荧光引导鼠脑胶质瘤切除的实验研究

目的探讨荧光引导鼠脑胶质瘤切除的有效性。方法利用含有荧光物质的胶质瘤模型在手术荧光显微镜下激发荧光，根据荧光影像判定肿瘤边界并切除肿瘤。切除后对肿瘤中心、边界和周边进行病理检查。结果有荧光物质的胶质瘤体在荧光显微镜下激发出绿色荧光。荧光强度高的肿瘤组织含有大量的肿瘤细胞，并可见血管内皮细胞增生，荧光强度较弱或者没有荧光的区域仅有少量的肿瘤细胞和血管内皮细胞增生。结论该方法能够有效的切除胶质瘤，并为手术者提供客观的肿瘤边界，提高了手术切除率，具有深远的临床应用前景。     

荧光导航辅助下切除功能区恶性胶质瘤

目的探讨荧光导航技术在切除功能区恶性胶质瘤手术中的应用价值。方法对8例功能区恶性胶质瘤病人．术中利用荧光素钠将肿瘤染色，根据荧光影像判定肿瘤的边界并切除肿瘤。比较术中所见与病理组织检查结果。结果术后复查CT或MRI．肿瘤全切除7例〈87．5％），次全切除1例。术后神经功能未受明显影响，无手术并发症。结论荧光引导技术具有实时导航，客观、安全、可靠等特点，能提高功能区恶性胶质瘤全切除率及降低手术并发症。     

荧光引导脑胶质瘤切除的临床应用

目的 探讨荧光素钠引导在脑胶质瘤切除中的应用.方法 对10例脑胶质瘤患者术中应用荧光素钠将肿瘤染色,根据荧光染色强度判定肿瘤的边界并切除.结果 星形细胞瘤( WHOⅡ级)4例,间变性星形细胞瘤(WHOⅢ级)、胶质母细胞瘤(WHOⅣ级)各3例,术中肿瘤切除范围与病理学检查相符,术后1周MRI增强扫描显示肿瘤全切除8例,次全切除2例.术后语言肢体运动障碍一过性加重3例,给予对症治疗后逐渐恢复.结论 该方法应用简便、安全、经济,对高级别胶质瘤术中可直观、实时判断肿瘤的边界,大大提高了肿瘤切除率.     

荧光引导手术治疗颅内胶质瘤的研究进展

荧光引导手术治疗颅内胶质瘤是近年来神经外科的发展方向,这种技术可通过荧光物质标记肿瘤边界,引导尽可能多的切除肿瘤,进而提高肿瘤全切率和部分预后指标.目前常用的荧光染料5-氨基乙酰丙酸,荧光素钠,可提高肿瘤全切率、延长病人无进展生存期,联合其他辅助技术如术中MRI、超声、神经导航等可取得更好效果.此外,吲哚菁绿、金丝桃素...     

荧光引导在颅内肿瘤术中应用研究进展

颅内最常见的恶性肿瘤（如胶质瘤、转移瘤等）常呈浸润性生长,边界不清,手术全切率低,尤其是功能区肿瘤,手术风险高,因此,术中如何判断肿瘤边界对手术切除肿瘤及脑功能的保护至关重要。荧光引导切除术主要是通过荧光染色肿瘤组织,     

脊髓海绵状血管瘤的显微外科治疗

目的总结脊髓海绵状血管瘤的手术经验。方法回顾性分析39例海绵状血管瘤病人的临床表现、术前MRI表现、术中所见、手术切除情况、术后MRI表现及随访结果。均在显微镜下行手术治疗,根据肿瘤与脊髓有无明确边界,决定肿瘤切除的程度。手术前后采用McCormick分级评价脊髓功能。结果镜下见肿瘤有明确边界者行手术全切除,共34例;肿瘤有相对边界但不明确者仅行近全切除,共4例;肿瘤无边界且病人术前功能较差者行部分切除,计1例。病理证实均为海绵状血管瘤。术后McCormick分级改善30例,无变化5例,加重4例。结论MRI是脊髓海绵状血管瘤术前诊断最有效的方法;手术全切除病变是最主要的治疗方法,有症状者应积极行手术治疗。     

荧光素钠“黄荧光”染色技术引导胶质母细胞瘤手术的研究

目的研究荧光素钠(FLS)“黄荧光”染色引导手术切除胶质母细胞瘤(GBM)的作用,及其与临床因素的关系。方法回顾分析24例胶质母细胞瘤患者的临床资料,并对汉族与少数民族患者的临床资料进行比较。患者术中静脉注射荧光素钠染色,分别在肿瘤黄染边界及黄染边界外0.5 cm范围内的无黄染区域多点取材行病理检查,观察肿瘤细胞浸润程度,以确定肿瘤边界并引导手术切除肿瘤。对比术前、术后MRI增强扫描的肿瘤体积确定肿瘤切除程度。以术前、术后1周、术后1个月KPS评分评判患者的疗效。采用Spearman秩相关对肿瘤切除程度、瘤周无黄染区病理改变与临床因素的相关性进行分析。结果汉族与少数民族患者各临床资料比较,差异均无统计学意义。本组患者中,肿瘤黄染边界组织病理检查示,19例患者为胶质母细胞瘤,3例患者为胶质细胞增生,2例患者为间变星形细胞瘤;瘤周无黄染区组织病理检查示,22例患者为胶质细胞增生,2例患者为弥漫星形细胞瘤。肿瘤全切除者16例,次全切除者8例(肿瘤均涉及脑功能区、基底节区和脑室)。术后1个月与术前的KPS评分对比,好转17例,无变化3例,加重4例。肿瘤切除程度与肿瘤部位涉及基底节区核团和脑室呈负相关(r=-0.84,P<0.05);瘤周无黄染区组织病理改变与1P19Q呈负相关(r=-0.44,P<0.05)。结论荧光素钠“黄荧光”染色技术可在术中实时有效引导胶质母细胞瘤切除,提高切除率,改善患者预后;肿瘤切除程度与肿瘤部位,瘤周无黄染区病理改变与1P19Q相关。     

荧光引导下恶性胶质瘤切除的临床研究进展

由于恶性胶质瘤弥漫浸润性的生长方式,最大程度安全切除肿瘤,对神经外科医生具有挑战性。荧光引导手术利用荧光药物实时标识肿瘤,提高肿瘤边界可视性,增加肿瘤切除程度。本文对荧光引导手术中常用的吲哚菁绿(ICG)、荧光素钠(FLS)和5-氨基乙酰丙酸(5-ALA)三种荧光药物,在恶性胶质瘤切除中的临床研究进展进行综述。     

荧光素钠引导下高级别胶质瘤的手术治疗

目的探讨荧光素钠显影在高级别胶质瘤手术中的应用价值。方法回顾性分析2013年12月至2014年12月收治的55例高级别胶质瘤的临床资料,均在荧光素钠显影引导下手术治疗,术中在荧光模式显微镜下,根据荧光显影的范围进行肿瘤边界判定并切除。术后3 d内行MRI增强扫描,根据瘤腔T1序列强化范围估算切除程度。结果肿瘤全切除45例(81.8%),次全切除6例,大部分切除4例。55例术后随访1~1.5年,失访4例,42例以死亡为结局,9例直至随访截止仍存活;6个月无进展存活率为63.6%,中位生存期为16.3个月。荧光素显影钠判断肿瘤边界的敏感性及特异性分别为89.2%和90.7%。结论荧光素钠显影可以帮助高级别胶质瘤术中判定肿瘤边界,提高手术疗效。     

5-氨基酮戊酸荧光判定恶性胶质瘤边界的实验研究

目的建立5-氨基酮戊酸(5-ALA)荧光判定恶性胶质瘤边界的实验模型。方法采集存活率为99%的U87Δ胶质瘤细胞,采用立体定向仪将U87Δ胶质瘤细胞移植到裸鼠脑部。饲养观察3周,在荷瘤鼠腹腔内注射5-ALA4h后开颅,分别在白光及荧光系统下观察肿瘤与正常脑组织,在肿瘤最大冠状面不同荧光强度处取活检行苏木精-伊红染色。结果实验鼠成瘤率为100%。白光下肿瘤呈淡黄色,荧光系统下肿瘤整体边界呈现荧光。肿瘤冠状面边界亦显示荧光,正常脑组织无荧光。染色结果显示:新生物为恶性胶质瘤,而荧光处为胶质瘤边界。结论 5-ALA荧光引导下的胶质瘤模型能可靠区分恶性胶质瘤与正常脑组织边界,为此类研究提供较理想的实验基础。     

Effects of increasing serotonergic receptor activity in brain on analgesic activity in rats

In the rat, increasing serotonergic receptor activity or functional serotonin in the brain with inhibitors of serotonin reuptake (such as fluoxetine and chlorimipramine), with serotonin, or with the serotonin precursor, 5-hydroxytryptophan, in combination with the peripheral decarboxylase inhibitor benserazide had a significant analgesic effect shown by an increase in the latency to hind-paw lick in the hot plate test. The data indicate that activation of central serotonergic receptors with inhibitors of serotonin reuptake, serotonin, or the serotonin precursor produced pain inhibition.     

Renshaw cell discharge at the beginning of muscular contraction and its relation to the silent period

Renshaw cell activity was recorded simultaneously with the motoneuronal discharge during vibration or stretch of the triceps muscles. Both the monosynaptic reflex responses and the phasic discharge of Renshaw cells elicited by the first stroke of the vibrator or by the onset of muscle extension were followed by a period of silence in their electrical recordings. The Renshaw cell burst, recorded at the onset of both stimuli, coincided with the early part of the silent period in motoneuronal discharge. It preceded the onset of muscle contraction and ended within 30 to 40 ms after the silent period began. The silent period could still persist after the pause in the discharge of the primary endings of muscle spindles had completely disappeared. On the basis of these findings, the view that recurrent inhibition could contribute to the early part of the silent period is strongly favored.     

Effects of serotonin and morphine on spontaneous and evoked firing of nociceptive neurons in the trigeminal spinal nucleus of rats

Spontaneously firing neurons that were responsive to noxious face pinch or noxious heat were studied in the trigeminal spinal nucleus of the rat brain. These eurons responded with either an increase or decrease in firing rate. In these neurons serotonin (5-hydroxytryptamine; 5-HT) apparently acts through two mechanisms to attenuate the response to a noxious stimulus. One mechanism is mimicked by morphine; these two drugs block the response to the noxious stimuli without having a consistent effect on spontaneous firing. The effects of the two drugs were somewhat selective depending on the noxious stimulus used and the effect of the noxious stimulus; morphine and 5-HT were more effective in blocking the increase in firing rate evoked by the face pinch but 5-HT and morphine were more effective in blocking the decrease in firing rate evoked by the noxious heat stimulus. Interestingly, the direction of the response to a particular noxious stimulus frequently predicted whether or not both morphine and 5-HT would act on the same or different neurons. A second mechanism by which 5-HT, but not morphine, acted was to change the spontaneous firing in a direction opposite that evoked by the noxious stimulus. This type of effect apparently modulated the response to a noxious stimulus by changing the spontaneous firing rate such that a noxious stimulus had to be more intense before it could significantly alter the neuronal firing in the opposite direction. Morphine occasionally produced a change in firing pattern in neurons; this effect remains to be documented more extensively.     

Serotonergic mechanisms in amygdaloid-kindled seizures in the rat

The kindling model of epilepsy is based on a permanent alteration in brain function resulting from repeated subconvulsant stimulation. Because these alterations may be neurochemical in nature, the role of serotonin (5-HT) in the development of amygdaloid-kindled seizures was studied using female rats. Concentrations of 5-HT and 5-hydroxyindoleacetic acid (5-HIAA) were determined fluorometrically in the hypothalamus, amygdala, midbrain, and brain-stem regions. Amygdaloid kindling led to significant decreases of 5-HT and 5-HIAA in the midbrain region. The administration of 5-hydroxytryptophan (5-HTP), a 5-HT precursor, was found to retard the evolution of the kindling process and p-chlorophenylalanine (p-CPA), a depletor of brain 5-HT, facilitated the development of amygdaloid kindled seizures. Both 5-HTP and p-CPA produced an increase in afterdischarge duration of full kindled seizures. The data suggest that serotonergic mechanisms may play a suppressive role in the development of amygdaloid-kindled seizures.     

精神分裂症中枢—5羟色胺代谢的再探讨

了解性别因素对精神分裂症中枢５—羟色胺（５—ＨＴ）代谢的影响。方法应用高效液相色谱（ＨＰＬＣ）对３０例男性精神分裂症、３７例女性精神分裂症、２１例男性对照组、９例女性对照组脑脊液中５—ＨＴ及其代谢产物５—羟吲哚乙酸（５—ＨＩＡＡ）进行测试。结果男、女病例组及男、女对照组四组间５—ＨＴ、５—ＨＩＡＡ水平显著不同（Ｆ＝４．２６５，Ｐ＝０．０１７；Ｆ＝５．８９６，Ｐ＝０．００４）；同时还揭示男性精神分裂症５—ＨＩＡＡ显著低于男性正常对照组（ｑ＝４．０７７２，Ｐ＜０．０１）和女性精神分裂症５—ＨＩＡＡ显著低于女性正常对照组（ｑ＝４．６２１，Ｐ＜０．０１），但未见有病例组５—ＨＴ和５—ＨＩＡＡ的性别差异，亦未见有正常对照组的性别差异。结论不论男性还是女性精神分裂症其５—ＨＩＡＡ均低于相应对照组，表明精神分裂症有５—ＨＴ代谢低下。     

A marked rise in 5-S-cysteinyl-dopamine levels in guinea-pig striatum following reserpine treatment

Summary Reserpine administration (5 mg/kg, i.p.) to guinea pigs resulted in marked and long lasting dopamine (DA) depletion and a rapid, short lasting, increase of 3,4-dihydroxyphenylacetic acid (DOPAC) in the striatum. A marked and sustained increase of the level of 5-S-cysteinyl-dopamine, which is an adduct presumably formed following autoxidation of DA, started 3–4 h following the DA and DOPAC changes. Only small changes in the levels of the 5-S-cysteinyl adducts of DOPAC and 3,4-dihydroxyphenylalanine (DOPA) were found.     

Action of serotonin in the medial prefrontal cortex: mediation by serotonin3-like receptors.

In the present study, we investigated the effects of various serotonin (5-HT) antagonists on 5-HT's action on medial prefrontal cortical cells (mPFc) using the techniques of single cell recording and microiontophoresis. The microiontophoretic application of 5-HT (10-80 nA) produced a current-dependent suppression of mPFc cell firing and this effect was blocked by the selective 5-HT3 receptor antagonists (+/-)-zacopride, ICS 205930 and granisetron at currents of 5-20 nA. Furthermore, the intravenous (i.v.) administration of (+/-)-zacopride (5-50 micrograms/kg) markedly attenuates the suppressive action of 5-HT on mPFc cell firing. In contrast, the microiontophoresis of 5-HT1 and 5-HT2 receptor antagonists such as (+/-)-pindolol, spiperone, metergoline, and ritanserin (10-20 nA) failed to block 5-HT's effect. In fact, in some cells, spiperone and ritanserin potentiated 5-HT's action and prolonged neuronal recovery. In addition, the intravenous administration of either ritanserin (5-2,000 micrograms/kg) or metergoline (4-2,400 micrograms/kg) failed to alter 5-HT's action. The electrical stimulation of the caudal linear raphe nucleus (CLi) suppressed the spontaneous activity of 83% of the mPFc cells tested by 45 +/- 2%. This suppression was significantly attenuated by the iontophoresis of granisetron (2.5-5 nA) but not by the 5-HT2 and 5-HT1C receptor antagonist ritanserin or the relatively selective 5-HT2 receptor antagonist (+)-MDL 11,939 (10-40 nA). However, the i.v. administration of ritanserin (0.5-1.5 mg/kg) or S-zacopride (0.1 mg/kg) significantly blocked the suppression of mPFc cell firing produced by CLi stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)     

Inhibition of pontine omnipauser neurons in the cat by 5-hydroxytryptophan

We assessed ocular motor nerve discharges and omnipause neuronal activity in six adult alert cats before and after intravenous infusion of the serotonin precursor 5-hydroxytryptophan (5-HTP). In all animals, 5-HTP inhibited omnipause neuron activity synchronously with a disappearance of high-frequency bursts of the ocular motor nerves associated with vestibular-induced fast components. This effect was rapidly reversed by the serotonin blocker, methysergide. Our findings are most consistent with an indirect effect of 5-HTP on omnipause neurons.     

Effect of 5-hydroxytryptamine and pineal metabolites on the secretion of neurohypophysial hormones

It has been shown that 5-hydroxytryptamine and melatonin, an indoleamine for which 5-hydroxytryptamine is a precursor, influence the release of vasopressin and oxytocin from the rat hypothalamus both in vivo and in vitro. The oral administration of melatonin has been shown to decrease oxytocin release and modulate the nocturnal vasopressin release in humans. 5-Hydroxytryptamine and its metabolites, 5-hydroxytryptophol, 5-methoxytryptamine and 5-methoxytryptophol, are detected within the pineal, and there is evidence that 5-methoxytryptamine and 5-methoxytryptophol may have some physiological role. The aim of this study was to evaluate the effects of 5-hydroxytryptamine, 5-hydroxytryptophol, 5-methoxytryptamine and 5-methoxytryptophol on neurohypophysial hormone release from the rat hypothalamus in vitro. It was found that 5-hydroxytryptamine and 5-hydroxytryptophol increased neurohypophysial hormone release, 5-methoxytryptamine decreased the release of vasopressin and oxytocin and 5-methoxytryptophol was found to have no effect, thus providing further evidence for a role of indole compounds in the control of neurohypophysial hormone secretion.     

The descending and intrinsic serotoninergic innervation of an elasmobranch spinal cord

The descending and the intrinsic components of the Serotoninergic (5HT) innervation of the Atlantic stingray spinal cord were described by comparing the distributions of neuronal elements exhibiting 5HT-like immunoreactivity (peroxidase-antiperoxidase method) in sections caudal and rostral to spinal transections. The cells of origin of the descending 5HT system were located with a double labeling method for both retrogradely transported horseradish peroxidase (HRP) and 5HT staining. The descending system provides virtually the entire 5HT innervation of the dorsal horn, the intermediate zone, and the dorsal and lateral portions of the ventral horn. Fibers of the descending 5HT system course in the lateral funiculus, the dorsal portion of the ventral funiculus, and in the submeningeal zones of the dorsal and lateral aspects of the spinal cord. This projection primarily originates from the 5HT cell groups of the caudal rhombencephalon (groups II and III; Ritchie et al., '83), with a minor contribution from group IV in the rostral rhombencephalon. The organization of the descending 5HT system in stingrays is remarkably similar to that of mammals. The intrinsic spinal 5HT system consists of cells distributed in the ventromedial spinal cord that have processes extending longitudinally in a ventral submeningeal fiber network. Fibers were traced from the submeningeal system to the ventral horn, where varicose processes were restricted largely to the neuropil ventral to the somata of the fin motoneurons. The existence of a well-defined intrinsic 5HT system in stingrays supports the hypothesis that such a system exists in the spinal cords of a variety of vertebrates.