松果腺褪黑素对下丘脑-垂体-肾上腺轴的调节作用

松果腺褪黑素对多种不同功能状态下的下丘脑 垂体 肾上腺轴都有一定调节作用。其机制不仅在于直接与下丘脑 垂体 肾上腺轴上的褪黑素受体结合刺激激素释放 ,并影响糖皮质激素受体的功能 ,而且与五羟色胺、内阿片肽等神经递质、调质相互联系 ;且下丘脑 垂体 肾上腺轴对松果腺褪黑素存在反馈作用。这种调节的广泛性使褪黑素用于内分泌、免疫、精神神经系统疾患的治疗成为可能。

双肌束交叉双“桥”肾固定术(附34例报告)

报告采用双肌束交叉双“桥”肾固定术治疗肾下垂34例,经1～4年观察效果满意。认为:本术式能增加下垂肾固定在生理位置上的稳定性和牢固性;对保持正常肾上盏的纵轴与第五腰椎体中心连线所形成之夹角起到固定作用。临床可考虑采用。

MAGNETIC RESONANCE IMAGING CHARACTERISTICS AND SURGICAL RESULTS OF ADRENOCORTICOTROPIN-SECRETING PITUITARY ADENOMAS

Objective To evaluate magnetic resonance imaging （MRI） characteristics and surgical results of adrenocorticotropin （ACTH） -secreting pituitary adenomas. Methods MRI characteristics and relationship between MRI positive rate and surgical results of 266 patients with pathologically confn＇med Cushing＇s disease were analyzed retrospectively. All patients underwent thin-section sagittal and coronal scans of the pituitary gland before and after administration of gadolinium-diethylene triamine pentaacetic acid （Gd-DTPA） on a 1. 5 Tesla MR/scanner, and dynamic enhanced MR/was performed in 39 patients. All patients underwent transsphenoidal adenomectomy. Endocrinological examinations and assessments were performed. Results Preoperative MR/revealed normal results in 41 （ 15.4% ） cases, microadenoma in 179 （67. 3% ）, macroadenoma in 42 （ 15.8% ）, and huge adenoma in 4 （ 1.5% ）. Pituitary apoplexy was found in 13 （4.9%） cases. Positive rate of ACTH-secreting adenomas was 84.6% （225/266） on MR/scans, and that of small microadenomas was 87.2% （34/39） on dynamic enhanced MRI scans. Preoperative endocrinological tests of 199 cases supported the diagnosis of typical Cushing＇s disease, while the other 67 cases had atypical endocrinological results. The endocrinological cure rate, remission rate, and inefficacy rate were 85.7%, 7.9%, and 6. 4%, respectively. There was no difference in the initial endocrinological cure rate between the patients with positive and normal MRI results （90% vs. 87. 8%, P =0. 904）. Conclusions Enhanced coronal pituitary MR/ is helpful for preoperative localization of ACTH-secreting pituitary microadenoma. Dynamic enhanced MR/may improve detection rate of microadenoma. There is no marked difference in the surgical results for patients with preoperative MR/results indicating presence or absence of microadenoma.

Effects of repetitive transcranial magnetic stimulation on hypothalamic-pituitary-adrenal axis of patients with depression

Objective： To investigate the effects of sleep electroencephalogram-modulated repetitive transcranial magnetic stimulation （SEM-rTMS） and conventional rTMS （C-rTMS） on the activity of hypothalamic-pituitary-adrenal （HPA） axis in patients with depression. Methods： In a double-blind, randomized controlled trial, 164 patients diagnosed with depression were randomized to treatment with SEM-rTMS （n=57）, C-rTMS （n=55） or sham rTMS （n=52） for 30 rain every day for 10 d. Before and after treatment plasma concentrations of adrenocorticotropic hormone （ACTH） and cortisol （CORT） were measured, and the 24-item Hamilton Depression Rating Scale （HAMD-24） was used for assessment. Results： The HAMD-24 scores and plasma ACTH and CORT concentrations of these depressive patients before treatment were significantly different from those of the normal control group （P〈0.05）. The HAMD-24 scores and plasma ACTH and CORT concentrations in the SEM-rTMS group and conventional rTMS group were decreased significantly （P〈0.05）. There was a significant positive correlation between the HAMD-24 scores and plasma ACTH （n=240, r=0.105, P=0.048） and CORT concentrations （n-240, r=0.126, P=0.023） in the patients with depression before and after treatment. Conclusion： The antidepressant effect of rTMS, including SEM-rTMS, may be related to its decreasing HPA axis activity. （This trail was registered. No： ChiCTR-TRC-00000465）

Increased expression level of corticotropin-releasing hormone in the amygdala and in the hypothalamus in rats exposed to chronic unpredictable mild stress

Objective Corticotropin-releasing hormone（CRH）plays an important role in neuroendocrine,autonomic and behavioral responses to stressors.In the present study,the effect of chronic unpredictable mild stress（CUMS）on CRH neurons was investigated in rat brain.Methods The rats were exposed to one of the stressors each day for 21 d.Immunostaining was performed to detect the CRH-positive neurons in the paraventricular nucleus（PVN）of the hypothalamus and in amygdala.Results After the stress protocol,the animals showed a reduction in body weight gain as well as reduced sucrose preference and locomotor activity.Interestingly,the CRH neurons in both PVN and central nucleus of the amygdala（CeA）were stimulated by CUMS.The densities of CRH-containing neurons in both PVN and CeA were significantly higher than those in control group.Conclusion The CRH systems in PVN and CeA may both contribute to depression-like behaviors during CUMS.

Sini Powder extract produces antidepressant-like effects in a chronic social defeat stress model of depression in tree shrews

Sini Power（SP） is a famed traditional Chinese formula that has long been used to treat depression. Here, we investigated the effects and possible mechanisms of SP extract on an established model of depression： chronic stressed tree shrew, which mimics the human condition of social stress. The animals were divided into 4 groups. Except for the na？ve group, the other animals were subjected to daily social defeat stress for 5 weeks, and during the last 4 weeks treated with SP extract（3.6 g/kg/d）, fluoxetine（15 mg/kg/d）, and vehicle, respectively. The results showed that SP extract could reverse body weight loss to a certain extent and reduce the levels of urine/serum cortisol that were initially increased by chronic social defeat. In addition, SP extract increased hippocampus norepinephrine concentrations. Our data suggested that SP extract had positive effects on the main depression symptoms in the chronic stressed tree shrew model and that it may be used to help control hypothalamic-pituitary-adrenal axis hyperactivity.

Regulatory mechanism of hormones of the pituitary-target gland axes in kidney-Yang deficiency based on a support vector machine model

OBJECTIVE:To study the development mechanism of kidney-Yang deficiency through the establishment of support vector machine models of relevant hormones of the pituitary-target gland axes in rats with kidney-Yang deficiency syndrome.METHODS:The kidney-Yang deficiency rat model was created by intramuscular injection of hydrocortisone,and contents of the hormones of the pituita- ry-thyroid axis:thyroid stimulating hormone(TSH),3,3',5-triiodothyronine(T_3) and thyroxine(T_4);hormones of the pituitary-adrenal gland axis:adrenocorticotropic hormone(ACTH) and Cortisol(CORT);and hormones of the pituitary-gonadal axis:luteinizing hormone(LH),follicle-stimulating hormone(FSH),and testosterone(T),were determined in the early,middle,and advanced stages.Ten support vector regression(SVR) models of the hormones were established to analyze the mutual relationships among the hormones of the three axes.RESULTS:The feedback control action of the pituitary-adrenal axis began to lose efficacy from the middle stage of kidney-Kong deficiency.The contents all hormones of the three pituitary-target gland axes decreased in the advanced stage.Relative errors of the jackknife test of the SVR models all were less than 10%.CONCLUSION:Imbalances in mutual regulation among the hormones of the pituitary-target gland axes,especially loss of effectiveness of the pituitary-adrenal axis,is one pathogenesis of kidney-Yang deficiency.The SVR model can accurately reflect the complicated non-linear relationships among pituitary-target gland axes in rats with of kidney-Yang deficiency.

Influence of Acupuncture on HPA Axis in a Rat Model of Chronic Stress-induced Depression

Objective： To investigate the neurobiological mechanism of depression pathogenesis and reveal the mechanism of acupuncture treatment of depression. Methods： Wistar rats were selected for subjects. A rat model of depression was made by individually housing with unpredicted chronic moderate stimuli. Changes in behavior and hypothalamus-pituitaryadrenocortical axis were examined in rat models of stress-induced depression. Meanwhile, the intervening effect of acupuncture was evaluated and the curative effects of different acupuncture methods compared. Results： CORT and ACTH contents of serum were significantly higher in the model and normal saline groups than in the control group （P〈0.05）, significantly lower in the hand acupuncture and electroacupuncture groups than in the model group （P〈0.05） and significantly lower in the medication group than in the normal saline group （P〈0.05）. There were no significant differences between the hand acupuncture, electroacupuncture and medication groups. Conclusion： Acupuncture of Baihui（GV 20） and Taichong （LR 3） has a marked antidepressant effect. Its mechanism may be related to the regulation of HPA axis by acupuncture.

Effects of Electro-acupuncture on Hypothalamic-PituitaryAdrenal Index and Corticotropin Releasing Hormone mRNA Expression of Rats with Chronic Fatigue Syndrome

Objective： To investigate the mechanism of electroacupuncturein treating chronic fatigue syndrome（CFS） in term of the neuro-endocrine system by observing the regulative effect of EA on hypothalamic-pituitary-adrenal index （HPA index） and corticotropin releasing hormone mRNA （CRH mRNA） in CFS model rats. Methods： The rats were randomly divided into control group, model group, and electroacupuncture group. Model and electroacupuncture groups were forced to swim in cold water to make CFS model, while rats in electroacupuncture group were treated with electroacupuncture treatment at the same time. Electroacupuncture group was given at Baihui（GV 20） and Zusanli（ST 36）. Evaluation of the model was processed according to the behavior changes of the rats. Hypothalamic, pituitary, and adrenal were weighted to calculate HPA index. CRH mRNA in hypothalamic was measured by fluorescence quantitative polymerase chain reaction （FQPCR）. Results： The model rats had behavior changes, and both physical and mental fatigue was observed. HPA index raised and expression of CRH mRNA in hypothalamus increased in CFS rats. After electroacupuncture treatment, the physical and mental fatigue was improved, and the hypothalamic index and CRH mRNA decreased significantly, while the pituitary and adrenal index only had little decrease. Conclusion： Cold water swim press could mimic the pathogenesis and make similar manifestations in rats with the common clinical symptoms. CFS has close relationship with increase of HPA index and CRH mRNA expression. Electroacupuncture can regulate the function of HPA axis to deal with CFS.

Effects of neuro-immuno-modulation on healing of wound combined with local radiation injury in rats

Purpose： To investigate effects of neuro-immuno-modulation on wound healing by observing changes of cytokines and hypothalamic-pituitary-adrenal （HPA） axis hormones in acute stress reaction in rats with wound and combined local radiation injury. Methods： Sixty female Wistar rats （weighting 200 ± 20 g） were randomly divided into normal control group, wound group and combined wound-local radiation （CWR） group （25 Gy local radiation post wound）, 20 rats in each group. Contents of IL-1β, IL-6 and IFN-γ and IL-4 in serum were measured and changes of adrenocorticotropic hormone （ACTH） and glucocorticoid （GC） in serum were analyzed by using enzyme-linked immunosorbent assay and radioimmunologic assay, respectively at different time points post wound and radiation. Results： （1） The level of IFN-γ, one of the Thl cell cytokines increased significantly at 14 d post CWIL which was markedly higher than that in control group and wound group. However, the level of IL-4, IL-1β and IL-6, one of the Th2 cell cytokines, did not show obvious change. （2） Ratio of Thl/Th2 （IFN-γ/IL-4） in wound group and CWR group increased significantly at 7 d after wound and radiation, which suggested that Thl/Th2 balance drifted to Thl immune response. The ratio of Thl/Th2 in wound group returned to the normal level up to 14 d after the wound and radiation, while the Thl/Th2 ratio in CWR group increased persistently and was much higher than that in control and wound groups. （3） Level of serous ACTH and CC in CWR group increased at 3 d post wound and radiation, and among them, level of CC showed statistically significant increase, which was much higher than that in control and wound groups. Conclusion： Level of serous neurohormone CC in rats increased significantly immediately after wound and radiation; while the level of IFN-γ showed significant increase only up to 14 d after wound and radiation, and the Th1/Th2 imbalance sustained till 28 d post wound and radiation. In order to reduce acute damage caused by CWR, organic immune system and nerve system showed up a marked regulate effects simultaneously and mutually. Nonetheless, the excessive stress induced by CWR causes distur- bance of immunoregulation, which is one of the key reasons for delayed wound healing in CWR.