下丘脑室旁核的Ⅰ组促代谢型谷氨酸受体在压力感受性反射调节中的作用

目的 探讨下丘脑室旁核(PVN)内的Ⅰ组促代谢型谷氨酸受体(mGluRI)在压力感受性反射中枢调节中的作用.方法 ①在清醒自由活动大鼠中,用脑部微量透析法和高效液相色谱法测定静脉注射苯肾上腺素诱发压力感受性反射时的PVN区谷氨酸含量的变化;②用mGluRⅠ的阻断剂MCPG或激动剂ACPD直接灌流PVN区,同时诱发压力感受性反射,并观察血压和心率的变化.结果 ①静脉注射苯肾上腺素诱发压力感受性反射时,PVN内的谷氨酸含量迅速升高到基础水平的(384.82±91.77)%(P＜0.01).②PVN区灌流mGluR Ⅰ阻断剂MCPG(2.5 mmol/L),同时诱发压力感受性反射,其血压升值明显减小(P＜0.01),心率降值明显增大(P＜0.05),导致压力感受性反射的敏感性(△HR/△MAP)明显增大(P＜0.05).③PVN区灌流mGluRⅠ激动剂ACPD(1 mmol/L)同时诱发压力感受性反射,其血压升值明显增加(P＜0.001),心率降值明显减小(P＜0.001),导致压力感受性敏感性明显降低(P＜0.05).结论 PVN内的mGluRⅠ在压力感受性反射的中枢调节中起抑制作用.     

FKN对外周血单个核细胞ERK1/2活化和TNF-α表达的影响及ERK1/2的临床作用

目的 探讨趋化因子(FKN)对单个核细胞细胞外信号调节激酶(extracellular signal-regulated kinase,ERK)1/2和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)表达的影响及ERK1/2在其中的作用.方法 抗凝血用Ficoll密度梯度离心法分离外周血单个核细胞.将每份提取的单个核细胞分为3组:空白对照组、FKN组、FKN+PD98059(ERK特异性阻断剂)组;分别应用Western印迹法和酶联免疫法检测各组单个核细胞中磷酸化ERK1/2及TNF-α的表达水平.结果 FKN诱导组磷酸化的ERK1/2和TNF-α表达较空白组显著增多(P<0.05);PD98059组磷酸化的ERK1/2和TNF-α表达较FKN组显著减少(P<0.05).结论 FKN-CX3CR1可能通过增加单个核细胞磷酸化ERK1/2和TNF-α的表达而促进动脉粥样硬化的进展,FKN可能是通过ERK1/2途径诱导单个核细胞TNF-α的表达.     

颈部多发性神经鞘瘤和合并脑膜瘤1例

患者,男,颈部无痛性肿物3个月伴吞咽不适感1周,于2008年12月收入院。入院查体：右侧胸锁乳突肌前上缘触及7．0cm×3．0cm大小、下缘触及2．0cm×1．8cm大小的肿物,左侧锁骨上触及3．0cm×2．5cm大小的肿物,质中等硬,边界清楚,活动度尚可。     

青年教师提高生理学教学效果探讨

青年教师已成为高等院校教学的主体,其教学水平的提高至关重要.结合教学经验,从备课、制作课件、课堂讲授、教学方法等几个方面浅议青年教师如何提高生理学教学水平.     

MK-801对清醒大鼠习得性LTP中海马DG区谷氨酸浓度的影响

目的 观察条件反射的建立和消退过程中,N-甲基-D-门冬氨酸(N-methy1-D-asparate,NMDA)受体的非竞争性抑制剂MK-801对自由活动大鼠海马齿状回(denmte gyms,DG)细胞外液中谷氨酸(GIutanaate,Glu)浓度的影响,并进一步探讨它们与习得性突触效应长时程增强(learning dependenatlong-term potentiadon,LD-LTP)和行为学习之间的关系.方法 该实验选用Wistar系雄性大鼠,随机分4组(每组8只):对照1组和实验1组在用脑部微量注射法往海马DG区分别注射Ringer液和MK-801的条件下,利用脑部微量透析法和高效液相色谱法测定海马DG区细胞外液中Glu浓度,同时利用慢性埋植电极技术测定海马DG区群体峰电位(populafion spike,PS.LTP形成的指标)幅值;对照2组和实验2组进行条件反射训练,每天训练前往DG区分别注射Ringer液和MK-801,测定DG区Glu浓度和Ps幅值,并观察大鼠行为正确反应率.将未进行处理前的Glu浓度和PS幅值分别定为100%.结果 对照1组:海马DG区微量注射Ringer液后,DG区内Glu浓度与注射前相比无明显变化(P＞0.05).实验1组:海马DG区微量注射60μmol/L的MK-801 1μL后,Glu水平减少到注射前的(30.67±17.76)%,与注射前相比差异有显著性(P＜0.01).对照2组:随着条件反射的建立,DG区Glu出现明显增加,增加到训练开始前的(275.19±11.17)%,与训练前相比差异有显著性(P＜0.001),随着条件反射的消退,Glu水平又逐渐回降,这与DG区PS幅值以及大鼠行为正确反应率的变化呈平行关系.实验2组:DG区微量注射MK-801,显著推迟条件反射的形成,而且条件反射形成时的PS幅值及Glu浓度的变化明显小于对照2组(P＜0.01).结论 NMDA受体参与谷氨酸(Glu)介导的海马DG区习得性LTP的形成过程,而且用MK-801阻断NMDA受体的作用可明显抑制突触前膜Glu的释放.     

蓝斑参与调节室旁核对心血管活动的作用

为探讨化学刺激室旁核对心血管活动的影响及蓝斑在这一效应中的作用 ,给乌拉坦和氯醛糖混合液麻醉的 Wistar系雄性大鼠室旁核微量注射 L-谷氨酸 ,观察了血压、心率和肾交感神经放电活动的变化以及用红藻氨酸损毁蓝斑对刺激室旁核效应的影响。另外 ,为进一步研究室旁核与蓝斑功能联系的机制 ,也观察了蓝斑核区微量注射血管升压素对心血管活动的影响。结果表明 :1室旁核内注射 L-谷氨酸引起血压下降、心率减慢和肾交感神经活动减弱 ;2损毁蓝斑后 ,刺激室旁核引起的心血管效应明显减弱 ;3蓝斑区注射血管升压素导致血压升高、心率加快、肾交感神经放电增加。提示 :1 L-谷氨酸兴奋室旁核抑制心血管活动 ;2室旁核的上述效应可能与交感神经紧张性降低有关 ;3蓝斑参与室旁核对心血管活动的调节过程 ;4血管升压素刺激蓝斑引起心血管活动加强。     

大剂量阿托伐他汀预防对比剂肾病

Objective To compare the efficacy of high and low dose atorvastatin on preventing contrast induced nephropathy (CIN) in patients underwent diagnostic and therapeutic coronary intervention. Methods All patients received atorvastatin 10 mg/d on the basis of hydrated therapy (n =100) and high dose group received additional atorvastatin 80 nag at 12 to 24 hours before procedure (n =50). Scr, Ccr, blood β2-M, urine NAG/Cr, and urine osmolality before and after the procedure were compared between the groups. Results Baseline demographic characteristics and nephropathy risk factors were similar between groups. Cer was significantly reduced while blood β2-M and uric NAG/Cr were significantly increased in low dose group (all P ＜ 0.05) . Blood β2-M in the high dose group was significantly lower than that in the low dose group at day 1 [(2.35±0.52) mg/L vs. (2.67±0.64) mg/L, P =0.008], day 3[(2.49±0.55)mg/L vs. (2.80±0.64) mg/L,P =0.011] and day 5[(2.29±0.53) mg/L vs. (2.56±0.66) nag/L, P = 0.026] post-procedure respectively; urine NAG/Cr in the high dose group was also significantly lower than that in the low dose group at day 1 [(1.19±0.30) U/mmol vs. (1.46±0.34) U/mmol, P ＜ 0.001], day 3 [(1.30±0.30) U/mmol vs. (1.59±0.33) U/mmol, P ＜ 0.001], and day 5 [(1.10±0.30) U/mmol vs. (1.34±0.35) U/mmol, P = 0.001] post-procedure respectively;Cer in the high dose group was significantly higher than that in the low dose group at day 1 [(73.69±20.99) mL/min vs. (65.19±18.72) mL/min,P =0.035], day 3[(64.04±15.82) ml/min vs. (56.79±14.50)ml/min,P =0.019] post-procedure respectively. Conclusion High dose atorvastatin use before angiography is superior than low dose atorvastatin on attenuating contrast induced renal dysfunction.     

直立倾斜试验对血管迷走性晕厥诊断的价值

目的：探讨直立倾斜试验对血管迷走性晕厥的诊断价值。方法：40例不明原因晕厥者，进行直立倾斜试验（tilt table test,TTT)，试验全程行心电，血压监护，结果：TTT诱发晕厥16例，阳性率40％（16／40），其中基础倾斜试验诱发晕厥3例，阳性率7．5％（3／40），发生严重反应5例，占诱发晕厥者的31．2％（5／16），结论：TTT对血管迷走性晕厥具有较好的诊断价值。虽为无创检查，但严重反应并不少见，应于试验前严格筛选病人，试验中及时对症处理，减少严重重反应发生。     

大剂量阿托伐他汀预防对比剂肾病

Objective To compare the efficacy of high and low dose atorvastatin on preventing contrast induced nephropathy (CIN) in patients underwent diagnostic and therapeutic coronary intervention. Methods All patients received atorvastatin 10 mg/d on the basis of hydrated therapy (n =100) and high dose group received additional atorvastatin 80 nag at 12 to 24 hours before procedure (n =50). Scr, Ccr, blood β2-M, urine NAG/Cr, and urine osmolality before and after the procedure were compared between the groups. Results Baseline demographic characteristics and nephropathy risk factors were similar between groups. Cer was significantly reduced while blood β2-M and uric NAG/Cr were significantly increased in low dose group (all P ＜ 0.05) . Blood β2-M in the high dose group was significantly lower than that in the low dose group at day 1 [(2.35±0.52) mg/L vs. (2.67±0.64) mg/L, P =0.008], day 3[(2.49±0.55)mg/L vs. (2.80±0.64) mg/L,P =0.011] and day 5[(2.29±0.53) mg/L vs. (2.56±0.66) nag/L, P = 0.026] post-procedure respectively; urine NAG/Cr in the high dose group was also significantly lower than that in the low dose group at day 1 [(1.19±0.30) U/mmol vs. (1.46±0.34) U/mmol, P ＜ 0.001], day 3 [(1.30±0.30) U/mmol vs. (1.59±0.33) U/mmol, P ＜ 0.001], and day 5 [(1.10±0.30) U/mmol vs. (1.34±0.35) U/mmol, P = 0.001] post-procedure respectively;Cer in the high dose group was significantly higher than that in the low dose group at day 1 [(73.69±20.99) mL/min vs. (65.19±18.72) mL/min,P =0.035], day 3[(64.04±15.82) ml/min vs. (56.79±14.50)ml/min,P =0.019] post-procedure respectively. Conclusion High dose atorvastatin use before angiography is superior than low dose atorvastatin on attenuating contrast induced renal dysfunction.     

冠心病介人检查治疗中心律失常并发症及其处理体会

冠状动脉造影及冠心病介入治疗是目前临床诊断和治疗冠状动脉病变的最佳手段,但术中可能并发各种类型的心律失常,其中以心室颤动、阵发性室性心动过速(室速)及窦性心动过缓(窦过缓)多见,且需及时处理.我室2年来在冠心病介入检查治疗中发生并处理心室颤动5例,室速20例,窦过缓125例,现将体会报道如下.