慢性实验性变应性猴脑脊髓炎的超微结构改变

目的：探讨自身免疫性中枢神经系统脱髓鞘疾病慢性型的病理特点及其可能机制。方法：成功建立猴实验性态反应性脑脊髓炎模型数年后，根据MR摄片结果位病灶并作分类，然后进行病理取材和电镜观察超微结构。结果：（1）活动性病灶内成片的髓鞘松解、断裂或融合，轴突空泡样变性，皱缩或消失，少突胶质细胞变性，未见淋巴细胞浸润，仅见散在巨噬细胞，伴明显的间质水肿；（2）可疑活动性病灶内见部分髓鞘内板松解，其内轴突有较度空泡样变，亦见少突胶质细胞变性，散在巨噬细胞，未见淋巴瘤浸润，结论：慢性EAE的病理改变不仅有髓鞘的变性，同时轴突的病变也十分明显。     

进行性多灶性白质脑病

正进行性多灶性白质脑病是一种中枢神经系统脱髓鞘性疾病,由JC病毒机会性感染所致。病变常位于灰白质交界处,髓鞘染色可见髓鞘脱失,病灶内特别是活动性病灶内有大量泡沫细胞,仅可见散在淋巴细胞浸润。受感染的少突胶质细胞胞核较大、深染,"毛玻璃"样改变的少突胶质细胞多见于病灶周边(图1a),病灶内及周围脑组织可见体积增大、深染、异形性或多核、     

实验性自身免疫性脑脊髓炎的视神经病理改变

目的 研究实验性自身免疫性脑脊髓炎(EAE)的视神经病理改变.方法 足垫皮下注射豚鼠脊髓匀浆和完全弗氏佐剂(CFA)混合物制作Wismr大鼠EAE模型,于发病后第6d将大鼠处死,取视神经、脑和脊髓,行HE和LFB染色,光镜和电镜下观察其病理改变.结果 病理检查发现EAE模型组大鼠脑、脊髓有不同程度的炎症反应和脱髓鞘改变;均有视神经病变,光镜主要表现为炎症反应和脱髓鞘,视神经髓鞘脱失重于炎症反应;电镜主要表现为髓鞘稀疏,少突胶质细胞数量减少、胞核固缩,其周围包裹的髓鞘板层松解,轴突髓鞘分离.结论 EAE大鼠存在明显的视神经病变,主要为视神经炎症反应和脱髓鞘改变.     

实验性变应性猴脑脊髓炎的超微结构改变

目的探讨自身免疫性中枢神经系统（ＣＮＳ）脱髓鞘的病理特点和发病过程。方法建立猴实验性变态反应性脑脊髓炎（ＥＡＥ）的模型，并从病情不同阶段进行病理取材和电镜观察。结果（１）ＥＡＥ脱髓鞘最早的靶是少突胶质细胞（ＯＤＣ），而不是髓鞘本身；（２）无论急性期还是慢性期，脱髓鞘病灶内只有极少的炎细胞浸入；（３）急性期髓鞘改变轻微，以变性为主，ＯＤＣ肿胀显著，轴突相对完整。远离髓鞘变性区有大量炎细胞浸入；（４）慢性期病变区髓鞘脱失明显，ＯＤＣ严重变性或部分丢失，继发性轴突变性，边缘可见少量薄的髓鞘再生，血脑屏障破坏。结论ＥＡＥ的ＣＮＳ脱髓鞘过程首先累及ＯＤＣ。     

进行性多灶性白质脑病(附1例临床病理报告)

报告我国首例进行性多灶性白质脑病,临床上表现为精神症状后出现以锥体外系及锥体束损害为主的进行性弥漫性脑部病变,两大脑半球白质有散在众多与血管分布无关的脱髓鞘小病灶,并具有正常少突胶质细胞消失和星形胶质细胞增生肥大的病理特征,未发现核内包涵体的存在。     

小鼠实验性自身免疫性脑脊髓炎的病理变化

目的用髓鞘少突胶质细胞糖蛋白多肽(MOG35-55)诱发实验性自身免疫性脑脊髓炎(experi-m ental autoimmune encephalomyelitis,EAE)小鼠模型。方法应用MOG35-55抗原加完全弗氏佐剂免疫C57BL/6小鼠,利用光镜、电镜观察小鼠组织学改变。结果光镜下可见小血管周围炎细胞浸润,呈袖套状改变、血管周围明显脱髓鞘及神经元变性,B ieschowsky银染显示大量轴索肿胀和轴索卵形体的形成,电镜下可见髓鞘结构松散、断裂或融合,包括不同程度的髓鞘重建,脊髓病变广泛,程度重于脑部。结论EAE的病理改变为血管周围炎性细胞浸润、白质脱髓鞘及髓鞘重建。     

载脂蛋白E拟肽对EAE小鼠的髓鞘和轴突损伤的影响

目的探讨载脂蛋白E(ApoE)拟肽对实验性自身免疫性脑脊髓炎(EAE)小鼠中枢神经系统髓鞘脱失和轴突损伤的影响。方法以髓鞘少突胶质细胞糖蛋白多肽(MOG35-55)为抗原建立EAE模型。将40只雌性C57BL/6J小鼠随机分为4组,即正常组、EAE组、正常治疗组和EAE治疗组,两个治疗组皮下注射ApoE拟肽。免疫组化法检测髓鞘碱性蛋白(MBP)和神经丝轻链(NF-L)的表达。结果 EAE治疗组中脑和脊髓的MBP和NF-L的表达均高于EAE组(P<0.05)。结论 ApoE拟肽可能对EAE的髓鞘和轴突的损伤有保护作用。     

少突胶质细胞包涵体对多系统萎缩的诊断意义

目的 观察多系统萎缩脑和脊髓内少突胶质细胞包涵体并评估其诊断意义。方法 应用Gallyas-Braak银染色法研究4例经临床和传统病理方法诊断的多系统萎缩的脑和脊髓标本，以8例运动神经元病的脑和脊髓，6例无神经系统症状和病理改变的同龄人脑标本作对照。结果 4例病例中3例的脑和脊髓白质发现少突胶质细胞包涵体，该包涵体位于少突胶质细胞胞质内，呈半月形、镰刀形、火焰形。主要分布于脑桥、小脑、苍白球－壳核、延髓白质纤维束，脊髓外侧束，且与髓鞘变性脱失的分布一致。另有1例临床缺乏植物神经症状，黑质和脊髓中间外侧柱细胞无明显病变者，其脑和脊髓白质未观察到这种包涵体。所有对照病例的脑和脊髓白质内也未发现少突胶质细胞包涵体。结论 少突胶质细胞包涵体是散发性多系统萎缩特异性较高的病理标志，提示少突胶质细胞变性可能与多系统萎缩的髓鞘脱失有关。     

经颅磁刺激调控中枢神经系统髓鞘形成的研究进展

<正>中枢神经系统(central nervous system, CNS)髓鞘形成涉及多种细胞、信号通路和细胞因子的调控。少突胶质细胞(oligodendrocyte, OL)是CNS的髓鞘形成细胞,提供营养支持轴突和产生髓鞘包裹轴突;少突胶质前体细胞(oligodendrocyte progenitor cell, OPC),可增殖分化补充OL;小胶质细胞可以释放炎症分子影响OL的发育和髓鞘修复,也可以吞噬髓鞘碎片;     

猴急慢性实验性变应性脑脊髓炎的病理研究

目的　探讨急、慢性猴 (猕猴类 )实验性变应性脑脊髓炎 (EAE)的病理特点。方法　从EAE猴病程不同阶段进行病理取材 ,制成切片 ,用HE、Bielschowsky改良法、Page法、Holzer法染色及间接免疫荧光法观察CD4、CD8和B淋巴细胞。结果　 ( 1)猴急性EAE脑组织炎症反应重 ,分布在小静脉周围形成血管套 ,以CD4淋巴细胞浸入为主。脱髓鞘病灶微小 ,分布弥散 ,轴突改变轻 ,无出血 ,类似急性播散性脑脊髓炎 (ADEM)。 ( 2 )猴慢性EAE脑组织炎症反应轻 ,分布在血管外周 ,以CD8和B细胞为主。脱髓鞘病灶较大 ,界线清晰 ,呈局灶性分布。病变部位轴突变性严重及轴突丧失 ,有胶质斑块形成 ,与慢性多发性硬化 (MS)的活动期病理改变有惊人的相似。结论　支持猴慢性EAE是MS的优秀模型。另外 ,用相同抗原诱导出不同病程的EAE提示ADEM和MS可能是同一疾病的不同病程 ,或可能是同一种病因 ,而致病程不同。     

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.