泰勒斯的思索

正2020年7月16日,《新英格兰医学杂志》(NEJM)发表了替格瑞洛和阿司匹林治疗急性缺血性卒中或TIA预防卒中和死亡(Acute Stroke or Transient Ischaemic Attack Treated With Ticagrelor and ASA for Prevention of Stroke and Death,THALES)试验的结果(图1)。作为氯吡格雷用于急性非致残性脑血管事件高危人群(Clopidogrel in High-risk Patients with Acute Non-     

嗅鞘细胞对神经干细胞增殖与分化的影响

BACKGROUND： Olfactory ensheathing cells can promote oriented differentiation and proliferation of neural stem cells by cell-secreted neural factors. OBJECTIVE： To observe the effect of olfactory ensheathing cells on the differentiation and proliferation of neural stem cells. DESIGN, TIME AND SETTING： Cytology was performed at the Department of Neurology, Tongji Medical College, Huazhong University of Science and Technology, China, from September 2007 to October 2008. MATERIALS： Mouse anti-nestin polyclonal antibody （Chemicon, USA）, mouse anti-glial fibrillary acidic protein （GFAP） IgG1, mouse anti-2＇, 3＇-cyclic nucleotide 3＇-phosphodiesterase （CNPase） IgG1, mouse anti-Tubulin Class-Ill IgG1 （Neo Markers, USA）, Avidin-labeled Cy3 （KPL, USA）, and goat anti-mouse IgGl： fluorescein isothiocyanate （FITC） （Serotec, UK） were used in this study. METHODS：Tissues were isolated from the embryonic olfactory bulb and subependymal region of Wistar rats. Serum-free DMEM/F12 culture media was used for co-culture experiments. Neural stem cells were incubated in serum-free or 5% fetal bovine serum-containing DMEM/F12 as controls. MAIN OUTCOME MEASURES： After 7 days of co-culture, neural stem cells and olfactory ensheathing cells underwent immunofluorescent staining for nestin, tubulin, glial fibrillary acidic protein, and CNPase. RESULTS： Olfactory ensheathing cells promoted proliferation and differentiation of neural stem cells into neuron-like cells, astrocytes and oligodendrocytes. The proportion of neuron-like cells was 78.2%, but the proportion of neurons in 5% fetal bovine serum DMEM/F12 was 48.3%. In the serum-free DMEM/F12, neural stem cells contracted, unevenly adhered to the glassware wall, or underwent apoptosis at 7 days. CONCLUSION： Olfactory ensheathing cells promote differentiation of neural stem cells mainly into neuron-like cells, and accelerate proliferation of neural stem cells. The outcome is better compared with serum-free medium or medium containing 5% fetal bovine serum.     

脂肪干细胞侧脑室定向移植改善脑出血大鼠的神经功能

Objective To study improvement of neural function by stereotaxic transplantation of adipose-derived stem cells (ADSC) into lateral cerebral ventricle after intracerebral hemorrhage in rats and its mechanism. Methods ADSC were cultured and proliferated in vitro, which had been marked with Brdu for 48 h before transplantation. The rat caudate nucleus hemorrhage (ICH) models were divided into 2 groups. ADSC were stereotaxically transplanted into the right lateral ventricles in ADSC group, and equal volume of saline was transplanted into control group. The score of neurological behavior were evaluated at modeling and 1, 3, 7, 14, 28 days after transplantation respectively.Double-staining immunofluorescence technique was used to detect Brdu-positive cells and the differentiation of neurons and astrocytes. In accordance with the instructions of TUNEL kit, cell apoptosis, and the expression of VEGF and angiogenesis were assayed. Results In vitro ADSC expressed undergo osteogenic and adipogenic differentiation. Compared with the control group, ADSC group had better motor function at 3, 7, and 14 days (P＜0. 05). Double-staining immunofluorescence showed mostly grafted Brdu-reactive ADSC had migrated to the hematoma zone, and some survivedand expressed Neun of Gfap. TUNEL analysis revealed that, 3 days after transplantation, the number of apoptotic cells in ADSC group was significantly less than in the control group (P＜0. 05). Three days after transplantation, VEGF expression levels in ADSC group were significantly higher than in the control group (P＜0. 05). Conclusion ADSC stereotaxially transplanted into the lateral ventricle can survive and differentiate into neuron-like cells. ADSC transplantation may reduce apoptosis and secret VEGF to promote the angiogenesis, and improve neural functional in intracerebral hemorrhage rats.     

胶原蛋白复合硫酸肝素生物支架材料研制及其扫描电镜观察

目的：研制一种新型神经组织工程生物支架：胶原蛋白-硫酸肝素支架材料，用于神经损伤的修复。方法：将注有胶原蛋白-硫酸肝素悬浊液的硅胶管缓慢浸入-180℃液氮中，冷冻干燥，通过显微物镜、扫描电镜扫描观察所制胶原蛋白-硫酸肝素内部孔隙结构排列规律及走行方向，测量孔的大小。结果：制备的胶原蛋白复合硫酸肝素支架材料具有纵行的、平行排列的微管结构，高度仿生神经的内部空间三维结构。结论：胶原蛋白复合硫酸肝素生物支架材料作为新型神经组织工程材料基体，可用于周围神经损伤的修复。     

嗅鞘细胞微环境和水凝胶生物支架对脂肪干细胞成嗅鞘样细胞分化的影响

目的 比较研究脂肪干细胞和嗅鞘细胞以两种不同方式共培养后脂肪干细胞P75的阳性表达.方法 以Transwell小室为共培养载体.无支架共培养组以脂肪干细胞接种于上室,嗅鞘细胞接种于下室,支架共培养组以脂肪干细胞联合水凝胶生物支架(BDTM PuraMatrixTM Peptide Hydrogel)接种于上室,嗅鞘细胞接种于下室.检测两组细胞共培养12 d后其脂肪干细胞P75的表达.结果 共培养12 d后无支架共培养组和支架共培养组都有部分细胞表达P75,且支架共培养组表达率更高.结论 脂肪干细胞在嗅鞘细胞生长微环境中能向嗅鞘样细胞分化.     

促红细胞生成素对血管性痴呆大鼠模型海马神经细胞凋亡的影响

目的:探讨促红细胞生成素(EPO)对血管性痴呆(VaD)模型大鼠海马神经细胞凋亡的影响。方法:将经行为学筛选合格的Wistar大鼠分为假手术组、VaD组、EPO组,采用永久性结扎双侧颈总动脉的方法建立VaD模型。应用TUNEL染色检测大鼠海马的凋亡细胞数;通过免疫组化学和RT-PCR方法,检测大鼠海马Bcl-2和Bax蛋白以及其mRNA表达水平的变化。结果:EPO能明显抑制海马神经细胞凋亡,上调Bcl-2表达,抑制Bax表达。结论:EPO可能通过调控VaD大鼠海马Bcl-2和Bax表达,从而抑制神经细胞凋亡。     

颈椎手术后良性阵发性位置性眩晕的诊治

目的探讨颈椎术后良性阵发性位置性眩晕（BPPV）的诊治。方法回顾分析2012年度颈椎术后后半规管BPPV（PC-BPPV）患者的临床资料。结果4例患者于颈椎术后2—4个月出现单侧PC-BPPV发作,改良侧躺诱发试验提示左侧受累1例、右侧受累3例。给予改良Semont方法治疗经1—3个循环后,患者眩晕症状消失。结论改良侧躺诱发试验和改良Semont方法对颈椎术后BPPV患者安全、有效,颈椎手术不是BPPV诊治的禁忌证。     

神经干细胞与胶原蛋白－硫酸肝素生物支架生物相容性研究

目的：评价神经干细胞与胶原蛋白-硫酸肝素支架的生物相容性，探讨胶原蛋白-硫酸肝素支架作为中枢神经组织工程载体材料的可行性。方法：以冷冻干燥法制备胶原蛋白-硫酸肝素支架。体外培养新生小鼠海马神经干细胞。将神经干细胞与生物支架共培养，通过倒置相差显微镜、扫描电镜观察胶原蛋白-硫酸肝素支架内部结构和细胞生长状况。结果：制备的胶原蛋白-硫酸肝素支架材料具有纵行的、平行排列的微管结构。神经干细胞在支架上生长良好。结论：胶原蛋白一硫酸肝素支架与神经干细胞具有良好的生物相容性，有望作为中枢神经组织工程载体材料。     

氯胺酮联合异氟烷吸入麻醉在制作猪脑出血模型中的效果观察

目的:探讨氯胺酮联合异氟烷吸入麻醉的安全性和临床效果.方法:选用20只小型猪,制作脑出血模型在氯胺酮麻醉的基础上,联合异氟烷面罩吸入麻醉,观察术中麻醉剂的效果和并发症.结果:在麻醉手术过程中,呼吸、血氧饱和度维持在正常范围内,体温有持续下降趋势,心率明显增快,肌肉松弛,镇静、镇痛效果良好.结论:氯胺酮联合异氟烷面罩吸入麻醉进行外科手术是安全和可靠的,且操作简单,是动物行外科手术较为理想的麻醉手段.     

前庭康复在急性前庭神经炎治疗中的效果评价

目的 观察及评价前庭康复在急性前庭神经炎治疗中的临床效果。方法 对2013年6月~2014年6月期间眩晕门诊确诊前庭神经炎患者28例,进行分组研究及定期随访,观察并评价前庭康复疗效,共观察及随访3个月。结果 经随访观察,予以前庭康复干预组在治疗3个月后,前庭功能情况与对照组相比差异无统计学意义,但在眩晕残障量表评分中得到明显改善。结论 经随访观察,在前庭神经炎早期予以前庭康复治疗能改善患者预后,值得临床推荐。