表里经穴电针时脑葡萄糖代谢PET对照研究

目的 了解针刺表里特定经穴(解剖位置相对)对脑功能区影响的位置及其效应差异.方法 表里经穴为手少阳三焦经的外关和支沟(10例),手厥阴心包经的内关和间使(12例),随机选单侧取穴.空白对照(5例)用正电子发射型计算机断层显像(PET)技术观察电针后局部脑葡萄糖代谢变化.结果 针刺表经穴位后,可见两侧中额叶和颞叶、丘脑、对侧小脑、海马等葡萄糖代谢增高变化(以对侧为主).针刺里经穴位后,可见两侧巾额叶,对侧颞叶、丘脑、小脑葡萄糖代谢减低变化和同侧海马、尾状核葡萄糖代谢增高变化.对照组没有变化.结论 在生理状态下,针刺表里经穴对大脑起不同的调节作用.说明了穴位电针与脑功能区活动存在一定联系.     

电针配合盆底肌锻炼治疗女性压力性尿失禁疗效观察

目的观察电针配合盆底肌锻炼治疗女性压力性尿失禁的疗效。方法将78例女性压力性尿失禁患者随机分为两组,电针结合盆底肌锻炼治疗(实验组)39例,服用维生素(安慰剂)配合盆底肌锻炼治疗(对照组)39例,对两组患者疗效进行分析。结果实验组有效率84.6%,对照组有效率59.0%,两组差异有统计学意义(P<0.01)。结论电针配合盆底肌锻炼治疗女性压力性尿失禁有效率明显优于安慰剂配合盆底肌锻炼治疗。     

毫针浅刺法治疗椎基底动脉供血不足的疗效观察

[目的]探讨毫针浅刺法针灸治疗椎基底动脉供血不足症(VBI)的临床疗效。[方法]将40例患者随机分为观察组和对照组各20例,观察组采用毫针浅刺法治疗,对照组采用常规针刺法治疗,两组均每日治疗1次,10天为1个疗程,均治疗两个疗程后判断疗效。[结果]观察组痊愈17例,显效2例,无效1例,总有效率为95.0%;对照组痊愈9例,显效7例,无效4例,总有效率为80.0%。观察组疗效明显优于对照组(P<0.05)。[结论]浅刺法针灸治疗椎基底动脉供血不足症(VBI)疗效显著。     

In vitro metabolism of a nitroderivative of acetylsalicylic acid (NCX4016) by rat liver: LC and LC-MS studies

The metabolism of a nitroderivative of acetylsalicylic acid, benzoic acid, 2-(acetyloxy)-3-[(nitrooxy)methyl]phenyl ester (NCX4016), the lead compound of a new class of NO-releasing non steroidal-antiinflammatory drugs has been studied in vitro in rat liver subcellular fractions (S 9000xg, microsomes, cytosol). Samples were extracted with CH3CN (2 vol.) containing 1% H3PO4 (2 M), vortexed for 3 min and then centrifuged for 5 min at 5000 rpm. Supernatants were diluted with 0.02 M phosphoric acid and analysed by reverse-phase LC. Linearity of calibration for NCX4016 and metabolites was observed over the range 0.25-50 microg/ml with coefficients of determination greater than 0.9996. Extraction efficiency from spiked liver samples ranged from 85 to 95% for all the analytes. In the S 9000xg fraction, NCX4016 undergoes rapid metabolization, with the formation of salicylic acid (SA) and [3-(nitrooxymethyl)phenol] (HBN). HBN is then rapidly metabolised to 3-hydroxybenzylalcohol (HBA), and mainly to a new metabolic species, whose formation takes place specifically in the liver cell cytosol. LC-MS analysis (electrospray ionisation) of the cytosol extract in negative and positive-ion modes furnished deprotonated [M-H]- and protonated [M+H]+ molecular ions at m/z 412 and 414, respectively, accompanied by the typical clusters with sodium. MS/MS analysis in negative-ion mode, by selection and collision of the ion at m/z 412, gave a fragmentation pattern characterized by the ions at m/z 272 and 254, which allowed to assign the structure of 1-(glutathion-S-yl)methylene-3-hydroxy-benzene, a conjugated product between GSH and the benzyl carbon atom of HBN. In rat liver cytosol HBN is completely metabolised to this thioether adduct within 30 min incubation; the process is enzymatically mediated by GSH transferase and strictly dependent on GSH availability. The relevance of this new metabolic pathway in NCX4016 detoxification by rat liver is discussed.     

Arteroportal fistulas between the accessory right hepatic, gastroduodenal and superior mesenteric arteries and portal vein: a difficult technical problem to overcome in liver transplantation

BACKGROUND: Fistulous communications between the accessory right hepatic (ARHA), gastroduodenal (GD), and superior mesenteric (SMA) arteries and the portal vein (PV) may represent a contraindication for liver transplantation (LT). MATERIAL: A patient with HCV-related liver cirrhosis and progressive liver decompensation underwent preoperative LT work-up. Doppler ultrasound (DU), Angiography and MRI revealed arteroportal fistulas (APF) and diversion of mesenteric-splenoportal flow through spontaneous splenorenal shunts (SSRS) in the systemic circulation. The patient was transplanted and the ARHA and GDA were distally sectioned; the HA was anastomosed to the donor HA; the superior mesenteric vein (SMV) was detached from the splenopancreatic venous bed by sectioning and ligating the Henle trunk, by ligating an posterior-inferior pancreatic vein and, finally, by positioning an iliac vein interposition graft between the SMV and the donor PV. The postanastomotic SMV trunk and recipient PV were ligated below and above the pancreatic head, respectively. RESULTS: Reperfusion and late liver function were good. DU and MRI studies showed an effective portal flow and the maintenance of a normal splenopancreatic vein outflow through the SSRS. DISCUSSION: APF represent a serious clinical problem, particularly in patients who need LT. The persistence of arterial flow into the PV is dangerous for the long-term liver function. A particular surgical strategy, strictly tailored to the hemodynamic conditions, has to be planned. CONCLUSIONS: Extrahepatic multiple APF would no longer to represent a contraindication to LT, although this claim needs to be confirmed in the light of further experience and a longer-term follow-up.     

Effects of dark rearing on phosphorylation of neurotrophin Trk receptors

Total lack of visual experience (dark rearing, DR) is known to affect development of mammalian visual cortex (VC) and to prolong the critical period of visual cortical plasticity. Neurotrophins (NTs) have been proposed to play a relevant role in activity dependent processes important for the final shaping of cortical visual connections. Neurotrophin supply or antagonism of endogenous NT action profoundly affect visual cortical development and plasticity; in particular, exogenous supply of NTs counteracts DR effects on VC development. However, the effects of DR on NT expression are still debated and mounting evidence reports a mismatch between BDNF mRNA and protein expression in DR animals. To gain insight into the effects of DR on expression of nerve growth factor (NGF) and the functional state of NT signalling pathways, we assessed the phosphorylation state of Trk receptors in light-reared animals (LR), in dark-reared animals (DR), in DR animals briefly exposed to light and in DR animals with exogenous supply of NTs [NGF, brain-derived neurotrophic factor (BDNF) and NT-4] in the VC. We report that DR increases the expression of NGF but reduces the phosphorylation of TrkA and TrkB receptors with respect to LR; normal phosphorylation is rapidly rescued by a brief exposure to light. Exogenous supply of NGF, BDNF or NT4 in DR animals also rescues the phosphorylation of their receptors.     

复肝解毒汤治疗慢性乙型肝炎36例

为观察自拟复肝解毒汤（主药;虎杖、白花蛇舌草、田基黄、广郁金、川楝子、白芍药、柴胡、生麦芽、五味子、砂仁）的疗效,将72例慢性乙型肝炎患者,随机分为两组,治疗组（36例）肝炎灵加服复肝解毒汤,对照组（36例）用肝炎灵加服乙肝清热解毒冲剂。观察治疗中（4周）、后（12周）症状体征及实验室指标的变化。结果：两组患者症状体征的改善情况相似;治疗组ALT、AST、TBiL在第4周已有明显降低,而对照组在12周明显降低;肝功能的复常率和HBV－DNA、HbeAg的转阴率治疗组优于对照组,但无统计学意义。提示复肝解毒汤能缩短慢性乙型肝炎的疗程。     

History of childhood attention deficit/hyperactivity disorder symptoms and borderline personality disorder: a controlled study

To evaluate the association between history of childhood attention deficit/hyperactivity disorder (ADHD) symptoms and the diagnosis of borderline personality disorder (BPD) in adulthood, the Wender Utah Rating Scale (WURS) was administered to 42 consecutively admitted BPD subjects, 94 consecutively admitted controls with any cluster B personality disorder (PD) diagnosis other than BPD, 38 consecutively admitted controls with any cluster A or cluster C PD diagnosis but no cluster B PD diagnosis, and 69 consecutively admitted controls with no PD diagnosis. A fourth control group was composed by 201 nonclinical volunteers. According to Dunn-Bonferroni contrasts, BPD subjects showed a significantly higher mean WURS total score compared to all control groups (minimum t = 7.93, maximum t = 11.63, all Ps <.001). These contrasts remained significant even controlling for potential confounders such as antisocial personality disorder (ASPD) diagnosis, gender, inpatient status, and axis I diagnoses. The results of this study seem to support the hypothesis of an association between history of childhood ADHD symptoms and adult BPD diagnosis.     

HIV-Ⅰ CN54株gagprotease基因嵌合脊髓灰质炎病毒cDNA质粒的构建和表达研究

目的 构建HIV-1 CN54株gagprotease基因嵌合脊髓灰质炎病毒cDNA的表达质粒，并鉴定、检测基因及其表达。方法 用PCR技术获得人免疫缺陷病毒CN54株的gagprotease基因，并使其两端带上合适的酶切住点，将其定向插入到包含脊髓灰质炎病毒cDNA的表达质粒pSVA14中，替代其部分结构基因，构建HIV基因嵌合缺陷性脊髓灰质炎病毒基因组的表达质粒。经筛选、鉴定后用脂质体转染技术将新构建的质粒转入Hela细胞内，用Western Blot方法检测目的基因在Hela细胞内的表达。结果 PCR技术扩增所得的人免疫缺陷病毒CN54株gagprotease基因经琼脂糖凝胶电泳、DNA测序证实成功获得，未引入突变碱基，筛选、鉴定证明gagprotease基因被正确定向插入到脊髓灰质炎病毒的cDNA序列之中，Western Blot检测到gagpro-tcase基因正确表达了相关蛋白。结论 成功构建了表达人免疫缺陷病毒CN54株gagprotease基因的缺陷性脊髓灰质炎病毒基因组嵌合质粒，为利用脊髓灰质炎病毒作人免疫缺陷病毒基因的表达载体奠定了基础，此研究对开发以脊髓灰质炎病毒为艾滋病的疫苗载体有重要意义。     

自我效能感与晕船症状的相关研究

目的 探讨自我效能感与晕船症状的相关，以期寻找影响晕船的心理因素。方法 对某院校参加海上实习的123名医疗本科学员用一般自我效能感量表、晕船自我效能感量表于出海作业前进行施测，用晕船症状评分量表于出海作业返回后进行评估。结果 晕船自我效能感与晕船症状显著负相关（r=-0．470，P〈0．01），而一般自我效能感量表与晕船症状的相关无统计学意义（r=-0．102，P〉0．05）。结论 晕船自我效能感可能为个体发生晕船的心理影响因素之一。