补肾活血法对血管性认知障碍大鼠血管新生的实验研究
详细信息    本馆镜像全文|  推荐本文 |  |   获取CNKI官网全文
摘要
目的:血管新生是决定脑缺血病理损伤后缺血性神经元存活的关键因素,与认知障碍的程度密切相关。本课题从分子和细胞两个水平探讨补肾活血方——首乌益智胶囊通过调节VEGF-Notch/Delta级联信号通路,从而对血管性认知障碍大鼠血管新生产生的影响,为补肾活血法治疗血管性认知障碍提供初步的实验数据和理论依据。
     方法:以SD大鼠为实验对象,采用大脑中动脉缺血再灌注法建立血管性认知障碍动物模型。将120只大鼠经Morris水迷宫实验筛选出100只,随机分为假手术组、模型组、脑复康组、首乌益智组。造模后药物干预4周,Morris水迷宫试验检测各组大鼠行为学改变,HE染色及透射电镜观察脑组织形态学变化,免疫组化法检测第Ⅷ因子表达以观察缺血脑组织微血管密度的改变,实时荧光定量PCR检测VEGF-Notch/Delta级联信号通路上Notch4、D114、VEGF、VEGFR-2等基因表达。
     结果:形态学观察,造模后海马锥体细胞缺失、线粒体肿胀、血管管壁变薄,治疗后锥体细胞缺失减少,细胞器基本正常、血管周围水肿减轻。Morris水迷宫实验逃避潜伏期时间,模型组大鼠明显延长,与假手术组相比有极显著差异(P<0.01)。脑复康组、首乌益智组逃避潜伏期时间依次缩短,与假手术组比较,首乌益智组差异无显著性(P>0.05),脑复康组差异有极显著性(P<0.01);与脑复康组比较,首乌益智组差异有极显著性(P<0.01)。缺血灶周围微血管密度方面,模型组、脑复康组、首乌益智组较假手术组依次升高;各组与假手术组相比,差异均有极显著性(P<0.01);与模型组比较,脑复康组、首乌益智组差异均有极显著性(P<0.01);与脑复康组比较,首乌益智组差异无显著性(P>0.05)。血管性认知障碍模型大鼠脑组织VEGF、VEGFR-2、Notch4、D114水平较假手术组大鼠升高,差异有显著性(P<0.01,P<0.05)。药物干预后,脑复康组和首乌益智组脑组织VEGF、VEGFR-2、Notch4、D114水平进一步升高;除VEGFR-2外,首乌益智组大鼠脑组织VEGF、Notch4、D114表达升高,与脑复康组相比存在显著差异(P<0.01,P<0.05)。在首乌益智胶囊干预的VCI模型大鼠的VEGF和D114之间存在着显著正相关性。
     结论:补肾活血法通过对VCI大鼠VEGF-Notch/Delta级联信号通路的调节,精确调节脑组织缺血灶及其周围组织的血管新生,对受损神经元产生营养和修复作用,从而有效纠正脑缺血导致的认知障碍。并且,对缺血脑组织血管新生的调节作用,首乌益智胶囊明显优于脑复康。
Objective:Angiogenesis is the key factor for the ischemic neuron survival after cerebral ischemic injury and is closely correlated with the level of cognitive impairment. This study explored the effect of Shouwuyizhi Capsule on angiogenesis in rats with vascular cognitive impairment through the regulation of the VEGF-Notch/Delta cascade signaling pathway from molecular and cellular level, and therefore provides the preliminary experimental data and theoretical base for the treatment of tonifying the kidney and activating the blood for vascular cognitive impairment.
     Method:SD rats were used and the VCI model was established with MCAO.100 rats were chosen from 120 rats by Morris water maze and randomly divided into sham operation group, model group, Naofukang group and Shouwuyizhi group. After 4 weeks'medication, the rats'behavioral change was detected by Morris water maze and the cerebral histomorphological change was observed by HE stain and transmission light microscope.Ⅷfactor expression was measured by immunohistochemistry method and the expression of the genes of Notch4, Delta4, VEGF, VEGFR-2 was measured using real time PCR.
     Results:The escape escape latency of rats of model group was significantly longer than that of rats of shan group (P<0.01); The escape escape latency of rats of Naofukang group and Shouwuyizhi group were shortened successively.Compared with sham group,Shouwuyizhi group had no significant difference (P>0.05), while Naofukang group had the significant difference (P<0.01); Compared with Naofukang group, Shouwuyizhi group had the significant difference (P<0.01)。About the microvessel dencity of ischemia cerebral tissue,all of the other three groups were higher than sham group with the significant difference(P<0.01); Compared with model group,Naofukang group and Shouwuyizhi group had the significant difference (P<0.01); Shouwuyizhi group had no difference with Naofukang group (P>0.05)。The content of cerebral tissue of angiogenesis factors (VEGF,VEGFR-2, Notch4,D114) of rats model with vascular congnitive impairment were higher than the rats of sham group (P<0.01); After the treatment,the content of theses factors were further highter than model group.Except VEGFR-2,the content of VEGF、Notch4、D114 of Shouwuyizhi group were highter than Naofukang group (P<0.01, P<0.05).In Shouwuyizhi group,the contents of VEGF and that of D114 had significantly correlation (P<0.01).The content of serum anti-inflammatory cytokines ((IL-4, IL-10) of rats model with chronic inflammatory disease were lower than these of normal rats; the differences were very significant (P<0.01). After treatment, pro-inflammatory cytokine levels of the treatment group had decreased anti-inflammatory cytokine levels were elevated. At the regulation of IL-4, IL-8, IL-10, IL-1(3 the therapeutic effects of Jingangteng capsule group were better than GuizhiFuling capsule group and Shaofuzhuyu group, At the regulation of TNF-a, therapeutic effects of Guizhi Fuling Capsule medium dose group and Shaofuzhuyu group were better than Jingangteng capsule group.The expression of adhesions related immune molecules(TNF-α, TGF-β1, VEGF, ICAM-1, MMP-2) in model rats uterine tissue elevated above normal group, the differences were very significant (P<0.01) After treatment, expression of TNF-αTGF-β1 ICAM-1 in the treatment group had decreased, and MMP-2 had elevated. therapeutic effects of Guizhi Fuling Capsule medium dose group and Shaofuzhuyu group were better than Jingangteng capsule group (P<0.05). VEGF expression in each group reduced.
     Conclusion:The treatment of tonifying the kidney and activating the blood could positively regulate the angiogenesis of the ischemic cerebral tissue and the surrounding tissue by regulating the VEGF-Notch/Delta cascade signaling pathway so as to nourish and repair the damaged neuron and effectively improve the cognitive impairment induced by the cerebral ischemia.
引文
[1]Bowler JV. The concept of vascular cognitive impairment[J].Neurological Sciences, 2002,203-204:11-15
    [2]Hachinski V,Iadecola C,Petersen RC,et al.National Institute of Neurological Disorders and Stroke-Canadian Stroke Network vascular cognitive impairment harmonization standards[J].Stroke,2006,37:2220-2241
    [3]Hachinski VC,Bowler JV.Vascular dementia[J].Neurology,1993,43:2159-2160
    [4]Rockwood K,Davis H,Mac Knight C,et al.The consortium to investigate vascular impairment of cognition:methods and first findings[J].Can J Neurol Sci,2003, 30(3):237-243
    [5]Ingles JL,Wentzel C,Fisk JD,et al.Neuropsychological predictors of incident dementia in patients with vascular cognitive impairment,without dementia[J].Stroke,2002, 33(8):1999-2002
    [6]Bowler J V. The concept of vascular cognitive impairment[J].J Neurol Sci,2002,15: 11-15
    [7]Erkinjuntti T,Inzitari D,Pantoni L,et al.Research criteria for subcortical vascular dementia in clinical trials[J].J Neural Transm Suppl,2000,59:23-30.
    [8]Erkinjuntti T,Rockwood K.Vascular dementia[J].Semin Clin Neuropsychiatry,2003, 8(1):37-45
    [9]Rockwood K,Howard K,Mac Knight C,et al.Spectrum of disease in vascular cognitive impairment[J].Neuroepidemiology,1999,18(5):248-254
    [10]Wentzel C,Darvesh S,Mac Knight C,et al.Interrater reliability of the diagnosis of vascular cognitive impairment at a memory clinic[J].Neuroepidemiology,2000,19(4): 186-193
    [11]Rockwood K,Wentzel C,Hachinski V,et al.Presence and treatment of vascular risk factors in patients with vascular cognitive impairment[J].Arch Neurol,1997, 54(1):33-39
    [12]Rockwood K, Wentzel C,Hachinski V,et al. Prevalence and outcomes of vascular cognitive impairment.Vascular Cognitive Impairment Investigators of the Canadian Study of Health and Aging[J].Neurology,2000,54(1):33-39.
    [13]Tuokko H,Frerichs R,Graham J,et al.Five-year-follow-up cognitive impairment with no dementia[J].Arch Neurol,2003,60(4):577-582.
    [14]Gorelick PB.Status of Risk Factors for Dementia Associated with Stroke[J].Stroke, 1997,28(2):459-463
    [15]Jellinger KA. The pathology of ischemic vascular dementia:an update[J]. Neurol Sci, 2002,204:153-157.
    [16]Chui H. Dementia due to subcortical ischemic vascular disease[J]. Clin Cornerstone, 2001,3:40-51.
    [17]Knopman DS,Parisi JE,Boeve BF,et al.vascular dementia in a population-based autopsy study[J].Arch Neurol,2003,60:569-575
    [18]Pandya NM, Dhalla NS, Santani DD. Angiogenesis--a new target for future therapy. Vascul Pharmacol,2006,44(5):265-274
    [19]Wen T.C, Matsuda S, Yoshimuro H, et al.Ciliary neurotropic factor prevents ischemia induced learning disability and neuronal loss in gerbils[J].Neurosci Lett 1997,223(3): 201-205
    [20]刘汉兴,章军建.慢性脑缺血与认知障碍[J].国外医学.脑血管疾病分册,2004,12(4):278-281
    [21]Ghajar CM, Blevins KS,Huqhes CC, et a.l Mesenchymal stem cells enhance angiogenesis in mechanically viable prevascularized tissues via early matrix metalloproteinase upregulation[J].Tissue Eng,2006,12:2875-2888.
    [22]王永炎.老年性痴呆发病机理与诊治[M].北京:北京医科大学中国协和大学联合出版社,1998:11
    [23]李长生,李军,关新华,等.首乌益智胶囊治疗血管性痴呆80例临床研究[J].中国老年学杂志,2008,28(4):369-371
    [24]颜德馨.老年性痴呆与瘀血的关系[J].辽宁中医杂志,1991,2(8):37
    [25]唐启盛.中医药治疗老年期血管性痴呆的研究[J].北京中医药大学学报,1997,19(5):32-33
    [26]尚炽昌,蒋士卿,张尚臣,等.地黄饮子加味治疗髓海不足型老年呆病的临床报道[J].中国医药学报,1996,11(5):36
    [27]傅仁杰,郭改惠.多发性梗塞性痴呆中医治疗体会[J].中医杂志,1991,4:24
    [28]胡杰一,冯应祥,张玉安,等.活血化淤法治疗脑血管性痴呆体会[J].河南中医,1992,12(5):226-227
    [29]贾金铭.中医辨证治疗脑血管性痴呆36例[J].河北中医,1997,19(2):17-18.
    [30]孔繁林.血管性痴呆的辨证论治[J].山西中医,1997,13(5):32-33.
    [31]郭海英.血管性痴呆中医治疗原则探讨[J].南京中医药大学学报,2005,21(4):221-222.
    [32]夏小军.谢君国诊治老年性痴呆经验[J].中医药临床杂志,2006,1(2):113-114.
    [33]张伯礼,王永炎,宫涛,等.血管性痴呆的分期证治[J].中国中医药学会内科脑病专业委员会第七次学术研讨会(广州)论文汇编,2001,0-13.
    [34]江霞.老年性痴呆治法探微[J].浙江中医杂志.2003,11:493-494
    [35]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:91-994
    [36]田金洲,韩明向,涂晋文.血管性痴呆诊断、辨证及疗效评定标准(研究用)[J].中国老年学杂志,2002,22(5):329—331
    [37]Richard F, Bert C,Amant C,et al. Effect of the angiotensin I-converting enzyme I/D polymorphism on cognitive decline. The EVA Study Group[J].Neurobiol Aging,2000, 21(1):75-80.
    [38]White L,Petrovitch H,Hardman J,et al.Cerebralvascular pathology and dementia in autopsied Honolulu-Asia Aging Study participants[J].Ann N Y Acad Sci,2002, 977:9-23
    [39]Atwood LD,Wolf PA,Heard-Costa NL,et al.Genetis varitation in white matter hyperintensity volume in the Framingham Study.Stroke,2004,35:1609-1613
    [40]de Leeuw FE, Richard F, de Groot JC.et al. Interaction between hypertension, apoE, and cerebralwhite matter lesions[J]. Stroke,2004,35(5):1057-1060.
    [41]Bruce DG,Casey GP,Grange VC.Cognitive impairment,physical disability and depressive symptoms in older diabetic patients:the Fremantle Cognition in Diabetes Study[J].Diabetes Res Clin Pract,2003,61(1):59
    [42]朱以诚,高山,刘秀琴,等.轻-中度血管件痴呆患者的头部影像学与认知功能障碍的关系[J].中华老年心脑血管病杂志,2000,2:315-317.
    [43]Ding YH, Li J, Zhou Y-Cerebral angiogenesis and expression of angiogenic factors in aging rats after exercise[J].Curr Neurovasc Res.2006,3(1):15-23.
    [44]Krupinski J,Kaluza J,Kumar P. el al.Role of angiogenesis in patients with cerebral ischemic stroke[J]. Stroke.1994,25:1794-1798.
    [45]Cheung WM.Chen SF,Nian GM, et al. Induction of angiogenesis related genes in the contralateral cortexwith a rat three-vessel occlusion model[J]. Chin J Physio,2000,43: 119-124.
    [46]王药,张军平.从中医络病学说认识血管新生[J].中国中医基础医学杂志,2005,11(7):493.
    [47]朱瑾波,李玉鼎,李玉书.黄芪治疗慢性皮肤溃疡对血管生成过程的机理探讨[J].河北中医,1996,18(1):21-22
    [48]吴勇.黄芪多糖对动脉粥样硬化内皮细胞损伤的影响[J].湖北中医学院学报,2002,4(1):21-22
    [49]张建国,陈良金,蒋文跃.外敷中药对骨折愈合微血管重建的影响[J].中国骨伤,2000,13(2):86-87.
    [50]罗增刚.参麻益智胶囊治疗老年血管性痴呆的临床研究[J].中医杂志,2001,42(8):470.
    [51]王健,陈其维,白丽.健脑聪明口服液治疗血管性痴呆的临床研究[J].辽宁中医杂志,2005,32(1):3-4.
    [52]张维颖,卢致鹏.补肾健脑汤治疗血管性痴呆的临床研究[J].中西医结合心脑血管病杂志,2006,4(8):680-681.
    [53]刘兴山,王静慧.补肾活血化痰法治疗血管性痴呆的临床研究[J].中国老年学杂志,2005,25(5):657-658.
    [54]师会,惠明.补肾活血法治疗血管性痴呆临床疗效观察[J].天津中医药,2006,23(3):200-202.
    [55]吴军君,周启棣,王海燕.中医补肾醒脑法治疗血管性痴呆64例的临床观察[J].光明中医,2006,21(8):64-65.
    56 57[58]李林,魏海峰,张兰等.中医“肾生髓,脑为髓海”现代生物学基础探讨[J].中国中药杂志,2006,31(17):1397-1400
    [59]阮成伟.对活血化瘀法治疗炎症的认识[J].现代中西医结合杂志,2008,17(3):354-355.
    [60]王峰,薛兴涛,郑绍周.补肾活血化痰法对血管性痴呆大鼠氧自由基和肿瘤坏死因子的影响[J].河南中医,2004,24(2):26-28
    [61]Longa E, Weinstein P, Carlson S,et al. Reversible Middle Cerebral artery:Occlusion without Craniotomy in Rats[J]. Stroke,1989,20:84
    [62]金玉玲,吴盛华,朱晓峰.电刺激小脑顶核联合神经干细胞共移植体治疗大鼠局 灶性脑缺血[J].中国组织工程研究与临床康复,2007,11(20):3956-3959
    [63]Smith CD, Chebrolu H, Wekstein DR, et al.Brain structural alterations before mild cognitive impairment[J]. Neurology.2007 68(16):1268-73
    [64]Kroppensted S, Ulrich P,Heimann A,et al.Significance of resting and stimulated cerebral blood flow for predicting the risk of hemodynamic cerebral ischemia in a model of chronic hemodynamic insufficiency[J]. Neurosurgery,2000;46(5):1204-10.
    [65]Amore PA,Thompson RW.Mechanisms of angiogenesis[J].Annu Rev Physio,1987, 49(3):453-464.
    [66]孙冬,姚长江.养血清脑颗粒对血管性认知功能障碍大鼠空间记忆能力和海马CREB活性的影响[J].长江大学学报2009,4(6):93-96
    [67]Hockel M, Schlenger K, Doctrow S,et al. Theraputic angionesis[J]. Arch Surg,1993, 128(4):423-9.
    [68]谭峰.脑缺血中的微血管重建[J].中西医结合心脑血管病杂志,2006,4(4):30-33.
    [69]Widenfalk J,Lipson A,Jubran M,et al.Vascular endothelial growth factor improves functional outcome and decreases secondary degeneration in experimental spinal cord contusion injury[J].Neuroscience,2003,120(4):951-960
    [70]Snider B J,Gottron F J,Choi D W,et al.Apoptosis and necrosis in cerebrovascular disease[J].Ann N Y Acad Sci,1999,893:243-253
    [71]Tarada K,Inao S,Mizutani N,et al.Cerebral blood flow,glucose metabolism and tunnel-positive cells in the development of ischemia[J].Cerebrovasc Dis,2001,11 (1): 8-9
    [72]Chen HH, Chien CH, Liu HM. Correlation between angiogenes and basic fibroblast growth factor expression in experimental brain infarct[J].Stroke,1994,25(8): 1651-1657.
    [73]Hai J, Li ST, Lin Q, et al.Vascular endothelialgrowth factor expression and angiogenesis induced by chronic cerebral hypoperfusion in rat brain[J].Neurosurgery, 2003,53 (4):963-970.
    [74]Marti H,Bemaudin M.Bellail A,et al.Hypoxia-induced vascular endothelial growth factor expression precedes neovascularization after cerebral ischemia[J].Am J Pathol,2000,156:965-976.
    [75]Slevin M, Krupinski J, Slowik A, et al. Serial measurement of vascular endothelial growth factor and transforming growth factor-beta 1 in serum of patients with acute ischemic stroke[J]. Stroke,2000,31(8):1863-1870.
    [76]Folkman J.Angiogenesis[J].Annu Rev Med,2006,57:1-18.
    [77]Belizon A, Balik E, Feingold DL, et al.Major abdominal surgery increases plasma levels of vascular endothelial growth factor:open more so than minimally invasive methods[J].Ann Surg,2006,244:792-798.
    [78]赵建华,唐金海,孟凡青,等.乳腺癌组织和血清中内皮细胞抑制素VEGF表达与肿瘤血管生成[J].中国肿瘤临床,2005,32(2):79-82
    [79]Larrivee B, Karsan A. Signaling pathways induced by vascular endothelial growth factor (review)[J]. Int J Mol Med,2000,5(5):447-456.
    [80]Sun FY,Guo X.Molecular and cellar mechanism of neuroprotection by vascular endothelial growth factor[J].J Neurosci Res,2005,79(12):180-184
    [81]Jin KL,Mao,XO,Nagayama T,et al.Induction of vascular endothelial growth factor receptors and phosphatidylinositol 3-kinase/Akt signaling by global cerebral ischemia in the rat[J].Neuroscience,2000,100:713-717
    [82]Pages G,Pouyssegur J.Transcriptional regulation of the vascular endothelial growth factor gene-a concert of activating factors[J]. Cardiovasc Res,2005,65(3):564-573
    [83]Harrigan MR.Angiogenic factors in the central nervous system[J]. Neurosurgery, 2003,53(3):639-661.
    [84]StorkebaumE, Carmeliet P. VEGF:a critical player in neurodegeneration[J]. Clin Invest,2004,113(1):14-18.
    [85]Hugo JH,Myriam B, Anita B.Hypoxia-induced vascular endothelial growth factor expression precedes neovascularization afte cerebral ischemial[J].Am J Patho,2000, 156(3):965-976.
    [86]Hohenester E, Sasaki T,Olsen BR, et al.Crystal structure of the angiogenesis inhibitor endostatin at 1.5 A resolution [J].EMBO J,1998,17:1656-1664.
    [87]Dhanabal M, Ramchandran R, Volk R, et al. Endostatin:yeast production, mutants, and antitumor effect in renal cell carcinoma[J].Cancer Res,1999,59:189-197.
    [88]Kim YM, Hwang S, Pyun BJ, et al. Endostatin blocks VEGF-mediated signaling via direct interaction with KDR/Flk-1 [J]. Biol Chem,2002,277:27872-27879.
    [89]Luttun A,Carmeliet G,Carmeliet P.Vascular progenitors:from biology to treatment[J]. Trends Cradiovasc Med.2002,12(2):88-96
    [90]Kolev V,Kacer D,Trifonova R.et al.The intracellular domain of Notch ligand Delta induces cell growth arrest[J].FEBS Lett,2005,579(25):5798-5802
    [91]Osborne BA,Minter LM.Notch signaling during peripheral T-cell activation and differentiation[J].Nat Rev Immunol,2007,7(1):64-75
    [92]Williams CK, Li JL, Murga M,et al.Up-regulation of the Notch ligand Delta-like 4 inhibits VEGF-induced endothelial cell function[J].Blood2006,107:931-939.
    [93]Hellstrom M, Phng LK, Hofmann J.D114 signalling through Notchl regulates formation of tip cells during angiogenesis[J]. Nature,2007,445(7129):722-725
    [94]Krebs LT,Xue Y, Norton CR, et al. Notch signaling is essential for vascular morphogenesis in mice[J].Genes Dev,2000,14(11):1343-1352
    [95]Gale NW, Dominguez MG, Noguera I et al.Haploinsufficiency of delta-like 4 ligand results in embryonic lethality due to major defects in arterial and vascular development[J]. Proc Natl Acad Sci U-S-A,2004,101 (45):15949-54
    [96]Hofmann J,Luisa Iruela-Arispe M. Notch expression patterns in the retina:An eye on receptor-ligand distribution during angiogenesis[J]. Gene Expr Patterns,2007,7(4): 461-470
    [97]Gridley T.Vascular biology:vessel guidance[J].Nature,2007,445 (7126):722-723
    [98]Luttun A,Carmeliet G,Carmeliet P.Vascular progenitors:from biology to treatment[J]. Trends Cradiovasc Med,2002,12(2):88-96
    [99]Gerhardt H,Golding M,Fruttiger M,et al. VEGF guides angiogenic sprouting utilizing endothelial tip cell filopodia[J]. Cell Biol,2003,161:1163-1177
    [100]Lobov IB,Renard RA,Papadopoulos N,et al.Delta-like ligand 4 (D114) is induced by VEGF as a negative regulator of angiogenic sprouting[J].Proc Natl Acad Sci USA,2007,104(9):3219-3224
    [101]Siekmann AF,Lawson ND.Notch signalling limits anglogenic cell behaviour in developing zebrafish arteries [J].Nature,2007,445 (7129):781-4.
    [102]Leslie JD,Ariza-McNanghton L.Bermange AL.Endothelial signalling by the Notch ligand Delta-like 4 restricts angiogenesis[J].Development,2007,134(5):839-44
    [103]Suchting S,Freitas C,le Noble F, et al.The Notch ligand Delta-like 4 negatively regulates endothelial tip cell formation and vessel branching[J].Proc Natl Acad sci USA,2007,104(9):3225-3230
    [104]Leslie JD,Ariza-McNaughton L,Bermange AL,et al. Endothelial signalling by the Notch ligand Delta-like 4 restricts angiogenesis[J]. Development,2007,134(5): 839-844
    [105]李吴,杜小平,杨期东,等.何首乌对海人藻酸致大鼠脑ACh能神经元及纤维损伤的保护作用[J].卒中与神经疾病,2002:9(5):299-302.
    [106]侯德仁,杨期东,周琳,等.何首乌对Alzhemer病模型大鼠学习记忆的影响及其机制的研究[J].中国医师杂志,2004,6(3):347-349.
    [107]武晓群,周坤福.黄芪延缓衰老的实验研究[J].河南中医,2005,25(5):24.
    [108]张鹏霞,朴金花,欧芹,等.黄芪对老年小鼠脑线粒体Mn-SOD、MDA及脑细胞凋亡影响的实验研究[J].中国老年学杂志,2003,23(9):596-597
    [109]李海龙.银杏叶提取物的神经保护作用机制概述[J].中华实用中西医杂志,2006,19(20):2459-2463.
    [110]李利平,王全胜,吴艳萍.银杏叶提取物对学习记忆功能的保护作用的研究进展[J].军医进修学院学报,2006,27(1):67-69.
    [111]高南南.天麻对老龄鼠学习记忆的改善作用[J].中国中药杂志,1995,20(9):563.
    [112]陈秋月,黄米武,柯绍发,等.水蛭胶囊对颈动脉斑块稳定性及血小板膜糖蛋白分子表达的影响[J].中华中医药杂志,2009,24(12):1643-1645
    [113]孙莉,陈英杰,刘超,等.益智仁对束缚应激大鼠海马CA3区神经元损伤的影响[J].大连大学学报,2009,6:86-90
    [114]李文明,刘洪涛,李佳佳,等.川芎有效成分的体外抗氧化研究[J].食品与生物技术学报,2010,29(1):64-68
    [1]Erkinjuntti T. Diagnosis and management of vascular cognitive impairment and dementia. J Neural Transm Suppl,2002,63:91—109.
    [2]Rockwood K, Howard K, Macknight C, et al. Spectrum of disease in vascular cognitive impairment. Neuroepidemiology,1999,18:248—254.
    [3]BowlerJV, HachinskiV. Vascular cognitive impairment:a new approach to vascular dementia. Baillieres Clin Neurol.1995.4:357—376.
    [4]. Bowler JV. The Concept of vascular cognitive impairment. J Neurol Sci,2002, 203:11—15.
    [5]贾建平.重视血管性认知障碍的早期诊断和干预.中华神经科杂志,2005,38:4-6.
    [6]Hachinski VC, Bowler JV. Vascular dementia、Neurology,1993,43:2159—2160.
    [7]Moorhouse P, Rockwood K. Vascular cognitive impairment:current concepts and clinical developments. Lancet Neurol,2008,7:246-255.
    [8]Rockwood K, Wentzel C, Hachinski V, et al.Prevalence and outcomes of vascular cognitive impairment-Vascular Cognitive Impairment Investigators of the Canadian Study of Health and Aging[J].Neurology,2000:4(2):447
    [9]贾建平.应重视血管性认知障碍诊断标准的建立及临床研究.中国脑血管病杂志.2004,1:14-16
    [10]Rockwood K.Vascular cognitive impairment and vascular dementia.J Neurol Sci, 2002,203(204):23-27
    [11]Tham W, Auchus AP, Thong M, et al. Progression of cognitive impairment after stroke:one year results from a longitudinal study of Singaporean stroke patients[J]. J Neurol Sci,2002,203—204:49—52.
    [12]李建民,陈长香,刘洁.621例缺血性脑卒中患者认知障碍现状及其影响因素.现代预防医学,2008,35(16):3205-3207
    [13]陈湛情,陆兵勋,陈文荣,等.脑梗死后情感障碍和认知障碍的影响因素.中国神经精神疾病杂志,2008,34(7):417-421
    [14]Rockwood K, Ebly E, Hachinski V, et al. Presence and treatment of vascular risk factors in patients with vascular cognitive impairment[J]. Arch Neurol,1997,54 (1): 33.
    [15]Straatena ECW, Scheltensa P, Barkhof F, et al. MRI and CT in the diagnosis of vascular dementia[J]. J Neurol Sci,2004,226:9.
    [16]Erkinjuntti T. Inzitari D, Pantoni I, et al. Research criteria for subcortical vascular dementia in clinical trials[J]. J Neural Transm,2000,59(Suppl 3):230
    [17]朱以诚,高山,刘秀琴,等.轻一中度血管件痴呆患者的头部影像学与认知功能障碍的关系.中华老年心脑血管病杂志,2000,2:315—317.
    [18]张巧俊,郭生龙,向丽,等.血管性认知功能损害的P300特点及其相关因素[J].中国临床康复,2005,7(7):1090——1091.
    [19]王荫华.如何提高认知功能障碍相关量表在临床的应用.中华内科杂志,2005,44(9):713~714
    [20]Orgogozo JM, Rigaud AS, Stoffler A, et al.Efficacy and Safety of memantine In patients with mild to moderate vascular dementia[J].Stroke,2002,33:1834-1839
    [21]Pantoni L,Del SetT, Soglian AG,et al.Efficacy and safety of nimodipine in subcortical vascular dementia[J].Stroke,2005,36:619-624
    [1]Widenfalk J,Lipson A.Jubran M,et al.Vascular endothelial growth factor improves functional outcome and decreases secondary degeneration in experimental spinal cord contusion injury[J].Neuroscience,2003,120(4):951-960
    [2]Ferrara N, Henzel WJ. Pituitary follicular cells secrete a novel heparin-binding growth factor specific for vascular endothelial cells[J].Biochem Biophys Res Comm, 1989,161(2):851-858.
    [3]Jazwa A,Loboda A,Golda S,et al. Effect of he me and he me oxygenasel on vascular endothelial growth factor synthesis and angiogenic potency of human keratinocytes[J].Free Radic Biol Med,2006,40(7):1250-1263
    [4]Larrivee B, Karsan A. Signaling pathways induced by vascular endothelial growth factor (review)[J]. Int J Mol Med,2000,5(5):447-456.
    [5]Sun FY,Guo X.Molecular and cellar mechanism of neuroprotection by vascular endothelial growth factor[J].J Neurosci Res,2005,79(12):180-184
    [6]Jin KL,Mao XO,Greenberg DA.Vascular endothelial growth factor:direct neuroprotective effect in invitro ischenmia[J].Proc Natl Acad Sci USA,2000,18: 10242-10247
    [7]Pages G,,Pouyssegur J.Transcriptional regulation of the vascular endothelial growth factor gene-a concert of activating factors[J]. Cardiovasc Res,2005,65(3):564-573
    [8]Lennmyr F,Terent A, Syvanen AC, et al. Vascular endothelial growth factor gene expression in middle cerebral artery occlusion in the rat[J]. Acta Anaesthesiol Scand, 2005,49(4):488-493
    [9]Chen HH, Chen CH, Liu HM. Correlation between angiogenesis and basic fibroblast growth factor expression in experimental brain infarct[J]. Stroke,1994, 25(8):1651-1657.
    [10]Marti HJ, Bernaudin M, Bellail A, et al. Hypoxia-induced vascular endothelial growth factor expression precedes neovascularization after cerebral ischemia[J]. Am J Pathol, 2000,156(3):965-976.
    [11]Zhang ZG, Zhang L, Tsang W, et al. Correlation of VEGF and angiopoietin expression with disruption of blood-brain barrier and angiogenesis after focal cerebral ischemia [J]. J Cereb Blood Flow Metab,2002,22(4):379-392.
    [12]Sun Y, Jin K, Xie L, et al. VEGF-induced neuroprotection, neurogenesis, and angiogenesis after focal cerebral ischemia[J]. J Clin Invest,2003,111(12):1843-1851.
    [13]Ehebauer M,Hayward P,Arias A M. Notch, a universal arbiter of cell fate decisions[J].Science,2006,314(5804):1414-1415
    [14]Luttun A.Carmeliet G,Carmeliet P.Vascular progenitors:from biology to treatment[J]. Trends Cradiovasc Med,2002,12(2):88-96
    [15]张莉莉,王景周,刘文生,等.血管性痴呆大鼠脑中生长抑素和乙酰胆碱含量的变 化[J].第三军医大学学报,2004,26(8):714-716.
    [16]Krebs LT, Xue Y, Norton CR, et al. Notch signaling is essential for vascular morphogenesis in mice[J].Genes Dev,2000,14(11):1343-1352
    [17]Gridley T.Vascular biology:vessel guidance[J].Nature,2007,445(7126):722-723
    [18]Hellstrom M, Phng LK, Hofmann J. D114 signalling through Notchl regulates formation of tip cells during angiogenesis[J]. Nature.2007;445(7129):722-723.
    [19]Krebs LT, Xue Y, Norton CR,et al.Notch signaling is essential for vascular morphogenesis in mice[J].Genes Dev,2000,14(11):1343-1352.
    [20]Gale NW, Dominguez MG,Noguera I et al.Haploinsufficiency of delta-like 4 ligand results in embryonic lethality due to major defects in arterial and vascular development [J]. Proc Natl Acad Sci USA 2004;101(45):15949-15954
    [21]Hofmann JJ,Luisa Iruela-Arispe M. Notch expression patterns in the retina:An eye on receptor-ligand distribution during angiogenesis[J]. Gene Expr Patterns,2007, 7(4):461-470
    [22]Andreas Androutsellis-Theotokis, Ronen R. Leker, Frank Soldner, et al. Notch signalling regulates stem cell numbers in vitro and in vivo[J].Nature,2006,442 (7104):823-826
    [23]Gerhardt H, Golding M, Fruttiger M,et al. VEGF guides angiogenic sprouting utilizing endothelial tip cell filopodia[J]. J Cell Biol.2003,161:1163-1177
    [24]Suchting S,Freitas C.le Noble F, et al.The Notch ligand Delta-like 4 negatively regulates endothelial tip cell formation and vessel branching[J].Proc Natl Acad Sci USA,2007,104(9):3225-3230
    [25]Leslie JD,Ariza-McNaughton L,Bermange AL, et al. Endothelial signalling by the Notch ligand Delta-like 4 restricts angiogenesis[J]. Development,2007 134(5):839-844

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700