人羊膜上皮细胞移植治疗帕金森病模型大鼠的疗效评价

目的观察原位移植人羊膜上皮细胞(Human amniotic epithelial cells,hAECs)对帕金森病(Parkinson’s disease,PD)模型大鼠的疗效及其在体内的存活与分化。方法方法采用胰蛋白酶消化法分离hAECs,流式细胞术分析表型。30只雌性Wistar大鼠随机分为假手术组、模型组和hAECs原位移植组。单侧前脑内侧束(Medial forebrain bundle,MFB)注射6-羟基多巴胺(6-OHDA)建立PD大鼠模型。通过MFB原位移植3×105个hAECs。每周腹腔注射阿朴吗啡诱导旋转观察大鼠的行为变化,免疫荧光染色法检测人细胞核抗原及神经元微管结合蛋白(microtubule-associated protein 2,MAP-2)的表达,免疫组化染色检测酪氨酸羟化酶(Tyrosine hydroxylase,TH)的表达。结果与模型组比较,hAECs原位移植组大鼠旋转次数均明显减少(均P<0.05),行为学改善可至少持续至移植后10 w;免疫荧光染色结果显示,hAECs在原位移植区可存活至少12 w,并表达MAP-2;免疫组化染色显示,原位移植hAECs可上调PD模型大鼠黑质TH表达。结论 hAECs原位移植能改善PD模型大鼠的运动行为,其机制可能与上调黑质TH表达有关。hAECs可在原位移植区分化为多巴胺能神经元样细胞。     

酪氨酸羟化酶cDNA移植治疗帕金森病的实验研究

帕金森病(PD)的主要病因是黑质多巴胺能神经元损伤,表达的酪氨酸羟化酶(TH)减少。本文在应用6-羟多巴胺(6-OHDA)制备偏侧PD大鼠模型的前提下,首次将TH cDNA移植到PD大鼠纹状体内,模型动物的旋转行为明显改善,用免疫组化法及PCR法证实了外源性THcDNA可以进入脑细胞内,并表达出有生物活性的TH。     

人胎盘底蜕膜间充质干细胞抗炎特性对帕金森病模型大鼠的神经保护作用

目的 研究人胎盘底蜕膜间充质干细胞(hPDB-MSCs)抗炎特性对帕金森病(PD)模型大鼠多巴胺能神经元的影响. 方法 体外培养hPDB-MSCs,6-羟基多巴(6-OHDA)制备大鼠PD模型并按照随机数字表法分为模型组与移植组,每组32只.hPDB-MSCs尾静脉移植观察各组大鼠行为学改变.免疫组化检测移植后3d、1周、2周及4周各组大鼠损伤侧黑质酪氨酸羟化酶(TH)、离子钙接头蛋白(Ibal)表达.实时荧光定量PCR检测各时间点各组大鼠损伤侧黑质抗炎因子人白细胞介素-10 (hIL-10)、人转化生长因子-β(hTGF-β)及肿瘤坏死因子-α(TNF-α)表达. 结果 hPDB-MSCs移植后1周、2周、4周,移植组大鼠阿朴吗啡诱导的平均旋转圈数明显低于模型组,差异有统计学意义(P＜0.05).免疫组化结果显示移植组大鼠损伤侧黑质部位TH阳性细胞数较模型组明显增加,1周、2周、4周时差异有统计学意义(P＜0.05).移植组大鼠损伤侧黑质部位Ibal阳性细胞则明显减少,4周时最为显著.mRNA水平,移植组大鼠hIL-10及hTGF-β表达均较模型组增加,而TNF-α表达量则逐渐降低. 结论 hPDB-MSCs尾静脉移植后能够通过抗炎机制抑制PD模型大鼠多巴胺能神经元丧失,改善PD模型大鼠症状.     

人羊膜上皮细胞侧脑室移植对帕金森病大鼠模型行为、多巴胺能神经元、神经递质影响的实验研究

目的 观察人羊膜上皮细胞(HAECs)移植入帕金森病(PD)大鼠模型侧脑室后的存活及分化情况,及其对PD大鼠模型旋转行为、纹状体区多巴胺及其代谢产物的影响.方法 采用6-羟多巴立体定向脑内注射制作PD大鼠模型,将制模成功大鼠随机分成3组:人羊膜上皮细胞移植组(HAECs组)、磷酸缓冲组(PBS组)和帕金森组(PD组),1w后腹腔注射阿朴吗啡观察各组大鼠旋转行为的变化,连续观察10w,HAECs组5w后用人特异性抗体Nestin和Vimentin检测人羊膜细胞的存活情况,10w后酪氨酸羟化酶(TH)染色观察各组PD大鼠模型黑质部TH阳性神经元的变化情况及HAECs的分化情况,高效液相色谱--电化学仪测定纹状体多巴胺(DA)、高香草酸(HVA)、3,4-二羟基苯乙酸(DOPAC)等神经递质的水平.结果 HAECs在PD大鼠侧脑室内移植可以长期存活达10w,并且可以分化为DA能神经元,HAECs组大鼠旋转数较PBS组及PD组明显降低(P<0.01),黑质部TH阳性神经元数量较PD组及PBS组升高(P<0.01),HAECs组大鼠纹状体区DA及其代谢产物DOPAC、HVA含量较PBS组明显升高(P<0.05).结论 人羊膜上皮细胞移植入PD大鼠侧脑室可以改善PD大鼠的旋转行为,其机制可能与增加纹状体区DA等神经递质有关.     

青藤碱防护脂多糖所致PD大鼠黑质多巴胺能神经元损伤实验研究

目的观察中药青藤碱(SN)对脂多糖(LPS)所致大鼠黑质多巴胺能(DA)神经元损伤的保护作用。方法黑质内注射LPS制作PD大鼠模型。应用SN对实验动物进行预处理。实验分为对照组、PD组及SN组,采用行为学、酪氨酸羟化酶(TH)、环氧化酶-2(COX-2)等免疫组化及免疫印迹技术等观察SN对LPS所致黑质DA能神经元损伤的保护作用。结果对照组大鼠无任何行为变化,PD组大鼠平均旋转圈数为196.90±9.52,SN组明显减少,为98.79±8.81,差异非常显著(P<0.01)。TH免疫组化表明对照组黑质TH阳性神经元数量较多,胞体较大,突起明显;PD组TH阳性神经元数量明显减少,甚至消失,神经元胞体萎缩,突起亦不清晰,差异非常显著(P<0.01)。SN组TH阳性神经元数量与PD组相比明显增加(P<0.01),神经元形态变化亦不明显。COX-2免疫组化表明对照组黑质致密部偶见COX-2阳性细胞,PD组可见大量散在分布的COX-2阳性细胞,SN组COX-2阳性细胞数与PD组相比明显减少,差异非常显著(P<0.01)。小胶质细胞特异性抗体(OX-42)免疫组化表明对照组大鼠黑质小胶质细胞多呈静止的分枝样状态,PD组多...     

立体定向技术注射6-OHDA至内侧前脑束建立帕金森病大鼠模型

目的 建立大鼠帕金森病模型,观测其行为学和多巴胺能神经元的变化.方法 利用立体定向技术,注射6-OHDA至大鼠脑的内侧前脑束,于注射后2、4、6、8周观测阿朴吗啡诱导的大鼠旋转行为学变化;采用免疫组化染色检测TH的表达,了解中脑黑质多巴胺能阳性神经元变化.结果 所有大鼠分别于第2、4、6、8周的进行阿朴吗啡诱导旋转行为测试,67只大鼠中出现16只大鼠(23.8%)旋转圈数＞7r/min,并且＞210r/30min,为合格的PD大鼠模型.第8周时,大鼠旋转次数平均为10.48±1.91/分.免疫组化检测,成功模型光镜下分别计数双侧黑质TH阳性神经元,损毁侧黑质TH阳性神经元占正常侧的3.8%,即毁损侧TH阳性神经元减少96.2%.结论 利用立体定向技术,选择内侧前脑束为靶点,可建立6-OHDA大鼠PD模型.     

帕金森病基因治疗的实验研究

帕金森病(PD)的主要病理特征是中脑黑质多巴胺能神经元变性,表达的酪氨酸羟化酶(TH)减少或者活性降低。目前外源性多巴是最有效的抗PD药物,但常在数年后失去其有效的治疗作用。用胚胎脑细胞移植虽有效果,但胚胎脑来源困难。因此需要探索新的有效治疗方法。本研究将遗传修饰的成肌细胞植入偏侧PD鼠模型纹状体进行基因治疗。移植转TH基因的成肌细胞(治疗组,n=24)和未经遗传修饰的成肌细胞(对照组,n=10)于偏侧PD鼠损毁侧纹状体。用阿朴吗啡(APO)诱发旋转行为,RT-PCR、TH免疫组化检测TH基因的表达和TH蛋白的合成以及HPLC-ECD检测纹状体多巴胺及代谢产物含量以此评估基因治疗的效果。治疗组移植治疗后APO诱发的旋转行为明显改善(P<0.01),且可持续13个月,而对照组APO诱发的旋转行为无改善(P>0.05),应用RT-PCR、TH免疫组化和HPLC-ECD在治疗组移植部位检测到TH基因的表达、TH蛋白的合成和移植侧纹状体部多巴胺及其代谢产物含量增高。遗传修饰的成肌细胞能够在体内长时间、有效地表达TH,并改善PD鼠的病理行为,是PD基因治疗的合适靶细胞之一。     

双靶点注射6-OHDA建立帕金森病大鼠模型并提高成功率

目的建立大鼠帕金森病模型,观测其行为学、中脑黑质多巴胺能神经元及超微结构的变化。方法利用立体定向技术,注射6-OHDA至大鼠中脑黑质SNc和中脑腹侧被盖区VTA,于注射后2、4、6、8周观测阿朴吗啡诱导的大鼠旋转行为学变化;采用免疫组化染色检测TH的表达,了解中脑黑质多巴胺能阳性神经元变化;利用透射电镜了解黑质区超微结构的变化。结果所有大鼠进行阿朴吗啡诱导旋转行为测试,旋转圈数>7r/min,并且>210r/30min,为合格的PD大鼠模型。大鼠模型于第4、6和8周时,大鼠行为学变化较为恒定。第8周时,50只大鼠中出现32只大鼠大鼠旋转次数平均为11.5±1.2/分,造模成功率为64%。PD模型大鼠超微结构观察,黑质神经元数目明显减少,线粒体肿胀,粗面内质网囊性扩张、脱颗粒,髓鞘扩张。免疫组化检测,成功模型光镜下分别计数双侧黑质TH阳性神经元,损毁侧黑质TH阳性神经元占正常侧的3.0%,即毁损侧TH阳性神经元减少97.0%。结论利用立体定向技术,选择黑质和中脑腹侧被盖区等双靶点,可建立6-OHDA大鼠PD模型,具有明确病理变化,提高模型成功率。     

帕金森病大鼠模型神经元型一氧化氮合酶(nNOS)阳性神经元的实验研究

目的 观察研究帕金森病(PD)大鼠模型纹状体神经元型一氧化氮合酶(nNOS)阳性神经元，探讨一氧化氮(NO)在PD发病机制中所起作用。方法 应用立体定向技术建立6-OHDA毁损的大鼠PD模型，通过多巴胺受体激动剂阿扑吗啡(APO)测试大鼠旋转行为，免疫组化方法观察黑质酪氨酸羟化酶(TH)阳性神经元和纹状体nNOS阳性神经元的变化。结果 大鼠6-OHDA损毁侧黑质TH阳性神经元数目较对侧明显减少，双侧纹状体nNOS阳性神经元数目无显著差异。结论 6-OHDA对TH阳性神经元有损伤作用，而NOS阳性神经元对其具有抵抗作用。NO可能参与了PD发病机制。     

P2X4R过表达对帕金森病模型鼠脑黑质中白介素-1β、α突触核蛋白及多巴胺能神经元的影响

目的探讨使用慢病毒过表达P2X4R嘌呤受体(P2X4R)对帕金森病(PD)模型大鼠脑黑质中白介素-1β(IL-1β)和α突触核蛋白的表达及多巴胺能神经元数量的影响。方法 Wistar雄性大鼠,体质量200～250 g,随机分为6组(均n=20)。经立体定向定位左侧黑质,对照组:注入含0. 02%维生素C的生理盐水; PD组:注入6-羟基多巴胺(6-OHDA);目的基因阴性对照组:注入携带过表达P2X4R的慢病毒;空载病毒阴性对照组:注入空载病毒;目的基因阴性对照+PD组:注入携带过表达P2X4R的慢病毒1周后再注射6-OHDA;空载病毒阴性对照+PD组:注入空载病毒1周后再注射6-OHDA。模型判定成功后处死大鼠取左侧黑质,Western blot法检测各组黑质P2X4R、IL-1β、α突触核蛋白表达水平;免疫荧光染色法检测各组黑质酪氨酸羟化酶(TH)阳性多巴胺能神经细胞数的变化。结果①与PD组和空载病毒阴性对照+PD组比较,目的基因阴性对照+PD组P2X4R(P 0. 001)、IL-1β(P 0. 001)和α突触核蛋白(P 0. 01)相对表达量增加;②与PD组和空载病毒阴性对照+PD组比较,目的基因阴性对照+PD组TH阳性多巴胺能神经元数量明显减少(P 0. 001)。结论慢病毒介导P2X4R过表达可上调PD模型大鼠黑质中IL-1β和α-突触核蛋白表达水平、减少TH阳性多巴胺能神经细胞数;小胶质细胞的炎症反应增强,α-突触核蛋白沉积增加,对多巴胺能神经元有一定的损伤作用。     

Head injuries in children: a chronicle of a quarter of a century

Children aged 0–15 years hospitalized in Geneva for head trauma during the last quarter of a century are reviewed. More than half of the severely injured children were not from Geneva area. New methods of management have been introduced progressively. The cases are divided in four successive time periods and classified according to their pathology. A continuous improvement in mortality is obvious, decreasing from 29.4% to 2.2%, but climbing again to 15.2% in the last period, probably due to more severe pathologies. For the Geneva area the mortality decreased progressively from 10.4/100 000 to 3.5/100 000 annually, due to better organization and management, but also to a drop in the incidence of severe cases from 35.5–13.5/100 000 per year. A decrease in the number of traffic accidents is responsible for this. However, the number of handicapped children has not changed.     

Brain embolization of a healthy artery fragment as a complication of a cardiac catheterization

Ischemic stroke is the most common neurological complication of cardiac catheterization resulting in a high morbidity and mortality. We present a 44-year-old man admitted for vasospastic angina that suffered a right middle cerebral artery (MCA) occlusion after a cardiac catheterization. Mechanical thrombectomy was indicated and complete arterial recanalization was achieved. The material obtained showed a fragment of a healthy artery. Partial radial endarterectomy and cerebral embolization may be a rare complication of cardiac catheterization.     

Experimental research of a set as a means of a set as a means of understanding specific characteristics of psychological constitutions

Primary specific characteristics of psychological reactions, typical of the individual and undoubtedly influencing the formation and dynamics of his character, can be defined as "psychological constitution." Experimental study of peculiarities of an individual's set by the method elaborated by D.N. Uznadze and his school was chosen as a way to elicit psychological constitution. The manner in which the subject creates a model of the situation and the rate at which this model is destroyed when it fails to correspond to the perceptual data, appear to be the central question. A conceptual approach is suggested for evaluation of experimental data as characteristics of the individual's psychological constitution. It turns out thereby to be possible, theoretically and experimentally, to single out 8 basic types of psychological constitutions, or "primary psychotypes."     

Hemiballism as a presentation of a meningioma

A 73-year-old woman with a meningioma presented with hemiballism. This is the report of an unusual presentation of a primary brain tumor.     

Importance of the recognition of a warning leak as a sign of a ruptured intracranial aneurysm

In the Danish Aneurysm Study 1076 patients (pts.) were admitted with an aneurysmal subarachnoid hemorrhage in the 5-year period 1978-83. A warning leak (WL), defined as a sudden episode of headache, vomiting, nuchal pain, dizziness or drowsiness, was identified in 166 pts. (15.4%). In 99 of these the episode was evaluated by a physician but misdiagnosed. A 2-year follow-up examination of the 99 pts. showed that 30 pts. had a normal mental outcome and 43 pts. were dead. If these patients were correctly diagnosed after the WL, when they were in Hunt grade 1-2, the outcome-figures would probably have been significantly better. A theoretical transfer of the outcome-probabilities for pts. in Hunt grade 1-2 to the above mentioned 99 pts. would result in 66 pts. with a normal mental outcome and 25 dead pts. This shows the importance of recognition of a WL episode.     

Axon-glia transfer of a protein and a carbohydrate

We have investigated the transfer of a fluorescent protein, the fluorescein isothiocyanate derivative of bovine serum albumin (FITC-BSA), and a fluorescent carbohydrate, FITC-dextran, from the crayfish medial giant axon (MGA) to the periaxonal glial cells. The dialyzed tracer was injected into one of the two MGAs, and, after a transfer period of 15-60 min, the tissue was fixed for histological examination of fluorescence distribution. With each tracer, the periaxonal sheath of the injected MGA was specifically labeled. Similar results were obtained with several different fixatives. During the transfer period, there was no appreciable change in the resting potential or conducted action potential of the MGA or in the resting potentials of the adaxonal glial cells. Polyacrylamide gel electrophoresis indicated that the axoplasmic and sheath fluorescence was produced by the intact tracers. These results suggest that "foreign" macromolecules can be exchanged from crayfish axons to glia under physiological conditions. Such transfers may indicate a substantial intercellular traffic of molecules or a means whereby neurons can eliminate waste materials.     

Mobilization of a nursing community after a disaster

TOPIC: This article is a personal account of the author's experience of coordinating American Red Cross Disaster Health Services in her home community (Fort Worth, TX) following Hurricane Katrina. Although the community was 550 miles away from the impacted area, thousands of evacuees arrived in this community in need of immediate attention. PURPOSE: The purpose of this article is to share significant lessons that were learned from the experience to help other communities prepare for future disasters. SOURCE FOR INFORMATION: The article is derived from the author's experience and observation. CONCLUSIONS: In the midst of a disaster, nurses have a unique opportunity to make a professional contribution to recovery efforts. Learning from previous experiences can strengthen the effectiveness of our response.     

Urethral extrusion of a peritoneal catheter in a patient with a neobladder: a rare complication of shunt insertion

The insertion of a ventriculoperitoneal shunt (VPS) is considered the standard of care for several forms of hydrocephalus. Abdominal complications are most common with this procedure, comprising up to 30% of all shunt-related problems. Conversely, visceral perforation or extrusion of the shunt apparatus is rare. Herein we report a rare complication of VPS insertion in which the peritoneal catheter was spontaneously extruded through the urethra of a patient with a neobladder. We further discuss the pathogenesis, diagnosis, and treatment of this condition.