硝普钠诱导胶质瘤细胞株U251细胞凋亡的研究

目的探讨一氧化氮（NO）供体药物硝普钠（SNP）对胶质瘤细胞株U251细胞凋亡诱导效应及其机制。方法以0．2、0．5、1．5和2．0mmol／L浓度SNP作用于U251细胞24h,甲基噻唑基四唑法检测U251细胞生长抑制率,Griess法检测其NO含量,流式细胞术检测其凋亡率,免疫印迹法检测SNP作用24h前后B淋巴细胞瘤-2基因（Bcl-2）、天冬氨酸特异性半胱氨酸蛋白酶3（caspase-3）在U251细胞的表达。结果不同浓度SNP对U251细胞生长均有抑制作用（P〈0．01）,且随SNP浓度升高而增强（P〈0．01）。U251细胞内NO含量随SNP浓度升高递增（P〈0．01）,并与细胞生长抑制率的呈正相关（P〈0．01）。不同浓度的SNP均能诱导U251细胞凋亡,且随浓度升高而增强（P〈0．01）。随SNP浓度升高U251细胞Bcl-2表达减少,caspase-3表达增加（P〈0．05）。结论SNP可抑制U251细胞生长并诱导其凋亡,其生长抑制效应可能与NO浓度有关,凋亡诱导作用与U251细胞Bcl-2下调和caspase-3上调有关。     

白藜芦醇抑制SHG-44胶质瘤细胞生长实验研究

目的探讨白藜芦醇(Res)在体外诱导脑胶质瘤SHG-44细胞凋亡并抑制其生长的作用。方法四甲基偶氮唑蓝(MTT)比色法测量不同剂量的Res作用6h、24h和48h后对SHG-44胶质瘤细胞增殖的影响。HE染色、Hoechst33342荧光染色观察细胞形态改变,DNAladder检测细胞DNA裂解情况,流式细胞仪用异硫氰酸荧光素标记的膜联蛋白V(AnnexinV-FITC)和碘化丙啶(PI)双染检测凋亡率,并测定细胞周期的改变。结果Res明显抑制SHG-44细胞的生长和增殖(P<0.01),呈浓度及时间依赖性反应;Res所致的SHG-44胶质瘤细胞凋亡为浓度依赖关系,随着浓度的增高,凋亡更明显。此凋亡细胞周期主要发生G1期比例升高,S、G2期比例降低。结论Res明显抑制SHG-44细胞生长并诱导其发生凋亡和细胞周期改变,为Res用于治疗脑胶质细胞瘤提供了实验依据。     

肿瘤坏死因子相关凋亡诱导配体诱导胶质瘤细胞凋亡机制研究

目的 探讨肿瘤坏死因子相关凋亡诱导配体(TRAIL)诱导胶质瘤细胞凋亡的机制.方法 以人重组可溶性TRAIL蛋白(rsTRAIL)处理人胶质瘤细胞U87;AnnexinV-FITC/PI双染色流式细胞术检测细胞凋亡;DiOC6荧光染色流式细胞术检测细胞线粒体跨膜电位(△ψm);比色法测定细胞caspase-3、8、9活性的变化;ELISA法检测胞浆cytC浓度;观察caspase-8阻断剂(Z-IETD-fmk)对U87细胞凋亡、△ψm和caspase-3、8、9活性变化的影响. 结果 rsTRAIL以时间依赖方式诱导U87细胞凋亡.同时导致U87细胞△ψm进行性下降,caspase-3、8、9活性及胞浆内cyt C浓度升高:caspase-8阻断剂可明显减弱rsTRAIL对U87细胞的上述生物学效应. 结论 TRAU通过激活caspase-8间接启动线粒体凋亡途径诱导恶性胶质瘤细胞U87凋亡.     

肿瘤坏死因子相关细胞凋亡诱导配体诱导人胶质瘤细胞U87的凋亡

目的 探讨肿瘤坏死因子相关细胞凋亡诱导配体(Tumor Necrosis Factor-related Apoptosis-inducing Ligand,TRAIL)诱导胶质瘤细胞凋亡的机制。方法 以人重组可溶性TRAIL蛋白(human recombinant soluble TRAIL,rsTRAIL)处理人胶质瘤细胞U87;用AnnexinV-FITC-PI双染色流式细胞术检测细胞凋亡;用DiOC6荧光染色流式细胞术检测细胞线粒体跨膜电位(ΔΨm);比色法测定细胞Caspase-3、8、9活性的变化;ELISA法检测胞浆cyt C浓度;观察Caspase-8阻断剂(Z-IETD-fmk)对U87细胞凋亡、ΔΨm和Caspase-3、8、9活性变化的影响。结果 rsTRAIL以时间依赖方式诱导U87细胞凋亡,同时导致U87细胞ΔΨm进行性下降、Caspase-3、8、9活性及胞浆内cyt C浓度的升高;Caspase-8阻断可明显减弱rsTRAIL对U87细胞的上述生物学效应。结论 TRAIL通过激活caspase-8间接启动线粒体凋亡途径诱导恶性胶质瘤细胞U87凋亡。     

白藜芦醇对脑胶质瘤U87细胞及干细胞凋亡诱导作用

目的比较研究白黎芦醇(Res)对人脑胶质瘤U87细胞及其胶质瘤干细胞(GSC)的作用。方法膜联蛋白Ⅴ(AnnexinⅤ)和碘化丙啶(PI)染色法测定细胞凋亡;CD133标记、CD133与AnnexinⅤ/PI共标记检测GSC相对含量及GSC的凋亡;实时荧光定量逆转录-聚合酶链式反应(RT-PCR)检测mdr1基因mRNA表达,流式细胞术(FCM)测定P-糖蛋白(P-gp)的表达;集落形成法(CFU)检测细胞的自我更新和增殖能力。结果不同浓度的Res显著诱导U87细胞凋亡,抑制U87细胞集落的形成。40～160μmol/L Res作用后U87细胞群体中CD133+GSC相对含量显著增高、GSC凋亡细胞数量增加,但GSC对Res的敏感性低于U87群体细胞。Res诱导后U87细胞群体中高表达mdr1/P-gp的细胞显著增高,并与GSC含量的增高基本相一致。结论白黎芦醇可诱导脑恶性胶质瘤U87群体细胞及其干细胞凋亡。     

I型γ-分泌酶抑制剂对恶性胶质瘤细胞株增殖及凋亡的影响

目的 探讨I型γ-分泌酶抑制剂(GSI-I)对U87、U251胶质瘤细胞的增殖抑制及诱导凋亡作用.方法 应用GSI-I作用于U87、U251胶质瘤细胞,通过MTT法观察GSI-I对上述两种细胞的增殖抑制作用,通过流式细胞仪检测GSI-I对该两种细胞细胞周期的影响及诱导凋亡的作用.结果RT-PCR及实时定量荧光RT-PCR结果显示,GSI-T可明显抑制胶质瘤细胞中Notch通路的活性,主要体现为Notch通路的靶基因Hes-1表达明显下调.MTT检测结果显示2.5μmol/L及以上浓度的GSI-I对U87及U251胶质瘤细胞有明显的增殖抑制作用.与对照组比较,差异有统计学意义(P<0.05),且该抑制作用呈剂量依赖型增加.流式细胞检测结果显示GSI-I主要使U87胶质瘤细胞的细胞周期阻滞在G1期而抑制细胞增殖,对于U251胶质瘤细胞则主要通过诱导凋亡来抑制增殖.结论 GSI-I可明显抑制U87及U251胶质瘤细胞的增殖并诱导凋亡,为恶性胶质瘤的临床治疗提供了理论参考依据.     

白藜芦醇抑制U251人胶质瘤细胞增殖及其相关机制的探讨

目的 探讨白藜芦醇（Res）对U251胶质瘤细胞增殖和侵袭的抑制作用及其机制。方法 将不同浓度Res作用于U251胶质瘤细胞系，相差显微镜下观察其形态的变化，MTT法检测其对细胞生长增殖的抑制作用，流式细胞术（FCM）检测其对细胞周期的影响，用蛋白印迹（Western blot）检测Res处理前后U251细胞表皮生长因子受体（EGFR）、p53、p21、CDK4、CyclinD1、Bcl-2及caspase-3的表达，免疫组化分析MMP9、NFKB、P-AKT及AKT2的表达。结果 U251细胞经Res处理后，细胞形态发生一定变化，U251胶质瘤细胞的增殖被抑制，呈浓度和时间依赖性，细胞周期被阻滞在S期，Western blot检测显示EGFR、CyclinD1、CDK4、Bcl-2的表达降低，p21、p53、caspase-3蛋白表达升高，免疫组化检测显示MMP9，NFKB、P-AKT及AKT2的表达降低。结论 Res有可能通过调节EGFR及p53信号通路而抑制U251胶质瘤细胞的增殖和侵袭，诱导肿瘤细胞凋亡。     

白藜芦醇抑制胶质瘤细胞生长与诱导细胞凋亡实验研究

目的探讨白藜芦醇(Res)对脑胶质瘤细胞(C6细胞株)和正常成纤维细胞(3T3细胞株)体外增殖的影响,进而观察Res诱导C6和3T3细胞系的凋亡作用.方法用不同浓度的Res处理C6和3T3细胞,以四甲基偶氮唑蓝(MTT)比色法检测Res对C6和3T3细胞的增殖作用,通过HE染色、扫描电子显微镜(SEM)、原位末端标记法(TUNEL)和流式细胞仪Annexin Ⅴ荧光染色,观察细胞的形态学结构改变,并定量检测细胞凋亡.结果 Res抑制了C6细胞的生长与增殖( P < 0.01 ),呈浓度依赖性反应;Res能明显诱导C6细胞凋亡,经210 μmol/L、120 μmol/L Res处理24 h后及对照组的C6细胞,其凋亡率分别为29.7%、14.6%及2.1%;相应的3T3细胞凋亡率分别为4.3%、3.5%、2.6%. 结论 Res能通过诱导C6细胞凋亡而抑制其生长与增殖,但对3T3细胞无此作用.本研究为临床应用Res治疗脑胶质细胞瘤提供了实验依据.     

白藜芦醇对胶质瘤U87细胞迁移和侵袭能力的影响

目的探讨白藜芦醇对胶质瘤U87细胞迁移和侵袭能力的影响和作用机制。方法采用四唑盐(MTT)比色实验检测胶质瘤U87细胞经不同浓度白藜芦醇作用24 h、48 h、72 h后生存率的变化;细胞划痕试验和transwell侵袭试验检测白藜芦醇对胶质瘤U87细胞迁移和侵袭能力的影响;明胶酶谱法分析白藜芦醇对细胞基质金属蛋白酶(MMP)活性的改变。结果 MTT法显示一定浓度的白藜芦醇可抑制U87细胞生长,并随着浓度的增加和作用时间的延长而明显增强(P<0.05);与对照组比较,经白藜芦醇作用后U87细胞迁移和侵袭能力明显降低,MMP-2分泌减少。结论白藜芦醇可有效抑制胶质瘤U87细胞迁移和侵袭能力,其机制可能与白藜芦醇降低细胞MMP-2活性相关。     

白藜芦醇对裸鼠U87细胞移植瘤生长及血管生成的影响

目的 研究白藜芦醇(Res)对人脑胶质瘤系U87细胞的体内抗癌活性及血管生成的影响. 方法 BALB/c裸鼠20只,背部皮下接种胶质瘤细胞U87建立皮下移植瘤模型.随机数字表法分为10、100mg/kgRes治疗组,溶剂对照组,空白对照组,每组5只.观察4组裸鼠移植瘤的生长曲线并应用免疫组织化学法检测瘤组织中微血管密度(MVD)及血管内皮生长因子(VEGF)的表达:采用原位末端标记法(TUNEL)检测瘤组织细胞的凋亡. 结果与空白对照组及溶剂对照组相比,100 mg/kg Res治疗组裸鼠移植瘤的体积、重量降低;100 mg/kg Res治疗组瘤组织中MVD、VEGF的表达明显降低,凋亡细胞数增高,差异均有统计学意义(P<0.05). 结论 Res对U87人脑胶质瘤细胞裸鼠移植瘤的生长具有明显抑制作用,这可能与Res导致U87移植瘤细胞凋亡及血管生成减少有关.     

Epilepsy and anomalies of neuronal migration: MRI and clinical aspects

Neuronal migration disorders are the result of disturbed brain development. In such disorders, neurons are abnormally located. In diagnosing these conditions, magnetic resonance imaging is superior to any other imaging technique. This enables us to improve our knowledge of the clinical correlates of neuronal migration. With reference to migrational disorder, a retrospective study of all 303 patients with epileptic seizures referred for magnetic resonance imaging during a 3-year period was performed, 13 patients (aged 12-41, mean age 27) were identified. They represent 4.3% of the entire study group. Of the patients with known epilepsy, 6.7% and of the mentally retarded, 13.7% had migrational disorders. Four patients had schizencephaly as the dominant finding, one was classified as hemimegalencephaly, 2 had isolated heterotopias, and 6 had localized pachy- and/or poly-microgyria. The clinical pictures are complex. Ectopias of grey matter are recognised foci of epilepsy, but from an epileptological and a clinical viewpoint little attention has been given to these disorders. The present study shows that malmigration is not rare in epilepsy patients, especially not in the mentally retarded.     

Hepatic Considerations in the Use of Antiepileptic Drugs

Summary: Virtually all of the major antiepileptic drugs (AEDs) can cause hepatotoxicity, although fatal hepatic reactions are rare. The mechanisms, incidences, and risk profiles for such reactions differ from drug to drug. With carbamazepine and phenytoin, hepatotoxicity may be due to drug hypersensitivity. Although the profiles of patients at risk have not been well-defined for these two antiepileptic drugs, it would appear from reports in the literature that older adolescents and adults are at higher risk than children of developing serious or fatal hepatotoxicity. Once hepatotoxicity develops, mortality rates are 10–38% with phenytoin and 25% for carbamazepine. The risk profile for valproate fatal hepatotoxicity has been more clearly defined. Those at primary risk of fatal hepatic dysfunction are children under the age of 2 years who are receiving multiple anticonvulsants and also have significant medical problems in addition to severe epilepsy. The risk is considerably lower for patients over the age of 2 years on valproate monotherapy. In contrast to the risk profile with other AEDs, adults receiving valproate as monotherapy have the lowest risk of hepatotoxicity. Fatal hepatic dysfunction coincident with valproate may be the result of aberrant drug metabolism. Concomitant use of AEDs that induce microsomal P450 enzymes (e.g., phenytoin and phenobarbital) may enhance the production of a toxic metabolite, and hence the greater risk of hepatotoxicity with polypharmacy.     

Vascular Malformations and Epilepsy: Clinical Considerations and Basic Mechanisms

Summary: Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to provoke epilepsy determine treatment strategies. Investigations have probed the mechanisms of epileptogenesis associated with these lesions. Electrophysiologic changes are associated with epileptogenic cortex adjacent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial physiology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology.     

Classification of methods in transcranial Electrical Stimulation (tES) and evolving strategy from historical approaches to contemporary innovations

Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.     

Carbamazepine Efficacy and Utilization in Children

Summary: Carbamazepine is effective for preventing partial and generalized tonic-clonic seizures in children. Although absence epilepsies are more common in children than adults, an estimated 80% of children with epilepsy have seizure types or epilepsies that are potentially responsive to carbamazepine. The differential diagnosis of ictal staring is an especially important issue in children because absence and atypical absence seizures are more prevalent in children than adults. Age-related pharmacokinetic differences and drug interactions are major considerations in children. On average, children have higher clearance rates of carbamazepine, shorter half-lives, and higher ratios of carbamazepine-10, 11-epoxide to carbamazepine than adults. In addition, children with severe epilepsy are more likely to require multiple-drug therapy, which can lead to complex drug interactions. When carbamazepine is administered along with valproate, drug protein binding interactions can cause intermittent side effects.     

Neonatal Seizures: Problems in Diagnosis and Classification

Summary: The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo-graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction.     

Valproate Monotherapy in the Management of Generalized and Partial Seizures

Summary: For decades, therapeutic tradition has promoted the concept of polypharmacy in the management of epilepsy. In recent years, however, studies have shown that, for most patients, monotherapy can provide comparable or better seizure control than administration of multiple anticonvulsants, while diminishing the potential for adverse reactions, drug interactions, and poor compliance. Valproate is an important monotherapeutic agent that is highly effective in the control of idiopathic primary and secondarily generalized epilepsies, and partial seizures that do not generalize. Comparative studies have found that valproate is at least as effective as phenytoin and carbamazepine in the treatment of generalized and partial seizures. Given the similar efficacy, other factors such as pharmacokinetics and side effects may therefore determine anticonvulsant selection for monotherapy.     

Un nouveau cadre conceptuel de travail pour la psychiatrie

In an attempt to place psychiatric thinking and the training of future psychiatrists more centrally into the context of modern biology, the author outlines the beginnings of a new intellectual framework for psychiatry that derives from current biological thinking about the relationship of mind to brain. The purpose of this framework is twofold. First, it is designed to emphasize that the professional requirements for future psychiatrists will demand a greater knowledge of the structure and functioning of the brain than is currently available in most training programs. Second, it is designed to illustrate that the unique domain which psychiatry occupies within academic medicine, the analysis of the interaction between social and biological determinants of behavior, can best be studied by also having a full understanding of the biological components of behavior.