大鼠实验性脑出血后脑水肿与MMP-9表达的关系及依达拉奉干预效应的研究

目的 探讨脑出血后脑水肿和MMP-9表达的动态变化及依达拉奉的干预效应.方法 采用立体定向技术制作大鼠脑出血模型,干湿重法测量脑组织含水量和免疫组化法测定脑组织MMP-9的表达.结果 与假手术组比较,脑出血12h时脑组织含水量明显增加(P＜0.05), 72h时达到高峰,随后逐渐下降, 7d时仍高于假手术组(P＜0.05).出血组大鼠脑含水量与血肿周围MMP-9阳性细胞数呈正相关(r=0.846, P=0.034),且差异有统计学意义.(3)治疗组脑含水量和MMP-9阳性细胞数与假手术组比较差异有统计学意义,与出血组比较差异亦有统计学意义(P＜0.05).结论 MMP-9参与了脑出血后脑水肿的形成,依达拉奉对脑水肿有抑制作用.     

二硫代氨基甲酸吡咯烷对实验性脑出血血肿周围脑组织含水量及水通道蛋白-9表达的影响

目的探讨二硫代氨基甲酸吡咯烷(PDTC)对实验性脑出血血肿周围脑组织含水量和水通道蛋白9(AQP9)表达的影响。方法将128只SD大鼠随机分成正常组、对照组、脑出血组及PDTC组,建立脑出血模型;制模2 h予PDTC组腹腔注射PDTC;通过干湿法和SABC法检测各组大鼠各时点脑组织含水量、AQP9表达。结果(1)脑出血组脑组织含水量出血侧在制模后4 h开始升高,72 h达高峰,持续到120 h后下降;出血对侧在4 h也升高,48 h达高峰;脑组织含水量较对照组明显增加,出血侧更明显(均P<0.01)。(2)脑出血组AQP9表达制模后4 h开始升高,72 h表达最强,120 h降低,较对照组明显增加,出血侧较出血对侧增加更明显(均P<0.01)。(3)PDTC组脑组织含水量和AQP9表达在制模后24 h开始各时间点较脑出血组明显降低(均P<0.01)。结论脑出血后脑组织含水量和AQP9表达均呈平行增加,PDTC干预对出血后脑组织含水量和AQP9表达有平行抑制作用,提示AQP9参与了脑出血后脑水肿的形成。     

DF-521巴曲酶对大鼠脑出血后脑水肿区补体表达的影响

目的 :观察降纤酶制剂对大鼠脑出血后脑水肿形成及血肿周边脑组织补体C3d和C9表达的影响。方法 :一侧基底节区注射自体血 10 0 μL制作大鼠脑出血 2 4、72h模型 ,一组给予腹腔注射降纤酶制剂DF 5 2 1巴曲酶处理 ,一组不给 ,另设一组空白对照脑内注射生理盐水 10 0 μL。用干湿重法 ,测定大鼠脑组织的含水量 ;免疫组化法检测C3d的表达 ,免疫Westernblot方法研究脑组织补体C9表达情况。结果 :大鼠脑出血后 ,血肿侧脑组织含水量上升 ,同时出血侧脑组织内C3d和C9的表达量增加 ;给予DF 5 2 1巴曲酶制剂处理后 ,血肿侧脑水肿减轻〔2 4h由 (81 8± 1 14 ) %降至 (79 46± 0 68% ) ,P <0 0 1;72h由 (83 14± 0 3 6) %降至 (81 0 9±0 3 4) % ,P <0 0 1〕 ;并且脑组织C3d和C9的表达较对照组有所下降。结论 :降纤酶制剂能下调脑出血后血肿周边脑组织补体C3d和C9的表达并减轻大鼠脑出血后脑水肿的程度。     

亚低温治疗对高血压脑出血后水通道蛋白-4表达的影响

目的探讨亚低温治疗对大鼠高血压脑出血后血肿周围脑组织水通道蛋白-4（AQP-4）表达的影响。方法将制成高血压脑出血模型的大鼠随机分为亚低温治疗组（40只）和常温对照组（10只）,其中治疗组又根据从发病至亚低温治疗的时间间隔分为2、4、8、12h四个亚组,每亚组10只动物。大体观察动物行为学变化,3d后处死动物取脑组织进行脑含水量测定（干湿重法）及AQP-4表达的测定。结果对照组的脑含水量为（89．16±0．48）％,治疗组中出血后2h、4h和8h三个亚组的脑含水量分别为（81．42±0．58）％、（83．86±0．28）％和（86．95±0．29）％,与对照组相比有显著性差异（P〈0．05）,而出血后12h亚组的含水量与对照组相比无显著性差异（P〉0．05）。对照组AQP-4的表达（以吸光度表示）明显高于出血后2h、4h及8h三个亚组（P〈0．05）,与出血后12h亚组相比无显著差别（P〉0．05）。结论本研究提示高血压脑出血后早期应用亚低温治疗可以下调AQP-4的表达,并可有效控制脑水肿的发生。     

Df—521巴曲酶对大鼠脑出血后脑水肿形成的影响

目的:观察Df-521巴曲酶对大鼠脑出血后脑水肿对血肿周边区脑组织ICAM-1表达的影响。方法:一侧基底节注射自体血制作大鼠脑出血模型,用干湿重法,测定脑组织含水量;用免疫组化法检测血肿周边水肿带ICAM-1的表达情况。结果:大鼠脑出血后,血肿侧脑组织含水量上升,同时水肿区ICAM-1的表达量增加;给予Df-521巴曲酶制剂处理后,血肿侧脑水肿减轻,脑组织ICAM-1的表达有所下降。结论:Df-521巴曲酶能下调脑出血后血肿周边组织ICAM-1的表达并减轻脑水肿的程度。     

实验性大鼠脑出血后TNF-α、ICAM-1的表达和脑水肿的研究

目的:探讨TNF-α、ICAM-1在大鼠脑出血后脑水肿中的表达及意义。方法:利用立体定向技术建立中等 量大鼠自体尾动脉血脑出血模型(50μl),于脑出血后6h、24h、48h、72h处死大鼠,进行脑含水量测定,并于脑出血后3h、 6h、12h、24h、48h、72h、7d处死大鼠,进行TNF-α、IGAM-1的免疫组化染色,并对结果进行统计处理。结果:大鼠脑出血 后脑水肿于48h达到高峰;大鼠脑组织表达TNF-α也于48h达到高峰,高于假手术组,分别为58．4±6．19和2±1．12,P <0．01;ICAM-1表达72h达高峰,与假手术组比较存在显著性差异,分别为7．8±0．84和0．8±0．84,P<0．01。结论: TNF-α、ICAM-1在大鼠脑出血后血肿周围表达的高峰与脑水肿高峰存在时间上的相关性,提示高表达的TNF-α、ICAM- 1可能参与了脑水肿形成。     

拉莫三嗪对脑出血大鼠脑组织含水量的影响

目的研究拉莫三嗪（LTG）能否通过减轻脑水肿,发挥神经保护作用。方法通过建立大鼠脑出血模型,采用干湿重法分别检测脑组织含水量的动态变化,以及LTG对脑水肿的干预情况。结果手术组脑组织含水量在出血后12h～1d时增加。3d时水肿达到峰值,7d明显减轻,治疗组较手术组则明显减轻（P〈0．05）,对照组在12h～7d变化不明显。结论拉莫三嗪可以减轻实验性脑出血大鼠脑组织含水量。     

强啡肽A1—13对大鼠脑出血后脑水肿的作用

在建立稳定的大臣脑出血模型的基础上，用放免法测定不同脑区和垂体中DynA1-13含量，干湿重法测定含水量，旨在观察DynA1-13对脑出血后脑组织合水量的影响。结果发现：大鼠尾核注射胶原酶，可造成稳定的脑实质出血；注射胶原酶后4，24，48h脑组织含水量均明显升高（P＜0．01）；在脑出血后4，24，48h，Dy－nA1-13含量，在皮质、海马与尾壳核均明显降低（P＜0．05，P＜0．01），而在下丘脑及垂体则明显升高（P＜0．05，P＜0．01）；DynA1-13可减轻胶原酶诱导的脑出血后脑水肿（P＜0．01），并呈剂量依赖效应。本研究提示：脑组织DynA1-13含量降低，可能是造成脑出血后脑水肿的一个重要原因，DynA1-13对脑出血后脑水肿具有潜在的治疗价值。     

实验性大鼠脑出血血肿周围组织胶质细胞纤维酸性蛋白的动态表达

目的:动态观察胶质细胞纤维酸性蛋白(GFAP)在脑出血动物模型脑组织中的表达及其意义。方法应用脑立体定向技术,建立大鼠脑出血模型,假手术作为对照组。分别测定脑组织含水量,观察血肿周围GFAP的表达规律。结果:大鼠脑出血后脑水肿于48h达到高峰,与对照组比较有统计学意义(P<0.05)。脑出血后脑内GFAP阳性细胞数6h表达最强,在72h时表达最少,7d的阳性细胞数量比72h增加(P<0.05),但数量少于6h(P<0.05)。相应时间点出血组阳性细胞数与对照组比较,有明显统计学意义,(P<0.05)。结论:脑出血后脑内GFAP的表达与脑水肿相关,提示星形胶质细胞在脑出血的病理变化过程中有重要作用。星形胶质细胞在损伤的修复作用具有二重性,即可以抑制也可以促进损伤修复。     

疏血通对大鼠脑出血后脑水肿的影响

目的探讨应用疏血通对大鼠脑出血后脑水肿的影响以及用药的安全性.方法将胶原酶用定向注入法注入大鼠一侧的尾壳核制作大鼠脑出血模型,并在注入胶原酶后4 h通过大鼠尾静脉注入疏血通,通过观察大鼠的脑组织含水量、K 、Na 的含量以及血肿体积来评价疏血通的影响.结果疏血通治疗组的大鼠脑组织含水量较对照组明显低(P＜0.01),两组间脑组织K 、Na 的含量有明显差异(P＜0.05),而血肿体积无明显差异.结论疏血通能减轻大鼠脑出血后脑水肿,并且不引起血肿增大.其可能是治疗脑出血后脑水肿的一种安全有效的药物.     

Mental illness in England,in Scotland and in Scots living in England

Summary Beginning from the observation that Scots living in England have much higher rates of mental hospital admission than do the English, several hypotheses are proposed to account for this. Much of the excess in rates of mental illness is accounted for by those diagnosed as having alcohol-related disorders and behaviour and personality problems. The results of an examination of offical statistics in the two countries enabled some explanations to be offered. It was found that rates of admissions to mental hospitals are higher in Scotland than in England but not as high as those found among Scots migrants who have a much higher rate of readmission to hospitals than either of the other groups. In fact, if first admissions only are considered the rates of admission in Scotland are not only higher than rates for English natives but also higher than for Scottish migrants. It seems that Scots living in England are somewhat less likely to become mental patients than Scots in Scotland but that once they do achieve this status they are very much more likely to be readmitted on subsequent occasions. It was concluded that there might be two fairly distinct groups of migrants from Scotland to England who have different backgrounds, different reasons for migrating and different psychological characteristics. On the one hand there are stable, economically motivated migrants who move south for definite employment related reasons and who show few psychological symptoms. While on the other hand there is a group of migrants who perhaps have psychological problems and who move more in hope than expectation without definite prospects and who account for the high rates of mental hospital admission found in Scottish migrants.     

Prostacyclin release in the coronary circulation during sustained stimulation in in vitro and in in vivo experimental systems

Prostacyclin release from rat isolated perfused hearts and from dog coronary circulation was studied by measuring immunoreactive 6-keto-PGF1 alpha (6-keto-PGF1a) in heart perfusate and in plasma obtained from the great cardiac vein respectively. Continuous infusion of arachidonic acid at constant concentration in isolated perfused hearts induced an increased prostacyclin release. This release showed a rapid peak within 10 min and a subsequent decrease. Low-flow ischemia induced an increased perfusate concentration of 6-keto-PGF1a but, considering the decreased flow, prostacyclin release was actually reduced. During the whole period of ischemia (60 min) prostacyclin release was constant. In open-chest anesthetized dogs 6-keto-PGF1a concentration in the great cardiac vein was increased after ligation of the left anterior descending coronary artery. A prolonged period of coronary occlusion (4.5 hours) resulted in a progressive rise of prostacyclin release. 6-keto-PGF1a determinations in the femoral vein and in the aorta did not show relevant variations during the observation period.     

癫痫与抑郁关系的研究进展

抑郁是癫痫患者中常见的精神障碍,严重地影响了患者的生活质量。传统的观点认为癫痫患者因为存在着诸多社会学问题易出现抑郁倾向,癫痫和抑郁是单向的联系,但大量的研究已经证明癫痫和抑郁之间存在双向的联系,一种异常状态的存在可能易转化为另一种异常状态的发展。癫痫和抑郁存在着共同的发病机制。本文主要就癫痫和抑郁的双向联系以及抗抑郁药物在癫痫患者中的应用进行阐述。     

神经介入：回眸2022

<正>2022年,国际上公布了多项大型神经介入领域的随机对照试验（randomized controlled trial,RCT）结果,在血管内治疗（endovascular treatment,EVT）急性大血管闭塞（large vessel occlusion,LVO）适应证的扩展、药物治疗、管理,症状性颅内动脉粥样硬化性狭窄（symptomatic intracranial atherosclerotic stenosis,sICAS）治疗,无症状性颈动脉狭窄治疗,     

Neuroimaging in epilepsy in tropics

Epilepsy is a major public health problem in many tropical countries. Also, some of the tropical diseases are major contributors to the higher prevalence of epilepsy in these countries. The etiologic factors responsible for epilepsy in these countries are quite different from those in the developed world. This article discusses the etiologic factors and neuroimaging of epilepsy in light of the conditions in these tropical countries.