人胚神经干细胞及人脐血干细胞移植治疗大鼠脑缺血的实验研究

目的 研究人胚神经干细胞（hNSCs）、人脐血干细胞（hUCBCs）移植治疗脑缺血大鼠的效果及其在缺血大鼠脑内的增殖、分化状况,并对两种干细胞移植的效果进行比较。方法 从自然流产的孕10～13周的人胚脑组织中分离、培养hNSCs;采集足月新生儿脐带血60～100ml,分离出其中的单个核细胞;移植前hNSCs、hUCBCs均经5–溴脱氧嘧啶尿苷（Brdu）标记48h。采用线栓法制作大鼠脑缺血模型,1d后经尾静脉移植未分化的hNSCs、hUCBCs入脑缺血大鼠体内,对移植后大鼠进行神经损害严重程度评分（NSS）,用免疫组化方法观察移植后hNSCs、hUCBCs的存活、迁移、分化状况。结果 从人胚脑中成功培养出hNSCs,培养条件下呈悬浮状态生长,形成神经球;hUCBCs在体外具有增殖能力。两移植组大鼠均自移植后21d起其NSS显著低于对照组（P<0.05）,两移植组移植前及移植后各时间点NSS分别比较未发现显著性差异（P>0.05）;移植后14、21、28、35d脑组织切片中均可见Brdu染色阳性细胞,缺血侧明显多于对侧（P<0.05）,移植后21、28、35d明显多于移植后14d（P<0.05）;hNSCs组Brdu染色阳性细胞数多于hUCBCs组（P<0.05）;移植组各时间点脑组织切片中均可见nestin染色阳性细胞;在Brdu阳性细胞群中,hNSCs组73.8%为胶质纤维酸性蛋白（GFAP）染色阳性细胞,16.7%为2,3–环核苷酸磷酸二脂酶（CNPase）染色阳性 细胞,9.5%为神经元特异性烯醇化酶（NSE）染色阳性细胞;hUCBCs移植组74.5%为GFAP染色阳性细胞,15.4%为CNPase染色阳性细胞,10.1%为NSE染色阳性细胞;两组比较差异无显著性（P>0.05）。结论 hNSCs、hUCBCs均具有多分化潜能,受缺血部位微环境信号的影响分化成3种主要类型的神经细胞;静脉移植hNSCs、hUCBCs能有效改善脑梗死动物的神经功能;除了hNSCs外,hUCBCs移植也是治疗缺血性脑血管病的一种可能手段。     

人脐血干细胞移植治疗大鼠脑缺血的实验研究

目的研究人脐血干细胞(HUCBCs)移植治疗脑缺血大鼠的疗效及HUCBCs在缺血大鼠脑内的状况。方法采集足月新生儿脐带血60～100ml,分离出其中的单个核细胞,体外培养并予5溴脱氧嘧啶尿苷(Brdu)标记48h。采用线栓法制作大鼠脑缺血再灌注模型,1d后将3×106HUCBCs经缺血侧侧脑室注射入大鼠脑内。在移植后不同时间对大鼠进行神经损害严重程度评分(NSS),用免疫组化技术观察移植后的HUCBCs的存活、迁徙、分化状况。结果HUCBCs在体外具有增殖能力;移植组大鼠自移植后3周起其NSS显著低于对照组(均P<0.05);移植后2周、4周、6周脑组织切片中均可见Brdu染色阳性细胞,缺血侧明显多于对侧(均P<0.05),移植后4周、6周明显多于移植后2周(均P<0.05);移植组各时间点脑组织切片中均可见神经巢蛋白阳性细胞;植入的HUCBCs在大鼠脑内能向损伤区域迁徙并能分化为星形胶质细胞、少突胶质细胞和神经元。结论HUCBCs能在缺血大鼠脑内存活、迁徙和分化,并能改善其神经功能。HUCBCs移植可作为脑梗死的有效治疗手段。     

神经干细胞移植治疗暂时性脑缺血的实验研究

目的:探讨神经干细胞移植治疗暂时性脑缺血的价值。方法:从孕14 d SD胎鼠海马组织中分离培养出神经干细胞,将BrdU标记的神经干细胞经立体定向移植到SD大鼠暂时性大脑中动脉梗死模型(tMCAO)纹状体缺血半暗区。移植后2～12周以神经损害严重程度评分(NSS)评价各组动物神经功能状况。移植后12周,免疫荧光染色观察移植后神经干细胞的分化、迁徙和整合情况。结果:分离和纯化出大鼠胚胎神经干细胞,呈nestin阳性,并具有自我更新及多向分化潜能。移植后的神经干细胞在宿主脑内迁徙,部分分化并表达神经元特异性标记Neurofilament。移植后8周起,神经干细胞移植组大鼠NSS评分明显低于其他2组。结论:神经干细胞移植能改善缺血后大鼠的神经功能状况。     

神经干细胞移植治疗大鼠脑缺血再灌注损伤的实验研究

目的探讨胎鼠皮质培养的神经干细胞移植治疗大鼠脑缺血再灌注损伤的可行性及疗效。方法取孕龄15d Sprague-Dawley(SD)胎鼠皮质细胞培养为神经干细胞;用线栓法制备大鼠脑缺血再灌注损伤模型;将24只健康SD大鼠分为假手术组、缺血对照组、缺血移植组,在移植后2周、4周依据Garcia的18分评分法对各组大鼠的神经功能进行评分;行脑灌注固定取材,免疫组化染色观察移植后神经干细胞的分化、迁移和整合情况。结果用胎鼠皮质培养的细胞nestin表达阳性;缺血移植组大鼠的神经功能评分明显高于缺血对照组(P<0.05);缺血移植组免疫组织化学染色能够检测到存活的BrdU阳性细胞,移植后4周时可见移植细胞向周围迁移、分化、参与血管形成,并可见梗死区边缘微血管明显增生;缺血移植组大鼠脑GFAP阳性细胞数较缺血对照组明显增多(P<0.05)。结论分离、培养胎鼠皮质细胞Nestin表达阳性,即是大鼠的神经干细胞;移植体外培养的神经干细胞能在脑缺血大鼠脑内存活、迁移、分化,并且对脑梗死大鼠的神经功能修复起到了积极作用。     

TRPC1沉默对脑缺血大鼠神经干细胞迁移的影响

目的探讨瞬时受体电位通道1(TRPC1)沉默对脑缺血大鼠内源性神经干细胞增殖、迁移和分化的影响。方法 SD大鼠分为假手术组、脑缺血组、TRPC1沉默组(脑缺血+TRPC1沉默)和阴性对照组,以脑室内注射siRNA沉默TRPC1,以线栓法制作大鼠大脑中动脉脑缺血(MCAO)模型,脑缺血模型制作成功后,腹腔内注射Brdu标记内源性神经干细胞,分别于48 h、4 w后处死大鼠,行Brdu免疫组化染色、免疫荧光双标染色(Brdu/GFAP、Brdu/Neun)观察NSC的增殖、迁移和分化情况。结果脑缺血后48 h,脑缺血组和TRPC1沉默组SVZ区Brdu阳性表达均较假手术组明显增多(P0.01),但TRPC1沉默组Brdu阳性细胞数较缺血组低(P0.01)。脑缺血4 w后,缺血组与假手术组相比,皮质区具有更多的Brdu阳性细胞(P0.01),同样TRPC1沉默组Brdu阳性细胞数多于假手术组,但明显低于脑缺血组(P0.01);免疫荧光双标染色发现,脑缺血各组Brdu/GFAP、Brdu/Neun双阳性细胞的数量均比假手术组明显增高,但TRPC沉默组双阳性细胞显著少于脑缺血组和阴性对照组(P0.01)。结论 TRPC1沉默显著影响脑缺血大鼠SVZ区NSC的增殖、向脑缺血区迁移及向成熟细胞的分化。     

神经干细胞脑室内移植治疗大鼠脑缺血的实验研究

目的 探讨大鼠胚胎神经干细胞移植治疗局灶性脑缺血再灌注损伤的可行性。方法 取胎龄8～10d大鼠神经干细胞体外扩增．采用免疫组织化学方法检测神经干细胞及其分化后代的特异性标志巢蛋白（nestin）、胶质纤维酸性蛋白（GFAP）和神经元特异性烯醇化酶（NSE）的表达。以Brdu标记神经干细胞，分别于缺血后24h和4周移植至局灶性脑缺血大鼠模型的脑室内和梗死中心，比较不同移植部位和不同移植时间神经干细胞的存活、增殖和迁移情况。结果 移植后可见移植细胞存活至少8周以上．移植部位不同不影响细胞存活。脑室内移植细胞向脑缺血区域迁移．且以缺血后24h移植组较缺血后4周移植组迁移趋向性更强。结论 大鼠胚胎神经干细胞移植至局灶性脑缺血大鼠脑室内和梗死中心均可长期存活并广泛迁移．其迁移趋化能力与缺血后移植时间有关。     

神经干细胞移植治疗大鼠脑缺血再灌注损伤实验研究

目的探讨大鼠胚胎神经干细胞移植治疗局灶性脑缺血再灌注损伤的可行性。方法孕龄8~10d的大鼠神经干细胞在体外扩增后,用免疫组织化学方法分别检测神经干细胞及其分化后代的特异性标志蛋白nestin、胶质纤维酸性蛋白(GFAP)和神经元特异性烯醇化酶(NSE)的表达。分别于缺血后不同时间窗将神经干细胞移植到局灶性脑缺血大鼠模型的缺血半暗带和梗塞中心,移植4w后比较不同移植部位神经干细胞存活、增殖和迁移的差异。结果从胎鼠中成功培养出悬浮生长的可表达nestin的神经球,其在含血清条件下可分化为表达GFAP的胶质细胞和表达NSE的神经元。神经干细胞移植4w后可见所有移植动物的细胞都存活,梗塞中心移植的细胞存活、增殖水平明显低于半暗带移植的细胞。结论大鼠胚胎神经干细胞移植到局灶性脑缺血再灌注损伤大鼠梗塞中心和半暗带均可长期存活,其增殖能力与移植部位密切相关。     

Xbp-1基因重组神经干细胞移植对大鼠局灶脑缺血再灌注损伤的影响

背景：将转染Xbp-1基因的神经干细胞移植至脑损伤病变部位,不但确保了Xbp-1基因的稳定及持续表达发挥抗凋亡的作用,也可促进移植后神经干细胞的存活与分化能力。 目的：验证Xbp-1基因对移植大鼠脑缺血损伤处神经干细胞的分布、分化、抗凋亡作用及神经功能恢复的影响。 方法：选取成年SD大鼠采用线栓法建立大脑中动脉阻塞模型,并随机分成4组干预：对照组(不作处理)、PBS移植组、神经干细胞移植组、Xbp-1-神经干细胞移植组。于干预后7,14,28 d进行NSS评分,并取脑制备组织切片,免疫荧光染色观察神经干细胞在脑内的存活与分布情况。移植后第28天使用TUNEL染色检测缺血区域神经细胞凋亡情况,Western blot检测Bcl-2表达水平。 结果与结论：移植后7,14,28d Xbp-1-神经干细胞移植组NSS评分显著低于其他3组(P < 0.05);神经干细胞可以成功迁徙到脑缺血区域并成活、分化为成熟神经细胞,Xbp-1基因修饰后的神经干细胞成活、增殖以及分化能力均强于普通神经干细胞(P < 0.05);与其他3组比较,Xbp-1-神经干细胞移植组脑缺血区域神经细胞凋亡数量明显减少,Bcl-2水平升高 (P < 0.05)。证实了Xbp-1基因修饰可以增加神经干细胞存活、迁徙能力,并通过抗内质网应激显著降低移植后大鼠缺血模型的NSS评分,促进其神经功能恢复。     

移植神经干细胞的存活与迁移：电刺激小脑顶核可提高移植效率吗？**

背景：缺血早期半暗带中神经元和内皮细胞的坏死和凋亡无法得到缓解,加之移植后的存活率低,向功能细胞的分化率低,是单纯神经干细胞移植的缺陷。课题组提出整体干预理念,期望给移植细胞提供优化的整体环境。 目的：观察神经干细胞移植与电刺激小脑顶核相结合整体干预对移植神经干细胞存活与迁移的影响。 方法：体外分离、培养新生Wistar大鼠海马表皮生长因子反应性神经干细胞,Brdu标记,并用胎牛血清诱导,观察其多向分化潜能;80只Wistar大鼠分为4组：顶核刺激+神经干细胞移植组(n=32)：左侧小脑顶核刺激24 h后行右侧大脑中动脉梗死,再24 h后将神经干细胞立体定向注入右侧侧脑室内;顶核刺激组(n=8)：PBS代替神经干细胞,其余同顶核刺激+神经干细胞移植组;单纯神经干细胞移植组(n=32)：同心圆电极插入小脑顶核,不通电其余同顶核刺激+神经干细胞移植组;对照组(n=8)：同心圆电极插入小脑顶核后不通电,其余同顶核刺激组。记录梗死后6,24 h,3,7,14,28 d大鼠的神经功能;分别在移植后3,7,14,28 d处死大鼠,以梗死灶为中心切片,Brdu免疫组织化学染色,观察移植神经干细胞的存活与迁移。 结果与结论：分离培养的表皮生长因子反应性细胞表达nestin抗原,并有自我更新及多向分化潜能,在胎牛血清诱导下可分化为神经胶质细胞和神经元。经Brdu标记后,85%以上神经干细胞表达Brdu抗原。移植28 d内顶核刺激+神经干细胞移植组功能评分明显优于与其他3组(P < 0.05~0.01)。顶核刺激+神经干细胞移植组在移植14,28 d存活细胞数明显多于单纯神经干细胞移植组;提示电刺激小脑顶核可显著提高移植神经干细胞的存活率及大脑中动脉梗死大鼠的神经功能评分;优化的整体环境可提高移植神经干细胞对局灶性脑缺血损伤细胞的替代作用。     

脑缺血再灌流诱导内源性神经干细胞的增殖、分化

目的 观察脑缺血再灌注后内源性神经干细胞的分布、增殖和分化.方法 阻塞大鼠大脑中动脉2h不同时间的再灌流制成局灶性脑缺血模型,免疫组化单标、双标观察神经干细胞的增殖、分布、分化.结果 正常组和假手术组,多数脑室室管膜细胞Brdu免疫反应阳性,脑实质内有零星散在Brdu阳性细胞.再灌流1d,室管膜及室管膜下层的Brdu阳性细胞显著增多;再灌流3～10d,视前区梗死区周边区、缺血纹状体和额顶皮质的Brdu阳性细胞显著增加.再灌流3d,Brdu阳性细胞出现于海马齿状回的颗粒下层,并随再灌流时间延长,阳性细胞数量增多.免疫组化双标显示再灌流3d视前区有很少量的Brdu/GFAP双阳性细胞,随后增多.再灌流10d内,未检查到Brdu/NF双标阳性细胞.结论 成年哺乳动物的室管膜、脑实质有少量神经干细胞,脑缺血后室管膜、齿状回颗粒下层出现大量的神经干细胞增殖,这些增殖神经干细胞向缺血区迁移、分化,试图补偿丢失的细胞,重塑受损的神经组织.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

Release of endogenous catecholamines from slices of hypothalamus of rats

The release of endogenous catecholamines from superfused slices of rat hypothalamus was studied under basal conditions and during release evoked by 40 mM K⁺. Catecholamines in superfusates, and in extracts of the tissue after stimulation, were isolated by column chromatography and quantitated by liquid chromatography with electrochemical detection. Norepinephrine (NE) was not consistently demonstrable in superfusate collected under basal conditions, but 40 mM K⁺ caused the release of from 2 to 4 ng/g of tissue per min. The addition of cocaine to the superfusate caused increases in basal and evoked release of NE. Epinephrine (E) could be measured in superfusates of slices from male but not female rats and then only when cocaine was added to the superfusate. Accordingly, the concentration of E in hypothalamus was greater in male rats than in female rats. Dopamine (DA) was not consistently measurable in the spontaneous overflow from slices either in the presence or absence of cocaine. K⁺-evoked release of DA could be demonstrated in slices from female rats. The addition of cocaine increased the evoked release of DA from slices from both sexes. Corticosterone, added to cocaine, had no effects on the efflux of any of the catecholamines. The experiments suggest that neuronal reuptake of all catecholamines is very efficient in the hypothalamus both under basal conditions and during evoked release.     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。