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The secondary injury cascade after spinal cord injury:an analysis of local cytokine/chemokine regulation 被引量:1
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作者 Daniel J.Hellenbrand Charles M.Quinn +8 位作者 Zachariah J.Piper Ryan T.Elder Raveena R.Mishra Taylor L.Marti Phoebe M.Omuro Rylie M.Roddick Jae Sung Lee William L.Murphy Amgad S.Hanna 《Neural Regeneration Research》 SCIE CAS CSCD 2024年第6期1308-1317,共10页
After spinal cord injury,there is an extensive infiltration of immune cells,which exacerbates the injury and leads to further neural degeneration.Therefore,a major aim of current research involves targeting the immune... After spinal cord injury,there is an extensive infiltration of immune cells,which exacerbates the injury and leads to further neural degeneration.Therefore,a major aim of current research involves targeting the immune response as a treatment for spinal cord injury.Although much research has been performed analyzing the complex inflammatory process following spinal cord injury,there remain major discrepancies within previous literature regarding the timeline of local cytokine regulation.The objectives of this study were to establish an overview of the timeline of cytokine regulation for 2 weeks after spinal cord injury,identify sexual dimorphisms in terms of cytokine levels,and determine local cytokines that significantly change based on the severity of spinal cord injury.Rats were inflicted with either a mild contusion,moderate contusion,severe contusion,or complete transection,7 mm of spinal cord centered on the injury was harvested at varying times post-injury,and tissue homogenates were analyzed with a Cytokine/Chemokine 27-Plex assay.Results demonstrated pro-inflammatory cytokines including tumor necrosis factorα,interleukin-1β,and interleukin-6 were all upregulated after spinal cord injury,but returned to uninjured levels within approximately 24 hours post-injury,while chemokines including monocyte chemoattractant protein-1 remained upregulated for days post-injury.In contrast,several anti-inflammatory cytokines and growth factors including interleukin-10 and vascular endothelial growth factor were downregulated by 7 days post-injury.After spinal cord injury,tissue inhibitor of metalloproteinase-1,which specifically affects astrocytes involved in glial scar development,increased more than all other cytokines tested,reaching 26.9-fold higher than uninjured rats.After a mild injury,11 cytokines demonstrated sexual dimorphisms;however,after a severe contusion only leptin levels were different between female and male rats.In conclusion,pro-inflammatory cytokines initiate the inflammatory process and return to baseline within hours post-injury,chemokines continue to recruit immune cells for days post-injury,while anti-inflammatory cytokines are downregulated by a week post-injury,and sexual dimorphisms observed after mild injury subsided with more severe injuries.Results from this work define critical chemokines that influence immune cell infiltration and important cytokines involved in glial scar development after spinal cord injury,which are essential for researchers developing treatments targeting secondary damage after spinal cord injury. 展开更多
关键词 ASTROCYTES CHEMOKINES cytokines inflammation macrophages MICROGLIA secondary damage spinal cord injury
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Secondary endoscopic submucosal dissection for locally recurrent or incompletely resected gastric neoplasms 被引量:3
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作者 Da Hyun Jung Young Hoon Youn +2 位作者 Jie-Hyun Kim Jae Jun Park Hyojin Park 《World Journal of Gastroenterology》 SCIE CAS 2018年第33期3776-3785,共10页
AIM To investigate the feasibility and safety of secondary endoscopic submucosal dissection(ESD) for residual or locally recurrent gastric tumors. METHODS Between 2010 and 2017, 1623 consecutive patients underwent ESD... AIM To investigate the feasibility and safety of secondary endoscopic submucosal dissection(ESD) for residual or locally recurrent gastric tumors. METHODS Between 2010 and 2017, 1623 consecutive patients underwent ESD for gastric neoplasms at a single tertiary referral center. Among these, 28 patients underwent secondary ESD for a residual or locally recurrent tumor. Our analysis compared clinicopathologic factors between primary ESD and secondary ESD groups. RESULTS The en bloc resection and curative rate of resection of secondary ESD were 92.9% and 89.3%, respectively. The average procedure time of secondary ESD was significantly longer than primary ESD(78.2 min vs 55.1 min, P = 0.004), and the adverse events rate was not significantly different but trended slightly higher in the secondary ESD group compared to the primary ESD group(10.7% vs 3.8%, P = 0.095). Patients who received secondary ESD had favorable outcomes without severe adverse events. During a mean follow-up period, no local recurrence occurred in patients who received secondary ESD. CONCLUSION Secondary ESD of residual or locally recurrent gastric tumors appears to be a feasible and curative treatment though it requires greater technical efficiency and longer procedure time. 展开更多
关键词 secondary ENDOSCOPIC SUBMUCOSAL DISSECTION ENDOSCOPIC SUBMUCOSAL DISSECTION Gastric neoplasms Residual TUMORS RECURRENT TUMORS
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A comprehensive look at the psychoneuroimmunoendocrinology of spinal cord injury and its progression: mechanisms and clinical opportunities 被引量:1
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作者 Miguel A.Ortega Oscar Fraile-Martinez +9 位作者 Cielo García-Montero Sergio Haro Miguel Ángel Álvarez-Mon Diego De Leon-Oliva Ana M.Gomez-Lahoz Jorge Monserrat Mar Atienza-Pérez David Díaz Elisa Lopez-Dolado Melchor Álvarez-Mon 《Military Medical Research》 SCIE CAS CSCD 2024年第2期228-267,共40页
Spinal cord injury(SCI)is a devastating and disabling medical condition generally caused by a traumatic event(primary injury).This initial trauma is accompanied by a set of biological mechanisms directed to ameliorate... Spinal cord injury(SCI)is a devastating and disabling medical condition generally caused by a traumatic event(primary injury).This initial trauma is accompanied by a set of biological mechanisms directed to ameliorate neural damage but also exacerbate initial damage(secondary injury).The alterations that occur in the spinal cord have not only local but also systemic consequences and virtually all organs and tissues of the body incur important changes after SCI,explaining the progression and detrimental consequences related to this condition.Psychoneuroimmunoendocrinology(PNIE)is a growing area of research aiming to integrate and explore the interactions among the different systems that compose the human organism,considering the mind and the body as a whole.The initial traumatic event and the consequent neurological disruption trigger immune,endocrine,and multisystem dysfunction,which in turn affect the patient's psyche and well-being.In the present review,we will explore the most important local and systemic consequences of SCI from a PNIE perspective,defining the changes occurring in each system and how all these mechanisms are interconnected.Finally,potential clinical approaches derived from this knowledge will also be collectively presented with the aim to develop integrative therapies to maximize the clinical management of these patients. 展开更多
关键词 spinal cord injury(SCI) Psychoneuroimmunoendocrinology(PNIE) secondary injury Immunoinflammatory dysfunction Gut microbiota Translational opportunities
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Function of microglia and macrophages in secondary damage after spinal cord injury 被引量:36
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作者 Xiang Zhou Xijing He Yi Ren 《Neural Regeneration Research》 SCIE CAS CSCD 2014年第20期1787-1795,共9页
Spinal cord injury (SCI) is a devastating type of neurological trauma with limited therapeutic op- portunities. The pathophysiology of SCI involves primary and secondary mechanisms of injury. Among all the secondary... Spinal cord injury (SCI) is a devastating type of neurological trauma with limited therapeutic op- portunities. The pathophysiology of SCI involves primary and secondary mechanisms of injury. Among all the secondary injury mechanisms, the inflammatory response is the major contrib- utor and results in expansion of the lesion and further loss of neurologic function. Meanwhile, the inflammation directly and indirectly dominates the outcomes of SCI, including not only pain and motor dysfunction, but also preventingneuronal regeneration. Microglia and macrophages play very important roles in secondary injury. Microglia reside in spinal parenchyma and survey the microenvironment through the signals of injury or infection. Macrophages are derived from monocytes recruited to injured sites from the peripheral circulation. Activated resident microglia and monocyte-derived macrophages induce and magnify immune and inflammatory responses not only by means of their secretory moleculesand phagocytosis, but also through their influence on astrocytes, oligodendrocytes and demyelination. In this review, we focus on the roles of mi- croglia and macrophages in secondary injury and how they contribute to the sequelae of SCI. 展开更多
关键词 astrocytes cytokines CHEMOKINES DEMYELINATION inflammation OLIGODENDROCYTES MI/M2 activation MACROPHAGES MICROGLIA secondary damage spinal cord injury
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Extrapancreatic malignancies and intraductal papillary mucinous neoplasms of the pancreas 被引量:5
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作者 Jaime Benarroch-Gampel Taylor S Riall 《World Journal of Gastrointestinal Surgery》 SCIE CAS 2010年第10期363-367,共5页
Over the last two decades multiple studies have demonstrated an increased incidence of additional malignancies in patients with intraductal papillary mucinous neoplasms(IPMNs).Additional malignancies have been identif... Over the last two decades multiple studies have demonstrated an increased incidence of additional malignancies in patients with intraductal papillary mucinous neoplasms(IPMNs).Additional malignancies have been identified in 10%-52% of patients with IPMNs.The majority of these additional cancers occur before or concurrent with the diagnosis of IPMN.The gastrointestinal tract is most commonly involved in secondary malignancies,with benign colon polyps and colon cancer commonly seen in western countries and gastric cancer commonly seen in Asian countries.Other extrapancreatic malignancies associated with IPMNs include benign and malignant esophageal neoplasms,gastrointestinal stromal tumors,carcinoid tumors,hepatobiliary cancers,breast cancers,prostate cancers,and lung cancers.There is no clear etiology for the development of secondary malignancies in patients with IPMN.Although population-based studies have shown different results from single institution studies regarding the exact incidence of additional primary cancers in IPMN patients,both have reached the same conclusion:there is a higher incidence of extrapancreatic malignancies in patients with IPMNs than in the general population.This f inding has signif icant clinical implications for both the initial evaluation and the subsequent long-term followup of patients with IPMNs.If a patient has not had recent colonoscopy,this should be performed during the evaluation of a newly diagnosed IPMN.Upper endoscopy should be performed in patients from Asian countries or for those who present with symptoms suggestive of upper gastrointestinal disease.Routine screening studies(breast and prostate) should be carried out as currently recommended for patient's age both before and after the diagnosis of IPMN. 展开更多
关键词 INTRADUCTAL PAPILLARY MUCINOUS neoplasm secondary MALIGNANCY Malignant potential Invasive Non-invasive
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Interactions of primary insult biomechanics and secondary cascades in spinal cord injury: implications for therapy 被引量:4
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作者 Michael B.Orr John C.Gensel 《Neural Regeneration Research》 SCIE CAS CSCD 2017年第10期1618-1619,共2页
The complex and variable nature of traumatic spinal cord inju- ry (SCI) presents a unique challenge for translational research. SCI is not bound by any demographic nor is it limited to specific injury biomechanics.
关键词 SCI Interactions of primary insult biomechanics and secondary cascades in spinal cord injury:implications for therapy
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Photobiomodulation provides neuroprotection through regulating mitochondrial fission imbalance in the subacute phase of spinal cord injury 被引量:2
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作者 Xin Li Xuan-Kang Wang +14 位作者 Zhi-Jie Zhu Zhuo-Wen Liang Peng-Hui Li Yang-Guang Ma Tan Ding Kun Li Xiao-Shuang Zuo Cheng Ju Zhi-Hao Zhang Zhi-Wen Song Hui-Lin Quan Jia-Wei Zhang Liang Luo Zhe Wang Xue-Yu Hu 《Neural Regeneration Research》 SCIE CAS CSCD 2023年第9期2005-2010,共6页
Increasing evidence indicates that mitochonarial lission imbalance plays an important role in derayed neuronal cell death. Our previous study round that photo biomodulation improved the motor function of rats with spi... Increasing evidence indicates that mitochonarial lission imbalance plays an important role in derayed neuronal cell death. Our previous study round that photo biomodulation improved the motor function of rats with spinal cord injury.However,the precise mechanism remains unclear.To investigate the effect of photo biomodulation on mitochondrial fission imbalance after spinal cord injury,in this study,we treated rat models of spinal co rd injury with 60-minute photo biomodulation(810 nm,150 mW) every day for 14 consecutive days.Transmission electron microscopy results confirmed the swollen and fragmented alte rations of mitochondrial morphology in neurons in acute(1 day) and subacute(7 and 14 days) phases.Photo biomodulation alleviated mitochondrial fission imbalance in spinal cord tissue in the subacute phase,reduced neuronal cell death,and improved rat posterior limb motor function in a time-dependent manner.These findings suggest that photobiomodulation targets neuronal mitochondria,alleviates mitochondrial fission imbalance-induced neuronal apoptosis,and thereby promotes the motor function recovery of rats with spinal cord injury. 展开更多
关键词 low-level laser therapy MITOCHONDRIA mitochondrial dynamics mitochondrial fission imbalance NEURON PHOTOBIOMODULATION secondary injury spinal cord injury
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Alterations in gut microbiota are related to metabolite profiles in spinal cord injury 被引量:2
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作者 Jian-Ning Kang Zheng-Fang Sun +8 位作者 Xin-Yu Li Xiao-Di Zhang Zheng-Xin Jin Ce Zhang Ying Zhang Hui-Yun Wang Na-Na Huang Jian-Hao Jiang Bin Ning 《Neural Regeneration Research》 SCIE CAS CSCD 2023年第5期1076-1083,共8页
Studies have shown that gut microbiota metabolites can enter the central nervous system via the blood-spinal cord barrier and cause neuroinflammation, thus constituting secondary injury after spinal cord injury. To in... Studies have shown that gut microbiota metabolites can enter the central nervous system via the blood-spinal cord barrier and cause neuroinflammation, thus constituting secondary injury after spinal cord injury. To investigate the correlation between gut microbiota and metabolites and the possible mechanism underlying the effects of gut microbiota on secondary injury after spinal cord injury, in this study, we established mouse models of T8–T10 traumatic spinal cord injury. We used 16 S rRNA gene amplicon sequencing and metabolomics to reveal the changes in gut microbiota and metabolites in fecal samples from the mouse model. Results showed a severe gut microbiota disturbance after spinal cord injury, which included marked increases in pro-inflammatory bacteria, such as Shigella, Bacteroides, Rikenella, Staphylococcus, and Mucispirillum and decreases in anti-inflammatory bacteria, such as Lactobacillus, Allobaculum, and Sutterella. Meanwhile, we identified 27 metabolites that decreased and 320 metabolites that increased in the injured spinal cord. Combined with pathway enrichment analysis, five markedly differential amino acids(L-leucine, L-methionine, L-phenylalanine, L-isoleucine and L-valine) were screened out, which play a pivotal role in activating oxidative stress and inflammatory responses following spinal cord injury. Integrated correlation analysis indicated that the alteration of gut microbiota was related to the differences in amino acids, which suggests that disturbances in gut microbiota might participate in the secondary injury through the accumulation of partial metabolites that activate oxidative stress and inflammatory responses. Findings from this study provide a new theoretical basis for improving the secondary injury after spinal cord injury through fecal microbial transplantation. 展开更多
关键词 16S rRNA gene amplicon sequencing amino acid metabolism DYSBACTERIOSIS gut microbiota inflammation metabolic disturbance METABOLITES metabolomics secondary injury spinal cord injury
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Effects of low dose Glibenclamide on secondary damage after acute spinal cord injury in rats
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作者 李熙 《外科研究与新技术》 2011年第2期87-88,共2页
Objective To investigate the effects of Glibenclamide on reduction of secondary damage after acute spinal cord injury in rats.Methods Ninety rats were randomly divided into control group(laminectomy alone),spinal cord... Objective To investigate the effects of Glibenclamide on reduction of secondary damage after acute spinal cord injury in rats.Methods Ninety rats were randomly divided into control group(laminectomy alone),spinal cord injury group(injury group),and treatment group(treated 展开更多
关键词 Effects of low dose Glibenclamide on secondary damage after acute spinal cord injury in rats
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口腔专科医院非计划二次手术的回顾性分析
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作者 王晓颖 宋颖 王晓霞 《中国卫生标准管理》 2024年第18期62-66,共5页
目的探讨口腔专科医院非计划二次手术发生的特点及影响因素。方法选取北京大学口腔医院2016—2021年所有二次手术患者信息,对非计划二次手术的病种、发生原因等进行统计分析,通过logistic回归进一步分析舌恶性肿瘤非计划二次手术的相关... 目的探讨口腔专科医院非计划二次手术发生的特点及影响因素。方法选取北京大学口腔医院2016—2021年所有二次手术患者信息,对非计划二次手术的病种、发生原因等进行统计分析,通过logistic回归进一步分析舌恶性肿瘤非计划二次手术的相关性因素。结果2016—2021年共发生非计划二次手术468例(1.17%),与第一次手术的间隔时间为0~20 d。构成比排在前3位的病种为颌面部恶性肿瘤、颌面部良性肿瘤、颌面部感染,导致非计划二次手术的主要原因为皮瓣血管危象、手术后血肿出血,占比为90.17%(422/468)。非计划二次手术组男性319例,女性149例,男女之比为2.14∶1,年龄53.00(36.00,62.00)岁,住院时间14.00(12.00,18.00)d,总费用为68694.91(51773.01,89850.04)元;对照组男性19932例,女性19495例,年龄31.00(18.00,53.00)岁,住院时间7.00(4.00,10.00)d,总费用为12338.96(8869.90,28650.17)元,比较差异有统计学意义(P<0.05)。非计划二次手术术式以有皮瓣为主,占比为76.07%。2016—2021年三四级手术中非计划二次手术发生率为3.62%(397/10966),高于一二级手术的0.25%(71/28929)。年龄、饮酒史、高血压、皮瓣手术是影响舌恶性肿瘤非计划二次手术的主要危险因素(P<0.05)。结论应针对口腔颌面外科专业非计划二次手术危险因素,加强围手术期和手术分级管理,以提升医疗质量。 展开更多
关键词 非计划二次手术 口腔专科医院 恶性肿瘤 医疗质量 围手术期管理 手术级别
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外胚层间充质干细胞来源的外泌体通过控制炎症和氧化损伤减少M1型小胶质细胞并促进H2O2处理后PC12细胞的存活 被引量:1
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作者 孙晓鹏 史航 +7 位作者 张磊 刘中 李克威 钱玲玲 朱星宇 杨康佳 付强 丁华 《南方医科大学学报》 CAS CSCD 北大核心 2024年第1期119-128,共10页
目的探究外胚层间充质干细胞来源的外泌体(EMSCs-exo)对脊髓继发性损伤的潜在修复作用。方法从大鼠鼻黏膜中分离培养EMSCs,并通过免疫荧光染色鉴定。采用超速离心法获取EMSCs-exo,并通过透射电镜、纳米颗粒跟踪分析(NTA)和Westernblot... 目的探究外胚层间充质干细胞来源的外泌体(EMSCs-exo)对脊髓继发性损伤的潜在修复作用。方法从大鼠鼻黏膜中分离培养EMSCs,并通过免疫荧光染色鉴定。采用超速离心法获取EMSCs-exo,并通过透射电镜、纳米颗粒跟踪分析(NTA)和Westernblot进行鉴定。利用差速贴壁法纯化小胶质细胞,并通过免疫荧光染色鉴定。根据BCA法测得的蛋白浓度对EMSCs-exo进行定量分析。设置对照组、含100μg/L脂多糖(LPS)的组和含LPS及37.5mg/L或75mg/LEMSCs-exo的组对小胶质细胞进行处理。设置对照组、含400μmol/LH2O2的组和含H2O2及37.5mg/L或75mg/LEMSCs-exo的组对PC12细胞进行处理。通过Western blot和qRT-PCR测定小胶质细胞各组Arg1和iNOS蛋白和mRNA表达量。通过酶联免疫吸附实验测定上清中IL-6、IL-10和IGF-1的浓度。通过CCK-8和AnnexinV-FITC/PI凋亡检测试剂盒检测PC12细胞各组的活力和凋亡情况。结果免疫荧光染色显示EMSCs高表达标志物Nestin、CD44、CD105、Vimentin。透射电镜显示EMSCs-exo呈典型的杯状结构,NTA显示其平均粒径为142nm,Westernblot显示其表达外泌体标志蛋白CD63、CD81、TSG101,不表达Vimentin。当小胶质细胞在LPS环境中时,75mg/L的EMSCs-exo能够有效提高其Arg1蛋白量、降低iNOS蛋白量(P<0.05),且相比于37.5mg/L的浓度,其更能有效提高其Arg1mRNA水平和IGF-1、IL-10(P<0.05)的生成,降低iNOSmRNA水平和IL-6的生成(P<0.05);也更有效促进H2O2环境中PC12细胞的存活,降低凋亡率(P<0.05)。结论75mg/L的EMSCs-exo在体外有效减少M1型小胶质细胞比例,减轻氧化应激下的神经元凋亡,促进神经元存活,因此在控制脊髓继发性损伤中具有一定应用潜能。 展开更多
关键词 外胚层间充质干细胞 外泌体 小胶质细胞 炎症 氧化应激 脊髓继发性损伤
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中药单体治疗脊髓损伤后神经炎症:核转录因子κB信号通路的作用 被引量:1
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作者 徐振华 李彦杰 +3 位作者 秦合伟 刘昊源 朱博超 王煜普 《中国组织工程研究》 CAS 北大核心 2025年第3期590-598,共9页
背景:基于核转录因子κB通路探究神经炎症的靶向治疗越来越值得探究,中药靶点多、范围广、机制丰富及不良反应少等优点在治疗各类疾病时都具有十分巨大的潜力。目的:基于核转录因子κB信号通路,对近年研究中出现的山奈酚、红花黄、汉黄... 背景:基于核转录因子κB通路探究神经炎症的靶向治疗越来越值得探究,中药靶点多、范围广、机制丰富及不良反应少等优点在治疗各类疾病时都具有十分巨大的潜力。目的:基于核转录因子κB信号通路,对近年研究中出现的山奈酚、红花黄、汉黄芩苷及雷公藤甲素等中药单体治疗脊髓损伤后神经炎症的研究进展进行系统的阐述与归纳。方法:以“脊髓损伤,炎症,抗炎,中药单体,单体化合物,NF-κB信号通路,黄酮,糖苷,酚类,酯类,生物碱”为检索词在中国知网数据库中进行检索;以“Spinal cord injury,inflammation,anti-inflammatory,traditional Chinese medicine monomer,monomeric compound,NF-κB signaling pathway,flavonoids,glycosides,phenols,esters,alkaloids”为检索词在PubMed数据库中进行检索,最终共纳入67篇文献进行综述分析。结果与结论:①核转录因子κB信号通路在神经系统中的作用复杂多样,能够调控中性粒细胞、小胶质细胞、星形胶质细胞和巨噬细胞等,介导损伤后炎症的发生与发展;②中药单体如汉黄芩苷对核转录因子κB抑制蛋白的降解、红花黄素对核转录因子κB信号通路磷酸化过程的抑制、山奈酚对核转录因子κB信号通路p65核易位的抑制等作用可以降低炎症反应对机体造成的影响,从而促进神经功能恢复;③核转录因子κB信号通路在损伤早期能够促进炎症反应和免疫细胞迁移活化,在损伤中后期能够促进损伤部位的修复和纤维化的发生等,适当的激活核转录因子κB信号通路具有促进炎症因子的释放、提高细胞的抗氧化能力及促进免疫细胞的活化等能力,但过度激活的核转录因子κB信号通路则容易导致慢性炎症的发生和持续、细胞凋亡受到抑制等;④未来的研究可以进一步探索如何准确调控核转录因子κB信号通路的活化水平、如何实现对神经系统炎症和损伤的精准干预展开,也可围绕中药单体的制备及中药单体对信号通路的作用机制展开,以期为神经系统疾病的康复和功能恢复提供更有效的治疗策略。 展开更多
关键词 核转录因子ΚB 信号通路 脊髓损伤 中药单体 继发性损伤 神经炎症 小胶质细胞 星形胶质细胞 糖苷 机制
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针刺联合神经干细胞修复脊髓损伤的科学依据 被引量:1
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作者 黄晓萌 张芝兰 +4 位作者 尚文雅 黄靖 韦慧麟 李冰 任亚锋 《中国组织工程研究》 CAS 北大核心 2025年第19期4111-4121,共11页
背景:脊髓损伤是由创伤性或非创伤性事件引起的一种神经系统疾病,常导致损伤节段以下严重功能障碍。近年来,神经干细胞移植被认为在调控脊髓损伤后的炎症反应、抑制胶质瘢痕的过度增生以及促进神经再生方面具有显著的治疗潜力。目的:综... 背景:脊髓损伤是由创伤性或非创伤性事件引起的一种神经系统疾病,常导致损伤节段以下严重功能障碍。近年来,神经干细胞移植被认为在调控脊髓损伤后的炎症反应、抑制胶质瘢痕的过度增生以及促进神经再生方面具有显著的治疗潜力。目的:综述并讨论针刺及神经干细胞移植疗法在抑制脊髓损伤诱导的继发性损伤中的潜在作用机制,深入探讨其治疗脊髓损伤的科学依据。方法:以“脊髓损伤,针刺,神经干细胞,SDF-1α/CXCR4轴”为中文检索词,以“Spinal cord injury,acupuncture,neural stem cells,SDF-1α/CXCR4 axis”为英文检索词,分别检索PubMed、Elsevier、万方及中国知网数据库,最终纳入96篇文献,汇总分析了针刺联合神经干细胞治疗脊髓损伤的相关研究成果,总结了这一联合疗法在治疗脊髓损伤后继发性损伤中的相关机制。结果与结论:①基质细胞衍生因子1α(stromal-derived factor 1α,SDF-1α)/CXC趋化因子受体4(chemokine receptor 4,CXCR4)轴在神经干细胞移植治疗脊髓损伤中扮演着至关重要的角色,该信号传导机制不仅影响神经干细胞的迁移、增殖和分化,更是决定干细胞归巢至损伤部位效率的关键因素。因此,针对该轴线的调控,对于提升脊髓损伤的治疗效果具有重要意义。②针刺作为一种传统中医疗法,在脊髓损伤的继发性损伤调控中展现出独特的优势,它能够通过调节炎症反应、抑制细胞凋亡、改善微循环、减少神经胶质瘢痕形成以及对抗氧化应激等多种途径,有效减轻脊髓损伤后的继发性损伤。③针刺还能够影响SDF-1α/CXCR4轴的表达与功能,从而增强神经干细胞的归巢和存活能力,促进神经再生和功能恢复。④结合针刺与干细胞移植的疗法,是一种创新且较好的脊髓损伤治疗策略,适用于修复神经环路,它结合了传统中医的智慧与现代生物技术的优势,为脊髓损伤患者提供了新的治疗选择。然而,目前这种联合疗法仍处于研究和探索阶段,其长期疗效和安全性尚需进一步验证。⑤综合而言,针刺及神经干细胞移植治疗脊髓损伤具有巨大的临床应用潜力,但仍需深入研究和优化治疗方案。未来,期待通过更多的临床试验和机制研究,进一步揭示这一疗法的疗效机制和最佳适应证,为脊髓损伤患者带来更好的康复希望和更高效的治疗效果。 展开更多
关键词 针刺 神经干细胞 脊髓损伤 继发性损伤 神经再生 炎症反应 氧化应激 神经保护 基质细胞衍生因子1α(SDF-1α)/CXC趋化因子受体4(CXCR4)轴 协同机制
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腰椎转移性恶性黑色素瘤1例误诊分析
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作者 陈东 周全 +2 位作者 蒲川成 胡敏 余东名 《临床骨科杂志》 2024年第5期671-671,共1页
患者,女,63岁,因“腰痛伴双下肢疼痛1年,加重2个月”于2022年7月5日入院。查体:腰段深压痛,叩击痛,左踝背伸肌力4+级,左下肢小腿胫前感觉减退。CT检查(见图1A)显示:L_(4)椎体呈虫蚀样改变,破坏以左侧椎体及椎弓根为主,矢状面可见骨岛。... 患者,女,63岁,因“腰痛伴双下肢疼痛1年,加重2个月”于2022年7月5日入院。查体:腰段深压痛,叩击痛,左踝背伸肌力4+级,左下肢小腿胫前感觉减退。CT检查(见图1A)显示:L_(4)椎体呈虫蚀样改变,破坏以左侧椎体及椎弓根为主,矢状面可见骨岛。MRI检查(见图1B)显示:L_(4)椎体左侧血肿,硬脊膜受压,其内可见骨岛,T_(1)WI呈高低混杂信号、T_(2)WI呈低信号。PET-CT检查显示:L_(4)椎体骨质破坏,代谢增高。考虑原发性恶性肿瘤可能。2022年7月8日在全身麻醉下行L_(4)椎体肿瘤切除植骨融合内固定术。 展开更多
关键词 转移性恶性黑色素瘤 脊柱肿瘤 误诊
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结直肠癌肝转移患者的血浆胆汁酸谱特征及临床价值
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作者 贾茹 张平平 +2 位作者 袁苑 王炎 冯琴 《海军军医大学学报》 CAS CSCD 北大核心 2024年第5期578-583,共6页
目的分析不同转移情况结直肠癌患者血浆胆汁酸含量及胆汁酸谱分布的差异,并评估血浆胆汁酸含量比值联合肿瘤标志物对结直肠癌肝转移的诊断价值。方法纳入2021年4月至2022年1月于上海中医药大学附属曙光医院就诊的结直肠腺癌肝转移或无... 目的分析不同转移情况结直肠癌患者血浆胆汁酸含量及胆汁酸谱分布的差异,并评估血浆胆汁酸含量比值联合肿瘤标志物对结直肠癌肝转移的诊断价值。方法纳入2021年4月至2022年1月于上海中医药大学附属曙光医院就诊的结直肠腺癌肝转移或无转移患者163例,其中无转移组82例、肝转移组81例。收集患者的临床资料,用Karnofsky功能状态(KPS)评分评估生存质量;收集患者外周血样本,检测总胆汁酸及肿瘤标志物[癌胚抗原(CEA)和糖类抗原125(CA125)]水平,用高效液相色谱-串联质谱法检测血浆中15种胆汁酸的含量。分析两组患者胆汁酸含量及胆汁酸谱分布的差异,并绘制ROC曲线分析胆汁酸含量比值联合肿瘤标志物对结直肠癌肝转移的临床诊断效能。结果两组结直肠癌患者年龄、性别、肿瘤位置、病理分化程度、KPS评分差异无统计学意义(均P>0.05)。肝转移组患者总胆汁酸、CEA、CA125均较无转移组患者升高(均P<0.001),血浆胆汁酸谱中甘氨胆酸、脱氧胆酸、牛磺脱氧胆酸、甘氨脱氧胆酸、甘氨熊脱氧胆酸、石胆酸和甘氨石胆酸含量均较无转移组患者升高(均P<0.05),血浆次级胆汁酸含量高于无转移组患者(P<0.001),次级胆汁酸与初级胆汁酸含量比值高于无转移组患者(P<0.001)。次级胆汁酸与初级胆汁酸含量比值联合CEA、CA125诊断结直肠癌肝转移的灵敏度为71.60%,特异度为80.49%,AUC为0.820(95%CI 0.754~0.885,P<0.001)。结论结直肠癌肝转移患者血浆胆汁酸含量升高,胆汁酸谱异于无转移患者;次级胆汁酸与初级胆汁酸含量比值联合CEA、CA125对结直肠癌肝转移有较高的诊断价值。 展开更多
关键词 结直肠肿瘤 肝转移 胆汁酸 次级胆汁酸 诊断标志物
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经皮椎体成形术与经皮椎体后凸成形术治疗胸腰椎骨折继发椎管狭窄效果比较
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作者 吴林清 陈运崇 +3 位作者 陈宏帅 王婧婧 王继宏 张国如 《中国中西医结合外科杂志》 CAS 2024年第2期215-218,共4页
目的:比较经皮椎体成形术与经皮椎体后凸成形术在胸腰椎骨折继发椎管狭窄患者中的治疗效果。方法:选择我院2017年1月1日—2021年12月31日收治的胸腰椎骨折继发椎管狭窄患者76例,分为椎体成形术组(接受经皮椎体成形术,n=31)和椎体后凸成... 目的:比较经皮椎体成形术与经皮椎体后凸成形术在胸腰椎骨折继发椎管狭窄患者中的治疗效果。方法:选择我院2017年1月1日—2021年12月31日收治的胸腰椎骨折继发椎管狭窄患者76例,分为椎体成形术组(接受经皮椎体成形术,n=31)和椎体后凸成形术组(接受经皮椎体后凸成形术,n=45)。比较两组患者的一般临床资料以及手术前后的疼痛评分(VAS评分),功能障碍评分(ODI评分),术后椎体前缘、中央、后缘高度和椎体Cobb角以及并发症发生情况。结果:与椎体成形术组患者相比,椎体后凸成形术组患者透视时间显著缩短,手术时间和住院费用显著增加,手术后ODI评分显著降低,椎体前缘高度、椎体中央高度和椎体后缘高度显著增加,椎体Cobb角显著降低(P<0.05)。两组患者术后VAS评分、并发症发生率比较无显著差异(P>0.05)。结论:经皮椎体后凸成形术在降低患者透视时间,改善患者功能障碍、椎体情况和促进锥体高度恢复方面存在优势,经皮椎体成形术在提高椎体Cobb角具有明显优势。 展开更多
关键词 胸腰椎骨折继发椎管狭窄 经皮椎体成形术 经皮椎体后凸成形术
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富血小板血浆及水凝胶治疗脊髓损伤
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作者 赵文琪 于海驰 +2 位作者 宋艺儒 袁天阳 刘钦毅 《中国组织工程研究》 CAS 北大核心 2025年第10期2189-2200,共12页
背景:大量文献报道了富血小板血浆、水凝胶治疗脊髓损伤的作用及其机制,但较少文章归纳总结它们治疗脊髓损伤的策略。目的:归纳总结脊髓损伤的病理进程,富血小板血浆和水凝胶单独及联合应用修复脊髓损伤的策略。方法:应用计算机检索Pub ... 背景:大量文献报道了富血小板血浆、水凝胶治疗脊髓损伤的作用及其机制,但较少文章归纳总结它们治疗脊髓损伤的策略。目的:归纳总结脊髓损伤的病理进程,富血小板血浆和水凝胶单独及联合应用修复脊髓损伤的策略。方法:应用计算机检索Pub Med和中国知网数据库建库至2024年3月之前发表的文献,中文检索词为“脊髓损伤,富血小板血浆,水凝胶”,英文检索词为“spinal cord injury,spinal cord,Platelet-rich plasma,hydrogel,angiogenesis,neuralgia,combination therapy”,按照纳入和排除标准对文献进行筛选,最终纳入128篇文献进行综述分析。结果与结论:(1)富血小板血浆的分类复杂多样,在脊髓损伤的修复性治疗应用中的效果也是各有不同,但都表现出一定的积极的效果,即具有一定的促进轴突再生、刺激血管生成、治疗神经性疼痛等作用;(2)富血小板血浆的作用主要得益于其所含的生长因子等成分;(3)水凝胶的种类也很多,在脊髓损伤的修复性治疗中主要起到填充、模拟细胞外基质、搭载药物与生物产品、作为支架搭载细胞等作用;(4)与单一的治疗方式相比,富血小板血浆和水凝胶联合治疗可更有效地促进神经再生和脊髓功能的恢复。 展开更多
关键词 脊髓损伤 原发性损伤 继发性损伤 富血小板血浆 水凝胶 血管再生 轴突再生 神经疼痛 联合治疗
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微创手术与传统开放手术治疗椎管肿瘤的荟萃分析
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作者 李昊楠 胡宇坤 +2 位作者 荀传辉 高书涛 盛伟斌 《脊柱外科杂志》 2024年第5期332-340,共9页
椎管肿瘤是指发生在脊髓、脊膜和神经根等椎管及周围组织的原发性或转移性肿瘤,是脊柱外科常见肿瘤。根据肿瘤发生的位置,可将其分为硬膜外肿瘤、硬膜下髓外肿瘤和硬膜下髓内肿瘤。椎管肿瘤的发生率为0.096~0.099,其中以神经鞘瘤、脊膜... 椎管肿瘤是指发生在脊髓、脊膜和神经根等椎管及周围组织的原发性或转移性肿瘤,是脊柱外科常见肿瘤。根据肿瘤发生的位置,可将其分为硬膜外肿瘤、硬膜下髓外肿瘤和硬膜下髓内肿瘤。椎管肿瘤的发生率为0.096~0.099,其中以神经鞘瘤、脊膜瘤和神经纤维瘤等良性肿瘤多见[1-2]。 展开更多
关键词 椎管 肿瘤 外科手术 微创性 荟萃分析
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干细胞移植修复脊髓损伤的策略与进展 被引量:3
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作者 何宛俞 程乐平 《中国组织工程研究》 CAS 北大核心 2024年第19期3090-3096,共7页
背景:脊髓损伤不仅给患者的身体和心理造成严重的伤害,而且给社会带来沉重的经济负担。脊髓损伤最初由机械性创伤造成,随后引起继发性损伤,并且随着病情的发展,逐渐形成胶质瘢痕。目的:归纳总结脊髓损伤的病理进程和干细胞移植修复脊髓... 背景:脊髓损伤不仅给患者的身体和心理造成严重的伤害,而且给社会带来沉重的经济负担。脊髓损伤最初由机械性创伤造成,随后引起继发性损伤,并且随着病情的发展,逐渐形成胶质瘢痕。目的:归纳总结脊髓损伤的病理进程和干细胞移植修复脊髓损伤的策略,以期为脊髓损伤的治疗提供最佳方案。方法:应用计算机检索PubMed和中国知网数据库,中文检索词为“干细胞移植,脊髓损伤”,英文检索词为“stem cell,spinal cord injury,spinal cord,mesenchymal stem cells,neural stem cells,pathophysiology,clinical trial,primary injury,secondary injury”,按照纳入和排除标准对文献进行筛选,最终纳入91篇文献进行综述分析。结果与结论:①干细胞移植修复脊髓损伤的策略分为外源性干细胞移植和内源性干细胞移植,将治疗脊髓损伤的外源性干细胞移植策略分为4种,分别是将干细胞注射到损伤部位、负载干细胞的生物材料移植、胚胎组织移植、工程神经网络组织或脊髓样组织的移植;②与单一的治疗方式相比,联合治疗可更有效促进神经再生和脊髓功能恢复;③调控损伤部位的微环境、磁刺激、电刺激、振荡电场刺激、过表达转录因子、康复治疗等可与干细胞移植进行联合治疗,从而促进脊髓功能的恢复。 展开更多
关键词 脊髓损伤 原发性损伤 继发性损伤 胶质瘢痕 干细胞移植 生物材料 间充质干细胞 联合治疗
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Mechanisms of vascular injury in neurotrauma: A critical review of the literature
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作者 Jonathan Willman Annu Lisa Kurian Brandon Lucke-Wold 《World Journal of Meta-Analysis》 2024年第3期6-16,共11页
One in every two individuals will experience a traumatic brain injury in their lifetime with significant impacts on the global economy and healthcare system each year.Neurovascular injury is a key aspect of neurotraum... One in every two individuals will experience a traumatic brain injury in their lifetime with significant impacts on the global economy and healthcare system each year.Neurovascular injury is a key aspect of neurotrauma to both the brain and the spinal cord and an important avenue of current and future research seeking innovative therapies.In this paper,we discuss primary and secondary neurotrauma,mechanisms of injury,the glymphatic system,repair and recovery.Each of these topics are directly connected to the vasculature of the central ner-vous system,affecting severity of injury and recovery.Consequently,neurova-scular injury in trauma represents a promising target for future therapeutics and innovation. 展开更多
关键词 NEUROTRAUMA Neurovascular injury Primary neurotrauma secondary neurotrauma Traumatic brain injury Traumatic spinal cord injury Glymphatic system Vascular Injury
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