脊髓损伤的病理改变及修复策略

脊髓损伤造成神经组织坏死,传导通路中断,损伤平面以下运动和感觉功能丧失,导致瘫痪甚至死亡.脊髓损伤的病理变化极其复杂,早期主要为分子基因水平的改变,亚急性期主要为细胞组织水平的变化.这些变化引发继发性损伤,致使组织坏死、神经元死亡、轴突断裂并形成由瘢痕组织包裹的囊性空洞,抑制轴突再生.目前临床上仅能通过手术减压或者使用药物对症干预,无法从根本上改善受损神经的功能.脊髓损伤后功能难以恢复有多方面的原因:炎症反应贯穿脊髓损伤全过程,炎症介质导致损伤区域的神经元及胶质细胞变性坏死,轴突因瓦勒变性而萎缩;神经元再生能力弱,轴突再生乏力,并且瘢痕组织导致轴突无法穿越损伤区域与远端的轴突形成联系.本文就脊髓损伤后的病理改变进行综述并探讨修复策略.     

支链氨基酸治疗肝性脑病

<正> 基于肝脏病时有特殊的血浆氨基酸型式改变,Fischer于1976首先用含有丰富支链氨基酸(缬氨酸、亮氨酸、异亮氨酸)的FO80溶液纠正肝性脑病患者的血浆氨基酸不平衡,收到良好效果~(〔1〕)。现将我们应用4.275％支链氨基酸溶液治疗肝性脑病37例的结果报道如下:     

支链氨基酸治疗肝性脑病

<正> 基于肝脏病时有特殊的血浆氨基酸型式改变,Fischer于1976首先用含有丰富支链氨基酸(缬氨酸、亮氨酸、异亮氨酸)的FO80溶液纠正肝性脑病患者的血浆氨基酸不平衡,收到良好效果~(〔1〕)。现将我们应用4.275％支链氨基酸溶液治疗肝性脑病37例的结果报道如下:     

肠道菌群影响脊髓损伤后焦虑情绪的研究进展

脊髓损伤作为一种严重的创伤性应激可以引发焦虑情绪,对患者心理健康造成极大影响。研究发现,脊髓损伤后肠道菌群失调与焦虑情绪的发生存在密切联系,因此本文从5-羟色胺系统失调、多巴胺系统失调、脑源性神经营养因子缺乏及炎症反应4个方面,探讨脊髓损伤后肠道菌群改变影响焦虑情绪发生的机制,为今后治疗脊髓损伤后焦虑情绪的深入研究和药物开发提供理论依据。     

肝性脊髓病临床分析

目的：探讨肝性脊髓病（HM）的临床特点及治疗方法。方法：对30例确诊HM患者的临床资料进行回顾性分析。结果：30例患者均具有典型的痉挛性截瘫的临床表现;4例（13．3％）曾接受门腔静脉分流术;28例（93．3％）血氨轻中度增高,血氨检测正常者2例（6,6％）;28例（93．3％）内科治疗无明显效果。结论：HM患者以痉挛性截瘫为主要表现,血氨增高可能不是惟一致病因素,常规内科治疗效果不佳,肝移植为HM的治疗带来希望。     

脊髓缺血再灌注损伤的防治概况

脊髓缺血-再灌注损伤(SCII)是一种严重的神经系统损伤,是缺血脊髓组织恢复血液灌注后,脊髓组织的损伤反而加重,表现为其神经损害体征和形态学改变较前更加明显,其发生机制是多因素的综合结果,治疗措施也具有多样性,脊髓缺血后脊髓微血管结构及功能的破坏和脊髓水肿等是脊髓功能损害的主要诱因,至今为止,脊髓缺血再灌注损伤的防治主要有药物及物理治疗等方法,本文作者通过查阅中外文献对脊髓缺血再灌注损伤的特征、发生机制及防治措施作一综述,希望对研究脊髓缺血再灌注损伤防治的学者能有所帮助。     

皮肤型孢子丝菌病316例临床分析

目的探讨孢子丝菌病的临床特征及病理特点,指导临床实践。方法分析1972～2007年间就诊于我院的孢子丝菌病447例,其中有详细资料者316例,做皮肤组织病理检查的203例中,105例做了PAS染色检查。结果春季发病者占50．34％,临床分型以固定型略多（52．53％）。儿童主要以面部发病。主要病理改变为混合细胞性肉芽肿。PAS染色阳性率为38．1％。结论孢子丝菌病常年皆可发病,近几年有增多的趋势,春季为本病高发季节。儿童皮损主要在面部,多为固定型。病理改变多为混合细胞性肉芽肿。病理切片、PAS染色诊断阳性率不高,确诊主要靠真菌培养。     

ALS转基因小鼠脊髓中miRNA-132表达减少BDNF表达增加

目的研究miRNA-132和脑源性神经营养因子(brain derived neurotrophic factor,BDNF)在肌萎缩侧索硬化症(amyotrophic lateral sclerosis,ALS)转基因小鼠脊髓中的表达变化,探讨miRNA-132、BDNF在ALS发病中的作用。方法取SOD1-G93A ALS转基因鼠发病早期(95d)、中期(108d)和晚期(122d)脊髓组织,应用qRT-PCR及原位杂交(hybridization in situ, ISH)技术检测miRNA-132的表达及定位,应用qRT-PCR及Western blot技术检测BDNF在mRNA及蛋白水平变化,免疫荧光技术检测BDNF在脊髓中的表达及分布,以同窝野生型鼠作为对照。结果与野生型鼠比较,miRNA-132在ALS转基因鼠脊髓组织表达下降,miRNA-132阳性信号主要定位脊髓前角细胞胞体;在ALS转基因鼠脊髓组织BDNF mRNA及蛋白水平均增高,BDNF免疫阳性细胞主要表达于脊髓前角神经元,表达信号明显增强。结论 miRNA-132、BDNF可能在ALS发病过程中发挥了重要作用。     

肠道菌群与脊髓损伤并发症

脊髓损伤是严重的致残性神经系统疾病,脊髓损伤后产生的水肿、炎症反应和代谢紊乱等并发症是致使脊髓损伤继发性加重的主要原因。近年来,随着对肠道微生物的研究越来越深入,肠道菌群对神经系统疾病的影响得到广泛关注。肠道菌群可以通过调节机体能量代谢、炎症反应及作用于神经内分泌和脑-肠轴的途径影响中枢神经系统疾病。最近研究发现,肠道菌群与脊髓损伤并发症的关系非常紧密。脊髓损伤后肠道菌群的变化可能影响脊髓损伤后并发症发生以及加重。本文主要就肠道菌群对脊髓损伤后并发症的影响和可能的作用机制进行综述,为临床研究和治疗脊髓损伤提供新思路。     

小鼠脊髓损伤模型的建立及其评价

通过对模型的制备模拟脊髓损伤,研究其病理和影像的变化及脊髓组织的病理分析,为后期的唔疗提供了实验信息。使用7～8周龄小鼠,咬除T9～T10棘突及相应椎板,用重物压迫脊髓,缝合皮肤,制成脊髓损伤模型。分不同的时间进行行为学评分及病理和影像学的检测。结果显示对照组在不同时间行为学评分较高,而实验组评分较低。脊髓损伤区出现明显的病理改变和影像学的改变。可见在实验组中小鼠脊髓损伤区无脊髓组织残留,且出现明显的组织和影像改变,在行为学上两组相比具有显著差异,适用于脊髓再生的研究,从而为进一步研究脊髓损伤提供了较为可靠的模型。     

Hepatic Encephalopathy: From Metabolic to Neurodegenerative

Neurochemical Research - Hepatic encephalopathy (HE) is a neuropsychiatric syndrome of both acute and chronic liver disease. As a metabolic disorder, HE is considered to be reversible and therefore...     

Hepatic microsomal oxygenation of aldehydes to carboxylic acids

Hepatic microsomal oxygenation of aldehydes to carboxylic acids was investigated. Aldehydes (veratrum aldehyde, cinnamic aldehyde, myrtenal, cuminaldehyde, 3-phenylpropionaldehyde, perillaldehyde and 9-anthraldehyde) were incubated with hepatic microsomes of mice in the presence of an NADPH-generating system under 18O2 (97 atom%). The incorporation of oxygen-18 into carboxylic acids formed was determined by gas chromatography-mass spectrometry. Oxygen-18 was incorporated into the carboxylic acids formed from all aldehyde substrates examined. Hepatic microsomal formation of 3,4-dimethoxybenzoic acid and cumic acid from veratrum aldehyde and cuminaldehyde, respectively, was inhibited by CO and SKF 525-A. These results indicate that the oxygenation of aldehydes which may be catalyzed by cytochrome P450 is a common reaction in the biotransformation of xenobiotic aldehydes.     

Monoamine oxidase A from human placenta and monoamine oxidase B from bovine liver both have one FAD per subunit.

Choline and C1 metabolism pathways intersect at the formation of methionine from homocysteine. Hepatic S-adenosylmethionine (AdoMet) concentrations are decreased in animals ingesting diets deficient in choline, and it has been suggested that this occurs because the availability of methionine limits AdoMet synthesis. If the above hypothesis is correct, changes in hepatic AdoMet concentrations should relate in some consistent manner to changes in hepatic methionine concentrations. Rats were fed on a choline-deficient or control diet for 1-42 days. Hepatic choline concentrations in control animals were 105 nmol/g, and decreased to 50% of control after the first 7 days on the choline-deficient diet. Hepatic methionine concentrations decreased by less than 20%, with most of this decrease occurring between days 3 and 7 of choline deficiency. Hepatic AdoMet concentrations decreased by 25% during the first week, and continued to decrease (in total, by over 60%) during each subsequent week during which animals consumed a choline-deficient diet. Hepatic S-adenosylhomocysteine (AdoHcy) concentrations increased by 50% when animals consumed a choline-deficient diet. AdoHcy is formed when AdoMet is utilized as a methyl donor. In summary, choline deficiency can deplete hepatic stores of AdoMet under dietary conditions that only minimally decrease the availability of methionine within liver. Thus decreased availability of methionine may not have been the only mechanism whereby choline deficiency lowers hepatic AdoMet concentrations. We suggest that increased utilization of AdoMet might also have occurred.     

Cloning and characterization of a mammalian fatty acyl-CoA elongase as a lipogenic enzyme regulated by SREBPs

The mammalian enzyme involved in the final elongation of de novo fatty acid biosynthesis following the building of fatty acids to 16 carbons by fatty acid synthase has yet to be identified. In the process of searching for genes activated by sterol regulatory element-binding protein 1 (SREBP-1) by using DNA microarray, we identified and characterized a murine cDNA clone that is highly similar to a fatty acyl-CoA elongase gene family such as Cig30, Sscs, and yeast ELOs. Studies on the cells overexpressing the full-length cDNA indicate that the encoded protein, designated fatty acyl-CoA elongase (FACE), has a FACE activity specific for long-chains; C12-C16 saturated- and monosaturated-fatty acids. Hepatic expression of this identified gene was consistently activated in the livers of transgenic mice overexpressing nuclear SREBP-1a, -1c, or -2. FACE mRNA levels are markedly induced in a refed state after fasting in the liver and adipose tissue. This refeeding response is significantly reduced in SREBP-1 deficient mice. Dietary PUFAs caused a profound suppression of this gene expression, which could be restored by SREBP-1c overexpression. Hepatic FACE expression was also highly up-regulated in leptin-deficient ob/ob mice. Hepatic FACE mRNA was markedly increased by administration of a pharmacological agonist of liver X-activated receptor (LXR), a dominant activator for SREBP-1c expression. These data indicated that this elongase is a new member of mammalian lipogenic enzymes regulated by SREBP-1, playing an important role in de novo synthesis of long-chain saturated and monosaturated fatty acids in conjunction with fatty acid synthase and stearoyl-CoA desaturase.     

Effects of dieldrin on hepatic carbohydrate metabolism in the suckling and adult rat

Hepatic carbohydrate metabolism was studied in adult and suckling rats given age-specific LD50 doses of dieldrin po. These doses in 5-, 10-, and 60-day-old Wistar rats were 38, 28, and 63 mg/kg, respectively. Plasma glucose and free fatty acids (FFA), and hepatic glycogen, phosphoenolpyruvate carboxykinase (PEPCK), fructose-1,6-diphosphatase (FDP), and glucose-6-phosphatase (G6P) were measured 1 and 3 h after administration of the insecticide. Plasma glucose concentrations were elevated (17%) in some 5-day-old rats after 1 h and in all adults after 1 and 3 h (45 and 30%, respectively). Plasma FFA concentrations were decreased (9%) in the 5-day-old rat 1 h after dieldrin. Hepatic glycogen content was reduced in both 5- and 10-day-old pups at 1 hour (22 and 17%, respectively). Hepatic FDP activity was elevated in the 5-day-old rat at 1 h (17%) and was decreased (10%) in the 10-day-old rat at 3 h. Hepatic PEPCK activity was increased in adult animals by 30% 1 h after dieldrin. Furthermore, PEPCK activity was increased at 3 h in rats of all ages (76%, 5-day-old pup; 115%, 10-day-old pup; 56%, 60-day-old adult). Hepatic G6P activity was unaltered by dieldrin. Thus only the activity of hepatic PEPCK is consistently elevated by dieldrin exposure. However, this enhanced PEPCK activity is associated with dieldrin-induced hyperglycemia only in the adult rat.     

Bile pigment formation and excretion in the rabbit

Bile and plasma levels of biliverdin and bilirubin, together with the hepatic biliverdin reductase and bilirubin UDP-glucuronosyl transferase activities, were studied in the rabbit. No biliverdin could be detected in the blood plasma. The bilirubin concentration in blood was 7.81 +/- 0.79 mumol/l. Biliverdin was the predominant pigment in bile (63%). Hepatic biliverdin reductase activity was 0.086 +/- 0.016 nmol/mg protein/hr. The synthesis of bilirubin was apparently limited by the enzyme activity. Most of the bilirubin in bile was conjugated (90%) with monoconjugates predominating (75%). Hepatic UDP-glucuronosyl transferase activity was 2.65 +/- 0.18 and 1.14 +/- 0.16 mumol/mg protein/hr with and without activation, respectively.     

Metabolomic analysis of sulfur-containing substances and polyamines in regenerating rat liver

We studied the significance of alterations in the metabolomics of sulfur-containing substances in rapidly regenerating rat livers. Male rats were subjected to two-thirds partial hepatectomy (PHx), and the changes in hepatic levels of major sulfur-containing amino acids and related substances were monitored for 2?weeks. Liver weight began to increase from 24?h after the surgery, and appeared to recover fully in 2?weeks. Serum alanine aminotransferase and aspartate aminotransferase activities were elevated immediately after the surgery and returned slowly to normal levels in 2?weeks. Methionine, S-adenosylmethionine (SAM), cystathionine and cysteine were increased rapidly and remained elevated for longer than 1?week. Hepatic glutathione concentration was increased gradually for 24?h, and then decreased thereafter, whereas hypotaurine was elevated drastically right after the surgery. Hepatic concentrations of polyamines were altered significantly by PHx. In the hepatectomized livers putrescine concentration was elevated rapidly, reaching a level 40- to 50-fold greater than normal in 6–12?h. Ornithine, the metabolic substrate for putrescine synthesis, was also elevated markedly. Spermidine was increased significantly, whereas spermine was depressed below normal, which appeared to be due to the increased consumption of decarboxylated SAM for spermidine biosynthesis. The results show that the metabolomics of sulfur-containing amino acids and related substances is altered profoundly in regenerating rat livers until the original weight is recovered. Hepatic concentrations of polyamines after PHx are closely associated with the alteration in the metabolomics of sulfur-containing substances. The implication of these changes in the progression of liver regeneration is discussed.     

Developmental changes in hepatic metallothionein, zinc, and copper levels in genetically altered mice.

Using mice that either overexpress metallothionein 1 (MT-1*) or do not express metallothionein 1 and 2 (MT-null) and a control strain (C57BL/6), the essential metal storage function of hepatic metallothionein and its subcellular localization were investigated during development. Hepatic metallothionein, zinc, and copper levels were measured in all groups from gestational day 20 to 60 days of age. Hepatic metallothionein levels were maximal during the perinatal period in both MT-1* and C57BL/6 mice with levels approximately three times higher in MT-1* mice. MT-null mice had no detectable hepatic metallothionein throughout development. Hepatic zinc levels were highest in the neonatal period of MT-1* and C57BL/6 mice and declined to adult levels by 30 days of age, while hepatic zinc levels in MT-null mice did not vary markedly throughout development. Hepatic copper profiles were very similar in MT-1* and MT-null mice as compared with the C57BL/6 mice. Correlation analysis showed a strong positive correlation between hepatic metallothionein and zinc levels in MT-1* mice, moderate correlation between hepatic metallothionein and metals in C57BL/6 mice, but only a very weak correlation between hepatic metallothionein and copper levels in MT-1* mice. Immunohistochemical localization showed specific nuclear staining in both MT-1* and C57BL/6 mice during the neonatal period with a gradual shift to the cytoplasm. The results show that hepatic metallothionein is a major determinant of zinc but not copper levels during murine development. Additionally, hepatic metallothionein levels and localization are regulated in a similar manner in MT-1* and C57BL/6 mice. The MT-null mice maintain a basel level of zinc sufficient for development, which was found to be 15.9 micrograms/g. This value was similar to the levels of hepatic zinc that was not bound to metallothionein in MT-1* and C57BL/6 mice during development.     

Comparative activities of glycogen phosphorylase and gamma-amylase in livers of carp (Cyprinus carpio) and goldfish (Carassius auratus).

1. The activity of glycogen phosphorylase in goldfish liver is fivefold greater than that in carp liver, suggesting that the enzyme may not be as important in regulating glycogenolysis in the latter species. 2. The activity of gamma-amylase is comparable in carp and goldfish liver. 3. The activity of hepatic gamma-amylase is approximately one-half that of glycogen phosphorylase in carp whereas in goldfish, the activity of gamma-amylase is less than one-sixth that of phosphorylase. Hepatic gamma-amylase may be an important glycogenolytic enzyme in carp but makes an insignificant contribution to glycogenolysis in goldfish.     

Evidence of species differences in the ultrastructure of the Hepatic sinusoid

Summary Hepatic sinusoids in the calf have been studied by light and electron microscopy. The endothelial lining is shown to be continuous and to be associated with a prominent basement membrane. The perisinusoidal space (of Disse) contains collagen fibrils and is otherwise nearly filled with hepatic cell microvilli. Perisinusoidal cells resembling fibroblasts or reticular cells in morphology and distribution are present in moderate numbers. Hepatic sinusoids in the rat were examined for purposes of comparison. In the rat the sinusoidal lining is discontinuous and there is no identifiable basement membrane. The perisinusoidal space is larger than in the calf and contains more sparsely distributed collagen fibrils. Perisinusoidal cells have not been identified. It is suggested that the difference in structure is not artifactitious but represents a species variation. This species difference seems important to record since observations on the rat and other small laboratory animals provide the basis for most of the current generalizations about the organization of the mammalian liver sinusoid. The functional significance of the two types of sinusoidal arrangement is not clear.A preliminary report of this work was presented at the VII th International Congress of Anatomists (Wood 1960).Supported in part by Grant H-2698 from the National Institutes of Health, U. S. Public Health Service.