双侧延髓内侧梗死临床分析

目的分析并探究双侧延髓内侧梗死(BMMI)的血管病因、临床表现、MRI特征和预后,以期提高BMMI的早期诊断率.方法对青岛大学附属烟台毓璜顶医院诊治的14例BMMI患者临床资料进行分析.结果BMMI血管病因以动脉粥样硬化为主;临床症状表现为四肢瘫痪、舌瘫、感觉异常、头晕、构音障碍、饮水呛咳等,危重时出现呼吸衰竭.头颅DWI示双侧延髓内侧可呈特征性"心型"、"Y"字型、"V"字型或倒"八"字型高信号影.出院NIHSS评分、卒中进展(尤其呼吸衰竭)为BMMI的预后不良因素.结论BMMI临床少见,临床表现多样,预后较差;头颅MRI为其主要的影像学检查,有助于早期诊断.     

Enhanced heat shock protein 25 immunoreactivity in cranial nerve motoneurons and their related fiber tracts in rats prenatally‐exposed to X‐irradiation

Alterations in histoarchitecture of the brainstem were examined immunohistochemically in 4‐week‐old rats with a single whole body X‐irradiation at a dose of 0.5, 1.0, or 1.5 Gy on embryonic day (ED) 15 using anti‐heat shock protein 25 (HSP25). HSP25 immunostaining was seen in the neuronal perikarya of cranial nerve motoneurons, that is, the motor and mesencephalic nuclei of the trigeminal nerve, facial nucleus, abducens nucleus and accessory facial nucleus in the pons, and the ambiguous nucleus, dorsal nucleus of vagus nerve and hypoglossus nucleus in the medulla oblongata of intact controls. In 0.5 to 1.5 Gy‐irradiated rats, HSP25 immunostaining in those neurons was more intense than in controls, while the most intense immunostaining was marked in 1.5 Gy‐irradiated rats. HSP25 immunostaining was also apparent in the spinal tract of the trigeminal nerve and facial nerve tracts in 0.5 to 1.5 Gy‐irradiated rats, but was faint in controls. Interestingly, HSP25 immunostaining was aberrantly enhanced in dendritic arbors in the magnocellular region of medial vestibular nucleus of 0.5–1.5 Gy‐irradiated rats. Those arbors were identified as excitatory secondary vestibulo‐ocular neurons by double immunofluorescence for HSP25 and SMI‐32. The results suggest an increase of HSP25 expression in cranial nerve motoneurons and their related fiber tracts from prenatal exposure to ionizing irradiation. This may be an adaptive response to chronic hypoxia due to malformed brain arteries caused by prenatal ionizing irradiation.     

超声腹腔注水成像技术对大鼠肾上腺髓质增生的研究

目的借助腹腔注水成像技术研究大鼠肾上腺髓质增生(AMH)声像图特征,并与病理结果对比,为腹腔注水成像技术诊断AMH提供声学基础。方法雄性SD大鼠60只,依体质量大小随机分为A、B、C3组,皮下注射利血平0.4mg/(kg.d);a、b、c对照组,每组10只SD大鼠皮下注射等量生理盐水。A、a,B、b,C、c组分别连续注射40、60和80d后停药,用腹腔注水成像技术进行探测,并和病理研究作对照。结果注射60d后B组髓质百分数(34.29%±5.81%)显著高于b组(25.66%±8.94%),t=2.462,P<0.05,C组(36.36%±7.83%)也显著高于c组(24.80%±7.87%)t=3.104,P<0.01,显示注射利血平60dAMH造模成功;超声下B和b组、C和c组肾上腺体积分别为(5.21±0.65)mm×(4.56±0.53)mm×(4.12±0.66)mm和(4.62±0.27)mm×(4.13±0.35)mm×(3.86±0.71)mm、(5.36±0.52)mm×(4.64±0.48)mm×(4.25±0.39)mm和(4.55±0.47)mm×(3.99±0.45)mm×(3.91±0.38)mm,差异显著(t=2.151,P<0.05;t=2.768,P<0.01);超声下中心髓质区范围及回声强度B组显著高于b组(Z=-4.226,P<0.01)、C组显著高于c组(Z=-4.115,P<0.01);镜下见B和C组髓质明显增厚,细胞数增多、密集,呈实质性片状或条索状分布,形成细胞巢。结论大鼠AMH时,声像图主要表现为肾上腺体积增大;中心的髓质回声增高,且回声增高的髓质区范围增大,大部分超过整个肾上腺范围的一半。大鼠肾上腺中心髓质回声的强弱程度及范围可反应髓质增生的程度。     

Switching on the Aire conditioner

Aire has been cloned as the gene responsible for a hereditary type of organ‐specific autoimmune disease. Aire controls the expression of a wide array of tissue‐restricted Ags by medullary thymic epithelial cells (mTECs), thereby leading to clonal deletion and Treg‐cell production, and ultimately to the establishment of self‐tolerance. However, relatively little is known about the mechanism responsible for the control of Aire expression itself. In this issue of the European Journal of Immunology, Haljasorg et al. [Eur. J. Immunol. 2015. 45: 3246–3256] have reported the presence of an enhancer element for Aire that binds with NF‐κB components downstream of the TNF receptor family member, RANK (receptor activator of NF‐κB). The results suggest that RANK has a dual mode of action in Aire expression: one involving the promotion of mTEC differentiation and the other involving activation of the molecular switch for Aire within mature mTECs.     

疏肝和胃汤对抑郁模型大鼠延髓、脊髓及胃粘膜组织诱导型一氧化氮合酶表达的影响

目的观察疏肝和胃汤对抑郁模型大鼠延髓、脊髓及胃粘膜组织诱导型一氧化氮合酶(i-Nos)表达的影响,探讨疏肝和胃汤改善抑郁状态及胃肠功能的作用机制。方法 100只大鼠随机分成生理盐水组、模型组、百优解组和疏肝和胃汤大、小剂量组。采用慢性心理应激加孤养法制作抑郁模型,共计造模4周。在第3周,百优解组及疏肝和胃汤大、小剂量组分别予以0.36mg/(kg·d)、20g/(kg·d)、10g/(kg·d)灌胃给药,生理盐水组及模型组给予等体积生理盐水,每天分2次灌胃。在第4周结束后,使用内固定法取大鼠延髓迷走神经背核部位的脑、胸髓(T6-T8,根据脊神经定位)及胃粘膜组织,应用免疫组织化学技术检测上述部位i-Nos的表达。结果模型组大鼠延髓、脊髓及胃黏膜中i-Nos阳性表达明显上升,与生理盐水组比较有非常显著性差异(P0.01);治疗2周后,疏肝和胃汤大、小剂量组和百优解组大鼠延髓、脊髓及胃黏膜组织中i-Nos阳性表达显著下降,与模型组比较有显著性差异(P0.05或P0.01);疏肝和胃汤大、小剂量组与百优解组比较,除外大剂量组延髓中i-Nos含量无显著性差异(P0.05),其余均有显著性差异(P0.05或P0.01)。结论疏肝和胃汤可能是通过降低延髓、脊髓及胃黏膜中i-Nos的表达,调节"脑(延髓)-脊髓-胃"脑肠轴通路中i-Nos的含量,达到改善抑郁状态与胃肠功能的作用。     

Heme oxygenase-1 and chronic hypoxia

A myriad of changes are necessary to adapt to chronic hypoxemia. Key among these changes increases in arterial oxygen carrying capacity, ventilation and sympathetic activity. This requires the induction of several gene products many of which are regulated by the activity of HIF-1α, including HO-1. Induction of HO-1 during chronic hypoxia is necessary for the continued breakdown of heme for the enhanced production of hemoglobin and the increased respiratory and sympathetic responses. Several human HO-1 polymorphisms have been identified that can affect the expression or activity of HO-1. Associations between these polymorphisms and the prevalence of hypertension have recently been assessed in specific populations. There are major gaps in our understanding of the mechanisms of how HO-1 mediates changes in the activity of the hypoxia-sensitive chemosensors and whether HO-1 polymorphisms are an important factor in the integrated response to chronic hypoxia. Understanding how HO-1 mediates cardiorespiratory responses could provide important insights into clinical syndromes such as obstructive sleep apnea.     

成年大鼠延髓薄片制备的改良方法

目的:建立一种适用于膜片钳记录研究的成年大鼠延髓薄片制备方法。方法:用改制的注射器将延髓和上颈髓段从离断的椎管中直接吹出;采用水平切的方式制备延髓薄片;记录三叉神经脊束核尾侧亚核(Vc)神经元的自发放电和诱发放电活动。结果:分离得到的延髓和上颈髓标本光滑完整;水平切的延髓薄片较好地保持了Vc的形态学结构和神经元活性,可较好地记录到Vc神经元自发的兴奋性突触后电流和诱发的双脉冲抑制活动。结论:本方法操作简单,取材快速,延髓薄片外形完整且能保持神经元活性,适用于成年大鼠Vc的膜片钳研究。