外科手术在高血压脑出血治疗中的应用

高血压脑出血是当今社会一种发病率及死亡率都非常高的神经科疾病,对于它的治疗,则是神经内外科的重点难点。目前治疗高血压脑出血的方法分为内科保守治疗和外科手术治疗两种,作者阅读了大量国内外临床相关文献,综述了高血压脑出血相关内外科治疗的方法,以及具体应用,望能为其相关研究提供有益的思路。     

苏州市玻璃体积血的临床病因分析

目的:探讨苏州市不同年龄组玻璃体积血的常见病因,为疾病预防提供依据。方法:对在2009年~2011年住我院的287例295眼玻璃体积血患者的临床资料进行回顾性分析。结果:在所有玻璃体积血患者中,糖尿病性视网膜病变(diabetic retinopathy,DRP)111例(38.7%),眼外伤60例(20.9%),视网膜静脉阻塞(retinal vein occlusion,RVO)59例(20.6%),孔源性视网膜脱离(rhegmatogenous retinal detachment,RRD)32例(11.1%)。年龄<45岁的青年组中,眼外伤导致的玻璃体积血最多,为36例(48.6%),其次为DRP 26例(35.1%),视网膜血管炎(retinal vasculitis,RV)10例(13.5%)。45~59岁中年组中,DRP导致玻璃体积血最多,为61例(50.8%),其次为RVO 20例(16.7%)、眼外伤17例(14.2%)、RRD 16例(13.3%)。≥60岁老年组中,RVO导致玻璃体积血最多,为38例(40.9%),其次为DRP 24例(25.8%),RRD 15例(16.1%)。结论:DRP、眼外伤、RVO、RRD是引起玻璃体积血最常见的病因。青年患者的主要病因是眼外伤、DRP和RV,而中老年患者的主要病因是DRP及RVO。     

Molecular characterization and expression analysis of interferon- inducible protein 56 gene in large yellow croaker Pseudosciaena crocea

In mammals, interferon-inducible protein 56 (IFI56) has been considered to play a role in mediating inhibition of viral replication and cell growth, and possibly in mediating cell apoptosis. Here, we reported the cloning of an IFI56 homologue from the spleen of large yellow croaker, a marine fish (LycIFI56). The complete cDNA of LycIFI56 gene is 1628 nucleotides (nt) encoding a protein of 437 amino acids (aa), with a putative molecular weight of 50.8 kDa. The deduced LycIFI56 protein has a high-level homology with all members of IFIT (IFN-inducible proteins with TPR domain) family, and its 9 putative TPR motifs all locate the corresponding position of these IFIT proteins. Phylogenetic analysis showed that five fish IFIT members form a unique clad independent of mammalian homologues, reflecting a distant evolutionary relationship from mammals. LycIFI56 gene was constitutively expressed in various tissues examined, such as gills, intestine, liver, kidney, heart, spleen, muscle and blood. Upon induction with poly(I:C), LycIFI56 gene expression is obviously up-regulated in spleen, gills, intestine, liver and kidney at 24 h post-induction, suggesting that LycIFI56 may be involved in the immune response induced by poly(I:C). Analysis of the expression kinetics of LycIFI56 and IRF1 genes revealed that the up-regulation of LycIRF-1 expression by poly (I:C) was apparently earlier than that of LycIFI56. These results would facilitate a better understanding of the expression regulation of fish IFI56 gene, and of its roles in immunity of bony fish.     

墨旱莲对4种蝮蛇毒引起的炎症和出血的影响

目的探讨墨旱莲提取液对短尾蝮蛇毒、蛇岛蝮蛇毒、白眉蝮蛇毒及尖吻蝮蛇毒所致的炎症和出血的影响。方法应用短尾蝮蛇毒、蛇岛蝮蛇毒、白眉蝮蛇毒及尖吻蝮蛇毒所致大鼠足跖肿胀的致炎模型,观察墨旱莲提取液对蛇毒所致大鼠足跖肿胀的影响。墨旱莲提取液分别与不同蛇毒混合,给小鼠腹部皮下注射,观察其对蛇毒引起的小鼠皮下出血的影响。结果墨旱莲提取液15g／kg连续2次灌胃给药,对短尾蝮蛇毒、蛇岛蝮蛇毒、白眉蝮蛇毒或尖吻蝮蛇毒所致大鼠足跖肿胀的急性炎症造模和短尾蝮蛇毒棉球肉芽肿的慢性炎症造模(20g／kg)均有明显的抑制作用,对这些蛇毒引起的小鼠皮下出血也能明显抑制。结论墨旱莲提取液对短尾蝮蛇毒、蛇岛蝮蛇毒、白眉蝮蛇毒及尖吻蝮蛇毒引起的炎症和出血均有明显的抑制作用。     

双链RNA病毒诱导的牙鲆胚胎细胞差减cDNA文库的构建

以紫外线灭活的dsRNA病毒草鱼出血病病毒(GCHV)诱导和模拟诱导的牙鲆胚胎细胞为材料,利用抑制性差减杂交(SSH)技术,成功构建了双链RNA病毒诱导的牙鲆胚胎细胞(FEC)差减cDNA文库.以管家基因α-tublin作为差减指标,经检测,该文库差减效率达2 10倍,表明经病毒诱导后某些差异表达基因也得到了相应倍数的富集.将获得的cDNA片段连接到pGEM-T载体,PCR检测显示差减片段在250bp～2 000bp之间.该差减cDNA文库的构建为从分子水平研究牙鲆培养细胞对dsRNA病毒的免疫反应、以及进一步鉴定和克隆差异表达基因打下了坚实基础.     

液血分流吸引器在剖宫产术中失血量估算的临床应用

目的为了及时诊断产后出血和正确测量剖宫产术中的失血量,及时补充血容量,降低孕产妇死亡率。方法同一剖宫术孕妇分别采用精测法（称重法和液血分流吸引器相结合）和目测法两种方法进行失血量的比较。结果目测法估算失血量明显低于精测法,结果显示用精测法对剖宫产术中进行失血量的估算是目测法的1．5倍（1．5：1）。结论在剖宫产术中精确测量失血量,及时诊断产后出血,有利于及时补充血容量,提高孕产妇身心健康。     

Identification of SNP markers for common CNV regions and association analysis of risk of subarachnoid aneurysmal hemorrhage in Japanese population

Copy number variation (CNV) is emerging as a new tool for understanding human genomic variation, but its relationship with human disease is not yet fully understood. The data for a total of 317,503 genotypes were collected for a genome-wide association study of subarachnoid aneurismal hemorrhage (SAH) in a Japanese population (cases and controls, n = 497) using Illumina HumanHap300 BeadChip^®. To identify multi-allelic CNV markers, we visually inspected all genotype clusters of 317,503 SNP markers covering the whole genome using Illumina’s BeadStudio 3.0^® software. As a result, we identified 597 multi-allelic CNV markers for common (copy loss frequency > 0.05) CNV regions in a Japanese population (n = 497). The identified CNV markers shared the following characteristics: enrichment of Hardy–Weinberg disequilibria, Mendelian inconsistency among families, and high missing genotype rate. All annotated information for those markers is summarized in our database (http://www.snp-genetics.com/user/srch.htm). In addition, we performed case-control association analyses of identified multi-allelic CNV markers with the risk of subarachnoid aneurysmal hemorrhage. One SNP marker (rs1242541) within a CNV region neighboring the Sel-1 suppressor of lin-12-like protein (SEL1L) was significantly associated with a risk of SAH (P = 0.0006). We also validated the CNV around rs1242541 using real-time quantitative polymerase chain reaction (PCR). Information and methods used in this study would be helpful for accurate genotyping of SNPs on CNV regions, which could be used for association analysis of SNP markers within CNV regions.     

Evolving anisotropy and degree of elastolytic insult in abdominal aortic aneurysms: Potential clinical relevance?

Accurately estimating patient-specific rupture risk remains a primary challenge in timing interventions for abdominal aortic aneurysms (AAAs). By re-analyzing published biaxial mechanical testing data from surgically repaired human AAAs, material anisotropy emerged as a potentially important determinant of patient-specific lesion progression. That is, based on a new classification scheme, we discovered that anisotropic aneurysmal specimens correlated with increased patient age at surgery when compared with more isotropic specimens (79.7 vs. 70.9 years, p<0.002), despite no significant difference in maximum diameter. Furthermore, using an idealized axisymmetric, finite-element growth and remodeling model of AAA progression, we found that both the initial axial extent of elastin loss and ongoing damage to elastin in the shoulder region of the AAA directly affected the degree of anisotropy as the lesion evolved, with more extensive insults increasing the anisotropy. This effect appeared to be mediated by alterations in axial loading and subsequent differences in orientation of deposited collagen fibers. While the observed increased age before surgical intervention may suggest a potential benefit of anisotropic remodeling, future biaxial tests coupled with pre-surgical data on expansion rates and detailed theoretical analyses of the biostability of a lesion as a function of anisotropy will be required to verify its clinical relevance to patient-specific rupture risk.     

Receptor-interacting protein 3-phosphorylated Ca2+/calmodulin-dependent protein kinase II and mixed lineage kinase domain-like protein mediate intracerebral hemorrhage-induced neuronal necroptosis

Necroptosis-mediated cell death is an important mechanism in intracerebral hemorrhage (ICH)-induced secondary brain injury (SBI). Our previous study has demonstrated that receptor-interacting protein 1 (RIP1) mediated necroptosis in SBI after ICH. However, further mechanisms, such as the roles of receptor-interacting protein 3 (RIP3), mixed lineage kinase domain-like protein (MLKL), and Ca²⁺/calmodulin-dependent protein kinase II (CaMK II), remain unclear. We hypothesized that RIP3, MLKL, and CaMK II might participate in necroptosis after ICH, including their phosphorylation. The ICH model was induced by autologous blood injection. First, we found the activation of necroptosis after ICH in brain tissues surrounding the hematoma (propidium iodide staining). Meanwhile, the phosphorylation and expression of RIP3, MLKL, and CaMK II were differently up-regulated (western blotting and immunofluorescent staining). The specific inhibitors could suppress RIP3, MLKL, and CaMK II (GSK'872 for RIP3, necrosulfonamide for MLKL, and KN-93 for CaMK II). We found the necroptosis surrounding the hematoma and the concrete interactions in RIP3-MLKL/RIP3-CaMK II also both decreased after the specific intervention (co-immunoprecipitation). Then we conducted the short-/long-term neurobehavioral tests, and the rats with specific inhibition mostly had better performance. We also found less blood–brain barrier (BBB) injury, and less neuron loss (Nissl staining) in intervention groups, which supported the neurobehavioral tests. Besides, oxidative stress and inflammation were also alleviated with intervention, which had significant less reactive oxygen species (ROS), tumor necrosis factor (TNF)-α, lactate dehydrogenase (LDH), Iba1, and GFAP surrounding the hematoma. These results confirmed that RIP3-phosphorylated MLKL and CaMK II participate in ICH-induced necroptosis and could provide potential targets for the treatment of ICH patients.

     

Relationship between somatosensory function and the spinothalamocortical pathway in chronic stroke patients

Abstract

Diffusion tensor tractography (DTT) allows for identification and evaluation of the spinothalamic tract and its thalamocortical pathway (STP). We attempted to investigate the relationship between tactile sensation and the STP in chronic stroke patients. We measured fractional anisotropy, mean diffusivity, and tract volume of the STP. The tactile sensation score of the affected side in patients with preserved STP integrity was higher compared with that of patients with an interrupted STP. The remaining volume and integrity of the STP in the affected hemisphere were important factors for tactile sensation of the affected side in chronic patients with intracerebral hemorrhage (ICH).