糠尿病缺血性中风证侯特征与神经内分泌免疫网络,脑病理？…

目的：对Ⅱ型糖尿病（ＮＩＤＤＭ）并发急性脑梗死（ＡＣＩ）的中风证侯特征与神经内分泌免疫网络（ＮＥＩＮ）及其相应脑病理改变进行观察研究，以从宏观和微观辨证阐明该病的发病机理。方法：采用中风辨证量表、血液流变学等指标对脑卒中患者始发状态进行评分和放射免疫分析，包括下丘脑－垂体－肾上腺轴（ＨＰＡ）激素（促肾上腺皮质激素释放激素、促肾上腺皮质激素、皮质醇）与免疫细胞因子（肿瘤坏死因子α、白细胞介素－６）水     

急性脑梗死HPA轴激素与胰腺内分泌变化的研究

目的:研究急性脑梗死(ACI)下丘脑-垂体-肾上腺(HPA)轴激素与胰腺内分泌的变化,以探讨其发病机理.方法:采用放射免疫分析法(RIA)分别对151例ACI患者进行CRH(促肾上腺皮质激素释放激素)、ACTH(促肾上腺皮质激素)、CS(皮质醇)、INS(胰岛素)及GLC(胰高血糖素)入院时始发状态血液检测,并与60例年龄相仿健康人组作对照.结果:ACI者HPA轴激素显著高于健康正常人组(P＜0.01～0.001),胰腺内分泌也发生了有重要统计学意义的变化(P＜0.05～0.001).结论:CRH、ACTH、CS、INS与GLC参与了ACI的病理发生发展过程,测定其水平可作为判断病情程度、愈后转归及疗效评定的客观指标.     

细胞因子在神经-内分泌-免疫网络中的调节机制

免疫和神经内分泌系统之间的联系是双向的。它们有着共同的化学语言,有典型的激素和免疫调节剂中介的配体和受体。肾上腺糖皮质激素(GC)对调节内分泌起着非常重要的作用,是免疫活动的主要调节物;在证实神经-内分泌-免疫之间存在调节反馈机制后,研究发现细胞因子是联系免疫-神经-内分泌系统的关键。除了IL-1,还有许多细胞因子如IL-6、TNF等都能影响下丘脑-垂体-肾上腺轴(HPA轴)的活性。研究显示,细胞因子对HPA轴的影响不仅发生在感染、外伤和肿瘤等疾病中,而且在心理和生理应急时也出现。已有研究证明外源性和内源性细胞因子均能激活HPA轴。维护机体自我平衡,单个细胞因子的努力是绝对不够的,应该系统研究多种细胞因子对HPA轴活性作用的机制。     

急性缺血性中风始发状态风证与垂体-肾上腺轴激素的关系研究

目的 :探讨急性缺血性中风 (急性脑梗死 ,ACI)始发状态风证与垂体 -肾上腺轴激素 (促肾上腺皮质激素ACTH、皮质醇CS)的关系。方法 :采用中风病专家经验辨证量表对 15 1例ACI患者的始发状态进行证候评分 ,同时利用放射免疫分析 (RIA)测定ACTH、CS含量 ,再按证候评分将患者分成风证组与非风证组 ,对比两组患者ACTH、CS的变化水平 ,并与健康人组 (6 0例 )作对照。结果 :①风证组的ACTH、CS水平非常显著地高于非风证组 (p <0 0 0 1) ;风证组与非风证组的ACTH、CS含量与正常健康人组比较也呈上述变化 (p <0 0 0 1) ,②77例风证组患者的风证评分与ACTH含量呈高度正相关关系 (r =0 89、t=14 6 1) ,与CS含量呈中度相关关系(r=0 5 3、t=4 83)。结论 :风证与ACTH、CS具有正相关关系 ,其升高水平可作为判定风证与非风证的微观指标     

运动应激与下丘脑—垂体—肾上腺轴

下丘脑 垂体 肾上腺 (HPA)轴的激活是机体对应激最重要的适应性反应 ,有利于机体动员能量和保持内环境的稳定。多种不同强度的运动形式都可引起促肾上腺皮质激素 (ACTH)和皮质醇的升高。在运动应激中 ,精氨酸加压素 (AVP)对ACTH起着重要的调节作用。正常人对运动可表现出不同程度的神经内分泌反应 ,运动可降低地塞米松对HPA轴的负反馈作用     

急性脑死HPA轴激素与胰腺内分泌变化的研究

目的：研究急性脑梗死（ＡＣＩ）下丘脑－垂体－肾上腺（ＨＰＡ）轴激素与胰腺内分泌的变化，以探讨其发病机理。方法：采用施放免疫分析法（ＲＩＡ）分别对１５１例ＡＣＩ患者进行ＣＲＨ（促肾上腺皮质激素释放激素）、ＡＣＴＨ（促肾上腺皮质激素）、ＣＳ（皮质醇）、ＩＮＳ（胰岛素）及ＧＬＣ（胰高血糖素）入院时始发状态血液检测，并与６０例年龄相仿健康人组作对照。结果：ＡＣＩ者轴激素显著高于健康正常人组（Ｐ〈０．０１～     

下丘脑-垂体-肾上腺轴在抑郁症发病中的作用

越来越多的研究表明，下丘脑一垂体一肾上腺轴(hypothalamic pituitary adrenal axic，HPA轴)在抑郁的发病机制中发挥着重要的作用。HPA轴的活化机制是：下丘脑通过垂体门脉系统运送下丘脑调节肽(促肾上腺皮质激素释放激素，CRH)到脑垂体，从而调节腺垂体的分泌。腺垂体在调节肽的作用下释放促肾上腺皮质激素(ACTH)，然后作用于肾上腺皮质，释放肾上腺皮质激素到全身。下面我们将从HPA轴的三个水平(CRH、ACTH、肾上腺皮质激素)来论述HPA轴在抑郁发病过程中的作用。     

褪黑素对创伤后应激障碍大鼠下丘脑-垂体-肾上腺轴的影响

目的:探讨褪黑素(MLT)对足部电击所致创伤后应激障碍(PTSD)大鼠下丘脑-垂体-肾上腺(HPA)轴的影响。方法:利用足底电击法制备大鼠PTSD模型,通过腹腔注射方法给予治疗组大鼠MLT。通过拒俘反应测试检测大鼠的行为学变化,利用real time RT-PCR方法检测下丘脑中促肾上腺皮质激素释放激素(CRH)mRNA的表达,利用酶联免疫吸附试验(ELISA)检测血清中促肾上腺皮质激素(ACTH)、肾上腺素(EPI)和糖皮质激素(GC)的含量。结果:PTSD组大鼠拒俘反应明显(P<0.05),下丘脑中CRH mRNA表达升高(P<0.05),血清中ACTH和EPI明显升高(P<0.05),但是GC水平下降(P<0.05)。MLT治疗后可以明显缓解PTSD大鼠拒俘反应(P<0.05),同时降低下丘脑中CRH mRNA表达(P<0.05),降低血清中ACTH和EPI水平并升高GC的水平(P<0.05)。结论:MLT治疗可缓解PTSD大鼠的症状,并恢复HPA轴的神经内分泌平衡。     

中国劲酒对肾阳虚模型大鼠下丘脑-垂体-肾上腺轴及免疫功能的影响

目的:研究中国劲酒对皮质酮致肾阳虚模型的大鼠下丘脑-垂体-肾上腺(Hypothalamic-pituitary adrenal,HPA)轴及免疫功能的影响。方法:取健康清洁级雄性SD大鼠45只,按随机数字表法分为空白对照组、模型组和中国劲酒组,每组15只,通过皮下注射外源性皮质酮(10 mg/kg体重)连续14天抑制HPA轴,制备肾阳虚模型。皮质酮注射前5天,以50 ml/kg体重灌胃中国劲酒(相当于中国劲酒日推荐服用剂量的30倍),连续19天。采用酶联免疫吸附试验(ELISA)方法检测血浆皮质酮(Corticosterone,CORT)含量;采用放射性免疫法测定血浆中促肾上腺皮质激素(Adrenocorticotropic hormore,ACTH)含量,采用实时定量-聚合酶链反应法(Real-time PCR)测定下丘脑促肾上腺皮质激素释放激素(Corticotropin releasing hormone,CRH)mRNA表达水平;取胸腺称重,淋巴细胞凋亡及增殖率分别采用流式细胞仪法和改良四氮唑盐(XTT)法。结果:在外源性皮质酮作用下,肾阳虚模型大鼠较空白对照组HPA轴和免疫功能受到明显抑制,中国劲酒灌胃后可显著提高大鼠下丘脑CRH mRNA水平、血浆ACTH含量,与肾阳虚模型组比较差异有统计学意义(P<0.05);血浆CORT水平有升高倾向;同时在免疫调节方面,中国劲酒可明显增加皮质酮模型大鼠胸腺重量和降低脾脏淋巴细胞凋亡率,与肾阳虚模型组比较差异有统计学意义(P<0.01);中国劲酒有促进淋巴细胞增殖的趋势。结论:中国劲酒能改善肾阳虚模型大鼠HPA轴功能;也具有改善肾阳虚模型大鼠免疫功能的作用。     

中风病痰湿证与垂体-肾上腺激素水平关系的探讨

目的：探讨中风病痰湿证与垂体－肾上腺激素水平关系，以从微观角度寻找中风症证侯的辨证依据。方法：应用“证侯辨证量化”诊断的方法对１５１例经ＣＴ或ＭＲＩ确诊为缺血性中风始发态的患者进行量化评分，将其分为痰湿证和非痰湿证两组，同时用放射免疫分析（ＲＩＡ）法测定本病患者及健康体检者的促肾上腺皮质激素（ＡＣＴＨ）、皮质醇（ＣＳ）含量并进行对照。结果：两组患者ＡＣＴＨ、ＣＳ含量均升高，与健康对照组比较具有非常     

Photoperiodicity and the function of the hypophysis and the adrenal cortex

Summary The ACTH content of the hypophysis of rats rises from a minimum in the morning to a maximum in the evening hours. These fluctuations are associated with the diurnal rhythm of light and darkness, and are abolished under conditions of continual light or darkness for 30 days. Rhythmic fluctuations of the ascorbic acid content of the adrenals are also found, with maximum values in the evening, and these are likewise abolished by maintenance under conditions of constant illumination.Presented by Active Member AMN SSSR V. V. Parin     

Characteristics of the topographic interrelation of the head of the pancreas and the duodenum and pathology of the organs of the pancreatoduodenal area

Seventy pancreatoduodenal complexes of 55 patients with chronic pancreatitis and tumours of this zone and 15 patients died from other diseases are studies histotopographically . The pieces of the pancreatic head tissue in the medial wall of the duodenum were found in 12 cases of the first group and in 4 control cases. The pancreatic tissue consisted either of all elements of this organ or cystically dilated ducts and seemed to infiltrate different layers of the duodenum wall. Three variants of the pancreatic head structure are suggested on the basis of anatomo-topographical interrelationships of the pancreatic head and duodenum. In 12 out of 14 cases chronic pancreatitis and carcinoma of organs of this zone were combined with the variants of the pancreatic head structure, in 2 cases there was a true heterotopy . Pathogenetic significance of these variants for the development of chronic pancreatitis is discussed.     

Organization and distribution of the upper and lower esophageal motoneurons in the medulla and the spinal cord of the rat

The upper cervical esophagus is exerted on swallowing and peristalsis by somatic and visceral motoneurons, whereas the lower esophagus is exerted on only peristalsis by visceral motoneurons. We examined the origin of the esophageal motoneurons and whether there were any differences between the distributions of the upper and the lower esophageal motoneurons in the medulla and the spinal cord using cholera toxin subunit b (CTb) as the retrograde tracer. Following injection of CTb into the cervical esophagus resulted in heavy labeling of the neurons in the nucleus ambiguus including the compact (AmC), semicompact (AmS) and loose (AmL) formations, and the medial column of lamina IX at the C1-C5 levels of the cervical spinal cord corresponding to the spinal accessory nucleus. A few labeled neurons were found in the inferior salivatory nucleus, the rostral division of the dorsal motor nucleus of the vagus (DMX), the accessory facial nucleus and the lateral column of lamina IX at the C2 and C3 levels. All these labeled neurons showed ChAT immunoreactivity. When CTb was injected into the cut end of the unilateral recurrent laryngeal nerve, many labeled neurons were found in the ipsilateral AmC, the AmL, and the bilateral medial column at the C1 and C2 levels. Following injection of CTb into the subdiaphragmatic esophagus resulted in heavy labeling of the neurons only in the AmC and the DMX. When CTb was injected into the sternomastoid muscle, many labeled neurons were found in the medullary reticular formation, the facial nucleus, the medial column at the C1-C3, C5 and C6 levels, and the lateral column at the C2, C3, C5 and C6 levels. Injections of a Fluoro-Gold into the cervical esophagus and a CTb into the sternomastoid muscle or the subdiaphragmatic esophagus in the same animal showed many double labeled neurons in the medial column of the accessory nucleus at the C1 and C2 levels, but no double labeled neurons in the AmC. These results indicated that the upper cervical esophagus is innervated by the visceral medullary vagal motoneurons as well as the somatic spinal accessory motoneurons. The lower esophagus is innervated only by the visceral medullary vagal motoneurons.     

指背腱膜滑动与近侧指间关节屈曲关系及临床意义

目的:探讨指背腱膜滑动距离与近侧指间关节(PIP)屈曲关系,为临床修复提供解剖学基础。方法:男性成人新鲜尸体标本10侧30指(示、中、环指各10指),切除手指皮肤,不破坏腱鞘、屈肌支持带、伸肌支持带、内在肌及外在肌,使肌腱保持正常的生理状态,分别测量各指中央束(CS)、侧束(LB)在PIP屈曲45°和90°时的滑动距离。结果:当PIP屈曲45°时,CS滑动距离为(2.7±0.4)mm,LB滑动距离为(2.8±0.6)mm;当PIP屈曲90°时,CS滑动距离为(4.3±0.7)mm,LB滑动距离为(4.8±0.6)mm。结论:指背腱膜滑动距离减少,严重影响手指的屈曲功能。对于指背腱膜的新鲜性损伤应予以精确修复;对于陈旧性损伤的修复应确保指背腱膜的正常滑动范围。