经颅磁刺激联合高压氧（HBO)治疗脑梗死240 例临床疗效分析

目的:观察经颅磁刺激(transcranial magnetic stimulation,TMS)联合高压氧(hyperbaricoxygen,HBO)治疗脑梗死的临床疗效。方法:采用随机数字表法将240例脑梗死患者分为联合治疗组、HBO组及常规组,每组80例。常规组患者给予常规治疗,HBO组患者在常规干预基础上辅以HBO治疗,联合治疗组患者则在常规干预基础上辅以HBO及TMS联合治疗。上述治疗均以10 d为1个疗程,共治疗2个疗程。于治疗前、治疗2个疗程后比较各组患者神经功能缺损程度,并同时于上述时间点检测各组患者中枢运动传导时间(CMCT)及血清中脑源性神经营养因子(BDNF)、神经生长因子(NGF)表达情况。结果:各组患者分别经2个疗程治疗后,发现联合治疗组NIHSS评分、总有效率均显著优于HBO组及常规组水平(均P0.05);另外联合治疗组血清中BDNF含量与NGF含量均较治疗前明显升高(P0.05),与常规组及HBO组间差异亦具有统计学意义(均P0.05)。结论:TMS联合HBO治疗脑梗死具有协同作用,能进一步改善患者受损神经功能及日常生活质量,其治疗机制可能与增强神经营养因子表达有关。     

血浆循环DNA水平与血常规指标的关联分析

目的:通过观察血浆循环DNA(cfDNA)浓度与血常规指标间的关系,探索cfDNA的来源。方法:用实时荧光定量PCR测定选定人群的血浆cfDNA浓度,用ADVIA120血细胞分析仪测定血常规指标,用双变量关联分析和逻辑回归分析血浆cfDNA浓度与性别、年龄及血常规指标间的相关性。结果:男性的血浆cfDNA浓度(23.23±3.186)略高于女性(18.55±2.037),但差异无显著性(P=0.2183);在各年龄段中,61~70岁年龄段的cfDNA浓度(23.20±4.274)最高,其次为70岁以上年龄段(20.92±2.089),51~60岁年龄段最低(15.81±1.747),但三者之间的差异没有显著性(P=0.3276);双变量关联分析表明血浆cfDNA浓度与过氧化物酶活性指数、血红蛋白及红细胞比积呈正相关(P<0.05),与性别、年龄及其他血常规指标无关;逻辑回归分析提示血浆cfDNA浓度升高只与平均血小板浓度和过氧化物酶活性指数呈正相关(P<0.05)。结论:血浆cfDNA增加可能与平均血小板浓度升高及过氧化物酶含量或活性有关,血小板前体细胞(即巨核细胞)可能是cfDNA的一个重要来源。     

Biochemical indicators of oxygen poisoning]

Content of extra erythrocyte hemoglobin (EEH), total peroxidase activity (TPA), tseruloplasmin oxidase activity (TOA) and chemiluminescence intensity have been investigated in plasma. The dose-dependent changes of EEN, TPA, TOA are shown in experiments on the animals under hyperbaric oxygen (HBO) pressure (0.2, 0.3, 0.5, 0.7 MPa from 30 min. to 120 min.) and EEH, TPA--under hyperbaric air (1.1 MPa; 4 hours). All these parameters have been studied in patients treated with HBO for the assessment of HBO efficacy in the clinical investigations. These biochemical parameters may be used as informative tests of the functional state of the organism under HBO and hyperbaric air.     

The effect of hyperbaric oxygen treatment on oxidative stress in experimental acute necrotizing pancreatitis

Various protocols may be used for acute pancreatitis treatment. Recently, the benefit of hyperbaric oxygen (HBO) has been demonstrated. To clarify the mechanism of HBO on the process of the acute pancreatitis, we determined the levels of antioxidant enzymes in an acute pancreatitis model. Forty-five Sprague-Dawley rats were randomly divided into three groups: Group I: sham group (n=15), Group II: pancreatitis group (n=15), Group III: pancreatitis group undergoing HBO therapy (n=15). HBO was applied postoperatively for 5 days, two sessions per day at 2.5 fold absolute atmospheric pressure (ATA) for 90 min. Superoxide dismutase (Cu/Zn-SOD), malondialdehyde (MDA), and glutathione peroxidase (GSH Px) activity were measured in pancreatic tissue and erythrocyte lysate. MDA and GSH Px were also determined in plasma. In addition, amylase levels were measured in the serum. While serum amylase levels and MDA values in erythrocyte, plasma and pancreatic tissue were decreased, the levels of GSH Px and SOD were found to be significantly increased in the Group III as compared to those of the Group II. The findings of our study suggest that HBO has beneficial effects on the course of acute pancreatitis and this effect may occur through the antioxidant systems.     

A preliminary analysis of EMG variance as an index of change in EMG biofeedback treatment of tension-type headache

The effectiveness of EMG biofeedback training for tension headache has been well established. Previous studies evaluating changes in an average EMG activity score from pre- to posttreatment have not consistently found a relationship between a reduction in average EMG activity and headache improvement at posttreatment. The current study is a preliminary analysis of the utility of EMG variance as another possible mechanism of change. Frontalis EMG average activity and variances from 6 chronic tension-type headache sufferers who demonstrated significant improvement in headache activity at posttreatment (at least 70%) and 6 chronic tension-type headache sufferers who did not demonstrate improvement (less than 30%) were examined across 6 sessions of biofeedback treatment. The improved group demonstrated larger time-specific EMG variance in relation to mean EMG amplitudes during all treatment sessions. A dramatic decline in time-specific variance was observed during the later treatment sessions for improved participants; this pattern was not observed in the group who demonstrated little or no improvement. Results from the current study suggest that the inclusion of both average EMG activity and EMG variance may provide a more comprehensive measure to evaluate possible physiological changes responsible for improvement in headache activity following EMG biofeedback training.     

Effect of hyperbaric oxygen on experimental acute distal colitis

It has been demonstrated that hyperbaric oxygen (HBO) is useful as an adjunctive therapy for Crohn's disease. However, its effects on ulcerative colitis have not been investigated. In the present study, HBO was tested for acetic acid-induced colitis, and antioxidant systems were evaluated to clarify its possible mode of action. Thirty-six Sprague-Dawley rats were randomly divided into three groups: sham control (Group I), colitis induced by acetic acid without any therapy (Group II), colitis induced by acetic acid and treated with HBO (Group III). HBO was given for 5 days, 2 sessions per day at 2.5-fold absolute atmosphere pressure (ATA) for a period of 90 min in rats in which colitis had been induced (Group III). Rats were sacrificed on the 5th day after the procedure. Superoxide dismutase (SOD), malondialdehyde (MDA) and glutathione peroxidase (GSH Px) activity were measured in the intestinal tissue and erythrocyte lysate. MDA and GSH Px were also determined in the plasma. Whereas MDA levels in erythrocyte, plasma and intestinal tissue were decreased, the levels of GSH Px and SOD were significantly increased in Group III as compared to those of Group II. The results of our study suggest that hyperbaric oxygen therapy has beneficial effects on the course of experimental distal colitis and that antioxidant systems may be involved in its mode of action.     

Genetic effects of hyperbaric oxygen therapy

Patients with several diseases have been examined for detection of chromosome aberrations in peripheral blood cells after 10 sessions of hyperbaric oxygen (HBO) at 0.15-0.20 MPa for 40 min. The present study reveals that HBO increases the level of chromosome aberrations, and that individual reactions to HBO differ. Pure erythrocytes treated with high-pressure oxygen (HBO) at 0.7 MPa for 1 h are clastogenic for intact syngeneic lymphocytes. The effect of HBO (0.3 MPa, 5 sessions of 1 h daily) on induction of chromosome aberrations in somatic cells and germinal tissues of rat males has been studied. Induction of aberrations in bone marrow cells after HBO was seen for 3 months. In lymphocytes of patients, it was seen for 9 months. Chromosome rearrangements at the first meiotic division were detected only 90 days after exposure. HBO affects neither the functional nor the morphological condition of gonads and does not induce dominant lethals. It is proposed that a high quantity of chromosome breaks in cells of somatic tissues is an adaptive reaction of organisms to HBO.     

Exposure Time Related Oxidative Action of Hyperbaric Oxygen in Rat Brain

Hyperbaric oxygen (HBO) is known to cause oxidative stress in several organs and tissues. Due to its high rate of blood flow and oxygen consumption, the brain is one of the most sensitive organs to this effect. The present study was performed to elucidate the relation of HBO exposure time to its oxidative effects in rats’ brain cortex tissue. For this purpose, 49 rats were randomly divided into five groups. Except the control group, study groups were subjected to three atmospheres HBO for 30, 60, 90, and 120 min. Their cerebral cortex layer was taken immediately after exposure and used for analysis. Thiobarbituric acid reactive substances (TBARS), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and nitrate–nitrite (NO_X) levels were determined. TBARS and SOD levels were found to increase in a time-dependent manner. GSH-Px activity reflected an inconsistent course. NO_X levels were found to be increased only in the 120 min exposed group. The results of this study suggests that HBO induced oxidative effects are strongly related with exposure time.     

Iron-containing proteins and the proteolytic activity in the blood serum in hyperbaric oxygenation and the protective action of urea

The number and composition of ferro-containing proteins, the total number of iron, summary peroxidase activity and peptide-hydrolase activity have been determined under different hyperbaro-oxygenation (HBO) in blood serum. It has been established that under HBO the concentration of ferro-containing proteins increases, the fraction composition of serum and erythrocyte haemoglobin changes, the activity of acid peptide-hydrolases increases and the protamine-splitting peptide-hydrolase activity lowers. The administration of urea before HBO-experiments leads to the normalization of the most biochemical indicators of blood serum. The tests of oxygen intoxication depth assessment have been suggested.     

Simultaneous biofeedback of heart rate and frontal EMG as a pretraining for the control of EEG theta activity

Following one base-line session, 20 normal subjects received four half hour sessions consisting of simultaneous feedback of heart rate and frontalis muscle (pretraining). Ten subjects received contingent (CF), the other ten noncontingent feedback (NCF). Subjects were asked to lower heart rate and frontal muscle tension (EMG). Heart rate within sessions decreased up to 19 bpm, with a mean of 4 bpm for the CF group. There was only a weak decrease over sessions, however, because of the strong habituation effect. The following events accompanied the heart rate decrease: (1) an increase of the variability of the heart rate, (2) a decrease of the variance of the EMG, (3) an increased correlation between heart rate slowing and EMG decrease, and (4) an increasing subjective experience of control of heart rate and EMG. After pretraining, subjects received eight sessions of auditory feedback of their frontal EEG theta activity (four sessions with CF and four sessions with NCF in balanced order). There was a weak increase of theta for the CF condition over sessions, but a decrease within the sessions. Pretraining on heart rate and frontal EMG control had no influence on the performance during theta training. It was hypothesized that control of heart rate slowing and theta control involve different mechanisms.     

Pulmonary protective effects of hyberbaric oxygen and N-acetylcysteine treatment in necrotizing pancreatitis

The purpose of this study is to analyze the protective effect of combining N-acetylcysteine (NAC) and hyberbaric oxygen (HBO) treatment in the lung tissue during acute pancreatitis. Sixty Sprague-Dawley male rats were randomly divided into five groups; Group I; Control group (n=12), Group II; pancreatitis group (n=12), Group III; pancreatitis + NAC treatment group (n=12), Group IV; pancreatitis + HBO treatment group (n=12), Group V; pancreatitis + HBO + NAC treatment group (n=12). HBO was applied postoperatively for 5 days, twice a day at 2.5 fold absolute atmospheric pressure for 90 min. Lung tissue was obtained for measuring malondialdehyde (MDA), superoxide dismutase (Cu/Zn-SOD) and glutathione peroxidase (GSH-Px) levels along with histopathological tissue examinations. This study showed that all three treated groups (HBO alone, NAC alone and combined HBO+NAC treatment) had pulmonary protective effects during acute necrotizing pancreatitis.     

Influence of an orally effective SOD on hyperbaric oxygen-related cell damage

In a prospective, double-blind, randomised placebo-controlled study, we tested the hypothesis that a new formulation consisting of wheat gliadin chemically combined with a vegetal (thus orally effective) preparation of superoxide dismutase (SOD) allows to prevent hyperbaric oxygen (HBO)-induced oxidative cell stress. Twenty healthy volunteers were exposed to 100% oxygen breathing at 2.5 ATA for a total of 60 min. DNA strand breaks (tail moments) were determined using the alkaline version of the comet assay. Whole blood concentrations of reduced (GSH) and oxidised (GSSG) glutathione and F₂-isoprostanes, SOD, glutathione peroxidase (GPx) and catalase (Cat) activities and red cell malondialdehyde (MDA) content were determined. After HBO exposure the tail moment [Formula: See Text] and isoprostane levels [Formula: See Text] were significantly lower in the group that received the vegetal formulation. Neither SOD and Cat nor GSH and GSSG were significantly affected by this preparation or HBO exposure. By contrast, blood GPx activity, which tended to be lower in the SOD-group already before the HBO exposure [Formula: See Text] was significantly lower afterwards [Formula: See Text] We conclude that an orally effective SOD-wheat gliadin mixture is able to protect against DNA damage, which coincided with reduced blood isoprostane levels, and may therefore be used as an antioxidant.     

Peroxidase activities in relation to plant height and grain weight in bread wheat (Triticum aestivum L.)

Summary The relationship of peroxidase activity with plant height and grain weight has been studied in seven different varieties of bread wheat belonging to diverse genotypes, and their F₁ crosses. The association between plant height and peroxidase activity was highly significant and negative. Based on the similarity index values of peroxidase isoenzymes, the seven wheat genotypes could be classified into two groups: the first group consisting of triple and quadruple dwarf varieties and the other of tall, single and double dwarf. A negative correlation between peroxidase activity and grain weight was also observed. However, the results of this study indicate a possibility of developing a dwarf plant type with low peroxidase activity and well filled grains.     

Influence of an Orally Effective SOD on Hyperbaric Oxygen-related Cell Damage

In a prospective, double-blind, randomised placebo-controlled study, we tested the hypothesis that a new formulation consisting of wheat gliadin chemically combined with a vegetal (thus orally effective) preparation of superoxide dismutase (SOD) allows to prevent hyperbaric oxygen (HBO)-induced oxidative cell stress. Twenty healthy volunteers were exposed to 100% oxygen breathing at 2.5 ATA for a total of 60 min. DNA strand breaks (tail moments) were determined using the alkaline version of the comet assay. Whole blood concentrations of reduced (GSH) and oxidised (GSSG) glutathione and F₂-isoprostanes, SOD, glutathione peroxidase (GPx) and catalase (Cat) activities and red cell malondialdehyde (MDA) content were determined. After HBO exposure the tail moment [Formula: See Text] and isoprostane levels [Formula: See Text] were significantly lower in the group that received the vegetal formulation. Neither SOD and Cat nor GSH and GSSG were significantly affected by this preparation or HBO exposure. By contrast, blood GPx activity, which tended to be lower in the SOD-group already before the HBO exposure [Formula: See Text] was significantly lower afterwards [Formula: See Text] We conclude that an orally effective SOD-wheat gliadin mixture is able to protect against DNA damage, which coincided with reduced blood isoprostane levels, and may therefore be used as an antioxidant.     

Molecular forms of adiponectin: Comparative evaluation of their correlations with parameters of carbohydrate and lipid metabolism

Interrelationship between total, multimer (MM) and oligomer (OM) adiponectin blood concentrations with some metabolic parameters has been investigated in 49 men and 49 women (mean age of 57.3 ± 10.1 years). We have found negative correlations between total blood adiponectin and its MM form content with body mass index, waist circumference, the insulin resistance index HOMA, with blood concentrations of insulin, glucose, free fatty acids, triglycerides and also positive correlations with high density lipoprotein cholesterol content. There was a poor correlation between OM adiponectin concentration with any parameter studied. According to the regression analysis, concentration of total adiponectin but not its MM form was an independent determinant of the HOMA index in women and free fatty acid concentration in men. In the group of men with the low level of adiponectin its MM form but not total adiponectin reversely correlated with the HOMA index and was its independent determinant. Thus, correlation between blood adiponectin concentration and metabolic parameters is associated with its MM rather than OM form. Study of the role of adiponectin in development of metabolic disorders may be limited to determination of total blood adiponectin concentration except a group of male patients characterized by a low level of this adipokine. In these patients concentrations of the MM form should be determined.     

A therapeutic alternative for tension headache in children: treatment and 1-year follow-up results

Ten young subjects, ranging in age from 12 to 15 years, suffering from tension headache were treated by electromyographic biofeedback (EMG-BFB) twice a week for 12 sessions. The Pain Total Index (PTI) was recorded every month from the beginning to the end of the treatment. At the end of the treatment the PTI decreased significantly in all our patients and, at the same time, the muscular tension values also decreased. This result supports the hypothesis of a correlation between clinical symptom and muscular tension level. We saw our patients for follow-up sessions, and the clinical improvement was confirmed to 1 year from the completion of the treatment; however, the muscular tension values were increased with respect to the last-session values.     

A therapeutic alternative for tension headache in children: Treatment and 1-year follow-up results

Ten young subjects, ranging in age from 12 to 15 years, suffering from tension headache were treated by electromyographic biofeedback (EMG-BFB) twice a week for 12 sessions. The Pain Total Index (PTI) was recorded every month from the beginning to the end of the treatment. At the end of the treatment the PTI decreased significantly in all our patients and, at the same time, the muscular tension values also decreased. This result supports the hypothesis of a correlation between clinical symptom and muscular tension level. We saw our patients for follow-up sessions, and the clinical improvement was confirmed to 1 year from the completion of the treatment; however, the muscular tension values were increased with respect to the last-session values.     

Antioxidant status in humans after exposure to hyperbaric oxygen.

Hyperbaric oxygen (HBO) treatment (i.e., exposure to 100% oxygen at a pressure of 2.5 atmosphere absolute (ATA) for a total of 3 x 20 min periods) of human subjects induced DNA damage in the alkaline comet assay with leukocytes and protected against the DNA damaging effects of subsequent in vivo HBO exposures. Furthermore, blood taken 24 h after the first HBO was well protected against the in vitro induction of genotoxic effects by hydrogen peroxide. To investigate the mechanisms which led to this apparent adaptive response, we determined the antioxidant status of blood from subjects before and after HBO. We did not find differences in the plasma concentrations of the antioxidant vitamins A, C and E after HBO treatment. HBO had also no effect on the 'antioxidant power' of the plasma as measured with the FRAP-assay or on the concentration of reduced glutathione determined in the plasma or in lymphocytes. Red cell concentrate activities of superoxide dismutase, catalase, glutathione peroxidase were not influenced by HBO. In contrast, synthesis of the heat shock protein HSP70 which has been implicated to play an important role in cellular protection against oxidative stress, was significantly induced in lymphocytes after a single HBO treatment. To investigate whether intake of antioxidants may protect against HBO-induced DNA damage, we supplemented subjects with vitamin E (800 mg for 7 days) or with N-acetylcysteine (400 mg, 1 h before the HBO treatment). However, these supplementations did not influence the induction of DNA damage by HBO.     

Elevated plasma homocysteine elicits an increase in antioxidant enzyme activity

Elevated plasma homocysteine is considered to be a risk factor for cardiovascular disease. The mechanisms for this effect are not fully understood but there is some evidence for a role for reactive oxygen species (ROS). This study was conducted to explore the effects of elevated plasma total homocysteine (tHcy) concentration on activity of antioxidant enzymes in the circulation. The study group consisted of 10 patients with inherited defects of homocysteine metabolism, from whom 41 blood samples were collected over a period of six months. Blood samples were also collected from 13 of their obligate heterozygous parents. For data analysis samples were classified as those with plasma tHcy < 20 microM or > 20 microM. The activity of erythrocyte superoxide dismutase (SOD) and plasma glutathione peroxidase (GSHPx) was elevated in samples with plasma tHcy > 20 microM. Moreover, a significant correlation was demonstrated between plasma GSHPx activity, plasma glutathione peroxidase protein and plasma tHcy. III vitro studies confirmed that this observation was not due to a simple chemical enhancement of enzyme activity. Homocysteine protected GSHPx from loss of activity following incubation at 37 degrees C. A similar effect was seen with another thiol-containing amino acid, cysteine. Results suggest that elevated plasma tHcy represents an oxidative stress, resulting in an adaptive increase in activity of antioxidant enzymes in the circulation.     

Antioxidant enzymes activity in patients with peripheral vascular disease, with and without presence of diabetes mellitus

The study evaluated antioxidant status in patients with peripheral vascular disease (PVD), with and without concomitant diabetes mellitus (DM). 211 participants were divided into standardized 4 groups: patients with PVD and DM (PVD+DM+), patients with PVD without DM (PVD+DM-), patients without PVD with DM (PVD-DM+) and patients without PVD and DM (PVD-DM-). The diagnosis of PVD was established by Doppler sonography analysis, including determination of the ankle brachial index (ABI), partial pressures along the leg, and CW Doppler sonography at typical locations. Antioxidant status has been evaluated through the colorimetrically assessed serum activity of key antioxidant enzymes: superoxide dismutase (SOD), catalase, and glutathione peroxidase (GLPX) as well as through total antioxidant status (TAS) determination. In PVD+DM- group, as well as PVD-DM+ group, a significantly lower activity of the GLPX, catalase and TAS was found, whereas activity of SOD was significantly higher. There was no statistically significant difference between PVD+DM+ and PVD-DM+ group. Likewise, there was no statistically significant difference between PVD+DM- and PVD-DM-group. This study has shown that there is statistically significant difference in activity of antioxidant enzymes between diabetic and non-diabetic patients, irrespectively of PVD presence. Furthermore, PVD present alone does not alter key antioxidant enzymes activity in comparison with healthy subjects.