基因芯片研究针刺人迎穴对SHR主动脉弓基因表达的影响

目的应用基因芯片观察针刺人迎穴对SHR主动脉弓基因表达的影响。方法将20只SHR大鼠随机分为模型组、人迎组,10只WKY大鼠作为空白组。人迎组大鼠双侧人迎穴进行针刺干预,并记录各组大鼠收缩压变化。4周后剪取大鼠主动脉弓,进行基因芯片检测。结果与模型组比较,人迎组大鼠收缩压显著降低(P0.05)。模型组与空白组相比,452个基因表达上调,245个基因表达下调;人迎组和模型组相比,261个基因表达上调,986个基因表达下调。KEGG通路分析显示在模型组VS空白组、人迎组VS模型组分别发现了12条、10条显著表达(P0.05)的差异通路。结论针刺人迎穴降压机制可能与调控高血压血管重构的细胞外基质受体相互作用通路及通路中的相关基因表达有关。     

The ESPAD Study: implications for prevention

The European Schools Project on Alcohol and other Drugs (ESPAD) was concerned with the substance use, beliefs, attitudes and risk factors among over 50,000 16-year-olds in 26 European countries. Based on this data, the present paper focuses on critical issues in prevention and uses a country-level analysis with focus on the extent that contextual and cultural factors interact with factors influencing the use of alcohol and other drugs. The results indicate that: (i) an emphasis on risks and dangers may be a poor prevention strategy since many young people do not believe the widely accepted dangers of certain forms of substance use (e.g. cigarette smoking); (ii) misperception of norms in relation to substance use, that is, the belief that use of alcohol and other drugs is more common than it actually is, emerged in most countries with the exception of Nordic countries; (iii) the correlation between perceived access to substances and actual use depended on the substance involved; correlations were strongest for cannabis but low for alcohol; (iv) the measure of problem behaviour was used in the ESPAD study (truancy from school), is correlated with substance use in a way that is opposite to that predicted in problem behaviour theory; and (v) there were no indications that the potential restraining factors that were examined in this study (involvement in athletics and leisure) acted in a way that prevented people from experimenting with drugs. The results of this analysis suggests that far from our having identified a core set of universal influences that act to determine substance use, the importance of cultural and contextual factors have been underestimated as has the importance of the specific substance involved.     

Evening administration of melatonin and bright light: Interactions on the EEG during sleep and wakefulness

Both the pineal hormone melatonin and light exposure are considered to play a major role in the circadian regulation of sleep. In a placebo- controlled balanced cross-over design, we investigated the acute effects of exogenous melatonin (5 mg p.o. at 20.40 hours) with or without a 3-h bright light exposure (5000 lux from 21.00 hours–24.00 hours) on subjective sleepiness, internal sleep structure and EEG power density during sleep and wakefulness in healthy young men. The acute effects of melatonin, bright light and their interaction were measured on the first day (treatment day), possible circadian phase shifts were assessed on the post-treatment day. On the treatment day, the evening rise in subjective sleepiness was accelerated after melatonin and protracted during bright light exposure. These effects were also reflected in specific changes of EEG power density in the theta/alpha range during wakefulness. Melatonin shortened and bright light increased sleep latency. REMS latency was reduced after melatonin administration but bright light had no effect. Slow-wave sleep and slow-wave activity during the first non-rapid eye movement (NREMS) episode were suppressed after melatonin administration and rebounded in the second NREMS episode, independent of whether light was co-administered or not. Self rated sleep quality was better after melatonin administration whereas the awakening process was rated as more difficult after bright light. On the post-treatment day after evening bright light, the rise in sleepiness and the onset of sleep were delayed, independent of whether melatonin was co-administered or not. Thus, although acute bright light and melatonin administration affected subjective sleepiness, internal sleep structure and EEG power density during sleep and wakefulness in a additive manner, the phase shifting effect of a single evening bright light exposure could not be blocked by exogenous melatonin     

Renal Kallikrein Excretion in Alcoholic Cirrhosis

Severe liver disease is often associated with renal hemodynamic changes, and these changes may involve vasoactive hormones. The vasodilatory renal kallikrein-kinin system has received little previous study in these patients. We measured urinary kallikrein in nine patients with alcoholic cirrhosis under rigid metabolic conditions and simultaneously evaluated renin, aldosterone and urinary prostaglandins. Plasma renin und aldosterone were generally increased as expected but urinary kallikrein was surprisingly diminished (13.3 ± 3.7 vs. 38.8 ± 11.1 SE, E.U./day. P < 0.05). despite adequate creatinine clearance (81 ± 9 ml./min.). Administration of prostaglandin inhibitors reduced urinary prostaglandin E by 72% and creatinine clearance by 56% but did not alter urinary kallikrein. Mineralocor-ticoid inhibition by spironolactone induced a natriuresis in four patients with ascites (from 1.4–140 mEq. Na⁺/day) but also failed to alter kallikrein. Thus, kallikrein excretion is paradoxically reduced and seemingly unresponsive to alterations in the prostaglandin and renin-aldosterone systems. If urinary kallikrein quantitatively reflects intrarenal kallikrein-kinin activity, the impairment in this vasodilatory system may mediate the altered renal hemodynamics of severe liver disease.     

Use of premedication for intubation in tertiary neonatal units in the United Kingdom

Background:  Endotracheal intubation and laryngoscopy are frequently performed procedures in neonatal intensive care. These procedures represent profoundly painful stimuli and have been associated with laryngospasm, bronchospasm, hemodynamic changes, raised intracranial pressure and an increased risk of intracranial hemorrhage. These adverse changes can cause significant neonatal morbidity but may be attenuated by the use of suitable premedication.
Aims:  To evaluate current practices for premedication use prior to elective intubation in UK tertiary neonatal units.
Methods:  Telephone questionnaire survey of all 50 tertiary neonatal units in the UK.
Results:  Ninety percent of units report the routine use of sedation prior to intubation and 82% of units routinely use a muscle relaxant. Morphine was the most commonly used sedative and suxamethonium was the most commonly used muscle relaxant. Approximately half of the units also used atropine during intubation. Seventy seven percent of units had a written policy for premedication. Ten percent of the units did not routinely use any sedatives or muscle relaxants for elective intubation.
Conclusions:  In comparison with data from a 1998 survey, our study demonstrated an increase in the number of units that have adopted a written policy for premedication use, and in the number routinely using premedication drugs for elective intubation. There remains little consensus as to which drugs should be used and in what dose.     

Quality of recovery from two types of general anesthesia for ambulatory dental surgery in children: a double-blind, randomized trial

Background:  Pediatric dental procedures are increasingly performed under general anesthesia because of the inability to cooperate, situational anxiety, or other behavioral problems. Volatile anesthetics have been associated with emergence delirium in children, whereas the use of propofol for anesthetic maintenance has been shown to reduce the incidence of emergence delirium after other types of surgeries. The aim of this study is to compare a sevoflurane-based anesthetic with a propofol-based technique as it relates to the incidence of emergence delirium and the quality of recovery after pediatric dental surgery, in patients who present with risk factors for perioperative behavioral issues.
Methods:  We prospectively collected data of 179 pediatric patients scheduled for ambulatory dental surgery using a double-blind and randomized trial design. Subjects were anesthetized following standardized protocols for either a sevoflurane- or a propofol-based technique. The incidence of emergency delirium, as measured by the Pediatric Anesthesia Emergence Delirium score, was the primary outcome. Secondary outcomes included the incidence of postoperative nausea and vomiting (PONV), number of nursing interventions in the recovery room, time to discharge readiness, and parental satisfaction.
Results:  We found no difference in the incidence of emergence delirium after both types of anesthesia. However, use of sevoflurane significantly increased both the risk of PONV and the number of postoperative nursing interventions. Discharge criteria were met about 10 min earlier in patients anesthetized with sevoflurane. Parental satisfaction was equally high with both anesthesia regimens.
Conclusions:  A propofol-based anesthetic technique did not lead to a lower incidence of emergence delirium after dental surgery in children but did result in significantly less PONV and fewer postoperative nursing interventions.     

The Effect of Castration and Androgen Replacement on Rat Pituitary Follicle Stimulating Hormone Investigated by Reversed-Phase High Performance Liquid Chromatography

Rat follicle stimulating hormone (rFSH) was analysed in extracts of rat anterior pituitary using a newly developed separation method of reversed-phase high performance liquid chromatography (RP-HPLC) and post-column detection of immunoreactivity (rFSH-IR) by radioimmunoassay (RIA) or immunoprecipitation with a specific anti-rFSH antibody. Good separation of rFSH was achieved on a Waters Radial-Peak 8MBC18 cartridge with a linear (60 min) gradient from 10-60% acetonitrile at constant 0.1% trifluoroacetic acid concentration. The elution profiles of radioiodinated purified rFSH [(125I)rFSH] as well as extracts of adult male and female rat pituitaries contained two main immunoreactive components (peaks 1 and 2) which eluted at 16-17 min and 21 min respectively. In the (125I)rFSH elution profile, the peaks of immunobinding corresponded to two major peaks of radioactivity. The male pituitary showed greater binding to anti-rFSH-serum of peak 1 and 2 eluate compared to female pituitary. At day 20 after orchidectomy, the amount of immunoreactive rFSH (rFSH-IR) increased in both peaks (by 30% in peak 1 and 180% in peak 2); however, the rFSH-IR level in peak 2 appeared to be more variable compared with that in peak 1. Subcutaneous implantation of 5 mg or 15 mg of dihydrotestosterone (DHT) at the time of orchidectomy prevented the post-castration elevation of rFSH-IR at 10 and 20 days after surgery. The precise nature and physiological significance of the two elution peaks are not clear at this time; however, only peak 2 showed immunoreactivity with anti-rLH-alpha-subunit antibody (AFP 87713681) and the elution time of peak 2 coincided with that of (125I) rLH-alpha subunit (AFP-7264 B).(ABSTRACT TRUNCATED AT 250 WORDS)     

EVIDENCE FOR DIFFERING DOPAMINERGIC ACTIVITY IN CHILDHOOD- OR ADULT-ONSET OBESITY

In order to investigate dopaminergic activity in two types of human obesity, childhood- and adult-onset, we have studied the responses of plasma TSH and prolactin to domperidone, a dopamine receptor antagonist, in 12 patients obese since early childhood, 12 patients with adult-onset obesity, and in 12 lean controls. All subjects were females. In childhood-onset obese patients the responses of plasma prolactin and TSH to antidopaminergic stimulation were lower than those of adult-onset obese patients and lean controls. Conversely, the stimulus elicited a normal response of plasma prolactin and an exaggerated response of plasma TSH in adult-onset obese patients. These data indicate the presence of differing dopaminergic tone in the two types of human obesity.     

Isolation,structure determination and synthesis of a novel tryptophan-containing heptapeptide (basic tryptophyllin) from the skin of Phyllomedusa rohdei

A novel tryptophyllin has been isolated from the methanol extracts of the skin of the South American frog Phyllomedusa rohdei. Its primary structure, as determined by chemical/enzymatic methods and by FAB mass spectrometry, is the following: Lys-Pro-Hyp-Ser-Trp-Ile-Pro-NH₂. This basic tryptophyllin has been synthesized in solid phase, in order to allow its complete pharmacological characterization.