CB1大麻素受体激动剂抑制基质金属蛋白酶参与脊髓损伤后血-脊髓屏障通透性调节

目的探讨CB1大麻素受体激动剂在大鼠脊髓损伤后对血-脊髓屏障通透性调节的作用。方法将150只雌性SD大鼠随机分为假手术组(Sham组)、脊髓损伤组(SCI组)和CB1激动剂处理组(ACEA组)。采用改良Allen法建立T9脊髓损伤实验动物模型。Sham组仅行T9椎板切除术,SCI组和ACEA组以30 g·cm致伤力制作模型。ACEA组建模成功后,每日腹腔给药ACEA 3mg/(kg·d);Sham组和SCI组以生理盐水代替。建模术后12、24、72 h分时段处死动物,取T8~T10脊髓节段,Evans蓝含量测定法检测SCI后血-脊髓屏障通透性变化,定量RT-PCR法检测脊髓组织基质金属蛋白酶9(MMP9)表达水平。结果 Sham组脊髓通透性无改变,脊髓组织中无Evans蓝渗入,ACEA组Evans蓝通过血-脊髓屏障渗漏至脊髓,但渗漏量明显低于SCI组。ACEA组MMP9表达水平显著低于Sci组。结论 CB1受体激动剂ACEA能降低Allen's大鼠脊髓损伤模型血-脊髓屏障的破坏,其作用机制可能与MMP9的表达下调相关。     

虎杖苷对急性脊髓损伤大鼠氧化应激反应和炎症反应影响

目的探讨虎杖苷对急性脊髓损伤大鼠氧化应激反应和炎症反应的影响。方法将54只雄性Sprague-dawley大鼠随机分入3组,每组18只:假手术对照组(Sham组),仅行单纯T10椎板摘除;急性脊髓损伤组(SCI组),行单纯T10椎板摘除后,以改良Allen's法制备大鼠急性脊髓损伤模型;虎杖苷治疗组(P组),同SCI组制备大鼠急性脊髓损伤模型后,于术后即刻和术后第1、3、5、7天给予大鼠腹腔注射虎杖苷(20 mg/kg)。比较3组大鼠术后第1、3、7、14天的BBB运动功能评分和斜板实验评分;术后第7天,行苏木素-伊红(HE)染色,观察3组大鼠术后脊髓形态学改变;术后第7天,Western blot法检测3组大鼠脊髓沉默调节蛋白1(SIRT1)、诱导型一氧化氮合酶(i NOS)、环氧化酶-2(COX-2)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)蛋白表达水平。结果术后第1、3、7、14天,SCI组的BBB运动功能评分和斜板实验评分均显著低于Sham组,差异有统计学意义(P<0.05);与SCI组比较,P组的BBB运动功能评分和斜板实验评分均显著高于SCI组,差异有统计学意义(P<0.05)。HE染色结果显示,与Sham组比较,SCI组大鼠脊髓中神经元数量和突起锐减,细胞核肿胀且核膜明显,可见明显间质水肿和中性粒细胞浸润;与SCI组比较,P组大鼠脊髓神经元数量和突起明显增多,间质水肿和中性粒细胞浸润明显减轻。与Sham组比较,SCI组大鼠脊髓SIRT1蛋白表达水平显著降低,i NOS、COX-2、IL-6及TNF-α蛋白表达水平明显增高,差异有统计学意义(P<0.05);与SCI组比较,P组大鼠脊髓SIRT1蛋白表达水平显著升高,i NOS、COX-2、IL-6及TNF-α蛋白表达水平明显降低,差异有统计学意义(P<0.05)。结论虎杖苷可改善急性脊髓损伤并促进运动功能恢复,其机制可能与抑制脊髓氧化应激反应和炎症反应有关。     

脊髓损伤后星型胶质细胞活化与线粒体融合蛋白2表达变化

目的探索脊髓损伤后星型胶质细胞(AS)活化与线粒体融合蛋白2(Mfn2)的表达规律及其意义,为脊髓损伤修复寻求合适的干预靶点及时机。方法建立成年SD大鼠脊髓损伤(SCI)模型,运用免疫荧光和Western Blotting方法,检测Mfn2及AS活化相关蛋白胶质纤维酸性蛋白(GFAP)的表达变化。清洁级成年雄性SD大鼠48只,随机分为两组:假手术组(sham组,n=24),脊髓损伤组(SCI组,n=24),SCI组采用Allen’s法建立大鼠胸段脊髓损伤模型,sham组只行椎板切除术,分别于术后第1天、第3天、第7天、第14天4个时间点分批处死大鼠,取大鼠胸段脊髓组织,行组织免疫荧光染色观察脊髓形态变化,Western Blotting检测各个时间点Mfn2与GFAP的表达变化。结果脊髓损伤后,大鼠胸段脊髓灰质两背角之间会形成结构紊乱、边界不清的损伤灶;Western Blotting及免疫荧光结果显示脊髓损伤后,大鼠胸段脊髓Mfn2蛋白表达从第1天开始下降,与sham组相比,脊髓损伤组胸段脊髓Mfn2表达整体呈下降趋势,术后第3天开始明显下降,差异有统计学意义(P0.05);而GFAP表达随时间延长则逐渐增加,术后第3天开始差异有统计学意义(P0.05)。结论脊髓损伤后,AS的特异性标志物GFAP表达整体呈上升趋势,提示此时AS出现大量增殖;与此相反,Mfn2(增殖抑制基因)表达产物则明显减少。     

白藜芦醇对大鼠脊髓损伤后水通道蛋白-4表达的影响

目的:探讨白藜芦醇(Resveratrol)对大鼠脊髓损伤后水通道蛋白-4 (Aquaporin-4,AQP-4)表达的影响.方法:36只SD大鼠随机分为假手术组(Sham组)、损伤组(Control组)和白藜芦醇处理组(Res组),每组12只.Sham组仅行手术暴露,不给予打击及治疗;Control组采用Allen's打击法建立大鼠脊髓损伤模型;Res组模型建立后给予Res 200mg/kg腹腔注射.术后72 h处死动物取材,采用于湿重法测定损伤段脊髓组织水含量,采用免疫组织化学和Westemblot法检测损伤段脊髓AQP-4表达.结果:损伤组和白藜芦醇处理组脊髓组织含水量较假手术组明显增加(P＜0.01),白藜芦醇处理组较损伤组有所减少(P＜0.05).损伤组AQP--4表达较假手术组显著增强(P＜0.01),白藜芦醇处理组AQP-4表达较损伤组明显减弱(P＜0.05).结论:白藜芦醇明显减少损伤脊髓AQP-4表达,减轻脊髓水肿,消除继发性损伤,保护了残存的正常脊髓组织,促进脊髓神经组织重建和功能恢复.     

异丙酚对大鼠脊髓损伤后诱导型一氧化氮合酶表达的影响

目的 探讨异丙酚对大鼠急性压迫性脊髓损伤后诱导型一氧化氮合酶（iNOS）表达的影响。方法 采用改良Allen’s打击法制备急性脊髓压迫性损伤模型。雄性SD大鼠74只，随机分为正常组（n=4）、脊髓损伤后异丙酚干预组（n=35）和生理盐水对照组（n=35），采用免疫组化和Western blot法检测脊髓损伤后不同时间点（1h、3h、8h、1d、3d、7d、14d）脊髓组织中iNOS蛋白的表达。结果 与生理盐水对照组比较，异丙酚干预组大鼠损伤后脊髓组织iNOS表达明显降低，差异有统计学意义（P〈0．05或0．01）。结论 异丙酚可通过抑制iNOS蛋白表达对大鼠急性脊髓损伤起保护作用。     

高压氧对大鼠急性脊髓损伤炎症因子表达的影响

目的 观察大鼠脊髓损伤(spinal cord injury,SCI)后早期高压氧(HBO)治疗对肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)mRNA表达的影响.方法 将36只SD大鼠随机分为2组:SCI组(18只)和HBO组(18只).2组均采用改良的Allen打击法建造大鼠脊髓损伤模型.模型建造成功后,HBO组于损伤2 h后开始行HBO治疗,1次/d.2组分别于损伤后6、12、24、72、120、168 h各取3只大鼠,取损伤部位脊髓组织采用逆转录-聚合酶链式反应(RT-PCR)法测定其中TNF-α、IL-10 mRNA表达的变化.结果 SCI组大鼠脊髓组织中TNF-α mRNA表达逐渐升高,在伤后12h表达明显上调,至24h达高峰,高表达持续至损伤后72 h;HBO组大鼠脊髓组织中TNF-α mRNA表达变化趋势与SCI组一致,但升高幅度降低(P＜0.05);SCI组大鼠IL-10 mRNA表达在损伤后12 h开始升高,并随时间的推移逐渐升高,至168 h达高峰;HBO组表达变化趋势较一致,IL-10 mRNA升高幅度更明显(P＜0.05).结论 HBO能够减少前炎性细胞因子的释放,增加抗炎性细胞因子的表达,从而减少脊髓组织的继发损伤,保护受损的神经细胞,达到促进恢复的作用.

Abstract：

Objective To investigate the effects of early HBO therapy on the expressions of pro inflammatory cytokine mRNA including tumor necrosis factor-α (TNF-α ) and interleukin-10 (IL-10) following spinal cord injury (SCI) in rats. Methods Forty SD rats were randomly divided into 3 groups:the sham operation group (n=4) , the SCI group (n = 18) , and the hyperbaric oxygen group (n = 18). Spinal cord injury model was developed by using the modified Allen impact. Then, the SCI group and the HBO group received HBO therapy 2 hours after injury, once a day. And 3 rats were randomly selected at 6, 12, 24, 72, 120 and 168 h following injury to take samples of injured spinal cord tissue and measure dynamic changes in the expressions of TNF-α, IL-10 mRNA by semi-quantitative RT-PCR method. Results Faint expression of the cytokine mRNA could be noticed in the sham group. The expression of TNF-α mRNA in the injured spinal cord tissue in the SCI group elevated gradually, increased obviously at 12 h after injury and reached peak at 24 h, and its high expression maintained till 72 h after injury. The tendency in the expression of TNF-α mRNA in the HBO group was identical to that of the SCI group, however, the amplitude in the increase of TNF-α mRNA decreased (P＜0. 05). The expression of IL-10 mRNA in the SCI group began to increase at 12 h after injury and increased gradually over time and reached peak at 168 h. The expressions of both TNF-α and IL-10 mRNA were more consistent in the HBO group, with more obvious increase in the expressions of IL-10 mRNA. Conclusions HBO could reduce the release of pro-inflammatory cytokines and increase the expression of anti-inflammatory cytokines,resulting in reduction of secondary spinal cord injury,protection of the damaged nerve cells and promotion of recovery.     

他克莫司抑制脂质过氧化对大鼠脊髓的保护效应观察

目的 探讨大鼠脊髓损伤后早期应用他克莫司对脊髓的保护效应.方法 健康成年雄性Wistar大鼠40只,随机分为他克莫司组(n=20)和损伤组(n=20).采用Allen's法建立大鼠脊髓损伤模型,他克莫司组在脊髓损伤后5min一次性经尾静脉注射他克莫司0.3mg/kg,损伤组以相同方法给予等量生理盐水.伤后3、7、14、21d应用BBB评分法进行后肢运动功能评价,并分别采用黄嘌呤氧化酶法和硫代巴比妥酸法测定血浆超氧化物歧化酶(SOD)活性和丙二醛(MDA)含量变化,免疫组织化学染色检测脊髓组织诱导型一氧化氮合酶(iNOS)的表达.结果 与损伤组比较,他克莫司组各时间点行为学评分明显改善(P＜0.05或P＜0.01),血浆MDA含量降低、SOD活性升高(P＜0.05或P＜0.01).损伤组和他克莫司组iNOS蛋白表达均于伤后3d升高,7d达峰值,且他克莫司组各时间点阳性细胞率均明显低于损伤组(P＜0.05或P＜0.01).结论 他克莫司可减少大鼠脊髓损伤后iNOS的表达和自由基生成,从而抑制脂质过氧化损伤,改善神经功能.     

高压氧对损伤脊髓GAP-43mRNA表达影响的实验研究

目的　研究高压氧 (HBO)治疗对脊髓损伤 (SCI)组织 GAP- 4 3m RNA表达水平的影响。方法　用 Allen氏 WD法制作鼠脊髓损伤模型。5 5只成年 Wistar鼠随机分为 11组 :正常对照组、SCI后第1,4 ,7,10 ,14 d组和 HBO(SCI后 HBO治疗 )第 1,4 ,7,10 ,14 d治疗组 ,每组各 5只。用半定量 RT- PCR法检测鼠损伤脊髓组织中 GAP- 4 3m RNA表达水平。结果　 GAP- 4 3m RNA在正常成年鼠脊髓中微量表达 ,SCI后表达增加 ,且 HBO治疗组较 SCI组表达更为显著 (P<0 .0 1)。术后 7d时 ,SCI组的GAP- 4 3m RNA表达达到高峰 ,14 d时降至接近初始水平 ,但 HBO治疗组 GAP- 4 3m RNA表达仍维持较高水平。结论　 HBO可增强损伤脊髓组织 GAP- 4 3m RNA表达水平 ,促进损伤脊髓神经元再生和修复 ,对脊髓损伤起保护作用。     

神经节苷脂对大鼠脊髓损伤后神经元的保护作用

目的 通过观察单唾液酸四己糖神经节苷脂( monosialotetrahexosyl gangliosides,GM-1)对大鼠脊髓损伤后微管相关蛋白-2（microtubule - associated protein 2,MAP -2）和胆碱乙酰转移酶( choline acetyhransterase,ChAT)的表达及运动功能的影响,探讨GM -1对大鼠脊髓损伤后神经元的保护作用及其机制。方法 Wistar雌性大鼠66只（体重260～ 300 g）,随机取6只作为正常对照组,余60只采用改良Allen打击法于Tt0节段制作大鼠急性脊髓损伤模型,并按随机数字表法分为GM -1组（A组）和等渗盐水对照组（B组）,每组30只大鼠。分别于术后1,3,7,14和28 d采用改良Tarlov评分法评价大鼠脊髓损伤后后肢运动功能恢复程度后处死取材,每组各时相点6只大鼠。以免疫荧光染色观察大鼠脊髓损伤后MAP -2和ChAT的表达情况。结果 术后7d起,Tarlov评分在A、B组间比较差异有统计学意义(P＜0.05),即A组大鼠运动功能恢复优于B组。免疫荧光染色发现,A组术后各时相点MAP -2及ChAT呈阳性表达的细胞数量较B组同时相点明显增多（P＜0.05）。结论 脊髓损伤后大鼠神经功能的恢复与MAP -2及ChAT的表达呈一定的相关性;GM -1可通过增强脊髓损伤后MAP -2及ChAT的表达来保护神经元。     

NRG1基因修饰的骨髓基质干细胞移植对大鼠脊髓半横切损伤的修复作用及其机制

目的 探讨移植神经调节蛋白1(NRG1)基因修饰的骨髓基质干细胞(BMSCs)对大鼠脊髓半横切损伤(SCI)的修复作用及其可能机制。方法 分离培养大鼠BMSCs,转染NRG1基因,采用ELISA法测定BMSCs裂解液和培养液上清中NRG1蛋白含量,细胞计数法检测BMSCs增殖活性。43只健康8周龄SD大鼠,随机分为对照组(n=10)、SCI模型组(n=10)、BMSCs组(n=10)与NRG1-BMSCs组(n=13)。建立大鼠脊髓半横切损伤模型后,原位移植BMSCs和NRG1-BMSCs。移植第1、7、14、21、28天,采用BBB评分、斜板实验评估大鼠后肢运动功能;移植第7天,应用荧光显微镜观察移植细胞迁移及分布情况;移植第28天,采用HE染色和Nissl染色观察大鼠脊髓组织病理学变化,TUNEL染色检测脊髓组织细胞凋亡情况,Western blotting检测脊髓组织内质网应激相关蛋白[X-box结合蛋白1(XBP1)、C/EBP同源蛋白(CHOP)、转录激活因子4(ATF4)、ATF6和葡萄糖调节蛋白78(GRP78)]及凋亡相关蛋白[B淋巴细胞瘤-2蛋白(Bcl-2)、Bcl...     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

磁共振DWI和动态增强鉴别颅底脊索瘤和侵袭性垂体瘤的应用

目的 探讨磁共振扩散加权成像(DWI)和动态增强在颅底脊索瘤和侵袭性垂体瘤(IPA)鉴别诊断中的应用价值.方法 搜集经手术病理证实且影像学有鞍区破坏的颅底脊索瘤患者15例、向鼻咽部侵犯的IPA患者20例.测量二者的表观扩散系数(ADC)值,绘制受试者工作特征曲线(ROC),分析动态增强曲线的类型,统计达峰时间(TTP)、增强峰值(EP)和最大对比增强率(MCER),分析各个参数在鉴别诊断中的价值.结果 颅底脊索瘤的ADC值为(1.274±0.07)×10-3mm2/s,高于IPA ADC值(0.672±0.03) ×10-3 mm2/s(P ＜0.001),ADC阈值为0.964×10-3mm2/s时,ROC曲线下面积为0.997,敏感度为93.3％,特异度为100％.颅底脊索瘤时间-信号强度曲线(TIC)Ⅰ型14例,TICⅢ型1例,此例TICⅢ型者TTP约40 s;IPA TIC Ⅰ型7例,TICⅢ型13例.颅底脊索瘤和IPA的EP、MCER差异均有统计学意义(P ＜0.001).结论 ADC值和TIC的类型及其相关参数(EP,MCER)有助于颅底脊索瘤和IPA之间的鉴别.     

Treatment of intrahepatic arteriovenous fistula in hepatocellular carcinoma with N-butyl-2-cyanoacrylate

Primary hepatocellular carcinoma (HCC) continues to be one of the most common malignancies with an incidence of approximately one million cases per year and a dismal prognosis; some authors have reported a median survival of 1 ～ 2 months after diagnosis. Although surgery remains the only hope for cure, few patients are candidates[1,2].     

U50,488H对正常及缺氧心肌细胞L型钙电流的作用

目的 探讨心脏阿片受体和β-受体相互作用的机制。方法 采用全细胞膜片钳技术，观察U50，488H(β-阿片受体选择性激动剂)对正常和缺氧心肌细胞L型钙电流的作用。结果 U50，488H剂量依赖性(0．1～100μmol／L)抑制正常心肌细胞的L型钙电流及异丙肾上腺素(0．1μmol／L)激动的钙电流，而细胞缺氧后，这一抑制作用减弱；U50，488H对Forskolin(10μmol／L)激动的L型钙电流无明显影响。结论 β-阿片受体对β-受体信号的负性调节作用在细胞缺氧后减弱，其作用位点可能发生于β-受体与腺苷酸环化酶环节之间。     

Overtraining syndrome : la piste de la suractivité ?

Introduction

Overtraining is clearly a multifactorial disturbance. We aimed at evaluating the relative importance of overactivity and nutritional imbalances.

Methods

A comparison of 17 footballers with seven subjects with a diagnosis of overtraining evidenced that the two groups differ by energy expenditure resulting from physical activity (1573 ± 378.6 kcal/d from 804.7 ± 184.7 kcal/d) while food intake does not exhibit significant differences.

Conclusion

In this sample of subjects, inadequate food intake is found in both groups, so that overtraining appears rather characterized by a higher level of physical activity. Therefore, a relative energy deficit resulting from overactivity rather than dietary mistakes appears to explain the syndrome in these athletes, who are thus truly “overtrained”.     

Prenatal detection of brain anomalies with ultrasonography

Ultrasound is the first-line imaging study of the fetal brain performed at 12, 22 and 32 weeks of gestation. The very structured evaluation of biometric and morphological data, facilitated by the use of a checklist, ensures a high quality examination. All patients where an anomaly of any key element is suspected should be referred to a center dedicated to prenatal diagnosis for confirmation irrespective of the gestational age. Prenatal diagnosis plays a significant role in France since medical interruption of pregnancy until term is authorized.