丹参乙酸镁对大鼠局灶性脑缺血损伤后神经营养因子表达的影响

目的观察丹参乙酸镁对局灶性脑缺血后大鼠神经行为、梗死体积、组织形态及缺血半暗带神经生长因子(NGF)、脑源性神经营养因子(BDNF)表达的影响,探讨丹参乙酸镁的神经保护作用及其机制。方法健康雄性SD大鼠36只随机分为3组,Ⅰ组(假手术+安慰剂组);Ⅱ组(脑缺血+安慰剂组);Ⅲ组(脑缺血+药物组)。用线栓法建立动物模型,不给予再灌注,各组在术后48h断头取脑,处死前行神经功能评分,用氯化三苯基四氮唑(TTC)染色计算脑梗死体积,用苏木精-伊红(HE)染色观察组织学形态,用免疫组织化学染色观察NGF、BDNF的表达。结果Ⅰ组在神经功能评分、梗死体积、组织形态及大脑皮质相应部位NGF、BDNF阳性细胞数均正常。与Ⅱ组相比,Ⅲ组的神经功能评分和梗死体积比较差异无统计学意义(P>0.05);光镜下,Ⅱ组、Ⅲ组缺血性病理改变均较重,两组之间无明显差别;Ⅲ组缺血半暗带NGF、BDNF阳性神经元数较Ⅱ组增加(P<0.05)。与Ⅰ组相比,Ⅱ组缺血半暗带NGF、BDNF阳性神经元数增加(P<0.05)。结论丹参乙酸镁可增加脑缺血损伤后缺血半暗带NGF、BDNF的表达,但其发挥的神经保护作用并不明显。     

大鼠局灶性脑缺血后神经营养因子表达的自然变化

目的 观察大鼠局灶性脑缺血后大鼠神经行为、梗死体积、组织形态及缺血半暗带神经生长因子(NGF)、脑源性神经营养因子(BDNF)的表达水平变化。方法 将健康雄性SD大鼠24只随机分为2组,Ⅰ组(假手术组); Ⅱ组(脑缺血组)。用线栓法建立动物模型,不给予再灌注,各组在术后48h断头取脑,处死前行神经功能评分,用氯化三苯基四氮唑(TTC)染色计算脑梗死体积,用HE染色观察组织学形态,用免疫组织化学染色观察NGF、BDNF的表达水平。结果 Ⅰ组在神经功能评分、梗死体积、组织形态及大脑皮层相应部位NGF、BDNF阳性细胞数均正常。与Ⅰ组比较,Ⅱ组的神经功能评分和梗死体积均严重受损; 光镜下Ⅱ组缺血性病理改变较重,与Ⅰ组比较,Ⅱ组缺血半暗带NGF、BDNF阳性神经元数增加(P<0.05)。结论 脑缺血本身可上调缺血半暗带NGF、BDNF的表达水平。     

疏血通对局灶性脑缺血大鼠神经保护和hsp70表达水平的影响

目的 探讨疏血通对脑缺血-再灌注后神经保护作用的机制,拟为临床应用提供理论依据.方法 90只健康雄性SD大鼠,随机分为假手术组、缺血-再灌注组和疏血通治疗组,建立大脑中动脉闭塞模型.采用神经功能缺损评分对人鼠神经功能缺损程度进行评价,HE染色、TUNEL染色和免疫组织化学染色检测大鼠脑组织梗死灶体积、细胞凋亡及hsp70表达水平.结果 经疏血通治疗后,大鼠神经功能缺损程度明显改善,除再灌注后6h,其余各时间点疏血通治疗组评分均优于缺血-再灌注组(P<0.05).疏血通治疗组大鼠梗死灶体积明显缩小(P<0.01).再灌注后6 h,缺血半暗带区和海马区即可见凋亡细胞,分别于再灌注后48 h和72 h达峰值水平,疏血通治疗组表达高峰时间延迟,且各时间点凋亡细胞数目均少于缺血-再灌注组(P<0.05).再灌注后6 h,缺血半暗带区和大脑皮质即可见少量hsp70表达阳性细胞,两组均于再灌注后24 h达峰值水平,但疏血通治疗组各时间点hsp表达水平均高于缺血-再灌注组(P<0.05).结论 疏血通通过上调脑组织hsp70表达水平,减轻脑缺血-再灌注损伤,从而使梗死灶体积缩小、神经功能改善.     

经颅磁刺激对局灶性脑梗死大鼠梗死周边区BDNF表达及神经功能的影响

目的观察经颅磁刺激(transcranial magnetic stimulation,TMS)对局灶性脑梗死大鼠脑源性神经营养因子(brain derived neurotrophic factor,BDNF)及梗死后神经功能的影响。方法线栓法制备大鼠大脑中动脉闭塞(middle cerebral artery occlusion,MCAO)模型。在不同缺血时间点观察大鼠神经行为评分和脑梗死体积,用免疫组化法检测BDNF阳性细胞数。结果在经颅磁刺激1 d,7 d,14 d,21 d组神经行为评分和脑梗死体积均低于对应时程的MCAO组(P<0.05),二者的2 h组之间的神经行为评分及脑梗死体积无统计学差异(P>0.05);各组缺血半暗带BDNF阳性细胞数均增高,经颅磁刺激组的BDNF阳性细胞数高于对应时程的MCAO组(P<0.05)。结论经颅磁刺激能提高大鼠局灶脑缺血半暗带BDNF的表达水平,促进神经元的修复和神经功能的恢复。     

大鼠脑缺血再灌注半暗带β淀粉样前蛋白mRNA表达与梗死体积的关系

为了探讨大鼠局灶性脑缺血再灌注缺血半暗带β淀粉样前蛋白(APP)转录水平与缺血时间及梗死体积的相互关系,用插线法建立大鼠局灶性脑缺血再灌注模型,剥取缺血半暗带皮质组织,采用半定量逆转录-聚合酶链式反应(RT-PCR),测定永久性缺血48 h和不同缺血时间再灌注48 h后,APPmRNA水平的变化.结果显示,梗死体积随再灌注前缺血时间的延长而增大,皮质半暗带缺血30 min再灌注48 h APPmRNA表达升高;缺血60min和缺血120 min再灌注48 h APPmRNA升高明显;缺血180 min再灌注48 h和永久性缺血48 h APPmRNA达到高峰.提示缺血半暗带APPmRNA的表达随再灌注前缺血时间延长而增加并与梗死体积有一定的相关性,早期再灌注可减少其表达.((GFDAl))     

神经生长因子对兔局灶性脑缺血再灌注损伤的治疗时间窗及MR影像学评价

目的研究神经生长因子(NGF)对脑缺血再灌注损伤保护作用的有效时间窗,同时利用MR成像技术对其进行评价。方法采用兔大脑中动脉阻断(MCAO)局灶性脑缺血2 h再灌注72 h模型,分别于缺血再灌注0、1、36、h应用微量进样器将NGF立体定向导入梗死灶周,并于再灌注不同时间点应用MR影像学、TTC染色和流式细胞术评价家兔梗死体积、神经功能缺损和凋亡状态。结果缺血再灌注0、13、h组梗死灶周注射NGF后,经MRI检查所测梗死体积分别为(229.9±17.1)(、260.7±24.2)、(314.6±25.3)mm3,与对照组[(468.6±29.7)mm3]比较差异有统计学意义(均P<0.01);缺血再灌注6 h组梗死体积为(441.1±14.8)mm3,与对照组比较差异无统计学意义(P>0.05)。采用TTC染色所测梗死体积与MRI检查结果一致。脑缺血再灌注3 h内注射NGF,其神经功能缺损评分明显降低,凋亡率明显下降;再灌注6 h后注射NGF则无明显作用。结论NGF对兔局灶性脑缺血再灌注损伤的有效时间窗为再灌注损伤3 h内,MR影像学检查可作为定量评价基因疗效的可靠指标。     

大鼠脑缺血再灌注半暗带β淀粉样前蛋白mRNA表达与梗死体积的关系

为了探讨大鼠局灶性脑缺血再灌注缺血半暗带β淀粉样前蛋白(APP)转录水平与缺血时间及梗死体积的相互关系，用插线法建立大鼠局灶性脑缺血再灌注模型，剥取缺血半暗带皮质组织，采用半定量逆转录－聚合酶链式反应（RT－PCR），测定永久性缺血48h和不同缺血时间再灌注48h后，APPmRNA水平的变化。结果显示，梗死体积随再灌注前缺血时间的延长而增大，皮质半暗带缺血30min再灌注48h APPmRNA表达升高；缺血60min和缺血120min再灌注48h APPmRNA升高明显；缺血180min再灌注48h和永久性缺血48h APPmRNA达到高峰。提示缺血半暗带APPmRNA的表达随再灌注前缺血时间延长而增加并与梗死体积有一定的相关性，早期再灌注可减少其表达。（（GFDA1））。     

黄芪甲苷对大鼠脑缺血再灌注后神经元的保护作用

目的 探讨不同剂量黄芪甲苷(AST)预处理对大鼠脑缺血再灌注(IR)后神经元凋亡的影响.方法 将60只大鼠随机分为假手术组、IR组、AST 10 mg/kg组、40 mg/kg组和100 mg/kg组.各AST组分别于制模前30 min腹腔注射相应剂量的AST.应用线栓法制作一侧大脑中动脉缺血2 h、再灌注24 h大鼠IR模型,观察各组大鼠脑梗死体积、神经功能缺损程度以及缺血灶中心区和半暗带区神经元凋亡数和神经元核抗原(Neun)阳性细胞数.结果 与假手术组相比,IR组及各AST组凋亡细胞数明显增多,Neun阳性细胞数明显减少(均P<0.01);与IR组相比,AST40 mg/kg组和100 mg/kg组梗死体积、神经功能缺损评分及缺血半暗带区凋亡细胞数明显减少,Neun阳性细胞数明显增多(P<0.05～0.01);AST 40 mg/kg组和100 mg/kg组梗死体积明显少于AST 10 mg/kg组(均P<0.01);AST 40 mg/kg组缺血半暗带区凋亡细胞数明显少于AST10 mg/kg组,Neun阳性细胞数明显多于AST 10 mg/kg组(均P<0.05).结论 AST具有减轻脑IR后神经细胞凋亡的作用,AST 40 mg/kg对神经元保护作用最好.     

17β-雌二醇对去势大鼠脑缺血半暗带区神经细胞凋亡的影响

目的:研究17β-雌二醇(E2)对去势大鼠脑缺血半暗带区细胞凋亡的影响以及脑保护作用。方法:利用E2 治疗1周的36只去势SD大鼠制作大脑中动脉缺血再灌注(MCAO／R)模型,缺血90min后再灌注48h后制作石蜡切 片,行TTC染色、TUNEL凋亡染色,显微镜下观察染色结果。结果:正常组织染成粉红色,梗死灶染成白色。和未治疗 组相比,治疗组脑梗死体积比减小(P<0．01),且神经细胞凋亡的数量也明显减少(P<0．01)。结论:E2可减少梗死体积 比并能通过减少神经细胞凋亡发挥神经保护作用。     

大鼠局灶性脑缺血再灌注后BDNF mRNA及其蛋白的表达变化

目的 观察大鼠脑缺血再灌注后缺血半暗带皮质脑源性神经营养因子(BDNF)mRNA和蛋白的表达变化.方法 采用线栓法制作局灶性脑缺血大鼠(MCAO)模型,用原位杂交法和免疫组化法观察脑缺血后3、6、12h及1、3、7d共6个时间点BDNF mRNA及其蛋白的表达变化.结果 缺血半暗带BDNF mRNA及其蛋白的表达均于缺血再灌注后3h开始明显上升,6h表达继续增强,12h达高峰,3d后表达开始减弱(P＜0.05或0.01),7d后降至基础水平.结论 脑缺血再灌注后缺血半暗带BDNFmRNA及蛋白表达均明显增加,提示其可能参与了脑缺血后神经保护.     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

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     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.