Ghrelin对脑缺血再灌注大鼠脑水肿和水通道蛋白4表达的影响

 目的： 探讨ghrelin对脑缺血再灌注大鼠脑水肿、血脑屏障通透性及水通道蛋白4（AQP4）表达的影响。方法： 成年SD雄性大鼠随机分为3组:sham组、大脑中动脉阻塞（MCAO）组和ghrelin处理组。采用线栓法复制MCAO模型（缺血2 h,再灌注22 h）。Ghrelin组大鼠于再灌开始时经股静脉注射ghrelin 10 nmol/kg。TTC染色观察脑梗死体积,神经功能评分判断脑功能障碍程度,分别以体积计算和干湿重法检测脑肿胀程度和脑含水量的变化,收集脑血管外伊文思蓝(EB)来评估血脑屏障的破坏程度,免疫组化和Western blotting检测AQP4的表达变化。结果： 与MCAO组比较,ghrelin处理组的脑梗死体积较小（P<0.01）,神经功能评分较低（P<0.01）,脑组织中的EB渗出量较少（P<0.01）。Ghrelin处理组大鼠的脑肿胀体积、脑含水量和AQP4表达明显低于MCAO组（P<0.05）。结论： Ghrelin减轻大鼠脑缺血/再灌注损伤,减轻脑水肿和血脑屏障的破坏,抑制脑组织中AQP4的表达。AQP4在ghrelin的脑保护机制中可能发挥重要作用。     

NO调控JNKs通路对鼠海马神经元保护作用研究

Background C-Jun N-terminal kinase (JNK) signaling pathway plays a critical role in cerebral ischemia. Although the mechanistic basis for this activation of JNK1/2 is uncertain, oxidative stress may play a role. The purpose of this study was to investigate whether the activation of JNK1/2 is associated with the production of endogenous nitric oxide. Methods Ischemia and reperfusion was induced by cerebral four-vessel occlusion (4-VO). Sprague–Dawley (SD) rats were divided into 6 groups: sham group, ischemia and reperfusion group, neuronal nitric oxide synthase (nNOS) inhibitor 7-Nitroindazole (7-NI) (Sigma St Louis, MO, USA) given group, inducible nitric oxide synthase (iNOS) inhibitor (AMT) (Sigma) given group, sodium chloride control group and 1% dimethyl sulfoxide (DMSO) control group. The levels of protein expression and phospho-JNK1/2 were detected by western blot and the survival hippocampus neurons in CA1 zone were observed by cresyl violet (CV) staining. Results The study illustrated two peaks of JNK1/2 activation occurred at 30 min and 3 days during reperfusion. 7-NI inhibited JNK1/2 activation during the early reperfusion, whereas AMT preferably attenuated JNK1/2 activation during the later reperfusion. At same time, the results also showed that administration of 7-NI and AMT can decrease ischemia/Reperfusion (I/R)-induced neuronal loss in hippocampal CA1 region. Conclusions JNK1/2 activation is associated with endogenous nitric oxide (NO) in response to ischemic insult.     

不同术式治疗高血压基底节区脑出血的临床疗效分析

目的探讨显微镜下小骨窗开颅血肿清除术和微创颅内血肿硬通道穿刺术治疗高血压基底节区脑出血的效果及预后,以期更好地指导临床救治。方法选择高血压基底节区脑出血患者209例为研究对象,其中开颅血肿清除术70例(开颅组),穿刺引流术139例(穿刺组)。采用SPSS19.0统计软件分析两组患者年龄、性别、血肿侧别及术前血肿量、术中出血量、术后残余血肿量、手术时间、平均住院时间和术后6个月格拉斯哥预后评分(GOS)。结果两组患者年龄、性别、血肿侧别及术前血肿量比较,差异无统计学意义(P>0.05),穿刺组患者手术时间、术中出血量、术后残余血肿量及术后6个月GOS与开颅组比较,差异有统计学意义(P<0.05)。结论微创颅内血肿硬通道穿刺引流术在一定程度上明显优于显微镜下小骨窗开颅血肿清除术,值得临床推广应用。     

左右颈动脉支架植入术发生颈动脉窦综合征比较

目的 对比分析左右两侧颈内动脉分别行球囊扩张颈动脉支架植入术(CAS)时发生颈动脉窦综合征(CSS)的差异.方法 回顾性分析64例接受CAS术颈动脉狭窄患者,男36例,女28例,平均年龄62.7岁(49～75岁);右侧颈动脉狭窄36处、左侧颈动脉狭窄30处,2例患者为双侧狭窄;重度狭窄(＞70％)37处,狭窄伴溃疡(30％～70％)29处;共植入66枚支架.术中均选用Wallstent自膨式支架.结果 36处接受右侧CAS术治疗颈动脉狭窄中发生重度CSS 5处、中度19处、轻度12处,发生率分别为13.89％、52.78％、33.33％;30处接受左侧CAS术治疗颈动脉狭窄中发生重度CSS 3处,中度10处、轻度17处,发生率分别为10.00％、33.33％、56.67％.两组数据差异有统计学意义(P＜0.05).结论 CSS是CAS术时常见并发症,右侧颈动脉行CAS时CSS发生率高于左侧.