心肌营养素1修饰的神经干细胞移植对癫(癎)持续状态大鼠海马损伤及苔藓纤维发芽的影响

Objective To observe the survival,migration and differentiation of grafted neural stem cells(NSCs)transfected with cardiotrophin-1(CT1)in hippocampus in status epilepticus(SE)rats,and investigate its effect on neuron loss and mossy fiber sprouting(MFS)in hippocampus of SE rats.Methods (1)Lithium-pilocarpine induced SE model rats were divided into 3 groups randomly:CT1-NSCs transplantation group(n=18);NScs transplantation group(n=18)and SE model group(n=18).Another 18 rats served as normal control group.Each group was further divided into 3 time points testing groups(n=6 at each point)corresponding to 1,4 and 8 weeks after transplantation respectively.(2)Under the confocal microscopy,the survival,migration and differentiation of the grafted cells were observed by immunofluorescenee.(3)Morphological changes and neuron loss in the hippocampal CA1 region were examined by Nissl staining.(4)MFS in hippocampal dentate gyrus in rats was obserred by Timm histochemistry.Results(1)At 4 and 8 weeks post-tmusplantation,the numbers of double-labeled NF-200 and EGFP pesitive cells in the CT1-NSCs group were significantly hisher than those in NSCs group.In the former group most of the grafted NSCs migrated away from the needle tract,but in the latter group,grafted ceHs remained at the transplantation site.(2)The numbers of neuron in the hippocampal CA1 region reduced gradually after SE.The numbers of neuron in the CA1 region in CT1-NSCs transplantation rats (68.85±11.49,60.89±12.17 and 51.51±13.34 in 1,4,8 weeks after transplantation respectivelv)were greater than that in NSCs transplantation rats(67.92±10.78,42.56±11.47 and 30.49±10.12).tvalue were 4.650 and 5.334 in 4 and 8 weeks after transplantation(P<0.05).(3)Aberrant MFS in the inner molecular layer of dentate gyrus was observed,and the scores of MFS gradually increased with timelapse.The scores of MFS in CT1-NSCs transplantation rats(0.77±0.04,2.48±0.89 and 2.39±0.82 in 1,4,8 weeks after transplantation respectively)were significant lower than that in NSCs transplantation rats (1.12±0.62,3.17±0.64 and 3.88±0.51,t=6.059,9.511 and 9.728,P<0.05).Conclusions CT1 could promote the survival,migration and differentiation of engrafted NSCs in hippocampud in SE rats.Engrafted NSCs transfected with CT1 have effect on repair of the injured hippocampus,and could inhibit hippocampus MFS in SE rats.     

SMC1A基因新生突变致Cornelia de Lange综合征2型2例

分析2019年3月遵义医科大学附属医院收治的Cornelia de Lange综合征(CdLs)患儿2例的临床资料及基因变异结果。2例均在婴儿期起病,表现为难治性癫痫,均伴发育落后及特殊外貌,基因检测显示X染色体上 SMC1A基因突变,例1为c.2561dupA(p.K854fs)移码突变;例2为c.3441...     

伴中央颞区棘波儿童良性癫(癎)的不典型表现

目的 探讨不典型儿童良性癫(癎)伴中央颞区棘波(BECT)患儿的临床特点、认知、脑电图特点及患儿对治疗的反应.方法 分析及随访9例(男5例,女4例;起病年龄3岁～8岁2个月,平均5岁3个月.起病前精神运动发育正常)诊断为不典型BECT患儿的临床特点、智力、认知、脑电图特点及对治疗的反应.结果 9例中4例出现脑电图慢波睡眠电持续状态(ESES),并伴有发作频率增加及明显的神经精神症状,经抗癫(癎)药物(AEDs)治疗发作控制,3例脑电图得到改善,但3例患儿仍伴有较明显的行为及认知问题.1例出现癫(癎)性失语,还表现有淡漠、孤独症样表现伴脑电图恶化,经AEDs 治疗发作及脑电图明显改善,随访3 a仍少语、表达困难.2例病程中出现难以控制的频繁局限运动性发作,伴注意力缺陷及多动,脑电图放电频率增多,对多种AEDs反应不佳,但1.0 a及1.5 a后自然缓解.2例出现不典型失神,伴有精神行为症状,亦伴脑电图恶化,换用丙戊酸或加用氯硝西泮后发作控制,脑电图好转,精神行为症状部分改善.结论 BECT存在较为不典型的复杂多样的演变过程,因存在认知障碍方面的缺陷,其良性预后应受到挑战.     

偏侧惊厥-偏瘫-癫(间)综合征的临床特点及诊断

目的探讨偏侧惊厥-偏瘫-癫癎(HHE)综合征的临床特点及诊断。方法对5例HHE综合征患儿的临床资料进行回顾性分析,总结临床特征及其发病的危险因素,进行必要的辅助检查,包括头颅CT和(或)MRI、脑电图及诊断性智力测定或精神运动发育评价。结果4例4岁内起病,3例伴热性惊厥,最长惊厥时间均在2 h以上,并惊厥侧肢体偏瘫。5例均在偏瘫后2年内出现癫癎反复发作。4例为局限性运动发作,1例为精神运动性发作。5例均存在智力障碍或精神发育迟滞。头颅MRI检查4例发现左侧海马硬化,1例CT示右半球萎缩。脑电图均异常,4例见异常放电,1例示明显不对称。5例均予卡马西平为主的药物治疗,癫癎发作得到控制或部分控制。结论HHE综合征是持续偏侧惊厥导致的偏瘫-癫癎综合征,海马硬化可能是反复癫癎所致海马的继发性损伤,而非癫癎的起源灶。应提高对该病的认识,早期正确处理惊厥持续状态将减少HHE综合征发生。     

心肌营养素1修饰的神经干细胞移植对癫(癎)持续状态大鼠海马损伤及苔藓纤维发芽的影响

Objective To observe the survival,migration and differentiation of grafted neural stem cells(NSCs)transfected with cardiotrophin-1(CT1)in hippocampus in status epilepticus(SE)rats,and investigate its effect on neuron loss and mossy fiber sprouting(MFS)in hippocampus of SE rats.Methods (1)Lithium-pilocarpine induced SE model rats were divided into 3 groups randomly:CT1-NSCs transplantation group(n=18);NScs transplantation group(n=18)and SE model group(n=18).Another 18 rats served as normal control group.Each group was further divided into 3 time points testing groups(n=6 at each point)corresponding to 1,4 and 8 weeks after transplantation respectively.(2)Under the confocal microscopy,the survival,migration and differentiation of the grafted cells were observed by immunofluorescenee.(3)Morphological changes and neuron loss in the hippocampal CA1 region were examined by Nissl staining.(4)MFS in hippocampal dentate gyrus in rats was obserred by Timm histochemistry.Results(1)At 4 and 8 weeks post-tmusplantation,the numbers of double-labeled NF-200 and EGFP pesitive cells in the CT1-NSCs group were significantly hisher than those in NSCs group.In the former group most of the grafted NSCs migrated away from the needle tract,but in the latter group,grafted ceHs remained at the transplantation site.(2)The numbers of neuron in the hippocampal CA1 region reduced gradually after SE.The numbers of neuron in the CA1 region in CT1-NSCs transplantation rats (68.85±11.49,60.89±12.17 and 51.51±13.34 in 1,4,8 weeks after transplantation respectivelv)were greater than that in NSCs transplantation rats(67.92±10.78,42.56±11.47 and 30.49±10.12).tvalue were 4.650 and 5.334 in 4 and 8 weeks after transplantation(P<0.05).(3)Aberrant MFS in the inner molecular layer of dentate gyrus was observed,and the scores of MFS gradually increased with timelapse.The scores of MFS in CT1-NSCs transplantation rats(0.77±0.04,2.48±0.89 and 2.39±0.82 in 1,4,8 weeks after transplantation respectively)were significant lower than that in NSCs transplantation rats (1.12±0.62,3.17±0.64 and 3.88±0.51,t=6.059,9.511 and 9.728,P<0.05).Conclusions CT1 could promote the survival,migration and differentiation of engrafted NSCs in hippocampud in SE rats.Engrafted NSCs transfected with CT1 have effect on repair of the injured hippocampus,and could inhibit hippocampus MFS in SE rats.     

心肌营养素1修饰的神经干细胞移植对癫(癎)持续状态大鼠海马损伤及苔藓纤维发芽的影响

Objective To observe the survival,migration and differentiation of grafted neural stem cells(NSCs)transfected with cardiotrophin-1(CT1)in hippocampus in status epilepticus(SE)rats,and investigate its effect on neuron loss and mossy fiber sprouting(MFS)in hippocampus of SE rats.Methods (1)Lithium-pilocarpine induced SE model rats were divided into 3 groups randomly:CT1-NSCs transplantation group(n=18);NScs transplantation group(n=18)and SE model group(n=18).Another 18 rats served as normal control group.Each group was further divided into 3 time points testing groups(n=6 at each point)corresponding to 1,4 and 8 weeks after transplantation respectively.(2)Under the confocal microscopy,the survival,migration and differentiation of the grafted cells were observed by immunofluorescenee.(3)Morphological changes and neuron loss in the hippocampal CA1 region were examined by Nissl staining.(4)MFS in hippocampal dentate gyrus in rats was obserred by Timm histochemistry.Results(1)At 4 and 8 weeks post-tmusplantation,the numbers of double-labeled NF-200 and EGFP pesitive cells in the CT1-NSCs group were significantly hisher than those in NSCs group.In the former group most of the grafted NSCs migrated away from the needle tract,but in the latter group,grafted ceHs remained at the transplantation site.(2)The numbers of neuron in the hippocampal CA1 region reduced gradually after SE.The numbers of neuron in the CA1 region in CT1-NSCs transplantation rats (68.85±11.49,60.89±12.17 and 51.51±13.34 in 1,4,8 weeks after transplantation respectivelv)were greater than that in NSCs transplantation rats(67.92±10.78,42.56±11.47 and 30.49±10.12).tvalue were 4.650 and 5.334 in 4 and 8 weeks after transplantation(P<0.05).(3)Aberrant MFS in the inner molecular layer of dentate gyrus was observed,and the scores of MFS gradually increased with timelapse.The scores of MFS in CT1-NSCs transplantation rats(0.77±0.04,2.48±0.89 and 2.39±0.82 in 1,4,8 weeks after transplantation respectively)were significant lower than that in NSCs transplantation rats (1.12±0.62,3.17±0.64 and 3.88±0.51,t=6.059,9.511 and 9.728,P<0.05).Conclusions CT1 could promote the survival,migration and differentiation of engrafted NSCs in hippocampud in SE rats.Engrafted NSCs transfected with CT1 have effect on repair of the injured hippocampus,and could inhibit hippocampus MFS in SE rats.     

永存动脉干(附二例报告)

永存动脉干(Persistent truncus arteriosus,PTA)是一少见的青紫型先心病,占先心病的0.8％。其病理表现多种多样,临床诊断较困难。现将本院经尸检后证实的二例报告如下: 临床资料例一:男性,8岁,活动后气促心悸半年入院。自幼常感冒,多汗,哭闹后口唇发绀,运动耐力差。体查:生长发育尚可,口唇青柴,见杵状指(趾),胸骨左缘第2—4肋间闻及Ⅱ/Ⅳ吸     

生物反馈对儿童抽动障碍疗效研究

目的比较生物反馈和泰必利对抽动障碍患儿的治疗效果,为临床治疗抽动障碍提供参考。方法采用随机对照试验方法,将未经治疗的抽动障碍患儿45例,随机分为生物反馈组23例和泰必利组22例。生物反馈组采用生物反馈治疗仪给予强化感觉运动节律（SMR）波,降低肌电（MyoScan）、皮电（SC）,升高皮温（TEMP）治疗;泰必利组口服泰必利片治疗。抽动障碍严重程度采用耶鲁全面抽动严重程度量表（YGTSS）进行评价,同时记录不良反应情况。结果①生物反馈治疗20次有效率（78.26%）与泰必利组（81.82%）比较无统计学差异（χ2=1.87,P〉0.05）。生物反馈治疗40次有效率进一步增高（91.3%）。6mo随访时生物反馈组21例（91.30%）可维持疗效,较泰必利组14例（63.64%）高,差异显著（χ2=11.92,P〈0.05）。②二组治疗后YGTSS总评分均明显降低（P〈0.05）,生物反馈40次较20次更低（P〈0.05）。生物反馈组随访6mo评分仍维持在治疗后水平,明显低于泰必利组（t=2.73,P〈0.05）。③不良反应：生物反馈组无不良反应,泰必利组16例发生不良反应。结论生物反馈治疗儿童抽动障碍临床疗效与传统药物泰必利疗效相似,但疗效更持久稳定,且无不良反应。     

儿童假性甲状旁腺功能减低症一例报告并文献复习

儿童假性甲状旁腺功能减低症是临床上少见的一种先天性遗传病,常表现为手足搐搦,癫痫样发作,低血钙、高血磷等生化特点,临床表现复杂多样,易与癫痫等其它有类似发作的疾病相混淆,从而导致误诊和漏诊。现总结1例就诊于我院的儿童假性甲状旁腺功能减低症患儿的临床表现及治疗过程,报告如下。