应用人骨髓基质细胞治疗大鼠缺血性脑梗塞的实验研究

目的　探索应用骨髓基质细胞治疗缺血性脑梗塞的途径 ,效果 ,机理。方法　从健康人肋骨取原代骨髓基质细胞后扩增。线栓法制作大鼠大脑中动脉缺血模型 (n=5 6 ) ,2小时后再灌注。 2 4小时后治疗组 (n =2 8)尾静脉注射 3× 10 6 骨髓基质细胞 ,对照组 (n =2 8)尾静脉注射 1ml生理盐水。分别采用神经损伤评分 (NSS)检测大鼠神经系统功能 ,ELISA检测BDNF、NGF ,流式细胞仪检测细胞凋亡 ,免疫组化方法检测脑内骨髓基质细胞或骨髓基质细胞来源的细胞。结果　在 7,14 ,2 1,2 8天治疗组的NSS较对照组明显低 (P <0 0 5 ) ,治疗组的BDNF和NGF较对照组明显高(P <0 0 5 ) ,治疗组的凋亡细胞较对照组明显减少 (P <0 0 5 )。在缺血侧半球可以发现骨髓基质细胞 ,并且一部分骨髓基质细胞表达了神经细胞表面标志物。结论　静脉移植骨髓基质细胞治疗缺血性脑梗塞是一种简单有效的方法。骨髓基质细胞移植后缺血脑组织中生长因子的增加对神经功能的恢复起到了重要作用。     

静脉注射骨髓基质细胞对大鼠局灶性脑缺血区域ICAM-1表达的影响

目的 探讨静脉注射骨髓基质细胞治疗大鼠局限性脑缺血后的ICAM-1的表达.方法 贴壁+胰酶消化法分离培养大鼠骨髓基质细胞,取传至第8代前的细胞用于移植,接种前1d进行BrdU标记,制成单细胞悬液,调整细胞密度为3×109/ml.各组大鼠均采用改良Longa线栓法建立大脑中动脉栓塞1h模型,造模后24h,细胞移植组每只大鼠股静脉注射骨髓基质细胞悬液1ml,盐水对照组同法注射等量生理盐水,空白对照组不做任何处理.造模后3、7、14d对各组大鼠进行神经功能评分.免疫组化测定脑缺血再灌注3、7、14d ICAM-1蛋白表达.结果 股静脉注射骨髓基质细胞后,骨髓基质细胞可在缺血半球大量存活,在对侧半球也有少量存活,并可使大鼠的神经功能改善,抑制梗死后ICAM-1的表达.结论 经静脉注射骨髓基质细胞可改善大鼠神经功能评分,抑制ICAM-1表达,从而减轻脑缺血再灌注的危害.     

骨髓基质细胞移植治疗大鼠实验性脑梗死的疗效分析及组织病理学观察

目的 观察大脑中动脉闭塞(MCAO)模型大鼠脑内移植骨髓基质细胞fBMSCs)的治疗作用,分析植入梗死灶不同区域的BMSCs的存活、迁移情况以及植入细胞的行为与脑内微环境中GFAP阳性细胞的形态关系.方法 75只成年SD大鼠采用随机数字表法分为MCAO组(n=50)和BMSCs移植组(n=25),所有动物均采用线栓法制作MCAO 1 h模型,24 h后BMSCs移植组脑内注射BrdU标记的同种异体BMSCs(2x106个),MCAO组注射等量PBS.MCAO前及MCAO后第1(移植前)、3、5、7、10、14天应用加速转轮试验和贴纸去除试验检测神经功能缺损情况;第14天处死动物,取脑组织切片应用HE染色观察两组的缺血病灶范围,行BrdU和GFAP免疫组化染色观察BMSCs在不同区域和不同胶质细胞环境下的存活和迁移情况.结果 BMSCs移植组MCAO后7 d加速转轮试验结果优于MCAO组,差异有统计学意义(P＜0.05);组织学观察发现植入缺血半暗带区的细胞存活数量最多,且向病变方向放射状迁移,植入缺血病灶核心的细胞甚少存活,且无迁移现象.结论 BMSCs脑内移植可改善MCAO后大鼠神经运动功能;活化的星形胶质细胞构成适合植入细胞存活、迁移的环境,而胶质瘢痕阻碍了细胞的迁移.     

骨髓基质细胞静脉移植治疗大鼠短暂性局灶性脑缺血

目的探讨骨髓基质细胞静脉移植治疗大鼠短暂性局灶性脑缺血的可行性及其机制。方法将大鼠骨髓基质细胞在体外纯化、扩增并经BrdU标记后,经尾静脉移植到局灶性脑缺血大鼠体内,通过神经缺损评分观察移植后大鼠神经行为学改善情况,通过组织学方法观察移植到脑内的骨髓基质细胞表达脑源性神经营养因子、缺血灶周围细胞凋亡及脑微血管密度的变化。结果骨髓基质细胞移植组大鼠的神经缺损评分显著低于对照组(P<0.05);移植到脑内的骨髓基质细胞主要选择性分布于缺血灶周围区域并表达BDNF;骨髓基质细胞移植组大鼠梗死灶周围的凋亡细胞明显少于对照组(P<0.01)、微血管密度显著高于对照组(P<0.001)。结论经静脉注射移植骨髓基质细胞能够明显促进局灶性脑缺血大鼠的神经行为功能恢复;抗凋亡及促微血管增生可能是骨髓基质细胞移植治疗局灶性脑缺血的机制之一。     

骨髓基质细胞移植缺血性脑梗死大鼠后神经营养因子的表达

背景：骨髓基质细胞在适宜条件下可分化为神经元和星形胶质细胞,分泌可溶性分子促进神经元存活。 目的：观察骨髓基质细胞移植后缺血性脑梗死大鼠脑组织神经营养因子表达情况及其对神经功能的影响。 方法：改良的Longa栓线法制作大鼠大脑中动脉缺血模型,1 h后再灌注,24 h后治疗组尾静脉注射3×106骨髓基质细胞,盐水对照组尾静脉注射1 mL生理盐水,空白对照组不进行注射。 结果与结论：在梗死后第7,14天治疗组的神经损伤评分明显低于对照组(P < 0.05);治疗组神经生长因子和脑源性神经营养因子表达在各时间点均高于对照组(P < 0.05)。结果显示静脉移植骨髓基质细胞可改善缺血性脑梗死大鼠神经功能,移植骨髓基质细胞后缺血脑组织中神经生长因子及脑源性神经营养因子表达促进了神经功能的恢复。     

骨髓基质细胞立体定向移植治疗大鼠脑缺血损伤的实验研究

目的:观察骨髓基质细胞立体定向移植对大鼠脑缺血损伤后神经功能恢复的作用并探讨其作用机制。方法:制作SD大鼠大脑中动脉缺血模型(MCAO);体外培养骨髓基质细胞,观察其生物学特性以及立体定向移植后对脑缺血损伤后神经功能改善情况。结果:骨髓基质细胞体外可以长期传代、扩增,分泌NGF、VEGF等多种神经保护性因子;立体定向移植后,骨髓基质细胞在脑内存活、迁徙,小部分分化成具有神经元表面标志的细胞,与对照组相比,骨髓基质细胞移植组神经功能改善情况好于对照组。结论:骨髓基质细胞具有多向分化潜能,表达并分泌多种神经保护性营养因子。立体定向移植MSCs,对改善脑缺血损伤后的神经功能状况具有积极作用。     

联合应用骨髓基质细胞与bcl-2基因对脑缺血大鼠的神经保护作用

目的 探讨联合应用骨髓基质细胞(MSC)与bcl-2基因对大鼠脑缺血再灌注损伤后神经细胞凋亡和细胞色素C蛋白表达的影响.方法 采用改良线栓法制成大脑中动脉闭塞大鼠模型.将30只Wistar大鼠随机分为空白对照组、MSC组及MSC+bcl-2组3组,每组10只.MSC+bcl-2组于大鼠脑缺血再灌注3 h后经颈动脉注入pLXSN-bcl-2质粒,MSC组及MSC+bcl-2组于大鼠脑缺血再灌注24 h后经尾静脉植入MSC.各组于再灌注后7 d进行神经功能评分,采用免疫组化法检测脑组织细胞色素C蛋白表达,通过TUNEL法检测细胞凋亡情况.结果 再灌注7 d后,MSC组和MSC+bcl-2组大鼠神经功能缺损评分明显低于空白对照组(P<0.05),MSC+bcl-2组大鼠神经功能评分明显低于MSC组(P<0.05);MSC组和MSC+bcl-2组大鼠细胞色素C免疫反应阳性细胞较空白对照组明显减少(P<0.05),MSC+bcl-2组大鼠细胞色素C免疫反应阳性细胞较MSC组明显减少(P<0.05);空白对照组大鼠缺血侧凋亡细胞明显多于MSC组和MSC+bcl-2组(P<0.05),MSC+bcl-2组大鼠凋亡细胞明显少于MSC组(P<0.05).结论 MSC和bcl-2基因联合治疗脑缺血大鼠可下调其组织细胞色素C表达及抑制神经细胞凋亡,促进大鼠神经功能恢复.     

脑源性神经营养因子基因重组慢病毒转染骨髓间质干细胞移植治疗大鼠脑出血的实验研究

目的 观察脑源性神经营养因子(BDNF)基因重组慢病毒转染骨髓间质干细胞(MSCs)移植治疗大鼠脑出血的疗效.方法 分离培养大鼠MSCs;将带有BDNF的慢病毒载体转染MSCs;RT-PCR、蛋白质印迹检测转基因MSCs BDNF基因及蛋白水平表达.制备大鼠脑出血模型,采用抽签法随机分为磷酸盐缓冲液(PBS)组、MSCs组、空病毒转染骨髓问质干细胞(MSCs-EGFP)组、脑源性神经营养因子基因重组慢病毒转染骨髓间质干细胞(MSCs-EGFP-BDNF)组,每组15只.72 h后细胞移植,记录各组细胞移植后7、14、21 d神经功能缺损改善程度;免疫荧光双标检测MSCs脑内迁移和分化情况.结果 MSCs-EGFP-BDNF组BDNF基因及蛋白水平表达明显高于MSCs组及MSCs-EGFP组;与PBS组(7 d:2.0±0.4,14 d:1.7 ±0.2,21 d:1.3±0.2)相比,MSCs组(7 d:1.6±0.2,14 d:1.2 ±0.3,21 d:0.8±0.2)、MSCs-EGFP组(7 d:1.6±0.3,14 d:1.1 ±0.2,21 d:0.8 ±0.3)及MSCs-EGFP-BDNF组(7 d:1.2±0.3,14 d:0.6±0.1,21 d:0.2 ±0.2)大鼠神经功能评分均有不同程度改善(F=6.667、18.417、20.882,均P＜0.05),其中MSCs-EGFP-BDNF组改善最为显著;免疫荧光双标显示MSCs-EGFP-BDNF组胶原纤维酸性蛋白、神经元特异性核蛋白、环核苷酸磷酸二酯酶阳性率明显高于MSCs组及MSCs-EGFP组,而MSCs组与MSCs-EGFP组比较差异无统计学意义.结论 BDNF基因重组慢病毒修饰的MSCs基因及蛋白水平表达均增高;修饰的MSCs移植后可迁移至脑出血灶周围存活并分化表达神经细胞标志物,促进脑出血后神经功能修复.     

转染肝细胞生长因子的骨髓间质细胞治疗大鼠缺血性脑卒中

目的探讨转染肝细胞生长因子（HGF）的骨髓间质细胞（MSCs）治疗大鼠脑缺血的效果。方法制备大鼠一过性大脑中动脉缺血（MCAO）模型。MCAO后24h分别将磷酸盐溶液（PBS）、MSCs和转染HGF的MSCs（MSC—HGF）通过立体定向技术植人缺血脑组织。通过改良神经功能严重性评分（mNSS）评价神经功能,应用免疫组织化学染色分析脑组织HGF表达、缺血脑组织边缘带细胞凋亡及存活神经元。结果治疗后2周,MSC—HGF组mNSS明显低于PBS组和EMCs组（P〈0.05）。治疗后第1天MSC—HGF组病变脑组织中HGF蛋白表达明显高于PBS组和EMCs组（P〈0．05）。治疗后1周,与PBS组和EMCs组相比,MSC—HGF组在梗死边缘带凋亡细胞的百分比明显减少（P〈0．05）,存活神经元的百分比明显增加（P〈0.05）。结论转染HGF的MSCs治疗缺血性脑卒中具有抗细胞凋亡、神经保护作用。     

尾静脉移植骨髓间充质干细胞治疗脑缺血损伤大鼠的研究

目的通过尾静脉途径移植大鼠骨髓间充质干细胞(MSCs)到大脑中动脉闭塞模型(MCAO)的大鼠体内,观察MSCs移植对大鼠缺血性脑损伤后神经功能恢复的作用并探讨其作用机制。方法分离和培养大鼠的MSCs,线栓法制作脑缺血再灌注模型。将48只SD大鼠随机分为对照组和尾静脉移植组2组,移植组在造模7d后尾静脉途径将MSCs植入MCAO大鼠体内,对照组仅造模。比较两组大鼠在不同时间的神经功能评分的差异,免疫组化染色和脑源性神经生长因子(BDNF)分泌的情况。结果移植后1d两组之间无统计学差异;在2w、1m、2m、3m时移植组NSS评分均低于对照组;免疫组化结果发现尾静脉组见到双侧半球均可见较多的Brdu阳性细胞。移植后1m即可见到MSCs分化为Brdu+NSE、Brdu+GFAP免疫组化双阳性细胞。不同时间点移植组的BDNF分泌较对照组明显增高。结论 MSCs可以在体外分离、培养和传代,尾静脉移植的MSCs可在宿主脑内存活和分化并改善神经功能。MSCs移植后可促进脑内BDNF的分泌。     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

他汀类药物的使用和颅内动脉瘤破裂相关性分析

目的 探讨他汀类药物对颅内动脉瘤破裂的影响。方法 2010年3月至2014年3月收治颅内囊状动脉瘤67例,其中破裂者32例,未破裂者35例。采用多变量Logistic回归评估他汀类药物的使用和颅内动脉瘤破裂的关系。结果 破裂组术前使用他汀类药物4例（12.5%,4/32）,未破裂组16例（45.7%,16/35）。破裂组服用他汀类药物的百分比显著低于未破裂组（P<0.01）。纠正潜在的混杂干扰后（or值: 0.30,95%可信空间:0.12~="" 0.64）显示,颅内动脉瘤破裂与他汀类药物的使用呈显著负相关,也与高血清总胆固醇浓度有关。结论 本结果提示他汀类药物对颅内动脉瘤破裂有一定的预防效果。     

Impact of our understanding of the genetic aetiology of epilepsy

A genetic contribution to aetiology is estimated to be present in up to 40% of patients with epilepsy. It is useful to categorise genetic epilepsies according to the mechanisms of inheritance into Mendelian disorders, non-mendelian or ‘complex’ disorders, and chromosomal disorders. Over 200 Mendelian diseases include epilepsy as part of the phenotype, and the genes for a number of these have been identified recently. These include autosomal recessive progressive myoclonic epilepsies such as Unverricht-Lundborg disease, Lafora disease and the neuronal ceroid lipofuscinoses, and three autosomal dominant idiopathic epilepsies. The last named have been shown to arise from mutations in ion channel genes. Autosomal dominant nocturnal frontal lobe epilepsy is caused by mutations in CHRNA4, benign familial neonatal convulsions by mutations in KCNQ2 and KCNQ3, and generalised epilepsy with febrile seizures plus by mutations in SCN1B. ‘Complex’, familial epilepsies are more difficult to analyse, but evidence has been obtained for loci predisposing to juvenile myoclonic epilepsy on chromosome 6p and 15q. Lastly, the genes underlying several spike-wave epilepsies in mice have been cloned, and three of these encode sub-units of voltage-gated calcium channels. Received: 29 September 1999/Accepted: 7 December 1999     

肌萎缩侧索硬化三例误诊分析

目的掌握肌萎缩侧索硬化(ALS)的诊断标准,以便早期准确诊断,避免误诊。方法分析3例ALS患者早期被误诊的临床资料。结果 3例患者均以下肢无力发病,逐渐波及上肢或对侧肢体,脊柱MR I示颈部或腰部椎间盘突出压迫硬膜囊,手术治疗后,症状无缓解,病情仍进行性加重,经肌电图检查证实为ALS。结论临床医师应熟知ALS的诊断标准,对患者详细询问病史、认真查体和电生理检查是减少ALS误诊的关键。     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

Modelling of movement of the lamprey: Control of oscillators

This article discusses the control methods of the central pattern generator (CPG). First a control model of the CPG is presented using 2 oscillators, and we suggest that phasic modulation to the CPG by means of phasic information is effective for controlling the phase difference between oscillators. Next, two models for controlling the CPG of a lamprey are proposed. One model describes a control system from the brain stem, in which the reticulospinal neurons control the CPG by receiving feedback signals and sending control signals to the neck region of the CPG. The other is a model for learning an localized control system to generate a desired motor pattern. By means of these models, a role of the efference copy is suggested.     

利培酮对精神分裂症患者生活质量的影响

目的：比较利培酮与氟哌啶醇对精神分裂症患者生活质量的影响。方法：对门诊72例服用氟哌啶醇及74例服用利培酮的精神分裂症患者用生活质量综合评定问卷（GQOLI）、阳性与阴性症状量表（PANSS）、副反应量表（TESS）进行评定。结果：利培酮组患者治疗后生活质量有所提高,而氟哌啶醇组患者生活质量有所下降。结论：利培酮治疗有利于患者提高生活质量。