实验性脑出血后脑组织核因子-κB表达和含水量的变化及其相关性

目的 研究实验性脑出血(ICH)后血肿周围脑组织核因子-κB(NF-κB)表达和脑组织含水量的改变及其相关性.方法 采用自体不凝血注人大鼠尾状核制备ICH模型;用免疫组化法检测血肿周围脑组织NF-κB表达;用干湿重法测脑组织含水量.结果 与对照组相比,ICH 6h组血肿周围脑组织NF-κB表达开始明显增加,ICH 48h组达高峰,并持续到ICH 1周(P＜0.01～0.05);脑组织含水量ICH 12h组开始增多,24h组显著增高,72h组达高峰;NF-κB表达和脑组织含水量ICH 24h～1周组与假手术组之间差异有统计学意义(均P＜0.01);ICH后NF-κB阳性细胞数与脑组织含水量呈正相关(r=0.644,P＜0.01),NF-κB表达从开始到高峰均早于脑组织含水量的变化.结论 ICH后脑组织NF-κB表达增加,NF-κB可能通过炎性机制参与了ICH后继发脑水肿的形成.     

局部亚低温对大鼠脑出血后血肿周围脑组织白介素-1β表达的影响

目的 观察局部亚低温对脑出血大鼠血肿周围脑组织的形态学变化和对白介素(IL)-1β表达的影响.方法 72只Wistar大鼠随机分为假手术组和脑出血后6 h、24 h、48 h、72 h、7 d组,每组再分为常温亚组和亚低温亚组,每个亚组6只大鼠.采用自体不凝血注人大鼠尾状核制备脑出血模型.各亚低温亚组注血后实施亚低温治疗4 h,维持脑温在(33±0.5)℃.观察血肿周围组织的形态学改变和IL-1β表达的变化.结果 亚低温亚组各时间点脑组织水肿明显轻于常温亚组;神经元变性坏死、炎症反应及胶质细胞增生程度明显轻于常温亚组.脑出血后6 h血肿周围脑组织IL-1β开始表达,48 h达高峰,7 d时仍明显高于对照亚组(均P＜0.01).脑出血24 h～7 d亚低温亚组IL-1β表达水平较相应时点常温亚组显著降低(均P＜0.01).结论 亚低温治疗能明显抑制血肿周围IL-1β的过度表达,减轻血肿周围脑组织的炎症反应.     

实验性自身免疫性脑脊髓炎大鼠脑组织中NF-κB p65,TNF-α表达及雷公藤多甙的干预研究

目的 观察Wistar大鼠实验性自身免疫性脑脊髓炎(EAE)脑组织中核转录因子-κBp65(NF-κB p65)、肿瘤坏死因子-α(TNF-a)的表达情况,用雷公藤多甙(TWP)进行干预,探讨TWP对EAE的防治效果及作用机制.方法 建立Wistar大鼠EAE模型,并选用TWP、泼尼松(PRD)干预治疗.65只Wistar大鼠随机分成5组:对照组5只,EAE组、TWPⅠ组(EAE+TWP 10 mg·kg-1·d-1)、TWPⅡ组(EAE+TWP 30mg·kg-1·d-1)和PRD组(EAE+PRD 5 mg·kg-1·d-1)各15只.观察各组大鼠发病情况并进行神经功能评分.大鼠脑和脊髓腰膨大段组织切片:苏木素-伊红(HE)染色+罗克沙尔坚牢蓝(LFB)髓鞘染色,光镜下进行炎性病灶计数,并免疫组化方法检测大鼠脑组织内NF-κB p65、TNF-α的表达.结果 EAE组及干预组大鼠脑组织内NF-κB p65、TNF-α表达水平随病情加重而升高,随病情缓解而降低.与EAE组比较,干预组大鼠发病率减低,潜伏期延长,神经功能评分及体重损失明显降低,脑组织炎性病灶数明显减少;同时脑组织NF-κB p65和TNF-α阳性细胞数量明显减少.TWP大剂量组与PRD治疗效果相当,且优于TWP小剂量组.结论 NF-κB p65、TNF-α过表达可能参与EAE发生及进展;TWP有明显防治大鼠EAE作用,在一定程度上呈剂量相关性,其机制可能与下调NF-κB p65、TNF-α表达有关.     

抑肽酶对大鼠脑出血血肿周围组织核转录因子表达的影响

目的 探讨抑肽酶(ATG)对大鼠脑出血血肿周围组织核转录因子(NF)-κB p65表达的影响.方法 采用立体定向手术脑尾状核胶原酶注射制备大鼠脑出血(ICH)模型,随机分为ICH组、ATG组和吡咯烷二硫代氨基甲酸盐(PDTC)组;分别于制模后6 h、24 h、72 h、7 d应用免疫组化法及逆转录-聚合酶链反应法检测血肿周围脑组织NF-κB p65蛋白及mRNA的表达.结果 各组NF-κB阳性细胞数制模后24 h明显增加,72 h达高峰,随之下降.NF-κB阳性细胞数在ICH组和ATG组各时间点差异无统计学意义;PDTC组ICH 24 h～7 d较ICH组和ATG组显著下降(P<0.05～0.001);各组NF-κB mRNA表达在ICH 24 h达到高峰,72 h稍下降,7 d下降至术前水平.ICH组和ATG组 NF-κB mRNA表达各时点间差异无统计学意义;与ICH组及ATG组相比,PDTC组ICH 24 h后显著下降(P<0.05～0.001),7 d时显著低于术前水平(P<0.01).结论 ATG对ICH后脑组织NF-κB p65表达无明显抑制作用,其抗炎与抗凋亡作用可能是通过其他途径实现的.     

实验性脑出血后脑组织核因子-κB表达和含水量的变化及其相关性

目的研究实验性脑出血（ICH）后血肿周围脑组织核因子-кB（NF-кB）表达和脑组织含水量的改变及其相关性。方法采用自体不凝血注入大鼠尾状核制备ICH模型;用免疫组化法检测血肿周围脑组织NF-кB表达;用干湿重法测脑组织含水量。结果与对照组相比,ICH6h组血肿周围脑组织NF-кB表达开始明显增加,ICH48h组达高峰,并持续到ICH1周（P〈0.01~0.05）;脑组织含水量ICH12h组开始增多,24h组显著增高,72h组达高峰;NF-кB表达和脑组织含水量ICH24h~1周组与假手术组之间差异有统计学意义（均P〈0.01）;ICH后NF-кB阳性细胞数与脑组织含水量呈正相关（r=0.644,P〈0.01）,NF-кB表达从开始到高峰均早于脑组织含水量的变化。结论ICH后脑组织NF-кB表达增加,NF-кB可能通过炎性机制参与了ICH后继发脑水肿的形成。     

脑出血后抑制NF-κBp65mRNA表达对脑和肺炎症反应的影响

目的探讨抑制核因子-κB（nuclear factor-kappaB,NF-κB）p65mRNA表达是否影响肺和脑组织中组织因子（tissue factor,TF）mRNA的表达,以及能否减轻脑出血（intracerebral hemorrhage,ICH）所致的急性肺损伤（acute lung injury,ALI）。方法采用立体定向技术自体血尾状核注入法制备ICH大鼠模型。造模成功的36只SD大鼠随机分为ICH组、二硫氨基甲酸酯吡咯烷（pyrrolidine dithinocarbamate,PDTC）组和地塞米松（dexa—methasone,Dex）组,每组12只,另设假手术（sham-operative,Sham）组12只作对照。应用苏木素-伊红（HE）染色观察各组ICH周围脑组织与肺组织的炎症反应情况,透射电镜观察肺组织超微结构变化。以反转录一聚合酶链反应（RT-PCR）检测NF-κBp65mRNA、TFmRNA在脑与肺组织中的表达。结果（1）Sham组：术后脑、肺组织细胞结构完整、排列整齐,无炎症细胞浸润,肺泡上皮细胞及毛细血管内皮细胞结构相对正常。（2）ICH组：ICH后24-48h脑水肿明显,神经元变性坏死,胶质细胞增生,血肿周围炎症明显。肺组织损伤以间质性肺炎表现为主,肺泡结构破坏明显,血肿周围脑组织和肺组织中NF-κBp65mRNA表达较Sham组增高（P〈0．05）。（3）PDTC组：与ICH组比较,脑水肿明显减轻,肺组织炎症细胞浸润减少,但仍可见红细胞漏出现象。ICH后24、48h脑组织及肺组织中NF-κBp65mRNA和TFmRNA表达均较ICH组明显降低（P〈0．05）。（4）Dex组：与ICH组比较,血肿周围脑组织水肿及炎症反应减轻,ICH后24、48hNF-κBp65mRNA明显降低（P〈O．05）;TF mRNA表达在ICH后24h脑、肺组织内表达下调,而ICH后48h表达上调。结论NF-κBp65mRNA表达可有效减轻ICH所致ALI,PDTC可使TFmRNA在肺和脑组织的表达下调,而Dex则使TFmRNA在肺和脑组织的表达呈先下调后上调的趋势。     

亚低温治疗窒息后新生儿脑损伤NF-κB和TNF-α的变化

目的观察窒息后新生儿脑损伤在亚低温治疗后NF-κB和TNF-α的变化,探讨亚低温治疗窒息后脑损伤的作用及机制。方法将符合亚低温入选条件55例窒息后脑损伤新生儿随机分成亚低温组28例与常规治疗组27例,同期正常产足月儿17例为对照组,亚低温组入院后即行亚低温联合三支持三对症治疗,常规治疗组给予三支持三对症治疗,分别于治疗前及治疗后24h、治疗后72h、生后7d检测血NF-κB和TNF-α水平。结果窒息组新生儿血清NF-κB和TNF-α水平较正常新生儿显著升高,亚低温治疗组的血清NF-κB和TNF-α水平低于常规治疗组(均P0.01),亚低温治疗可降低窒息后脑损伤新生儿血清NF-κB和TNF-α水平。结论亚低温治疗窒息后脑损伤的作用机制可能与减少炎症介质NF-κB和TNF-α的表达,降低其含量有关。     

糖调节受损大鼠认知障碍及脑组织NF-κBp65、TNF-α的表达

目的观察糖调节受损大鼠脑组织NF-κBp65、TNF-α及NF-κB mRNA、TNF-αmRNA表达,探讨糖耐量受损大鼠的炎症机制及其对认知功能障碍的影响。方法将Wistar大鼠随机分为对照组和实验组,高脂、高糖饲养法建立糖耐量受损大鼠模型;采用免疫组织化学和原位杂交的方法分别从蛋白水平和转录水平检测糖调节受损组与糖耐量正常组大鼠脑组织NF-κBp65、NF-κB mRNA和TNF-α、TNF-αmRNA的表达;Morris水迷宫法评定两组大鼠认知功能。结果与NGT组比较,IGR组第10周NF-κBp65、NF-κB mRNA高表达;第15周TNF-α、TNF-αmRNA高表达。两组间学习记忆能力在第5周无差异(P>0.05);在第10周IGR组优于NGT组;第15、第20周实验组逐次下降(P<0.05),低于同时点NGT组(P<0.05)。Pearson相关分析显示NF-κBp65、NF-κB mRNA和TNF-α、TNF-αmRNA高表达与大鼠认知障碍相关。结论糖调节受损与大鼠认知障碍相关,NF-κB调控的炎症反应可能是其重要机制。     

单次地塞米松治疗对实验性脑出血后肺、脑组织的保护作用及机制

目的 研究单次地塞米松(Dex)治疗对脑出血(ICH)后肺、脑组织的保护作用及可能机制.方法 采用立体定向技术自体血尾状核注入法制备SD大鼠ICH模型,将大鼠分为假手术组、ICH模型组和Dex治疗组.采用HE染色观察血肿周围组织与肺组织的炎症反应情况,采用透射电镜观察各组肺组织超微结构变化.采用RT-PCR法半定量检测NF-кB p65 mRNA及糖皮质激素受体α(GRα)mRNA在脑与肺中的表达情况.结果 (1)ICH模型组脑水肿明显,血肿周围炎症反应重,肺组织损伤以间质性肺炎表现为主,肺泡结构破坏;Dex治疗组脑水肿较ICH模型组明显减轻,肺组织炎性反应减少.(2)NF-кB p65 mRNA表达,ICH模型组脑出血后血肿周围脑组织(0.44±0.08)和肺组织(0.69±0.16)均较假手术组(分别为0.27±0.05和0.26±0.04)增高(P<0.01),Dex治疗组脑(0.17±0.14)及肺(0.17±0.03)组织中NF-кB p65 mRNA均明显低于ICH模型组和假手术组(P<0.01);ICH模型组GRα mRNA表达水平,无论在脑组织(0.47±0.07)还是在肺组织(0.49±0.07)均低于假手术组(分别为0.64±0.03和0.65±0.13)(P<0.01),Dex治疗组脑组织(1.01±0.09)和肺组织(0.89±0.08)GRα mRNA表达较ICH模型组和假手术组均明显增强(P<0.01).结论 ICH后早期、单次给予Dex治疗可减轻脑组织损害,亦可明显改善继发肺损害,其可能作用机制为Dex提高了GRα mRNA水平并抑制NF-кB p65 mRNA表达.     

肿瘤坏死因子-α在大鼠实验性脑出血脑损伤中的作用

目的 探讨肿瘤坏死因子-α（TNF-α）在大鼠实验性脑出血（ICH）后脑损伤中的作用。方法 采用立体定向自体血注入大鼠尾状核建立ICH模型。观察ICH大鼠术前及术后各时点血肿周围脑组织的TNF-α水平、含水量变化及神经功能障碍评分,并与对照组比较。对TNF-α水平与脑含水量、神经功能障碍评分进行相关分析。结果 ICH组术后12～96hTNF-α水平明显高于对照组（均P〈0．05）。ICH组术后各时点神经功能障碍评分与相应时点脑组织TNF-α水平呈负相关（r=-0．678,P〈0．001）,脑含水量与TNF-α水平呈正相关（r=0．541,P〈0．05）。结论 大鼠ICH后腑组织TNF-α水平明显增加,加重脑损伤和脑水肿。     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.