阿托品联合综合疗法治疗青少年屈光不正的疗效及安全性分析

目的:分析阿托品联合综合疗法治疗青少年屈光不正弱视的近期疗效及安全性。方法:以2017年2月至2017年5月于我院接受诊治的60例青少年屈光不正弱视患者(患眼102只)为研究对象,按接受诊治时间先后顺序分为对照组和观察组各30例。患眼分别为52和50只。观察治疗前后所有屈光不正弱视患者的视觉敏感度、图像诱发电位(P-VEP)、立体视功能的改善、治疗有效率和不良反应的发生情况。结果:治疗后,两组患眼对比度、波幅均较治疗前显著升高(P0.05),潜伏期低于治疗前(P0.05),且观察组各空间频率下的对比度、波幅均显著高于对照组(P0.05),潜伏期低于对照组(P0.05);观察组患眼的矫正幅度范围和矫正分开范围显著高于对照组,矫正近立体视锐角显著低于对照组(P0.05);观察组的治疗总有效率为92.00%,高于对照组的71.15%(P0.05);两组患者均未见明显的不良反应发生。结论:阿托品联合综合疗法对青少年屈光不正弱视的近期疗效较好,且安全性高。     

Effects of cholinergic agents on the vasopressin-mediated water transport in the isolated toad bladder

The aim of this work was to study the effect of some pharmacological cholinergic agents on the events that follow the interaction of arginine vasopressin with toad bladder membrane receptors related to synthesis of 3′5′_cAMP. The water flow through the membrane was measured gravimetrically in sac preparations of the membrane. In the absence of arginine vasopressin (AVP), carbachol induced a significant increase in the water flow (37%) related to the basal (Ringer's solution). On the other hand, when carbachol and AVP were associated, a significant decrease of AVP hydrosmotic activity occurred (23%). The inhibitory effect of carbachol on the AVP action was almost completely abolished by the cholinergic antagonists atropine, pirenzepine, 4-diphenylacetoxy-N-methylpiperidine methiodide (4-DAMP) and the calcium antagonist lanthanum. Similarly, when carbachol and 3′5′ cyclic adenosine monophosphate (3′5′_cAMP) were associated, a decrease of nucleotide hydrosmotic activity was observed (12.80%). This effect was partially restored by the addition of pirenzepine or 4-DAMP in the bath solution. These results suggest a role for muscarinic receptors of sub-type M₁ and M₃, which are involved in the intracellular calcium release. The increase of calcium concentration in the intracellular medium acts as a negative modulator in the hydrosmotic action of antidiuretic hormone.     

乙酰胆碱对大鼠丘脑束旁核痛兴奋和痛抑制神经元放电的影响

本实验观察了脑室注射乙酰胆碱(ACh)对丘脑束旁核(Pf)痛兴奋神经元(PEN)和痛抑制神经元(PIN)电活动的影响,并与吗啡的作用进行了比较。结果表明,脑内ACh增加可使PEN放电潜伏期延长,频率降低,持续时程缩短;可使PIN的完全抑制时程缩短。腹腔注射吗啡与ACh的作用相似。M胆碱受体阻断剂阿托品能阻断ACh对PEN和PIN的作用,但不影响吗啡对PEN和PIN的作用。说明吗啡镇痛不是通过胆碱能转递而实现的。     

Measurement of Acetylcholine Release in Freely Moving Rats by Means of Automated Intracerebral Dialysis

The present study demonstrates the feasibility of measuring acetylcholine in perfusion samples collected by means of in vivo brain dialysis in the striata of freely moving rats. The output of the dialysis device was directly connected to an automated sample valve of a HPLC-assay system that comprises a cation exchanger, a post-column enzyme reactor, and an electrochemical detector. The presence of an acetylcholinesterase inhibitor (neostigmine) in the perfusion fluid was required for the detection of acetylcholine in the perfusate. Increasing concentrations of neostigmine induced increasing amounts of acetylcholine. Continuous perfusion with a fixed concentration (2 microM) of neostigmine resulted in gradually increasing amounts of collected acetylcholine over time although a considerable variation between successive samples exists. The brain dialysis technique was further validated by studying the effect of various drugs. Systemically administered atropine increased the output of acetylcholine, whereas the addition of tetrodotoxin to the perfusion fluid resulted in a complete disappearance of the neurotransmitter.     

Atropine inhibits the degranulation of Paneth cells in ex-germ-free mice

Summary Previous studies have shown that the secretory products of Paneth cells contain antibacterial agents (lysozyme, IgA) that are affected by the bacterial milieu in the intestine. To investigate whether Paneth-cell secretion is controlled via cholinergic mechanisms, the ultrastructure of Paneth cells was studied in four animal groups: (1) germfree (GF) control mice (Jcl: ICR [GN], male, 13 weeks old), (2) GF mice injected subcutaneously with atropine sulfate (200 mg/kg body weight, dissolved in physiological saline 20 mg/ml), (3) ex-GF mice inoculated with feces from specific-pathogen-free (SPF) mice, and (4) ex-GF mice injected with atropine and inoculated with feces from SPF mice. In ex-GF mice inoculated with feces, 70–90% of the Paneth cells showed fewer secretory granules than those from GF mice (p<0.01). Approximately 30% of the Paneth cells had a large vacuole (3–10 m diameter) in the apical cytoplasm. Exocytosed electron-dense material from secretory granules was observed in a few crypt lumens. In ex-GF mice inoculated with feces and given atropine, about 90% of the Paneth cells contained numerous secretory granules, like those in GF control mice, but vacuolated Paneth cells and exocytotic figures were rare; thus the secretion of Paneth cells was blocked by atropine. It is therefore possible that the bacterial milieu in the intestine affects the secretory activity of Paneth cells via cholinergic mechanisms.     

急性下壁心肌梗死急诊PCI术中应用临时起搏器与阿托品的对比研究

目的：探讨临时起搏器与阿托品在急性下壁心肌梗死急诊经皮冠状动脉介入治疗（PCI）中应用的疗效。方法：入选2012 年2 月至2013 年8 月我院收治的发病12 小时内,诊断为急性下壁心肌梗死并接受急诊PCI治疗的患者92 例,依据治疗方法的不同 将病例分为临时起搏组和阿托品组,并对病例进行为期一年的追踪随访,收集患者平均住院天数、平均住院费用、再灌注心律失 常、心肌梗死后心绞痛、心肌梗死后心衰发生率资料。结果：临时起搏组的平均住院天数、平均住院费用、心肌梗死后心绞痛、心肌 梗死后心衰发生率均显著低于阿托品治疗组（P 均<0.05）,阿托品治疗组的再灌注心律失常发生率则明显低于临时起搏组（P<0. 05）。结论：急性下壁心肌梗死急诊PCI中应用临时起搏器,具有治疗成本低,降低心血管事件发生率的优点,而阿托品治疗在改 善再灌注心律失常的疗效上则显著优于临时起搏治疗。     

Cholinergic mechanism involved in the nociceptive modulation of dentate gyrus

Acetylcholine (ACh) causes a wide variety of anti-nociceptive effects. The dentate gyrus (DG) region of the hippocampal formation (HF) has been demonstrated to be involved in nociceptive perception. However, the mechanisms underlying this anti-nociceptive role have not yet been elucidated in the cholinergic pain-related neurons of DG. The electrical activities of pain-related neurons of DG were recorded by a glass microelectrode. Two kinds of pain-related neurons were found: pain-excited neurons (PEN) and pain-inhibited neurons (PIN). The experimental protocol involved intra-DG administration of muscarinic cholinergic receptor (mAChR) agonist or antagonist. Intra-DG microinjection of 1 μl of ACh (0.2 μg/μl) or 1 μl of pilocarpine (0.4 μg/μl) decreased the discharge frequency of PEN and prolonged firing latency, but increased the discharge frequency of PIN and shortened PIN inhibitory duration (ID). Intra-DG administration of 1 μl of atropine (1.0 μg/μl) showed exactly the opposite effects. According to the above experimental results, we can presume that cholinergic pain-related neurons in DG are involved in the modulation of the nociceptive response by affecting the discharge of PEN and PIN.     

Blood pressure responses of conscious rats to intravenous administration of enkephalin derivatives (D-ala methionine and leucine enkephalinamide, and methionine and leucine enkephalinamide)

The present study was designed to determine the blood pressure (BP) responses of conscious rats given intravenous (IV) injections of enkephalin derivatives (D-ala²-methionine enkephalinamide, DAMEA; D-ala²-leucine enkephalinamide, DALEA; methionine enkephalinamide, MEA; leucine enkephalinamide, LEA) and the receptor mechanisms mediating the resultant change in BP. IV injection of 1.6–16.0 nmoles of DAMEA or DALEA caused a transient but potent decrease in mean arterial pressure (MAP) and mean heart rate (MHR). LEA and MEA (16.0 nmoles) given IV produced slight pressor responses, which were not associated with concomitant tachycardia whereas 48 nmoles of MEA elicited a hypotensive effect accompanied by a fall in MHR. Pretreatment studies whereby various receptor antagonists (naloxone, diprenorphine, phentolamine, D-L-propranolol or atropine) were given IV 5 min before subsequent IV administration of DAMEA, DALEA, MEA or LEA (16 nmoles) showed that naloxone, diprenorphine and atropine blocked the depressor and bradycardic effects of DALEA and DAMEA. Naloxone and phentolamine suppressed the pressor reponse of both MEA and LEA (16.0 nmoles) while diprenorphine blocked the rise in MAP to only MEA. The results show that DAMEA and DALEA mediate their depressor actions in conscious rats via a negative chronotropic effect through an interaction of muscarinic cholinergic receptors on the myocardium. It is suggested that the pressor response of MEA and LEA may be produced via an -receptor mediated effect on the peripheral vasculature to cause vasoconstriction.     

术前应用长托宁对老年患者心率变异性的影响

目的：探讨长托宁对老年患者心率变异性的影响,为长托宁作为术前药提供理论依据。方法：60例ASAII~III级老年患者随机分成阿托品组（A组）和长托宁组（B组）,静脉注射阿托品或长托宁0.01 mg/kg。观察注药前、注药后1、3、5、10、20及30min各组心率（HR）、心率变异总功率（TP）、低频（LF）、高频（HF）、心率变异性（HRV）的改变。结果：与A组相比,B组注药后1、3、5、10、20 min时HR均降低（P〈0.05）,1、3 min,TP降低（P〈0.05）,5、10、20、30 minTP升高（P〈0.01）,3、5、10、20、30 min,LF、HF均升高（P〈0.05或P〈0.01）。结论：长托宁对老年患者心率变异性影响较小,更适合术前用药。     

Mechanisms of carbacholine and GABA action on resting membrane potential and Na+/K+-ATPase of Lumbricus terrestris body wall muscles

This work was aimed to identify the action of several ion channel and pump inhibitors as well as nicotinic, GABAergic, purinergic and serotoninergic drugs on the resting membrane potential (RMP) and assess the role of cholinergic and GABAergic sensitivity in earthworm muscle electrogenesis. The nicotinic agonists acetylcholine (ACh), carbacholine (CCh) and nicotine depolarize the RMP at concentrations of 5 μM and higher. The nicotinic antagonists (+)tubocurarine, α-bungarotoxin, muscarinic antagonists atropine and hexamethonium do not remove or prevent the CCh-induced depolarization. Verapamil, tetrodotoxin, removal of Cl(-) and Ca(2+) from the solution also cannot prevent the depolarization by CCh. In a Na(+)-free medium, however, CCh lost this depolarization ability and this indicates that the drug opens the sodium permeable pathway. Serotonin, glutamate, glycine, adenosine triphosphate (ATP) and cis-4-aminocrotonic acid (GABA(C) receptor antagonist) had no effect on the RMP. On the other hand, isoguvacin, γ-aminobutyric acid (GABA) and baclofen (GABA(B) receptor agonist) hyperpolarized the RMP. Ouabain, bicucullin (GABA(A) antagonist) and phaclofen (GABA(B) antagonist), as well as the removal of Cl(-), suppressed the effect of GABA and baclofen. CCh did not enhance the depolarization generated by ouabain but, on the other hand, hindered the hyperpolarizing activity of baclofen both in the absence and presence of atropine and (+)tubocurarine. The long-term application of CCh depolarizes the RMP primarily by inhibiting the Na(+)/K(+)-ATPase. The muscle membrane also contains A and B type GABA binding sites, the activation of which increases the RMP at the expense of increasing the action of ouabain- and Cl(-) -sensitive electrogenic pumps.