动员自体骨髓干细胞对大鼠脑缺血／再灌注损伤及细胞凋亡的影响

目的 探讨应用G-CSF动员自体骨髓干细胞对大鼠脑缺血／再灌注损伤及细胞凋亡的影响。方法 应用线栓法制备大鼠局灶性大脑中动脉栓塞／再灌注(MCAO／R)模型，应用粒细胞集落刺激因子(G-GSF)刺激自体骨髓干细胞分裂增殖，并用5-溴脱氧尿核苷(Brdu)标记。观察大鼠神经病学评分，HE染色和免疫组化检测脑缺血区病理改变及CD34和Brdu阳性细胞，原位末端标记法(TUNEL法)观察细胞凋亡。结果 模型动员组大鼠脑缺血／再灌注后24h，大量炎症细胞浸润。再灌注后48h，缺血区可见CD34和Brdu阳性细胞；72h后CD34阳性细胞消失，而Brdu阳性细胞持续存在；模型未动员组缺血区无CD34和很少Brdu阳性细胞表达。48h缺血区新生毛细血管密度明显高于对照组。再灌注后24h细胞凋亡显著，1周时达高峰；与模型非动员组比较，模型动员组48h后细胞凋亡改善明显。结论 自体骨髓干细胞经G-CSF动员后可向大鼠脑缺血区趋化并可分化为神经元前体细胞，显著促进脑缺血区血管再生，降低脑神经功能评分，降低细胞凋亡率。     

外科手术联合自体骨髓干细胞动员治疗大鼠脑缺血

背景：研究表明干细胞治疗能够促进脑功能恢复,联合外科干预能更有效地改善预后。 目的：分析外科手术联合自体骨髓干细胞动员治疗脑缺血的疗效和机制。 方法：用线栓法制作SD大鼠脑缺血模型后随机分为4组：对照组不干预,其他3组分别行外科手术、重组人粒细胞集落刺激因子和粒/巨噬细胞集落刺激因子动员自体骨髓干细胞治疗或联合治疗。 结果与结论：外科手术联合自体骨髓干细胞动员组大鼠的神经功能缺损评分、缺血坏死面积和细胞凋亡数明显低于对照组、外科手术组和自体骨髓干细胞动员组(P < 0.01);BrdU、BDNF阳性细胞数、微血管数较其他组明显增多(P < 0.05)。结果显示外科手术联合自体骨髓干细胞动员可减少大鼠脑梗死面积,抗细胞凋亡,促进神经再生和修复,改善脑功能。     

头针诱导神经干细胞的增殖分化

目的研究脑缺血再灌注大鼠神经干细胞（neural stem cells,NSCs）增殖、分化情况及头针对其影响。方法将Wistar大鼠70只,随机分为假手术组10只、模型组和头针组各30只;模型组和头针组采用线栓法制作大脑中动脉闭阻（middle cerebralartery occlusion,MCAO）模型,各组大鼠又按照缺血时间（7、14、28d）分为3个亚组,每个时相点10只。头针组大鼠于缺血再灌注成功后即行头针治疗,每日1次,直至处死前;各组大鼠处死前1d腹腔注5-溴脱氧尿核苷（bromodeoxyuridine,BrdU）液;对各亚组大鼠行神经功能缺损评分（neurological severity score,NSS）,免疫荧光法计数各组大鼠海马（dentate gyrus,DG）BrdU阳性细胞和BrdU/NeuN阳性双标细胞。结果第28d头针组的NSS显著低于模型组（P〈0.05）。大鼠缺血再灌注后各组阳性细胞有明显表达,而头针组在不同时相的阳性细胞数较同时相模型组有明显增加。结论头针能促进神经干细胞的增殖和分化,改善神经功能缺损评分,从而促进神经功能的修复。     

脂肪来源干细胞移植对脑缺血大鼠运动功能的影响

目的 观察脂肪来源干细胞(ADAS)移植入脑缺血大鼠后存活、迁移、分化以及大鼠的运动功能障碍恢复情况,探讨ADAS移植治疗大鼠局灶性脑缺血的有效性和可能机制. 方法 将雄性SD大鼠饲养至250～300 g时,制作左侧大脑中动脉阻塞模型(MCAO),按照随机数字表法分为未处理组、对照组和移植组,每组6只.未处理组造模后不作特殊处理,对照组在造模后3h通过尾静脉注射杜氏改良培养基(DMEM),移植组造模后3 h通过尾静脉注射ADAS.造模后14 d处死大鼠,通过免疫荧光染色观察5-溴脱氧尿嘧啶核苷(BrdU)、神经元特异性烯醇化酶(NSE)、人微管相关蛋白2(MAP-2)和神经胶质纤维酸性蛋白(GFAP)的表达.造模后1、7及14 d时神经功能缺损评分评价大鼠运动功能改善情况. 结果 (1)移植后,标记了BrdU的ADAS大量出现在缺血灶周围;(2)MCAO后14d,缺血灶周围出现了少量BrdU/GFAP双染阳性细胞;同时出现少量BrdU/NSE和BrdU/MAP-2双染阳性细胞;(3)14d时移植组大鼠神经功能缺损评分与对照组相比明显降低,差异有统计学意义(P＜0.05). 结论 (1)成年大鼠ADAS在MCAO大鼠体内存活并少量分化为神经元样细胞和星形胶质细胞样细胞;(2)移植ADAS可使大鼠脑缺血所致的运动功能缺损得到改善.     

雌激素对大鼠脑缺血再灌注神经干细胞内源性激活的实验研究

目的探讨雌激素对脑缺血再灌注神经干细胞(neural stem cell,NSC)内源性激活的作用.方法将44只雄性大鼠随机分成假手术组、对照组和实验组.采用传统的线栓法制备大鼠大脑中动脉闭塞再灌注模型,实验组大鼠腹腔注射苯甲酸雌二醇,对照组腹腔注射生理盐水,通过免疫组织化学技术标记大鼠海马齿状回颗粒下层(subgranular zone,SGZ)、侧脑室室下层(subventricular zone,SVZ)以及梗死皮质周边区在缺血再灌注3、7、11、18 d的5-溴脱氧尿嘧啶核苷(bromodeoxyuridine,BrdU)阳性细胞,并采用HPIAS图像分析系统进行分析.结果正常成年大鼠脑组织SGZ和SVZ存在少量Brdu阳性细胞,对照组脑缺血再灌注3 d SGZ、SVZ和梗死皮质周边Brdu阳性细胞的数量开始增多,7 d达到高峰,11d后开始减少,18 d进一步下降.实验组与对照组相比,在各个时间点均能显著提高BrdU阳性细胞的数量(P＜0.01),而且增殖可以持续11d.结论脑缺血再灌注可激活脑内NSC的增殖,雌激素可以促进脑缺血再灌注多个区域NSC的增殖.     

运动训练对大鼠脑缺血再灌注后神经修复及GAP-43和Neurocan表达的影响

目的 观察运动训练对大鼠脑缺血再灌注后不同时间神经修复及GAP-43与Neurocan表达的影响.方法 健康雄性Wistar大鼠72只,随机分成运动训练组、对照组、假手术组.采用线栓法制作一侧大脑中动脉闭塞(MCAO)模型,以神经功能缺损评分和Morris水迷宫试验进行神经功能评价,免疫组化法观察对脑缺血周围GAP-43与Neuorcan的表达.结果 与对照组比较,脑缺血再灌注后14d、21d,运动组的肢体运动及记忆功能明显恢复;缺血再灌注后7d,对照组缺血周围出现GAP-43阳性细胞,14d减少,21d、28d明显减少,运动组GAP-43表达在14d、21d、28d较对照组显著增加(P<0.05).Neurocan阳性细胞在对照组缺血再灌注7d出现,14d达高峰,21d、28d时下降;运动组Neurocan表达在缺血再灌注14d、21d、28d较对照组显著减少(P<0.05).结论 运动训练上调大鼠脑缺血区GAP-43表达与下调Neurocan表达,可能是其促进脑损伤区中枢神经修复的重要机制之一.     

系统移植骨髓造血干细胞向大鼠局部脑缺血再灌注损伤区迁移分化的研究

目的 探讨系统移植骨髓造血干细胞(HCSs)对大鼠局灶性大脑中动脉栓塞／再灌注(MCAO／R)模型的治疗作用。方法 应用线栓法制备大鼠局灶性MCAO／R模型，制作成功后24h经大脑中动脉移植大鼠骨髓HCSs。HE染色和免疫组化法检测大鼠脑缺血区病理改变及CD34、巢蛋白(Nestin)阳性细胞。结果 大鼠脑缺血／再灌注后，缺血组织有大量炎性细胞浸润。HCSs移植后24h．模型移植组皮质缺血区可见CD34和Nestin阳性细胞，部分呈神经元样细胞改变，48h后不能再检测到CD34阳性细胞，仍能检测到Nestin阳性细胞；模型未移植组不能检测到CD34阳性细胞，且Nestin阳性细胞明显少于模型移植组。结论 在MCAO／R大鼠模型，系统移植HCSs可向脑缺血区迁移和分化为神经元前体细胞而发挥修复治疗性作用。     

东菱迪夫对脑缺血大鼠侧脑室下区神经干细胞分化及迁移的影响

目的 观察东菱迪夫对脑缺血损伤后大鼠神经干细胞分化、迁移的影响,并探讨东菱迪夫治疗急性脑缺血损伤的可能机制.方法 采用大脑中动脉阻塞法(MCAO)建立局灶性脑缺血再灌注模型;运用神经功能缺陷评分和TTC染色评定神经功能与脑梗死体积;免疫组化检测缺血侧脑室下区(SVZ)5-溴脱氧尿嘧啶核苷(BrdU)以及胶质纤维酸性蛋白GFAP(作为检测脑缺血后神经干细胞的分化、迁移的指标),从而评价东菱迪夫对缺血脑损伤后神经干细胞分化迁移的作用.结果 东菱迪夫组(DLDF)再灌后第7天脑梗死灶体积明显小于模型组(P<0.01),DLDF组大鼠在第7、8、9、16天的神经功能缺陷评分明显优于模型组(P<0.05);和模型组相比,缺血损伤后第7天,东菱迪夫组大鼠SVZ的GFAP阳性细胞数明显增多(P<0.05);缺血损伤后第14天,东菱迪夫组大鼠SVZ的BrdU阳性细胞数明显增多(P<0.05),并且观察到从SVZ至其背外侧带的BrdU阳性细胞的迁移带.结论 东菱迪夫能减少脑缺血大鼠的脑梗死灶体积和改善神经功能评分;缺血脑损伤后,脑内神经干细胞发生分化、迁移;东菱迪夫可促进SVZ神经干细胞的分化、迁移.     

动员自体骨髓干细胞治疗急性缺血性脑卒中的临床研究

目的初步探讨粒细胞集落刺激因子(G-CSF)动员自体骨髓干细胞治疗急性缺血性脑卒中的有效性及安全性.方法将25例急性缺血性脑卒中患者随机分为G-CSF治疗组和对照组.G-CSF治疗组12例,接受G-CSF(5μg/kg皮下注射,1次/d连续7 d)和常规治疗;对照组13例,接受常规治疗;观察治疗前及治疗后1个月或出院时神经功能缺损程度,并随访6个月时临床神经功能及日常生活活动能力.结果治疗1个月时或出院时G-CSF治疗组神经功能缺损评分较对照组略有改善,但差异无显著意义(t=0.842,P＞0.05),但随访6个月时G-CSF治疗组的疗效明显优于对照组(U=1.801,P＜0.05),日常生活活动能力的恢复亦优于对照组(t=2.587,P＜0.05),G-CSF治疗组未出现严重不良反应.结论G-CSF动员自体骨髓干细胞治疗急性缺血性脑卒中有效、安全.     

骨髓间充质干细胞静脉注射移植对脑缺血大鼠脑内神经细胞增殖和分化的影响

目的观察骨髓间充质干细胞（bone marrow stromal cells,BMSCs）经静脉注射移植对缺血/再灌注脑内神经细胞增殖和分化的影响。方法体外培养和扩增成年雄性大鼠BMSCs;以“四管阻断法”制作大鼠前脑缺血/再灌注模型;造模后3、5、7d通过尾静脉注射Hoechst33342标记的BMSCs（2×10^6/1ml/只）,另设对照组于相同时间点通过尾静脉注射载体溶液。于造模后4周处死大鼠,取脑切片,HE染色观察大鼠海马缺血性损伤情况;BrdU/GFAP、BrdU/MAP2和BrdU/Hoechst33342免疫荧光双标染色,观察大鼠脑内神经细胞的增殖及分化情况。结果BMSCs移植组海马CA1区存活锥体细胞数显著多于载体溶液对照组（P〈0.05）。BMSCs移植大鼠脑内海马结构BrdU阳性细胞数显著多于载体溶液对照组（P〈0.05）,BrdU/MAP-2双标阳性细胞占BrdU阳性细胞的比例显著高于载体溶液对照组（P〈0.05）。结论BMSCs经静脉注射移植能够减轻缺血性脑损伤,促进宿主脑内自体神经细胞增殖,并提高其分化为神经元样细胞的比例。     

不同病房模式对精神分裂症病情影响的研究

目的探讨不同病房模式对首发精神分裂症患者病情的影响及康复情况。方法开放式病房的患者为研究组68例,同时选择住封闭式病房患者为对照组130例,对两组患者的临床资料进行比较分析。结果对照组患者入院时焦虑抑郁及敌对猜疑出现明显变化（P＜0.05）;研究组患者在第1周时焦虑抑郁已经开始改善,第2周时病情、阳性症状、一般精神病理、敌对猜疑、激活性也出现明显变化（P＜0.05）;第4周时研究组病情及各因子、认知功能及自知力显著改善,与对照组比较存在统计学差异（P＜0.05）。结论开放式病房模式可以减少患者的负性影响,更快改善患者的认知功能,有利于患者自知力的恢复,使患者的病情达到更全面的康复。     

Certain predictions on the effectiveness of l-DOPA on parkinsonism

Summary Sixty nine patients with Parkinson's disease were treated with L-DOPA for more than a year. L-DOPA produced remarkable improvement in akinetic patients, moderate improvement in rigidity and slight improvement in tremor. The degree of improvement in akinesia, rigidity and tremor tended to be reversely related to the severity of the disease. Rigidity and akinesia improved better in young patients, but there was no correlation between age and the response of tremor to the treatment. Except for rigidity there was no correlation between the improvement and the duration of the disease.

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Zusammenfassung 69 Parkinsonpatienten wurden während mehr als 1 Jahr mit L-DOPA behandelt. Es wurde dadurch bei akinetischen Patienten eine beachtliche, bei Patienten mit Rigor eine mäßige und bei Patienten mit Tremor eine geringfügige Besserung erreicht. Das Ausmaß der Besserung war in allen drei Formen um so geringer, je ausgeprägter die Symptome bei Behandlungsbeginn waren. Rigor und Akinesie sprachen bei jungen Patienten besser auf die Therapie an, aber es bestand keine Korrelation zwischen dem Alter der Patienten und der Beeinflußbarkeit des Tremors durch die L-DOPA-Therapie. Außer für den Rigor bestand keine Korrelation zwischen dem Ausmaß der Besserung und der Dauer der Erkrankung vor Behandlungsbeginn.

     

Efficacy of milnacipran on poststroke depression on inpatient rehabilitation

Post-stroke depression (PSD) has a negative impact on rehabilitation following stroke. No satisfactory antidepressant treatment for PSD has yet been developed. The present study examined the effect of milnacipran, a serotonin and norepinephrine reuptake inhibitor, on PSD patients. Eleven PSD patients taking milnacipran in a rehabilitation hospital were compared to age-matched, sex-matched, and severity of depression at admission-matched PSD patients hospitalized during 2001 who did not take any antidepressant as historical control. Severity of depression was measured using self-rating depression scale for depression (SDS) assessed at admission and discharge after 3 months inpatient rehabilitation. Activities of daily living (ADL) and quality of life (QOL) were measured, respectively, by the functional independence measure (FIM) and a self-completed questionnaire for QOL (QUIK) as outcomes of rehabilitation. For the SDS score, the group taking milnacipran showed significant improvement compared to the control group in our study. FIM was improved in both groups. In the end QUIK did not change significantly in either group. We found no major side-effects of milnacipran among the patients. These results suggest that milnacipran is a safe and effective treatment for PSD for inpatients undergoing rehabilitation.     

Influence of abciximab on the adhesion of platelets on a shielded plasma gradient prepared on polyethylene

INTRODUCTION: Thrombotic effects of biomaterial implants are mediated merely through activation of the platelet glycoprotein IIb-IIIa (GpIIb-IIIa) receptor. Consequently, platelet GpIIb-IIIa receptor inhibitors are successfully used during stent implantation procedures to prevent thrombosis. However, currently a new generation of stents contains surface coating, which changes the surface to more hydrophobic or hydrophilic. This change markedly affects the interaction of platelets and may influence the efficiency of GpIIb-IIIa inhibitors. MATERIALS AND METHODS: To study the influence of the wettability of biomaterials on the effectiveness of abciximab, 5-cm polyethylene gradients with contact angles of 100 degrees to 40 degrees were made by means of glow discharge. Fresh whole blood with or without abciximab was recirculated over this gradient. RESULTS: Inhibition of platelet adhesion by abciximab was maximal, but not complete, on the hydrophobic and moderate hydrophobic part of the gradient, with contact angles of 55 degrees to 90 degrees. Percentage inhibition by abciximab was maximal around 60 degrees. CONCLUSIONS: Intermediate hydrophobicity of currently applied stent materials, such as stainless steel, seems optimal in combination with abciximab. However, on hydrophobic and particularly on hydrophilic materials, abciximab is less effective.     

散发神经鞘瘤22号染色体杂合子丢失发生的研究

目的探讨散发神经鞘瘤病人22号染色体（CHR22）杂合子丢失（LOH）情况及其与肿瘤增殖的关系。方法选取4个与NF2基因密切相关的多态性微卫星标记物,应用PCR方法研究54例神经鞘瘤的LOH情况。采用Ki-67和增殖细胞核抗原（PCNA）评估增殖指数。结果23例（42.6%）CHR22发生LOH,听神经鞘瘤发生率显著性高于脊神经鞘瘤（χ2=5.14,P〈0.05）。发生LOH者增殖指数明显高于无LOH者（Pki-67=0.0079,PPCNA=0.0021）。结论在散发神经鞘瘤中,CHR22LOH是常发事件;听神经瘤与脊神经鞘瘤LOH发生率有显著性差异,CHR22LOH与神经鞘瘤的增殖活动性有关。     

Clinical and experimental studies on the action of ethamsylate on haemostasis and on platelet functions

In a series of tests,the action of ethamsylate on haemostasis and on platelet functions was examined. After oral administration of the drug,a highly significant diminution of the bleeding time and of the blood loss from a standard wound was observed. This effect was demonstrated in healthy individuals and in patients suffering from platelet dysfunctions,and there was a distinct dose relation. There was also an increase of platelet adhesion,of PF 3 availability and of PF 4 release. The action of prostacyclin on the epinephrine induced platelet aggregation could be inhibited by ethamsylate. This offers a possible explanation for some of the effects on hemostasis. In addition,an action of ethamsylate on the platelet membrane was assumed since an in vitro increase of functions of the platelet membrane like PF 3 availability would not be explainable by a possible inhibition of prostacyclin.     

Laser therapy on points of acupuncture on nerve repair

正Paresthesia is the name given to a temporary or permanent sensory loss caused by several surgical procedures that affected the peripheral sensory nerve.In dentistry,common iatrogenic procedures that can lead to sensory loss include third molar removal,blocking of the inferior alveolar nerve