脱髓鞘脑病脑诱发电位、CT 对比观察

脑干听觉诱发电位(BAEP),视觉诱发电位(VEP),体感诱发电位(SEP)三项检查在早期诊断脱髓鞘病中越来越受到重视,本文对12例经 CT 扫描确诊为“脱髓鞘脑病”患者进行诱发电位与 CT 对比观察,并探讨诱发电位对其诊断的意义。资料与方法我室从87年至89年期间收集12例脱髓鞘脑,病患者进行了脑诱发电位检查(BAEP、VEP、SEP)。其中住院病人7例;门诊病人5例。诊断为多数性硬     

青少年型帕金森病的临床特征

目的　探讨青少年型帕金森病 (PD)的临床特征。方法　对 2 8例青少年型PD患者的临床资料进行回顾性分析。结果　 2 8例中 5例有家族史 ,呈常染色体隐性遗传 (AR JP) ;症状轻、病程长 ,症状常左右不对称 ,腱反射活跃和症状波动较常见 ;头部CT或MRI检查一般正常 ;对多巴制剂反应良好 ,但其所诱发的症状波动出现早。与散发性PD患者相比 ,AR JP患者发病年龄更早 ,为 (2 0 6± 5 6 8)岁 ,病程更长 ,为 (9 5±5 77)年 ,而病情较轻、症状波动和腱反射活跃更多见 ,多巴制剂不良反应更常见。结论　青少年型PD具有独特的临床特征 ,可能是一个独立的疾病实体。AR JP与散发性青少年型PD临床特征不同 ,提示二者可能具有不同的发病机制。     

58例视神经脊髓炎患者的临床随访分析

视神经脊髓炎(Neuromyelitis opfica)又名Devic病，是一种中枢神经系统脱髓鞘疾病，其病因和发病机制尚未完全明确。目前，众多学者认为Devic病是多发性硬化(Multiple Sclerosis，MS)的一个亚型，且主要见于东亚地区。为进一步探讨Devic病的临床表现以及预后情况，笔者通过临床检查以及头部MRI和脑干诱发电位辅助检查追踪58例Devie病患者，现报告如下。     

三个常染色体隐性遗传性青少年型帕金森综合征家系的基因型与表型分析

目的探讨常染色体隐性遗传性青少年型帕金森综合征(autosomal recessive juvenile parkinson-ism,AR-JP)parkin基因的突变及临床特征。方法应用聚合酶链反应、DNA测序和限制性核酸内切酶酶切等技术对15个AR-JP家系先证者的parkin基因进行突变研究。结果发现3个家系有parkin基因的突变,其中2个家系含parkin基因的杂合缺失突变,分别为第2外显子的202-203delAG及第9外显子的1069-1074delGTGTCC;另一家系发现一个杂合点突变,为第12外显子的1422(T→C)。其中1069-1074delGTGTCC和1422(T→C)为新的突变。3个家系共6名患者,发病年龄18~31岁,平均25.2±5.7岁;病情进展慢,腱反射活跃或亢进、症状波动常见;对小剂量多巴制剂反应良好。结论我国的AR-JP家系存在parkin基因的突变;含parkin基因突变的AR-JP患者有帕金森病的一般临床表现,又有其独特的临床特征。     

原发性中枢神经系统淋巴瘤MRI动态观察一例

患者 女,41岁。自2004年4月无明显诱因渐起写字不灵活,右侧肢体持续性麻木乏力,行腰穿未见异常,MRI示左丘脑异常信号和两侧脑室前角旁小片状陈旧病灶,考虑多发性脑梗死。     

伴颅内疾患语前聋病人的人工耳蜗植入术(附3例报告)

目的探讨伴有颅内疾患的聋儿人工耳蜗植入术候选者的手术和术前评估的问题.方法总结在我院发现的3例伴有颅内疾病的语前聋病人,3例都已经实施了人工耳蜗植入术.结果3例病人均在术前的磁共振检查发现了合并有颅内疾病,手术后病人均成功重建了听力.结论对于伴有颅内疾病的人工耳蜗植入术候选者在经过术前全面评估和审慎观察后可以实施手术;术前磁共振检查是发现大脑疾病的重要手段.     

尼古丁对MPTP—PD小鼠纹状体NOS活性的影响

为观察帕金森病 (Parkinsondisease,PD)模型小鼠脑组织中一氧化氮合酶 (NOS)活性的变化 ,研究尼古丁在PD中的可能作用机制。本实验采用 1 甲基 4 苯基 1,2 ,3,6 四氢吡啶 (MPTP)建立C5 7BL小鼠PD模型 ,分别应用比色分析、高效液相色谱 电化学以及免疫组织化学检测MPTP和尼古丁对C5 7BL小鼠纹状体NOS活性 ,多巴胺 (DA)、二羟基苯乙酸 (DOPAC)、高香草酸 (HVA)水平及酪氨酸羟化酶 (TH)、神经元型一氧化氮合酶(nNOS)免疫组化的影响。结果发现尼古丁能明显抑制MPTP引起的NOS活性增加 (每mg蛋白质分别为 15 .6 3IU± 1.5IU和 13.0 9IU± 0 .89IU ,P <0 .0 1)及nNOS阳性神经元的数量 (分别为 6 8.6 1± 3.84和 39.2 6± 2 .6 4,P <0 .0 1) ,并能明显减轻MPTP引起的小鼠纹状体DA(每g脑组织中分别为 0 .73μg± 0 .2 8μg和 1.4 0 μg± 0 .19μg ,P <0 .0 1)、DOPAC(每g脑组织中分别为 0 .4 1μg± 0 .13μg和 0 .90 μg± 0 .0 9μg ,P <0 .0 1)、HVA(分别为0 .31μg± 0 .0 7μg和 0 .4 7μg± 0 .19μg ,P <0 .0 1)的降低及TH阳性神经纤维的损害。因此认为 ,尼古丁可能通过抑制nNOS的活性而对MPTP的神经毒性具有保护作用。     

应用SYBR GreenⅠ实时荧光定量聚合酶链反应检测常染色体隐性遗传早发性帕金森综合征的parkin基因外显子重排突变

目的 建立应用SYBR GreenⅠ实时荧光定量聚合酶链反应(Real-time PCR,RT-PCR)检测parkin基因外显子重排突变的技术平台,应用该技术对常染色体隐性遗传早发型帕金森综合征(autosomal recessive early-onset parkinsonism,AREP) 家系进行parkin基因外显子重排突变分析.方法 应用SYBR GreenⅠRT-PCR技术对32个中国AREP家系进行parkin基因外显子重排突变分析.结果 14个家系先证者存在parkin基因外显子重排突变,其中3个为纯合缺失突变、3个为复杂杂合缺失突变和8个杂合缺失突变,未发现外显子重复突变,突变主要累及第2～4号外显子.结论 建立了应用SYBR GreenⅠRT-PCR技术检测parkin基因外显子重排突变的基因检测平台;中国AREP 家系的parkin基因外显子重排突变频率为43.8%,与国外报道相似.     

RNA干扰技术阻断α-synuclein过表达诱导的细胞凋亡

BACKGROUND： Overexpression of α-synuclein can induce cell apoptosis. RNA interference （RNAi） may block specific gene function and cause gene silencing. OBJECTIVE： To construct a specific and effective RNAi plasmid for the α-synuclein gene and investigate if RNAi can block apoptosis in HEK293 cells, induced by overexpression of wild-type α-synuclein.
DESIGN, TIME AND SETTING： A contrast experiment based on genetically engineered cytobiology was performed at the State Key Lab of Medical Genetics of China, Xiangya Medical College of Central South University, between October 2004 and October 2008.
MATERIALS： HEK293 cells and pBSHH1 plasmid were provided by the State Key Lab of Medical Genetics of China; OligDNA sequence by Sagon Bioengineering Company, Shanghai; Lipofectamine 2000 by Invitrogen, USA; α-synuclein monoclonal antibody, Hoechst 33258, and MTT by Sigma, USA; Horseradish peroxidase-coupled goat anti-rat IgG by KPL, USA; FACSan flow cytometry by BD, USA.
METHODS： Four target sites were used to construct hairpin RNA pBSHH1 vectors - pSYNi-1, pSYNi-2, pSYNi-3 and pSYNi-4 - which were cloned in the pBSHH1 plasmid. HEK293 cells were transfected using Lipofectamine 2000. In addition, a non-transfect group and a negative plasmid transfect group were established. The cultured HEK293 cells were processed as follows： transfection of blank plasmid （blank control group）, transfection of α-synuclein-pEGFP and RNAi negative vector （negative control group）, and transfection of α-synuclein-pEGFP and pSYNi-1 （transfection group）. Cells in all groups were transfected with Lipofectamine 2000 for 48 hours.
MAIN OUTCOME MEASURES： Expression of α-synuclein mRNA and protein were detected by RT-PCR and Western blot. Cell morphology was observed under an inverted fluorescence microscope; cell viability was measured using MTT method; and cell apoptosis was determined with Annexin V-PE flow cytometry.
RESULTS： α-synuclein mRNA and protein expressions were significantly decreased in the pSYNi-1 group when compared with the non-transfect and negative plasmid transfect groups （P 〈 0.05）. The expressions were partially decreased in the pSYNi-2 group, but there was no significant difference in the pSYNi-3 and pSYNi-4 groups. Hoechst staining indicated that cell nuclei were enlarged in the negative control group, coloring was not uniform, and chromatin was accumulated and appeared spot-like. The nucleus coloring was uniform in the transfection group compared to negative control group. Cell viability in the negative control group was significantly lower than blank control group with cell apoptosis being significantly increased （P 〈 0.05）. In comparison with negative control group, cell viability was significantly increased in the transfection group and cell apoptosis was significantly decreased （P 〈 0.05）.
CONCLUSION： pSYNi-1 can inhibit α-synuclein gene expression and block apoptosis of HEK293 cells induced by overexpression of wild-type α-synuclein.     

远端型遗传性运动神经病的小分子热休克蛋白22、27基因突变分析

远端型遗传性运动神经病(distalhereditarymotor neuropathy,dHMN)是一组由于脊髓前角运动神经元退行性变引起对称性的肌无力和肌萎缩,常成年起病,病程一般缓慢发展。到目前为止,dHMN已定位9型,其中5型疾病基因已被克隆,HSP22(heat shockprotein22)基因和HSP27(heatshockprotei