Objective:To investigate the effect of acupuncture on brain derived neurotrophic factor (BDNF) expression and receptor tyrosine kinase B (TrkB) activity after moderate traumatic brain injury (TBI).Methods:Forty-two adult SD male rats were randomly divided into TBI group (21 rats) and TBI+acupuncture group (21 rats) according to random number table method. The moderate TBI model was established by fluid percussion instrument in both groups. The TBI group was only modeled, and the TBI+acupuncture group was given acupuncture treatment after the TBI model was established. Tissue homogenates and sections were harvested 21 d after moderate TBI. The level of BDNF was examined by ELISA. Immunofluorescence staining was used to detect the expression level of TrkB protein at 6 and 12 h after moderate TBI, Western blot was used to detect the expression levels of TrkB protein at 48, 96, and 168 h after moderate TBI, and the expression of protein kinase B (Akt) and extracellular regulated protein kinase 1/2 (ERK1/2) at 12 and 48 h.Results:The expression level of BDNF protein in two groups of rats reached its peak at 12 h after moderate TBI and gradually decreased at 48 h. The BDNF protein levels in the TBI+acupuncture group were higher than those in the TBI group at 6, 48, 96, 168 h after TBI, with statistical significance (P<0.05), there was no statistically significant difference in BDNF protein levels at 12 h (P>0.05). The levels of p-TrkB protein in the TBI+acupuncture group were higher than those in the TBI group at 6, 12, 48, 96, 168 h, while p-Akt and p-Erk1/2 protein levels were higher than those in the TBI group at 12, 48 h, with statistical significance (P<0.05).Conclusion:Acupuncture therapy can upregulate the expression level of BDNF protein after moderate TBI, and activate TrkB protein by phosphorylation, ultimately activating its downstream signaling pathway.

目的 评估弥散张量成像(diffusion tensor imaging,DTI)在慢性意识障碍(disturbance of consciousness,DOC)患者预后研究中的应用价值.方法 以2016年1月—2019年1月于中国人民武装警察部队特色医学中心(以下称本院)神经外科就医的26名患者为研究对象,主要结局指标为随访1年后患者意识状态的结局及CRS-R评分.将基于束的空间统计与感兴趣区域分析相结合,并应用主成分分析、多重Logistic回归和多重线性回归进行分析.结果 基线时26例患者符合纳入标准,1年后随访时有8例患者意识状态好转,失访1例,好转率为32％.DTI参数与患者预后结局(OR=0.09,OR95％CI:0.000～0.0.548,P=0.024)和CRS-R评分变化(β=-3.246,β95％CI:-5.064～-1.428,P=0.001)均有关.预测模型的敏感度为92.9％,特异度为77.8％,曲线下面积(AUC)为0.903(95％CI:0.785～0.968,Z=9.646,P<0.001),约登指数为0.706(95％CI:0.441～0.806).结论 DTI在慢性DOC患者的预后评估中具有较高的应用价值.

脑卒中是神经内科伴严重神经功能障碍的常见疾病之一,目前认为其发病机制是遗传和环境等多因素相互作用的结果.而载脂蛋白E(ApoE)有调节脂类代谢的作用,可降低动脉粥样硬化的发生率,且ApoE基因与脑卒中的发生密切相关,ApoE在体内有重要的生物学功能,其基因多态性会引起ApoE结构与功能发生改变.目前国内外对于ApoE基因多态性与缺血性脑卒中(IS)相关性的研究结论并不统一.此外,对于ApoE基因多态性与IS相关性的内部机制研究仍未完全明确,联合应用基因组学与蛋白质组学技术或许可为阐释ApoE基因多态性与IS关联的分子生物学机制提供支持.现从ApoE的生物学特性及功能、ApoE基因多态性与脂质代谢和动脉粥样硬化、ApoE基因多态性与IS、ApoE与缺血后血管神经修复方面进行综述,从而为IS的治疗提供更为科学、合理的方案.

颅脑创伤是人类致残、致死的主要原因之一.由于受伤机制和脑组织的复杂性,颅脑创伤可诱发广泛的病理生理学改变.代谢组学可提供颅脑创伤患者单一时间点生理、生化状态的"瞬时快照".目前,高通量、高灵敏度的代谢组学分析工具能够检测和定量小浓度的代谢物,使客观化、精细化评估颅脑创伤成为可能.本文就代谢组学的概况及其在颅脑创伤诊疗、预后评估等方面的研究进展做一综述.