托吡酯和丙戊酸钠治疗特发性全面性强直阵挛发作的临床疗效比较

目的:探讨中等剂量托吡酯(商品名:妥泰)200mg对特发性全面性强直阵挛(GTCS)发作的疗效。方法:64例GTCS患者分成三组,妥泰单药治疗21例,妥泰联合丙戊酸钠治疗22例,另外21例采用丙戊酸钠治疗作对照。结果:妥泰单药组及联用药组治疗GTCS有效例数明显高于单用丙戊酸钠组,差异显著(P<0.05);同时单用妥泰组与联用丙戊酸钠组疗效相近(P>0.05)。结论:妥泰治疗GTCS疗效优于丙戊酸钠,且妥泰单一用药与联用丙戊酸钠治疗疗效相近。     

Acupuncture at otoacupoint heart for treatment of vascular hypertension.

The immediate, short-term and long-term depressor effects, the immediate effects on cardiac functions in grade II and grade III vascular hypertension, and the effects on angiotensin II in grade III vascular hypertension by acupuncture at otoacupoint Heart were studied in 30 cases of vascular hypertensive patients. The immediate depressor effect of acupuncture at otoacupoint Stomach was also recorded for comparison. It was found that acupuncture at otoacupoint Heart produced marked immediate depressor effect, and the short-term effective rate was 100%, the long-term effective rate was 63.3%, as well as evident immediate effects on cardiac functional activities in grade II and grade III hypertension and marked effects on angiotensin II in grade III hypertension. Acupuncture at otoacupoint Stomach produced no depressor effect on vascular hypertension.     

横窦和窦汇的浅表解剖学标志

目的为神经外科手术准确定位横窦的下缘和窦汇确定出一个可靠的浅表解剖学标志。方法对10例经10%甲醛溶液固定的尸头标本进行逐步解剖,测量各相关解剖结构到横窦下缘的距离。结果实验所收集的数据表明在定位横窦下缘和窦汇时,上项线及枕外隆凸尖不是一个可靠的浅表解剖学标志。而以半脊肌附着点作为浅表解剖学标志比以上项线作为浅表解剖标志更准确、可靠。本组10例标本中,无1例的半脊肌附着点超过横窦下部边界3mm,并且它可以作为一个可靠的浅表解剖学标志用以定位接近中线部分的横窦。结论这些发现可以帮助神经外科医生在治疗后颅窝和颅颈接合处病变而进行的各种中线入路手术时更准确的定位横窦。     

凋亡调控因子在凝血酶诱导海马神经元凋亡中的变化

目的探讨凝血酶（TM）对海马神经元凋亡调控凶子Bcl-2、Bax及c-jun氨基末端激酶（JNK）表达的影响，阐明TM诱导凋亡的机制。方法海马神经元经40U／mLTM作用0h、6h、12h、24h、48h、72h后终止培养，应用免疫细胞化学方法检测Bcl-2及Bax蛋白表达，Western blot检测磷酸化JNK（P—JNK）及JNK蛋白表达。结果TM作用6h后，Bcl-2蛋白表达增加，12h后开始下降，到48h达到最低值（P〈0．01），72h后Bcl-2蛋白表达开始回升。TM作用6h后，Bax蛋白表达增加，随作用时间的延长，Bax蛋白表达水平逐渐上升，到48h达到最高值（P〈0．01）。Bcl-2／Bax比值逐渐降低，在48h达最低。TM作用0h时P-JNK蛋白无表达，6h后开始表达，与0h组比较差异存在显著性（P〈0．011，12h时达高峰（P〈0．01），并持续到24h，48h后逐渐降低。0h组可见有少量JNK蛋白表达，6h后JNK蛋白表达显著增加（P〈0．01），随TM作用时间的延长，JNK蛋白表达无明显变化。结论TM可能是通过抑制Bcl-2的表达，增强Bax的表达，降低Bcl-2和Bax的比值，激活JNK信号传导通路导致海马神经元凋亡。     

p38丝裂原活化蛋白激酶在糖尿病大鼠神经病理性痛中的作用

目的探讨p38丝裂原活化蛋白激酶（p38MAPK）在链脲菌素诱导的糖尿病大鼠神经病理性痛中的作用。方法雌性Wistar大鼠31只，3月龄，体重180～220g，随机分为3组：对照组（C组，n=10）、糖尿病神经病理性痛组（D组，n=11）和p38MAPK抑制剂组（Ⅰ组，n=10）。D组、Ⅰ组单次腹腔注射链脲菌素65mg／kg制备糖尿病模型。糖尿病模型制备成功后，Ⅰ组尾静脉注射p38MAPK抑制剂SB203580 0．5mg／kg，1次／周，连续4周；C组和D组尾静脉注射等体积的生理盐水。给药4周后，测定机械缩足反应阈值（MWT）、左侧坐骨神经传导速率（NCV）、背根神经节（DRG）和脊髓的磷酸化p38MAPK水平。结果与C组比较，D组、Ⅰ组MWT下降，NCV减慢，伴有脱髓鞘现象，DRG和脊髓的磷酸化p38MAPK水平升高；与D组比较，Ⅰ组MWT升高，NCV增快，脱髓鞘程度减轻，DRG和脊髓的磷酸化p38MAPK水平下降。结论p38MAPK信号转导通路参与了糖尿病大鼠神经病理性痛的形成。     

Association of the polymorphism in manganese superoxide dismutase gene with diabetic retinopathy in Chinese type 2 diabetic patients

OBJECTIVE: To investigate the association of the polymorphism in manganese superoxide dismutase (Mn-SOD) gene in Chinese type 2 diabetic patients with diabetic retinopathy. METHODS: The Ala(-9)Val polymorphism of the Mn-SOD gene was determined by polymerase chain reaction and direct sequencing in 198 normal control subjects and 264 patients with type 2 diabetes mellitus, among them there were 139 non-diabetic retinopathy (NDR) subjects and 125 subjects with diabetic retinopathy (DR). RESULTS: There was no statistic difference in the frequencies of VV genotype and V allele between the type 2 diabetic group and the control group. However, the frequencies of VV genotype and V allele were significantly higher in the DR group than that in the NDR group (chi-square (2)=5.015, P=0.025?chi-square (2)=10.253, P=0.001),but there was no statistic difference in the NDR group compared with the control group (P > 0.05). The presence of V allele was shown to be associated with diabetic retinopathy (OR=1.96, 95%CI: 1.29-2.97). Furthermore, the subjects carrying the VV genotype had lower serum Mn-SOD level (P=0.025) and had a tendency of higher total serum SOD activity, but this tendency had no statistic significance. CONCLUSION: The Ala(-9)Val polymorphism in the Mn-SOD gene may not be related to the etiology of type 2 diabetes, but it seems to contribute to the development of diabetic retinopathy in Chinese type 2 diabetic patients.     

Safety and efficacy of oral nemonoxacin versus levofloxacin in treatment of community-acquired pneumonia: A phase 3, multicenter,randomized, double-blind,double-dummy,active-controlled,non-inferiority trial

Background/Purpose

Nemonoxacin is a novel nonfluorinated quinolone with excellent in vitro activity against most pathogens in community-acquired pneumonia (CAP), especially Gram-positive isolates. The purpose of this study was to assess the efficacy and safety of nemonoxacin compared with levofloxacin in patients with CAP.

131I治疗对Graves''''病患者近期红细胞免疫功能的影响

目的观察131I治疗对Graves'病(GD)患者红细胞免疫功能(EIF)的影响.方法检测并比较56例GD患者经131I治疗前及治疗后1周、1月、3月、6月和12个月时血清TT3、TT4、TSH、FT3、FT4、TSH以及红细胞C3b受体花环率(RBC-C3bRR)、红细胞免疫复合物花环率(RBC-ICR),45例健康成人作为对照组.结果 131I治疗后3月、6月和12月,GD患者TT3、TT4、FT3、FT4、RBC-C3bRR较治疗前明显下降,TSH和RBC-ICR较治疗前明显升高;RBC-C3bRR与TT3、TT4、FT3、FT4水平呈负相关,RBC-ICR与TT3、TT4、FT3、FT4水平呈正相关.结论131I治疗能增强机体红细胞免疫功能;EIF与甲状腺激素水平之间存在显著相关性,其检测可作为GD病人免疫状态、疗效评价指标.     

败血症休克大鼠血管L-精氨酸/一氧化氮途径的变化

目的:观察败血症休克大鼠主动脉内膜、中膜和外膜一氧化氮合成途径的改变。方法:雄性Wistar大鼠盲肠结扎并穿孔复制败血症休克模型,分别测定假手术组、早期休克组和晚期休克组大鼠主动脉内膜、中膜和外膜的亚硝酸盐(NO^-₂)含量、一氧化氮合酶(NOS)活性及L-精氨酸(L-Arg)转运;免疫组化染色检测诱导型一氧化氮合酶(iNOS)在主动脉各层的分布。结果:早期及晚期败血症休克大鼠主动脉内膜产生的NO^-₂含量、NOS活性及L-Arg转运速率均低于假手术组,而中膜和外膜的NO^-₂、NOS活性及L-Arg转运速率则显著高于假手术组,外膜增加的程度尤为显著。免疫组织化学染色显示,败血症休克时血管中膜和外膜尤其是外膜iNOS阳性染色明显较强。结论:败血症休克时血管内膜NO合成受到抑制,而中膜和外膜NO合成显著增强,这一改变与休克状态下血管中L-Arg转运、iNOS表达及其活性的变化有关。     

心血管组织钙化时内源性硫化氢系统下调

目的：观察心血管组织钙化时内源性硫化氢生成系统(CSE/H2S)的变化，以探讨内源性硫化氢在心血管组织钙化中的作用及血管钙化的细胞分子机制。方法：在维生素D3 (Vit D3)和尼古丁(nicotine)诱导大鼠血管钙化模型上，测定钙含量、［45Ca2+］沉积及碱性磷酸酶（ALP）活性判断心血管钙化程度,采用生化法测定血浆、心肌组织和主动脉H2S含量及CSE活性，半定量RT-PCR方法测定心血管组织CSE mRNA水平。结果：钙化组大鼠心肌组织钙含量较对照组高3.8倍,主动脉钙含量、［45Ca2+］ 沉积及ALP 活性分别较对照组高6.8倍、1.4倍和 1.9倍（P＜0.01）；钙化组大鼠血浆H2S含量较对照组低39%（P<0.01），心肌和主动脉组织的 H2S含量也分别较对照组低39%和31%，CSE mRNA表达也分别低28％和36％（P<0.01），CSE活性分别低56%和53%(P<0.01)。结论：钙化心血管组织CSE/H2S通路受抑制，内源性H2S生成减少。