恢复也有同样趋势,统计学分析治疗组与对照组间有显著性差异.免疫组织化学检查,术后8周A、B组NF着色点较C组密集,且没有明显的胶质增生.结论：脊髓损伤后联合应用胚胎脊髓移植和 bFGF可以防止神经元的萎缩,并且对神经纤维再生及功能的恢复有促进作用.     

粪菌移植疗法对大鼠脊髓损伤后的作用研究

目的:探讨粪菌移植疗法(FMT)对大鼠脊髓损伤(SCI)后的作用.方法:将36只SD大鼠随机分为对照组(A组)、SCI组(B组)、FMT组(C组),每组12只.A组仅手术暴露,不进行击打,B组和C组用改良Allen's击打法建立SCI模型.C组灌胃给予粪菌液,连续14d.对16SrDNAV3-V4高度保守区进行HiSeq平台测序,比较SCI后肠道菌群变化,Basso-Beattie-Bresnahan(BBB)评分评估大鼠后肢情况,酶联免疫吸附试验(ELISA)法检测脊髓组织IL-17、IL-4和IL-10水平,苏木精—伊红(HE)染色法观察脊髓组织病理学变化,尼氏染色观察脊髓神经元细胞及尼氏小体.结果:与A组比较,B组有益菌Bacteroide-tes和Saccharibacteria数量减少,BBB评分下降,脊髓组织中抗炎因子IL-10和IL-4下降和促炎因子IL-17升高(均P＜0.05),炎性细胞浸润和神经元细胞核固缩,尼氏小体数量明显减少;与B组比较,C组BBB评分升高,脊髓组织IL-10和IL-4含量升高,IL-17含量下降(均P＜0.05),细胞变性水肿情况改善,尼氏小体数量增加.结论:FMT疗法能够有效抑制SCI后炎症反应,从而治疗SCI.     

利拉鲁肽对脊髓损伤修复作用的探讨

目的探讨利拉鲁肽对大鼠脊髓损伤(SCI)神经的修复作用及机制。方法将雌性大鼠分为利拉鲁肽干预组、正常对照组,每组24只。采用大鼠脊髓动脉瘤夹夹伤法建立大鼠脊髓损伤模型。术后分别给予利拉鲁肽(0.12 mg/kg,0.5 m L)、生理盐水(0.5 m L)。术后2 d应用细胞凋亡技术检测神经细胞损伤程度,术后3 d采用Western blotting蛋白印迹技术检测损伤脊髓组织中白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)表达水平,术后14 d对损伤脊髓组织行HE染色观察组织形态变化并计算损伤空洞面积,术后3 d至28 d定期记录大鼠后肢行为学BBB评分。结果 SCI后利拉鲁肽干预组细胞凋亡、炎性因子表达、空洞面积计算均较正常对照组降低(P<0.05),利拉鲁肽干预组双后肢BBB评分同期较正常对照组高(P<0.05)。结论脊髓损伤后给予利拉鲁肽可降低细胞凋亡及急性炎症反应,有利于后期神经组织修复以及运动功能恢复。     

BDNF联合chABC鞘内注射对大鼠脊髓损伤修复的影响

目的 探究脑源性神经营养因子（BDNF）联合软骨素酶（chABC）鞘内注射对大鼠脊髓损伤后运动感觉功能的影响以及脊髓组织中神经干细胞、神经元、星形胶质细胞、少突胶质细胞的影响。方法 将SD大鼠分为假手术对照组（A组）,损伤对照组（B组）,chABC治疗组（C组）,BDNF治疗组（D组）,联合治疗组（E组）,采用后肢运动功能评分法（CBS）对大鼠术后1周、2周、4周和2个月后肢运动功能进行评定,苏木精-伊红（HE）染色法观察不同时间点大鼠脊髓组织变化,免疫组化法观察各组大鼠脊髓组织神经干细胞的影响,荧光免疫组化法观察各组大鼠神经元、星形胶质细胞、少突胶质细胞的变化。结果 术前各组大鼠神经功能均正常,术后1~2周,B、C、D、E各组CBS评分降低,但各组间对比差异无统计学意义（P>0.05）;术后4周~2个月,C、D、E组CBS评分逐渐降低,低于B组,差异有统计学意义（P<0.05）。与A组相比,B组不同时间点BrdU阳性细胞数目降低,差异有统计学意义（P<0.05）。脊髓损伤后1周,C、D、E组大鼠脊髓组织BrdU阳性细胞数目与B组比较,差异无统计学意义（P>0.05）;脊髓损伤后第2~4周,C、D、E组BrdU阳性细胞数高于B组,差异有统计学意义（P<0.05）。与空白对照A组比较,B组脊髓损伤后不同时间点Nestin阳性细胞数目均减少,差异有统计学意义（P<0.05）。脊髓损伤后2周、4周、2个月,C、D、E组脊髓组织Nestin阳性细胞数高于B组,差异有统计学意义（P<0.05）。脊髓损伤后1周,A组星形胶质细胞比例逐渐降低,神经元细胞比例逐渐升高。B组细胞3种细胞比例均较低,随着时间延长,神经元细胞比例缓慢升高,星形胶质细胞比例缓慢下降。C、D、E组脊髓受损后脊髓受损后4周~2个月,C、D、E组神经元比例逐渐升高,星形胶质细胞逐渐下降,与B组比较,差异有统计学意义（P<0.05）。结论 BDNF、chABC鞘内注射后对大鼠脊髓损伤后运动、感觉功能恢复具有一定的促进作用,可能与促进神经干细胞增殖以及神经元细胞的分化有关,但两者联合后效果并不显著。     

神经干细胞移植联合促红细胞生成素对大鼠脊髓损伤的修复作用

目的:观察神经干细胞(NSCs)联合促红细胞生成素(EPO)对横断性大鼠脊髓损伤的修复作用,为临床治疗脊髓损伤提供理论依据。方法:40只成年雌性Wistar大鼠建立大鼠T10全横断脊髓损伤模型,并随机分为对照组、NSCs组、EPO组和NSCs+EPO组,每组10只。术后8周采用NF-200免疫组织化学染色和免疫荧光染色对各组大鼠损伤区脊髓神经纤维再生情况进行形态学观察;应用BBB评分评估各组大鼠后肢运动功能恢复情况。结果:组织形态学观察,对照组大鼠横断处脊髓组织残端萎缩,脊髓白质和灰质间可见大量空洞形成,未见有明显的神经纤维再生;NSCs+EPO组大鼠横断处脊髓组织残端轻度萎缩,横断区可见大量呈杂乱、无序生长的神经纤维,可见有连续性神经纤维通过脊髓横断区,脊髓白质和灰质间可见少量空洞形成。NSCs+EPO组大鼠中,FITC共轭抗神经丝蛋白抗体NF-200标记的再生神经纤维在横断区头侧大量再生,呈无序状生长,并通过损伤区到达尾侧;NSCs组大鼠可见少量神经纤维再生,未通过损伤区到达尾侧。NSCs+EPO组大鼠后肢运动功能BBB评分,术后7 d内均高于其他各组(P<0.05);NSCs组大鼠后肢运动功能BBB评分术后7 d内均高于对照组和EPO组(P<0.05)。结论:NSCs移植联合腹腔注射EPO可有效促进大鼠损伤脊髓功能的恢复、轴突的存活和再生。     

神经干细胞在体外诱导向胆碱能神经元定向分化后移植治疗脊髓损伤

目的 研究神经干细胞向胆碱能神经元定向分化后对脊髓横断损伤的修复作用.方法 采用GFP转基因孕鼠(E 12～14d)的海马分离、培养神经干细胞并诱导其向胆碱能神经元方向分化.SD成年大鼠以显微剪横断脊髓制成SCI模型.将SD大鼠18只分为3组:A组注入DMEM/F12培养液;B组注入神经于细胞的细胞液,C组注入在体外定向诱导为胆碱能神经元的细胞液;3组实验动物均于细胞移植后采用B B B评分法定期评估运动功能.于移植后第8周末,取出相应的脊髓阶段,行ChAT免疫组织化学染色,光镜观察.结果 从海马分离的细胞群具有自我更新能力,表达nestin,胎鼠骨骼肌提取液可以诱导这些细胞中的11.8%分化成为胆碱能神经元,与对照组差异明显.B组和C组所有大鼠BBB评分在移植细胞3周以后明显高于A组(P＜0.05),C组所有大鼠BBB评分在移植细胞4周以后明显高于B组(P＜0.05).在移植第8周末,冰冻切片中可见ChAT染色阳性细胞.结论 神经干细胞可以在体外诱导向胆碱能神经元定向分化,定向分化后移植应用在脊髓横断损伤治疗中,可明显改善运动功能.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.