Silver nanoparticles (Ag NPs) are highly sought-after metal nanoparticles globally due to their distinctive electronic and optical characteristics, as well as their biological properties. These attributes stem from the synchronized movements of conduction electrons, referred to as surface plasmon resonance. Currently, numerous bio-medical characteristics of biosynthesized Ag nanoparticles have been thoroughly documented, including their anti-inflammatory, antioxidant, anticancer, and antimicrobial properties. Nevertheless, there have been no reports regarding the neuroprotective efficacy of these nanoparticles against cytotoxic agents. It appears that the defensive capabilities of the NPs formulated by green methods have been disregarded thus far. We recently did research to assess the neuroprotective effects of a combination of Tribulus terrestris and green-mediated silver nanoparticles on a contusive spinal cord injury model in animals. The silver nanoparticles underwent comprehensive characterization through UV-Vis, FE-SEM, FT-IR, and TEM analyses. In the in vivo phase of the research, a total of forty rats were categorized into three groups: untreated, normal, and silver nanoparticles (50 mu g/kg) groups. The post-injury lesions were analyzed using H&E staining. To evaluate the restoration of neural conduction, somatosensory evoked potential testing was conducted. The presence of astrogliosis was determined by evaluating the expression of GFAP. The rats' behavioral outcomes were assessed using the BBB score every week. The utilization of silver nanoparticles demonstrated neuroprotective properties and resulted in enhancements in spinal cord injury. The results of the sensory assessments indicated a notable rise in the Basso, Beattie, and Bresnahan scales, along with a marked decline in delayed reactions, among the subjects who received treatment with silver nanoparticles. The most substantial decrease in GFAP levels was noted in the group that was administered silver nanoparticles. Furthermore, there was a substantial decrease in the size of the cavity regions, while the quantity of ventral motor neurons experienced a significant rise within the silver nanoparticles group. The electromyography (EMG) results demonstrated a remarkable enhancement in the hindlimbs of the subjects who received treatment with silver nanoparticles (50 mu g/kg).

目的 研究轻型颅脑爆炸冲击伤后大鼠不同时间脑组织星形胶质细胞、小胶质细胞和神经元损伤反应的病理改变和过程.同时探讨富含鱼油饮食对轻型颅脑爆炸冲击伤大鼠的神经保护作用.方法 收集54只刚断乳SD大鼠,随机均分为对照组、模型组、治疗组,模型组及治疗组大鼠分别在喂养普通饲料和富含鱼油的饲料33 d后建立由冲击波诱导的轻型颅脑爆炸冲击损伤模型,对照组大鼠在喂养普通饲料33 d后不建立爆炸冲击波损伤模型.结果 与对照组相比,模型组和治疗组的大鼠体质量在致伤后出现一定程度的减轻,随后恢复至致伤前水平;轻型爆炸伤后6 h、24 h、3 d,模型组和治疗组大鼠大脑海马区GFAP阳性染色星形胶质细胞数量及海马区锥体细胞数量均减少.反之,模型组和治疗组大鼠脑组织中海马区的激活态小胶质细胞和皮层区域凋亡神经元数量均增加,且具有时间依赖性.此外,与模型组相比,治疗组可增加伤后星形胶质细胞和海马区锥体细胞数量,并降低激活态小胶质细胞和皮层区域凋亡神经元数量.结论 富含鱼油饮食可通过减轻颅脑爆炸伤后神经细胞损伤,抑制神经炎性反应等方面发挥其神经保护作用.

目的 探讨桥小脑角区肿瘤患者术中及术后的眼部护理措施.方法 选取2014年3月至2020年3月战略支援部队特色医学中心收治的122例桥小脑角区肿瘤患者为研究对象,采用随机数字表法分为对照组和试验组,每组各61例.对照组术中应用3M贴膜封闭眼睑,试验组在术中应用3M贴膜封闭眼睑的基础上加用红霉素眼膏,比较分析对照组和试验组患者术后即刻的眼部并发症发病率.将术后出现面瘫症状的45例患者按照护理方法不同分为遮盖组(23例)和联合组(22例),遮盖组在夜间使用3M贴膜将闭合不严的上下眼睑封闭,外用小块纱布遮挡眼部,联合组在遮盖组的基础上加用红霉素眼膏.比较分析遮盖组和联合组患者术后7d的眼部并发症发病率.结果 试验组患者未发生眼部并发症,对照组患者有2例发生结膜炎,试验组患者和对照组患者术后眼部并发症发生率比较差异无显著性(P>0.05).遮盖组中有1例患者同时并发结膜炎和角膜炎,联合组患者眼部并发症发生率显著低于遮盖组(P<0.05).结论 桥小脑角区肿瘤患者术中应做好眼部闭合护理,而对术后面瘫患者预防性使用药物亦有利于减少其眼部并发症的发生.

目的探讨前外侧腹膜后入路切除椎管内外沟通性巨大哑铃型肿瘤的诊疗经验.方法回顾性分析采用前外侧腹膜后入路一期手术切除的1例腰椎管巨大哑铃型肿瘤的临床资料.先由骨科医生根据C型臂透视定位,从左侧12肋后部向脐行倒八字切口手术,显露肿瘤的椎管外部分并切除;然后,由神经外科医生在显微镜下将椎管内肿瘤切除.结果术后MRI检查示肿瘤完全切除.术后病理证实为神经鞘瘤.术后3个月随访,恢复良好,术前症状完全消失;复查MRI示椎管内无强化影像.结论多学科联合,前外侧腹膜后入路一期手术切除腰椎椎管内外沟通性巨大哑铃型良性肿瘤,可取得较好的效果.

目的 探讨脊柱侧弯伴发脊髓拴系综合征患者行脊髓拴系松解手术的治疗要点和临床疗效.方法 回顾性分析2000年4月至2018年12月收治的282例脊柱侧弯伴发脊髓拴系综合征患者的临床资料,并对其临床表现、术前诊断和手术要点进行探讨,根据Hoffman功能分级、Kirollos松解分级、神经电生理结果评估手术疗效.结果 280例患者在显微镜辅助下行终丝切断术联合拴系松解术,均取得良好效果,未发生脊髓及神经严重损伤等并发症.187例患者随访12～36个月,中位随访时间17.6个月,患者临床症状和神经功能均有不同程度的改善和好转.结论 终丝切断及粘连松解术是治疗脊髓拴系综合征的唯一手段,对于生长发育期的青少年和行脊柱矫形术会使脊柱纵向延长的患者尤为重要,可为下一步脊柱侧弯矫形手术打下良好基础.术前腰骶椎CT三维重建、MRI检查、术中神经电生理监测的使用可以提供有价值的诊断信息并提高手术的安全性.

Objective To observe the outcomes of seizure control by three different surgical approaches,hippocampal transection,anterior temporal lobectomy and selective amygdalo-hippocampectomy,for the treatment of intractable medial temporal epilepsy,and explore their influences in the impairments of cognitive and memorial functions.Methods Twenty-nine patients with intractable medial temporal epilepsy,admitted to our hospital from January 2012 to October 2015,were chosen in our study;8 patients accepted hippocampal transection,10 accepted anterior temporal lobectomy and 11 accepted selective amygdalo-hippocampectomy.Seizure controls after treatment with these 3 approaches were compared and results of neuropsychological examinations (verbal intelligence quotient [VIQ],performance intelligence quotient [PIQ],full intelligence quotient [FIQ] and memory quotient [MQ]) were compared before and after operation.Results The effective rates of seizure controls were all higher than 80％ and seizure free rate was about 60％ in the 3 groups;Engel grading showed no significant differences among the three groups (P＞0.05).Results of all the neuropsychological examinations in the hippocampal transection group before and after operation had no significant differences (P＞0.05);however,all results in the anterior temporal lobectomy group after operation were significantly declined as compared with those before operation (P＜0.05);and PIQ,FIQ and MQ scores in the selective amygdalo-hippocampectomy group after operation were significantly lower as compared with those before operation (P＜0.05).Conclusions Hippocampal transection will not cause significant damage in intelligence and memory functions.As compared with both anterior temporal lobectomy and selective amygdalo-hippocampectomy,hippocampal transection can have good seizure control and preserve memory function.

Objective To investigate the effect of blocking hairy and enhancer of split 1 (Hes1) on gamma aminobutyric acid (GABA) neurons' differentiation in human neural stem cells.Methods The human neural stem cells were cultured for 10 days and identified by nestin immunofluorescence stain,then using the human neural stem cells to differentiate GABA neurons.The design project of experiment was adopted completely random.The control cultured medium were the common differentiated medium added 10％ bovine serum albumin.And the experimental cultured mediums were identical with the control excepted for the anti-Hes1.Anti-GABA immunofluorescence stain was carried out when most of the cells were differentiated.Results A lot of 150-200 μm diameter neurosphere which were identified when cultured for 10 days.The second generation of neurospheres were using for GABA neurons differentiation.At the sixth day,more than half of cells were differentiated and begin to concentrate.Digested and inoculated again,then 90％-95％ cells were adherent and differentiated at day 14.Anti-GABA immuno-fluorescence stain showed that 55-70 positive cells were be found in 100 cells in every visual field,the rate was (64.0 ± 0.6)％ in anti-Hes1 differentiated group and in the same condition the positive cells were only 15-20 positive cells,the rat was (16.6 ± 0.6)％ in control group,there are significant difference between the two groups.Conclusion blocking Hes1 can significant increase the differentiation rate of GABA neurons in human neural stem cells.

背景:对胎儿、胎鼠及成鼠神经干细胞培养已有大量研究,但成体人自体神经干细胞培养相关研究较少。目的:通过改进原代培养方法,从颅内动脉瘤破裂脑出血患者血肿腔周边废弃脑组织中培养和鉴定神经干细胞,并进行冻存与复苏研究,建立成人自体神经干细胞库。方法:收集3例动脉瘤破裂脑出血（2例大脑中动脉瘤及1例前交通动脉瘤）手术中血肿腔周边的废弃脑组织各约500 mg以上,采用细小组织块接种法进行原代无血清悬浮培养成人自体神经干细胞,倒置显微镜下观察细胞生长情况,免疫荧光细胞化学技术检测神经干细胞标志物巢蛋白（Nestin）的表达。培养获得的神经干细胞球以体积分数4%胎牛血清诱导其贴壁生长,待细胞增殖达到一定数量后传代培养。传代后部分细胞予以冻存建库,并复苏继续传代及诱导分化培养。体积分数10%胎牛血清诱导神经干细胞分化,通过免疫荧光细胞化学技术检测胶质纤维酸性蛋白（标记星形胶质样细胞）,β-tubulinⅢ（标记神经元样细胞）,SOX10（标记少突胶质样细胞）蛋白的表达来测定神经干细胞的分化能力。结果与结论:改进培养方法后,3例患者废弃脑组织中,在无血清培养液中均可形成Nestin阳性表达的神经球,并可在体外大量扩增和连续传代。在给予体积分数10%FBS条件下神经球可分化为神经元样细胞、少突胶质细胞及星形胶质细胞,即β-tubulin Ⅲ,SOX10及胶质纤维酸性蛋白阳性表达。经传代培养至5代后,仍呈Nestin阳性即可维持其神经干细胞特征。冻存细胞复苏后生长状态良好且呈Nestin阳性,可继续传代扩增。结果表明,从动脉瘤破裂脑出血患者不同脑区（颞极及额底）血肿腔周边废弃脑组织中可成功培养获得自体神经干细胞,并可向神经元样细胞、少突胶质样细胞及星形胶质样细胞分化,使自体神经干细胞移植促进神经功能修复从实验室到临床应用成为可能。

Objective To observe the seizure control and the effect on cognitive and memory function of hippocampal transection in intractable medial temporal epilepsy patients.Methods Eight cases of hippocampal transection and 10 cases of anterior temporal lobectomy were selected in which were all performed by the same operator.All the patients' basic information(including age,gender,seizure time and so on),preoperative examination(head magnetic resonance imaging,video electroencephalogram),seizure control and neuropsychological examinations (including VIQ:verbal intelligence quotient,PIQ:performance intelligence quotient,FIQ:full intelligence quotient and memory quotient) before and after the operation were collected and analyzed.Results The basic information and preoperative examinations have no significant difference in two groups.The seizure control were all high than 80％ in two groups and there is also no significant difference.All the neuropsychological examinations' scores before operation have no significant difference compared with the that of two weeks after operation in the hippocampal transection group (P＞0.05).However,in the anterior temporal lobectomy group,all scores were significantly declined (P＜0.05).According to the span D-value of the scores before and after operation,the decline of MQ was found with significant difference in two groups (P＜0.05).Conclusion In the meanwhile of seizure control,hippocampal transection will not cause significant damage of intelligence and memory function.Compared with anterior temporal lobectomy,th-e memory function can be preserved well after hippocampal transection.So it is a good surgical approach for intractable medial temporal epilepsy.

Objective To compare the surgical outcome and its influences on cognition and memory of hippocampal transection and selective amygdalohippocampectomy for intractable medial temporal lobe epilepsy. Methods Clinical data of 19 patients with intractable medial temporal lobe epilepsy were analyzed retrospectively, including 8 patients receiving hippocampal transection (observation group) and 11 receiving selective amygdalohippocampectomy (control group). The seizure control rate after surgery and neuropsychological examinations before and after surgery were analyzed and compared. Results There was no significant difference in seizure control rates between two groups (P>0.05). There was no significant difference in performance intelligence quotient (PIQ), verbal intelligence quotient (VIQ), full intelligence quotient (FIQ) and memory quotient (MQ) before and after surgery in observation group (P>0.05). The PIQ, FIQ and MQ after surgery in control group were obviously lower than those before surgery (P<0.05). There was significant difference in MQ differentials before and after surgery between the two groups (P<0.05). Conclusion Hippocampal transection can effectively control seizure, make little damage to the function of neuropsychology and especially can well preserve the memory function.

目的 探讨金刚烷胺对双侧轻型颅脑损伤后神经细胞的保护作用,并对不同剂量金刚烷胺进行药效学分析.方法 建立大鼠液压脑损伤模型,56只大鼠随机分为4组,分别于伤后每8h一次,连续16 d给予三组剂量(15 mg/kg、45 mg/kg或135 mg/kg)金刚烷胺或等渗盐水,首次给药于伤后1h完成.脑组织于伤后第48小时或16天提取行Fluoro Jade-B组织荧光染色或甲酚紫染色比较双侧海马CA3区神经细胞存活情况,液相色谱-质谱/质谱(LS-MS/MS)方法测定大鼠体内不同剂量金刚烷胺血药浓度,研究金刚烷胺经腹腔单次给药后在大鼠体内的药代动力学过程.结果 45 mg/kg或135 mg/kg两组治疗剂量在大鼠体内血药浓度与临床治疗监测浓度(717 ng/ml)相似.与安慰剂组相比,45或135 mg/kg两组剂量金刚烷胺可明显减少伤后48 h脑组织急性变性神经元数量(P＜0.05),高剂量组(135 mg/kg) CA3区长期存活神经细胞数量显著增加(P=0.032).结论 治疗剂量金刚烷胺可显著减轻脑损伤后海马结构CA3区神经细胞损伤程度,为临床治疗轻型颅脑损伤提供新的治疗手段.

<正>自发性脑出血是指没有明显外因情况下的脑内出血,是中老年常见的疾病,多由高血压引起,其病死率和致残率较高。传统治疗方法为开颅手术,开颅手术创伤大,费用高,微创颅内血肿清除术采用YL-1型颅内血肿粉碎穿刺针进行颅内血肿清除,取得较好的临床疗效。我院从2006年1月开始采用YL-1颅内血肿粉碎穿刺针治疗自发性脑出血117例,临床疗效较好,报告如下。1资料与方法

BACKGROUND/AIMS:The coexistence of scoliosis and split cord malformation (SCM) is often encountered. The characteristics of the osseous septum of SCM are still unknown to us. Here we try to delineate the configuration and nature of the osseous septa. The correlation between scoliosis and SCM is also discussed.METHODS:48 patients hospitalized for scoliosis were studied. SCM was subsequently identified in all of the patients. These patients underwent operations and were retrospectively evaluated.RESULTS:The figuration, component, location and nature of osseous septa are described. 47 of the 48 SCMs (98%) were type I. Only 1 case was type II. 43 patients (90%) had 1 osseous septum. The other 5 patients (10%) had 2 osseous septa at different levels. 41 septa (78%) were mainly made of cortical bone, another 6 septa (11%) were mainly made of cancellous bone, while the other 6 (11%) were bone together with soft tissues. The prominent central blood vessels were found in 19 cases (36%). 10 osseous septa (19%) were derived from neural arches. 15 osseous septa (28%) were from both vertebral bodies and neural arches.CONCLUSION:We assumed that SCM might contribute to the progress of scoliosis. It is recommended that removal of the spur be carried out before corrective surgery on the spine.