人脐血间充质干细胞移植联合神经节苷脂注射治疗脑性瘫痪

BACKGROUND:In recent years, some studies have demonstrated that ganglioside can promote survival and differentiation of umbilical blood cord mesenchymal stem cells in vitro. OBJECTIVE:To observe the effect of injection of human umbilical blood cord mesenchymal stem cells and ganglioside into rat lateral ventricles on neurological functional recovery from cerebral palsy. METHODS:Totally 60 cerebral palsy neonatal rats were delivered from pregnant rats which were modes were given intraperitoneal injection of lipopolysaccharide for 2 successive days on day 17 of gestation. Then those neonatal rats were randomly divided into five groups, including model group (n=10), sham transplantation group (n=10), stem cell transplantation group (n=18), ganglioside group (n=10) and combination group (n=12). Under stereotaxic instrument, umbilical blood cord mesenchymal stem cells or ganglioside were injected into left lateral ventricles of the rat brain, respectively, and the sham transplantation group was given the same volume of phosphate buffered saline. Two rats from the stem cell transplantation group were put to death for immunofluorescence staining at 7, 14, 21 and 28 days after transplantation, respectively, and two rats in the combination group were killed for immunofluorescence staining at 14 days. Besides, all rats were underwent neurologic evaluation at 28 days after transplantation. RESULTS AND CONCLUSION:The umbilical blood cord mesenchymal stem cells could survive, migrate and differentiate, which mainly distributed in the lateral ventricle, hippocampus and cortex. At 14 days after transplantation, positive expressions of BrdU and glial fibrillary acidic protein in the combination group were significantly higher than those in the stem cell transplantation group (P < 0.05). In addition, compared with the model group, the holding time significantly prolonged and foot error times significantly decreased in the latter three groups (P < 0.05), as well as in the combination group compared with the stem cell transplantation and ganglioside groups (P < 0.05). These results indicate that umbilical blood cord mesenchymal stem cells and ganglioside can both improve neurological function of rats with cerebral palsy. Given that ganglioside can promote survival and differentiation of umbilical blood cord mesenchymal stem cells in vivo, the combined transplantation is preferred.     

神经节苷脂在神经系统发育过程中的作用

1935年,Klenk首先在大脑灰质的Ganglionzellen细胞中发现了一种新物质,命名为ganglioside-神经节苷脂,其种类繁多,至今已分离鉴定出70余种。神经节苷脂是一组含有唾液酸的鞘糖脂,分子由疏水的神经酰胺和亲水的含唾液酸的寡糖链组成,广泛分布于脊椎动物各组织的细胞膜上,其中以神经系统含量最为丰富。通常根据唾液酸数目不同分为GM(单唾液酸神经节苷脂)、GD(二唾液酸神经节苷脂)和GT(三唾液酸神经节苷脂)等。又根据糖基数目不同将GM分为GMl(含4个糖基)、     

神经节苷脂肿瘤疫苗研究进展

神经节苷脂是一类细胞膜上的糖鞘脂类化合物 ,其伸展于胞膜表面的糖基具有免疫原性抗原决定簇 ,能够诱发IgM抗体反应。由于其在多种神经外胚层起源的肿瘤组织中过度表达 ,因此可作为肿瘤疫苗的靶分子。各种经过加工、处理的神经节苷脂肿瘤疫苗的免疫原性明显增强 ,诱导产生IgM及IgG。经多种动物模型及临床实验证明 ,其抗体产生的水平和持续时间与肿瘤患者的预后明显相关 ,因此在肿瘤生物治疗上是一很有前景的研究目标。     

神经节苷脂GM_1对神经生长因子作用的调节

<正> 脑是一个动力学器官。中枢神经系统内的神经元能够对它们微环境内的化学信号起反应,此过程被广义地称为神经可塑性。在各种分子的调节之中神经可塑性的表达受到一些神经营养因子的调节。这些神经营养因子都是蛋白质,它们对不同种类神经元的存活、维持和修复能力发生影响,神经生长因子(NGF)就是一个典型的例子。消除神经元的靶区或阻断突触连接则使神经元丧失充分的营养支持,导致萎缩和死亡。 NGF的作用并不局限于神经元发育过程的某些固定时期,成年动物的中枢和周围神经系统的神经元均能对NGF起反应。在实验性损毁、中断海马产生的NGF向隔区的胆碱能神     

神经节苷脂肿瘤疫苗研究进展

神经节苷脂是一类细胞膜上的糖鞘脂类化合物，其伸展于胞膜表面的糖基具有免疫原性抗原决定簇，能够诱发IgM抗体反应。由于其在多种神经外胚层起源的肿瘤组织中噎度表达，因此可作为肿瘤疫苗的靶分子。各种经过加工、处理的神经节苷脂肿瘤疫苗的免疫原性明显增强，诱导产生IgM及IgG。经多种动物模型及临床实验证明，其抗体产生的水平和持续时间与肿瘤患者的预后明显相关，因此在肿瘤生物治疗上是一很有前景的研究目标。     

神经节苷脂与细胞功能的调控

神经节苷脂对细胞间的识别及多种膜相关蛋白起着重要的调节作用；在胚胎发育、分化及肿瘤形成中，神经节苷脂亦发生结构和功能的变化。     

神经节苷脂治疗糖尿病性周围神经病的临床及电生理分析

神经节苷脂治疗糖尿病性周围神经病5例:对照组5例用VitB_1 VitB_(12)混合肌注,治疗组和对照组均为60天一疗程,在治疗前后对临床感觉及运动传导速度测定作为判断疗效标准,发现治疗组疗效提高30％,对无力及疼痛有明显改善,治疗组电生理指标明显好转,疗效较肯定。     

神经节苷脂对损伤胎鼠背根神经节的保护作用

目的观察神经节苷脂(GM1)对受损伤胎鼠背根神经节(DRG)神经元形态改变的影响,探讨其可能的保护作用。方法选择胎龄为15d的SD大鼠为研究对象,获取DRG神经元并进行体外分散培养,培养48h后,随机分为对照组、谷氨酸损伤组和谷氨酸损伤+GM1保护组,继续培养12h。终止培养后,观察各组神经元的形态结构改变,用MTT法鉴定细胞的存活率。结果对照组DRG神经元细胞贴壁呈单层散在分布,少部分出现细胞聚集现象,突起较长且互相交织形成网状。谷氨酸损伤组DRG神经元细胞聚集现象明显,神经元突起变短、断裂甚至消失。谷氨酸损伤+GM1保护组DRG神经元细胞部分呈簇状聚集,部分呈单个散在分布,突起仍然相互交织。MTT结果显示谷氨酸损伤+GM1保护组细胞存活率高于谷氨酸损伤组。结论神经节苷脂可以影响损伤胎鼠DRG神经元的形态改变,对胎鼠背根神经节神经元具有一定的保护作用。     

脑瘫患儿头颅MR与病因、智能发育相关性研究

对１５０例脑瘫患儿的头颅ＭＲ及智能发育进行了检测,结果表明：ＭＲ１４例正常,１３６例异常,将ＭＲ成像结果与ＤＱ及病因分别进行对比研究,发现ＭＲ异常者ＤＱ发育明显落后于正常者。ＤＱ异常率由高到低排列次序依次为脑发育畸形,脑室周围白质软化（ＰＶＬ）,脑萎缩,脑软化。     

100例脑性瘫痪患儿的临床分析

目的从年龄、病因、诊断及治疗等方面综合观察和分析脑瘫患儿,确定其疗效结果。方法将我院脑瘫门诊康复诊治就诊的100例患儿进行回顾性研究分析,综合治疗以三个月为一疗程,参照婴幼儿运动功能评定量表(GM-FM)作为评估指标,探讨其疗效。结果患儿年龄越小,治疗时间越长,临床治疗效果越好。结论小儿脑病要早期诊断、早期干预、坚持治疗,以提高脑瘫患儿的生存质量。     

人胚胎神经干细胞移植治疗脑瘫患儿的临床研究

目的脑瘫是围产期获得性非进行性脑病导致的先天性运动障碍及姿势异常疾病或综合征。国际上脑瘫的发病率为1%～5%,我国脑瘫的发病率为1.8%～4%,每年新增小儿脑瘫患儿40万。脑瘫目前还无有效的治疗手段。近年来,神经干细胞移植治疗脑瘫的研究越来越多,提供了广阔的空间。人胚胎细胞来源的神经干细胞在形态、功能上具备神经元的特性,与宿主神经元突触联系,接受宿主细胞传递的冲动,与患者大脑发生整合,完成再生功能,从根本上治疗脑瘫。方法提取人胚胎脑组织,体外分化、诱导成神经干细胞,将P2-51-5×105-8神经干细胞通过颈动脉或腰穿的方法移植到病人脑内。一个疗程3～4次,间隔1周,1年2-3个疗程。结果临床治疗25例脑瘫病人,好转23例,无效2例。结论人胚胎神经干细胞移植是治疗脑瘫的最有效手段。     

小儿脑性瘫痪与孕妇嚼食槟榔的相关性研究

目的通过对全市0～7岁患儿的患病率及相关因素调查,了解湘潭市特殊生活习惯(嚼食干果制槟榔)与小儿脑性瘫痪发病关联度.方法?参加调查的人员进行统一培训并经考核合格,调查时严格按照课题设计要求进行,调查时间为2002年8～10月. 结果共调查0～7岁儿童179 895人,确诊为小儿脑性瘫痪385名,患病率为2.14‰,高危因素以新生儿窒息、低体重、早产为前3位,统计学处理孕妇孕期嚼食干果制槟榔与小儿出生低体重和早产具有显著性关联.结论嚼食干果制槟榔与小儿脑性瘫痪具有相关性,易导致早产、出生低体重,孕妇应慎食.     

GMAE软件系统在脑瘫患儿评估及康复治疗中的临床意义

目的为脑瘫患儿粗大运动功能障碍程度及康复疗效评估提供科学、简便的工具。方法采用GMAE、GDSGM分别对34例脑瘫患儿治疗前后粗大运动功能进行评估比较。对83例脑瘫患儿随机分组,分别在治疗前后评估,将得分输入GMAE进行数据分析。A组：治疗时间3个月,常规治疗加GMAE提供的预期训练目标;B组：治疗2个月,方案同A组;C组：仅常规治疗3个月。对照组为30例健康患儿,两次测评间隔3个月。结果 34例脑瘫患儿治疗前后评估,GMAE结果差异显著（t=5.26,P〈0.0001）;GDS-GM结果差异不显著（S=87.5,P〉0.05）。83例患儿中,各组首次、二次检测及两次检测GMAE结果差值均低于对照组（P〈0.05）;A组两次检测结果差值明显高于B组和C组（P〈0.05）。对照组中,3岁以上组GMAE首次测量值显著高于3岁以内组（P〈0.05）。3岁以内组两次测量差值明显高于3岁以上儿童,差异显著（P〈0.05）。结论 GMAE可量化脑瘫患儿粗大运动功能障碍程度及康复训练后进步变化幅度,具有科学、简便、实用的特点。其敏感性、特异性均优于GDS-GM。还能反映不同年龄粗大运动发育水平的特点,其显示的预期训练目标对脑瘫患儿个体精细化康复训练有一定的指导意义,适合国内临床广泛使用。     

Eye hand coordination in children with cerebral palsy

Reaching to grasp an object of interest requires complex sensorimotor coordination involving eye, head, hand and trunk. While numerous studies have demonstrated deficits in each of these systems individually, little is known about how children with cerebral palsy (CP) coordinate multiple motor systems for functional tasks. Here we used kinematics, remote eye tracking and a trunk support device to examine the functional coupling of the eye, head and hand and the extent to which it was constrained by trunk postural control in 10 children with CP (6–16 years). Eye movements in children with CP were similar to typically developing (TD) peers, while hand movements were significantly slower. Postural support influenced initiation of hand movements in the youngest children (TD & CP) and execution of hand movements in children with CP differentially depending on diagnosis. Across all diagnostic categories, the most robust distinction between TD children and children with CP was in their ability to isolate eye, head and hand movements. Results of this study suggest that deficits in motor coordination for accurate reaching in children with CP may reflect coupled eye, head, and hand movements. We have previously suggested that coupled activation of effectors may be the default output for the CNS during early development.     

Constraints on grip selection in cerebral palsy

The present study examined whether movement characteristics of individuals with spastic hemiparesis could be accounted for by disorders in movement planning. Two experiments were performed that tested minimisation of postural discomfort and minimisation of movement costs as constraints on grip selection. In the 1st experiment, spastic subjects and controls had to pick up a bar and place it in one of 5 boxes with either the left or right side down. In addition, awkwardness ratings of the different postures were given. Minimisation of posture discomfort as constraint on grip selection was examined. In line with previous studies, grip selection for the control subjects was based on minimisation of end posture discomfort. For the unimpaired hand of the spastic subjects, no discrimination was made in discomfort ratings among the different postures. Accordingly, with this hand, subjects showed no preference for a particular grip type. The posture ratings for the impaired hand were more varied both within and between spastic subjects, and minimisation of discomfort at either the start or end could not completely account for the grips chosen. Rather, the results suggest that minimisation of total posture discomfort acted as a constraint on grip selection for this hand. In the 2nd experiment, minimisation of total movement costs as a constraint on grip selection was tested. Spastic subjects and a control group had to grasp a bar on a clockface and rotate one end to the top position, starting from 15 different starting positions. Again, the end-state comfort effect was demonstrated in the control group. For the impaired hand of the spastic subjects, minimisation of total movement costs as expressed by a reduction of the total amount of joint rotation was shown to account for the grips chosen. The lack of consistency in grip selection for the unimpaired hand at some starting positions seemed to stem from an unresolved conflict between minimisation of end posture discomfort and minimisation of total movement costs. The combined results of the two experiments suggest that grip planning in spastic hemiparetic subjects is not disturbed per se. Rather, different constraints are imposed during the grip selection process. If movements are difficult to execute (i.e. because the hand is impaired), grip planning proceeded by a minimisation of total movement costs by choosing a task solution that reduced the total amount of joint rotation.     

脑性瘫痪儿童红外热成像特点观察研究

目的　探讨脑瘫儿童热像特点,为临床应用热像观察脑瘫患儿提供参考。 方法　选取广州市社会儿童福利院中符合入选标准的脑瘫儿童（n=42）和正常儿童（n=42）分别作为观察组和对照组,使用TMI-BX1便携式红外线热影像测温系统采集儿童全身热像,通过计算机抓取额头、前胸、上腹、下腹、脊椎T4、脊椎T12、脊椎L4、左手心、右手心、左足背、右足背共11个点的平均温度值,并统计分析。 结果　两组的左右侧肢端温度差异无统计学意义（P>0.05）,两组的头面及躯干温度均高于四肢肢端温度（P<0.01）;最高温度与最低温度的极差,观察组大于对照组（P<0.05）;两组的头面温度分别低于其腹部温度,两者差异均有显著意义（P<0.01）;观察组腹部温度高于背部温度,对照组反之,两组间比较差异有显著意义（P<0.01）。 结论　脑瘫儿童腹部温度高于背部温度,正常儿童均反之,此热像特点可为临床研究提供参考。     

大脑性瘫痪患者的体感诱发电位和运动诱发电位分析

目的；观察大脑性瘫痪（脑瘫，CP）患者体感诱发电位（SEP）和运动诱发电位（MEP）的表现。方法：对15例CP患者作四肢SEP和磁刺激MEP测试，并与对照组进行比较。结果：14例CP患者SEP中有3例异常，异常率21％，15例CP患者中MEP有14例异常，异常率93％，与临床表现相一致。结论：SEP和MEP可检测神经感觉和运动通路功能状况，对CP的诊断可提供客观依据。     

脑瘫高危因素与脑瘫患儿智商相关性研究

目的　探讨脑瘫患儿高危因素、临床分型与智力低下的关系。方法　我科 1997年 1月至 2 0 0 0年 12月共收治32 9名脑瘫患儿 ,经过询问病史、体格检查、智力测验及必要的实验室检查 ,排除贫血、营养不良、头小畸形、癫痫、视听觉障碍等影响智力的因素后 ,脑瘫单独伴有智力低下者 10 2名 ,这 10 2名患者按高危因素、临床分型、父母文化程度分别分组。数据输入计算机用spss10 .0统计软件对上述几种因素与智力低下的关系进行分析。结果　在不同高危因素中其大运动能 ,DQ差异显著 ,(P <0 .0 5 ) ,窒息组的大运动能低于早产组 (P <0 .0 1) ,高胆红素血症组DQ低于其他高危因素组 (P <0 .0 5 )。脑瘫伴智力低下者 ,其发育商的 5个行为领域均明显下降 ,(P <0 .0 5 ) ,手足徐动型、痉挛型脑瘫的精细动作 ,认知、语言、社交行为明显降低 (P <0 .0 5 ) ,混合型脑瘫智测的 5个行为领域均明显下降 (P<0 .0 1) ,母亲的文化程度与患儿的语言能区相关(P <0 .0 5 )。结论　不同的高危因素及临床类型可导致相同程度的智力残疾。