替普瑞酮诱导AD模型大鼠海马HSP70表达及其神经保护作用的研究

目的 研究替普瑞酮（Geranylgeranylacetone，GGA）诱导阿尔茨海默病（Alzheimer disease，AD）模型大鼠海马热休克蛋白70（heat shock protein70，HSP70）表达及其对AD大鼠的神经保护作用。方法 90只SD大鼠随机分为替普瑞酮组、模型组与生理盐水组，双侧海马注射Aβ1-42。建立阿尔茨海默病大鼠模型，替普瑞酮组给予替普瑞酮800mg·kg^-1·d^-1灌胃，余两组给予等量生理盐水灌胃；术后1d、7d、14d、21d并于Y迷宫行为学测试后处死大鼠；采用western-blot方法检测各组大鼠海马HSP70表达的变化，HE染色观察海马神经元形态学改变，TUNEL法检测海马神经元凋亡。结果术后14d、21d模型组大鼠学习记忆能力较生理盐水组明显减退（P〈0．05），替普瑞酮组较模型组明显改善（P〈0．05）；术后7d、14d、21d模型组大鼠海马HSP70表达较生理盐水组逐渐减少（P〈0．05），替普瑞酮组HSP70表达明显增加（P〈0．05）；术后21d模型组大鼠海马CA1区神经元结构紊乱，细胞减少，凋亡细胞较生理盐水组明显增加（P〈0．01），替普瑞酮组凋亡细胞较模型组显著减少（P〈0．05），细胞形态学改变减轻。结论替普瑞酮能够诱导AD模型大鼠海马HSP70表达，减少大鼠海马神经元凋亡而产生神经保护作用，改善大鼠的学习记忆能力。     

在缺氧条件下培养的海马神经元形态结构及热休克蛋白(HSP)70表达变化及丹参的影响

在体研究曾发现在缺血再灌注模型中，丹参具神经保护作用。本文采用新生大鼠海马神经元培养技术，以细胞形态学及HSP70免疫性细胞表达为指标，首次观察了缺氧条件下培养的海马神经无形态结构及HSP70表达变化及丹参的影响。结果发现：（1）不论缺氧1h或2h，在培养的海马神经细胞中，有的细胞出现细胞体周围光晕消失，胞浆内颗粒变性，细胞膜肥厚、粗糙，轴突变粗、断裂，并且出现HSP70免疫阳性细胞；（2）缺氧1h组的海马神经细胞存活率及HSP70免疫阳性细胞率均显著高于缺氧2h组，（3）丹参组（在缺氧0．5h前给丹参100mg／ml（终浓度）的海马神经细胞存活率及HSP70免疫阳性细胞率均显著高于缺氧2h组。结果提示丹参具有直接的抗缺氧性神经细胞损伤的作用，减轻了缺氧所造成的神经细胞形态学上的改变。     

脑缺血再灌注后热休克蛋白70、c-fos的表达及柘树制剂的神经保护作用

目的 观察局灶脑缺血再灌注后热休克蛋白（HSP）70、c-fos的表达及其与细胞调亡的关系,探讨柘树制剂对脑缺血后神经细胞损伤的保护作用。方法 采用改良Longa法制作大鼠局灶脑缺血冉灌注模型。柘树制剂预处理组（柘树组）大鼠在实验前灌服柘树制剂2ml每日3次,连用5d。在缺血再灌注不同时点（1h、6h、12h、24h、3d、7d）将大鼠处死取腑,进行HSP70及c-fos免疫组化染色、c-fos mRNA原位杂交、原位末端标记（TUNEL）及HE染色,许对其阳性结果进行半定量分析。结果脑缺血再灌注能诱导HSP70及c-fos的表达。缺血冉灌注6h绀HSP70存缺血侧皮质及基底节开始表达,24h达高峰。缺血再灌注1h组c-fos即有表达,6h达高峰,后逐渐下降。细胞凋亡于缺血再灌注6h最显著。柘树组HSP70及c-fos表达的阳性细胞数均较缺血再灌注组明监增加,两组比较差异均有显著性（均P〈0．01）,而TUNEL阳性细胞数明显减少。结论 HSP70及c=-ros均参与了脑缺血的病理生理过程,柘树制剂对脑缺吡冉灌注损伤有保护作用。     

自由基清除剂预处理对大鼠脑缺血再灌注损伤后脑组织细胞凋亡及其相关蛋白表达的影响

目的探讨自由基清除剂依达拉奉预处理对大鼠脑缺血再灌注损伤后神经细胞凋亡及其相关蛋白Bcl-2、Bax、热休克蛋白70(HSP70)表达的影响。方法将45只雄性SD大鼠随机分为假手术组、对照组、依达拉奉预处理组,每组15只。采用线栓法制作大鼠缺血2h再灌注24h模型。预处理组大鼠建模前12h腹腔注射依达拉奉(3mg/kg),对照组给予等容量生理盐水。再灌注24h后断头取脑,应用免疫组织化学法检测Bcl-2、Bax、HSP70蛋白表达,末端脱氧核糖核酸转移酶介导的原位缺口末端标记法检测凋亡细胞。结果依达拉奉预处理组和对照组大鼠缺血周围脑组织中凋亡细胞和Bcl-2、Bax及HSP70阳性细胞数比假手术组均明显增加(P<0.01);与对照组比较,其凋亡细胞和Bax阳性细胞数均明显减少(P<0.01),而Bcl-2和HSP70阳性细胞数明显增加(P<0.01)。结论细胞凋亡在缺血再灌注损伤中起着重要作用;依达拉奉可能通过上调Bcl-2、HSP70蛋白表达、下调Bax蛋白表达减轻大鼠脑缺血再灌注后的细胞凋亡,增加脑缺血再灌注损伤耐受性,从而起到神经保护作用。     

亚低温对大鼠脑缺血再灌注损伤后HSP70mRNA表达及损伤神经细胞凋亡的影响

目的 探讨亚低温对大鼠脑缺血再注损伤后HSP70mRNA、HSP70（热休克蛋白70）表达及损伤神经细胞凋亡的影响。方法 采用大鼠局灶性脑缺血再灌注损伤模型,大脑中动脉阻塞2小时,再灌注损伤10小时,用逆转录聚合酶链反应（RT－PCR）技术、免疫组织化学法和原位缺口末端标记（TUNEL）法分别检测假手术组、对照组和亚低温组HSP70mRNA、HSP70表达水平和凋亡细胞百分率。结果 亚低温组HSP70mRNA、HSP70表达水平较对照组显著升高（P＜0．05）,而凋亡细胞百分率明显低于对照组（P＜0．05）。结论 亚低温上调大鼠脑缺血再灌注损伤后HSP70mRNA、HSP70表达水平可能与其抗损伤神经细胞凋亡作用有关。     

血管内皮生长因子基因修饰C17.2神经干细胞移植治疗脑梗死的实验研究

目的 探讨血管内皮生长因子（VEGF）基因修饰神经干细胞（NSC）移植治疗脑梗死大鼠模型的治疗效果，以及基因的表达情况和神经保护作用。方法 通过移植腺病毒载体介导的VEGF165基因转染的C17-2NSC到大鼠大脑中动脉阻断（MCAO）的局灶性脑缺血模型脑梗死半暗带区，观察移植后大鼠神经功能变化，神经特异性烯醇化酶（NSE）、CD31免疫组化检查观察细胞存活分化和血管新生情况。结果 VEGF病毒组、NSC移植组和VEGF基因修饰NSC组神经功能严重度评分均较对照组显著减少（P〈0．05），以VEGF基因修饰NSC组最为显著（P〈0．05）；NSC移植后NSE阳性细胞数较对照组显著增多（P〈0．05），VEGF基因修饰NSC组更为碌著（P〈0．05）；VEGF病毒组和VEGF基因修饰NSC移植组脑梗死灶周围血管数较对照组显著增多（P〈0．05），以VEGF基因修饰NSC组更为显著（P〈0．05）。结论 转染VEGF基因的C17．2NSC脑内移植治疗MCAO脑梗死模型可促进NSC向神经元分化，可促进新生血管形成，改善神经功能。VEGF基因修饰NSC移植治疗效果优于单纯的C17．2NSC移植或VEGF基因治疗。     

bFGF对大鼠脑出血周边组织NO含量、HSP70表达及细胞凋亡的影响

目的 研究碱性成纤维生长因子(bFGF)对大鼠脑出血周边组织一氧化氮(NO)含量、热休克蛋白70(HSP70)表达及细胞凋亡的影响.方法 Wistar大鼠112只,随机分为脑出血组、脑出血+bFGF组,两组各分为(出血前和出血后4h、6h、12h、24h、72h、7d)7个时间点.利用化学方法测定大鼠脑出血周边组织NO含量,免疫组化法测定HSP70的表达,利用原位末端标记法测定出血周边组织中神经细胞的凋亡情况.结果 大鼠脑出血周边组织NO含量4h开始升高(P＜0.05),24h到7d显著升高(P＜0.01),大约72h左右NO达峰值.大鼠脑出血周边组织HSP70表达4h开始升高(P＜0.01),大约24h左右HSP70表达达峰值.大鼠脑出血周边组织6h出现凋亡细胞,12h上升显著(P＜0.01),72h左右凋亡细胞达峰值,与NO峰值对应,7d时仍存在较多凋亡细胞.bFGF干预后,NO含量、凋亡细胞数量与脑出血组对应时间点比较显著下降(P＜0.01);HSP70表达与脑出血组对应时间点比较显著升高(P＜0.01).结论 大鼠脑出血周边组织神经细胞存在长时间凋亡,NO可以促进其凋亡,HSP70可以抑制其凋亡,bFGF能使NO含量降低,HSP70表达增高,从而抑制神经细胞凋亡.     

Celecoxib对糖尿病大鼠缺血再灌注脑组织NF-kB和ICAM-1表达的影响

目的探讨celecoxib对糖尿病大鼠脑缺血再灌注后脑组织中NF-xB和ICAM-1表达的影响。方法采用SD大鼠腹腔注射链脲佐菌素（STZ）和线栓法制作糖尿病大鼠大脑中动脉缺血再灌注模型;大鼠分为假手术组（S组）、脑缺血再灌注生理盐水组（NS组）、celecoxib低剂量组（LCIR组）和高剂量组（HCIR组）,分别于缺血后30rain给予生理盐水或celecoxib溶液灌胃,再灌注后6、12、24、48h将大鼠断头取脑,免疫组化法检测脑组织中NF-kB和ICAM-1的表达水平。并对大鼠进行神经功能缺损评分。结果NS组、LCIR组、HCIR组大鼠神经功能缺损评分有显著差异（P〈0．05）;NS组、LCIR组、HCIR组NF-kB阳性细胞及ICAM-1阳性微血管主要表达于缺血周边区,较S组表达明显增强（P〈0．05）,LCIR组、HCIR组NF_KB阳性细胞表达率及ICAM-1阳性微血管数较NS组减少（P〈0．05）,LCIR组、HCIR组之间未见明显差异（P〉0．05）,每组不同时间点之间NF-gB阳性细胞表达率有明显差异（P〈0．05）以及它们之间的ICAM-1阳性微血管数也有明显差异（P〈0．05）。结论celecoxib可能通过抑制糖尿病大鼠脑缺血一再灌注后脑组织中NF-kB和ICAM-1的表达而减轻神经功能缺损,从而发挥脑保护作用。     

脑室出血大鼠不同部位脑组织热休克蛋白70表达的差异

目的 观察实验性大鼠脑室出血后,不同部位脑组织热休克蛋白70（heat shock protein 70,HSP70）表达的差异。方法 18只成熟雄性SD大鼠随机均分为正常组、对照组和模型组,采用侧脑室注血法制备大鼠脑室出血动物模型,然后用酶联免疫吸附方法制作热休克蛋白70组织切片,在显微镜下直接计数阳性细胞;采用干湿重法计算脑含水量。结果 模型组大鼠脑组织HSP70阳性细胞数和含水量明显高于正常组和对照组（P分别为0.015和0.013）,而且HSP70阳性细胞主要分布于皮层和皮层下,室周也有表达。结论 大鼠脑室内出血可引起远隔部位的皮层和皮层下组织HSP70的高度表达。     

不同剂量牛型结核杆菌卡介苗对EAE模型的诱导

目的 探讨实验性自身免疫性脑脊髓炎（experimental autoimmune encephalomyelitis，EAE）非敏感品系Wistar大鼠加用不同剂世牛型结核杆菌卡介苗（mycobacterium bovis bacillus ealmette-guerin，M．bovis BCG）对EAE模型诱导的作用。方法将Wistar大鼠分为EAEl、EAE2、EAE3、EAE4共4组，然后分别用含4、8、10、12mg M．bovis BCG／mL完全福（氏）佐剂（CFA）加豚鼠脑脊髓匀浆（GPSCH）制备不同浓度的完全抗原．分别免疫诱导Wistar大鼠EAE。观察不同剂量M．bovis BCG对诱导EAE模型发病情况、各项临床指标的影响，同时取脑和脊髓制成石蜡切片，行HE染色观察组织形态变化．行单核细胞趋化蛋白-1（MCP-1）mRNA原位杂交（ISH）计数其阳性细胞百分率。结果EAE3、EAE4组的发病率、体重减轻、临床症状评分、MCP-1 mRNA阳性细胞数显著高于EAE1、EAE2组（均P〈0．05）。结论M．bovis BCG浓度的高低影响Wistar大鼠EAE的发病率。     

Ultrastructure of non-myelinated neurons during energy deprivation

Summary This paper examines the neuropathology of oxygen-glucose deprivation uncomplicated by stagnant conditions. Rabbit vagus nerves were pulled into asmulti-compartment perfusion chamber, stimulated five times per second and deprived of energy by substituting nitrogen and deoxyglucose for oxygen and glucose in the Locke's perfusate. After incubation the compartments were perfused with gluteraldehyde solution, and the nerves were prepared for electron microscopy. Fixation in the compartments ensured precise cross and longitudinal sections which permitted quantitative comparisons. Although the action potentials ceased in 45 min, 1 h of energy deprivation did not significantly affect the ultrastructure. After 2 h of deprivation the axons were smaller and flattened and microtubules appeared packed together. In the smallest axons the microtubules were gone, the neurofilaments were compacted and the few mitochondria had a dense, homogenous appearance. By 4 h the shrinking was extreme, yet 8% were swollen much larger than any of the controls. Longitudinal views showed these balloned areas were greatly expanded regions of the smallest axons. Both tiny and huge regions were devoid of microtubules and the swollen axons contained expanded mitochondria.Calcium is indirectly implicated in the pathogenesis by the concurrence of mitochondrial alteration as the microtubules disappear coupled with the known role of mitochondria in calcium regulation and the reported effect of high calcium on microtubual dissociation. In is suggested that axons first shrink as osmotially active molecules are used or washed out. After a time without energy the mitochondria can no longer regulate the intracellular calcium, microtubules dissociate, and calcium-activated phospholipases create osmotically active molecules. Finally, high-amplitude, disruptive swelling occurs.Supported, in part, by a Grant-in-aid from the American Heart Association with funds contributed by the American Heart Association, Kansas Affiliate and by the University of Kansas Biomedical Sciences Support Grant RR0737     

星形胶质细胞对天冬氨酸特异性半胱氨酸蛋白酶介导β淀粉样蛋白早期突触毒性作用的影响

目的探讨星形胶质细胞(astrocyte,AS)对天冬氨酸特异性半胱氨酸蛋白酶(cysteinyl aspartate specific proteinase,caspase)介导β淀粉样蛋白(β-amyloid,Aβ)早期突触毒性作用的影响,以期为进一步研究与血管性痴呆(vascular dementia,Va D)的发病机制奠定基础。方法以原代培养大鼠海马纯神经元体系(NE-S)及混合培养体系(MIX-S,主要包含神经元及AS)为研究对象,各体系分为6组:对照组、caspase-8抑制剂组、caspase-9抑制剂组、Aβ处理组、caspase-8抑制剂预处理加Aβ组和caspase-9抑制剂预处理加Aβ组。免疫荧光检测各组近胞体10μm段树突中突触后密度蛋白(postsynaptic density-95,PSD95)表达量的变化。结果 1在NE-S与MIX-S中,与对照组相比,caspase-8抑制剂组、caspase-9抑制剂组PSD95的表达量均无明显差异,Aβ处理组PSD95的表达量均显著降低(P均0.001)。2在NE-S中,与Aβ处理组相比,caspase-9抑制剂预处理加Aβ组PSD95的表达量显著回升至对照组水平,caspase-8抑制剂预处理加Aβ组则无显著改变;在MIX-S中的结果则相反,即caspase-8抑制剂预处理加Aβ组PSD95的表达量显著回升至对照组水平,而caspase-9抑制剂预处理加Aβ组则无显著改变。3MIX-S与NE-S两种培养系统间相比较,对照组间及Aβ处理组间PSD95的表达量均无显著差异,而caspase-8抑制剂预处理加Aβ组间及caspase-9抑制剂预处理加Aβ组间PSD95的表达量差异有显著性。结论在Aβ早期突触毒性作用中,AS参与caspase-8介导的死亡受体通路激活过程,且参与抑制神经元的线粒体通路。     

Effects of genistein on neuronal apoptosis, and expression of Bcl-2 and Bax proteins in the hippocampus of ovariectomized rats

Genistein is one of several isoflavones that has a structure similar to 17β-estradiol, has a strong antioxidant effect, and a high affinity to estrogen receptors. At 15 weeks after ovariectomy, the expression of Bcl-2 in the hippocampus of rats decreased and Bax expression increased, with an obvious upregulation of apoptosis. However, intraperitoneal injection of genistein or 17β-estradiol for 15 consecutive weeks from the second day after operation upregulated Bcl-2 protein expression downregulated Bax protein expression, and attenuated hippocampal neuron apoptosis. Our experimental findings indicate that long-term intervention with genistein can lead to a decrease in apoptosis in hippocampal neurons following ovariectomy, upregulate the expression of Bcl-2, and downregulate the expression of Bax. In addition, genistein and 17β-estradiol play equal anti-apoptotic and neuroprotective roles.     

Magnetic resonance morphometry of the loss of gray matter volume in Parkinson’s disease patients

Voxel-based morphometry can be used to quantitatively compare structural differences and functional changes of gray matter in subjects.In the present study,we compared gray matter images of 32 patients with Parkinson’s disease and 25 healthy controls using voxel-based morphometry based on 3.0 T high-field magnetic resonance T1-weighted imaging and clinical neurological scale scores.Results showed that the scores in Mini-Mental State Examination and Montreal Cognitive Assessment were lower in patients compared with controls.In particular,the scores of visuospatial/executive function items in Montreal Cognitive Assessment were significantly reduced,but mean scores of non-motor symptoms significantly increased,in patients with Parkinson’s disease.In addition,gray matter volume was significantly diminished in Parkinson’s disease patients compared with normal controls,including bilateral temporal lobe,bilateral occipital lobe,bilateral parietal lobe,bilateral frontal lobe,bilateral insular lobe,bilateral parahippocampal gyrus,bilateral amygdale,right uncus,and right posterior lobe of the cerebellum.These findings indicate that voxel-based morphometry can accurately and quantitatively assess the loss of gray matter volume in patients with Parkinson’s disease,and provide essential neuroimaging evidence for multisystem pathological mechanisms involved in Parkinson’s disease.     

Development of 18F-labeled radiotracers for neuroreceptor imaging with positron emission tomography

Positron emission tomography (PET) is an in vivo molecular imaging tool which is widely used in nuclear medicine for early diagnosis and treatment follow-up of many brain diseases. PET uses biomolecules as probes which are labeled with radionuclides of short half-lives, synthesized prior to the imaging studies. These probes are called radiotracers. Fluorine-18 is a radionuclide routinely used in the radiolabeling of neuroreceptor ligands for PET because of its favorable half-life of 109.8 min. The delivery of such radiotracers into the brain provides images of transport, metabolic, and neurotransmission processes on the molecular level. After a short introduction into the principles of PET, this review mainly focuses on the strategy of radiotracer development bridging from basic science to biomedical application. Successful radiotracer design as described here provides molecular probes which not only are useful for imaging of human brain diseases, but also allow molecular neuroreceptor imaging studies in various small-animal models of disease, including genetically-engineered animals. Furthermore, they provide a powerful tool for in vivo pharmacology during the process of pre-clinical drug development to identify new drug targets, to investigate pathophysiology, to discover potential drug candidates, and to evaluate the pharmacokinetics and pharmacodynamics of drugs in vivo.     

Differential expression of carboxyl terminal derivatives of amyloid precursor protein among cell lines.

Understanding the pathway for amyloid percursor protein (APP) catabolism has become an important line of investigation. APP is a ubiquitous membrane bound protein that is rapidly cleaved at the membrane, yielding a secreted protein identical to protease nexin II and an internalized 11.5 kDa 100 residue C terminal derivative (CTD). The levels of CTDs in a variety of cell lines have been examined and were found to differ. Cell types associated with the pathology of Alzheimer's disease (AD), such as olfactory neuroblasts (ON) and cortical vascular endothelial cells, have higher levels of CTDs than lymphoblasts and melanoma cells. The mechanism of CTD catabolism appears to involve the lysosome because blockade of lysosomal but not endosomal or mitochondrial function results in increased levels of CTDs. Under these conditions, production of larger, amyloidogenic CTDs is also seen. In cells possessing higher levels of CTDs we find that the mechanism for production of amyloidogenic CTDs may involve the internalization of intact full-length APP. Thus, inhibition of the lysosomal system appears capable of generating amyloidogenic peptides. The amount of amyloidogenic peptides appears to vary among cell lines. Such variation may shed light on why amyloid accumulates around specific cell types such as vascular endothelial cells, neurons, and glia. Finally, disfunction of the lysosomal system may play a role in the pathogenesis of Alzheimer's disease.     

Neuroprotective role of fibronectin in neuron-glial extrasynaptic transmission

Most hypotheses concerning the mechanisms underlying Parkinson’s disease are based on altered synaptic transmission of the nigrostriatal system.However,extrasynaptic transmission was recently found to affect dopamine neurotransmitter delivery by anisotropic diffusion in the extracellular matrix,which is modulated by various extracellular matrix components such as fibronectin.The present study reviewed the neuroprotective effect of fibronectin in extrasynaptic transmission.Fibronectin can regulate neuroactive substance diffusion and receptor activation,and exert antineuroinflammatory,adhesive and neuroprotective roles.Fibronectin can bind to integrin and growth factor receptors to transactivate intracellular signaling events such as the phosphatidylinositol 3-kinase/protein kinase B pathway to regulate or amplify growth factor-like neuroprotective actions.Fibronectin is assembled into a fibrillar network around cells to facilitate cell migration,molecule and ion diffusion,and even drug delivery and treatment.In addition,the present study analyzed the neuroprotective mechanism of fibronectin in the pathogenesis of Parkinson’s disease,involving integrin and growth factor receptor interactions,and discussed the possible therapeutic and diagnostic significance of fibronectin in Parkinson’s disease.     

Clinical and molecular research of neuroacanthocytosis

Neuroacanthocytosis is an autosomal recessive or dominant inherited disease characterized by widespread, non-specific nervous system symptoms, or spiculated "acanthocytic" red blood cells. The clinical manifestations typically involve chorea and dystonia, or a range of other movement disorders. Psychiatric and cognitive symptoms may also be present. The two core neuroacanthocytosis syndromes, in which acanthocytosis is atypical, are autosomal recessive chorea-acanthocytosis and X-linked McLeod syndrome. Acanthocytes are found in a smaller proportion of patients with Huntington’s disease-like 2 and pantothenate kinase-associated neurodegeneration. Because the clinical manifestations are diverse and complicated, in this review we present features of inheritance, age of onset, neuroimaging and laboratory findings, as well as the spectrum of central and peripheral neurological abnormalities and extraneuronal involvement to help distinguish the four specific syndromes.     

轻型缺血性卒中静脉溶栓后双重抗血小板疗效观察

目的 观察rt-PA静脉溶栓联合双重抗血小板治疗轻型缺血性卒中的有效性及安全性。 方法 以2013年12月-2016年12月在石家庄市第一医院连续住院治疗的轻型缺血性卒中患者为研究 对象,将其随机分为对照组、溶栓+单抗组和溶栓+双抗组。对照组不进行静脉溶栓,长期口服阿 司匹林（100 mg/d）抗血小板治疗;溶栓+单抗组在rt-PA静脉溶栓（0.9 mg/kg,最大剂量90 mg）基 础上长期单用阿司匹林（100 mg/d）抗血小板治疗;溶栓+双抗组在溶栓后单抗基础上加用氯吡格雷 （75 mg/d）双重抗血小板治疗,双抗治疗21 d后改为阿司匹林长期单抗治疗。随访3个月,有效性指标 为3个月时NIHSS 0～1分、Barthel指数（Barthel index,BI）95～100分和mRS 0～1分的比例,3个月时缺 血性卒中的复发率;安全性指标为治疗24 h出血转化和症状性出血转化的发生率。另外比较三组间 基线和3个月时血清hs-CRP和IL-6的水平差异。 结果 研究共纳入85例患者,对照组28例,溶栓+单抗组28例,溶栓+双抗组29例,全部患者均完 成3个月随访,无死亡患者。对照组、溶栓+单抗组和溶栓+双抗组3个月随访时NIHSS 0～1分比例分 别为46.43%、78.57%和93.10%,BI 95～100分比例分别为53.57%、82.14%和89.66%,mRS 0～1分 的比例分别为50.00%、82.14%和93.10%,三组上述有效性指标差异均有统计学意义,两两比较显 示,溶栓+双抗组高于溶栓+单抗组和对照组,溶栓+单抗组高于对照组,差异均有统计学意义;对 照组、溶栓+单抗组和溶栓+双抗组3个月时缺血性卒中复发率分别为32.14%、7.14%和3.45%,差异 有统计学意义。安全性指标方面,三组均无出血转化事件。对照组、溶栓+单抗组和溶栓+双抗组3 个月时的hs-CRP水平分别为11.92±3.58 mg/L、9.04±2.85 mg/L和6.04±2.65 mg/L,IL-6水平分别为 26.18±4.65 ng/L、16.11±6.93 ng/L和12.84±2.57 ng/L,三组上述炎症因子水平差异均有统计学意 义,其中溶栓+双抗组低于溶栓+单抗组和对照组,溶栓+单抗组低于对照组。 结论 对于急性轻型缺血性卒中患者,rt-PA静脉溶栓治疗后短期双重抗血小板治疗可显著改善患 者神经功能,降低炎症因子水平,降低复发率,且不增加出血风险。     

Gene-environment interaction and covariation in schizophrenia: the role of obstetric complications

While genetic factors account for a significant proportion of liability to schizophrenia, a body of evidence attests to a significant environmental contribution. Understanding the mechanisms through which genetic and environmental factors coalesce in influencing schizophrenia is critical for elucidating the pathways underlying psychotic illness and for developing primary prevention strategies. Although obstetric complications (OCs) remain among the most well-documented environmental indicators of risk for schizophrenia, the pathogenic role they play in the etiology of schizophrenia continues to remain poorly understood. A question of major importance is do these factors result from a genetic diathesis to schizophrenia (as in gene-environment covariation), act additively or interactively with predisposing genes for the disorder in influencing disease risk, or independently cause disease onset? In this review, we evaluate 3 classes of OCs commonly related to schizophrenia including hypoxia-associated OCs, maternal infection during pregnancy, and maternal stress during pregnancy. In addition, we discuss several mechanisms by which OCs impact on genetically susceptible brain regions, increasing constitutional vulnerability to neuromaturational events and stressors later in life (ie, adolescence), which may in turn contribute to triggering psychosis.