人脑损伤后皮质细胞间黏附分子1表达及甲泼尼龙的影响

目的:观察细胞间黏附分子1在人创伤性脑损伤后挫伤区皮质中的表达情况,包括表达位置、表达强度和表达时相,同时观察甲泼尼龙对其表达的影响。方法:2004-01/2005-06南京军区南京总医院神经外科收治的48例创伤性脑损伤患者,按伤后时间分为8组,<24h创伤性脑损伤组、24～48h创伤性脑损伤组、48～72h创伤性脑损伤组、>72h创伤性脑损伤组以及相同时间段创伤性脑损伤+甲泼尼龙组。选择南京军区南京总医院收治的6例脑外肿瘤患者为阴性对照组。取样时间从伤后5h到5d,所有病例均行常规开颅血肿清除术,术中用咬骨钳夹取约0.5cm3挫伤区边缘的脑组织,各时间段创伤性脑损伤+甲泼尼龙组患者于术前2小时给予甲泼尼龙30mg/kg,快速静脉滴注。利用免疫组化技术测定细胞间黏附分子1的表达,在200倍显微镜下随机选择10个高倍视野,计数阳性血管数。同一时间段各组间使用独立样本的t检验,不同时间段各组间比较采用单因素方差分析及StudentNewmanKeuls检验。结果:入选的48例脑损伤患者都进入结果分析。免疫组化测定结果显示,在人创伤性脑损伤后的挫伤区皮质中,细胞间黏附分子1主要在血管内皮细胞中表达,在神经胶质细胞和神经元细胞中未见表达。与阴性对照组比较,各时间段创伤性脑损伤组、创伤性脑损伤+甲泼尼龙组,细胞间黏附分子1表达极显著上调(P<0.01),同一时间段中创伤性脑损伤与创伤性脑损伤+甲泼尼龙组比较,甲泼尼龙治疗组的患者细胞间黏附分子1显著下调(P<0.05),伤后48～72小时组与其它组比较,细胞间黏附分子1表达升高差异有显著性(P<0.05)。结论:细胞间黏附分子1在人创伤性脑损伤后的挫伤区皮质中表达上调,提示其可能在创伤性脑损伤后的病理生理过程中起着重要作用,甲泼尼龙抑制了细胞间黏附分子1的表达。     

辛伐他汀对新生鼠脑缺氧缺血后细胞间黏附分子1的影响

目的：观察缺血缺氧性脑损伤时皮质和海马区细胞间黏附分子1mRNA的表达，以及辛伐他汀的干预作用，并以胞二磷胆碱作标准对照。方法：实验于2003-04／2004-02在东南大学临床医学院实验室进行。选用144只7日龄SD大鼠，随机分为4组，每组又分为0，12，24，48，72h和7d6个时间点，每个时间点6只。①假手术组：手术游离左侧颈总动脉但不结扎，不干预。②生理盐水组：结扎左侧颈总动脉建立缺氧缺血性脑损伤模型后，于即刻及之后的每天同一时刻腹腔注射生理盐水10mL／kg。③胞二磷胆碱组：同前造模，于相同时间点给予胞二磷胆碱稀释液（胞二磷胆碱15mL＋生理盐水85mL）10mL／kg。④辛伐他汀组：造模同前，于相同时间点给予辛伐他汀20mg／kg。各组均于相应时间点取脑皮质和海马，观察脑外观，反转录-聚合酶链反应检测细胞间黏附分子1mRNA表达，以细胞间黏附分子1／β-actin吸光度表示。结果：144只动物进入结果分析。①左侧脑皮质细胞间黏附分子1mRNA表达：假手术组各时间点无差异（P〉0．05），其他3组于缺氧缺血后12h时始显著升高，24h达高峰，然后开始回落，但胞二磷胆碱组、辛伐他汀组于12，24，48和72h时显著低于生理盐水组，7d时，辛伐他汀组已接近假手术组水平（P〉0．05），且72h时，辛伐他汀组显著低于胞二磷胆碱组（P〈0．05）。②脑左侧海马细胞间黏附分子1mRNA表达：与脑皮质类似，生理盐水组、胞二磷胆碱组和辛伐他汀组在缺氧缺血后12h始升高，24h达高峰，然后开始下降，但胞二磷胆碱组、辛伐他汀组于12，24，48和72h时显著低于生理盐水组，7d时，辛伐他汀组已接近假手术组水平（P〉0．05），生理盐水组和胞二磷胆碱组表达量接近（P〉0．05），仍然显著高于假手术组（P〈0．01）。③脑外观：12h开始，生理盐水组结扎侧大脑半球出现水肿、苍白、液化坏死、萎缩的全过程，胞二磷胆碱组程度明显减轻，辛伐他汀组仅出现轻微水肿。结论：细胞间黏附分子1在缺氧缺血脑损伤后12h的表达显著升高，24h达高峰，然后持续下降，7d时虽明显下降，但仍高于正常水平，胞二磷胆碱和辛伐他汀均能有效地抑制其表达，对缺氧缺血脑损伤起到保护作用，但辛伐他汀的作用更强更快。     

辛伐他汀对新生鼠脑缺氧缺血后细胞间黏附分子1的影响

目的:观察缺血缺氧性脑损伤时皮质和海马区细胞间黏附分子1mRNA的表达,以及辛伐他汀的干预作用,并以胞二磷胆碱作标准对照。方法:实验于2003-04/2004-02在东南大学临床医学院实验室进行。选用144只7日龄SD大鼠,随机分为4组,每组又分为0,12,24,48,72h和7d6个时间点,每个时间点6只。①假手术组:手术游离左侧颈总动脉但不结扎,不干预。②生理盐水组:结扎左侧颈总动脉建立缺氧缺血性脑损伤模型后,于即刻及之后的每天同一时刻腹腔注射生理盐水10mL/kg。③胞二磷胆碱组:同前造模,于相同时间点给予胞二磷胆碱稀释液(胞二磷胆碱15mL+生理盐水85mL)10mL/kg。④辛伐他汀组:造模同前,于相同时间点给予辛伐他汀20mg/kg。各组均于相应时间点取脑皮质和海马,观察脑外观,反转录-聚合酶链反应检测细胞间黏附分子1mRNA表达,以细胞间黏附分子1/β-actin吸光度表示。结果:144只动物进入结果分析。①左侧脑皮质细胞间黏附分子1mRNA表达:假手术组各时间点无差异(P>0.05),其他3组于缺氧缺血后12h时始显著升高,24h达高峰,然后开始回落,但胞二磷胆碱组、辛伐他汀组于12,24,48和72h时显著低于生理盐水组,7d时,辛伐他汀组已接近假手术组水平(P>0.05),且72h时,辛伐他汀组显著低于胞二磷胆碱组(P<0.05)。②脑左侧海马细胞间黏附分子1mRNA表达:与脑皮质类似,生理盐水组、胞二磷胆碱组和辛伐他汀组在缺氧缺血后12h始升高,24h达高峰,然后开始下降,但胞二磷胆碱组、辛伐他汀组于12,24,48和72h时显著低于生理盐水组,7d时,辛伐他汀组已接近假手术组水平(P>0.05),生理盐水组和胞二磷胆碱组表达量接近(P>0.05),仍然显著高于假手术组(P<0.01)。③脑外观:12h开始,生理盐水组结扎侧大脑半球出现水肿、苍白、液化坏死、萎缩的全过程,胞二磷胆碱组程度明显减轻,辛伐他汀组仅出现轻微水肿。结论:细胞间黏附分子1在缺氧缺血脑损伤后12h的表达显著升高,24h达高峰,然后持续下降,7d时虽明显下降,但仍高于正常水平,胞二磷胆碱和辛伐他汀均能有效地抑制其表达,对缺氧缺血脑损伤起到保护作用,但辛伐他汀的作用更强更快。     

川芎嗪干预局灶性脑缺血再灌注大鼠脑内细胞间黏附分子1表达的动态变化

目的：探讨大鼠急性脑缺血再灌注后脑组织中细胞间黏附分子1的表达与白细胞浸润的关系，观察中药川芎嗪的治疗作用，并进行不同时限点的分析。方法：实验于2002-09／2003-02在湖南中医学院中心实验室进行。①分组：健康SD大鼠125只随机分为假手术组，模型组和川芎嗪组3组，假手术组分术后3，6，12，24和48h组，后两组又分为缺血3，6，12，24和48h组和再灌注3，6，12，24和48h组，每个时相点5只动物。②造模：假手术组仅分离动脉，不插入线栓，术后即刻腹腔注射生理盐水8mL／kg．其他两组线栓法制备脑缺血或缺血再灌注模型。③给药：川芎嗪组于缺血或再灌注后腹腔注射川芎嚷50mg／kg（71g／L），24h组追加给药1次，48h组追加给药两次。假手术组和模型组腹腔注射生理盐水8mL／kg。④指标检测：大鼠按相应时相点麻醉后断头处死，取脑组织免疫组化测定大鼠脑内细胞间黏附分子1表达阳性微血管数，苏木精-伊红染色观察白细胞计数，并分析两者间的相关性。结果：经补充后125只大鼠进入结果分析。①脑内细胞间黏附分子1表达阳性微血管数：免疫组化显示假手术组两侧半球大脑皮质可见少量表达。与假手术组比，模型组缺血6h表达明显增多，持续至48h时仍维持较高水平（P〈0．01），再灌注组3h即明显高于对照组，24h达高峰（P〈0．01）。川芎嗪组缺血及缺血再灌注6，12,24和48h均明显低于模型组相应时间点（P〈0．01）。②白细胞计数结果：苏木精-伊红染色显示假手术组术后3h可见脑内针遭周围有极少量，以后未继续增加。模型组脑缺血后3h即见，以后进行性增加，缺血再灌注3h有少量，6h逐渐增多，24h达到高峰，均显著高于对照组（P〈0.01）。川芎嚓组缺血及缺血再灌注6，12，24和48h均明显低于模型组相应时间点（P〈0．01）。③细胞间黏附分子1表达与白细胞浸润的相关性：脑缺血再灌注时两者呈正相关（rI=0．854, rIM=0．825，P〈0．01）。结论：脑缺血再灌注后细胞间黏附分子1的表达与白细胞浸润在时相上有相关性，细胞间黏附分子1表达略早于白细胞浸润，提示细胞间黏附分子1可介导白细胞和内皮细胞的黏附。川芎嚷在不同时限点均可显著下调细胞间黏附分子1的表达，从而进一步抑制白细胞浸润，减轻缺血脑组织炎症反应。     

大鼠中等程度创伤性脑损伤后神经细胞凋亡及半胱氨酸天冬氨酸蛋白酶3表达与活性的时效关系

目的：观察大鼠中等程度创伤性颅脑损伤后神经细胞凋亡及凋亡执行因子半胱氨酸天冬氨酸蛋白酶3表达和活性的时间动态演变，并探讨三者之间的时效关系。方法：实验于2004-04／10在解放军第三军医大学创伤、烧伤、复合伤国家重点实验室完成。选择健康SD大鼠48只，随机分为假致伤组8只和损伤组40只，损伤组根据处死时间分为2，12，24，48，72h共5个时相点，每个时相点8只大鼠。损伤组制备中等程度创伤性脑损伤模型，假致伤组仅作颅骨钻孔而不致伤，术后24h处死。观察中度脑损伤后2h-3d伤侧大脑皮质、海马神经细胞凋亡情况采用原位末端标记技术；观察半胱氨酸天冬氨酸蛋白酶3表达和活性的变化采用免疫组织化学及免疫荧光技术。结果：48只大鼠全部进入结果分析。①各组大鼠中度脑损伤后不同时间点大脑皮质、海马神经细胞凋亡情况：创伤性脑损伤后2h在伤侧皮质和海马区即可见有少量凋亡细胞，并呈逐渐增多趋势，主要分布在伤侧皮质、皮质下白质、海马等区域，12-24h凋亡细胞增多，48-72h达到凋亡高峰，明显高于假致伤组。②各组大鼠中度脑损伤后不同时间点半胱氨酸天冬氨酸蛋白酶3表达：脑损伤后2h在损伤灶及其周围皮质即有少量的半胱氨酸天冬氨酸蛋白酶3阳性细胞，脑损伤后24-48h阳性细胞数量明显增加。脑挫伤后72h半胱氨酸天冬氨酸蛋白酶3阳性细胞数有所下降。假致伤组脑组织偶见半胱氨酸天冬氨酸蛋白酶3阳性细胞。③各组大鼠中度脑损伤后不同时间点半胱氨酸天冬氨酸蛋白酶3活性变化：脑损伤后损伤灶及附近皮质神经细胞内半胱氨酸天冬氨酸蛋白酶3活性2h开始升高，伤后48h达高峰，损伤侧海马区域神经细胞内半胱氨酸天冬氨酸蛋白酶3活性2h开始升高，24h达高峰，而后开始下降。结论：大鼠创伤性脑损伤后损伤区周围皮质和损伤侧海马神经细胞凋亡数量的变化与伤后时程有关。伤后细胞半胱氨酸天冬氨酸蛋白酶3活性增加可能是导致细胞凋亡的因素。     

大鼠中等程度创伤性脑损伤后神经细胞凋亡及半胱氨酸天冬氨酸蛋白酶3表达与活性的时效关系

目的:观察大鼠中等程度创伤性颅脑损伤后神经细胞凋亡及凋亡执行因子半胱氨酸天冬氨酸蛋白酶3表达和活性的时间动态演变,并探讨三者之间的时效关系。方法:实验于2004-04/10在解放军第三军医大学创伤、烧伤、复合伤国家重点实验室完成。选择健康SD大鼠48只,随机分为假致伤组8只和损伤组40只,损伤组根据处死时间分为2,12,24,48,72h共5个时相点,每个时相点8只大鼠。损伤组制备中等程度创伤性脑损伤模型,假致伤组仅作颅骨钻孔而不致伤,术后24h处死。观察中度脑损伤后2h～3d伤侧大脑皮质、海马神经细胞凋亡情况采用原位末端标记技术;观察半胱氨酸天冬氨酸蛋白酶3表达和活性的变化采用免疫组织化学及免疫荧光技术。结果:48只大鼠全部进入结果分析。①各组大鼠中度脑损伤后不同时间点大脑皮质、海马神经细胞凋亡情况:创伤性脑损伤后2h在伤侧皮质和海马区即可见有少量凋亡细胞,并呈逐渐增多趋势,主要分布在伤侧皮质、皮质下白质、海马等区域,12～24h凋亡细胞增多,48～72h达到凋亡高峰,明显高于假致伤组。②各组大鼠中度脑损伤后不同时间点半胱氨酸天冬氨酸蛋白酶3表达:脑损伤后2h在损伤灶及其周围皮质即有少量的半胱氨酸天冬氨酸蛋白酶3阳性细胞,脑损伤后24～48h阳性细胞数量明显增加。脑挫伤后72h半胱氨酸天冬氨酸蛋白酶3阳性细胞数有所下降。假致伤组脑组织偶见半胱氨酸天冬氨酸蛋白酶3阳性细胞。③各组大鼠中度脑损伤后不同时间点半胱氨酸天冬氨酸蛋白酶3活性变化:脑损伤后损伤灶及附近皮质神经细胞内半胱氨酸天冬氨酸蛋白酶3活性2h开始升高,伤后48h达高峰,损伤侧海马区域神经细胞内半胱氨酸天冬氨酸蛋白酶3活性2h开始升高,24h达高峰,而后开始下降。结论:大鼠创伤性脑损伤后损伤区周围皮质和损伤侧海马神经细胞凋亡数量的变化与伤后时程有关。伤后细胞半胱氨酸天冬氨酸蛋白酶3活性增加可能是导致细胞凋亡的因素。     

亚低温状态对大鼠脑缺血再灌注损伤的保护途径

目的：大鼠局灶性脑缺血再灌注造成的脑损伤系炎症反应的细胞因子细胞间黏附分子1表达上调，并使中性粒细胞聚集的结果。髓过氧化物酶活性可作为中性粒细胞浸润的定量指标，观察亚低温状态下细胞因子和酶动态变化的特点。方法：实验于2004-09／12在武汉大学人民医院实验中心完成。选取90只SD大鼠，随机分为3组：①假手术组（n=10）：仅分离并牵拉左侧颈内动脉，不阻断其血流，肛温稳定在37℃，术后24h麻醉状态下处死。②常温组（n=40）：采用大鼠大脑中动脉线栓闭塞／再通法建立大鼠局灶性缺血再灌注模型，缺血期肛温稳定在37℃，分别于脑缺血3h再灌注6，24．48和72h麻醉状态下处死，每个时间点10只。③亚低温组（n=40）：同前造模，缺血期间肛温保持在32-33℃，缺血结束后立即自然复温，处死时间和只数同常温组。细胞间黏附分子1阳性微血管数用免疫组化测定，同时检测髓过氧化物酶活性。结果：经补充后90只大鼠进入结果分析。①细胞间黏附分子1阳性微血管数：常温组再灌注6h缺血侧脑组织中可见到和增高，48h达到高峰[（98．01&;#177;9．00）条]，再灌注72h仍保持一定水平的表达，亚低温组各时间点均低于相应的常温组（P〈0．05，P〈0．01），但两组均高于假手术组[（5．35&;#177;3．07）条，P〈0．05，P〈0．01]。②髓过氧化物酶活性：常温组再灌注6h增高，48h达高峰，显著高于假手术组[（0．5594&;#177;0．1662），（1．9099&;#177;0．2507），（0．2037&;#177;0．0637）kat／g，P〈0．01]，亚低温组各时间点均低于相应的常温组（P〈0．05，P〈0．01），但仍高于假手术组。结论：脑缺血再灌注后炎症反应是造成脑损伤的重要因素之一。亚低温所起到的脑保护作用，其途径为抑制脑缺血再灌注后缺血区细胞间黏附分子1的表达和脑组织中的髓过氧化物酶活性，从而使白细胞聚集浸润减少。     

通心络对大鼠脑缺血再灌注模型微血管细胞间黏附分子1和血管细胞黏附分子1表达的影响

背景：现代医学发现通心络制剂除了具有抗凝和抑制血小板聚集作用外，对血管内皮细胞有一定的保护作用。目的：观察中药复方制剂通心络是否影响脑缺血再灌注动物模型黏附分子的表达。设计：随机对照实验。单位：解放军第二军医大学长征医院神经内科。材料：实验于2002—10／2003—01在解放军第二军医大学长征医院神经内科实验室完成。选择雄性SD大鼠25只，随机分为假手术组5只、模型组10只和通心络组10只。方法：线栓法制备大鼠大脑中动脉脑局灶性脑缺血再灌注模型，假手术组除将尼龙线插在颈外动脉接近颈内动脉分叉处外，其余同模型组。通心络组大鼠在缺血再灌注前给予通-15,络粉剂1．0g／（kg-d），溶在生理盐水中灌胃1周。模型组和假手术组灌胃等剂量生理盐水。各组大鼠麻醉后取脑制备切片．行常规苏木精-伊红染色、免疫组化及原位杂交染色。主要观察指标：①缺血再灌注后细胞间黏附分子1和血管细胞黏附分子1阳性微血管表达数目。②缺血再灌注后细胞间黏附分子1mRNA阳性微血管表达数目。结果：①假手术组手术侧大脑半球皮质和基底节区未见细胞间黏附分子1、血管细胞黏附分子1蛋白和细胞间黏附分子1mRNA阳性微血管表达。②模型组大鼠缺血2h再灌注6h后，缺血侧大脑细胞间黏附分子1、血管细胞黏附分子-1蛋白表达水平和细胞间黏附分子1mRNA表达水平显著升高。③通心络组缺血侧大脑半球皮质和基底节区蛋白和mRNA阳性微血管数较模型组显著降低[（10．42&;#177;1．98），（12．42&;#177;2．14）／高倍视野；（8．54&;#177;2．00），（11．12&;#177;1．56）／高倍视野]（P〈0．05），血管细胞黏附分子1蛋白阳性微血管表达数目无显著变化（P〉0．05）。结论：通心络可以降低大鼠脑缺血再灌注后细胞间黏附分子1的转录和翻译过程，有助于减轻脑缺血后的炎症性损伤过程。     

红参附子提取物保护下肾缺血再灌注损伤大鼠细胞问黏附分子1的表达

目的：观察细胞问黏附分子1表达与大鼠肾缺血再灌注损伤的关系及红参附子提取物对其的保护作用。 方法：实验于2004—03／2004—09在锦州医学院附属第一医院肾内科实验室完成。将60只雄性SD大鼠以随机数字表法分为3组，即假手术组，模型组，观察组，每组20只。对模型组，观察组大鼠采取右侧肾切除，夹闭左侧肾蒂1h，制造再灌注模型；假手术组仅切除右肾，分离左肾肾蒂但不夹闭。观察组于缺血前0.5h予红参附子提取物（参附注射液，三九雅安制药公司，批号：2003091821，20mL／支）10mL／kg门静脉注射；假手术组和模型组均注射等量生理盐水。各组分别于术后24，48h取10只大鼠处死，取肾脏标本做组织学检查，观察形态学变化，用免疫组化方法检测肾组织中细胞间黏附分子1的表达水平，并计数再灌注模型肾组织中多型核白细胞的浸润数。 结果：60只大鼠全部进入结果分析。①模型组镜下可见近曲小管排列紊乱、疏松，有广泛空泡变性及片状坏死，细胞核固缩、深染。远曲小管内有大量管型形成。肾间质局部出血伴炎细胞浸润。观察组肾小管排列基本正常，小管上皮细胞轻度浊肿，偶见管型。炎细胞浸润亦较模型组明显减轻。除假手术组，各组48h改变较24h严重。②模型组肾小管Paller氏评分和肾组织中自细胞计数与假手术组比较，均显著增加（P＜0．01），观察组均显著低于模型组（P＜0．01）。除假手术组，各组24h与48h间差异有显著性意义（P＜0．01）。③假手术组肾脏细胞间黏附分子1仅见微量表达。模型组24h出现明显细胞间黏附分子1表达，48h表达显著高于24h组（P＜0．01）。观察组细胞间黏附分子1表达明显弱于模型组（P＜0．01）。④再灌注24h及48h肾小管评分与肾组织中自细胞数、细胞间黏附分子1表达均呈正相关（r=0．65，0．58，P＜0．05）。肾组织中自细胞数、细胞间黏附分子1表达呈正相关（r=0．85，P＜0．05）。 结论：细胞间黏附分子1可介导炎细胞浸润并造成肾脏缺血再灌注损伤，红参附子提取物能够抑制这种损伤过程，发挥肾保护作用。     

川芎嗪干预局灶性脑缺血再灌注大鼠脑内细胞间黏附分子1表达的动态变化

目的:探讨大鼠急性脑缺血再灌注后脑组织中细胞间黏附分子1的表达与白细胞浸润的关系,观察中药川芎嗪的治疗作用,并进行不同时限点的分析。方法:实验于2002-09/2003-02在湖南中医学院中心实验室进行。①分组:健康SD大鼠125只随机分为假手术组,模型组和川芎嗪组3组,假手术组分术后3,6,12,24和48h组,后两组又分为缺血3,6,12,24和48h组和再灌注3,6,12,24和48h组,每个时相点5只动物。②造模:假手术组仅分离动脉,不插入线栓,术后即刻腹腔注射生理盐水8mL/kg,其他两组线栓法制备脑缺血或缺血再灌注模型。③给药:川芎嗪组于缺血或再灌注后腹腔注射川芎嗪50mg/kg(71g/L),24h组追加给药1次,48h组追加给药两次。假手术组和模型组腹腔注射生理盐水8mL/kg。④指标检测:大鼠按相应时相点麻醉后断头处死,取脑组织免疫组化测定大鼠脑内细胞间黏附分子1表达阳性微血管数,苏木精-伊红染色观察白细胞计数,并分析两者间的相关性。结果:经补充后125只大鼠进入结果分析。①脑内细胞间黏附分子1表达阳性微血管数:免疫组化显示假手术组两侧半球大脑皮质可见少量表达。与假手术组比,模型组缺血6h表达明显增多,持续至48h时仍维持较高水平(P<0.01),再灌注组3h即明显高于对照组,24h达高峰(P<0.01)。川芎嗪组缺血及缺血再灌注6,12,24和48h均明显低于模型组相应时间点(P<0.01)。②白细胞计数结果:苏木精-伊红染色显示假手术组术后3h可见脑内针道周围有极少量,以后未继续增加。模型组脑缺血后3h即见,以后进行性增加,缺血再灌注3h有少量,6h逐渐增多,24h达到高峰,均显著高于对照组(P<0.01)。川芎嗪组缺血及缺血再灌注6,12,24和48h均明显低于模型组相应时间点(P<0.01)。③细胞间黏附分子1表达与白细胞浸润的相关性:脑缺血再灌注时两者呈正相关(rI=0.854,rIR=0.825,P<0.01)。结论:脑缺血再灌注后细胞间黏附分子1的表达与白细胞浸润在时相上有相关性,细胞间黏附分子1表达略早于白细胞浸润,提示细胞间黏附分子1可介导白细胞和内皮细胞的黏附。川芎嗪在不同时限点均可显著下调细胞间黏附分子1的表达,从而进一步抑制白细胞浸润,减轻缺血脑组织炎症反应。     

Mediators of brain edema and secondary brain damage

Progress is our understanding of the roles of vasogenic and cytotoxic brain edema in secondary brain damage can be expected from studies of the ability of biochemical factors to open the blood-brain barrier, derange the microcirculation, and cause cell swelling and necrosis. Mediator compounds are considered to form or to become released in an area of primarily damaged brain (necrosis) and to enter the cerebral parenchyma through the broken blood-brain barrier from the intravascular space. Many biochemical factors must be considered. We suggested three criteria for determining the roles of mediators: a) they must inflict brain tissue damage, b) they must occur in pathologic concentrations or in compartments not normally present, and c) specific inhibition should attenuate secondary brain damage. These requirements are met by the kallikrein-kinin system and by glutamate. In the case of arachidonic acid and its many metabolites, the concept is difficult to test because fatty acids may be active only if not bound to proteins, and therapeutic inhibition might be difficult. A variety of mediators may enhance each other in a cascade manner by various initiating reactions that might be amenable for pharmacologic inhibition.     

Imaging brain development: the adolescent brain

The past 15 years have seen a rapid expansion in the number of studies using neuroimaging techniques to investigate maturational changes in the human brain. In this paper, I review MRI studies on structural changes in the developing brain, and fMRI studies on functional changes in the social brain during adolescence. Both MRI and fMRI studies point to adolescence as a period of continued neural development. In the final section, I discuss a number of areas of research that are just beginning and may be the subject of developmental neuroimaging in the next twenty years. Future studies might focus on complex questions including the development of functional connectivity; how gender and puberty influence adolescent brain development; the effects of genes, environment and culture on the adolescent brain; development of the atypical adolescent brain; and implications for policy of the study of the adolescent brain.     

Enhanced brain extraction improves the accuracy of brain atrophy estimation

BET (Brain Extraction Tool) is a widely used computer program to automatically separate brain from non-brain structures in MR images. This procedure is used in SIENAX and SIENA, which are robust approaches to quantifying brain volume (atrophy state) and volume change (atrophy rate), respectively. Occasionally, however, BET produces imperfect results (e.g., inclusion of non-brain structures). This is usually either ignored (if inaccuracies are small) or corrected by manual adjustment, with the disadvantages of user intervention. We describe here a new, automated option in BET. This is based on the original BET, but uses standard-space masking to remove tissue around the eyes, and further morphological operations and thresholding to refine eyeball removal and eliminate additional non-brain tissues. To assess whether the new BET procedure improves brain volume measurements, this was compared with the traditional and manual editing procedures in SIENA and SIENAX. Measures of atrophy rate and state were significantly higher with the traditional procedure than with the manual editing and new procedures. In contrast, both atrophy measures were almost identical and highly correlated when the manual editing and new procedures were used. The voxels excluded with these two procedures showed close overlap, as judged by the Dice overlap coefficient. We conclude that, in SIENA and SIENAX, the proposed BET procedure shows results matching those obtained after manual editing, thus more closely approximating the "true" brain volume. Multicentre studies monitoring brain atrophy in clinical trials may receive benefit by using this unbiased, fully automated procedure.     

Effect of brain cooling on brain ischemia and damage markers after fluid percussion brain injury in rats

Although systemic cooling had recently been reported as effective in improving the neurological outcome after traumatic brain injury, several problems are associated with whole-body cooling. The present study was conducted to test the effectiveness of brain cooling without interference with the core temperature in rats after fluid percussion traumatic brain injury (TBI). Brain dialysates ischemia (e.g., glutamate and lactate-to-pyruvate ratio) and injury (e.g., glycerol) markers before and after TBI were measured in rats with mild brain cooling (33 degrees C) and in the sham control group. Brain cooling was accomplished by infusion of 5 mL cold saline via the external jugular vein under general anesthesia. The weight loss was determined by the difference between the first and third day of body weight after TBI. The maximum grip angle in an inclined plane was measured to determine motor performance, whereas the percentage of maximal possible effect was used to measure blockade of proprioception. The triphenyltetrazolium chloride staining procedures were used for cerebral infarction assay. As compared with those of the sham-operated controls, the animals with TBI had higher values of extracellular levels of glutamate, lactate-to-pyruvate ratio, and glycerol in brain and intracranial pressure, but lower values of cerebral perfusion pressure. Brain cooling adopted immediately after TBI significantly attenuated the TBI-induced increased cerebral ischemia and injury markers, intracranial hypertension, and cerebral hypoperfusion. In addition, the TBI-induced cerebral infarction, motor and proprioception deficits, and body weight loss evaluated 3 days after TBI were significantly attenuated by brain cooling. We successfully demonstrate that brain cooling causes attenuation of TBI in rats by reducing cerebral ischemia and injury resulting from intracranial hypertension and cerebral hypoperfusion. Because jugular venipuncture is an easy procedure frequently used in the emergency department, for preservation of brain function, jugular infusion of cold saline may be useful in resuscitation for trauma patients.     

重型颅脑损伤术后顽固性脑蕈的临床分析

目的 探讨重型颅脑损伤术后顽固性脑蕈的形成原因及有效治疗措施。方法 对32例病人进行回顾性分析，总结其形成原因、有效治疗措施。结果 脑水肿、脑积水、颅内感染是重型颅脑损伤术后形成顽固性脑蕈的主要原因，有效运用脱水药物和各种措施降低颅内压、预防感染、保证创口I期愈合是治疗顽固性脑蕈的有效措施。结论 针对不同情况采取相应措施治疗重型颅脑损伤术后顽固性脑蕈，取得较好疗效。     

Human fetal brain imaging by magnetoencephalography: verification of fetal brain signals by comparison with fetal brain models

Fetal magnetoencephalogram (fMEG) is measured in the presence of a large interference from maternal and fetal magnetocardiograms (mMCG and fMCG). This cardiac interference can be successfully removed by orthogonal projection of the corresponding spatial vectors. However, orthogonal projection redistributes the fMEG signal among channels. Such redistribution can be readily accounted for in the forward solution, and the signal topography can also be corrected. To assure that the correction has been done properly, and also to verify that the measured signal originates from within the fetal head, we have modeled the observed fMEG by two extreme models where the fetal head is assumed to be either electrically transparent or isolated from the abdominal tissue. Based on the measured spontaneous, sharp wave, and flash-evoked fMEG signals, we have concluded that the model of the electrically isolated fetal head is more appropriate for fMEG analysis. We show with the help of this model that the redistribution due to projection was properly corrected, and also, that the measured fMEG is consistent with the known position of the fetal head. The modeling provides additional confidence that the measured signals indeed originate from within the fetal head.     

脑胶质瘤中肿瘤干细胞的体外傲射敏感性

背景：目前放疗治疗脑胶质瘤效果不理想,可能因素有很多.目的：探讨脑胶质瘤中肿瘤干细胞的体外放射敏感性.方法：取脑胶质瘤细胞,接种于含生长因子的无血清培养基中培养,取细胞活力最强的位点扩增3-5代的肿瘤球细胞,给予不同X射线剂量照射,检测其细胞活力,以确定最适的放疗剂量.结果与结论：胶质瘤中不同部位的肿瘤细胞增殖活力有差异;8 Gy以上X射线剂量对脑肿瘤干细胞具有显著的杀伤作用.说明脑胶质瘤具有异质性,部位不同,脑肿瘤干细胞增殖活力不同;不同的放疗剂量对脑肿瘤干细胞有不同的影响.