CO_2气腹对正常及缺氧缺血性脑损伤大鼠S-100、NSE mRNA和蛋白水平的影响
|
摘要
目的：随着腹腔镜技术的迅速发展，基础和临床工作中同时也对气腹下正常机体脏器的功能变化作了大量研究。随着微创外科的深入发展，腹腔镜手术适应症范围的拓宽、手术难度的增加，由人工气腹所带来的一系列病理生理变化日益受到重视，一些研究表明：气腹状态下，引起腹腔室间隔综合症，作为实质性器官的中枢神经系统发生低血流量损害及再灌注损伤，解除气腹后中枢神经系统功能受到不同程度的损害。气腹对于机体呼吸、循环、免疫及重要脏器影响的实验研究得以重视与深入，但有关预存有功能不全时气腹对脏器功能的不良影响及其机制的报道尚少。本课题旨在探讨不同CO_2气腹压及不同时段下正常及缺氧缺血性脑损伤大鼠血、脑脊液及脑组织S-100蛋白(S-100)、神经元特异性烯醇化酶(NSE)水平的变化，并进而探讨CO_2气腹对中枢神经系统的影响。
方法：采用健康成年Wistar大鼠建立气腹模型和缺氧缺血性脑损伤模型，确定成模大鼠80只，随机分组，闭合法建立CO_2气腹，分别施加5mmHg(0.67Kp)、1小时气腹和10mmHg(1.33KPa)、2小时气腹，并分别于气腹解除后48小时处死各组动物。用光镜和电镜观察大鼠脑组织胶质细胞和神经元细胞组织学变化；应用抗体夹心法检测气腹模型后血液和脑脊液中S-100、NSE水平变化，用逆转录-聚合酶链式反应(RT-PCR)技术和免疫组织化学的方法观察脑组织中S-100、NSEmRNA和蛋白水平表达的变化；TUNEL法检测石蜡组织块切片中脑组织细胞凋亡，分别随机计脑组织胶质细胞和神经元细胞凋亡细胞数。
结果：(1)CO_2气腹后，A_(5-1)组与对照组比较，海马区胶质细胞和神经元细胞均无明显变化，A_(10-2)组胶质细胞和神经元细胞在光镜下呈局轻度水样变，电镜下线粒体轻度肿胀；缺氧缺血性脑损伤组(B)与对照组比较，海马区胶质细胞和神经元细胞均呈水样变，无核坏死，电镜下线粒体、内质网中度水肿，B_(5-1)组与B组比较，海马区胶质细胞和神经元细胞水肿加重，B_(10-2)组胶质细胞和神经元细胞在光镜下呈弥漫性水样变，部分胶质细胞核浓缩和细胞皱缩，神经元细胞胞浆酸性细胞增多，电镜下胶质细胞水样变，线粒体肿胀、脊断裂，胶质细胞内髓鞘样结构形成，神经元细胞线粒体、内质网肿胀变性，核膜破裂。(2)CO_2气腹后血液中S-100在A_(5-1)组(0.415±0.096)ug/L和A_(10-2)组(0.445±0.086)ug/L，NSE分别为(0.511±0.022)ng／ml和(0.531±0.041)ng/ml，对照组S-100和NSE分别为(0.393±0.100)ug/L和(0.493±0.045)ng/ml；脑脊液中S-100在A_(5-1)组(0.440±0.082)ug/L和A_(10-2)组(0.458±0.127)ug/L，NSE分别为(0.538±0.059)ng/ml和(0.574±0.048)ng/ml，对照组S-100和NSE分别为(0.431±0.124)ug/L和(0.531±0.048)ng/ml，血液和脑脊液中S-100、NSE随CO_2气腹压力及时间增加而逐渐增加，但差异无显著性意义(P＞0.05)；缺氧缺血性脑损伤组(B)与对照组比较，血液和脑脊液中S-100、NSE水平均明显增高，差异有显著性意义(P＜0.05)，B_(5-1)组与B组比较水平均有增加，差异无显著性意义，在B_(10-2)组差异有显著性意义(P＜0.05)。S-100和NSE在血液和脑脊液中水平变化分别呈正相关(P＜0.05)。(3)S-100 mRNA在A_(5-1)组(64.215±10.404)和A_(10-2)组(67.020±13.339)，NSE分别为(8.976±2.379)和(9.183±3.365)，对照组S-100、NSE mRNA分别为(59.340±11.378)和(8.500±2.940)，S-100、NSE mRNA在CO_2气腹后逐渐增加，但与对照组比较，差异无显著性意义(P＞0.05)，B组与对照组或B_(10-2)组与B组比较均有显著性差异(P＜0.05)。(4)CO_2气腹后脑组织S-100蛋白、NSE表达阳性面积随时间及压力增加而逐渐增加，在A_(5-1)点和A_(10-2)点与对照组比较无显著性差异(P＞0.05)，B组与对照组或B_(10-2)组与B组比较均有显著性差异(P＜0.05)。(5)细胞凋亡检测显示低气腹压时脑组织胶质细胞和神经元细胞凋亡数无显著变化，高气腹压凋亡细胞数增多。
结论：(1)在5mmHg压力、1小时位点，CO_2气腹对正常大鼠中枢神经系统组织学、生化标志物、蛋白转录水平、蛋白水平表达的变化及脑组织胶质细胞和神经元细胞凋亡细胞数无显著影响，CO_2气腹在这一范围应用对中枢神经系统是安全的。(2) 10mmHg压力、2小时位点，CO_2气腹对正常大鼠中枢神经系统组织学、生化标志物、蛋白转录水平、蛋白水平表达的变化及脑组织胶质细胞和神经元细胞凋亡细胞数无显著影响，CO_2气腹在这一范围应用对中枢神经系统是安全的。(3)在5mmHg压力、1小时位点，CO_2气腹对缺血缺氧性脑损伤大鼠中枢神经系统组织学、生化标志物、蛋白转录水平、蛋白水平表达的变化及脑组织胶质细胞和神经元细胞凋亡细胞数有一定影响，CO_2气腹在这一范围应用对中枢神经系统仍是安全的。(4)在10mmHg压力、2小时位点，CO_2气腹对缺血缺氧性脑损伤大鼠中枢神经系统组织学、生化标志物及蛋白转录水平、蛋白水平表达的变化及脑组织胶质细胞和神经元细胞凋亡细胞数有显著影响，CO_2气腹在这一范围应用应充分考虑中枢神经系统并发症的危险，应尽量缩短手术时间或采取相应的调控措施。
Objective With the rapid development and renovation of laparoscopic technology, many experimental and clinical researches concerned on the function changes of normal organs under carbon dioxide pneumoperitoneun which was largely used expend manipulative working space during laparoscopic procedure. With the rapid development of minimally invasiving surgery, the spectrum of laparoscopic operation have been growing wider and the difficulty of them also have been the focus in the field. Some studies have indicated that the brain ischemic and reperfusive injury developed during pneumoperitoneun and the function of Central nerous system were impaired after pneumoperitoneun. The reason for the abdominal compartment syndrome is an important factor for the injury of parenchymatous organ. The researches about the influence of pneumoperitoneun on the respiration, circulation, immunology and the vital abdominal organs are spring up. Howerver, the studies on the influence of pneumoperitoneun on the vital parenchymal organs in the pathological situation were very few and superficial. In healthy patients, carbon dioxide pneumoperitoneun effect on the body is transient and without any apparent sequelae. however, few articles in the literature were reported about the influence of CO_2 PP on the body with dysfunctional organ , such as heart failure、chronic liver dysfunction and so on. The purpose of this study was to evaluate the changes of blood ,cerebrospinal fluid(CSF) and brain tissue S-100 protein (S-100),neuron specific enolse (NSE) levels and the expression of the mRNA and protein level for S-100 and NSE following pneumoperitoneun with carbon dioxide (CO_2 PP) at different of time and pressuer,and to explore whether CO_2 PP produces effect on central nerous system(CNS) in normal and hypoxic-ischemic brain damage rats. Methods Healthy adult Wistar rats were used to establish models of CO_2 PP and of hypoxic-ischemic brain damage .80 model rats were randomly divided into group s.The abdominal cavity of these rats were gradually insufflated CO_2 gas by closeing method and maintained at the pressure of 5mmHg (0.67Kp) for 1hour and 10mmHg (1.33Kp) for 2 hours.animals in each group were sacrificed at 48 hours individually after deflation .Astrocytes and neurons in the hippocamps of brian tissue of rat were observed by light microscope and electron microscope. Their serial blood and CSF S-100 and NSE were measured by ELISA way. By using the RT-PCR technique the expression of mRNA for S-100 and NSE in the brain tissue were tested .Immunohistochemical assay was used to investigate the changes of the expression of S-100 and NSE at the protein level. Detected by terminal deoxynucleotidyl transferase mediated dUTP-biotin nick and labeling (TUNEL),apoptosis of the astrocytes and neurons in the hippocampus of brian tissue of rat was counted on each slices.
Results (1) There were no any histologic different between A_(5-1) group and control group after pneumoperitoneun with carbon dioxide. The astrocytes and neurons in the hippocampus of brian tissue of rat in A_(10-2) group showed local hydropic degeneration under light microscope , mitochondrion swelling under electron microscope. There were significantly histologic difference between B group and control group . The astrocytes and neurons in the hippocampus of brian tissue of rat in B group showed hydropic degeneration, no nuclear necrosis under light microscope , mitochondrion swelling under electron microscope. Astrocytes in the hippocampus of the B_(10-2) group showed diffuse hydropic degeneration, nuclear pyknosis, and cell shrinkage under light microscope.mitochondrion and glycogen swelling , fragmentation of ridge myelinogenesis in the astrocytes .Neuron in the B_(10-2) group showed diffuse hydropic degeneration, cytoplasmic hyperosinophilia , local nuclear pyknosis and cell shrinkage under light microscope .Nuclear membrane disruption under electron microscope. (2) The values of S-100, NSE were (0.415±0.096)ug/L and (0.511±0.022) ng/ml respectively in A_(5-1) group and (0.445±0.086)ug/L, (0.531±0.04)ng/ml respectively in A_(10-2) group in the blood, were (0.440±0.082) ug/L and (0.538±0.059) ng/ml respectively in A_(5-1) group and (0.458±0.127)ug/L, (0.574±0.048)ng/ml respectively in A_(10-2) group in the CSF after CO_2 PP. The values of S-100 ,NSE were increased in both blood and CSF samples in A_(5-1) group and A_(10-2) group after CO_2 PP than the values of control group (0.393±0.100ug/L,0.493±0.045 ng/ml and 0.431±0.124ug/L,0.531±0.048ng/ml) respectively. Nevertheless there were no significance between A_(5-1) group and control group or A_(10-2) group and control group ( P>0.05). The findings showed a significantly increased levels of S-100 and NSE in the B group compared with the control group (P<0.05) or the B_(10-2) group compared with the B group (P<0.05)respectively. The values of S-100, NSE in the blood were found to be positively correlated with the values in the CSF (P<0.05) )respectively.(3) The values of expression of mRNA for S-100 and NSE were (64.22±10.40) and (8.98±2.38) in A_(5-1) group and (67.02±13.34), (9.18±3.37) respectively in A_(10-2) group after CO_2 PP,were (59.34±11.38) and (8.50±2.94) in control group .The expressions of S-100 and NSE increased with the increase of pressure and time of CO_2 PP. There were no significance between them ( P>0.05). The protein s of mRNA for S-100 and NSE increased progressively in B group ,B_(5-1) group and B_(10-2) group than the expressions of control group. There were significance between B group and control group (P<0.05) or B_(10-2) group and B group (P<0.05).(4) The positive areas of the expression of S-100,NSE in the brian tissue increased progressively with the increase of pressure and time of CO_2 PP. There were no significance between A_(5-1) group and control group ( P>0.05) or A_(10-2) group and control group ( P>0.05). There were significance between B group and control group ( P<0.05) or B_(10-2) group and Bgroup ( P<0.05).(5) Apoptosis of astrocytes and neurons in the hippocampus of brian tissue of rat had the similar amount to the control group at low IAP. Dramatical increase of apoptosis of astrocytes and neurons in per high visual field were demonstrated increased significantly after CO_2 PP pressure at 10mmHg (1.33Kp) for 2 hours .There were significance between B_(10-2) group and control group. Apoptosis cells in astrocytes and neurons in the hippocampus of brian tissue had slightly but not significantly enhanced in normal rat, significantly enhanced in hypoxic-ischemic brain damage rats at 10mmHg (1.33Kp) for 2 hours.
Conclusion (1) CO_2 PP at pressure of 5 mmHg and within 1 hour does not produce any effect on histology, biochemical marker, protein transcriptase level, protein expression level and apoptosis of astrocyte and neuron of central nervous system in normal rat. CO_2 PP is used during this extent is safe to central nervous system.(2) CO_2 PP at pressure of 10mmHg and within 2 hours does not produce significantly effect on histology, biochemical marker, protein transcriptase level, protein expression level and apoptosis of astrocyte and neuron of central nervous system in normal rat. CO_2 PP is used during this extent is safe to central nervous system . (3) CO_2 PP at pressure of 5 mmHg and within 1 hour produce a some effect on histology, biochemical marker, protein transcriptase level, protein expression level and apoptosis of astrocyte and neuron of central nervous system in hypoxic-ischemic brain damage rats. CO_2 PP is used during this extent is safe to central nervous system (4) CO_2 PP at pressure of 10 mmHg and within 2 hours produce significantly effect on histology, biochemical marker, protein transcriptase level, protein expression level and apoptosis of astrocyte and neuron of central nervous system in hypoxic-ischemic brain damage rats. CO_2 PP is used during the extent is injurious to central nervous system, and trying to short PP time or use control way.
方法：采用健康成年Wistar大鼠建立气腹模型和缺氧缺血性脑损伤模型，确定成模大鼠80只，随机分组，闭合法建立CO_2气腹，分别施加5mmHg(0.67Kp)、1小时气腹和10mmHg(1.33KPa)、2小时气腹，并分别于气腹解除后48小时处死各组动物。用光镜和电镜观察大鼠脑组织胶质细胞和神经元细胞组织学变化；应用抗体夹心法检测气腹模型后血液和脑脊液中S-100、NSE水平变化，用逆转录-聚合酶链式反应(RT-PCR)技术和免疫组织化学的方法观察脑组织中S-100、NSEmRNA和蛋白水平表达的变化；TUNEL法检测石蜡组织块切片中脑组织细胞凋亡，分别随机计脑组织胶质细胞和神经元细胞凋亡细胞数。
结果：(1)CO_2气腹后，A_(5-1)组与对照组比较，海马区胶质细胞和神经元细胞均无明显变化，A_(10-2)组胶质细胞和神经元细胞在光镜下呈局轻度水样变，电镜下线粒体轻度肿胀；缺氧缺血性脑损伤组(B)与对照组比较，海马区胶质细胞和神经元细胞均呈水样变，无核坏死，电镜下线粒体、内质网中度水肿，B_(5-1)组与B组比较，海马区胶质细胞和神经元细胞水肿加重，B_(10-2)组胶质细胞和神经元细胞在光镜下呈弥漫性水样变，部分胶质细胞核浓缩和细胞皱缩，神经元细胞胞浆酸性细胞增多，电镜下胶质细胞水样变，线粒体肿胀、脊断裂，胶质细胞内髓鞘样结构形成，神经元细胞线粒体、内质网肿胀变性，核膜破裂。(2)CO_2气腹后血液中S-100在A_(5-1)组(0.415±0.096)ug/L和A_(10-2)组(0.445±0.086)ug/L，NSE分别为(0.511±0.022)ng／ml和(0.531±0.041)ng/ml，对照组S-100和NSE分别为(0.393±0.100)ug/L和(0.493±0.045)ng/ml；脑脊液中S-100在A_(5-1)组(0.440±0.082)ug/L和A_(10-2)组(0.458±0.127)ug/L，NSE分别为(0.538±0.059)ng/ml和(0.574±0.048)ng/ml，对照组S-100和NSE分别为(0.431±0.124)ug/L和(0.531±0.048)ng/ml，血液和脑脊液中S-100、NSE随CO_2气腹压力及时间增加而逐渐增加，但差异无显著性意义(P＞0.05)；缺氧缺血性脑损伤组(B)与对照组比较，血液和脑脊液中S-100、NSE水平均明显增高，差异有显著性意义(P＜0.05)，B_(5-1)组与B组比较水平均有增加，差异无显著性意义，在B_(10-2)组差异有显著性意义(P＜0.05)。S-100和NSE在血液和脑脊液中水平变化分别呈正相关(P＜0.05)。(3)S-100 mRNA在A_(5-1)组(64.215±10.404)和A_(10-2)组(67.020±13.339)，NSE分别为(8.976±2.379)和(9.183±3.365)，对照组S-100、NSE mRNA分别为(59.340±11.378)和(8.500±2.940)，S-100、NSE mRNA在CO_2气腹后逐渐增加，但与对照组比较，差异无显著性意义(P＞0.05)，B组与对照组或B_(10-2)组与B组比较均有显著性差异(P＜0.05)。(4)CO_2气腹后脑组织S-100蛋白、NSE表达阳性面积随时间及压力增加而逐渐增加，在A_(5-1)点和A_(10-2)点与对照组比较无显著性差异(P＞0.05)，B组与对照组或B_(10-2)组与B组比较均有显著性差异(P＜0.05)。(5)细胞凋亡检测显示低气腹压时脑组织胶质细胞和神经元细胞凋亡数无显著变化，高气腹压凋亡细胞数增多。
结论：(1)在5mmHg压力、1小时位点，CO_2气腹对正常大鼠中枢神经系统组织学、生化标志物、蛋白转录水平、蛋白水平表达的变化及脑组织胶质细胞和神经元细胞凋亡细胞数无显著影响，CO_2气腹在这一范围应用对中枢神经系统是安全的。(2) 10mmHg压力、2小时位点，CO_2气腹对正常大鼠中枢神经系统组织学、生化标志物、蛋白转录水平、蛋白水平表达的变化及脑组织胶质细胞和神经元细胞凋亡细胞数无显著影响，CO_2气腹在这一范围应用对中枢神经系统是安全的。(3)在5mmHg压力、1小时位点，CO_2气腹对缺血缺氧性脑损伤大鼠中枢神经系统组织学、生化标志物、蛋白转录水平、蛋白水平表达的变化及脑组织胶质细胞和神经元细胞凋亡细胞数有一定影响，CO_2气腹在这一范围应用对中枢神经系统仍是安全的。(4)在10mmHg压力、2小时位点，CO_2气腹对缺血缺氧性脑损伤大鼠中枢神经系统组织学、生化标志物及蛋白转录水平、蛋白水平表达的变化及脑组织胶质细胞和神经元细胞凋亡细胞数有显著影响，CO_2气腹在这一范围应用应充分考虑中枢神经系统并发症的危险，应尽量缩短手术时间或采取相应的调控措施。
Objective With the rapid development and renovation of laparoscopic technology, many experimental and clinical researches concerned on the function changes of normal organs under carbon dioxide pneumoperitoneun which was largely used expend manipulative working space during laparoscopic procedure. With the rapid development of minimally invasiving surgery, the spectrum of laparoscopic operation have been growing wider and the difficulty of them also have been the focus in the field. Some studies have indicated that the brain ischemic and reperfusive injury developed during pneumoperitoneun and the function of Central nerous system were impaired after pneumoperitoneun. The reason for the abdominal compartment syndrome is an important factor for the injury of parenchymatous organ. The researches about the influence of pneumoperitoneun on the respiration, circulation, immunology and the vital abdominal organs are spring up. Howerver, the studies on the influence of pneumoperitoneun on the vital parenchymal organs in the pathological situation were very few and superficial. In healthy patients, carbon dioxide pneumoperitoneun effect on the body is transient and without any apparent sequelae. however, few articles in the literature were reported about the influence of CO_2 PP on the body with dysfunctional organ , such as heart failure、chronic liver dysfunction and so on. The purpose of this study was to evaluate the changes of blood ,cerebrospinal fluid(CSF) and brain tissue S-100 protein (S-100),neuron specific enolse (NSE) levels and the expression of the mRNA and protein level for S-100 and NSE following pneumoperitoneun with carbon dioxide (CO_2 PP) at different of time and pressuer,and to explore whether CO_2 PP produces effect on central nerous system(CNS) in normal and hypoxic-ischemic brain damage rats. Methods Healthy adult Wistar rats were used to establish models of CO_2 PP and of hypoxic-ischemic brain damage .80 model rats were randomly divided into group s.The abdominal cavity of these rats were gradually insufflated CO_2 gas by closeing method and maintained at the pressure of 5mmHg (0.67Kp) for 1hour and 10mmHg (1.33Kp) for 2 hours.animals in each group were sacrificed at 48 hours individually after deflation .Astrocytes and neurons in the hippocamps of brian tissue of rat were observed by light microscope and electron microscope. Their serial blood and CSF S-100 and NSE were measured by ELISA way. By using the RT-PCR technique the expression of mRNA for S-100 and NSE in the brain tissue were tested .Immunohistochemical assay was used to investigate the changes of the expression of S-100 and NSE at the protein level. Detected by terminal deoxynucleotidyl transferase mediated dUTP-biotin nick and labeling (TUNEL),apoptosis of the astrocytes and neurons in the hippocampus of brian tissue of rat was counted on each slices.
Results (1) There were no any histologic different between A_(5-1) group and control group after pneumoperitoneun with carbon dioxide. The astrocytes and neurons in the hippocampus of brian tissue of rat in A_(10-2) group showed local hydropic degeneration under light microscope , mitochondrion swelling under electron microscope. There were significantly histologic difference between B group and control group . The astrocytes and neurons in the hippocampus of brian tissue of rat in B group showed hydropic degeneration, no nuclear necrosis under light microscope , mitochondrion swelling under electron microscope. Astrocytes in the hippocampus of the B_(10-2) group showed diffuse hydropic degeneration, nuclear pyknosis, and cell shrinkage under light microscope.mitochondrion and glycogen swelling , fragmentation of ridge myelinogenesis in the astrocytes .Neuron in the B_(10-2) group showed diffuse hydropic degeneration, cytoplasmic hyperosinophilia , local nuclear pyknosis and cell shrinkage under light microscope .Nuclear membrane disruption under electron microscope. (2) The values of S-100, NSE were (0.415±0.096)ug/L and (0.511±0.022) ng/ml respectively in A_(5-1) group and (0.445±0.086)ug/L, (0.531±0.04)ng/ml respectively in A_(10-2) group in the blood, were (0.440±0.082) ug/L and (0.538±0.059) ng/ml respectively in A_(5-1) group and (0.458±0.127)ug/L, (0.574±0.048)ng/ml respectively in A_(10-2) group in the CSF after CO_2 PP. The values of S-100 ,NSE were increased in both blood and CSF samples in A_(5-1) group and A_(10-2) group after CO_2 PP than the values of control group (0.393±0.100ug/L,0.493±0.045 ng/ml and 0.431±0.124ug/L,0.531±0.048ng/ml) respectively. Nevertheless there were no significance between A_(5-1) group and control group or A_(10-2) group and control group ( P>0.05). The findings showed a significantly increased levels of S-100 and NSE in the B group compared with the control group (P<0.05) or the B_(10-2) group compared with the B group (P<0.05)respectively. The values of S-100, NSE in the blood were found to be positively correlated with the values in the CSF (P<0.05) )respectively.(3) The values of expression of mRNA for S-100 and NSE were (64.22±10.40) and (8.98±2.38) in A_(5-1) group and (67.02±13.34), (9.18±3.37) respectively in A_(10-2) group after CO_2 PP,were (59.34±11.38) and (8.50±2.94) in control group .The expressions of S-100 and NSE increased with the increase of pressure and time of CO_2 PP. There were no significance between them ( P>0.05). The protein s of mRNA for S-100 and NSE increased progressively in B group ,B_(5-1) group and B_(10-2) group than the expressions of control group. There were significance between B group and control group (P<0.05) or B_(10-2) group and B group (P<0.05).(4) The positive areas of the expression of S-100,NSE in the brian tissue increased progressively with the increase of pressure and time of CO_2 PP. There were no significance between A_(5-1) group and control group ( P>0.05) or A_(10-2) group and control group ( P>0.05). There were significance between B group and control group ( P<0.05) or B_(10-2) group and Bgroup ( P<0.05).(5) Apoptosis of astrocytes and neurons in the hippocampus of brian tissue of rat had the similar amount to the control group at low IAP. Dramatical increase of apoptosis of astrocytes and neurons in per high visual field were demonstrated increased significantly after CO_2 PP pressure at 10mmHg (1.33Kp) for 2 hours .There were significance between B_(10-2) group and control group. Apoptosis cells in astrocytes and neurons in the hippocampus of brian tissue had slightly but not significantly enhanced in normal rat, significantly enhanced in hypoxic-ischemic brain damage rats at 10mmHg (1.33Kp) for 2 hours.
Conclusion (1) CO_2 PP at pressure of 5 mmHg and within 1 hour does not produce any effect on histology, biochemical marker, protein transcriptase level, protein expression level and apoptosis of astrocyte and neuron of central nervous system in normal rat. CO_2 PP is used during this extent is safe to central nervous system.(2) CO_2 PP at pressure of 10mmHg and within 2 hours does not produce significantly effect on histology, biochemical marker, protein transcriptase level, protein expression level and apoptosis of astrocyte and neuron of central nervous system in normal rat. CO_2 PP is used during this extent is safe to central nervous system . (3) CO_2 PP at pressure of 5 mmHg and within 1 hour produce a some effect on histology, biochemical marker, protein transcriptase level, protein expression level and apoptosis of astrocyte and neuron of central nervous system in hypoxic-ischemic brain damage rats. CO_2 PP is used during this extent is safe to central nervous system (4) CO_2 PP at pressure of 10 mmHg and within 2 hours produce significantly effect on histology, biochemical marker, protein transcriptase level, protein expression level and apoptosis of astrocyte and neuron of central nervous system in hypoxic-ischemic brain damage rats. CO_2 PP is used during the extent is injurious to central nervous system, and trying to short PP time or use control way.
引文
1．陈训如，Peter Mack．腹腔镜外科理论与实践．昆明：云南科技出版社，1997年6月
2．刘国礼．中国腹腔镜外科进展．世界华人消化杂志，1999；7(3)：263-264
3．郑成竹．微创外科的发展．中国实用外科杂志，1999；19(1)：14
4. Sato M,Watanable Y, Uedas S,et al.Minimally invasive hepatic resection using laparoscopic surgery and minithoratomy. Arch Surg,1997;132(20):206-211
5. Smit MJ, Beelen RHJ,Eijsbouts QAJ,et al.Immunological response in laparoscopic surgery.Acta Gastroenterologica Belgica,1996;245-247
6. Wittgen CM,Andrus CH,Fitzgerald SD,et al. Analysis of the hemodynamic and ventilatory effectsof laparoscopic cholecystectomy. Arch Surg,1991; 126(9): 997-1001
7. Westerband A,Van De Water JM,Amzallag M,et al.Cardiovascular changes laparoscopic cholecystectomy..Surg Gynecol Obstet,1992;175(6):535-538
8. Luca A, Cirera I,Garcia-Pagan JC,et al. Hemodynamic effects of acute changes in intra-abdominal pressure in patients withcirrhosis. Gastroenterology, 1993; 104(3) 225-227
9. Oleary E,Hubbard K,Tomey W, et al. laparoscopic cholecystectomy.-hemodynamic and neuroendocrine response following pneumoperitoneum.Br J Anaesth, 1995; 74:123
10. Glaser F,Sannwald GA,Buhr HJ,et al.General stress response to conventional and laparoscopic cholecystectomy.Ann Surg,1995;221(3):372-380
11．段体德，刘筱衡，帅建，等．腹腔镜胆囊切除术围手术期神经内分泌代谢变化德临床研究，1995；16(5)339-341
12. Schein M,Wittman DH,Aprahamian CC,et al. The abdominal compartment syndrome:The physiological and clinical consequence of elevated intra-abdominal pressure.J AM Coll Surg,1995;180:745-753
13. Richards WO,Scovill W,Shin B, et al.Acute renal failure associated with increased intra-abdominal pressure.Ann Surg.1983;197:183-187
14. Holthausen UH,Razek TS,Hinchey EJ,et al. Monitoring intracranial pressure with a "head injury" model:carbon dioxide(CO_2) pneumoperitoneum versus laprolift procedure.Langenbecks Arch Chir Suppl Kongressbd. 1997,114:257-260
15. Uzzo RG,Bilsky M,Mininberg DT,et al. laparoscopic surgery in children with ventriculoperitoneal shunts:effect of pneumoperitoneum on intracranial pressure:preliminary experience.Urology. 1997,49:753-757
16．吴子顺，汪明惠，牧素玲．腹腔镜胆囊切除术CO_2气腹对脑脊液压德影响．临床麻醉学杂志．1997；13(3)：161
17. Rosenthal RJ,Hiatt JR,Phillips EH,et al. Intracranial pressure effect of pneumoperitoneun! in a large animal model.Surg Endosc.1997,11:376-380
18. Wright AD, Imray CH,Morrissey MS. et al. Intracranial pressure at high altitude and acute mountain sickness.Clin Sci.1995,89:201-204
19. Horvath K,Whelan R.Liver B,et al. The effect of elevated intraabdominal pressure,hypercarbia,andpositioning on the hemodynamic response to laparoscopic colectomy in pigs. Surg Endosc.1998,12:107-114
20. Moncure M, Grande P0, Asgeirsson B, et al. Intracranial pressure effect of pneumoperitoneum in dogs with injured brian.Am Surg 1999;14(4):227-236
21. 刘宿,葛衡江,周蓉,等.腹腔镜手术期间二氧化碳气腹对脑氧供影响.中华麻醉学杂志.1997;17(6):339-340
22. Lawreence N,Diebel MD,Robert F,et al.Effects of increased intra-abdominal pressure on hepatic,portal venous and hepatic microcirculation blood flow. J trauma,1992;33:279-283
23. Hamilton BD,Chow CK, Jnman SR,et al. Increased intra-abdominal pressure during pneumoperitoneum stimulates endothelin release in a canine model. J Eneourol,1998;12:193-197
24. Allan D,Alfred C.Cardiovascular consequences of laparoscopic surgery. The lancet,1998;352(15):568-570
25. Greif W,Forse R. Hemodynamic effects of the laparoscopic pneumoperitoneum during sepsis in a porcine endotoxic shock model. Ann Surg, 1998;277(16): 474-480
26. Sharma A,Pake D,Alfred H,et al. laparoscopy and potential complications. Heart and Lung,1997;26(1):52-61
27. Joris JC, Chiche JD,Canivet JC.et al. Hemodynamic changes induced by laparoscopy and their endocrine corrlates :effects of clonidine J Am coll Cardiol,1998;32:89-96
28. Wolf TS,Monk TG,McDougall EM,et al. The extraperitoneal approach and subcutaneous empllysema are associated with greater absortion of carbon dioxide laparoscopic renal surgery. J Urol,1995;154:959-967
29. Ho HS,Gunther RA, Wolfe BM.intraperitoneal carbon dioxide insufflation and cardiopulmonary function. Arch Surg, 1992; 127:928-932
30. Ferrandez LL,Saenz A,Traura D, rt al. Helium and carbon dioxide pneumoperitoneum in patients with pheochromocytoma undergoing laparoscopic adrenalectomy. Word J Surg,1998;22:1250-1255
31. Joris JL,Hamoir EE,Hartstein GM, et al. Hemodynamic changes and catecholamine release during laparoscopic adrenalectomy for phechromocytoma . Anesth Analg,1999;88:16-21
32. Missler U . S-100 protein and neuronspecific enolase concentration in blood as indicators of infarction volume and prognosis in acute ischemic stroke [J].Stroke, 1997; 28: 1956-1960.
33. Barone FC, Clark PK, Price WJ, et al. Neuron-specific enolase increase in cerebral and systemic circulation following focal ische mia. Brain Res, 1993, 623 (1): 77—82
34. Buttner T, Weyers S, Postert T, et al. S-100 protein : Serum marker of focal brian damage after ischemic territorial MCA infarction. Stroke, 1997, 28 (10): 1961-1965
35. Levison SW, Ducleschi MH, Young GM; et al. Exp Ncurol, 1996, 141 (2): 256.
36.Grasso G,Passalacpasm M,Sfacteria A,et al.Does administration of recombinant human erythropoietin attenuate the increase of S-100 protein observed in cerebrospinal fluid after experimental subarachnoid hemorrhage? J Nerurosurg, 2002,96 (3): 565-570
37. Love S.Oxidative stress in brain ischemia. Br Path,1999,9:119-131
38.Mussack T.Biberthaler P,Wiedemann E, et al .S-100b as a screening marker of the severity of minor head trauma(MHT)-a pilot study. Acta Neurochir Suppl,2000,76:393-396
39.Elting JW,De jager AE,Teelken AW,et al.Comparison of serum S-100 protein levels following stroke and traumatic brian injury. J Neurol Sci, 2000,181(1-2): 104-110
40.Schein M,Wittman DH,Aprahamian CC,et al. The abdominal compartment syndrome :The physiological and clinical consequence of elevated intra-abdominal pressure.J AM Coll Surg,1995;180:745-753
41.Morrison CA, Schreiber MA, Olsen SB, et al. Femoral Venous flow dynamics intraperitoneal and preperitoneal laparoscopic insufflation. Surg Endosc, 1998; 12: 1213—1221
42.Holthausen UH,Razek TS,Hinchey EJ,et al. Monitoring intracranial pressure with a "head injury " model:carbon dioxide(CO_2) pneumoperitoneum versus laprolift procedure.Langenbecks Arch Chir Suppl Kongressbd.1997,114:257-260
43. Struthers AD, Cuschieri A.Cardiovascular consequences of laparoscopic surgery (J) .Lacent, 1998, 352 (15): 568-570
44. Galizia G, Prizio G, Lieto E, et al. Hemodynamic and pulmonary changes during open, carbon dioxide pneumoperitoneum and abdominal wall — lifting cholecystectomy. Aprospective, randomized study. Surg Endosc.2001, 15 (5): 477—483
45. Neuhaus SJ, Gupta A, Watson D. Helium and other alternative insufflation gases for laparoscopy. Surg Endosc.2001, 15 (6): 553—560
46.Fujii Y, Tanaka H, Tsuruoka SH, et al. Middle cerebral arterial blood fiow velocity increases during laparoscopic cholecystectomy. Anesth ANalg, 1994, 78: 80—83
47. Kumano H, Furuya H, Yomasa H, et al. Response of pialvessel diameter and regional CBF to CO_2 during midazolam administration in cats. Acta Anaesth Scand, 1994, 38: 729 -733
48．单闯，祝建刚，刘诚，等．腹腔镜胆囊切除术中二氧化碳气腹对脑血流的影响．中华麻醉学杂志，2000，20(7)：411-412．
49. Levison SW, Ducleschi MH, Young GM; et al. Exp Ncurol, 1996, 141 (1): 116.
50. Grasso G,Passalacpasm M,Sfacteria A,et al.Does administration of recombinant human erythropoietin attenuate the increase of S-100 protein observed in cerebrospinal fluid after experimental subarachnoid hemorrhage? J Nerurosurg, 2002, 96 (3):565-570
51．黄志东，顾承志，李新玲．短暂性脑缺血发作患者血清NSE的测定及临床意义．中风与神经系统疾病杂志．2003，10(6)：364-365
52．李雪斌，韦世革，潘耀新，等．血清神经原特异性烯醇化酶检测在短暂性脑缺血发作中应用价值的探讨．广西医学．2003，9(25)：1591-1593
53. Nardemark HG, Ericsson N, Kotwica E, et al. S-100 protein and neuron-speci fic enolase in CSF after experimental traumatic or focal ischemic brian damage .J neurosurg, 1989, 71: 727-731.
54．王知非，廖达光，易善楚，等．神经原特异性烯醇化酶在颅脑损伤中的意义．中国医师杂志．2004，6(3)：355-357
55．李建军，张保才．孟宪君，等．急性颅脑损伤患者血清及脑脊液中NSE动态监测及其临床意义．上海医学检验杂志．2002，17(2)：101-102
56. Laisalmi M, Koivusalo AM, Valta, et al. clonidine provides opiodsparing effect, stable hemodvnamics, and renal intrgrity during laparoscopic: cholecvstectomy. Surg Endosc.2001, 15 (11): 1331—1335
57. Safran DB, Orlando MFR. Connecticut H.Physiologic effects of. pneumoperitoneum. AM J Surg.1994, 167 (2): 281—286
58. Groffrey L, Bloomfield MD, Charles R, et al. Elevated intra—abdominal pressure increase plasma rennin activity and aldosterone levels J Trauma.1997, 42 (6): 997—1003
59..Hamilton BD, Chow CK, Jnman SR, et al.Increased intra—abdominal pressure during pneumoperitoneum stlimulates endothelin s release in a canine model. J Eneourol..1998, 12: 193—197
60. Wallase KB, Eells JT, Madeira VM, et al. Mitochondria-mediated cell injury: symposium overview. Fundam Appl Toxicol.1997; 38 (1): 23—37
61. Lyass S, Levin S, Pizov R, et al. Hemodynamic effects of helium vs carbon dioxide pneumoperitoneum in an experimental model of acute heartfailure.Surg Endosc.2001, 15(8): 861—866
62．孙建新，顾洪，王辉．银杏叶提取物对小鼠脑缺血能量代谢的影响．第二军医大学学报，1995；16(6)：570-1．
63. Petito CK, Morgell S, Felix JC. The two patterns of reactive astrocytosis in post ischemic rat brian. Cere Blood Flow metab,1990;10:850-9
64．王兴河，秦梅，樊绍曾，等．新生鼠缺氧缺血性脑损伤S-100 NSE mRNA和蛋白水平变化．中国当代儿科杂志，2000，2(6)：381-385．
65．侯琳，濮海平，邵伯芹．银杏叶提取物对新生鼠缺血缺氧性脑损伤NSE S-100 mRNA表达的影响．中国药理学通报．2003，19(1)：100-102．
66. Schoenberg MH, Buchler M, Younes M, et al. Effect of antioxidant treatment in rats with acute hemorrhagic pancreatitis.Dig DIS Sci.1994, 39 (5): 1034—1040
67. Galat JA, Robinson AV, Rhodes RS.Oxygen free radical mediated renal dysfunction.J Surg RES 1989, 46: 520—532
68. Suarez—pinzon WL, Strynadka K, Rabinovitch A.Destruction of rat pancreatic islet beta—cells by cytokines involves the production of cytotoxic aldehydes s.Endocriology.1996, 137 (12): 5290—5296
69. Reilly PM, Bulkery GB. Tissue injury by free radicals and other toxic oxygen metabolites.Br J Surg. 1997, 77: 1324—1331
70．吴氢孙．自由基与临床医学．微循环杂志．1998，8：34—36
71. Simonson MS. Endothelins: Multifunction renal peptides. Physiol Rew.1993; 73: 375
72. Bcklund M, Kellokumpu I, Smitten K, et al. Effect of temperature of insufflated CO_2 during and after prolonged laparoscopic surgery.Surg Endosc .1998, 12 (9): 1126—1130
1. Moore BW. Brain specific proteins: S-100 protein and glial fibrivary protein. Adv Neurochem,1975; 1: 137-55.
2. Van Eldik LJ. Christie Pope B, Bolin LM. Neurotrophic activity of S-100β in cultures of dorsal root ganglia from embryomic chick and fetal rat.Brain Res, 1991; 52: 280.
3. Heizmamn CW. Ca~(2+)—binding S-100 protein in central mervous system [J]. Neurochem Res, 1999; (24): 1097-100.
4. Shashoua E, Hease GW, Moore BW. Protein of brain extracellular fluid: Evidence for release of S-100 protein..J Neurochem, 1984; 42: 1536.
5．黄继林．S-100蛋白在神经系统疾病诊断和预后判断中的应用．国外医学神经病学神经外科学分册．2001，28(1)：56-58
6. Infante JR,Torres M,martinez A,et al.Evaluation of tumor marker S-100 in cerebrospinal fluid from subjects with nonischemic brain pathologies.Tumour Biol,2000,21(1):38-45
7. Tateishi N, Kagamiishi Y, Shintaku K, et al. Astrocytes activation and delayed infarct expansion after permanent focal ischemia in rats. Part Ⅱ: suppression of astrocytes activation by a novel agent(R)-(-)-2-propyloctanoic acid(ONO-2506)leads to mitigation of delayed infarct expansion and early improvement of neurologic deficits. J Cereb Blood Flow Metab,2002,22(6):723-734
8. Lefrannc F, Golzarian J,Chevalier C,et al.Expression of members of the calcium-binding S-100protein family in a rat model of cerebral basilar artery vasospasm.J Neurosurg,2002,97(2):408-415
9. Tateishi N, Kagamiishi Y, Shintaku K, et al. Activation of astrocytes and ischemic damage following the transient focal ischemia. nippon yakurigaku Zasshi, 1998, 112 (suppl 1): 103-107.
10. Matsui T, Mori T, Tateishi N, et al. Astrocytic activation and delayed infarct expansion after permanent focal ischemia in rats.Part Ⅰ: enhanced astrocytic synthesis of S-100β in the per infarct area precedes delayed infarct expansion .J Cereb Blood Flow Metab, 2002, 22(6): 711-722.
11. Levison SW, Ducleschi MH, Young GM; et al. Exp Ncurol, 1996, 141 (2): 256.
12. Grasso G.Passalacpasm M,Sfacteria A,et al.Does administration of recombinant human erythropoietin attenuate the increase of S-100 protein observed in cerebrospinal fluid after experimental subarachnoid hemorrhage? J Nerurosurg,2002,96(3):565-570
13. Missler U. S-100 protein and neuronspecific enolase concentration in blood as indicators of infarction volume and prognosis in acute ischemic stroke [J].Stroke, 1997; 28: 1956-1960.
14. Love S.Oxidative stress in brain ischemia. Br Path,1999,9:119-131
15. Mussack T, Biberthaler P,Wiedemann E, et al .S-100b as a screening marker of the severity of minor head trauma(MHT)-a pilot study. Acta Neurochir Suppl,2000,76:393-396
16. Elting JW, De jager AE,Teelken AW, et al.Comparison of serum S-100 protein levels following stroke and traumatic brian injury. J Neurol Sci,2000,181(1-2):104-110
17. Buttner T, Weyers S, Postert T, et al. S-100 protein: Serum marker of focal brian damage after ischemic territorial MCA infarction. Stroke, 1997, 28 ( 10): 1961—1965.
18. Abraha HD, Butterworth RJ, Bath PMW, et al. Serum S-100 protein, relationship to clinical outcome in acute stroke. Ann Clin Biochem, 1997, 34: 366—370.
19. Diego Gazzolo.S-100 protein concentration in cord blood:correlations with gestational age in term and preterm deliveries [J], Clin chem.,2000;46(7):998-1000
20．陈俊，何国厚，余绍祖，等．急性脑梗死患者S-100蛋白的动态变化及其临床意义．中风与神经系统疾病杂志．2003，20(4)：334-336．
21. Marangos PJ, Schmechel D, Parma AM, et al。Measurement of neuron—specific (NSE) and non-neuronal (NNE) isoenzymes of enolase in rat, monkey, and human nervous tissue. J Neurochem, 1979, 33 (1): 319-329.
22．陈琼，黄志．儿童血清和脑脊液中NSE正常参考值的测定及其临床应用价值．儿科药学杂志．2004，10(2)：14-16
23．文志华，陈卫国，储建中，等．血清NSE正常参考值的测定和影响因素的探讨及其临床应[J]．湖北医科大学学报．2000，21(2)：144
24. Barone FC, Clark PK, Price WJ, et al. Neuron-specific enolase increase in cerebral and systemic circulation following focal ische mia. Brain Res, 1993, 623 (1): 77—82.
25. Hatfield RH, Mckernan RM. CSF neuron-specific enolase as a quantitative marker of neuronal damage in a rat stroke model. Brain Res, 1992, 577 (2): 249-252.
26. Kittaka M, Giannotta SL, Zelman V, et al. Attenuation of brain injury and reduction of neuron-specific enolase by nicardipine in systemic circulation following focal ischemia and reperfusion in a rat model. J Neurosurg, 1997, 87 (5): 731-737.
27. Woertgen C, Rothoerl RD, Brawanski A. Neuron-specific enolase serum levels after controlled cortical impact injury in the rat. J Neurotrauma, 2001, 18 (5): 569-573.
28. Cunningham RT, Watt M, Winder J, et al. Serum neuron—specific enolases is an indicator of stroke volume. Eur J Clin Invest, 1996, 23 (4): 298-303.
29. Hideo Mabe, Satoru Suzuki, Mitsuhito Mase, et al. Serum neuron-specific enolase levels after subarachnoid hemorrhage. SurgNeurol, 1991, 36 (3): 170-174.
30. Schaarschmidt H, Prange HW, Reiber H. Neuron-specific enolase concentration in blood as a prognosis parameter in cerebrovascular disease. Stroke, 1994, 25 (3): 558-565.
31. Herrmann M, Jost S, Kutz S, et al. Temporal profile of release of neurobiochemical markers of brain damage after traumatic brain injury is associated with intracranial pathology as demonstrated in cranial computerized tomography. J Neurotrauma, 2000, 70 (2): 113-122.
32 黄志东，顾承志，李新玲．短暂性脑缺血发作患者血清NSE的测定及临床意义．中风与神经系统疾病杂志．2003，10(6)：364-365
33．李雪斌，韦世革，潘耀新，等．血清神经原特异性烯醇化酶检测在短暂性脑缺血发作中应用价值的探讨．广西医学．2003，9(25)：1591-1593
34. Nardemark HG, Ericsson N, Kotwica E, et al. S-100 protein and neuron-speci tic enolase in CSF after experimental traumatic or focal ischemic brian damage .J neurosurg, 1989, 71: 727-731.
35．王知非，廖达光，易善楚，等．神经原特异性烯醇化酶在颅脑损伤中的意义．中国医师杂志．2004，6(3)：355-357
36．李建军，张保才．孟宪君，等．急性颅脑损伤患者血清及脑脊液中NSE动态监测及其临床意义．上海医学检验杂志．2002，17(2)：101-102
37．陈俊，何国厚，余绍祖．脑特异性蛋白在急性脑梗死诊断及预后中临床价值埙B阳医学院学报．2002，21(2)：122-124
38．王义刚，刑永前，郑华，等．神经原特异性烯醇化酶与急性脑梗死．临床神经病学杂志．200114(2)：74
39．龚玉芳，黄宏远，潘正柏，等．血液内神经原特异性烯醇化酶在缺血缺氧性脑疾病中的临床意义[J]．实用医学杂志，2003，19(2)：141
40．张华，张建华，吴咪辛．神经原特异性烯醇化酶预测缺血缺氧性脑损伤[J]．新生儿科杂志，2002，17(1)：44
41. Wunderlich MT, Ebert AD, Kratz TY, et al. Early Neurobehavioral outcome after stroke is related to release of neurobiochemical markers of brain damage. Stroke, 1999, 30 (6): 1190-1195.
42. Hinkle DA, Baldwin SA, Scheff SW, et al. GFAP and S-100 beta expression in the cortex and hippocampus in response to mild cortical contusion [J]. J Neurotrauma, 1997, 14 (10): 729-738.
43．王兴河，秦梅，樊绍曾，等．新生鼠缺氧缺血性脑损伤S-100 NSE mRNA和蛋白水平变化．中国当代儿科杂志，2000，2(6)：381-385．
44．侯琳，濮海平，邵伯芹．银杏叶提取物对新生鼠缺血缺氧性脑损伤NSE S-100 mRNA表达的影响．中国药理学通报．2003，19(1)：100-102．
1. Wittgen CM,Andrus CH,Fitzgerald SD,et al. Analysis of the hemodynamic and ventilatory effects of laparoscopic cholecystectomy. Arch Surg, 1991;126(9):997-1001
2. Westerband A,Van De Water JM,Amzallag M,et al.Cardiovascular changes laparoscopic cholecystectomy..Surg Gynecol Obstet,1992;175(6):535-538
3. Luca A,Cirera I,Garcia-Pagan JC,et al. Hemodynamic effects of acute changes in intra-abdominal pressure in patients withcirrhosis.Gastroenterology, 1993;104(3) 225-227
4. Oleary E, Hubbard K, Tomey W, et al. laparoscopic cholecystectomy. -hemodynamic and neuroendocrine response following pneumoperitoneum.Br J Anaesth,1995;74:123
5. Glaser F,Sannwald GA, Buhr HJ,et al.General stress response to conventional and laparoscopic cholecystectomy.Ann Surg,1995;221(3):372-380
6．段体德，刘筱衡，帅建，等．腹腔镜胆囊切除术围手术期神经内分泌代谢变化德临床研究，1995；16(5)339-341
7. Schein M,Wittman DH,Aprahamian CC,et al. The abdominal compartment syndrome :The physiological and clinical consequence of elevated intra-abdominal pressure.J AM Coll Surg, 1995; 180:745-753
8. Richards WO,Scovill W, Shin B, et al.Acute renal failure associated with increased intra-abdominal pressure.Ann Surg.1983;197:183-187
9. Holthausen UH,Razek TS,Hinchey EJ,et al. Monitoring intracranial pressure with a "head injury" model:carbon dioxide(CO_2) pneumoperitoneum versus laprolift procedure.Langenbecks Arch Chir Suppl Kongressbd.1997,114:257-260
10. Uzzo RG,Bilsky M,Mininberg DT,et al. laparoscopic surgery in children with ventriculoperitoneal shunts:effect of pneumoperitoneum on intracranial pressure:preliminary experience.Urology.1997,49:753-757
11．吴子顺，汪明惠，牧素玲．腹腔镜胆囊切除术CO_2气腹对脑脊液压德影响．临床麻醉学杂志．1997；13(3)：161
12. Rosenthal RJ,Hiatt JR,Phillips EH,et al. Intracranial pressure effect of pneumoperitoneum in a large animal model.Surg Endosc.1997,11:376-380
13. Wright AD,Imray CH,Morrissey MS. et al. Intracranial pressure at high altitude and acute mountain sickness.Clin Sci. 1995,89:201-204
14. Cooke S,Psterson-Brown. Assciation between laparoscopic abdominal surgery and postoperative symptoms of raised intracranial pressure. Surg Endosc.2001, 15: 723-725
15. Luz CM,Polarz H,Bohrer H,et al. Hemodynamic and respiratory effects of pneumoperitoneum and PEEP during laparoscopic pelvic lymphadenectomy in dogs.Surg Endosc.1994,8:25-27
16. Horvath K,Whelan R,Liver B,et al. The effect of elevated intraabdominal pressure,hypercarbia,andpositioning on the hemodynamic response to laparoscopic colectomy in pigs. Surg Endosc.1998,12:107-114
17. Moncure M, Grande PO, Asgeirsson B, et al. Intracranial pressure effect of pneumoperitoneum in dogs with injured brian.Am Surg 1999;14(4):227-236
18．刘宿，葛衡江，周蓉，等．腹腔镜手术期间二氧化碳气腹对脑氧供影响．中华麻醉学杂志．1997；17(6)：339-340
19．单闯，祝建刚，刘诚，等．腹腔镜胆囊切除术中二氧化碳气腹对脑血流的影响．中华麻醉学杂志，2000，20(7)：411—412
20．杨庆堂．妇科腹腔镜手术中CO_2气腹对脑摄氧的影响．第四军医大学学报．2002，23(24)：2304
21. Erkan N,Gokmen A,Goktay Y, et al.Effects of CO_2 pneumoperitoneum on the basilar artery: An experimental study in rabbits. Surg Endosc.2001,15: 806—811
22. Lawreence N,Diebel MD,Robert F, et al.Effects of increased intra-abdominal pressure on hepatic,portal venous and hepatic microcirculation blood flow.J Trauma,1992;33:279-283
23. Hamilton BD,Chow CK,Jnman SR,et al.Increased intra-abdominal pressure during pneumoperitoneum stimulates endothelin release in a canine model.J Eneourol, 1998;12:193-197
24. Allan D,Alfred C.Cardiovascular consequences of laparoscopic surgery. The lancet,1998;352(15):568-570
25. Greif W, Forse R. Hemodynamic effects of the laparoscopic pneumoperitoneum during sepsis in a porcine endotoxic shock model.Ann Surg,1998;277(16):474-480
26. Sharma A,Pake D,Alfred H,et al. laparoscopy and potential complications. Heart and Lung,1997;26(1):52-61
27. Joris JC,Chiche JD,Canivet JC,et al. Hemodynamic changes induced by laparoscopy and their endocrine corrlates :effects of clonidine .J Am coll Cardiol,1998;32:89-96
28. Wolf TS,Monk TG,McDougall EM,et al. The extraperitoneal approach and subcutaneous empllysema are associated with greater absortion of carbon dioxide laparoscopic renal surgery. J Urol,1995; 154:959-967
29. Ho HS,Gunther RA,Wolfe BM.intraperitoneal carbon dioxide insufflation and cardiopulmonary function. Arch Surg,1992;127:928-932
30. Ferrandez LL, Saenz A,Traura D,rt al.Helium and carbon dioxide pneumoperitoneum in patients with pheochromocytoma undergoing laparoscopic adrenalectomy.Word J Surg,1998;22:1250-1255
31. Joris JL, Hamoir EE,Hartstein GM, et al. Hemodynamic changes and catecholamine release during laparoscopic adrenalectomy for phechromocytoma. Anesth Analg,1999;88:16-21
32.Sato M,Watanable Y,Uedas S,et al.Minimally invasive hepatic resection using laparoscopic surgery and minithoratomy. Arch Surg,1997;132(20):206-211
33.mOrrison CA,Schreiber MA,Olsen SB,et al.Femoral Venous flow dynamics intraperitoneal and preperitoneal laparoscopic insufflation . Surg Endosc. 1998; 12: 1213—1221
34.Bonatsos G, Leandros E,Dourakisn,et al. laparoscopic cholecystectomy: Intraoperative finding and postoperative complications. Surg Endosc. 1995, 9: 889—893
35.Struthers AD, Cuschieri A.Cardiovascular consequences of laparoscopic surgery (J) .Lacent, 1998, 352 (15): 568-570
36.Galizia G, Prizio G, Lieto E, et al. Hemodynamic and pulmonary changes during open, carbon dioxide pneumoperitoneum and abdominal wall — lifting cholecystectomy. Aprospective, randomized study. Surg Endosc.2001, 15 (5): 477—483
37.Neuhaus SJ, Gupta A, Watson D. Helium and other alternative insufflation gases for laparoscopy. Surg Endosc.2001, 15 (6): 553-560
38.Fujii Y, Tanaka H, Tsuruoka SH, et al. Middle cerebral arterial blood flow velocity increases during laparoscopic cholecystectomy. Anesth ANalg, 1994, 78: 80—83
39.Kumano H, Furuya H, Yomasa H, et al. Response of pialvessel diameter and regional CBF to CO_2 during midazolam administration in cats. Acta Anaesth Scand, 1994, 38: 729 -733
40.Laisalmi M, Koivusalo AM, Valta, et al. clonidine provides opiodsparing effect, stable hemodynamics , and renal intrgrity during laparoscopic : cholecvstectomy. Surg Endosc.2001, 15 (11): 1331-1335
41.Safran DB, Orlando MFR. Connecticut H.Physiologic effects of. pneumoperitoneum. AM J Surg.1994, 167 (2): 281-286
42.Groffrey L, Bloomfield MD, Charles R, et al. Elevated intra—abdominal pressure increase plasma rennin activity and aldosterone levels J Trauma.1997, 42(6): 997—1003
43.Hamilton BD, Chow CK, Jnman SR, et al.Increased intra—abdominal pressure during pneumoperitoneum stlimulates endothelin s release in a canine model. J Eneourol..1998, 12: 193-197
44.Schoenberg MH, Buchler M, Younes M, et al. Effect of antioxidant treatment in rats with acute hemorrhagic Pancretitis. Dig Dis. Sci.1994, 39 (5): 1034—1040
45.Galat JA, Robinson AV, Rhodes RS. Oxygen free radical mediated renal dysfunction. J Surg Res. 1989, 46: 520-532
46.Suarez—Pinzon WL, Strynadka K, Rabinovitch A. Destruction of rat pancreatic islet beta — cells by cytokines involves the production of cytotoxic aldehydes.Endocrinology.1996, 137 (12): 5290—5296
47. Reilly PM, Bulkery GB. Tissue injury by free radicals and other toxic oxygen metabolites. Br J Surg.1997, 77: 1324—1331
48．吴氢孙．自由基与临床医学．微循环杂志．1998，8：34—36
49. Simonson MS. Endothelins :Multifunction renal peptides.Physiol Rew. 1993; 73: 375
50. Bcklund M,Kellokumpu I,Smitten K, et al. Effect of temperature of insufflated CO_2 during and after prolonge laparoscopic surgery.Surg Endosc.1998, 12 (9): 1126—1130
51. Wallase KB,Eells JT, Maderira VM,et al.Mitochondria-mediated cell injury:symposium overview. Fundam Appl toxicol.1997,38(1):23-37
52. Green DR,Reed JC..Mitochondria and apoptosis.Science.1998,281:1309-1312
53. Green DR,Reed JC..Mitochondria and apoptosis.Science. 1998,281:1309-1312
54. Horvath KD,Whelan RL, Lier B,et al. The effects of elevate intraabdominal pressure,hypercarbia,and positioning on the hemodynamic response to laparoscopic cholecystectomy. Surg Endosc.1998, 12 (2): 107—114
55. Neuhaus SJ,Gupta A,Watson DJ. Helium and other alternative insufflation gases for laparoscopy.Surg Endosc.2001, 15 (6): 553—560
56. Lyass S,Levin S,Pizov R,et al.Hemodynamic effects of helium VS carbon dioxide pneumoperitoneum in an experimental model of acute heart failure.Surg Endosc.2001, 15 (8): 861—866
57. Weijer DW, Rademmaker BPW, Schlooz,et al. Laparoscopic cholecystectomy using wall retraction.Surg Endosc,1997, 11 (6); 645—649
58. Cuschieri A.Adverse cardiovascular changes induced by positive pressure pneumoperitoneum.Surg Endosc.1998, 12 (1): 93—94
59．陈训如．微创慨念的讨论加速了我国微创外科的健康发展．中国普外基础与临床杂志．2003，10(3)：218—221
2．刘国礼．中国腹腔镜外科进展．世界华人消化杂志，1999；7(3)：263-264
3．郑成竹．微创外科的发展．中国实用外科杂志，1999；19(1)：14
4. Sato M,Watanable Y, Uedas S,et al.Minimally invasive hepatic resection using laparoscopic surgery and minithoratomy. Arch Surg,1997;132(20):206-211
5. Smit MJ, Beelen RHJ,Eijsbouts QAJ,et al.Immunological response in laparoscopic surgery.Acta Gastroenterologica Belgica,1996;245-247
6. Wittgen CM,Andrus CH,Fitzgerald SD,et al. Analysis of the hemodynamic and ventilatory effectsof laparoscopic cholecystectomy. Arch Surg,1991; 126(9): 997-1001
7. Westerband A,Van De Water JM,Amzallag M,et al.Cardiovascular changes laparoscopic cholecystectomy..Surg Gynecol Obstet,1992;175(6):535-538
8. Luca A, Cirera I,Garcia-Pagan JC,et al. Hemodynamic effects of acute changes in intra-abdominal pressure in patients withcirrhosis. Gastroenterology, 1993; 104(3) 225-227
9. Oleary E,Hubbard K,Tomey W, et al. laparoscopic cholecystectomy.-hemodynamic and neuroendocrine response following pneumoperitoneum.Br J Anaesth, 1995; 74:123
10. Glaser F,Sannwald GA,Buhr HJ,et al.General stress response to conventional and laparoscopic cholecystectomy.Ann Surg,1995;221(3):372-380
11．段体德，刘筱衡，帅建，等．腹腔镜胆囊切除术围手术期神经内分泌代谢变化德临床研究，1995；16(5)339-341
12. Schein M,Wittman DH,Aprahamian CC,et al. The abdominal compartment syndrome:The physiological and clinical consequence of elevated intra-abdominal pressure.J AM Coll Surg,1995;180:745-753
13. Richards WO,Scovill W,Shin B, et al.Acute renal failure associated with increased intra-abdominal pressure.Ann Surg.1983;197:183-187
14. Holthausen UH,Razek TS,Hinchey EJ,et al. Monitoring intracranial pressure with a "head injury" model:carbon dioxide(CO_2) pneumoperitoneum versus laprolift procedure.Langenbecks Arch Chir Suppl Kongressbd. 1997,114:257-260
15. Uzzo RG,Bilsky M,Mininberg DT,et al. laparoscopic surgery in children with ventriculoperitoneal shunts:effect of pneumoperitoneum on intracranial pressure:preliminary experience.Urology. 1997,49:753-757
16．吴子顺，汪明惠，牧素玲．腹腔镜胆囊切除术CO_2气腹对脑脊液压德影响．临床麻醉学杂志．1997；13(3)：161
17. Rosenthal RJ,Hiatt JR,Phillips EH,et al. Intracranial pressure effect of pneumoperitoneun! in a large animal model.Surg Endosc.1997,11:376-380
18. Wright AD, Imray CH,Morrissey MS. et al. Intracranial pressure at high altitude and acute mountain sickness.Clin Sci.1995,89:201-204
19. Horvath K,Whelan R.Liver B,et al. The effect of elevated intraabdominal pressure,hypercarbia,andpositioning on the hemodynamic response to laparoscopic colectomy in pigs. Surg Endosc.1998,12:107-114
20. Moncure M, Grande P0, Asgeirsson B, et al. Intracranial pressure effect of pneumoperitoneum in dogs with injured brian.Am Surg 1999;14(4):227-236
21. 刘宿,葛衡江,周蓉,等.腹腔镜手术期间二氧化碳气腹对脑氧供影响.中华麻醉学杂志.1997;17(6):339-340
22. Lawreence N,Diebel MD,Robert F,et al.Effects of increased intra-abdominal pressure on hepatic,portal venous and hepatic microcirculation blood flow. J trauma,1992;33:279-283
23. Hamilton BD,Chow CK, Jnman SR,et al. Increased intra-abdominal pressure during pneumoperitoneum stimulates endothelin release in a canine model. J Eneourol,1998;12:193-197
24. Allan D,Alfred C.Cardiovascular consequences of laparoscopic surgery. The lancet,1998;352(15):568-570
25. Greif W,Forse R. Hemodynamic effects of the laparoscopic pneumoperitoneum during sepsis in a porcine endotoxic shock model. Ann Surg, 1998;277(16): 474-480
26. Sharma A,Pake D,Alfred H,et al. laparoscopy and potential complications. Heart and Lung,1997;26(1):52-61
27. Joris JC, Chiche JD,Canivet JC.et al. Hemodynamic changes induced by laparoscopy and their endocrine corrlates :effects of clonidine J Am coll Cardiol,1998;32:89-96
28. Wolf TS,Monk TG,McDougall EM,et al. The extraperitoneal approach and subcutaneous empllysema are associated with greater absortion of carbon dioxide laparoscopic renal surgery. J Urol,1995;154:959-967
29. Ho HS,Gunther RA, Wolfe BM.intraperitoneal carbon dioxide insufflation and cardiopulmonary function. Arch Surg, 1992; 127:928-932
30. Ferrandez LL,Saenz A,Traura D, rt al. Helium and carbon dioxide pneumoperitoneum in patients with pheochromocytoma undergoing laparoscopic adrenalectomy. Word J Surg,1998;22:1250-1255
31. Joris JL,Hamoir EE,Hartstein GM, et al. Hemodynamic changes and catecholamine release during laparoscopic adrenalectomy for phechromocytoma . Anesth Analg,1999;88:16-21
32. Missler U . S-100 protein and neuronspecific enolase concentration in blood as indicators of infarction volume and prognosis in acute ischemic stroke [J].Stroke, 1997; 28: 1956-1960.
33. Barone FC, Clark PK, Price WJ, et al. Neuron-specific enolase increase in cerebral and systemic circulation following focal ische mia. Brain Res, 1993, 623 (1): 77—82
34. Buttner T, Weyers S, Postert T, et al. S-100 protein : Serum marker of focal brian damage after ischemic territorial MCA infarction. Stroke, 1997, 28 (10): 1961-1965
35. Levison SW, Ducleschi MH, Young GM; et al. Exp Ncurol, 1996, 141 (2): 256.
36.Grasso G,Passalacpasm M,Sfacteria A,et al.Does administration of recombinant human erythropoietin attenuate the increase of S-100 protein observed in cerebrospinal fluid after experimental subarachnoid hemorrhage? J Nerurosurg, 2002,96 (3): 565-570
37. Love S.Oxidative stress in brain ischemia. Br Path,1999,9:119-131
38.Mussack T.Biberthaler P,Wiedemann E, et al .S-100b as a screening marker of the severity of minor head trauma(MHT)-a pilot study. Acta Neurochir Suppl,2000,76:393-396
39.Elting JW,De jager AE,Teelken AW,et al.Comparison of serum S-100 protein levels following stroke and traumatic brian injury. J Neurol Sci, 2000,181(1-2): 104-110
40.Schein M,Wittman DH,Aprahamian CC,et al. The abdominal compartment syndrome :The physiological and clinical consequence of elevated intra-abdominal pressure.J AM Coll Surg,1995;180:745-753
41.Morrison CA, Schreiber MA, Olsen SB, et al. Femoral Venous flow dynamics intraperitoneal and preperitoneal laparoscopic insufflation. Surg Endosc, 1998; 12: 1213—1221
42.Holthausen UH,Razek TS,Hinchey EJ,et al. Monitoring intracranial pressure with a "head injury " model:carbon dioxide(CO_2) pneumoperitoneum versus laprolift procedure.Langenbecks Arch Chir Suppl Kongressbd.1997,114:257-260
43. Struthers AD, Cuschieri A.Cardiovascular consequences of laparoscopic surgery (J) .Lacent, 1998, 352 (15): 568-570
44. Galizia G, Prizio G, Lieto E, et al. Hemodynamic and pulmonary changes during open, carbon dioxide pneumoperitoneum and abdominal wall — lifting cholecystectomy. Aprospective, randomized study. Surg Endosc.2001, 15 (5): 477—483
45. Neuhaus SJ, Gupta A, Watson D. Helium and other alternative insufflation gases for laparoscopy. Surg Endosc.2001, 15 (6): 553—560
46.Fujii Y, Tanaka H, Tsuruoka SH, et al. Middle cerebral arterial blood fiow velocity increases during laparoscopic cholecystectomy. Anesth ANalg, 1994, 78: 80—83
47. Kumano H, Furuya H, Yomasa H, et al. Response of pialvessel diameter and regional CBF to CO_2 during midazolam administration in cats. Acta Anaesth Scand, 1994, 38: 729 -733
48．单闯，祝建刚，刘诚，等．腹腔镜胆囊切除术中二氧化碳气腹对脑血流的影响．中华麻醉学杂志，2000，20(7)：411-412．
49. Levison SW, Ducleschi MH, Young GM; et al. Exp Ncurol, 1996, 141 (1): 116.
50. Grasso G,Passalacpasm M,Sfacteria A,et al.Does administration of recombinant human erythropoietin attenuate the increase of S-100 protein observed in cerebrospinal fluid after experimental subarachnoid hemorrhage? J Nerurosurg, 2002, 96 (3):565-570
51．黄志东，顾承志，李新玲．短暂性脑缺血发作患者血清NSE的测定及临床意义．中风与神经系统疾病杂志．2003，10(6)：364-365
52．李雪斌，韦世革，潘耀新，等．血清神经原特异性烯醇化酶检测在短暂性脑缺血发作中应用价值的探讨．广西医学．2003，9(25)：1591-1593
53. Nardemark HG, Ericsson N, Kotwica E, et al. S-100 protein and neuron-speci fic enolase in CSF after experimental traumatic or focal ischemic brian damage .J neurosurg, 1989, 71: 727-731.
54．王知非，廖达光，易善楚，等．神经原特异性烯醇化酶在颅脑损伤中的意义．中国医师杂志．2004，6(3)：355-357
55．李建军，张保才．孟宪君，等．急性颅脑损伤患者血清及脑脊液中NSE动态监测及其临床意义．上海医学检验杂志．2002，17(2)：101-102
56. Laisalmi M, Koivusalo AM, Valta, et al. clonidine provides opiodsparing effect, stable hemodvnamics, and renal intrgrity during laparoscopic: cholecvstectomy. Surg Endosc.2001, 15 (11): 1331—1335
57. Safran DB, Orlando MFR. Connecticut H.Physiologic effects of. pneumoperitoneum. AM J Surg.1994, 167 (2): 281—286
58. Groffrey L, Bloomfield MD, Charles R, et al. Elevated intra—abdominal pressure increase plasma rennin activity and aldosterone levels J Trauma.1997, 42 (6): 997—1003
59..Hamilton BD, Chow CK, Jnman SR, et al.Increased intra—abdominal pressure during pneumoperitoneum stlimulates endothelin s release in a canine model. J Eneourol..1998, 12: 193—197
60. Wallase KB, Eells JT, Madeira VM, et al. Mitochondria-mediated cell injury: symposium overview. Fundam Appl Toxicol.1997; 38 (1): 23—37
61. Lyass S, Levin S, Pizov R, et al. Hemodynamic effects of helium vs carbon dioxide pneumoperitoneum in an experimental model of acute heartfailure.Surg Endosc.2001, 15(8): 861—866
62．孙建新，顾洪，王辉．银杏叶提取物对小鼠脑缺血能量代谢的影响．第二军医大学学报，1995；16(6)：570-1．
63. Petito CK, Morgell S, Felix JC. The two patterns of reactive astrocytosis in post ischemic rat brian. Cere Blood Flow metab,1990;10:850-9
64．王兴河，秦梅，樊绍曾，等．新生鼠缺氧缺血性脑损伤S-100 NSE mRNA和蛋白水平变化．中国当代儿科杂志，2000，2(6)：381-385．
65．侯琳，濮海平，邵伯芹．银杏叶提取物对新生鼠缺血缺氧性脑损伤NSE S-100 mRNA表达的影响．中国药理学通报．2003，19(1)：100-102．
66. Schoenberg MH, Buchler M, Younes M, et al. Effect of antioxidant treatment in rats with acute hemorrhagic pancreatitis.Dig DIS Sci.1994, 39 (5): 1034—1040
67. Galat JA, Robinson AV, Rhodes RS.Oxygen free radical mediated renal dysfunction.J Surg RES 1989, 46: 520—532
68. Suarez—pinzon WL, Strynadka K, Rabinovitch A.Destruction of rat pancreatic islet beta—cells by cytokines involves the production of cytotoxic aldehydes s.Endocriology.1996, 137 (12): 5290—5296
69. Reilly PM, Bulkery GB. Tissue injury by free radicals and other toxic oxygen metabolites.Br J Surg. 1997, 77: 1324—1331
70．吴氢孙．自由基与临床医学．微循环杂志．1998，8：34—36
71. Simonson MS. Endothelins: Multifunction renal peptides. Physiol Rew.1993; 73: 375
72. Bcklund M, Kellokumpu I, Smitten K, et al. Effect of temperature of insufflated CO_2 during and after prolonged laparoscopic surgery.Surg Endosc .1998, 12 (9): 1126—1130
1. Moore BW. Brain specific proteins: S-100 protein and glial fibrivary protein. Adv Neurochem,1975; 1: 137-55.
2. Van Eldik LJ. Christie Pope B, Bolin LM. Neurotrophic activity of S-100β in cultures of dorsal root ganglia from embryomic chick and fetal rat.Brain Res, 1991; 52: 280.
3. Heizmamn CW. Ca~(2+)—binding S-100 protein in central mervous system [J]. Neurochem Res, 1999; (24): 1097-100.
4. Shashoua E, Hease GW, Moore BW. Protein of brain extracellular fluid: Evidence for release of S-100 protein..J Neurochem, 1984; 42: 1536.
5．黄继林．S-100蛋白在神经系统疾病诊断和预后判断中的应用．国外医学神经病学神经外科学分册．2001，28(1)：56-58
6. Infante JR,Torres M,martinez A,et al.Evaluation of tumor marker S-100 in cerebrospinal fluid from subjects with nonischemic brain pathologies.Tumour Biol,2000,21(1):38-45
7. Tateishi N, Kagamiishi Y, Shintaku K, et al. Astrocytes activation and delayed infarct expansion after permanent focal ischemia in rats. Part Ⅱ: suppression of astrocytes activation by a novel agent(R)-(-)-2-propyloctanoic acid(ONO-2506)leads to mitigation of delayed infarct expansion and early improvement of neurologic deficits. J Cereb Blood Flow Metab,2002,22(6):723-734
8. Lefrannc F, Golzarian J,Chevalier C,et al.Expression of members of the calcium-binding S-100protein family in a rat model of cerebral basilar artery vasospasm.J Neurosurg,2002,97(2):408-415
9. Tateishi N, Kagamiishi Y, Shintaku K, et al. Activation of astrocytes and ischemic damage following the transient focal ischemia. nippon yakurigaku Zasshi, 1998, 112 (suppl 1): 103-107.
10. Matsui T, Mori T, Tateishi N, et al. Astrocytic activation and delayed infarct expansion after permanent focal ischemia in rats.Part Ⅰ: enhanced astrocytic synthesis of S-100β in the per infarct area precedes delayed infarct expansion .J Cereb Blood Flow Metab, 2002, 22(6): 711-722.
11. Levison SW, Ducleschi MH, Young GM; et al. Exp Ncurol, 1996, 141 (2): 256.
12. Grasso G.Passalacpasm M,Sfacteria A,et al.Does administration of recombinant human erythropoietin attenuate the increase of S-100 protein observed in cerebrospinal fluid after experimental subarachnoid hemorrhage? J Nerurosurg,2002,96(3):565-570
13. Missler U. S-100 protein and neuronspecific enolase concentration in blood as indicators of infarction volume and prognosis in acute ischemic stroke [J].Stroke, 1997; 28: 1956-1960.
14. Love S.Oxidative stress in brain ischemia. Br Path,1999,9:119-131
15. Mussack T, Biberthaler P,Wiedemann E, et al .S-100b as a screening marker of the severity of minor head trauma(MHT)-a pilot study. Acta Neurochir Suppl,2000,76:393-396
16. Elting JW, De jager AE,Teelken AW, et al.Comparison of serum S-100 protein levels following stroke and traumatic brian injury. J Neurol Sci,2000,181(1-2):104-110
17. Buttner T, Weyers S, Postert T, et al. S-100 protein: Serum marker of focal brian damage after ischemic territorial MCA infarction. Stroke, 1997, 28 ( 10): 1961—1965.
18. Abraha HD, Butterworth RJ, Bath PMW, et al. Serum S-100 protein, relationship to clinical outcome in acute stroke. Ann Clin Biochem, 1997, 34: 366—370.
19. Diego Gazzolo.S-100 protein concentration in cord blood:correlations with gestational age in term and preterm deliveries [J], Clin chem.,2000;46(7):998-1000
20．陈俊，何国厚，余绍祖，等．急性脑梗死患者S-100蛋白的动态变化及其临床意义．中风与神经系统疾病杂志．2003，20(4)：334-336．
21. Marangos PJ, Schmechel D, Parma AM, et al。Measurement of neuron—specific (NSE) and non-neuronal (NNE) isoenzymes of enolase in rat, monkey, and human nervous tissue. J Neurochem, 1979, 33 (1): 319-329.
22．陈琼，黄志．儿童血清和脑脊液中NSE正常参考值的测定及其临床应用价值．儿科药学杂志．2004，10(2)：14-16
23．文志华，陈卫国，储建中，等．血清NSE正常参考值的测定和影响因素的探讨及其临床应[J]．湖北医科大学学报．2000，21(2)：144
24. Barone FC, Clark PK, Price WJ, et al. Neuron-specific enolase increase in cerebral and systemic circulation following focal ische mia. Brain Res, 1993, 623 (1): 77—82.
25. Hatfield RH, Mckernan RM. CSF neuron-specific enolase as a quantitative marker of neuronal damage in a rat stroke model. Brain Res, 1992, 577 (2): 249-252.
26. Kittaka M, Giannotta SL, Zelman V, et al. Attenuation of brain injury and reduction of neuron-specific enolase by nicardipine in systemic circulation following focal ischemia and reperfusion in a rat model. J Neurosurg, 1997, 87 (5): 731-737.
27. Woertgen C, Rothoerl RD, Brawanski A. Neuron-specific enolase serum levels after controlled cortical impact injury in the rat. J Neurotrauma, 2001, 18 (5): 569-573.
28. Cunningham RT, Watt M, Winder J, et al. Serum neuron—specific enolases is an indicator of stroke volume. Eur J Clin Invest, 1996, 23 (4): 298-303.
29. Hideo Mabe, Satoru Suzuki, Mitsuhito Mase, et al. Serum neuron-specific enolase levels after subarachnoid hemorrhage. SurgNeurol, 1991, 36 (3): 170-174.
30. Schaarschmidt H, Prange HW, Reiber H. Neuron-specific enolase concentration in blood as a prognosis parameter in cerebrovascular disease. Stroke, 1994, 25 (3): 558-565.
31. Herrmann M, Jost S, Kutz S, et al. Temporal profile of release of neurobiochemical markers of brain damage after traumatic brain injury is associated with intracranial pathology as demonstrated in cranial computerized tomography. J Neurotrauma, 2000, 70 (2): 113-122.
32 黄志东，顾承志，李新玲．短暂性脑缺血发作患者血清NSE的测定及临床意义．中风与神经系统疾病杂志．2003，10(6)：364-365
33．李雪斌，韦世革，潘耀新，等．血清神经原特异性烯醇化酶检测在短暂性脑缺血发作中应用价值的探讨．广西医学．2003，9(25)：1591-1593
34. Nardemark HG, Ericsson N, Kotwica E, et al. S-100 protein and neuron-speci tic enolase in CSF after experimental traumatic or focal ischemic brian damage .J neurosurg, 1989, 71: 727-731.
35．王知非，廖达光，易善楚，等．神经原特异性烯醇化酶在颅脑损伤中的意义．中国医师杂志．2004，6(3)：355-357
36．李建军，张保才．孟宪君，等．急性颅脑损伤患者血清及脑脊液中NSE动态监测及其临床意义．上海医学检验杂志．2002，17(2)：101-102
37．陈俊，何国厚，余绍祖．脑特异性蛋白在急性脑梗死诊断及预后中临床价值埙B阳医学院学报．2002，21(2)：122-124
38．王义刚，刑永前，郑华，等．神经原特异性烯醇化酶与急性脑梗死．临床神经病学杂志．200114(2)：74
39．龚玉芳，黄宏远，潘正柏，等．血液内神经原特异性烯醇化酶在缺血缺氧性脑疾病中的临床意义[J]．实用医学杂志，2003，19(2)：141
40．张华，张建华，吴咪辛．神经原特异性烯醇化酶预测缺血缺氧性脑损伤[J]．新生儿科杂志，2002，17(1)：44
41. Wunderlich MT, Ebert AD, Kratz TY, et al. Early Neurobehavioral outcome after stroke is related to release of neurobiochemical markers of brain damage. Stroke, 1999, 30 (6): 1190-1195.
42. Hinkle DA, Baldwin SA, Scheff SW, et al. GFAP and S-100 beta expression in the cortex and hippocampus in response to mild cortical contusion [J]. J Neurotrauma, 1997, 14 (10): 729-738.
43．王兴河，秦梅，樊绍曾，等．新生鼠缺氧缺血性脑损伤S-100 NSE mRNA和蛋白水平变化．中国当代儿科杂志，2000，2(6)：381-385．
44．侯琳，濮海平，邵伯芹．银杏叶提取物对新生鼠缺血缺氧性脑损伤NSE S-100 mRNA表达的影响．中国药理学通报．2003，19(1)：100-102．
1. Wittgen CM,Andrus CH,Fitzgerald SD,et al. Analysis of the hemodynamic and ventilatory effects of laparoscopic cholecystectomy. Arch Surg, 1991;126(9):997-1001
2. Westerband A,Van De Water JM,Amzallag M,et al.Cardiovascular changes laparoscopic cholecystectomy..Surg Gynecol Obstet,1992;175(6):535-538
3. Luca A,Cirera I,Garcia-Pagan JC,et al. Hemodynamic effects of acute changes in intra-abdominal pressure in patients withcirrhosis.Gastroenterology, 1993;104(3) 225-227
4. Oleary E, Hubbard K, Tomey W, et al. laparoscopic cholecystectomy. -hemodynamic and neuroendocrine response following pneumoperitoneum.Br J Anaesth,1995;74:123
5. Glaser F,Sannwald GA, Buhr HJ,et al.General stress response to conventional and laparoscopic cholecystectomy.Ann Surg,1995;221(3):372-380
6．段体德，刘筱衡，帅建，等．腹腔镜胆囊切除术围手术期神经内分泌代谢变化德临床研究，1995；16(5)339-341
7. Schein M,Wittman DH,Aprahamian CC,et al. The abdominal compartment syndrome :The physiological and clinical consequence of elevated intra-abdominal pressure.J AM Coll Surg, 1995; 180:745-753
8. Richards WO,Scovill W, Shin B, et al.Acute renal failure associated with increased intra-abdominal pressure.Ann Surg.1983;197:183-187
9. Holthausen UH,Razek TS,Hinchey EJ,et al. Monitoring intracranial pressure with a "head injury" model:carbon dioxide(CO_2) pneumoperitoneum versus laprolift procedure.Langenbecks Arch Chir Suppl Kongressbd.1997,114:257-260
10. Uzzo RG,Bilsky M,Mininberg DT,et al. laparoscopic surgery in children with ventriculoperitoneal shunts:effect of pneumoperitoneum on intracranial pressure:preliminary experience.Urology.1997,49:753-757
11．吴子顺，汪明惠，牧素玲．腹腔镜胆囊切除术CO_2气腹对脑脊液压德影响．临床麻醉学杂志．1997；13(3)：161
12. Rosenthal RJ,Hiatt JR,Phillips EH,et al. Intracranial pressure effect of pneumoperitoneum in a large animal model.Surg Endosc.1997,11:376-380
13. Wright AD,Imray CH,Morrissey MS. et al. Intracranial pressure at high altitude and acute mountain sickness.Clin Sci. 1995,89:201-204
14. Cooke S,Psterson-Brown. Assciation between laparoscopic abdominal surgery and postoperative symptoms of raised intracranial pressure. Surg Endosc.2001, 15: 723-725
15. Luz CM,Polarz H,Bohrer H,et al. Hemodynamic and respiratory effects of pneumoperitoneum and PEEP during laparoscopic pelvic lymphadenectomy in dogs.Surg Endosc.1994,8:25-27
16. Horvath K,Whelan R,Liver B,et al. The effect of elevated intraabdominal pressure,hypercarbia,andpositioning on the hemodynamic response to laparoscopic colectomy in pigs. Surg Endosc.1998,12:107-114
17. Moncure M, Grande PO, Asgeirsson B, et al. Intracranial pressure effect of pneumoperitoneum in dogs with injured brian.Am Surg 1999;14(4):227-236
18．刘宿，葛衡江，周蓉，等．腹腔镜手术期间二氧化碳气腹对脑氧供影响．中华麻醉学杂志．1997；17(6)：339-340
19．单闯，祝建刚，刘诚，等．腹腔镜胆囊切除术中二氧化碳气腹对脑血流的影响．中华麻醉学杂志，2000，20(7)：411—412
20．杨庆堂．妇科腹腔镜手术中CO_2气腹对脑摄氧的影响．第四军医大学学报．2002，23(24)：2304
21. Erkan N,Gokmen A,Goktay Y, et al.Effects of CO_2 pneumoperitoneum on the basilar artery: An experimental study in rabbits. Surg Endosc.2001,15: 806—811
22. Lawreence N,Diebel MD,Robert F, et al.Effects of increased intra-abdominal pressure on hepatic,portal venous and hepatic microcirculation blood flow.J Trauma,1992;33:279-283
23. Hamilton BD,Chow CK,Jnman SR,et al.Increased intra-abdominal pressure during pneumoperitoneum stimulates endothelin release in a canine model.J Eneourol, 1998;12:193-197
24. Allan D,Alfred C.Cardiovascular consequences of laparoscopic surgery. The lancet,1998;352(15):568-570
25. Greif W, Forse R. Hemodynamic effects of the laparoscopic pneumoperitoneum during sepsis in a porcine endotoxic shock model.Ann Surg,1998;277(16):474-480
26. Sharma A,Pake D,Alfred H,et al. laparoscopy and potential complications. Heart and Lung,1997;26(1):52-61
27. Joris JC,Chiche JD,Canivet JC,et al. Hemodynamic changes induced by laparoscopy and their endocrine corrlates :effects of clonidine .J Am coll Cardiol,1998;32:89-96
28. Wolf TS,Monk TG,McDougall EM,et al. The extraperitoneal approach and subcutaneous empllysema are associated with greater absortion of carbon dioxide laparoscopic renal surgery. J Urol,1995; 154:959-967
29. Ho HS,Gunther RA,Wolfe BM.intraperitoneal carbon dioxide insufflation and cardiopulmonary function. Arch Surg,1992;127:928-932
30. Ferrandez LL, Saenz A,Traura D,rt al.Helium and carbon dioxide pneumoperitoneum in patients with pheochromocytoma undergoing laparoscopic adrenalectomy.Word J Surg,1998;22:1250-1255
31. Joris JL, Hamoir EE,Hartstein GM, et al. Hemodynamic changes and catecholamine release during laparoscopic adrenalectomy for phechromocytoma. Anesth Analg,1999;88:16-21
32.Sato M,Watanable Y,Uedas S,et al.Minimally invasive hepatic resection using laparoscopic surgery and minithoratomy. Arch Surg,1997;132(20):206-211
33.mOrrison CA,Schreiber MA,Olsen SB,et al.Femoral Venous flow dynamics intraperitoneal and preperitoneal laparoscopic insufflation . Surg Endosc. 1998; 12: 1213—1221
34.Bonatsos G, Leandros E,Dourakisn,et al. laparoscopic cholecystectomy: Intraoperative finding and postoperative complications. Surg Endosc. 1995, 9: 889—893
35.Struthers AD, Cuschieri A.Cardiovascular consequences of laparoscopic surgery (J) .Lacent, 1998, 352 (15): 568-570
36.Galizia G, Prizio G, Lieto E, et al. Hemodynamic and pulmonary changes during open, carbon dioxide pneumoperitoneum and abdominal wall — lifting cholecystectomy. Aprospective, randomized study. Surg Endosc.2001, 15 (5): 477—483
37.Neuhaus SJ, Gupta A, Watson D. Helium and other alternative insufflation gases for laparoscopy. Surg Endosc.2001, 15 (6): 553-560
38.Fujii Y, Tanaka H, Tsuruoka SH, et al. Middle cerebral arterial blood flow velocity increases during laparoscopic cholecystectomy. Anesth ANalg, 1994, 78: 80—83
39.Kumano H, Furuya H, Yomasa H, et al. Response of pialvessel diameter and regional CBF to CO_2 during midazolam administration in cats. Acta Anaesth Scand, 1994, 38: 729 -733
40.Laisalmi M, Koivusalo AM, Valta, et al. clonidine provides opiodsparing effect, stable hemodynamics , and renal intrgrity during laparoscopic : cholecvstectomy. Surg Endosc.2001, 15 (11): 1331-1335
41.Safran DB, Orlando MFR. Connecticut H.Physiologic effects of. pneumoperitoneum. AM J Surg.1994, 167 (2): 281-286
42.Groffrey L, Bloomfield MD, Charles R, et al. Elevated intra—abdominal pressure increase plasma rennin activity and aldosterone levels J Trauma.1997, 42(6): 997—1003
43.Hamilton BD, Chow CK, Jnman SR, et al.Increased intra—abdominal pressure during pneumoperitoneum stlimulates endothelin s release in a canine model. J Eneourol..1998, 12: 193-197
44.Schoenberg MH, Buchler M, Younes M, et al. Effect of antioxidant treatment in rats with acute hemorrhagic Pancretitis. Dig Dis. Sci.1994, 39 (5): 1034—1040
45.Galat JA, Robinson AV, Rhodes RS. Oxygen free radical mediated renal dysfunction. J Surg Res. 1989, 46: 520-532
46.Suarez—Pinzon WL, Strynadka K, Rabinovitch A. Destruction of rat pancreatic islet beta — cells by cytokines involves the production of cytotoxic aldehydes.Endocrinology.1996, 137 (12): 5290—5296
47. Reilly PM, Bulkery GB. Tissue injury by free radicals and other toxic oxygen metabolites. Br J Surg.1997, 77: 1324—1331
48．吴氢孙．自由基与临床医学．微循环杂志．1998，8：34—36
49. Simonson MS. Endothelins :Multifunction renal peptides.Physiol Rew. 1993; 73: 375
50. Bcklund M,Kellokumpu I,Smitten K, et al. Effect of temperature of insufflated CO_2 during and after prolonge laparoscopic surgery.Surg Endosc.1998, 12 (9): 1126—1130
51. Wallase KB,Eells JT, Maderira VM,et al.Mitochondria-mediated cell injury:symposium overview. Fundam Appl toxicol.1997,38(1):23-37
52. Green DR,Reed JC..Mitochondria and apoptosis.Science.1998,281:1309-1312
53. Green DR,Reed JC..Mitochondria and apoptosis.Science. 1998,281:1309-1312
54. Horvath KD,Whelan RL, Lier B,et al. The effects of elevate intraabdominal pressure,hypercarbia,and positioning on the hemodynamic response to laparoscopic cholecystectomy. Surg Endosc.1998, 12 (2): 107—114
55. Neuhaus SJ,Gupta A,Watson DJ. Helium and other alternative insufflation gases for laparoscopy.Surg Endosc.2001, 15 (6): 553—560
56. Lyass S,Levin S,Pizov R,et al.Hemodynamic effects of helium VS carbon dioxide pneumoperitoneum in an experimental model of acute heart failure.Surg Endosc.2001, 15 (8): 861—866
57. Weijer DW, Rademmaker BPW, Schlooz,et al. Laparoscopic cholecystectomy using wall retraction.Surg Endosc,1997, 11 (6); 645—649
58. Cuschieri A.Adverse cardiovascular changes induced by positive pressure pneumoperitoneum.Surg Endosc.1998, 12 (1): 93—94
59．陈训如．微创慨念的讨论加速了我国微创外科的健康发展．中国普外基础与临床杂志．2003，10(3)：218—221