U-74389G对大鼠脑创伤后细胞凋亡及bcl-2表达的影响

目的探讨脂质过氧化反应与脑损伤后细胞凋亡及bcl-2基因表达的关系。方法在大鼠液压颅脑损伤模型中,观察其运动神经功能;脑创伤后细胞凋亡的形态和生化特征;伤后bcl-2基因表达情况;比较伤前给予U-74389G对上述指标的影响。结果治疗组的颅脑伤大鼠伤后行走功能、平衡功能障碍程度明显低于未治疗组（P<0.01）。治疗组大鼠不同脑区各个时间点凋亡细胞数均显著减少,DNA电泳未见凋亡带谱。Bcl-2免疫反应阳性细胞主要位于伤侧大脑半球皮质、皮层下白质、海马及齿状回的神经细胞。表达Bcl-2蛋白的神经细胞很少见到凋亡或坏死的形态特征。Bcl-2早期改变出现在伤后6h,比细胞凋亡出现早。注射U-74389G能阻止bcl-2蛋白下调。结论U-74389G能阻止大鼠液压脑损伤后bcl-2基因表达下调,抑制脑创伤所致细胞凋亡,具有明显的神经保护作用。     

脑损伤及胎脑移植的实验研究

目的　观察胎脑细胞悬液延迟移植于脑损伤的生长情况。　方法　46只SD大鼠采用自由落体撞击法制备脑损伤模型。16只仅做单纯脑损伤,伤后14,20,30,40d处死大鼠做HE染色形态学观察;另30只做胎脑移植,于伤后14d做同种胎脑经机械分离的细胞悬液延迟移植,移植后1,5,14,30,75d处死大鼠做HE染色形态学观察。　结果　所有实验大鼠生长良好,无肢体偏瘫。胎脑细胞悬液浓度为4.48×107/ml,活细胞占85.3％,神经细胞占48.2％。伤后14d表现为陈旧性损伤,随时间推移,创伤灶被胶质细胞充填。移植后5d出现免疫细胞,14d胎脑细胞存活,宿主的毛细血管、胶质细胞增生,30d胎脑细胞发生分化,75d胎脑细胞与宿主相互融合。免疫细胞和小部分移植物碎片同时始终存在。　结论　大鼠脑损伤后行胎脑细胞悬液移植,移植物是可以存活并可能发挥功能的。     

脑外伤后氧化应激对神经细胞凋亡及c-myc蛋白表达的影响

目的　探讨氧化应激对脑损伤后神经细胞凋亡和c -myc蛋白表达的影响及c -myc基因在脑损伤神经细胞凋亡中的作用。　方法　 90只SD大鼠液压冲击致脑损伤后 ,随机分成两组 ,实验组给予单甲氧基聚乙二醇 -超氧化物歧化酶 (monomethoxypolyethleneglycolmodified -SOD ,MPEG -SOD) ,对照组给予等渗盐水 ,分别于伤后 3,12 ,2 4 ,4 8,72h采用原位末端标记法 (TdT -med iatedbiotinylated -dUTPnickendlabeling ,TUNEL)检测脑损伤区神经细胞凋亡 ,流式细胞仪检测神经细胞凋亡率 ;免疫组织化学法检测c-myc蛋白的表达。　结果　大鼠脑损伤后 3h ,在实验组和对照组均可检测到神经细胞的凋亡和c-myc蛋白的表达 ,至 2 4～ 4 8h达到高峰。实验组神经细胞凋亡率和c -myc蛋白的灰度明显较对照组低 (P <0 .0 1)。TUNEL阳性细胞数和c -myc蛋白灰度具有明显的相关性 (实验组r=0 .92 ,对照组r =0 .84 ,P <0 .0 1)。　结论　脑损伤后氧化应激诱导神经细胞凋亡和c -myc蛋白表达 ;c -myc蛋白可促进脑损伤后神经细胞凋亡     

垂体腺苷酸环化酶激活肽对大鼠创伤性脑损伤后神经细胞凋亡的影响

目的观察大鼠创伤性颅脑损伤(TBI)后神经细胞凋亡现象。应用垂体腺苷酸环化酶激活肽(PACAP)观察其对损伤后大鼠神经细胞凋亡的影响。方法采用TBI模型,运用原位末端标记(Tunel)技术,观察大鼠中度脑损伤后2小时～3天伤侧大脑皮层、海马神经细胞凋亡情况。结果(1)Tunel染色:伤侧大脑半球广泛存在细胞凋亡,以受伤区周缘为甚,伤后2小时即可见凋亡细胞,2～3天达高峰。(2)PACAP治疗后12小时～3天,伤侧皮层、海马区细胞凋亡数与损伤组比较明显减少(P<0.05)。结论大鼠TBI后,神经元在发生变性、坏死的同时,存在凋亡现象。PACAP能阻滞大鼠TBI后神经细胞的凋亡,具有脑保护作用。     

TBI大鼠海马糖皮质激素受体表达变化对认知功能的影响

目的 研究创伤性脑损伤(traumatic brain injury,TBI)后大鼠海马区糖皮质激素受体(ghcocorticoid receptor,GR)表达的变化对认知功能的影响.方法 建立大鼠脑损伤模型,应用免疫组化、Western blot和Morris水迷宫检测伤后大鼠海马区GR表达与学习记忆功能的关系.结果伤后4～10 d大鼠海马区GR持续低表达;Morris水迷宫检测伤后大鼠出现认知功能障碍.结论 TBI大鼠海马区GR表达变化与认知功能的障碍改变具有相关性.

Abstract：

Objective To explore the effect of glucocorticoid receptor(GR)expression in rat hippocampus on cognitive function after traumatic brain injury(TBI). Methods The TBI model wag established in rats.Then,immunohistochemistry and Western blot were used to detect the GR expression and evaluate its relation with cognitire dysfunction by Morris water maze. Results Expression of hippocampal GR was down-regulated 4-10 days after TBI.Morris water maze test showed significant impairment of the cognitive function in rats. Conclusion There is correlation between expression change of hippocampal GR and cognitive dysfunction.     

创伤性脑损伤后脑组织c-fos表达及细胞凋亡

目的研究创伤性脑损伤（TBI）后脑组织c-fos表达及神经细胞凋亡，探讨神经细胞凋亡在脑继发性损害中的作用，及c-fos基因表达与凋亡的关系。方法雄性Wistar大鼠，随机分为假手术对照组和脑创伤后3、12、24、72小时和7天组，采用自由落体撞击致重型颅脑损伤。应用TUNEL法检测神经细胞凋亡，免疫组化法观测c-fos的表达。结果TBI后3小时创伤组各组脑组织即出现c-fos表达和神经细胞凋亡，随伤后时间逐渐增强，至伤后72小时达高峰，伤后7天仍有明显的c-fos表达和神经细胞凋亡。其分布区域为脑挫伤区、挫伤周围皮质和海马，累及细胞类型包括神经元和胶质细胞。c-fos表达与神经细胞凋亡在时序空间分布上基本一致，两者呈正相关。结论创伤性脑损伤可引起脑组织明显的c-fos表达和神经细胞凋亡，c-fos表达增加在神经细胞凋亡和修复中可能起重要作用。     

脑损伤后大鼠神经功能及海马神经元的变化

目的：观察并探讨Feeney法创伤性脑损伤中大鼠神经功能及海马神经元的变化，以选择一种合理的大鼠脑损伤模型致伤方案，方法：用20g重棒分别从10，30，40g重棒从25cm的高度打击SD大鼠一侧脑皮层致伤，观察伤后大鼠神经功能及海马神经元的变化。结果：200g.cm所致的损伤伤后无明显的神经功能障碍和海马结构的改变。600g.cm可造成一定程度的神经功能障碍及伤侧海马神经元变性坏死；1000g.cm可引起伤后严重的神经功能缺损，伤侧海马结构被完全毁损，结论：Feeney法创伤性脑损伤模型中600g.cm打击方案是较为合理且又能致创伤性脑损伤后大鼠神经功能及海马神经元改变的脑损伤方案。     

脑损伤早期神经细胞c－fos基因表达变化与脑水肿

采用免疫细胞化学方法（ＡＢＣ）研究大鼠脑损伤早期神经细胞ｃ－ｆｏｓ基因表达变化，探讨脑损伤时神经细胞ｃ－ｆｏｓ基因表达变化与脑水肿的关系。结果发现，脑损伤后仅０．５ｈ，脑损伤区周围神经细胞中ｃ－ｆｏｓ基因表达已明显，伤后３～６ｈ更为显著。同时伴有相应部位脑灰质及脑白质水含量增加。初步研究结果提示，脑损伤早期神经细胞ｃ－ｆｏｓ基因表达变化与脑水肿的发生有密切关系。     

脑损伤早期神经细胞c—fos基因表达变化与脑水肿

采用免疫细胞化学方法研究大鼠脑损伤早期神经细胞ｃ－ｆｏｓ基因表达变化，探讨脑损伤时神经细胞ｃ－ｆｏｓ基因表达变化与脑水肿的关系。结果发现，脑损伤后仅０．５ｈ，脑损伤区周围神经细胞中ｃ－ｆｏｓ基因表达已明显，伤后３￣６ｈ更为显著，同时伴有相应部位脑灰质及脑白质水含量增加，初步研究结果提示，脑损伤早期神经细胞ｃ－ｆｏｓ基因表达变化与脑水肿的发生有密切关系。     

脑复合剂对脑损伤大鼠Na+-K+-ATP酶、Ca2+-ATP酶活性及Ca2+调控的影响

目的 观察刨伤性脑损伤(traumatic brain injury,TBI)大鼠脑组织匀浆及线粒体Na+-K+-ATP酶、Ca2+-ATP酶活性、神经细胞内游离Ca2+浓度及脑组织钙调蛋白(CaM)表达的动态变化,探讨脑复合剂脑保护作用的分子生物学机制.方法 建立大鼠TBI模型,分别设立假手术组、TBI组及中药治疗组.中药治疗组给予脑复合剂10 g·kg-1·d-1,假手术组及TBI组给予同等剂量等渗盐水,2次/d,连续7 d.分别于TBI后24 h、72 h、1周等3个时相点处死大鼠,动态定量分析各组大鼠脑组织匀浆及线粒体Na+-K+-ATP酶、Ca2+-ATP酶活性、神经细胞内游离Ca2+浓度及脑组织CaM表达的变化.结果 TBI组各时相点大鼠脑组织匀浆及线粒体Na+-K+-ATP酶、Ca2+-ATP酶活性均明显降低,于TBI后72 h后逐渐恢复,1周时仍明显低于假手术组.中药治疗组大鼠脑组织Na+-K+-ATP酶、Ca2+-ATP酶活性显著增加(P＜0.05);TBI组各时相大鼠脑组织神经细胞内游离Ca2+浓度及脑组织CaM表达均有不同程度增高,于伤后24 h达高峰,持续至72 h仍高于假手术组.而中药治疗组各时相大鼠神经细胞内游离Ca2+浓度及脑组织CaM表达明显低于TBI组(P＜0.05).结论 脑复合剂的脑保护作用可能与增加脑组织Na+-K+-ATP酶、Ca2+-ATP酶的活性,从而减轻TBI后脑细胞的能量代谢障碍,降低神经细胞内游离Ca2+浓度及脑组织CaM表达,减轻Ca2+超载所导致的继发性脑损伤有关.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

磁共振DWI和动态增强鉴别颅底脊索瘤和侵袭性垂体瘤的应用

目的 探讨磁共振扩散加权成像(DWI)和动态增强在颅底脊索瘤和侵袭性垂体瘤(IPA)鉴别诊断中的应用价值.方法 搜集经手术病理证实且影像学有鞍区破坏的颅底脊索瘤患者15例、向鼻咽部侵犯的IPA患者20例.测量二者的表观扩散系数(ADC)值,绘制受试者工作特征曲线(ROC),分析动态增强曲线的类型,统计达峰时间(TTP)、增强峰值(EP)和最大对比增强率(MCER),分析各个参数在鉴别诊断中的价值.结果 颅底脊索瘤的ADC值为(1.274±0.07)×10-3mm2/s,高于IPA ADC值(0.672±0.03) ×10-3 mm2/s(P ＜0.001),ADC阈值为0.964×10-3mm2/s时,ROC曲线下面积为0.997,敏感度为93.3％,特异度为100％.颅底脊索瘤时间-信号强度曲线(TIC)Ⅰ型14例,TICⅢ型1例,此例TICⅢ型者TTP约40 s;IPA TIC Ⅰ型7例,TICⅢ型13例.颅底脊索瘤和IPA的EP、MCER差异均有统计学意义(P ＜0.001).结论 ADC值和TIC的类型及其相关参数(EP,MCER)有助于颅底脊索瘤和IPA之间的鉴别.     

Treatment of intrahepatic arteriovenous fistula in hepatocellular carcinoma with N-butyl-2-cyanoacrylate

Primary hepatocellular carcinoma (HCC) continues to be one of the most common malignancies with an incidence of approximately one million cases per year and a dismal prognosis; some authors have reported a median survival of 1 ～ 2 months after diagnosis. Although surgery remains the only hope for cure, few patients are candidates[1,2].