目的 探讨脑脉利颗粒治疗急性前循环缺血性卒中的有效性及安全性.方法 2015年5月-2018年3月前瞻性入组13家研究中心神经内科收治的前循环急性缺血性卒中患者,随机分为治疗组和对照组,对照组给予常规药物治疗并加用脑脉利颗粒模拟剂治疗20?d,治疗组在常规药物治疗的基础上加用脑脉利颗粒(每次10?g,每天3次)口服,治疗20?d.治疗后30?d、60?d和90?d随访评估患者的NIHSS和Barthel指数(Barthel index,BI)评分,90?d随访评估mRS,以mRS≤2分为功能独立.比较两组上述治疗指标的差异,并比较两组90?d急性心脑血管事件(包括心肌梗死、缺血性卒中、TIA)和不良反应的发生率.结果 研究共入组190例患者,排除脱落患者,共187例纳入最终统计分析,其中治疗组93例,对照组94例.治疗组90?d NIHSS评分低于对照组(2.54±2.16分vs?3.84±3.08分,P=0.006),60?d(86.08±17.24分vs?82.61±16.91分,P=0.031)及90?d BI评分(89.62±13.50分vs?83.78±17.08分,P=0.004)高于对照组;90?d治疗组和对照组分别有50例和42例完成mRS评分,治疗组功能独立率高于对照组(70.00％?vs?45.24％,P=0.016).研究期间,两组不良反应发生率及急性心脑血管事件发生率差异均无统计学意义.结论 在常规药物治疗基础上加用脑脉利颗粒能有效减轻急性缺血性卒中患者的神经功能缺损与残障,改善日常生活能力,且治疗安全性良好.

Background : It is of vital importance for the treatment and prognosis of Acute Stroke to find effective Chinese medicine that can be combined with western medicine in the acute stage. The purpose of this study is to investigate the effect and safety of Naomaili Granules (脑脉利颗粒, NML) for the treatment of acute stroke, hoping to provide a new idea and drug choice for the integrated treatment of Chinese and Western medicine in the acute stage of ischemic stroke, and at the same time to improve the treatment plan in the acute stage of ischemic stroke from the perspective of TCM syndromes. Methods : A total of 187 patients with acute ischemic stroke were randomly divided into the NML group (93 cases) and the placebo group (94 NML mimics), 1 bag (10g/bag), thrice daily for 20 days. Basic medications during the trial: Aspirin enteric-coated tablets, 1 tablet (0.1g/tablet), once a day. After treatment, the modified Rankin scale, the incidence of cardiovascular events and TCM Syndrome effect were the main efficacy indicators. Meanwhile, adverse events (AEs) were evaluated during the whole clinical trial. Results : In the FAS 90 days after the onset, the experimental group was 70.00%, and the control group was 45.24%. There was a statistically significant difference between the two groups. The incidence of acute cardio-cerebrovascular events was 1 case (1.08%) in the experimental group and 0 in the control group after 20 days of FAS treatment. Conclusion : The combined application of NML in the acute stage of ischemic stroke can effectively improve the prognosis of patients, and improve the independent survival ability of patients, and its safety is reliable, providing a new way of thinking and medication choice for the treatment of acute ischemic stroke with integrated traditional Chinese and western medicine. Trial registration: ChiCTR, ChiCTR2000033619. Registered 7 June 2020 - Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=54619

Recent genome-wide association studies (GWAS) reported CR1 rs3818361 polymorphism to be an Alzheimer’s disease (AD) susceptibility variant in European ancestry. Three independent studies investigated this association in Chinese population. However, these studies reported weak or no significant association. Here, we reinvestigated the association using all the samples from three independent studies in Chinese population (N = 4047, 1244 AD cases and 2803 controls). We also selected three independent studies in European ancestry population (N = 11787, 3939 AD cases and 7848 controls) to evaluate the effect of rs3818361 polymorphism on AD risk in different ethnic backgrounds. In Chinese population, we did not identified significant heterogeneity using additive, recessive, and dominant genetic models. Meta-analysis showed significant association between rs3818361 and AD with P = 6.00E-03 and P = 5.00E-03. We further identified no heterogeneity of rs3818361 polymorphism between Chinese and European populations. We found that rs3818361 polymorphism contributed to AD with similar genetic risk in Chinese and European populations. In summary, this is the first study to show significant association between rs3818361 polymorphism and AD in Chinese population by a meta-analysis method. Our findings indicate that the effect of CR1 rs3818361 polymorphism on AD risk in Chinese cohorts is consistent with the increased risk observed in European AD cohorts.

Background Posterior cortical atrophy (PCA) is a kind of progressive neurodegenerative disease with cortical visual impairment as the first symptom. Because of rare clinical incidence, early onset age, special clinical symptoms and unobvious MRI abnormality, the definitive diagnosis of PCA is difficult. This study used 18F-fluoro-2-deoxy-D-glucose (18F-FDG) PET and 11C-Pittsburgh compound B (11C-PIB) PET for PCA patients with unobvious MRI abnormality, so as to discuss the value of PET in the early diagnosis of PCA. Methods Five patients diagnosed as PCA in our hospital between April 2012 and March 2015 were enrolled in this study. Cognitive function was measured by Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Activities of Daily Living (ADL) and Clock Drawing Test (CDT). Brain MRI, 18F-FDG PET and 11C-PIB PET were performed to analyze glucose metabolism and perfusion of posterior cortex. Results Neuropsychological tests revealed that the ability of writing, calculating, visuospatial and executive function of all these patients were impaired. Color vision tests showed abnormal results. MRI showed that the posterior atrophy (PA) scores were 0-2 (average 1) on the left side and 0-1 (average 0.80) on the right side. The medial temporal atrophy (MTA) scores were 1-3 (average 1.80) on the left side and 1-4 (average 2) on the right side. The ventricular enlargement (VE) scores were 1-2 (average 1.80) on the left side and 1-2 (average 1.60) on the right side. 18F-FDG PET showed glucose metabolism decreased obviously on bilateral temporo-parieto-occipital cortex, precuneus and cingulate gyrus, and slightly on frontal lobes and subcortical structure. 11C-PIB PET showed radioactive 11C-PIB deposition on bilateral frontal, temporal, parietal and occipital cortex, and the outline of cerebellar cortex was clear. Conclusions For PCA patients whose parietal and occipital cortical atrophy is not obvious on MRI, 18F-FDG PET combined with 11C-PIB PET plays an important role in early diagnosis. DOI: 10.3969/j.issn.1672-6731.2015.08.005

脑血管疾病的发病率日益增加，脑组织对氧和血供应的要求特别高，当脑血管闭塞致供应区缺血超过一定时限后，即发生脑梗死。近年来，对超急性脑梗死的病理生理研究已经进入细胞和分子水平，比较深入地阐明了缺血性脑损伤与抗损伤的机制，尤其是缺血性半暗带（ ischemic penumbra， IP）概念的提出，及磁共振成像技术的发展，对急性期脑梗死的检测显示出极大的优势，为临床及时治疗提供了直观个体化的影像学信息。本文就这些技术作如下简述。

The relationship between serum cystine protease inhibitors C, senile dementia and cerebral perfusion was discussed to provide certain instructions for the next clinical diagnosing work.60 patients were as the clinical objects which admitted in the period of March 2013 to February 2015 by the second hospital of Harbin. The results show that, there is an significant relationship between the age and the level of serum cystine protease inhibitors C(Cystatin C),volume of hippocampal, Evans index, MMSE rating, P<0.05.the practice has shown that by testing and analyzing Cystatin C in patients, more information of the recognizing function of patients can be acquired that are helpful for the clinical diagnosing.

目的：观察复智散对转基因阿尔茨海默病（AD）小鼠脑神经细胞内神经颗粒素（Ng）通路的影响，探讨复智散治疗AD的作用机制。方法将小鼠分为对照组、模型组、低剂量组、中剂量组、高剂量组和安理申组。连续灌胃21 d后，Morris水迷宫实验， Western印迹方法检测蛋白表达量。结果模型组潜伏期和电击时间明显长于对照组（P＜0．01）。中剂量组和安理申组的潜伏期明显短于模型组（P＜0．01）。与模型组相比，用药组Ng 蛋白表达量均有不同程度增高，安理申组、中剂量组变化最明显，与模型组相比差异显著（P＜0．05或P＜0．01），其中复智散中剂量组优于安理申组。结论 AD可能通过影响中枢重要脑区中以Ng为上游调控子的信号转导通路损害机体的学习记忆功能。复智散可通过提高 Ng通路蛋白表达而改善AD鼠的认知功能。

目的 探讨针对caspase-3基因的 RNA抑制对缺血再灌注(I/R)神经细胞凋亡的影响,为I/R神经细胞基因治疗的可行性提供依据.方法 NGF诱导PC12细胞为类神经细胞.细胞随机分为对照组、模型组、GFP siRNA组;caspase-3 siRNA组.于制作模型前24 h进行转染.于造模后对caspase-3及细胞凋亡率等指标进行检测.结果 (1)凋亡率:模型组细胞(48.30±12.15)明显高于对照组(5.00±1.08),差异有显著性(P<0.01);caspase-3 siRNA组(7.04±2.00)明显低于模型组(P<0.01).(2)Caspase-3阳性率:模型组模型组的caspase-3阳性率[(36.55±8.72)%]明显高于对照组[(10.25±2.50)%],差异有统计学意义(P<0.01);caspase-3 siRNA 组caspase-3阳性率[(12.25±3.25)%]明显低于模型组,差异有统计学意义(P<0.01).结论 针对caspase-3的siRNA能有效地抑制细胞凋亡.对缺血再灌注神经细胞损伤有一定的保护作用.

目的 探讨针对caspase-3基因的 RNA抑制对帕金森病细胞的抗凋亡作用.方法 NGF诱导PC12细胞为类神经细胞.细胞随机分为对照组、模型组、GFP siRNA组、caspase-3 siRNA组.对照组用完全培养液培养,其他3组细胞用6-羟基多巴胺制作帕金森病细胞模型.于制作模型前24 h进行转染.造模后对caspase-3及细胞凋亡率等指标进行检测.结果 (1)凋亡率:模型组细胞凋亡率[(65.36±10.10)%]明显高于对照组[(5.00±1.00)%],有显著性差异(P<0.01);caspase-3 siRNA组[(19.00±4.08)%]明显低于模型组(P<0.01).(2)caspase-3阳性率:模型组的caspase-3阳性率[(30.15±7.02)%]明显高于对照组[(8.20±2.45)%],差异有统计学意义(P<0.01);caspase-3 siRNA 组caspase-3阳性率[(12.00±2.90)%]明显低于模型组,差异有统计学意义(P<0.01).结论 针对caspase-3的 siRNA能有效地抑制帕金森病细胞凋亡,对6-羟基多巴胺毒性作用下的神经细胞损伤有一定的保护作用.

目的探讨Fas-RNAi对缺血再灌注(I/R)损伤后神经细胞凋亡的保护作用。方法细胞随机分四组对照组、模型组、GFPsiRNA组、FassiRNA组。对照组用完全培养液培养,其他三组细胞制作体外(I/R)模型,GFPsiRNA组、FassiRNA于转染24h后造模,造模后6h进行Caspase-3、Fas表达检测,24h进行细胞凋亡相关检测。结果(1)Fas、Caspase-3阳性率模型组模型组的Fas阳性率(37.25±8.37)%、caspase-3阳性率(28.79±6.23)%明显高于对照组(7.21±3.28,8.01±2.31)%,差异有统计学意义(P<0.01)。GFPsiRNA组Fas阳性率(14.35±7.31)%、caspase-3阳性率(16.33±4.15)%明显低于模型组,差异有统计学意义(P<0.01)。(2)凋亡率模型组细胞(39.13±10.63)明显高于对照组(2.85±0.43),差异有显著性(P<0.01)。FassiRNA组(1.70±0.31)明显低于模型组(P<0.01)。结论针对Fas的siRNA能有效地抑制I/R损伤后神经细胞凋亡。对神经细胞I/R损伤有一定的保护作用。

目的探讨Fas基因的RNA抑制对阿尔茨海默病(AD)的抗细胞凋亡作用。方法NGF诱导PC12细胞为类神经细胞。细胞随机分为对照组、模型组、GFP siRNA组;Fas siRNA组。对照组用完全培养液培养,其他三组细胞用Aβ25~35制作AD细胞模型。于制作模型前24 h进行转染。于造模后对Fas、Caspase-3及细胞凋亡率等指标进行检测。结果(1)模型组细胞凋亡率(49.33±18.93)明显高于对照组(4.05±0.67)(P<0.01),Fas siRNA组凋亡率(6.74±1.01)明显低于模型组(P<0.01)。(2)Fas、Caspase-3阳性率:模型组的Fas阳性率(41.65±9.67)、caspase-3阳性率(36.75±9.61)明显高于对照组(9.12±4.18,10.12±3.69)(P<0.01)。Fas siRNA组Fas阳性率(15.46±8.69)、caspase-3阳性率(19.13±6.75)明显低于模型组(P<0.01)。结论针对Fas的siRNA能有效地抑制AD细胞凋亡,对Aβ毒性作用下的神经细胞损伤有一定的保护作用。

Objective To investigate the statistical association between the G/C promoter polymorphism at(-174) of the IL-6 gene and transient ischemia attack(TIA) events,as well as the progress of cerebral infarction in(3 months.)Methods 121 TIA patients and 114 age-and sex-matched healthy control subjects were examined for the(-174) IL-6 G/C polymorphism by mutagenic separated polymerase chain reaction(MS-PCR).The progress of cerebral infarction in 3 months was recorded.Results In the patients with TIA,the pro-portion of genotype GG(54.6%)was significantly higher than that in the control group(38.6%)(P0.05),and also higher than those of GC(30.6%) and CC(14.9%)(P0.05).The incidence rate of cerebral infarction in 3 months had significant differences between GG patients(28/66,54.6%) and GC(6/37,16.2%),CC(3/18,16.7%)(P0.05).Conclusion The genotype GG of IL-6 promoter is associated with pathogenesis and prognosis of TIA.

Objective To investigate relationship between GHBA's protective effect on hypoxia-reoxygena-tion neuronal damage and GABA and GABA,\Ral positive neurons. Methods Make hypoxia-reoxygenation damage model on newborn rat cortical neurons, which were randomly devided into three groups intervention A group, intervention B group and non-intervention group. Every group had 24 hours' reoxygenation,observed at different time. Results (l)Survival neurons,GABA and GABAARal positive neurons in intervention groups were more than non-intervention group (P0. 05). (2)Survival neurons,GABA and GABAARal positive neurons in intervention A group were more than non-intervention group(P0. 05). Conclusion GHBA can protect hypoxia-reoxygenation neurons through upregulatmg GABA and GABAARal positive neurons.

Objective To investigate bFGF mRNA expression and of TNF protein expression after brain trauma in rats brain and providing the evidence of rehabilitation of neural function. Methods To set up brain trauma model by weight-dropping. Expression of bFGF and TNF were analyzed by Northernblot, Westernblot and optical density scanning. Results bFGF mRNA expression and TNF protein expression were peaked in the 3th day, and decreased on the 7th day detected. Conclusion TNF protein expression increased with corresponding enhancement of bFGF expression, a kind of protective factor in rats brain following brain trauma. Probably this is noe of the endogenous mechanisms for rehabilitation of neural function in the course of brain trauma.

目的:观察针刺促通术对脑血栓病人肢体功能的治疗效果.方法:病人随机分为治疗组与对照组,治疗组采用针刺促通术.对照组采用平补平泻法.从肌力、肌张力、神经功能缺损评价,Fugl-Meyer评价,Barthel记数记分,比较两组治疗前后疗效.结果:治疗前后肢体运动功能的改善很明显的,主要的治疗效果是改善了异常运动模式.结论:针刺促通术是在现代神经康复基础上形成的新理论及技术,对临床工作有指导意义.

目的:探讨溶栓合剂静脉治疗急性脑梗死的有效性与安全性.方法:自体血栓栓子法制作中动脉脑梗死动物模型,本组分为盐水对照组、尿激酶组与溶栓合剂组,分别通过神经功能评分、梗死体积、病理分级等方法进行比较.结果:溶栓合剂组动物神经功能恢复、梗死体积、病理分级等方面的评价明显优于另外两组.结论:溶栓合剂是一种相对安全有效的治疗方法,可用于急性脑梗死的治疗.

Objective To study the expression of platelet membrane glycoproteins (MG) CD62P in peripheral blood in patients with transient ischemic attack (TIA) and its clinical significance, and the effects of aspirin on platelet MG. Methods The CD62P expressions of 30 cases of TIA patients were measured with flow cytometry (FCM), including patients (9 cases) with progressing to infarction and non-progressing (21 cases). Whether taking aspirin orally or not, samples were divided into 2 groups (the former 12 cases, the latter 18 cases). And the results between groups and between the patients and healthy volunteers were compared. Results The expression of CD62P in healthy volunteers was lower, the positive rate was (30.17±3.55)% while that of TIA patients was higher, the positive rate was (65.23±21.11)%, among which positive rate of patients progressing to infarction was (68.21±2.42)% and that of non-progressing patients was (60.07±3.46)%. After TIA patients took orally aspirin more than 6 months regularly, the activation rate of platelet was (60.75±2.03)%. Patients without aspirin taken orally had a platelet activation rate of (70.01±3.43)%. Conclusion CD62P is able to reflect the activation level of platelet so as to forecast the onset of TIA and to estimate its evolvement trend; aspirin may play a suppressive effect on CD62P expression.