凝闭双侧椎动脉预处理对大鼠全脑缺血损伤的防护作用

目的：观察凝闭双侧椎动脉与夹闭双侧颈总动脉之间的不同时间间隔对Pulsinelli四血管闭塞法全脑缺血模型的影响、以及在凝闭单侧椎动脉的基础上夹闭双侧颈总动脉后的脑缺血的特点。方法：84只Wistar大鼠．随机分为以下4组：对照组、双侧椎动脉凝闭组、全脑缺血组、单侧椎动脉凝闭＋双侧颈总动脉夹闭组。全脑缺血组中,根据凝闭双侧椎动脉与夹闭双侧颈总动脉之间的时间间隔不同,又分为24h间隔、48h间隔和72h间隔3个亚组。观察大鼠脑缺血过程中的反应包括瞳孔散大、对光反射等情况,脑缺血后恢复翻正反射所需要的时间、以及动物的一般状况,并应用硫堇染色法观察海马CA1区锥体神经元迟发性死亡的情况：结果：全脑缺血72h间隔亚组的大鼠,脑缺血过程中的反应、脑缺血后的一般状况和锥体神经元迟发性死亡程度均明显重于全脑缺血24h间隔亚组及48h间隔亚组,但24h间隔亚组与48h间隔亚组之间无显著差异一单侧椎动脉凝闭＋双侧颈总动脉夹闭组大鼠的凝闭侧瞳孔散大、对光反射消失、海马CA1区神经元大量死亡;而未凝闭侧未见上述相关变化。结论：凝闭双侧椎动脉本身也具有脑缺血预处理样作用,对其后48h内夹闭双侧颈总动脉所致的严重脑缺血具有一定程度的保护作用;大鼠椎动脉对脑干及海马的血液供应均存在明显的同侧优势效应,     

Ischemic adaptation of the rat brain as a method for protection of endothelium from ischemic reperfusion injury

This study represents results of investigation carried out to determine the endothelium-protective effect of early and late phases of brain ischemic preconditioning as well as local and remote adaptation. The experiments were performed on adult male rats. Prolonged 30-min four vessels brain ischemia followed by 120-min reperfusion on carotid arteries, was performed (control group). Early and late local ischemic preconditioning was due to both 5-min ischemia and 30-min and 48 h reperfusion respectively on carotid arteries. Remote ischemic preconditioning was caused by 30-min ischemia and also by 15-min and 48 h reperfusion, respectively (early and late phases of adaptation) on femoral artery before prolonged brain ischemia described above. To estimate the role of nitric oxide in ischemic adaptation, mechanisms involved both nonselective blocker of NO-synthesis (N omega-nitro-L-arginine) in the time of early adaptation phase and the relatively selective iNOS inhibitor S-methylisothiourea sulfate, given before sustained brain ischemia, on the late preconditioning. Registration of brain blood flow was made by ultrasonic high-frequency Doppler device. Degree of brain edema was studied and evaluation of desquamated endothelial cells in blood was carried out. Early and late phases of local ischemic preconditioning were found to improve the brain blood flow and level of circulatory endothelial cells as well as to reduce degree of edema. The endothelium-protective effect of remote ischemic preconditioning has been proved in this study only on the late phase. Nitric oxygen was found to be important endothelium-protective factor in ischemic preconditioning.     

Recovery of breathing pattern after 15 min of cerebral ischemia in rabbits

The study was undertaken to ascertain the neural control of breathing and vagal reflexes during and after cerebral ischemia. The experiments were performed on anesthetized, paralyzed, and artificially ventilated rabbits. Cerebral ischemia was induced by reversible intrathoracic occlusion of the brachiocephalic trunk and the left subclavian and both internal thoracic arteries for 15 min. The effect of cerebral ischemia on breathing pattern was assessed by monitoring the integrated activities of phrenic and recurrent laryngeal nerves. Ischemia produced enhancement of breathing followed by apnea and gasping. During enhanced breathing as well as during gasping, the inspiratory-inhibiting effect of lung inflation (Breuer-Hering reflex) was abolished. When brain circulation was restored, respiratory activity started with gasps, which later were intermingled with eupneic type of inspirations. During the onset of a eupneic breath, lung inflation produced inspiratory facilitation but never an inhibition. However, after 30 min of recovery from cerebral ischemia, the Breuer-Hering reflex was restored. Results show that precise analysis of vagal reflexes and respiratory pattern during ischemia and resuscitation may be used as an indicator of resumption of autonomic activity in the brain stem.     

Histological study of brain in the rats exposed to 93-days' tail-suspension

Antiorthostatic position of rats during 93-days' tail suspension induced in the brain strongly pronounced edema of nervous tissue, alteration of structure in horoid plexus, pointing out the decrease in liquor secretion by exocytosis and increase in itraventricular pressure, morphological changes in veins and capillaries, reflecting the development of plethora in veins and tendency to thrombogenesis, and also the appearance of structural signs of prolonged arterial vasoconstriction and narrowing of arterial lumen in surface arteries which be considered as an adaptive process lying the obstacles to excessive blood inflow to brain and dumping the pulse wave during prolonged antiorthostatic state.     

Unilateral microdialysis of gabazine in the dorsal medulla reverses thermal prolongation of the laryngeal chemoreflex in decerebrate piglets.

The laryngeal chemoreflex (LCR) is elicited by water in the larynx and leads to apnea and respiratory disruption in immature animals. The LCR is exaggerated by the elevation of brain temperature within or near the nucleus of the solitary tract (NTS) in decerebrate piglets. Thermal prolongation of reflex apnea elicited by superior laryngeal nerve stimulation is reduced by systemic administration of GABA(A) receptor antagonists. Therefore, we tested the hypothesis that microdialysis within or near the NTS of gabazine, a GABA(A) receptor antagonist, would reverse thermal prolongation of the LCR. We examined this hypothesis in 21 decerebrate piglets (age 3-13 days). We elicited the LCR by injecting 0.1 ml of water into the larynx before and after each piglet's body temperature was elevated by approximately 2.5 degrees C and before and after 2-5 mM gabazine was dialyzed unilaterally and focally in the medulla. Elevated body temperature failed to prolong the LCR in one piglet, which was excluded from analysis. Elevated body temperature prolonged the LCR in all the remaining animals, and dialysis of gabazine into the region near the NTS (n = 10) reversed the thermal prolongation of the LCR even though body temperature remained elevated. Dialysis of gabazine in other medullary sites (n = 10) did not reverse thermal prolongation of the LCR. Gabazine had no consistent effect on baseline respiratory activity during hyperthermia. These findings are consistent with the hypothesis that hyperthermia activates GABAergic mechanisms in or near the NTS that are necessary for the thermal prolongation of the LCR.     

Ischemia-Induced Mitochondrial Apoptosis is Significantly Attenuated by Ischemic Preconditioning

Ischemic preconditioning (IPC) represents an important adaptation of CNS to sub-lethal ischemia, which results in increased tolerance of CNS to the lethal ischemia. Ischemia-induced mitochondrial apoptosis is considered to be an important event leading to neuronal cell death after cerebral blood flow arrest. In presented study, we have determined the effect of IPC on ischemia/reperfusion-induced mitochondrial apoptosis. Global brain ischemia was induced by permanent occlusion of vertebral arteries and temporal occlusion of carotid arteries for 15 min. Rats were preconditioned by 5 min of sub-lethal ischemia and 2 days later 15 min of lethal ischemia was induced. With respect to mitochondrial apoptosis initiation, translocation of p53 to mitochondria was observed in hippocampus but not in cerebral cortex. However, level of both apoptotic bax and anti-apoptotic bcl-xl in both hippocampal and cortical mitochondria was unchanged after global brain ischemia. Detection of genomic DNA fragmentation as well as Fluoro-Jade C staining showed that ischemia induces apoptosis in vulnerable CA1 layer of rat hippocampus. IPC abolished completely ischemia-induced translocation of p53 to mitochondria and had significant protective effect on ischemia-induced DNA fragmentation. In addition, significant decrease of Fluoro-Jade C positive cells was observed as well. Our results indicate that IPC abolished almost completely both initiation and execution of mitochondrial apoptosis induced by global brain ischemia.     

Significance of source and size in the mechanical response of human cerebral blood vessels

Cerebral blood vessels are frequently damaged in traumatic brain injury. Mechanical properties of fresh human cerebral vessels obtained through surgeries have been reported. Because surgical sources of human specimens are rare and produce a limited amount of material, we sought to compare the properties of more readily available cerebral arteries and veins obtained from cadavers to fresh vessel data. Additionally, because the previous study was limited to small vessels available in surgery, it was unknown how generally applicable the results were to larger cerebral arteries and veins. In the current study, large and small cerebral vessels from autopsy were stretched axially. Data from these and similar tests on fresh vessels were combined to determine the significance of source and size on mechanical properties. Structural comparisons of histological samples were additionally utilized to characterize differences. Results indicate that specimens from autopsy and surgery behave similarly except that vessels from autopsy tend to be less extensible. While tests on large vessels were limited, small arteries obtained from autopsy tended to be slightly stiffer than large arteries. In contrast, bridging veins from cadavers were typically stiffer and stretched less before structural failure than cortical veins from the same source. These effects are, however, secondary to differences identified between arteries and veins in the previous study.     

Effects of transient, global, cerebral ischemia on striatal extracellular dopamine, serotonin and their metabolites

Rat striatal extracellular fluid levels of dopamine, serotonin, 3-methoxytyramine (3-MT), 3,4-dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) were measured before, during and after transient, global cerebral ischemia in awake rats using in vivo brain microdialysis. Before ischemia, extracellular levels of dopamine, DOPAC, HVA and 5-HIAA were detectable and consistent from sample to sample. During cerebral ischemia, there was a large increase in extracellular dopamine levels and a decrease in the extracellular levels of DOPAC, HVA, and 5-HIAA. During reperfusion, dopamine levels returned to normal as did those of DOPAC, HVA and 5-HIAA. Dialysate serotonin and 3-methoxytyramine concentrations were below detection limits except for samples collected during ischemia and early reperfusion.     

The relationship between erythropoietin pretreatment with blood-brain barrier and lipid peroxidation after ischemia/reperfusion in rats

Blood-brain barrier (BBB) leakage plays a role in the pathogenesis of many pathological states of the brain including ischemia and some neurodegenerative disorders. In recent years, erythropoietin (EPO) has been shown to exert neuroprotection in many pathological conditions including ischemia in the brain. This study aimed to investigate the effects of EPO on BBB integrity, infarct size and lipid peroxidation following global brain ischemia/reperfusion in rats. Wistar male rats were divided into four groups (each group n=8); Group I; control group (sham-operated), Group II; ischemia/reperfusion group, Group III; EPO treated group (24 h before decapitation--000 U/kg r-Hu EPO i.p.), Group IV; EPO+ ischemia/reperfusion group (24 h before ischemia/reperfusion--3000 U/kg r-Hu EPO i.p.). Global brain ischemia was produced by the combination of bilateral common carotid arteries occlusion and hemorrhagic hypotension. Macroscopical and spectrophotometrical measurement of Evans Blue (EB) leakage was observed for BBB integrity. Infarct size was calculated based on 2,3,5-triphenyltetrazolium chloride (TTC) staining. Lipid peroxidation in the brain tissue was determined as the concentration of thiobarbituric acid-reactive substances (TBARS) for each group. Ischemic insult caused bilateral and regional BBB breakdown (hippocampus, cortex, corpus striatum, midbrain, brain stem and thalamus). EPO pretreatment reduced BBB disruption, infarct size and lipid peroxide levels in brain tissue with 20 min ischemia and 20 min reperfusion. These results suggest that EPO plays an important role in protecting against brain ischemia/reperfusion through inhibiting lipid peroxidation and decreasing BBB disruption.     

Transient global amnesia after mild head injury in childhood

In seven entirely healthy children in the age group of 6.5 to 14.5 years, mild head injury produced transient global amnesia (TGA) of median duration of 4.5 hours. None of the patients had convincing signs of brain concussion or clinical focal symptomatology. In four cases CT examination of the brain showed normal findings. Four children had a transient abnormal EEG (intermittent delta rhythms, slowed background activity inconstant local finding (of slow waves). During the period monitored (2-34 months) there was no recurrent attack and the children have had no difficulties. Pathologically, the authors assume ischemia of temporobasal structures induced by mild trauma with a relationship to migraine diathesis and rank the child group among so called benign posttraumatic encephalopathy with a noncomplicated course and good outcome.     

Relationships between the extent of apnea-induced bradycardia and the vascular response in the arm and leg during dynamic two-legged knee extension exercise

Our aim was to test the hypothesis that apnea-induced hemodynamic responses during dynamic exercise in humans differ between those who show strong bradycardia and those who show only mild bradycardia. After apnea-induced changes in heart rate (HR) were evaluated during dynamic exercise, 23 healthy subjects were selected and divided into a large response group (L group; n = 11) and a small response group (S group; n = 12). While subjects performed a two-legged dynamic knee extension exercise at a work load that increased HR by 30 beats/min, apnea-induced changes in HR, cardiac output (CO), mean arterial pressure (MAP), arterial O(2) saturation (Sa(O(2))), forearm blood flow (FBF), and leg blood flow (LBF) were measured. During apnea, HR in the L group (54 ± 2 beats/min) was lower than in the S group (92 ± 3 beats/min, P < 0.05). CO, Sa(O(2)), FBF, LBF, forearm vascular conductance (FVC), leg vascular conductance (LVC), and total vascular conductance (TVC) were all reduced, and MAP was increased in both groups, although the changes in CO, TVC, LBF, LVC, and MAP were larger in the L group than in the S group (P < 0.05). Moreover, there were significant positive linear relationships between the reduction in HR and the reductions in TVC, LVC, and FVC. We conclude that individuals who show greater apnea-induced bradycardia during exercise also show greater vasoconstriction in both active and inactive muscle regions.     

Cerebral ischemia: Changes in brain choline,acetylcholine, and other monoamines as related to energy metabolism

The relationship of cerebral neurotransmitters acetylcholine (ACh), noradrenaline (NA), dopamine (DA), 5-hydroxytryptamine (5HT) to the energy state of the brain was examined in mice at various times following complete ischemia produced by decapitation, in gerbils submitted to transient global ischemia (10 min bilateral carotid artery occlusion, 5 or 30 min recirculation), and in rats 24 hr after irreversible microembolism. Ischemia caused significant reductions in brain monoamine concentrations. The alterations in NA, DA, and 5HT levels persisted during recirculation and were unrelated to energy restoration. They were accompanied by an increase in the concentrations of related metabolites, suggesting that synthesis was unable to compensate for the release of the transmitters at early post-ischemic time periods. As described for the catecholamines and 5HT, ischemia resulted in a significant decrease in ACh level, but recirculation was associated with a rapid increase in ACh concentration. Impaired synthesis and/or increased release of ACh can be responsible for the decrease in ACh concentration during ischemia. Early post-ischemic elevation of ACh may be related to the large increase in brain choline brought about by ischemia.     

Early ischemic preconditioning against focal transient and permanent brain ischemia in rats: role of collateral circulation

We hypothesize that early ischemic preconditioning (IPC) can afford protection against focal brief and prolonged cerebral ischemia with subsequent reperfusion as well as permanent brain ischemia in rats by amelioration of regional cerebral blood flow. Adult male Wistar rats (n=97) were subjected to transient (30 and 60 minutes) and permanent middle cerebral artery (MCA) occlusion. IPC protocol consisted of two episodes of 5-min common carotid artery occlusion + 5-min reperfusion prior to test ischemia either followed by 48 hours of reperfusion or not. Triphenyltetrazolium chloride and Evans blue were used for delineation of infarct size and anatomical area at risk (comprises ischemic penumbra and ischemic core), respectively. Blood flow in the MCA vascular bed was measured with use of Doppler ultrasound. The IPC resulted in significant infarct size limitation in both transient and permanent MCA occlusion. Importantly, IPC caused significant reduction of area at risk after 30 min of focal ischemia as compared to controls [med(min-max) 11.4% (3.59-2 0.35%) vs. 2.47% (0.8-9.31%), p = 0.018] but it failed to influence area at risk after 5 min of ischemia [med(min-max) 7.61% (6.32-10.87%) vs. 8.2% (4.87-9.65%), p > 0.05]. No differences in blood flow were found between IPC and control groups using Doppler ultrasound. This is suggestive of the fact that IPC does not really influence blood flow in the large cerebral arteries such as MCA but it might have some effect on smaller arteries. It seems that, along with well established cytoprotective effects of IPC, IPC-mediated reduction of area at risk by means of improvement in local cerebral blood flow may contribute to infarct size limitation after focal transient and permanent brain ischemia in rats.     

Diminished mesenteric vaso- and venoconstriction and elevated plasma ANP and BNP with simulated microgravity.

Diminished constriction of arteries and veins following exposure to microgravity or bed rest is associated with a reduced ability to augment peripheral vascular resistance (PVR) and stroke volume during orthostasis. We tested the hypothesis that small mesenteric arteries and veins, which are not exposed to large pressure shifts during simulated microgravity via head-down tail suspension (HDT), will exhibit decrements in adrenergic constriction after HDT in rats. Small mesenteric arteries and veins from control (Con; n = 41) and HDT (n = 35) male Sprague-Dawley rats were studied in vitro. Vasoactive responsiveness to norepinephrine (NE) in arteries (10(-9) to 10(-4) M) and veins (pressure-diameter responses from 2 to 12 cmH(2)O after incubation in 10(-6) or 10(-4) M NE) were evaluated. Plasma concentrations of atrial (ANP) and NH(2)-terminal prohormone brain (NT-proBNP) natriuretic peptides were also measured. In mesenteric arteries, sensitivity and maximal responsiveness to NE were reduced with HDT. In mesenteric veins there was a diminished venoconstriction to NE at any given pressure in HDT. Plasma concentrations of both ANP and NT-proBNP were increased with HDT, and maximal arterial and venous constrictor responses to NE after incubation with 10(-7) M ANP or brain natriuretic peptide (BNP) were diminished. These data demonstrate that, in a vascular bed not subjected to large hydrodynamic differences with HDT, both small arteries and veins have a reduced responsiveness to adrenergic stimulation. Elevated levels of circulating ANP or NT-proBNP could adversely affect the ability of these vascular beds to constrict in vivo and conceivably could alter the intrinsic constrictor properties of these vessels with long-term exposure.     

Microvasculature of the thyroid gland in the common tree shrew (Tupaia glis): microvascular corrosion cast/scanning electron microscopy study.

A thyroid vascular cast of the common tree shrew (Tupaia glis) was obtained by injection of Batson's No. 17 plastic mixture into the ascending aorta. The cast was studied under the scanning electron microscope. It was found that each half of the gland is supplied by a large superior and a rather small inferior thyroid artery. After plunging into the gland, the arteries divide into smaller branches that are the interlobular, intralobular and follicular arteries (afferent vessels). The basket-like capillaries arising from the follicular arteries and encapsulating thyroid follicles are of large diameter and are arranged in a single layer. The follicular side of the capillary casts was observed to contain numerous small and some large projecting knobs compatible with the presence of fenestrations in the endothelial cells. On the other hand, endothelial nuclear imprints were found mainly on the stromal surface of the follicular capillary casts. Transfollicular capillaries connecting the adjacent follicular capillary networks were also observed. Blood from the follicular capillaries either drains into the follicular veins (efferent vessels) or abruptly drains into the intralobular veins before proceeding to intralobular and interlobular veins, respectively. The interlobular veins are collected into a few small superior, a few larger middle and a few even larger inferior thyroid veins. These veins drain directly into the laryngeal vein lying adjacent to the deep surface of the thyroid gland before joining the jugular vein. Venous valves were identified outside the thyroid gland. In addition, the glomerular capillary island of the parathyroid gland was often seen at the cranioanterolateral and sometimes at the cranioposterolateral aspect of the thyroid gland.     

Leukocyte adhesion to walls of the rat pial venules in normoxia and during brain ischemia

With the help of contact optic system direct observations were carried out on leukocyte movements and on the acts of their adhesion to the inner surface of the walls of pial venules of the rats in normoxia and ischemia resulting from ligating two carotid arteries. After ligating the carotid artery and subsequent gradual development of ischemia, an abrupt increase in the number of the acts of adhesion to the walls of pial venules was shown to occur, the leukocytes adhere to each other inside the venules. A complete occlusion of venules and small veins results, which can be one of the reasons for the animal death in brain ischemia.     

十六排螺旋CT血管造影在颅内疾病中应用初探

脑血管疾病是危及人体生命的危险疾病。传统的血管造影虽然是诊断该类疾病的最佳方法,但属于有创伤检查,且有1．5％-2．0％的合并症或死亡危险的报导^[1]。CT血管造影(computed tomographic angiography cTA)的应用给传统的血管造影带来了极大的挑战。1998年问世的多层螺旋CT(MSCT)以亚秒级的扫描速度具有更长的解剖覆盖、更薄的层厚、多种后处理能力、更简单方便等优势。2002年7月,我院引进GE公司Lightspeed十六排螺旋CT机,并进行了几十例颅内CTA检查,现对其应用情况进行分析。目的：初讨十六排螺旋CT血管造影在颅内病变中的应用及其技术优势。材料与方法：使用GE公司的十六排螺旋CT对自发性脑内出血、动脉瘤、脑肿瘤等几十例病人进行CTA检查,对血管显示情况进行评价;其中AVM和动脉瘤进行DSA检查并与CTA结果比较;另外颜面部AVM及脑肿瘤病人与手术结果比较。结果：CTA检查结果如下,脑血管主干及其1-3级分支显示率为100％,大脑中动脉4—5级分支显示率为94．7％。发现动脉瘤并清晰显示了瘤体、瘤颈、载瘤动脉及其详细关系;AVM清楚地显示了AVM的畸形团及其供血动脉和引流静脉;脑肿瘤显示了肿瘤与周围血管、颅骨间的三维关系。结论：十六排螺旋CT血管造影重建图像质量显著提高,它对颅内各种血管性病变以及血管与颅内其他病变三维空间关系,对各类疾病的诊断具有重要价值,它能显示更细小分支,具备作为动脉瘤等其他血管性病变筛选的首选方法。     

Pharmacological properties of canine intrapulmonary blood vessels

The contractile response of ring segments of large, medium, and small pulmonary arteries and veins of the dog to histamine, norepinephrine, and serotonin have been studied. The maximum contractile response to these drugs was normalized with respect to the maximal response obtained in stimulation with 127 mM K+. The small pulmonary artery was more reactive to histamine, norepinephrine, and serotonin when compared with large and medium pulmonary arteries. The medium and large pulmonary artery showed no difference in reactivity to histamine. However, the mean effective dose (ED50) values for these agonists among the different segments of pulmonary arteries showed no significant difference. The small and medium pulmonary veins demonstrated increased reactivity to histamine, but not norepinephrine and serotonin. The ED50 values also indicated that both small and medium veins were more sensitive to histamine when compared with the large pulmonary vein. The log concentration percent response curves for both small and medium pulmonary veins were displaced leftward (increased sensitivity) with respect to that for the large pulmonary vein. However, the reactivity and sensitivity to histamine between medium and small pulmonary veins were no different. The reactivity and sensitivity of different segments of pulmonary veins to norepinephrine and serotonin showed no significant differences among them. We conclude that histamine and other vasoactive substances, which are directly or indirectly related to mast cell degranulation, exert pharmacological effects on the pulmonary vasculature which possesses differential responsiveness at various levels of the vascular tree.     

CT诊断用于胰腺癌侵犯胰周动静脉的临床价值分析

目的：探究CT诊断对于胰腺癌侵犯胰周动静脉的临床价值。方法：随机选取在我院就诊的64例胰腺癌患者,在他们进行手术前全在距离肿瘤边缘1cm内的血管进行分期和诊断进而进行螺旋CT检查。结果：经组织学术后病理切片染色发现胰周动脉29条,静脉48条。运用外科手术探查方法发现86条胰周动脉,89条胰周静脉。在这些血管中,有23条动脉、47条静脉经外科手术证实的确是肿瘤侵犯,并且经过CT诊断,我们最终断定为有25条动脉、46条静脉处于1～4级。结论：胰周动、静脉受到侵犯时,具有不同的CT表现特征,因此在利用CT方法判断胰周动、静脉遭受侵犯时应当根据不同情况不同对待。