脑卒中患者恢复期血清BDNF含量与抑郁发生的相关性分析

目的调查脑卒中患者卒中恢复期血清BDNF含量与卒中后抑郁发生的相关性。方法选择住院确诊为急性脑卒中患者76例,男45例,女31例;年龄34～82岁,平均57.64岁;脑梗死43例,脑出血33例。于病程2周后采用17项版本的汉密尔顿抑郁量表(HAMD)对入组患者进行抑郁程度评分,并用酶联免疫吸附实验(ELISA)法测定患者血清BDNF蛋白含量。根据量表测评结果将入组患者分为脑卒中后抑郁组(PSD组)和脑卒中后非抑郁组(非PSD组)。结果本组患者中发生PSD 42例,卒中后抑郁的发生率为55.26%,其中轻度抑郁30例(39.47%),中度抑郁患者8例(10.53%),重度抑郁患者4例(5.26%);非PSD组34例。Wilcoxon秩和检验结果提示PSD组患者血清BDNF含量较非PSD组患者明显降低(P<0.001)。直线相关分析结果发现,脑卒中恢复期患者血清BDNF含量的表达变化与脑卒中后抑郁程度呈负相关关系,Pearson相关系数为-0.347,P=0.024(双侧)。结论脑卒中后抑郁患者在脑卒中恢复期血清BDNF含量显著降低,且脑卒中后抑郁程度与脑卒中恢复期血清BDNF含量呈负相关关系。提示脑卒中患者血清BDNF含量在预示脑卒中后抑郁的发生及病情严重程度等方面可能发挥了重要作用。     

早期综合治疗脑卒中后抑郁临床对比观察

脑卒中后抑郁(PSD)是脑卒中后的一种常见并发症,脑卒中后抑郁发生率约为60%[1],严重影响脑卒中患者急性期的治疗,延缓患者的神经功能和认知功能恢复,影响患者后期的生活能力和生活质量。随着对PSD认识的提高,临床神经内科医师意识到抑郁状态是影响脑卒中患者康复的主要障碍之一,对脑卒中患者抑郁的治疗直接关系到病人的预后,因而早期诊断和治疗抑郁在脑血管病治疗中愈来愈重要。     

脑卒中后抑郁的研究进展

脑卒中后抑郁(poststroke depression,PSD)是脑卒中后最常见的情绪障碍。PSD会影响患者日常生活能力和神经功能缺损的恢复,造成脑卒中病程迁延,是影响脑卒中后患者生活质量的因素之一。PSD的病理生理机制尚未完全阐明,可能涉及生物学、行为和社会等多项因素。本文对脑卒中后抑郁的发病机制以及诊断和治疗的最新进展进行综述。     

288例脑卒中后抑郁的临床分析

目的探讨脑卒中后抑郁（PSD）的发生率及其主要相关因素。方法选择在本院住院确诊为脑卒中患者769例,采用汉密尔顿抑郁量表（HAMD）17项评分≥18分及卒中患者神经功能缺损程度进行评估。结果 PSD288例,发生率为37.45%,且与卒中性质、部位、程度、生化指标异常等密切相关。动态观察卒中患者CRP水平有助于早期发现PSP。结论预防性抗抑郁剂应用和抗抑郁剂治疗PSD,不仅减低PSD发生率,且有助于PSD和卒中患者神经功能的恢复。     

脑卒中后抑郁患者的护理

目的探讨脑卒中后抑郁（PSD）症状及护理手段。方法采用汉密尔顿抑郁量表的抑郁标准判定脑卒中患者有无抑郁症状。结果经综合护理措施,20例PSD患者的抑郁情绪于2～3个月内康复。结论及早判断脑卒中后抑郁症状,采取综合护理措施,使患者积极配合治疗,在康复训练的基础上,促进功能障碍肢体恢复。     

肠道菌群与脑卒中后抑郁潜在机制的研究进展

<正>脑卒中是全世界最常见的神经系统疾病之一,脑卒中后抑郁(Post-stroke depression,PSD)是脑卒中后常见的神经心理并发症之一。在脑卒中后5 y内,大约有1/3的脑卒中幸存者患有PSD^[1],且由于精神疾病相关的病耻感、较低的治疗寻求率使得患病率可能被低估。PSD与脑卒中患者身体和认知恢复、神经功能结果和生活质量的改善密切相关,抑郁和卒中之间存在双向关系:脑卒中造成PSD,而抑郁增加了脑卒中和脑卒中后死亡风险。     

脑卒中后抑郁患者的护理

目的 探讨脑卒中后抑郁(PSD)症状及护理手段.方法 采用汉密尔顿抑郁量表的抑郁标准判定脑卒中患者有无抑郁症状.结果 经综合护理措施,20例PSD患者的抑郁情绪于2～3个月内康复.结论 及早判断脑卒中后抑郁症状,采取综合护理措施,使患者积极配合治疗,在康复训练的基础上,促进功能障碍肢体恢复.     

卒中后抑郁的影响因素

脑卒中是当今危害人类健康的最主要疾病之一,卒中后抑郁(poststrokedepression,PSD)是脑卒中后常见的并发症,卒中后一年内PSD的累积发病率在30%左右[1]。PSD临床表现为情绪低落、焦虑、自责内疚、精力明显减退、睡眠障碍等。它不仅影响患者生活质量,导致患者出现不良的心境体验和躯体功能障碍,同时还影响患者神经功能和肢体活动功能的康复,而且PSD患者的死亡率要比未患者高[2]。因此研究PSD发病的相关因素,阐明其发生发展规律,对于PSD的早期发现和治疗有实际意义。与PSD相关的因素可以归纳为下列几方面。1生物学因素1.1脑卒中的部…     

脑卒中后抑郁患者载脂蛋白H水平检测

目的了解脑卒中后抑郁症(PSD)患者载脂蛋白H水平特点,为PSD的临床诊断提供新的客观依据。方法采用酶联免疫吸附法(ELISA)和实时荧光定量PCR技术对92例PSD患者进行ApoH水平检测。结果 (1)PSD组ApoH基因mRNA表达量低于脑卒中组,差异具有统计学意义(P<0.05)。(2)PSD组血清ApoH水平高于脑卒中非抑郁组,差异具有统计学意义(P<0.05)。结论脑卒中后抑郁患者外周血载脂蛋白H基因mRNA表达和血清载脂蛋白H水平与单纯脑卒中患者不同。     

卒中后抑郁37例临床分析

脑卒中是我国发病率、病死率和致残率都很高的一组疾病,卒中后抑郁（post-strokedepression,PSD）是常见的卒中后心理障碍,不仅影响患者的生存质量,还防碍其神经功能的恢复。本文分析了90例脑卒中患者伴发抑郁的发生率、影响因素及治疗方案,现总结如下。     

早年创伤对认知功能影响的研究进展

早年创伤是一个全球普遍存在的问题,严重影响儿童、青少年的大脑发育,继而导致认知功能、人格水平、社会行为的改变。早年创伤主要是父母、监护人或其他年长者对孩子施加躯体虐待、躯体忽视、情感虐待、情感忽视或性虐待。美国一项调查显示：儿童虐待事件的发生率高达1．2％[1]。早年创伤影响认知功能的多个领域,包括学习／工作记忆、视觉空间能力、执行功能、言语智能、复杂推理搜决策、学业表现等比]。创伤造成的认知功能改变是目前国内外神经科学和精神医学领域研究的热点,但其发病机制仍不明确,鉴于早年创伤与认知功能的关系问题,现就早年创伤对大脑发育、神经认知的影响加以综述。     

Differential cognitive responses to guqin music and piano music in Chinese subjects： an event-related potential study

Objective To compare the cognitive effects of guqin （the oldest Chinese instrument） music and piano music. Methods Behavioral and event-related potential （ERP） data in a standard two-stimulus auditory oddball task were recorded and analyzed. Results This study replicated the previous results of culture-familiar music effect on Chinese subjects： the greater P300 amplitude in frontal areas in a culture-familiar music environment. At the same time, the difference between guqin music and piano music was observed in NI and later positive complex （LPC： including P300 and P500）： a relatively higher participation of right anterior-temporal areas in Chinese subjects. Conclusion The results suggest that the special features of ERP responses to guqin music are the outcome of Chinese tonal language environments given the similarity between Guqin＇s tones and Mandarin lexical tones.     

Brain network markers of abnormal cerebral glucose metabolism and blood flow in Parkinson＇s disease

Neuroimaging of cerebral glucose metabolism and blood flow is ideally suited to assay widely-distributed brain circuits as a result of local molecular events and behavioral modulation in the central nervous system. With the progress in novel analytical methodology, this endeavor has succeeded in unraveling the mechanisms underlying a wide spectrum of neurodegenerative diseases. In particular, statistical brain mapping studies have made significant strides in describing the pathophysiology of Parkinson＇s disease （PD） and related disorders by providing signature biomarkers to determine the systemic abnormalities in brain function and evaluate disease progression, therapeutic responses, and clinical correlates in patients. In this article, we review the relevant clinical applications in patients in relation to healthy volunteers with a focus on the generation of unique spatial covariance patterns associated with the motor and cognitive symptoms underlying PD. These characteristic biomarkers can be potentially used not only to improve patient recruitment but also to predict outcomes in clinical trials.     

Effect of Ganoderma lucidum spore on expression of insulin-like growth factor-1, nuclear factor-kappa B, and neuronal apoptosis in the epileptic rat brain*★

BACKGROUND：It has been reported that Ganoderma lucidum spore powder, a very well known Chinese traditional medicine, can affect immunoregulation, free radical scavenging, and anti-hypoxia responses. OBJECTIVE： To investigate the effect of Ganoderma lucidum spore powder on expression of insulin-like growth factor-1 （IGF-1）, nuclear factor-κB （NF-κB） and neuronal apoptosis in rats with pentylenetetrazol （PTZ）-induced epilepsy. DESIGN, TIME AND SETTING： A cellular and molecular biology experiment with randomized controlled study design was performed at the Central Laboratory of Basic Medical College of Jiamusi University from June to August 2005. MATERIALS： Thirty healthy, adult, male, Wistar rats were selected and randomly divided into 3 groups （10 rats per group）： control, epilepsy model, and Ganoderma lucidum spore powder. A sub-eclampsia PTZ dose （35 mg/kg） was intraperitoneally injected to induce epilepsy in the latter two groups. Wild Ganoderma lucidum spore powder （30 g/L） was provided by the wild Ganoderma lucidum plant nursery at Jiamusi, China. Immunohistochemical detection and terminal deoxynucleotidyl transferase-mediate dUTP nick end-labeling （TUNEL） kits were purchased from Wuhan Boster Biological Technology Co., Ltd., China. METHODS： Ganoderma lucidum spore powder was intragastrically administered at a dose of 10.0 mL/kg, once a day for 28 days. In the epilepsy and control groups, an equivalent volume of normal saline was intragastrically administered. MAIN OUTCOME MEASURES： Immunoreactivity for IGF-1 and NF-κB/P65 were detected by immunohistochemical staining. Neuronal apoptosis was detected using TUNEL methods. RESULTS： The hippocampus and cerebral cortex of rats with PTZ-induced epilepsy exhibited a higher number of apoptotic cells at high magnification （×400）, compared with the control group. Expression of IGF-1 and NF-κB were higher in the epilepsy group, compared with the control group （P 〈 0.01）. In Ganoderma lucidum spore-treated rats,     

Neuroprotective effects of recombinant human erythropoietin on facial motoneurons after facial nerve injury in rats★

BACKGROUND： Erythropoietin and recombinant human erythropoietin （rhEPO） inhibit apoptosis of motor neurons caused by spinal cord injury and brain damage in rats. However, it still remains to be shown whether rhEPO can protect facial motoneurons （FMNs） as Well. OBJECTIVE： To test the neuroprotective effects of rhEPO on injured VMNs, as well as the influence on Caspase-3 expression. DESIGN, TIME AND SETTING： Randomized, controlled, animal experiment. This study was performed at the Central Laboratory of Basic Medical College, Chongqing Medical University from January to October 2007. MATERIALS： Seventy-five female SD rats, weighing 210-230 g. rhEPO injection was provided by Sansheng pharmaceuticals company, Shenyang City, Liaoning Province, China, and the License number was HMLN S20010001. METHODS： A total of 75 female rats were randomly divided into rhEPO treatment, control, and sham operation groups, with 25 rats in each group. Rat models of facial nerve injury were established in the rhEPO treatment group and the control group by crushing the main trunk of the left facial nerve. Surgical microscopic observation of the facial nerve damage displayed perineurial disruption. The left stylomastoid foramen of the sham operation group were only exposed, but without nerve injury. The rhEPO treatment group was treated with rhEPO （5 000 U/kg, i.p.） once following injury and once a day for two weeks. The control and sham operation groups were treated with the same dose of normal saline （i.p.）, once following injury and once a day for two weeks. MAIN OUTCOME MEASURES： Rats were sacrificed 3, 7, 14, 21, and 28 days after injury, FMN survival after facial nerve injury was analyzed by Toluidine blue staining, and then survival ratios （L/R） were calculated. The number of apoptotic profiles in the injured FMNs were evaluated by TUNEL staining. Expression of Caspase-3 in the facial nucleus was detected by immunohistochemistry methods. RESULTS： A total of 75 rats were included in the final analysi     

Effect of bilobalide B on cholinergic hippocampal neurons exposed to cholesterol and apolipoprotein E4*☆

BACKGROUND： Extracts of ginkgo biloba leaves have been reported to improve nerve function and activity in Alzheimer＇s disease, which is associated with reduced secretion of cholinergic neurotransmitter in hippocampal neurons. OBJECTIVE： To validate the protective effect of bilobalide B against in vitro injury of cholinergic neurons of the hippocampus induced by combined cholesterol and apoE4 DESIGN, TIME AND SETTING： This randomized, controlled animal experiment was performed in the Pathology Laboratory, Tianjin University of Traditional Chinese Medicine from July 2003 to July 2006. MATERIALS： Neonatal Wistar rats, 1-day-old, both male and female, and mean body mass of 5 g were selected for this study. Cholesterol and apolipoprotein E4 （apoE4） were purchased from Sigma Company （USA）, bilobalide B was purchased from Tianjin Zhongyi Pharmaceutical Factory, batch number 20050312. METHODS： Hippocampal neurons were divided into three groups： a normal control group （routinely added media）, a model group （exposed to media containing 40 mg/L cholesterol and 30 mg/L apoE4 for 24 hours） and a bilobalide B group （exposed to media containing 160 mg/L bilobalide B for 16 hours, and then with addition of 40 mg/L cholesterol and 30 mg/L apoE4 for an additional 24 hours）. MAIN OUTCOME MEASURES： Levels of acetylcholine （ACh） and activity of acetylcholinesterase （ACHE） and choline acetyltransferase （CHAT） in hippocampal neurons were determined by microdosage hydroxylamine colorimetry, hydroxylamine colorimetry and radiological chemistry, respectively. RESULTS： The ACh level was significantly lower in the model group than that in the normal control group （P 〈 0.01）, while it was markedly higher in the bilobalide B group than in the model group （P 〈 0.05）. Activity of AChE was significantly decreased in the model group compared with the normal control group （P 〈 0.05）. However, there was no significant difference between the model group and the bilobalide B group ?     

Naoxintong dose effects on inflammatory factor expression in the rat brain following focal cerebral ischemia

BACKGROUND： Certain components of tetramethylpyrazine, a traditional Chinese medicine, exhibit protective effects against brain injury. OBJECTIVE： To investigate the effects of different Naoxintong doses on expression of nuclear factor-kappa B （ kB）, interleukin-6, tumor necrosis factor-α, and complement 3 in rats following focal cerebral ischemia. DESIGN, TIME AND SETTING： The randomized experiment was performed at the Laboratory of Neurology, Second Hospital of Hebei Medical University from June 2004 to June 2006. MATERIALS： A total of 150 adult, healthy, male, Sprague Dawley rats, weighing 280-320g, were selected. Naoxintong powder （mainly comprising szechwan lovage rhizome, milkvetch root, danshen root, and radix angelicae sinensis） was obtained from Buchang Pharmacy Co., Ltd. in Xianyang City of Shanxi Province of China, lot number 040608. METHODS： The rats were randomly assigned into sham operation, saline, high-dose Naoxintong, moderate-dose Naoxintong, and low-dose Naoxintong groups, with 30 rats in each group. Rat models of middle cerebral artery occlusion were established using the suture method, with the exception of the sham operation group. Rats in the high-dose, moderate-dose and low-dose Naoxintong groups received 4, 2, and 1 g/kg Naoxintong respectively, by gavage. Rats in the saline group were treated with 1 mL saline by gavage All rats were administered by gavage at 5 and 23 hours following surgery, and subsequently, once per day. MAIN OUTCOME MEASURES： At 6, 24, 48, 72 hours, and 7 days following model establishment, brain water content was measured. Histopathological changes in brain tissues were detected using hematoxylin-eosin staining. Expression of nuclear factor- kB, interleukin-6, tumor necrosis factor- α, and complement 3 was examined by immunohistochemistry. RESULTS： A total of 150 rats were included in the final analysis with no loss. Brain water content was significantly increased in the ischemic hemisphere of rats from the saline, as well as the high-dose, mo     

Activation of extrasynaptic GABA. receptors inhibits cyclothiazide- induced epileptiform activity in hippocampal CA1 neurons

Extrasynaptic GABAA receptors （GABAARs）-mediated tonic inhibition is reported to involve in the patho- genesis of epilepsy. In this study, we used cyclo- thiazide （CTZ）-induced in vitro brain slice seizure model to explore the effect of selective activation of extrasynaptic GABAARS by 4,5,6,7-tetra- hydroisoxazolo[5,4-c] pyridine-3-ol （THIP） on the CTZ-induced epileptiform activity in hippocampal neurons. Perfusion with CTZ dose-dependently induced multiple epileptiform peaks of evoked population spikes （PSs）in CA1 pyramidal neurons, and treatment with THIP （5 μmol/L） significantly reduced the multiple PS peaks induced by CTZ stimulation. Western blot showed that the 6-subunit of the GABAAR, an extrasynaptic specific GABAAR subunit, was also significantly down-regulated in the cell membrane 2 h after CTZ treatment. Our results suggest that the CTZ-induced epileptiform activity in hippocampal CA1 neurons is suppressed by the activation of extrasynaptic GABAARs, and further support the hypothesis that tonic inhibition mediated by extrasynaptic GABAARs plays a prominent role in seizure generation.     

晚发性精神分裂症的研究进展

精神分裂症是一种常见的病因尚未完全阐明的精神病,常有特殊的思维、知觉、情感和行为等多方面的障碍和精神活动与环境的不协调。多起病于青壮年,而临床上起病年龄为40岁以上的精神分裂症患者并不少见。Bleuler于1943年首次提出“晚发性精神分裂症”（Late—onset Schizophrenia）,指出发病年龄在40岁以后的为晚发性精神分裂症。