虚拟现实技术应用于脑卒中患者步行功能康复的研究进展

目的：探讨脑性瘫痪患儿头MRI改变与病因及临床的关系。方法：对100例脑性瘫痪患儿进行头MRI检查,并对不同的MRI改变与病因及临床表现进行分析。结果：100例脑性瘫痪患儿头MRI检查异常94例,异常率94％,脑白质损伤70例,脑白质软化52例,胼胝体发育不全48例,其中脑白质软化中早产34例,足月儿18例,胼胝体发育不全48例中,合并有智力低下34例。结论：脑性瘫痪患儿MRI检查阳性率高,其中脑白质损伤发生率为70％。     

鹅去氧胆酸氨基酸衍生物的合成

鹅去氧胆酸(Chenodeoxycholic acid简称CDCA)是70年代进行临床研究、可用于胆固醇胆石症的治疗药物,能使胆石逐渐溶解,但该药毒副作用较大,因为CDCA易被肠道内细菌7-脱羟酶的作用生成石胆酸(LC),引起腹泄、腹部痉挛、高转氨酶血症等毒副作用。据国外文献报道,CDCA与     

神经突起生长导向因子（netrin）受体家族研究进展

神经突起生长导向因子netrin是一种分泌蛋白 ,在神经发育所需的轴突导向及细胞迁移中发挥双重导向功能———吸引或排斥 ,主要依赖于生长锥所表达的不同受体结肠癌缺失蛋白 (DCC)或UNC5同源物 (UNC5H) ,从而传递不同信息。同时 ,dcc和unc5h也是肿瘤抑制基因 ,近年来的研究显示这种双重导向功能可能归因于它们属于配体依赖性受体家族。依赖性受体的重要特征是缺乏相应配体时将诱导细胞凋亡 ,因此推测DCC和UNC5H不仅为神经元传递信号所必需 ,同时也是细胞生存因子 ,与细胞存活及正常功能的发挥密切相关。     

STUDY OF LOSS OF HETEROZYGOSITY AT DCC AND APC/MCC GENETIC LOCI OF GASTRIC CANCER

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Potential effect of mechano growth factor E‐domain peptide on axonal guidance growth in primary cultured cortical neurons of rats

Establishing appropriate synaptic connections and plasticity is a critical need in neuronal regeneration and development. Mechano growth factor (MGF) and its C‐terminal E‐domain peptide with 24 amino acids, MGF‐Ct24E, are potential neuroprotective agents. Our preliminary study indicates that Netrin‐1 can guide axonal growth and its expression is sensitive to MGF, but how MGF regulates the expression of Netrin‐1 and its receptor DCC is still unclear. Here, we investigate the effect of MGF‐Ct24E on the expression of Netrin‐1 and DCC in primary cultured cortical neurons in vitro and the adult rat brain in vivo. MTT assay shows that MGF‐Ct24E can significantly protect primary cortical neurons against nerve injury. There is a significant increase in axonal elongation after MGF‐Ct24E treatment at concentrations of 0.5 and 1.0 μg/ml. Real‐time polymerase chain reaction assay indicates that MGF‐Ct24E can effectively promote the expression of Netrin‐1 and DCC in primary cultured cortical neurons. To identify the certain mechanism of MGF‐Ct24E on neuronal guidance and growth, adult rats are subjected to intramuscular injection of MGF‐Ct24E after traumatic brain injury. Rats injected with MGF‐Ct24E start eating and drinking within 14 days, indicating that MGF‐Ct24E can promote rehabilitation. HE staining and immunohistochemistry assays of brain section slices reveal that MGF‐Ct24E treatment can significantly inhibit the haemorrhage of traumatic brain injury and promote expression of Netrin‐1. Further investigation of protein expression by Western blot assay shows that MGF‐Ct24E promotes expression of Netrin‐1 and DCC after nerve injury. MGF‐Ct24E can effectively improve axonal guidance through upregulation of Netrin‐1/DCC signalling in neuronal regeneration. Copyright © 2016 John Wiley & Sons, Ltd.     

Ventilator-dependent survivors of catastrophic illness transferred to 23 long-term care hospitals for weaning from prolonged mechanical ventilation

STUDY OBJECTIVES: This multicenter study was undertaken to characterize the population of ventilator-dependent patients admitted to long-term care hospitals (LTCHs) for weaning from mechanical ventilation. DESIGN: Observational study with concurrent data collection. Characteristics of the LTCHs were also surveyed. SETTING: Twenty-three LTCHs in the United States. PATIENTS: Consecutive ventilator-dependent patients admitted over a 1-year period: March 1, 2002, to February 28, 2003. RESULTS: A total of 1,419 patients were enrolled in the Ventilation Outcomes Study. Median age of the patients was 71.8 years old (range, 18 to 97.7 years), with an equal gender distribution. The premorbid domicile was home or assisted living in 86.5%; "good" premorbid functional status (Zubrod score 0-2) was assessed in 77%. There was a history of smoking in 59% (mean, 57 +/- 42 pack-years [+/- SD]); premorbid diagnoses averaged 2.6 per patient. Patients came to the LTCH after mean of 33.8 +/- 29 days at the transferring hospital; mean time to tracheotomy was 15.0 +/- 10 days. A medical illness led to ventilator dependency in 60.8% of patients; a surgical procedure led to ventilatory dependency in 39.2%. On admission to the LTCH, the median acute physiology score of APACHE (acute physiology and chronic health evaluation) III was 35 (range, 4 to 115); > 90% of patients had at least three penetrating indwelling tubes/catheters; 42% of patients had stage 2 or higher pressure ulceration. CONCLUSIONS: This is the first multicenter study to characterize ventilator-dependent survivors of catastrophic illness admitted to the post-ICU venue of LTCHs for weaning from prolonged mechanical ventilation (PMV). Overall, our findings suggest that ventilator-dependent patients admitted to LTCHs for weaning will continue to require considerable medical interventions and treatments, owing to the burden of acute-on-chronic diseases resulting in PMV.     

Spatio‐temporal deleted in colorectal cancer (DCC) and netrin‐1 expression in human foetal brain development

P. N. Harter, B. Bunz, K. Dietz, K. Hoffmann, R. Meyermann and M. Mittelbronn (2010) Neuropathology and Applied Neurobiology 36, 623–635
Spatio‐temporal deleted in colorectal cancer (DCC) and netrin‐1 expression in human foetal brain development Aims: Deleted in colorectal cancer (DCC) and its ligand netrin‐1 are known as axonal guidance factors, being involved in angiogenesis, migration and survival of precursor cells in the embryonic mammalian central nervous system (CNS). So far, little is known about the distribution of those molecules in human CNS development. Methods: We investigated 22 human foetal brain specimens (12th and 28th week of gestation) for DCC and netrin‐1 expression by means of immunohistochemistry, immunofluorescence and confocal laser microscopy. Statistical analysis was performed by applying a semi‐quantitative score, including staining intensity and frequency and correlation with foetal age. Results: DCC and netrin‐1 were differentially expressed throughout the developing human foetal telencephalic and cerebellar cortical layers. Netrin‐1 exhibited the highest levels in telencephalic germinal layers, whereas the strongest DCC immunoreactivity was seen in the developing cortical plate. Netrin‐1 and DCC were predominantly present on cerebellar external granule layer cells. Distinct co‐expression was seen in maturing foetal brainstem nuclei, cerebellar external granular layer and the choroid plexus. In contrast, endothelial cells showed strong netrin‐1 expression with subsidiary DCC immunoreactivity. Pontine and telencephalic axonal fibre tracts also demonstrated strong netrin‐1 expression. Conclusions: We show that DCC and netrin‐1 are ubiquitously expressed in the human foetal brain; however, both exhibit a distinct spatio‐temporal expression pattern. Together with the data from animal experiments, our findings might indicate also an important role for DCC and netrin‐1 in human foetal CNS development.     

DCC protein expression in clear cell renal cell carcinoma

OBJECTIVES: To investigate whether the expression of protein from the "deleted in colorectal cancer" (DCC) gene, which predicts a poor outcome for patients with colorectal carcinoma, can also serve as a prognostic factor in renal cell carcinoma (RCC). PATIENTS AND METHODS: The expression of DCC was evaluated immunohistochemically in 94 paraffin-embedded tumour samples from patients with stage T1, T2, and T3 clear cell RCC. The mean follow-up was 52.3 months. The endpoints of the study were recurrence of disease and death from disease. RESULTS: The under-expression of DCC protein was detected in 63% of patients who died from the disease and in 36% with no evidence of disease. DCC protein under-expression was detected in all patients with T1 tumours who died from the disease, in half the T2 tumours and in two-thirds of T3 tumours. CONCLUSION: DCC protein under-expression correlated with more aggressive tumour behaviour and a greater risk of death from RCC. However, a larger cohort of patients should be assessed before drawing definitive conclusions.     

DCC基因在卵巢恶性肿瘤组织中的表达

目的　探讨DCC基因表达缺失与卵巢恶性肿瘤发生、发展及临床病理特征的关系。方法　应用逆转录聚合酶链反应 (RT PCR)技术、目的基因片段克隆测序的方法 ,证实正常卵巢组织中DCC基因的正常表达 ;并以 β 肌动蛋白作为内对照 ,在 10例正常卵巢组织、10例卵巢良性肿瘤组织、34例原发性卵巢恶性肿瘤组织中检测DCC基因表达缺失情况。结果　正常卵巢组织中DCC基因表达缺失率为 0 % ;卵巢良性肿瘤组织为 2 0 % ;卵巢恶性肿瘤为 5 6 % (19 34) ,其中浆液性囊腺癌 14例(14 18)、黏液性囊腺癌 4例 (4 11) ,两者比较 ,差异有显著意义 (P <0 0 5 )。卵巢恶性肿瘤临床分期Ⅲ～Ⅳ期的 2 5例中 ,17例DCC基因表达缺失 (6 8% ) ;组织学分级低分化 10例中 ,9例DCC基因表达缺失 (90 % ) ;盆腹腔转移的 2 8例中 ,17例DCC基因表达缺失。结论　卵巢恶性肿瘤组织中 ,DCC基因呈表达缺失或低表达 ;临床分期Ⅲ～Ⅳ期、组织学分化程度低、有盆腹腔肿瘤转移的恶性肿瘤组织中 ,DCC基因表达缺失率增高。DCC基因表达缺失与卵巢恶性肿瘤的发生、发展及转移、浸润有关。