甲基强的松龙治疗实验性变态反应性脑脊髓炎的作用机制

目的:研究细胞因子、T细胞凋亡和淋巴细胞增殖在实验性变态反应性脑脊髓炎(EAE)形成中的作用及甲基强的松龙(MP)治疗EAE的作用机制。方法:采用人脑纯化的髓鞘碱性蛋白(MBP)与完全福氏佐剂免疫Lewis大鼠,建立EAE动物模型。用双抗体夹心ELISA法检测各组大鼠血清中IL-10、TNF-α、IFN-γ的含量:流式细胞仪检测外周血T细胞凋亡;3H-TdR释放法检测外周血淋巴细胞转化率。结果:与对照组比较,EAE组的外周血IFN-γ、TNF-α水平明显增高,IL-10水平明显降低,MP治疗后IFN-γ和TNF-α水平下降,IL-10浓度上调。MP还诱导外周血T细胞凋亡和抑制MBP致敏淋巴细胞增殖并呈剂量依赖性。结论:应用人MBP成功建立EAE大鼠模型,MP可能通过调节Th细胞因子格局、促进Th2细胞因子分泌、抑制MBP致敏淋巴细胞增殖及外周血T细胞凋亡而发挥治疗多发性硬化的作用。     

马索罗酚对实验性自身免疫性脑脊髓炎小鼠Th1/Th2细胞炎症因子平衡的影响

目的探讨马索罗酚对实验性自身免疫性脑脊髓炎(EAE)小鼠白细胞介素-4(IL-4)、IL-12、干扰素-γ(IFN-γ)表达的调节作用。方法将8~10周雌性C57BL/6小鼠54只随机分成对照组、模型组、治疗组。每组再随机均分为发病后10d及20d亚组,每亚组9只。采用皮下注射髓鞘少突胶质细胞糖蛋白35-55(MOG35-55)多肽0.1mL诱导EAE模型。自发病当天起,治疗组小鼠给予马索罗酚10mg/(kg·d)治疗,模型组及对照组给予等量5%二甲基亚砜(DMSO)10mL/(kg·d)处理。比较3组小鼠临床症状评分。应用实时定量PCR检测小鼠脊髓和脾组织中IL-4、IL-12、IFN-γmRNA表达水平。应用ELISA检测脑组织中IL-4、IL-12、IFN-γ蛋白表达水平。结果与模型组比较,治疗组小鼠临床症状较减轻(P0.05)。与模型组相比,治疗组小鼠10d时脊髓和脾组织IL-12、IFN-γmRNA表达水平降低(P0.05),IL-4mRNA水平增高(P0.05),脑组织IL-12、IFN-γ蛋白水平降低(P0.05),IL-4蛋白水平增高(P0.05);与模型组相比,治疗组20d时脊髓组织IL-12、IFN-γmRNA表达水平降低(P0.05),脑组织IFN-γ含量降低(P0.05)。结论马索罗酚可能通过降低脑、脊髓及脾组织中IL-12、IFN-γ表达,增加IL-4表达,调节Th1/Th2细胞炎症因子平衡,进而改善EAE小鼠疾病严重程度。     

口服法舒地尔治疗EAE对巨噬细胞、T细胞及TLR/NF-B通路的作用研究

目的探讨口服盐酸法舒地尔(Fasudil)对实验性自身免疫性脑脊髓炎(experimental allergic encephalomyelitis,EAE)小鼠巨噬细胞及TLR/NF-B通路的作用。方法采用小鼠髓鞘少突胶质细胞糖蛋白35-55肽(myelin oligodendrocyte glycoprotein 35-55peptide,MOG35-55)诱导C57BL/6小鼠建立EAE模型,将EAE小鼠随机分为EAE模型组和Fasudil治疗组,免疫后第3天给予Fasudil治疗组小鼠Fasudil灌胃干预,直到免疫后第27天,EAE模型组同样处理给予等量生理盐水。光镜观察脊髓组织CD4+T细胞/CD68巨噬细胞表达的变化,Western blot法测定脊髓诱导型一氧化氮合酶(iNOS)、精氨酸酶1(Arg-1)、Toll样受体2(TLR-2)、TLR-4和磷酸化核因子B(p-NF-B)蛋白的表达,ELISA法测定培养72h脾细胞分泌细胞因子的含量。结果与EAE模型组比较,Fasudil组CD4+T细胞数和CD68巨噬细胞数明显减少(P0.01),巨噬细胞M1表型iNOS表达减少(P0.05),M2表型Arg-1表达增加(P0.01),炎性通路蛋白p-NF-B、TLR-2和TLR-4表达减少(P0.05),外周细胞炎性因子白细胞介素-6(IL-6)、IL-1β、肿瘤坏死因子α(TNF-α)、干扰素γ(IFN-γ)和IL-17分泌减少(P0.05),而IL-10分泌增加(P0.05)。结论口服Fasudil可抑制CD4+T细胞/CD68巨噬细胞的激活,促进巨噬细胞表型M1向M2转化,抑制脊髓组织中p-NF-B、TLR-2和TLR-4的表达,抑制外周免疫细胞炎性因子分泌,而增加IL-10的分泌。     

神经肽Y对多发性硬化动物模型血清Th1细胞因子的影响

目的 探讨神经肽Y(NPY)对实验性自身免疫性脑脊髓炎(EAE)豚鼠发病及血清Th1细胞因子TNF-α、IFN-γ水平的影响,研究NPY对EAE发病的作用及其可能的免疫机制.方法 30只豚鼠随机分为健康对照组、EAE对照组、NPY干预组3组,向健康对照组和EAE对照组侧脑室注射生理盐水、向NPY干预组侧脑室注射等量NPY各1次,1周后造模,观察EAE对照组、NPY干预组的发病潜伏期、神经功能障碍评分情况及3组豚鼠血清TNF-α、IFN-γ水平.结果 与EAE对照组相比较,NPY干预组发病潜伏期明显延长(P<0.001),高峰期神经功能障碍评分明显降低(P<0.001),血清TNF-α、IFN-γ水平均降低(P<0.05).结论 向侧脑室注射NPY对EAE豚鼠的发病确具有抑制作用,而且其保护机制可能是通过降低TNF-α、IFN-γ水平而实现.     

雌二醇对实验性自身免疫性脑脊髓炎调节性T细胞及细胞因子的影响

目的 探讨雌二醇(E2)对实验性自身免疫性脑脊髓炎(EAE)大鼠调节性T细胞及细胞因子的影响.方法 将大鼠随机分为E2干预组和EAE对照组,记录其临床评分, 测定外周血CD4+CD25+、CD4+CD25+Foxp3+ T细胞水平以及TNF-α、IL-12表达水平,并观察腰膨大处炎细胞浸润情况.结果 (1)E2干预组发病率仅为30% ,低于EAE对照组(100%), 且发病高峰延迟;临床评分E2干预组[(1.8±1.3)分]比EAE对照组[(3.4±0.5)分]低, 差异有统计学意义(P<0.05);(2)E2干预组CD4+CD25+/CD4+ T细胞比值 (5.6±0.9)、CD4+CD25+Foxp3+/CD4+CD25+ T细胞比值(9.3±1.0)均高于EAE对照组[分别为(4.4±0.9)与(7.6±0.8)], 差异有统计学意义(均P<0.05);(3)血管"套袖"样改变EAE对照组较E2干预组明显;(4)E2干预组TNF-α及IL-12表达明显低于EAE对照组, 差异有统计学意义(均P<0.05).结论 E2可能通过改变调节性T细胞比例及细胞因子表达参与EAE免疫调节过程, 推测EAE临床症状缓解可能也与此机制相关.     

IFN-γ和caspase-3在实验性自身免疫性脑脊髓炎病程中动态表达及雷公藤多甙保护作用的探讨

目的观察EAE大鼠模型脊髓caspase-3和IFN-γ的表达,探讨雷公藤多甙对EAE大鼠的保护作用。方法将60只Wistar大鼠随机分成CON组、EAE组、TWP1组、TWP2组,建模后各组又分为第7天、第14天、第21天3个亚组,分别行神经功能评分,大鼠脊髓组织行HE染色,免疫组化检测脊髓中caspase-3和IFN-γ的表达情况。结果 (1)行为学观察:在第14天、第21天TWP1、TWP2组神经功能评分均小于EAE组(P<0.05);第14天TWP2组神经功能评分小于TWP1组(P<0.05)。(2)组织病理学观察:CON组大鼠脊髓无炎性细胞浸润;第14天、第21天,TWP1组和TWP2组血管袖套数目少于同期的EAE组(P<0.05)。(3)caspase-3和IFN-γ表达:TWP1组、TWP2组低于同期EAE组(P<0.05);EAE组中21d组、7d组分别与14d组比较差异有统计学意义(P<0.05)。结论 EAE大鼠脊髓caspase-3和IFN-γ阳性表达的细胞数量与病情变化一致,雷公藤多甙干预能减轻EAE大鼠发病,减少大鼠脊髓内caspase-3和IFN-γ的表达。     

雌激素对实验性自身免疫性脑脊髓炎小鼠的抗炎机制

目的 探讨雌激素减轻实验性自身免疫性脑脊髓炎(experimental autoimmune encephalomyelitis,EAE)炎症反应的可能机制.方法 用MOG35-55多肽诱发60只EAE小鼠模型,做去卵巢术.分为治疗组(n=30)和对照组(n=30),治疗组予雌激素治疗.比较两组EAE小鼠的临床症状评分.取脑和脊髓,行H-E染色观察病理学改变,实时荧光定量PCR及ELISA检测EAE小鼠CNS中白细胞介素(interleukin,IL)-17、IL-23、肿瘤坏死因子α(tumor necrosis factor α,TNF-α)、干扰素γ(interferon γ,IFN-γ)、IL-4水平.结果 治疗组EAE小鼠与对照组相比临床症状减轻(P＜0.05);H-E染色显示治疗组炎细胞浸润减少(P＜0.05),实时荧光定量PCR及ELISA结果示治疗组CNS中IL-17、IL-23、TNF-α、IFN-γ表达降低而IL-4增加(P＜0.05).结论 雌激素可能通过降低IL-17、IL-23、TNF-α、IFN-γ,增加IL-4,从而减轻EAE小鼠炎症反应.     

阿伐他汀对实验性自身免疫性脑脊髓炎免疫功能的影响

目的观察阿伐他汀（Atorvastatin）对EAE的治疗作用并初探其治疗机制。方法以豚鼠脑、脊髓为原料提取髓鞘碱性蛋白MBP,免疫Lewis大鼠建立EAE模型。建模后每日对大鼠神经症状进行评分,采用ELISA法检测大鼠脾细胞培养上清液中IFN-γ、IL-12和IL-4水平。结果与EAE组相比,Atorvastatin组大鼠发病时间有所延迟,症状有不同程度减轻。与正常组相比,EAE组大鼠17d、21d时,IL-4水平明显升高（P〈0．01）,13,17,21d时IFN-γ、IL-12水平均明显升高（P〈0．01）;IFN-γ、IL-12浓度与神经症状评分有较强的正相关关系（RIFN-γ=0．904,P〈0．01;RIL-12=0．885,P〈0．01）。与EAE组相比,Atorvastatin组13d、17d时IL-4水平明显升高（P〈0．01）。IFN-γ、IL-12水平在13,17,21d时均显著低于EAE组（P〈0．05）。结论Alorvastalin能改善EAE大鼠的症状,其机制可能与纠正Th1／Th2失衡有关。     

载脂蛋白E拟肽对实验性自身免疫性脑脊髓炎小鼠脑脊髓CD4+、CD8+T淋巴细胞表达的影响

目的 探讨载脂蛋白(Apo)E拟肽对实验性自身免疫性脑脊髓炎(EAE)小鼠脑脊髓CD4+、CD8+T淋巴细胞表达的影响.方法 40只C57BL/6J雌性小鼠随机分成EAE组、EAE治疗组、正常对照组、正常治疗组;采用髓鞘少突胶质细胞糖蛋白制备的完全抗原诱导EAE模型小鼠.免疫诱导次日,EAE治疗组和正常治疗组小鼠每隔2d皮下注射ApoE拟肽,EAE组和正常对照组小鼠皮下注射等量的生理盐水.免疫诱导后各组每日进行神经功能缺损评分(NDS);35 d后用免疫组化检测各组小鼠脑脊髓CD4+T细胞、CD8+T细胞的表达.结果 EAE治疗组NDS的峰值及终末评分显著低于EAE组(均P＜0.05).与正常对照组及正常治疗组比较,EAE组大脑、脑干和脊髓中CD4+T细胞数明显增高,大脑CD8+T细胞数明显增高(均P＜0.05).EAE治疗组小鼠大脑、脑干、脊髓组织CD4+T细胞表达显著低于EAE组(均P＜0.05);两组间CD8+T细胞表达水平的差异无统计学意义.结论 ApoE拟肽可抑制CD4+T细胞的表达,减轻免疫炎症反应,对EAE小鼠有神经保护作用;而对CD8+T细胞的表达无明显影响.     

EAE大鼠胸腺CD4~+ CD25~+ Foxp3~+ Treg细胞的动态变化及α-硫辛酸的干预作用

目的探讨实验性变态反应性脑脊髓炎(EAE)大鼠不同病程中胸腺CD4+CD25+Foxp3+Treg细胞变化情况及α-硫辛酸对EAE大鼠胸腺的干预作用。方法取不同时期对照组、自然病程EAE组及α-硫辛酸EAE组大鼠的胸腺组织做流式细胞学,动态检测CD4+CD25+Foxp3+Treg细胞的变化情况。结果 EAE组大鼠急性期、复发期CD4+CD25+Foxp3+Treg细胞较同时期对照组明显减少(P<0.05),缓解期有所上升;α-硫辛酸组与同期EAE组相比CD4+CD25+Foxp3+Treg细胞无明显变化;半年期三组大鼠胸腺CD4+CD25+Foxp3+Treg细胞都明显下降,各组间无统计学差异。结论 CD4+CD25+Foxp3+Treg细胞参与了EAE的发病,与病程的发展密切相关;α-硫辛酸对EAE大鼠的干预作用并非通过CD4+CD25+Foxp3+Treg细胞发挥其治疗作用;随着年龄的增长,胸腺不再是机体的主要免疫器官。     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

Release of endogenous catecholamines from slices of hypothalamus of rats

The release of endogenous catecholamines from superfused slices of rat hypothalamus was studied under basal conditions and during release evoked by 40 mM K⁺. Catecholamines in superfusates, and in extracts of the tissue after stimulation, were isolated by column chromatography and quantitated by liquid chromatography with electrochemical detection. Norepinephrine (NE) was not consistently demonstrable in superfusate collected under basal conditions, but 40 mM K⁺ caused the release of from 2 to 4 ng/g of tissue per min. The addition of cocaine to the superfusate caused increases in basal and evoked release of NE. Epinephrine (E) could be measured in superfusates of slices from male but not female rats and then only when cocaine was added to the superfusate. Accordingly, the concentration of E in hypothalamus was greater in male rats than in female rats. Dopamine (DA) was not consistently measurable in the spontaneous overflow from slices either in the presence or absence of cocaine. K⁺-evoked release of DA could be demonstrated in slices from female rats. The addition of cocaine increased the evoked release of DA from slices from both sexes. Corticosterone, added to cocaine, had no effects on the efflux of any of the catecholamines. The experiments suggest that neuronal reuptake of all catecholamines is very efficient in the hypothalamus both under basal conditions and during evoked release.     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。