妊娠期高血压疾病对新生儿凝血功能、NSE及PCT水平的影响

［摘要］ 目的探讨妊娠期高血压疾病（hypertensive disorder complicating pregnancy,HDCP）对新生儿凝血功能、神经元特异性烯醇化酶（neuron-specific enolase,NSE）及降钙素原（procalcitonin,PCT）水平的影响。 方法以重症监护病房（intensive care unit,ICU）收治的HDCP患者分娩的新生儿592例为观察对象,并根据产妇病情严重情况将新生儿分为3组：A组（重度子痫前期,112例）、B组（轻度子痫前期,197例）、C组（HDCP,283例）,选取同期未患有HCDP的产妇所分娩的新生儿500例为对照组。于生后2 h检测各组新生儿凝血功能指标［凝血酶原时间（prothrombin time,PT）、活化部分凝血激酶时间（activated partial thromboplastin time,APTT）、纤维素原（fibrinogen,FIB）、D-二聚体（D dimer,D-D）、血小板计数（platelet count,PLT）、纤维蛋白原降解产物（fibrinogen degradation product,FDP）］、NSE及PCT水平,并进行组间比较。分析各指标与HDCP病情严重程度的相关性。 结果A、B、C及对照组中各指标水平比较差异均有统计学意义（P＜0.01）。相关性分析结果显示,PT、APTT、D-D、FDP、PCT及NSE水平与HDCP病情严重程度呈正相关,而FIB、PLT水平与HDCP病情严重程度呈负相关（P＜0.05或P＜0.01）。 结论HDCP易导致新生儿凝血功能障碍,使新生儿血液处于低凝和继发性纤溶亢进的状态,并增加新生儿脑损伤及感染发生风险。孕妇病情越严重,新生儿越易导致凝血功能障碍及脑损伤。     

鲑鱼降钙素在预防人工股骨头置换术后假体无菌性松动的临床应用研究

目的：探讨鲑鱼降钙素在预防人工股骨头置换术后假体无菌性松动的临床应用效果。方法通过随访江门市五邑中医院骨伤科二区2010年1月至2011年1月146例人工股骨头置换术后患者,按照随机数字表法分为对照组和治疗组,各73例,对照组每天口服钙剂片（钙尔奇D,每片含元素钙600 mg,含维生素D 125u）;治疗组在对照组的基础上应用鲑鱼降钙素（密盖息50 u）,每日皮下注射一次,连续治疗6个月。两组均分别于术前、术后4、8、12和24周检测假体周围感应区（ ROI）骨密度（BMD）;于术前及术后4、12、24周行血清骨代谢指标检测：骨钙素（BGP）、I型胶原C端异构肽（β－CTX）,通过测量术后随访过程中假体周围骨密度、骨代谢和生化指标与术前上述指标对比,进行临床分析。结果术后24周,实验组假体周围局部感应区BMD增加近5％,而对照组假体周围局部感应区BMD下降了6％,两组比较有显著性差异（ P＜0．01）;骨代谢指标中,术后24周实验组的BGP、β－CTX稍有下降,但组内无显著性差异（ P＞005）,这些指标与对照组比较差异显著（ P＜0．05或P＜0．01）。结论鲑鱼降钙素（密盖息）联合基础治疗,能显著提高人工股骨头假体周围的骨量,是预防无菌性松动的有效方法之一,值得推广。     

Peptidergic innervation and the nicotinic acetylcholine receptor in the primate basal nucleus

Peptidergic innervation and localization of the neuronal nicotinic acetylcholine receptor (nAChR) was studied in the basal forebrain of Macaca fascicularis in order to provide microstructural proofs for the theory ( 1 ) that calcitonin gene-related peptide (CGRP) is responsible for the maintenance of the acetylcholine receptor. Distribution and localization of five neuropeptides, namely substance P (SP), CGRP, neuropeptide Y (NPY), vasoactive intestinal polypeptide (VIP) neurotensin (NT), and the neuropeptides parvalbumin (PV) and the α-bungarotoxin- (α-BTX-) binding protein was studied by means of light- and electron microscopic pre-embedding immunocytochemistry. Immunohistochemical double staining revealed that large cholinergic principal nerve cells in the basal forebrain, corresponding to cell group Ch4 constituting Meynert’s basal nucleus (BNM), and exerting intense choline acetyltransferase (ChAT) immunoreactivity, are synaptically innervated by axons displaying CGRP immunoreactivity. While SP, NPY, PV and CGRP establish dense networks in BNM, innervation by NT and VIP is sparse. Biotinylated α-BTX visualizes beaded axons that surround dendrites and perikarya of cholinergic principal cells. Electron microscopic organization of the neuropil in BNM is characterized by a glomerular (or rather cartridge-like) arrangement of axons surrounding dendrites of non-cholinergic principal nerve cells. At least one of the axons establishing the glomerulus (cartridge) exerts CGRP immunopositivity while α-BTX-immunopositive axons, presynaptic to dendrites of principal cells, are attached to the glomeruli (cartridges) from outside. As α-BTX-binding indicates localization of the α7 subunit of the neuronal nAChR, the microtopographical arrangement supports the idea that, in a manner similar to that in the neuromuscular junction, CGRP might contribute to the maintenance of nAChR also in BNM. Our results suggest that presynaptic nAChR-s are involved in the regulation of acetylcholine release from a feed-forward amplification mechanism of cholinergic principal cells of BNM.     

成年大鼠脑底动脉环含NPY、VIP、SP和CGRP神经的分布

本文应用免疫组织化学(ABC)方法,观察了含NPY、VIP、SP、CGRP神经在成年大鼠完整脑底动脉环的分布,并在免疫组化染色标本上,将神经依其走行分为三种类型,采用交点计数法,分别计数各类纤维的密度,定量分析动脉环各段血管上的四种含肽神经。结果表明,1.在成年大鼠脑底动脉环上,四种含肽神经的密度大小次序是含NPY、VIP、CGRP、SP神经;四种含肽神经在动脉环吻侧的密度大于尾侧。2.在Ⅰ、Ⅱ类纤维,四种含肽神经的密度差异在动脉环多数血管段上不明显;在Ⅲ类纤维,含NPY和VIP、含CGRP和SP神经的密度接近,含NPY和VIP神经的密度明显大于含CGRP和SP神经。3.在多数血管段上,含NPY和含VIP神经的Ⅰ类纤维的密度和Ⅱ类纤维接近,Ⅲ类纤维的密度在动脉环吻侧大于Ⅰ、Ⅱ类纤维,向尾侧逐渐和它们接近。各段血管上,含SP和CGRP神经的Ⅲ类纤维的密度较Ⅰ、Ⅱ类纤维小,Ⅰ类纤维和Ⅱ类纤维的密度接近。4.含NPY、VIP神经Ⅰ、Ⅱ类纤维在动脉环吻侧的密度和尾侧接近,Ⅲ类纤维的密度从吻侧到尾侧逐渐降低。含SP和CGRP神经三种类型纤维在吻侧的密度均高于尾侧。5.在大脑中动脉延伸过程中,含NPY和含VIP神经的密度下降,尤以Ⅲ类纤维密度降低明显。含SP和CGRP神经仅少量分布于MCA近侧段。     

Oral multiple w/o/w emulsion formulation of a peptide salmon calcitonin: in vitro-in vivo evaluation

BACKGROUND: Salmon calcitonin (sCT) is a polypeptide hormone consisting of 32 amino acid residues (MW approx. 3400 Da), which can be used successfully for the treatment of osteoporosis, Paget's disease and hypercalcaemia. Only nasal and parenteral preparations of sCT are currently available, and as injections are poorly accepted by patients, nonparenteral preparations for oral, rectal and nasal administration are highly desirable. However, oral sCT is poorly bioavailable, being susceptible to enzymatic degradation in the gastrointestinal tract. OBJECTIVES: To design a formulation of sCT suitable for oral use. METHOD: A water/oil/water (w/o/w) type multiple emulsion formulation was designed for oral application of sCT. sCT was placed in the inner water phase, and a protease inhibitor, aprotinin, was included in the outer water phase of this system to investigate the influence of protease inhibitors in the presence of sCT. The effectiveness of the formulation was evaluated in vitro by placing emulsion samples in a dialysis medium and in vivo by using a rat model. RESULTS: Incorporating sCT in the inner aqueous phase of a w/o/w emulsion appears to protect the peptide from enzymatic degradation. sCT was further protected by incorporating the protease inhibitor, aprotinin, in the outer aqueous phase. CONCLUSION: w/o/w emulsion formulations appear to be promising carrier systems for peptide-protein drugs.     

Local anesthetics inhibit veratridine-induced secretion of calcitonin gene-related peptide (CGRP) from cultured rat trigeminal ganglion cells

Secretion of calcitonin gene-related peptide (CGRP) was studied with the model system of dispersed adult rat trigeminal ganglion cells. Veratridine stimulated secretion of CGRP immunoreactivity. Tetrodotoxin and local anesthetics inhibited veratridine-stimulated peptide secretion. These observations implicate sodium channels in CGRP secretion and are consistent with a role for the peptide as an extracellular neuromodulator in the sensory nervous system.     

Light and electron microscopic studies of calcitonin gene-related peptide-like immunoreactive neurons and axon terminals of the nucleus of the tractus solitarius of the rat

This study was an examination of the ultrastructural characteristic features of calcitonin gene-related peptide (CGRP)-like immunoreactive neurons and their axon terminals in the nucleus of the tractus solitarius of the rat. Some axon terminals were identified as receiving synaptic inputs from non-immunoreactive axon terminals. This may suggest that part, if not all, CGRP containing afferents are affected presynaptically by other afferents.     

56例老年腰背痛临床治疗分析

目的观察6周的抗骨质疏松药物治疗老年人腰背疼痛的效果,探索较好的治疗老年腰痛的方法。方法选择2006年1月～2009年7月期间吴江市第二人民医院收治的60岁的腰背疼痛患者,使用鲑降钙素、阿法骨化醇、钙剂以及康复锻炼等综合治疗,6周为1个疗程,治疗2周及6周后,观察腰背疼痛缓解的效果,与治疗前对比。结果治疗2周后,本组56例,显效5例(占8.9%),有效45例(占80.4%),无效6例(占10.7%),总有效率为89.3%。治疗6周后,本组56例,显效14例(占25%),有效39例(占69.6%),无效3例(占5.4%),总有效率为94.6%。绝大部分患者在治疗1周后疼痛就有明显改善。结论由于老年人腰背疼痛与骨质疏松有密切相关,联合应用鲑降钙素、阿法骨化醇、钙剂以及康复锻炼等综合治疗,是一种较好的治疗老年人腰背疼痛的方法。