Résumé
Traumatic brain injury(TBI)in combination with its sequelae is currently a public health problem that seriously endangers human health. Accumulating studies have deeply investigated the pathological processes of TBI to find possible therapeutic targets. In recent years,the relationship between TBI pathogenesis and gut-brain axis changes in aspects of microflora,metabolites,inflammatory factors and neurohumoral changes has drawn widespread attention,which not only provides a better understanding how TBI affects gut-brain axis,but also provides new therapeutic targets in improving cure rate and recovery level after TBI. However,due to the existence of complicated gut-brain axis self-regulation as well as the individual differences of TBI patients,the recognition and transformation for the latest experimental research are largely limited. In this review,the authors summarize how TBI event influences gut-brain axis balance,as well as how gut-brain axis regulates TBI pathogenesis mutually,so as to provide a better understanding of the interaction between gut-brain axis and TBI.
Résumé
Objective To summarize the efficacy and adverse reactions of incremental corticotrophin (ACTH) therapy in the treatment of infantile spasms (IS),and to provide new clinical treatment options.Methods The clinical data of 40 children with IS who were hospitalized in the Department of Neurology,Shanghai Children's Medical Center,Shanghai Jiaotong University School of Medicine,treated with ACTH from January 2016 to January 2018 were collected and retrospectively analyzed.All the children were treated with intravenous infusion of ACTH with an initial dose 12.5 U/d for 3 days.If the spasms did not disappear,dosage of ACTH increased to 25.0 U/d for another 3 days.If the spasms could not yet be fully controlled,the dosage increased to 40.0 U/d,and the total course of treatment did not exceed 2 weeks.If the spasms disappeared at each dose stage or the course of treatment reached to 2 weeks,ACTH would be changed to Prednisone 2 mg/(kg · d) orally,which gradually decreased in 2 months.All children underwent electroencephalogram examination before and after treatment.Results Forty patients with IS were treated with ACTH increasing therapy.The disappearance rate of spasms was 40.0% (16/40 cases) totally,with 7.5% (3/40 cases) at the dosage phase of 12.5 U/d,16.2% (6/37 cases) at the dosage stage of 25.0 U/d,and 22.6% (7/31 cases) at the dosage of 40.0 U/d.The disappearance rate of hypsarrhythmia on electroencephalogram was 60.0% (24/40 cases) generally,and 5.0% (2/40 cases),10.8% (4/37 cases),58.1% (18/31 cases),respectively at above different dosage phases,while 37.5% (15/40 cases) of the children had mild adverse reactions,mostly respiratory infections.Conclusions The short-term efficacy of the ACTH incremental therapy in the treatment of IS is positive,and the incidence of adverse reactions is low.
Résumé
To establish a model of inactivation adenosine A2A receptors in brain tissues of mice, we transplanted bone marrow cells (BMCs) from wild type (WT) C57BL/6 mice into A2A receptor knockout (A2A KO) C57BL/6 mice which were previously fractionated total body irradiation of 6.2 Gyx2. Six weeks later, we identified and evaluated the model. The results showed that the sexual chromagene pattern on white blood cells of recipient mice changed from female pattern to male pattern and there were 95.9% of A2AR+ cells in peripheral white blood cells of recipient mice, whereas there was no significant difference of A2AR mRNA level in brains between these recipient mice and A2AR KO mice. Furthermore, there was no significant difference of breathing frequency, brain water content and level of glutamate between the model mice and WT mice. These results indicated that we established successfully a mouse model of inactivation adenosine A2A receptors in brain tissues. This may provide a new and efficient strategy to study the effect of adenosine A2A receptors in disease and injuries of central nervous system.