简介:国家级继续医学教育项目“第五期颈动脉硬化狭窄外科治疗及进展学习班”将于2008年5月21-24日在复旦大学附属华山医院举办。本次学习班将邀请国内知名专家教授系统讲解颈动脉硬化狭窄外科治疗的应用解剖、流行病学研究、影像学检查、颈动脉内膜切除术(CEA)的手术技巧、术中监护、围手术期处理、并发症防治、
简介:目的:通过监护仪所示的呼吸率、心率和血氧饱和度(SpO2)参数探索肺源性心脏病病理生理变化的昼夜生物节律特征。方法,15例样本均符合肺源性心脏病诊断标准,其中男12例,女4例,平均年龄68岁,设置6个时点:0点、4点、8点、12点、16点、20点,从24h监护仪中获取呼吸率(次数)、心率(次数)和SpO2(百分率)的监测数据,分项输入余弦法程序进行生物节律分析。结果:在所观测的15个病例中,呼吸率9例和心率10例的峰值相位位于356.89°--84.50°(23点44分-4点36分),其中5例其中5例P〈0.05,提示有显著生物节律特征。SpO2的峰值相位,12例位于-130.60°--310.16°(8点20-20点20分),其中5例P〈0.05,提示有显著生物节律特征。结论:肺源性心脏病例的呼吸率和心率夜间明显快于白天,SpO2明显夜间低于白天,提示该病的病理生理具有昼夜生物节律特征。
简介:脑白质损害(WML),也称为“脑白质疏松”,是老年人中常见的神经放射学表现。WML通常位于脑室周围和皮质下白质,在MRI上表现为高信号。最近的研究提示心血管危险因素与WML的发生有关。这些损害可以出现老年综合征的各种表现,如跌倒、执行功能障碍、抑郁症状和尿失禁。低灌注引起的额叶和皮质下区域内相关通路的损害可以破坏额叶执行功能、运动控制功能及其他系统,从而导致上术症状。WML可造成严重的残疾,而不像原来认为的那样是一种良性静止性状态。应该在青年期和中年期针对心血管危险因素进行干预以防止晚年出现与WML相关的功能障碍。当这些损害形成并造成执行功能减退后,患者对复杂的风险降低计划的依从能力可能会显著下降。
简介:目的:了解医院不同科室护理人员所经受的道义性苦恼,提出有效的应对措施,方法:采用问卷调查法对延边地区二级综合医院护理人员的状况苦恼,认知苦恼、情绪苦恼,行动蕾恼及其与一般特征的关系作了调查。将所收集的资料利用SPSS软件包进行统计学分析和处理。结果:护理人员经受的状况苦恼分值为(72.94±25.59)分,认知苦恼分值为(36.63±11.12)分,情绪苦恼分值为(36.0l±8.27)分,除了状况苦恼在不同科室人群间有统讨‘学差异之外,道义性苦恼与护理人员在一般特征不同的人员间均无统计学差异。在道义性状况的行动反应中,设想应付战略占76.8%,默认状况占15.9%。结论:护理管理者应注意引导护理人员正确对待来自多方的冲突,建议通过伦理决策这一道德思维模式,规范行为,为护理人员创造良好的王作环境,解决各类冲突。
简介:目的探讨大鼠脑缺血再灌流后Bcl-2蛋白、Caspase-3mRNA的表达及炎性细胞漫润与神经细胞凋亡的关系.方法将54只Wistar大鼠随机分为二组:假手术组,缺血再灌流组.采用原位末端标记(TUNEL)、免疫组化和原位杂交技术分别观察脑缺血再灌流后不同时间点神经细胞凋亡及损伤的变化与Bcl-2、Caspase-3mRNA表达.结果Bcl-2表达于缺血再灌流12~24h达高峰,再灌流2~4d呈下降趋势,至16d略高于假手术组;Caspase-3mRNA于缺血再灌流12~24h达高峰,2~4d呈降低趋势,至16d略高于假手术组.结论脑缺血再灌流后细胞凋亡介导神经细胞损伤、坏死是一个渐进的动态演变过程.Bcl-2蛋白、Caspase-3mRNA表达在抑制细胞凋亡和介导神经细胞损伤等方面起非常重要的作用.
简介:Heatshockprotein70(HSP70)maintainsCa~(2+)homeostasisinPC12cells,whichmayprotectagainstapoptosis;however,themechanismsofneuroprotectionareunclear.Therefore,inthisstudy,weexaminedCa~(2+)levelsinPC12cellstransfectedwithanexogenouslentiviralHSP70geneexpressionconstruct,andwesubsequentlysubjectedthecellstoischemia-hypoxia/reoxygenationinjury.HSP70overexpressionincreasedneuronalviabilityandATPaseactivity,anditdecreasedcellularreactiveoxygenspecieslevelsandintracellularCa~(2+)concentrationafterhypoxia/reoxygenation.HSP70overexpressionenhancedtheproteinandmRNAexpressionlevelsofsarcoplasmic/endoplasmicreticulumCa~(2+)-ATPase(SERCA),butitdecreasedtheproteinandmRNAlevelsofinositol1,4,5-trisphosphatereceptor(IP3R),therebyleadingtodecreasedintracellularCa~(2+)concentrationafterischemia-hypoxia/reoxygenation.TheseresultssuggestthatexogenousHSP70protectsagainstischemia-hypoxia/reoxygenationinjury,atleastinpart,bymaintainingcellularCa~(2+)homeostasis,byupregulatingSERCAexpressionandbydownregulatingIP_3Rexpression.
简介:Thestudyaimstoconfirmtheneuroregenerativeeffectsofbacterialmelanin(BM)oncentralnervoussysteminjuryusingaspecialstainingmethodbasedonthedetectionofCa~(2+)-dependentacidphosphataseactivity.Twenty-fourratswererandomlyassignedtoundergoeitherunilateraldestructionofsensorimotorcortex(groupI;n=12)orunilateralrubrospinaltracttransectionatthecervicallevel(C3–4)(groupⅡ;n=12).Ineachgroup,sixratswererandomlyselectedaftersurgerytoundergointramuscularinjectionofBMsolution(BMsubgroup)andtheremainingsixratswereintramuscularlyinjectedwithsaline(salinesubgroup).NeurologicaltestingconfirmedthatBMacceleratedtherecoveryofmotorfunctioninratsfrombothBMandsalinesubgroups.Twomonthsaftersurgery,Ca~(2+)-dependentacidphosphataseactivitydetectionincombinationwithChilingarian'scalciumadenosidetriphosphatemethodrevealedthatBMstimulatedthesproutingoffibersanddilatedthecapillariesinthebrainandspinalcord.TheseresultssuggestthatBMcanpromotetherecoveryofmotorfunctionofratswithcentralnervoussysteminjury;anddetectionofCa~(2+)-dependentacidphosphataseactivityisafastandeasymethodusedtostudytheregeneration-promotingeffectsofBMontheinjuredcentralnervoussystem.
简介:Intraperitonealinjectionofrecombinanthumaninterleukin-2(rhIL-2)inhibitsneuronalapoptosisinthechronicocularhypertensionretinalganglioncelllayer.IntravitreousinjectionwasperformedonretinalganglioncellsinaWistarratmodelofchronicallyelevatedintraocularpressuretoobservetheeffectsofLY294002andAG490onretinalganglioncellsurvival,macrophageactivation,andPI3K/AktandJAK/STATactivation.ThenumberofretinalganglioncellsintherhIL-2treatmentgroupwasmuchgreaterthaninthenormalcontrolandphosphate-bufferedsalinegroups.WesternblotanalysisrevealedlowAktandSTAT3proteinexpressionintheretinaafter3-hourintravitreousinjectionsofrhIL-2.However,proteinexpressionwasincreasedat12hours,butdecreasedagainat24hours,withverylowexpressionat96hours.LY294002andAG490,whichareinhibitorsofthePI3K/AktandJAK/STAT3signalpathways,preventedupregulationofAktandSTAT3proteinexpressionintheretina,respectively.IntravitreousinjectionofrhIL-2exhibitedneuroprotectiveeffectsbydecreasingretinalganglioncelllayerdamageinaratmodelofchronicglaucoma.TheseresultssuggestthatintravitrealinjectionofrhIL-2couldinducethePI3K/AktandJAK/STAT3signalingpathwaystoprotectretinalganglioncellsinchronicallyelevatedintraocularpressuremodels.
简介:目的初步探讨以问题为基础的学习(problem-basedlearning,PBL)在神经内科进修医师的头晕诊断学教学中的应用及其价值。方法选取首都医科大学附属北京天坛医院神经内科的进修医师20名随机分为试验组和对照组,分别采用PBL教学和以授课为基础的教学法,比较两组的教学效果。结果试验组与对照组相比较,病例分析考试成绩和总成绩显著提高(P分别为0.005和0.013);基础理论知识考试成绩有增高趋势,但无显著差异。结论PBL教学法是适合于进修医师的头晕诊断学教学的有效方法,有助于培养进修医师的临床思维能力。在文献检索培训和基础理论铺垫的基础上开展PBL教学,有可能进一步提高教学质量。
简介:SpinaldorsalhornN-Methyl-D-asparticacidreceptor2B(NR2B)overexpressionplaysanimportantroleintheproductionandmaintenanceofneuropathicpain.BecausesmallinterferingRNA(siRNA)caninhibitNR2Bexpression,siRNAmayprovideanovelapproachtotreatneuropathicpainandpossiblynerveinjury.However,anefficientandsafevectorforNR2BsiRNAhasnotbeendiscov-ered.Thisstudyshowsthatawatersolublelipopolymer(WSLP)comprisedoflowmolecularweightpolyethyleneimine(PEI)andcholesterolcandeliversiRNAtargetingNR2Bforthetreatmentofneuropathicpain.ResultsshowthatintrathecalinjectionofWSLP/siRNAcomplexesfor3daysin-hibitNR2BgeneexpressionwithreductionsinmRNAandproteinlevelsby59%and54%,respec-tively,comparedwithcontrolrats(P<0.01).InjectionofWSLPcomplexedwithscrambledsiRNA,orPEIwithsiRNAdidnotshowthisinhibitoryeffect.Moreover,injectionofWSLP/siRNAcomplexessignificantlyrelievedneuropathicpainat3,7,12,and21days,whileinjectionofWSLPwithscrambledsiRNAorPEIwithsiRNAdidnot.TheseresultsdemonstratethatWSLPcanefficientlydeliversiRNAtargetingNR2Binvivoandrelieveneuropathicpain.