TH基因修饰的神经干细胞移植治疗帕金森病的实验研究

目的 探讨TH基因修饰的神经干细胞脑内移植对帕金森病(PD)的治疗作用。方法 构建pN：ATH逆转录病毒载体质粒，用PA317细胞包装，G418筛选阳性克隆，病毒上清感染神经干细胞，将表达TH的神经干细胞植入：PD大鼠纹状体内，测定：PD大鼠旋转行为改善，DA和DOPAC含量变化，以及TH在纹状体的表达。结果 TH基因修饰的神经干细胞移植8周时能显著降低PD大鼠旋转行为，增加纹状体DA和DOPAC含量，TH在纹状体内的表达增加，疗效好于单纯神经干细胞移植组。结论 TH基因修饰的神经干细胞移植对PD大鼠有明显的治疗作用，可望为PD治疗提供新的途径。     

阳离子脂质体介导AADC基因重组体脑内直接注射治疗帕金森病的实验研究

目的　探讨芳香族氨基酸脱羧酶 (AADC)基因脑内移植对帕金森病的治疗作用及其在左旋多巴 (L dopa)治疗过程中的地位 ,并探讨阳离子脂质体介导的基因治疗方法的有效性。 方法　实验组与对照组分别以 pCDNA3 AADC重组体和 pCDNA3空载体进行阳离子脂质体包裹后 ,注射于帕金森病SD大鼠纹状体内 ,观察两组大鼠旋转行为的改善 ;并在该基础上对两组大鼠分别采用一定浓度的L dopa进行治疗 ,观察脑内移植AADC基因后对大鼠旋转行为的进一步改善。采用免疫组化方法确定AADC的表达。结果　 (1 )阳离子脂质体包裹的pCDNA3 AADC重组体脑内注射后 ,在 3、7、1 4、2 1、2 8d时大鼠的旋转行为获得了一定的改善 (P <0 0 5) ,分别改善 56 0 % ,62 6 % ,49 4% ,36 3 % ,2 7 4% ,以第 1周时最为明显 ,在第 5周时 ,其旋转行为则与移植前差异无显著意义 (P >0 0 5) ;(2 )使用同等浓度的左旋多巴 (L dopa ,1 0mg·kg- 1 ·d- 1 )治疗后 ,在上述相同的时间点时 ,实验组较对照组明显改善模型大鼠的旋转行为 (P <0 0 5) ,以第 1周时最为明显 ,其旋转行为改善达93 4% ,在第 5周时 ,两组间差异无显著意义 (P >0 0 5) ;(3)免疫组化方法确定AADC在纹状体区的稳定表达。结论　增加脑内AADC基因的表达可有效改善帕金森病大鼠的旋转行     

人胎盘间充质干细胞移植治疗帕金森病的实验研究

目的探讨人胎盘间充质干细胞(placenta mesenchymal stem cells,PMSCs)脑内移植对帕金森病(Parkinson’s disease,PD)大鼠的治疗作用。方法在分离、培养、鉴定人胎盘间充质干细胞的基础上,应用6-羟基多巴胺(6-hydroxydopamine,6-OHDA)纹状体注射制作24只帕金森病大鼠模型,随机分为3组,每组8只。A组为空白对照组;B组为生理盐水组;C组为细胞移植组,将已标记CM-Di I的PMSCs移植PD模型大鼠,在移植后4 w取脑组织行冰冻切片,并在荧光显微镜下观察移植细胞的分布情况。采用免疫组织化学方法检测PD大鼠黑质多巴胺能神经元,ELISA检测纹状体多巴胺(dopamine)的含量,并从行为学变化对PD大鼠进行综合评价。结果胎盘组织经酶消化后获得贴壁细胞,倒置显微镜下可见PMSCs形态为梭形,成漩涡样生长,将CM-Di I标记的PMSCs移植到PD大鼠纹状体治疗4 w后,可见细胞散在分布于注射侧脑组织,细胞移植组dopamine含量(7.812±0.46)ng/ml明显高于对照组(4.898±0.32)ng/ml(P<0.05),PD大鼠的旋转行为得到显著改善。结论人胎盘间充质干细胞移植治疗帕金森病大鼠可使其旋转行为得到改善,其机制可能与增加黑质多巴胺能神经元的数量,提高纹状体dopamine含量有关。     

人羊膜上皮细胞移植治疗帕金森病鼠的研究

目的 观察人羊膜上皮细胞在帕金森病鼠移植后的存活情况,以及它对帕金森病鼠旋转行为的改善作用.方法 采用6-羟多巴胺立体定向纹状体注射制作帕金森病鼠模型;51只大鼠随机分三组:人羊膜上皮细胞移植组、假手术PBS对照组以及空白模型对照组.制模成功后第5周用人特异性抗体Nestin和Vimentin检测人羊膜细胞的存活情况,第10周切片观察黑质部TH阳性神经元的变化情况,高效液相色谱--电化学仪测定纹状体多巴胺(DA),高香草酸(HVA),3,4-二羟基苯乙酸(DOPAC)等浓度以及脑脊液DA的含量.结果 人羊膜上皮细胞帕金森病鼠侧脑室内移植可以存活达10周;移植组大鼠旋转数较对照组明显降低(P≤0.01);黑质部TH阳性神经元数量较对照组升高(P≤0.01),纹状体区DA、HVA和DOPAC含量较PBS对照组明显升高(P＜0.01～0.05),移植组脑脊液DA含量较PBS对照组也显著增加(P＜0.01).结论 人羊膜上皮细胞侧脑室移植可以改善帕金森病鼠的旋转行为,其机制可能与其增加纹状体区多巴胺等递质水平有关.     

微囊化牛视网膜色素上皮细胞移植治疗伴Lewy小体形成帕金森病的实验研究

目的观察微囊化牛视网膜色素上皮细胞(RPE)移植对伴Lewy小体形成帕金森病(PD)大鼠的治疗作用。方法用蛋白酶体选择性抑制剂lactacystin制作伴Lewy小体形成的PD模型;将微囊化牛RPE植入大鼠纹状体,移植分生理盐水对照组(NS)、RPE、空微囊(APA)及微囊化RPE(RPE-APA)四组;观察移植后旋转行为变化、纹状体中多巴胺(DA)和高香草酸(HVA)及酪氨酸羟化酶(TH)含量的变化。结果微囊化RPE的旋转行为在移植后第1周开始改善(改善程度为21.3%,与空微囊组相比P<0.05),第4周改善更加明显(改善程度为57.89%,与第1周相比P<0.05),并一直持续到第14周(改善程度为59.47%,与空微囊组相比P<0.05)。行为学改善的大鼠,纹状体内DA和HVA含量的变化同其行为学改善相符合。行为学有改善大鼠囊内细胞TH染色呈弱阳性,微囊周边的纹状体可见TH阳性纤维密度较空微囊组高。结论微囊化牛RPE脑内移植对伴Lewy小体形成PD大鼠有治疗作用。     

人羊膜上皮细胞侧脑室移植对帕金森病大鼠模型行为、多巴胺能神经元、神经递质影响的实验研究

目的 观察人羊膜上皮细胞(HAECs)移植入帕金森病(PD)大鼠模型侧脑室后的存活及分化情况,及其对PD大鼠模型旋转行为、纹状体区多巴胺及其代谢产物的影响.方法 采用6-羟多巴立体定向脑内注射制作PD大鼠模型,将制模成功大鼠随机分成3组:人羊膜上皮细胞移植组(HAECs组)、磷酸缓冲组(PBS组)和帕金森组(PD组),1w后腹腔注射阿朴吗啡观察各组大鼠旋转行为的变化,连续观察10w,HAECs组5w后用人特异性抗体Nestin和Vimentin检测人羊膜细胞的存活情况,10w后酪氨酸羟化酶(TH)染色观察各组PD大鼠模型黑质部TH阳性神经元的变化情况及HAECs的分化情况,高效液相色谱--电化学仪测定纹状体多巴胺(DA)、高香草酸(HVA)、3,4-二羟基苯乙酸(DOPAC)等神经递质的水平.结果 HAECs在PD大鼠侧脑室内移植可以长期存活达10w,并且可以分化为DA能神经元,HAECs组大鼠旋转数较PBS组及PD组明显降低(P<0.01),黑质部TH阳性神经元数量较PD组及PBS组升高(P<0.01),HAECs组大鼠纹状体区DA及其代谢产物DOPAC、HVA含量较PBS组明显升高(P<0.05).结论 人羊膜上皮细胞移植入PD大鼠侧脑室可以改善PD大鼠的旋转行为,其机制可能与增加纹状体区DA等神经递质有关.     

帕金森病基因治疗的实验研究

帕金森病(PD)的主要病理特征是中脑黑质多巴胺能神经元变性,表达的酪氨酸羟化酶(TH)减少或者活性降低。目前外源性多巴是最有效的抗PD药物,但常在数年后失去其有效的治疗作用。用胚胎脑细胞移植虽有效果,但胚胎脑来源困难。因此需要探索新的有效治疗方法。本研究将遗传修饰的成肌细胞植入偏侧PD鼠模型纹状体进行基因治疗。移植转TH基因的成肌细胞(治疗组,n=24)和未经遗传修饰的成肌细胞(对照组,n=10)于偏侧PD鼠损毁侧纹状体。用阿朴吗啡(APO)诱发旋转行为,RT-PCR、TH免疫组化检测TH基因的表达和TH蛋白的合成以及HPLC-ECD检测纹状体多巴胺及代谢产物含量以此评估基因治疗的效果。治疗组移植治疗后APO诱发的旋转行为明显改善(P<0.01),且可持续13个月,而对照组APO诱发的旋转行为无改善(P>0.05),应用RT-PCR、TH免疫组化和HPLC-ECD在治疗组移植部位检测到TH基因的表达、TH蛋白的合成和移植侧纹状体部多巴胺及其代谢产物含量增高。遗传修饰的成肌细胞能够在体内长时间、有效地表达TH,并改善PD鼠的病理行为,是PD基因治疗的合适靶细胞之一。     

AADC和NURR1基因联合c17.2神经干细胞移植治疗帕金森病的实验研究

目的研究芳香族氨基酸脱羧酶(AADC)基因和NURR1基因联合c17．2神经干细胞脑内移植后对帕金森病模型大鼠的治疗效果。方法人类神经元性AADC基因和NURR1基因真核表达载体分别转染至c17．2神经干细胞内。将帕金森病(PD)模型大鼠随机分为4组,分别予以脑内毁损侧纹状区移植含空质粒的c17．2神经干细胞(A组),pCDNA3-AADC转染后的c17．2神经干细胞(B组),pCDNA3-NURR1转染后的c17．2神经干细胞(C组)以及含有pCDNA3-AADC和pCDNA3-NURR1转染后的c17．2 神经干细胞(D组)。观察其病理性旋转行为的改善,采用酪氨酸羟化酶(TH)的免疫组化方法研究脑内多巴胺含量的变化,并用荧光示踪方法观察c17．2细胞在PD模型脑内的移行。结果各组动物脑内移植后动物旋转行为较前均有改善(P<0．05),尤以D组改善最为明显,其行为学最大改善达73．7％,且同A、B、C组间差异具有显著性(P<0．05)。免疫组化可见各组移植TH阳性细胞明显增多,TH染色的神经元树突或轴突密集,体内TH阳性区域明显较PD模型组扩大,其中尤以D组病理学改善最为明显。荧光示踪观察c17．2神经干细胞有突触形成,并与临近的细胞建立突触联系。结论 AADC基因联合NURR1基因共转染c17．2神经干细胞脑内移植后改善了动物的旋转行为,增加了脑内多巴胺的表达,且植入的神经干细胞可同宿主神经元形成突触联接,为研究多基因联合神经干细胞移植治疗帕金森病提供了新方法。     

脑源性神经营养因子基因工程细胞脑内移植治疗帕金森病大鼠的实验研究

目的观察脑源性神经营养因子（ＢＤＮＦ）基因工程成肌细胞脑内纹状体移植对帕金森病大鼠的治疗作用。方法建立逆转录病毒介导的ＢＤＮＦ表达质粒并转染成肌细胞,筛选阳性细胞进行脑内移植。结果基因工程成肌细胞脑内移植可明显提高帕金森病大鼠黑质酪氨酸羟化酶（ＴＨ）阳性神经元的存活率,使纹状体多巴胺含量明显增加,动物的旋转行为改善约５０％,并持续２个月之久。结论脑源性神经营养因子基因工程成肌细胞脑内纹状体移植可明显改善动物的旋转行为并可促进黑质神经原的存活,为帕金森病的治疗提供了一种新的有效的治疗方法     

粉防己碱和还原型谷胱甘肽治疗帕金森病大鼠模型的实验研究

目的 观察粉防己碱合用还原型谷胱甘肽对帕金森病(Parkinson's disease,PD)大鼠模型脑内多巴胺及代谢产物的影响并探讨其作用机制.方法 采用6-羟基多巴立体定向注射制作PD大鼠模型,将成功模型随机分为4组未治疗组(生理盐水)组,谷胱甘肽加粉防己碱(GSH Tet)组,谷胱甘肽(GSH)组,左旋多巴(L-dopa)组及正常对照组,分别腹腔注射上述药物共50 d,给药结束后观察大鼠旋转行为,测定各组大鼠脑纹状体单胺氧化酶B(MAO-B),高效液相色谱-电化学仪测定纹状体多巴胺(DA),高香草酸(HVA),3,4-二羟基苯乙酸(DOPAC)水平及DA的代谢率(HVA/DA).结果 ①GSH合用Tet能显著改善模型大鼠旋转行为[(7.72±2.05)r/min vs (12.39±3.20)r/min,P＜0.05].②GSH Tet组的DA、HVA、DOPAC含量明显高于其他对照组,且其DA,HVA含量与GSH组比较有统计学差异(P＜0.05).③GSH Tet组的HVA/DA(11.48±1.08)及MAO-B活性[(10.5±2.50)U/h/mgprot]明显低于其他治疗组,与GSH组比较均有统计学差异(P＜0.05).结论 粉防己碱合用还原型谷胱甘肽能增强对PD大鼠的神经保护作用.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

Release of endogenous catecholamines from slices of hypothalamus of rats

The release of endogenous catecholamines from superfused slices of rat hypothalamus was studied under basal conditions and during release evoked by 40 mM K⁺. Catecholamines in superfusates, and in extracts of the tissue after stimulation, were isolated by column chromatography and quantitated by liquid chromatography with electrochemical detection. Norepinephrine (NE) was not consistently demonstrable in superfusate collected under basal conditions, but 40 mM K⁺ caused the release of from 2 to 4 ng/g of tissue per min. The addition of cocaine to the superfusate caused increases in basal and evoked release of NE. Epinephrine (E) could be measured in superfusates of slices from male but not female rats and then only when cocaine was added to the superfusate. Accordingly, the concentration of E in hypothalamus was greater in male rats than in female rats. Dopamine (DA) was not consistently measurable in the spontaneous overflow from slices either in the presence or absence of cocaine. K⁺-evoked release of DA could be demonstrated in slices from female rats. The addition of cocaine increased the evoked release of DA from slices from both sexes. Corticosterone, added to cocaine, had no effects on the efflux of any of the catecholamines. The experiments suggest that neuronal reuptake of all catecholamines is very efficient in the hypothalamus both under basal conditions and during evoked release.     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。