心脏停跳复苏后全脑浅低温对脑组织前列环素和血栓素A2含量…

观察犬心脏停跳复跳后全脑浅低温对脑组织前列环素和血栓素Ａ２含量的影响。结果表明，脑缺血再灌注后常规治疗４小时，６－ｋｅｔｏ－ＰＧＦ１ａ水平无明显变化。ＴＸＢ２含量明显上升，ＴＸＢ２／６－ｋｔｅｏ－ＰＧＦ１ａ（Ｔ／Ｋ）比值明显升高；浅低温治疗组与缺血再灌常规治疗组比较６－ｋｅｔｏ－ＰＧＦ１ａ水平仍无明显变化，而ＴＸＢ２含量下降（Ｐ＜０．０５），Ｔ／Ｋ比值降低（Ｐ＜０．０５）。提示全脑浅低温能抑制脑缺     

阿魏酸钠对犬心脏停跳复苏后脑组织TXB_2、6-keto-PGF_(1a)及MDA含量的影响

研究了阿魏酸钠对犬心脏停跳１０分钟复苏后４小时脑组织中血栓素Ｂ２（ＴＸＢ２）、６－酮－前列腺素Ｆ１ａ（６－ｋｅｔｏ－ＰＧＦ１ａ）及丙二醛（ＭＤＡ）含量的影响。１７只犬随机分为非缺血对照组（Ａ组）、缺血再灌注常规治疗组（Ｂ组）及缺血再灌注阿魏酸钠治疗组（Ｃ组）。结果发现，Ｂ组ＴＸＢ２、ＭＤＡ含量及ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１ａ比值均较 Ａ组明显升高（Ｐ＜０． ０１）。 Ｃ组 ＴＸＢ２、ＭＤＡ含量及 ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１ａ比值升高幅度均较Ｂ组明显低（Ｐ＜０．０１）。表明阿魏酸钠可明显抑制犬心脏停跳复苏后脑组织花生四烯酸代谢及脂质过氧化反应。     

甲泼尼松龙对体外循环肺内血小板聚集、血栓素生成的抑制作用及其意义

探讨大剂量甲泼尼松龙（ＭＰＳＳ）对肺再灌注早期血小板聚集、血栓素生成的抑制作用。方法将３０例体外循环心脏手术患者随机分成对照组与ＭＰＳＳ用药组，各１５例。用药组于体外循环前静注ＭＰＳＳ１５ｍｇ／ｋｇ体重。３０例患者分别于体外循环前、复跳后１０、４５分钟、２小时抽左右心房血，检测血小板数、ＴＸＢ２及６－ｋｅｔｏ－ＰＧＦ１αｏ。结果对照组复跳后各时相左房血血小板数明显比右房者低（Ｐ＜０．０５），左房血ＴＸＢ２含量明显比右房者高（Ｐ＜０．０１）；而用药组复跳后左、右房血血小板数、ＴＸＢ２差异无显著意义。用药组并能明显降低复跳后ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值（Ｐ＜０．０５～０．０１）。结论大剂量ＭＰＳＳ对肺再灌注早期血小板聚集有明显抑制作用，减少肺内血栓素生成，降低血栓素／前列环素比值，起到预防或减少灌注肺发生的作用。     

再灌注损伤胃粘膜组织前列腺素含量的变化及丹参提取物F的作用

研究失血性休克再灌注大鼠胃粘膜损伤指数，组织 ＰＧＥ２、 ＰＧＩ２（ ６－ｋｅｔｏ－ＰＧＦ１ａ示） ＴＸＡ２（ＴＸＢ２示）含量，６－ｋｅｔｏ－ＰＧＦ１ａ／ＴＸＢ２比值及丹参提取物 Ｆ对上述各值的影响。结果显示，再灌注后胃粘膜有明显的出血性损伤，组织ＰＧＥ２、６－ｋｅｔｏ－ＰＧＦ１ａ含量明显下降，ＴＸＢ２含量明显增加，６－ｋｅｔｏ－ＰＧＦ１ａ／ＴＸＢ２比值明显降低，单纯失血性休克组未见上述损伤；丹参提取物Ｆ能明显降低胃粘膜损伤指数，且与组织ＰＧＥ２含量６－ｋｅｔｏ－ＰＧ１ａ／ＴＸＢ２比值的增加呈负相关。     

硬膜外阻滞下妊高征剖宫产患者血浆TXB2,6—keto—PGF1α的变化

观察硬膜外阻滞对９例中－重度妊高征剖宫产患者血浆血栓素Ａ２（ＴＸＡ２）、前列环素（ＰＧＩ２）的代谢产物－ＴＸＢ２、６－ｋｅｔｏ－ＰＧＦ１α的影响。结果表明，硬膜外阻滞后ＴＸＢ２无显著性改变，６－ｋｅｔｏ－ＰＧＦ１α于切皮前、剖宫前显著升高，ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值显著下降。提示硬膜外阻滞对妊高征剖宫产患者是一种安全、有效的麻醉方法，并可能有助于妊高征的治疗。     

移植肾急性排斥时血栓素A2、前列环素代谢改变及其对肾小球滤过率的影响

用放射免疫法检测２１例移植肾急性排斥时，肾移植患者尿液以及血浆血栓素Ｂ２（ＴＸＢ２）和６－酮－前列腺素Ｆ１α（６－ｋｅｔｏ－ＰＧＦ１α）浓度，并检测４例不可逆急性排斥和７例慢性排斥移植肾切除后肾组织ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１α含量。发现急性排斥出现时，尿中ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１α含量均明显升高，ＴＸＢ２增多出现较早；血浆ＴＸＢ２浓度也显著增加，６－ｋｅｔｏ－ＰＧＦ１α浓度下降。尿液和血浆中ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值增大。正常肾组织标本中，肾髓质ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１α含量为皮质的４～５倍，皮髓质中ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值水平相同。不可逆急性排斥肾组织中，肾皮质ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值明显高于髓质。急性排斥时，尿液中ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１α比值变化与肾皮质平行。分析表明，急性排斥时，尿液ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值增大和移植肾肾小球滤过率负相关。     

气管插管应激时血浆血栓素A2和前列环素含量变化

为比较气管插管应激时血浆血栓素Ａ２（以ＴｘＢ２表示）和前列环素（以６－ｋｅｔｏ－ＰＧＦ１ａ表示）的变化，２２例患者随机分为芬太尼组和对照组，两组患者均给予硫喷妥钠４ｍｇ／ｋｇ和琥珀胆碱１。５ｍｇ／ｋｇ诱导后插管，结果显示诱导后５分内，对照组ＳＢＰ、ＤＢＰ、ＭＡＰ、ＨＲ、ＰＡＷＰ、ＴＰＲ及血浆ＴＸＢ２含量较芬太尼组明显升高（Ｐ＜０。０５），对照组ＴＸＢ２的升高与ＭＡＰ及ＴＰＲ的升高呈高度正相关系，对     

体外震波碎石前后血浆和尿液PGI2与TXA2的变化及其临床意义

应用放射免疫技术，对１４例非梗阻性单纯肾结石患者ＳＥＷＬ前后血浆和尿液中ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１ａ水平进行了动态检测。结果显示，血浆ＴＸＢ２在ＥＳＷＬ后第一天明显升高（Ｐ＜０．００１），而６－ｋｅｔｏ－ＰＧＦ１α无显著意义的改变（Ｐ＞０．０５），两者的比值也随ＴＸＢ２而升高（Ｐ＜Ｏ．００１），第三天时都降至基础水平；尿液中上述指标也出现类似变化。我们认为，ＥＳＷＬ后早期肾脏内ＴＸＡ２合成与释放增加，ＴＸＡ２与ＰＧＩ２平衡失调，有可能参与了肾损害的病理生理过程。     

青心酮对大鼠被动吸烟胎儿宫内生长迟缓的疗效观察

选择１５０只健康ＳＤ妊娠大鼠，均于妊娠Ｄ４～Ｄ２０天仿Ｙｏｕｎｏｓｚａｉ法制备胎儿宫内生长迟缓模型。按治疗药物随机分为６组。观察复方氨基酸和青心酮的疗效。结果：（１）模型组的胎仔平均体重、身长和肝重量都明显低于对照组（Ｐ＜０．０１）。胎仔发育参数各用药组与模型组比较有显著差异（Ｐ＜０．０１）。各用药组之间无明显差异（Ｐ＞０．０５）。（２）孕鼠血红蛋白（Ｈｂ）、红细胞压积（Ｈｔ）水平在模型组明显高于其它５组（Ｐ＜０．０１），各用药组之间无明显差异（Ｐ＞０．０５）。各组胎仔平均体重与母血Ｈｂ、Ｈｔ呈负相关。（３）孕鼠血浆Ｅ３，６－ｋｅｔｏ－ＰＧＦ１ａ水平模型组明显低于其它５组（Ｐ＜０．０１），而ＴＸＢ２无明显改变，ＴＸＢ２／６－ｋｅｔｏ－ｐＧＦ１ａ比值模型组明显高于其它５组（Ｐ＜０．０１）。结果说明青心酮治疗胎儿宫内生长迟缓的药效与其调整ＴＸＡ２－ＰＧＩ２失衡有关。     

呼气末正压通气对血栓素和前列环素的影响

本实验对１５只健康家猪在基础麻醉后进行ＰＥＥＰ机械通气，观察在０，５，１０，１５，２０，２５，３０ｃｍＨ２Ｏ七个不同压力阶段下血浆中血栓素，前列环素变化，通过放射免疫方法测定ＴＸＡ２，ＰＧＩ２的稳定降解产物ＴＸＢ２，６－ｋｅｔｏ－ＰＧＦ１２，从而了解ＰＥＥＰ通所对ＴＸＡ２，ＰＧＩ２的影响。结果：ＰＥＥＰ压力从０增至３０ｃｍＨ２Ｏ，ＴＸＢ２增加４１．０％，６－ｋｅｔｏ－ＰＧＦ１２增加２１．１％，ＴＸ     

Remifentanil and the brain

Background and aim: Remifentanil is an ultra-short-acting opioid, increasingly used today in neuroanesthesia and neurointensive care. Its characteristics make remifentanil a potentially ideal agent, but previous data have cast a shadow on this opioid, supporting potentially toxic effects on the ischemic brain. The aim of the present concise review is to survey available up-to-date information on the effects of remifentanil on the central nervous system.
Method: A MEDLINE search within the past seven years for available up-to-date information on remifentanil and brain was performed.
Results: Concise up-to-date information on the effects of remifentanil on the central nervous system was reported, with a particular emphasis on the following topics: cerebral metabolism, electroencephalogram, electrocorticography, motor-evoked potentials, regional cerebral blood flow, cerebral blood flow velocity, arterial hypotension and hypertension, intracranial pressure, cerebral perfusion pressure, cerebral autoregulation, cerebrovascular CO₂ reactivity, cerebrospinal fluid, painful stimulation, analgesia and hyperalgesia, neuroprotection, neurotoxicity and hypothermia.
Conclusion: The knowledge of the influence of remifentanil on brain functions is crucial before routine use in neuroanesthesia to improve anesthesia performance and patient safety as well as outcome.     

Testosterone and the brain

The effects of testosterone on sexual appetite are obvious. Furthermore, treatment of hypogonadal men with testosterone leads almost always to unmistakable positive changes in mood, self-esteem and vitality. This testifies to the profound effects testosterone exerts on the brain and the mind. Conversely, hypogonadism and particularly the profound hypogonadism resulting from androgen deprivation treatment in men with prostate cancer, is associated with loss of vitality and mood disorders, if not depression.Several studies have found a role for testosterone on cognition (particularly visuo-spatial abilities), mood and depression, and low testosterone values may predict the development of Alzheimer's disease. Testosterone administration to hypogonadal men supports this notion. But not all studies have been able to confirm the association between testosterone and mental functions. These discrepancies might be explained by the large variations in design, inclusion criteria with regard to threshold values of testosterone, duration of study and psychometric instruments. It is likely that men with plasma testosterone values below the lower limit of normal will benefit (most). It is presently not justified to prescribe testosterone as a primary treatment for men with impaired cognitive functioning or mood disorders. These complaints are common in elderly men, and one of the diagnostic considerations might be testing for testosterone deficiency as an etiological factor, and if, upon laboratory measurement, testosterone levels are truly hypogonadal, testosterone treatment is warranted. This probably will not only benefit mental functioning but there will be somatic benefits as well as a result of normalization of testosterone levels.     

Anesthetics and the brain

The action of anesthetics on the nervous system can be understood by considering their possible interactions with neuronal function. Anesthesia may be produced by a change in the balance of inhibitory synapses (notable via GABAa receptors) and excitatory synapses (notably glutamate receptors). Our knowledge of the specific mechanisms of anesthetic drugs and the structures in the CNS remains inadequate to explain the anesthetic state by one mechanism. The action of anesthetics can also be considered based on the action of the drugs on cerebral physiology, notably CMR, CBF, metabolic coupling, and autoregulation. Some specific anesthetic recommendations can be made for certain neurosurgical procedures and pathology based on the effects on physiology.     

Evolution of the human brain: changing brain size and the fossil record

Although the study of the human brain is a rapidly developing and expanding science, we must take pause to examine the historical and evolutionary events that helped shape the brain of Homo sapiens. From an examination of the human lineage to a discussion of evolutionary principles, we describe the basic principles and theories behind the evolution of the human brain. Specifically, we examine several theories concerning changes in overall brain size during hominid evolution and relate them to the fossil record. This overview is intended to provide a broad understanding of some of the controversial issues that are currently being debated in the multidisciplinary field of brain evolution research.     

多模态MRI技术评估脑老化及脑老化与脑疾病的关系研究进展

人类脑随年龄增长而退化,即脑老化;其过程与认知能力下降趋势一致,即神经退行性疾病发病风险随年龄增长而逐渐增加。加强对脑老化的认识并筛选相关生物标志物,对于早期诊断神经退行性疾病、预测年龄相关认知能力下降至关重要。本文对多模态MRI技术用于评估脑老化及脑老化与脑疾病关系的研究进展进行综述。