多巴胺神经元联合中脑神经干细胞移植治疗帕金森病

目的探讨多巴胺神经元联合中脑神经干细胞移植治疗帕金森病大鼠的作用效果。方法体外分离大鼠胚胎腹侧中脑神经干细胞并行增强型绿色荧光蛋白(EGFP)修饰。分离大鼠胚胎多巴胺神经元,并用CM-Di I染料标记。构建经典的6-羟多巴胺毁损帕金森病大鼠模型。采用立体定向注射技术,将细胞移植到帕金森病大鼠纹状体区,阿朴吗啡(APO)腹腔注射诱导其偏侧旋转,评估细胞移植后运动障碍改善情况。采用免疫荧光组织化学鉴定移植细胞的定植存活、迁移及分化。结果细胞移植能显著改善帕金森病大鼠的运动障碍,以多巴胺神经元联合中脑神经干细胞移植(联合移植组)治疗最为显著,有更多的神经干细胞分化为多巴胺神经元。绝大多数移植细胞停留在移植部位,仅极少数向周围脑区迁移。结论多巴胺神经元联合神经干细胞移植治疗帕金森病大鼠可显著改善其运动障碍,其具体相关分子机制还有待进一步研究。     

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.     

脐血间充质干细胞移植后帕金森病大鼠纹状体内多巴胺含量的变化

背景：目前干细胞移植对帕金森病动物模型的研究多集中在骨髓间充质干细胞和胚胎干细胞方面,关于脐血间充质干细胞移植对帕金森病动物模型的研究相对较少,且未见测量脐血间充质干细胞移植前后多巴胺含量变化的报道。 目的：观察脐血干细胞移植对帕金森病大鼠纹状体内多巴胺含量的影响。 方法：帕金森病模型大鼠随机分成实验组和对照组。将第3代脐血间充质干细胞用Hoechst33258标记后植入实验组大鼠纹状体内,对照组注射磷酸盐缓冲溶液。移植后2,4,8周用免疫荧光双标法检测间充质干细胞的存活、迁移以及胶质纤维酸性蛋白、神经元特异性烯醇化酶、酪氨酸羟化酶和突触素的表达。移植后8周利用高效液相色谱-电化学检测仪检测纹状体多巴胺含量。 结果与结论：脐血间充质干细胞移植后可在大鼠脑内存活,随时间延长迁移范围扩大,分布于纹状体、胼胝体和皮质;胶质纤维酸性蛋白、神经元特异性烯醇化酶、酪氨酸羟化酶都有表达,突触素无表达。多巴胺水平与对照组相比有明显提高 (P < 0.05)。     

被动吸烟对大鼠纹状体多巴胺及黑质自由基含量的影响

目的研究被动吸烟对帕金森病(PD)大鼠的影响,探讨其作用机制。方法通过6-羟多巴胺(6-O-HDA)脑立体定向注射术建立大鼠PD模型。术前4周开始被动吸烟及术后持续2周为预防组;术后3周给予被动吸烟持续2周为治疗组。采用生化的方法观察PD大鼠纹状体黑质自由基、抗氧化剂及多巴胺含量的变化。结果吸烟治疗组和吸烟预防组大鼠黑质自由基及抗自由基酶较对照组有明显改善(P<0.05);吸烟预防组PD大鼠纹状体DA含量较对照组有明显改善(P<0.05);吸烟治疗组PD大鼠纹状体DA含量较对照组无变化(P>0.05)。结论被动吸烟能减轻黑质纹状体DA能神经元的损伤。     

人羊膜间充质干细胞移植治疗帕金森病模型大鼠的疗效评价

目的观察不同途径移植人羊膜间充质干细胞(human amniotic mesenchymal stem cells,h AMSCs)对帕金森病(Parkinson’s disease,PD)模型大鼠的生物学效应及其在体内的分化。方法采用胰蛋白酶-胶原酶消化法分离hAMSCs,流式细胞术分析表型。40只雌性Wistar大鼠随机分为假手术组、模型组、hAMSCs静脉移植组和原位移植组。采用单侧前脑内侧束(MFB)注射6-羟基多巴胺建立PD大鼠模型。通过舌下静脉或于MFB原位移植3×105个hAMSCs。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,免疫组化染色法检测酪氨酸羟化酶(tyrosine hydroxylase,TH)的表达。结果与模型组比较,hAMSCs静脉移植组和原位移植组大鼠旋转次数均明显减少(均P<0.05),前者行为学改善可持续至移植后6 w,后者则至8 w;免疫荧光染色显示,hAMSCs在原位移植区可存活至少12 w,并表达MAP-2;免疫组化染色显示静脉和原位移植hAMSCs均可上调PD模型大鼠黑质TH表达,但后者强于前者。结论 hAMSCs能改善PD模型大鼠的运动行为,原位移植优于静脉移植,其机制可能与上调黑质TH表达有关。hAMSCs可在原位移植部位分化为多巴胺能神经元样细胞。     

帕金森病的细胞治疗

帕金森病（PD）是一种中脑黑质多巴胺能神经元进行性退化导致黑质-纹状体通路受损的中枢神经系统退行性疾病。目前主要治疗方式是多巴胺能药物和深部脑刺激（DBS）,但这两种治疗方案只能暂时缓解症状并不能完全根治且有不良反应。干细胞具有自我更新和多向分化的潜能,干细胞移植能够修复受损的组织,为PD的治疗带来了曙光。本文介绍了细胞移植治疗帕金森病的研究进展。     

胚胎多巴胺神经元移植治疗帕金森病的实验研究

目的探讨胚胎多巴胺神经元移植对帕金森病大鼠的治疗作用。方法立体定向注射6-羟多巴胺建立帕金森病大鼠模型,随机分为对照组(n=12)和细胞移植组(n=12)。细胞移植组将荧光染料CM-DiI标记的大鼠胚胎多巴胺神经元立体定向注入帕金森病大鼠纹状体区,对照组于相同部位注入生理盐水。用阿扑吗啡诱导帕金森病大鼠旋转行为评估细胞移植的治疗作用。细胞移植8周后取大脑标本行冷冻切片,荧光显微镜下观察移植细胞在脑内存活情况。结果与对照组比较,移植多巴胺神经元能显著改善阿扑吗啡诱导帕金森病大鼠的异常旋转行为(P0.01)。移植8周后,仅少量多巴胺神经元存活。结论多巴胺神经元移植可短期内改善帕金森病大鼠的运动障碍,但长期疗效不佳,可能与移植多巴胺神经元长期存活率较低有关。     

脑源性神经营养因子对帕金森病大鼠多巴胺能神经元的影响

目的观察脑源性神经营养因子对帕金森病(Parkinson’s disease,PD)大鼠模型黑质多巴胺能神经元的影响。方法选用Wistar种系大白鼠30只,体质量230~250g,随机分3组,通过左侧中脑黑质立体定向注射法,组1为生理盐水对照组(简称对照组)10只,注射相应量(5μL)的生理盐水;组2为注射6-OHDA制作帕金森病模型组(简称6-OHDA组)10只,注射6-OHDA,5μL(2μg/μL);组3为(6-OHDA+BDNF)组,在制成帕金森病模型后再向同侧中脑黑质注射BDNF 5μL(3μg/5μL),连续6d,1次/d。分别观察动物的旋转行为,免疫组化染色方法观察黑质酪氨酸羟化酶(tyrosine hydroxylase,TH)阳性神经元的数量,高效液相法测定纹状体部多巴胺(dopamine,DA)含量的变化。结果单侧黑质内注入6-OHDA制成帕金森病大鼠模型后,6-OHDA组与对照组比较,产生旋转行为,(6-OHDA+BDNF)组在观察旋转行为时,症状明显改善;镜下见TH阳性神经元主要见于对照组的黑质致密部,数量为(42.3±7.56)个/μm2,模型组黑质致密部TH阳性神经元数明显减少为(2.41±1.07)个/μm2,(6-OHDA+BDNF)组黑质致密部TH阳性神经元数为(15.36+3.04)个/μm2;纹状体部多巴胺含量:生理盐水组为(11.4±1.2)μg/g,6-OHDA组(3.6±0.5)μg/g,(6-OHDA+BDNF)组(5.5±0.6)μg/g。结论 BDNF能改善6-OHDA所致的帕金森病大鼠黑质多巴胺能神经元数目的减少;明显抑制6-OHDA引起的纹状体部多巴胺含量降低;并可抑制6-OHDA对黑质多巴胺能神经元的毒性作用。     

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.     

尼古丁对帕金森病大鼠纹状体GDNF和多巴胺含量的影响

目的 研究尼古丁对帕金森病（PD）大鼠纹状体脑胶质细胞源性神经营养因子(GDNF)和多巴胺（DA）含量的影响。方法 将6－羟多巴胺（6－OHDA）立体定向注射到大鼠右侧中脑腹侧背盖部（VTA）和黑质致密部（SNpc)，建立PD大鼠模型。采用生化、免疫组织化学方法观察不同剂量尼古丁对PD大鼠的作用，检测纹状体GDNF表达及DA含量的变化。结果 造模前及造模后皮下注射尼古丁的PD大鼠，纹状体GDNF表达及DA含量较PD组有明显改善（P＜0．05）。结论 尼古丁可减轻6－OHDA对黑质DA能神经元的损伤，对PD大鼠具有保护作用。     

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。     

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.     

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.     

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.     

《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。     

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.     

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。