利舒康对兔颈动脉斑块中COX-2 mRNA表达的影响

目的探讨利舒康对兔颈动脉斑块中COX-2mRNA表达的影响。方法选取32只雄性新西兰大白兔,其中正常对照组8只(A组),24只硅橡胶圈兔颈动脉粥样斑块的动物模型。将模型兔随机分为颈动脉斑块无干预组(B组)、小剂量利舒康治疗组(50mg/kg,C组),大剂量利舒康治疗组(400mg/kg,D组),每组8只。治疗4周后取双侧颈动脉并分为平等2段,采用实时荧光定量PCR(RT-qPCR)技术检测A、B、C、D组COX-2mRNA的相对表达量。结果与A组比较,B组颈动脉粥样硬化模型兔的斑块COX-2mRNA表达增高,差异有统计学意义(P0.05);与B组比较,C、D组颈动脉斑块COX-2mRNA表达明显下调,差异有统计学意义(P0.05)。结论利舒康的干预下兔颈动脉粥样斑块的COX-2mRNA下调,有可能具有抗动脉粥样硬化的炎性反应作用。     

颈动脉粥样硬化斑块ABCA1表达及辛伐他丁干预的影响

目的 探讨模型兔颈动脉粥样硬化斑块三磷酸腺苷结合盒运转体A1（ATP bindingcassette A1,ABCA1）、视黄酸X受体（Retinoid X recepter,RXRα）表达机制及辛伐他丁对其表达的影响.方法 32只新西兰大白兔,分为4组,空白对照组8只（A组）,余24只于兔右侧颈动脉放置改良的硅橡胶圈加1%高胆固醇喂养的方法建立粥样硬化斑块性颈动脉狭窄动物模型.颈动脉狭窄模型无干预对照组8只（B组）;小剂量辛伐他丁治疗组8只（辛伐他丁每天2.5mg/kg每天1次;C组）;大剂量辛伐他丁治疗组8只（辛伐他丁5mg/kg,每日1次,D组）.辛伐他丁干预前后检测兔模型静脉血的TG、TC、LDL及HDL水平,干预4周后处死动物取右侧颈动脉狭窄段及对侧相应段血管,以WesternBlot法测定其ABCA1、RXRα蛋白质表达量.结果 与A组比较,B、C、D组的ABCA1、RXRα蛋白质表达水平下调（P＜0.05）;辛伐他丁治疗4周后,与B组比较,C、D组ABCA1、RXRα蛋白质表达水平均有所上调（P＜0.05）;与C组比较,D组的ABCA1、RXRα蛋白质表达水平下调无统计学意义（P＞0.05）;与B组比较,C、D组的血脂水平显著下降（P＜0.05）.结论 ABCA1、RXRα蛋白表达下调可能参与颈动脉粥样硬化形成的机制,辛伐他丁可能通过上调ABCA1、RXRα蛋白质表达的机制,而有益于抗动脉粥样硬化斑块形成作用.     

改良硅橡胶圈加高胆固醇喂养诱导颈动脉狭窄兔模型的建立

目的探讨粥样硬化性颈动脉狭窄兔模型的建立。方法40只雄性新西兰大白兔随机分为4组:空白对照组4只(A组)、高胆固醇喂养组4只(无硅橡胶圈干预,B组)、硅橡胶圈干预组16只(C组,分C1,C2、C3、C4亚组),高胆固醇 硅橡胶圈干预组(D组,分D1、D2、D3、D4亚组)。硅橡胶圈置于右颈动脉外膜,对侧颈动脉行伪手术,术后次日给予1%胆固醇饲料喂养2周,过量麻醉处死动物前,动物模型行DSA证实颈动脉狭窄程度,切除硅橡胶圈下方狭窄的动脉及对侧相应位置的颈动脉标本,光学显微镜观察病理变化。结果置入改良的硅橡胶圈加高胆固醇喂养2周后,病理证实D组的硅橡胶圈诱导的颈动脉内膜面增厚、管腔狭窄;中膜平滑肌细胞排列紊乱。病理和DSA证实模型颈动脉管腔狭窄程度为12%～88%之间,其中以D4组的颈动脉粥样硬化斑块和狭窄程度较为显著。结论应用改良硅橡胶圈加高胆固醇喂养的方法成功地建立了与人有相似病理表现的粥样硬化性颈动脉狭窄模型兔,颈动脉狭窄程度与硅橡胶圈的形状、内壁直径及弹性回缩力相关,模型制作方法简便易行,便于重复。     

颈动脉粥样硬化斑块与急性脑梗死患者血脂、血压关系的探讨

目的探讨急性脑梗死患者血脂浓度、血压与颈动脉粥样硬化斑块的关系。方法应用彩色多普勒超声检查急性脑梗死患者的颈动脉内膜-中膜厚度、斑块数和性状，同时检测血压。查血脂；121例急性脑梗死患者根据有无高血压分为脑梗死组47例、高血压并发脑梗死组74例，年龄相匹配的正常对照组35例。各项数据用SPSS10．0软件统计分析。结果脑梗死合并高血压组颈动脉粥样硬化斑块发生率最高（69．7％），且以软斑及混合斑为主，脑梗死组次之（59．6％），正常组最低（20％）。有颈动脉粥样硬化斑块与无颈动脉粥样硬化斑块相比．血清LDL—C水平明显升高。结论颈动脉粥样硬化斑决是脑梗死的重要危险因素，高血压及高LDL—C血症是颈动脉粥样硬化的危险因素．     

2型糖尿病合并脑梗死患者颈动脉、血脂及血浆纤维蛋白原的变化

目的 探讨2型糖球病合并脑梗死（DC1）患者颈动脉、血脂及血浆纤维蛋白原（Fg）的变化。方法 对58例DC1患者（DC1组）及36例非糖尿病不合并脑梗死患者（对照组）进行颈动脉超声检测，观察颈动脉粥样硬化斑块的部位、数目、性质和颈动脉内径；并作血糖、血脂和Fg含量测定。结果 DC1组颈动脉粥样硬化斑块的发生率（79．3％）、颈总动脉（CCA）内膜-中层厚度（1MT）和CCA内径与对照组比较差异有极显著性（均P〈0．01），斑块发生部化以CCA分叉处及颈内动脉（ICA）入口和起始处最多（86．0％）；以软斑为主（62．5％）。脑梗死部位与出现斑块的颈动脉存在同侧相关性（P〈0．01）。DC1组血糖、总胆固醇、三酰甘油及Fg较对照组显著增高（均P〈0．01）。结论 DC1患者大多有颈动脉粥样硬化及血脂、血糖、Fg水平异常，对糖尿病患者颈动脉粥样硬化斑块和血脂、血糖等异常进行早期干预，对预防脑梗死的发生有重要临床意义。     

颈动脉粥样硬化斑块形成与脑梗死的相关研究

目的探讨颈动脉粥样硬化斑块因素与脑梗死的关系。方法将我科2009-05-2011—07收治的颈动脉粥样硬化斑块形成患者175例分为脑梗死组（研究组）112例,无脑梗死组（对照组）63例,对照分析2组的颈动脉粥样硬化斑块特点及临床表现异同点。结果脑梗死组颈动脉粥样硬化斑块发生率高于对照组,脑梗死组颈动脉内中膜厚度（IMT）大于对照组,脑梗死组斑块中软斑块比例高于对照组,脑梗死组与对照组患者均有短暂性脑缺血发作（TIA）症状,脑梗死组TIA发作次数及频率均高于对照组。结论颈动脉粥样硬化斑块是导致脑梗死的重要因素之一,脑梗死患者的颈动脉粥样硬化斑块数量相对较多,且以不稳定软斑块为主,应早期对其进行干预。     

缺血性脑血管病与颈动脉粥样硬化的关系

目的 探讨颈动脉粥样硬化与缺血性脑血管病的关系。方法 以2001年6月至2004年12月在我院住院的1583例急性缺血性脑血管病患者为研究对象，应用超声诊断仪检测双侧颈动脉，采用非条件Logistic回归分析颈动脉粥样硬化的危险因素及与缺血性脑血管病的关系。结果 86．5％（1369／1583）患者存在不同程度颈动脉粥样硬化；脑梗死组颈动脉粥样硬化患病率（1087／1266，85．9％）较短暂性脑缺血发作组（198／317，62．5％）高。颈动脉粥样硬化病变特点以斑块居多（1286／1583，81．2％），而中重度狭窄发生率较低（214／1583，13．5％）；颈动脉斑块以颈总动脉分叉处最多见（665／1286，51．7％）。斑块发生率及颅外段颈动脉狭窄程度与脑血管病危险因素有明显相关性。结论 佛山地区缺血性脑血管病患者颈动脉粥样硬化病变可能以斑块居多，颈动脉粥样硬化与缺血性脑血管病有关。     

黄连素对颈动脉粥样硬化斑块的干预研究

目的探讨黄连素对颈动脉粥样硬化斑块干预的效果及机制。方法将92例伴有颈动脉粥样硬化斑块的缺血性脑血管病患者随机分成研究组及对照组;研究组口服黄连素,对照组口服氟伐他汀;于治疗前、治疗后2及4个月进行颈动脉超声检查,测量颈动脉TMT、颈动脉粥样硬化斑块面积及数量,以及检查治疗前、治疗后2及4个月sICAM-1、sVCAM-1、sE-selectin数值。结果与治疗前相比,治疗后4个月2组颈动脉IMT及颈动脉粥样硬化斑块面积、数量减小,差异有显著性（P〈0.05）,2组之间差异无显著性（P〉0.05）。与治疗前相比,治疗后2组sICAM-1、sVCAM-1、sE-selectin均降低,有显著差异（P〈0.05）,2组之间差异无显著性（P〉0.05）。结论黄连素可用于治疗颈动脉粥样硬化斑块,从而可应用于缺血性脑血管病的二级预防。     

颈动脉粥样硬化斑块和血脂异常与短暂性脑缺血发作相关分析

目的探讨短暂性脑缺血发作与颈动脉粥样硬化斑块及血脂异常的关系。方法对82例短暂性脑缺血发作患者（TIA组）和76例非心脑血管病患者（对照组）进行颈动脉超声检查,观察颈动脉血管形态、内-中膜厚度、有无斑块和颈动脉内径。同时进行血脂水平测定。结果TIA组颈动脉粥样硬化斑块检出率（63.41%）,对照组检出率（21.05%）,差异有统计学意义（P〈0.01）;血脂水平与对照组比较,差异有统计学意义（P〈0.05）;两组中颈动脉粥样硬化斑块组血脂水平明显高于无斑块组（P〈0.05）。结论颈动脉粥样硬化斑块与短暂性脑缺血发作的发生有密切关系,血脂代谢异常与颈动脉粥样硬化斑块形成有关,对颈动脉粥样硬化斑块及血脂异常进行的积极干预,对预防短暂性脑缺血发作发生有重要临床意义。     

家兔不同类型颈动脉斑块中基质金属蛋白酶-2表达的形态学研究

目的 建立不同类型颈动脉斑块的动物模型，比较不同斑块内基质金属蛋白酶-2（MMP-2）的阳性表达，观察MMP-2与斑块易损性的关系。方法 将动物随机分为高脂饲料（加或不加蛋氨酸）喂养组（B／A组），再以加或不加内膜空气干燥法分为B1、A1／B2、A2组，建立不同类型的颈动脉粥样硬化斑块的动物模型；免疫组化观察斑块内MMP-2表达，并进行纤维帽厚度／脂质核比值及免疫灰度测定。结果（1）病变管腔偏心性狭窄，呈不规则裂隙状；内膜不均匀增厚；中膜变薄；内、中膜大部分离。可见泡沫细胞的典型聚集形态和典型的纤维帽形态。（2）斑块易损性分析，依次是B1〉A1〉B2〉A2（P〈0．01）。（3）颈动脉斑块内MMP-2的阳性表达与斑块易损性呈正相关，免疫灰度依次是B1〉A1〉B2〉A2（P〈0．01）。结论 （1）采用高脂饲料加空气干燥法能成功建立颈动脉斑块的动物模型。（2）MMP-2的阳性表达与斑块的易损性呈正相关，MMP-2阳性表达结合纤维帽厚度／脂质核比值来判断颈动脉斑块易损性的方法能为研究斑块易损性提供一个有意义的标准。     

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.