一种硬膜外局部低温方法的降温效能和安全性研究

目的应用自制降温线圈发展一种硬膜外局部低温治疗方法,对其降温效能和安全性进行评估。方法SD大鼠随机分为常温对照组（Nor组）、硬膜外局部低温组（LH组）和全身低温组（SH组）,对LH组和SH组分别实施硬膜外局部降温和全身降温,观察降温前后同侧脑温、对侧脑温、肛温以及呼吸、心率、血压变化,降温后24h对各组大鼠进行神经功能评测,取脑组织标本行光镜、电镜检查,并检测脑组织水、钠、钾离子含量和血脑屏障通透性。结果降温后,LH组大鼠的降温侧脑温在数分钟内从（36．5±0．3）℃下降到（31．4±0．4）℃并维持稳定,其对侧脑温和肛温无明显下降,R、HR和MABP无明显变化;SH组降温后双侧脑温、肛温均出现降低,降温后HR下降。降温后,LH组和SH组大鼠神经功能评分正常,光镜和电镜下脑组织无损伤表现,其脑组织水、钠、钾离子含量和血脑屏障通透性与常温对照组比较无统计学差异。结论应用这种硬膜外局部低温方法可以达到与全身降温一样的效果,且不会引起生命体征波动及对脑组织产生急性损害。     

Bilateral Eye Movements, Attentional Flexibility and Metaphor Comprehension: The Substrate of REM Dreaming?

Explanations for the effects of the rapid eye movements induced during Eye Movement Desensitization Reprocessing (EMDR; Shapiro, 2001) have drawn upon an analogy with the eye movements of REM sleep (Kuiken, Bears, Miall, and Smith, 2002). An extension of that analogy posits two orienting systems, one involving threat-fear related mnemonic contextualization and another involving loss-pain related monitoring of conflicting response alternatives. In a study involving individuals who had recently experienced significant loss or trauma, we found that experimentally induced saccadic eye movements decreased reaction times to unexpected stimuli among those reporting traumatic distress (characterized by hyperarousal and intrusive thoughts) and increased reaction times among those reporting separation distress (characterized by vivid reminiscences and the sense of a foreshortened future). Also, we found that saccadic eye movements increased the perceived strikingness of metaphoric sentence endings among those reporting amnesia for events related to either loss or trauma. The eye movements of both EMDR and REM sleep may differently affect the attentional and cognitive reorienting activity of those living with the consequences of loss or trauma. These differences may be evident in their waking reflections and in their dreams. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

GlideScope视频喉镜和Macintosh直接喉镜在颈椎损伤患者气管插管中的应用比较

目的:比较GlideScope视频喉镜(加拿大Saturn生物技术有限公司)和普通直接喉镜在颈椎损伤患者气管插管中的难易,及两种工具插管对血液动力学的影响。方法:拟在经口气管插管全身麻醉下行择期手术的患者40例,ASAI级,年龄18～60岁,随机分为G组和M组(n=20)。常规麻醉诱导后,手法制动头颈部,G组采用GlideScope视频喉镜,M组用Macintosh直接喉镜行气管插管。分析比较两组声门暴露情况(Cormark-Lehane分级)以及暴露时间,试插次数,失败例数,有无助手辅助,插管前后心率与收缩压乘积(RPP)变化。结果:与M组比较,G组声门暴露情况较好,但暴露时间显著延长(P<0.05)。M组需要助手辅助及插管失败的比例均高于G组。两组RPP的变化在各个时点无显著差别。结论:在为颈椎损伤患者气管插管中,GlideScope视频喉镜能够更好的显露声门,降低插管难度,提高插管的成功率。     

The dangers of multi‐male groupings: trauma and healing in cercopithecoid monkeys from Cameroon

This study examines the potential linkage between social organization and trauma in a sample of cercopithecids from Cameroon. Skeletal trauma is described in a museum collection of eight sympatric monkey species. Macroscopic analysis was carried out on a total of 139 complete skeletons of mangabeys, colobines and guenons. Species in multi‐male groups were found to have higher fracture frequencies than those in uni‐male groups. These higher frequencies may be related to intra‐specific male–male aggression; however, similarities in fracture patterning between males and females in multi‐male groups suggest that other factors may be involved. Although fracture etiology may not be identified with certainty, this study suggests that predation may indirectly be a cause of traumatic injuries in those species of cercopithecid monkeys displaying multi‐male social organizations. The data presented also highlight the utility of museum collections as an additional resource in analyses of primate behavior, demonstrating that behavioral information does not die when the animal does. Am. J. Primatol. 71:567–573, 2009. © 2009 Wiley‐Liss, Inc.     

Microdialysis of dopamine interpreted with quantitative model incorporating probe implantation trauma

Although microdialysis is widely used to sample endogenous and exogenous substances in vivo, interpretation of the results obtained by this technique remains controversial. The goal of the present study was to examine recent criticism of microdialysis in the specific case of dopamine (DA) measurements in the brain extracellular microenvironment. The apparent steady-state basal extracellular concentration and extraction fraction of DA were determined in anesthetized rat striatum by the concentration difference (no-net-flux) microdialysis technique. A rate constant for extracellular clearance of DA calculated from the extraction fraction was smaller than the previously determined estimate by fast-scan cyclic voltammetry for cellular uptake of DA. Because the relatively small size of the voltammetric microsensor produces little tissue damage, the discrepancy between the uptake rate constants may be a consequence of trauma from microdialysis probe implantation. The trauma layer has previously been identified by histology and proposed to distort measurements of extracellular DA levels by the no-net-flux method. To address this issue, an existing quantitative mathematical model for microdialysis was modified to incorporate a traumatized tissue layer interposed between the probe and surrounding normal tissue. The tissue layers are hypothesized to differ in their rates of neurotransmitter release and uptake. A post-implantation traumatized layer with reduced uptake and no release can reconcile the discrepancy between DA uptake measured by microdialysis and voltammetry. The model predicts that this trauma layer would cause the DA extraction fraction obtained from microdialysis in vivo calibration techniques, such as no-net-flux, to differ from the DA relative recovery and lead to an underestimation of the DA extracellular concentration in the surrounding normal tissue.     

Traumatic Brain Injury Increases β-Amyloid Peptide 1-42 in Cerebrospinal Fluid

Abstract: The β-amyloid peptides, Aβ1-42 and Aβ1-40, were quantified in ventricular CSF taken daily for up to 3 weeks from six individuals with severe traumatic brain injury (TBI). There was considerable interindividual variability in the levels of Aβ peptides, but in general Aβ1-42 levels equalled or exceeded those of Aβ1-40. Averaging the daily totals of our trauma cohort revealed that the levels of Aβ1-42 and Aβ1-40 rose after injury, peaking in the first week and then declining toward control levels over the next 2 weeks. Aβ1-42 levels were on average two to three times higher in the trauma cohort than in CSF from nontrauma samples. Compared with nontrauma samples, the Aβ1-40/Aβ1-42 ratio decreased about fivefold in the trauma patients, further indicative of increased Aβ1-42 levels. The ratio remained low at all time points studied. No change was measured in the levels of β-amyloid precursor protein during the same interval. These results suggest that Aβ1-42 becomes elevated in the CSF after severe brain trauma.     

Stress protein synthesis and accumulation after traumatic injury of crayfish CNS

By several days after a crush injury of crayfish CNS, the wound site heals. Changes in protein synthesis and accumulation occur at the lesion site and nearby. During the first few hours, synthesis of 35, 70, 90, and 150 kDa proteins is induced in the injured tissue. By one day, the relative amounts of 70–90 kDa proteins increase dramatically, particularly at the crush site and adjacent to it. The 70 kDa proteins, which are related to mammalian stress proteins (SPs), remain elevated for at least one month in the traumatized region or nearby. The crushed tissue contains an SP70 isoform not present in its uncrushed counterpart. These biochemical changes may reflect the cellular changes that accompany wound healing and/or a cellular stress response to compensate for the lesion. Since similar adaptations occur in the mammalian CNS, they may represent a phylogenetically conserved attempt to retard or repair CNS tissue deterioration.     

The impact of early adversity and education on genetic and brain morphological predictors of cognitive ability

Cognitive ability is a strong predictor of occupational achievement, quality of life and physical health. While variation in cognition is strongly heritable and has been robustly associated with early environment and brain morphology, little is known about how these factors combine and interact to explain this variation in cognition. To address this, we modelled the relationship between common genetic variation, grey matter volume, early life adversity and education and cognitive ability in a UK Biobank sample of N = 5237 individuals using structural equation modelling. We tested the hypotheses that total grey matter volume would mediate the association between genetic variation and cognitive ability, and that early life adversity and educational attainment would moderate this relationship. Common genetic variation, grey matter volume and early life adversity were each significant predictors in the model, explaining ~15% of variation in cognitive ability. Contrary to our hypothesis, grey matter volume did not mediate the relation between genetic variation and cognition performance. Neither did early life adversity or educational attainment moderate this relation, although educational attainment was observed to moderate the relationship between grey matter volume and cognitive performance. We interpret these findings in terms of the modest explanatory value of currently estimated polygenic scores accounting for variation in cognitive performance (~5%), making potential mediating and moderating variables difficult to confirm.     

Inhibition of IL-17 prevents the progression of traumatic heterotopic ossification

Traumatic heterotopic ossification (HO) is the abnormal formation of bone in soft tissues as a consequence of injury. However, the pathological mechanisms leading to traumatic HO remain unknown. Here, we report that aberrant expression of IL-17 promotes traumatic HO formation by activating β-catenin signalling in mouse model. We found that elevated IL-17 and β-catenin levels are correlated with a high degree of HO formation in specimens from patients and HO animals. We also show that IL-17 initiates and promotes HO progression in mice. Local injection of an IL-17 neutralizing antibody attenuates ectopic bone formation in a traumatic mouse model. IL-17 enhances the osteoblastic differentiation of mesenchymal stem cells (MSCs) by activating β-catenin signalling. Moreover, inhibition of IL-17R or β-catenin signalling by neutralizing antibodies or drugs prevents the osteogenic differentiation of isolated MSCs and decreases HO formation in mouse models. Together, our study identifies a novel role for active IL-17 as the inducer and promoter of ectopic bone formation and suggests that IL-17 inhibition might be a potential therapeutic target in traumatic HO.     

A Talent for Life: Reflections on Human Vulnerability and Resilience

This article explores the limitations of the dominant psychological trauma model. Drawing on the experiences and the aftermaths of chronic ‘states of emergency ‘ among shantytown families in rural Northeast Brazil, among hunted street kids in urban Brazil, and among revolutionaries and warriors of different political stripes following the anti-apartheid struggle in South Africa, I identify several features of human resilience, the sources of strength, toughness, hardiness, and relative immunity from personal and psychological collapse that we have come to associate with exposure to a variety of human calamities. We need to rethink our notions of trauma, violence and its sequalae.