癫痫大鼠额叶、海马丙戊酸神经药代动力学的研究

目的 研究癫痫大鼠额叶、海马的丙戊酸神经药代动力学。方法 健康雄性ＳＤ大鼠１２只,随机分成对照组与癫痫组,每组各６只。癫痫组大和印防己碱腹腔注射点燃,腹腔注射丙戊酸钠４００ｍｇ／ｋｇ后不同时间点收集两组大鼠额叶、海马细胞外液透析液及血标本。结果 丙戊酸迅速吸收人脑中,在脑中浓度显著低于血中浓度;癫痫大鼠与正常大鼠贩神经药代动力学参数之间差异无显著性,阗痫大鼠额叶、海马浓度时间曲线下面积差异无显著性     

匹罗卡品致(癎)大鼠海马中表达生长抑素的中间神经元数目变化及其轴突出芽

目的 探讨表达生长抑素(SS)的中间神经元在颞叶癫(癎)的发生和自我修复中的作用.方法 建立匹罗卡品致(癎)大鼠模型.免疫组织化学方法检测各时间点海马不同区域SS中间神经元的数目变化及其轴突出芽情况;结合Fluoro-Jade B(FJB)行免疫荧光双标方法特异性检测大鼠癫(癎)持续状态(status epilepticus,SE)后7 d和60 d海马不同区域SS中间神经元及其轴、树突的变性情况.结果 实验组大鼠海马各区Ss阳性神经元数目均在SE后7 d减至最低(门区11.1±3.3,CA1区2.8±0.9,CA1区1.8±0.7,t=13.519、9.644、8.808,均P<0.01),慢性期开始部分恢复,SE后60 d时CA1区SS神经元数目(12.8±1.5)超过对照组(8.8±1.3,t=-4.506,P<0.01),但门区和CA3区SS神经元数目(分别为25.5±4.6和4.8±0.8)仍明显低于正常水平(t=4.691、3.953,P<0.01);sE后30 d大鼠海马回腔隙.分子层(lacunosum-moleculare,lm)和齿状回外分子层出现大量SS染色阳性纤维,60 d时海马CA1区全层均可见大量增多的SS阳性纤维.实验组中SE后7 d的海马CA1区、60 d的CA1、CA1区和门区均可观察到少部分被FJB染色的SS中间神经元胞体及其轴、树突.结论 SS中间神经元的缺失在颞叶癫(癎)的发生中起重要作用,其缺失部分是由于神经元的变性死亡所致;慢性期CA,区SS阳性纤维大量增多,可能在颞叶癫(癎)的发生和自我修复中起重要作用.     

五灵脂炮制前后指纹图谱及含量测定比较

目的:建立五灵脂及其炮制品指纹图谱,并对主要指标成分穗花杉双黄酮和扁柏双黄酮进行定量测定。方法:采用HPLC色谱法,Agilent extend-C18柱(4. 6 mm×250 mm,5μm),流动相为乙腈-0. 1%甲酸,梯度洗脱,柱温30℃,检测波长335 nm,建立五灵脂及其炮制品指纹图谱,采用指纹相似度软件进行分析,并对2个主要色谱峰进行含量分析。结果:醋五灵脂、酒五灵脂、清炒五灵脂与五灵脂生品指纹图谱和含量测定结果基本一致,炭炒五灵脂较五灵脂生品新增2个峰,且穗花杉双黄酮和扁柏双黄酮含量相对减少。结论:所建立的指纹图谱精密度、重复性、稳定性良好,含量测定方法准确率达到要求,对五灵脂及其炮制品的质量评价和炮制原理研究有提供依据。     

匹罗卡品致(癎)大鼠海马中表达生长抑素的中间神经元数目变化及其轴突出芽

Objective To investigate the roles of somatostatin(SS)positive intemeurons in the development and compensation of temporal lobe epilepsy.Methods Piloearpine-induced epilepsy rat model was established.Immunohistochemistry method was used to detect number changes and axonal sprouting of SS positive intemeurons in different domains of the hippocampus at difierent time points.Degeneration of SS positive interneurons and their neurophils were detected by the double immunofluorescence staining with SS and Fluoro-Jade B(FJB)at 7 and 60 days after status epilepticus (SE).Results In the exoerimental rat group,the number of SS positive neurons decreased in each hippocampal domain,and it reached the lowest at 7 days post-SE(There were 11.1±3.3 in hilus,2.8±0.9 in CA1region and 1.8±0.7 in CA1region,t=13.519,9.644 and 8.808,all P<0.01).In chronic phase,the number of SS neurons gradually recovered,and exceeded the control group in CA1 area at 60 days post-SE(12.8±1.5 vs 8.8±1.3,t=-4.506,P<0.01),however,the number of SS neurons in the hilus(25.5±4.6)and CA1 area(4.8±0.8)remained significantly less than normal levels(t value were 4.691 and 3.953.both P<0.01).Increased SS positive fibers were found in the lacunosum-molecular (1m)layer and outer molecular layer of dentate gyrus after 30 days post-SE,and numerous SS positive fibers were seen threnghout the layers of area CA1 at 60 days post-SE.Double immunofluuorescence revealed that a few SS positive interneurons and fibers were also labeled by FJB in area CA1 at 7 days post-SE and in CA domain/hilus at 60 days post-SE.Conclusions SS intemeurons loss plays an important role in the development of temporal lobe epilepsy.The loss is partially caIlsed by the degeneration and death of neurons;SS positive neurophils increase within area CA1 in chronic phase may play a significant role in the generation and compensation of temporal lobe epilepsy.     

隐球菌性脑膜炎48例临床分析

【目的】分析隐球菌性脑膜炎的临床特点、诊疗及转归。【方法】回顾性分析48例经病原学证实的隐球菌脑膜炎患者的临床特点、辅助检查、诊断、治疗及预后。【结果】隐脑的临床表现以头痛、呕吐、发热、为主,颅内压升高明显,所有病例均经病原学检查确诊。应用两性霉素B或两性霉素B脂质体加氟康唑治疗的治愈及好转率为70.4%。【结论】脑脊液或脑组织病原学检查发现新型隐球菌是确诊此病的金标准。两性霉素B或两性霉素B脂质体联合氟康唑治疗疗效确切,两性霉素B脂质体较两性霉素B副作用轻、患者的耐受好,对肾功能不全或两性霉素B治疗效果不佳时改用两性霉素B脂质体治疗可提高治愈好转率。     

丙戊酸在癫痫大鼠额叶的神经药代动力学特征

目的 研究丙戊酸在癫痫大鼠的额叶神经药代动力学特征。方法 健康雄性SD大鼠12只，随机分成对照组与癫痫组，每组各6只。癫痫组大鼠用印防己碱（PTX）腹腔注射点燃，腹腔注射丙戊酸钠400mg/kg后不同时间点收集两组大鼠额叶细胞外液透析液及血标本。结果 丙戊酸迅速吸收入额叶中，在额叶中浓度显低于血中浓度；癫痫大鼠与正常大鼠额叶的神经药代动力学参数之间的差异无显性；给药1h后额叶丙戊酸浓度与血清丙戊酸浓度均呈下降趋势。结论 癫痫大鼠与正常大鼠额叶丙戊酸神经药代动力学特征相似；丙戊酸在癫痫大鼠额叶的分布可能与额以局部脑血管流量变化，血脑屏蔽功能障碍，丙戊契穿过血脑屏蔽需单羧酸（MCA）载体转运等因素有关；监测给药一段时间后血清丙戊酸 度有助于了解脑卒中后晚发性癫痫患的额叶丙戊酸浓度，指导临床合理用药。     

POEMS综合征20例临床分析

目的探讨POEMS综合片的临床特征,提高对POEMS综合征的诊疗认识。方法回顾性分析20例POEMS综合征患者的临床表现、辅助检查、治疗及预后。结果20例患者均有多发性神经病、水肿及皮肤色素沉着,淋巴结肿大者18例,内分泌改变者18例,异常球蛋白血症者16例。16例患者给予激素治疗,其中7例合用人血免疫球蛋白静滴。18例患者有不同程度的好转。结论POEMS综合征临床表现复杂多样,各主要症状出现顺序不一,涉及多系统,临床应注意鉴别诊断。     

尿源性脓毒血症的危险因素和早期生物学标志物的研究进展

尿源性脓毒血症是机体对泌尿道感染异常反应引起的一种危及生命的全身炎症反应综合征(SIRS), 常可由泌尿道或男性生殖器局部感染逐渐发展为严重败血症、多器官功能衰竭(MODS)和脓毒血症休克。尽早识别、多样化的诊疗方案和多学科间协作是降低病死率、提高该类患者预后生活质量的有效方法。本文总结了近年来尿源性脓毒血症的危险因素和早期生物学标志物, 以期为尿源性脓毒血症患者的临床诊疗方案的制定提供新思路。     

匹罗卡品致(癎)大鼠海马中表达生长抑素的中间神经元数目变化及其轴突出芽

Objective To investigate the roles of somatostatin(SS)positive intemeurons in the development and compensation of temporal lobe epilepsy.Methods Piloearpine-induced epilepsy rat model was established.Immunohistochemistry method was used to detect number changes and axonal sprouting of SS positive intemeurons in different domains of the hippocampus at difierent time points.Degeneration of SS positive interneurons and their neurophils were detected by the double immunofluorescence staining with SS and Fluoro-Jade B(FJB)at 7 and 60 days after status epilepticus (SE).Results In the exoerimental rat group,the number of SS positive neurons decreased in each hippocampal domain,and it reached the lowest at 7 days post-SE(There were 11.1±3.3 in hilus,2.8±0.9 in CA1region and 1.8±0.7 in CA1region,t=13.519,9.644 and 8.808,all P<0.01).In chronic phase,the number of SS neurons gradually recovered,and exceeded the control group in CA1 area at 60 days post-SE(12.8±1.5 vs 8.8±1.3,t=-4.506,P<0.01),however,the number of SS neurons in the hilus(25.5±4.6)and CA1 area(4.8±0.8)remained significantly less than normal levels(t value were 4.691 and 3.953.both P<0.01).Increased SS positive fibers were found in the lacunosum-molecular (1m)layer and outer molecular layer of dentate gyrus after 30 days post-SE,and numerous SS positive fibers were seen threnghout the layers of area CA1 at 60 days post-SE.Double immunofluuorescence revealed that a few SS positive interneurons and fibers were also labeled by FJB in area CA1 at 7 days post-SE and in CA domain/hilus at 60 days post-SE.Conclusions SS intemeurons loss plays an important role in the development of temporal lobe epilepsy.The loss is partially caIlsed by the degeneration and death of neurons;SS positive neurophils increase within area CA1 in chronic phase may play a significant role in the generation and compensation of temporal lobe epilepsy.