缺血性脑卒中后小鼠脑组织中星形胶质细胞的异质性分析

目的：基于单细胞测序技术对缺血性脑卒中（ischemic stroke,IS）后脑组织中星形胶质细胞的动态变化进行研究,以更好地理解星形胶质细胞在IS发生发展中的作用。方法：利用GEO公共数据库下载IS小鼠脑组织测序数据（GSE227651）,通过tSNE聚类降维分析获取不同的星形胶质细胞亚群,并对IS后第1、3和7天缺血损伤脑组织中不同星形胶质细胞亚群的动态变化及功能进行分析;利用Monocle软件包对不同星形胶质细胞亚群所处的发育阶段进行分析;利用CellChat软件包对星形胶质细胞与其他细胞亚群之间的配受体相互作用情况进行动态分析。结果：小鼠脑组织细胞聚类为19个细胞亚群,注释为16种不同的细胞;对星形胶质细胞重新聚类分析,进一步分为6个星形胶质细胞亚群,根据功能分析将星形胶质细胞亚群2和亚群5定义为反应性星形胶质细胞,亚群0和亚群3定义为修复性星形胶质细胞,亚群1和亚群4为静息性星形胶质细胞。根据拟时序分析结果进一步将星形胶质细胞亚群2定义为急性反应性星形胶质细胞,亚群0定义为缺血损伤后修复性星形胶质细胞。细胞配受体相互作用分析显示,星形胶质细胞与星形胶质细胞、B细胞、NK细胞、内皮细胞、巨噬细胞、上皮细胞和神经元的配受体作用关系随时间动态改变。结论：星形胶质细胞的功能状态在IS后随时间动态改变,在IS后的早期主要通过急性反应性星形胶质细胞介导损伤后的急性炎症反应,而在IS后第3天开始通过缺血损伤后修复性星形胶质细胞参与损伤后脑组织的功能重建。     

Intraosseous thrombosis in ischemic necrosis of bone and osteoarthritis

It has been proposed that nontraumatic ischemic necrosis of bone (INB) is a result of lipid associated intraosseous thrombosis. A histological study of 15 patients with INB confirmed the presence of intravascular lipid and thrombosis in the vessels of the femoral head. A similar analysis of 11 patients with primary osteoarthritis (OA) showed similar changes at lower levels. These changes were not observed in seven control femoral heads. The possibility that both INB and OA result from intraosseous thrombosis is discussed.     

大鼠心肌IP第二窗对I/R心肌细胞凋亡的影响及对bcl-2、bcl-xl表达的调节

目的：研究缺血预适应（ＩＰ）第二保护穿对大鼠缺血再灌注（Ｉ／Ｒ）心肌细胞凋亡的影响及戎对调亡抑制基因ｂｃｌ－２、ｂｃｌ－ｘｆｌ蛋白表达的调节。方法：采用ＴＵＮＥＬ法和免疫组化方法。结果：（１）ＩＰ＋ＩＲ２４ｈ组ＴＵＮＥＬ法阳性心肌细胞核数量及阳性心中总心肌细胞核数的百分比均明显少于ＩＲ２４ｈ组（Ｐ〈０．０５－０．０１）;９２）ＩＰ＋ＩＲ２４ｈ组表达ｂｃｌ－２、ｂｃｌ－ｘｌ蛋白阳性的心肌细胞数及阳性     

缺血性脑血管病患者用天新利博前后血小板聚集的变化

目的探讨天新利博对缺血性脑血管病(ICVD)患者血小板聚集影响的程度.方法比浊法测定12例ICVD患者治疗前后,用二种诱聚剂诱导的血小板聚集率.结果(-x±S)ICVD组用药后第5天、第10天ADP诱导血小板聚集率(32.87%±14.2%,44.99%±12.3%)显著低于用药前(71.9%±11.1%)P<0.01;Adr诱导的血小板聚集率与用药前比较则无显著性差异(P>0.05).结论天新利博对ICVD患者ADP诱导的血小板聚集有明显抑制作用,对Adr诱导的血小板聚集无影响.监测其血小板聚集率时,应选用ADP作为诱聚剂.     

BN3C对缺血性心肌损伤的保护作用

观察ＢＮ３Ｃ对缺血性心肌损伤的影响。方法：大鼠皮下注射大剂量异丙肾上腺素造成缺血性,心肌损伤模型;结果：ＢＮ３Ｃ可明显降低血中ＣＰＫ,ＦＦＡ及心肌组织中的ＭＤＡ,升高ＧＳＨ－Ｐｘ活性,并使ＥＣＧ抬高的Ｊ点下降;结论ＢＮ３Ｃ对ＩＳＯ诱发的大鼠缺血性心有肌损伤有明显的保护作用。     

心肌缺血预适应对急性心肌梗死患者临床及近期预后的影响

目的 对初次急性心肌梗死（ＡＭＩ）发生前４８ｈ有无发作过心绞痛的患者的临床及近期预后进行评价。方法 ７４例初次ＡＭＩ的患者,接受住院常规治疗,按梗死前４８ｈ有无心胶痛分为有ＩＰ组（ｎ－３６）、无ＩＰ组（ｎ＝３８）,两组基本临床情况相似。结果有ＩＰ组较无ＩＰ组心肌梗死范围小（Ｐ〈０．０１）,心肌酶峰值低（Ｐ〈０．０１）,恶性心律失常、心力衰竭、心源性休克发生率及病死率均明显降低（Ｐ〈０．０５）。结     

新生儿缺氧缺血性脑病心肌酶谱测定的临床意义

目的：观察新生儿缺氧缺血性脑病（ＨＩＥ）心肌酶活性化及心脏受损的情况,方法：采用连续监测法等方法检测了１１０例新生儿ＨＩＥ与４５例正常新生儿脐血心肌酶谱测定值比较。结果：血清心肌酶谱ＨＩＥ新生儿组明显高于新生儿正常对照组（Ｐ〈０．０１）,而重度ＨＩＥ组显高于轻、中度ＨＩＥ组（Ｐ〈０．０１）。结论：新生儿ＨＩＥ做心肌产谱测定是诊断其心肌损害、损害程度和估计预后的临床指标之一,有助于临床早期预测新生儿ＨＩＥ心肌损害有给予早期治疗。     

中西医结合治疗成人股骨头缺血坏死120例

采用中西医结合疗法 ,经皮股骨头内减压引流、靶血管脉冲式加压药物灌注、髂内动脉部分血管栓塞灌药和口服中药治疗成人股骨头缺血坏死 12 0例。通过 12～ 36个月的随访观察 ,髋关节疼痛缓解率为 92 5 0 % ,关节活动度改变率为 96 67% ,DSA检查血管增加达 88 33% ,CT、X线片股骨头骨质改变占 5 5 83%。综合疗效优于任何单项治疗     

The role of postischemic recirculation in the development of ischemic neuronal injury following complete cerebral ischemia

Summary The neuronal response to complete cerebral ischemia (CCI) of 5–15 min duration was evaluated at the light and electron microscopic level subsequent to postischemic recirculation periods of up to 60 min. Following postischemic reperfusion, the homogeneous neuronal changes characteristic of permanent CCI were modified into a heterogeneous pattern of selectively vulnerable neuronal responses. Four basic types of neuronal injury were represented within this heterogeneous neuronal population. The Type I neuronal response was most numerous and consisted of chromatin clumping, nucleolar condensation and a breakdown of polysomes. This response may represent a reversal of some of the neuronal changes observed after permanent CCI. In addition to the above changes, Type II neurons contained swollen mitochondria and Golgi saccules which appeared as microvacuoles under the light microscope. Type III neurons displayed varying degrees of neuronal shrinkage and numerous swollen mitochondria. Type IV neurons were markedly shrunken and electron-dense with few identifiable subcellular structures. The distribution of Type I neurons was random but the other neuronal responses occurred in selectively vulnerable brain regions. The number of Type II, III, and IV neurons increased with extended insult durations but were unaffected by the length of recirculation. Ten minutes of CCI represented the threshold for a significant increase in the number of severely altered neurons. These findings suggest that considerable neuronal injury may be present after 10–15 min of CCI, and the lack of a recirculation period following CCI appears to afford the brain parenchyma an extensive degree of structural protection.Supported by PHS Grant NS-12587     

针刺治疗缺血性脑卒中的神经生化研究

围绕脑缺血后 ,能量衰竭 ,膜失衡 ,钙超载 ,兴奋性氨基酸聚集 ,自由基产生 ,细胞因子释放 ,神经递质、调质紊乱 ,促发细胞凋亡 ,促进了细胞死亡 ,本文探讨了针刺治疗缺血性脑卒中的神经生化机制。认为针刺通过调节上述神经生化紊乱的各个方面 ,阻断了缺血损伤级联样“瀑布”反应 ,挽救了缺血“半暗带” ,减轻了细胞损伤 ,从而可有效治疗缺血性脑卒中