γ-氨基丁酸在中枢神经系统痛觉调制中的作用

目的：观察大鼠脑室或伏隔核加入外源性γ-氨基丁酸后,伏隔核痛反应神经元的电变化,以及γ-氨基丁酸A受体拮抗剂荷包牡丹碱的阻断效应,进一步研究γ-氨基丁酸在痛觉信息通路中的作用.方法：实验于2004-07/12在哈尔滨医科大学电神经生理学实验室进行.①取30只成年Wistar大鼠随机分为γ-氨基丁酸组和对照组两组各15只,侧脑室注射γ-氨基丁酸（50 g/L）10μL或等量的生理盐水.②取26只大鼠随机分为γ-氨基丁酸组和对照组两组各13只,伏隔核内注射γ-氨基丁酸（50 g/L）10μL或等量的生理盐水.③取24只大鼠随机分为γ-氨基丁酸组和对照组两组各12只,伏隔核内注射γ-氨基丁酸（50 g/L）10μL后2 min,侧脑室注荷包牡丹碱（1 g/L,Sigma）10μL对照组给予等量生理盐水.所有大鼠由脉冲强直刺激坐骨神经作为伤害性痛刺激,玻璃微电极细胞外记录注药前后痛反应神经元的电变化,以刺激坐骨神经引起的伏隔核中痛兴奋神经元诱发放电秒净增值、潜伏期和痛抑制神经元诱发放电秒净增值、抑制时程为主要指标.结果：80只大鼠进入结果分析.①侧脑室注射γ-氨基丁酸后,痛兴奋神经元诱发放电潜伏期延长,诱发放电秒净增值减少;痛抑制神经元诱发放电抑制时程缩短,诱发放电频率增加,而后逐渐恢复接近注药前水平.②伏隔核内注射γ-氨基丁酸使痛兴奋神经元诱发放电潜伏期延长,诱发放电秒净增值减少,而后逐渐恢复接近注药前水平;痛抑制神经元诱发放电抑制时程缩短,诱发放电频率增加,而后逐渐恢复接近注药前水平.③侧脑室注入荷包牡丹碱能够阻断γ-氨基丁酸的上述效应.结论：脑室和伏隔核外源性增加γ-氨基丁酸后均可提高伏隔核中痛兴奋神经元的兴奋性而抑制痛抑制神经元的电活动,证实γ-氨基丁酸在痛觉调制中起抑制性作用,介导中枢伤害性信息的传递,荷包牡丹碱能够阻断其效应.     

环肺静脉消融术治疗心房颤动并发症的观察及护理

心房颤动是临床最常见的心律失常。研究证明，在未来50年中心房颤动将成为最流行的心血管疾病之一。心房颤动可不同程度影响病人的生活质量，易导致心房血栓形成，血栓一旦脱落可以引起全身各器官栓塞，尤其是脑血管栓塞，心室反应快速的心房颤动会导致心动过速性心肌病。心房颤动的治疗有电复律治疗、药物复律治疗、介入治疗，前两种治疗效果不明显，且复律后维持时间短。目前，介入治疗最有效的方法是肺静脉电隔离术和环肺静脉消融术，而环肺静脉消融术的成功率较前者高。     

情志护理联合早期功能锻炼对老年全膝关节置换术后谵妄及关节功能恢复的影响

目的：探讨情志护理联合早期功能锻炼对老年全膝关节置换术后谵妄及关节功能恢复的影响。方法选择接受膝关节置换术的86例患者为研究对象,采用随机数字表法分为观察组和对照组各43例,观察组患者接受情志护理联合早期功能锻炼,对照组患者接受常规护理联合早期功能锻炼,比较两组患者心理状态、谵妄状态、膝关节功能。结果心理状态：观察组焦虑(SAS)、抑郁(SDS)评分明显低于对照组(t=6.866~7.655,P<0.05);谵妄状态：观察组谵妄分级量表(DRS-R-98)评分均明显低于对照组(t=13.824~16.874,P<0.05);关节功能：观察组患者的Lysholm评分、Tenger评分均明显高于对照组(t=8.205~7.662,P<0.05)。结论情志护理联合早期功能锻炼有助于化解负性情绪,减轻术后谵妄状态,改善膝关节功能,是老年全膝关节置换术后理想的护理方法。     

复方益肾胶囊对糖尿病肾病大鼠血清AGEs表达影响的实验研究

1实验材料复方益肾胶囊：哈尔滨医科大学大庆校区药理教研室提供。链脲佐菌素（Strptoxotocin,STZ）：美国Sigma公司。58只清洁级雄性Wistar大鼠体重200～230g,由哈尔滨医科大学大庆校区提供。OneTouchII型强生血糖仪,岛津RF-5300型荧光分光光度计,全自动生化分析仪。     

射频热疗联合化疗对肺癌的疗效观察

目的 评价射频热疗联合化疗治疗肺癌的疗效,毒副反应及对生活质量的影响.方法 40例肺癌病人随机分为两组.治疗组20例采用射频热疗联合化疗药物,根据不同病种选择不同用药方案,TF,TB,CAP,NB.热疗5次/周,电脑实时测温温度控制在40℃～43℃,并维持45～60min.对照组20例采用化疗药物治疗,方法 同治疗组.结果 治疗组与对照组总有效率分别为75%和45%,两组比较差异有显著性(P＜0.05);治疗组KPS评分与对照组比较差异有显著性(P<0.05).急性毒性反应比较差异没有显著性,均可耐受.结论 射频热疗联合化疗药物能显著提高肺癌的治疗效果,改善了病人的生存质量,是一种安全有效的方法.     

体外诱导骨髓间充质干细胞向肾小管上皮样细胞分化

Objective To investigate the differentiation of rat bone marrow mesenchymal stem cells (MSCs) to renal tubular epithelial-like cells under different conditions. Methods MSCs were obtained from rat marrow. MSCs were isolated by gradient density centrifugation and plastic adherence and then purified. Surface markers were identified with flow cytometry after amplification in vitro. The purified MSCs of the third passage were cultured respectively as follows: (1) control group: DMEM medium with fetal bovine serum(FBS). (2) all-trans retinoic acid (ATRA) group: DMEM medium with FBS, ATRA and ischemic reperfusion-injured kidney tissue homogenate. (3)combination group: DMEM medium with FBS, ATRA, ischemic reperfusion-injured kidney tissue homogenate, epidermal growth factor (EGF) and bone morphogenetic protein 7 (BMP-7). After 7 days, the MSCs were collected for alkaline phosphatase (AKP) staining, cytokeratin-18 and E-cadherin immunocytochemical analysis. Results The positive rates of the third passage MSCs in CD44, CD90 and CD29 were 97.8%±0.9%, 96.8%±1.4% and 97.6%±2.4%,respectively, but in CD11b/c and CD34 were only 13.2%±0.6% and 1.2%±0.5%. The MSCs in control group were spindle. The MSCs in ATRA group were round and elliptic. The MSCs in combination group became cobblestone-like cells after 7 days. AKP staining showed that tubular epithelial-like cells from MSCs in control group were negative, some above cells in ATRA group were positive and number of above cells increased in combination group. Compared with negative control group, the ratios of cytokeratin-18 positive cells in ATRA group and combination group were respectively increassed by 29.47%±1.08% and 47.52%±2.13% (all P<0.05), the ratios of E-cadherin positive cells in ATRA group and combination group were respectively increased by 14.88%±2.46% and 36.15%±1.13% (all P<0.05). Conclusion MSCs may differentiate by renal tubular epithelial-like cells under the induction of ischemic reperfusion-injured kidney tissue homogenate and ATRA in vitro, which are further differentiated under the combined induction of EGF and BMP-7.     

自动调节压力和固定压力持续正压通气呼吸机在阻塞性睡眠呼吸暂停低通气综合征治疗中的对比研究

目的观察自动调节压力持续正压通气呼吸机(A-CPAP)和固定压力持续正压通气呼吸机(F-CPAP)在治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)中平均压力的对比。方法选择100例诊断为OSAHS的患者随机单盲分成两组,分别使用A-CPAP和F-CPAP呼吸机,观察治疗前后的平均血氧饱和度,以及两种呼吸机的平均压力值。结果两组呼吸机治疗前后的平均血氧饱和度明显升高(P<0.01),A-CPAP治疗组平均压力较低,差异有统计学意义(P<0.01)。结论A-CPAP和F-CPAP呼吸机在治疗OSAHS中均有明显疗效,A-CPAP有更好的舒适性和耐受性。     

芎芍胶囊对人脐静脉内皮细胞分泌血管新生因子的影响

目的探讨芎芍胶囊对人脐静脉内皮细胞（HUVEC）分泌血管新生因子影响的机制。方法采用血清药理学和体外干预培养HUVEC的方法,通过MTF法和酶联免疫吸附分析法观察芎芍胶囊低、中、高剂量对HUVEC的体外增殖和分泌Ang、Ang-2、VEGF、bFGF、EGF和TGF-β1的影响。结果芎芍胶囊各剂量组均有促HUVEC增殖的作用。低剂量组有促进HUVEC分泌Ang、Ang-2、EGF和VEGF的作用,而对bFGF、TGF-β1分泌的影响无明显差异;中剂量组有促进HUVEC分泌Ang、Ang-2、EGF和bFGF的作用,抑制TGF-β1的分泌,对VEGF的分泌无明显影响;高剂量组有促进HUVEC分泌Ang、EGF和bFGF的作用,并抑制VEGF与TGF-β1的分泌,而对Ang-2的影响无明显差异。结论芎芍胶囊能促进HUVEC的增殖,增加HUVEC分泌促血管新生因子和降低抑血管生成因子表达,且与剂量有一定的关系。     

Modulation of γ-aminobutyric acid on painful sense in central nervous system of morphine-dependent rats

OBJECTIVE: To observe the effects of gamma-aminobutyric acid (GABA) on the electric activities of pain-excited neurons (PEN) in nucleus accumbens (NAc) in central nervous system (CNS) of morphine-dependent rats. METHODS: After GABA or the GABA(A)-receptor antagonist, bicuculline (Bic), was injected into cerebral ventricles or NAc, right sciatic nerve was stimulated by electrical pulses, which was considered as traumatic pain stimulation. Extracellular recordings methods were used to record the electric activities of PEN in NAc. RESULTS: When GABA was injected into intracerebroventricle (ICV) as well as NAc, it could decrease the pain-evoked discharge frequency and prolong the latency of PEN. Bic could interdict the above effects of GABA on the electric activities of PEN. CONCLUSION: Exogenous GABA might have an inhibitory effect on the central pain adjustment. Furthermore, GABA and GABA(A) receptor participate and mediate the traumatic information transmission process in CNS.     

腔隙性脑梗死小动脉病变的血流动力学特点研究

【目的】探讨腔隙性脑梗死中小动脉病变的脑血流动力学特点。【方法】采用经颅多普勒(TCD)观察85例排除伴有明显大血管病变的腔隙性脑梗死患者脑内主要动脉的血流动力学改变,并与年龄和动脉血压等指标进行相关性分析。并设立相同年龄段的头颅影像检查正常的25例健康体检者作为对照。【结果】腔隙性脑梗死组大脑中、前、后动脉的平均血流速度分别为(62.09±16.90)cm.s-1、(50.42±13.11)cm.s-1、(32.33±7.55)cm.s-1,均低于对照组的(69.65±19.20)cm.s-1、(57.75±16.75)cm.s-1、(38.75±8.81)cm.s-1(均P<0.05),脉动指数分别为1.05±0.26、1.01±0.24、1.05±0.23,均高于对照组的0.87±0.12、0.88±0.20、0.88±0.16(均P<0.05)。其中大脑中、前、后动脉的平均血流速度与性别、年龄和动脉血压无明显相关性,而脉动指数与年龄呈正相关(r分别为0.394、0.299、0.352,均P<0.05),大脑前动脉的脉动指数与收缩压和脉压差呈正相关(r分别为0.338、0.353,P<0.05),大脑中动脉的脉动指数与脉压差呈正相关(r=0.220,P<0.05),梗死灶所在的患侧和没有梗死灶的健侧的血流速度和脉动指数均未见显著性差异(P>0.05)。【结论】腔隙性脑梗死患者小动脉病变可导致血流速度轻度减慢,脉动指数升高,其中脉动指数与年龄和动脉血压有一定相关性。