糖皮质激素联合抗凝在急性/亚急性重症颅内静脉血栓治疗中的探索

目的 本研究初步探讨糖皮质激素联合抗凝治疗在急性/亚急性重症颅内静脉血栓(cerebral venous thrombosis, CVT)中的作用。方法 纳入10例经过糖皮质激素联合抗凝治疗的急性/亚急性重症CVT患者,对治疗前后及出院3个月时的神经功能缺损、颅内压增高情况和血清、脑脊液炎症指标及不良事件进行回顾性分析。结果 10例患者经过糖皮质激素冲击治疗后2周,与入院时基线值相比,血清中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio, NLR)(P<0.05),超敏C反应蛋白(hypersensitive C-reactive protein, hs-CRP)(P<0.01),白细胞介素-6(interleukin 6,IL-6)(P<0.01)和脑脊液IL-6浓度(P<0.01)均明显下降;与入院时基线值相比,出院时改良Rankin量表(modified Rankin Scale, mRS)评分(P<0.01)、美国国立卫生研究院卒中评分(National Institutes of Health Stroke ...     

基于信任源模型的全科医疗服务医患信任问题及对策建议

在全科医疗服务制度背景下,增强医患信任是提升医疗服务质量的关键。基于医患信任源模型,结合文献分析,本文对全科医疗服务中的医患信任问题进行了深入探索,得出卫生行政部门对签约服务的监督力度、社区卫生服务机构的设施环境、全科医生提供的服务质量、居民自身的信任倾向是影响医患信任的关键因素。基于此,文章从四方主体角度出发,提出要加强卫生行政部门监管力度、提升制度信任、加强医患沟通、增强人际信任、发挥居民的社会监督力量等建议,以进一步提高居民对基层医疗卫生服务的利用意愿和全科医疗的服务质量。     

Synaptic transmission of chaotic spike trains between primary afferent fiber and spinal dorsal horn neuron in the rat

Primary sensory neurons can generate irregular burst firings in which the existence of significant deterministic behaviors of chaotic dynamics has been proved with nonlinear time series analysis. But how well the deterministic characteristics and neural information of presynaptic chaotic spike trains were transmitted into postsynaptic spike trains is still an open question. Here we investigated the synaptic transmission of chaotic spike trains between primary Adelta afferent fiber and spinal dorsal horn neuron. Two kinds of basic stimulus unit, brief burst and single pulse, were employed by us to comprise chaotic stimulus trains. For time series analysis, we defined "events" as the longest sequences of spikes with all interspike intervals less than or equal to a certain threshold and extracted the interevent intervals (IEIs) from spike trains. Return map analysis of the IEI series showed that the main temporal structure of chaotic input trains could be detected in postsynaptic output trains, especially under brief-burst stimulation. Using correlation dimension and nonlinear prediction methods, we found that synaptic transmission could influence the nonlinear characteristics of chaotic trains, such as fractal dimension and short-term predictability, with greater influence made under single-pulse stimulation. By calculating the mutual information between input and output trains, we found the information carried by presynaptic spike trains could not be completely transmitted at primary afferent synapses, and that brief bursts could more reliably transmit the information carried by chaotic input trains across synapses. These results indicate that although unreliability exists during synaptic transmission, the main deterministic characteristics of chaotic burst trains can be transmitted across primary afferent synapses. Moreover, brief bursts that come from the periphery can more reliably transmit neural information between primary afferent fibers and spinal dorsal horn neurons.     

Analysis of immobilized L-cysteine on polymers

Recently, we reported that L-cysteine attached to polymeric biomaterials, without prior nitrosation, enhances the hemocompatibility of biomaterials via exploiting endogenous nitric oxide (NO). As part of the polymer optimization process to further enhance platelet inhibition, a kinetic model is being developed to predict the release rate of NO. A key model parameter is the immobilized concentration of L-cysteine. This article demonstrates how several chemiluminescence-based assays, previously utilized for measuring thiols in solution, were successfully adapted to quantify immobilized L-cysteine. The assays showed that the immobilized L-cysteine on the modified PET sample is within the range of 4.1 to 6.5 nmol/cm(2). An advantage of using the more successful chemiluminescence-based assay is that it can accurately measure molar concentrations of any thiol-containing compound with a detection limit in the pmol range. The major disadvantage is that L-cysteine must first be broken off of the polymer and released into solution prior to measurement, therefore leaving the sample unable to be reused. Other thiol-measuring techniques, such as fluorescence microscopy and X-ray photoelectron spectroscopy (XPS), were used to provide qualitative and semiquantitative analysis to substantiate the polymer development.     

磷酸化的细胞外信号调节蛋白激酶1/2在正常小鼠脑内的免疫细胞化学定位

细胞外信号调节蛋白激酶(ERK)1/2是重要的信号转导分子。现已知在正常动物的中枢神经系统内有其活化形式即磷酸化的ERK1/2(pERK1/2)分子的存在,但其在小鼠脑内的分布目前还没有全面的观察。本研究用免疫组织化学技术(ABC法)研究了pERK1/2样免疫反应阳性产物在脱臼处死的正常小鼠全脑内的分布。结果发现pERK1/2在正常小鼠脑内有广泛的表达,阳性产物主要存在于神经元,亦见于个别白质内的胶质细胞,脑膜及室管膜细胞也有表达。强阳性表达的核团主要有:岛皮质、视听皮质、边缘前皮质、扣带前皮质、海马垂直部、弓状核、蓝斑和小脑Purkinje细胞;中等阳性表达的核团主要有:感觉运动皮质、外侧隔区、内侧杏仁核、皮质杏仁核和外侧杏仁核、丘脑室旁核前部、视交叉上核、穹隆下器、终板血管器、前腹侧视前核和下丘脑背内侧核;弱阳性表达的核团主要有:视上核、下丘脑室旁核大细胞部、下丘脑后区、顶盖前区、室周灰质腹外侧柱、A5区、孤束核和延髓腹外侧网状结构等。本文结果观察到pERK1/2在正常小鼠脑内广泛存在,提示pERK1/2作为重要的信号转导分子,可能参与许多脑区在正常状态下的功能活动,揭示其分布特点为了解其在脑内的多样性功能提供了形态学依据。     

圆孔外面的观察和测量及其面积的回归方程

60具成人颅骨颅底外面的圆孔观察和测量结果表明:圆孔多呈圆形,其次是卵圆形,其它形较少见.据圆孔与翼突外侧板根部延长线的位置关系,分圆孔位置为三型.圆孔外面观的各项测值左右间均无统计学差异,但其中管性圆孔管长度个体差异较大.圆孔的面积左右比较对称者占3.33±2.34%,左>右者占65.51±6.30%,右>左者占34.48±6.30%.圆孔面积左右对称性比较,对临床诊断疾病有参考意义.其面积的回归方程可由其长、宽径乘积推算 .     

雌性大鼠下丘脑5-羟色胺1A和2A受体亚型的定位分布

本研究应用免疫细胞化学技术观察了雌性成年SD大鼠下丘脑内5-HT1A受体亚型(5-HT1AR)和5-HT2AR免疫阳性结构的分布。结果显示:5-HT1AR免疫阳性神经元在视前区大细胞核、视前室周核、视上核和下丘脑外侧前核等核团内密集分布。在内侧视前核、外侧视前区、下丘脑室周核、下丘脑外侧区、背内侧核、腹内侧核、结节核、结节乳头体核、乳头体内侧核和乳头体外侧核等结构内也有较多的分布;而在正中视前核、视交叉上核、下丘脑室旁核、下丘脑背侧核、弓状核、乳头体上核和乳头体前核等部位有散在的分布。与5-HT1AR不同,5-HT2AR免疫阳性反应产物主要见于纤维和终末,阳性胞体少且染色淡。5-HT2AR阳性胞体见于下丘脑室旁核、视上核、腹内侧核、结节核、视前内侧区、外侧区、外侧前核、下丘脑背内侧核等处。另外,在视前区前内侧视前核、视交叉上核背侧和外侧可见围绕血管分布、密集成团簇状、带有大小不同膨体的阳性神经纤维缠结。本文结果提示5-HT1AR阳性结构广泛地分布于大鼠下丘脑,而5-HT2AR在下丘脑分布较为局限。二者不同的分布特点,提示它们可能介导5-HT在下丘脑的不同生理功能。     

蝎蜂毒肽对大鼠纤溶系统作用初探

本研究采用大鼠肢体血管灌流和整体给药两种模型，观察蝎蜂毒（ＳＢＰ）对血管理灌流液内纤溶酶原激活物（ＰＡ）活性、血浆优球蛋白纤溶性（ＥＦＡ）和纤溶酶（ＰＬ）活性的影响。结果说明，ＳＢＰ有明显激活纤溶系统作用；其机制可能涉及血管内皮细胞释放ＰＡ活性增加，进一步促使纤溶酶原活化为ＰＬ增多的途径。     

大鼠下丘脑及邻近区域催产素免疫阳性神经元与垂体后叶的关系

本文运用免疫细胞化学PAP及ABC法,显示大白鼠下丘脑内OXT免疫阳性神经元,并于垂体后叶注射WGA-HRP,显示下丘脑中逆行标记细胞,结合免疫细胞化学方法,观察下丘脑及其邻近区域内HRP与OXT双标记细胞,证实下丘脑视上核、室旁核、穹窿前核和后核、血管周细胞群、下丘脑视前区、下丘脑前区及外侧区、背侧副细胞群内、室周部、第三脑室侧壁室管膜细胞下及室间孔部室管膜细胞下,均有OXT免疫阳性神经元,其中至少部分神经元可发出向垂体后叶的投射纤维。位于第三脑室侧壁室管膜下及室间孔部室管膜下的神经元,可能监测脑脊液中各种因素的变化,调节垂体后叶OXT的分泌,也可能直接通过共树突向脑脊液内释放OXT。