硼中子俘获疗法的硼携带剂研究进展

硼中子俘获疗法（boron neutron capture therapy,BNCT）是一种新型的放疗方法,它是将与肿瘤有特异性亲合力的10B化合物（硼携带剂）注入人体,经中子束局部照射使聚集在肿瘤组织中的10B与热中子发生核反应,生成7Li与α粒子。这些粒子均属高传能线密度（linear energy transfer,LET）射线,具有能量高和射程短的特点,产生的α粒子能量可达1.7 Mev,平均LET为200 kev·μm-1（理论上几个α粒子释放的能量足以使瘤细胞致死）,射程分别为5μm和10μm（相当于一个肿瘤细胞的直径,该直径<10μm）。其相当空间内发生的电离反应可杀伤吸收硼化物的瘤细胞及与之相邻的细胞,而对正常的组织损害甚小。该疗法的基本特点是:①治疗靶向效应好,对正常组织损伤小,全身副作用轻;②肿瘤局部杀伤剂量大,可达2000cGy以上;③不需增氧效应（oxygenenhancement ratio,OER）,即α粒子不仅可以杀死富氧细胞,同时也能杀死乏氧细胞及未增殖的G0期细胞;④产生的亚致死损伤（sublethal damage,SLD）和潜在致死损伤（potentiallethal damage,PLD）不可修复;⑤使用的10B能与各种载体相结合,可通过生物结合或代谢途径进入靶组织,除可治疗脑内恶     

硼中子俘获治疗脑脑质瘤的研究进展

硼中子俘获疗法治疗脑胶质瘤是基于硼-10在热中子的辐射下能产生放射性作用的原理,硼化合物/硼携带剂和热中子源是治疗成功的两个关键因素。本文对此疗法的作用原理、硼化合物/硼携带剂和热中子源的研究作一综述。     

硼中子俘获治疗中硼的转运方法研究进展

脑胶质瘤是一种死亡率较高的病变,用目前的常规治疗方法很难治愈,而硼中子俘获治疗(BNCT)是一种很有希望治愈胶质瘤的方法,但由于血脑屏障(BBB)的存在,阻止了很多含硼药物进入脑内,因此如何向瘤组织中转运足够剂量的10B,是BNCT成功应用的关键。借助肿瘤比正常组织代谢快的特点,利用针对肿瘤细胞表面特异性抗原的抗体,采取脂溶性较好的微粒包裹药物,通过电通透作用,药物破坏或者选择性开放BBB,直接颅内或者瘤内注射等方法单独或联合运用转运含硼药物,可以在瘤组织中获得理想的10B剂量,为BNCT在胶质瘤治疗中发挥重要作用奠定基础。     

硼中子俘获疗法治疗中枢神经系统肿瘤的研究进展

硼中子俘获疗法是一种选择性生物靶向核素治疗方法,最初于20世纪30年代提出,相较于肿瘤治疗的其他传统方法,具有靶向性好,对周围正常组织损伤小等特点,一直被认为是可以成为治疗各种肿瘤的理想方法之一。但由于缺乏理想的硼携带剂以及适合医院使用的中子源等问题,硼中子俘获疗法一直未能成为肿瘤治疗的一线选择。随着新型硼携带剂的研发,对不同给药方式的探索以及小型基于回旋加速器的中子源的使用,硼中子俘获疗法在肿瘤治疗方面已取得许多令人瞩目的成果。     

脑肿瘤的硼中子俘获疗法（综述）

放疗是脑肿瘤综合治疗中的一个重要组成部分,理想的放疗方法不但要求能杀伤肿瘤细胞,又不损害正常的脑组织结构与功能。目前,常用的~(60)CO、X—射线、加速器等放疗方法很难满足上述条件,虽然部分病人可以延长生命,但也会发生脑损害的并发症,如脑水肿、迟发性脑坏死、痴呆样的神经功能减退等,尤其治疗剂量超过50Gy 时更是如此。硼中子俘获疗法(Boron Neutron CaptureTherapy,BNCT)可选择性的杀伤肿瘤细胞,不     

硼中子俘获治疗

硼中子俘获治疗（ＢｏｒｏｎＮｅｕｔｒｏｎｓＣａｐｔｕｒｅＴｈｅｒａｐｙ,ＢＮＣＴ）是一种利用发生在肿瘤细胞内的原子核反应１０Ｂ（ｎ．α）７Ｌｉ摧毁肿瘤细胞的治疗方法。该方法先给肿瘤病人注射稳定性同位素１０硼（１０Ｂ）,１０硼进入体内后迅速在肿瘤细胞中浓聚,然后用能量为００２５３ｅＶ的热中子（ｎｔｈ）照射瘤体。照射时１个１０硼原子吸收１个中子变成１１硼原子并立即发生原子核裂变,裂变释放出α粒子（４Ｈｅ）和锂原子（７Ｌｉ）。裂变过程仅１０－１２秒,但产生２７９ＭｅＶ能量［１］。　　１０Ｂ＋ｎｔｈ…     

硼中子俘获疗法治疗小鼠颅内G422胶质细胞瘤

目的探讨硼中子俘获疗法（BNCT）治疗G422胶质细胞瘤的效果。方法建立小鼠颅内G422胶质细胞瘤模型，以ICP—AES法测定荷瘤小鼠不同组织中的10^B浓度。将荷瘤小鼠随机分为未照射组（0Gy）、γ射线对照组（5、10Gy）、反应堆组（5、10Gy）、BNCT组（5、10Gy）。采用生存时间的中位数、平均生存时间、生存时间延长率作为评价指标，观察各组的治疗效果。结果荷瘤小鼠腹腔注射对二羟苯丙氨酸硼溶液后1．5h，瘤组织内的10^B浓度达到峰值[（43．78±3．02）μg/g]。BNCT5、10Gy照射后，移植G422胶质细胞瘤小鼠的生存时间延长率分别为235％（233％）、329％（342％）。BNCT5Gy组的生存率与未照射组、γ射线5Gy组和反应堆5Gy组相比差异有统计学意义（P〈0．05）。BNCT10Gy组的生存率与未照射组、γ射线5Gy组、γ射线10Gy组、反应堆5Gy组、反应堆10Gy组、BNCT5Gy组相比差异有统计学意义（P〈0．05）。结论BNCT可以显著提高荷G422胶质细胞瘤小鼠的生存率，并具有剂量依赖性的特点；同时BNCT具有较高的相对生物学效应，优于同剂量γ射线的治疗效果。     

用于中子俘获疗法的钆携带剂研究进展

中子俘获治疗(neutron capture therapy,NCT)是一种理想的肿瘤(特别是恶性脑胶质瘤)治疗方法。在所有用于NCT的核素中,研究最多的是硼-10(10B),其次是钆-157(gadolin ium-157,157Gd)。与10B相比,157Gd具有的优势是[1]:天然丰度较高,为15.68%,热中子俘获截面2.55×105靶,为天然核素中最大的;Gd3+的自旋量子数为7/2,有7个未成对电子,可在MR I中用为反差增强剂,使钆携带剂能在体内显像。由于157Gd具有鲜明的特点,近年来肿瘤的GdNCT疗法逐渐引起人们的重视。本文试图结合GdNCT的原理、特点,对钆携带剂的研究现状进行综述,并就进一步研…     

硼中子俘获疗法诱导U87胶质瘤细胞凋亡

目的 探讨硼中子俘获疗法(BNCT)对人脑胶质瘤细胞株U87的增殖抑制和诱导凋亡的作用及可能机制.方法 实验分为未照射组(0 Gy)、γ射线对照组(4、8 Gy)、反应堆组(3.5 Gy)、BNCT组(4、8 Gy).采用形态观察、流式细胞仪Annexin V/PI荧光染色、四甲基偶氮唑蓝(MTT)法等方法观察BNCT对U87细胞的增殖抑制和诱导凋亡的作用,以免疫组织化学技术检测P53蛋白的表达,应用western blot检测BCL-2、BAX蛋白表达的变化.结果 硼中子照射后细胞出现典型的凋亡形态改变.BNCT 4、8 Gy组处理后48 h细胞的凋亡率分别为65.1%、85.9%.BNCT 4、8 Gy组细胞生长抑制作用显著高于同等剂量的γ射线照射组(P＜0.01).未照射的U87细胞P53蛋白表达阴性,BNCT4、8 Gy照射后P53蛋白表达阳性.BNCT4、8 Gy照射后BCL-2蛋白表达下降,BAX蛋白上升.结论 BNCT对U87细胞具有显著的增殖抑制作用,并有剂量、时间依赖性特点.     

硼中子俘获疗法诱导U251胶质瘤细胞凋亡

目的研究硼中子俘获疗法（BNCT）能否诱导体外培养的U251细胞发生凋亡，并探讨其诱导细胞凋亡的机制。方法采用四甲基偶氮唑蓝（MTT）法绘制细胞生长曲线，应用光镜、荧光显微镜、透射电子显微镜观察BNCT后细胞形态改变；使用流式细胞仪检测细胞凋亡率；利用细胞克隆形成实验分析细胞存活分数；用免疫组织化学方法检测相关蛋白表达的变化。结果在体外试验中BNCT对U251细胞的杀伤力强，并观察到了典型的细胞凋亡改变，4、8Gy照射后48h流式细胞仪检测，细胞凋亡率分别为60．2％、80．6％。在凋亡过程中，p53蛋白表达明显增高，而bcl-2蛋白表达下调。结论BNCT可诱导U251细胞发生凋亡，其机制可能与p53基因表达上调及bcl-2基因表达下调有关。     

Environmental factors in the development and progression of late-onset Alzheimer＇s disease

Late-onset Alzheimer＇s disease （LOAD） is an age-related neurodegenerative disorder characterized by gradual loss of synapses and neurons, but its pathogenesis remains to be clarified. Neurons live in an environment constituted by neurons themselves and glial cells. In this review, we propose that the neuronal degeneration in the AD brain is partially caused by diverse environmental factors. We first discuss various environmental stresses and the corresponding responses at different levels. Then we propose some mechanisms underlying the specific pathological changes, in particular, hypothalamic-pituitary adrenal axis dysfunction at the systemic level; cerebrovascular dysfunction, metal toxicity, glial activation, and Aβ toxicity at the intercellular level; and kinase-phosphatase imbalance and epigenetic modification at the intracellular level. Finally, we discuss the possibility of developing new strategies for the prevention and treatment of LOAD from the perspective of environmental stress. We conclude that environmental factors play a significant role in the development of LOAD through multiple pathological mechanisms.     

Total saponins of Panax ginseng effects on proliferation and differentiation of human embryonic neural stem cells and in a Parkinson’s disease mouse model

BACKGROUND： Total saponins of Panax ginseng （TSPG） exhibits neuroprotection against Parkinson＇s disease in the substantia nigra. OBJECTIVE： To investigate the effects of TSPG on human embryonic neural stem cells （NSCs） proliferation and differentiation into dopaminergic neurons using in vitro studies, and to observe NSC differentiation in a mouse model of Parkinson＇s disease, as well as behavioral changes before and after transplantation. DESIGN, TIME AND SETTING： In vitro neural cell biology trial and in vivo randomized, controlled animal trial were performed at the Institute of Basic Medical Sciences, Chongqing Medical University between September 2004 and December 2007. MATERIALS： TSPG （purity 〉 95%） was isolated, extracted, and identified by Chongqing Academy of Chinese Materia Medica. Recombinant human basic fibroblast growth factor （bFGF） and recombinant human epidermal growth factor （EGF） were purchased from PeproTech, USA. A total of 25 C57/BL6J mice, aged 18-20 weeks were included. Twenty were used to establish a Parkinson＇s disease model with i.p. injection of MPTP （1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine） and TSPG alone or combined with interleukin-1 （IL-1）-treated NSCs prior to transplantation into the corpus striatum. The remaining five mice were pretreated for 3 days with TSPG prior to MPTP injection, serving as the TSPG prevention group. METHODS： Primary NSCs were isolated, cultured and purified from embryonic cerebral cortex. Immunocytochemistry was employed to detect specific antigen expression in the NSCs. In vitro experiment： （1） to induce proliferation, NSCs were treated with TSPG, EGF＋bFGF, or TSPG＋EGF＋bFGF, respectively; （2） to induce dopaminergic neuronal differentiation, NSCs were treated with TSPG, IL-1, or TSPG＋IL-1, respectively. MAIN OUTCOME MEASURES： In vitro experiment： the effects of TSPG on NSCs proliferation were evaluated with flow cytometry and MTT assay. Tyrosine hydroxylase expression was determined by immunocytochemistry assay to observe effects of TSPG on dopaminergic neuronal differentiation. In vivo experiment： differentiation of grafted NSCs in the mouse brain was determined by immunohistochemical staining. Behavioral changes were evaluated by spontaneous activity frequency, memory function, and score of paralysis agitans. RESULTS： （1） NSCs were cultured and passaged for more than three passages. Immunocytochemistry revealed positive nestin staining, as well as neurofilament protein and glial fibrillary acidic protein. （2） TSPG significantly increased NSC proliferation, in particular when combined with EGF and bFGF, which was twice as effective as FGF or bFGF alone. TSPG also induced dopaminergic differentiation in NSCs, in particular when TSPG was added together with IL-1, resulting in an effect five times greater than that of IL-1 alone. （3） At day 30 following transplantation, most NSCs in the TSPG prevention group differentiated into dopaminergic neurons, and the scores of paralysis agitans, spontaneous activity, and memory function were significantly increased compared with TSPG alone or TSPG＋IL-1 groups （P 〈 0.05）. CONCLUSION： TSPG stimulated NSC proliferation, in particular when combined with FGF and bFGF. TSPG significantly induced dopaminergic neuronal differentiation of NSCs, and the effect was greater when combined with IL-1. In addition, TSPG greatly improved behavior in the Parkinson＇s disease mouse model following NSC transplantation. Following NSC transplantation, TSPG pretreatment exhibited superior efficacy over either TSPG alone or TSPG in combination with IL-1, in terms of behavioral improvements in the Parkinson＇s disease mouse model.     

高血压脑出血的显微外科治疗进展

高血压脑出血（Hypertensive intrac-rebral hemorrhage,HICH）是具有高发病率、高病死率、高致残率的急性脑血管疾病,占所有脑卒中患者的10%-20%,早期病死率可高达49.4%。随着人口老龄化,其发病率逐年提高;而外科手术的干预,使其病死率有所下降,但致残率居高不下。如何提高手术疗效和患者生存质量,一直是神经外科医师努力的方向。微侵袭血肿清除术因其手术创伤小,恢复快,是目前国内治疗高血压脑出血的重要手段。     

神经内镜联合亚低温治疗高血压基底节区脑出血

目的 探讨神经内镜联合亚低温在治疗高血压基底节区脑出血中的临床应用价值.方法 回顾性分析我院神经内镜治疗高血压基底节区脑出血患者40例的临床资料,并对治疗结果进行分析.结果 神经内镜治疗组22例(甲组),神经内镜联合亚低温治疗组18例(乙组),术后3个月根据GCS评分,甲组恢复良好1例,中残4例,重残6例,植物生存6例,死亡5例;乙组恢复良好4例,中残8例,重残3例,植物生存1例,死亡2例,两组比较差异有统计学意义(P＜0.05).两组颅内压比较第1天两者差异不明显,但第2、3天亚低温组颅内压明显降低.结论 神经内镜是治疗高血压基底节区脑出血较为有效的手术方式,联合亚低温治疗能有效降低颅内压,改善术后神经功能恢复,具有较好的临床应用价值.     

Targeting 13-secretase with RNAi in neural stem cells for Alzheimer＇s disease therapy

There are several major pathological changes in Alzheimer＇s disease, including apoptosis of cho- linergic neurons, overactivity or overexpression of 13-site amyloid precursor protein cleaving enzyme 1 （BACE1） and inflammation. In this study, we synthesized a 19-nt oligonucleotide targeting BACE1, the key enzyme in amyloid beta protein （AI3） production, and introduced it into the pSilenCircle vector to construct a short hairpin （shRNA） expression plasmid against the BACE1 gene. We transfected this vector into C17.2 neural stem cells and primary neural stem cells, resulting in downregulation of the BACE1 gene, which in turn induced a considerable reduction in reducing AI3 protein production. We anticipate that this technique combining cell transplantation and gene ther- apy will open up novel therapeutic avenues for Alzheimer＇s disease, particularly because it can be used to simultaneously target several pathogenetic changes in the disease.     

Disrupted structural and functional brain connectomes in mild cognitive impairment and Alzheimer＇s disease

Alzheimer＇s disease （AD） is the most common type of dementia, comprising an estimated 60-80% of all dementia cases. It is clinically characterized by impairments of memory and other cognitive functions. Previous studies have demonstrated that these impairments are associated with abnormal structural and functional connections among brain regions, leading to a disconnection concept of AD. With the advent of a combination of non-invasive neuroimaging （structural magnetic resonance imaging （MRI）, diffusion MRI, and functional MRI） and neurophysiological techniques （electroencephalography and magnetoencephaJography） with graph theoretical analysis, recent studies have shown that patients with AD and mild cognitive impairment （MCI）, the prodromal stage of AD, exhibit disrupted topological organization in large-scale brain networks （i.e., connectomics） and that this disruption is significantly correlated with the decline of cognitive functions. In this review, we summarize the recent progress of brain connectomics in AD and MCI, focusing on the changes in the topological organization of large-scale structural and functional brain networks using graph theoretical approaches. Based on the two different perspectives of information segregation and integration, the literature reviewed here suggests that AD and MCI are associated with disrupted segregation and integration in brain networks. Thus, these connectomics studies open up a new window for understanding the pathophysiological mechanisms of AD and demonstrate the potential to uncover imaging biomarkers for clinical diagnosis and treatment evaluation for this disease.     

Edema and neuronal apoptosis in the hippocampus and cortex of elderly rats following transient cerebral ischemia/reperfusion injury

BACKGROUND： Previous studies of cerebral ischemia have used young animals, with an ischemic time greater than 5 minutes （safe time limit）. Despite an increased understanding of neuronal apoptosis, it remains uncertain whether brief cerebral ischemic events of 5 minutes or less damage brain tissue in elderly rodents. OBJECTIVE： To investigate the effects of transient cerebral ischemia （5 minutes）/reperfusion injury on brain cortical and hippocampal edema, aquaporin-4 （AQP-4） expression, and neuronal apoptosis in aged rats, and to compare ischemic sensitivity between cortex and hippocampus. DESIGN, TIME AND SETTING： A randomized, controlled, animal experiment was performed at the Institute of Cerebrovascular Disease, Qingdao University Medical School from April 2008 to March 2009. MATERIALS： Rabbit anti-AQP-4 polyclonal antibody, TUNEL kit, and SABC immunohistochemistry kit were purchased from Wuhan Boster Bioengineering, China. METHODS： A total of 160 healthy, male, aged 19-21 months, Wistar rats were randomly assigned to 4 groups： sham-surgery, and ischemia 1-, 3-, and 5-minute groups, with 40 rats in each group. The global cerebral ischemia model was established using the Pusinelli four-vessel occlusion, and the three cerebral ischemia groups were subdivided into reperfusion 12-hour, 1-, 2-, 3-, and 7-day subgroups, with 8 rats in each subgroup. The sham-surgery group was subjected to exposure of the first cervical bilateral alar foramina and bilateral common carotid arteries. MAIN OUTCOME MEASURES： The dry-wet weight assay was used to measure brain water content and histopathology of the cortex and hippocampus was observed following hematoxylin-eosin staining. In addition, cortical and hippocampal AQP-4 expression was detected by streptavidin-biotin complex immunohistochemistry, and neuronal apoptosis was detected by the TUNEL method. RESULTS： There was no significant difference in brain water content or AQP-4 expression in the cortex and hippocampus between ischemia 1- and 3-minute groups and the sham-surgery group or brain water content or AQP-4 expression in the cortex between ischemia 5-minute group and sham-surgery group （P 〉 0.05）. However, brain water content and AQP-4 expression in the hippocampus after 5 minutes of cerebral ischemia were significantly increased compared with the sham-surgery group （P 〈 0.05 or P 〈 0.01）. Several TUNEL-positive cells were observed in the cortex and hippocampus of the sham-surgery group and ischemia 1-minute group, as well as in the cortex of the ischemia 3-minute group. In addition, the number of apoptotic neurons in the hippocampus of ischemia 3-minute group and in the cortex and hippocampus of ischemia 5-minute group was significantly increased （P 〈 0.05 or P 〈 0.01 ）. Neuronal apoptosis was increased after 12 hours of ischemia/reperfusion, and it reached a peak by 2 days （P 〈 0.01）. CONCLUSION： Transient cerebral ischemia （5 minutes） resulted in increased hippocampal edema, AQP-4 expression, and neuronal apoptosis. Moreover, cerebral ischemia had a greater effect on neuronal apoptosis than brain edema or AQP-4 expression, and the hippocampus was more sensitive than the cortex.     

阿尔茨海默病治疗的研究进展

阿尔茨海默病（AD）是一种隐匿性起病,进行性恶化的神经退行性疾病,临床最初表现为认知功能障碍,并有可能在5～10年内完全衰退。患者往往伴随严重的记忆力丧失、精神行为异常、人格改变、言语功能障碍,无法独立生活,最终近乎于植物状态。Ferri等采用DISMOD软件在全球60岁以上人群中估计,全球的痴呆患者人数到2040年将达到8llO万左右。     

墨蝶呤还原酶基因与精神分裂症相关性的研究进展

墨蝶呤还原酶（SPR）催化四氢生物蝶呤（BH4）从头合成途径的最后一步反应。SPR基因遗传缺陷或突变可导致BH。的合成紊乱,影响单胺类神经递质（如多巴胺、5-羟色胺及谷氨酸等）的合成或释放,进而参与包括精神分裂症在内的多种神经精神系统疾病的发生发展过程。此外,SPR基因敲除小鼠表现出持续增强的自主活动等类精神分裂症症状,说明该基因在精神分裂症的发病中扮演重要的角色。进一步研究SPR基因及其单核苷酸多态性的功能,可为阐明精神分裂症的发病机制提供重要的线索,也为新一代抗精神病药物的研制及开发开拓新的视野。现对SPR基因与精神分裂症的相关研究做一综述。