重症肌无力病人血清中IgM型乙酰胆碱受体,突触前膜抗体检测及 …

应用ＡＢＣ－ＥＬＩＳＡ法检测了９６例重症肌无力（ＭＧ）病人血清中ＩｇＭ－ＡｃｈＲ、Ｐｓｍａｂ。发现ＭＧ组中，有１８例（１８．７％）ＩｇＭ－ＡｃｈＲａｂ阳性；１０例（１０．４％）ＩｇＭ－Ｐｓｍａｂ阳性。ＩｇＭ－Ｐｓｍａｂ阳性频见于病程〈２年的ＭＧ病人；而与ＭＧ组病人的年龄和临床分型均无显著的相关性（Ｐ〉０．０５）。结果提示ＩｇＭ型抗体也与ＩｇＭ型抗体共同参与了ＭＧ的发病机制，且提示有神经肌肉接头突触     

AChRAb阳性和阴性重症肌无力患者IL—4和IFN—γ…

将行胸腺切除术的重症肌无力（ＭＧ）患者分成乙酰胆碱受体抗体（ＡＣｈＲＡｂ）阳性和阴性２组，采用免疫酶点法检测其外周血、骨髓和胸腺白细胞介素４－（ＩＬ－４）分泌细胞和干扰素－γ（ＩＦＮ－γ）分泌细胞的数量，结果表明ＡＣｈＲＡｂ阳性组其外周血和骨髓中ＩＬ－４和ＩＦＮ－γ分泌细胞数量均显著高于ＡＣｈＲＡｂ阴性组（Ｐ〈０．０５），而胸腺细胞两组间差异无显著性意义（Ｐ〉０．０５）。提示ＩＬ－４和ＩＦＮ－γ在     

格林-巴利综合征患者脑脊液抗P2蛋白IgG抗体增高

用ＥＬＩＳＡ方法，检测３６例格林－巴利综合征（ＧＢＳ）患者和４０例其他神经病（ＯＮＤ）患者的血清和脑脊液及４０例健康对照（ＮＣ）血清标本的抗Ｐ２蛋白ＩｇＧ和ＩｇＭ抗体。结果发现：ＧＢＳ和ＯＮＤ血清抗Ｐ２Ｉｇ６和ＩｇＭ抗体与ＮＣ血清比较无明显差异（Ｐ＞０．０５）。ＧＢＳ脑脊液抗Ｐ２ＩｇＧ抗体明显高于ＯＮＤ（Ｐ＜０．０５），而抗Ｐ２ＩｇＭ抗体则两者无显著差异（Ｐ＞０．０５）。     

重症肌无力B细胞免疫应答涉及乙酰胆碱受体的全部亚单位

用酶联免疫斑点（Ｅｌｉｓｐｏｔ）法计数乙酰胆碱受体（ＡＣｈＲ）及其α－、β－、γ－和δ－４种亚单位的特异性ＩｇＧ抗体分泌细胞，评价重症肌无力（ＭＧ）患者外周血Ｂ细胞免疫应答。与其他神经疾病（ＯＮＤ）组相比，ＭＧ组存在显著高水平的ＡＣｈＲ及其４种亚单位的抗体分泌细胞，ＭＧ组４种ＡＣｈＲ亚单位的抗体分泌细胞平均值为１０／１０５～１５／１０５外周血单个核细胞（ＭＮＣ），ＯＮＤ组为０．６／１０５～１．４／１０５ＭＮＣ（Ｐ＜０．０００１）。ＭＧ组ＡＣｈＲ抗体分泌细胞数总是高于任何一种亚单位抗体分泌细胞数，且对α－亚单位的Ｂ细胞免疫应答占有明显优势，这可能是α－亚单位存在主要免疫源区（ＭＩＲ）的间接证据。     

糖皮质激素受体阻断对大鼠实验性自身免疫性重症肌无力的影响

研究重症肌无力（ＭＧ）患者外周血白细胞糖皮质激素受体（ＧＲ）减少，而血浆皮质醇则在正常范围，探讨其与ＭＧ发病的关系。方法ＳＤ大鼠３２只，随机分成４组。实验组先以ＧＲ的竞争性拮抗剂米非司酮（ＲＵ３８４８６，ＲＵ４８６）阻断其ＧＲ，再以从人肌肉中粗提的乙酰胆碱受体（ｎＡＣｈＲ）进行免疫；实验对照组单用ｎＡＣｈＲ，试剂对照组只用ＲＵ４８６，而正常对照组仅用福氏佐剂。以临床症状、血清抗ｎＡＣｈＲ抗体（ｎＡＣｈＲ－ａｂ），重复刺激坐骨神经递减幅度为观察指标。结果实验组的临床症状和ｎＡＣｈＲ－ａｂ滴度升高及肌电图递减幅度均较明显，经ｔ检验分析，均与实验对照组有显著性差异（Ｐ＜０．０５），而试剂对照组和正常对照组均无ＭＧ的表现。结论ＧＲ被阻断后，对大鼠的实验性自身免疫性ＭＧ（ＥＡＭＧ）发病有易化作用。     

左旋咪唑迟发性脑病免疫功能的研究

用间接免疫荧光法测定４８例左旋咪唑迟发性脑病（ＬＩＤＥ）患才外周血淋巴细胞亚群，同时用ＩＣＳ－Ⅱ分析仪以速率散射比浊法检测患者血清和脑脊液（ＣＳＦ）配对标本的部分体液免疫指标。结果表明：ＬＩＤＥ组ＣＤ３、ＣＤ４、ＣＤ２５、ＣＤ４／ＣＤ８比值均显著高于对照组，ＣＤ８低于对照组（Ｐ〈０．００１）。血清和ＣＳＦＩｇＧ、ＩｇＡ、ＩｇＭ及ＩｇＧ鞘内合成率（ＩｇＧ－Ｓｙｎ）亦均明显高于对照组（Ｐ〈０．００１）     

重症肌无力患者周围血中CD4+T淋巴细胞亚群的研究

目的研究ＣＤ４＋Ｔ淋巴细胞的功能亚群在重症肌无力（ｍｙａｓｔｈｅｎｉａｇｒａｖｉｓ，ＭＧ）发病中的作用。方法采用免荧光双标记技术和流式细胞仪对３９例ＭＧ患者和１８例健康对照者周围血中ＣＤ４＋Ｔ淋巴细胞的两个亚群（ＣＤ４＋ＣＤ４５ＲＡ＋、ＣＤ４＋ＣＤ４５ＲＡ－）的百分率进行测定。结果ＣＤ４＋ＣＤ４５ＲＡ＋亚群的百分率在ＭＧ组和ＡＣｈＲＡｂ阳性组明显低于对照组和ＡＣｈＲＡｂ阴性组；而ＣＤ４＋ＣＤ４５ＲＡ－细胞的百分率在ＭＧ组和ＡＣｈＲＡｂ阳性组显著高于对照组和ＡＣｈＲＡｂ阴性组。结论表明ＣＤ４＋Ｔ淋巴细胞的两个功能不同亚群在ＭＧ患者体内发生了异常改变，与ＡＣｈＲＡｂ的产生有关。     

格林—巴利综合征患者血清和脑脊液中的抗硫脂抗体

探讨抗硫脂抗体与格林－巴利综合征（ＧＢＳ）的关系。方法采用固相酶联免疫吸附法对急性期ＧＢＳ患者血清和脑脊液（ＣＳＦ）中抗硫脂ＩｇＧ和ＩｇＭ抗体进行检测。结果ＧＢＳ患者血清和ＣＳＦ中抗硫脂ＩｇＧ及ＩｇＭ抗体的阳性率均明显高于正常对照组；血清中抗硫脂ＩｇＭ抗体滴度与标本收集时患者发病天数呈负相关（Ｐ＜０．０５），而血清中抗硫脂ＩｇＧ抗体滴度与临床分级（Ｐ＜０．０１）、ＣＳＦ中抗硫脂ＩｇＧ抗体滴度（Ｐ＜０．０１）呈正相关；血清中抗硫脂ＩｇＧ或ＩｇＭ阳性的ＧＢＳ患者，体检时有不同程度的感觉障碍患者为５６％，而血清中抗硫脂抗体阴性患者仅为１６％，两者之间差异有显著意义（Ｐ＜０．０５）。结论抗硫脂抗体可能在ＧＢＳ的病理过程中起重要作用     

84例脑梗塞病人抗心磷脂抗体的研究

８４例脑梗塞病人和 ５０例对照者进行了抗心磷脂抗体（Ａｎｔｉｃａｒｄｉｏｌｉｐｉｎ ａｎｔｉｂｏｄｉｅｓ，ＡＣＡ）检测，结果发现。脑梗塞病人组２２例ＩｇＧ—ＡＣＡ和ＩｇＭ－ＡＣＡ滴度均高于正常人（Ｐ分别＜０．０１、０．０５），脑梗塞组ＡＣＡ阳性率为２６％，其中ＩｇＧ—ＡＣＡ阳性１２例、ＩｇＧ和ＩｇＭ—ＡＣＡ均为阳性６例，ＩｇＭ—ＡＣＡ阳性４例，提示ＡＣＡ与脑梗塞的发病有一定关系。     

肌球蛋白抗体在重症肌无力病人血清中的表达及其在发病机？…

目的：探讨ｍｙｏｓｉｎ－Ａｂ在ＭＧ发病机制中所起的作用。方法：采用ＥＬＩＳＡ法检测重症肌无力（ＭＧ）组５４例，正常人组９２例及其他疾病对照组２８例血汪肿ｍｙｏｓｉｎ－Ａｂ的表达。结果：Ｍｙｏｓｉｎ－Ａｂ在血清中的正常值Ｐ／Ｎ（病人与正常人ＯＤ值之比）范围：０～２．９８。高于２．９３％则为阳性。Ｍｙｏｓｉｎ－Ａｂ阳性率与肌无力严重程度呈正相关。Ｍｙｏｓｉｎ－Ａｂ效价与ＡＣｈＲ－Ａｂ呈正相关。结论：Ｍ     

Mental illness in England,in Scotland and in Scots living in England

Summary Beginning from the observation that Scots living in England have much higher rates of mental hospital admission than do the English, several hypotheses are proposed to account for this. Much of the excess in rates of mental illness is accounted for by those diagnosed as having alcohol-related disorders and behaviour and personality problems. The results of an examination of offical statistics in the two countries enabled some explanations to be offered. It was found that rates of admissions to mental hospitals are higher in Scotland than in England but not as high as those found among Scots migrants who have a much higher rate of readmission to hospitals than either of the other groups. In fact, if first admissions only are considered the rates of admission in Scotland are not only higher than rates for English natives but also higher than for Scottish migrants. It seems that Scots living in England are somewhat less likely to become mental patients than Scots in Scotland but that once they do achieve this status they are very much more likely to be readmitted on subsequent occasions. It was concluded that there might be two fairly distinct groups of migrants from Scotland to England who have different backgrounds, different reasons for migrating and different psychological characteristics. On the one hand there are stable, economically motivated migrants who move south for definite employment related reasons and who show few psychological symptoms. While on the other hand there is a group of migrants who perhaps have psychological problems and who move more in hope than expectation without definite prospects and who account for the high rates of mental hospital admission found in Scottish migrants.     

Prostacyclin release in the coronary circulation during sustained stimulation in in vitro and in in vivo experimental systems

Prostacyclin release from rat isolated perfused hearts and from dog coronary circulation was studied by measuring immunoreactive 6-keto-PGF1 alpha (6-keto-PGF1a) in heart perfusate and in plasma obtained from the great cardiac vein respectively. Continuous infusion of arachidonic acid at constant concentration in isolated perfused hearts induced an increased prostacyclin release. This release showed a rapid peak within 10 min and a subsequent decrease. Low-flow ischemia induced an increased perfusate concentration of 6-keto-PGF1a but, considering the decreased flow, prostacyclin release was actually reduced. During the whole period of ischemia (60 min) prostacyclin release was constant. In open-chest anesthetized dogs 6-keto-PGF1a concentration in the great cardiac vein was increased after ligation of the left anterior descending coronary artery. A prolonged period of coronary occlusion (4.5 hours) resulted in a progressive rise of prostacyclin release. 6-keto-PGF1a determinations in the femoral vein and in the aorta did not show relevant variations during the observation period.     

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。     

神经介入：回眸2022

<正>2022年,国际上公布了多项大型神经介入领域的随机对照试验（randomized controlled trial,RCT）结果,在血管内治疗（endovascular treatment,EVT）急性大血管闭塞（large vessel occlusion,LVO）适应证的扩展、药物治疗、管理,症状性颅内动脉粥样硬化性狭窄（symptomatic intracranial atherosclerotic stenosis,sICAS）治疗,无症状性颈动脉狭窄治疗,     

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.