创伤性脑损伤与机体免疫的关系研究进展

创伤性脑损伤((Traumatic Brain Injury,TBI)发生后因患者血脑屏障被破坏导致中枢神经系统发生一系列免疫反应,既往研究文献多强调这些免疫反应是导致TBI患者脑继发性损伤及预后不良的重要危险因素,认为TBI与机体免疫之间呈现更多的是一种消极关系。而近年来随着国内外研究学者对TBI后机体免疫机制研究的进一步深入,强调TBI与机体免疫二者之间也有一定的积极关系,即机体免疫具有阻断继发性损害及保护、修复神经的重要作用。本文通过对近年来国内外相关文献的回顾和整理,对TBI与机体免疫的积极关系和消极关系进行综述。     

铁代谢在创伤性颅脑损伤中的研究进展

创伤性颅脑损伤(traumatic brain injury,TBI)是一类由多种因素导致的颅脑损伤性疾病,可引起一系列复杂的病理生理过程.缺乏早期干预靶点是TBI预后不良的重要因素.另外,TBI不良预后与损伤脑组织铁代谢紊乱密切相关,铁代谢调节干预,尤其是铁螯合剂,在TBI中显示出巨大治疗潜力.本文将对铁代谢与TBI...     

反应性星形胶质细胞在颅脑创伤后作用的研究进展

颅脑创伤（TBI）是世界范围内年轻人和成年人致残、致死的最重要的原因之一。TBI死亡率 高，而幸存者常伴有身体的残疾、精神障碍等后遗症，为社会发展带来了沉重的负担。星形胶质细胞是 TBI后参与损伤和修复的主要细胞。近年来关于TBI继发性损害机制中反应性星形胶质细胞的研究逐渐 增多，但仍有许多机制有待阐明，现对TBI后反应性星形胶质细胞参与的几种相关机制进行阐述。     

创伤性脑损伤与神经炎性反应

近年来,交通事故、军事行动及对抗类体育运动等所导致的颅脑损伤(traumatic brain injury,TBI)的发病率逐年上升。全面了解TBI发病机制对其治疗具有重要意义,其中炎性因子和免疫细胞参与的神经炎性反应在TBI继发性损伤中扮演重要角色,本文将对TBI后神经炎性反应相关机制研究的进展作一综述。     

钙离子在创伤性脑损伤中的致病机制研究

创伤性脑损伤（TBI）是一类常见且严重威胁公众健康的疾病,国内外对TBI发病机制和治疗方面的研究都有了巨大突破。通过对国内外文献研究发现,TBI后所致神经损害包括原发性和继发性损伤两大类机制,而钙离子（Ca²⁺）在TBI继发性损伤中扮演着极其重要的角色。本文围绕Ca²⁺在TBI后继发性损害的致病机制及其治疗展望综述如下。     

颅脑损伤后血脑屏障的损伤机制与检测方法新进展

<正>颅脑损伤(traumatic brain injury,TBI)是外伤导致死亡和残疾的主要原因。最近的研究显示TBI继发性损伤与血脑屏障(blood-brain barrier,BBB)的功能障碍相关^[1,2]。TBI后BBB损伤的机制包括细胞内信号的改变和BBB内细胞-细胞相互作用。许多生物学标志物和放射学改变与TBI后BBB功能障碍相关^[3]。     

给氧治疗对颅脑损伤的作用与机制研究进展

颅脑损伤（traumatic brain injury,TBI）是45岁以下人群死亡和致残的首要原因。TBI患者的预后与损伤的类型、原发性损伤的严重程度以及二次损伤的发生（脑缺血缺氧、脑低灌注压等）有关[1]。流行病学研究显示,高达44%的重型TBI患者合并脑缺氧。     

神经炎症反应在动物创伤性脑损伤中的研究进展

神经炎症反应在创伤性脑损伤(TBI)的继发性损伤中扮演重要的角色。创伤后神经炎症反应在中枢神经系统中的分子、细胞和组织器官等不同层次都有表现,TBI发生后,受损或死亡的细胞释放危险信号,诱导炎症因子分泌,激活免疫细胞和胶质细胞相关受体,诸多细胞和炎症介质相互影响,共同介导有害或有益的神经炎症反应。神经炎症引发的级联反应影响TBI的预后,在TBI的治疗中,针对性应用了许多抑制神经炎症反应的手段,但神经炎症反应在TBI中的二重性也应得到重视。     

CXCL12与创伤性颅脑损伤后神经细胞凋亡的相关性

创伤性颅脑损伤（TBI）后的神经细胞凋亡是继发性TBI中最严重的病理生理变化，是临床上致残、致死率高的重要原因。有效控制神经细胞凋亡是治疗TBI的关键，直接关系到TBI患者的预后。CXCL12是一类具有趋化活性的细胞因子，在中枢神经系统有广泛的表达，在神经保护、神经功能调节、神经细胞发生和神经炎症反应中起着关键作用。随着研究的不断深入，发现CXCL12与TBI后神经细胞凋亡有着密切的联系。本文就CXCL12与TBI后神经细胞凋亡关系的研究进展展开综述。     

孕酮治疗对急性颅脑损伤患者血清中内源性阿片肽的影响

正急性颅脑损伤(traumatic brain injury,TBI)已成为普遍的公共卫生问题和突出的社会问题,在欧美国家成为青壮年人死亡的首要原因;在我国也已成为继癌症死亡的第二位因素,怎样降低其高死亡率和致残率,是神经外科医师努力的课题。除了常规手术治疗之外,药物治疗也是重要的手段之一,遗憾的是迄今为止还不能推荐一种有效的药物治疗以减轻脑水肿,延缓神经细胞凋亡,阻止神经细胞的继发性损害。近年来     

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.     

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。     

Sudanophilic lipid accumulation in astrocytes in periventricular leukomalacia in monkeys

Summary Sudanophilic lipid accumulation is a characteristic feature of periventricular leukomalacia (PVL) of infants. At least two types of lipid-containing cells have been identified, one being the macrophage, the other the pre-myelin glial cell. A third type of lipid-containing cell has been seen in two monkeys with spontaneous PVL. Electron microscopically this cell appears to be an astrocyte. This probably represents a reaction of the astrocyte to hypoxia and may be the equivalent of the hypertrophic astrocytes found in human infants.Supported in part by NIH grant HDO 8633 and the Regional Primate Research Center Grant RR-00166     

Increase in cathepsin D activity in rat brain in aging

Cathepsin D-like activity in homogenates of five brain areas of 3-month-old and 24-month-old Fischer 344 rats was measured. With hemoglobin as substrate at pH 3.2, more than 90% of the activity was inhibited by pepstatin. In each area studied, activity was more than twice as high in the old rat brain: 140-160% higher in the cortex, cerebellum, pons-medulla, and striatum and 90-100% higher in the hippocampus and spinal cord. The greatly increased metabolic capacity in the absence of an increase in protein turnover may have a role in age-related pathological degeneration in the brain.     

Issues in evaluation of cognition in the elderly in developing countries

Background:

Developing regions of the world host the majority of elderly subjects who are at risk for dementia. Reliable epidemiological data from these countries is invaluable in tackling this global problem. Scarcity of such data in literature is largely attributable to problems that are unique to developing communities worldwide.

Objective:

To classify and describe the problems that interfere with the collection of reliable epidemiological data on cognitive impairment in the elderly in developing communities, and to suggest practical solutions for some of them.

Methods:

Inferring from the experiences of a large, ongoing, population-based study on the cognitive impairments in the elderly in South India and from the review of literature.

Conclusion:

A fatalistic attitude regarding aging in the communities, significant heterogeneity in educational abilities and activities of daily living, high illiteracy among rural subjects, and lack of an organized health care system and updated demographic figures are some of the major factors that contribute to technical, namely, methodology-related problems and practical, namely, subject-related problems in such epidemiological studies.     

Characteristics of nociceptors in the periodontium--an in vitro study in rats

Recent studies have indicated that nociceptors can be classified into various types according to their physiological properties. These studies have clarified that the frequency distribution of various nociceptor types is different among body sites and animal species. In the present study, we investigated the physiological properties of rat's periodontal nociceptors in an in vitro jaw-nerve preparation. Responses were recorded from functional single filaments in the inferior alveolar nerve. To determine the nociceptor type, calibrated von Frey filaments, heat, and bradykinin (BK) stimuli were used. We found five subtypes of nociceptors in the periodontal ligaments of the lower incisor: Adelta-high threshold mechanonociceptors (Adelta-HTM, n=28), Adelta-mechanoheat nociceptors (Adelta-MH, n=6), Adelta-polymodal nociceptors (Adelta-POLY, n=26), C-high threshold mechanonociceptors (C-HTM, n=3) and C-polymodal nociceptors (C-POLY, n=4). Most nociceptors were Adelta-innervated, while only a small number of C-innervated nociceptors were found. The present results suggest that periodontal nociceptors transmit mainly fast pain, and may thus play a role in rapid detection of injure-related stimuli during mastication.     

Defects in Bioenergetic Coupling in Schizophrenia

Synaptic neurotransmission relies on maintenance of the synapse and meeting the energy demands of neurons. Defects in excitatory and inhibitory synapses have been implicated in schizophrenia, likely contributing to positive and negative symptoms as well as impaired cognition. Recently, accumulating evidence has suggested that bioenergetic systems, important in both synaptic function and cognition, are abnormal in psychiatric illnesses such as schizophrenia. Animal models of synaptic dysfunction demonstrated endophenotypes of schizophrenia as well as bioenergetic abnormalities. We report findings on the bioenergetic interplay of astrocytes and neurons and discuss how dysregulation of these pathways may contribute to the pathogenesis of schizophrenia, highlighting metabolic systems as important therapeutic targets.     

Gender in Voice Perception in Autism

Deficits in the perception of social stimuli may contribute to the characteristic impairments in social interaction in high functioning autism (HFA). Although the cortical processing of voice is abnormal in HFA, it is unclear whether this gives rise to impairments in the perception of voice gender. About 20 children with HFA and 20 matched controls were presented with voice fragments that were parametrically morphed in gender. No differences were found in the perception of gender between the two groups of participants, but response times differed significantly. The results suggest that the perception of voice gender is not impaired in HFA, which is consistent with behavioral findings of an unimpaired voice-based identification of age and identity by individuals with autism. The differences in response times suggest that individuals with HFA use different perceptual approaches from those used by typically developing individuals.     

Progress in neuroprotection in Parkinson's disease

Slowing or aborting the progress of neurodegeneration in Parkinson's disease (PD) remains the most important unmet need of this disorder. There are several recent developments in trial design and also in drugs under investigation for possible neuroprotective effect. Emphasis has been placed on clinical as opposed to imaging end-points and these include change in a clinical rating scale, e.g. United Parkinson's disease Rating Scale (UPDRS), or time to additional therapy. The introduction of the delayed-start, or wash-in, trial design adds an additional dimension to drug evaluation for neuroprotection. Compounds that have been recently tested in clinical trial include the monoamine oxidase-B inhibitor rasagiline, the anti-apoptotic agents TCH346 and CEP1347, and the promitochondrial agent creatine. The dopamine agonists have been evaluated for a neuroprotective effect using imaging end-points. Perhaps the most important and simplest concept for neuroprotection has been the theory that early dopaminergic support for the degenerating dopaminergic system per se provides significant long-term clinical benefit for PD patients.     

Ethnic disparities in problem behaviour in adolescence contribute to ethnic disparities in social class in adulthood

BACKGROUND: It is important for prevention of social class disparities to know how ethnic disparities in social class arise among migrant children. We contribute to this understanding by examining the role of problem behaviour in adolescence. METHODS: Prospective observational study with 753 Dutch native and 217 Turkish migrant adolescents (11-18 year) followed for 10 years. Internalising and externalising problems were assessed in adolescence and employment status and occupational level were assessed in adulthood. The difference in odds ratios (OR) before and after adjustment for internalising and externalising problems was an indication of the predictive value of disparities in internalising and externalising problems for the development of social class disparities. RESULTS: A total of 135 (62%) of the Turkish and 602 (80%) of the Dutch adults were employed. Internalising and externalising problems were not associated with employment status. Of the employed, 65 (48%) Turkish and 179 (30%) Dutch adults worked in low-level occupations (p < 0.0001). Internalising and externalising problems were associated with both ethnicity and occupation. The OR for low-level occupation for Turkish adults was 1.78 (1.19-2.65), indicating ethnic disparities. Adjustment for internalising problems lowered the OR with 36% to 1.50 (0.97-2.31), and adjustment for externalising problems lowered it with 8% to 1.72 (1.15-2.57). Findings were similar for men and women and did not vary by age. CONCLUSIONS: Ethnic disparities in occupational level in adulthood could partly be attributed to disparities in mental health between Turkish migrants and Dutch natives in adolescence. Prevention of ethnic disparities in mental health at young age may therefore also contribute to the prevention of occupational differences in adulthood.