阿片肽与缺血性脑损伤

阿片肽及其受体系统在缺血性脑损伤的病理生理发展过程中具有非常重要的作用。其在缺血性脑损伤中的作用尚存争议，本文综述了阿片肽及其受体系统在缺血性脑损伤中的作用及其可能机制，有助于探索阿片肽在围术期的合理应用，为缺血性脑损伤防治研究提供新方向。     

选择性周围神经部分切断术治疗脑瘫性肢体痉挛

目的观察选择性周围神经部分切断术治疗痉挛性脑瘫的效果。方法采用显微神经外科手术治疗的68例痉挛型脑瘫病例,根据患者肢体痉挛的不同情况采用相应的选择性周围神经部分切断术,包括胫神经、坐骨神经和正中神经,其中选择性胫神经切断术36侧,选择性正中神经切断术28侧,选择性坐骨神经切断术28侧,共计92侧。结果全部患者经3-15个月的随访,术后即刻肢体痉挛状态缓解率为97.8%(90/92),随访期间为94.6%(87/92),随访期间运动功能改善率为76.5%(52/68),术后肢体痉挛状态不同程度复发5侧(5.4%)。结论选择性周围神经部分切断术对降低痉挛性脑瘫患者肌张力、纠正痉挛性畸形近期疗效满意,手术创伤小,治疗效果能够被医患双方同时认可。     

Multiple tachykinin binding sites in peripheral tissues and in brain

Tachykinin binding sites in guinea pig urinary bladder (GPUB), rat salivary gland (RSG), hamster urinary bladder (HUB), rat vas deferens (RVD) and rat cerebral cortex (RCC) were compared using ¹²⁵I-Bolton Hunter conjugates of substance P (¹²⁵I-BHSP), eledoisin (¹²⁵I-BHE) and neurokinin A (¹²⁵I-BHNKA). In typical SP-P tissues (GPUB, RSG) and in RCC, SP was the most potent displacer of ¹²⁵I-BHSP and [Glp⁶, D-Pro⁹]-SP(6–11) was 90 times less active than [Glp⁶, L-Pro⁹]-SP(6–11) while SP methyl ester (SPOMe) was 5–10 times more active than the Bolton Hunter conjugate of SPOMe (I-BHSPOMe). On the other hand, in typical SP-E tissues (HUB, RVD), neurokinin A was most potent in displacing ¹²⁵I-BHE and [Glp⁶,D-Pro⁹]-SP(6–11) was over 300 times more active than [Glp⁶,L-Pro⁹]-SP(6–11) while SPOMe was 160 times less active than I-BHSPOMe. In rat cerebral cortex, the rank order of potency of tachykinins and related analogues in displacing ¹²⁵I-BHE was distinct from that of peripheral SP-E sites, with neurokinin B being the most potent displacer, and SPOMe was over 1 000 times more active than I-BHSPOMe; ¹²⁵I-BHE binding sites in CNS may represent a third category of tachykinin receptor, designated SP-N.     

脑瘫患儿脑干听觉诱发电位研究

本文采用日本光电公司生产的 MEB-5304K 诱发电位测定仪,对101名6月-14岁脑瘫患儿和40名正常儿测定了脑干听觉诱发电位(BAEP)。结果表明:给予80dBNHL,20Hz 刺激时 BAEP 异常率为45.54%,随刺激强度减小及刺激重复率增加,BAEP 阳性率提高。BAEP 改变与病情、病型及并发症有关。为脑瘫的发病机理及病理生理学研究提供神经电生理学依据。对脑瘫合并听力障碍者有助于及早选用助听装置,解决其听力障碍问题。     

Application of technetium-99m hexamethylpropylene amine oxime single-photon emission tomography to neurologic prognosis in patients undergoing urgent carotid surgery

In this study we aimed to work out a quantitative prognostic index for preoperative assessment of brain technetium-99m hexamethylpropylene amine oxime (HMPAO) single-photon emission tomography (SPET) in patients referred for urgent carotid endarterectomy due to acute obstructive disease of the internal carotid artery (ICA) and neurological deficit. To this end we compared data from preoperative SPET studies with the postinterventional changes in neurological status in 20 patients (17 males, three females; mean age 53 years, SD 4 years) with acute ischaemic cerebral disorders induced by obstruction of the ICA. Carotid obstruction was diagnosed by ultrasound B-mode study. All patients underwent urgent carotid endarterectomy from the ICA. Patients were divided into two groups in accordance with the results of postoperative follow-up: group A comprised patients with significant (more than 3 points) postoperative improvement in neurological condition as quantified by the Canadian Neurological Scale (11 patients); group B consisted of patients with minimal improvement or deterioration (nine, three of whom died). All patients were studied preoperatively by^99mTc-HMPAO SPET. The volume of nonperfused tissue (VS, cm³) was quantified using the Mountz technique. Hypoperfused volume (V _hypoperf, cm³) in the affected hemisphere was calculated as the total volume of voxels with^99mTc-HMPAO uptake <90% of the contralateral symmetric voxels. Discriminant prognostic function was calculated by discriminant analysis as:PF = 0.072×VS + 29.46×(VS/V _hypoperf). Patients with preoperativePF values <8.20 demonstrated postoperative improvement in neurological status, while the group withPF>8.90 comprised patients who demonstrated minimal improvement or deterioration. PF values in the range 8.20–8.90 carried an indefinite prognosis. We conclude that the preoperative^99mTc-HMPAO SPET can be used for the selection of patients in whom improvement in neurological status may be expected after urgent surgical correction of acute extracranial obstruction of the ICA.     

Ultrastructural characterization of the tau-immunoreactive tubules in the oligodendroglial perikarya and their inner loop processes in progressive supranuclear palsy

Coiled bodies and interfascicular threads are conspicuous white matter abnormalities of brains of patients with progressive supranuclear palsy (PSP). Both structures are argyrophilic and immunoreactive for the microtubule-binding protein tau. This report concerns the ultrastructural localization of interfascicular threads and their relationship to coiled bodies in five PSP patients. We showed for the first time that abnormal tubules with a 13- to 15-nm diameter and fuzzy outer contours were the common structures of coiled bodies in the oligodendroglial perikarya and of interfascicular threads. Moreover, the tubules were immunolabeled by anti-tau antibodies. The abnormal tau-positive tubules of interfascicular threads were located in the inner loop of the myelin sheath. Our study further indicated that the thread-like structures in the white matter comprised, at least in part, oligodendroglial processes, and that they were also present in gray matter. We consider that the formation of coiled bodies in the perikarya and of interfascicular threads represents a common cytoskeletal abnormality of the oligodendroglia of PSP patients. Moreover, even though the white matter alterations of PSP resemble those of corticobasal degeneration, there are certain ultrastructural differences in the abnormal oligodendroglial tubules of the two diseases. Received: 4 October 1996 / Accepted: 6 December 1996     

床上体操训练对偏瘫患者的效果观察

目的：观察偏瘫患者早期床上训练的效果。方法：对５８例脑血管意外致偏瘫患者随机分成２组：观察组３０例，护理中指导早期床上体操训练；对照组２８例，按常规护理。以上、下肢肌力和日常生活活动能力（ＡＤＬ）为评价指标，于训练开始时、训练４周、训练８周各评价１次。结果：观察组训练４周、８周时患侧上肢肌力以及ＡＤＬ水平明显增加，与对照组比较有显著差异（Ｐ＜００１）。患侧下肢肌力训练４周及８周时均增加，与对照组比较，４周时无明显差异（Ｐ＞００５），８周时有显著性差异（Ｐ＜００１）。结论：对早期偏瘫患者实施床上功能训练，不仅可以提高患者的生命质量，而且可以减少、甚至解除患者及家属的经济和精神负担。     

Effects of interleukin-1α on platelet-derived growth factor release from bovine cerebral microvascular endothelial cells

ThepreviousworkofourlabshowedthatILlastimulatedtheproliferationofbovinecerebralmicrovascularsmoothmusclecells(BCMSMC);",butthemechanismremainsunknown.EarlierreportsshowedthatIL--1stimulatedendothelialcellstosecretesomefactorswhichweremitogenictothevascularsmoothmusclecells[2].Amongthosefactors,platelet--derivedgrowthfactor(PDGF)wasthemainone[3j.OurexperimentwasdesignedtoinvestigatetheeffectofPDGFonproliferationofbovinecerebralmicrovascularsmoothmusclecells(BCMSMC)stimulatedbyIL--la.…     

Studies of the antagonistic effect of BQ-123 on cerebral vasospasm induced by intracisternal injection of endothelin-1 and subarachnoid hemorrhage

Cerebralvasospasm(CVS)remainsoneofthemajorcausesofseriousoutcomeinpatientswithsubarachnoidhemorrhage(SAH);however,themechanismofwhichisstillnotwellunderstood.Sofaralargenumberofputativespasmogenshavebeenproposedandoneofwhichisendothelins(ETs).ETs,akindofverypotentendogenousvasoconstrictorsubstancesknown[1],hasthreeiso-forms:ET-1,2and3,andET-1isthemostpo-tentvasoconstrictorofthem.lnrecentstudies,ET-lhasbeenproposedasamediatorofCVSfol-lowingSAH[2-4j.TheavailabilityofETantagonistprovided…