脊髓性肌萎缩症中运动神经元生存蛋白缺失抑制p53泛素化降解致其积累的研究

目的 探究脊髓性肌萎缩症（spinal muscular atrophy,SMA）中p53积累的分子机制。方法 构建运动神经元生存基因（Survival motor neuron,Smn）敲低的稳转小鼠运动神经元细胞系NSC34,采用蛋白质印迹和荧光定量PCR检测蛋白和基因的变化;用蛋白合成抑制剂放线菌酮（Cycloheximide,CHX）抑制蛋白合成,蛋白质印迹检测p53蛋白降解情况,采用免疫共沉淀检测p53与MDM2结合情况;采用免疫荧光检测小鼠脊髓组织运动神经元数量,运用流式细胞仪分析细胞周期的分布。结果 在Smn敲低的NSC34细胞中,p53蛋白水平显著增加,但是其基因水平未发生明显变化;当蛋白合成被抑制后,SMN缺失会抑制p53蛋白降解,p53积累后会调控下游MDM2表达显著增加,但是其与p53结合却显著减少;p-p53（Ser18）和acetyl-p53（K382）水平显著升高,K382乙酰化位点会影响p53泛素化结合,导致其泛素化被抑制;最终p53积累导致NSC34细胞和SMA小鼠脊髓组织中细胞周期阻滞和凋亡增加。结论 SMN蛋白缺失通过抑制p53泛素化降解途径导致其积累,进而引起细胞周期阻滞和凋亡。     

多巴胺对猕猴额叶随机延缓反应作业相关神经元活动的影响(英文)

在猕猴执行随机延缓反应作业的同时,观察了微电泳多巴胺及其受体阻断剂氟哌啶醇对额叶作业相关神经元自发放电活动和诱发反应的影响。在该作业中,延缓期在1～4秒之间随机变化,在延缓期动物必须高度注意黄灯信号的出现,如稍不注意就会导致操作错误。在反应期,动物要在1秒钟内作出放开杠杆的反应。在实验中,对109个作业相关神经元观察了多巴胺的效应,这些神经元在作业间期共表现出神经元反应134个。神经元反应多出现在延缓期(48个)和反应期(72个),约占反应总数的90%。有近60%的神经元(61/109)对多巴胺敏感,多巴胺对神经元的自发放电活动既有兴奋效应(21/61),又有抑制效应(40/61),但以抑制效应为主。在延缓期出现反应的神经元中有31个(31/48)对多巴胺敏感,多巴胺对神经元的诱发反应主要起抑制作用(23/31);在反应期出现反应的神经元中有44个(44/72)对多巴胺敏感,多巴胺也以抑制作用为主(32/44),即使神经元的放电活动减弱。对54个(54/61)多巴胺敏感神经元观察了氟哌啶醇的效应,氟哌啶醇的效应与多巴胺相反,并能阻断多巴胺的效应。形态学检查表明,多巴胺敏感性神经元主要分布在大脑额叶弓状沟上支的内侧部。本实验表明,在延缓期和反应期出现放电变化的额叶神经元半数以上都对多巴胺敏感,且以抑制效应为主。由于作业的这两个时期分别与注意和视觉指导下的运动有关,因此,在视-运动耦合以及注意等过程中,在大脑额叶有多巴胺敏感神经元参与,而且主要是参与神经元活动的抑制过程。     

Influence of spinal cord compression on the C3–C4 propriospinal neurons in cats

The C3-C4 propriospinal neurons (PNs) transmit motor signals to forelimb motoneurons. Stem axons of the PNs bifurcate in the same segments and send ascending axons to the lateral reticular nucleus (LRN) as well as descending axons to the cervical motor nucleus. After laminectomy of decerebrated cats, ascending axons were stimulated by tungsten electrodes placed in the LRN. The N1 descending incoming volleys via axon reflexes with a latency of approximately 1.5 ms (N1 potential) were recorded in the forelimb motoneuron pools at C8 segment. We compressed the spinal cord at C3 or C6 segment by 6 x 5 mm plastic material and analyzed amplitudes of the N1 potentials at C8 motoneuron pools. After spinal compression step by step until 3000 microm from the surface for 30 min at the C3 segment, the amplitude of N1 potentials decreased to approximately 39.7% of the control. On the other hand, the amplitude of N1 potentials changed little after the same compression of the C6 segment. The N1 potentials during compression of the C3 segment did not recover to the initial amplitude of 63.5% after decompression. It is concluded that activities of axons at C3 segment are more sensitive than those at C6 to compression of the spinal cord. We discuss the properties of the bifurcation of the stem axons and the central spinal cord injury.     

间置空肠肌黏膜瓣成形在贲门癌术后抗反流中的应用

目的寻找一种能有效对抗贲门癌术后反流性食管炎的消化道重建术式. 方法将62例贲门癌患者分为两组,实验组30例,贲门癌手术采用间置空肠附加肌黏膜瓣成形消化道重建;对照组32例,采用"常规"食管-残胃套叠吻合.应用同位素测定胃食管反流指数,24小时食管pH监测及临床反流症状评定方法进行对比分析. 结果同位素胃食管反流指数测定显示,实验组反流阳性率为0%,对照组为93.33%.24小时食管pH测定显示,实验组Demeester评分为2.01±2.21,对照组为103.40±91.35,两组比较差别具有显著性意义(P<0.01).反流临床症状评定结果实验组无1例出现反流症状,而对照组24例(75%)出现反流症状. 结论间置空肠肌黏膜瓣成形术式具有优异的抗反流功效,能有效地防止贲门癌术后反流性食管炎的发生.     

The Expression of Calcitonin Gene-related Peptide on the Neurons Associated Zusanli (ST 36) in Rats

Objective:To investigate the biochemical characteristic of the neurons associated Zusanli(ST 36)in the rat by using Alexa Fluor 594 conjugated cholera toxin subunit B(AF594-CTB)neural tracing and calcitonin gene-related peptide(CGRP)fluorescent immunohistochemical techniques.Methods:Four male Sprague Dawley rats were injected with AF594-CTB into the corresponding area of the Zusanli in the human body.After 3 surviving days,the rat's spinal cord and dorsal root ganglia(DRGs)at lumbar segments were dissected following perfusion with 4%paraformaldehyde,cut into sections,and then stained with CGRPfluorescent immunohistochemical method.Results:AF594-CTB labeled sensory neurons were detected in the L3-L6 DRGs with high concentration in L4 DRG,and the labeled motor neurons located in the dorsolateral and intermediate regions of laminaⅨfrom L3-L5 segments with high concentration at L4.Meanwhile,CGRPpositive neural labeling distributed symmetrically on both sides of DRGs,anterior and dorsal homs of spinal cord.In the AF594-CTB labeled neurons,37%sensory neurons and 100%motor neurons expressed CGRPpositive.Conclusion:These findings present the morphological evidence to demonstrate that the sensory and motor neurons associated Zusanli in the rat distributed with segmental and regional patterns,and contained CGRP-expression.     

温针灸治疗运动神经元病临床研究

目的:观察温针灸对运动神经元病(motor neurone disease,MND)的疗效及对患者日常生活活动能力(activities of daily living,ADL)的影响。方法:选取40例运动神经元病患者随机分为治疗组和对照组,对照组采用常规治疗,治疗组采用温针灸联合常规治疗,2周为1个疗程,3个疗程后评价疗效,并比较两组患者ADL评分与神经功能缺损评分。结果:治疗组有效率81.81%,对照组有效率50.00%,两组比较,差异有统计学意义(P0.05);两组治疗后ADL评分与神经功能缺损评分比较,差异有统计学意义(P0.05)。结论:温针灸治疗有助于改善患者的日常生活活动能力,提高生活质量。     

Retrograde (reverse) jejunal intussusception might not be such a rare problem: a single group’s experience of 23 cases

BACKGROUND: Retrograde (reverse) intussusception of the jejunum is thought to be a very rare occurrence, having been reported approximately 15 times (21 patients) in medical studies. A review of our own experience of >15,000 Roux-en-Y gastric bypass patients found 23 cases treated since 1996. This is the largest single-center report to date. METHODS: A chart review dating back to 1996 revealed 23 patients with retrograde intussusception involving the jejunum. Their charts were reviewed. A variety of data was reviewed to identify the risk factors for developing intussusception, as well as the presentation, findings, and treatment. RESULTS: We identified 23 patients with retrograde intussusception involving the jejunum. Of these 23 patients, 22 had undergone Roux-en-Y gastric bypass. One patient had undergone Roux-en-Y choledochojejunostomy. Of the 23 patients, 1 (4%) had a gastrojejunal intussusception and 22 (96%) jejunojejunal intussusceptions. All patients were women, with a median age of 32 years (range 20-50). The mean body mass index at gastric bypass was 45.2 kg/m2 (range 39.4-55). Of the 23 patients, 19 (83%) had undergone open and 4 (17%) laparoscopic gastric bypass. The median duration from gastric bypass to the diagnosis of intussusception was 51 months (range 6-288). Of the 23 patients, 8 (35%) presented with gangrene, perforation, or nonreducable obstruction, 9 (39%) had a spontaneous reduction, and in 6 (26%), the obstruction was successfully reduced at surgery. The treatment was surgical resection in 16 (70%) with 2 recurrences (12.5%), simple reduction in 2 (9%) with 100% recurrence, and plication in 5 patients (22%) with 2 recurrences (40%). CONCLUSION: Retrograde intussusception of the jejunum after gastric bypass is probably more common than previously believed. Although resection and revision of the area of intussusception appears to be effective, more information is needed about the treatment and possible prevention of this disorder.     

胆管空肠搭桥内引流治疗恶性胆道梗阻

目的：探索恶性胆道梗阻更安全简便的手术方法。方法：我院设计采用胆管空肠搭桥术治疗不能行根治术的恶性胆道梗阻病人25例,并与同期外引流组12例和传统内流20例比较。结果：搭桥组及外引流组比内引流组术后黄疸消退快,搭桥组术后不带引流管,生存期生活质量较高,优于外引流组。结论：认为胆管空肠塔桥术是一种简单,创伤小,安全性大的术式。     

低强度微波辐射对大鼠神经细胞死亡率影响的实验研究

目的 探讨低强度微波辐射对大鼠神经细胞死亡率的影响。方法 在对体外新生大鼠(0～1天)皮层神经细胞进行原代培养的基础上,以频率900MHz,功率密度分别为0．025mW／cm^2、0．05mW／cm^2、0．1mW／cm^2的低强度微波辐射4、8、12、16、20、24小时。检测细胞死亡率。结果 和对照组相比,0．05mW／cm^2功率密度组辐射12小时、0．1mW／cm^2功率密度组辐射8小时后均可引起神经细胞细胞死亡率增高,且随着辐射时间的延长,细胞死亡率也逐渐上升,0．025mW／cm^2功率密度组未见明显改变。结论 长期连续的低强度微波辐射对培养大鼠神经细胞存在损伤作用。     

全胃切除术后2种消化道重建术式患者消化道动力的变化分析

目的 对比分析全胃切除术后行食管空肠Roux-Y吻合术和单腔空肠间置术患者消化道动力的变化。方法 选取2010年1月至2011年6月辛集市第一医院行全胃切除术的126例患者作为研究对象,患者生存期均达6个月,根据全胃切除术后消化道重建方式分为观察组（n=63例）与对照组（n=63例）,另外设63例健康人作为健康组。对照组全胃切除术后给予单腔空肠间置术,观察组全胃切除术后给予食管空肠Roux-Y吻合术,健康组不施加干预措施。结果 观察组患者的体质量、每日进餐次数、每日进食量均低于对照组,差异有统计学意义（P<0.05）,两组均低于健康组,差异有统计学意义（P<0.05）。观察组患者出现上腹饱胀、倾倒综合征、嗳气的发生率明显高于对照组,差异有统计学意义（P<0.05）。结论 Roux-Y吻合术法营养状况的改善情况差于单腔空肠间置术,术后不适症状较多,应根据患者的具体情况选择重建方法,如果患者体质允许应以单腔空肠间置术作为首选。