[目的]初步探究表没食子儿茶素没食子酸酯(EGCG)对高频刺激(HFS)诱导雌性小鼠慢性原发性疼痛的镇痛作用及其机制.[方法]采用10 V的HFS(波宽0.5 ms,100 Hz,4串,每串持续1 s,间隔10 s)左后肢坐骨神经建立雌性小鼠慢性原发性疼痛模型.将小鼠随机分为假手术组、溶剂(生理盐水)+HFS组、不同浓度EGCG+HFS组(每组4～5只).手术前1 h,鞘内注射10μL溶剂或EGCG(10、20、50、200μmol/L).采用后爪机械撤足阈值(PWT)和镇痛效率评价EGCG的治疗效果.最后用免疫荧光法检测腰段脊髓蛋白表达,探讨其可能的作用机制.[结果]与溶剂HFS组比较,EGCG鞘内注射剂量依赖性缓解雌性小鼠HFS引起的机械痛敏,其最大镇痛效率达84.95％.EGCG还可阻断疼痛雌性小鼠同侧腰段脊髓背角c-Fos(神经元兴奋性标记物)阳性神经元数量以及降钙素基因相关肽(CGRP+)终末、Iba1(小胶质细胞标记物)、GFAP(星形胶质细胞标记物)表达的增加.[结论]鞘内注射EGCG可通过抑制脊髓背角突触前CGRP终末增加、突触后神经元兴奋性以及胶质细胞激活,对HFS诱导的慢性原发性疼痛产生镇痛作用.

目的:翻译挪威版改良躯干损伤量表(the Trunk Impairment Scale-modified to Norwegian Version,mTIS),并探讨其在脑卒中患者应用中的信度与效度,为其临床应用提供客观依据.方法:将挪威版mTIS翻译为中文版mTIS.共入组30例病例,在入组第一天,评定者A与B同时但独立对患者进行中文版mTIS量表评估,评定者A再对患者进行Fugl-Meyer量表的下肢运动部分(The Fugl-Meyer Assessment of Lower Extremity,FMA-LE)、改良 Barthel 指数(Modified Barthel Index,MBI)、Berg 平衡量表(Berg Balance Scale,BBS)和脑卒中患者姿势评定量表(Postural Assessment Scale for Stroke Patient,PASS)评估.在入组第二天,评定者A再进行一次中文版mTIS评估.采用组内相关系数法(Intra-class Correlation Coefficient,ICC))分析评定者内部的重测信度和评定者间信度,采用Pearson相关系数法检测效度.结果:在信度研究中,评定者A与B之间的中文版mTIS总分、动态坐位平衡分量表得分、协调分量表得分的ICC分别为0.978,0.967,0.902,评定者A两次评定结果之间的中文版mTIS总分、动态坐位平衡分量表得分、协调分量表得分的ICC分别为0.971,0.969,0.901.在效度研究中,中文版mTIS得分与FMA-LE得分的相关系数r=0.806,P＜0.05;与MBI得分的相关系数r=0.802,P＜0.05;与BBS得分的相关系数r=0.734,P＜0.05;与PASS得分的相关系数r=0.775,P＜0.05.结论:中文版改良躯干损伤量表在脑卒中患者应用中具有良好的重测信度、评定者间信度和较好的效度.

Objective:To discuss whether the alteration of neurological impairment of rats with cerebral infarction after the treatment of functional electrical stimulation(FES) was relevant to the phosphorylation of glycogen synthase kinase-3β(GSK-3β) in their ischemic penumbra fields.Method:Totally 72 rats were randomly divided into three groups:sham-operation,control and NMES treatment.They were subdivided into 4 subgroups,0-day(before treatment),3-day,7-day,14-day treatments,and 6 rats in each.Cerebral infarction was achieved by the permanent middle cerebral artery occlusion(pMCAO).NMES treatment with hypodermic electrodes was provided once per day and 30 min per time.Modified neurological severity score (mNSS) and phosphorylation of GSK-3 in brain were assessed at each observation point.Result:For the mNSS points and comparing with the control group,the improvement of neurological function was observed among rats treated for 7 and 14 days (P＜0.05),but not in 3 days treatment.As the phosphorylation of GSK-3β in the rats penumbra field,it is higher in control group and NMES group than those in sham operation group,and the highest is the 7days treatment group.Conclusion:NMES can ameliorate the neurological impairment after cerebral infarction,and its mechanism involves elevating the phosphorylation of GSK-3β.

Objective To observe the clinical effect of electrical acupuncture on the chemotherapy-induced neuropathic pain (CINP) and the quality of life. Methods Thirty patients with CINP were randomly divided into three groups:group A (n=10) treated with electri-cal acupuncture, group B( n=10) treated with mecobalamin tablets, and group C( n=10) treated with electrical acupuncture and mecobalamin tablets.Visual Analogue Scale (VAS) and Karnofsky Performance Status Scale(KPS)were used to evaluate the curative effect and the quality of life before and after treatment. Results After the treatment, the scores of VAS were decreased in three groups,which were lower in group A and group C than that in group B ( P＜0.05). the scores of KPS were increased in three groups, which were higher in group A and group C than that in group B ( P＜0.05). Conclusion The EA can relieve CINP and improve the quality of life in patients.

Objective:To investigate the regulation effect of electroacupuncture (EA) on Notchl at dentate gyrus in rats with acute cerebral infarction.Method:Intraluminal middle cerebral artery occlusion (MCAO) was performed to establish the cerebral ischemia model.The male adult SD rats were randomly divided into the electroacupuncture group (EA group),the ischemia model group (MCAO group),and the sham operation group (sham group).EA was applied at Baihui and Renzhong after operation,15min once a day from operation to the day sacrificed.Each group rats were assessed the Morris water maze test before and after intervention.The expression of Notchl protein in hippocampus was detected by Westem Blotting.Result:Compared with the model group,EA at Baihui and Renzhong acupoints alleviated cognitive impairment significantly and the expression of Notchl protein in hippocampal of EA group was significantly increased.Conclusion:EA at Baihui and Renzhong acupoints can improve cognition and upregulate the expression of Notchl of protein of hippocampal,so as to reduce the damage of cerebral ischemia on neurons,and provide the therapeutic effect on cerebral ischemia.

目的 观察经皮穴位电刺激对化疗药物所致神经病理性痛的治疗效果.方法 化疗药物所致神经病理性痛患者30例随机分为西药组、电刺激组、电刺激+西药组各10例,其中西药组服用甲钴铵治疗,电刺激组给予经皮穴位电刺激双侧足三里、外关穴位,电刺激+西药组给予经皮穴位电刺激和口服甲钴铵联合治疗.结果 三组治疗后VAS评分均明显降低,差异有显著性(P<0.01).采用方差分析方法,三组治疗后VAS评分组间差异有显著性(P<0.05).三组间的比较采用单因素方差分析,电刺激组与西药组间差异有显著性(P<0.05);电刺激+西药组与西药组间差异有显著性(P<0.05);电刺激+西药组与电刺激组间差异无显著性(P>0.05).治疗后,三组患者Levi评分均降低,与治疗前比较差异有显著性(P<0.05).采用方差分析,三组治疗后的Levi分级组间差异无显著性(P>0.05).结论 三种方法均能提高患者感觉功能,改善患者生活质量.电刺激组与电刺激+西药组的疗效明显优于单纯的西药组,且电刺激组与电刺激+西药组的疗效相当.

Objective To explore the effect of electroacupuncture and transcutaneous electrical acupoint stimulation (TEAS) on somato-sensory evoked potential (SEP) of the upper extremity in healthy subjects. Methods From October, 2015 to April, 2016, ten healthy young volunteers were selected. Each of the subjects was randomly treated with electroacupuncture and TEAS. Before and after treatment, the la-tency and amplitude of N20 and N9 of SEP were detected. Results After electroacupuncture, the latency of N20 prolonged in the stimulated side (Z=-2.620, P<0.01);the latency of N9 prolonged (Z=-2.454, P<0.05), and the amplitude of N9 decreased (Z=-2.330, P<0.05) in the non-stimulated side. After TEAS, the latencies of N9 both in the stimulated side and the non-stimulated side prolonged (Z>2.695, P<0.01). There was no significant difference in the D-value of latency and amplitude of N20 and N9 in both two sides between two treatments (Z<1.817, P>0.05). Conclusion Both electroacupuncture and TEAS could affect the latency and amplitude of N20 and N9, and no difference was found between two treatments.

本文应用气管内滴注PS治疗17例新生儿重症肺炎,治疗后于24、48、72h测定PaO2、PaCO2、pH值均有不同程度改善,与常规治疗组相比有显著性差异(P＜0.05、＜0.01);提示PS能增加肺泡通气量.呼吸机使用天数缩短,住院天数减少,与对照组相比有显著性差异(P＜0.05,＜0.01),提示PS治疗重症肺炎能够明显改善肺氧舍功能,对改善症状及预后有重要作用,值得推广.

目的 探讨轴突生长抑制因子少突胶质细胞髓鞘糖蛋白(OMgp)在新生大鼠缺氧缺血性脑损伤(HIBD)后海马区的表达及意义.方法 将128只7日龄SD大鼠随机分为HIBD组和对照组各64只.建立HIBD模型,取HIBD后1、3、7天和14天为观察点,采用实时荧光定量聚合酶链反应(RT-PCR)技术和免疫组织化学技术,检测各时间点OMgp在海马区的表达情况(n=8).结果 RT-PCR结果显示,OMgp mRNA表达从HIBD后1天开始升高,7天达高峰,14天降低,并且HIBD组各个时间点OMgp mRNA表达量均高于对照组[1天:(1.54±0.12)比(1.11±0.19),3天:(2.56±0.14)比(1.14±0.08),7天:(2.95±0.11)比(1.43±0.17),14天:(2.53±0.11)比(1.08±0.08),P＜0.05].免疫组织化学结果显示,HIBD组与对照组比较,海马区OMgp蛋白表达在HIBD后1天开始升高,7天达高峰,14天表达降低,各时间点OMgp蛋白表达量均高于对照组[1天:(33.69±0.75)比(15.67±1.18),3天:(40.89±1.20)比(30.81±2.56),7天:(60.55±1.72)比(48.53±0.65),14天:(51.31±2.06)比(17.40±0.57),P＜0.05].结论 OMgp蛋白可能在未成熟中枢神经系统的发育及损伤中起重要作用.

<正>患者,女,28岁,无职业,孕4产1,孕38+2周,因下腹胀痛5h于2010年9月29日8∶00入院。末次月经时间为2010年1月4日,预产期为2010年10月11日,孕期定期检查,孕32周时彩色超声发现边缘性前置胎盘。一般情况可,生命体征正

Objective:To investigate the effect of the joint use of neuroprotectant and early intervention on the intelligence of neonates with severe hyperbilirubinemia.Methods:Sixty-seven neonates with severe hyperbilirubinemia were randomly divided into conventional treatment group and comprehensive treatment group.The neonates in conventional treatment group received symptomatic treatment,drug treatment,phototherapy,exchange transfusion by peripheral vessels in accordance with Recommended program for management of neonatal jaundice.Besides these,the neonates in comprehensive treatment group were given newborn touch twice a day and GM-1 20 mg/d×10d.When the neonates in comprehensive treatment group were gradually stable,they were given early intervention including seeing,listening,sense impressions,movement by doctors and their parents until they were 6 months following the Clinical guidelines of early intervention for 0-3 years baby.The DQ of the babies in both groups was examined with the method of Beijing Gesell Baby Development Test when the babies were 6 months old.The incidence of sequelae was compared in two groups.Results:The babies ability in the comprehensive treatment group were significantly better than those in the conventional treatment group(P 0.01) in four large intelligent area such as limb movement,language,social intercourse,adaptability and also better(P 0.05)in small joint movement intelligent area.The incidence of sequelae was less in comprehensive treatment group compared with conventional treatment group.Conclusion:The joint use of neuroprotectant and early intervention could improve babies' intelligence development and decrease sequelae in the neonates with severe hyperbilirubinemia.