尿毒症脑病大鼠脑组织多巴胺、5-羟色胺含量变化及发病机制的探讨

目的研究急性肾功能衰竭及并发脑病时脑组织中多巴胺、5-羟色胺含量变化,从而探讨尿毒症脑病的发病机制。方法成年健康Wister大鼠36只,随机分为两组:正常对照组(12只)、模型组(24只)。模型组大鼠给予顺铂10mg/kg连续两日腹腔注射,诱导急性肾功能衰竭,按设定的分组标准据其临床表现再将模型组大鼠分为尿毒症组和尿毒症脑病组。高效液相-电化学检测法分别检测上述三组大鼠大脑额叶皮质内多巴胺、5-羟色胺两种单胺类神经递质的含量;自动生化仪检测三组大鼠的血肌酐值。结果尿毒症组、尿毒症脑病组血肌酐值(205.67±27.69μmol/l,304.50±66.17μmol/l)明显高于正常对照组(97.00±27.44μmol/l),差别有统计学意义(P<0.05)。尿毒症脑病组肌酐值明显高于尿毒症组,差别有统计学意义(P<0.05);尿毒症组大鼠脑组织中多巴胺含量(0.74±0.10μg/g)、5-羟色胺含量(0.36±0.11μg/g)低于正常组(0.78±0.11μg/g,0.38±0.11μg/g),差别没有统计学意义(P>0.05)。尿毒症脑病组多巴胺含量(0.65±0.09μg/g)、5-羟色胺含量(0.24±0.09μg/g)低于正常组,差别有统计学意义(P<0.05)。尿毒症脑病组多巴胺、5-羟色胺浓度低于尿毒症组,差别有统计学意义(P<0.05);尿毒症脑病组多巴胺、5-羟色胺含量与血肌酐值无线性相关(r=-0.347;-0.277,P>0.05)。结论顺铂10mg/kg连续两日腹腔注射可以成功建立大鼠急性肾功能衰竭动物模型。急性肾功能衰竭无神经系统并发症时脑组织中多巴胺、5-羟色胺-浓度无变化,并发神经系统症状时含量降低,因此多巴胺、5-羟色胺可能参与了尿毒症脑病的发生。急性肾功能衰竭时血肌酐值越高,越容易并发神经系统症状。急性肾功能衰竭并发脑病时,并非血肌酐值越高,脑组织中多巴胺、5-羟色胺浓度越低,二者无线性相关性。

Acupuncture/electroacupuncture enhances antidepressant effect of Seroxat:the Symptom Checklist-90 scores

One hundred and five patients with primary unipolar depression were randomly divided into three groups： drug group （Seroxat administration）, acupuncture group （Seroxat plus acupunc- ture）, and electroacupuncture group （Seroxat plus acupuncture plus electroacupuncture）. Patients＇ symptoms were evaluated using a psychometric questionnaire, the Symptom Check- list-90, before intervention and after 2, 4, 6 and 10 weeks of treatment. The individual factor scores and the total score from the Symptom Checldist-90 reduced in all three groups as treat- ment progressed. In the acupuncture and electroacupuncture groups, the total score and the factor scores for obsessive-compulsive symptoms, depression, and anxiety were significantly lower than those in the drug group. There was no significant difference in the factor scores or total scores between the acupuncture and electroacupuncture groups. Some factor scores in the electroacupuncture group, such as somatization, depression, hostility, and phobic anxiety, were increased at 10 weeks compared with the respective score immediately after the course of electroacupuncture at 6 weeks. Our findings indicate that administration of Seroxat alone or in combination with acupuncture/electroacupuncture can produce a significant effect in patients with primary unipolar depression. Furthermore, acupuncture/electroacupuncture has a rapid onset of therapeutic effect and produces a noticeable improvement in obsessive-compulsive, de- pressive and anxiety symptoms.

Mifepristone modulates serotonin transporter function

Regulating serotonin expression can be used to treat psychotic depression. Mifepristone, a glu- cocorticoid receptor antagonist, is an effective candidate for psychotic depression treatment. However, the underlying mechanism related to serotonin transporter expression is poorly un- derstood. In this study, we cloned the human brain serotonin transporter into Xenopus oocytes, to establish an in vitro expression system. Two-electrode voltage clamp recordings were used to detect serotonin transporter activity. Our results show that mifepristone attenuates serotonin transporter activity by directly inhibiting the serotonin transporter, and suggests that the se- rotonin transporter is a pharmacological target of mifepristone for the treatment of psychotic depression.

男性早泄诊疗进展综述

早泄是男性常见的性功能障碍。对早泄的认识分为神经官能症和身心障碍阶段、后天习得行为阶段、神经生物学和精神药理学阶段以及制药公司阶段。射精的生理过程需要交感神经、躯体神经和多种递质参与。目前早泄的发病机制尚未完全明确,有些疾病,如甲状腺功能亢进,也会引起早泄症状。对于继发于其他疾病产生的早泄症状,应积极治疗原发病。作为原发病,仅有少数数据支持生物学和心理学方面的理论,包括阴茎超敏感反应、焦虑、伴侣关系问题和5-HT受体功能紊乱等。研究表明,心理-行为治疗、α-1受体阻滞剂、局部麻醉、磷酸二酯酶-5(PDE-5)抑制剂和选择性5-羟色胺再摄取抑制剂(SSRIs)均不同程度的对早泄有效。尽管早泄的发病机理尚未完全明确,但是,生理和心理方面的因素均对早泄的发生产生影响。因此,在早泄的治疗上,不仅要关注患者生理方面阴道内潜伏射精时间的改善,也要关注心理方面的改善。

东莨菪碱对吗啡成瘾大鼠脊髓和心房中5－羟色胺、5－羟吲哚乙酸含量的影响

采用高效液相色谱－电化学检测法测定吗啡成瘾大鼠脊髓和心房中５－羟色胺、５－羟吲哚乙酸的含量。吗啡成痛大鼠随机分为自然戒断组和东莨菪碱组（ｎ＝６）。结果显示，吗啡成瘾大鼠脊髓中５－羟色胺、５－羟吲哚乙酸含量高于正常对照（Ｐ＜０．０１），东莨菪碱组二者含量降低。停用吗啡后１天，自然戒断组大鼠脊髓５－羟色胺含量降至正常水平以下，东莨菪碱组大鼠则升高。停用吗啡后６天，二实验组大鼠脊髓５－羟色胺含量均高于正常对照组。东莨菪碱对吗啡刺激的大鼠心房中５－羟色胺含量的升高无影响，结果提示，胆碱能Ｍ受体可能参与吗啡成瘾大鼠脊髓中５－羟色胺代谢的调控。