Subthreshold transpupillary thermotherapy of the retina and experimental choroidal neovascularization in a rat model

PURPOSE: To study the effect of subthreshold transpupillary thermotherapy (TTT) on the retina and experimental choroidal neovascularization (CNV) in the rat. METHODS: Subthreshold TTT was performed on normal Brown Norway rats or those with krypton laser-induced CNV and appropriate controls with an 810-nm diode laser coupled to a slit lamp. At different intervals after TTT, fundus fluorescence angiography (FFA) and histopathological examinations were performed. Terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling (TUNEL) was used to detect apoptosis. Immunohistochemistry was used to detect heat shock protein 70 (Hsp70) expression. RESULTS: In normal retina, edema and whitening was found on day 1 after TTT. Different degrees of hyperfluorescence could be seen on FFA. Obvious retina damage, especially in the outer layers, was observed by histology in all the lesions that appeared whitened. In the CNV there was congestion and less damage in the overlying retina than in normal retina on day 1 after TTT. Apoptosis was detected in all retinal layers and CNV lesions by TUNEL. In normal eyes, after TTT, Hsp70 expression was increased in the inner layers of the retina and some of the cells in the choroid. Hsp70 was also increased in laser-induced CNV. Two weeks after TTT, the CNV showed a tendency for fibrosis by Masson staining. FFA did not show much change in the CNV lesions 2 weeks after TTT. CONCLUSION: Subthreshold TTT has adverse effects on the overlying retina and thus is likely to cause significant functional and morphological long-term sequelae. Subthreshold TTT can cause apoptosis in laser-induced CNV in rats.     

开展卫勤指挥员任职培训的教学实践和体会

近几年来,第二军医大学卫生勤务学系承担了大量卫勤指挥员的任职培训任务.通过几年的理论研究和实践摸索,在教学的组织、管理、实施、保障等方面积累了一些经验,获得了一些具体的体会.我们认为要做好卫勤指挥员的任职培训教学必须明确培训目标,科学制定教学方案,精心安排教学内容,做好施训教员的培训,并在教学中注重合理运用教学方法,特别是要做好下部队调研,切实提高教学实效.     

Enhancement of the intrinsic defecation reflex by mosapride, a 5-HT4 agonist, in chronically lumbosacral denervated guinea pigs.

The defecation reflex is composed of rectal distension-evoked rectal (R-R) reflex contractions and synchronous internal anal sphincter (R-IAS) reflex relaxations in guinea pigs. These R-R and R-IAS reflexes are controlled via extrinsic sacral excitatory nerve pathway (pelvic nerves), lumbar inhibitory nerve pathways (colonic nerves) and by intrinsic cholinergic excitatory and nitrergic inhibitory nerve pathways. The effect of mosapride (a prokinetic benzamide) on the intrinsic reflexes, mediated via enteric 5-HT(4) receptors, was evaluated by measuring the mechanical activity of the rectum and IAS in anesthetized guinea pigs using an intrinsic R-R and R-IAS reflex model resulting from chronic (two to nine days) lumbosacral denervation (PITH). In this model, the myenteric plexus remains undamaged and the distribution of myenteric and intramuscular interstitial cells of Cajal is unchanged. Although R-R and R-IAS reflex patterns markedly changed, the reflex indices (reflex pressure or force curve-time integral) of both the R-R contractions and the synchronous R-IAS relaxations were unchanged. The frequency of the spontaneous R and IAS motility was also unchanged. Mosapride (0.1-1.0 mg/kg) dose-dependently increased both intrinsic R-R (maximum: 1.82) and R-IAS reflex indices (maximum: 2.76) from that of the control (1.0) 6-9 days following chronic PITH. The dose-response curve was similar to that in the intact guinea pig, and had shifted to the left from that in the guinea pig after acute PITH. A specific 5-HT(4) receptor antagonist, GR 113808 (1.0 mg/kg), decreased both reflex indices by approximately 50% and antagonized the effect of mosapride 1.0 mg/kg. This was quite different from the result in the intact guinea pig where GR 113808 (1.0 mg/kg) did not affect either of the reflex indices. The present results indicate that mosapride enhanced the intrinsic R-R and R-IAS reflexes and functionally compensated for the deprivation of extrinsic innervation. The actions of mosapride were mediated through endogenously active, intrinsic 5-HT(4) receptors which may be post-synaptically located in the myenteric plexus of the anorectum.     

单发室性早搏中RT间期规律的分析

目的探讨室性早搏前后RT间期变化的规律。方法选取单发、有完全代偿间期的室性早搏心电图,测量室早及其前后相邻波群(简称室早前、室早、室早后)的RT间期,进行对比。对室早前心室舒张时间与室早RT间期变化的关系进行分析。结果RT间期由短到长的顺序为:室早<室早前<室早后。室早前心室舒张时间与室早RT间期无线性相关关系。结论室早时RT间期最短,室早后RT间期最长,这一变化规律与心室舒张时间无关。     

卡托普利对血管成形术后再狭窄作用的实验研究

目的探讨卡托普利对血管成形术后再狭窄的干预作用。方法SD雄性大鼠60只,分单损组、干预组和对照组。单损组采用改良导丝法制作大鼠颈动脉再狭窄模型。干预组将卡托普利研磨成粉状,生理盐水稀释配制成5mg/ml溶液,分别于制模前6 d开始按10 mg/(kg.d)剂量经灌胃针给予大鼠至术后各时间点。对侧颈总动脉作为假手术对照组。每组各时间点6只大鼠,于制模后1天、4天、7天、14天及28天原位灌注固定取材。根据HE染色标本情况,选血管形态结构完整的50个标本,进行HE染色,采用病理图像分析系统染色片进行形态计量分析。结果损伤后从第7天起新生内膜厚度和面积逐渐增加,到28天达峰值;与单损组比较,干预组血管壁三层厚度无显著差别,干预组第14、28天新生内膜面积显著减低。狭窄率于血管损伤后逐渐增加,到28天达峰值,与单损组比较,干预组在14天和28天狭窄率明显变小,各时间点内弹力板面积、外弹力板面积及重塑指数两组之间无显著差别。结论卡托普利减小大鼠颈动脉损伤后新生内膜面积及狭窄率,抑制新生内膜形成,但不改变内、外弹力板面积及重塑指数,不影响血管收缩性重塑。     

老年人颅脑外伤后缺血性脑卒中发作特点及治疗

目的探讨老年人颅脑外伤后缺血性脑卒中发作特点及个性化治疗方案。方法针对7例颅脑外伤后急性期出现缺血性脑血管病症状的老年患者，通过脑血管造影检查分析其发病原因并根据不同的脑血管特点决定治疗方案。结果大多数患者（6／7）受伤前已存在不同程度的颅内外血管狭窄、血管壁溃疡以及附壁血栓形成等改变，提示脑缺血发作主要与这些病变为基础的脑血流下降、血栓脱落等因素密切相关。而外伤后脑灌注降低、脑血管痉挛是脑缺血发作的诱发因素。结论老年人外伤后的缺血性脑卒中发作主要与原有的脑血管基础疾病有关，预防和治疗老年人外伤后缺血性脑卒中发作，应基于这些病变特征并选择个体化治疗方案。     

脑梗塞患者血清叶酸维生素B12浓度与同型半胱氨酸及血脂水平的研究

目的探讨本地区脑梗塞患者的血清叶酸、维生素B12（VitB12）与同型半胱氨酸（Hcy）水平及血脂水平的关系。方法应用全自动化学发光免疫法测定115例脑梗塞患者血清叶酸、维生素B12水平，采用荧光定量分析法测定血清同型半胱氨酸水平，采用免疫比浊法测定血脂水平。结果脑梗塞患者血清叶酸水平明显低于对照组（P〈0．001），血清Hcy及甘油三酯（TG）水平明显高于对照组（P〈0．01），而维生素B12及其余所测血脂指标与健康对照组无显著差异（P〉0．05）。结论即时监测血清叶酸、Hcy及TG水平，适当补充叶酸，可早期预防和及时治疗脑血管疾病，降低脑梗塞的发生率及复发率。     

64层螺旋CT在冠状动脉支架置入术后评估中的价值

目的:评价64层螺旋CT在冠状动脉支架置入术后复查中的临床价值。方法:采用64层螺旋CT对27例冠状动脉支架置入术后的患者(共47个支架)进行CT冠状动脉成像。观察支架及其支架血管和非支架血管的通畅性。结果:支架通畅43例,支架内狭窄3个、闭塞1个,支架前后血管狭窄25支(包括两近端狭窄4例),非支架血管狭窄26支。结论:64层螺旋CT比16层螺旋CT观察冠状动脉内支架优越,可作为冠状动脉支架置入术后效果随访观察和了解原有冠心病进展情况的重要手段。     

Nitric oxide and gamma-aminobutyric acid as regulators of neurogenesis in the brain of adult mammals: Models of seizure activity

New neurons are known to be generated in the brain of adult mammals throughout their entire life in the area of the lateral ventricles and the subgranular zone of the dentate gyrus. The regulatory mechanisms of neurogenesis are complex and poorly understood. Numerous studies performed during the last decade have shown that the intensity of generation of new cells in the germinative regions of the brain is significantly influenced by various environmental factors. Pronounced changes in neurogenesis were also found in the models of various pathologies of the central nervous system (such as neurodegeneration, brain ischemia, and epilepsy). This review is focused on the regulation of neurogenesis in the brain of adult mammals in the course of experimental epilepsy. The involvement of nitric oxide and gamma-aminobutyric acid in the regulation of the proliferation and differentiation of brain cells during seizure activity is discussed.     

改良的后腹腔镜肾囊肿去顶术

目的 评估改良的后腹腔镜肾囊肿去顶术(RLRC)的临床应用价值.方法 15例为在减压前完整游离囊肿壁后减压的传统后腹腔镜肾囊肿去顶,12例为术中先行囊肿减压的改良去顶术,两相比较手术时间和出血量.结果 用改良的手术方法可以明显缩短手术时间,但出血量相比较无明显差异.结论 改良后的后腹腔镜肾囊肿去顶术使操作更简单、便捷,并同样安全有效.