血管性痴呆大鼠海马区核因子-κB、环氧合酶-2的表达变化

目的通过检测血管性痴呆(vascular dementia,VD)大鼠海马CA1区核因子-κBp65(nuclear factor-κB p65,NF-κBp65)与环氧合酶-2(cyclooxygenase-2,COX-2)的表达,探讨NF-κB、COX-2对VD大鼠的损伤作用。方法28只大鼠随机分为两组,假手术(SOG)组(n=13)和模型(VD)组(n=15),采用HE染色,光镜下观察海马CA1区锥体细胞的改变,免疫组化方法检测海马CA1区NF-κBp65、COX-2蛋白的表达。结果与假手术组相比,模型组组海马CA1区锥体细胞损伤、丧失明显,NF-κBp65、COX-2蛋白表达高于假手术组,与假手术组相比有统计学意义(P(0.01)。结论血管性痴呆大鼠海马CA1区NF-κBp65、COX-2蛋白的表达增加,NF-κBp65、COX-2蛋白的高表达可能是学习记忆障碍的原因之一。     

多奈哌齐对血管性痴呆大鼠海马CA_1区NF-κB及COX-2表达的影响

目的观察血管性痴呆(VD)大鼠行为学改变及海马CA1区核转录因子-κB(NF-κB)、环氧化酶-2(COX-2)表达的变化及多奈哌齐干预效果。探讨多奈哌齐对VD大鼠脑保护作用的可能机制。方法双侧颈总动脉结扎法建立血管性痴呆大鼠动物模型,120只雄性SD大鼠随机分为:假手术4w、8w组、模型4w、8w组;多奈哌齐治疗4w、8w组。Morris水迷宫实验检测认知行为学改变,免疫组织化学法检测大鼠海马CA1区NF-κB、COX-2的表达。结果多奈哌齐可以显著提高血管性痴呆大鼠的学习记忆力和反应能力;模型组和多奈哌齐治疗组NF-κB、COX-2表达均较假手术组明显增高(P0.01),但多奈哌齐治疗组两者表达较模型组明显降低(P0.01)。结论多奈哌齐可以明显改善血管性痴呆大鼠的行为学症状,可能是抑制大鼠脑组织NF-κB、COX-2的表达发挥其脑保护作用。     

下调miR-203靶向MEF2C/NF-κB抑制颞叶癫痫大鼠海马胶质细胞的活化和炎症反应

目的 探讨下调miR-203对颞叶癫痫大鼠海马胶质细胞活化和炎症反应的影响。方法 将46只成年SD大鼠随机分为假手术组（n=10）、模型组（n=12）、阴性对照组（n=12）和miR-203低表达组（n=12）。立体定向辅助下,将海人酸注入大鼠左侧海马CA3区建立颞叶癫痫模型,miR-203低表达组和阴性对照组大鼠左侧海马CA3区分别注射携带miR-203 inhibitor的腺相关病毒和空腺病毒载体,7 d后取左侧海马组织,PCR法检测miR-203水平,ELISA法检测炎症因子[白细胞介素-1β（IL-1β）、IL-6和肿瘤坏死因子α（TNF-α）]水平,免疫印迹法检测肌细胞增强因子2c（MEF2C）、核因子-κB（NF-κB）p65蛋白表达,TUNEL法检测神经元凋亡,GFAP/CD11b/c免疫荧光染色分析胶质细胞活化。结果 模型组大鼠海马组织miR-203、NF-κB p65蛋白表达量、炎症因子（IL-1β、IL-6和TNF-α）水平明显增高（P<0.05）,MEF2C蛋白表达量明显降低（P<0.05）,活化的胶质细胞数量、神经元凋亡数量明显增多（P<0.05）。双荧光素酶报告基因实验显示,MEF2C是miR-203的靶基因。miR-203表达低表达组大鼠海马组织miR-203表达量、NF-κB p65蛋白表达量、炎症因子（IL-1β、IL-6和TNF-α）水平明显降低（P<0.05）,MEF2C蛋白表达量明显增高（P<0.05）,活化的胶质细胞数量、神经元凋亡数量明显减少（P<0.05）。结论 下调miR-203,靶向调控MEF2C/NF-κB信号通路,抑制颞叶癫痫大鼠海马胶质细胞的活化、神经元凋亡和炎症反应。     

ω-3不饱和脂肪酸DHA改善β淀粉样蛋白沉积致AD的小鼠模型记忆功能的机制研究

目的 探讨ω-3不饱和脂肪酸二十二碳六烯酸(DHA)改善β淀粉样蛋白(Aβ1-42)沉积所致阿尔茨海默病(Alzheimer’s disease,AD)的小鼠模型记忆功能的作用机制。方法 采用Aβ-intrahippocampal injection法向36只小鼠脑内海马部位注射寡聚态Aβ1-42建立AD小鼠模型,随机分为假手术组(羧甲基纤维素钠灌胃)、Aβ模型组(羧甲基纤维素钠灌胃)和Aβ+DHA组(DHA灌胃)。Morris水迷宫检测小鼠的记忆功能;尼氏染色检测海马神经元的变化; ELISA法检测海马组织中肿瘤坏死因子α(TNF-α)和白细胞介素16(IL-16)的含量; Western blot检测海马组织中脑源性神经营养因子(BDNF)、干扰素-γ(IFN-γ)、核转录因子-κB(NF-κB)蛋白表达。结果 与假手术组相比,Aβ模型组和Aβ+DHA组小鼠的潜伏期延长,跨越平台次数和BDNF蛋白相对表达量减少,而TNF-α和IL-16含量、IFN-γ和NF-κB蛋白表达量升高;与Aβ模型组相比,Aβ+DHA组小鼠的潜伏期缩短,跨越平台次数和BDNF蛋白表达量增加,而TNF-α和IL-16含量、IFN-γ和NF-κB蛋白表达量降低,差异均有统计学意义(P 0. 05)。结论 DHA可以改善Aβ1-42致AD小鼠模型记忆功能障碍,其作用机制可能与降低海马组织中TNF-α和IL-16含量,抑制IFN-γ和NF-κB蛋白表达,促进BDNF蛋白表达有关。     

活血益智片对血管性痴呆大鼠海马区环氧化酶-2、核因子-κB表达的影响

目的观察活血益智片对血管性痴呆(VD)大鼠行为学改变及海马区环氧化酶-2(COX-2)、核转录因子-κB(NF-κB)表达的变化,探讨其对VD大鼠脑保护作用的可能机制。方法反复缺血再灌注建立血管性痴呆大鼠动物模型,60只雄性SD大鼠随机分为:假手术组、模型组和活血益智片低剂量(1.55g/kg)组、中剂量(3.1g/kg)组、高剂量(6.2g/kg)组、甲磺酸二氢麦角毒碱片(5.4mg/kg)组。Y迷宫及Morris水迷宫实验检测认知行为学改变,Western blot法检测大鼠海马区COX-2、NF-κB的表达。结果活血益智片可以显著提高血管性痴呆大鼠的学习记忆力和反应能力;与假手术组相比,模型组COX-2、NF-κB表达明显增高,活血益智片组可降低其表达。结论活血益智片可以明显改善血管性痴呆大鼠的行为学症状,可能是通过抑制大鼠脑组织COX-2、NF-κB的表达发挥其脑保护作用。     

美满霉素改善血管性痴呆大鼠认知功能损伤并抑制氧化应激

目的 观察美满霉素(minocycline)对血管性痴呆大鼠学习记忆功能和脑组织内皮型一氧化氮合酶(endothelial nitric oxide synthase,eNOS)、诱导型一氧化氮合酶(inducible nitric oxide synthase,iNOS)表达的影响,探讨美满霉素对血管性痴呆的脑保护作用的机制.方法 Wistar大鼠随机分为假手术组(S组)、痴呆模型组(M组)、美满霉素治疗组(MT组).RT-PCR和免疫组织化学法检测大鼠脑组织eNOS、iNOS的表达,行为学检测大鼠学习记忆功能的改变.结果 M组与S组行为学检查显示,M组大鼠有显著学习记忆障碍(P＜0.01),MT组与M组比较行为学检测结果显示,MT组大鼠学习记忆障碍有显著改善(P＜0.01).MT组iNOS表达较M组降低(P＜0.01),MT组eNOS表达较M组增高(P＜0.05);MT组eNOS、iNOS表达较S组增高(P＜0.01);M组eNOS、iNOS表达较S组显著增高(P＜0.01).结论 美满霉素能降低血管性痴呆大鼠脑组织iNOS表达,增强eNOS表达,抑制氧化应激反应,发挥脑保护作用.     

血管性痴呆大鼠海马区核因子-κB、环氧合酶-2的表达变化

目的 通过检测血管性痴呆(vascular dementia,VD)大鼠海马CA1区核因子-κBp65(nuclear factor-κB p65, NF-κBp65)与环氧合酶-2(cyclooxygenase-2,COX、2)的表达,探讨NF -κB和COX-2的损伤作用.方法 28只大鼠随机分为假手术组(SOG)13只和模型组(VD)15只,取海马CA1区为观察部位,HE染色观察锥体细胞的改变,免疫组化检测NF-κBp65、COX-2的表达.结果 与SOG相比,VD大鼠海马CA1区锥体细胞损伤、丧失明显,NF-κBp65、COX-2蛋白增加,差异有统计学意义(P﹤0.01).结论 VD大鼠海马CA1区NF-κBp65、COX-2蛋白的高表达可能是学习记忆障碍的原因之一.     

糖基化终产物对大鼠海马组织小胶质细胞活化及COX-2、p-NF-κB表达的影响

目的 研究糖基化终产物(AGEs-BSA)对大鼠海马小胶质细胞活化及COX-2、p-NF-κB表达的影响.方法 30只Wistar大鼠随机分为正常对照组(NC组)、BSA-C组、AGEs-BSA组、RAGE-Ab组及RAGE-Ab-C组.通过向大鼠海马区注射AGEs-BSA,建立AD大鼠局部炎症病理模型.Morris水迷宫检测大鼠认知功能,免疫荧光观察海马组织小胶质细胞标记物(CD11b)、星形胶质细胞标记物胶质纤维酸性蛋白(GFAP)表达的变化;蛋白质免疫印迹法检测各组海马组织COX-2、p-NF-κB的表达.结果 与NC组比较,AGEs-BSA组大鼠认知功能下降,在海马区可见神经胶质细胞增生,以小胶质细胞为主;COX-2、p-NF-κB的表达明显增高(P<0.001);RAGE-Ab组海马区小胶质细胞增生减弱,COX-2、p-NF-κB表达显著下调(P<0.01),但仍高于NC组;NC组、BSA-C组、RAGE-Ab-C组COX-2、p-NF-κB表达差异不显著(P>0.05).结论 大鼠海马区注射AGEs-BSA可诱导小胶质细胞增殖、活化,促进COX-2、p-NF-κB的蛋白表达增强.     

乙酰唑胺对慢性癫痫大鼠海马NF-κB p65、IL-1β、IL-6及TNF-α表达的影响

目的观察戊四氮(Pentylenetetrazole,PTZ)致慢性癫痫大鼠发作以及应用AQP4抑制剂乙酰唑胺(Acetazolamide,AZA)干预后对海马核因子-κB p65(NF-κB p65)、白介素-1β(IL-1β)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的表达影响,探讨AQP4与炎症因子表达间的关系及乙酰唑胺抑制癫痫发作的可能机制。方法将50只健康成年SD大鼠随机分为对照组(每日腹腔注射生理盐水)、致痫组(每日腹腔注射亚惊厥剂量PTZ35 mg/(kg·d)建立慢性癫痫大鼠模型)、乙酰唑胺干预组[每日先腹腔注射AZA35 mg/(kg·d)预处理,30 min后再腹腔注射亚惊厥剂量PTZ]。连续注射28 d,每天记录大鼠的发作级别。最后一次给药1 d后处死所有大鼠以备实验,RT-q PCR和ELISA检测大鼠海马中IL-1β、IL-6、TNF-α的表达;Western blot检测海马内NF-κB p65表达。结果对照组无明显癫痫发作,RT-q PCR和ELISA检测结果显示致痫组IL-1β、IL-6、TNF-α水平均显著高于对照组(P<0.001);乙酰唑胺干预组的三者水平明显低于致痫组(P<0.05),但仍高于对照组(P<0.05);Western blot结果显示致痫组海马组织NF-κB p65的表达与对照组相比显著升高(P<0.01),而乙酰唑胺干预组表达量与致痫组相比明显下降(P<0.05),但仍高于对照组(P<0.05)。结论乙酰唑胺抑制癫痫的发作的作用机制可能与乙酰唑胺抑制星形胶质细胞膜上AQP4的表达、改善星形胶质细胞水肿损伤状况、下调炎性因子表达有关。     

血管性痴呆大鼠的炎症损伤机制及罗格列酮的保护作用

目的探讨血管性痴呆大鼠炎症损伤机制及罗格列酮对血管性痴呆大鼠炎性细胞因子TNF-α、IL-1β、IL-8表达的影响。方法采用2-血管阻断方法制作血管性痴呆模型。随机分为正常组、假手术组、模型组、罗格列酮治疗组。Morris水迷宫实验检测大鼠的空间学习以及记忆能力;ELISA法检测大鼠海马区TNF-α、IL-1β、IL-8表达。结果 (1)与正常组相比,模型组、治疗组海马区TNF-α、IL-1β、IL-8表达明显升高(P<0.05)。(2)与模型组相比,治疗组的行为学症状较模型组明显改善,治疗组海马区TNF-α、IL-1β、IL-8表达明显下降(P<0.05)。结论炎症反应在血管性痴呆的发生中起到重要的作用。罗格列酮能改善血管性痴呆大鼠的行为学症状,罗格列酮可能是通过降低炎性因子(如TNF-α、IL-1β、IL-8等)抑制炎症反应的途径发挥脑保护作用,使血管性痴呆症状得到改善。     

Chronic cerebral hypoperfusion induces vascular plasticity and hemodynamics but also neuronal degeneration and cognitive impairment

Chronic cerebral hypoperfusion (CCH) induces cognitive impairment, but the compensative mechanism of cerebral blood flow (CBF) is not fully understood. The present study mainly investigated dynamic changes in CBF, angiogenesis, and cellular pathology in the cortex, the striatum, and the cerebellum, and also studied cognitive impairment of rats induced by bilateral common carotid artery occlusion (BCCAO). Magnetic resonance imaging (MRI) techniques, immunochemistry, and Morris water maze were employed to the study. The CBF of the cortex, striatum, and cerebellum dramatically decreased after right common carotid artery occlusion (RCCAO), and remained lower level at 2 weeks after BCCAO. It returned to the sham level from 3 to 6 weeks companied by the dilation of vertebral arteries after BCCAO. The number of microvessels declined at 2, 3, and 4 weeks but increased at 6 weeks after BCCAO. Neuronal degeneration occurred in the cortex and striatum from 2 to 6 weeks, but the number of glial cells dramatically increased at 4 weeks after BCCAO. Cognitive impairment of ischemic rats was directly related to ischemic duration. Our results suggest that CCH induces a compensative mechanism attempting to maintain optimal CBF to the brain. However, this limited compensation cannot prevent neuronal loss and cognitive impairment after permanent ischemia.     

Dendritic morphology of neurons in medial prefrontal cortex and hippocampus in 2VO rats

Cerebral ischemia is the main cause of cognitive impairment. Changes in dendritic morphology and spines have been shown to occur with synaptic plasticity and cognitive function. Bilateral occlusion of the common carotid arteries (2VO) in rats was an effective model of chronic cerebral ischemia. In this experiment, SD rats were divided into model group (2VO) and sham-operated group. At 2, 4, 8 and 16?weeks, rats were tested in Morris water maze to observe learning and memory abilities, and then the brain tissue was stained by Golgi method to investigate the morphology of dendrites of pyramidal neurons under light microscope. Dendritic length and arborization and spine density of pyramidal neurons in medial prefrontal cortex (mPFC) and hippocampal CA1 were analyzed by ImageJ. Progressive learning and memory deficits appeared since 2?weeks. Compared to the sham-operated group, the dendritic length and arborization significantly decreased in the model group at 4, 8 and 16?weeks after 2VO in CA1, while there was no significant difference in mPFC. Dendritic spine density in hippocampal CA1 of the model group significantly decreased after 2?weeks, and it was decreased after 8?weeks in mPFC. The results suggest that under the condition of chronic cerebral ischemia, the alteration of dendritic morphology and spine density underlay cognitive impairment.     

血管性轻度认知功能损害对大鼠前脑神经元和胶质细胞的影响

目的：观察血管性轻度认知功能损害（VMCI）大鼠模型的前脑神经元、星形胶质细胞和小胶质细胞数的变化。方法：用分次结扎大鼠双侧颈总动脉（BCCAO）40d建立VMCI模型（BCCAO组）,以假手术组（SHAM组）为对照,每组n=6。在模型建立前和建立后40d对大鼠进行感觉、运动神经功能和步态的评估,采用T型迷宫评估额叶皮质下环路相关的空间工作记忆和海马相关的空间及非空间相关记忆,免疫组化染色分别检测不同脑区的神经元和胶质细胞数的变化。结果：两组大鼠均无明确感觉和运动神经功能缺失,但BCCAO组的大鼠出现步态障碍。T型迷宫评估,BCCAO组的大鼠额叶皮质下环路相关的空间工作记忆和海马相关的空间及非空间相关记忆受损。两组大鼠海马CA1区β-tubulin阳性细胞面积百分比的定量分析差异无统计学意义（P〉0．05）。BCCAO组在CC区、ic区和opt区GFAP的阳性细胞面积百分比明显高于SHAM组（P〈0．05）;BCCAO组CC区、ic区和opt区和海马CA1区的CD11b阳性细胞面积百分比亦明显高于SHAM组（P〈0．05）。结论：VMCI模型大鼠表现为无运动障碍的步态损害和轻度的空间工作记忆障碍;VMCI早期可不表现为神经元数量的缺失,但其功能可能已经受损,病理特点还包括发挥神经毒性作用的小胶质细胞的活化和白质病变。     

一种C-Jun N-末端激酶肽抑制剂在沙土鼠全脑缺血中的保护作用

目的 为了进一步研究海马C1区域神经细胞活动中JNK的作用，我们评价了一种JNK抑制剂即D-JNKI1在沙土鼠一过性大脑缺血模型中对迟发性神经细胞死亡（DND）的作用。方法 55只沙土鼠随机分为11个组。5组沙土鼠先接受5min前脑缺血处理，再灌注3h后，通过立体定向方法。向每组沙土鼠右侧侧脑室内分别注入不同浓度的D-JNKI1（2μL PBS内加入0．00012，0．0012，0．012，0．12，1．2μmol／L D-JNKI1，每组n=5）。对照组（n=5）：沙土鼠先接受5min前脑缺血处理，再灌注3h后，通过立体定向方法方法向右侧侧脑室内仅注入PBS2μL。腹腔内注射组（n=5）沙土鼠；先接受5min前脑缺血处理，再灌注3h后，1．2μmol／L D-JNKI1溶于0．5mL PBS腹腔内注射。假手术组（n=5）；沙土鼠仅暴露双侧颈总动脉，未夹闭。预处理组（共3组，n=15）：先将0．0012μmol／L D-JNKI1，0．00012μmol／L D-JNKI1溶于2μL PBS，分别注入两组沙土鼠的右侧侧脑室内，另外一组沙土鼠的右侧侧脑室内仅仅注入PBS2μL，30min后三组均夹闭双侧颈总动脉2min，48h后再次接受双侧颈总动脉夹闭5min。所有沙土鼠从接受夹闭5min双侧颈总动脉后4d处死，作冰冻切片和Niss1染色。结果 缺血再灌注3h后用D-JNKI-1治疗，有神经保护作用，最好的神经保护效应浓度为0．0012μmol／L。D-JNKI-1预处理加强了2min预处理所诱导的缺血耐受效应。结论D-JNKI1在沙土鼠全脑缺血模型中对海马CA1区域的迟发性神经细胞死亡有潜在的神经保护作用。     

激素性股骨头坏死模型兔血管内皮细胞生长因子表达与普伐他汀的干预*****

背景：有研究表明他汀类药物可使体外培养的人脐静脉内皮细胞的血管内皮细胞生长因子呈高表达,血管内皮细胞生长因子可促进内皮细胞增殖,明显提高成骨细胞活性并加速骨形成。 目的：观察普伐他汀对激素性股骨头坏死兔模型血管内皮生长因子的蛋白表达的影响。 方法：将新西兰白兔随机分为对照组,模型组和普伐他汀组。模型组和普伐他汀组制备兔激素性股骨头缺血坏死模型。普伐他汀组建模成功后以普伐他汀(1.2 mg/kg)灌胃,1次/d,模型组和对照组以等体积的蒸馏水灌胃。于造模后8,12,16周截取各组股骨头行免疫组织化学检测血管内皮生长因子蛋白的表达情况。 结果与结论：对照组不同时间点股骨头血管内皮生长因子蛋白表达均为阳性。造模后8周,模型组血管内皮生长因子蛋白表达呈阴性表达,普伐他汀组呈弱阳性表达。造模后12周,模型组和普伐他汀组血管内皮生长因子蛋白表达呈阳性表达,16周呈弱阳性表达。结果证实,普伐他汀可有效促进早期激素性股骨头坏死兔模型坏死股骨头内源性血管内皮生长因子的蛋白表达。     

代谢综合征患者缺血性卒中后认知损害的观察

目的 探讨代谢综合征与缺血性卒中后认知损害之间的关系.方法 连续收集94例首发缺血性卒中患者的临床资料.分为非代谢综合征(非MetS)组和代谢综合征(MetS)组,对发病后2周和3个月时患者记忆力、执行功能、注意力、视空间等功能进行评价,参照Ballard等方法 观察两组间认知功能演变的差异性.结果 发病后2周和3个月时,94例患者认知损害发生率分别为24.47%(23/94)和22.34%(21/94),其中非痴呆性认知损害发生率分别为21.28%(20/94)和19.15%(18/94),痴呆性认知损害发生率均为3.19%(3/94、3/94).MetS组患者发病2周和3个月时认知损害发生率分别为37.50%(15,40)和35.00%(14/40),与非MetS组之间差异有统计学意义(Z=2.500,P=0.012;Z=2.513,P=0.012);MMSE总评分,以及延迟回忆和画钟测验评分均低于非MetS.组(P<0.05).Mets组患者发病后3个月时认知功能进一步恶化的病例数高于非MetS组患者,差异有统计学意义(Z=2.134,P=0.033).结论 代谢综合征可增加缺血性卒中后认知损害发生率,以非痴呆性认知损害为主,主要累及执行功能、记忆力.其认知状态演变亦呈恶化趋势.     

Capillary loss precedes the cognitive impairment induced by fractionated whole-brain irradiation: a potential rat model of vascular dementia

Brain tumor patients who are long-term survivors after whole-brain irradiation (WBI) often suffer cognitive impairment, including dementia. Although the pathogenic mechanisms remain poorly understood, our studies suggest that radiation-induced cognitive impairment may be a form of vascular dementia. We used a fractionated dose of gamma-rays that is biologically similar to that given to brain tumor patients. The brains of adult rats were irradiated with 40 Gy, in eight 5 Gy fractions over 4 weeks. Cognitive function was assessed prior to WBI and up to 9 months post-irradiation using a partially-baited radial arm maze. A significant increase in working memory errors was found in the irradiated rats by two-way ANOVA (p=0.0042). The increased errors occurred primarily at 6 and 9 months (p < 0.05, student's t-test). Vessel density was quantified using a stereology method with computerized image processing and analysis. Vessel density was unchanged 24 h after the last dose, but significantly decreased (p=0.002), by approximately 30%, from 10 weeks to 52 weeks. Thus, cognitive impairment arose after brain capillary loss in irradiated rats that show no other gross brain pathology. Capillary loss may play an important role in radiation-induced dementia and this may be a model of vascular dementia.     

Astrocytes react to oligemia in the forebrain induced by chronic bilateral common carotid artery occlusion in rats

The effects of oligemia (moderate ischemia) on the brain need to be explored because of the potential role of subtle microvascular changes in vascular cognitive impairment and dementia. Chronic bilateral common carotid artery occlusion (BCCAO) in adult rats has been used to study effects of oligemia (hypoperfusion) using neuropathological and neurochemical analysis as well as behavioral tests. In this study, BCCAO was induced for 1 week, or 2, 4, and 6 months. Sensitive immunohistochemistry with marker proteins was used to study reactions of astrocytes (GFAP, nestin), and lectin binding to study microglial cells during BCCAO. Overt neuronal loss was visualized with NeuN antibodies. Astrocytes reacted to changes in the optic tract at all time points, and strong glial reactions also occurred in the target areas of retinal fibers, indicating damage to the retina and optic nerve. Astrocytes indicated a change in the corpus callosum from early to late time points. Diffuse increases in GFAP labeling occurred in parts of the neocortex after 1 week of BCCAO, in the absence of focal changes of neuronal marker proteins. No significant differences emerged in the cortex at longer time points. Nestin labeling was elevated in the optic tract. Reactions of microglia cells were seen in the cortex after 1 week. Measurements of the basilar artery indicated a considerable hypertrophy, indicative of macrovascular compensation in the chronic occlusion model. These results indicate that chronic BCCAO and, by inference, oligemia have a transient effect on the neocortex and a long-lasting effect on white matter structures.     

计算机辅助认知训练联合多奈哌齐治疗卒中后认知障碍

目的研究计算机辅助认知训练联合多奈哌齐治疗卒中后认知障碍的临床疗效。方法筛选脑卒中后轻中度血管性认知障碍的患者83例,随机分为2组。其中,对照组42例予脑卒中规范治疗并口服盐酸多奈哌齐5 mg,qd;观察组41例在上述治疗基础上应用计算机辅助认知训练,40 min/d,每周5 d。治疗前及6周后应用蒙特利尔认知测验(MoCA)评价总体认知功能;数字广度测验评估注意力及工作记忆;连线测验评估执行功能;动物流畅性测验评估语言功能;改良Barthel指数(MBI)评估患者日常生活活动能力。结果治疗6周后,观察组和对照组在MoCA评分、数字广度测验正背及倒背、连线测验B-连线测验A、言语流畅性测验、日常生活能力评分均明显改善,差异有统计学意义(P<0.01)。其中,观察组在MoCA、数字广度测验正背及倒背、言语流畅性测验、日常生活能力评分方面较对照组明显提高,差异有统计学意义(P<0.05)。结论计算机辅助认知训练联合多奈哌齐治疗卒中后认知障碍,能显著改善患者整体认知功能、注意力、工作记忆、言语能力、日常生活能力,提高患者的生活质量。     

Prevalence and outcomes of vascular cognitive impairment. Vascular Cognitive Impairment Investigators of the Canadian Study of Health and Aging

OBJECTIVE: To assess the importance of vascular cognitive impairment and its three subgroups (cognitive impairment, no dementia; vascular dementia; and AD with a vascular component) to the prevalence and burden of cognitive impairment in elderly people. BACKGROUND: Vascular lesions may produce a spectrum of cognitive changes. Omitting elderly patients whose cognitive impairment falls short of dementia (vascular cognitive impairment, no dementia) may give a falsely low indication of the prevalence and burden of disease. To test this proposition, we compared the rates of adverse outcomes for patients with no cognitive impairment, vascular cognitive impairment (and its subgroups), and probable AD. METHODS: The Canadian Study of Health and Aging is a prospective cohort study of 10,253 randomly selected community-dwelling and institution-dwelling respondents aged 65 years or older. In the community, all participants (n = 9,008) were screened for cognitive impairment; those who screened positive and a sample of those who screened negative received a clinical assessment (n = 1,659). All patients living in institutions received a clinical assessment (n = 1,255). Participants were reassessed 5 years after the original survey. RESULTS: Vascular cognitive impairment without dementia was the most prevalent form of vascular cognitive impairment among those aged 65 to 84 years. Rates of institutionalization and mortality for those with vascular cognitive impairment were significantly higher than those of people who had no cognitive impairment, and the mortality rate for patients with vascular cognitive impairment was similar to that of patients with AD. CONCLUSIONS: Failure to consider vascular cognitive impairment without dementia underestimates the prevalence of impairment and the risk for adverse outcomes associated with vascular cognitive impairment.