Inhibitory and excitatory amino acids in the cerebrospinal fluid of children with two types of cerebral palsy

BACKGROUND： Under normal conditions, excitatory amino acids are dynamically balanced with inhibitory amino acids. Excitatory amino acids have been implicated in perinatal brain injury. OBJECTIVE： To investigate differences in the levels of the excitatory amino acids glutamic acid and aspartic acid, and the inhibitory amino acid gamma-aminobutyric acid （GABA） in the cerebrospinal fluid （CSF） of children with spastic cerebral palsy or athetotic cerebral palsy. DESIGN, TIME AND SETTING： Case-control exploratory observation of neurotransmitter in patients. The experiment was performed in the Pediatrics Department of the Second Affiliated Hospital of Changsha Medical College, the Cerebral Palsy Center of Xiangtan Affiliated Hospital of South China University and the Pediatrics Department of Xiangya Hospital, between February 2006 and May 2007. PARTICIPANTS： We selected 27 children with cerebral palsy, including 13 with spastic cerebral palsy and 14 with athetotic cerebral palsy. We selected 10 patients who were not affected by any neurological disease as controls. METHODS： Two mL blood-free CSF was harvested between the third and fourth lumbar vertebrae of each patient after anesthesia, and stored at -70℃. One mL CSF was mixed with 10 mg sulfosalicylic acid and placed in ice-bath for 10 minutes, then centrifuged 2 000 g for 10 minutes. The supernatant was collected for amino acid quantitation. MAIN OUTCOME MEASURES： The concentrations of glutamic acid, aspartic acid and GABA in the CSF were determined by high-performance liquid chromatography and fluorometric method. The correlation of glutamic acid, aspartic acid and GABA levels with muscular tension in children with cerebral palsy was analyzed using linear dependence. RESULTS： The concentration of GABA was significantly lower in both spastic cerebral palsy and athetotic cerebral palsy patients than in the control group （P 〈 0.01）. Glutamic acid and aspartic acid were significantly higher in both cerebral palsy groups than in the control group （P 〈 0.05-0.01）. The concentration of GABA was significantly decreased in spastic cerebral palsy patients compared with the athetotic cerebral palsy group （P 〈 0.05）. Muscular tension was positively correlated with the concentration of glutamic acid in spastic cerebral palsy patients （P 〈 0.05） but there was no significant correlation between aspartic acid or GABA and muscular tension （P 〉 0.05）. CONCLUSION： Spastic cerebral palsy and athetotic cerebral palsy patients exhibit an imbalance of excitatory amino acids and inhibitory amino acids in their CSF： an increase in glutamic acid and aspartic acid, and a decrease in GABA. Amino acid levels are different in the CSF in varied types of cerebral palsy.

Cerebrospinal Fluid Biomarkers in Dementia Patients with Cerebral Amyloid Angiopathy

Objective To study the changes of biomarkers in cerebrospinal fluid(CSF) in cerebral amyloid angiopathy(CAA) dementia and Alzheimer's disease.Methods Levels of amyloid protein β(Aβ42,Aβ40) and phosphorylated Tau-protein(P-tau) in CSF and ratio of Aβ42/Aβ40 were tested in 5 cases with CAA dementia and 20 cases with Alzheimer's disease collected at Peking Union Medical College Hospital from December 2001 to March 2011.Results The levels of Aβ42,Aβ40,and P-tau in CSF and ratio of Aβ42/Aβ40 were(660.4±265.2) ng/L,(7111.0±1033.4) ng/L,(71.8±51.5) ng/L,and 0.077±0.033,respectively in CAA dementia and(663.6±365.6) ng/L,(5115.0±2931.1) ng/L,(47.7±38.8) ng/L,and 0.192±0.140,respectively in Alzheimer's disease patients.There were no statistically significant differences between CAA dementia and Alzheimer's disease in terms of these CSF biomarkers(all P>0.05).Conclusion Measurements of CSF biomarkers may not be helpful in differential diagnosis of CAA and Alzheimer's disease.

Mathematical Model of Cerebrospinal Fluid Formation in the Brain

In this paper,we present a mathematical model of the cerebrospinal fluid(CSF)formation based on fluid mechanics concepts.Maintenance of intracranial pressure(IP)in the cases of patients with head injury has been a problem for some time now.Cerebrospinal fluid is one of the cranial vault content that influences the normality of the IP.It was assumed that cerebrospinal fluid(CSF)formation begins as plasma,

Discovery and nomenclature of nucleus that regulate cerebrospinal fluid

The difference of composition in extracellular fluid in brain parenchyma and CSF suggests that CSF-brain barrier(CBB)is objective,which is necessary to maintain the stability of their internal environment.However,the information exchange between brain and CSF is also objective.For example,CSF is changes during diseases,the application of drugs(such as lumbar anesthesia)or tissue transplantation via the CSF pathway may also produce central(cerebral)effects.Who breaks through the barrier and mediates brain-CSF communication?Since 1992,we have found that the peripheral nerve tracer CB-HRP injected into the lateral ventricle of mice,rats and macaques is blocked in the ventricle wall and can only run in CSF,but a large number of CB-HRP-positive labeled neurons can be seen in specific parts of the brain stem parenchyma.Understandably,these neurons touch markers in CSF.Otherwise,they cannot be tagged.

首诊于精神科的脑淀粉样血管病1例

目的 探讨脑淀粉样血管病的临床症状及影像学表现。方法 回顾性分析1例首诊于精神科的脑淀粉样血管病的临床资料。结果 患者女性,56岁,临床主要表现为情感平淡、言语减少、记忆力减退。患者脑脊液蛋白0.51g/L,氯118.9mmol/L,潘氏试验弱阳性,脑电图α波不规则,慢波较多,磁敏感加权成像显示颅内弥漫性微出血,蒙特利尔认知评估11分,韦氏智力测试55分。给予甲强龙500 mg/d和罂粟碱90 mg/d治疗,出院2个月后复查,症状部分改善。结论 磁敏感加权成像对诊断脑淀粉样血管病具有较高的临床应用价值。

Simultaneous quantification of evodiamine,rutaecarpine,and dehydroevodiamine in rat cerebrospinal fluid and cerebral nuclei after oral administration by UPLC-MS/MS

Evodiamine,rutaecarpine,and dehydroevodiamine have been demonstrated as the major alkaloids in the fruits of Euodia rutaecarpa,a well-known traditional Chinese medicine with central nervous system activities.To study their cerebrospinal fluid pharmacokinetics and cerebral nuclei distribution,the alkaloids were mixed at the weight ratio of 1:1:1 and orally administered via gavage to the rats at each dose of 15 mg/kg.A quick and reliable ultra-performance liquid chromatographic-tandem mass spectrometry method was developed and applied for the simultaneous analysis of the alkaloids in rat cerebrospinal fluid and cerebral nuclei collected at different time points.Non-compartmental pharmacokinetic profiles were calculated,and the distribution in cerebral nuclei was compared.All the tested compounds were absorbed into rat cerebrospinal fluid and distributed to the brain nuclei quickly.Their distribution in different nuclei varied,as evodiamine mainly in cerebellum and brainstem,rutaecarpine with its maximum in the brainstem,and dehydroevodiamine mostly in the cerebellum and hippocampus.They were eliminated from the brain rapidly without long-time accumulation.In summary,this study revealed the targeting discrepancy of evodiamine,rutaecarpine,and dehydroevodiamine in the brain,and highlighted the possibility for drug candidates in the encephalopathy treatment of the fruits of E.rutaecarpa.

脑脊液联合血常规检测在多发性脑胶质瘤与原发性中枢神经系统淋巴瘤鉴别诊断中的临床价值

目的探讨脑脊液(CSF)和血常规多项指标联合检测对多发性脑胶质瘤(MCG)与原发性中枢神经系统淋巴瘤(PCNSL)鉴别诊断的临床价值。方法回顾性分析首都医科大学附属天坛医院2017年11月至2023年3月收治的62例MCG患者和56例PCNSL患者临床资料、CSF及血常规检测指标,并分析有意义指标单独及联合应用鉴别诊断MCG与PCNSL的临床价值。结果MCG组CSF细胞总数、CSF白细胞数、CSF蛋白(CSF:pro)、乳酸、血常规中性粒细胞计数、中性粒细胞%水平显著高于PCNSL组(P<0.05);PCNSL组CSF糖(CSF:Glu)、CSF氯(CSF:cl)、血常规淋巴细胞计数、嗜酸性粒细胞、淋巴细胞%、嗜酸性粒细胞%水平显著高于MCG组(P<0.05)。CSF细胞总数、CSF白细胞、CSF:pro、乳酸、血常规中性粒细胞计数、中性粒细胞%鉴别诊断MCG和PCNSL的AUC为:0.900、0.899、0.797、0.867、0.828、0.772;灵敏度为:72.4%、77.6%、63.8%、67.2%、72.4%、82.8%;特异度为:97.1%、100.0%、88.2%、91.2%、88.2%、64.7%。此外,CSF细胞总数、CSF白细胞、CSF:pro、血常规中性粒细胞计数和中性粒细胞%指标联合检测鉴别诊断MCG和PCNSL的AUC为0.919,敏感度和特异度为77.6%和100.0%。结论脑脊液学指标CSF细胞总数、CSF白细胞、CSF:pro及血常规指标中性粒细胞计数和中性粒细胞%联合检测鉴别诊断MCG和PCNSL具有较高的临床应用价值。

Effect of Ligustrazine on Nitric Oxide Contents in Cerebrospinal Fluid and Plasma of Patients with Cerebral Infarction

Objective: To probe into the significance of Nitric Oxide (NO) in ischemic cerebral damage and effect of ligustrazine on it. Methods: The NO contents in cerebrospinal fluid (CSF) and plasma of 20 controls and 62 patients with arteriosclerotic thrombotic cerebral infarction (ligustrazine group and common treatment group) were determined with Griess method before and after treatment. Results:The NO content in CSF before treatment was higher in severe type, it was higher than that in moderate type, and than that in mild type,again higher than that in control group (all P < 0. 05) and was positively correlated with the size of infarction (P < 0. 01 ). There was no significant difference between the plasma NO content of patients and that of control group (P < 0. 05), but there was a trend that plasma NO content decreased as the patient's condition worsened. After treatment, the curative effect and plasma NO content of ligustrazine group were both markedly higher than those of common treatment group (P < 0. 05, 0. 05 ).There were no significant differences between CSF NO contents of the two groups, respectively, and that of control group (P > 0. 05,0. 05). Conclusion: Excessive NO produced in brain tissue and insufficient plasma NO participate the course of ischemic brain damage.Ligustrazine could increase the contents of plasma NO selectively.Original article on CJIM(Chin) 1998; 18(6). 342

Ommaya囊治疗脑出血并发急性期脑积水疗效及对血脑屏障功能的影响

目的探讨Ommaya囊在脑出血并发急性期脑积水治疗中的应用及对血脑屏障功能和预后的影响。方法选取2021年1月至2023年1月安庆一一六医院脑出血并发急性期脑积水患者80例,按照随机数字表法分组,各40例。对照组给予腰大池介入治疗,观察组给予Ommaya囊介入治疗。比较2组治疗效果、治疗前后血脑屏障(BBB)指数、血清S100β蛋白(S100β)、脑脊液细胞数、葡萄糖、髓鞘碱性蛋白(MBP)、美国国立卫生研究院卒中量表(NIHSS)、特异性烯醇化酶(NSE)、氯化物、中国脑卒中临床神经功能缺损量表(CSS)评分及并发症发生情况,并随访6个月,对比2组预后情况。结果观察组总有效率90.00%(36/40)高于对照组72.50%(29/40),P<0.05;治疗后1周、2周观察组血清S100β、MBP、BBB指数、NSE、脑脊液细胞数水平低于对照组,脑脊液葡萄糖、氯化物水平高于对照组(P<0.05);治疗后1周、2周观察组CSS、NIHSS评分较对照组低(P<0.05);观察组并发症发生率7.50%(3/40)低于对照组25.00%(10/40),P<0.05;随访6个月观察组预后分级情况优于对照组(P<0.05)。结论脑出血并发急性期脑积水患者中应用Ommaya囊治疗,可调控神经损伤因子水平,恢复血脑屏障,改善神经功能,还能降低并发症风险,提升临床疗效,促进预后恢复。

缺血性脑卒中SD大鼠血清、脑脊液中NSE、MBP水平及其与神经功能缺损评分和脑梗死体积的相关性

目的探讨缺血性脑卒中SD大鼠血清、脑脊液中神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)水平及其与神经功能缺损评分和脑梗死体积的相关性。方法购买SD大鼠进行大脑中动脉闭塞缺血模型造模手术,将术后成功造模的大鼠随机分为8组,每组8只,术后8 h进行神经功能缺损评分,术后在8 h、12 h、1 d、3 d、5 d、7 d及21 d时间段采集腹腔静脉血及抽取延髓脑脊液后,断头取脑,进行0.4%的2,3,5-氯化三苯基四氮唑大脑染色测定脑梗死体积,并检测NSE及MBP水平。采用Spearman相关对血清、脑脊液NSE、MBP水平与脑梗死体积和神经功能缺损评分的相关性进行分析。结果各组血清、脑脊液中NSE和MBP水平在术后8 h开始升高,3 d达峰值,7 d下降至与对照比较差异无统计意义(P>0.05);术后8 h至5 d,脑脊液NSE和MBP水平明显高于血清。血清、脑脊液NSE、MBP水平与脑梗死体积、神经功能缺损评分均呈正相关(P<0.05)。结论血清、脑脊液中NSE、MBP为脑梗死的新型标志物,通过动物实验可为临床患者标本采集推荐最佳时间窗口。

脑脊液中TXB2、S100B水平与高血压脑出血患者预后的相关性

目的探究脑脊液中血栓素B2(thromboxane B2,TXB2)、S100钙结合蛋白B(S100 calcium-binding protein B,S100B)水平与高血压脑出血患者预后的相关性。方法选取2020年5月至2023年5月西安市长安医院急诊收治的高血压脑出血患者96例,均行微创血肿清除术治疗,收集所有患者的病历资料,检测患者术后24 h脑脊液中的TXB2、S100B水平。依据患者术后28 d预后分为预后良好组和预后不良组。分析高血压脑出血预后的影响因素,评价脑脊液中TXB2、S100B水平对高血压脑出血患者预后的预测效能。采用χ^(2)检验、独立样本t检验,影响因素的分析采用多因素logistic逐步回归模型。结果术后28 d,96例高血压脑出血患者中预后良好68例(70.83%),预后不良28例(29.17%)。两组性别、年龄、体重指数等一般资料比较,差异均无统计学意义(均P>0.05);预后良好组美国国立卫生研究院卒中量表(NIHSS)评分、中线移位占比及脑脊液TXB2、S100B水平均低于预后不良组[(15.34±2.61)分比(20.18±3.32)分、19.12%(13/68)比39.29%(11/28)、(156.04±17.31)ng/L比(190.35±18.29)ng/L、(1.72±0.34)μg/L比(1.93±0.47)μg/L],差异均有统计学意义(均P<0.05)。NIHSS评分(OR=3.691,95%CI 1.262~10.799)、中线移位(OR=3.425,95%CI 1.171~10.019)、脑脊液TXB2(OR=5.675,95%CI 1.939~16.602)及S100B(OR=4.486,95%CI 1.533~13.125)是高血压脑出血预后的危险因素(均P<0.05)。脑脊液中TXB2、S100B单一及联合预测高血压脑出血患者预后的灵敏度分别为0.764、0.727、0.799,特异度分别为0.641、0.703、0.782,曲线下面积分别为0.731、0.705、0.823。结论脑脊液中TXB2、S100B水平的变化与高血压脑出血患者预后有关,且两者联合检测对高血压脑出血患者预后的预测效能良好。

Kallikrein-related peptidases 6 and 10 are elevated in cerebrospinal fluid of patients with Alzheimer’s disease and associated with CSF-TAU and FDG-PET

Background:Alterations in the expression of human kallikrein-related peptidases(KLKs)have been described in patients with Alzheimer’s disease(AD).We elucidated the suitability of KLK6,KLK8 and KLK10 to distinguish AD from NC and explored associations with established AD biomarkers.Methods:KLK levels in cerebrospinal fluid(CSF),as determined by ELISA,were compared between 32 AD patients stratified to A/T/(N)system with evidence for amyloid pathology and of 23 normal controls with normal AD biomarkers.Associations between KLK levels and clinical severity,CSF and positron emission tomography(PET)based AD biomarkers were tested for.Results:Levels of KLK6 and KLK10 were significantly increased in AD.KLK6 differed significantly between AD A+/T+/N+and AD A+/T−/N+or NC with an AUC of 0.922.CSF pTau and tTau levels were significantly associated with KLK6 in AD.Conclusions:KLK6 deserves further investigations as a potential biomarker of Tau pathology in AD.

Cerebrospinal fluid amyloid beta and tau proteins in atypical Parkinsonism: a review

Progressive supranuclear palsy,corticobasal degeneration,multiple system atrophy and dementia with Lewy bodies are the most common causes of atypical Parkinsonism and enter the differential diagnosis of Parkinson's disease.multiple system atrophy,dementia with Lewy bodies and Parkinson's disease are synucleinopathies,whereas progressive supranuclear palsy and corticobasal degeneration are tauopathies.Multiple cerebrospinal fluid markers have been applied on cohorts of patients with Parkinsonism,with the aim to develop biomarkers for these disorders.Total tau(τΤ),phosphorylated tau at threonine 181(τP-181)and amyloid-beta with 42 amino acids(Aβ42)are considered classical biomarkers for Alzheimer's disease.The aim of the present study is to review the literature regarding these classical cerebrospinal fluid biomarkers in cohorts with Parkinsonism,as well as present data on novel approaches regarding analysis of these proteins.

MALDI-TOF Mass Spectrometric Analysis of Brain Tumor Cyst Fluid Reveals a Protein Peak Corresponding to ApoC1 and LuzP6

Objectives: SELDI-TOF and MALDI-TOF mass spectrometry (MS) are laser desorption technologies that allow for proteomic examination of molecular masses in small amounts of samples. In a precedent study, the feasibility of SELDI-TOF MS assessment of proteins in cerebrospinal fluid and tumor cyst fluid had been shown. In the present study, we analyzed whether MALDI-TOF MS examination of these fluids leads to comparable results. Methods: During neurosurgical intervention, cyst fluids from 24 glioblastomas and 15 metastases were collected. As control, cerebrospinal fluid samples from 23 patients were obtained. The samples were prepared using a protocol optimized for MALDI-TOF MS. Mass spectra were recorded and peaks were extracted, characterized by masses and relative intensities. These peaks were analyzed for statistically significant differences between the diagnosis groups and compared to SELDI-TOF MS data. Results: 41 protein peaks known from the SELDI-TOF MS analysis could be confirmed by MALDI-TOF MS, and the cellular expression of the proteins LuzP6 and ApoC1, corresponding to the protein peaks 6433 and 6632, was shown immunohistochemically in glioblas-toma tissue. The MALDI-TOF spectrometry extends the range of analysis down to 1.4 kDa, whereas the upper detection limit lies below 23 kDa. Discussion: The presented proteomic approach yields an inventory of protein masses, found in the tumor cyst at the time of puncture. It does not reveal pathophysiologic, metabolic or secretory pathways that lead to the presence of proteins in the cyst. These have to be assessed immunohistochemically or on mRNA level in the surrounding tumor cells. Conclusion: MALDI-TOF MS of tumor cyst fluid discloses protein sizes, overexpressed or lost in tumor tissue. A thorough proteomic work-up is needed to identify the underlying proteins and metabolic pathways.

动脉瘤性蛛网膜下腔出血患者脑脊液D-二聚体水平与迟发性脑缺血的关系

目的探讨动脉瘤性蛛网膜下腔出血(aSAH)患者脑脊液D-二聚体水平与迟发性脑缺血(DCI)的关系。方法以2018年5月至2020年12月经南阳市第一人民医院收治的68例aSAH患者为研究对象进行前瞻性研究,所有患者均接受动脉瘤夹闭术或血管内动脉瘤栓塞术,分别于术后即刻、术后24 h、术后48 h、术后72 h取静脉血和脑脊液进行D-二聚体(D-D)水平检测,根据住院期间是否发生DCI分为DCI组和NDCI组,对比两组患者各时间点血液D-D和脑脊液D-D水平变化特点,采用二元Logistic逐步回归分析影响DCI发生的因素,并建立DCI预测模型,通过绘制受试者操作特征(ROC)曲线图观察其临床预测价值。结果单因素分析显示,DCI组术后各时间点血液D-D、脑脊液D-D水平均高于NDCI组。以DCI发生为阳性时间进行Logistic回归分析显示:①术后即刻-24 h、术后即刻-72 h血液D-D水平平均差是影响术后DCI发生的独立危险因素(P<0.05)。ROC曲线分析显示,该预测模型对预测DCI发生有效(AUC=0.913,95%CI:0.847~0.979,P<0.001),敏感性和特异性分别为100.00%、69.50%。②术后48 h脑脊液D-D水平是影响DCI发生的危险因素(P<0.05)。ROC曲线分析显示,该预测模型对预测DCI发生有效(AUC=0.990,95%CI:0.974~1.000,P<0.001),敏感性和特异性分别为100.00%、91.50%。以96 h内DCI发生为阳性事件进行Logistic回归分析显示,各时间点血液D-D水平改变均不是该事件发生的影响因素(P>0.05);仅术后即刻-72 h脑脊液D-D平均水平差是影响术后96 h DCI发生的独立危险因素(P<0.001)。ROC曲线分析显示,该预测模型预测术后96 h DCI发生有效(AUC=0.901,95%CI:0.804~0.998,P<0.001),敏感性和特异性最高,分别为78.60%、88.90%。结论脑脊液D-D和血液D-D水平变化均可有效预测SAH患者术后DCI的发生,然而通过监测术后脑脊液D-D水平改变有助于预测患者术后96 h内DCI的发生,相比血液D-D监测临床价值更高。

脑性瘫痪儿童脑脊液内外泌体的蛋白质组学分析

背景:脑性瘫痪(简称脑瘫)是一种广泛的神经损伤性疾病,其病因在很大程度上仍不明确,用于该病分类或监测的分子指标也尚未见报道。目的:分离培养儿童脑瘫患者脑脊液来源的外泌体,使用无标记定量质谱蛋白质组学方法分析其外泌体的蛋白质组表达谱特征,为儿童脑瘫群体的分型、诊断和预后评估等提供分子生物学依据。方法:选择在北京中医药大学东直门医院进行选择性脊神经后根切断术的脑瘫患者,其中痉挛型脑瘫患者4例,混合型脑瘫患者3例,每位患者抽取3 mL脑脊液,通过超速离心法分离儿童脑瘫患者脑脊液中的外泌体,并使用纳米颗粒跟踪分析、透射电镜和蛋白质质谱分析对外泌体进行表征。结果与结论:①透射电镜观察显示,儿童脑瘫患者脑脊液内存在外泌体形态的囊泡。Western blot检测到外泌体标志蛋白Syntenin-1和Flotillin-1的表达;②纳米颗粒跟踪分析显示囊泡的大小和浓度符合外泌体的异质性特征。对痉挛性脑瘫、混合性脑瘫的脑脊液外泌体进行蛋白质谱分析,共鉴定出551个蛋白;③生物信息学分析显示,鉴定出的脑脊液外泌体蛋白与负责外泌体功能和神经发育过程的分子信号机制相关,这些蛋白主要富集于额叶皮质、运动皮质等脑部区域,与脑瘫病理密切相关。研究结果提示儿童脑瘫患者脑脊液内存在外泌体,外泌体蛋白可能与脑瘫分子病理机制相关。

大黄素通过调控Wnt/β-catenin信号通路减轻缺血性脑卒中大鼠BCFB

目的 本研究旨在探讨大黄素对缺血性脑卒中(CAT)后血-脑脊液屏障(BCFB)的影响及其潜在机制。方法 SD大鼠随机分为:假手术组、模型组、大黄素低剂量组(20 mg·kg^(-1))、大黄素高剂量组(40 mg·kg^(-1))以及阳性对照组(尼莫地平12 mg·kg^(-1))。构建大鼠大脑中动脉闭塞/再灌注(MCAO/R)模型,通过腹腔注射不同药物进行治疗。对各组大鼠进行神经功能缺损评分;TCC染色检测脑梗死体积;测定脑组织含水量;伊文思蓝(EB)染色检测BCFB通透性;明胶酶谱法评估MMP-9的活性;Western blotting检测基质金属蛋白酶-9 (MMP-9)、闭合蛋白-5 (Claudin-5)和咬合蛋白(Occludin)和磷酸化糖原合成酶激酶(p-GSK-3 β)、β-连环素(β-catenin)蛋白的表达。结果 与假手术组相比,模型组大鼠神经功能缺损评分明显增加,脑梗死体积和脑组织含水量均明显增加,脑组织EB含量明显增加,脑组织中Claudin-5、Occludin、p-GSK-3 β、β-catenin蛋白表达明显降低,MMP-9酶活性和蛋白表达明显升高(P<0.05);与模型组相比,大黄素低、高剂量组和阳性对照组大鼠神经功能缺损评分明显降低,脑梗死体积和脑组织含水量均明显降低,脑组织EB含量明显降低,脑组织中Claudin-5、Occludin、p-GSK-3 β、β-catenin蛋白表达明显升高,MMP-9酶活性和蛋白表达明显降低(P<0.05)。结论 大黄素可通过激活Wnt/β-catenin通路减轻BCFB损伤,对CAT具有神经保护作用。

脑动脉瘤破裂出血后脑脊液中miRNA-3177-3p与脑血管痉挛的发病关系及临床意义

目的 测定动脉瘤性蛛网膜下腔出血(aSAH)后脑血管痉挛(CV)患者与脑血管未痉挛患者脑脊液中miRNA-3177-3p的表达情况,探讨其与CV的发病关系及临床意义。方法 将29例aSAH患者分成脑血管痉挛组(CV组)与脑血管未痉挛组(nonCV组)。比较两组患者的一般临床资料;通过生物信息数据分析确定miRNA-3177-3p作为研究对象,测定两组患者脑脊液中miRNA-3177-3p实际表达情况并比较差异;预测miRNA-3177-3p下游靶基因ATP1B3,构建ATP1B3质粒,双萤光素酶报告实验验证miRNA-3177-3p与ATP1B3靶向关系;最后,ELISA法测定两组患者脑脊液中ATP1B3转录产物ATP1β3含量并比较差异。结果 CV组患者Hunt评级高于non-CV组(P<0.05);CV组脑脊液中miRNA-3177-3p表达丰度为(0.873±0.044),与non-CV组(0.908±0.034)比较,差异有统计学意义(t=2.157,P=0.040);双萤光素酶报告实验结果显示,与miRNA-3177-3p作用后,ATP1B3-3’UTR区相较对照组活性降低15%(P<0.05);将ATP1B3-3’UTR区进行突变,ATP1B3-3’UTR区相较突变前活性上升14%(P<0.05);ELISA法证实表达产物ATP1β3在CV组脑脊液中(1.776±0.013)ng/mL高于non-CV组(1.722±0.016)ng/mL(t=7.778,P=0.000)。结论 CV患者脑脊液中miRNA-3177-3p表达下调,ATP1B3高表达可能参与了CV的发病过程,该机制可能在预测与治疗CV上具有一定临床意义。

自粘性弹性绷带在脑室外引流伤口包扎中的应用

目的观察自粘性弹性绷带在脑室外引流伤口包扎中的应用效果。方法将2020年4月—2022年6月63例行脑室外引流术的脑出血患者纳入本研究,按照随机数字表法将其分为观察组和对照组。对照组30例采用普通绷带包扎伤口,观察组33例采用自粘性弹性绷带包扎伤口,观察2组患者脑脊液漏发生率、引流管折叠率、换药总费用及换药协助率。结果对照组脑脊液漏4例(13.3%),引流管道发生折叠6例(20.0%),换药需要协助27例(90.0%)。观察组引流导管发生折叠1例(3.0%),换药需要协助10例(30.3%)。观察组的换药总费用为(197.63±28.58)元人民币,少于对照组的(280.93±24.01)元人民币,差异有统计学意义(P<0.05)。结论采用自粘性弹性绷带对脑室外引流术后患者进行伤口包扎,能降低脑脊液漏发生率、引流管折叠率、换药协助率和换药总费用,为脑室外引流术伤口包扎绷带的选用提供临床依据。

血清IL-1β、MMP-9与急性脑梗死患者血-脑脊液屏障损伤的相关性

目的探讨血清白细胞介素-1β(IL-1β)、基质金属蛋白酶-9(MMP-9)与急性脑梗死(ACI)患者血-脑脊液屏障(BCFB)损伤的相关性。方法选取2020年1月至2021年6月宜宾市中医医院收治的98例ACI患者,根据脑脊液和血清白蛋白商值(QAlb)评估BCFB损伤情况,检测血清IL-1β、MMP-9水平,分析血清IL-1β、MMP-9表达与BCFB功能状况的关系。结果98例ACI患者发生BCFB损伤71例,损伤率为72.45%。BCFB损伤患者NIHSS评分、梗死体积以及血清IL-1β、MMP-9水平高于未损伤患者(P<0.05)。Logistic回归显示,NIHSS评分高、梗死体积大以及血清IL-1β、MMP-9高表达是ACI患者发生BCFB损伤的危险因素(P<0.05)。随着损伤程度的加重,血清IL-1β、MMP-9水平呈显著升高趋势(P<0.05)。ACI患者血清IL-1β、MMP-9水平与QAlb值呈显著正相关(P<0.05)。结论血清IL-1β、MMP-9水平与ACI患者BCFB损伤及损伤程度密切相关。