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The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.
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Objective:To investigate the clinical characteristics of vasa previa (VP) with low-lying placenta (LP).Methods:A retrospective case-control study was conducted on pregnant women with VP who delivered at Guangzhou Women and Children's Medical Center from January 2015 to August 2021. According to the status of LP, these cases were classified into VP with LP (VP+LP) and VP without LP (VP-LP) group. The cases diagnosed with placenta previa (PP, n=128) during the same period were collected as control. Maternal-fetal clinical characteristics and outcomes were compared among the three groups using t-test, Mann-Whitney U test, and Chi-square test (or Fisher's exact test). Results:During the study period, 116 VP cases were diagnosed, accounting for 0.085% (116/136 450) of all deliveries. Apart from one case of intrauterine death caused by non-VP reasons in the third trimester, there were 64 in the VP+LP group and 51 in the VP-LP group. VP+LP cases accounted for about 2.9% (64/2 219) of all the cases with PP or LP. The proportions of multiparae and women with a history of cesarean section were significantly higher in the VP+LP group than in the VP-LP group [62.5% (40/64) vs 39.2% (20/51), χ 2= 6.17, P=0.013; 31.3% (20/64) vs 13.7% (7/51), χ 2= 4.85, P=0.028]. Besides, a rare type of VP (type Ⅲ) was only found in the VP+LP group (9.4%, 6/64). The median gestational age at first diagnosis by prenatal ultrasound was significantly larger in the VP+LP group than in the VP-LP group [28.3 (23.6-31.7) vs 23.9 (23.3-25.9) weeks, Z=2.61, P=0.007]. There was no significant difference in the incidence of antepartum hemorrhage between the two groups. In contrast, the amount of postpartum hemorrhage was significantly increased in the VP+LP group [550 (436-732) vs 420 (300-540) ml, Z=3.37, P=0.001]. Compared with the VP-LP group, the VP+LP group showed a lower incidence of lower neonatal Apgar score (<7 at 5 min) and hypoxic-ischemic encephalopathy [0.0%(0/64) vs 6.9%(4/58), 0.0%(0/64) vs 8.6% (5/58), Fisher's exact test, both P<0.05]. No neonatal death was reported in the VP+LP and VP-LP groups. No significant difference in the incidence of antepartum hemorrhage was found between the VP+LP group and the PP group. Still, the median time at delivery was earlier [36.0 (34.3-36.9) vs 37.0 (35.7-37.3) weeks, Z=3.79, P<0.001], and the incidence of abnormal fetal heart rate was higher [10.9% (7/64) vs 3.1% (4/128), Fisher's exact test , P=0.044] in the VP+LP group. Furthermore, the neonatal NICU admission rate and the incidence of respiratory distress syndrome were significantly higher in the VP+LP group than in the PP group [36.4% (24/66) vs 12.1% (16/132), χ 2= 16.04, P<0.001; 25.8% (17/66) vs 12.1% (16/132), χ 2= 5.89, P=0.015]. Conclusions:For VP+LP cases, there might be an additional type (type Ⅲ VP). Patients with VP+LP would have more blood loss within 24 h after delivery and a higher risk of adverse neonatal outcomes. Intensive attention should be paid to those diagnosed with LP during the third trimester to identify any VP.
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Objective:To investigate the effect of Guilu Erxian Jiao (GEJ) on the negative feedback function of hypothalamic-pituitary-adrenal (HPA) axis and its possible mechanism in rats with post-traumatic stress disorder(PTSD).Methods:The PTSD rat model was established using single prolonged stress (SPS). Ninety six SD rats were randomly divided into control group (control), model group (SPS), GEJ group (GEJ) and paroxetine group (PRX) according to the random number table with 24 rats in each group. Except the control group, the rats in the other groups were constructed using the PTSD model. On the 8th day after the establishment of the model, the rats of the GEJ group (3.6 g/kg) and the PRX group (10 mg/kg) were respectively given the drug by gavage for 21 days. The rats in control group and SPS group were given the same amount of distilled water once a day for 21 days. After continuous administration for 21 days, 12 rats were randomly selected from each group for the dexamethasone suppression test (DST), then 6 rats were selected for the RT-PCR, and the remaining 6 rats were used for immunohistochemistry. The contents of plasma adrenocorticotrophic hormone (ACTH) were measured by Elisa. The expression levels of glucocorticoid receptor (GR), mineralocorticoid receptor (MR), adrenocorticotropic hormone releasing factor Ⅰ receptor (CRF1R) and adrenocorticotropic hormone releasing factor Ⅱ receptor (CRF2R) were detected by RT-PCR and immunohistochemistry.Results:(1) In DST, plasma ACTH level in SPS group was significantly lower than that in control group((145.89±19.41)μg/L, (203.59±35.78)μg/L, t=3.16, P<0.01), and that in the PRX group and GEJ group were significantly higher than that in SPS group((218.47±37.55)μg/L, t=3.98, P<0.01; (205.33±66.54)μg/L, t=3.26, P<0.01). (2) RT-PCR results showed that, in hippocampus, the GR mRNA and MR mRNA expressions in SPS group were significantly higher than those in control group((1.29±0.02), (1.00±0.06), t=6.88, P<0.01; (1.38±0.02), (1.00±0.05), t=7.97, P<0.01), and that in the GEJ group significantly decreased comparing to SPS group((0.96±0.07), t=7.87, P<0.01; (0.86±0.13), t=11.03, P<0.01). (3) Immunohistochemical results showed that, in hippocampus, the positive cell expressions of GR and MR in the SPS group were significantly higher than those in control group((84.33±12.82), (69.33±8.19), t=2.50, P<0.05; (77.33±6.65), (56.33±11.79), t=2.25, P<0.05), and that in the GEJ group significantly were lower than SPS group((68.33±4.55), t=2.67, P<0.05; (59.50±4.18), t=2.25, P<0.05). In amygdala, the positive cells expression of GR, MR and CRF1R in the SPS group significantly decreased compared with the control group((62.67±6.89), (77.17±10.70), t=3.10, P<0.05; (60.50±11.66), (91.83±15.63), t=3.43, P<0.05; (54.50±19.96), (88.17±22.43), t=2.31, P<0.05); and that in GEJ group significantly increased compared with the SPS group((74.33±5.85), t=2.11, P<0.05; (83.67±12.55), t=2.53, P<0.05; (88.67±16.28), t=2.35, P<0.05). Conclusion:GEJ can inhibit the enhanced HPA axis negative feedback function induced by SPS, which may be related to regulating expression of GR, MR and CRF1R in the hippocampus and amygdala.
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With the growth of number of Chinese patent medicines and clinical use, the rational use of Chinese medicine is becoming more and more serious. Due to the complexity of Chinese medicine theory and the uncertainty of clinical application, the prescription review of Chinese patent medicine always relied on experience in their respective, leading to the uncontrolled of clinical rational use. According to the traditional Chinese medicine (TCM) theory and characteristics of the unique clinical therapeutics, based on the practice experience and expertise comments, our paper formed the expert consensus on the prescription review of Chinese traditional patent medicine for promoting the rational use of drugs in Beijing. The objective, methods and key points of prescription review of Chinese patent medicine, were included in this expert consensus, in order to regulate the behavior of prescription and promote rational drug use.
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Objective To investigate the effects of damage control surgery (DCS) in the treatment of severe craniocerebral injury patients combined with multiple extremity fractures.Methods The clinical data of 128 patients with severe craniocerebral injury[Glasgow coma scale (GCS) scored 3-8] combined with multiple extremity fractures admitted from May 2011 to August 2015 were retrospectively analyzed by case-control study.There were 81 males and 47 females,with an average age of 37.3 years (range,19-77 years).The patients were treated with intracranial pressure monitoring in addition to the common administration.The patients were subdivided into two groups:87 patients treated with DCS concept as damage control group and 41 patients treated with non-DCS routine concept as control group.The DCS group received craniotomy and fracture fixation operation in stage Ⅰ with selective operation of open reduction and internal fixation.The control group received craniotomy and open reduction and internal fixation in stage Ⅰ.The postoperative intracranial pressure,operation duration,intraoperative blood loss,hospital stay and prognosis [Glasgow outcome scale (GOS)] were analyzed statistically.Results No intracranial infection was found in all patients during the treatment process.In damage control group,the postoperative intracranial pressure was normal in 44 cases (51％),which was significantly better than that in control group [8 cases (20％)] (P ＜ 0.05).In damage control group,operation duration [(150.1 ± 12.4)minutes],intraoperative blood loss [(270.6 ± 15.3)ml],and hospital stay [(29.7 ± 9.3) days] were significantly shortened compared with control group,whose operation duration,intraoperative blood loss and hospital stay were (270.6 ± 9.8) minutes,(460.2 ± 17.5) ml,and (34.4 ± 6.2) days,respectively (P ＜ 0.05).The GOS rating of damage control group (70％) was notably higher than that in control group (42％) (P ＜ 0.05).Conclusion For severe craniocerebral injury patients combined with multiple extremity fractures,the application of DCS contributes to control of postoperative intracranial pressure,which can also shorten the duration of hospitalization and improve prognosis.
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Currently,the worldwide frequency of catastrophic e-vents has made post-traumatic stress disorder (PTSD)a major public health problem.As a stress-related psychiatric disorder, PTSD is considered as the result of interaction between gene and environments (especially early life adversity).The epigenetics plays an important role in PTSD pathogenesis.Due to the core role of hypothalamic-pituitary-adrenal (HPA)axis,the research on the relationship between HPA axis epigenetics and PTSD pathogenesis in recent years was reviewed in the paper so as to provide references and thinking of the prevention and therapy for PTSD in the future.
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Objective To explore the prenatal ultrasonic types ,sonographic features of malformation , ultrasonic diagnosis and prognosis of fetuses with adrenal area space‐occupying lesions . Methods Forty‐four fetuses with adrenal area space‐occupying lesions were retrospectively analyzed . Compared with postpartum neonatal special inspection results or the anatomical and pathological examination results of the corpses after induced labor ,the ultrasound types ,sonographic feature ,the key points of differential diagnosis were summarized . The newborns were followed up to 6 months after birth ,tracking the prognosis . Results Totally 44 fetuses among 166 471 fetuses(166 471 pregnant women) were detected with adrenal area space‐occupying lesions , 41 cases after delivery , including 24 cases adrenal hematoma ( 2 cases prenataly misdiagnosed as neuroblastoma) ,14 cases adrenal cyst and 3 cases neuroblastoma ,were accurately diagnosed through color Doppler or MRI or CT or pathological examination results . Three cases after induced labor , including 1 case adrenal neuroblastoma ,1 case mullerian duct cyst and 1 case adrenal hematoma( prenataly misdiagnosed as neuroblastoma ) were confirmed through the anatomical and pathological examination results of the corpses . So the conformity rate of adrenal area space‐occupying lesions was 90 .9% (40/44) . The postnatal ultrasound showed that the tumor disappeared in twenty‐four cases of adrenal hematoma without surgery ,and the longest time of the tumor disappearance was 1 year . The size of 14 cases adrenal cyst had no obvious change . One case of adrenal neuroblastoma was operated at 2 months ,2 cases were operated at 2 years of age . Conclusions Ultrasound can be used as qualitative diagnosis and differential diagnosis for fetal adrenal area space‐occupying lesions . The majority of the children with adrenal area space‐occupying lesions have a good prognosis .
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Aim To study the regulatory of Jiaweisini-san on expression of hippocampal BDNF, NR1 and dental gyrus ( DG ) neurogenesis in rats with chronic stressed-depression and its possible mechamisms. Methods Chronic unpredictable mild stress was used to establish the rat model of stressed depression. The expression of BrdU, NeuN, brain -derived neurotro-phic factor ( BDNF ) and N-methyl-D-aspartate recep-tor1 ( NR1 ) in hippocampal dental gyrus were detected by fluorescently labeled immunohistochemical method. In addition, BDNFmRNA was detected by in situ hy-bridization. Results Chronic stress could inhibit the proliferation of neural precursors in hippocampal DG ( P<0. 01 );the expression of BDNF decreased signifi-cantly in DG in model rats ( P <0. 01 ) , while the ex-pression of NR1 increased significantly ( P <0. 01 ) . JWSNS and Fluoxetine hydrochloride significantly en-hanced the amount of new proliferating cells and the number of neurons in unit area of DG ( P<0. 01 ) , in-creased the expression of BDNF ( P <0. 01 ) and de-creased the expression of NR1 in DG(P<0. 01). Con-clusion JWSNS could promote the neuronal prolifera-tion in hippocampal DG of rat with chronic stressed-de-pression,and may exert an effect of promoting the pro-liferation of neurons in hippocampal DG by enhancing the expression of BDNF and decreasing the expression of NR1 .
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Objective To investigate the clinical value of evaluation of fetal cardiac function in congenital heart disease by brain natriuretic peptide (BNP) and velocity vector imaging (VVI). Methods Fetuses who came from Shenzhen Maternity & Child healthcare Hospital were divided into the congenital heart disease group and the control group. At the same time we collected amniotic fluid and assayed BNP concentration. Using the VVI software, the velocity, strain and strain rate of the global and segmental of the left ventricle were measured. Comparison and correlation were made between the two groups. Results There was significantly difference of BNP concentrations in amniotic fluid between two groups. The gestational age had significant positive correlation with BNP concentrations in disease group. The comparison of global velocity, strain and strain rate of left ventricle between the two groups showed significant differences. All of the left ventricular dynamic parameters in disease group were lower than those of the control group. Conclusions Compared with the control group, the disease group had a high level of BNP in amniotic fluid and a lower level of dynamic parameters of left ventricular. There was a positive correlation between BNP concentration and gestational age in disease group. So we can conclude that theBNP concentration can be a biological parameter for evaluating the latent impairments of fetal cardiac function.
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Aim To study the effects of timeshare ad-ministration of Jiaweisinisan ( JWSNS ) on biological rhythm of rats with chronic stress. Methods Unpre-dictable mild chronic stress was used. Cosine rhythm analysis was adopted to observe and analyze the chan-ges of circadian rhythms of body temperature and se-cretion of 5-hydroxy tryptamine ( 5-HT ) , melatonin ( MT) and corticosterone ( CORT ) and the effects of JWSNS. Serum 5-HT,MT and CORT were detected by enzyme-linked immunosorbent assay. Results Three groups of administration of JWSNS had no inhibitory effects on weight gain in model rats,but improved the sucrose preference ( P Administration at 17 : 30 had biphasic regulatory effects on the peak and valley value,while administra-tion at 7 : 30 and 17 : 30 respectively mainly acted on the light phase,namely regulated the valley value. Rats with chronic stress showed delays of body temperature rhythm,namely postponed phase, which could only be inhibited by administration at 7 : 30 . There were de-creases in votatility and disorders in secretion rhythm, as was shown by dramatically accelerated phase of ser-um 5-HT, MT and CORT in rats with chronic stress. Administration of JWSNS at 17 : 30 or at 7 : 30 and 17 : 30 respectively had inhibitory effects on lower ser-um level of 5-HT in model rats ( P increase and the decreases in volatility. ConclusionAdministration of JWSNS at 7 : 30 achieves anti-de-pressant effects by regulating rhythms of hormones and neurotransmitters. Administration of JWSNS at 17 : 30 achieves anti-depressant effects by adjusting the secre-tion of hormones and neurotransmitters,while adminis- tration of JWSNS at 7 : 30 and 17 : 30 respectively a-chieves anti-depressant effects by those two above-men-tioned aspects.
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Objective To determine whether anticoagulation markers can improve mortality prediction in patients of surgical intensive care unit (ICU).Methods A case-control study was adopted,252 patients from Tongji hospital's surgical ICU and 30 healthy control individuals were investigated.The protein C,antithrombin,thrombomodulin,and other coagulation/ inflammatory markers were detected.The Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score were obtained.Markers level comparison among survivors,non-survivors and controls were conducted with single factor variance analysis,Kruskal-Wallis test or Mann-Whitney U test.Results Between survivors and non-survivors after 28-day hospitalization,there were significant difference on protein C levels[(70.2 ±22.7)％ vs (48.6 ±29.8)％,t=2.84,P＜0.01],APACHE Ⅱ scores[(21.0±8.2) vs (29.5 ±10.9),t =-2.51,P＜0.05] and prothrombin times[(12.9-± 3.5) s vs (18.8 ± 10.2) s,t =-2.13,P ＜ 0.05].Combining protein C levels with APACHE Ⅱ score could obtain a higher mortality prediction efficiency in patients of surgical ICU than any single marker (AUC =0.806).That protein C concentration less than 47.5％ [OR =6.40,95％confidence interval(CI) 2.526-16.216,P ＜0.001] and APACHE Ⅱ score (OR =1.123,95％ CI 1.012 -1.250,P ＜ 0.05) were the independent risk factors for surgical ICU death.Conclusion Decrease of protein C levels predict increase of mortality risk in patients of surgical ICU,combining protein C with APACHE Ⅱ score can improve the prognostic accuracy for patients of surgical ICU.(Chin J Lab Med,2013,36:339-342)
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<p><b>OBJECTIVE</b>To evaluate the perinatal management and outcome of different types of fetal arrhythmia.</p><p><b>METHODS</b>A retrospective analysis was conducted among the fetuses with arrhythmia identified by M-mode and pulsed Doppler echocardiography in a single institution between October 2003 and December 2010.</p><p><b>RESULTS</b>A total of 130 fetuses were found to have fetal arrhythmia. The most common arrhythmia during pregnancy was extrasystole (n=59), followed by bradycardia (n=23), tachycardia (n=16), atrial flutter (AF, n=3), atrioventricular block (AVB, n=12) and other arrhythmia (n=17). The overall incidence of cardiac anomalies (commonly fetal bradycardia) was 9.2% in these cases. The prognosis of arrhythmia differed significantly between cases of different classifications. The type of fetal arrhythmia (P=0.024), presence of congenital heart defect (CHD, P=0.000) and fetal hydrops (P=0.008) were significant risk factors associated with termination of pregnancy.</p><p><b>CONCLUSION</b>Fetal arrhythmias without CHD or hydrops under close monitoring often have good clinical outcome, while fetal bradycardia is associated with a high mortality rate. CHD and the presence of fetal hydrops are significant risk factors for pregnancy termination.</p>
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Adult , Female , Humans , Pregnancy , Young Adult , Arrhythmias, Cardiac , Classification , Diagnostic Imaging , Fetal Diseases , Diagnostic Imaging , Heart Defects, Congenital , Diagnostic Imaging , Pregnancy Trimester, Second , Pregnancy Trimester, Third , Retrospective Studies , Ultrasonography, Doppler, Color , Ultrasonography, PrenatalABSTRACT
The theory of traditional Chinese medicine (TCM) deems that kidney essence is the material basis of formation, development and function of the brain and it maintains human being's psychomotility and behavior. Moreover, kidney essence is the material basis of emotional activity. The emotion theory in TCM deems that kidney stores will and responds to fear. The so called will in this theory refers to memory which includes three basic steps such as memorization, storage and recollection. Meanwhile, Western medicine considers stress as a kind of information that forms memory trace in central nervous system. Combining the TCM theory with the modern psychological theory on stress, and from the points of views of the emotion regulation, the formation, consolidation, extraction and extinction of fear memory, and the plasticity of amygdala-hippocampus-prefrontal cortex nervous pathway, as well as the results of pharmacological studies of prescriptions and herbs for invigorating the kidney, the authors explained in this article the pathological mechanisms of kidney deficiency due to attack of fear, and revealed the material basis, the action modes, and the neurobiological mechanisms of the kidney in controlling and regulating emotional activity.
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BACKGROUND: When one is in a stress state, some amino acids as neurotransmitter in his brain are of important regulating action to his cerebral functions and his psychic behaviors,and some traditional Chinese drugs can regulate the stress state of the body.OBJECTIVE:To observe the content changes of glutamic acid,aspartic acid, γ-aminobutyric acid and taurine in the hypothalamus and hippocampus of rats under repeatedly psychic stress so as to investigate the effects of tiaogan recipe, jianpi recipe, bushen recipe and ginsenoside on them.DESIGN: A randomized grouping and controlled observation trial.SETTING:Department of Basic Theory of Traditional Chinese Medicine(TCM) of Basic Medical Science College, Guangzhou University of TCM.MATERIALS:The experiment was completed from March 2002 to January 2003 at the Animal Center of Guangzhou University of TCM.Totally60 Wistar rats were randomly divided into 6 groups: normal, model, tiaogan, bushen, jianpi and ginsenoside groups, with 10 in each group. Compositions and doses of tiaogan recipe: radix bupleuri 5 g, fruetus gardeniae 5 g,radix paeoniae alba 15 g,fructus lycii 15 g,fructus aurantii 6 g,radix rehmanniae 18 g, concha haliotidis 30 g. Compositions and doses of shenqi pill: radix rehmanniae 30 g, rhizoma dioscoreae 15 g, fructus corni 15 g,rhizoma alismatis 10 g,poria 10 g,cortex moutan radicis 10 g,ramulus cinnamomi 4 g, radix aconiti praeparata 4 g. Compositions and doses of sijunzi decoction:radix codonopsis pilosulae 20 g,rhizoma atractylodis macrocephalae 15 g, poria 15 g, radix glycyrrhizae preparata 6 g.METHODS:① The traditional Chinese medicines were conventionally decocted; and the tiaogan recipe condensed to the liquid containing1.69 g/mL crude drug, shenqi pill containing 1.76 g/mL crude drug,sijunzi decoction containing 1.01 g/mL crude drug.Ginsenoside was prepared as 7 g/L water solution.The rats in the normal and model groups were by gavage given 2 mL of 9.0 g/L sodium chloride injection.The rats in the tiaogan, bushen, jianpi and ginsenoside groups were respectively by gavage given 2 mL of tiaogan recipe, shenqi pill, sijunzi decoction and ginsenoside solution 1 hour before immobilization stress. ② Except for rats in the normal group, those in the rest groups were all conducted for establishment of psychic stress reaction model.The rats were put into an immobilization tube,their action space was gradually reduced by using a mobile insertion piece,they were regulated to a nervous state without prpduction of intense revolting, which was done once a day, starting with 4 hours immobilization on the first day, and later on increased by 30-60 minutes per day, for consecutive 14 days. ③ The whole brain of the rats in each group was collected by decapitation,OPA high-performance liquid chromatography was used for assays of the contents of glutamic acid, aspartic acid, γaminobutyric acid and taurine in hypothalamus and hippocampus of the rats.MAIN OUTCOME MEASURES: The content changes of glutamic acid,aspartic acid,γ-aminobutyric acid and tanrine in the hypothalamus and hippocampus of rats in each group.RESULTS: Totally 60 rats involved all entered into the result analysis. ①The content changes of glutamic acid in the hypothalamus and hippocampus of rats in each group:Compared with normal group,the contents of glutamic acid in hypothalamus of rats in the tiaogan, jianpi,bushen and ginsenoside groups were markedly decreased [(21.85±8.19), (15.76±1.80),(14.68±7.91), (21.46±5.45), (13.43±7.68) μmoL/g]; compared with model group,the contents in the tiaogan, bushen, jianpi and ginsenoside groups were obviously raised [(11.04±3.65), (11.78±2.17), (18.67±2.98), (20.91 ±3.96),(17.71±1.83) μ moL/g, P ＜ 0.05, P ＜ 0.01, P ＜ 0.01, P ＜ 0.05]. ② The content changes of aspartic acid in the hypothalamus and hippocampus of rats in each group:Compared with model group,the contents of aspartic acid in the hypothalamus in the jianpi and ginsenoside groups were obviously decreased [(8.65±1.18), (5.72±1.32), (4.67±1.88) μmoL/g, P ＜ 0.01,P ＜ 0.01], while the contents in the hippocampus of rats in the jianpi,bushen and ginsenoside groups were markedly raised[(2.58 ±0.87),(3.93±0.49), (4.52±0.98), (3.83±0.41) μmoL/g, P ＜ 0.01, P ＜ 0.01, P ＜ 0.05].③ The content changes of γ-aminobutyric acid in the hypothalamus and hippocampus of rats in each group:Compared with model group,the contents of γ-aminobutyric acid in the hypothalamus of rats in the tiaogan,jianpi,bushen and ginsenoside groups were markedly decreased[(20.92±4.96), (15.87±2.90), (13.84±2.63), (14.94±3.98), (10.94±3.68) μ moL/g,P ＜ 0.05, P ＜ 0.05, P ＜ 0.01, P ＜ 0.01], while the contents in the hypothalamus were obviously raised [(4.12±1.66), (4.18±1.04), (6.67±1.29),(6.11±0.99), (6.37±0.78) μmoL/g, P＜ 0.05, P＜ 0.01, P＜ 0.01, P＜ 0.01].④ The content changes of taurine in the hypothalamus and hippocampus of rats in each group: Compared with model group, the contents of taurine in the hypothalamus of rats in the tiaogan, jianpi, bushen and ginsenoside groups were markedly decreased [(10.24±1.72), (7.82±1.14), (8.00±2.05),(6.42±3.17) μmoL/g, P ＜ 0.05, P ＜ 0.05, P ＜ 0.01], while the contents in the hippocampus in the jianpi and ginsenoside groups were obviously raised [(12.61±3.51), (17.03±2.74), (18.04±2.14) μnoL/g, P＜ 0.01, P＜ 0.01].CONCLUSION:The central acting site of tiaogan recipe may mainly be in the hypothalamus,possibly being related with down-regulating amino acids.While the central acting sites ofjianpi recipe,bushen recipe and ginsenoside may include the hippocampus and hypothalamus, being mainly related with up-regulating amino acids,through enhancing the integration of the hippocampus on stress so as to gain the effect of anti-injury of stress.
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Methods and thoughts of the further research on central neurobiological mechanisms of Gan in taking charge of dispersion and regulating emotion are discussed. By applying the holistic approach and homeostasis theory, combined with modern psychological stress theory, the authors put forward their hypothesis of study. They offered that the TCM theory of "Gan takes charge of dispersion and could regulate emotion" is affirmatively to have certain mechanisms of central neurobiology. So, cut-in from the point of psychological stress reaction, adopting the research thoughts of "prescription-syndrome-therapeutic effectiveness--essence of Zang-Fu function", a model of chronic psychological stress reaction (CPSR) for imitating the process of comprehensive pathologic change due to Gan fails to take charge of dispersion and leads to emotional disorder was established. It is considered based on analysis of materials obtained from previous studies, that the central neurobiologic mechanism of so called dispersion, which Gan in charge of, is related to the regulation of hypothalamus-pitutary-adrenal gland axis. Concretely, the function of Gan in TCM may be, in the gross, related with the changes of multiple neurotransmitters and their synthetase produced in the process of CPSR (emotional disorder) regulation, such as neuropeptides, hormones, cyclic necleotide system and Fos protein expression, showing the characteristics of multiple links, multiple levels and multiple targets, with the effects involve several brain regions including various clusters of nuclei in hypothalamus, hippocampus and amygdala, etc.
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Humans , Brain , Physiology , Emotions , Liver , Physiology , Medicine, Chinese Traditional , Stress, PsychologicalABSTRACT
【Objective】To observe the effect of Modified Sini Powder(MSP)on the expression of hippocampal neuronal nitric oxide synthase(nNOS)in rats with chronic psychological stress.【Methods】Twenty-four Wistar rats were randomized into 3 groups: normal group,model group(receiving random stress stimulation for 21 days),and MSP group(receiving gastric infusion of MSP 3.38 g for each rat one hour before stimulation).The normal group and the model group received the same volume of saline.The expression of hippocampal nNOS was detected with immunohistochemical method.【Results】nNOS expression was found in neuronal pyramidal cells of hippocampus CA3 area in the three groups.The expression was obvious,positive cell count and its scoring were increased in the model group as compared with the normal group(P
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【Objective】To investigate the effects of Dan Zhi Xiaoyao San(DZXS) and its extracts on hypothalamic corticotropin releasing hormone(CRH) and plasma corticosterone(CORT) in rats with chronic psychological stress.【Methods】Wistar rats were randomized into 6 groups: A(normal control),B(model control),C (extract of DZXS extracted by water extraction and alcohol precipitation,3.608?g/kg),D(extract of DZXS extracted by petroleum ether,0.087?g/kg),E(extract of DZXS extracted by polysaccharide,2.20?g/kg) and F(DZXS 14.4?g/kg).Except group A,the rat models of chronic multi-phase psychological stress were established in other groups by improved Cart method.Groups A and B were given normal saline,and groups C,D and E were given the corresponding drugs according to the experimental design.Hypothalamic CRH and plasma CORT contents were examined to explore the therapeutic mechanism.【Results】Compared with group A,hypothalamic CRH and plasma CORT contents were increased in group B;hypothalamic CRH content was decreased in groups C,E and F(P
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Aim To study the anti-stress depression effect of Jiaweisinisan(JWSNS)and it's mechanism of N-methyl-D-aspartate(NMDA)receptor channel in hippocampus.Methods Chronic mild unpredictable stress(CMUS)was adopted to establish the rat depres-sion model.Before and after model establishing,the sucrose consumptions and the weight of rats were detected.TTC dyeing of hippocampus brain slices ex vivo were used to detect the situation of hippocampus neuron damage and the protective effect of serum containing components of JWSNS.The opening probability and the average opening time of NMDA receptor channels were detected by attach on cell patch clamp,the Ca2+ concentrations in single cell of hippocampus neurons were detected by Tillvis ION software.Results CMUS could decrease the sucrose preference and the weights of rats(P
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Aim The purpose of this study was to investigate mec ha nism of different therapies and formulas regulating chronic psychological stress . Methods The way of chronic bandaging and confining activity space w as adopted to establish chronic psychological stress rat model. The effects of d ifferent therapies and formulas on CRH mRNA expression in Hypothalamus were anal yzed by RT-PCR method. Results There was significant increase of CRH mRNA expression in Hypothalamus of rats with continual 2 wk psychological stres s(P
ABSTRACT
[Objective] To observe the influence of Xiaoyao Powder on the concentration of Ca2+ in hippocampal synaptosome of multi - stress model rats.[Methods] Wistar rats were randomly allocated to five groups: normal control (Group A) , model 1 (Group B), Xiaoyao Powder 1 (Group C), model 2 (Group D), and Xiaoyao Powder 2 (Group E) . All the rats except those of Group A were replicated to chronic multi-stress models. At the meantime, Groups C andE were given the decoction of Xiaoyao Powder, 1.06g each for 21 days and 42 days respectively. Groups A, B and D were administered by gavage the equal amount of normal saline. After the administration, the hippocampal homogenate was taken to detect the concentration of hippocampal synaptic Ca2+ by fluorimetry. [Results] Compared with Group A, the concentration of Ca2+ in hippocampal synaptosome of Groups B and C was increased, having significant difference ( P