蛛网膜下腔出血后血浆不对称二甲基精氨酸的含量研究

研究血浆中不对称二甲基精氨酸（ADMA）浓度与蛛网膜下腔出血（SAH）的关系。蛛网膜下腔出血患者血浆ADMA平均水平,第3、7和14天分别为2．3±0．8μmol／L、6．4±1．5μmol／L和14．1±0．9μmol／L,对照组平均为1．1±0．3μmol／L,两组间比较差异显著（P〈0．01）。ADMA参与了蛛网膜下腔出血病理生理过程,水平与脑血管痉挛关系密切。     

蛛网膜下腔出血并发脑血管痉挛的护理体会

脑血管痉挛是蛛网膜下腔出血最重要、最严重的并发症,致残率和死亡率较高,临床上以迟发型脑血管痉挛最常见,多发生于出血后4——12天,早期发现,及时治疗,可提高治愈率,笔者对20例并发脑血管痉挛患者的护理进行了探讨。     

自发性蛛网膜下腔出血的观察及护理

目的:探讨自发性蛛网膜下腔出血的护理.方法:本文总结了对58例自发性蛛网膜下腔出血患者的病情观察和护理体会.结果:认为严密观察病情,实施针对性护理,采取有效治疗,预防再出血是必不可少的.结论:自发性蛛网膜下腔出血是一种起病突然、病情危重、表现复杂的疾病,做好出血期护理对预防再出血、缓解血管痉挛、改善愈后有重要意义.     

蛛网膜下腔出血致脑血管痉挛的发病机制与治疗进展

脑血管痉挛（cerebral vasospasm,CVS）是指颅内动脉的一支或多支发生部分或完全性的狭窄,是蛛网膜下腔出血（subarachnoid hemorrhage,SAH）最常见的并发症。在SAH病人中30％-70％可出现脑血管痉挛,严重的脑血管痉挛可造成脑缺血和脑损害,是增加病人死亡和致残最重要的原因。近年来随着分子生物学技术的发展,国内外对SAH导致CVS的机制研究有了一些较新的认识,治疗方法也有了新的进展。     

足月新生儿缺氧缺血性脑病CT诊断

目的 :分析足月新生儿缺氧后脑损伤的机理 ,总结其CT征象 ,以提高诊断正确率 ,为临床采取及时而准确的治疗措施提供依据。方法 :回顾性分析近 10年经我院临床确诊的HIE患儿的临床资料和CT片 4 3例 ,分析其CT特征表现。结果 :4 3例均为足月产 ,生后出现不同程度缺氧体征 ,阿氏评分 3～ 6分 / 1min ,于发病 2h～ 2 2d行CT检查。影像学表现 :4 3例患儿双侧脑实质均出现不同程度的密度减低区 ,占 10 0 % ;9例蛛网膜下腔出血 ,占 2 1% ,其中 ,发生于右颞部 1例 ,后纵裂池 8例 ;管膜下出血 1例 ,占 2 .3% ,并破入侧脑室。结论 :新生儿缺氧缺血性脑病主要依靠临床诊断 ,影像检查可以发现脑损害的程度范围及是否伴发蛛网膜下腔出血。为诊断、选择治疗方案及判断预后提供重要依据。脑组织发生缺氧时 ,随着时间及乏氧程度的进展 ,其CT表现具有一定特征性 ,因此 ,对临床怀疑及已诊断为HIE的患儿进行CT检查是必要的。     

腰池放液治疗蛛网膜下腔出血疗效观察

目的:探讨腰池放液治疗蛛网膜下腔出血的疗效。方法:将蛛网膜下腔出血患者随机分为两组,分别采用腰大池穿刺放液配合小剂量甘露醇降颅压方法(简称腰穿组)和大剂量甘露醇降颅压方法(简称对照组)治疗,观察颅内压变化及病程。结果:腰穿组降颅压效果显著优于对照组;病程也较对照组明显缩短。结论:腰池穿刺放液配合小剂量甘露醇降颅压方法治疗蛛网膜下腔出血疗效显著,值得临床推广。     

腰终池持续引流治疗蛛网膜下腔出血临床研究

目的 :探讨腰终池持续引流在治疗自发性蛛网膜下腔出血 (SAH)中能否降低SAH后脑血管痉挛 (CVS)和颅内高压的发生。方法 :通过对 2 4例SAH患者随机分组 ,治疗组 12例 ,除腰终池持续引 3～ 5d ,余常规治疗药物等同。结果 :治疗组无 1例发生脑血管痉挛 (CVS) ,对照组 4例发生CVS。结论 :腰终池持续引流 ,在短时间内将颅内血液引至体外 ,可以迅速解除脑血管痉挛 ,防止蛛网膜粘连 ,缓解颅内压力。     

老年人蛛网膜下腔出血的护理要点

目的:提高老年人蛛网膜下腔出血的抢救成功率.方法:回顾分析180例老年人蛛网膜下腔出血的临床资料,总结其临床特点,提出相应的护理策略.结果:老年人蛛网膜下腔出血的症状体征不典型,很容易忽视,预后差,并发症多,死亡率高.结论:更好地认识老年人蛛网膜下腔出血的临床特点,在护理上及时发现并处理各种并发症,是提高抢救成功率的关键.     

脑弥漫性轴索损伤57例临床分析

报告57例脑弥漫性轴索损伤,占同期重型颅脑损伤的21％,其主要临床特征是大多数病人为车祸致伤,伤后立即持续昏迷,CT显示无占位效应的脑白质内单发或多发小出血灶以及脑室、脑池和蛛网膜下腔出血等改变。本文结合文献对弥漫性轴索损伤的临床诊断和治疗进行了讨论。     

50岁以上老年人蛛网膜下腔出血44例临床表现分析

自发性蛛网膜下腔出血是神经内科的常见疾病,其发病原因多为脑动脉瘤破裂、脑动脉硬化、高血压、脑血管畸形。较少见的原因有各种血液病、脑膜炎、脑肿瘤和结节性多动脉炎等,因出血破入脑室内或穿破皮层而至蛛网膜下腔者称继发性蛛网膜下腔出血。本院神经内科自1979年至1985年的7年期间,共收治了50岁以上老年人自发性蛛网膜下腔出血44例占本院同期收治的蛛网膜下腔出血114例总数的38.5％。说明老年人患自发蛛网膜下腔出血并非罕见的疾病,本病可以发生在任何年龄,本文提出50岁以上的病例作一临床观察分析:     

蜕皮甾酮对SAH后早期脑血管痉挛的实验研究

探讨传统中药蜕皮甾酮对大鼠实验性蛛网膜下腔出血后早期脑血管痉挛的干预效应。90只SD大鼠随机分为假手术组、SAH组、EDS干预组,观察各实验组大鼠24h死亡率和神经功能缺损、局部脑血流量及形态学变化。结果表明,与假手术组比较,SAH组大鼠有明显的神经功能缺损,局部脑血流量下降,基底动脉管腔缩小,内膜皱缩呈波纹状等形态学异常、EDS干预后神经功能缺损好转,局部脑血流量在EDS干预后12h增加,形态学也有不同程度改善。蜕皮甾酮能改善大鼠实验性蛛网膜下腔出血后早期脑血管痉挛。     

康脑液对脑缺血再灌注损伤大鼠血管内皮生长因子、脑源性神经生长因子、基质金属蛋白酶表达的影响

目的：通过康脑液干预观察其对脑缺血再灌注损伤大鼠血管内皮生长因子（vascular endothelial growth factor,VEGF）、脑源性神经生长因子（brain derived neurotrophic factor,BDNF）、基质金属蛋白酶（matrix metalloproteinase-9,MMP-9）表达的影响,探讨康脑液对脑缺血再灌注损伤的保护机制.方法：将雄性SD大鼠随机分为假手术组、脑缺血再灌注模型组及康脑液28.6、14.3、7.15 g·kg-1·d-1剂量组（灌胃给药7 d）,改进Longa等线栓法制备大鼠右侧大脑中动脉阻塞（middle cerebral artery occlusion,MCAO）再灌注模型.于缺血2h后再灌注（分别于再灌注后6h、12h、24 h、72 h、7d处死大鼠）;采用TTC染色法观察大鼠的脑梗死面积;免疫组织化学法观察大鼠脑组织VEGF、BDNF、MMP-9的表达.结果：比较各组缺血再灌注24 h大鼠脑梗死灶面积,发现28.6、14.3 g·kg--1·d-1剂量组较脑缺血再灌注模型组明显减小（P＜0.05）;与脑缺血再灌注模型组相比,28.6、14.3 g·kg--1·d-1剂量组各时间点的VEGF、BDNF表达量明显上调（P＜0.01）,MMP-9表达的阳性细胞明显减少（P＜0.01）,差异有统计学意义.结论：康脑液可促进大鼠局灶性脑缺血后脑组织中VEGF,BDNF的表达,同时抑制脑内MMP-9的表达,缩小脑梗死面积,发挥对神经血管单元（neurovascular unit,NVU）的保护作用,减轻脑缺血再灌注损伤.     

大鼠脑缺血再灌注后血清NSE变化和脑病理形态学改变的研究

目的 探讨大鼠脑缺血再灌注后血清神经元特异性烯醇化酶（ Ｎｅｕｒｏ－ ＳｐｅｃｉｆｉｃＥｎｏｌａｓｅ，ＮＳＥ）水平和脑组织病理形态改变及其相关性．方法采用线栓法将健康Ｓｐｒａｇｕｅ－Ｄａｗｌｅｙ（ＳＤ）大鼠制成大脑中动脉堵塞（Ｍｉｄｄｌｅ　Ｃｅｒｅｂｒａｌ　Ａｒｔｅｒｙ　Ｏｃｃｌｕｓｉｏｎ，ＭＣＡＯ）２ｈ再灌注模型来探讨血清ＮＳＥ和脑组织病理形态改变的关系．将９０只ＳＤ大鼠分成脑缺血 ２ ｈ再灌注后 １、 ２、３、 ４、 ５天 ５个实验组（每组１０只），每个时间点备配一个假手术组（每组６只）．观测各组血清ＮＳＥ、脑梗塞灶体积及脑组织病理形态（脑组织大体标本、光镜和电镜的病理变化）．结果①脑缺血再灌注后脑梗塞灶体积逐渐增大，第３天达高峰（ｐ＜０．０５）；②血清ＮＳＥ水平在脑缺血再灌注后逐渐升高，第３天达高峰（ｐ＜０．０５），然后逐渐下降；③血清ＮＳＥ水平与脑梗塞灶体积呈正相关（ｒ＝０．９２，ｐ＜０．００１）；④脑组织病理形态大体、光镜及电镜脑组织病理检查可见神经组织缺血坏死改变于第３天最明显，并且在第３天时缺血脑组织中中性粒细胞ＰＭＮ（Ｐｏｌｙｍｏｒｐｈｏｎｕｃｌｅａｒ　Ｌｅｕｋｏｃｙｔ，ＰＭＮ）浸润最明显．结论血清Ｎ?     

A research on the relationship between ejaculation andserum testosterone level in men

ＩＮＴＲＯＤＵＣＴＩＯＮＴｅｓｔｏｓｔｅｒｏｎｅｉｓａｐｒｉｍａｒｙｈｏｒｍｏｎｅｉｎｍｅｎａｎｄａｓｓｏｃｉａｔｅｄｗｉｔｈｓｐｅｒｍａｔｏｇｅｎｅｓｉｓａｎｄｓｐｅｒｍｍａｔｕｒａｔｉｏｎ (Ｓｔｅｉｎｂｅｒｇｅｒｅｔａｌ.,1 973 ;Ｍａｒｓｈａｌｌｅｔａ     

A research on the relationship between ejaculation and serum testosterone level in men

The purpose of this study is to gain understanding of the relationship between ejaculation and serum testosterone level in men. The serum testosterone concentrations of 28 volunteers were investigated daily during abstinence periods after ejaculation for two phases. The authors found that the fluctuations of testosterone levels from the 2nd to 5th day of abstinence were minimal. On the 7th day of abstinence, however, a clear peak of serum testosterone appeared, reaching 145.7% of the baseline (P<0.01). No regular fluctuation was observed following continuous abstinence after the peak. Ejaculation is the precondition and beginning of the special periodic serum testosterone level variations, which would not occur without ejaculation. The results showed that ejaculation-caused variations were characterized by a peak on the 7th day of abstinence; and that the effective time of anejaculation, is 7 days minimum. These data are the first to document the phenomenon of the periodic change in serum testosterone level; the correlation between ejaculation and periodic change in the serum testosterone level, and the pattern and characteristics of the periodic change.     

Study on the neurotoxic effects of low-level lead exposure in rats

Objective: To investigate effects of developmental lead exposure on nitric oxide synthase (NOS) activity in different brain regions and on N-methyl-D-aspartate (NMDA) receptor mRNA expression in the hippocampus of rats. On the basis of these observations, we explored possible mechanisms by which lead exposure leads to impaired learning and memorizing abilities in children. Methods: A series of rat animal models exposed to low levels of lead during the developing period was established (drinking water containing 0.025%, 0.05% and 0.075% lead acetate). NOS activities in the hippocampus, the cerebral cortex, the cerebellum and the brain stem were determined with fluorescence measurement and levels of mRNA expression of the NMDA receptor 2A (NR2A) subunit and NMDA receptor 2B (NR2B) subunit in the rat hippocampus were measured with Retro-translation (RT-PCR). Results: There were no differences in the body weight of rat pups between any of the groups at any given time (P>0.05). The blood lead level of Pb-exposed rat pups showed a systematic pattern of change: at 14 d of age, it was lower than that at 7 d of age, then rising to the peak level at 21 d and finally falling to lower levels at 28 d. The hippocampal NOS activities of lead-exposed groups were all lower than that of the control group on the 21st and 28th day (P<0.01). NOS activities in the cerebellum of lead-exposed groups were all lower than that of the control group on the 21st and 28th day (P<0.001) and the NOS activity of the 0.025% group was significantly lower than that of the 0.05% and 0.075% groups on the 28th day (P<0.05). NOS activity in the cerebral cortex of the 0.075% group was significantly lower than that of the control, 0.025% and 0.05% groups on the four day spans (P<0.001). There was no significant difference of NOS activity in the brain stem between any lead-exposed group and the control group on the four day spans. In the 0.05% and the 0.075% groups, the level of NR2A mRNA expression was higher than that in the control group at 7 d and 14 d of age (P<0.05). In the 0.025% group, the level of NR2A was found to be higher than that in the control group at 7 d of age only (P<0.05). No significant differences were found for the levels of NR2B mRNA expression between any of the groups at any given time. Conclusions: NOS activity in the hippocampus, the cerebral cortex and the cerebellum are inhibited by lead exposure. The degree of the inhibitory effect depends on the time span of exposure and the lead concentration. Developmental low-level lead exposure was found to raise the level of NR2A mRNA expression in the hippocampus of rats. Developmental low-level lead exposure does not affect the level of NR2B mRNA expression in the hippocampus.     

Ds-echinoside A, a new triterpene glycoside derived from sea cucumber, exhibits antimetastatic activity via the inhibition of NF-κB-dependent MMP-9 and VEGF expressions

Ds-echinoside A (DSEA), a non-sulfated triterpene glycoside, was isolated from the sea cucumber Pearsonothuria graeffei. In vitro and in vivo investigations were conducted on the effects of DSEA on tumor cell adhesion, migration, invasion, and angiogenesis. In this study, we found that DSEA inhibited the proliferation of human hepatocellular liver carcinoma cells Hep G2, with a half-maximal inhibitory concentration (IC₅₀) of 2.65 μmol/L, and suppressed Hep G2 cell adhesion, migration, and invasion in a dose-dependent manner. DSEA also reduced tube formation of human endothelial cells ECV-304 on matrigel in vitro and attenuated neovascularization in the chick embryo chorioallantoic membrane (CAM) assay in vivo. Immunocytochemical analysis revealed that DSEA significantly decreased the expression of matrix metalloproteinase-9 (MMP-9), which plays an important role in the degradation of basement membrane in tumor metastasis and angiogenesis. DSEA also increased the protein expression level of tissue inhibitor of metalloproteinase-1 (TIMP-1), an important regulator of MMP-9 activation. From the results of Western blotting, the expressions of nuclear factor-kappa B (NF-κB) and vascular endothelial growth factor (VEGF) were found to be remarkably reduced by DSEA. These findings suggest that DSEA exhibits a significant antimetastatic activity through the specific inhibition of NF-κB-dependent MMP-9 and VEGF expressions.     

Correlation of matrix metalloproteinase-2, −9, tissue inhibitor-1 of matrix metalloproteinase and CD44 variant 6 in head and neck cancer metastasis

This study aimed to explore the molecular mechanism in tumor invasion and metastasis. The expression of matrix metalloproteinase-2, −9 (MMP-2, MMP-9), tissue inhibitor-1 of matrix metalloproteinase (TIMP-1), cell adhesion molecule 44 variant 6 (CD44v6), HER2/neu and p53 was investigated in 154 patients with head and neck squamous cell carcinoma (SCC) by ABC and ImmunoMax immunohistochemical method. Their clinical relevance and correlation were analysed. The expression of MMP-2, MMP-9, TIMP-1, CD44v6, HER2/neu and p53 was found in cancer cells in 87.01%, 85.71%, 68.18%, 98.05%, 55.19% and 50.65% cases respectively. Linear regression and correlation analysis revealed that there was close positive relationship (P<0.05) between the expression of MMP-2 and MMP-9, TIMP-1 and CD44v6, HER2/neu and MMP-9, MMP-2 and p53. Up-regulation of MMP-2 was accompanied by advanced T stage (P<0.01). There was also a trend of MMP-2 expression being related with tumor metastasis. Increased expression of HER2/neu was found in patients with tumor recurrence (P<0.05). The expression of TIMP-1 was higher in laryngeal cancer than that in pharyngeal cancer, and higher in keratinizing and non-keratinizing SCC than that in basaloid SCC (P<0.05). These findings suggested that MMP-2 and MMP-9, HER2/neu and MMP-9, MMP-2 and p53 had a coordinate function in aggression of tumor; that MMP-2 had a more important function than MMP-9 in tumor invasion and metastasis; and that HER2/neu might serve as a biomarker for poor prognosis in HNSCC. Project supported by Lübeck Medical University, Germany     

大鼠实验性胃溃疡期间大脑皮层SS免疫组织化学和原位杂交组织化学研究

目的 观察大鼠实验性胃溃疡期间大脑皮层生长抑素免疫反应(SS-ir)和SSmRNA神经元的变化。方法 免疫细化PAP法;地高辛标记反意SScRNA探针mRNA原位杂交组化法。结果 正常大鼠SS-ir神经元广泛分布于大脑皮层。溃疡术后1d,大脑皮层纹状皮质区各层SS-ir神经元减少,但可见大量串珠样SS强阳性纤维,溃疡组SS-ir神经元数与盐水组相比无差异;术后4d,溃疡组大脑皮层纹状皮质区各层SS-ir神经元密集、数量明显增多,与盐水组、正常组相比均有差异(P<0.05,P<0.01或P<0.001)。术后10和23d,以上核区SS-ir神经元数仍高于盐水组和正常组(P<0.01,P<0.001)。术后4d,溃疡组大脑皮层SSmRNA神经元数量明显多于盐水组(P<0.001)。结论 大鼠实验性胃溃疡时期,大脑皮层SS-ir和SSmRNA神经元可能参与了胃溃疡自愈过程的调节。