康脑液对脑缺血再灌注损伤大鼠软脑膜微循环的影响

目的 探讨康脑液对脑缺血再灌注损伤大鼠软脑膜微循环的干预作用.方法 大鼠分为2组,干预组每日以康脑液灌胃,对照组以生理盐水代替,连续18 d后,采用颈动脉引流法复制脑缺血再灌注损伤模型,用活体显微电视录像技术,观察软脑膜微循环变化,并以田牛氏加权积分法对流态进行分析.结果 ①康脑液可改善脑缺血再灌注时软脑膜微血流的流态：造模前微血流速度快,细动脉为线流,细静脉为线粒流,无红细胞聚集,两组间未见统计学差异（P〉0.05）.造模后模型组微血流速度显著变慢（P〈0.01）,多为粒流及粒缓流,重度红细胞聚集;微动脉血流明显减少,再灌注后渗出明显.康脑液组微血流速度也变慢,但流态变化较轻（P〈0.05）,多为线粒流及粒线流,红细胞聚集及渗出也较轻,其流态积分值显著低于模型组（P〈0.05～0.01）.②康脑液可拮抗脑缺血再灌注时微血管口径的收缩：造模后模型组微血管立即收缩,细动脉以脑缺血15～30 min及再灌注后15～120 min、细静脉以脑缺血15 min收缩显著（P〈0.05～0.01）,而康脑液组微血管口径变化不明显（P〉0.05）.两组比较,康脑液组软脑膜微血管口径缩窄明显较轻（P〈0.05～0.01）.③康脑液可改善脑缺血再灌注时毛细血管的关闭：造模后虽两组毛细血管交点计数均减少（P〈0.01）,但模型组可见毛细血管大量关闭,而康脑液组毛细血管交点数显著多于模型组（P〈0.05～0.01）.结论 康脑液能减轻大鼠脑缺血再灌注时软脑膜微循环障碍,表现为对脑缺血再灌注时的微血流变慢、红细胞聚集、微血管口径缩窄及毛细血管关闭具有很好的干预作用.     

结核性脊膜炎MRI表现及治疗后动态变化研究

目的: 研究结核性脊膜炎MRI表现、治疗后演变及患者预后情况,以提高临床认识。方法: 通过《首都医科大学附属北京胸科医院病案电子化管理系统》和《图像获取及传输系统》(PACS),收集2012年1月1日至2016年12月31日确诊并有完整MRI资料的31例结核性脊膜炎患者,记录脊膜、蛛网膜下腔及脊髓改变。 结果: 96.8%(30/31)的患者有脊膜增厚和强化。48.4%(15/31)的患者蛛网膜下腔不规则或狭窄,12.9%(4/31)的患者蛛网膜下腔闭塞,6.5%(2/31)的患者有髓外硬膜内结核瘤。脊髓炎见于51.6%(16/31)的患者,而髓内结核瘤见于9.7%(3/31)的患者。58.3%(7/12)的患者在随访MRI中显示病情缓解,25.0%(3/12)的患者有进展,16.7%(2/12)患者的MRI表现无变化。71.0%(22/31)的结核性脊膜炎患者预后不良,包括13例死亡及9例残疾。结论: MRI增强扫描能发现增厚强化的脊膜、脊髓及蛛网膜下腔改变,并且能观察抗结核治疗后的疗效,可以作为结核性脊膜炎患者首选的影像检查方法。     

Localized transmeningeal muscimol prevents neocortical seizures in rats and nonhuman primates: Therapeutic implications

Purpose:   To determine whether muscimol delivered epidurally or into the subarachnoid space can prevent and/or terminate acetylcholine (Ach)–induced focal neocortical seizures at concentrations not affecting behavior and background electroencephalography (EEG) activity.
Methods:   Rats (n = 12) and squirrel monkeys (n = 3) were chronically implanted with an epidural or subarachnoid drug delivery device, respectively, over the right frontal/parietal cortex, with adjacent EEG electrodes. Recordings were performed in behaving rats and chaired monkeys. Via the implants, either a control solution (artificial cerebrospinal fluid, ACSF) or muscimol (0.25–12.5 m m ) was delivered locally as a "pretreatment," followed by the similar delivery of a seizure-inducing concentration of Ach. In five additional rats, the quantities of food-pellets consumed during epidural ACSF and muscimol (2.5 m m ) exposures were measured. In a last group of four rats, muscimol (0.8–2.5 m m ) was delivered epidurally during the ongoing, Ach-induced EEG seizure.
Results:   In contrast to ACSF pretreatments, epidural muscimol pretreatment in rats completely prevented the seizures at and above 2.5 m m . In the monkeys, subarachnoid muscimol pretreatments at 2.5 m m completely prevented the focal-seizure–inducing effect of Ach, whereas similar deliveries of ACSF did not affect the seizures. Furthermore, 2.5 m m epidural muscimol left the eating behavior of rats intact and caused only slight changes in the EEG power spectra. Finally, muscimol delivery during Ach-induced EEG seizures terminated the seizure activity within 1–3 min.
Conclusions:   The results of this study suggest that muscimol is a viable candidate for the transmeningeal pharmacotherapy of intractable focal epilepsy.     

Invasion of the rat ventral root L5 by putative sympathetic C-fibers after neonatal sciatic nerve crush

The present study examines the occurence of C-fibers in lumbar ventral roots after sciatic nerve crush in neonatal and adult rats. Electron microscopic analysis showed that the number of C-fibers in the ventral root L5 increased significantly on the lesion side after neonatal but not adult sciatic nerve crush and that the number of C-fibers was higher in the ventral root L5 on the unoperated side compared to this root in normal control rats. In order to determine whether the new C-fibers in the L5 root on the lesion side are sensory or sympathetic we made immunohistochemical studies on roots from neonatally crushed rats. We found that there was no obvious lesion side/contralateral side or operated rat/control rat difference with respect to the occurence and general configuration of axons with substance P-, calcitonin gene-related peptide- or vasoactive intestinal polypeptide-like immunoreactivity. However, the occurrence of axons with tyrosine hydroxylase-like immunoreactivity appeared clearly higher in the ventral root L5 on the lesion side compared to the unoperated side in neonatally crushed rats. Moreover, these axons seemed to be more numerous also in the ventral root L5 on the unoperated side compared to normal control rats. No lesion side/contralateral side or operated rat/control rat differences were seen in the ventral root L4. We propose that the ventral root L5 is invaded by putative sympathetic C-fibers after sciatic nerve crush lesions in newborn rats.     

Ultrastructure of the outer cortex and thepia mater in man

Summary The pia mater consists of a single, interrupted layer of elongated cells which lie fairly close to the surface of the cortex. Granular material and some collagen fibres lie between the pial cells and the cortex, a greater amount of collagen being present where the pial cells are discontinuous. Basement membrane covers the outer aspect of the cortex, the outer layer of which is formed by interlacing astrocyte processes of varying size. The processes are closely applied with occasional desmosomes between them. Projections of astrocyte processes of different dimensions covered by basement membrane extend at irregular intervals from the cortex into the subarachnoid space.     

The pia mater at the site of the entry of blood vessels into the central nervous system

Summary The entry of blood vessels into the central nervous system (CNS) has been studied at the surface of the brain stem and the spinal cord of two cats and two rabbits. The study was carried out by scanning electron microscopy (SEM). The results obtained by SEM concerning the layers of the pia mater corresponded to those obtained by other authors who used transmission electron microscopy. Between the basal lamina of the superficial glial membrane of the CNS and the cells lining the subarachnoid space, a pial connective tissue space could be clearly recognized. The blood vessles crossing the subarachnoid space were also covered by leptomeningeal lining cells. At the site of entry of these blood vessels into the pia mater their cellular coverings were reflected onto the pial surface. At this point, some vessels were partly surrounded by a small depression of the surface of the pia mater. Having crossed the pial connective tissue space the vessel enters a funnel-shaped channel that leads into the CNS. Within this channel, the vessel is surrounded by pial connective tissue. The outer wall of the channel consists of the basal lamina of the superficial glial membrane. The outer surface of the vessel is also covered by a homogeneous membrane, interpreted as being the basal lamina of the tunica media or, if the tunica media was absent, that of the tunica intima. Only in two instances could it be noted that an entering vessel was surrounded by deep recesses of the surface of the pia mater. In one of these cases, not too deep in the recess to prevent examination by SEM, it could be seen that the cellular coverings of the outer wall of the vessel were reflected onto the layer of the pial lining cells. This observation would indicate that also the deeper perivascular depressions of the pial surface probably do not conform to the classic concept of the Piatrichter (funnel-shaped perivascular depression of the subarachnoid space communicating with the perivascular space of intracerebral vessels). This mode of entry of blood vessels, commonly described in text-books, could not be substantiated by this study.     

大脑中动脉阻断对大鼠软脑膜微血管管径及血流速度的影响

应用闭合式颅骨开窗法观察大鼠大脑中动脉阻断（MCAO）后软脑膜微血管的改变。结果显示,MCAO后微动脉之间的吻合支发生严重的痉挛,而内外两端却均明显扩张,血液倒流,但速度较慢。微静脉明显扩张,血流速度变慢。末梢动脉收缩,血流速度变慢甚或停止。     

内皮素对失血性休克鼠脑微循环的影响及尼莫地平、川芎嗪的治疗作用

利用大鼠颅骨开窗观察脑软膜微循环的方法研究了内皮素（ＥＴ－１）从１０－７～１０－１０Ｍ对脑软膜微循环的影响以及失血性休克时脑软膜对ＥＴ－１的反应性。并用１０－７Ｍ造成失血性休克后脑血管痉挛的模型，观察尼莫地平、川芎嗪、６５４－２内对皮素引起血管痉挛的治疗作用。结果显示：１０－９、１０－８、１０－７Ｍ三种浓度ＥＴ－１可使脑软膜小动脉、细动脉强烈收缩，收缩率分别为２７．７％、１６．８％、７８．５％，其收缩强度与ＥＴ－１的浓度有关。对静脉的作用不明显。１０－１０ＭＥＴ－１可使细动脉轻度扩张。出血性休克时，脑软膜血流明显减慢，小动脉、细动脉管径对ＥＴ－１的收缩作用更敏感，脑组织血流明显减少。尼莫地平具有较好的拮抗ＥＬ－１引起脑软膜动脉的收缩和改善局部微循环的作用。川芎嗪也能拮抗ＥＴ－１引起脑软膜动脉的收缩，但作用较尼莫地平弱。６５４－２不能缓解ＥＴ－１对脑软膜动脉的收缩作用。     

蝙蝠葛诺林碱对小鼠软脑膜微循环障碍的改善作用

目的:探讨蝙蝠葛诺林碱对小鼠软脑膜微循环障碍的改善作用.方法:制备开放式颅窗,采用B12000图像分析系统监测小鼠软脑膜微循环,并在软脑膜局部滴加去甲肾上腺素复制微循环障碍模型,观察局部给予蝙蝠葛诺林碱对小鼠软脑膜微小血管管径和开放数目的影响.结果:不同剂量的蝙蝠葛诺林碱对去甲肾卜腺素所致的软脑膜微动脉和微静脉收缩均有...