脑卒中偏瘫康复训练程序化研究

目的 :观察脑卒中偏瘫患者进行康复训练的疗效。方法 :2 2例脑卒中患者 :康复组 12例 ,对照组 10例。 2组均接受神经科常规药物治疗。康复组按“中风后程序化康复训练表”进行康复训练 ,分别于康复前、康复后 1月和 3月进行疗效评定。结果 :日常生活活动能力量表 (ADL)测评结果显示 :康复组有效率 83 3% (10 / 12 ) ,对照组 30 % (3/10 ) ,2组差别有显著意义 (P <0 0 5 )。神经功能缺损评分结果显示 :康复组有效率 91 7% (11/ 12 ) ,对照组 4 0 % (4 / 10 ) ,2组差别有显著意义 (P <0 0 1)。结论 :康复训练能降低脑卒中偏瘫患者的致残率 ,提高生活质量。     

磁共振弥散加权成像在脑脓肿与坏死囊变性脑肿瘤鉴别诊断中的价值

目的　评价磁共振弥散加权成像 (diffusiionwieghtedimaging ,DWI) ,在脑脓肿与坏死囊变性脑肿瘤鉴别诊断中的价值。方法　 12例经手术病理 ( 10例 )或临床随访 ( 2例 )证实的脑脓肿和 5 0例经手术病理证实的坏死囊变性脑脓肿 (其中星形细胞瘤 2 8例、脑转移瘤 10例、血管母细胞瘤 6例、听神经瘤 6例 ) ,在术前或治疗前接受了常规MRI检查及DWI。结果　脑脓肿 (脓腔 )在DWI上表现为明显的高信号 ,而脑肿瘤坏死囊变区表现为低信号。结论　DWI对脑脓肿与坏死囊变性脑肿瘤的鉴别诊断具有重价值 ,应与常规MRI序列一起列为基本序列。     

急性重型颅脑损伤ET和CGRP含量变化及其临床意义

目的　探讨急性重型颅脑损伤 (ASBI)患者血浆中内皮素 (ET)和降钙素基因相关肽 (CGRP)的含量变化及其临床意义。方法　用放免法测定 2 8例ASBI患者伤后 6～ 2 4h血浆中ET及CGRP含量。结果　ASBI患者ET含量明显增多 ,差别有显著性 (P <0 .0 5 ) ;CGRP也有一定的增多 ,但无显著性差异。结论　ET和CGRP共同参与ASBI病理生理反应过程 ,ET释放增加是加重脑继发性损害的重要因素     

应用胰岛素对颅脑外伤后高血糖预后探讨

目的:探讨及早应用胰岛素对颅脑外伤后高血糖患者治疗转归的影响。方法:对83例颅脑外伤后血糖升高者于入院时及伤后第1、2、3、5、7、10、14(如血糖仍未恢复正常者酌情延长时间)日晨空腹抽血检测血糖。且在使用胰岛素期间对末梢血糖进行动态的监测直至清晨空腹静脉血糖连续2次正常,同时制定饮食护理措施及对患者或家属进行相应的健康教育。结果:血糖升高者中72.12％(59例)的患者血糖在1-3d内恢复正常,且预后与血糖正常者无差别。组中仅7例患者血糖持续升高,均因伤情重而死亡,占本组重症(GCS≤8分)患者(25例)的29.41％,明显低于文献报道组。结论:对颅脑外伤后高糖血患者尽早应用胰岛素,能改善患者预后,降低死亡率。     

脑干出血的CT诊断与预后评估

目的 探讨脑干出血的CT诊断与预后评估的意义。方法 通过对48例脑干出血病例的临床治疗与CT资料分析，探讨脑干出血的位置、大小、出血量与治疗及预后的关系。结果 脑干平均出血量G=3．3675ml，病死率与出血量有关，出血量小于5ml病死率为35．71%（17．97-53．46％)。早期诊断与治疗是影响预后的关键。结论 CT是目前脑干急性出血快速、准确的检查手段，对其临床治疗及预后评估有重要的价值。     

Why study transport of peptides and proteins at the neurovascular interface

The blood–brain barrier (BBB) is an immense neurovascular interface. In neurodegenerative, ischemic, and traumatic disorders of the central nervous system (CNS), the BBB may hinder the delivery of many therapeutic peptides and proteins to the brain and spinal cord. Fortunately, the mistaken dogma that peptides and proteins do not cross the BBB has been corrected during the past two decades by the accumulating evidence that peptides and proteins in the periphery exert potent effects in the CNS. Not only can peptides and proteins serve as carriers for selective therapeutic agents, but they themselves may directly cross the BBB after delivery into the bloodstream. Their passage may be mediated by simple diffusion or specific transport, both of which can be affected by interactions in the blood compartment (outside the BBB) and within the endothelial cells (at the BBB level). Although the majority of current delivery strategies focuses on modification of the molecule to be delivered, understanding the mechanisms of transport will eventually facilitate regulation of the BBB directly. We review the different aspects of interactions and discuss recent advances in the cell biology of peptide/protein transport across the BBB. Better understanding of the nature and regulation of the transport systems at the BBB will provide a new direction to enhance the interactions of peripheral peptides and proteins with the CNS.     

Highly resolved in vivo 1H NMR spectroscopy of the mouse brain at 9.4 T.

An efficient shim system and an optimized localization sequence were used to measure in vivo 1H NMR spectra from cerebral cortex, hippocampus, striatum, and cerebellum of C57BL/6 mice at 9.4 T. The combination of automatic first- and second-order shimming (FASTMAP) with strong custom-designed second-order shim coils (shim strength up to 0.04 mT/cm2) was crucial to achieve high spectral resolution (water line width of 11-14 Hz). Requirements for second-order shim strengths to compensate field inhomogeneities in the mouse brain at 9.4 T were assessed. The achieved spectral quality (resolution, S/N, water suppression, localization performance) allowed reliable quantification of 16 brain metabolites (LCModel analysis) from 5-10-microL brain volumes. Significant regional differences (up to 2-fold, P < 0.05) were found for all quantified metabolites but Asp, Glc, and Gln. In contrast, 1H NMR spectra measured from the striatum of C57BL/6, CBA, and CBA/BL6 mice revealed only small (<13%, P < 0.05) interstrain differences in Gln, Glu, Ins, Lac, NAAG, and PE. It is concluded that 1H NMR spectroscopy at 9.4 T can provide precise biochemical information from distinct regions of the mouse brain noninvasively that can be used for monitoring of disease progression and treatment as well as phenotyping in transgenic mice models.     

针刺对缺血再灌注大鼠海马脑源性神经营养因子mRNA的影响

目的 探讨针刺对缺血再灌注大鼠海马内脑源性神经营养因子（BONF）基因表达的影响，推测针刺改善缺血再灌注的可能机制。方法 采用4-血管阴断法制备大鼠全脑缺血再灌注模型，电针刺激百会、肾俞、足三里穴后，利用RT-PCR检测BDNF mRNA。结果 正常组大鼠海马BDNF mRNA表达极低，缺血再灌注组大鼠海马BDNF mRNA表达明显增高，治疗15d的针刺1、2组大鼠海马BDNF mRNA表达较缺血再灌注组更高，及早治疗且治疗时间为20d的针刺3组大鼠海马BDNF mRNA表达较降低。结论 缺血再灌注大鼠海马BDNF水平增高有利于损伤的神经元存活、恢复；针刺促进脑内细胞分泌内源性BDNF可能是针刺有效治疗缺血再灌注的机制之一。     

正常成人脑海马区多潜能神经前体细胞的体外分离鉴定

目的 从正常成人脑海马分离鉴定多潜能神经前体细胞并探讨体外培养条件.方法 材料取自8例非神经系统疾病的死亡者.分离正常成人脑海马细胞,在培养基中添加生长因子体外培养.通过细胞培养成球和BrdU染色鉴定培养细胞的增殖能力.利用免疫细胞化学三标染色来鉴定分化神经细胞的表型.结果 从正常人海马分离的细胞培养2周时,开始增殖成簇,致一个月时,形成细胞球,这些细胞能与BrdU结合,并能在体外分化成神经系统不同谱系的细胞.结论 与在啮齿类动物和猴的研究中结果一致,从正常成人脑海马区分离的细胞是多潜能神经前体细胞.     

Quantification of perfusion fMRI using a numerical model of arterial spin labeling that accounts for dynamic transit time effects.

A new approach to modeling the signal observed in arterial spin labeling (ASL) experiments during changing perfusion conditions is presented in this article. The new model uses numerical methods to extend first-order kinetic principles to include the changes in arrival time of the arterial tag that occur during neuronal activation. Estimation of the perfusion function from the ASL signal using this model is also demonstrated. The estimation algorithm uses a roughness penalty as well as prior information. The approach is demonstrated in numerical simulations and human experiments. The approach presented here is particularly suitable for fast ASL acquisition schemes, such as turbo continuous ASL (Turbo-CASL), which allows subtraction pairs to be acquired in less than 3 s but is sensitive to arrival time changes. This modeling approach can also be extended to other acquisition schemes.