2Hz电针减轻神经源性痛大鼠的痛觉超敏和冷诱发的持续性疼痛

目的 :已知电针能减轻大鼠辐射热引起的疼痛和急、慢性炎症痛 ,本文探讨电针能否减轻大鼠神经源性痛。方法 :将大鼠右侧L5/L6 脊神经结扎 ,用引起 5 0 %缩足的机械刺激阈值评价机械性痛觉超敏 ,用大鼠 5min内在 5± 1℃冷板上的缩足次数反映冷诱发的持续性疼痛。用韩氏穴位神经刺激仪给予电刺激 ,波宽 0 .6ms ,频率 2Hz ,电流强度为 0 .5 ,1和 2mA ,各 10min ,共刺激 30min。结果 :2Hz电针能减轻痛觉超敏 (持续 1h)和冷诱发的持续性疼痛 (持续 12小时 )。电针前15min皮下注射纳洛酮 (1mg/kg)能阻断电针对冷诱发的持续性疼痛的作用 ,但不能阻断对痛觉超敏的作用。结论 :低频 (2Hz)电针可能通过阿片机制减轻持续性的神经源性疼痛 ,低频电针也能减轻机械性痛觉超敏 ,该作用可能不是通过阿片机制完成的。     

Preoperative evaluation with T-staging system for hilar cholangiocarcinoma

AIM： To investigate the clinical value of T-staging system in the preoperative assessment of hilar cholangiocarcinoma. METHODS： From March 1993 to January 2006, 85 patients who had cholangiocarcinoma diagnosed by operative tissue-biopsy were placed into one of three stages based on the new T-staging system, and it was evaluated the resectability and survival correlated with T-staging. RESULTS： The likelihood of resection and achieving tumor-free margin decreased progressively with increasing T stage （P 〈 0.05）. The cumulative 1-year survival rates of T1, T2 and T3 patients were 71.8%, 50.8% and 12.9% respectively, and the cumulative 3-year survival rate was 34.4%, 18.2% and 0% respectively; the survival of different stage patients differed markedly （P 〈 0.001）. Median survival in the hepatic resection group was greater than in the group that did not undergo hepatic resection （28 mo vs 18 mo; P 〈 0.05）. The overall accuracy for combined MRCP and color Doppler Ultrasonagraphy detecting disease was higher than that of combined using CT and color Doppler Ultrasonagraphy （91.4% vs 68%; P 〈 0.05 ）. And it was also higher in detecting port vein involvement （90% vs 54.5%; P 〈 0.05）.CONCLUSION： The proposed staging system for hilar cholangiocarcinoma can accurately predict resectability, the likelihood of metastatic disease, and survival. A concomitant partial hepatectomy would help to attain curative resection and the possibility of longterm survival. MRCP/MRA coupled with color Doppler UItrasonagraphy was necessary for preoperative evaluation of hilar cholangiocarcinoma.（OR = 2.46, 95% CI = 0.98-6.14）, and a significantly elevated risk of developing esophageal cancer among alcohol drinkers among alcohol drinkers （OR = 9.86, 95% CI = 3.10-31.38）. CONCLUSION： ADH2 and ALDH2 genotypes areassociated with esophageal cancer risk. ADH2＊1 allele and ALDH2＊2 allele carriers have a much higher risk of developing esophageal cancer, especially among alcohol drinkers.     

A comparison between spontaneous electroencephalographic activities induced by morphine and morphine-related environment in rats

Previous studies demonstrated that drug cues could elicit drug-like or withdrawal-like effect, both subjectively and physiologically. However, few studies have compared the central activities induced by a drug-related environment and the drug itself. The aim of this study was to observe and compare electroencephalographic (EEG) changes induced by acute morphine administration and by the morphine-related environment. EEG activities were recorded via twelve skull electrodes scattered on the left and right cortex in conscious, freely moving rats, either after acute morphine administration or after successful training of conditioned place preference. Acute administration of morphine (0.1, 0.5, 1, 5, 10, 20 mg/kg, i.p.) produced an increase in absolute EEG power in the delta, theta, alpha1, alpha2, beta1, and beta2 bands, as well as a decrease in the gamma band. Topographic mapping revealed a maximal increase in the lateral leads in the theta band and a maximal change in the centro-frontal region in the remaining bands. After place conditioning training, the morphine-related environment induced a diffuse decrease in absolute power in the delta, theta, alpha1, alpha2, beta1, and beta2 bands, which was opposite to the changes induced by acute morphine administration. In addition, the changes in relative power induced by the two situations also diverged. These results indicate that the central mechanisms underlying the motivation of morphine-induced place preference may be somehow different from those underlying the reward effects produced by acute morphine administration.     

NR2B-containing NMDA receptor is required for morphine-but not stress-induced reinstatement

Glutamate receptors are known to be densely distributed in the forebrain rewarding circuits, and glutamatergic transmission is actively involved in the regulation of rewarding and reinstating effects of drugs of abuse. Here we investigated the possible involvement of the N-methyl-D-aspartate (NMDA) receptors in the reinstatement of extinguished morphine conditioned place preference (CPP) in rats. We found that previously extinguished morphine (3 mg/kg, i.p.) CPP was markedly reinstated by a priming injection of morphine (2 mg/kg, i.p.) or an acute environmental stressor (forced swim for 10 min), but not by the stress induced by a 24-h food deprivation. Parallel with this, protein levels of the NMDA receptor 2B subunit (NR2B) were elevated in the nucleus accumbens (NAc) and the hippocampus, but not the prefrontal cortex, of reinstated rats. Systemic administration of an NR2B selective antagonist ifenprodil (1, 3, 10 mg/kg, i.p.) attenuated the reinstatement induced by a priming morphine injection, although not by the forced swim. Ifenprodil (2.0 microg/rat) directly injected into the NAc shell or the CA1 region of the dorsal hippocampus produced a similar effect. These results indicate that the NR2B-containing NMDA receptors in the NAc and the dorsal hippocampus play a significant role in mediating the reinstatement of rewarding responses to morphine.     

国产和进口利福平的生物利用度比较

在10名健康受试者口服利福平后2,4,6,8及11h用紫外分光光度仪测定血浆利福平浓度。在2,4,6,8,11及24h测定尿中药物的排出量。共测定3个药厂的产品,结果表明国产和进口利福平胶囊的生物利用度相似。     

家兔隔区和伏核内钙、镁离子对抗电针镇痛与吗啡镇痛

本文通过脑内慢性埋植套管向家兔一侧隔区或伏核内注射微量(10 nmol)CaCl_2或MgCl_2,可显著对抗吗啡镇痛和电针镇痛。注入核外则无效。家兔一侧隔区或伏核内注入阳离子螯合剂CDTA(20 nmol)加强吗啡镇痛和电针镇痛。文中就Ca~(2 ),Mg~(2 )作用的相似性,电针镇痛与吗啡镇痛机理的相似性,以及伏核和隔区在上述镇痛中的重要性进行了讨论。     

三个中文版神经病理性疼痛诊断量表的制定与多中心验证

目的:制定并验证三个中文版神经病理性疼痛诊断量表LANSS( Leeds Assessment of Neuropathic Symptoms and Signs,LANSS)、NPQ (Neuropathic Pain Questionnaire,NPQ)和ID pain.方法:1.制定中文版LANSS、NPQ和ID pain:两名中文为母语、英文流畅的翻译人员,各自将LANSS、NPQ和ID pain翻译成中文.将这两份翻译版本综合成第一个中文版本.另两名英文为母语、中文流畅的翻译人员,各自将第一个中文版本再翻译回英文.然后比较原版LANSS、NPQ和ID pain和翻译成英文的LANSS、NPQ和ID pain.每一个不一致的地方都要认真分析,有必要的话修改中文版本得到第二个中文版本.经预实验和专家讨论后得出最终中文版本.2.验证中文版LANSS、NPQ和ID pain:共十家中心参与研究,每个中心神经病理性疼痛患者7例,伤害感受性疼痛患者7例.入选的患者自行填写NPQ和ID pain量表,必要时由调查者为患者解释量表中的问题.LANSS量表由调查者询问患者并进行填写.3.分析量表的信度(使用Cronbach's Alpha系数和Guttman分半系数分析组内一致性)和效度(表面效度、ROC曲线下面积、敏感度、特异度、阳性预测值和阴性预测值).结果:经10个研究中心的专家评价,3个量表的表面效度好.中文版LANSS、NPQ和ID pain的信度好.中文版LANSS和ID pain的效度好.结论:中文为母语的患者可以使用本研究制定并验证的中文版LANSS和ID pain量表作为神经病理性疼痛的诊断工具.