阿加曲班治疗急性前循环脑梗死的疗效观察及对PLA2、NSE水平的影响

目的探讨阿加曲班治疗急性前循环脑梗死的疗效及对PLA2、NSE水平的影响。方法随机选取2019年3月~2019年11月普宁市人民医院神经内科收治的急性前循环脑梗死患者100例,按照随机数字表随机分为对照组和观察组,对照组患者给予阿司匹林治疗,观察组给予阿加曲班联合阿司匹林治疗;对比两组患者临床治疗效果及对脂蛋白磷脂酶A2(PLA2)、血清神经元特异性烯醇化酶(NSE)水平的影响。结果两组患者干预7 d后NIHSS评分低于干预前,ADL评分高于干预前,对比差异具有统计学意义(P<0.05);干预7 d后,与对照组对比,观察组患者NIHSS评分较低、ADL评分较高,对比差异具有统计学意义(P<0.05)。两组患者干预7 d后PLA2、NSE均低于干预前,对比差异具有统计学意义(P<0.05);干预7 d后,与对照组对比,观察组患者NSE水平明显降低,对比差异具有统计学意义(P<0.05)。结论阿加曲班可有效提高急性前循环脑梗死患者的临床治疗效果,降低PLA2、NSE水平,改善患者大脑炎症反应,促进大脑功能的恢复。     

GABAARG2基因C588T多态性与癫痫的相关性研究

目的探讨中国粤西地区汉族人群GABAARG2基因C588T的单核苷酸多态性与癫痫的关系。方法采用病例-对照研究方法,收集粤西地区汉族人群189例癫痫患者,100例健康人作为正常对照组,根据患者对抗癫痫药物的反应性分为耐药组(92例)和药物敏感组(97例),提取所有研究对象外周血基因组DNA,采用PCR扩增后基因测序鉴定GABAARG2基因C588T多态性,测定该位点基因型频率和等位基因频率,并进行统计学分析。结果耐药组与药物敏感组、正常对照组的CC、CT、TT基因型频率及C、T等位基因频率比较差异均无统计学意义;药物敏感组与正常对照组的CC、CT、TT基因型频率比较(χ~2=6.468,P=0.039)差异有统计学意义,CC与CT优势比为1.669(95%CI=0.842~3.306,P=0.141),CC与TT的优势比为2.652(95%CI=1.240~5.668,P=0.011);C、T等位基因频率比较(χ~2=7.411,P=0.006)差异有统计学意义,C等位基因与T等位基因优势比为1.737(95%CI=1.166~2.588,P=0.006)。结论 GABAARG2基因5号外显子的C588T多态性与癫痫的易感性相关,但与癫痫的耐药风险不相关。     

细胞传代对骨髓间充质干细胞向神经干细胞分化的影响

BACKGROUND:It is unclear whether serial cell passage in vitro influences the differentiation of bone marrow mesenchymal stem cells into neural stem cells. OBJECTIVE:To investigate the effect of cell passage on the differentiation of bone marrow mesenchymal stem cells into neural stem cells. METHODS:Rat bone marrow mesenchymal stem cells were isolated and cultured by the whole bone marrow adherence method. Bone marrow mesenchymal stem cells at passages 3, 6, 9, 12 were incubated in serum-free medium. After culture for 7 and 14 days, cell biological characterization was observed and differenitaiton ability into neural stem cells was observed by detecting Nestin expression in cells using flow cytometry. Then, the cells were further induced to differentiate and cell multipotential differentiation capacity was detected by measurement of nerve enolase and glial acidic protein expression. RESULTS AND CONCLUSION:Under induction, bone marrow mesenchymal stem cells at different passages were all differentiated into Nestin-positive neural stem cells. However, there was a significant difference in differentiation proportion of cells at different passages (P < 0.05). Strongest differentiation ability was found in the passage 6 cells, with the Nestin expression up to (93.7±2.3)% at 7 days of induction and (96.2±1.8)% at 14 days of induction. The proportion of differentiated cells at passages 6 and 9 was signfiicantly higher than that at passages 3 and 12. Moreover, adherent cells were positive for nerve enolase and glial acidic protein. All these findings indicate that the differentiation of bone marrow mesenchymal stem cells into neural stem cells is correlated with cell passage. Cells at lower or higher passages are both detrimental to cell differentiation.     

y-氨基丁酸受体与颞叶癫痫的研究进展

颞叶癫痫（TemporalLobeEpilepsy,TLE）是最常见的一种癫痫综合征,根据发病位置分为内、外侧颞叶癫痫,其中内侧颞叶癫痫（MesialTLE,MTLE）以海马硬化为主要病理改变,与海马局部中间神经元功能障碍、环路重构,胶质增生以及大脑兴奋抑制失衡有关。TLE多数呈耐药性,严重影响患者的生活质量,对TLE的研究一直是学术界的热点。近年来发现7-氨基丁酸（GABA）受体改变与TLE关系密切。GABA作为哺乳动物脑内最主要的抑制性神经递质,在大脑广泛分布。现对GABA受体与TLE相关性的研究进展作一综述。     

经颅多普勒超声发泡试验与经胸心脏超声心动图检查对中青年隐源性卒中卵圆孔未闭诊断价值比较

目的比较经颅多普勒超声(transcranial doppler,TCD)发泡试验与经胸心脏超声心动图(transthoracic echocardiography,TTE)检查中青年隐源性卒中(cryptogenic ischemic stroke,CS)的价值。方法选取普宁市人民医院2015-08~2017-08依据TOAST分型诊断鉴别为隐源性卒中患者110例,年龄18~60岁,对比患者TCD发泡试验、TTE结果阳性率及患者一般资料特征、卒中危险因素、影像学特点。结果 TCD发泡试验卵圆孔未闭(PFO)的阳性检出率(44.5%)与TTE的阳性检出率(31.8%)差异明显;随PFO程度加重两种方法检出率均逐渐增高。TCD发泡试验阴性者年龄与阳性者无明显差异(P0.05),发病原因多为高血压与高胆固醇及吸烟。阳性患者与阴性患者相比并无明显的传统致脑卒中疾病危险原因;TCD发泡试验阳性患者与阴性患者梗死病灶血管分布无明显差异,阳性患者梗死病灶多发于皮层或皮层下区域,而阴性患者则多发于深部灰质区域。结论 TCD发泡试验能够较好检测出PFO导致的中青年隐源性卒中,阳性病灶多位于皮层或皮层下区域,对卒中病因诊断具有重要价值。     

进展型脑梗死危险因素分析

目的分析进展型脑梗死的危险因素。方法回顾性分析2014-01~2015-02某院收治192例脑梗死患者的临床资料,其中进展型脑梗死(观察组)62例,非进展型脑梗死(对照组)130例,研究其人口学资料、病史、神经功能缺损程度评分、颅内动脉狭窄等方面共19个因素,并用Logistic回归法进行相关分析研究。结果 Logistic回归分析结果显示,进入模型的各因素按其OR值大小排列顺序为脑梗死病史(OR=13.093)、短暂性脑缺血发作史(OR=12.556)、颅内动脉狭窄(OR=5.684)、降压过低或过快(OR=3.141)、纤维蛋白原增高(OR=2.867)、糖尿病史(OR=1.954)。结论脑梗死病史、短暂性脑缺血发作史、颅内动脉狭窄、降压过低或过快、纤维蛋白原增高、糖尿病史可能为进展型脑梗死的危险因素。