亚低温对急性重型颅脑损伤患者血清S-100 B蛋白的影响

Objective To dynamically observe the effect of mild hypothermia on concentration of plasma S-100B protein in patients with acute severe brain injuries so as to further explore its role in treat-ment of acute severe brain injury. Methods A total of 120 patients with acute severe brain injuries were randomly divided into mild hypothermia group and general group. The patients in mild hypothermia group were treated with mild hypothermia besides conventional therapy, with maintenance of rectal tem-perature at 33℃-35℃ for 3-5 days. Serial concentration of S-IOOB protein in serum was measured in all patients from 6 hours to 6 days after hospitalization. GOS evaluation was done three months after treat-ment. Results The concentration of S-100B protein in serum of mild hypothermia group and general group was significantly higher than of normal group (P <0.05), with significant lower level in mild hypo-thermia group than general group(P <0.05). Mild hypothermia could improve prognosis of patients with acute severe brain injury. Conclusions Early use of mild hypothermia can decrease concentration of S-100B protein in serum, protect neurofunction and improve prognosis, as may be related to its function in alleviating damnification brain cell inflammation reaction mediated by S-100B protein.     

亚低温对急性重型颅脑损伤患者血清S-100 B蛋白的影响

Objective To dynamically observe the effect of mild hypothermia on concentration of plasma S-100B protein in patients with acute severe brain injuries so as to further explore its role in treat-ment of acute severe brain injury. Methods A total of 120 patients with acute severe brain injuries were randomly divided into mild hypothermia group and general group. The patients in mild hypothermia group were treated with mild hypothermia besides conventional therapy, with maintenance of rectal tem-perature at 33℃-35℃ for 3-5 days. Serial concentration of S-IOOB protein in serum was measured in all patients from 6 hours to 6 days after hospitalization. GOS evaluation was done three months after treat-ment. Results The concentration of S-100B protein in serum of mild hypothermia group and general group was significantly higher than of normal group (P <0.05), with significant lower level in mild hypo-thermia group than general group(P <0.05). Mild hypothermia could improve prognosis of patients with acute severe brain injury. Conclusions Early use of mild hypothermia can decrease concentration of S-100B protein in serum, protect neurofunction and improve prognosis, as may be related to its function in alleviating damnification brain cell inflammation reaction mediated by S-100B protein.     

VEGF、纤维蛋白原及D-二聚体在慢性硬膜下血肿中的作用及临床意义

目的研究血管内皮生长因子(VEGF)、纤维蛋白原(Fibrinogen)及D-二聚体(D-dimer)与慢性硬膜下血肿(CSDH)发病机制及复发的关系。方法测定74例CSDH患者(包括7例术后复发病人)静脉血及血肿液中VEGF、纤维蛋白原及D-二聚体三种因子的含量,测定9例健康人静脉血中3种因子的含量作为对照。结果①CSDH患者血肿液中VEGF、D-二聚体的含量明显高于静脉血中的含量(P<0.05),而纤维蛋白原的含量明显低于静脉血中的含量(P<0.05);②CSDH术后复发患者血肿液中VEGF、D-二聚体的含量明显高于未复发患者(P<0.05),而复发患者纤维蛋白原的含量明显低于未复发患者(P<0.05);③CSDH患者静脉血中3种因子含量与健康人静脉血比较,差异无统计学意义(P>0.05)。结论 VEGF、Fibrinogen及D-dimer在CSDH的发病机制及复发中起重要作用。     

经颅多普勒监测通心络胶囊对高血压脑出血后脑血管痉挛的治疗作用

目的 分析经颅多普勒(TCD)监测通心络胶囊对高血压脑出血后脑血管痉挛(CVS)的治疗价值. 方法 将70例有症状并经TCD证实有CVS的高血压脑出血患者采用数字随机表法随机分为两组,即常规西医治疗组35例,通心络胶囊治疗组35例.通心络胶囊治疗组在常规西医治疗的基础上加用通心络胶囊治疗,治疗期间根据患者症状变化动态检测TCD,包括大脑中动脉(MCA)及椎动脉(VA)腩血流速度,分析通心络胶囊对CVS的治疗效果. 结果 通心络胶囊组血管痉挛的改善程度明显优于对照组,且CVS恢复正常所需要时间也短于对照组(P＜0.05). 结论 TCD是监测CVS的有效方法,通心络胶囊对高血压脑出血后脑血管痉挛及相关临床症状有明显的改善作用.     

手术治疗妊娠合并脑内海绵状血管瘤破裂出血

脑血管病是危害健康的常见病．发病率、病残率、病死率高．而发生于妊娠分娩期的脑血管病直接影响母子两代．海绵状血管瘤是脑血管畸形中较常见的一种，属于血管错构的出血性病变。妊娠合并脑内海绵状血管瘤破裂出血临床上少见，笔者报告1例典型病例并结合文献复习讨论其临床特点、诊断及治疗方法．     

亚低温对急性重型颅脑损伤患者血清S-100 B蛋白的影响

Objective To dynamically observe the effect of mild hypothermia on concentration of plasma S-100B protein in patients with acute severe brain injuries so as to further explore its role in treat-ment of acute severe brain injury. Methods A total of 120 patients with acute severe brain injuries were randomly divided into mild hypothermia group and general group. The patients in mild hypothermia group were treated with mild hypothermia besides conventional therapy, with maintenance of rectal tem-perature at 33℃-35℃ for 3-5 days. Serial concentration of S-IOOB protein in serum was measured in all patients from 6 hours to 6 days after hospitalization. GOS evaluation was done three months after treat-ment. Results The concentration of S-100B protein in serum of mild hypothermia group and general group was significantly higher than of normal group (P <0.05), with significant lower level in mild hypo-thermia group than general group(P <0.05). Mild hypothermia could improve prognosis of patients with acute severe brain injury. Conclusions Early use of mild hypothermia can decrease concentration of S-100B protein in serum, protect neurofunction and improve prognosis, as may be related to its function in alleviating damnification brain cell inflammation reaction mediated by S-100B protein.     

亚低温对急性重型颅脑损伤患者血清S-100 B蛋白的影响

Objective To dynamically observe the effect of mild hypothermia on concentration of plasma S-100B protein in patients with acute severe brain injuries so as to further explore its role in treat-ment of acute severe brain injury. Methods A total of 120 patients with acute severe brain injuries were randomly divided into mild hypothermia group and general group. The patients in mild hypothermia group were treated with mild hypothermia besides conventional therapy, with maintenance of rectal tem-perature at 33℃-35℃ for 3-5 days. Serial concentration of S-IOOB protein in serum was measured in all patients from 6 hours to 6 days after hospitalization. GOS evaluation was done three months after treat-ment. Results The concentration of S-100B protein in serum of mild hypothermia group and general group was significantly higher than of normal group (P <0.05), with significant lower level in mild hypo-thermia group than general group(P <0.05). Mild hypothermia could improve prognosis of patients with acute severe brain injury. Conclusions Early use of mild hypothermia can decrease concentration of S-100B protein in serum, protect neurofunction and improve prognosis, as may be related to its function in alleviating damnification brain cell inflammation reaction mediated by S-100B protein.     

新型超顺磁性氧化铁在雪旺细胞移植后活体示踪中的应用研究

目的：研究一种新型超顺磁性氧化铁（Superparamagnetic iron oxide,SPIO）在雪旺细胞（SCs）标记及磁共振（MRI）活体示踪中的应用。方法： 以二巯基丁二酸修饰三氧化二铁（Fe2O3）配制成一种新型SPIO,用于标记SCs。实验组用SPIO标记SCs,对照组不用SPIO标记,每组各10个样本。对标记后的SCs行普鲁士蓝染色鉴定、MTT测试细胞相对数量。最后将标记后的SCs移植入大鼠脑内,MRI扫描活体示踪。结果： 普鲁士蓝染色发现该SPIO可高效率标记SCs,MTT测试表明实验组与对照组的雪旺细胞相对数量无统计学差异（P〉0．05）,MRI检查发现脑内移植的SPIO标记SCs在T。相上呈明显的低信号。结论：通过二巯基丁二酸修饰Fe2O2获得了新型SPIO,该新型SPIO对细胞增殖及活力无明显影响,不需要转染剂仍可高效率标记SCs,MRI活体显影示踪效果良好。     

组织工程脊髓支架材料:聚乳酸-羟基乙酸最佳孔径的筛选

背景:细胞支架是细胞生长的载体,其孔径是影响组织工程脊髓疗效的重要因素之一.目的:通过将神经干细胞与不同孔径的聚乳酸-羟基乙酸(poly lactic-co-glycolic acid,PLGA)支架体外复合培养,筛选确立组织工程脊髓支架材料的最佳孔径.方法:取传第1代的神经干细胞悬液50 pL(细胞数10~(10)L~(-1)),分别种植在孔径200～300 μm、400-500 μm的PLGA支架上复合培养7 d,得到两种组织工程脊髓.30只大鼠均建立脊髓损伤模型,造模后分为3组,分别在脊髓缺损处立即填塞上述两种组织工程脊髓,空白对照组在缺损处不进行材料移植.倒置相差显微镜及电镜下观察神经干细胞在PLGA支架中的生长增殖与分布,MTT检测两种组织工程脊髓所含神经干细胞的相对数量,采用BBB运动功能评分比较不同孔径的组织工程脊髓的移植疗效.结果与结论:镜下神经干细胞在各孔径材料上均紧密贴附并增殖分化,组织相容性良好.共培养7 d后,孔径200～300 μmPLGA支架组、孔径400-500 μm PLGA支架组的吸光度值基本相似(P>0.05),说明PLGA支架的孔径大小对培养的神经干细胞增殖数量无明显影响.移植第4周与空白对照组比较,孔径200-300 μm PLGA支架组、孔径400～500 μm PLGA支架组大鼠的神经功能均有不同程度恢复,BBB运动功能评分均明显升高(P<0.05),且孔径200-300 μm的PLGA支架其移植效果更好.     

新型超顺磁性氧化铁在干细胞活体示踪中的应用研究

目的：研究超顺磁性氧化铁（superparamagnetic iron oxide,SP10）标记干细胞的效率及其在磁共振活体示踪中的应用价值。方法：以3-氨丙基三乙氧基硅烷（APTS）修饰Fe2O3配制成SP10,用SP10转染标记骨髓间充质干细胞（MSCs）,对标记后的MSCs行普鲁士蓝染色鉴定、MTT测试细胞相对数量。最后将标记后的MSCs移植入大鼠脑内,磁共振（MRI）扫描示踪显示。结果：普鲁士蓝染色可直接显示SP10高效率标记MSCs,MTT测试表明SP10标记对MSCs增殖数量及其活力无明显影响,MRI检查发现脑内移植的SP10标记MSCs在T2上呈明显的低信号。结论：APTS修饰Fe2O3配制而成的新型SP10对细胞无明显毒性,没有多聚赖氨酸（PLL）等转染剂仍可直接高效率标记MSCs,MRI活体显影示踪效果良好。