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艾司氯胺酮切皮前用药对腹腔镜全子宫切除术后患者抑郁情绪与睡眠质量的影响

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中国计划生育学杂志 2024年第8期32卷 1791-1795页

作者：丁美平黎健刘勇吴鼎安徽省宣城市中心医院 242000

目的:探讨腹腔镜全子宫切除术(LTH)切皮前艾司氯胺酮用药镇痛效果。方法:选取2021年2月-2023年5月本院LTH患者110例,随机数字表法分为2组各55例。均择期行全麻下LTH治疗,观察组于切皮前予以艾司氯胺酮0.3 mg/kg静脉注射、对照组同时间... 详细信息

目的:探讨腹腔镜全子宫切除术(LTH)切皮前艾司氯胺酮用药镇痛效果。方法:选取2021年2月-2023年5月本院LTH患者110例,随机数字表法分为2组各55例。均择期行全麻下LTH治疗,观察组于切皮前予以艾司氯胺酮0.3 mg/kg静脉注射、对照组同时间点予以同剂量生理盐水注射。统计两组各时间点17项汉密尔顿抑郁量表(HAMD-17)、数字评定量表(NRS)以及匹兹堡睡眠质量指数(PSQI)评分,比较两组血清神经递质[多巴胺(DA)、肾上腺素(E)、去甲肾上腺素(NE)]水平,统计不良反应。结果:观察组剔除术中转开腹1例、个人因素退出1例,纳入53例;对照组剔除数据不全1例,纳入54例。观察组术后4 h、12 h、24 h、48 h静息时NRS评分(2.27±0.36分、2.53±0.41分、2.40±0.30分、2.12±0.32分)均低于对照组(2.62±0.40分、3.08±0.46分、2.85±0.38分、2.52±0.42分),术后2 d和5 d HAMD-17评分(13.24±2.16分、10.16±2.42分)、PSQI评分(12.46±1.84分、9.35±1.75分)均低于对照组(15.07±2.33分、11.59±2.51分、13.85±2.13分、10.08±1.92分),术后5 d观察组血清NE(129.45±17.25ng/L)、E(33.46±5.42ng/L)及DA(7.37±0.86μg/L)水平均高于对照组(113.62±13.48ng/L、30.72±4.15ng/L、7.03±0.72μg/L)(均P0.05)。结论:艾司氯胺酮切皮前用药可减轻LTH患者术后疼痛,调节神经递质表达水平,改善抑郁、睡眠状态,且未增加不良反应。

关键词：腹腔镜全子宫切除术艾司氯胺酮切皮前用药术后疼痛抑郁睡眠质量

颞叶癫痫伴双侧海马硬化与单侧海马硬化的临床特征差异分析

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中华神经医学杂志 2024年第5期23卷 450-457页

作者：陶琪何晨敏邱晶晶杨育育徐莎郭谊李宏丁瑶丁美萍王爽浙江大学医学院附属第二医院神经内科杭州310009 浙江大学医学院附属第二医院放射科杭州310009 湖州市中心医院神经内科湖州313000

目的探讨颞叶癫痫伴双侧海马硬化(TLE-bHS)与颞叶癫痫伴单侧海马硬化(TLE-uHS)临床特征的差异。方法回顾性纳入浙江大学医学院附属第二医院神经内科癫痫中心自2013年1月至2022年1月收治的48例明确诊断为TLE-bHS且临床资料完整的患者(TLE... 详细信息

目的探讨颞叶癫痫伴双侧海马硬化(TLE-bHS)与颞叶癫痫伴单侧海马硬化(TLE-uHS)临床特征的差异。方法回顾性纳入浙江大学医学院附属第二医院神经内科癫痫中心自2013年1月至2022年1月收治的48例明确诊断为TLE-bHS且临床资料完整的患者(TLE-bHS组),以及同期收治的101例明确诊断为TLE-uHS且临床资料完整的患者(TLE-uHS组),分析2组患者的临床资料如发病年龄、病程、既往病史、癫痫发作频率、抗发作药物种类、视频脑电图结果、神经心理测试结果以及治疗结局等方面的差异。结果与TLE-uHS组相比,TLE-bHS组患者男性占比更高,发病年龄更晚,病程更短,癫痫发作频率更高,既往及现用抗发作药物种类更多,癫痫发作时自主神经先兆比例更低、无先兆比例更高,视频脑电图中后头部背景活动偏慢比例更高,记忆商数、言语记忆评分及非言语记忆评分更低,差异均有统计学意义(P<0.05)。另外,2组患者既往病史构成比、发作间期癫痫样异常分布区域构成比的差异亦均有统计学意义(P<0.05),其中TLE-bHS组既往常伴有颅内感染/脑炎史,双侧颞区癫痫样异常比例更高;而TLE-uHS组常伴有热性惊厥史,单侧颞区癫痫样异常比例更高。TLE-bHS组患者中仅10例(20.8%)接受了非药物治疗,包括前颞叶切除手术3例(术后随访2年均为Engel分级Ⅰ级)、神经调控治疗4例、生酮饮食治疗4例;TLE-uHS组患者中55例(54.5%)接受了前颞叶切除手术,术后随访2年时Engel分级Ⅰ级48例(87.3%)、Ⅱ级1例(1.8%)、Ⅲ级4例(7.3%)、Ⅳ级2例(3.6%)。结论TLE-bHS患者与TLE-uHS患者在性别、既往病史、发病年龄、病程、癫痫发作频率、抗发作药物种类、视频脑电图、神经心理测试等方面的差异有助于将两者相鉴别。

关键词：颞叶癫痫双侧海马硬化单侧海马硬化

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Rapid resolution of subdural hematoma after targeted epidural blood patch treatment in patients with spontaneous intracranial hypotension

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Chinese Medical Journal 2014年第11期127卷 2063-2066页

作者： Wang Jin Zhang Dan Gong Xiangyang ding meiping Department of Neurology Sir Run Run Shaw Hospital Zhejiang University School of Medicine Sir Run Run Shaw Institute of Clinical Medicine of Zhejiang University Hangzhou Zhejiang 310016 China Department of Radiology Sir Run Run Shaw Hospital Zhejiang University School of Medicine Sir Run Run Shaw Institute of Clinical Medicine of Zhejiang University Hangzhou Zhejiang 310016 China Department of Neurology The Second Affiliated Hospital Zhejiang University School of Medicine Hangzhou Zhejiang 310009 China

Background Subdural hematoma （SDH） is a common complication of spontaneous intracranial hypotension （SIH）.To date,the management of SDH caused by SIH remains *** this paper,we reviewed the clinical course of SDH in patients with SIH,and discuss the underlying mechanism and attributing factors for rapid resolution of subdural hematomas after epidural blood patch （EBP） *** We retrospectively reviewed a cohort of seventy-eight SIH patients diagnosed and treated with targeted EBP in our neurology *** who received early CT/MRI follow-up after EBP operation were *** A series of four cases of SIH complicated with SDHs were *** follow-up neuroimages of these patients revealed that SDHs could be partially or totally absorbed just two to four days after targeted epidural blood patch *** Targeted epidural blood patch can result in rapid hematoma regression and good recovery in some patients with a combination of SDH and SIH.

关键词： cerebrospinal fluid leak spontaneous intracranial hypotension subdural hematoma epidural blood patch

γ-secretase inhibitor DAPT prevents neuronal death and memory impairment in sepsis associated encephalopathy in septic rats

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Chinese Medical Journal 2014年第5期127卷 924-928页

作者： Huang Man Liu chunhui Hu Yueyu Wang Pengfei ding meiping Department of Intensive Care Unit Sir Run Run Shaw HospitalZhejiang University School of Medicine Hangzhou Zhejiang 310020 China

Background Brain dysfunction is a frequent complication of sepsis,usually defined as sepsis-associated encephalopathy （SAE）.Although the Notch signaling pathway has been proven to be involved in both ischemia and neuronal proliferation,its role in SAE is still ***,the effect of the Notch signaling pathway involved γ-secretase inhibitor DAPT on SAE in septic rats was investigated in a cecal ligation and puncture （CLP） *** Fifty-nine Sprague-Dawley rats were randomly divided into four groups,with the septic group receiving the CLP ***-four hours after CLP or sham treatment,rats were sacrificed and their hippocampus was harvested for Western blot ***-αexpression was determined using an enzyme-linked immunosorbent assay （ELISA） *** apoptosis was assessed by TUNEL staining,and neuronal cell death was detected by H＆E ***,a novel object recognition experiment was used to evaluate memory *** Our data showed that sepsis can increase the expression of hippocampal Notch receptor intracellular domain （NICD） and poly （adenosine diphosphate [ADP]-ribose） polymerase-1 （PARP-1）,as well as the inflammatory response,neuronal apoptosis,neuronal death,and memory dysfunction in *** γ-secretase inhibitor N-[N-（3,5-difluorophenacetyl）-1-alanyl]-S-phenylglycine t-butyl ester （DAPT） can significantly decrease the level of NICD and PARP-1,reduce hippocampal neuronal apoptosis and death,attenuate TNF-α release and rescue cognitive impairment caused by *** The neuroprotective effect of DAPT on neuronal death and memory impairment in septic rats,which could be a new therapeutic approach for treating SAE in the future.

关键词： DAPT γ-secretase memory impairment sepsis Notch

Serotonin 1A receptor inhibits the status epilepticus induced by lithium-pilocarpine in rats

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Neuroscience Bulletin 2014年第3期30卷 401-408页

作者： Yi Yang Yi Guo Yifang Kuang Shan Wang Yan Jiang Yao ding Shuang Wang meiping ding Department of Neurology Second Affiliated Hospital School of Medicine Zhejiang University

Status epilepticus （SE） is a life-threatening neurological emergency associated with a high mortality rate. The serotonin 1A （5-HTIA） receptor is a possible target for the treatment of SE, but its role in animal models and the precise area of brain involved remain controversial. The hippocampus is a candidate site due to its key role in the development of SE and the existence of a high density of 5-HT1A receptors. Therefore, we investigated the effects of subcutaneous and intrahippocampal activation of 5-HT1A receptors in lithium-pilocarpine-induced SE, and tested whether the hippocampus is a true effector site. We developed SE in male Sprague-Dawley rats by giving lithium chloride （LiCI; 3 meq/kg, i.p.） 22-24 h prior to pilocarpine （25 mg/kg, i.p.）, and found that 8-OH-DPAT, a 5-HT1A receptor agonist administered subcutaneously （s.c.） at 0.5 or 1.0 mg/kg 1 h before pilocarpine injection increased the latency to the first epileptiform spikes, the electrographic SE, and the behavioral generalized seizures （GS）, while reducing the total EEG seizure time （P 〈0.01）. The duration of GS was shortened only by 1.0 mg/kg 8-OH-DPAT s.c. （P 〈0.05）. All these effects were inhibited by combined administration of WAY-100635 （1.0 mg/kg, s.c.）（P 〈0.05）, an antagonist of the 5-HT1A receptor, but WAY-100635 alone and low doses of 8-OH- DPAT （0.01 and 0.1 mg/kg） did not alter seizure activity. Furthermore, intrahippocampal 8-OH-DPAT only shortened the GS duration （P 〈0.05）. These findings imply that the 5-HT1A receptor is a promising therapeutic target against the generation and propagation of SE, and hippocampal receptors are involved in reducing the seizure severity.

关键词： status epilepticus serotonin 1A receptor 8-OH-DPAT WAY-100635 lithium pilocarpine

Ketogenic dietary therapy in adult status epilepticus:current progress and clinical application

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Acta Epileptologica 2022年第2期5卷 71-77页

作者： Mengting Cail Wanyin Xu Yang Zheng meiping ding Department of Neurology School of MedicineSecond Afliated HospitalZhejiang University310009 HangzhouChina Department of Nutrition Zhejiang Provincial Hospital of Chinese MedicineHangzhou 310009China Department of Neurology Zhejiang Provincial Hospital of Chihese MedicineHangzhou 310009China.

Status epilepticus(SE)is a common fatal neurological disease with high morbidity and mortality,Even if a large proportion of patients might be relieved from anti-seizure medications,sedatives and anesthetics,some still remain out of *** ketogenic dietary(KD)has been proven useful in patients refractory to medications and/or who have failed to respond to surgical ***,KD has shown beneficial therapeutic effects in children with SE,but studies in adults have rarely been *** this paper,we review the efficacy and utility of KD in adult SE patients and highlight its application for clinical reference and management.

关键词： Adults Drug-resistant epilepsy Ketogenic enteral nutrition Ketogenic dietary Ketogenic parenteral nutrition Management Status epilepticus

不同品种脐橙根际土丛枝菌根真菌群落多样性分析

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南昌工程学院学报 2024年第1期43卷 51-58页

作者：姬绍晖丁美萍陈彦芳房焕英朱丽琴邹显花黄荣珍李燕燕王金平南昌工程学院流域生态智能监测与综合治理江西省重点实验室江西南昌330099 信丰县气象局江西赣州341600 江西省鄱阳湖流域生态水利技术创新中心江西南昌330029

以赣南早脐橙、红肉脐橙和纽荷尔脐橙3个品种脐橙的根际土壤为研究对象,研究不同品种脐橙根际土壤中丛枝菌根真菌(Arbuscular mycorrhizal fungi,AM真菌)群落特征。结果表明:脐橙品种显著影响根际土壤中AM真菌群落α多样性,纽荷尔脐橙... 详细信息

以赣南早脐橙、红肉脐橙和纽荷尔脐橙3个品种脐橙的根际土壤为研究对象,研究不同品种脐橙根际土壤中丛枝菌根真菌(Arbuscular mycorrhizal fungi,AM真菌)群落特征。结果表明:脐橙品种显著影响根际土壤中AM真菌群落α多样性,纽荷尔脐橙根际土壤中的OTU数和ACE指数均显著低于赣南早脐橙和红肉脐橙(P<0.05);在各个菌属中,赣南早脐橙根际土壤中类球囊霉(Paraglomus)的相对丰度显著高于红肉脐橙和纽荷尔脐橙(P<0.05)。冗余分析(RDA)表明,土壤因子中,碱解氮显著影响脐橙根际土壤中AM真菌群落α多样性(F=7.8,P=0.034),速效钾显著影响脐橙根际土壤中AM真菌群落结构(F=2.7,P=0.008)。

关键词：脐橙 AM真菌群落品种差异高通量测序土壤化学性质

Excitatory somatostatin interneurons in the dentate gyrus drive a widespread seizure network in cortical dysplasia

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Signal Transduction and Targeted Therapy 2023年第6期8卷 3111-3122页

作者： Yang Zheng Cenglin Xu Jinyi Sun Wenjie Ming Sijie Dai Yuying Shao Xiaoyun Qiu Menghan Li Chunhong Shen Jinghong Xu Fan Fei Jiajia Fang Xuhong Jiang Guoqing Zheng Weiwei Hu Yi Wang Shuang Wang meiping ding Zhong Chen Department of Neurology Zhejiang Provincial Hospital of Chinese MedicineThe First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou310060China Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province School of Pharmaceutical SciencesZhejiang Chinese Medical UniversityHangzhou310053China Institute of Pharmacology and Toxicology College of Pharmaceutical SciencesZhejiang UniversityHangzhou310058China Epilepsy Center Department of NeurologySecond Affiliated Hospital Zhejiang University School of MedicineHangzhou310009China Department of Neurology Fourth Affiliated Hospital of Zhejiang University School of MedicineYiwu322000China

Seizures due to cortical dysplasia are notorious for their poor prognosis even with medications and surgery,likely due to the widespread seizure *** studies have primarily focused on the disruption of dysplastic lesions,rather than remote regions such as the ***,we first quantified the epileptogenicity of the hippocampus in patients with late-stage cortical *** further investigated the cellular substrates leading to the epileptic hippocampus,using multiscale tools including calcium imaging,optogenetics,immunohistochemistry and *** the first time,we revealed the role of hippocampal somatostatin-positive interneurons in cortical dysplasia-related ***-positive were recruited during cortical dysplasia-related ***,optogenetic studies suggested that somatostatin-positive interneurons paradoxically facilitated seizure *** contrast,parvalbumin-positive interneurons retained an inhibitory role as in *** recordings and immunohistochemical studies revealed glutamate-mediated excitatory transmission from somatostatin-positive interneurons in the dentate *** together,our study reveals a novel role of excitatory somatostatin-positive neurons in the seizure network and brings new insights into the cellular basis of cortical dysplasia.

关键词： somatostatin dysplasia seizure

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卵巢性脑白质营养不良的研究进展

中华神经科杂志 2017年第5期50卷 384-387页

作者：郑扬章殷希丁美萍浙江大学医学院附属第二医院神经内科杭州310009

白质消融性白质脑病（leukoencephalopathywithvanishingwhitematter,VWM）又称儿童共济失调伴中枢神经系统髓鞘化不良（childhoodataxiawithcentralnervoussystemhypomyelination,CACH）,是近年来逐渐被认识的常染色体隐性遗传的脑白质营养不良,多于儿童期起病,临床异质性较大,其中有部分女性患者,成年后起病,除VWM表现外常伴有卵巢早衰.最早在1962年由Eicke[1]报道,1997年Schiffmann等[2]汇总了类似病例并将这类疾病命名为卵巢性脑白质营养不良（ovarioleukodystrophy,OLD）,现认为是VWM的变异型.目前在国外文献上详细描述的OLD约30例,基因确诊的有20余例,而国内只有1例报道[3].现就OLD的临床特征、影像学表现、病理和遗传学特点作一系统综述,旨在提高相关医生的认识和重视,避免误诊或漏诊.

关键词：脑白质营养不良卵巢性常染色体隐性遗传中枢神经系统临床异质性影像学表现遗传学特点白质脑病