异氟烷对东莨菪碱致大鼠空间认知功能障碍的影响

目的 观察异氟烷对东莨菪碱致大鼠空间认知障碍学习记忆的影响。方法 雄性SD大鼠55只随机分为8组:对照/1d组(Con/1d,n=6),异氟烷/1d组(Iso/1d,n=7),东莨菪碱/1d组(Sco/1d,n=9),异氟烷+东莨菪碱/1d组(Iso+Sco/1d,n=9);对照/7d组(Con/7d,n=6),异氟烷/7d组(Iso/7 d,n=6),东莨菪碱/7d组(Sco/7 d,n=6),异氟烷+东莨基碱/7 d组(Iso+Sco/7 d,n=6)。Iso组、Iso+Sco组大鼠每天吸入1.5％异氟烷2 h,连续4 d。分别在末次给药后1d和7d,对1d组、7d组大鼠行Morris水迷宫测试,测试连续3 d,Iso+Sco组、Sco组大鼠在测试前20min腹腔注射东莨菪碱0.8 mg/kg。结果 末次给药后1d,(1)潜伏期、游泳行程:测试 1、2、3 d Sco组和Iso+Sco组皆长于Con组和Iso组(均为P<0.01),测试2、3 d Sco组的潜伏期长于Iso+Sco组(均为P<0.01)、游泳行程也长于Iso+Sco组(分别为P<0.01或0.05)。(2)游泳速度:测试1、2、3 d Sco组和Iso+Sco组皆快于Con组(分别为P<0.05或0.01),测试1l、2d Sco组快于Iso组(均为P<0.05),测试1d Iso+Sco组高于Iso 组(P<0.05)。(3)正常认知策略所占百分比:测试1、2、3 d Sco组和Iso+Sco组皆低于Con组和Iso组(均为P<0.01),测试2、3 d Sco组也低于Iso+Sco组(均为P<0.01)。(4)记忆得分:Sco组低于Con组和Iso组(P<0.05或0.01)。末     

七氟烷和东莨菪碱对老年大鼠海马毒蕈碱受体表达的影响

目的 探讨七氟烷和东莨菪碱对老年大鼠海马毒蕈碱受体表达的影响.方法 健康雄性老年SD大鼠48只,月龄18月,体重560～600 g,随机分为对照组(Con组)、七氟烷组(Sev组)和东莨菪碱组(Sco组),每组16只.Sco组腹腔注射东茛菪碱0.8 mg/kg,Con组和Sev组腹腔注射等容量生理盐水,30 min后Sev组吸入3.0%七氟烷、Con组和Sco组吸入空气2 h.于给药后1、3 d时分别取8只大鼠,采用Y型迷宫实验测试学习记忆能力,然后断头处死,取脑分离海马,采用RT-PCR法检测M1受体和M,受体mRNA的表达,采用免疫组化法检测海马神经元M1受体和M2受体的表达.结果 与Con组相比,给药后1d时Sev组和Sco组学习次数增多、训练时间延长,海马M1受体和M2受体的表达下调(P<0.05);各组间给药后3 d时学习次数、训练时间及海马M1受体和M2受体的表达差异无统计学意义(P>0.05).结论 七氟烷和东莨菪碱均可诱发老年大鼠认知功能一过性降低,其机制与海马M1受体和M2受体表达下调有关.     

褪黑素对异氟醚麻醉大鼠海马胆碱乙酰基转移酶的影响

目的 探讨褪黑素对异氟醚麻醉大鼠海马胆碱乙酰基转移酶(ChAT)的影响.方法雄性SD大鼠60只,体重390～440 g,采用随机数字表法,将大鼠随机分为5组(n=12):对照组(C组)、1%异氟醚组(Ⅰ组)、1%异氟醚+褪黑素组(IM组)、2%异氟醚组(J组)和2%异氟醚+褪黑素组(JM组).IM组和JM组腹腔注射褪黑素10 mg/kg,1次/d,连续7 d,C组、Ⅰ组和J组给予等容量生理盐水.Ⅰ组、IM组第7天吸入1%异氟醚4 h,J组、JM组第7天吸入2%异氟醚4 h.于麻醉次日行Morris水迷宫实验,测试逃避潜伏期及原平台象限探索时间;水迷宫实验结束后取血浆及脑组织,采用ELISA法测定血浆褪黑素浓度,Western blot法测定海马ChAT表达水平,采用比色法测定海马ChAT活性,采用免疫荧光法测定海马CA1区和齿状回的ChAT阳性神经元数量.结果 与C组比较,Ⅰ组血浆褪黑素浓度、ChAT表达水平和活性降低(P＜0.01);J组逃避潜伏期延长,原平台象限探索时间缩短,血浆褪黑素浓度、ChAT表达水平和活性降低(P＜0.05或0.01).与Ⅰ组比较,IM组逃避潜伏期缩短,原平台象限探索时间延长,褪黑素浓度升高,ChAT表达水平和活性升高(P＜0.05或0.01).与J组比较,JM组逃避潜伏期缩短,褪黑素浓度升高,ChAT活性升高(P＜0.05或0.01).海马CA1区和齿状回的ChAT阳性神经元数量与ChAT表达水平变化一致.结论 褪黑素可减轻异氟醚麻醉对ChAT表达水平及活性的抑制,从而改善异氟醚麻醉后大鼠的认知功能.

Abstract：

Objective To investigate the effects of melatonin on choline acetyltransferase (ChAT) in rat hippocampus after isoflurane anesthesia. Methods Sixty male SD rats weighing 390 - 440 g were randomized into 5 groups (n = 12 each): control group (group C), 1% isoflurane group (group Ⅰ), 1% isoflurane + melatonin group (group IM) , 2% isoflurane group (group J) and 2% isoflurane + melatonin group (group JM) . In IM and JM groups, melatonin 10 mg/kg was administered intraperitoneally once a day for 7 consecutive days, while equal volume of normal saline was given intraperitoneally instead of melatonin in C, I and J groups. Groups Ⅰ and IM inhaled 1% isoflurane and groups J and JM 2% isoflurane for 4 h on 7th day. All the rats underwent Morris water maze test on the day after anesthesia for assessment of learning and memory ability (escape latency and probe time) . The training test was performed 4 times a day for S days. Six rats randomly selected from each group were sacrificed the end of the test. The blood samples were collected for detection of plasma melatonin level by ELISA.The brain tissues were removed for determination of the expression and activity of ChAT in hippocampus by Western blot or colorimetric assay. The left rats were selected and sacrificed for determination of the number of ChAT positive neurons in hippocampal CA1 region and entate gyrus by immunofluorescence. Results The plasma melatonin level and expression and activity of ChAT were significantly lower in group I than in group C ( P ＜ 0.01) . The escape latency was significantly longer, the probe time was significantly shorter, and the plasma melatonin level and expression and activity of ChAT were significantly lower in group J than in group C ( P ＜ 0.05 or 0.01) . The escape latency was significantly shorter, the probe time was significantly longer, and the plasma melatonin level and expression and activity of ChAT were significantly higher in group IM than in group Ⅰ ( P ＜ 0.05 or 0.01). The escape latency was significantly shorter and the plasma melatonin level and ChAT activity were significantly higher in group JM than in group J ( P ＜ 0.05 or 0.01) . The results of immunofluorescent staining showed that the number of ChAT positive neurons in hippocampal CA1 region and dentate gyrus wag consistent with the changes in the measured ChAT expression. Conclusion Melatonin can reduce isoflurane-mediated inhibition of ChAT expression and activity and thus improve spatial memory impaired by isoflurane anesthesia in rats.     

右美托咪定通过PI3K/Akt通路改善睡眠剥夺大鼠异氟醚暴露后的认知损害

目的探索右美托咪定(Dex)作为麻醉前药物是否可以改善睡眠剥夺大鼠异氟醚暴露后的认知损害及其可能的机制。方法采用随机数字表法将42只雄性SD大鼠分为7组(每组6只):对照组(C组)、异氟醚组(Iso组)、睡眠剥夺组(SD组)、睡眠剥夺+异氟醚组(SD+Iso组)、Dex+睡眠剥夺+异氟醚组(D+SD+Iso组)、磷脂酰肌醇3-激酶(PI3K)抑制剂(LY294002)+睡眠剥夺+异氟醚组(L+SD+Iso组)、Dex+LY294002+睡眠剥夺+异氟醚组(D+L+SD+Iso组)。C组不做处理, Iso组进行异氟醚吸入3 h处理, SD组进行48 h睡眠剥夺, SD+Iso组在睡眠剥夺48 h后吸入异氟醚3 h, D+SD+Iso组、L+SD+Iso组在睡眠剥夺48 h和吸入异氟醚3 h同时分别给予Dex(20 μg/kg)、LY294002(25 μg/kg), D+L+SD+Iso组在睡眠剥夺48 h和吸入异氟醚3 h同时给予Dex(20 μg/kg)、LY294002(25 μg/kg)。莫里斯水迷宫评估大鼠认知能力, 免疫荧光检测海马自噬体数量变化, 免疫印迹法(Western...     

竹节参皂苷对异氟醚所致发育期大鼠神经毒性和认知功能的影响

目的探讨竹节参皂苷对异氟醚所致发育期大鼠海马神经毒性及认知功能的影响。方法 7日龄SD大鼠60只,雌雄不限,体重20~25g,随机分为四组(n=15)。对照组(Con组):吸入对照气(空气)6h;异氟醚组(Iso组):吸入1.8%异氟醚6h;竹节参皂苷+异氟醚组(Iso+ChIV组):麻醉前30min腹腔注射竹节参皂苷30mg/kg后吸入1.8%异氟醚6h;竹节参皂苷(ChIV组):麻醉前30min腹腔注射竹节参皂苷30mg/kg后吸入对照气(空气)6h。麻醉结束后12h取海马组织检测突触后致密蛋白95(PSD95)、突触素I(Synapsin I)、B淋巴细胞瘤2相关X蛋白(Bax)、B淋巴细胞瘤2(Bcl-2)蛋白含量,TUNEL染色检测神经元凋亡情况,测定乳酸脱氢酶(LDH)活性。于出生后第31~35天采用水迷宫评估空间学习记忆能力。结果与Con组比较,Iso组PSD95、Bcl-2蛋白含量明显降低,Bax蛋白含量明显升高,TUNEL阳性细胞数明显增多,LDH活性明显增强(P0.05);与Iso组比较,Iso+ChIV组PSD95、Bcl-2蛋白含量明显升高,Bax蛋白含量明显降低,TUNEL阳性细胞数明显减少,LDH活性明显减弱(P0.05)。与Con组比较,Iso组第34和35天逃避潜伏路线明显延长(P0.05),第33、34和35天逃避潜伏期明显延长(P0.05),第35天目标象限停留时间明显缩短,平台穿越次数明显减少(P0.05)。与Iso组比较,Iso+ChIV组第34和35天逃避潜伏路线明显缩短,逃避潜伏期明显缩短(P0.05),第35天目标象限停留时间明显延长,平台穿越次数明显增多(P0.05)。结论竹节参皂苷可明显改善异氟醚所致发育期大鼠神经毒性和认知功能,其机制可能与抑制发育期神经凋亡有关。     

异氟醚调控Toll样受体4/核因子-κB信号通路保护大鼠肾缺血再灌注损伤

目的探讨异氟醚对肾缺血再灌注损伤(ischemic reperfusion injury, IRI)的保护作用及相关分子机制。方法 32只大鼠按随机数字表法分为假手术组(S组)、肾缺血再灌注损伤组(IRI组)、异氟醚预处理组(Iso+IRI组)和异氟醚+脂多糖组(Iso+IRI+LPS组), 每组8只。Iso+IRI组进行异氟醚(isoflurane, Iso)预处理, Iso+IRI+LPS组进行Iso预处理后腹腔注射脂多糖(lipopolysaccharide, LPS)0.1 mg/kg, 其他组同时注射同体积生理盐水。而后IRI组、Iso+IRI组及Iso+IRI+LPS组采用夹闭肾蒂法建立肾IRI模型, S组进行假手术。术后24 h检测大鼠静脉血Cr和BUN水平, ELISA法检测肾组织IL-1β、TNF-α、IL-6水平, 超氧化物歧化酶(superoxide dismutase, SOD)活性检测试剂盒检测肾组织SOD活性, 可见分光光度法检测肾组织丙二醛(malondialdehyde, MDA)、谷胱甘肽过氧化物酶(glutathion peroxidase, GSH...     

JNK信号通路在异氟醚预处理和七氟醚预处理减轻大鼠海马脑片缺氧无糖损伤中的作用

目的 评价c-Jun氨基末端激酶(JNK)信号通路在异氟醚预处理和七氟醚预处理减轻大鼠海马脑片缺氧无糖(OGD)损伤中的作用.方法雄性成年SD大鼠,体重270～290 g,断头处死,剥离海马,制备海马脑片.取大鼠海马脑片96张,采用随机数字表法,将其随机分为8组(n=12):对照组(C组)、OGD组、异氟醚预处理组(Iso组)、七氟醚预处理组(Sevo组)、SP600125+异氟醚预处理组(SP+Iso组)、SP600125+七氟醚预处理组(SP+Sevo组)、二甲基亚砜(DMSO)+异氟醚预处理组(DMSO+Iso组)和DMSO+七氟醚预处理组(DMSO+Sevo组).采用电生理技术,细胞外记录CA1区群锋电位(PS)波幅,计算PS恢复程度.采用碘化丙啶染色法,测定细胞活力.结果 与C组比较,其余各组PS恢复程度和细胞活力降低(P＜0.01);与OGD组比较,Iso组、Sevo组、SP+Iso.组、SP+Sevo组、DMSO+Iso组和DMSO+Sevo组PS恢复程度和细胞活力升高(P＜0.01);与180组比较,SP+Iso组PS恢复程度和细胞活力升高(P＜0.01),DMSO+Iso组PS恢复程度和细胞活力差异无统计学意义(P＞0.05);与Sevo组比较,SP+Sevo组PS恢复程度和细胞活力升高(P＜0.01),DMSO+Sevo组PS恢复程度和细胞活力差异无统计学意义(P＞0.05).结论 异氟醚预处理和七氟醚预处理可通过抑制JNK信号通路,减轻大鼠海马脑片缺氧无糖损伤.

Abstract：

Objective To evaluate the role of c-Jun N-terminal kinase (JNK) signaling pathway in the protective effect of isoflurane preconditioning and sevoflurane preconditioning against oxygen-glucose deprivation (OGD) injury in rat hippocampal slices. Methods Male adult SD rats weighing 270-290 g were anesthetized with ether and decapitated. The hippocampi were removed and sagittally sliced (400 μm thick) and placed in artificial cerebral spinal fluid aerated with 95% O2-5% CO2 . Ninety-six hippocampal slices were randomly divided into 8 groups (n = 12 each): control group (group C), OGD group, isoflurane preconditioning group (group Iso),sevoflurane preconditioning group (group Sevo) , SP600125 + isoflurane preconditioning group (group SP + Iso),SP600125 +sevoflurane preconditioning group (group SP + Sevo), DMSO + isoflurane preconditioning group (group DMSO + Iso) and DMSO + sevoflurane preconditioning group (group DMSO + Sevo). Electrophysiological technique was used to record the amplitude of population spike ( PS) in the stratum pyramidale of CA1 region and the degree of recovery of PS was calculated. The cell viability was determined by propidium iodide staining. Results Compared with group C, the degree of recovery of PS and cell viability were significantly decreased in the other groups ( P ＜ 0.01) . Compared with group OGD, the degree of recovery of PS and cell viability were significantly increased in groups Iso, Sevo, SP+Iso, SP+Sevo, DMSO+ Iso and DMSO + Sevo (P＜ 0.01). Compared with group Iso, the degree of recovery of PS and cell viability were significantly increased in group SP+Iso ( P ＜ 0.01) , while no significant change was found in group DMSO + Iso ( P ＞ 0.05) . Compared with group Sevo, the degree of recovery of PS and cell viability were significantly increased in group SP + Sevo ( P ＜ 0.01) , while no significant change was found in group DMSO + Sevo ( P ＞ 0.05). Conclusion Isoflurane preconditioning and sevoflurane preconditioning can attenuate the OGD injury to rat hippocampal slices through inhibiting JNK signaling pathway.     

不同浓度七氟醚对新生大鼠性成熟期空间学习记忆功能的影响

目的 探讨新生7d大鼠接受不同浓度七氟醚麻醉后对其性成熟期(出生后55 d～60 d)空间学习记忆能力的影响. 方法 出生7d龄SD大鼠48只,体重12 g～16 g,雌雄各半,采用随机数字表法分为3组(每组16只):3％七氟醚吸入6h组(A组)、1.5％七氟醚吸入6h组(B组)和空白对照组(C组).新生大鼠接受麻醉后次日(8 d)每组各取8只,采用直接断头法处死,取大脑海马CA1区组织,利用比色法测定乙酰胆碱酯酶(acetylcholine esterase,AchE)及胆碱乙酰转移酶(cholineacetyhransferase,ChAT)的活性.剩余大鼠继续生长至性成熟期(55 d～60 d)时,先利用Morris水迷宫实验测试其空间学习记忆能力,实验结束后再测定大脑海马CA1区AchE及ChAT的活性. 结果 ①8d时:A组及B组AchE活性分别为(0.34±0.07) U/mg和(0.33±0.07)U/mg,均较C组增加(P＜0.01);A组及B组ChAT活性分别为(81±22) U/mg和(96±29) U/mg,均较C组降低(P＜0.01).②性成熟期时:Morris水迷宫实验中,A组和B组平均逃避潜伏期、原平台象限活动时间及穿越原平台次数与C组比较,差异均无统计学意义(P＞0.05);60d时,AchE活性、ChAT活性各组间差异均无统计学意义(P＞0.05). 结论 新生7dSD大鼠接受不同浓度七氟醚麻醉后可短暂性升高大脑海马CA1区AchE活性,降低ChAT活性表达,但不影响其发育至性成熟期时的空间学习记忆能力.     

右美托咪啶对异氟醚致新生鼠海马神经细胞凋亡的影响

【摘要】 目的 比较右美托咪啶(Dex)预处理给药和分次给药两种方法对异氟醚(Iso)致新生大鼠海马细胞凋亡的影响。方法 将出生后7天(postnatal day 7, P7)的SD大鼠随机分成6组:空气+盐水组(Air+NS组)、空气+Dex 25 μg·kg-1分次给药组(Air+Dex25×3组)、空气+Dex 75 μg·kg-1预处理组(Air+Dex75组)、异氟醚+盐水组(Iso+NS组)、异氟醚+ Dex 25μg·kg-1分次给药组(Iso+Dex25×3组)以及异氟醚+Dex 75μg·kg-1预处理组(Iso+Dex75组)。前3组吸入空气,后3组吸入0.75%异氟醚6 h。Air+NS组、Iso+NS组、Air+Dex75组和Iso+Dex75组在麻醉前20 min腹腔内注射生理盐水或75 μg·kg-1剂量的Dex;Air+Dex25×3组和Iso+Dex25×3组分别在麻醉前20 min,麻醉开始后2 h和4 h腹腔内重复注射25μg·kg-1剂量的Dex。麻醉结束后用原位末端标记(TUNEL)法检测海马神经细胞凋亡(n=4); 用Western blot检测海马激活型caspase-3蛋白表达变化(n=4)。 结果 异氟醚能诱导海马CA1区TUNEL阳性细胞数增加391.0 %(P<0.001);激活型caspase-3表达增加122.0%(P<0.001)。Iso +Dex25×3组和Iso+Dex75分别减少异氟醚诱导的TUNEL阳性细胞的增加为80.7%(P<0.001)和73.2%(P<0.001);两组均能完全抑制激活型caspase-3表达的增加(P<0.001);两组间无统计学差异(P>0.05)。结论 右美托咪啶预处理给药和分次给药都能通过抑制海马细胞凋亡来减轻异氟醚对新生大鼠的脑毒性作用,且两者的抗凋亡效果相似。     

盐酸戊乙奎醚对老龄大鼠认知功能的影响

目的 比较盐酸戊乙奎醚与东莨菪碱对老龄大鼠认知功能及大鼠海马乙酰胆碱酯酶(ACHE)阳性纤维和基底前脑胆碱乙酰转移酶(ChAT)阳性细胞数量的影响.方法 24只老龄SD大鼠,随机均分为盐酸戊乙奎醚组(P组)、东莨菪碱组(S组)及对照组(C组).P、S组连续3 d腹腔给药,剂量分别为0.64、0.29 mg·kg-1·d-1,C组给予同等容积的生理盐水2 ml.于停药后1 d行水迷宫测试,记录潜伏期及游泳距离,连续测试3 d.末次水迷宫测试后1 h处死大鼠,用组织化学方法测定大鼠海马AChE以及免疫组化方法测定大鼠基底前脑ChAT的表达.结果 三组3 d潜伏期较1 d缩短(P＜0.05);S、C组3 d游泳距离较1 d缩短(P＜0.05);S组水迷宫2 d及3 d潜伏期及游泳距离较C组显著延长(P＜0.05).S组大鼠海马AChE阳性纤维数量较C组显著增加(P＜0.05),S组基底前脑ChAT阳性细胞数量较C组显著减少(P＜0.05).结论 盐酸戊乙奎醚对老龄大鼠的认知功能无显著影响,东莨菪碱则对认知功能产生一定程度的抑制作用.     

Histochemical and contractile properties of striated muscles of urethra and levator ani of dogs and sheep

AIMS: To understand their possible importance in long- and short-term control of continence, some properties of the striated muscles of the urethra and pelvic floor (levator ani) of dogs and sheep were investigated, especially fiber types and contractile characteristics. MATERIALS AND METHODS: Striated muscles of urethra and levator ani of 29 male and 6 female dogs and 11 male and 6 female sheep were removed and cut into strips. Some strips were frozen and stained for ATPase at pH 9.4 and 4.3 for fiber typing; others were set up in an organ bath to study contractile responses to nerve stimulation. RESULTS: All muscles contained both type I (slow) and type II fibers, ranging from 97% type II in female greyhound urethra to 60% in female sheep levator ani. For each muscle, there were fewer type II muscles in sheep than in dog. The diameters of the urethral fibers were about 60% of the levator ani in dogs and 34% in sheep. Contraction of the urethral muscle was faster than for levator ani and declined to about 80% of the peak, 500 msec after the beginning of stimulation at 20 Hz. The levator ani contraction rose to a steady level as long as stimulation continued. CONCLUSIONS: Both the levator ani and urethral striated muscles contain slow and fast fiber types. The levator ani muscles are capable of sustained contraction with rapid onset which will produce long-term closure of the urethra. The circular urethral muscle contraction was faster but less well maintained.     

Incorporation and release of85Sr and14C-proline-hydroxyproline in mineral and collagen of bone and incisor teeth of growing rats

The extent to which exchange and reutilization processes of mineral tracers affect skeletal mineral accretion and resorption measurements was evaluated by comparing the rates of appearance and disappearance of⁸⁵Sr and¹⁴C-proline-hydroxyproline in bones and teeth in growing rats for 12 days following simultaneous parenteral injection of these tracers. Expressions for the relative rates of collagen synthesis and breakdown, which unlike mineral metabolism are considered not to be complicated by exchange phenomena, were based on¹⁴C-proline conversion to¹⁴C-hydroxyproline; the specific activity of the latter was determined. Both the mineral and the collagen specific activities reflected the rates and patterns of growth of the samples assayed; rapid growth and a short interval of time between formation and resorption of tissue in themetaphyseal bone which contains the cartilagineous growth plate, slow growth and an interval of time between formation and resorption of tissue indiaphyseal bone and incisor teeth which is longer than the 12 days of the experiment. However, in metaphyseal bone the specific activity collagen/mineral ratio dropped by one half during the 4–12 day interval in contrast to diaphyseal bone and incisor teeth in which no change in this ratio was observed during this period of time. The data indicate that collagen in the metaphyseal growth zone is removed by resorption before it has become fully mineralized, and that exchange is a relatively unimportant factor in the long term kinetics of bone mineral.

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Zusammenfassung Das Ausmaß, bis zu welchem Austausch- und Wiederverwendungsprozesse der mineralen Tracer die Messungen des mineralen Skelett-Auf- und Abbaues beeinflussen können, wurde ausgewertet; zu diesem Zweck wurde die Geschwindigkeit des Auftretens und Verschwindens von⁸⁵Sr und von¹⁴C-Prolin-Hydroxyprolin in Knochen und Zähnen von wachsenden Ratten während der 12 auf die simultane parenterale Injektion dieser Tracer folgenden Tage verglichen.Der Ausdruck für die relative Geschwindigkeit des Kollagen-Auf- und Abbaues, bei welchem im Gegensatz zum Mineralmetabolismus kein Mitwirken des Austauschphänomens vermutet wird, basiert auf der Umwandlung von¹⁴C-Prolin zu¹⁴C-Hydroxyprolin; die spezifische Aktivität des letzteren wurde bestimmt.Aus der spezifischen Aktivität des Minerals sowie jener des Kollagens konnten die Geschwindigkeit und die Art des Wachstums der untersuchten Proben ersehen werden, d.h.schnelles Wachstum und ein kurzes Zeitintervall zwischen Bildung und Resorption des Gewebes imKnochen der Metaphyse, die auch die knorpelige Wachstumsplatte enthält, und andererseitslangsames Wachstum und längeres Zeitintervall (länger als die 12 Tage des Experimentes) zwischen Bildung und Resorption des Gewebes imKnochen der Diaphyse und in den Schneidezähnen. Immerhin fiel die spezifische Aktivität des Kollagen/Mineral-Anteils im Knochen der Metaphyse während dem 4–12tägigen Zeitintervall auf die Hälfte, im Gegensatz zum Knochen der Diaphyse und der Schneidezähne, bei welchen während dieser Zeitspanne kein Unterschied in diesem Verhältnis beobachtet wurde.Diese Ergebnisse zeigen, daß Kollagen in der Wachstumszone der Metaphyse durch Resorption verschwindet, bevor es ganz mineralisiert ist, und daß der Austausch ein relativ unwichtiger Faktor in der Kinetik auf lange Sicht des Knochenminerals ist.

     

Instrumented ligamentotaxis and stabilization of compression and burst fractures of dorsolumbar and mid-lumbar spines

Background:

Controversy continues regarding the best treatment for compression and burst fractures. The axial distraction reduction utilizing the technique employing the long straight rod or curved short rod without derotation to reduce fracture are practised together with short segment posterolateral fusion (PLF). Effects of the early postoperative mobilization without posterolateral fusion on reduction maintenance and fracture consolidation were not evaluated so far. The present prospective study is designed to assess the effectiveness of i) reduction and restoration of sagittal alignment, ii) no posterolateral fusion on the reduced, fractured vertebral body and injured disc, iii) fracture consolidation and iv) the fate of the unfused cephalad and caudal injured motion segments of the fractured vertebra.

Materials and Methods:

The study includes 15 Denis burst and two Denis type D compression fractures between T₁₂ and L₃. The lordotic distraction technique was used for ligamentotaxis utilizing the contoured short rods and pedicle screw fixator. Three vertebrae including the fractured one were fixed. The patients after surgery were braced for ten weeks with activity restriction for 2-4 weeks. The patients were evaluated for change in vertebral body height, sagittal curve, reduction of retropulsion, improvement in neural deficit. The unfused motion segments, residual postoperative pain and bone and metal failure were also evaluated.

Results:

The preoperative and postreduction percentile vertebral heights at, zero (immediate postoperative), at three, six and 12 months followup were 62.4, 94.8, 94.6, 94.5 and 94.5%, respectively. The percentages of the intracanal fragment retropulsion at preoperative, and postoperative at zero, 3, 6 and 12 months followup were 59.0, 36.2,, 36.0, 32.3, and 13.6% respectively.The preoperative and postreduction percentile loss of the canal dimension and at zero, three, six and 12 months were 52.1, 45.0, 44.0, 41.0 and 29% respectively suggesting that the under-reduced fragment was being resorbed gradually by a remodeling process. The mean initial kyphosis of 33° became mean 2° immediately after reduction and mean 3° at the final followup. The fractured vertebral bodies consolidated in an average period of ten weeks (range 8-14 weeks). The restored disc heights were relatively well maintained throughout the observation period. All paraparetic patients recovered neurologically. There were no postoperative complications.

Conclusion:

Instrument-aided ligamentotaxis for compression and burst fractures utilizing the short contoured rod derotation technique and the instrumented stabilization of the fractured spine are found to be effective procedures which contribute to the fractured vertebral body consolidation without recollapse and maintain the motion segment function.     

Principles and Practice of Hemofiltration and Hemodiafiltration

There is growing interest in the convective dialysis therapies, hemofiltration (HF) and hemodiafiltration (HDF). Both require dialysis membranes which are highly permeable to solutes as well as fluid, and in both cases large volumes of ultrafiltration are the condition for convective transport. In HDF the convection is combined with diffusion, and as a consequence, maximum clearance over the entire molecular weight spectrum is achieved. Optimal forms of HDF provide urea clearance 10–15% higher than the corresponding diffusive mode. The larger the solute, the greater is the impact of convection, and β₂-microglobulin (β₂m) levels may be up to 70% reduced. Traditional postdilution HF provides high clearance of medium sized and large molecules. Satisfactory clearance of small solutes requires blood flows in excess of 500 ml/min. With access to practically unlimited volumes of substitution solution through on-line ultrafiltration, predilution HF can now be used. This increases the clearance of small solutes to an acceptable range. For HDF as well as HF, large patient populations consistently treated for longer periods of time are needed to make valid outcome comparisons with other therapies.     

Recognition and management of phaeochromocytoma and paraganglioma

Phaeochromocytomas and paragangliomas (PPGL) are catecholamine-secreting neuroendocrine tumours arising from the chromaffin cells in the adrenal medulla. These tumours may be identified incidentally, as part of a work-up for multiple endocrine neoplasia or following haemodynamic surges during unrelated procedures. Advances in perioperative management and improved management of intraoperative haemodynamic instability have significantly reduced surgical mortality from around 40% to less than 3%. Surgery is the definitive treatment in most cases and laparoscopic resection where possible is associated with improved outcomes. Anaesthetic management of PPGL cases represents a unique haemodynamic challenge both before and after tumour resection. In this article we describe the physiology of these tumours, their diagnosis, preoperative optimization methods, intraoperative anaesthetic management and management of postoperative complications.     

骨折不愈合与延迟愈合的成因与治疗

目的探讨骨折不愈合与延迟愈合的成因、报肯治疗的方法与设果。方法对1990年7月～2004年12月间收治的107例骨折不愈台、54例骨折延迟愈合2例先天性胫骨骨不连进行回顾性研究，分析原因，随访治疗结果。18例延迟愈合行保守治疗，本组其他145例行手术治疗，结果除2例先天性胫骨骨不连外，其余161例的成因中均有医源性因素。10例失去随访，153例平均随访17（6-28）个月，骨折均获骨性连接，愈合时间平均10（6-14）个月，肢体功能恢复良好，结论医源性技术缺陷是骨折不愈合与延迟愈合的主要原因，针对各种不同因素进行合理治疗可获得满意效果。     

Physiology and pharmacology of nausea and vomiting

Nausea and vomiting are both very unpleasant experiences. The physiology is poorly understood; however, understanding what we do know is key to tailoring a preventative or therapeutic antiemetic regime. There are two key sites in the central nervous system implicated in the organization of the vomiting reflex: the vomiting centre and the chemoreceptor trigger zone. There are five key neurotransmitters involved in afferent feedback to these areas. These are histamine (H₁ receptors), dopamine (D₂), serotonin (5-HT₃), acetyl choline (muscarinic) and neurokinin (substance P). Postoperative nausea and vomiting will occur in around one-third of elective patients who have no prophylaxis. This can result in many detrimental effects including patient dissatisfaction, unplanned admission and prolonged recovery. It is therefore essential that clinicians understand how they can prevent and treat nausea and vomiting using either a single agent or a combination of antiemetics to target relevant receptors. Commonly used drugs include antihistamines, dopamine antagonists, serotonin antagonists and steroids. More novel agents are being developed such as aprepitant, a neurokinin receptor antagonist, palonosetron, a 5HT₃ receptor antagonist and nabilone, a synthetic cannabinoid.     

Physiology and pharmacology of nausea and vomiting

Nausea and vomiting are both very unpleasant experiences. The physiology is poorly understood; however, understanding what we do know is key to tailoring a preventative or therapeutic antiemetic regime. There are two key sites in the central nervous system implicated in the organization of the vomiting reflex: the vomiting centre and the chemoreceptor trigger zone. There are five key neurotransmitters involved in afferent feedback to these areas. These are histamine (H₁ receptors), dopamine (D₂), serotonin (5-HT₃), acetyl choline (muscarinic) and neurokinin (substance P). Postoperative nausea and vomiting will occur in around one-third of elective patients who have no prophylaxis. This can result in many detrimental effects including patient dissatisfaction, unplanned admission and prolonged recovery. It is therefore essential that clinicians understand how they can prevent and treat nausea and vomiting using either a single agent or a combination of antiemetics to target relevant receptors. Commonly used drugs include antihistamines, dopamine antagonists, serotonin antagonists and steroids. More novel agents are being developed such as aprepitant, a neurokinin receptor antagonist, palonosetron, a 5HT₃ receptor antagonist, and nabilone, a synthetic cannabinoid.