Systemic Antiinflammatory Corticosteroid Reduces Mechanical Pain Behavior, Sympathetic Sprouting, and Elevation of Proinflammatory Cytokines in a Rat Model of Neuropathic Pain

Background: Chronic pain models are commonly defined as either nerve-injury or inflammation models, but recent work suggests inflammatory processes are important in nerve injury-induced pain.

Methods: In the rat spinal nerve ligation model, the authors examined effects of systemic corticosteroid triamcinolone acetonide (TA) on the cytokine protein profile and sympathetic sprouting in the axotomized sensory ganglia, excitability of sensory neurons, and mechanical sensitivity.

Results: By postoperative day 3, marked increases (5- to 16-fold) in monocyte chemoattractant protein-1, growth-related oncogene (GRO/KC or CXCL1), and interleukin (IL)-6 were observed, whereas IL-4 and IL-2 levels fell more than fourfold. The increased cytokines and number of sympathetic basket formations in the sensory ganglia were reduced toward normal values by TA given starting at the time of injury. Interleukin-4 and IL-2 levels were not restored by TA. Systemic TA also reduced the firing rate and incidence of bursting activity, but not the overall incidence of spontaneous activity, in large- and medium-sized neurons. Mechanical hypersensitivity on postoperative day 3 was reduced by TA, and some effect could still be observed 4 days after cessation of TA. However, starting TA at day 7 was ineffective.     

阿片类药物依赖者立体定向脑深部核团毁损手术前患者心理症状特征

目的:了解主动要求立体定向脑深部核团毁损术治疗药物依赖的群体术前心理症状的特征。方法:选择2004-07/11自愿在沈阳军区总医院神经外科手术治疗的阿片类药物依赖连续病例34例。采用90项症状自评量表独立测试评估心理健康状况,计算机获得结果。与国内常模和国内燕殿学组、朱军红组、万萍组所测结果进行统计学分析。结果以“均值±标准差”表示,应用SPSS软件对测量结果进行t检验。结果:34例患者均完成量表测试,全部进入结果分析。①主动要求手术治疗的患者,多为32岁左右的男性已婚的个体经营者患者。依赖物质以海洛因为主;首吸年龄小;持续时间长;滥用方式多;复吸率高,并以心理依赖为主。②症状自评量表测查,总分中最高分374分、160分以上者23例占67.6%,平均分高于国内常模,差异有显著性[(38.29±4.08),(24.92±18.4),P<0.001]。阳性项目数最高分86分、43分以上者24例占70.6%,平均分高于国内常模,差异有显著性。③心理障碍总患病率高达91.2%。心理障碍因子分超出常模的构成比从高到低分别为:抑郁和躯体化、焦虑、强迫、敌对、精神病性和其他、偏执、恐怖以及人际关系。心理障碍显现强度的排列为,抑郁、敌对、强迫和其他、躯体化、焦虑、人际关系、偏执、精神病性以及恐怖。④与国内燕殿学组比较差异无显著性;与朱军红组比较,仅强迫因子差异有显著性;与万萍组所测结果比较,躯体、抑郁、焦虑、敌对、恐怖和精神病症状因子差异均有显著性。结论:阿片类药物依赖的患者术前心理障碍是普遍存在的临床问题。了解患者术前心理症状的特征,便于围手术期医学干预方法的选择。有利于对术后疗效做出科学的评价。     

外引流术后的白内障超声乳化手术

目的：探讨抗青光眼餐引流术后的白内障患眼进行超声乳化吸除术的手术入路，操作方式及临床效果。方法：避开功能性滤过泡，选择角巩膜隧道切口或透明角膜切口，瞳孔麻痹性散大时，做一个完美的直径约5mm的连续环形撕囊以补偿之；恰当处理虹膜后粘连后，在病理性小瞳孔下完成超声乳化手术；眼压失控者行青光眼白内障人工晶体植入三联术。结果：无后囊破裂，人工晶体全部囊袋内植入，术后1周视力≥0．5者20只眼（64．5％），0．1－0．4者8只眼（25．8％），＜0．1者3只眼（9．7％）。随访1－16个月，眼压均在20.55mmHg以下。结论：体外流术后的白内障患眼，超声乳化手术因其切口小，并发症少，不破坏功能性滤过泡，不损伤瞳孔，是目前各种手术方法中的最佳选择。     

催化光度法测定灵芝中微量锌

目的　研究催化光度法测定灵芝中微量锌。　方法　在非离子表面活性剂 Tween- 80存在下 ,于 p H9.5 0 NH3- NH4 Cl缓冲溶液中 ,Hg( )催化加速 Zn( )与 meso- 4 (4 -甲基 ,3-磺基苯基 )卟啉 (TTPS4 )的显色反应。　结果　 Zn( )与 TTPS4 、Tween- 80形成很稳定的三元配合物 ,其ε=3.86× 10 5,Zn( )浓度在 0 .0 0 5～ 0 .10μg/ m L,符合比尔定律 ,检出限为 0 .0 0 1μg/ m L。　结论　 Tween- 80对 Zn( )与 TTPS4 显色有增敏 ,而 Hg( )催化加速 Zn( )与 TTPS4 显色反应 ,应用本法可直接测定灵芝中的微量锌     

提高中医临床疗效的科学学检讨(连载三)

中医学的生命力在于临床疗效 ,社会对于中医学的需要也在于临床疗效。提高中医临床疗效的科学学研究 ,要以中医基础理论为依据 ,以理、法、方、药一脉相承的辨证论治为前提。造成中医临床疗效下降的问题在于“三个脱节” ,即中医学与自身文化基础脱节 ,中医临床与辨证论治脱节 ,中药与中医临床脱节。中医学正处于行将消亡的边缘 ,也处在新的突破的前夜。实事求是地进行科学、历史的反思 ,中医学完全有可能走出百年困惑 ,得到振兴和发展。     

切开复位内固定治疗髋臼骨折

目的:探讨切开复位内固定在治疗髋臼骨折中的临床应用价值。方法 :采用切开复位内固定治疗有移位的髋臼骨折共 15例。手术入路采用 Kocher- L angenbeck(K- L)入路 7例 ,髂腹股沟入路 3例 ,髂股加 K- L 入路 3例 ,三射线入路 2例。结果 :解剖复位 10例 ,满意 3例 ,差 2例。随访功能评分优 7例 ,良 3例 ,可 2例 ,差 3例。结论 :切开复位内固定已成为多数有移位髋臼骨折的治疗标准 ,L etournel分类对手术入路有很好的临床应用价值     

Dynamic observations on NK cell activity and IL-2 and IFNγ productionin vitro in patients on maintenance hemodialysis

Summary In order to study the immune function of patients on maintenance hemodialysis (MHD), we assayed NK cell cytotoxicity against K⁵⁶² targets in 40 patients on MHD, and the production of IL-2 and IFN in peripheral blood mononuclear cells (PBMC) after PHA stimulation, in contrast to those in normal controls. The results showed that NK cell activity and IL-2 and IFN levels were markedly lower in the patients than in the controls. Afeter a single dialysis, NK cell activity as well as IL-2 and IFN levels were elevated to different extent. But there was no significant change in patients after long-term dialysis. There was a positive correlation between the NK cell activity and IL-2 and IFN activity in the controls, but no such correlation was found in the patients on MHD. There was a positive correlation between the NK cell activity and IL-2 activity in patients after dialysis, suggesting that immune function were impaired in the patients on MHD, with a decline in the activity of NK cell and IL-2 and IFN, and a disorder of immune regulation cycle. These abnormal immune impairments in the patients could be partly corrected by hemodialysis. However, long-term hemodialysis is not much helpful in the improvement of patient’s immune function.     

Comparison of Marker Intervals and Number of Sib Pairs Used for Linkage Analysis on Simulated Nuclear Family Data

Using a two‐stage global scan design, we analyzed general population replicates 1 and 42 of the Genetic Analysis Workshop (GAW) 12 simulated data set using three methods: revisited Haseman‐Elston (HER), maximum likelihood variance estimation (ML), and variance components (VC). Three marker densities, 5‐, 10‐, and 15‐cM intervals, were examined in the first‐stage scan. We found that the 10‐cM interval appears to be the most cost‐effective approach in genotyping without sacrificing power when using a first stage significance level of 0.01. Subsequently, we performed the second‐stage scan at 1‐cM intervals for those putative positive regions identified in the first‐stage scan at a significance level of 0.01. We also compared the power to detect linkage using different numbers of sib pairs for a genome‐wide scan at a 10‐cM interval and found that power decreases nonlinearly as the number of sib pairs decreases. © 2001 Wiley‐Liss, Inc.     

椎管内占位病变的CT评价

本文回顾性分析了２８例椎管内占位病变（包括椎管内肿瘤２４例、蛛网膜囊肿２例、硬膜外脓肿和椎同盘突出各１例）的ＣＴ表现。着重讨论了造影剂增强ＣＴ的特征。大多数增强ＣＴ可显示肿块的轮廓，有助于肿块定位。室管膜瘤和星形细胞瘤的增强ＣＴ表现类似，但雪旺氏瘤、海绵状血管瘤和脓肿具有增强ＣＴ特征；同时还对脂肪瘤、脊膜瘤和蛛网膜囊肿的增强ＣＴ特征进行了探讨。增强ＣＴ定位困难时，ＣＴＭ可有很大的帮助。     

对侧网状巨细胞核对大鼠脊髓背表面电位的影响

以浅麻醉和麻痹大鼠为对象,利用计算机平均技术记录强电流刺激腓肠神经诱发的脊髓背表面电位(CDP),观察对侧网状三细胞核(NGC)微量注射L一谷氨酸钠,使神经细胞兴奋后对CDP的影响.实验发现,对侧NGC神经细胞兴奋后,Aβ和Aσ纤维引起的P_1波及Aσ和C类纤维引起的N_3波减小,C类纤维引起的P_2波明显减小,N_4 波消失.以上结果提示:对侧NGC对细纤维诱发的CDP成分有抑制作用.