几种静脉麻醉药对GABA能神经元的Phasic／Tonic抑制的影响

γ-氨基丁酸（gama-amino butyic acid ,GABA ）是广泛存在于中枢神经系统中一种重要的抑制性神经递质,参与调控睡眠和镇静等作用,主要通过作用于 GABAA 离子型亚基受体发挥生理效用。GABAA 受体属配体门控离子通道受体,通过增加神经细胞膜对氯离子和碳酸根离子的通透性,使细胞膜外高浓度的阴离子顺浓度梯度产生内向流动,从而引起突触后的超极化反应,导致神经元的兴奋性降低,这种由突触内的GABAA 型受体短暂的或“阶段性”的激活突触囊泡释放GABA ,从而产生的抑制,称为Phasic抑制,也是 GABAA 受体介导抑制性作用的经典途径。而近年来,研究者们提出了一种GABAA 受体介导的新型抑制作用即Tonic抑制［1］,它是由于轴突末梢保持一种持续少量的GA-BA释放,细胞外低浓度GABA 的环境能持续性的激活突触外的GABAA 受体引起的生理效应。本篇拟综述突触内和突触外GABAA 受体在控制神经元兴奋性的独特作用以及与全麻机制相关的最新研究进展。     

奥硝唑对映体对小鼠中枢抑制作用的机制探究

目的:探讨右奥硝唑中枢抑制效应与脑内γ-氨基丁酸(gamma amino butyric acid,GABA)系统的关系。方法:经不同剂量右/左奥硝唑处理后使用N,N-二甲基二吖啶硝酸盐(1-(Ethoxycarbonylmethyl)-6-methoxyquinolinium bromide,MQAE)荧光探针检测原代培养小鼠皮层神经元氯离子浓度,并通过western blot方法检测GABAA受体亚基的表达。尾静脉注射给予右/左奥硝唑后测定小鼠高架十字迷宫行为。结果:右奥硝唑剂量依赖性激活小鼠皮层神经元的氯离子通道,经右奥硝唑处理后的皮层神经元能增加GABAA受体α1亚基的水平,且右奥硝唑有潜在的抗焦虑活性。结论:右/左奥硝唑中枢作用不同,右奥硝唑较强的中枢抑制作用可能与激活GABA系统有关。     

γ-氨基丁酸及拮抗剂对大鼠黑质致密部神经元活动的影响

目的:研究γ-氨基丁酸(γ-Aminobutyric Acid,GABA)和GABAA受体阻断剂荷包牡丹碱(Bicuculine,Bic)对大鼠黑质致密部(pars compacta of substantia nigra,SNc)神经元自发放电活动的影响。方法:采用微电泳及细胞外记录方法观察GABA和Bic对SNc神经元自发放电活动的影响。结果:GABA使42个受试神经元自发放电活动几乎完全停止。在30个受试神经元中,Bic使22个神经元放电频率加快,6个神经元无作用,2个神经元受到抑制。在35个受试神经元中,微电泳GABA期间给予GABAA受体阻断剂Bic,其可使91.43%神经元放电频率加快。结论:GABA能投射对SNc神经元有抑制作用,GABAA受体阻断剂Bic能拮抗GABA的抑制作用。     

依托咪酯影响感觉刺激诱发小脑皮层分子层场电位变化的机制

依托咪酯(etomidate,ET)是一种作用强、短效的非巴比妥类静脉麻醉药,在临床中被广泛使用。前期在体电生理学和神经药理学手段研究发现,ET降低在体小脑皮层浦肯野细胞的单纯峰电位放电频率并具有浓度依赖性,ET(300μM)完全抑制自发性单纯性放电,但自发性复杂峰电位放电依然存在。ET(300μM)不仅完全抑制自发性单纯性放电,而且抑制自发性复杂峰电位放电小穗数量[1]。另有研究报道,ET通过激活GABAA和甘氨酸受体来抑制在体小鼠小脑浦肯野细胞(Purkinje cell,PC)活性[2],而目前为止ET影响在体动物小脑皮质分子层感觉信息处理的机制尚不清楚。因此,我们有必要深入研究ET对乌拉坦麻醉小鼠小脑分子层中感觉刺激诱发反应的影响,为探讨ET对小脑皮层功能的影响机制做好前期准备。     

γ-氨基丁酸及拮抗剂对大鼠黑质玫密部神经元活动的影响

目的：研究伸γ-基丁酸（γ-Aminobutyrie Acid，GABA）和GABAA受体阻断剂荷包牡丹碱（Bicuculine，Bic）对大鼠黑质致密部（pars compacta of substantia nigra，SNc）神经元自发放电活动的影响。方法：采用微电泳及细胞外记录方法观察GABA和Bic对SNc神经元自发放电活动的影响。结果：GABA使42个受试神经元自发放电活动几乎完全停止。在30个受试神经元中，Bic使22个神经元放电频率加快，6个神经元无作用，2个神经元受到抑制。在35个受试神经元中，微电泳GABA期间给予GABAA受体阻断剂Bic，其可使91．43％神经元放电频率加快。结论：GABA能投射对SNc神经元有抑制作用，GABAA受体阻断剂Bic能拮抗GABA的抑制作用。     

奥硝唑对映体对小鼠中枢抑制作用机制探究

【摘 要】 目的： 探讨右旋奥硝唑中枢抑制效应与脑内γ－氨基丁酸系统的关系。方法：经不同剂量右/左奥硝唑处理后使用Ｎ-Ｎ二甲基二吖啶硝酸盐(MQAE)荧光探针检测原代培养小鼠皮层神经元氯离子浓度， 并通过western blot方法检测GABAA受体亚基的表达。尾静脉注射给予右/左奥硝唑后测定小鼠高架十字迷宫行为。结果：右旋奥硝唑剂量依赖型激活小鼠皮层神经元的氯离子通道，经右旋奥硝唑处理后皮层神经元能增加GABAA受体α1亚基的水平且右旋奥硝唑有潜在的抗焦虑活性。结论: 右/左奥硝唑中枢作用不同，右旋奥硝唑较强的中枢抑制作用可能与激活GABA系统有关。     

大鼠耳蜗螺旋神经节神经元GABA_A受体激活电流的特性

目的研究大鼠耳蜗螺旋神经节神经元GABAA受体激活电流的特性。方法采用全细胞膜片钳记录技术,观察离体培养大鼠螺旋神经节神经元上GABAA受体激活电流的特点。结果不同浓度的GABA可诱出螺旋神经节神经元的内向电流,该电流可被10μM荷包牡丹碱可逆性阻断。GABA诱导出的内向电流幅度随着浓度（10、50、100、500μM）的增大而增大。结论耳蜗螺旋神经节神经元可诱出GABAA受体电流,GABA诱导的GABAA受体电流呈浓度依赖关系。     

脑源性神经营养因子对大鼠海马神经元GABAA受体效应的影响

目的:观察不同浓度脑源性神经营养因子(BDNF)对大鼠海马神经元γ-氨基丁酸(GABA)A受体效应的影响。方法:原代培养海马神经元,应用BDNF(100、300及1000 ng/L)处理20 min后,施加GABA(终浓度为100μmol/L),5 min后应用流式细胞仪测定细胞内钙离子浓度。采用全细胞膜片钳记录模式,向锥体细胞施加BDNF(100、300及1000 ng/L)2 min,再施加GABA 100μmol/L并持续5 s,记录钳制电位为-60 mV时的GABAA受体电流。将神经元钳制电位从-100 mV至0 mV以10 mV递增,记录BDNF作用下GABAA受体电流的幅度和方向,并绘制电流电压曲线,计算GABAA受体电流的反转电位。结果:BDNF 100 ng/L和300 ng/L对GABA诱发的细胞内钙浓度、GABAA受体电流及反转电位均无影响,但在BDNF 1000 ng/L作用下,GABA诱发的细胞内钙浓度显著增加(P<0.05),GABAA受体电流在钳制电位-60 mV时变为外向电流,并且反转电位由对照的0 mV左移至-93 mV。结论:高浓度BDNF可使GABAA受体电流反转电位左移,导致GABA诱发锥体细胞内钙浓度增高而发挥兴奋效应。     

γ-氨基丁酸受体的神经化学研究新进展

1引言γ－氨基丁酸（GABA）在中枢神经内大量存在，是一种具有神经传递抑制作用的氨基酸，其作用机制是通过激活GABAA和GABAB受体而发挥抑制作用。虽然这2种GABA受体在脑内均起抑制作用，但各自的作用机制不同。其中，GABAA受体以荷包牡丹碱（Bicuculline）为拮抗剂，而GABAB受体对荷包牡丹碱不敏感。从电生理学角度划分，GABAA受体为快速型抑制突触后电位（fastIPSP），而GABA。受体则为缓慢型抑制突触后电位（S10IPSP）oSo＊＊A＾受体的药理学GABA是一种脑内抑制性神经递质，它是通过激活GABAA受体使Q一细胞内流…     

GABAA受体药理学研究进展

GABAA受体为配体闸门离子通道超家族成员之一。本文简要概述了GABAA受体的提出和分类,重点介绍了国内外有关GABAA受体的药理学研究情况,包括GABAA受体的结构,作用于GABAA受体GABA识别位点、安定类识别位点、氯离子通道的药物等。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

基层医院护士在临床合理用药中的作用

目的充分利用护士在医师和患者间的特殊地位和作用,促进基层临床合理用药。方法从护士的工作性质出发,论述护士参与促进合理用药的方便和优势。结果通过实践,护士在促进合理用药中的作用得到有效发挥,基层合理用药环境得到极大改善。结论充分利用护士与医师和患者间的特殊桥梁作用,在基层医院促进合理用药,规范医师用药行为,防止药物滥用,引导患者安全用药,降低药源性疾病。