成年小鼠缺血性脑卒中后病理及行为功能的变化

文题释义：大脑中动脉末端闭塞模型：该模型最先由TAMURA等在大鼠上开发出来，即开颅手术找到大脑中动脉皮质分支并对其进行结扎或电凝，可以引起稳定的局灶性皮质梗死，在很好模拟人类卒中病理状态的同时死亡率较低。但这种手术方式对手术人员的技术以及设备有较高要求，并且需要后期评估才能确定造模成功与否。缺血性脑卒中：脑卒中分缺血性和出血性脑卒中，缺血性卒中是由于脑的供血动脉狭窄或闭塞，造成脑组织缺血、缺氧性坏死，是中国致死和致残的主要原因。 背景：大鼠大脑中动脉末端闭塞模型可以引起稳定的局灶性皮质梗死，在很好模拟人类卒中病理状态的同时死亡率较低，但对手术人员的技术以及设备有较高要求，并且需要后期评估才能确定造模成功与否。 目的：建立有效稳定简便的缺血性小鼠脑卒中模型；揭示小鼠脑卒中后梗死区及周围区域的病理变化；探索小鼠脑卒中后的行为学改变。 方法：对小鼠末端大脑中动脉进行永久电凝结扎，24 h后用TTC染色明确该模型梗死范围并统计该模型的成功概率；对小鼠大脑中动脉末端闭塞模型后不同时间点(1，3，7，10，14 d)的脑组织切片进行苏木精-伊红染色，观察缺血坏死区的体积在不同时间点的改变；进行胶质纤维酸性蛋白、Iba-1免疫组织化学染色，检测模型小鼠脑损伤后胶质反应及炎症反应变化；最后应用网格足部错误试验和圆柱体试验评价小鼠卒中后感觉运动功能的缺失情况。结果与结论：①大脑中动脉末端闭塞模型导致局灶性皮质梗死且该新模型死亡率仅9%，成功率达87%；②梗死区域主要位于M1/S1/S2区，梗死范围在闭塞10 d时趋于稳定；③脑卒中后3 d时炎症反应达到高峰，14 d时损伤区周围形成稳定星形胶质瘢痕；④局灶性皮质梗死后小鼠对侧肢体出现明显的感觉及运动的缺失；⑤结果表明，卒中后实验小鼠立即出现感觉及运动功能缺失，且持续至卒中后12周；实验建立的大脑中动脉末端闭塞模型稳定、可靠，梗死范围明确，适合缺血性脑卒中的研究。 ORCID: 0000-0002-5489-3807(梁彦峰) 中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程     

丹蛭降糖胶囊对糖尿病模型大鼠心、肾组织的影响

目的:探讨丹蛭降糖胶囊对糖尿病模型大鼠心脏和肾组织病理学变化的影响。方法:雄性SD大鼠70只,随机选取10只作为正常组,普通饲料饲养,其余大鼠高脂饲料喂养4周,腹腔注射链脲佐菌素(STZ)34 mg/kg制作Ⅱ型糖尿病大鼠模型,造模不成功大鼠腹腔注射补注STZ 25 mg/kg。成模大鼠根据血糖、体质量分为4组:模型组、高剂量[1.08 g/(kg·d)]丹蛭降糖胶囊组、低剂量[0.54 g/(kg·d)]丹蛭降糖胶囊组、吡咯列酮组[10 mg/(kg·d)],每组10只。正常组、模型组大鼠给予同体积生理盐水。连续灌胃给药6周,测定大鼠一般体征指标,全自动生化分析仪检测血糖、血脂、肾功能指标(BUN、Scr、m Alb、尿蛋白量),心脏组织采用HE及MASSON染色,肾组织采用HE、MASSON及糖原PAS染色,观察组织的病理变化。结果:与正常组相比,模型组大鼠体质量下降,摄食量、摄水量明显增加,血糖、血脂、肾功能指标升高(P<0.01),病理组织学观察可见心脏炎性细胞浸润,心肌纤维化增加,肾脏包曼氏囊结构改变,细胞质基质增多,纤维化程度明显增加。给药6周后,与模型组比较,吡咯列酮组、高、低剂量丹蛭降糖胶囊组大鼠体质量明显增加,摄食量、摄水量下降(P<0.01),病理学观察可见心脏、肾脏各项病变均有所减缓。吡格列酮组、高剂量丹蛭降糖胶囊组血糖、血脂、肾功能指标下降(P<0.05或P<0.01),低剂量丹蛭降糖胶囊组大鼠血糖、血脂、肾功能指标虽下降,但TC水平差异无统计学意义(P>0.05),且Hb Alc、TG、TC、m Alb水平与吡格列酮组存在统计学差异(P<0.05或P<0.01)。结论:高剂量丹蛭降糖胶囊能有效地改善大鼠的血糖血脂水平,缓解多饮、多食症状,并可减轻高血糖对大鼠心肌及肾脏组织的损害。     

真菌血症患者血小板计数动态变化回顾分析

目的调查了解临床真菌血症患者血小板计数动态变化情况,分析其与真菌血流感染发生、发展和转归的关系。方法收集2011年10月至2013年5月白求恩国际和平医院住院患者中发生真菌血症患者的临床资料,分析血小板计数动态变化情况,对数据进行整理和统计分析。结果重症感染(50.00%)和恶性肿瘤(34.38%)是真菌血症患者最主要的基础疾病。32例真菌血症患者中17例(53.13%)发生血小板计数明显下降。血小板计数动态曲线形态呈现3种变化形态:平稳型(15例)、U型(10例)和L型(7例),其病死率分别为20.00%、20.00%和100.00%,3种血小板曲线形态患者预后差异有统计学意义(χ2=14.93,P0.05)。结论在真菌血症患者中,发生血小板下降的概率较大。血小板下降,尤其是经治疗无法回升的患者往往病情凶险,应引起临床高度重视。     

短种植体(≤6 mm)在萎缩后牙区5~7年疗效的回顾性研究

目的:评估短种植体(≤6 mm)在萎缩后牙区的长期临床疗效。方法:选取2009年1月~2012年1月南昌大学第四附属医院口腔科接受种植治疗的患者17例,共植入33枚Bicon植体(植体长度≤6 mm),观察期60~84个月不等,观察并记录边缘骨吸收量、种植体存留率及并发症。结果:在观察期内,33枚植体有1枚脱落,种植体存留率为97.0%,种植体修复完成60~84个月内种植体近远中骨吸收水平分别为(-0.74±0.05)mm、(0.05±0.07)mm,种植体近、远中边缘骨高度与修复后即刻比较差异均无统计学意义(P>0.05)。结论:在5~7年观察期内,短种植体(≤6 mm)应用于骨量不足的萎缩后牙区,其存留率及骨吸收水平与常规种植体无差异,可获得良好的中远期疗效。     

Changes of MRI in inter-spinal distraction fusion for lumbar degenerative disease: A retrospective analysis covering 3 years

ObjectiveTo assess the preoperative and postoperative changes in MRI image and the short-term efficacy of the ISDF with BacFuse covering 3 years.Methods32 patients who underwent ISDF were involved in this retrospective study. The symptoms assessment including VAS, ODI, and SF-12 were evaluated preoperative and postoperative at 1 year and 3 years. The X-ray was used to measure posterior disk height (PDH), foramina height (FH), foramina width (FW), and MRI was taken to assess the cross-sectional area of dura sac (CSADS), cross-sectional area of canal (CSAC), herniated disc area, ligamentum flavum area. The preoperative ratio of herniated disc area and ligamentum flavum area to CSAC were compared with post-operative ratio. The modified Pfirrmann grade system was used to assess the surgical lumbar disc.ResultsThe symptom indexes were significantly improved after surgery. PDH and FH increased significantly (P < 0.05) after surgery compared with that before surgery, but there was no statistical difference in FW (P > 0.05). CSADS and CSAC increased obviously (P < 0.05), while the area of herniated disc and ligamentum flavum decreased significantly (P < 0.05). The ratio changes showed a significant difference between last follow-up and pre-operation (P < 0.05), but there was no statistical significance in grade changes of surgical disc.ConclusionISDF with BacFuse could relieve clinical symptoms and expanse the spinal canal area in MRI. During 3-year observation, it could provide continuous traction and maintain the area of spinal canal, so as to partially retract the herniated disc and make it possible to repair the disc.     

Postsurgical changes of mandible based on vertical dimension increase in Skeletal Class III deformities

The aim of this study was to evaluate the postsurgical mandibular changes after surgery based on vertical dimension increase in skeletal Class III deformities.Patients who underwent mandibular setback surgery for skeletal Class III malocclusion correction with surgery-first orthognathic treatment were enrolled in the study. Lateral cephalograms were obtained at initial visit, immediately after surgery, 6 months after surgery, and at post-treatment. Postsurgical change of the mandible based on the vertical dimension increase was estimated using a diagrammatic method before surgery and this amount was compared with the actual amount of mandibular forward movement at 6 months after the surgery, using a paired t-test and Bland–Altman plot.Thirty patients (16 men and 14 women; mean age, 22.6 years) with skeletal Class III deformities had undergone mandibular setback surgery with the surgery-first orthognathic treatment. Immediately after surgery, the mandible setback was 9.4 ± 3.7 mm at pogonion. Six months after surgery, the mandible moved forward at an average of 2.3 ± 1.5 mm which corresponded to the estimated value of 2.2 ± 0.9 mm. The estimated amount of postsurgical movement did not show a statistically significant difference from the actual value on paired t-test (p = 0.349). The Bland–Altman analysis showed that the difference between the two values was within the limits of agreement.The postsurgical changes based on vertical dimension increase in surgery-first orthognathic treatment might be predicted by using a diagrammatic method.     

Cerebral white matter microstructural changes in isolated maxillofacial trauma and associated neuropsychological outcomes

Isolated traumatic maxillofacial injury without concomitant brain injury may cause delayed post-concussive symptoms. Early identification allows optimal diagnosis, prognostication, and therapeutic intervention. The aim of this prospective observational study was to investigate longitudinal microstructural changes of the white matter (WM) tracts based on diffusion tensor imaging (DTI) indices in patients with isolated maxillofacial injuries, immediately and 6 months post-trauma, and to correlate these DTI indices with neuropsychological changes observed. Twenty-one patients with isolated maxillofacial injuries and 21 age-matched controls were recruited. DTI was performed and indices were calculated for 50 WM tracts. The neuropsychological evaluation was done using the screening module of the Neuropsychological Assessment Battery. Patients were subjected to repeat DTI and neuropsychological evaluation at 6 months post-trauma. Reduced fractional anisotropy (FA) and increased median (MD) and radial diffusivity (RD) in the acute phase were seen in major association, projection, and commissural fibre bundles, indicative of vasogenic oedema. These changes correlated with attention and executive function deficits in the acute phase, as well as improvement in memory and visuospatial function in the chronic phase. Isolated maxillofacial trauma patients develop WM microstructural damage, which may impair cognitive performance acutely and over time. DTI indices can serve as predictive imaging biomarkers for long-term cognitive deficits in isolated maxillofacial injuries.