With the development of ophthalmic optical coherence tomography (OCT) and OCT angiography (OCTA), including the improving of light source, resolution, scanning depth and upgrade of analysis softwares, they can more accurately display the structure of retinal layers and give accurate quantitative measurement. In neuro-ophthalmic diseases, the OCT indicators (the thickness of retinal nerve fiber layer around optic disc and plexus layer in macular gangle cells) and OCTA indicators (the blood flow density of capillaries around optic disc, superficial and deep capillaries in macular area, and the area of foveal avascualr zone) had special changes. It has important value in the differential diagnosis of central nervous system diseases and retinal diseases with visual dysfunction as the first symptom, the diagnosis and differential diagnosis of neuro-ophthalmic disease, the evaluation of progression of neurodegenerative diseases. Neuro-ophthamologists should pay more attention to the exploration and application of OCT and OCTA in the field of neuro-ophthalmology.
ObjectiveTo analyze the effect of carotid artery stenosis degree and intervention for carotid artery stenosis on the incidence of central nervous system complications after off-pump coronary artery bypass grafting (OPCABG) and explore the influencing factors. MethodsA total of 1 150 patients undergoing OPCABG in our hospital from June 2018 to June 2021 were selected and divided into two groups according to whether there were central nervous system complications, including a central nervous system complication group [n=61, 43 males and 18 females with a median age of 68.0 (63.0, 74.0) years] and a non-central nervous system complication group [n=1 089, 796 males and 293 females with a median age of 65.5 (59.0, 70.0) years]. The risk factors for central nervous system complications after OPCABG were analyzed. ResultsUnivariate analysis showed that age, smoking, hyperlipidemia, preoperative left ventricular ejection fraction, intra-aortic ballon pump (IABP), postoperative arrhythmia, postoperative thoracotomy and blood transfusion volume were associated with central nervous system complications. The incidence of central nervous system complications in patients with severe carotid artery stenosis or occlusion (11.63%) was higher than that in the non-stenosis and mild stenosis patients (4.80%) and moderate stenosis patients (4.76%) with a statistical difference (P=0.038). The intervention for carotid artery stenosis before or during the operation did not reduce the incidence of central nervous system complications after the operation (42.11% vs. 2.99%, P<0.001). Age, postoperative arrhythmia, severe unilateral or bilateral carotid artery stenosis and occlusion were independent risk factors for postoperative central nervous system complications (P<0.05). Conclusion The age, smoking, hyperlipidemia, preoperative left ventricular ejection fraction, intraoperative use of IABP, postoperative arrhythmia, secondary thoracotomy after surgery, blood transfusion volume and OPCABG are associated with the incidence of postoperative central nervous system complications in patients. Age, postoperative arrhythmia, severe unilateral or bilateral carotid artery stenosis and occlusion are independent risk factors for postoperative central nervous system complications. In patients with severe carotid artery stenosis, preoperative treatment of the carotid artery will not reduce the incidence of central nervous system complications.
Objective To evaluate the relation of human immunodeficiency virus (HIV)-1 ribonucleic acid (RNA) loads in cerebrospinal fluid with central neurological diseases. Methods The inpatients with HIV-1 infection diagnosed by Public Health Clinical Center of Chengdu between January 1st, 2015 and March 1st, 2018 were retrospectively included. The included patients were divided into central neurological disease group and non-central neurological disease group, and high viral load group and low viral load group. The demographic data, CD4+ T lymphocyte count, routine detection of cerebrospinal fluid, HIV RNA load in cerebrospinal fluid and plasma of patients with and without central neurological diseases were observed and compared.Multiple logistic regression analysis was used to identify risk factors for central neurological diseases. Results A total of 367 patients were included. In the central neurological disease group, 210 cases (57.22%) were complicated with central neurological diseases, and cryptococcus infection was the most. Compared with the non-central neurological disease group, the increase rate of cerebrospinal fluid cell counts, cerebrospinal fluid cell counts, cerebrospinal fluid HIV RNA positivity and cerebrospinal fluid HIV RNA load were higher in the central neurological disease group (P<0.05). Logistic regression analysis showed that HIV RNA load in cerebrospinal fluid≥100 000 copies/mL and CD4+ T lymphocyte count<200 cells/mm3 were risk factors for central neurological diseases. Conclusion Cerebrospinal fluid HIV RNA load≥100 000 copies/mL is an independent risk factor for HIV/AIDS patients with central neurological diseases and clinical treatment should take this factor into consideration to reasonably optimize the selection of antiretroviral therapy.
Objective To review the possible mechanisms of the mammal ian target of rapamycin (mTOR) in theneuronal restoration process after nervous system injury. Methods The related l iterature on mTOR in the restoration ofnervous system injury was extensively reviewed and comprehensively analyzed. Results mTOR can integrate signals fromextracellular stress and then plays a critical role in the regulation of various cell biological processes, thus contributes to therestoration of nervous system injury. Conclusion Regulating the activity of mTOR signaling pathway in different aspects cancontribute to the restoration of nervous system injury via different mechanisms, especially in the stress-induced brain injury.mTOR may be a potential target for neuronal restoration mechanism after nervous system injury.
Objective To review the role of integrin in nervous system injury and its repair, and to analyze the possible mechanisms. Methods Recent l iterature concerning integrin and its role in nervous system injury was reviewed and analyzed. Results Integrin and its related signall ing pathway were involved in nervous system injury, especially hypoxicischemic nervous injury, and their repair processes. Conclusion Intervention of integrin signall ing pathway would be a potential strategy to treat nervous system injury, especially hypoxic-ischemic nervous injury.
Objective To review the biologic characteristics and biologic effect of cholecystokinine (CCK) on the central nervous system. Methods The literatures of recent years on research advancement of cholecystokinine as neurotransmitters/peptides in signal transduction, neuron protection and pain management in the central nervous system are reviewed. Results CCK possesses the ability to suppress the convulsant effects of convulsants. CCK8 is able to reduce the neural damage caused and delay the neural aging. CCK antagonists play an important role in human pain transduction. Conclusion CCK has been proven to be one of the richest neurotransmitters/neuropeptides as well as an important signal factor in the brain, and its important biologic effect is being confirmed.
Age is the main cause of neurodegenerative changes in the central nervous system (CNS), and the loss of neurons would increase with the migration of the disease. The current treatment is also mainly used to relieve symptoms, while the function of CNS is very difficult to recover. The emergence of endogenous stem cells has brought new hope for the treatment of CNS diseases. However, this nerve regeneration is only in some specific areas, and the recovery of neural function remains unknown. More and more experts in the field of neuroscience have carried out various in vivo or in vitro experiments, in order to increase nerve regeneration and nerve function recovery through mechanism research, in the expectation that the results would be applied to the treatment of CNS diseases. This article reviews the recent progress of endogenous neural stem cells in degenerative diseases of CNS.
【摘要】 目的 探讨原发性中枢神经系统淋巴瘤(PCNSL)的CT及MRI表现特征,以提高术前对该病的影像诊断能力。方法 分析2008年1月—2009年8月华西医院16例经病理证实PCNSL患者的CT、MRI资料及病理资料。结果 病理检查均为B细胞来源的弥漫性大B细胞性淋巴瘤。16例PCNSL 29个病灶,单发11例(69%)，多发5例(31%)18个病灶。病灶好发部位依次是大脑半球临近蛛网膜下腔12个(41.4%)、脑室周围深部白质7个(24.1%)、胼胝体3个(10.3%)。有5例病变CT平扫表现为等或略高于脑实质密度影,无出血和钙化；MRI平扫75.9%(19/25)的病灶T1WI呈等低信号,T2WI等稍低信号,类似“脑膜瘤”样信号,均未见血管流空；增强后病灶大都均匀实质团块状或结节状强化,典型的可出现“尖角征”、“握拳征”,3例可见小囊变,呈“硬环征”。结论 CT对PCNSL的定性诊断作用有限,MRI具有一定特征性表现者,多可作出正确的诊断,但确诊有赖于病理。