Dual role of osteoblastic proenkephalin derived peptides in skeletal tissues

Proenkephalin encodes a group of small peptides with opiate-like activity, the endogenous opioids, known to function as neurohormones, neuromodulators, and neurotransmitters. Recently, we have demonstrated that in addition to its abundance in fetal brain tissue, proenkephalin is highly expressed in nondifferentiated mesodermal cells of developing fetuses. We identified the skeletal tissues, bone, and cartilage as major sites of proenkephalin expression. To examine the possibility that proenkephalin is involved in bone development we have studied the expression of this gene in bone-derived cells, its modulation by bone active hormones, and the effects of enkephalin-derived peptides on osteoblastic phenotype. Our studies revealed that osteoblastic cells synthesize high levels of proenkephalin mRNA which are translated, and the derived peptides are secreted. Reciprocal interrelationships between osteoblast maturation and proenkephalin expression were established. These results together with our observations demonstrating inhibitory effects of proenkephalin-derived peptides on osteoblastic alkaline phosphatase activity, strongly support the notion that proenkephalin is involved in bone development. A different direction of research by other investigators has established the capability of the opioid system in the periphery to participate in the control of pain. On the basis of these two lines of observation, we would like to present the following hypothesis: The potential of embryonic skeletal tissue to synthesize proenkephalin-derived peptides is retained in the adult in small defined undifferentiated cell populations. This potential is realized in certain situations requiring rapid growth, such as remodeling or fracture repair. We suggest that in these processes, similarly to the situation in the embryo, the undifferentiated dividing cells produce the endogenous opioids. In the adult these peptides may have a dual function, namely participating in the control of tissue regeneration and in the control of pain. © 1994 Wiley-Liss, Inc.     

左旋四氢巴马汀加强电针对兔大脑皮层牙髓诱发电位的抑制作用

家兔6只,用氨基甲酸乙酯和氯醛糖麻醉,电刺激牙髓,在对侧大脑皮层体感Ⅰ区引导其诱发电位,观察诱发电位各成分与痛的关系。结果观察到,在P1、N1、P2和 N2 4个波中,P1和 P2波相对稳定。其中,P2波(波峰潜伏期:66.1±1.9ms)具有较高的阈值,且不受无镇痛作用的中枢抑制剂安定的影响,而受小剂量镇痛剂度冷丁的抑制,提示 P2波与痛有关。以 P2波的波幅为指标,进一步在12只家兔上观察了 L-THP 和电针及两者合用对诱发电位的影响。结果显示,L-THP 和电针对诱发电位均有抑制作用,且两者在作用强度和时间上存在明显的协同,提示 L-THP 具有加强电针对兔大脑皮层牙髓诱发电位中痛相关成分的抑制作用。     

压脚痛阈测定法的改进和应用

本文介绍一种改进的压脚测痛法。采用电机驱动替代用手挤压橡皮球完成升压过程;通过一个自动的电路切断结构判定抽脚反应,较目视更加客观;用读数保持电路记录压力变化,较直接读取刻度值更加准确,可靠。这些优点,业经电针和吗啡镇痛实验验证。     

家兔中脑导水管周围灰质中甲七肽样免疫活性物质具有镇痛作用并参与电针镇痛

以辐射热照射家兔鼻嘴部皮肤,测定甩头反应潜伏期(ERL)作为痛阈。通过预先埋植的慢性套管向中脑导水管周围灰质(PAG)注射甲七肽降解酶抑制剂 Captopril,观察其镇痛作用以及加强电针镇痛的作用能否被特异的甲七肽抗血清所对抗。(1)单侧 PAG 注射 Captopril240 nmol 的镇痛作用可为同一部位注射甲七肽抗血清(1μl)所翻转,注入甲啡肽抗血清则无效。(2)单侧 PAG 注射 Captopril 60 nmol 有加强电针镇痛的作用。该作用可被1μl 甲七肽抗血清所完全取消,将抗血清量减少到0.1μl 则无效。以上结果说明 PAG 内的甲七肽样免疫活性物质在镇痛和电针镇痛中发挥重要作用。     

家兔中脑导水管周围灰质中注射八肽胆囊收缩素(CCK-8)拮抗吗啡镇痛和电针镇痛

家兔单侧PAG内注射CCK-83ng,能使静脉注射4mg/kg吗啡引起的镇痛作用降低73％或使电针镇痛效果降低67％。在1.5—6.0ng范围内呈量效关系。无硫的CCK-8无此作用。PAG内注射CCK受体拮抗剂proglumide 4μg可翻转CCK-8的抗吗啡镇痛作用。说明PAG部位注射外源性CCK-8可通过CCK受体对抗阿片镇痛。 PAG内注射CCK-8抗血清可显著增强静脉注射2mg/kg吗啡的镇痛效果。PAG内注射CCK抗血清本身也能引起痛阈轻度升高。说明PAG内有内源性的CCK-8发挥紧张性的抗阿片镇痛作用。     

福尔马林致痛提高大鼠中枢μ阿片受体密度及电针的加强作用

用放射自显影方法观察到;（１）大鼠脚掌注射福尔马林后,某些与镇痛有关的脑区如尾核头部、伏隔核、杏仁核、中央灰质、脚间核、中缝大核、脊髓背角等结构中μ阿片受体密度明显增加（Ｐ＜０．０５,Ｐ＜０．０１）;（２）给予电针抑制痛反应的大鼠,在其大部分上述结构及扣带回、隔区、视前内侧区、内膝体、上丘、中缝背核及中央上核受体密度明显增加;与福尔马林注射组相比,脚间核、中央灰质尾端腹外侧区、腰膨大背角的受体密度进一步增加。从而在受体水平支持伤害性刺激可以激活体内内阿片肽能活动,而电针可以加强这一活动的设想。     

大鼠杏仁核内注射八肽胆囊收缩素（CCK—8）拮抗吗啡镇痛的研究

大鼠双侧杏仁核内注射ＣＣＫ－８１ｎｇ（１μｌ）,能明显降低皮下注射４ｍｇ／ｋｇ吗啡产生的镇痛作用,并在０．１－１ｎｇ范围内呈量效关系。分别向双侧仁核注射ＣＣＫ－Ａ受体拮抗剂Ｄｅｖａｚｅｐｉｄｅ５０ｎｇ能部分翻转,２００ｎｇ则完全翻转ＣＣＫ－８的抗吗啡镇痛作用,１０ｎｇ无效;而ＣＣＫ－Ｂ受体拮抗剂Ｌ－３６５,２６０在５－８ｎｇ时即可完全番转ＣＣＫ－８的抗吗啡镇痛作用。杏仁核注射２００ｎｇ的Ｄｅｖａｚ     

The Ethanol Extract of Syringa oblata Heartwood,a Mongolian Folk Medicine Containing Major Lignans,Exerts Analgesic and Sedative Effects on Mice

The heartwood of Syringa oblata Lindl. (SO) is one of Mongolian folk medicines to treat insomnia and pain, while its pharmacological evaluation and underlying mechanism remain unclear. In this study, the sedative effect of ethanol extract of SO (ESO) was evaluated with the locomotor activity test and the threshold dose of pentobarbital sodium-induced sleep test in mice, and the hot plate test, acetic acid-induced writhing test, and formalin test in mice were used to evaluate its analgesic effect. The underlying mechanism of ESO analgesia was explored by RT-PCR and western blot analysis, which is associated with the regulation of the NF-κB signaling pathway. Besides, the main constituents of ESO were characterized by LC/MS data analysis and comparison with isolated pure compounds. The current findings brought evidence for clinical application and further pharmacological and phytochemical studies on SO.     

Stanford A型主动脉夹层孙氏手术患者术后血流感染的影响因素及术前PCT、IL-6、D-D的预测价值研究

摘要 目的：分析Stanford A型主动脉夹层（AD）孙氏手术患者术后血流感染（BSI）的影响因素,并探讨术前血清降钙素原（PCT）、白细胞介素-6（IL-6）、D-二聚体（D-D）对术后发生BSI的预测价值。方法：选取2019年1月～2022年1月贵州医科大学附属医院收治的236例接受孙氏手术的Stanford A型AD患者,根据术后是否BSI分为BSI组和非BSI组。收集患者基础资料和实验室指标,采用多因素Logistic回归分析Stanford A型AD孙氏手术患者术后发生BSI的影响因素,采用受试者工作特征（ROC）曲线分析血清PCT、IL-6、D-D水平对Stanford A型AD孙氏手术患者术后发生BSI的预测价值。结果：BSI组年龄≥60岁、糖尿病史、机械通气、气管切开、人工瓣膜植入比例和术后24 h引流量、血清C反应蛋白、PCT、IL-6、D-D水平高于非BSI组,手术时间、心包纵隔管保留时间长于非BSI组（P＜0.05）。多因素Logistic回归分析显示,年龄≥60岁、糖尿病史、机械通气、气管切开、术后24 h引流量上升,血清PCT、IL-6、D-D水平上升为Stanford A型AD孙氏手术患者术后发生BSI的危险因素（P＜0.05）。ROC曲线分析显示,血清PCT、IL-6、D-D三项联合预测的Stanford A型AD孙氏手术患者术后发生BSI的曲线下面积大于单独预测。结论：年龄、糖尿病史、机械通气、气管切开、术后24 h引流量、血清PCT、IL-6、D-D水平是Stanford A型AD孙氏手术患者术后发生BSI的影响因素,术前血清PCT、IL-6、D-D水平可作为Stanford A型AD孙氏手术患者术后发生BSI的辅助预测指标。     

超声引导下神经阻滞麻醉联合全身麻醉对股骨头置换老年患者麻醉效果及术后认知功能的影响

摘要 目的：研究超声引导神经阻滞麻醉联合全身麻醉对股骨头置换老年患者的麻醉效果及对术后认知功能的影响。方法：选取2019年1月至2021年12月期间我院收治的150例拟行股骨头置换术的老年患者,随机分为对照组和观察组,各75例。对照组患者行常规全身麻醉,观察组在对照组的基础上行超声引导下神经阻滞麻醉,比较两组患者的血流动力学指标,拔管时间、苏醒时间和复苏室停留时间,苏醒后疼痛,术后认知功能及不良反应的发生率。结果：观察组患者各时间点的心率（HR）和平均动脉压（MAP）均较对照组低（P＜0.05）。观察组拔管时间、苏醒时间和复苏室停留时间均较对照组短（P＜0.05）。观察组患者术后视觉模拟评分（VAS）均低于同一时间点的对照组（P＜0.05）。与对照组相比,观察组患者术后1 h、12 h和24 h的简易智力状态检查（MMSE）评分均较高（P＜0.05）,观察组术后1 h、12 h和24 h术后认知功能障碍（POCD）发生率较对照组低（P＜0.05）。两组患者不良反应发生率无差异（P＞0.05）。结论：超声引导神经阻滞麻醉可稳定血流动力学,缩短拔管、苏醒及复苏室停留时间,减轻术后疼痛,改善术后认知功能,减少POCD的发生,值得临床推广。