丹红注射液对自然衰老大鼠心脏、大脑组织SOD、MDA及GSH-Px的影响

衰老是一个受多因素影响的复杂自然生理过程,有关衰老机制的众多研究中,自由基学说和细胞凋亡学说越来越受到重视[1].丹红注射液作为一种活血化瘀药物,其是否也具有抗氧化作用尚未见报道.     

复方水蛭合剂对大鼠脑缺血再灌注损伤的影响

急性脑梗死 6小时内溶栓疗法已在国内外广泛展开 ,对抗溶栓后的再灌注损伤 ,目前还没有确切有效的药物。复方水蛭合剂主要由水蛭、黄芪、田七、赤芍、川芎等组成 ,药性有补气活血化瘀作用。一些补气活血化瘀药除有活血化瘀作用外 ,对缺血组织具有保护作用[1～ 3 ] 。本实验探讨复方水蛭合剂对脑缺血 再灌注大鼠脑匀浆、血清一氧化氮 (ＮＯ)、丙二醛 (ＭＤＡ)、超氧化物歧化酶(ＳＯＤ)的影响 ,了解本方剂抗脑缺血 再灌注的自由基损伤作用及对脑缺血 再灌注损伤的保护作用 ,为临床寻找新的抗脑缺血 再灌注损伤药物提供实验依据。1　资料1 1　…     

神经胶质瘤药物靶向性化疗的研究进展

在神经胶质瘤治疗中,药物化疗特别是药物靶向性化疗是胶质瘤治疗中最重要的环节之一,然而临床应用结果表明,胶质瘤化疗效果并不理想。本文对传统胶质瘤药物化疗存在的缺陷进行了分析,从化疗药物载体系统,胶质瘤化疗药物的一些重要靶点和胶质瘤干细胞标志物几个方面进行论述,介绍近年来胶质瘤靶向性化疗方面取得的一些进展和仍然存在的问题,旨在为胶质瘤化疗相关研究提供有价值的信息。     

鸢尾素的抗炎机制在卒中后抑郁治疗中的研究进展

卒中后抑郁指脑卒中后发生的抑郁状态,是脑卒中的一种常见后遗症,为患者家庭及社会带来了严重的经济负担。近年来,鸢尾素作为一种新型抗抑郁药物备受关注。然而,鸢尾素在缓解卒中后抑郁中的作用机制尚无相关文献进行总结。该文综述了相关研究,从抗炎机制探讨了鸢尾素在治疗卒中后抑郁中的相关作用,如改善能量代谢、神经保护、调节神经递质水平等,讨论其作为卒中后抑郁治疗药物的可能性,以期为临床缓解卒中后抑郁提供更多的药物选择,为进一步的研究提供参考。国际神经病学神经外科学杂志, 2023, 50(6): 72-77]     

新型抗精神病药物血药浓度与临床疗效的研究进展

在精神药理学领域,用“治疗药物监测（Therapeutic drug monitoring,TDM）”指导临床用药是近年来的研究热点.TDM通过长期有效血药浓度监测实现个体化合理用药.本文回顾近年的相关研究,阐述几种新型抗精神病药物血药浓度与临床疗效之间的关系.     

脑膜瘤的易感基因研究进展

脑膜瘤是颅内常见的良性肿瘤,研究发现脑膜瘤的发生与很多因素相关。脑膜瘤的研究应从多基因水平考虑,单核苷酸多态性作为一种新的研究肿瘤基因改变的方法,在脑膜瘤的研究中有重要作用。研究显示一些基因的遗传多态与脑膜瘤发生有一定联系。本文就有关DNA损伤修复基因、叶酸代谢基因、药物代谢基因、细胞凋亡基因等基因多态性与脑膜瘤易感性关系研究进展综述如下。     

丹参多酚酸盐注射液对急性脑梗死的疗效及TNF-αIL-6的影响

急性脑梗死是一种临床多发病，关于其发病机制及诊治方法一直是研究的热点，炎症反应在急性脑梗死发病中的作用已经被证实［1］。丹参多酚酸盐注射液是一种提取自丹参的具有活血化瘀、抗炎、保护心脑血管等作用的药物［2］。本文探讨丹参多酚酸盐注射液对急性脑梗死的疗效，并以常规治疗作为对照，同时检测所有患者治疗前后血清肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）、白介素-6（interleukin-6，IL-6）水平变化，现将研究结果总结如下。     

降钙素基因相关肽在偏头痛中的作用

偏头痛的具体发病机制至今尚未明确,但它严重影响患者的日常生活,因此寻找其特异性治疗成为重中之重。越来越多的研究表明,降钙素基因相关肽(CGRP)在偏头痛中发挥重要作用,本文将从CGRP结构、分布及其在偏头痛发作过程中的作用和相关药物研发几方面来进行阐述。     

多巴胺D3受体与药物成瘾的关系及研究进展

药物成瘾是一种慢性反复发作性脑病,对社会和个人都有极大的危害.多巴胺D3受体在大脑中主要分布于边缘系统,提示其在药物成瘾过程中起到重要作用.相关研究亦证实了这一点,使用成瘾性药物可使D3R表达发生适应性改变.D3R激动剂和拮抗剂的研究进一步阐述了D3R与药物成瘾的关系,也为抗成瘾药物的研发提供了可能.本文从D3R的分布、药理学研究、激动剂、拮抗剂这四个方面对D3R与药物成瘾的关系及相关研究进展做一综述.     

精神分裂症的发生机制在microRNA水平的研究进展

从microRNA水平对该病的研究近几年刚刚兴起,并取得了一些重要进展。目前已发现多种miRNA的表达异常可能与精神分裂症相关,进一步的功能研究也揭示了microRNA影响相应通路或基因的具体机制。microRNA的研究为我们解释精神分裂症的发病机制提供了一个新的角度,同时也可能为相应药物的开发提供新的作用靶点。     

中西医结合治疗突发性耳聋72例分析

目的 观察中西医结合治疗突发性耳聋的疗效.方法 138例患者随机分为2组,中西医组72例在西药三磷酸腺苷、辅酶A、胞二磷胆碱治疗的基础上,加用补肾益气、活血化瘀的中药(柴胡、丹参、龙胆草、钩藤、党参、当归、石菖蒲、川芎、葛根、天麻、香附、黄柏、夏枯草)治疗.结果 耳聋疗效比较,总有效率中西医组为87.3%,西医组为63.4%,2组比较差异有统计学意义(P＜0.05).结论 中西医结合治疗突发性耳聋疗效明显优于单纯西药治疗.     

高血压脑出血术后痰瘀腑实证血浆代谢组学的检测分析

目的从代谢组学层面寻找高血压脑出血术后痰瘀腑实证的本质以及通腑泻热活血合剂治疗作用机制。方法采用氢谱磁共振(1 H-NMR)CPMG脉冲序列检测12例高血压脑出血患者的术前及术后第1、3、7、12天血浆样本,每例患者采集5个血浆样本,本实验共收集60个血样本,所有患者的术前、术后第1天、术后第3天、术后第7天、术后第12天各为1组,分为5组,所有患者术后第3天开始服用通腑泻热合剂。对不同组之间代谢产物含量的变化,采用主成分分析(principal components analysis,PCA)、偏最小二乘判别分析(PLS-discriminant analysis,PLSDA),对比观察5组血浆中的磁共振波谱差异情况,分析相应的代谢产物积分值变化情况。最终选择对本次实验贡献值最大的代谢物,将此代谢物和自身前后进行比对,随后运用统计学方法进行检验,对比不同组别之间的血浆代谢物变化差异。结果患者术前、术后第1天、术后第3天、术后第7天、术后第12天中5组血浆代谢谱在对比中出现差异,且具有统计学意义(P0.05),在模式识别和主成份进行分析中,结果表明高血压脑出血术后第3天痰瘀腑实证形成,服用通腑泻热合剂前后具有可区分性、可比较性;术前组和术后第1天组患者血浆中差异较大的特异性代谢物6个:丙氨酸、异亮氨酸、α-酮戊二酸、糖蛋白、前列腺素、极低密度脂蛋白。术后第1天组和术后第3天组中患者血浆中差异较大的特异性代谢物6个:γ-氨基丁酸、α-酮戊二酸、甜菜碱、丝氨酸、前列腺素E1、脂蛋白;术后第3天组和术后第12天组中患者血浆中差异较大的特异性代谢物6个:N-乙酰糖蛋白、α-葡糖糖、胆碱、肌醇、亮氨酸、谷氨酰胺。术后第7天组和术后第12天组中患者血浆中差异较大的特异性代谢物2个:N-乙酰糖蛋白、乳酸。结论当高血压脑出血术后痰瘀腑实证形成,服用通腑泻热活血合剂可以改善脑出血后患者体内脂肪含量,更可以改善血糖代谢,稳定细胞膜等,促进已损伤细胞修复。     

In vivo platelet response to lipopolysaccharide in mice: proposed method for evaluating new antiplatelet drugs

We previously found evidence (based on the use of 5HT as a marker) that i.v. injection of a lipopolysaccharide (LPS) into mice induces a rapid accumulation of platelets in liver and lung. Our previous studies lacked measurement of the platelet count itself, but we have now compared the LPS-induced changes in 5HT levels with the change in platelet count. We also examined the effects on the platelet response of some drugs that act on platelets. In mice, sublethal doses of LPS induced parallel decreases in platelets and 5HT in the blood. The 5HT lost from the blood accounted well for the 5HT accumulated in liver and lung. Soon after this accumulation, the levels of platelets and 5HT in the blood recovered in parallel, and these recoveries corresponded well with the decreases in 5HT occurring in liver and lung. Aspirin and dexamethasone were effective at both reducing pulmonary platelet-accumulation and promoting their return to the circulation. By contrast, oestrogen tended to reduce the return of platelets from lung to circulation. Heparin did not inhibit pulmonary platelet-accumulation but it did decrease their return to the circulation. These results suggest that (i) in response to sublethal doses of LPS, platelets translocate into the liver and lung, then return to the circulation; (ii) this platelet response involves mechanisms that can be modified by drugs; and (iii) the use of this platelet response as a tool for drug evaluation might help identify new drugs with therapeutic potential.     

Traditional Chinese medicine for vascular protection in ischemic stroke

Although new drugs and intervention strategies have emerged from recent studies of neuroprotection, compared with haemodynamic and hemorheologic factors, knowledge of vascular factors of ischemic stroke is rather limited. In practical terms, any strategy shown to reduce the incidence of fatal and nonfatal vascular events can be termed ＂vascular protection＂, including anti-thrombotic and anti-hypertensive therapies, as well as agents that directly benefit vascular endothelium. Vascular events include myocardial infarction, stroke, and claudication. Factors involved in these events include statins, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers. In traditional Chinese medicine, the principles of ＂activating blood circulation to remove stasis＂, ＂tonifying the kidney and replenishing the essence＂, ＂dispelling pathogenic wind and removing obstruction from the meridians＂, and ＂warming Yang and promoting water metabolism＂ are possibly related to vascular protection. However, more evidence is needed to correlate these positive effects with vascular protection.     

Drug effects on regional cerebral blood flow in focal cerebrovascular disease

Hemispheric and regional cerebral blood flow (rCBF) were measured using the scintillation camera connected to a 1600-word memory and digital magnetic tape in a total of 211 patients, of whom 175 suffered from cerebrovascular disease and 36 from other neurological deficits. The effects of different drugs (2 sympathomimetics with α-and 2 with β-receptor stimulation, a central nervous system stimulant, a xanthine, 2 papaverine-like drugs, a vasodilator of cerebral vessels, 1 haemodiluting and 1 dehydrating agent) on hemispheric and regional blood flow were investigated and the results were compared to the blood flow changes between 2 measurements in untreated control patients. For the evaluation of effects on rCBF a regression analysis was applied. Homogeneous and heterogeneous responses of the regional cerebral circulation were observed: β-receptor stimulants and an α- and β-receptor stimulant in combination with xanthine caused a statistically-significant diffuse depression of rCBF, while the cerebral vasodilator hexobendine and haemodiluting and dehydrating agents caused a diffuse increase of rCBF in many cases. A significant heterogeneous response in the form of an intracerebral steal syndrome was observed only with the cerebral vasodilator, while the heterogeneous response in the form of an inverse cerebral steal syndrome was seen after the application of xanthines, papaverine-like drugs and haemodiluting and dehydrating agents. The data obtained in experimental studies of drug effects on cerebral blood flow provide the basis for controlled clinical studies, by which the therapeutic value of drugs for the treatment of cerebrovascular disease has to be proven.     

Factors associated with hydrocephalus after subarachnoid hemorrhage. A report of the Cooperative Aneurysm Study

Hydrocephalus is an important complication of subarachnoid hemorrhage (SAH). We analyzed several factors possibly related to hydrocephalus following SAH in 3521 patients from the International Study on the Timing of Aneurysm Surgery. Hydrocephalus was diagnosed on admission computed tomographic (CT) scans in 15% of patients and was thought to be clinically symptomatic in 13.2% of patients. There was a 5.9% overlap between these groups. Using contingency table analysis, we found the following were significantly related to clinical hydrocephalus: increasing age; preexisting hypertension; admission blood pressure measurements; postoperative hypertension; admission CT findings of intraventricular hemorrhage, a diffuse collection of subarachnoid blood, and a thick focal collection of subarachnoid blood; posterior circulation site of aneurysm; focal ischemic deficits; use of antifibrinolytic drugs preoperatively; hyponatremia; admission level of consciousness; and a low score on the Glasgow outcome scale. Using discriminate factor analysis to predict clinical hydrocephalus, the most important variables in order were the following: CT hydrocephalus, intraventricular hemorrhage, admission level of consciousness, presubarachnoid hypertension, increasing age, subarachnoid blood noted on CT scan, posterior circulation aneurysm site, and hypertension postoperatively (canonical correlation = .399). We conclude that the development of hydrocephalus after SAH is multifactorial. Factors that compromise cerebrospinal fluid circulation acutely (eg, intraventricular hemorrhage, hemorrhage from a posterior circulation site of aneurysm, and diffuse spread of subarachnoid blood) contribute to the development of acute hydrocephalus. These same factors, plus the use of antifibrinolytic drugs preoperatively, are also important in the pathogenesis of clinical hydrocephalus, perhaps by promoting subarachnoid fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS)     

Evaluation of a porcine model to study in vivo platelet activation

INTRODUCTION: In order to investigate if decompression sickness involves platelet activation an animal model was evaluated. MATERIALS AND METHODS: Twenty-four thiopentone-midazolam-fentanyl-anaesthetized pigs in four groups received 5-min infusions of adenosine diphosphate (25 mg/kg) or platelet activating factor (0.4 microg/kg). Groups 1 and 2 (adenosine diphosphate, n=6 and platelet activating factor, n=6) were studied for 30 min and then sacrificed. Groups 3 and 4 (adenosine diphosphate, n=6 and platelet activating factor, n=6) were sacrificed immediately afterwards to study short-term changes. Haemodynamics, platelet counts and post mortem lung platelet aggregates were registered. Groups 1 and 2 also had indium platelet labelling, lung scintigraphy and platelet accumulation index calculations performed. RESULTS: Adenosine diphosphate induced immediate and more profound transient shocks. Platelet and leukocyte count decreases and occurrences of post mortem lung platelet aggregates were significantly more profound in the 5-min adenosine diphosphate group (Group 3) than in the platelet activating factor group (Group 4). With platelet labelling there were positive platelet accumulation index trends in the 30-min adenosine diphosphate group (Group 1). Adenosine diphosphate also produced platelet aggregation in platelet-rich porcine plasma. Only adenosine diphosphate (an intermediate platelet agonist) showed signs of platelet activation when considering all platelet parameters. The model should be further evaluated with different bolus doses of adenosine diphosphate, but may be used to evaluate if gas bubbles introduced into the circulation (as with decompression sickness), or possibly if clinical drugs, might produce platelet activation in vivo.     

Neuroprotection in acute ischemic stroke

Neuroprotection of patients with acute ischemic stroke should start at the scene and continue in the ambulance with the assessment and treatment of the airway, breathing, circulation, body temperature, and blood glucose. The key goal in eligible patients should be fast vessel recanalization with intravenous recombinant tissue-type plasminogen activator Results from a meta-analysis suggest that systemic thrombolysis is effective when given within 4.5 hours after stroke onset. The time window extends to 6 hours for patients undergoing intravascular thrombolysis. Acute stroke patients should be admitted to stroke care units. A crucial component of neuroprotection is the prevention of secondary brain damage, which can be caused by hypoxemia, hypotension, hyperthermia and hyperglycemia. This can be achieved by avoiding complications, e.g. aspiration, and intensive control of oxygenation, hydration and blood pressure, body temperature, blood glucose, and cardiac monitoring. Neuroprotective agents are designed to try to salvage brain tissue within the penumbra. Thus far, despite promising preclinical studies, clinical trials with neuroprotective drugs in acute ischemic stroke have been disappointing. However, we have been able to identify many of the factors that were responsible for these failures, and better-designed clinical trials with neuroprotective drugs should look more promising. Mild induced hypothermia is another form of neuroprotective treatment that is currently being investigated in acute stroke.     

显微手术早期治疗破裂的前循环脑动脉瘤

目的旨在进一步提高早期手术治疗破裂的前循环脑动脉瘤的效果。方法回顾性分析早期显微手术治疗的112例破裂前循环脑动脉瘤患者的临床资料。结果112例病人,共125个脑动脉瘤,其中94个行动脉瘤颈夹闭,26个夹闭瘤颈后切除瘤体,另5个动脉瘤予以瘤壁包裹加固术。术后发生症状性脑血管痉挛16例,经积极治疗后,12例逐渐恢复,4例因大片的脑梗死而出现长时间昏迷。全部病例术后平均随访2年10个月,其中恢复良好92例,轻残16例,重残4例,无手术死亡。结论早期手术治疗破裂的脑动脉瘤,不仅可有效地防止再出血的危险,而且有利于脑血管痉挛的防治。术中一旦动脉瘤破裂,可采取暂时性阻断载瘤动脉和控制性低血压,但时间不宜过长。应用罂粟碱溶液冲洗脑池,扩充血容量,提升血压,高度扩张血管对防治脑血管痉挛具有相当好的疗效。     

Chinese preparation Xuesaitong promotes the mobilization of bone marrow mesenchymal stem cells in rats with cerebral infarction

After cerebral ischemia, bone marrow mesenchymal stem cells are mobilized and travel from the bone marrow through peripheral circulation to the focal point of ischemia to initiate tissue regeneration. However, the number of bone marrow mesenchymal stem cells mobilized into peripheral circulation is not enough to exert therapeutic effects, and the method by which blood circulation is promoted to remove blood stasis influences stem cell homing. The main ingredient of Xuesaitong capsules is Panax notoginseng saponins, and Xuesaitong is one of the main drugs used for promoting blood circulation and removing blood stasis. We established rat models of cerebral infarction by occlusion of the middle cerebral artery and then intragastrically administered Xuesaitong capsules(20, 40 and 60 mg/kg per day) for 28 successive days. Enzyme-linked immunosorbent assay showed that in rats with cerebral infarction, middle- and high-dose Xuesaitong significantly increased the level of stem cell factors and the number of CD117-positive cells in plasma and bone marrow and significantly decreased the number of CD54-and CD106-positive cells in plasma and bone marrow. The effect of low-dose Xuesaitong on these factors was not obvious. These findings demonstrate that middle- and high-dose Xuesaitong and hence Panax notoginseng saponins promote and increase the level and mobilization of bone marrow mesenchymal stem cells in peripheral blood.