5-lipoxygenase expression in a brain damage model induced by chronic oral administration of aluminum

A preliminary study has found that the 5-lipoxygenase inhibitor, caffeic acid, has a marked protective effect on acute brain injury induced by intracerebroventricular microinjection of aluminum. In this experiment, chronic brain injury and neuronal degeneration model was established in rats by chronic oral administration of aluminum, and then intervened using caffeic acid. Results showed that caffeic acid can downregulate chronic aluminum overload-induced 5-1ipoxygenase mRNA and protein expression, and repair the aluminum overload-induced hippocampal neuronal damage and spatial orientation impairment. It is suggested that direct intervention of 5-lipoxygenase expression has a neuroprotective role in the degeneration induced by chronic aluminum overload brain injury model.

Effects of electroacupuncture on c-Fos expression in the spinal cord and brain of rats with chronic visceral hypersensitivity

BACKGROUND： Visceral hypersensitivity is the main cause of irritable bowel syndrome, c-Fos is a marker of visceral hypersensitivity in the central nervous system. Electroacupuncture can relieve chronic visceral hypersensitivity in rats, but the mechanism is still unknown. OBJECTIVE： To identify c-Fos expression in the spinal cord and cerebral cortex of rats with chronic visceral hypersensitivity, and to test the effects of electroacupuncture on pain sensitivity in rats with chronic visceral hypersensitivity. DESIGN, TIME AND SETTING： A randomized controlled animal experiment was performed at the Animal E：~perimental Center, Shanghai University of Traditional Chinese Medicine, from January to April, 2007. MATERIALS： A total of 24 neonatal, male, Sprague Dawley rats, aged five days old, were equally and randomly assigned into a normal group, a model group, and an electroacupuncture group. Rabbit anti-rat c-Fos antibody and Evision secondary antibody kits （Sigma, USA）, diaminobenzidine kit （Dako, Denmark）, and an LD202H electroacupuncture apparatus （Huawei, Beijing, China） were used in this study. METHODS： Neonatal rats from the model and electroacupuncture groups were used to establish rat models of chronic visceral hypersensitivity by the saccule stimulation method. After model establishment, 0.25 mm diameter electric needles were inserted into Tianshu （ST 25） and Shangjuxu （ST37） at a depth of approximately 0.5 cm, with an square wave （alternating current frequency at 100/20 Hz, amplitude ranged 0.2-0.6 ms, intensity at 1 mA） once for 20 minutes, once a day, for seven days. Rats in the normal and model groups were not treated. MAIN OUTCOME MEASURES： Following 7 days of treatment, c-Fos expression in the spinal cord and cerebral cortex was detected by immunohistochemistry. After the first electroacupuncture treatment, abdominal withdrawal reflex scores were investigated to evaluate the pain threshold for chronic visceral hypersensitivity in rats. RESULTS： Visceral hypersensitivity increased c-Fos staining （P 〈 0.05）, and electroacupuncture significantly decreased the number of these cells to near normal levels （P 〉 0.05）. Abdominal withdrawal reflex scores were significantly lower in the electroacupuncture and normal groups than in the model group （P 〈 0.05） and were similar between the electroacupuncture and normal groups （P 〉 0.05）. CONCLUSION： Electroacupuncture decreases c-Fos expression in the spinal cord and cerebral cortex and increases pain threshold in a chronic visceral hypersensitivity model in rats.

Effect of propofol on brain-derived neurotrophic factor and tyrosine kinase receptor B in the hippocampus of aged rats with chronic cerebral ischemia

We intraperitoneally injected 10 and 50 mg/kg of propofol for 7 consecutive days to treat a rat model of chronic cerebral ischemia. A low-dose of propofol promoted the expression of brain-derived neurotrophic factor, tyrosine kinase receptor B, phosphorylated cAMP response element binding protein, and cAMP in the hippocampus of aged rats with chronic cerebral ischemia, but a high-dose of propofol inhibited their expression. Results indicated that the protective effect of propofol against cerebral ischemia in aged rats is related to changes in the expression of brain-derived neurotrophic factor and tyrosine kinase receptor B in the hippocampus, and that the cAMP-cAMP responsive element binding protein pathway is involved in the regulatory effect of propofol on brain-derived neurotrophic factor expression.

Differences in brain structure in patients with distinct sites of chronic pain:A voxel-based morphometric analysis

A reduction in gray matter volume is common in patients with chronic back pain, and different types of pain are associated with gray matter abnormalities in distinct brain regions. To examine differ- ences in brain morphology in patients with low back pain or neck and upper back pain, we investi- gated changes in gray matter volume in chronic back pain patients having different sites of pain using voxel-based morphometry. A reduction in cortical gray matter volume was found primarily in the left postcentral gyrus and in the left precuneus and bilateral cuneal cortex of patients with low back pain. In these patients, there was an increase in subcortical gray matter volume in the bilateral putamen and accumbens, right pallidum, right caudate nucleus, and left amygdala. In upper back pain patients, reduced cortical gray matter volume was found in the left precentral and left postcen- tral cortices. Our findings suggest that regional gray matter volume abnormalities in low back pain patients are more extensive than in upper back pain patients. Subcortical gray matter volume in- creases are found only in patients with low back pain.

IMPAIRED BLOOD-BRAIN BARRIER AFTER CHRONIC CEREBRAL HYPOPERFUSION

Ohjectire To examine the hypothesis of normal perjusion pressure breakthrough (NPPB). Methods A modified Spetzler carotid -jugular (CJ) fistula model was created to imitate NPPB. In 9 male adult Sprague- Dawley rats, the ipsilateral vertebral artery and bilateral external carotid arteries were occluded. The period of hypoperfusion CJ fistula was extended to 14 weeks, as a modofcation of Spetzler model. The histological change were examtned under transmission electron microscope 14 weeks after creation of the listula. Results Ischemic histological changes such as increased pinocytosis, increased lucency of the basal lamina, and frank necrosis of the cerebral capillary were found in rats of CJ fistula group. Conclusion The findings in this study suggest that blood - braln barrier (BBB) was impaired by chronic hypoperfusion. The impaired BBB mny be one of the important causes of the NPPB phenomenon.

Effects of Yulangsan polysaccharide on monoamine neurotransmitters, adenylate cyclase activity and brain-derived neurotrophic factor expression in a mouse model of depression induced by unpredictable chronic mild stress

The present study established a mouse model of depression induced by unpredictable chronic mild stress. The model mice were treated with Yulangsan polysaccharide （YLSPS; 150, 300 and 600 mg/kg） for 21 days, and compared with fluoxetine-treated and normal control groups. Enzyme-linked immunosorbent assay, radioimmunity and immunohistochemical staining showed that following treatment with YLSPS （300 and 600 mg/kg）, monoamine neurotransmitter levels, prefrontal cortex adenylate cyclase activity and hippocampal brain-derived neurotrophic factor expression were significantly elevated, and depression-like behaviors were improved. Open-field and novelty-suppressed feeding tests showed that mouse activity levels were increased and feeding latency was shortened following treatment. Our results indicate that YLSPS inhibits depression by upregulating monoamine neurotransmitters, prefrontal cortex adenylate cyclase activity and hippocampal brain-derived neurotrophic factor expression.

Neurotherapy for chronic headache following traumatic brain injury

Background: Chronic headache following traumatic brain injury(TBI) sustained in military service, while common, is highly challenging to treat with existing pharmacologic and non-pharmacologic interventions, and it may be complicated by co-morbid posttraumatic stress. Recently, a novel form of brainwave-based intervention known as the Flexyx Neurotherapy System(FNS), which involves minute pulses of electromagnetic energy stimulation of brainwave activity, has been suggested as a means to address symptoms of TBI. This study reports on a clinical series of patients with chronic headache following service-connected TBI treated with FNS.Methods: Nine veterans of the wars in Afghanistan and Iraq with moderate to severe chronic headaches following service-connected TBI complicated by posttraumatic stress symptoms were treated in 20 individual FNS sessions at the Brain Wellness and Biofeedback Center of Washington(in Bethesda, Maryland, USA). They periodically completed measures including the Brief Pain Inventory-Headache(BPI-HA), previous week worst and average pain ratings, the Posttraumatic Stress Disorder Checklist-Military version(PCL-M), and an individual treatment session numerical rating scale(NRS) for the degree of cognitive dysfunction. Data analyses included beginning-to-end of treatment t-test comparisons for the BPI-HA, PCL-M, and cognitive dysfunction NRS. Results: All beginning-to-end of treatment t-test comparisons for the BPI-HA, PCL-M, and cognitive dysfunction NRS indicated statistically significant decreases. All but one participant experienced a reduction in headaches along with reductions in posttraumatic stress and perceived cognitive dysfunction, with a subset experiencing the virtual elimination of headaches. One participant obtained modest headache relief but no improvements in posttraumatic stress or cognitive dysfunction. Conclusions: FNS may be a potentially efficacious treatment for chronic posttraumatic headache sustained in military service. Further research is needed to investigate the efficacy of FNS within a randomized, controlled clinical trial to identify the characteristics of those most likely to respond and to explore underlying mechanisms that may contribute to improvements.

Animal model of repetitive mild traumatic brain injury for human traumatic axonal injury and chronic traumatic encephalopathy

Chronic traumatic encephalopathy（CTE）is a chronic neurodegenerative disease featured with tauopathy.CTE is tightly related with repetitive mild traumatic brain injury（m TBI）,which is interchangeably known as concussion（Mc Kee et al.,2009,2013）.This disease is differentiated by neuropathological features from other neurological diseases that involve tau protein aggregation and tangle formation abnormalities like Alzheimer＇s disease （AD）, frontotemporal dementia, and Parkinson- ism linked to chromosome 17 （FTDP-17）.

Effect of thermal therapy using hot water bottles on brain natriuretic peptide in chronic hemodialysis patients

Introduction: The use of repeated thermal therapy for improving the symptoms of chronic heart failure (CHF) has been recently demonstrated. Usually, thermal therapy requires an infrared dry sauna. However, it is difficult for small clinics to acquire such an expensive and extensive system. The author assessed the efficacy of its substitution with hot water bottles. Moreover, there are no prior studies demonstrating the efficacy of thermal therapy in hemodialysis patients with chronic heart failure. Methods: The author evaluated plasma brain natriuretic peptide (BNP) levels in 98 hemodialysis patients in a clinic. A total of nine patients whose BNP levels were more than 500 pg/mL agreed to be enrolled in this study and received thermal therapy using hot water bottles. Results: Plasma BNP levels, a potential marker for CHF, tended to decrease (891 ± 448 pg/mL to 680 ± 339 pg/mL), but the difference was not significant (P = 0.0845). The oral temperature changed from 36.44℃± 0.45℃ to 37.04℃ ± 0.48℃ (+0.597℃, P < 0.0001). No side effects were experienced during the therapy. Moreover, most patients had an improvement in their symptoms and the ability to perform activities of daily living. Conclusion: Thermal therapy using hot water bottles is very safe and tends to reduce plasma BNP levels in hemodialysis patients with CHF.

Diagnostic Prospectives with Tau Protein and Imaging Techniques to Detect Development of Chronic Traumatic Encephalopathy

Brain damage sustained from repeated blows in boxing, wrestling, and other combat sports has serious physical and mental health consequences. The degenerative brain disease, chronic traumatic encephalopathy (CTE), presents clinically with memory loss, aggression, difficulty in rational thinking and other cognitive problems. This spectrum, which mimics Alzheimer’s disease, is diagnosed post-mortem through a brain biopsy in many professional athletes. However, little is known about the process of development and how to identify vulnerable individuals who may be on course for developing CTE. Boxing is a sport that has a severe toll on athletes’ health, primarily on their brain health and function. This review addresses the concerns of brain injury, describes the pathologies that manifest in multiple scales, e.g., molecular and cognitive, and also proposes possible diagnostic and prognostic markers to characterize the early onset of CTE along with the aim to identify a starting point for future precautions and interventions.

Brain remodeling after chronic median nerve compression in a rat model

Carpal tunnel syndrome is the most common compressive neuropathy,presenting with sensorimotor dysfunction.In carpal tunnel syndrome patients,irregular afferent signals on functional magnetic resonance imaging are associated with changes in neural plasticity during peripheral nerve injury.However,it is difficult to obtain multi-point neuroimaging data of the brain in the clinic.In the present study,a rat model of median nerve compression was established by median nerve ligation,i.e.,carpal tunnel syndrome model.Sensory cortex remodeling was determined by functional magnetic resonance imaging between normal rats and carpal tunnel syndrome models at 2 weeks and 2 months after operation.Stimulation of bilateral paws by electricity for 30 seconds,alternating with 30 seconds of rest period（repeatedly 3 times）,resulted in activation of the contralateral sensorimotor cortex in normal rats.When carpal tunnel syndrome rats received this stimulation,the contralateral cerebral hemisphere was markedly activated at 2 weeks after operation,including the primary motor cortex,cerebellum,and thalamus.Moreover,this activation was not visible at 2 months after operation.These findings suggest that significant remodeling of the cerebral cortex appears at 2 weeks and 2 months after median nerve compression.

基于脑-肠轴探讨半夏秫米汤治疗慢性失眠的疗效

目的探讨半夏秫米汤治疗慢性失眠的疗效及作用机制。方法选取2022年1月至2023年12月本院就诊的慢性失眠患者60例,随机分为半夏秫米汤治疗组及枣仁安神颗粒对照组,每组各30例。治疗4周后、8周后分别评估两组患者PSQI、AIS评分,在入院后及4周治疗后行多导睡眠监测、血清脑肠肽SP、NPY及5-HT检测,分析两组临床疗效及作用机制。结果在治疗4周及8周随访时,两组PSQI、AIS评分均明显改善(P<0.01),且治疗组PSQI及AIS改善优于对照组(P<0.05);在治疗4周后,治疗组总睡眠时间、入睡潜伏期、觉醒次数及睡眠效率较治疗前均明显改善(P<0.01),且在改善入睡潜伏期、觉醒次数及睡眠效率方面明显优于对照组(P<0.01)。同时治疗组患者脑肠肽SP、NPY及5-HT较治疗前明显改善(P<0.01),在改善SP、NPY方面明显优于对照组(P<0.01);PSQI评分与脑肠肽SP存在正性线性回归关系(P<0.05),与NYP及5-HT存在负性线性回归关系(P<0.01)。结论半夏秫米汤可明显提高慢性失眠患者睡眠质量,改善患者总睡眠时间、入睡潜伏期、觉醒次数及睡眠效率,其机制可能与调整脑肠肽表达有关,值得进一步研究和推广。

老年营养风险指数联合BNP对老年慢性心力衰竭患者再入院率的预测价值

目的 探讨老年慢性心力衰竭患者的营养风险指数(GNRI)和血浆脑钠肽(BNP)水平与再入院率之间的关系,以评估其在预测患者再入院风险中的潜在价值。方法 纳入2021年1-12月在安顺市人民医院因老年慢性心力衰竭住院的200例患者进行队列研究。好转出院后所有患者随访1年,根据是否再入院分为再入院组和非再入院组,比较2组患者一般资料、GNRI和BNP水平。采用二元logistic回归分析影响老年慢性心力衰竭患者再入院的危险因素。采用受试者工作特征(ROC)曲线分析GNRI和BNP的预测价值。结果 200例患者中共有66例老年慢性心力衰竭患者再入院治疗(再入院组)。再入院组患者的GNRI低于非再入院组,BNP水平显著高于非再入院组,差异均有统计学意义(P<0.05)。二元logistic回归分析结果显示,高密度脂蛋白、BNP和GNRI是影响老年慢性心力衰竭患者再入院的危险因素(P<0.05)。此外,ROC曲线结果显示,GNRI、BNP及二者联合预测老年慢性心力衰竭患者再入院率的曲线下面积(AUC)分别为0.797、0.785、0.883,敏感度分别为74.6%、69.7%、76.9%,特异度分别为78.8%、88.1%、89.4%。结论 BNP和GNRI是影响老年慢性心力衰竭患者再入院的危险因素。GNRI联合BNP检测在老年慢性心力衰竭患者再入院率中有更好的预测价值。

慢性心力衰竭患者超声参数与脑钠肽同型半胱氨酸的相关性研究

目的 探究慢性心力衰竭患者超声参数与脑钠肽、同型半胱氨酸的相关性研究。方法 本研究的对象为我院2021年4月至2022年4月纳入的100例慢性心力衰竭患者,并将其作为患病组,另外选取同时期于我院参加体检的100名健康体检者作为此次研究的健康对照组。对2组心功能、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、N端脑钠肽前体(NT-proBNP)以及同型半胱氨酸(Hcy)水平进行检测、比较。分析数据并评估慢性心力衰竭患者Hcy与LVEDD、LVEF以及NT-proBNP的相关性。结果 相较于健康对照组,患病组患者的NT-proBNP、Hcy、LVEDD均处于更高水平(P<0.05);患病组LVEF处于更低水平(P<0.05);Ⅳ级慢性心力衰竭患者的NT-proBNP、Hcy、LVEDD水平高于Ⅲ级和Ⅱ级,而Ⅲ级NT-proBNP、Hcy、LVEDD水平高于Ⅱ级(P<0.05);Ⅳ级慢性心力衰竭患者LVEF水平低于Ⅲ级和Ⅱ级,而Ⅲ级患者LVEF水平低于Ⅱ级(P<0.05)。Pearson相关性分析结果显示,慢性心力衰竭患者中,Hcy与NT-proBNP、LVEDD呈正相关(r=0.723,0.844,P<0.05),Hcy与LVEF呈负相关(r=-0.612,P<0.05)。结论 血清NT-proBNP、Hcy、LVEDD水平随着慢性心力衰竭患者心功能恶化严重程度而逐渐升高,LVEF与之相反,即随着慢性心力衰竭患者心功能恶化严重程度而逐渐降低。

降钙素原、D-二聚体、N-末端脑钠肽前体对重度慢性阻塞性肺疾病急性加重期患者预后的意义

目的:探讨降钙素原、D-二聚体、N-末端脑钠肽前体(NT-proBNP)对重度慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者预后的意义。方法:回顾性分析102例重度AECOPD的临床资料。根据患者预后情况分为预后不良组(36例)和预后良好组(66例),检测对比两组的降钙素原、D-二聚体和NT-proBNP,采用logistic回归分析进行多因素分析,并以ROC曲线评价预后预测价值。结果:预后不良组降钙素原、D-二聚体、NT-proBNP的浓度均明显高于预后良好组(P<0.01)。降钙素原、D-二聚体和NT-proBNP在logistic回归分析中的P值均<0.05。降钙素原、D-二聚体和NT-proBNP的AUC分别为0.743、0.778、0.708(P<0.01)。降钙素原联合D-二聚体、降钙素原联合NT-proBNP、D-二聚体联合NT-proBNP的AUC分别为0.847、0.815和0.798(P<0.01)。3项指标联合检测的AUC为0.862(P<0.01)。结论:降钙素原、D-二聚体和NT-proBNP均是重度AECOPD预后不良的独立危险因素,并在重度AECOPD预后预测中均有一定的价值,其中三者联合检测的预后预测效能最高。

基于“脑玄府-神机”理论的风药开玄在慢性主观性头晕中的应用进展

慢性主观性头晕(CSD)是临床常见的难治性疾病,其发病机制复杂,证候多变,病情反复,缠绵难愈。中医学认为,脑玄府开阖通利,气液流通,神机清明则体健;脑玄府闭郁,气液昧之,伤及脑体,损及脑用,神机散失则发为CSD,主张治疗上重在开玄通府,恢复神机。本文以脑玄府-神机理论为指导,主要探讨CSD的发病机制及治法治则。

参松养心胶囊联合沙库巴曲缬沙坦治疗阵发性心房颤动合并慢性心力衰竭对hs-CRP、BNP、AngⅡ及心功能的影响

目的 探讨参松养心胶囊联合沙库巴曲缬沙坦治疗阵发性心房颤动合并慢性心力衰竭对高敏C反应蛋白(High sensitivity C-reactive protein, hs-CRP)、脑钠肽(Brain natriuretic peptide, BNP)、血管紧张素Ⅱ(AngiotensinⅡ,AngⅡ)及心功能的影响。方法 选取100例阵发性心房颤动合并慢性心力衰竭患者,随机分为对照组与观察组,每组50例,对照组在常规治疗基础上给予沙库巴曲缬沙坦口服,观察组在常规治疗基础上给予参松养心胶囊联合沙库巴曲缬沙坦口服治疗,疗程6个月。观察血清hs-CRP、BNP、AngⅡ、左心室射血分数(Left ventricular ejection fraction, LVEF)、左室收缩末期内径(Left ventricular end systolic diameter, LVESD)、左室舒张末期内径(Left ventricular end diastolic diameter, LVEDD)变化。结果 两组治疗前血清hs-CRP、BNP、AngⅡ比较差异无统计学意义(P>0.05),治疗后下降(P<0.05),且观察组低于对照组(P<0.05);两组治疗前LVEF、LVESD、LVEDD比较差异无统计学意义(P>0.05),治疗后LVEF升高(P<0.05),且观察组高于对照组(P<0.05),治疗后LVESD、LVEDD下降(P<0.05),且观察组低于对照组(P<0.05);两组治疗前阵发性心房颤动发作次数、阵发性心房颤动持续时间、心室率比较差异无统计学意义(P>0.05),治疗后下降(P<0.05),且观察组低于对照组(P<0.05);对照组转为持续性心房颤动、心力衰竭恶化、缺血心源性死亡率分别为20.00%、22.00%、4.00%,观察组分别为4.00%、6.00%、0.00%,转为持续性心房颤动、心力衰竭恶化发生率对照组高于观察组(P<0.05);观察组治疗疗效优于对照组(P<0.05)。结论 参松养心胶囊联合沙库巴曲缬沙坦治疗阵发性心房颤动合并慢性心力衰竭有助于促进hs-CRP、BNP、AngⅡ下降,改善患者心功能,改善预后。

沙库巴曲缬沙坦钠片治疗慢性心力衰竭的效果

目的分析沙库巴曲缬沙坦钠片治疗慢性心力衰竭的临床效果。方法选择2021年12月—2022年12月六盘水市人民医院收治的186例慢性心力衰竭患者纳入研究。按照随机数字表法分为新式组和传统组,各93例。传统组使用马来酸依那普利片治疗,新式组使用沙库巴曲缬沙坦钠片治疗。比较2组心功能指标[左心室射血分数(left ventricular ejection fraction,LVEF)、左心室收缩末期内径(left ventricular end-systolic diameter,LVESD)、左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)及血浆脑钠肽(brain natriureticpeptide,BNP)]、治疗效果、预后情况。结果干预后,新式组LVEF水平[(48.36±5.29)%]高于传统组[(46.29±5.26)%],LVESD、LVEDD、BNP水平[(38.63±4.25)mm、(50.26±4.93)mm、(133.36±12.25)ng/L]低于传统组[(41.26±2.25)mm、(54.26±4.29)mm、(159.63±20.36)ng/L],差异有统计学意义(P<0.05)。新式组治疗总有效率(97.85%)高于传统组(82.80%),差异有统计学意义(P<0.05)。新式组再入院率、不良心血管事件发生率(11.83%、16.13%)低于传统组(32.26%、37.63%),差异有统计学意义(P<0.05)。结论沙库巴曲缬沙坦钠片治疗慢性心力衰竭可达到良好的治疗效果,同时可改善心功能,降低再入院率、不良心血管事件发生率。

血清BNP、cTnI及心肌酶谱水平检测在慢性心力衰竭患者中应用研究

目的探讨血清脑钠肽(BNP)、心肌肌钙蛋白I(cTnI)、心肌酶谱水平检测在慢性心力衰竭(CHF)中的应用价值。方法选取2020年8月-2022年8月我院收治的CHF患者及健康体检者作为观察组(116例)及对照组(116例)。均于清晨采血开展BNP、cTnI、肌酸激酶同工酶(CK-MB)及肌酸激酶(CK)检测,比较两组血清BNP、cTnI、CK-MB、CK水平差异,并依据心功能分级分为Ⅱ级、Ⅲ级、Ⅳ级组,比较不同心功能分级血清BNP、cTnI、CK-MB、CK水平差异;所有CHF患者均常规治疗,3个月后复查,比较治疗前后血清BNP、cTnI、CK-MB、CK水平差异;绘制ROC曲线,分析血清BNP、cTnI、CK-MB、CK及联合检测诊断CHF的临床价值。结果观察组血清BNP、cTnI、CK、CK-MB水平为(624.82±52.41)ng/mL、(0.15±0.03)ng/mL、(243.63±20.41)U/L、(48.52±4.23)U/L,高于对照组的(62.41±5.27)ng/mL、(0.02±0.01)ng/mL、(79.85±6.38)U/L、(19.85±2.14)U/L,差异有统计学意义(P<0.05);心功能Ⅳ级CHF患者血清BNP、cTnI、CK、CK-MB水平为(1053.24±86.34)ng/mL、(0.23±0.05)ng/mL、(345.62±31.45)U/L、(76.35±5.39)U/L,高于Ⅲ级[(602.51±65.18)n g/mL、(0.14±0.03)n g/mL、(249.85±22.65)U/L、(50.41±4.63)U/L]、Ⅱ级[(324.41±36.89)n g/mL、(0.07±0.02)n g/m L、(143.25±18.52)U/L、(33.21±3.42)U/L]患者,差异有统计学意义(P<0.05);116例CHF患者治疗后血清BNP、cTnI、CK、CK-MB水平为(92.63±8.14)n g/mL、(0.03±0.01)n g/mL、(102.32±10.35)U/L、(25.63±2.84)U/L,低于治疗前的(624.82±52.41)ng/mL、(0.15±0.03)n g/mL、(243.63±20.41)U/L、(48.52±4.23)U/L,差异有统计学意义(P<0.05);绘制ROC曲线显示,血清各指标及联合检测诊断CHF的曲线下面积分别为:0.815、0.768、0.835、0.776、0.972,联合检测价值最高。结论血清BNP、cTnI、CK-MB、CK检查在CHF患者病情诊断及严重程度评估中均具有较高价值,且联合检测可进一步提高诊断效能,有助于疾病早期诊疗方案的制定。

慢性脑缺血血脑屏障损伤的机制及中医药干预研究进展

血脑屏障位于血液与脑、脊髓的神经元之间,是中枢神经系统与循环系统物质交换的物理及生化屏障,对维持中枢神经系统内环境稳定及正常生理功能有重要意义。慢性脑缺血是脑血流灌注降低引起的一种功能可逆的缺血性脑血管疾病。慢性脑缺血可激活分子和细胞损伤级联反应,进而影响血脑屏障成分和结构,破坏其完整性。该病多见于中老年人,其临床表现以眩晕、睡眠障碍及认知功能减退最为常见。若不及时诊治,该病可进行性发展为脑白质病变、阿尔茨海默病、脑小血管病、急性脑卒中等疾病,严重影响患者的身心健康。文章通过检索近十余年来慢性脑缺血导致血脑屏障损伤的机制研究及中医药干预研究的相关文献,从细胞、分子机制角度进行简要综述,发现血脑屏障破坏是慢性脑缺血的重要病理学改变,长期缺血缺氧的脑低灌注状态可诱发细胞凋亡、免疫炎性损伤、血管内皮功能障碍等一系列病理生理改变,进一步加剧血脑屏障破坏。中医药治疗以整体观念为核心思维模式,实验和临床均证实中医药可改善头晕、失眠等慢性脑缺血相关症状,修复血脑屏障,降低血脑屏障受损的程度及范围,对延缓上述疾病的发生、进展具有可行性,且具有多靶点、多途径的治疗优势以及广阔的临床应用前景。