THE MECHANISM OF ACUPUNCTURE AND CLINICAL APPLICATIONS

This study presents the result of the studies explaining the effects of acupuncture on various systems and symptoms. It has been determined that endomorphin-1, beta endorphin, encephalin, and serotonin levels increase in plasma and brain tissue through acupuncture application. It has been observed that the increases of endomorphin-1, beta endorphin, encephalin, serotonin, and dopamine cause analgesia, sedation, and recovery in motor functions. They also have immunomodulator effects on the immune system and lipolitic effects on metabolism. Because of these effects, acupuncture is used in the treatment of pain syndrome illnesses such as migraine, fibromyalgia, osteoarthritis, and trigeminal neuralgia; of gastrointestinal disorders such as disturbance at gastrointestinal motility and gastritis; of psychological illnesses such as depression, anxiety, and panic attack; and in rehabilitation from hemiplegia and obesity.     

动脉粥样硬化大鼠弓状核内β－内啡肽免疫反应阳性细胞的变化

用免疫细胞化学ＰＡＰ法和计算机图象分析技术，对动脉粥样硬化大鼠下丘脑弓状核β－内啡肽免疫反应阳性细胞的变化进行半定量研究。结果发现；动脉粥样硬化大鼠的下丘脑弓状核内β－ＥＮＤ阳性细胞数量增加，实验组和对照组在单位剖面弓状核内，阳性细胞数分别为２９．１±５．１和１５．５±４．２个。计算机图象分析其阳性细胞的积分光密度，实验组和对照组分别为０．１１４４６±０．０５１３和０．０８３３０±０．０４１６，经统计学处理，两组之间阳性细胞和ＩＯＤ都具有显著差异（Ｐ＜０．０５）。本文提示：下丘脑弓状核内β－ＥＮＤ样阳性神经元对动脉粥样硬化的形成和／或调控过程可能有一定影响。     

Study of naloxone in normal awake man: Effects on spinal reflexes

The purpose of this work was to study the effects of naloxone (0.8 mg, 3 cm³i.v.) compared with a placebo (9% NaCl serum, 3 cm³i.v.) on spinal reflexes: monosynaptic (H reflex), polysynaptic tactile (PSR, RII) and nociceptive (PSR, RIII) in awake normal human subjects.The H reflex was significantly facilitated (+16%) whereas no significant variation was noted on PSR, RII and PSR, RIII responses. The excitatory action of naloxone appeared by the 2nd-3rd min following the injection, reached a maximum towards the 7–10th min, and decreased slightly during the end of the session. No significant variation in the above parameters was ever observed with the placebo.The nature of the excitatory effect of naloxone on monosynaptic reflexes and the functional implications of these results are discussed.     

二醋吗啡成瘾者红细胞阿片受体与G蛋白耦联状态的改变

用功能大分子复合体表观靶体积幅射失活法,比较二醋吗啡(海洛因)成瘾者,非吸毒志愿者及成功戒毒3个月以上者,其红细胞阿片受体与G蛋白耦联状态的异同. 结果表明,对照组,成瘾组和康复组的阿片μ-受体复合体的大小(表观分子量)依次为： (347±2) u(n=11); (228±5) u(n=16)和(279±11) u(n=9). 成瘾组明显低于对照组(P<0.01); 值得注意的是康复组虽然明显低于对照组(P<0.01),但明显高于成瘾组(P<0.01). 上述3组的阿片δ-受体复合体的大小(表观分子量)则分别为：(308±4) u(n=11), (224±4) u(n=16)和(299±7) u(n=9). 成瘾组明显低于对照组(P<0.01); 同样值得注意的是康复组明显高于成瘾组(P<0.01), 而且非常接近对照组(P>0.05). 结果提示：(1) 二醋吗啡成瘾时红细胞阿片μ-和δ-受体均可能与G蛋白发生解耦联现象; (2) 这种现象在红细胞是可逆转的.     

Changes in the states of opioid receptors coupled to G proteins in the erythrocytes of diamorphine addicts 1

用功能大分子复合体表观靶体积幅射失活法,比较二醋吗啡（海洛因）成瘾者,非吸毒志愿者及成功戒毒３个月以上者,其红细胞阿片受体与Ｇ蛋白耦联状态的异同．结果表明,对照组,成瘾组和康复组的阿片μ－受体复合体的大小（表观分子量）依次为：（３４７±２）ｕ（ｎ＝１１）;（２２８±５）ｕ（ｎ＝１６）和（２７９±１１）ｕ（ｎ＝９）．成瘾组明显低于对照组（Ｐ＜０．０１）;值得注意的是康复组虽然明显低于对照组（Ｐ＜０．０１）,但明显高于成瘾组（Ｐ＜０．０１）．上述３组的阿片δ－受体复合体的大小（表观分子量）则分别为：（３０８±４）ｕ（ｎ＝１１）,（２２４±４）ｕ（ｎ＝１６）和（２９９±７）ｕ（ｎ＝９）．成瘾组明显低于对照组（Ｐ＜０．０１）;同样值得注意的是康复组明显高于成瘾组（Ｐ＜０．０１）,而且非常接近对照组（Ｐ＞０．０５）．结果提示：（１）二醋吗啡成瘾时红细胞阿片μ－和δ－受体均可能与Ｇ蛋白发生解耦联现象;（２）这种现象在红细胞是可逆转的．     

Prolonged Receptor Blockade by Opioid Receptor Probes

Opioid receptor interactions of morphinan-type opioids derivatized at the C-6 carbon were investigated. The compounds, designed as probes for studying opioid receptors, were characterized with regard to affinity for the rat brain mu receptor by competition with tritium-labeled dihydromorphine (³H-DHM). All compounds were also screened for prolonged receptor blockade by preincubation of rat brain membranes with the compounds alone, followed by extensive washing, and incubation with ³H-DHM. The apparent dissociation profiles of congeners with prolonged blockade were further studied in the presence and absence of physiological concentrations of salts. Under conditions that completely dissociate the parent opioids, naltrexone, naloxone, and oxymorphone, the derivative l-(N-fluoresceinyl naltrexone thiosemicarbazone (6-FNX) and the opioid-steroid hybrids naloxone estrone azine (N-EH) and androstene bisoxymorphone azine (O-AD-O) showed more persistent receptor blockade than the bivalent opioid naloxonazine (NAz). Neither chemical reactivity nor a bivalent opioid structure was found to be a prerequisite for prolonged receptor blockade.     

Progressive central hypovolaemia in man—resulting in a vasovagal syncope?

Summary. Hypotensive functional haemorrhage induced by venous pooling of blood in the legs has been reported to be characterized by a vasovagal reaction. In the present study these observations were extended by determination of the hormonal profile developed during progressive central hypovolaemia and an emotionally induced vasovagal syncope. In six subjects venous pooling resulted in normotensive central hypovolaemia, in one subject hypotensive central hypovolaemia was induced, and one subject experienced an emotionally induced vasovagal syncope. During normotensive central hypovolaemia heart rate increased from 58 ± 4 to 76 ± 4 beats min^-1 (P<0·05) and cardiac output fell from 6·1 ± 0·4 to 4·1 ± 0·21 min^-1. Pulse pressure and central venous pressure decreased from 64 ± 4 to 53 ± 4 mmHg, and from 8 ± 2 to 3 ± 2 mmHg, respectively. Adrenalin and noradrenalin increased from 87 ± 10 to 120 ± 20 pg/ml and from 196 ± 33 to 370 ± 50 pg/ml, respectively. Angiotensin II increased from 13 ± 4 to 36 ± 6 pg/ml and aldosterone from 63 ± 9 to 180 ± 27 pg/ml. In hypotensive central hypovolaemia the decrease in mean arterial pressure was accompanied by a decrease in heart rate and increments in the plasma concentrations of pancreatic polypeptide, indicating increased vagal activity and β-endorphin, while plasma noradrenalin was unchanged. In emotionally induced syncope heart rate decreased to cardiac arrest for 13 s, associated with increments in the plasma concentrations of pancreatic polypeptide and β-endorphin. It is concluded (1) that normotensive functional haemorrhage in man is associated with increased sympathetic activity and (2) that the qualitatively similar observations obtained during an emotionally and a hypovolaemic-induced hypotensive episode indicate that the hypotensive functional haemorrhage is characterized by a vasovagal reaction.     

出血性中风患者血浆及脑脊液中β－内啡呔和强啡呔含量的变化

测定了１０例急性脑出血和８例急性蛛网膜下腔出血患者血浆及脑脊液（ＣＳＦ）中β－内啡呔（β－ＥＰ）和强啡呔（ＤｙｎＡ）的含量。结果脑出血组血浆和ＣＳＰ中β－ＥＰ和ＤｙｎＡ含量均显著增高；蛛网膜下腔出血组ＣＳＦ中β－ＥＰ和ＤｙｎＡ增高，血浆中仅β－ＥＰ含量增高，提示这两种内源性阿片肽参与了出血性中风的病理生理过程，并可能是加重其继发性中枢神经系统损害的因素之一。     

Emotional numbing: A possible endorphin-mediated phenomenon associated with post-traumatic stress disorders and other allied psychopathologic states

Numbeing of general responsiveness associated with post-traumatic stress disorders is postulated to represent a psychobiological response to overwhelming stress mediated by a hypersecretion of the endogenous opiate system. Evidence for the hypothesis is inferential and is based on: (1) similarities between behavioral symptoms of the numb state and the effects of opioids on animals and man; (2) the stress induced analgesia phenomenon, an endorphin mediated response leading to reduction of pain and fear; (3) Solomon's Opponent Process Theory, which offers a conceptual framework for understanding how the numb response can become the dominant psychopathologic disturbance in a chronic condition. Catastrophe theory models are introduced to describe and explain the relationship of emotional nonresponsiveness to rage and other affective states. In addition, other psychiatric states in which flat affect, apathy, and social withdrawal predominate are highlighted as phenomenologically and dynamically similar to the numb state and are posited to also be regulated by the endogenous opiate system.     

盐酸纳洛酮对颅脑手术病人血浆和脑脊液β-内啡肽的影响

目的:通过观察在颅脑手术中盐酸纳洛酮对血浆和脑脊液中β-内啡肽(β-EP)的影响,探讨盐酸纳洛酮的脑保护作用.方法:32例择期颅脑手术病人ASAⅠ～Ⅱ级,随机分为纳洛酮组(Ⅰ组)和对照组(Ⅱ组).采用放射免疫分析法检测血浆及脑脊液中β-EP的含量.结果:纳洛酮组在给药后1 h( T2期)、给药后2 h(T3期)和给药后3 h(T4期)血浆β-EP含量分别为(187.76±81.37)、(109.56±45.92)和(69.37±21.66) ng*L-1,脑脊液中含量分别为(2 169.61±416.37)、(1 369.85±433.55)和(987.62±278.19) ng*L-1,均较给药前(T1期)即开始切硬膜时低(P<0.05),纳洛酮组血浆和脑脊液中的β-EP均低于对照组同期值(P<0.05).结论:颅脑手术围术期应用纳洛酮可以使脑脊液和血浆中β-EP含量降低,从而说明应用纳洛酮可以减轻脑水肿和损伤,保护脑细胞.