重度OSAS患者前额叶皮质及岛叶1H—MR波谱研究

目的：利用氢质子MRS（IH-MRS）探讨重度阻塞性呼吸睡眠暂停综合症（Severeobstructivesleepapneasyndrome,S-OSAS）患者前额叶皮质及岛叶脑代谢产物特征。方法：选择18例S-OSAS患者（S-OSAS组）和15名健康志愿者（HC组）行左侧前额叶皮质及岛叶1H-MRS检查,测量两组左侧前额叶皮质区及岛叶N-乙酰天冬氨酸／肌酸（NAA／Cr）、胆碱／肌酸（Cho／Cr）值。对患S-OSAS累计时间与前额叶皮质及岛叶NAA／Cr作直线相关分析。结果：与正常对照组相比,S-OSAS患者左侧前额叶皮质、岛叶NAA／Cr比值降低,分别为1．43±0．47、1．34±0．06,对照组分别为1．51±0．65、1．45±0．07;S-OSAS组患者左侧前额叶皮质、岛叶Cho／Cr分别为0．90±0．08、1．195：0．13,对照组分别为0．87±0．07、1．09±0．02,两组差异有统计学意义。前额叶皮质及岛叶代谢物NAA／Cr与患S-OSAS累计时间成负相关性（r值分别为-0．965、-0．955,P〈0．01）。结论：1H-MRS显示S-OSAS患者前额叶皮质及岛叶病理生理变化,从该区代谢物的改变反应出S-OSAS患者执行及情感功能的异常,其NAA/Cr改变程度与患S-OSAS累计时间相关。     

内侧前额叶皮质DNA甲基化调控大鼠酒精相关行为

酒精滥用不仅导致组织器官损伤,还易诱发神经精神疾病。研究表明,DNA甲基化在酒精诱导基因表达和行为改变中发挥重要作用,但具体的神经生物学机制尚未被阐明。为了探索DNA甲基化在酒精滥用中的作用机制,本研究选取健康成年雄性SD大鼠(Rattus norvegicus)32只,随机分为饮水对照组(n=16)和慢性酒精暴露组(n=16),运用双瓶选择实验(two bottle choice test,TBCT)评估大鼠酒精偏爱率(alcohol preference),通过旷场行为(open field test,OFT)评估活动状态并检测血酒精浓度。分离两组大鼠内侧前额叶皮质(medial prefrontal cortex,mPFC),提取总DNA,利用简化代表性重亚硫酸盐测序技术(reduced representation bisulfite sequencing,RRBS)构建mPFC甲基化谱,对差异基因进行功能富集和通路分析,筛选与酒精滥用密切相关的甲基化差异基因,运用qRT-PCR技术检测差异基因的表达,验证DNA甲基化对基因的表达调控;利用qRT-PCR和Western blot检测甲基转移酶(DNA methyltransferases,DNMTs)和甲基化CpG位点结合蛋白2(methyl CpG binding protein 2,MeCP2)的表达;同时,还检测了短期酒精暴露(7 d)对大鼠mPFC内DNMTs和MeCP2的影响(n=8/组)。结果表明,慢性酒精暴露大鼠mPFC内基因启动子区甲基化水平显著升高。与酒精滥用密切相关的差异基因中,慢性酒精暴露组Ntf3和Ppm1G启动子区甲基化水平升高,mRNA表达降低;Hap1和DUSP1启动子区甲基化水平降低,mRNA表达升高。慢性酒精暴露使DNMT3B和MeCP2 mRNA和蛋白表达升高,而短期内酒精暴露不影响它们的表达。本研究初步证实DNA甲基化与酒精滥用的发展相关,可能受DNMT3B和MeCP2分子的调控,并发现了与酒精滥用相关的靶基因Ntf3、Ppm1G、Hap1和DUSP1,为研究酒精滥用的神经生物学机制提供了新见解,同时为酒精滥用治疗提供了可能的药理学靶点。     

慢性束缚诱导的广泛性焦虑障碍前额叶皮质中miRNA的表达

摘要 目的：研究慢性束缚(Chronic restraint stress,CRS)诱导的广泛性焦虑障碍模型小鼠前额叶皮质miRNA表达谱的变化及其意义。方法：小鼠经过7天的CRS,通过旷场实验与高架十字迷宫实验检测小鼠是否能够表现出紧张和焦虑行为。采用高通量测序的方法,定量分析对照组与模型组小鼠前额叶皮质组织中 miRNAs的表达水平,研究CRS诱导的焦虑有关的分子表达谱。通过RT-PCR对测序结果中差异表达的miRNAs 进行验证。结果：经CRS诱导的广泛性焦虑障碍模型组小鼠,模型组在活动总距离增多（P＜0.05）、平均速度（P＜0.05）增快、中央停留时间减少（P＜0.05）、开放臂进入次数百分比减少（P<0.01）、开放臂停留时间减少（P＜0.01）,与对照组相比结果均具有统计学意义,表明GAD小鼠造模成功。经高通量测序结果及生信学分析,对照组与模型组相比较,共28个上调miRNAs,34个下调miRNAs,5388个靶基因参与作用变化。上/下调的miR-GO分析结果中,主要共同参与神经系统发育、突触后密度、神经元投射、蛋白丝氨酸/苏氨酸激酶活性等过程;上/下调miR-KEGG结果中,参与共同通路主要包括轴突引导、神经营养因子信号通路、cAMP 信号通路、多巴胺能突触、MAPK信号通路等过程。结论：前额叶皮质中miR-7a-5p、miR-124-3p、miR-141-3p、miR-183-5p等miRNA变化参与广泛性焦虑障碍的发病,可能调控影响神经传导等功能。     

人胎前额叶皮质神经肽Y免疫反应阳性神经元的发育

本文用免疫组化方法研究了人胎前额叶皮质中神经肽Ｙ（ＮＰＹ）免疫反应阳性神经元的发育。结果显示,ＮＰＹ阳性神经元最早于１６周出现于前额叶皮质的皮质下板,为未成熟的双极神经元。随着胎儿生长,皮质下板的ＮＰＹ阳性神经元数量逐渐增加,胞体增大,着色加深,突起增多增长。３０周后较少数量的ＮＰＹ阳性神经元也见于皮质的Ⅵ层及白质,皮质其它层阳性神经元数量很少。２８周后皮质内还能见到各种走向的ＮＰＹ阳性神经纤维,其数量随胎儿生长而增加。本研究提示,与其它动物相比,人类大脑皮质ＮＰＹ阳性神经元出现较早,其成熟过程基本上在出生前完成     

大鼠内侧前额叶皮质内ERK1/2 活化参与脊髓损伤后抑郁情绪

目的:观察细胞外信号调节激酶1/2(ERK1/2)的活化在脊髓损伤引起抑郁中的作用。方法:应用Western blot和行为药理学方法,观察脊髓损伤后(SCI)大鼠内侧前额叶皮质内(mPFC)ERK1/2及磷酸化-ERK1/2(p-ERK1/2)的表达情况及ERK1/2磷酸化抑制剂U0126对抑郁样行为的影响。结果:脊髓损伤后的第2天到第8周,SCI模型大鼠的BBB评分均显著低于假手术组,差异具有统计学意义(p0.05)。脊髓损伤后8周-12周,SCI模型大鼠强迫游泳不动时间与假手术组相比明显缩短,mPFC内pERK1/2蛋白表达水平明显升高,总ERK 1/2的蛋白水平则未见组间差异,而给予U0126的大鼠的不动时间与给药之前相比明显延长增加,mPFC内pERK1/2蛋白表达水平较SCI模型大鼠明显降低,差异均具有统计学意义(P0.05)。结论:内侧前额叶皮质内ERK1/2的激活参与了脊髓损伤后引起的突触可塑性,在相关的抑郁样行为的产生中发挥了重要的作用。     

OSAS对冠心病患者的血糖和血脂水平的影响

目的:探讨阻塞性睡眠呼吸暂停综合征(Obstructive sleep apnea syndrome,OSAS)对冠心病患者血糖和血脂的影响。方法:纳入我科住院的明确诊断冠心病患者共168人,根据呼吸暂停低通气指数(Apnea-hypopnea index,AHI)共分2组:冠心病组133例,冠心病合并OSAS组45例(轻度OSAS组16例;中度OSAS组18例,重度OSAS组12例)。对比分析冠心病组和冠心病合并OSAS组患者血脂及血糖水平及其相关性。结果:BMI、LDL、HDL在四组间差异有统计学意义(P0.05)。冠心病合并OSAS的BMI、LDL、HDL明显高于冠心病组,各组间BMI差异有统计学意义(P0.05)。FPG、HOMA-I、RHb A1、OX-LDL、AHI在冠心病组和冠心病合并轻度OSAS组之间差异无统计学意义(P0.05)。FPG、HOMA-I、RHb A1、OX-LDL、AHI在OSAS轻、中、重各组间差异有统计学意义(P0.05)。冠心病合并OSAS患者AHI和BMI、LDL、FPG、HOMA-I、OX-LDL呈正相关关系(P0.05)。结论:OSAS增加了冠心病患者血脂水平和糖尿病的风险,及机制可能与胰岛素抵抗和OX-LDL水平增高有关。     

创伤后应激障碍大鼠海马与前额叶皮质中OREXIN受体的失调

目的:从食欲素(Orexin, ORX)系统挖掘创伤后应激障碍的神经生物学机制。方法:以单次延长刺激(single prolonged stimulation,SPS)法复制创伤后应激障碍(post traumatic stress disorder,PTSD)大鼠模型,以行为学结合血清中皮质酮和神经元特异性烯醇化酶进行模型评价,通过酶联免疫吸附试验(Elisa)分析大鼠血清与脑脊液中OREXIN水平,以实时荧光定量聚合酶链反应(RT-PCR)检测海马与前额叶皮质中的Orexin受体基因表达。结果:实验成功的复制了PTSD模型,与对照组相比,模型组大鼠血清中皮质酮和神经元特异性烯醇化酶的含量均极显著升高(P0.01),脑脊液中Orexin A、Orexin B的含量均显著升高(P0.01),海马和皮质中ORX1R与ORX2R均极显著下降(P0.01)。结论:PTSD大鼠的应激损伤与Orexin及其受体表达水平的变化密切相关。     

电针对氯胺酮成瘾大鼠内侧前额叶皮质酪氨酸羟化酶表达的影响

目的观察不同时辰电针“足三里”和“三阴交”穴对氯胺酮成瘾大鼠内侧前额叶皮质（mPFC）酪氨酸羟化酶（TH）表达的影响,探讨电针治疗氯胺酮滥用成瘾的作用机制。方法将56只SD大鼠随机分为正常对照组、生理盐水对照组、模型组、电针治疗组,电针治疗组再分为子时（23：00）、卯时（05：00）、午时（11：00）、酉时（17：00）4个电针组,每组8只。每天1次经腹腔注射氯胺酮复制氯胺酮成瘾模型,不同时辰电针组在给药7d后分别选取一侧“足三里”和“三阴交”穴给予低频（2Hz）电针治疗,每次30min,连续治疗7d。采用免疫组织化学染色方法检测mPFC内TH的表达。结果与正常对照组和生理盐水对照组相比较,模型组mPFC内TH免疫反应阳性神经元的数量明显增多（P〈0．01）,细胞平均灰度值降低（P〈0．01）,与模型组相比较,午时、酉时电针组TH免疫反应阳性神经元的数量明显减少（P〈0．01）,细胞平均灰度值升高（P〈0．01）;子时、卯时电针组则无明显变化（P〉0．05）。结论氯胺酮成瘾使mPFC内TH的表达明显增加;午时、酉时电针“足三里”和“三阴交”穴可明显下调mPFC内TH的表达,改善氯胺酮成瘾症状。     

电刺激大鼠内侧额叶前皮质对听皮层神经元频率感受野可塑性的调制

本文应用常规电生理学技术,研究电刺激大鼠内侧额叶前皮质（medial prefrontal cortex,mPFC）对初级听皮层神经元频率感受野（receptive field,RF）可塑性的调制。电刺激mPFC,137个听皮层神经元（72．8％）RF可塑性受到影响,其中抑制性调制71个神经元（37．7％）,易化性调制66个神经元（35．1％）,其余51个神经元（27．2％）不受影响。mPFC的抑制性调制效应表现为,RF的偏移时间延长,恢复时间缩短。相反,mPFC的易化性调制效应表现为,RF的偏移时间缩短,恢复时间延长。电刺激mPFC对RF可塑性的调制与声、电刺激之间的时间间隔有关,最佳时间间隔介于5-30ms之间。结果提示,大鼠mPFC可以调制听皮层神经元的功能活动,可能参与听觉学习记忆过程。     

睡眠呼吸暂停综合征患者血脂水平的研究

目的:了解阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆脂质代谢情况。方法:分别检测健康对照组、睡眠呼吸暂停综合征患者组甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A、载脂蛋白B、脂蛋白a、载脂蛋白E含量。进行统计学对比及分析。结果:睡眠呼吸暂停综合征患者的甘油三酯、总胆固醇、高密度脂蛋白、总胆固醇/高密度脂蛋白、载脂蛋白A、载脂蛋白B及载脂蛋白E与健康对照组比较有显著差异,且与其睡眠监测指标有明显相关。结论:OSAHS可导致血浆脂质代谢紊乱,与动脉粥样硬化发生及发展的存在重要的相关性,是独立于年龄、体重、饮食、遗传等原因的冠心病、高血压、脑卒中等心脑血管疾病的发病因素之一。因此,提高对OSAHS的警惕是非常重要的。     

"青春期"大鼠前额皮质内BDNF与trkB的表达

目的:探讨"青春期"大鼠前额皮质内BDNF与trkB的表达。方法:出生后35天大鼠作为"青春期"大鼠,出生后15天、75天大鼠分别作为幼年期与成年期对照,每组大鼠各6只,用ABC免疫组织化学方法与图像分析相结合技术检测前额皮质内BDNF与trkB免疫反应的强度和免疫阳性产物平均光密度值的变化。结果:各时间点大鼠前额皮质内均可见BDNF与trkB免疫阳性产物。35天组BDNF与trkB免疫反应最强,阳性产物平均光密度值最高,与其它两组相比差异有显著性(p<0.05)。结论:"青春期"大鼠前额皮质内BDNF与trkB高表达,提示在此时期内前额皮质对BDNF的需求最多。     

阻塞性睡眠呼吸暂停综合征临床监测分析

目的:探讨阻塞性睡眠呼吸暂停综合征患者的临床特征及评价疗效。方法:回顾分析70例阻塞性睡眠呼吸暂停综合征患者PSG监测数据。结果:随着呼吸紊乱指数的增加,年龄、体重指数、最长呼吸暂停时间、最低SaO_2%、平均SaO_2%下降等指标在轻度与中、重度SAS之间差异显著;70例患者中伴有高血压52.9%、糖尿病5.7%、冠心病21.4%。结论:OSAS是一种具有潜在危险的疾痛,对OSAS早期诊断治疗是预防发生严重并发症的关键。     

Glutamatergic Control of Dopamine Release During Stress in the Rat Prefrontal Cortex

Abstract: In vivo microdialysis was used to assess the hypothesis that the stress-induced increase in dopamine release in the prefrontal cortex is mediated by stress-activated glutamate neurotransmission in this region. Local perfusion of an α-amino-3-hydroxy-5-methylisoxazole-4-propionate (AMPA)/kainate receptor antagonist, 6-cyano-7-nitroquinoxaline-2,3-dione, blocked the stress-induced increase in dopamine levels, whereas an NMDA receptor antagonist, 2-amino-5-phosphonopentanoic acid, at the dose tested, was not able to alter this response significantly. These data indicate that the effect of stress on dopamine release in the prefrontal cortex is mediated locally by activation of AMPA/kainate receptors, which modulate the release of dopamine in this region.     

Changes in the Turnover of Monoamines in Prefrontal Cortex of Rats Fed on Vitamin E-Deficient Diet

Turnover of noradrenaline (NA), dopamine (DA), serotonin (5-HT), and their metabolites has been measured after a 15-day vitamin E-deficient diet in adult rat prefrontal cortex. Turnover rates of 3,4-dihydroxyphenylacetic acid, homovanillic acid, and 5-hydroxy-3-indoleacetic acid have been assayed from the disappearance rates after blocking by pargyline inhibition of monoamine oxidase. NA, DA, and 5-HT turnover rates have been measured as accumulation rates of NA, DA, and 5-HT after pargyline inhibition of monoamine oxidase. No change was found in the turnover rate of NA between control and experimental animals. In contrast, turnover rates of DA and homovanillic acid significantly increased in the animals fed on a low-vitamin E diet. However, the most striking results were found on the serotoninergic system. Levels of 5-HT and its main metabolite, 5-hydroxy-3-indoleacetic acid, and their respective turnover rates were lower in the vitamin E-deficient diet. These results could indicate that vitamin E is necessary for the normal functioning of the serotoninergic neurons in the rat prefrontal cortex. The involvement of vitamin E in preventing the formation of free radicals is well known. Therefore, this lack of protective effect after a 15-day vitamin E-deficient diet could be responsible for the neuronal damage to the serotoninergic system. The opposing results found in DA (increase) and 5-HT (decrease) turnover could provide further evidence for an inhibitory control of the serotoninergic ascending pathways to the dopaminergic system in the prefrontal cortex.     

Stimulation-Induced Release of Coexistent Transmitters in the Prefrontal Cortex: An In Vivo Microdialysis Study of Dopamine and Neurotensin Release

Extracellular fluid levels of dopamine and neurotensin in the rat prefrontal cortex were measured using in vivo microdialysis. Electrical stimulation of the median forebrain bundle resulted in increased release of both dopamine and neurotensin from the prefrontal cortex. Thus, stimulation of neurons in which dopamine and neurotensin are colocalized can evoke the in vivo release of both substances.     

An Excitant Amino Acid Projection from the Medial Prefrontal Cortex to the Anterior Part of Nucleus Accumbens in the Rat

High-affinity uptake of neurotransmitter substrates in synaptosome-containing homogenates and tissue concentrations of amino acids were examined in subcortical areas 5-6 days after bilateral N-methyl-D-aspartate lesions confined to rat medial prefrontal cortex. D-[3H]Aspartate (32% of control) and [3H] gamma-aminobutyric acid ( [3H]GABA) (60% of control) uptakes were significantly reduced in medial prefrontal cortex, whereas [3H]choline (110% of control) uptake was unchanged, suggesting the production of axon-sparing lesions. The uptake of D-[3H]aspartate (76% of control), but not of [3H]GABA or [3H]choline, was significantly reduced in nucleus accumbens, with no concomitant reduction in amino acid concentrations. When examined in serial coronal sections, reduced D-[3H]aspartate uptake was confined to the most anterior 500 micron of nucleus accumbens (67% of contralateral sample). No significant reductions of uptake or amino acid concentrations were observed in caudate putamen or ventral tegmental area. These results suggest a role for glutamate or aspartate as neurotransmitters in projections from medial prefrontal cortex to anterior nucleus accumbens. Medial prefrontal cortex may represent the major excitatory cortical input to the nucleus accumbens.     

舌骨肌切开悬吊术结合腭咽成形术治疗重度OSAHS

目的：应用联合应用舌骨肌切开悬吊术和腭咽成形术治疗重度阻塞性睡眠呼吸暂停低通气综合征。方法：用多导睡眠监测确定52例重度阻塞性睡眠呼吸暂停低通气综合征,不同方法确定均为以舌根平面阻塞为主的上气道多平面狭窄。采用舌骨肌切开悬吊术联合腭咽成形术进行治疗。结果：所有接受手术的患者术后鼾声均有不同程度的减轻,手术总有效率94．2％。无1例出现不良并发症。结论：舌骨肌切开悬吊术安全、易行,结合腭咽成形术治疗重度阻塞性睡眠呼吸暂停低通气综合征效果良好。     

Contribution of Noradrenergic Neurons to the Regulation of Dopaminergic (D1) Receptor Denervation Supersensitivity in Rat Prefrontal Cortex

3,4-Dihydroxyphenylethylamine (DA, dopamine) levels in the rat prefrontal cortex were selectively decreased by 52%, leaving noradrenaline (NA) levels unaffected, 4 weeks following restricted bilateral electrolytic lesions of the ventral mesencephalic tegmentum (VMT). These lesions also induced a significant increase in DA-sensitive, but not isoproterenol-sensitive, adenylate cyclase activity in tissue homogenates (+38%). We had shown previously that chemical (6-hydroxydopamine, 6-OHDA) lesions of the VMT destroy both ascending DA and NA fibers but do not alter the D1-receptor density in the prefrontal cortex. In this study, electrolytic lesions of the VMT were combined with bilateral injections of 6-OHDA made laterally in the pedunculus cerebellaris superior to assess the role of NA fibers in the development of D1-receptor supersensitivity. This combined treatment produces a large decrease of cortical NA levels (-95%), an increase in beta-adrenergic-sensitive adenylate cyclase activity (+110%), and a decrease in DA levels (-60%), but does not alter D1-receptor density in the prefrontal cortex. These results indicate that the development of D1-receptor supersensitivity in the prefrontal cortex following electrolytic lesion of the VMT depends on the presence of an intact NA innervation.