急性脑血管病患者红细胞免疫功能的临床评价

目的:探讨急性脑血管病患者的红细胞免疫功能的临床特点。方法:以2016年2月-2018年5月收治的急性脑血管患者55例为实验组(缺血性32例,出血性23例);选用同期健康体检者30例为对照组。采用酵母菌玫瑰花环法测定并比较其外周血红细胞C3b受体花环率(RBC-C3b RR)和红细胞免疫复合物花环率(RBC-ICR)。结果:与对照组相比,实验组的红细胞C3b受体花环率明显低,而红细胞免疫复合物花环率明显高(P均0.05);急性脑血管病患者按额叶、顶叶、颞叶、枕叶、基底神经节、脑干、小脑不同病变部位分组比较,各组Rbc-C3b RR和Rbc-ICR无明显(P均0.05)。结论:急性脑血管病患者存在红细胞的免疫功能低下,提高脑血管患者急性期免疫功能有助于改善预后。     

婴幼儿脑积水脑室-腹腔分流术引流管堵塞危险因素及间充质干细胞治疗的影响

目的探讨婴幼儿脑积水行脑室-腹腔分流手术后,引起引流管堵塞的术前相关危险因素,以及术前脐带间充质干细胞(Mesenchymal stme cells,MSC)治疗对并发症发生率的影响。方法回顾性分析125例婴幼儿行脑积水分流术后2年内,并发术后分流管堵塞的各种危险因素;同时,分析11例术前接受静脉输注MSC治疗的患儿危险因素水平减低程度及引流管堵塞的发生情况。结果分流术后引流管堵塞的客观危险因素按相关性排序,依次为:术前脑脊液细胞总数、术前脑脊液蛋白含量、月龄、引流管末端位置和术前血白蛋白指标;MSC治疗后血清白蛋白水平显著升高,术前进行干细胞治疗组引流管阻塞发生率为1/11,显著低于未治疗组(53/114)(P<0.01)。结论术前输注MSC可提高血清白蛋白水平,减少手术后并发症的发生。     

影响颅脑外伤术后继发脑梗死疗效的因素分析

目的：探讨影响颅脑外伤术后继发脑梗死疗效的因素。方法回顾性分析84例脑外伤术后继发脑梗死患者的临床资料，比较不同术前状态和治疗方式对脑功能恢复的影响，利用logistic回归分析影响疗效的独立因素。结果有脑疝形成者脑功能恢复情况明显差于无脑疝形成者（ P＜0．05）；行大骨瓣开颅减压术者脑功能恢复情况明显优于行常规开颅减压术者（P＜0．05），局限性梗死灶者脑功能恢复明显优于广泛性梗死灶者（P＜0．05）；脑疝形成、术后继发广泛性脑梗死是脑功能恢复不良的独立危险因素（P ＜0．05），大骨瓣开颅减压术是脑功能恢复不良的独立保护因素（P ＜0．05）。结论颅脑外伤术后继发脑梗死患者合并脑疝形成、行常规开颅减压术、术后广泛性脑梗死影响其疗效，是否脑疝形成、梗死灶状况和手术方式是疗效的独立影响因素。     

老年人高血压脑出血微创穿刺引流术与内科保守治疗的临床观察

目的比较微创穿刺引流术与内科保守治疗老年人高血压脑出血的临床治疗效果。方法选择60例高血压脑出血的老年患者进行本临床研究,随机分为微创穿刺引流术组30例和内科保守治疗组30例;分别进行微创穿刺引流术与内科保守治疗,观察其临床治疗效果。结果微创穿刺引流术组治愈率(73.33%)明显高于内科保守治疗组(30.0%)(P<0.05);微创穿刺引流术组显效以上率(93.33%)明显高于内科保守治疗组(73.33%)(P<0.01)。结论微创穿刺引流术治疗老年人高血压脑出血较内科保守治疗疗效好。     

毛喉素在大鼠脑损伤后血脑屏障损害中的作用

目的 探讨提高细胞内cAMP制剂毛喉素在脑损伤后血脑屏障损害中的作用.方法 雄性SD大鼠60只按随机数字表分为正常对照组、假手术组、脑损伤组和毛喉素治疗组,每组15只.后2组大鼠采用改进的自由落体硬膜外撞击方法制作脑损伤模型,治疗组大鼠于伤后0.5 h腹腔注射毛喉素,伤后24 h处死大鼠(处死前1 h静脉注射20 g/L伊文氏蓝),应用荧光显微镜观察伊文氏蓝的渗出,分光光度计恻定脑组织伊文氏蓝的含量.结果 正常对照组和假手术组大鼠损伤组织周围伊文氏蓝无明显渗出,脑损伤组伊文氏蓝大量渗出,治疗组与脑损伤组比较,伊文氏蓝渗出明显减少;脑损伤组大鼠左侧皮质、海马和右侧皮质、海马伊文氏蓝含量明显高于正常对照组和假手术组,差异有统计学意义(P＜0.05);毛喉素治疗组左侧皮质伊文氏蓝含量明显低于脑损伤组,但仍高于正常对照组,差异有统计学意义(P＜0.05).结论 提高细胞内cAMP制剂毛喉素能明显阻止血脑屏障开放.

Abstract：

Objective To explore the role of forskolin, a reagent elevating the cellular content of cAMP, in blood-brain barrier (BBB) damage in rats after cerebral injury damage. Methods Sixty male SD rats were equally randomized into normal control group, sham-operated group, injured group and forskolin treatment group. Rat models of cerebral injury in the later 2 groups were induced by the improved device of Feeney weight-dropping. Foskolin treatment group was peritoneally administered forskolin 5 mg/kg 0.5 h after the brain injury. Twenty g/L Evens blue was given through intravenous injection 23 h after the injury; all the rats were sacrificed 24 h after the injury. The permeation of Evens blue was observed qualitatively with a fluorescence microscope and measured quantitatively with a spectrophotometer. Results No obvious permeation of Evens blue was noted in the surrounding areas of the damaged tissue of normal controls and sham-operated group; Evans blue significantly permeated in the injured group; as compared with that in the injured group, the permeation of Evens blue was significantly decreased in the forskolin treatment group (P＜0.05). The level of Evens blue in the cortex and hippocampus of both side of the brain in the injured group was significantly higher that that in the normal controls and sham-operated group (P＜0.05); the level of Evens blue in the cortex of the left side of the brain in the forskolin treatment group was significantly lower that that in the injured group, but obviously higher than that in the normal controls and sham-operated group (P＜0.05).Conclusion Forskolin, the reagent elevating the cellular content of cAMP, can significantly prevent BBB opening.     

E1B缺陷性腺病毒对人恶性脑胶质瘤的溶瘤作用

目的 研究E1B缺陷性腺病毒d11520对人恶性脑胶质瘤细胞株U251的体外溶瘤作用. 方法 按感染复数(MOI)为50、5、0.5、0.05、0.005、0 pfu将E1B缺陷性腺病毒dl1520感染常规培养的U251、Hep3B、T24细胞(Hep3B为阳性对照,T24为阴性对照),结晶紫染色观察细胞病变(CPE)出现的时间:MOI为5pfu时病毒空斑试验检测dl1520在3种细胞中的复制.将携带报告基因βgal的腺病毒载体Ad-βgal感染细胞,计算dl1520对3种细胞的感染率. 结果 结晶紫染色结果显示Hep3B细胞对dl1520最敏感、发生CPE效应最快,U251次之,而T24则不产生CPE效应；dl1520在U251细胞中复制数和感染率均低于Hep3B细胞,但明显高于T24细胞,差异均有统计学意义(P＜0.05). 结论 E1B缺陷性腺病毒dl1520对人恶性脑胶质瘤细胞具有显著的溶瘤作用.