蝙蝠葛酚性碱对脑缺血再灌注大鼠脑水肿及血脑屏障通透性的影响

目的研究蝙蝠葛酚性碱对脑缺血再灌注大鼠脑水肿及血脑屏障通透性的影响。方法线栓法制备大鼠大脑中动脉阻断局灶性脑缺血模型,缺血2 h后实行再灌注,采用干湿重方法测定脑含水量,用伊文思蓝法(Evans Blue,EB)观察再灌注不同时间点血脑屏障通透性变化,并观察蝙蝠葛酚性碱对不同再灌注时间大鼠脑水肿和血脑屏障通透性的影响。结果蝙蝠葛酚性碱能明显降低脑缺血再灌注大鼠的脑含水量和EB含量。结论蝙蝠葛酚性碱对脑缺血再灌注大鼠脑水肿及血脑屏障通透性具有保护作用。     

蝙蝠葛碱对大鼠局灶性脑缺血再灌注损伤的治疗作用

目的研究蝙蝠葛碱(dauric ine,Dau)对脑缺血再灌注损伤的治疗作用和可能机制。方法线栓法阻断大鼠一侧大脑中动脉制备大鼠局灶性脑缺血再灌注模型,于脑缺血后即刻、再灌注后11 h和23 h分别腹腔注射给予Dau 2.5、5和10 mg.kg-1。观察不同剂量Dau对脑缺血再灌注大鼠的神经功能状态、脑梗死面积、脑水肿程度及缺血侧脑组织病理学改变和髓过氧化物酶(Myeloperoxidase,MPO)活性的影响。结果脑缺血后给予Dau,可明显降低缺血侧脑梗死及脑水肿程度,使神经病学症状得到明显改善;可减弱神经细胞损伤和脑实质内中性粒细胞浸润;能降低缺血再灌注损伤后脑组织内MPO的活性。结论蝙蝠葛碱对脑缺血再灌注损伤具有良好的治疗效果,其作用机制可能与其抗炎作用有关。     

卡托普利对脑缺血再灌注损伤大鼠血脑屏障通透性及MMP-9表达的影响

目的观察血管紧张素转化酶抑制药卡托普利对大鼠局灶性脑缺血再灌注损伤后血脑屏障通透性和基质金属蛋白酶-9(MMP-9)表达的影响,并探讨其机制。方法采用血管内栓线阻断法制备大鼠局灶性脑缺血再灌注损伤模型,于脑缺血2h、再灌注24h后测定脑组织含水量、伊文斯蓝(EB)含量,放射免疫方法测定血浆中血管紧张素Ⅱ的含量,免疫组织化学方法测定MMP-9表达。结果研究发现,脑缺血2h、再灌注24h,缺血再灌组大鼠脑组织含水量及EB含量明显增加,MMP-9呈现高表达。而卡托普利组脑组织含水量、EB含量及MMP-9表达明显低于脑缺血再灌注组(P<0.05)。结论卡托普利通过减少血管紧张素Ⅱ的生成从而降低脑缺血再灌注大鼠基质金属蛋白酶-9的活性及血脑屏障通透性,发挥对脑缺血再灌注损伤的保护作用。     

蝙蝠葛酚性碱对大鼠局灶性脑缺血-再灌注继发炎性损伤的保护作用

目的研究蝙蝠葛酚性碱对大鼠局灶性脑缺血-再灌注继发炎性损伤的保护作用及其机制。方法用线栓法制作大鼠右侧大脑中动脉栓塞模型，缺血2 h后，将线抽出实行再灌注，观察蝙蝠葛酚性碱对粘附分子(ICAM-1)表达、白细胞的粘附与浸润、髓过氧化物酶(MPO)活性和一氧化氮(NO)含量的影响。结果蝙蝠葛酚性碱可明显抑制ICAM-1的表达，减轻白细胞的粘附与浸润，降低缺血侧大脑皮层和海马组织中的MPO活性和NO含量。结论蝙蝠葛酚性碱对大鼠局灶性脑缺血-再灌注后的炎性损伤有明显保护作用，其机制可能与抑制ICAM-1表达，减轻白细胞的粘附与浸润，减少NO产生有关。     

蝙蝠葛酚性碱对小鼠脑缺血再灌注后软脑膜微循环的影响

目的:观察蝙蝠葛酚性碱对小鼠脑缺血再灌注后软脑膜微循环障碍的改善作用。方法:将60只小鼠随机分为假手术组、缺血再灌注组、蝙蝠葛酚性碱低、中、高剂量组、阳性对照组。用动脉夹夹闭小鼠双侧颈总动脉10 min后去掉动脉夹,制作脑缺血再灌注损伤模型, 应用BI2000微循环图像处理系统,通过开放式颅窗观察各组小鼠软脑膜微静脉、微动脉血流速度和微小血管开放数目,以及蝙蝠葛酚性碱对小鼠脑缺血再灌注后软脑膜微循环障碍的改善作用。结果:缺血损伤组软脑膜微小动脉、静脉血管直径明显缩小,血流速度缓慢,与正常对照组比较,差异有显著意义(P <0.05);蝙蝠葛酚性碱可剂量依赖性增加缺血再灌注所致的软脑膜微小动、静脉血流速度和血管开放数目。结论:蝙蝠葛酚性碱可增加小鼠脑缺血再灌注脑软膜血流量,改善脑缺血后脑软膜微循环障碍,发挥对脑缺血的保护作用。     

蝙蝠葛酚性碱调节p-NR1和NR2A对脑缺血再灌注大鼠发挥神经保护作用

目的：探讨蝙蝠葛酚性碱（phenolic alkaloids of Menispermum dauricum,PAMD）对脑缺血再灌注大鼠的神经保护作用及其机制。方法：大鼠局灶性脑缺血模型采用大脑中动脉线栓法制作。动物随机分为假手术组,缺血再灌注组,PAMD低（25 mg·kg^-1）、中（50 mg·kg^-1）、高（75 mg·kg^-1）剂量治疗组。持续栓塞2 h拔出线栓,再灌注4 h,然后断头取脑。干湿重法求出脑组织含水量,伊文思蓝含量测定法观察血脑屏障通透性。分离皮层组织,免疫印迹方法检测NR1和NR2A及各自对应的磷酸化蛋白。结果：（1）PAMD可以减少脑缺血再灌注大鼠脑组织含水量（P<0.05）,降低脑缺血再灌注大鼠血脑屏障通透性（P<0.05）;（2）与假手术组比较,缺血再灌注组NR1,NR2A,p-NR2A表达无明显变化,p-NR1表达减少（P<0.05）;与缺血再灌注组比较,PAMD使p-NR1表达增多（P<0.05）,NR2A表达减少（P<0.05）。结论：PAMD可通过调节p-NR1和NR2A对脑缺血再灌注大鼠发挥神经保护作用。     

蝙蝠葛苏林碱对小鼠和大鼠脑缺血的保护作用

目的研究蝙蝠葛苏林碱对小鼠缺氧、急性脑缺血和大鼠局灶性脑缺血的保护作用。方法采用小鼠常压密闭缺氧实验，观察了蝙蝠葛苏林碱对小鼠耗氧量和存活时间的影响；结扎小鼠双侧颈总动脉造成急性全脑缺血模型，观察了蝙蝠葛苏林碱对急性脑缺血小鼠死亡率的影响；电凝阻断大鼠一侧大脑中动脉造成大鼠局灶性脑缺血模型，观察了蝙蝠葛苏林碱对局灶性脑缺血大鼠梗塞面积和行为障碍的影响。结果蝙蝠葛苏林碱能明显降低常压密闭缺氧小鼠整体耗氧速度，延长缺氧小鼠的存活时间；明显降低急性脑缺血小鼠２ｈ死亡率；显著降低局灶性脑缺血大鼠梗塞范围，明显改善行为障碍。结论蝙蝠葛苏林碱具有抗缺氧、抗脑缺血作用。     

姜黄素预处理对大鼠脑缺血/再灌注损伤后AQP-4及脑水肿的影响

目的研究化学合成的姜黄素预处理对大鼠脑缺血/再灌注损伤后AQP-4及脑水肿的影响。方法采用线栓法阻塞大鼠大脑中动脉(MCAO),建立大鼠局灶性脑缺血/再灌注实验模型,72只SD大鼠被随机分为假手术组(S组)、缺血/再灌注组(I组)和姜黄素(缺血前30 min腹腔给予50、100 mg.kg-1)组(C1和C2组),每组18只。I组和C1、C2组分别在脑缺血/再灌注后24 h处死。观察大鼠神经功能缺失的评分;干湿重法观察大鼠脑含水量的变化,通过收集透出脑血管外的伊文思蓝(EB)来示踪血脑屏障(BBB)的变化,免疫印记法检测AQP-4和c-Jun氨基端激酶(JNK)的表达情况。结果 S组无神经行为改变;C1、C2组脑含水量、EB量、AQP-4表达及JNK磷酸化水平与I组相比明显降低(P<0.05);C1、C2组神经学评分高于Ⅰ组(P<0.05)。结论化学合成的姜黄素可减轻大鼠局灶性脑缺血/再灌注后AQP-4表达水平及BBB的破坏程度,减轻脑水肿,其机制可能与抑制JNK通路的磷酸化激活有关。     

丹红注射液对实验性脑缺血大鼠脑毛细血管通透性及脑含水量的影响

目的 研究丹红注射液对大鼠脑缺血所致脑水肿的影响.方法 建立以颈总动脉结扎致大鼠不完全性脑缺血模型,通过伊文氏蓝法和重量法观察丹红注射液对脑毛细血管通透性、脑指数、脑含水量的影响.结果 丹红注射液预防给药可明显降低模型大鼠脑毛细血管通透性、脑含水量和脑指数,减轻脑水肿(P＜0.05).结论 丹红注射液对实验性大鼠脑缺血所致脑水肿有一定的预防作用.     

扎鲁司特对大鼠局灶性脑缺血再灌注损伤的保护作用

目的:探讨白三烯受体拮抗剂扎鲁司特对大鼠局灶性脑缺血再灌注损伤的保护作用及机制。方法:线栓法制备大鼠大脑中动脉缺血2 h再灌注24 h模型,观察扎鲁司特(20、40 mg.kg-1,灌胃)对脑梗死体积、脑水肿程度、血脑屏障通透性的影响,测定脑组织中髓过氧化物酶(MPO)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-PX)、一氧化氮(NO)及诱导型一氧化氮合酶(iNOS)含量。结果:扎鲁司特能有效减少脑梗死体积、脑水肿程度与血脑屏障通透性,增高脑组织GSH-PX活性,降低MDA、MPO含量,抑制iNOS活性并减少NO含量。结论:扎鲁司特对脑缺血再灌注损伤有保护作用,其机制可能与降低血脑屏障通透性、抑制脑内炎症反应、抗脂质过氧化、降低NO毒性有关。     

Brain Tumor-Related Epilepsy

In patients with brain tumor (BT), seizures are the onset symptom in 20-40% of patients, while a further 20-45% of patients will present them during the course of the disease. These patients present a complex therapeutic profile and require a unique and multidisciplinary approach. The choice of antiepileptic drugs is challenging for this particular patient population because brain tumor-related epilepsy (BTRE) is often drug-resistant, has a strong impact on the quality of life and weighs heavily on public health expenditures.In BT patients, the presence of epilepsy is considered the most important risk factor for long-term disability. For this reason, the problem of the proper administration of medications and their potential side effects is of great importance, because good seizure control can significantly improve the patient’s psychological and relational sphere. In these patients, new generation drugs such as gabapentin, lacosamide, levetiracetam, oxcarbazepine, pregabalin, topiramate, zonisamide are preferred because they have fewer drug interactions and cause fewer side effects. Among the recently marketed drugs, lacosamide has demonstrated promising results and should be considered a possible treatment option. Therefore, it is necessary to develop a customized treatment plan for each individual patient with BTRE. This requires a vision of patient management concerned not only with medical therapies (pharmacological, surgical, radiological, etc.) but also with emotional and psychological support for the individual as well as his or her family throughout all stages of the illness.     

Dexmedetomidine Postconditioning Reduces Brain Injury after Brain Hypoxia-Ischemia in Neonatal Rats

Perinatal asphyxia can lead to death and severe disability. Brain hypoxia-ischemia (HI) injury is the major pathophysiology contributing to death and severe disability after perinatal asphyxia. Here, seven-day old Sprague-Dawley rats were subjected to left brain HI. Dexmedetomidine was given intraperitoneally after the brain HI. Yohimbine or atipamezole, two α2 adrenergic receptor antagonists, were given 10 min before the dexmedetomidine injection. Neurological outcome was evaluated 7 or 28 days after the brain HI. Frontal cerebral cortex was harvested 6 h after the brain HI. Left brain HI reduced the left cerebral hemisphere weight assessed 7 days after the brain HI. This brain tissue loss was dose-dependently attenuated by dexmedetomidine. Dexmedetomidine applied within 1 h after the brain HI produced this effect. Dexmedetomidine attenuated the brain HI-induced brain tissue and cell loss as well as neurological and cognitive dysfunction assessed from 28 days after the brain HI. Dexmedetomidine postconditioning-induced neuroprotection was abolished by yohimbine or atipamezole. Brain HI increased tumor necrosis factor α and interleukin 1β in the brain tissues. This increase was attenuated by dexmedetomidine. Atipamezole inhibited this dexmedetomidine effect. Our results suggest that dexmedetomidine postconditioning reduces HI-induced brain injury in the neonatal rats. This effect may be mediated by α2 adrenergic receptor activation that inhibits inflammation in the ischemic brain tissues.     

脑出血和重型颅脑伤术后的高血糖控制

目的观察高血压性脑出血和重型颅脑损伤术后患者血糖变化,并对胰岛素辅助治疗的疗效进行观测。方法对所有高血压性脑出血和重型颅脑损伤术后的患者,常规给予胰岛素皮下注射(6U/Q6h),应用one touchⅡ型血糖仪连续2周动态检测患者血糖水平。结果高血压性脑出血和重型颅脑损伤术后患者应激性高血糖得到有效控制,且控制不良者预后极差。结论在高血压性脑出血和重型颅脑损伤术后,采用正规胰岛素皮下注射法和血糖仪的连续监测,确实简单易行,安全有效,有助于对术后病情的评估和预后的判断。