目的 总结4例神经梅毒患者的临床特点,了解神经梅毒的发病机制、实验室检测及诊断标准.方法 回顾性分析2018年8月至2019年12月青岛市市立医院神经内科收治的4例神经梅毒患者的临床特征及实验室检查,并进行文献复习.结果 4例神经梅毒患者中,男性2例,女性2例,年龄45～64岁.3例患者为麻痹性痴呆,1例为脊膜脊髓型神经梅毒.4例患者血清及脑脊液梅毒螺旋体明胶凝集试验阳性,4例患者血清甲苯胺红不加热血清试验阳性,3例患者脑脊液甲苯胺红不加热血清试验阳性.3例患者脑脊液白细胞计数和蛋白含量均升高,1例患者仅脑脊液蛋白含量升高.4例患者糖化血红蛋白均高于5.7％.3例患者颅脑MRI可见异常改变,主要表现为脑萎缩,双侧半卵圆中心多发缺血灶,1例可见新发脑梗死灶,1例显示双侧额叶、左侧岛叶、左侧颞叶异常信号;1例颅脑MRI未见异常改变,但脊髓内(颈5/6)可见异常信号,增强扫描病灶无强化.经青霉素治疗,1例完全恢复,另3例症状有好转.结论 神经梅毒临床表现复杂多样,早期识别、早期诊断尤为重要.合并高糖化血红蛋白的梅毒患者更易转化为神经梅毒,因此要注意梅毒患者的血糖控制.

Objective To discuss clinical and neuroimaging changes of posterior reversible encephalopathy syndrome. Method Analyze the clinical data of 21 pateints with PRES. Result Clinical manifestation is headache, epilepsy, visual disorder, consciousness and mental changes. Risk factors:13 cases with eclampsia and preeclampsia; 5 cases with hypertensive encephalopathy; 2 cases with uremia; 1 case with postoperation of pulmonary arteriovenous fistula. Brain MRI shows vasogenic edema especially in the posterior white matter of the brain.It's not uncommon of the variant which frontal lobe, basal nuclei, pons or cerebellum are affected. Besides vasogenic edema, it may accompany with ischemic and hemorrhagic lesions. Conclusion The causes of PRES are variant. Brain MRI shows vasogenic edema especially in the posterior white matter of the brain, prognosis is relatively well if it can be identified and treated early.

>早期准确识别具有高卒中风险的短暂性脑缺血发作(TIA)患者, 对于卒中的预防、预后的改善极为重要[1]。Rothwell等[2]基于临床资料提出ABCD评分用于筛查具有高卒中风险的TIA患者, 根据评分高低对TIA患者进行分层管理, 最初的ABCD评分包括4项指标, 即TIA患者的年龄(age)、血压(blood)、临床特征(clinical features)和持续时间(duration);此后

目的：探讨脑静脉血栓形成的有效诊治方法。方法根据临床表现及颅脑影像学检查诊断脑静脉血栓形成患者17例，3例采用低分子肝素皮下注射溶栓，14例持续静脉泵入普通肝素，据APTT值调整普通肝素剂量，常规使用2～3周。肝素静脉泵入不能阻止病情进展者采取介入溶栓，肝素及介入溶栓后给予华法令口服抗凝治疗。结果17例肝素治疗2～3周，14例脑静脉窦血栓再通，2例足量普通肝素静脉泵入效果不佳采取介入溶栓再通，1例合并血液病治疗效果不佳。随访半年，12例预后好，生活自理；3例留有残疾，不能行走及言语；1例死亡；1例失访。结论颅脑MRI联合MRV是诊断脑静脉血栓的可靠手段，应用肝素抗凝治疗脑静脉血栓安全有效。

BACKGROUND:Both in vivo and vitro microenvironment can influence the proliferation and differentiation of neural stem cells (NSCs). In addition, cell culture solution plays variable roles in cell proliferation and differentiation.OBJECTIVE:To develop a convenient and rapid method to promote NSC primary culture by modifying traditional serum-free medium. DESIGN, TIME AND SETTING:Randomized controlled cell trial was performed at Institute of Brain Science, Qingdao University Medical School from November 2005 to September 2006.MATERIALS:Ten Wistar rat of gestation for 12-16 days; cell suspension fron brain tissue of embryonic rat. METHODS:Cell suspension were seeded into four 50-mL culture flasks with cell density of 1×106 mL-1, and divided into 2 groups with 2 flasks in each group. The control cells (flasks A and B) were cultured in serum-free medium containing DMEM/F12, B27 (2%), basic fibroblast growth factor (20 μg/L), and epidermal growth factor (20μg/L), and the experimental cells (flasks C and D) were firstly cultured with DMEM/F12 containing fetal bovine serum (FBS, 5%), following by the same serum-free medium 2 to 3 days later. MAIN OUTCOME MEASURES:The proliferation of NSCs was observed by inverted microscopy and immunocytochemistry.RESULTS:①Most of the cells in two culture conditions expressed nestin, the specific marker of NSCs, and were immunocytochemically positive. ②Neural stem cells cultured with FBS formed neurospheres 3-4 days earlier than those without FBS. ③There were no significant differences in cell number, but the neurospheres under the experimental condition were larger than those in control group. Some of the cells were neurone specific enolase-positive after serum-conditioned induction, and some were glial fibrillary acidic protein-positive, indicating NSCs had differentiated into neuron-like cells and neurogliocytes.CONCLUSION:FBS-conditioned pre-culture can accelerate the proliferation of neural stem cells.

对脑梗死患者应用颈部彩色多普勒超声检测颈部血管斑块形成情况,并同期检测患者血浆纤维蛋白原和尿酸水平。结果不稳定斑块组患者的纤维蛋白原和尿酸水平显著高于无斑块组和稳定斑块组(P<0.05,<0.01)。并且随着纤维蛋白原水平和尿酸水平升高,颈动脉不稳定斑块的发生率升高。认为颈动脉斑块的发生及其稳定性与血浆纤维蛋白原和尿酸水平有着密切的关系。

检测3个月胎龄人胎脑各个解剖部分神经巢蛋白(Nestin)的表达,分离神经干细胞进行培养,诱导其分化,利用免疫荧光细胞化学技术对培养的神经干细胞及分化细胞进行鉴定。结果在人胎脑室管膜下区、海马、纹状体、丘脑、嗅球、皮层部位发现数量不等的Nestin阳性表达细胞,从海马和皮层组织分离培养得到的大量悬浮生长具有连续增殖能力的神经干细胞球,能够传代培养,表达神经干细胞的标志物Nestin,经诱导分化为神经元和胶质细胞。

分别以DMEM/F12、2%B27、20 ng/ml的碱性成纤维细胞生长因子、20 ng/ml的表皮生长因子无血清培养液和5%胎牛血清培养液预先培养大鼠神经干细胞(NSCs)2~3 d后,换为无血清培养液;应用倒置显微镜和免疫细胞化学法对其进行观察和比较。结果用含胎牛血清培养液培养的NSCs聚球速度较无血清培养液明显加快,可提前3~4 d观察到NSCs球。细胞染色证实细胞系巢蛋白阳性,经血清培养液诱导分化后部分呈抗神经元特异性烯醇化酶(NSE)阳性,部分呈抗胶质纤维酸性蛋白阳性,表明可分化为神经元和胶质细胞。认为含血清培养液预先培养可以加快细胞培养速度,是获得NSCs的经济有效方法。

ObjectiveTo observe the presence or absence of nestin cells in different parts of human fetal brain.Me-(thodsThree) normal embryos of three-month old were collected from voluntary induced labor.The cells from hippocampus,striatum,ependyma,thalamus,olfactory bulb,cortex,brain stem and cerebellum of the brain were studied using HE staining and immunocytochemistry.ResultsDifferent amounts of positive nestin cells were detected in the hippocampus,striatum,subependymal region,thalamus,olfactory bulb,cortex.Positive nestin cells were not detected in the brain stem and cerebellum.Conclusion Different amounts of positive nestin cells exist in the hippocampus,striatum,subependymal region,thalamus,olfactory bulb,and cortex of human fetal brain.