大鼠脑出血后血肿周围脑组织PPARα的表达变化

目的观察大鼠脑出血后血肿周围组织过氧化物酶体增殖物激活受体α（PPARα）的表达变化。方法取成年雄性Wistar大鼠48只,采用自体血注入法制备脑出血模型。术后6、12、24、48、72、120h断头取脑,应用荧光定量PCR和蛋白印迹法检测血肿周围及对侧脑组织PPARαmRNA和蛋白的表达。结果与血肿对侧脑组织相比,血肿周围脑组织PPARα mRNA和蛋白表达在出血后6h显著升高并达高峰（P〈0．05）,随后降低,至48h与血肿对侧表达量无明显差异（P〉0．05）;然后再次升高,120h的表达量与6h无统计学差异（P〉0．05）。结论PPARα在大鼠脑出血后血肿周围脑组织动态表达变化提示其可能参与脑出血后继发性损伤过程。     

实验性脑出血大鼠脑内Caspase-3mRNA的表达作用研究

目的动态观察实验性脑出血大鼠脑内血肿周围神经细胞凋亡情况和Caspas-3蛋白及mRNA表达水平的变化,探讨脑H{血后血肿周围神经细胞损伤机制。方法健康雄性Wistar大鼠随机分为生理盐水对照组、假手术组和脑出血模型组,分为术后3h,6h,12h,24h,48h,3d,5d,7d共8个时相点,采用尾状核注射自体非抗凝动脉血复制大鼠脑出血模型,术后制作冰冻切片,对切片进行TUNEL染色,以及Caspase-5免疫组化和原位杂交染色,之后利用图像分析仪,观察阳性细胞数。结果脑出血后3h血肿周围尚无凋亡细胞出现,6h有凋亡发生,以后逐渐增多,3d达高峰后逐渐下降,生理盐水对照组仅有少量TUNEL阳性细胞。假手术组及生理盐水对照组3h无Caspase-3蛋白和mRNA表达,生理盐水对照组6h以后有少量表达,脑出血模型组在6hCaspase-3蛋白和mRNA开始表达,3d时Caspase-3的蛋白达到高峰,5d以后逐渐下降,24hCaspase-3mRNA表达达高峰,5d以后逐渐下降。脑出血后血肿周围脑组织Caspase-3蛋白的表达与TUNEL阳性细胞数呈正相关（r=0．515,P〈0．05）;Caspase-3蛋白表达与mRNA表达呈正相关（r=0．625,P〈0．05）。结论脑出血后血肿周围神经细胞损伤有凋亡机制参与,在出血后6h发生凋亡,第3天达高峰。Caspase-3的表达在Caspase-5蛋白水平变化趋势与脑m血后细胞凋亡的趋势一致,Caspase-3的mRNA水平的表达高峰时间先于Caspase-3蛋白的表达及凋亡的发生,提示Caspase-3的表达决定脑出血后细胞凋亡的发生,在脑出血后细胞凋亡中起促进作用。     

重组水蛭素对大鼠脑出血血肿周边组织炎性反应的干预作用

目的 探讨重组水蛭素对大鼠脑出血血肿周边组织炎性反应的干预作用。方法 采用自体血注入法建立大鼠脑出血模型,分别于注血时、注血后6h及12h血肿内给予重组水蛭素干预;分别检测脑出血组、各水蛭素干预组血肿周边组织肿瘤坏死因子（TNF-α）和细胞间黏附分子-1（ICAM—1）表达以及髓过氧化物酶（MPO）的活性,并与对照组比较。结果 脑出血后3d,血肿周围组织TNF-α免疫反应（IR）细胞数、ICAM—1阳性微血管数和MPO活性明显升高（均P〈0．01）;注血同时及注血后6h给予重组水蛭素可显著减少TNF—α、ICAM—1的表达,降低MPO活性（P〈0．01～0．05）,而出血后12h给予重组水蛭素干预对三者的表达无明显影响。结论 凝血酶参与脑出血血肿周围组织的炎性反应,并可能与TNF—α及ICAM—1的表达有关;出血后6h内采取抗凝血酶治疗可减轻局部炎性反应。     

脑出血24h后不同蛋白酶激活受体表达的初步筛查

目的初步探讨脑出血后血肿周围组织的不同蛋白酶激活受体（PARs）的表达情况。方法Wistar大鼠20只,随机分为脑出血组（采用2次注血/2次退针法建立脑出血大鼠模型,右侧尾状核注入自体血50μL）和对照组（右侧尾状核注人生理盐水50μL）。术后24h将大鼠处死取脑,制作冰冻切片,采用免疫荧光染色（间接法）检测血肿周围组织PAR-1、PAR-2、PAR-3、PAR-4阳性细胞的表达情况。结果①脑出血组,出血后24h血肿周围组织PAR-1表达明显增多,与对照组比较P〈0．01。②恼出血组,出血后24hPAR-2主要在血管内皮细胞表达,与对照组比较无明显差异。③脑出血组,出血后24h无PAR-3、PAR-4荧光表达,与对照组比较无明显差异。结论脑出血24h后血肿周围组织PAR-l表达增加。     

大鼠脑出血后血肿周围脑组织p75NTR的表达及其与细胞凋亡的关系

目的研究大鼠脑出血后不同时期血肿周围组织中p75NTR的表达规律及与其细胞凋亡的相关性。方法采用自体动脉血注入右侧尾状核制备大鼠脑出血动物模型,分别于脑出血后6h、24h、72h和10d处死大鼠获取血肿周围脑组织标本,通过流式细胞仪检测细胞凋亡率,免疫组化法及实时荧光定量PCR检测p75NTR蛋白及mRNA的表达。结果脑出血后6hpp75NTR蛋白和nRNA表达水平即上升,24h继续升高,72h到达高峰,至10d仍维持在较高水平,与对照组相比均差异显著（P〈0．05）。脑出血后细胞凋亡率的动态变化趋势与p75NTR蛋白及mRNA表达变化一致,两者之间呈显著正相关（P〈0．05）。结论脑出血后p75NTR可能参与介导脑细胞凋亡。     

前列地尔对实验性脑出血大鼠血肿周围组织炎性反应的影响

目的观察前列地尔对实验性脑出血模型大鼠血肿周围组织神经元形态的影响。方法采用立体定向技术于右侧基底节注射自体动脉血制备脑出血大鼠模型。前肢伸置和转身运动测验评价大鼠行为学变化,尼氏染色观察不同处理组大鼠血肿周围组织神经元形态变化,间接免疫荧光染色计数血肿周围组织TNF-α和IL-6表达阳性细胞数目及分布范围。结果脑出血后大鼠行为障碍主要表现为运动感觉损伤和动作不对称,给予前列地尔治疗后其症状与体征明显改善,且于实验第5、7和14天时行为功能恢复程度接近对照组（P〈0．05或P〈0．01）。组织形态学观察可见,脑出血后血肿周围组织有大量炎性细胞浸润、坏死,呈现“挤压区”,其外侧细胞水肿、轮廓不清;经前列地尔治疗后炎性细胞浸润和神经元肿胀不同程度改善,且随着治疗时间的延长脑出血同侧正中裂旁皮质区神经元数目逐渐增加,至治疗结束时接近正常水平（P=0．650）。脑出血后血肿周围组织神经元高表达TNF-α和IL-6,阳性细胞主要分布于血肿周围组织,血肿远隔部位和健侧几乎不表达;经前列地尔治疗后,二者表达水平呈逐渐降低趋势,并于治疗第7（P=0．035,0．023）和14天（P：0．024,0．020）时接近正常水平。结论前列地尔对脑出血模型大鼠神经功能改善的机制,可能与抑制血肿周围组织炎性反应、减少血肿周围组织继发性神经元损害有关。     

脑出血后血肿周围神经细胞凋亡与CasPase-3表达关系的实验研究

目的 研究脑出血后不同时期血肿周围神经细胞凋亡情况和Caspas-3蛋白表达，探讨脑出血后血肿周围神经细胞损伤机制。方法 用立体定向二次注入法向成年大鼠右尾核壳区注射自体动脉血60μl，制成大鼠脑内血肿模型，用相同方法注射等量无活性石蜡油作对照，于脑出血后4h，6h，ld，3d，5d，10d不同时间点断头，取脑，采用原位末端标记法(TUNEL法)和免疫组化法进行动态形态学观察，了解脑出血后不同阶段血肿周围神经细胞凋亡和Caspase-3蛋白的表达。结果 脑出血后4h血肿周围尚无凋亡细胞出现，6h有凋亡发生，以后随时间逐渐增多，3d达高峰后逐渐下降，10d仍可见凋亡细胞。在HE染色中病理改变明显的部位凋亡细胞比较集中，无改变的部位也有凋亡细胞存在。脑出血后6h血肿周围神经细胞Caspase-3开始表达，3d达高峰后逐渐恢复，对照组仅有少量TUNEL阳性细胞及Caspase-3阳性表达细胞。结论 脑出血后血肿周围神经细胞损伤有凋亡机制参与，在出血后6h发生凋亡，第3d达高峰，Caspase-3表达时相变化与血肿周围神经细胞凋亡相一致，Caspase-3表达增加与血肿周围神经细胞凋亡有关。     

大鼠实验性脑出血后脑组织中c-fos基因的表达与局部脑血流的改变

目的 探讨大鼠实验性脑出血后脑组织中即刻早期基因c-fos的表达和局部脑血流的变化。方法 采用Nath改良法建立大鼠脑出血模型；免疫组化法及RT－PCR法测定其脑组织中fos蛋白和c-fos mRNA的表达；氢清除法测定其局部脑血流。结果 大鼠血肿周围区（基底节）在脑出血后1小时即出现fos蛋白的表达，至3小时达高峰；c-fos mRNA于出血后1小时达表达高峰,至3小时后仍有较高水平的表达；出血后1小时全脑的的血流量均下降，4小时恢复至对照组水平，并维持至出血后24小时，随着的24小时内再次出现脑血流下降。结论 大鼠脑出血后，血肿周围区和双侧皮质区的脑组织中存在着c-fos基因的快速而长久的诱导表达。局部脑血流的下降相对短暂，且脑血流的下降在时程上与c-fos基因的表达不相一致。     

水蛭提取液对实验性脑内血肿周围组织tPA、PAI-1的影响

目的探讨水蛭提取液对实验性脑内血肿周围组织组织型纤溶酶原激活物（tPA）、纤溶酶原激活剂抑制物1（PAI-1）的影响。方法采用成组设计的随机对照研究。用定量胶原酶注入大鼠尾状核来建立脑出血模型．酶联免疫吸附法、发色府物法检测血肿周围脑组织生化指标（tPA、PAI-1含量与活性）变化，RT-PCR法观察鼠脑血肿周围脑组织tPA与PAI-1 mRNA的表达，免疫组化法观察鼠脑血肿周围脑组织tPA蛋白的表达。结果水蛭提取液治疗组较生理盐水对照组能增加血肿周围脑组织tPA含量、提高其活性，促进血肿周围脑组织tPA mRNA表达，增强tPA免疫表达．而不影响PAI-1含量与活性或mRNA表达。结论水蛭提取液促进实验性脑内血肿吸收的机制可能为通过对tPA的转录、翻译及合成蛋白的加工修饰来激活内源性纤溶系统，对PAI-1无影响。     

Mental illness in England,in Scotland and in Scots living in England

Summary Beginning from the observation that Scots living in England have much higher rates of mental hospital admission than do the English, several hypotheses are proposed to account for this. Much of the excess in rates of mental illness is accounted for by those diagnosed as having alcohol-related disorders and behaviour and personality problems. The results of an examination of offical statistics in the two countries enabled some explanations to be offered. It was found that rates of admissions to mental hospitals are higher in Scotland than in England but not as high as those found among Scots migrants who have a much higher rate of readmission to hospitals than either of the other groups. In fact, if first admissions only are considered the rates of admission in Scotland are not only higher than rates for English natives but also higher than for Scottish migrants. It seems that Scots living in England are somewhat less likely to become mental patients than Scots in Scotland but that once they do achieve this status they are very much more likely to be readmitted on subsequent occasions. It was concluded that there might be two fairly distinct groups of migrants from Scotland to England who have different backgrounds, different reasons for migrating and different psychological characteristics. On the one hand there are stable, economically motivated migrants who move south for definite employment related reasons and who show few psychological symptoms. While on the other hand there is a group of migrants who perhaps have psychological problems and who move more in hope than expectation without definite prospects and who account for the high rates of mental hospital admission found in Scottish migrants.     

Prostacyclin release in the coronary circulation during sustained stimulation in in vitro and in in vivo experimental systems

Prostacyclin release from rat isolated perfused hearts and from dog coronary circulation was studied by measuring immunoreactive 6-keto-PGF1 alpha (6-keto-PGF1a) in heart perfusate and in plasma obtained from the great cardiac vein respectively. Continuous infusion of arachidonic acid at constant concentration in isolated perfused hearts induced an increased prostacyclin release. This release showed a rapid peak within 10 min and a subsequent decrease. Low-flow ischemia induced an increased perfusate concentration of 6-keto-PGF1a but, considering the decreased flow, prostacyclin release was actually reduced. During the whole period of ischemia (60 min) prostacyclin release was constant. In open-chest anesthetized dogs 6-keto-PGF1a concentration in the great cardiac vein was increased after ligation of the left anterior descending coronary artery. A prolonged period of coronary occlusion (4.5 hours) resulted in a progressive rise of prostacyclin release. 6-keto-PGF1a determinations in the femoral vein and in the aorta did not show relevant variations during the observation period.     

癫痫与抑郁关系的研究进展

抑郁是癫痫患者中常见的精神障碍,严重地影响了患者的生活质量。传统的观点认为癫痫患者因为存在着诸多社会学问题易出现抑郁倾向,癫痫和抑郁是单向的联系,但大量的研究已经证明癫痫和抑郁之间存在双向的联系,一种异常状态的存在可能易转化为另一种异常状态的发展。癫痫和抑郁存在着共同的发病机制。本文主要就癫痫和抑郁的双向联系以及抗抑郁药物在癫痫患者中的应用进行阐述。     

神经介入：回眸2022

<正>2022年,国际上公布了多项大型神经介入领域的随机对照试验（randomized controlled trial,RCT）结果,在血管内治疗（endovascular treatment,EVT）急性大血管闭塞（large vessel occlusion,LVO）适应证的扩展、药物治疗、管理,症状性颅内动脉粥样硬化性狭窄（symptomatic intracranial atherosclerotic stenosis,sICAS）治疗,无症状性颈动脉狭窄治疗,     

Neuroimaging in epilepsy in tropics

Epilepsy is a major public health problem in many tropical countries. Also, some of the tropical diseases are major contributors to the higher prevalence of epilepsy in these countries. The etiologic factors responsible for epilepsy in these countries are quite different from those in the developed world. This article discusses the etiologic factors and neuroimaging of epilepsy in light of the conditions in these tropical countries.