苯妥英对颅脑损伤患者癲痫预防和治疗监测

苯妥英是临床常用的抗癫痫药物,亦常用于颅脑外伤或因为脑瘤、血管瘤、动静脉畸形等常见的神经外科手术后的癫痫发作。在ICU阶段(两周内)苯妥英药代动力学发生改变,血浆白蛋白浓度降低,苯妥英代谢清除率增加,总的趋势是总药浓度降低,游离分数增加,但现有的数学模型并不能准确迅速地预测苯妥英浓度变化,因此必须经常监测血药浓度以维持药物治疗浓度和防止毒性。     

冻结步态的帕金森病患者多巴胺转运体正电子发射断层显像研究

目的探讨帕金森病(PD)冻结步态的临床及多巴胺转运体显像特征。方法选取复旦大学附属华山医院PD数据库中的30例原发性PD患者,分为冻结步态(FOG+)组(11例)和无冻结步态(FOG--)组(19例)。分别对两组患者进行11C-CFT-DAT显像和临床运动评分,对11C-CFT-DAT显像结果与临床运动评分进行相关性分析。结果 FOG+组尾状核的纹状体不对称指数(SAI)显著增高(P=0.004);UPDRS运动评分与重侧(受累严重肢体对侧)尾状核与前壳核比值呈正相关(P=0.034);NFOGQ评分与重侧尾状核SAI呈负相关(P=0.020);冻结步态与尾状核SAI呈显著负相关(P=0.028)。结论双侧尾状核不对称性损害是导致PD患者冻结步态的重要原因,冻结步态可能是皮质-纹状体-脑干-躯体通路中不对称性损害的结果。     

百草枯急性干预对小鼠π型谷胱苷肽转硫酶mRNA表达的影响

目的:研究化学毒物百草枯(PQ)是否影响π型谷胱苷肽转硫酶(GSTP1)mRNA表达。方法:采用原位杂交方法观察PQ处理的小鼠脑内GSTP1mRNA的分布。不同时间窗处死小鼠,于不同脑区提取总RNA,RT-PCR扩增GSTP1。结果:GSTP1mRNA在正常小鼠脑内广泛表达。大剂量PQ(50mg·kg-1)导致脑内各部位GSTP1mRNA杂交显色明显降低,黑质-纹状体区域尤其显著。PQ20mg·kg-1腹腔注射后3h,中脑黑质区域GSTP1mRNA表达与对照组比明显降低(P=0.026);18h时纹状体GSTP1mRNA表达比对照组显著下降(P=0.044)。PQ50mg·kg-1腹腔注射,3h后中脑黑质区域和纹状体区域GSTP1mRNA表达与对照组比显著减少(P值分别为0.024和0.034);18h时黑质和皮质GSTP1mRNA的表达与对照组比显著下降(P值分别为0.008和0.037)。结论:PQ可影响小鼠黑质-纹状体区域神经元GSTP1mRNA的表达。因此,本研究提示PQ可能通过GSTP1增加罹患PD的风险。     

培高利特和左旋多巴对MPP^＋诱导的PC12细胞的作用

目的:研究不同剂量培高利特(pergolide)和左旋多巴(L-dopa)对MPP 诱导的PC12细胞的作用。方法:在细胞培养中用不同剂量的pergolide和L-dopa干预对MPP 所诱导的PC12细胞的影响。观察不同时点PC12细胞活力。酪氨酸羟化酶(TH)蛋白含量及细胞凋亡数。结果:0.01ìmol·L-1pergolid提高MPP 损害的PC12细胞的生长,细胞活力升高。0.01和0.1ìmol·L-1pergolid提高MPP 损害后的PC12细胞TH蛋白含量,减少该细胞的凋亡数。0.1ìmol·L-1L-dopa提高MPP 损害后PC12细胞的活力。随剂量递增细胞活力递量;当达1000ìmol·L-1L-dopa时细胞活力减少最明显。结论:提示小剂量pergolid对MPP 诱导的PC12细胞损害有一定的保护作用。高剂量则有一定的损伤。     

胰岛素对百草枯诱导的PC12细胞的保护作用

Objective To observe dopamine (DA) D2R protein expression in the cultured PC 12 cells and the effect of insulin on the survival rate,morphology,and DA of paraquat (PQ)-induced PC12 cells. Methods Immunoprecipitate Western blotting method was performed to observe DA D2R protein expression in PC 12 cells,MTT assay was used to analyze the changes in viability and morphology of PC 12 ceils which were exposed to different concentrations of PQ and insulin. Results (1) DA D2R protein was expressed in PC 12 ceils. (2) Normal PCI2 cells bodies showed fusiform shape and the synapses were in-tegrity. The cells which were exposed to the 600 μmol/L PQ became ball-like, vacuolar degeneration oc-urred,and the synapse became shorter or disappeared. But the morphology of PC12 cells had a little difference between the normal PC12 and the insulin groups,except that the cells were fusiform shape or a-nomalism but not round shape,and the synapses grew. (3) With the increase of the concentration of PQ, the viability of the cells was decreased. Insulin increased the viability of the ceils which were exposed to 600 μmol/L PQ. Insulin elevated DA concentration both in the normal PC12 cells and those exposed to 600 μmol/L PQ,but there was no significant difference ( P > 0.05 ). Conclusion Insulin could protect the PC12 dopaminergic neurons from injury induced by PQ.     

治疗帕金森病的不同药物对基底节多巴胺能系统的影响

目的:应用99mTc -TRODAT 1SPECT显像多巴胺转运体(DAT)和13 1I -epideprideSPECT显像多巴胺D2 受体,研究早期帕金森(PD)病人中用不同药物单一治疗14个月的随访情况。方法:72例早期(Hoehn&YahrⅠ～Ⅱ级)PD患者双盲、区组随机化方法分为4组,分别给予苯海索6mg·d-1(n =15 ) ;L 多巴制剂(美多巴2 5 0’,每天2 .5片) (n =2 2 ) ;L deprenyl(司来吉兰7.5mg·d-1) (n =2 2 ) ;多巴胺受体激动剂培高利特0 .5mg·d-1(n =13 )并随访14个月。分别在基线,随访7和14个月时,进行临床评分,同时以99mTc -TRODAT 1和13 1I -epidepride为配体,应用SPECT功能显像各组患者基底节区DAT和多巴胺D2 受体,比较不同治疗方案对基底节多巴胺能系统的影响情况。结果:99mTc -TRODAT 1SPECT显像结果显示,苯海索组和多巴制剂治疗组在治疗14个月后,基底节DAT均显著降低(P <0 .0 5 ) ,司来吉兰治疗组和多巴受体激动剂组在治疗7和14个月后,基底节区DAT虽有降低,但与基线比较无统计学意义(P >0 .0 5 )。随访14个月时,与对照组(苯海索组)比,仅受体激动剂组患者基底节区DAT值较高(P <0 .0 5 ) ,即减少程度最小。13 1I- epideprideSPECT显像结果显示,随访7和14个月时各组和基线比较均无显著差异,各组间亦无明显差异。结论:早期PD患者中,用多巴     

遗传性共济失调

遗传性共济失调是一组以脊髓、小脑、脑干为主的变性病,有时也累及周围神经、视神经、大脑等区域,病因不明。可能与遗传、生化代谢异常或尚未明确的内源性因素造成细胞变性有关。本文对遗传性共济失调的临床症状、分型和研究进展予以介绍。     

胰岛素对百草枯诱导的PC12细胞的保护作用

Objective To observe dopamine (DA) D2R protein expression in the cultured PC 12 cells and the effect of insulin on the survival rate,morphology,and DA of paraquat (PQ)-induced PC12 cells. Methods Immunoprecipitate Western blotting method was performed to observe DA D2R protein expression in PC 12 cells,MTT assay was used to analyze the changes in viability and morphology of PC 12 ceils which were exposed to different concentrations of PQ and insulin. Results (1) DA D2R protein was expressed in PC 12 ceils. (2) Normal PCI2 cells bodies showed fusiform shape and the synapses were in-tegrity. The cells which were exposed to the 600 μmol/L PQ became ball-like, vacuolar degeneration oc-urred,and the synapse became shorter or disappeared. But the morphology of PC12 cells had a little difference between the normal PC12 and the insulin groups,except that the cells were fusiform shape or a-nomalism but not round shape,and the synapses grew. (3) With the increase of the concentration of PQ, the viability of the cells was decreased. Insulin increased the viability of the ceils which were exposed to 600 μmol/L PQ. Insulin elevated DA concentration both in the normal PC12 cells and those exposed to 600 μmol/L PQ,but there was no significant difference ( P > 0.05 ). Conclusion Insulin could protect the PC12 dopaminergic neurons from injury induced by PQ.     

微囊化牛视网膜色素上皮细胞移植治疗帕金森大鼠的研究

目的： 观察微囊化牛视网膜色素上皮细胞（RPE）移植治疗帕金森病（PD）大鼠的疗效。方法： 酶消化法原代培养牛RPE细胞，纯化、传代后用高压静电微胶囊成型装置制作海藻酸钠-多聚赖氨酸微囊化细胞，将其立体定向移植入6-OHDA大鼠PD模型的右侧纹状体，移植分为NS组、RPE组、空微囊组（APA组）和微囊化RPE组（RPE-APA组）。观察移植后：阿朴吗啡诱导的旋转行为变化、移植侧纹状体中多巴胺和高香草酸含量的变化、移植区HE染色及TH免疫组化染色。结果： RPE-APA组阿朴吗啡诱发的旋转次数在移植后第2周开始减少，减少幅度为39.29％（与APA组相比，P<0.05），至第4周减少更加明显，减少幅度为：56.89％（与第2周相比，P<0.05），改善现象一直持续到第14周。行为学出现改善的大鼠纹状体多巴胺和高香草酸含量的增加同其阿朴吗啡诱发的旋转次数的减少相符合。行为学有改善的大鼠囊内细胞TH染色呈弱阳性，微囊周边的纹状体可见TH阳性纤维密度较APA组高。结论： 微囊化牛RPE细胞对6-OHDA大鼠PD模型有治疗作用，是一种前景良好的新型供体。     

脑胶质瘤病

目的 探讨脑胶质瘤病（GC）的诊断和治疗。方法 对本院神经外科1982－1997年间收治的13例GC进行回顾性研究。结果：GC临床表现以头痛（11／13）和癫痫（4／13）为常见,后期多出现严惩颅高压片象。病灶弥漫性生长6例,多发性生长7例,9例行开颅手术,3例行立体定向穿刺活检,1例行尸检,病理诊断：星形胶质瘤I级7例,星形胶质瘤I－II级2例,星形胶质瘤II级2例,少枝胶质瘤I级1例,少枝－星形混合胶质瘤II级1例,平均生存期为5．75月,结论 讨论了GC的发生,临床表现,影像学特点,病理特点,治疗方法以及预后。