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大脑 3

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Deformable image registration with geometric changes

Yu LIU,Bo ZHU

《信息与电子工程前沿（英文）》 2015年第16卷第10期页码 829-837 doi: 10.1631/FITEE.1500045

摘要： Geometric changes present a number of difficulties in deformable image registration. In this paper, we propose aglobal deformation framework to model geometric changes whilst promoting a smooth transformation between source and target images. To achieve this, we have developed an innovative model which significantly reduces the side effects of geometric changes in image registration, and thus improves the registration accuracy. Our key contribution is the introduction of a sparsity-inducing norm, which is typically L1 norm regularization targeting regions where geometric changes occur. This preserves the smoothness of global transformation by eliminating local transformation under different conditions. Numerical solutions are discussed and analyzed to guarantee the stability and fast convergence of our algorithm. To demonstrate the effectiveness and utility of this method, we evaluate it on both synthetic data and real data from traumatic brain injury (TBI). We show that the transformation estimated from our model is able to reconstruct the target image with lower instances of error than a standard elastic registration model.

关键词： Geometric changes Image registration Sparsity Traumatic brain injury (TBI)

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Leonurine protects ischemia-induced brain injury via modulating SOD, MDA and GABA levels

Shilei ZHENG, Jingru ZHU, Jiao LI, Shuang ZHANG, Yunfei MA

《农业科学与工程前沿（英文）》 2019年第6卷第2期页码 197-205 doi: 10.15302/J-FASE-2018245

摘要：

The present study was designed to investigate the protective effects of leonurine, a compound purified from that is active on ischemic rat behavior and cortical neurons, and explore the underlying mechanism. The general rat activity, cortical neuron morphology, superoxide dismutase (SOD), malondialdehyde (MDA), -aminobutyric acid (GABA) and glutamate decarboxylase 67 (GAD67) levels were measured. We found leonurine significantly improve the general activity of rats in an open-field test, which was associated with attenuated neuronal damage induced by ischemia. Moreover, serum SOD activity was significantly greater, MDA level lower in the leonurine group as compared with ischemia group. In addition, GABA content in the cerebral cortex was significantly greater in high-dose leonurine group. Correspondingly, GAD67 protein level coincided with the GABA level. Taken together, our results demonstrated that leonurine attenuated brain injury during ischemia via antioxidative and anti-excitotoxicity effects by targeting GABA and leonurine might become a useful adjuvant neuroprotective agent.

关键词： cerebral ischemia GABA neuroprotection leonurine SOD

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Bile duct injury repair — earlier is not better

null

《医学前沿（英文）》 2015年第9卷第4期页码 508-511 doi: 10.1007/s11684-015-0418-7

摘要：

Bile duct injury is a common complication of cholecystectomy. The timing of bile duct injury repair remains controversial. A recent review conducted in France reported 39% complications and 64% failure after immediate repair in 194 patients compared with 14% complications and 8% failure after late repair in 133 patients. A national review of 139 consecutive early repairs conducted at five hepatopancreaticobiliary centers in Denmark reported 4% mortality, 36% morbidity, and 42 restrictures (30%) at a median follow-up of 102 months, and only 64 patients (46%) demonstrated uneventful short-term and long-term outcomes. Most patients with bile duct injury present with bile leak and sepsis; thus, early repair is not recommended. Percutaneous drainage of bile and endoscopic stenting are the mainstays of treatment of bile leak because they convert acute bile duct injury into a controlled external biliary fistula. The ensuing benign biliary stricture should be repaired by a biliary surgeon after a delay of 4–6 weeks once the external biliary fistula has closed.

关键词： bile duct injury cholecystectomy laparoscopic cholecystectomy

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Loss of monocarboxylate transporter 1 aggravates white matter injury after experimental subarachnoid

《医学前沿（英文）》 2021年第15卷第6期页码 887-902 doi: 10.1007/s11684-021-0879-9

摘要： Monocarboxylic acid transporter 1 (MCT1) maintains axonal function by transferring lactic acid from oligodendrocytes to axons. Subarachnoid hemorrhage (SAH) induces white matter injury, but the involvement of MCT1 is unclear. In this study, the SAH model of adult male Sprague-Dawley rats was used to explore the role of MCT1 in white matter injury after SAH. At 48 h after SAH, oligodendrocyte MCT1 was significantly reduced, and the exogenous overexpression of MCT1 significantly improved white matter integrity and long-term cognitive function. Motor training after SAH significantly increased the number of ITPR2⁺SOX10⁺ oligodendrocytes and upregulated the level of MCT1, which was positively correlated with the behavioral ability of rats. In addition, miR-29b and miR-124 levels were significantly increased in SAH rats compared with non-SAH rats. Further intervention experiments showed that miR-29b and miR-124 could negatively regulate the level of MCT1. This study confirmed that the loss of MCT1 may be one of the mechanisms of white matter damage after SAH and may be caused by the negative regulation of miR-29b and miR-124. MCT1 may be involved in the neurological improvement of rehabilitation training after SAH.

关键词： microRNAs monocarboxylate transporter 1 motor training subarachnoid hemorrhage white matter injury

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Risk factors of prognosis after acute kidney injury in hospitalized patients

null

《医学前沿（英文）》 2017年第11卷第3期页码 393-402 doi: 10.1007/s11684-017-0532-9

摘要：

The risk factors, especially laboratory indicators, of prognosis after acute kidney injury (AKI) remain unclear. We conducted a retrospective survey of Chinese People’s Liberation Army General Hospital from January 1, 2012 to December 31, 2012 according to the AKI diagnosis standard issued by Kidney Disease Improving Global Outcomes. The epidemiological features and factors influencing hospital mortality and renal function recovery were evaluated through logistic regression analysis. Among 77 662 cases of hospitalized patients, 1387 suffered from AKI. The incidence rate and mortality of AKI were 1.79% and 14.56%, respectively. Multivariate logistic regression analysis revealed that high AKI stage, age greater than 80 years, neoplastic disease, low cardiac output, increased white blood cell count, and decreased platelet count and serum albumin levels were the risk factors affecting the mortality of AKI patients. Conversely, body mass index between 28 and 34.9 was a protective factor. Increased AKI stage, tumor disease, post-cardiopulmonary resuscitation, and RRT were the risk factors of renal function recovery upon discharge. In addition to traditional risk factors, white blood cell count, platelet count, albumin, and BMI were the predictors of the mortality of AKI patients. No laboratory indicators were found to be the risk factors of renal function recovery in AKI patients.

关键词： acute kidney injury risk factors prognosis

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Outcomes of patients awaiting lung transplantation after the implementation of donation after brain death

《医学前沿（英文）》 2022年第16卷第5期页码 760-765 doi: 10.1007/s11684-021-0899-5

摘要： Voluntary contribution has become the only source of donor lungs in China since 2015. To elaborate the outcomes of patients awaiting lung transplantation (LTx) after the implementation of donation after brain death, we performed a retrospective study that encompassed 205 patients with end-stage lung disease who registered for LTx at Shanghai Pulmonary Hospital from January 1, 2015 to January 1, 2021. A total of 180 patients were enrolled in the study. The median waiting time was 1.25 months. Interstitial lung disease (ILD) (103/180, 57.2%) and chronic obstructive pulmonary disease (COPD) (56/180, 31.1%) were the most common diseases in our study population. The mean pulmonary artery pressure (mPAP) of patients in the died-waiting group was higher than that of the survivors (53.29±21.71 mmHg vs. 42.11±18.58 mmHg, P=0.002). The mortality of patients with ILD (34/103, 33.00%) was nearly twice that of patients with COPD (10/56, 17.86%) while awaiting LTx (P=0.041). In the died-waiting group, patients with ILD had a shorter median waiting time than patients with COPD after being listed (0.865 months vs. 4.720 months, P=0.030). ILD as primary disease and mPAP > 35 mmHg were two significant independent risk factors for waitlist mortality, with hazard ratios (HR) of 3.483 (95% CI 1.311–9.111; P=0.011) and 3.500 (95% CI 1.435–8.536; P=0.006). Hence, LTx is more urgently needed in patients with ILD and pulmonary hypertension.

关键词： lung transplantation donation after brain death waitlist

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Cooling strategies and transport theories for brain hypothermia resuscitation

LIU Jing

《能源前沿（英文）》 2007年第1卷第1期页码 32-57 doi: 10.1007/s11708-007-0004-z

摘要： The brain is one of the most important organs in a biological body whose normal function depends heavily on an uninterrupted delivery of oxygen. Unlike skeletal muscles that can survive for hours without oxygen, neuron cells in the brain are easily subjected to an irreversible damage within minutes from the onset of oxygen deficiency. With the interruption of cardiopulmonary circulation in many cardiac surgical procedures or accidental events leading to cerebral circulation arrest, an imbalance between energy production and consumption will occur which causes a rapid depletion of oxygen due to the interrupted blood-flow to the brain. Meanwhile, the cooling function of the blood flow on the hot tissue will be stopped, while metabolic heat generation in the tissues still keeps running for awhile. Under such adverse situations, the potential for cerebral protection through hypothermia has been intensively investigated in clinics by lowering brain temperature to restrain the cerebral oxygen demands. The reason can be attributed to the decreased metabolic requirements of the cold brain tissues, which allows a longer duration for the brain to endure reduced oxygen delivery. It is now clear that hypothermia would serve as the principal way for neurologic protection in a wide variety of emergency medicines, especially in cerebral damage, anoxia, circulatory arrest, respiratory occlusion, etc. However, although brain cooling has been found uniquely significant in clinical practices, the serious lack of knowledge on the mechanisms involved prevents its further advancement in brain resuscitation. Compared with the expanded trials in clinics, only very limited efforts were made to probe the engineering issues involved, which turns out to be a major obstacle for the successful operation of brain hypothermia resuscitation. From the viewpoint of biothermal medical engineering, the major theories and strategies for administering brain cooling can generally be classified into three categories: heat transfer, oxygen transport and cooling strategy. Aiming to provide a complete overview of the brain hypothermia resuscitation, this article comprehensively summarizes the recent progresses made in theoretical, practical and experimental techniques in the area. Particularly, attention is paid to the mathematical models to quantify the heat and oxygen transport inside the cerebral tissues. Typical cooling strategies to effectively lower brain temperature and thus decrease oxygen consumption rate in the cerebral tissues are analyzed. Approaches to deliver oxygen directly to the target tissues are discussed. Meanwhile, some future efforts worth pursuing within the area of brain cooling are suggested.

关键词： mathematical interruption hypothermia metabolic generation

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Tramadol reinforces antidepressant effects of ketamine with increased levels of brain-derived neurotrophic

null

《医学前沿（英文）》 2012年第6卷第4期页码 411-415 doi: 10.1007/s11684-012-0226-2

摘要：

Ketamine exerts rapid and robust antidepressant properties in both animal models and depressed patients and tramadol possesses potential antidepressant effects. Brain-derived neurotrophic factor (BDNF) is an important biomarker for mood disorders and tropomyosin-related kinase B (TrkB) is a high affinity catalytic receptor for BDNF. We hypothesized that tramadol pretreatment might reinforce ketamine-elicited antidepressant effects with significant changes in hippocampal BDNF and TrkB levels in rats. Immobility time of rats receiving different treatment in the forced swimming test (FST) was observed. Levels of BDNF and TrkB in hippocampus were measured by enzyme linked immunosorbent assay. Results showed that tramadol (5 mg/kg) administrated alone neither elicited antidepressant effects nor altered BDNF or TrkB level. However, pretreatment with tramadol (5 mg/kg) enhanced the ketamine (10 mg/kg) -elicited antidepressant effects and upregulated the BDNF and TrkB levels in hippocampus. In conclusion, tramadol pretreatment reinforces the ketamine-elicited antidepressant effects, which is associated with the increased levels of BDNF and TrkB in rat hippocampus.

关键词： tramadol ketamine antidepressant brain-derived neurotrophic factor tropomyosin-related kinase B

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The influence of brain death on donor liver and the potential mechanisms of protective intervention

null

《医学前沿（英文）》 2011年第5卷第1期页码 8-14 doi: 10.1007/s11684-011-0109-y

摘要：

Brain-dead donors have become one of the main sources of organs for transplantation in Western countries. The quality of donor organs is closely related to the outcome of the transplantation. Experimental studies have confirmed the inferior graft survival of livers from brain-dead donors compared with those from living donors. Studies conducted in the past 10 years have shown that brain death is associated with effects on the decreased donor organ quality. However, whether the decrease in the viability of donor organs is caused by brain death or by the events before and after brain death remains uncertain. The purpose of this review is to introduce the advances and controversies regarding the influence of brain death on the viability of donor livers and to summarize the mechanisms of the different protective interventions for donor livers.

关键词： brain death donor liver

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Progress and perspectives of neural tissue engineering

null

《医学前沿（英文）》 2015年第9卷第4期页码 401-411 doi: 10.1007/s11684-015-0415-x

摘要：

Traumatic injuries to the nervous system lead to a common clinical problem with a quite high incidence and affect the patient’s quality of life. Based on a major challenge not yet addressed by current therapeutic interventions for these diseases, a novel promising field of neural tissue engineering has emerged, grown, and attracted increasing interest. This review provides a brief summary of the recent progress in the field, especially in combination with the research experience of the author’s group. Several important aspects related to tissue engineered nerves, including the theory on their construction, translation into the clinic, improvements in fabrication technologies, and the formation of a regenerative environment, are delineated and discussed. Furthermore, potential research directions for the future development of neural tissue engineering are suggested.

关键词： nerve injury tissue engineering nerve grafts

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Various brain-eating amoebae: the protozoa, the pathogenesis, and the disease

《医学前沿（英文）》 2021年第15卷第6期页码 842-866 doi: 10.1007/s11684-021-0865-2

摘要： Among various genera of free-living amoebae prevalent in nature, some members are identified as causative agents of human encephalitis, in which Naegleria fowleri followed by Acanthamoeba spp. and Balamuthia mandrillaris have been successively discovered. As the three dominant genera responsible for infections, Acanthamoeba and Balamuthia work as opportunistic pathogens of granulomatous amoebic encephalitis in immunocompetent and immunocompromised individuals, whereas Naegleria induces primary amoebic meningoencephalitis mostly in healthy children and young adults as a more violent and deadly disease. Due to the lack of typical symptoms and laboratory findings, all these amoebic encephalitic diseases are difficult to diagnose. Considering that subsequent therapies are also affected, all these brain infections cause significant mortality worldwide, with more than 90% of the cases being fatal. Along with global warming and population explosion, expanding areas of human and amoebae activity in some regions lead to increased contact, resulting in more serious infections and drawing increased public attention. In this review, we summarize the present information of these pathogenic free-living amoebae, including their phylogeny, classification, biology, and ecology. The mechanisms of pathogenesis, immunology, pathophysiology, clinical manifestations, epidemiology, diagnosis, and therapies are also discussed.

关键词： free-living amoebae central nervous system infection primary amoebic meningoencephalitis granulomatous amoebic encephalitis

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Protective effect of N-acetylcysteine against lipopolysaccharide injury in hepatocytes of neonatal mice

WANG Lin, LIU Yalan, XU Jianbo, TIAN Yuan, WU Heshui

《医学前沿（英文）》 2008年第2卷第2期页码 182-185 doi: 10.1007/s11684-008-0034-x

摘要： The present study provides supportive evidence for the effective prevention and treatment of lipopolysaccharide (LPS)-induced hepatocyte injury in neonatal mice by N-acetylcysteine (NAC). Hepatocytes of neonatal mice were obtained through collagenase digestion of the liver. The hepatocytes were treated either with LPS (10 ?g/mL) alone or with NAC (5 mmol/L) for 1 h before the addition of LPS (10 ?g/mL). After LPS treatment, 12 wells of the cultured hepatocytes and supernatants were harvested at 0, 6, and 12 h, respectively. Levels of alanine aminotransferase (ALT) and nitric oxide (NO) in the supernatant were biochemically quantified and reverse transcription-polymerase chain reaction (RT-PCR) was performed to detect the expression of inducible nitric oxide synthase (iNOS) mRNA after different treatments. At 0 h following the treatment of primary cultured hepatocytes with LPS, the levels of ALT, NO and iNOS mRNA in the supernatant were (21.1 ± 4.78) u/L, (1.6 ± 0.31) ?mol/L and 0.17 ± 0.023, respectively; at 6 h, (59.8 ± 8.59) u/L, (6.6 ± 0.81) ?mol/L, and 0.71 ± 0.091; and at 12 h, (89.6 ± 15.30) u/L, (7.8 ± 1.01) ?mol/L, and 0.71 ± 0.097. The levels of ALT, NO and iNOS mRNA at 6 and 12 h increased significantly, compared to those at 0 h ( < 0.01). In contrast to LPS treatment alone, pretreatment with NAC before LPS addition significantly reduced the levels of ALT, NO and iNOS mRNA in the supernatant at 6 h to (40.8 ± 7.30) u/L, (3.2 ± 0.71) ?mol/L, and 0.41 ± 0.060; and at 12 h to (55.4 ± 5.48) u/L, (4.0 ± 0.71) ?mol/L, and 0.40 ± 0.067, respectively ( < 0.01). However, the levels of ALT, NO and iNOS mRNA at 0 h did not change significantly with both treatment approaches. NAC has protective effects in hepatocytes of neonatal mice against LPS-induced injury as shown by the reduced levels of ALT, NO and iNOS mRNA when primary hepatocytes were treated with NAC prior to LPS stimulation. We postulate that NAC exhibits its protective function by inhibiting LPS-induced transcription of iNOS, resulting in decreased levels of NO.

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Experimental study on the establishment and maintenance of brain death model with pigs

ZHANG Shuijun, SHI Jihua, ZHAI Wenlong, SONG Yan, CHEN Shi

《医学前沿（英文）》 2007年第1卷第2期页码 161-166 doi: 10.1007/s11684-007-0030-6

摘要： It remains controversial that after the transplantation of using grafts from brain-dead donors, organs injury and rejection can influence the effects of transplantation. This study sought to explore methods of establishing a stable brain death (BD) model using Bama mini pigs and to maintain the brain-dead state for a comparatively long period to provide a model for investigating changes in brain death. Sixteen anesthetized Bama mini pigs were randomized into a control group ( = 5) and a BD group ( = 11). Intracranial pressure (ICP) was increased in a modified, slow, and intermittent way to establish BD. Respiration and circulation were sustained during the brain-dead state. Hemodynamic changes were monitored during the experiment. In the BD group, 10 pigs met the requirements for brain death and 1 died of cardiopulmonary complications following an increase in ICP. Brain death was maintained for more than 48 hours with artificial life support. During the experiment, the heart rate and blood pressure showed characteristic changes due to increased ICP. Prior to BD being established, a tic reaction inevitably occurred. We used an improved method of increasing ICP to establish a stable BD model. The BD state could be maintained for more than 48 hours with effective respiratory and circulatory support. Disappearance of the tic reaction was considered to be one of the verified indexes for BD via encephalic pressure increase.

关键词： BD control Hemodynamic cardiopulmonary modified

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Effect of oxytocin on gastric ischemia-reperfusion injury in rats

ZHANG Wenwen, ZHANG Jianfu, ZHANG Yongmei, XU Ming

《医学前沿（英文）》 2007年第1卷第4期页码 433-437 doi: 10.1007/s11684-007-0085-4

摘要： The effect of peripherally administered oxytocin (OT) on gastric ischemia-reperfusion injury (GI-RI) and its possible mechanism were investigated. The Sprague-Dawley (SD) rats were randomly divided into different treatment groups ( = 6). The animal GI-RI model was established by clamping the celiac artery for 30 min to induce ischemia and then released to allow reperfusion for 1 h, and the degree of GI-RI was assessed by scoring the gastric mucosal damage index (GMDI), the gastric fluid output, gastric fluid output, gastric acidity were measured and the surgical preparations of vagotomy and sympathectomy were used to investigate the possible mechanism of OT on GI-RI. The results were as follows. Compared with the control group (NS plus GI-R only, GMDI 121.33±10.40, = 6), the intra peritoneal (ip) administration of oxytocin (20, 100 μg/0.5 mL) obviously attenuated GI-RI (<0.05), GMDI were 82.33±14.26, 53.5±5.58 respectively ( = 6); the gastric fluid output and the gastric acidity (evaluated by pH) of the control group were (430.17±87.36) μL, 1.55±0.25 ( = 6), and those of the OT group were (102.45±48.00) μL, 2.65±0.40 ( = 6) res pectively; differences had statistical significance (<0.01). The effect of oxytocin was reversed by atosiban, a selective oxytocin receptor antagonist. The GMDI of the group given atosiban 10 min before OT was 138.17±24.06 ( = 6), which had no significant difference with the control group. Oxytocin further attenuated GI-RI after vagotomy and sympathectomy (GMDI 6.83±8.89, 29.67±5.54, = 6), compared with the GI-R group and the oxytocin group (<0.01). These results indicated that the oxytocin could significantly protect gastric mucosal against injury induced by ischemia-reperfusion, and the oxytocin receptor was involved. This effect of oxytocin may be mediated through the vagus and sympathetic nerve, and then lead to the reduction of gastric juice output and the depression of gastric acidity.

关键词： control significant difference surgical statistical significance Sprague-Dawley

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富含sn-2 DHA脂质对大脑的益处及其酶法合成综述 Review

金俊, 金青哲, 王兴国, Casimir C. Akoh

《工程（英文）》 2020年第6卷第4期页码 424-431 doi: 10.1016/j.eng.2020.02.009

摘要：

大脑中二十二碳六烯酸（DHA, ω-3脂肪酸）的含量与中枢神经系统的正常发育和功能维持高度相关。甘油酯sn-2位上的DHA可以被肠黏膜更好地吸收，从而实现机体对DHA的高效利用。然而，如今人们在饮食中摄入较多的饱和脂肪或富含ω-6脂肪酸的油脂，而摄入较少的DHA，从而导致了部分个体在行为和神经生理学方面的缺陷。为了全面了解DHA对大脑的有益功能，本文系统介绍了天然油脂甘油骨架上DHA的位置分布（sn-2和sn-1,3位）特征，并讨论了DHA补充和通过肠-脑轴传递信息的潜在功能机制。肠-脑轴包含的多条双向信息通道为DHA、肠道菌群和大脑健康的相互作用提供了新的研究思路。为了在日常饮食中摄入更多的sn-2 DHA，我们建议通过更为高效和经济的酯交换制造技术生产富含sn-2 DHA脂质，其中需要解决的关键技术包括强化酶的特异性和优化纯化工艺。这类饮食可满足对sn-2 ω-3脂质有强烈需求的人群，特别是婴儿、儿童、孕妇和哺乳期妇女。

关键词： DHA 和 sn-2 DHA 单甘酯大脑肠-脑轴结构脂质