通心络对大鼠脑缺血-再灌模型脑保护作用的研究

目的探讨通心络胶囊对脑缺血再灌注损伤的保护作用机制。方法用Zea Longa方法制作大鼠大脑中动脉缺血-再灌模型,观察不同剂量的通心络对缺血-再灌脑损伤大鼠脑组织形态学、脑脊液、行为学等的影响。结果通心络不同剂量均能降低脑缺血-再灌损伤大鼠神经功能评分,减轻脑水肿、缩小脑梗死面积、降低脑脊液中兴奋性氨基酸及乳酸含量。结论通心络对脑缺血再灌注损伤有保护作用。     

通心络对局灶性脑缺血再灌注损伤大鼠保护作用及机制研究

目的 探讨通心络对脑缺血再灌注损伤大鼠的保护作用及其机制。方法用Zea．Longa方法制作大鼠大脑中动脉缺血．再灌模型,观察不同剂量的通心络（0．5mg／kg,2．0mg／kg）对缺血．再灌脑损伤大鼠行为学、脑组织形态学等的影响,检测线粒体内NDA及FAD氧化呼吸链R3、R4、RCR、P／O等评价呼吸功能的指标,以及对脑组织匀浆中超氧化物岐化酶（SOD）,丙二醛（MDA）,谷胱甘肽过氧化物酶（GSH—Px）的影响。结果通心络（2．0mg／kg）能减轻脑缺血-再灌损伤大鼠神经功能缺损,减少脑水肿,缩小脑梗死面积,改善线粒体呼吸链功能,抑制脑组织匀浆中SOD含量的降低及MDA含量的升高。结论通心络对脑缺血再灌注损伤大鼠有保护作用,其机制与改善线粒体呼吸功能和抗脂质过氧化作用有关。     

G-CSF对局灶脑缺血再灌注大鼠脂质过氧化及神经细胞凋亡的影响

目的研究G-CSF对局灶脑缺血再灌注大鼠缺血区域脑组织脂质过氧化及神经细胞凋亡的影响,为G-CSF应用于缺血性脑血管病的治疗提供进一步的理论依据。方法 18只成年雄性Wistar大鼠随机分成3组:假手术组、盐水对照组和G-CSF治疗组,每组各6只大鼠。改良线栓法建立右侧大脑中动脉阻塞模型(t MCAO)。再灌注2 h后,G-CSF治疗组给予50μg/kg粒细胞集落刺激因子皮下注射一次;盐水对照组注入等量生理盐水;假手术组不作任何处理。再灌注24 h后处死大鼠取脑,化学比色法检测缺血区域SOD、GSH-PX、MDA、NO的含量;免疫组化染色计数p-JNK、p-p38MAPK阳性细胞;Tunel染色检测神经细胞凋亡情况。结果再灌注24 h后,G-CSF治疗组缺血区域SOD、GSH-PX的含量高于盐水对照组而低于假手术组(P<0.05),MDA、NO的含量低于盐水对照组而高于假手术组(P<0.05);G-CSF治疗组p-JNK、p-p38MAPK阳性细胞明显少于盐水对照组(P<0.05),tunel染色可见凋亡细胞数较盐水对照组减少。结论 G-CSF可以显著增加大鼠局灶脑缺血再灌注后SOD、GSH-PX的水平,减轻脂质过氧化反应程度,并且可以通过拮抗JNK、p38MAPK途径减轻神经细胞凋亡,发挥神经保护作用。     

β-七叶皂甙钠对脑缺血-再灌注损伤大鼠自由基的影响

目的探讨β-七叶皂甙钠在大鼠脑缺血-再灌注损伤时对自由基的影响。方法用Wistar大鼠45只制备局灶性脑缺血-再灌注模型,分为假手术组、缺血-再灌注组、β-七叶皂甙钠治疗组,每个组又分为缺血2 h后再灌注6 h、12 h、24 h三个时间点,每组每个时间点5只大鼠,术后观察脑组织梗死面积、大鼠的神经行为学变化评分、脑组织超微病理结构变化、脑组织TTC染色,对缺血区脑组织超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondiadehyde,MDA)含量进行测定和分析。结果假手术组相应时间点神经功能损害评分显著低于缺血-再灌注组和治疗组(P<0.05),治疗组SOD含量明显高于缺血-再灌注组各时间点(P<0.05)。光镜显示假手术组脑组织结构未见明显病理改变,脑缺血-再灌注组神经细胞缺血坏死,细胞水肿明显,胶质细胞弥漫增生,炎性细胞浸润。结论自由基参与了脑缺血-再灌注损伤,β-七叶皂甙钠可降低缺血-再灌注后脑组织中MDA的含量,增加SOD的活性,减轻梗死体积,显著减轻大鼠神经功能损害和脑组织水肿,对局灶性脑缺血-再灌注损伤具有一定的保护作用。     

依达拉奉对脑缺血再灌注大鼠脑组织及血清超氧化物歧化酶、一氧化氮、丙二醛水平的影响

目的探讨依达拉奉对局灶性脑缺血再灌注损伤的影响。方法将SD大鼠分为假手术组,脑缺血再灌注组和依达拉奉干预组(干预组),采用线栓法制备大脑中动脉缺血再灌注模型;缺血1h后,设再灌注2h、6h、12h、24h组,采用化学比色法检测各组脑组织及血清超氧化物歧化酶(SOD)、一氧化氮(NO)、丙二醛(MDA)浓度。结果缺血再灌注组脑组织SOD下降,血清SOD先升后降;脑组织NO浓度先降后升,血清NO浓度持续升高;脑组织及血清MDA浓度均先升后降;与缺血再灌注组比,干预组SOD下降幅度小(均P<0·01),NO、MDA浓度明显降低;干预组6h、12h脑组织含水量明显低于缺血再灌注组(均P<0·01)。结论依达拉奉可降低羟自由基水平,对脑缺血再灌注损伤有保护作用。     

PPARγ激动剂对大鼠局灶性脑缺血再灌注损伤的保护作用

目的观察PPARγ激动剂对大鼠局灶性脑缺血再灌注损伤(I/R)的保护作用,并对其作用机制进行初步探讨。方法复制大鼠大脑中动脉阻塞再灌注模型(MCAO/R),分别采用TTC染色法、神经功能缺损评分法观察PPARγ激动剂对大鼠脑梗死体积和行为学评分的影响,同时观察PPARγ激动剂对脑组织形态学和丙二醛(MDA)水平、超氧化物歧化酶(SOD)活性、诱导型一氧化氮合酶(iNOS)活化和一氧化氮(NO)含量的影响。结果PPARγ激动剂能够降低I/R大鼠脑梗死体积和行为学评分,减轻受损大鼠皮层脑组织的病理改变,抑制脑组织中MDA的生成、提高SOD的活性、抑制iNOS活性、降低NO含量。结论PPARγ激动剂对大鼠脑缺血再灌注损伤有一定保护作用,其作用机制与增强SOD活性,抑制脑组织中iNOS活性、降低NO和MDA含量及减轻I/R中氧化损伤有关。     

新型通心络制剂对大鼠脑缺血再灌注后血-脑屏障损伤的保护作用

目的探讨新型通心络制剂对大鼠脑缺血再灌注后血-脑屏障损伤的保护作用。方法将78只SD大鼠随机分为假手术组(6只)、手术组(36只)、通心络组(36只),后两组根据缺血再灌注时间不同再分为脑缺血2h再灌注0.5h、2h、6h、12h、24h和48h组,每组6只;参照Longa线栓法制作大脑中动脉阻塞再灌注动物模型;采用酶联免疫吸附法检测各组大鼠血清S100β蛋白;采用2,3,5-氯化三苯基四氮唑染色法观察各组大鼠脑梗死体积。结果(1)在缺血再灌注0.5h、2h、6h、12h和24h时,通心络组血清S100β蛋白水平较同期手术组降低,差异有显著性(P<0.05)。(2)在缺血再灌注12h、24h和48h,通心络组脑梗死体积明显小于手术组,差异有显著性(P<0.05)。结论新型通心络制剂在脑缺血再灌注后的早期可以降低血清中S100β蛋白水平,减少脑梗死体积;其机制可能是通过保护血-脑屏障而发挥作用。     

人参总皂甙对大鼠脑缺血再灌注后MDA、SOD及细胞凋亡的影响

目的:观察人参总皂甙对大鼠脑缺血再灌注的保护作用,探讨其作用机制。方法:将40只大鼠随机分为4 组:假手术组、缺血再灌注组、治疗组1、治疗组2,采用线栓法制备大鼠脑缺血再灌注模型,72h断头取脑,Nissel染色光镜下观察海马CA1区病理形态变化,TUNEL法检测细胞凋亡,同时检测脑组织中丙二醛(MDA)、超氧化物歧化酶(SOD)的含量。结果:与缺血再灌注组相比,人参总皂甙治疗组光镜下病理损伤轻,脑组织中MDA含量降低、SOD含量升高,细胞凋亡数降低。结论:人参总皂甙对大鼠脑缺血再灌注损伤具有保护作用,其机制可能与抑制自由基损伤有关。     

缺血后处理通过水通道蛋白-4对大鼠缺血再灌注损伤的脑保护作用及其机制

目的研究缺血后处理(IP)对大鼠脑缺血再灌注损伤的保护作用,探讨各组大鼠水通道蛋白-4(AQP4)的表达。方法实验分组:48只雄性SD大鼠,随机分为3组(n=16)。假手术组;对照组:行单纯缺血再灌注;缺血后处理组:IP组。采用线栓法阻断大脑中动脉制备大鼠局灶性脑缺血再灌注模型。大鼠脑缺血再灌注后24 h进行神经行为学评分和脑梗死体积测定,干湿重法测定脑水含量。并行免疫组织化学方法检测海马CA_1区细胞凋亡及AQP4表达的变化并行统计学分析。结果与对照组比较,IP组神经行为学评分明显降低,脑梗死体积、脑组织中的水分含量明显减少(P 0. 05)。再灌注24 h后,对照组海马CA_1区AQP4、凋亡细胞24 h表达量明显增加,IP组与对照组之间比较有差异(P 0. 05)。结论 IP组脑神经行为学评分、脑含水量、脑梗死体积均明显降低,提示缺血后处理可通过抑制AQP4的表达减轻缺血再灌注损伤后的脑水肿,起到脑保护作用。     

二烯丙基硫醚对大鼠脑缺血再灌注损伤后Nrf2、NQ01表达的影响

目的 探讨二烯丙基硫醚对大鼠局灶性脑缺血再灌注损伤后Nrf2、NQ01表达的影响.方法 实验动物随机分为假手术组、缺血再灌注组、200mg/kg二烯丙基硫醚预处理组.采用线栓法制备大鼠大脑中动脉缺血再灌注模型,缺血2h再灌注24h后进行神经行为学评分,测定脑梗死体积及脑组织中SOD、MDA活性,采用免疫荧光和Western Blot测定Nrf2、NQ01蛋白分子的表达.结果 与缺血再灌注组相比,大鼠经二烯丙基硫醚预处理后神经损害症状减轻,脑梗死体积缩小,SOD活性增强,同时MDA活性受到抑制,Nrf2、NQ01I蛋白分子表达上调.结论 二烯丙基硫醚对大鼠脑缺血再灌注损伤具有一定的神经保护作用,可能与其增强大鼠脑组织抗氧化酶活性和激活Nrf2/NQ01通路有关.     

Classification of methods in transcranial Electrical Stimulation (tES) and evolving strategy from historical approaches to contemporary innovations

Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.     

Neonatal Seizures: Problems in Diagnosis and Classification

Summary: The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo-graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction.     

Valproate Monotherapy in the Management of Generalized and Partial Seizures

Summary: For decades, therapeutic tradition has promoted the concept of polypharmacy in the management of epilepsy. In recent years, however, studies have shown that, for most patients, monotherapy can provide comparable or better seizure control than administration of multiple anticonvulsants, while diminishing the potential for adverse reactions, drug interactions, and poor compliance. Valproate is an important monotherapeutic agent that is highly effective in the control of idiopathic primary and secondarily generalized epilepsies, and partial seizures that do not generalize. Comparative studies have found that valproate is at least as effective as phenytoin and carbamazepine in the treatment of generalized and partial seizures. Given the similar efficacy, other factors such as pharmacokinetics and side effects may therefore determine anticonvulsant selection for monotherapy.     

Un nouveau cadre conceptuel de travail pour la psychiatrie

In an attempt to place psychiatric thinking and the training of future psychiatrists more centrally into the context of modern biology, the author outlines the beginnings of a new intellectual framework for psychiatry that derives from current biological thinking about the relationship of mind to brain. The purpose of this framework is twofold. First, it is designed to emphasize that the professional requirements for future psychiatrists will demand a greater knowledge of the structure and functioning of the brain than is currently available in most training programs. Second, it is designed to illustrate that the unique domain which psychiatry occupies within academic medicine, the analysis of the interaction between social and biological determinants of behavior, can best be studied by also having a full understanding of the biological components of behavior.     

Clobazam for Treatment of Intractable Epilepsy: A Critical Assessment

Summary: Clobazam (CLB), a 1,5-benzodiazepine, is a remarkably effective add-on drug for individual patients with refractory partial epilepsy. CLB has an excellent safety record. As with all benzodiazepines used for treating epilepsy, sedation and withdrawal effects, together with the development of tolerance, limit its usefulness. Recent efforts to prevent or reverse tolerance with intermittent administration of CLB or periodic injection of a benzodiazepine antagonist, flumazenil, are encouraging and justify further investigations.     

La passion de Torquemada et le terrorisme islamique : quelques points de comparaison

This original research compares the doctrinal, psychopathological and operational standpoints of the 15th century Spanish Inquisition (Torquemada) with those of radical Islamism from 1988 to 2005 (Al-Qaeda). The following are reviewed: (a) the main texts codifying the procedure for conducting the criminal investigation of a Holy Office trial (Directorium inquisitorum); (b) the life and work of the grand inquisitor Tomás de Torquemada (1420–1498); (c) the psychopathological relations between passion (passionate psychoses, passionate idealism, paranoid personality) and fanaticism; (d) “the madmen, the enlightened and the criminals” of Islamic terrorism; (e) the cognitive and emotional motives for engagement in the jihadist radicalization of young people; (f) the common principles of monotheistic fanaticism (Inquisition, Al-Qaeda) and the particular dogmas of Islamic terrorism in our time; (g) the operating modes of the Inquisition and the Jihadist holy war. The author concludes that the rigour and seriousness of the inquisitorial judicial procedure, which was precise, individual and personalized, contrasts with the revolutionary pamphlets of Al-Qaeda, which only provide broad guidelines for the modus operandi of the fight against infidels, who are usually random victims.     

Claustration et collectionnisme : réflexions à propos d’un cas de syndrome de Diogène avec vols kleptomaniaques et vengeurs

Social withdrawal is a pathognomonic behaviour that is consistently associated with mental illnesses. Compulsive hoarding can also be interpreted as a pathological behaviour, even when it does not involve kleptomania. Diogenes syndrome (DS) was first described in 1975, and is characterized by both behaviours - social withdrawal and compulsive hoarding. Even though it is often the manifestation of a psychiatric condition, its aetiology is diverse. The most frequent ones are however: dementia, schizophrenia and mental retardation. In this study, we describe an atypical case presenting with DS. Il consists of a young man, seen in a forensic setting, who had been diagnosed with kleptomania in the past, presents with compulsive hoarding, and whose recent thefts were fuelled by revenge. Finally, to our knowledge, the way social withdrawal is viewed is seldom taken into account. We analyse its implication on social withdrawal.     

Neurological soft signs and schizophrenia: a review of current knowledge

Schizophrenia is a frequent and disabling disorder emerging during adolescence or early adulthood. The identification of underlying processes has been hampered by the complex clinical expression and the probable etiological heterogeneity. The frequency of neurological soft signs (NSS) in patients with schizophrenia and their presence early in life (during the first two years) in high risk subjects support the hypothesis that schizophrenia is a "brain disease" reflecting pre- or perinatal insults during development. The growing interest for NSS has lead to multiple studies that are often difficult to compare. The objective of this review is to summarize the current knowledge on NSS, methodological issues and the future perspectives.     

Lacan, lecteur de Minkowski : l'approche structurale

The notion of structure occupies a predominant place in the theory of Lacan. He indicates that was developed from the work of Minkowski. In fact, through his phenomeno-structural approach, Minkowski does not limit himself to purely observable phenomena, but attempts to determine the underlying structure. He refers to the comprehensive phenomenology and psychopathology, and this method provides him with clinical finesse and another means of determining a diagnosis. Thus Lacan has used this as a basis for his approach to structure to develop a theory regarding the individual. This implies that the structure of the individual is based on his relation to language. From this concept, he then develops the clinical structures of neurosis, psychosis, and perversion. These structural landmarks also have an effect on the course of treatment.