海马局部脑组织血流量和神经元特征性变化与半胱氨酸天冬氨酸蛋白酶8介导癫痫大鼠的关系

目的:检测半胱氨酸天冬氨酸蛋白酶8在癫痫大鼠海马神经元的表达及其与癫痫发作大鼠局部脑血流量和神经元变化的关系。方法:实验于2002-05/2003-10在复旦大学神经病研究所完成。选择清洁级SD雄性大鼠60只,随机分为①正常对照组6只:杏仁核注射磷酸盐缓冲液。②空白对照组6只:磷酸盐缓冲液(脑室)+磷酸盐缓冲液(杏仁核内)。③单纯癫痫组36只:杏仁核内注射红藻氨酸诱发癫痫发作,发作1h后经股静脉注射安定(30mg/kg)终止发作,根据处死大鼠的时间点分0,2,4,8,24,72h6组,每组6只大鼠。④试验给药组6只:半胱氨酸天冬氨酸蛋白酶8抑制剂z-IETD-fmk(脑室,0.3μg于红藻氨酸注射前20min,5min及红藻氨酸注射后1h分3次给药)+红藻氨酸(杏仁核内)。⑤实验对照组6只:磷酸盐缓冲液(脑室)+红藻氨酸(杏仁核内);均于安定注射终止发作后24h处死大鼠。结果评估:①激光多普勒血流测定仪记录局部脑血流。②用脱氧核糖核酸末端转移酶介导的缺口末端标记染色和cresylviolet染色观察海马神经元凋亡和存活的变化及半胱氨酸天冬氨酸蛋白酶8抑制剂z-IETD-fmk对海马CA3区的脱氧核糖核酸末端转移酶介导的缺口末端标记阳性细胞和存活细胞的影响。③用免疫荧光和蛋白印迹检测海马半胱氨酸天冬氨酸蛋白酶8的表达。结果:造模过程中有2只大鼠死亡,     

A Pilot Study on the Relationship between Tongue Manifestation and the Degree of Neurological Impairment in Patients with Acute Cerebral Infarction

Objective:To discuss the relationship between tongue manifestation and the degree of neurological impairment in the patients with acute cerebral infarction.Methods:Two hundred patients with first unilateral cerebral infarction were recruited.The relationship between different tongue manifestation and National Institute of Health Stroke Scale(NIHSS) were analyzed.Results:NIHSS scores in the patients from different tongue color groups were analyzed and further analysis demonstrated that the NIHSS score was higher in the patients with red or bluish-purple tongue than that of those with the pink(P<0.01).On tongue fur,the NIHSS score in the patients with thick fur was higher than that of those with the thin(P=0.003).NIHSS score in patients with slippery,moist or dry fur was significant different(P=0.003),Further analysis demonstrated that the NIHSS score was higher in the patients with dry fur than that of those with moist fur,and had statistical significance(P=0.01).The NIHSS score was higher in patients from greasy fur group than that of the non-greasy(P=0.002).There was significant difference of NHISS score in the patients with different fur color(P=0.000),and further analysis demonstrated that the NHISS score in white-yellow,yellow fur group were higher than that of the white(P=0.06 or 0.000).Conclusion:The changes of tongue manifestation might be associated with the degree of neurological impairment in the patients with acute cerebral infarction.     

大鼠蛛网膜下腔出血模型的研究进展

蛛网膜下腔出血（subarachnoid hemorrhage,SAH）是一种具有极强危害性的出血性脑血管病,近年来,尽管在蛛网膜下腔出血的诊断和治疗方面取得了明显的进步,但其高死亡率和高致残率并未得到有效控制,原因在于其发病机制至今尚未完全阐明。因此,寻找一种理想的蛛网膜下腔出血动物模型将对其病理生理机制及临床防治的研究起到巨大的推动作用。本文介绍了多种大鼠蛛网膜下腔出血模型的制作方法、优缺点以及应用范围,期望对今后SAH的基础与临床研究提供帮助。     

从脾胃浅论现代人脑中风的风险因素

现代医学通过多中心临床观察,发现了越来越多的脑中风危险因素,临床上将这些危险因素分为不可干预因素和可干预因素两类.前者包括年龄、性别、种族等;后者包括高血压、糖尿病、心血管疾病、血脂、同型半胱氨酸、尿酸、心磷脂抗体异常、动脉硬化、代谢综合征、感染、血液病等疾病以及吸烟、酗酒等不健康的生活方式.     

小鼠脑缺血神经功能障碍行为学评价的研究进展

在脑缺血及脑缺血-再灌注损伤的研究中,小鼠的可逆性大脑中动脉阻塞(middle cerebral arteryocclusion,MCAO)模型应用广泛。除了测量脑梗死体积外,神经功能缺损的行为学评价也是判定脑缺血严重程度的重要指标。其评价指标大多移植于大鼠的评价体系,方法较多,没有统一的评价标准,本文对小鼠脑缺血后神经功能损伤的行为学评价方法及各自的优缺点及侧重点做一综述。     

长期远隔后适应对脑缺血再灌注大鼠脑组织神经中丝200表达的影响

目的研究长期远隔缺血后适应对大鼠局灶性脑缺血再灌注损伤后脑组织神经中丝200(NF200)表达的影响。方法应用线栓法制作大鼠大脑中动脉缺血2 h再灌注损伤模型,再灌注即刻给予远端肢体缺血后适应,即双侧股动脉夹闭10 min/放开10 min,反复3次。此后每天给予一次远端肢体缺血后适应。实验分为4组:缺血再灌注7 d组(C7组);缺血再灌注后适应7d组(P7组);缺血再灌注28 d组(C28组);缺血再灌注后适应28 d组(P28组)。每组6只大鼠。采用免疫印迹法研究各组大鼠脑组织中NF200蛋白的表达水平,并采用免疫荧光法观察大鼠脑组织NF200蛋白的表达部位。结果 P7组大鼠脑组织内NF200表达比C7组明显增高(P<0.05),P28组大鼠脑组织内NF200表达比C28组及P7组明显增高(P均<0.05),而C28组大鼠与C7组相比脑组织内NF200表达无明显变化。免疫荧光染色结果显示NF200在神经元胞体及轴突中均有表达。结论长期远隔缺血后适应可增加大鼠脑组织内NF200的表达,可能与减轻脑缺血损伤相关。     

支架成形术治疗特发性颅高压综合征合并静脉窦狭窄的疗效

目的 探讨支架成形术治疗特发性颅高压(IIH)综合征合并静脉窦狭窄(CVSS)的疗效和安全性.方法 25例诊断难治型IIH合并局限性CVSS患者行静脉窦造影及压力测定,对其中狭窄两端压力差超过150mm H2O(1 mm H2O=0.0098 kPa)的14例患者行支架成形术治疗.术后检测静脉窦的形态、压力差、临床改善情况.随访6个月以上,观察并发症和静脉窦是否通畅.结果 所有患者支架成形术成功.术后未出现相关并发症,高颅压症状迅速缓解.随访期间临床症状无复发,DSA或磁共振静脉成像(MRV)检查显示静脉窦血流通畅,无再狭窄.结论 对于存在CVSS的IIH患者,血管内支架成形术治疗可能是一种相对安全、有效的治疗手段.     

支架成形术治疗特发性颅高压综合征合并静脉窦狭窄的疗效

Objective To explore the diagnosis of cerebral venous sinus stenosis (CVSS) in idiopathic intraeranial hypertension(IIH),and to evaluate the efficacy and risk of venous sinus stenting treatment for CVSS.Methods Twenty-five patients with refractory IIH complicated with CVSS underwent examination with magnetic resonance venography(MRV),digital subtraction angiography(DSA)and direct retrograde cerebral venography and inanometry to confirm morphologic features of IIH and measure venous pressures.14 patients who showed severe stenosis of venous sinuses with the pressure gradient across the stenosis＞150 mm H2O(1mm H2O=0.0098 kPa)were treated with venous sinus stenting and were followed-up for more than 6 months.Intrasinus pressures and clinical progression were evaluated after the procedure.The IIH related clinical presentation,complications and the venous sinus condition were accessed during the follow-up period. Results Sinus stenting angioplasty was succeeded in all 14 patients.In all patients,venous sinus stenosis was improved after stenting procedure(the residual stenosis rate＜5%)and intrasinus pressure was reduced (the pressure gradient vanished or ＜20 mm H2O).The clinical symptoms in all the patients were impmved or disappeared at discharge and intracranial pressures were normalized within 3 monks after the procedure.During the follow-up period of (22.3±19.0) months (range 6 to 72 months),no patient had recurrence of IIH.In all cases,DSA or MRV was performed at 6-month follow-up and demonstrated absence of sinus thrombosis and stenosis.Conclusions Patients with IIH should be assessed for CVSS.MRV or DSA was recommended for these patients as a routine work-up.Cerebral venography and mauometry are helpful to evaluate the relation between venous ontflow obstruction and intracranial hypertension.If severe CVSS is presented in patient,endovascular treatment of venous sinus stenting shows promise as an alternative treatment. Additional randomized and controlled clinical research on treatment of CVSS is needed.     

大鼠超急性期脑缺血的磁共振扩散加权成像研究

目的：利用磁共振扩散加权成像（DWI）评价大鼠超急性期脑缺血的诊断价值。方法：12只Wistar雄性大鼠,采用线栓法制作右侧大脑中动脉闭塞（MCAO）脑缺血模型,分别于栓塞后1h和6h行大鼠冠状位磁共振DWI、T2WI和T1WI检查,并测量缺血区DWI异常高信号的体积、表观扩散系数（ADC）值,将所测值进行比较。磁共振检查结束后处死大鼠,断头取脑行TTC染色,并与DWI结果进行比较。结果：大鼠MCAO后1h进行MRI扫描右侧大脑中动脉供血区DWI可见异常稍高信号,ADC为低信号,T2WI和T1WI均未见异常信号;MCAO后6hDWI可见明显高信号,较1hADC值显著减低（P〈0.01）,DWI上梗死灶体积显著扩大（P〈0.01）,T2WI显示缺血区异常高信号,T1WI可见稍低信号。TTC染色者均显示脑梗死灶,与MCAO后6h的DWI显示脑缺血范围一致。结论：DWI对超急性期脑梗死较常规MRI敏感,是超急性期脑缺血重要的检查方法。