目的 系统评价高压氧(HBOT)联合药物治疗抑郁症的效果.方法 运用计算机检索PubMed、EMbase、Cochrane Library、CNKI、COJ数据库,全面检索HBOT治疗抑郁症的随机对照试验(RCT),并追溯纳入研究的参考文献,采用RevMan 5.2软件进行Meta分析.结果 共纳入11项RCT研究,1133例患者.分析结果显示:HBOT结合药物治疗组疗效优于对照组(P<0.00001).产后HBOT结合药物治疗的效果更加明显(P<0.00001).HBOT联用帕罗西汀治疗有效性优于使用其他药物(P<0.05).结论 当前证据表明,HBOT联合抗抑郁药物治疗抑郁症较常规药物治疗具有优势.由于受到纳入文献质量评价较低和被试患者数量较少的限制,有必要开展更多的RCT进一步评价联合治疗的效果和安全性.

眼球是一种构造复杂的器官,其各部位的结构和密度不同,且各层次间的依附性和连接性较差[1].大鼠眼球组织的石蜡切片被广泛应用于眼科相关疾病的实验研究,而常规石蜡切片方法极易造成眼球变形,各层次之间结构分离、移位,特别是固定液性的视网膜脱落,给组织病理学的诊断带来很大的阻碍.对此,我们结合眼球的结构特点及以往的文献报道[1-10],比较了3种不同的固定方法,总结出较适合制作大鼠眼球石蜡切片的固定方法,有效地提高了大鼠眼球石蜡切片的质量,现介绍如下.

Objective To study the effects of rehabilitation training on the synaptic ultrastructure of the brain cortex after cerebral ischemia.Methods Sixty rats were randomly divided into a sham operation group,a cerebral ischemia group and a rehabilitation training group.A model of focal cerebral ischemia was created in the rats of the cerebral ischemia and rehabilitation training groups.The rehabilitation training group was given balancing,grasping,rotation and walking training every day.The sham operation group and cerebral ischemia group were kept in normal cages,taking food and moving freely.Electron microscopy was used to observe the density and ultrastructure of the cortical synapses at days 1,7,14 and 21 after the operation.Results In the sham operation group there were numerous synaptic terminals in the cortical neuropil.The majority of synapses were Gray type Ⅱ,containing spherical synaptic vesicles in presynaptic elements.After cerebral ischemia,the number of synaptic terminals had decreased and the synaptic structure was damaged.The synaptic vesicles lessened and dissolved.The presynaptic and postsynaptic membranes became unclear.At 21d after ischemia,the synaptic vesicles had disappeared and the presynaptic and postsynaptic membranes were damaged so seriously that the typical synaptic structure disappeared.After rehabilitation training,the damaged synaptic terminals recovered.Conclusions The synaptic structure was damaged after cerebral ischemia,and the damaged synaptic terminals recovered after rehabilitation training.Rehabilitation training can enhance synaptogenesis in the brain's cortex after cerebral ischemia and promote the recovery of motor function,at least in rats.