神经节苷脂对颅脑损伤后认知功能障碍疗效的系统评价

目的 评价神经节苷脂在颅脑损伤后认知功能障碍中的疗效。方法 计算机检索PubMed、EMbase、CENTRAL、中国知网、维普数据库和万方数据库中近十年所有发表的神经节苷脂治疗颅脑损伤后认知功能障碍的临床随机对照试验,纳入符合标准的文献并提取数据,采用RevMan 5.1软件进行Meta分析,并用GRADEpro软件进行证据质量评价。结果 共纳入5个研究,347例患者,Meta分析结果显示神经节苷脂组患者治疗后1周[WMD=4.72,95%CI（3.22,6.21）,P<0.01]和治疗后3~4周[wmd>P<0.001]mmse评分均显著高于常规治疗组患者。>结论 神经节苷脂能改善患者颅脑损伤后患者的认知功能。     

高压氧治疗前交通动脉瘤术后认知功能障碍的效果分析

目的探讨高压氧治疗（HOT）前交通动脉瘤患者术后认知功能障碍的效果。方法50例前交通动脉瘤术后出现认知功能障碍患者,随机分为HOT组（26例）和对照组（24例）。两组患者治疗前及治疗后30d均采用简明精神状态检查量表（MMSE）和日常活动能力量表（ADL）评估认知功能。结果HOT组治疗前后MMSE评分分别为（23±4．1）分和（28±3．2）分,两者差异显著（P〈0．05）。对照组治疗前后MMSE评分分别为（22±2.3）分和（24±2．1）分,差异显著（P〈0．05）。HOT组治疗前后ADL评分分别为（47±2．3）分和（24±1．2）分,两者差异显著（P〈0．05）。对照组治疗前后ADL评分分别为（46±4．23）分和（37±2．4）分,两者差异显著（P〈0．05）。治疗后HOT组MMSE、ADL评分与对照组比较,均差异显著（P〈0．05）。结论早期HOT可有效改善前交通动脉瘤患者术后认知功能障碍。     

奥拉西坦联合神经节苷脂治疗血管性痴呆疗效观察

目的评价奥拉西坦（ORC商品名倍清星）联合单唾液酸四己糖神经节苷脂（GM-1,商品名澳甘）治疗血管性痴呆（VD的临床疗效。方法本研究将112例血管性痴呆患者分为治疗组58例及对照组54例,所有患者均给于抗血小板、改善循环、对症支持治疗,治疗组给予奥拉西坦注射液4g,加入0.9%氯化钠注射液100mL,1次/d,神经节苷脂注射液100mg,加入0.9%氯化钠注射液250mL,1次/d,连续用药3周,分别于用药前及用药后,采用简易精神状态（MMSE）量表进行评价。结果 2组患者MMSE治疗后比治疗前均有提高（P〈0.05）,治疗组明显优于对照组（P〈0.05）,治疗过程中未发现明显不良反应。结论奥拉西坦联合单唾液酸四己糖神经节苷脂治疗血管性痴呆效果好,不良反应少。     

神经节苷脂联合高压氧治疗颅脑损伤后认知功能障碍的疗效分析

目的观察神经节苷脂联合高压氧治疗颅脑损伤后认知功能障碍的临床疗效,为临床治疗提供理论依据。方法选取2011-06—2014-06我院收治的颅脑损伤后存在认知功能障碍患者98例,将其分为观察组与对照组,每组49例。对照组给予神经节苷脂治疗,观察组在对照组基础上给予高压氧治疗。对2组患者临床疗效进行观察与比较。结果观察组总有效率83.7%高于对照组的61.2%,差异有统计学意义(P0.05);2组治疗前MMSE评分及Barthel评分比较差异均无统计学意义(P0.05);与治疗前比较,治疗后2组MMSE评分及Barthel评分均明显提高,差异均具有统计学意义(P0.05);与对照组比较,观察组治疗后MMSE评分及Barthel评分改善情况更显著,差异有统计学意义(P0.05)。结论神经节苷脂联合高压氧治疗颅脑损伤后认知功能障碍具有显著临床疗效,能使患者认知功能及日常生活活动能力有效改善,值得临床进一步推广应用。     

安理申对急性一氧化碳中毒迟发性脑病认知功能的作用

目的观察安理申对急性一氧化碳中毒后迟发性脑病（DEAC—MP）的认知功能作用及安全性。方法60例I）EAC-MP患者随机分为对照组和观察组各30例，均给予常规治疗，观察组同时加用安理申10mg，qd，连续治疗8周。治疗4周及8周进行MMSE、ADL、HDS—R评分；治疗前及治疗8周行心电图、血常规、肾功能、肝功能检查及记录不良反应。结果治疗4、8周后MMSE、HDS-R评分2组均高于治疗前，观察组上升幅度高于对照组，差异有统计学意义（P〈0．05）；4周及8周后ADL评分2组均低于治疗前，观察组下降幅度高于对照组，差异有统计学意义（P〈0．05）；治疗后无心电图、血常规、肾功能、肝功能损害，无不良反应。结论 安理申能改善急性一氧化碳中毒迟发性脑病认知功能障碍且安全可靠。     

申捷治疗急性脑梗死的疗效观察

目的 观察单唾液酸四己糖神经节苷脂钠注射液（中捷）对急性脑梗死的治疗效果。方法 急性脑梗死病人50例，随机分为对照组24例，给予预防、控制脑水肿、抗凝、营养脑细胞等常规治疗；治疗组26例，在给予常规治疗的基础上，加用中捷40mg，溶于0．9％氯化钠注射液250ml中ivgtt，qd，14d。两组病人治疗前及治疗后第14d，进行神经功能缺损评分，并行疗效评定。结果 治疗组治疗后14d神经功能缺损评分与对照组相比有显著差异（P〈0．05），治疗组临床疗效明显优于对照组（P〈0．05）。结论 中捷能改善急性脑梗死病人的预后，治疗急性脑梗死有效。     

神经节苷脂治疗新生儿缺氧缺血性脑病疗效观察

目的探讨神经节苷脂治疗新生儿缺氧缺血性脑病的疗效。方法将80例中度新生儿缺氧缺血性脑病患儿随机分为治疗组和对照组，每组各40例，均给予常规治疗，对照组在此基础上应用胞二磷胆碱125mg／d，14d为1疗程。治疗组应用胞二磷胆碱＋神经节苷脂（GM1）20mg／d，14d为1疗程。观察2组疗效及新生儿行为神经测定（NBNA）的差异。结果2组总有效率及7dNBNA评分比较，差异无统计学意义（P〉0．05），14d NBNA评分比较，差异有统计学意义（P〈0．05）。在GM1的治疗过程中。未发现任何不良反应。结论GM1治疗新生儿缺氧缺血性脑病有明显疗效。     

帕金森病合并抑郁患者认知功能和P300的研究

目的 探讨帕金森病（PD）合并抑郁患者认知功能和P300的改变。方法 对67例PD患者依据Zung抑郁自评量表（SDS）和汉密顿抑郁量表（HAMD）评分分为PD抑郁组（22例）和PD非抑郁组（45例），分别对两组患者进行认知功能评定和P300检测，并对结果进行比较和相关性分析。结果 本组PD患者简明智力状态量表（MMSE）评分尚在正常范围，但明显低于正常对照组（P〈0．05），PD抑郁组MMSE评分更低（P〈0.01）；与正常对照组比较，PD组P300潜伏期延长、波幅降低（均P〈0．05），PD抑郁组改变更为明显（均P〈0．01）；PD组P300潜伏期与MMSE评分呈负相关（r=-0．413，P〈0．05），波幅与MMSE评分呈正相关（r=0．398，P〈0．05）。结论 PD患者存在认知功能障碍，以记忆损害最为明显；抑郁对认知功能有负性影响，P300检测可以早期发现PD患者的认知功能障碍。     

观察神经节苷脂联合醒脑静对急性脑卒中患者预后的影响

目的观察单唾液酸四己糖神经节苷脂联合醒脑静对急性脑卒中患者预后的改善作用。方法研究对象为2013-01—2014-07我院收治的急性脑卒中患者124例,随机法分为联合组(n=62)和对照组(n=62),对照组静滴醒脑静,联合组在此基础上加用单唾液酸四己糖神经节苷脂治疗,持续治疗6周。比较用药前后2组患者神经功能缺损评分、认知水平、不良反应率及疗效。结果联合组总有效率85.5%高于对照组66.1%,差异有统计学意义(P0.05)。2组患者用药后NIHSS评分均降低,MMSE、WMS评分均明显上升,与用药前比较差异有统计学意义(P0.05);联合组用药后NIHSS评分显著低于对照组,MMSE、WMS评分高于对照组,差异有统计学意义(P0.05)。联合组不良反应率9.7%低于对照组14.5%,差异无统计学意义(P0.05)。结论单唾液酸四己糖神经节苷脂联合醒脑静治疗急性脑卒中,能显著改善患者神经功能和认知水平,疗效显著,且不增加不良反应,预后好。     

电针对抑郁症的影响

目的：探讨电针对改善抑郁症认知功能的作用。方法：将93例首发抑郁症患者随机分为帕罗西汀加合用电针组（合用电针组）48例,单纯帕罗西汀组（单纯药物组）45例,观察3周。于治疗前硬治疗3周采用汉密顿抑郁量表（HAMD）、事件相关点位P300,评定临床疗效及认知功能改善情况。结果：治疗3周合用电针组有效率89．6％．单纯药物组为80％（P〈0．05）。治疗后HAMD评分、P300潜伏期均显著低于治疗前（P〈0．05）;两组治疗后P300波幅均明显高于治疗前（P〈0．05）;治疗后合用电针组P300波幅明显高于单纯药物组（P〈0．05）,合用电针组P300潜伏期明显低于单纯药物组（P〈0．05）。结论：电针治疗对改善抑郁症认知功能有显著增效作用。     

Development of the projection from the nucleus of the brachium of the inferior colliculus to the superior colliculus in the ferret

Neurons in the deeper layers of the superior colliculus (SC) have spatially tuned receptive fields that are arranged to form a map of auditory space. The spatial tuning of these neurons emerges gradually in an experience-dependent manner after the onset of hearing, but the relative contributions of peripheral and central factors in this process of maturation are unknown. We have studied the postnatal development of the projection to the ferret SC from the nucleus of the brachium of the inferior colliculus (nBIC), its main source of auditory input, to determine whether the emergence of auditory map topography can be attributed to anatomical rewiring of this projection. The pattern of retrograde labeling produced by injections of fluorescent microspheres in the SC on postnatal day (P) 0 and just after the age of hearing onset (P29), showed that the nBIC-SC projection is topographically organized in the rostrocaudal axis, along which sound azimuth is represented, from birth. Injections of biotinylated dextran amine-fluorescein into the nBIC at different ages (P30, 60, and 90) labeled axons with numerous terminals and en passant boutons throughout the deeper layers of the SC. This labeling covered the entire mediolateral extent of the SC, but, in keeping with the pattern of retrograde labeling following microsphere injections in the SC, was more restricted rostrocaudally. No systematic changes were observed with age. The stability of the nBIC-SC projection over this period suggests that developmental changes in auditory spatial tuning involve other processes, rather than a gross refinement of the projection from the nBIC.     

The organization of the connections between the cortex and the claustrum in the monkey

The distribution of labelled cells and of extracellular granules in the claustrum has been studied after injections of horseradish peroxidase in several areas of the neocortex. The frontal and parietal lobes are related to the anterior and posterior halves respectively of the claustrum, and the occipital and temporal cortex to the posterior and inferior margins. Parts of the claustrum related to areas of the cortex in the frontal lobe overlap considerably in the antero-posterior dimension with parts related to widely separated but interconnected areas of the parieto-temporal cortex. Areas of cortex within one lobe which are interconnected are related to parts of the claustrum which overlap in the dorsoventral dimension.     

A projection to the striatum from the medial subdivision of the posterior group of the thalamus in the cat

Injections of wheat germ agglutinin-conjugated horseradish peroxidase in the lateral part of the caudate nucleus or the putamen of the cat result in retrograde thalamic cell-labeling in the rostral extension of the medial subdivision of the posterior group (POM). Autoradiography after [³H]amino acid injection of POM reveals a dense and discontinuous distribution of axons in the lateral half of the caudate and putamen concentrated at their middle rostrocaudal levels. This newly discovered thalamostriatal projection of POM may account for somatosensory activity observed in striatal cells.     

Sexual pheromones and the evolution of the reward system of the brain: the chemosensory function of the amygdala

The amygdala of all tetrapod vertebrates receives direct projections from the main and accessory olfactory bulbs, and the strong similarities in the organization of these projections suggest that they have undergone a very conservative evolution. However, current ideas about the function of the amygdala do not pay sufficient attention to its chemosensory role, but only view it as the core of the emotional brain. In this study, we propose that both roles of the amygdala are intimately linked since the amygdala is actually involved in mediating emotional responses to chemical signals. The amygdala is the only structure in the brain receiving pheromonal information directly from the accessory olfactory bulbs and we have shown in mice that males emit sexual pheromones that are innately attractive for females. In fact, sexual pheromones can be used as unconditioned stimuli to induce a conditioned attraction to previously neutral odorants as well as a conditioned place preference. Therefore, sexual pheromones should be regarded as natural reinforcers. Behavioural and pharmacological studies (reviewed here) have shown that the females' innate preference for sexual pheromones is not affected by lesions of the dopaminergic cells of the ventral tegmental area, and that the systemic administration of dopamine antagonists do not alter neither the attraction nor the reinforcing effects of these pheromones. Anatomical studies have shown that the vomeronasal amygdala gives rise to important projections to the olfactory tubercle and the islands of Calleja, suggesting that these amygdalo-striatal pathways might be involved in the reinforcing value of sexual pheromones.     

Evidence for the collateral innervation of the esophagus and the heart from neurons in the compact formation of the nucleus ambiguus of the rat

We investigated whether the heart receives collateral projections from the neurons which innervate the esophagus with a retrograde double-labeling method using two fluorescent tracers. Following injections of True Blue (TB) into the esophagus and Diamidino Yellow (DY) into the heart, about 21.9% of the labeled esophageal motoneurons in the compact formation of the nucleus ambiguus (AmC) were retrogradely double labeled. No single-labeled cardiac motoneurons were found in the AmC. The present results provide anatomical substrates for the esophagocardiac reflex.     

Role of the paraventricular nucleus in the projection from the nucleus of the solitary tract to the olfactory bulb

Electrophysiological experiments were performed on anesthetized rats to determine the effects of lesions of the paraventricular nucleus on the amplitude of evoked potentials recorded in the periglomerular layer of the olfactory bulb after nucleus of the solitary tract electrical stimulation. Lesions of the paraventricular nucleus enhance the amplitude of both the positive and negative components of the evoked potential in the olfactory bulb. The pathway from the paraventricular nucleus to the olfactory bulb seems to exert a suppressive influence over the projection from the nucleus of the solitary tract to the olfactory bulb under these conditions.     

On the origin of the serotonergic input to the intermediate lobe of the rat pituitary

Single stimulations of the vagina and cervix were performed between proestrus and the first day of diestrus with a stimulator designed to grade the intravaginal penetration of a rod. The percent incidence of pseudopregnancy after this stimulation was exponentially related to the extent of intravaginal penetration and was also affected by the stage of the cycle at which the stimulation was performed. At 10.00 h on proestrus, an exponential increase in the incidence of pseudopregnancy was observed with shallow penetrations, while an exponential decrease was found when deeper penetrations were applied. Such negative exponential correlation had disappeared at 22.00 h on proestrus. At that time, also, some responses were elicited by very shallow penetrations (17 mm) and all the animals responded to penetrations of 20 mm or more. Sensitivity to cervicovaginal stimulation at 10.00 h on estrus was lower than that at 22.00 h on proestrus and it was even lower at 10.00 h on the first day of diestrus. The response to 18 mm of penetration was studied every 3 h between 10.00 h on proestrus and 10.00 h on estrus, and then every 12 h until 10.00 h on the first day of diestrus. This stimulation was usually ineffective to induce pseudopregnancy, except for a brief period encompassing the night between proestrus and estrus, when a peak in the incidence of responses was reached. This peak sensitivity could be advanced following the s.c. administration of 250 and 500 ng of LH-RH at 11.00 h on proestrus. Other doses were ineffective. The peptide (500 ng) was unable to induce pseudopregnancy in rats that received no cervicovaginal stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)     

On the development of the stratification of the inner plexiform layer in the chick retina

This study investigated the development of the subdivision of the chick inner plexiform layer (IPL). The approach included an immunohistological analysis of the temporal and spatial expressions of choline acetyltransferase, of the neural-glial-related and neural-glial cell adhesion molecules (NrCAM and NgCAM, respectively) and axonin-1, and of inwardly rectifying potassium (Kir) channels in 5- to 19-day-old (E5-E19) embryos. Ultrastructural investigations evaluated whether synaptogenesis accompanies the onset of differentiation of the IPL. We found that the differentiation of the IPL started at E9. Distinct cholinergic strata appeared, NrCAM immunoreactivity showed a poorly defined stratification, and Kir3.2 was expressed in the IPL and in the inner nuclear layer. From E10 until late E14, NgCAM- and axonin-1-immunoreactive strata emerged in an alternating sequence from the outer to the inner IPL. During this period, the NrCAM pattern sharpened, and eventually five bands of weaker and stronger immunoreactivity were found. Conventional synapses formed at the beginning of E9, and stratification of the IPL also began on the same day at the same location. Synaptogenesis and stratification followed a gradient from the central to the peripheral retina. The topographic course of differentiation of the IPL generally corresponded to the course of maturation of ganglion and amacrine cells. Synaptogenesis and the expression of G-protein-gated Kir3.2 channels accompanied the onset of stratification. These events coincide with the occurrence of robust and rhythmic spontaneous neuronal activity. The subsequent differentiation of the IPL seemed to be orchestrated by several mechanisms.