右美托咪定抑制大鼠创伤性脑损伤后神经细胞凋亡

目的 探讨右美托咪定(DEX)对创伤性脑损伤(TBI)的神经保护作用是否与抑制神经细胞凋亡有关,是否涉及SIRT1信号通路.方法 将SD大鼠随机分为Sham组、TBI+NS组、TBI+DEX组和TBI+DEX+EX527组.采用干/湿重法评估脑创伤后脑组织含水量;神经功能缺损评分检查神经功能受损情况;Western b...     

脑疏宁对颅脑创伤后大鼠血脑屏障通透性及MMP-9表达的影响

目的观察中药脑疏宁对创伤性脑损伤(TBI)大鼠血脑屏障(BBB)通透性及脑组织基质金属蛋白酶-9(MMP-9)蛋白表达的影响,探讨中药保护血脑屏障的作用机理.方法按Feeney自由落体撞击法造成TBI模型,采用免疫组织化学技术观察大鼠脑组织MMP-9表达.结果模型组创伤后24h BBB破坏,脑组织含水量增加,病灶区MMP-9蛋白表达增高,脑疏宁组BBB通透性、脑组织含水量及MMP-9表达较模型组降低(P＜0.01).结论颅脑损伤后MMP-9表达增高,促使BBB破坏,导致血管源性脑水肿.中药脑疏宁可以保护BBB,降低脑组织含水量,其作用可能与抑制MMP-9在损伤脑组织中的表达有关.     

中性粒细胞弹性蛋白酶抑制剂对颅脑创伤大鼠血脑屏障通透性和脑水肿的影响

目的：探讨中性粒细胞弹性蛋白酶（NE）抑制剂对颅脑创伤（TBI）大鼠血脑屏障（BBB）通透性改变和脑水肿的影响。方法将99只大鼠分为对照组、TBI组和干预组（分为6、24、48、72、168 h亚组）,复制大鼠液压打击模型,干预组给予西维来司钠,分别测定各组脑组织NE的浓度、BBB通透性和脑组织含水率,并进行比较分析。结果 TBI组和干预组大鼠脑组织NE浓度、BBB通透性和脑组织含水率在各时间点都高于对照组,干预组的NE浓度在24、48、72、168 h低于TBI组,BBB通透性和脑组织含水率在48、72、168 h低于TBI组（P＜0．05）。结论西维来司钠能抑制TBI大鼠脑组织NE的释放,降低BBB的通透性并减轻脑水肿发生,表明西维来司钠对大鼠TBI继发性损伤有保护作用。     

右美托咪定联合舒芬太尼对高血压性脑出血大鼠脑组织形态学改变的研究

目的 探究右美托咪定、舒芬太尼及其联合应用对高血压性脑出血大鼠脑组织形态学改变的影响。方法 SD大鼠采用随机数字表法分为假手术组、模型组、右美托咪定组、舒芬太尼组、右美托咪定联合舒芬太尼组,制备双肾双夹大鼠肾血管性高血压模型,除假手术组均经右侧尾状核注入含0.4 UⅦ型胶原酶等量生理盐水诱导脑出血,右美托咪定组构建模型前给予5μg/kg盐酸右美托咪定腹腔注射,舒芬太尼组构建模型前给予10μg/kg舒芬太尼腹腔注射,右美托咪定联合舒芬太尼组构建模型前给予5μg/kg盐酸右美托咪定+10μg/kg舒芬太尼腹腔注射。比较各组大鼠术后24 h神经功能缺损程度量表(neurological deficit score, NDS)评分差异、脑组织含水量;采用光学显微镜及电子显微镜观察各组右侧大脑皮层组织形态改变;荧光显微镜观察各组脑组织出血区存活神经元;采用定量试剂盒检测一氧化氮(nitric oxide, NO)含量及一氧化氮合酶(nitric oxide synthase, NOS)活性。结果 与假手术组比较,模型组、右美托咪定组、舒芬太尼组、右美托咪定联合舒芬太尼组NDS评分、脑组织含水量、...     

右美托咪定抑制大鼠创伤性脑损伤后神经细胞凋亡

  目的  探讨右美托咪定（DEX）对创伤性脑损伤（TBI）的神经保护作用是否与抑制神经细胞凋亡有关，是否涉及SIRT1信号通路。  方法  将SD大鼠随机分为Sham组、TBI + NS组、TBI + DEX组和TBI + DEX + EX527组。采用干/湿重法评估脑创伤后脑组织含水量；神经功能缺损评分检查神经功能受损情况；Western blot法检测大鼠皮质Bcl-2和Bax蛋白的表达水平。  结果  实验结果显示DEX干预后可减少脑创伤后促凋亡的调控蛋白Bax表达，差异有统计学意义（P < 0.05），增加抑制凋亡的调控蛋白Bcl-2表达，差异有统计学意义（P < 0.05），减轻脑水肿，差异有统计学意义（P < 0.05）和改善神经功能，差异有统计学意义（P < 0.05），上述观测指标的变化可被SIRT1抑制剂EX527逆转。  结论  提示DEX通过抑制神经细胞凋亡而减轻脑创伤后的继发性损害，该神经保护作用与SIRT1信号通路之间存在一定相关性。     

右美托咪定基于CD38/cADPR通路对罗哌卡因致惊厥大鼠大脑氧化应激的保护作用

目的观察右美托咪定是否经CD38/cADPR通路发挥抑制罗哌卡因致惊厥大鼠大脑氧化应激的作用。方法2020年1月—2021年1月于湖北省恩施土家族苗族自治州中心医院进行实验,选择SPF级雄性大鼠60只,随机数字表法选取20只作为空白对照组,其余40只大鼠腹腔注射0.5%罗哌卡因33.8 mg/kg制备惊厥模型,最终37只大鼠建模成功,随机数字表法分为模型组19只和右美托咪定组18只。右美托咪定组大鼠腹腔注射右美托咪定100μmol/L,空白对照组、模型组均腹腔注射等剂量生理盐水。测定各组大鼠学习记忆能力,比较各组大鼠脑组织病理变化、脑细胞凋亡率、脑组织氧化应激程度及脑组织CD38/cADPR通路蛋白表达量。结果与空白对照组比较,模型组大鼠学习能力下降,而与模型组比较,右美托咪定组学习能力提高(t/P=12.160/<0.001);空白对照组大鼠脑组织中神经细胞排列较为整齐,内含丰富的尼氏小体,染色均匀;神经细胞合成蛋白质功能较强。模型组大鼠脑组织神经细胞损伤较为严重,排列紊乱,尼氏小体着色较浅;右美托咪定组大鼠脑组织神经细胞形态较为完整,与模型组比较,尼氏小体数量增加,染色均匀。与空白对照组比较,模型组脑细胞凋亡率升高(P<0.05);与模型组比较,右美托咪定组脑细胞凋亡率降低(t/P=6.084/<0.001)。与空白对照组比较,模型组脑组织SOD含量减少,MDA含量增加(P<0.05);与模型组比较,右美托咪定组脑组织SOD含量增加,MDA含量减少(P<0.05)。与空白对照组比较,模型组脑组织CD38、cADPR、Bax、iNOS表达升高,Bcl-2、Caspase-3表达降低(P<0.05);与模型组比较,右美托咪定组脑组织CD38、cADPR、Bax、iNOS表达降低,Bcl-2、Caspase-3表达升高(P<0.05)。结论右美托咪定可能通过抑制CD38/cADPR通路活性,抑制大脑氧化应激反应、脑细胞凋亡,进而发挥保护罗哌卡因致惊厥大鼠的作用。     

右美托咪定联合浅低温对脑缺血损伤大鼠神经保护作用中炎症因子的影响

目的:探讨右美托咪定联合浅低温对脑缺血损伤大鼠神经的保护作用。方法:雄性SD大鼠60只随机分为5组,假手术组(SH组),缺血损伤组(I组),浅低温组(T组),右美托咪定组(D组),浅低温复合右美托咪定(DT组)。建立大鼠脑缺血损伤模型,SH组仅分离出颈部血管不处理,同时维持颞肌温度约37.5℃;I组,于恒温箱中保持体温37.5℃,分离并结扎右颈总动脉和颈内动脉,60min后松开结扎线复灌;T组,保持体温约35℃,其余处理同I组;D组,保持体温约37.5℃,于结扎前30min腹腔注射右美托咪定100μg/kg,其余处理同I组;DT组,保持体温约35℃,其余处理同D组。术后72h对大鼠进行神经功能评分后,断头取脑采用干湿重法测量缺血脑组织含水量,用ELISA法检测血清中TNF-α,IL-6含量。结果:复灌72h结束后,T组、D组、DT组脑组织含水量较I组明显减少(P<0.05),T组、D组及DT组血清中TNF-α和IL-6含量较I组明显减少(P<0.05)。结论:右美托咪定联合浅低温对脑缺血损伤大鼠神经有保护作用。     

右美托咪定通过HIF-1α对缺血性脑卒中线粒体功能的调控

目的 基于HIF-1α对线粒体功能调节作用,探讨右美托咪定对缺血性脑卒中大鼠神经功能的保护。方法 将48只SD大鼠随机分为假手术组、脑缺血组和右美托咪定组、右美托咪定+YC-1组。除假手术组大鼠,各组大鼠采用Longa法构建脑缺血再灌注模型,期间腹腔注射右美托咪定（50 μg/kg）或YC-1（5 mg/kg）。24 h后先评估大鼠神经功能与脑梗死体积占比,再取脑组织后提取线粒体检测线粒体膜电位与线粒体呼吸链复合物活性,最后通过试剂盒检测ROS、GSH与ATP水平,以Western blot检测HIF-1α表达。结果 脑缺血组大鼠神经功能评分降低,出现了脑梗死区域。与脑缺血组相比,右美托咪定明显增加了大鼠的神经功能评分,减少了脑梗死体积占比。此外,右美托咪定上调了线粒体膜电位水平,提高了线粒体呼吸链复合物Ⅰ/Ⅱ/Ⅲ活性。与此同时,右美托咪定组大鼠脑组织中HIF-1α表达明显上调,ROS水平下降的同时GSH与ATP水平明显增加。然而,右美托咪定+YC-1组大鼠脑组织中HIF-1α表达明显降低,且线粒体膜电位明显减低,呼吸链复合物活性降低。最终大鼠神经功能评分增加,脑梗死体积占比增加。结论 右美托咪定通过上调HIF-1α表达,改善了线粒体功能,从而降低氧化应激反应,减少脑梗死区域,最终发挥神经功能保护作用。     

右美托咪定与地西泮用于ICU重型颅脑外伤患者镇静效果比较研究

目的探讨ICU重型颅脑外伤采用右美托咪定镇静的临床效果。方法选择2013年1月至2013年7月昆明市延安医院收治的76例ICU重型颅脑外伤患者为研究对象,采用随机数字表法分为地西泮组和右美托咪定组各38例,地西泮组首次用量0.1 mg/(kg·h),然后根据镇静效果再进行剂量调整;右美托咪定组首次剂量1.0μg/kg,再以0.5μg/(kg·h)的剂量和速度持续微量泵入,然后逐渐减少使用剂量至停止,比较两组镇静效果。结果右美托咪定组患者镇静4、6、8 h时,生命体征各指标与治疗前比较差异有统计学意义(P<0.05);地西泮组镇静直至8 h时,生命体征各指标与治疗前比较差异有统计学意义(P<0.05)。右美托咪定组与地西泮组相比,镇静入睡时间[(17.3±6.2)min vs(20.1±6.0)min]、自然清醒时间[(31.4±9.6)min vs(83.7±9.3)min]、不良反应发生率(15.8%vs 44.7%)、Ramsay镇静评分[(3.7±0.3)分vs(5.2±0.4)分]的差异均有统计学意义(P<0.05)。结论 ICU重型颅脑外伤采用右美托咪定镇静,不良反应少、可控性好、镇静满意度高,值得临床推广。     

右美托咪定在大鼠脑出血延迟低温治疗中的作用

目的??探讨右美托咪定在大鼠脑出血后延迟低温治疗中的作用。方法??选取健康雄性 SD 大鼠 95 只, 采用立体定向尾状核注射法复制大鼠脑出血模型,将 76 只复制成功的大鼠作为手术组,随机分为模型组、延迟 低温组、右美托咪定组、右美托咪定联合延迟低温组, 每组 19 只。余下的为假手术组 19 只给予手术处置但不注 射药物,手术组分别给予相应的治疗。对大鼠神经功能缺损（NDS）评分、脑组织水分含量、血肿周围脑组织 细胞凋亡指数、血清炎症细胞因子及脑损伤标志物水平进行检测。结果??治疗后, 与模型组比较, 各组大鼠 NDS 评分及脑组织水分含量较低,且延迟低温组和右美托咪定组均高于右美托咪定联合延迟低温组（ P <0.05） ; 各组 大鼠血肿周围脑组织细胞凋亡指数较低,且延迟低温组和右美托咪定组均大于右美托咪定联合延迟低温组（ P < 0.05） ; 各组大鼠血清肿瘤坏死因子 α、白细胞介素 8 水平较低,且延迟低温组和右美托咪定组均高于右美托 咪定联合延迟低温组（ P <0.05） ; 各组大鼠血清神经元烯醇化酶、S100β 蛋白水平较低,且延迟低温组和右 美托咪定组均高于右美托咪定联合延迟低温组（ P <0.05） 。结论??右美托咪定能够提高延迟低温治疗对大鼠脑 出血的疗效, 有效改善神经功能缺损, 减轻脑组织水肿, 抑制脑细胞凋亡, 减轻相关炎症反应和脑损伤程度。     

Bloodletting Puncture at Hand Twelve Jing-Well Points Relieves Brain Edema after Severe Traumatic Brain Injury in Rats via Inhibiting MAPK Signaling Pathway

Objective:To investigate whether blood-brain barrier(BBB)served a key role in the edema-relief effect of bloodletting puncture at hand twelve Jing-well points(HTWP)in traumatic brain injury(TBI)and the potential molecular signaling pathways.Methods:Adult male Sprague-Dawley rats were assigned to the shamoperated(sham),TBI,and bloodletting puncture(bloodletting)groups(n=24 per group)using a randomized number table.The TBI model rats were induced by cortical contusion and then bloodletting puncture were performed at HTWP twice a day for 2 days.The neurological function and cerebral edema were evaluated by modified neurological severity score(mNSS),cerebral water content,magnetic resonance imaging and hematoxylin and eosin staining.Cerebral blood flow was measured by laser speckles.The protein levels of aquaporin 4(AQP4),matrix metalloproteinases 9(MMP9)and mitogen-activated protein kinase pathway(MAPK)signaling were detected by immunofluorescence staining and Western blot.Results:Compared with TBI group,bloodletting puncture improved neurological function at 24 and 48 h,alleviated cerebral edema at 48 h,and reduced the permeability of BBB induced by TBI(all P<0.05).The AQP4 and MMP9 which would disrupt the integrity of BBB were downregulated by bloodletting puncture(P<0.05 or P<0.01).In addition,the extracellular signal-regulated kinase(ERK)and p38 signaling pathways were inhibited by bloodletting puncture(P<0.05).Conclusions:Bloodletting puncture at HTWP might play a significant role in protecting BBB through regulating the expressions of MMP9 and AQP4 as well as corresponding regulatory upstream ERK and p38 signaling pathways.Therefore,bloodletting puncture at HTWP may be a promising therapeutic strategy for TBI-induced cerebral edema.     

脑疏宁对脑外伤大鼠脑水肿及脑组织AQP4表达的影响

目的 观察脑疏宁对脑外伤大鼠脑组织含水量及水通道蛋白4(AQP4)表达的影响,探讨其治疗创伤性脑水肿的机制.方法 SD大鼠264只,随机分为假手术组(88只)、模型组(88只)和脑疏宁组(88只),建立大鼠创伤性脑损伤模型.分别在6 h,1、3、5 d 4个时间点测定脑组织含水量、伊文思蓝(EB)含量,并采用免疫组化方法检测脑组织AQP4蛋白的表达,电镜观察血脑屏障超微结构改变.结果 模型组大鼠伤后各时间点伤侧脑组织含水量、EB含量及伤灶周围AQP4蛋白表达水平明显高于假手术组(均P<0.001);电镜下内皮细胞紧密连接开放、星形胶质细胞足突肿胀.中药治疗组各时间点脑组织含水量、EB含量及AQP4表达水平均较模型组降低(P<0.05);血脑屏障紧密连接的破坏减少、星形胶质细胞足突肿胀减轻.结论 脑疏宁可改善血脑屏障损伤,减轻创伤后脑水肿.其作用可能与抑制AQP4在损伤脑组织中的表达、减轻星形胶质细胞损害有关.     

脂肪源性干细胞移植对颅脑损伤大鼠神经功能评分的影响

目的分析脂肪源性干细胞(ADSCs)移植对颅脑损伤大鼠神经功能评分的影响,探讨ADSCs对神经系统的保护作用。方法将20只Wistar大鼠随机分为实验组和对照组,各10只,均进行颅脑损伤模型制作,实验组移入ADSCs,对照组移入等量的培养基。比较两组大鼠神经功能改善情况。结果两组术后不同时间点大鼠神经功能评分都不断降低,差异有统计学意义(P<0.05);实验组术后不同时间点大鼠神经功能评分明显低于对照组,差异有统计学意义(P<0.05)。结论 ADSCs对颅脑损伤后大鼠神经功能具有一定的改善作用。     

依达拉奉对创伤性脑损伤大鼠脑保护作用的实验研究

目的:研究依达拉奉对大鼠创伤性脑损伤(TBI)的脑保护作用。方法:SD雄性大鼠50只,随机分为假手术组、对照组、依达拉奉低剂量组(0.75g/kg)、中剂量组(1.5mg/kg)、高剂量组(3.0mg/kg),每组10只。采用改良的Feeney法建立大鼠TBI模型,手术后24h测定大鼠神经行为学评分、脑含水量、血脑屏障通透率,术后72h观察组织形态学改变。结果:与对照组相比,依达拉奉低、中、高剂量组均能改善TBI后大鼠神经行为学障碍,降低脑水肿程度,抑制血脑屏障的破坏,同时逆转组织病理学改变;依达拉奉高剂量组治疗效果更明显。结论:依达拉奉对于TBI大鼠具有明显的脑保护作用。     

大鼠创伤性脑水肿早期水通道蛋白 AQP-4的表达及意义

目的探讨水通道蛋白4（AQP-4）在大鼠创伤性脑水肿早期的表达及意义。方法按Feeney自由落体撞击法建立大鼠创伤性脑损伤（TBI）模型,用干／湿法测定大鼠TBI后不同时相脑组织含水量,并采用免疫组织化学方法检测脑组织AQP-4蛋白的表达．采用Western Blot方法对AQP-4蛋白进行半定量分析。结果TBI后48小时伤侧脑水肿达高峰,同时水通道蛋白AQP-4在大脑半球表达降低（P〈0．05）,损伤侧大脑半球伤后48小时降低最为明显（P〈0．01）。AQP-4的表达与脑组织水含量呈负相关。结论脑损伤后,AQP-4表达降低与脑水肿的形成密切相关。     

HMGB1介导急性高血糖对脑缺血大鼠血-脑脊液屏障的损伤

目的 探讨急性高血糖对脑缺血大鼠血-脑脊液屏障（BBB）损伤的作用及机制。方法 实验大鼠随机分为假手术组、正常血糖（NG）组、加甘草酸（GL）（NG+GL）组、高血糖（HG）组和加GL（HG+GL）组。于脑缺血再灌注不同时间段检测脑脊液高迁移率族蛋白B1（HMGB1）含量、BBB通透性、脑水肿和脑梗死体积,评估神经缺失。结果 与NG组比较, HG组大鼠的脑脊液HMGB1含量显著提高( P＜0. 01);同时,伊文思蓝（EB）外渗率,脑梗死体积及脑水肿显著加重( P＜0. 01), 神经功能缺陷加重（P＜0. 05）;进行GL干预后,上述指标显著改善( P＜0. 01)。结论 高血糖可促进缺血脑组织HMGB1的释放,加重BBB损伤。抑制HMGB1的活性,对高血糖大鼠脑缺血后BBB的损伤具有保护作用。     

Relationship between AQP4 expression and structural damage to the blood-brain barrier at early stages of traumatic brain injury in rats

Background Although some studies have reported that aquaporin-4 （AQP4） plays an important role in the brain edema after traumatic brain injury （TBI）, little is known about the AQP4 expression in the early stage of TBI, or about the correlation between the structural damage to the blood-brain barrier （BBB） and angioedema. The aim of this project was to investigate the relationship between AQP4 expression and damage to the BBB at early stages of TBI. Methods One hundred and twenty healthy adult Wistar rats were randomly divided into two groups： sham operation group （SO） and TBI group. The TBI group was divided into five sub-groups according to the different time intervals： 1, 3, 6, 12, and 24 hours. The brains of the animals were taken out at different time points after TBI to measure brain water content. The cerebral edema and BBB changes in structure were examined with an optical microscopy （OM） and transmission electron microscopy （TEM）, and the IgG content and AQP4 protein expression in traumatic brain tissue were determined by means of immunohistochemistry and Western blotting. The data were analyzed with SPSS 13.0 statistical software. Results In the SO group, tissue was negative for IgG, and there were no abnormalities in brain water content or AQP4 expression. In the TBI group, brain water content significantly increased at 6 hours and peaked at 24 hours following injury. IgG expression significantly increased from 1 to 6 hours following injury, and remained at a high level at 24 hours. Pathological observation revealed BBB damage at 1 hour following injury. Angioedema appeared at 1 hour, was gradually aggravated, and became obvious at 6 hours. Intracellular edema occurred at 3 hours, with the presence of large glial cell bodies and mitochondrial swelling. These phenomena were aggravated with time and became obvious at 12 hours. In addition, microglial proliferation was visible at 24 hours. AQP4 protein expression were reduced at 1 hour, lowest at 6 hours, and began to increase at 12 hours, showing a V-shaped curve. Conclusions The angioedema characterized by BBB damage was the primary type of early traumatic brain edema. It was followed by mixed cerebral edema that consisted of angioedema and cellular edema and was aggravated with time. AQP4 expression was down-regulated during the angioedema attack, but AQP4 expression was upregulated during intracellular edema.     

Inhibitory effect of progesterone on inflammatory factors after experimental traumatic brain injury

Objective Traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality in young people. Inflammatory cytokines play an important part in the pathophysiology of TBI. Recent studies demonstrate that progesterone significantly reduces cerebral edema and enhances functional recovery from TBI and stroke in several animal models. This study was designed to investigate the inhibitory effect of progesterone on inflammatory response after traumatic brain injury. Methods Progesterone was injected intraperitoneally using rats as a model of traumatic brain injury, and Western blot technique was applied to detect the expression of three inflammation-related factors: nuclear factor kappa B p65 (NFκB p65), glial fibrillary acidic protein (GFAP), and tumor necrosis factor-α (TNF-α). The water content of injured brain was also examined. A neurological severity score was recorded to evaluate the effect of progesterone on neurodeficit recovery. Results NFκB p65, GFAP, and TNF-α were increased in all injured animals. In rats treated with progesterone, the expression level of NFκB p65 and TNF-α were reduced significantly in comparison with vehicle-treated rats. However, progesterone did not alter the expression of GFAP in the injured rats. Progesterone also reduced the water content of injured brain and the lesion volume. In addition, progesterone-treated injured rats showed significant improvements in the Neurological Severity Score test, compared with vehicle-treated ones. Conclusions Progesterone inhibits the inflammatory response after experimental traumatic brain injury and mitigates the severity of brain damage.