Neurovascular disorders, such as traumatic brain injury and stroke, persist as leading causes of death and disability - thus, the search for novel therapeutic approaches for these disorders continues. Many hurdles hav...Neurovascular disorders, such as traumatic brain injury and stroke, persist as leading causes of death and disability - thus, the search for novel therapeutic approaches for these disorders continues. Many hurdles have hindered the translation of effective therapies for traumatic brain injury and stroke primarily because of the inherent complexity of neuropathologies and an inability of current treatment approaches to adapt to the unique cell death pathways that accompany the disorder symptoms. Indeed, developing potent treatments for brain injury that incorporate dynamic and multiple disorder-engaging therapeutic targets are likely to produce more effective outcomes than traditional drugs. The therapeutic use of hypothermia presents a promising option which may fit these criteria. While regulated temperature reduction has displayed great promise in preclinical studies of brain injury, clinical trials have been far less consistent and associated with adverse effects, especially when hypothermia is pursued via systemic cooling. Accordingly, devising better methods of inducing hypothermia may facilitate the entry of this treatment modality into the clinic. The use of the delta opioid peptide D-alanine D-leucine enkephalin（DADLE） to pharmacologically induce temperature reduction may offer a potent alternative, as DADLE displays both the ability to cause temperature reduction and to confer a broad profile of other neuroprotective and neuroregenerative processes. This review explores the prospect of DADLE-mediated hypothermia to treat neurovascular brain injuries, emphasizing the translational steps necessary for its clinical translation.展开更多
目的:探讨颅脑损伤护理相关研究的知识基础、研究热点及发展趋势。方法:使用CiteSpace分析2021年9月1日前Web of Science(WOS)数据库中颅脑损伤护理相关研究文献,使用文献共被引分析了解知识基础,运用关键词共现分析和突现分析研究热点...目的:探讨颅脑损伤护理相关研究的知识基础、研究热点及发展趋势。方法:使用CiteSpace分析2021年9月1日前Web of Science(WOS)数据库中颅脑损伤护理相关研究文献,使用文献共被引分析了解知识基础,运用关键词共现分析和突现分析研究热点及发展趋势。结果:神经科重症监护室病人及青少年是重点关注人群,颅脑损伤病人的身心健康、结局指标影响因素为研究热点,对病人的管理及病人、照护者的颅脑损伤预防、护理知识为研究前沿。结论:科学计量学有助于帮助了解颅脑损伤护理研究进程及最新发展。展开更多
目的:检测大鼠蛛网膜下腔出血(subarachnoid hemorrhage,SAH)后早期海马组织中含Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶-1(a disintegrin-like and metalloproteinase with thrombospondin type l motifs,ADAMTS-1)在基底动脉...目的:检测大鼠蛛网膜下腔出血(subarachnoid hemorrhage,SAH)后早期海马组织中含Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶-1(a disintegrin-like and metalloproteinase with thrombospondin type l motifs,ADAMTS-1)在基底动脉中的表达,分析其与大鼠SAH后急性脑血管痉挛(cerebral vasospasm,CVS)的相关性,探讨其在SAH后早期脑损伤(earlybrain injury,EBI)中的作用。方法:健康雄性成年SD大鼠108只,体质量250～300g,随机分为SAH组(n=90)和假手术组(sham组,n=18)。SAH组取大鼠自体动脉血,用视交叉池注血法建立大鼠SAH模型(sham组注入等量0.9%氯化钠液)。将SAH组随机分为6h、12h、24h、48h、72h5个亚组,每个亚组18只,分别在相应时间点处死。用蛋白质印迹(Western-blot)方法及实时荧光定量逆转录-聚合酶链反应(RT-PCR)法检测SAH各亚组及sham组基底动脉ADAMTS-1的表达,同时用HE染色法对基底动脉进行形态学观察。探讨ADAMTS-1与实验性大鼠SAH后急性CVS的相关性。结果:与sham组相比,SAH 6h亚组基底动脉ADAMTS-1表达无显著差异;12h亚组基底动脉ADAMTS-1蛋白表达显著增高,24h亚组最高,48h亚组、72h亚组逐渐下降,但仍维持在较高水平。与sham组相比,SAH 6h亚组大鼠基底动脉变化不明显;12h亚组大鼠基底动脉管腔缩小,管壁增厚;24h亚组基底动脉痉挛最为明显;48h亚组基底动脉痉挛较24h亚组减轻;与24h亚组、48h亚组相比,72h亚组基底动脉管腔直径更大、管壁厚度更薄。ADAMTS-1蛋白表达与SAH后急性CVS呈正相关(r=0.916,P=0.003)。结论:大鼠SAH后早期基底动脉ADAMTS-1表达与急性CVS正相关,提示ADAMTS-1可能参与大鼠SAH后EBI的病理过程。展开更多
目的探讨不同时间点床旁视频脑电图(video electroencephalogram,VEEG)监测对判断早产儿脑损伤的应用价值。方法选取2016年12月至2017年10月于首都医科大学附属北京儿童医院新生儿重症监护室(newborn intensive care unit,NICU)住院,出...目的探讨不同时间点床旁视频脑电图(video electroencephalogram,VEEG)监测对判断早产儿脑损伤的应用价值。方法选取2016年12月至2017年10月于首都医科大学附属北京儿童医院新生儿重症监护室(newborn intensive care unit,NICU)住院,出院后在新生儿科和神经康复中心进行随访的早产儿39例。根据住院期间头颅B超结果,将患儿分为早产儿脑损伤组和非脑损伤组,收集基本资料,分别在日龄(day of life,DOL)1周,纠正胎龄(correct age,CA)40周、44周及52周时各进行1次VEEG检查,每次2~3 h;对比分析两组早产儿发生脑损伤的情况及VEEG特点。结果早产儿脑损伤组16例,非脑损伤组23例。仅DOL 1周时的VEEG结果与脑损伤有相关性(P<0.05)。早产儿随日龄增大,VEEG结果趋于正常。结论早期应用VEEG结合床旁头颅B超评估,可辅助评估早产儿脑损伤情况,给予高风险患儿早期干预以减少脑损伤的危害。展开更多
基金supported by NIH R01NS071956,NIH R01 NS090962,NIH R21NS089851,NIH R21 NS094087,DOD W81XWH-11-1-0634,and VA Merit Review I01 BX001407(to CVB)
文摘Neurovascular disorders, such as traumatic brain injury and stroke, persist as leading causes of death and disability - thus, the search for novel therapeutic approaches for these disorders continues. Many hurdles have hindered the translation of effective therapies for traumatic brain injury and stroke primarily because of the inherent complexity of neuropathologies and an inability of current treatment approaches to adapt to the unique cell death pathways that accompany the disorder symptoms. Indeed, developing potent treatments for brain injury that incorporate dynamic and multiple disorder-engaging therapeutic targets are likely to produce more effective outcomes than traditional drugs. The therapeutic use of hypothermia presents a promising option which may fit these criteria. While regulated temperature reduction has displayed great promise in preclinical studies of brain injury, clinical trials have been far less consistent and associated with adverse effects, especially when hypothermia is pursued via systemic cooling. Accordingly, devising better methods of inducing hypothermia may facilitate the entry of this treatment modality into the clinic. The use of the delta opioid peptide D-alanine D-leucine enkephalin（DADLE） to pharmacologically induce temperature reduction may offer a potent alternative, as DADLE displays both the ability to cause temperature reduction and to confer a broad profile of other neuroprotective and neuroregenerative processes. This review explores the prospect of DADLE-mediated hypothermia to treat neurovascular brain injuries, emphasizing the translational steps necessary for its clinical translation.
文摘目的:探讨颅脑损伤护理相关研究的知识基础、研究热点及发展趋势。方法:使用CiteSpace分析2021年9月1日前Web of Science(WOS)数据库中颅脑损伤护理相关研究文献,使用文献共被引分析了解知识基础,运用关键词共现分析和突现分析研究热点及发展趋势。结果:神经科重症监护室病人及青少年是重点关注人群,颅脑损伤病人的身心健康、结局指标影响因素为研究热点,对病人的管理及病人、照护者的颅脑损伤预防、护理知识为研究前沿。结论:科学计量学有助于帮助了解颅脑损伤护理研究进程及最新发展。
文摘目的:检测大鼠蛛网膜下腔出血(subarachnoid hemorrhage,SAH)后早期海马组织中含Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶-1(a disintegrin-like and metalloproteinase with thrombospondin type l motifs,ADAMTS-1)在基底动脉中的表达,分析其与大鼠SAH后急性脑血管痉挛(cerebral vasospasm,CVS)的相关性,探讨其在SAH后早期脑损伤(earlybrain injury,EBI)中的作用。方法:健康雄性成年SD大鼠108只,体质量250～300g,随机分为SAH组(n=90)和假手术组(sham组,n=18)。SAH组取大鼠自体动脉血,用视交叉池注血法建立大鼠SAH模型(sham组注入等量0.9%氯化钠液)。将SAH组随机分为6h、12h、24h、48h、72h5个亚组,每个亚组18只,分别在相应时间点处死。用蛋白质印迹(Western-blot)方法及实时荧光定量逆转录-聚合酶链反应(RT-PCR)法检测SAH各亚组及sham组基底动脉ADAMTS-1的表达,同时用HE染色法对基底动脉进行形态学观察。探讨ADAMTS-1与实验性大鼠SAH后急性CVS的相关性。结果:与sham组相比,SAH 6h亚组基底动脉ADAMTS-1表达无显著差异;12h亚组基底动脉ADAMTS-1蛋白表达显著增高,24h亚组最高,48h亚组、72h亚组逐渐下降,但仍维持在较高水平。与sham组相比,SAH 6h亚组大鼠基底动脉变化不明显;12h亚组大鼠基底动脉管腔缩小,管壁增厚;24h亚组基底动脉痉挛最为明显;48h亚组基底动脉痉挛较24h亚组减轻;与24h亚组、48h亚组相比,72h亚组基底动脉管腔直径更大、管壁厚度更薄。ADAMTS-1蛋白表达与SAH后急性CVS呈正相关(r=0.916,P=0.003)。结论:大鼠SAH后早期基底动脉ADAMTS-1表达与急性CVS正相关,提示ADAMTS-1可能参与大鼠SAH后EBI的病理过程。
文摘目的探讨不同时间点床旁视频脑电图(video electroencephalogram,VEEG)监测对判断早产儿脑损伤的应用价值。方法选取2016年12月至2017年10月于首都医科大学附属北京儿童医院新生儿重症监护室(newborn intensive care unit,NICU)住院,出院后在新生儿科和神经康复中心进行随访的早产儿39例。根据住院期间头颅B超结果,将患儿分为早产儿脑损伤组和非脑损伤组,收集基本资料,分别在日龄(day of life,DOL)1周,纠正胎龄(correct age,CA)40周、44周及52周时各进行1次VEEG检查,每次2~3 h;对比分析两组早产儿发生脑损伤的情况及VEEG特点。结果早产儿脑损伤组16例,非脑损伤组23例。仅DOL 1周时的VEEG结果与脑损伤有相关性(P<0.05)。早产儿随日龄增大,VEEG结果趋于正常。结论早期应用VEEG结合床旁头颅B超评估,可辅助评估早产儿脑损伤情况,给予高风险患儿早期干预以减少脑损伤的危害。
