NADPH oxidase inhibition improves neurological outcomes in surgically-induced brain injury

Neurosurgical procedures can result in brain injury by various means including direct trauma, hemorrhage, retractor stretch, and electrocautery. This surgically-induced brain injury (SBI) can cause post-operative complications such as brain edema. By creating a mouse model of SBI, we tested whether NADPH oxidase, an important reactive oxygen species producing enzyme, is involved in SBI using transgenic mice lacking gp91^phox subunit of NADPH oxidase (gp91^phox KO) and apocynin, a specific inhibitor of NADPH oxidase. Neurological function and brain edema were evaluated at 24 h post-SBI in gp91^phox KO and wild-type littermates grouped into SBI and sham-surgery groups. Alternatively, mice were grouped into vehicle- and apocynin-treated (5 mg/kg, i.p. 30 min before SBI) groups. Oxidative stress indicated by lipid peroxidation (LPO) was measured at 3 and 24 h post-SBI. The gp91^phox KO mice, but not the apocynin-treated mice showed significantly improved neurological scores. Brain edema was observed in both gp91^phox KO and wild-type groups after SBI; however, there was no significant difference between these two groups. Brain edema was also not affected by apocynin-pretreatment. LPO levels were significantly higher in SBI group in both gp91^phox KO and wild-type groups as compared to sham group. A trend, although without statistical significance, was noted towards attenuation of LPO in the gp91^phox KO animals as compared to wild-type group. LPO levels were significantly attenuated at 3 h post-SBI by apocynin-pretreatment but not at 24 h post-SBI. These results suggest that chronic and acute inhibition of NADPH oxidase activity does not reduce brain edema after SBI. Long-term inhibition of NADPH oxidase, however improves neurological functions after SBI.     

HO-1/CO径路在肺缺血-再灌注损伤中的作用

目的：探讨血红素氧合酶-1（HO-1）/一氧化碳（CO）径路在肺缺血-再灌注损伤中的作用。 方法： 采用在体兔单肺原位缺血-再灌注模型。实验兔40只，随机均分为假手术对照（C）组、肺缺血-再灌注（I-R）组、肺缺血-再灌注加氯铁血红素(H)组和肺缺血-再灌注加锌原卟啉(Z)组。分别在缺血前、缺血后、再灌注1 h、2 h、3 h抽血，检测一氧化碳血红蛋白(COHb)浓度。实验结束时取肺组织检测湿干重比（W/D）、肺泡损伤率（IAR），观察肺组织超微结构的改变、HO-1的活力、表达部位及强度。 结果： 血浆COHb浓度，I-R组、H组明显高于C组，以H组为著（P<0.01）；H组、Z组显著高于、低于I-R组（P<0.01）。肺组织HO-1活力H组最高，其次是I-R组，Z组和C组最低（P<0.05和P<0.01）。I-R组、H组、Z组HO-1在肺血管内皮、部分血管平滑肌、外膜层及部分气道上皮均有阳性表达，明显高于C组，尤以H组最为明显（P<0.01）。W/D、IAR值，I-R组和Z组均明显高于C组，尤以Z组为著，H组虽较C组为高，但显著低于IR组和Z组（P<0.05和P<0.01）。肺组织形态学异常改变，以Z组为著，H组较轻。 结论： HO-1/CO径路对缺血-再灌注肺发挥积极的保护作用。     

活性氧在脊髓损伤中的作用

脊髓损伤(spinal cord injury，SCI)治疗的实验性研究在18世纪就已经开始，研究者发现兴奋性毒性、Ca2+超载、神经元凋亡与氧化应激参与了神经损伤病理过程。近期研究中活性氧学说在脊髓损伤中的作用越来越受到研究者的重视，并有研究表明线粒体呼吸链、炎症反应中的呼吸爆发等多种途径参与了SCI后活性氧生成。本文在阐述活性氧生物学作用的同时，并结合近年来以活性氧为靶点的SCI治疗策略做一小结。     

依赖性膜磷脂结合蛋白AnnexinⅡ对大鼠脊髓横断损伤的修复作用

目的在体内实验中观察钙依赖性膜磷脂结合蛋白AnnexinⅡ对大鼠脊髓损伤以及神经干细胞移植的作用。方法在成年大鼠全横断脊髓损伤的局部微量注射AnnexinⅡ，观察其对损伤的脊髓神经细胞存活、神经纤维生长和损伤后的功能恢复的影响，以及对联合移植的胚胎神经干细胞移植后存活和迁移的影响。结果在动物脊髓横断损伤6周，神经干细胞移植4周后，损伤局部微量注射AnnexinⅡ＋NSC移植组实验动物的运动评分结果较空白对照组和单独进行NSC移植组都有明显增高（JP〈0．01），脊髓损伤处的空洞面积也较上述两组显著减小（P〈0．01）；注射AnnexinⅡ＋NSC组损伤节段以上荧光金标记神经细胞数目较空白对照组明显增多（P〈0．01）。结论AnnexinⅡ蛋白可能具有减小局部损伤空洞面积，保护损伤的神经元和神经纤维并防止其走向变性和死亡的效应，并对神经干细胞的移植效应有一定的促进和协同作用，使脊髓损伤大鼠的功能得到一定程度的恢复。     

急性颅脑损伤患者血清NO、NOS和CNP测定的临床意义

目的:探讨了NO、NOS和血浆C-型利钠多肽(CNP)水平在急性颅脑损伤早期的病理、生理作用。方法:分别应用放免法测定血浆CNP水平,生化法测定NO、NOS水平。结果:在治疗前急性颅脑损伤患者血浆CNP水平和NO水平非常显著地低于正常人组水平(P<0.01),而NOS水平显著地高于正常人组水平(P<0.01),经治疗后一个月则与正常人组比较无显著性差异(P>0.05)。结论:观察血浆CNP、NO和NOS水平的变化对研究急性早期颅脑损伤的病理生理变化,判断疗效及预后观察是具有十分重要的临床意义。     

Zn~(2+)预处理对离体大鼠缺血再灌注损伤心肌的保护作用

目的 :观察Zn2 + 预处理诱导金属硫蛋白 (MT)在心肌细胞的表达及对离体大鼠缺血再灌注损伤心肌的保护作用。方法 :3 2只Sprague Dawley大鼠随机分为对照组及实验组 ,实验组按腹腔注射ZnSO4 到建立再灌注模型的时间分为E1 2h,E2 4h及E4 8h组 ,每组各 8只。检测LDH ,CK、ATP含量及心功能指标 (LVSP与±dp/dtmax) ,用1 0 9Cd/血红素饱和法测量心肌组织中金属硫蛋白的含量。结果 :E2 4h及E4 8h组MT表达量较对照组高 (P <0 .0 1) ,E1 2h组虽有表达 ,但其与对照组间差异无显著性。E2 4h及E4 8h组LDH与CK较其它二组低 ,而ATP较其它二组高 ,心功能指标较其它二组改善。E1 2h组及对照组之间相应各指标 (LDH ,CK、ATP、LVSP与±dp/dtmax)间差异无显著性 (P >0 .0 5 )。结论 :Zn2 + 预处理可诱导MT在心肌细胞的表达而对离体大鼠缺血再灌注损伤心肌具有保护作用。     

Autoimmune hepatitis associated with bile duct injury resembling chronic non-suppurative destructive cholangitis

Autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) are representative autoimmune liver diseases in which hepatocytes and intrahepatic bile ducts, respectively, are selectively damaged by autoimmune mechanisms. Bile duct injury and loss is characteristic of PBC and chronic non-suppurative destructive cholangitis (CNSDC), in particular, is a histological hallmark of PBC. In this report, we present an unusual case of AIH accompanied by CNSDC-like bile duct injury in a 46-year-old woman. The patient's serum aminotransferase level was abnormally high. The serum levels of alkaline phosphatase, gamma-GTP and IgG were also elevated, but the IgM level was within normal limits. The titer of antismooth muscle antibody (SMA) was 1:80, while antinuclear autoantibody (ANA) and the M2 fraction of antimitochondrial antibody (AMA) were both negative. Liver biopsy disclosed CNSDC-like bile duct injuries and severe interface hepatitis and lobular hepatitis with perivenular zonal necrosis were observed. The aggregate score of the International Autoimmune Hepatitis Group corresponded to the category of probable AIH. Immunohistochemically, histocompatibility leukocyte antigen-DR, which is aberrantly expressed in the damaged bile ducts of PBC, was not found in the injured bile ducts of this case. Laboratory data were much improved by treatment with prednisone, but ursodeoxycholic acid was not effective. Although the possibility of an overlapping syndrome of AIH- and AMA-negative PBC could not be excluded, this case was diagnosed as AIH with CNSDC-like bile duct lesions.     

A randomized study comparing the use of sublingual to vaginal misoprostol for pre-operative cervical priming prior to surgical termination of pregnancy in the first trimester

BACKGROUND: Misoprostol is an effective agent for pre-operative cervical priming before surgical termination of pregnancy in the first trimester. Previous studies have shown that both oral and vaginal routes are equally effective for such a purpose. This study aimed to compare a new route of sublingual administration to the vaginal route of administration for pre-operative cervical priming in first trimester surgical abortion. METHODS: Eighty women with gestational age <12 weeks were randomized by a computer-generated model to receive 400 micro g of misoprostol either sublingually or vaginally 3 h prior to vacuum aspiration. The primary outcome measure was the degree of cervical dilatation, and secondary outcomes included the force required to dilate the cervix from 3 to 8 mm, intra-operative blood loss and incidence of pre-operative side-effects. RESULTS: There was no significant difference in the baseline cervical dilatation (sublingual: 7.6 +/- 1.3 mm; vaginal: 7.7 +/- 0.73 mm), cumulative force required to dilate the cervix from 3 to 8 mm (sublingual: 9.0 +/- 9.8 N; vaginal: 6.6 +/- 5.4 N) and total blood loss (sublingual: 52.1 +/- 20.2 ml; vaginal: 48.3 +/- 12.3 ml). Pre-operative side-effects were also similar. CONCLUSIONS: Both sublingual and vaginal misoprostol are effective in cervical priming before surgical termination of pregnancy in the first trimester. Sublingual misoprostol has the advantage of being more convenient to administer and may be more suitable for day surgery.     

Motor and cognitive deficits in apolipoprotein E-deficient mice after closed head injury

Previous studies suggest that traumatic brain injury is associated with increased risk factor for developing Alzheimer's disease. Furthermore, the extent of the risk seems to be most pronounced in Alzheimer's disease patients who carry the ε4 allele of apolipoprotein E, suggesting a connection between susceptibility to head trauma and the apolipoprotein E genotype. Apolipoprotein E-deficient mice provide a useful model for investigating the role of this lipoprotein in neuronal maintenance and repair. In the present study apolipoprotein E-deficient mice and a closed head injury experimental paradigm were used to examine the role of apolipoprotein E in brain susceptibility to head trauma and in neuronal repair. Apolipoprotein E-deficient mice were assessed up to 40 days after closed head injury for neurological and cognitive functions, as well as for histopathological changes in the hippocampus. A neurological severity score used for clinical assessment revealed more severe motor and behavioural deficits in the apolipoprotein E-deficient mice than in the controls, the impairment persisting for at least 40 days after injury. Performance in the Morris water maze, which tests spatial memory, showed a marked learning deficit of the apolipoprotein E-deficient mice when compared with injured controls, which was apparent for at least 40 days. At this time, histopathological examination revealed overt neuronal cell death bilaterally in the hippocampus of the injured apolipoprotein E-deficient mice.

The finding that apolipoprotein E-deficient mice exhibit an impaired ability to recover from closed head injury suggests that apolipoprotein E plays an important role in neuronal repair following injury and highlights the applicability of this mouse model to the study of the cellular and molecular mechanisms involved.     

骨盆骨折出血动脉栓塞的解剖学基础

目的：了解骨盆动脉侧枝吻合特点，探讨骨盆骨折损伤血管的动脉栓塞的方法。方法：20具新鲜成人骨盆，采用前后双侧入路解剖，观察髂内外血管的走行特点、各动脉间的侧枝吻合情况。结果：骨盆动脉起点口径小于3mm的血管有闭孔动脉、髂腰动脉、骶外侧动脉。骨盆动脉起点口径3～5mm的血管有臀上动脉、臀下动脉、阴部内动脉。骨盆动脉起点口径大于5mm的血管有髂总动脉、髂内动脉、髂外动脉。距骨壁距离大于10mm的血管有髂总动脉、髂内动脉、髂外动脉。距骨壁距离小于10mm的血管有闭孔动脉、髂腰动脉、骶外侧动脉、臀上动脉、臀下动脉。骨盆动脉分支间有广泛的吻合支。结论：骨盆骨折动脉损伤应栓塞损伤的动脉及其主要的侧枝循环。