Blood Brain Barrier presentation

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脑缺血再灌注损伤机制PPT幻灯片

脑缺血再灌注损伤机制PPT幻灯片

㈥一氧化氮(NO)
NO是一氧化氮合酶(NOS)催化下生成的起维持和调节血管 张力的一种自由基,其广泛分布于神经组织。
NO脑保护方面的机制有:①作用于血管平滑肌,活化鸟 氨酸环化酶产生GMP,钙依赖性钾通道开放,产生舒张血 管作用,抑制粘附分子发挥抗血小板凝聚和白细胞粘附功 能,使脑血流得以维持和改善。②通过巯基亚硝酸化及 NMDA受体变构作用,限制EAA的细胞毒性作用。③在一 定条件下消除OH,中断自由基的链式反应。
㈣炎症免疫机制
中枢神经系统可对各种损害产生完整的炎症反应。急性炎症反应在缺 血再灌注损伤所引发的继发性脑损伤中起着关键作用。脑缺血再灌注 损伤时,氧自由基和其他信使激活炎性细胞因子和致炎症酶原引起趋化 因子释放,白细胞黏附分子(选择蛋白、整合素、免疫球蛋白超基因家 族等)表达上调,从而中性粒细胞向微血管内皮细胞移动和黏附,致使中 性粒细胞在缺血脑组织中浸润引起损伤。在脑缺血再灌注损伤中,中性 粒细胞的活化和积聚在缺血再灌注损伤区神经元的损伤中扮演重要的 角色。而且,缺血后再灌注大大增加中性粒细胞在微血管中的积聚。实 验研究表明中性粒细胞的活化和积聚发生在缺血再灌注损伤后1h 内,24~48h达高峰。中性粒细胞及红细胞、纤维蛋白沉积物、血小板 的积聚能导致毛细血管的堵塞、渗漏及减少微血管血流,甚至导致缺血 区域的血液停滞现象,即所谓的再灌注后的“无复流”现象。聚集的白 细胞释放氧自由基、溶蛋白酶及细胞激动素等造成组织坏死;当中性粒 细胞迁移出血管浸润到缺血组织,通过细胞因子(肿瘤坏死因子、白介 素-1等)的释放,还可直接导致细胞毒性损伤
NO毒性方面的机制有:①与超氧阴离子形成过氧化亚硝 酸(ONOO-),灭活线粒体MnSOD,促进大量自由基生成, 介导氧化损伤。②抑制甘油酰-3-磷酸脱氢酶、肌酸激酶、 顺乌头酸酶、NADPH-辅酶Q和琥珀酸氧化还原酶等,减 弱氧化磷酸化过程从而阻止能量合成。还可抑制核糖核酸 还原酶,引发碱基脱氨导致DNA损伤,继之活化PARS, 使细胞能量耗竭而死亡。③介导细胞凋亡。

吉大生科院的药物化学名词解释

吉大生科院的药物化学名词解释

吉大名词解释第二章1、巴比妥类药物(barbiturates agents):具有5,5二取代基的环丙酰脲结构的一类镇静催眠药。

20世纪初问市的一类药物,主要由于5,5取代基的不同,有数十个各具药效学和药动学特色的药物供使用。

因毒副反应较大,其应用已逐渐减少。

2、内酰胺-内酰亚胺醇互变异构(lactam-lactimtautomerism):类似酮-烯醇式互变异构,酰胺存在酰胺-酰亚胺醇互变异构。

即酰胺羰基的双键转位,羰基成为醇羟基,酰胺的碳氮单键成为亚胺双键,两个异构体间互变共存。

这种结构中的亚胺醇的羟基具有酸性,可成钠盐。

3、锥体外系反应(effects of extrapyramidalsystem,EPS):锥体外系指在中枢锥体系以外的连接大脑皮层、基底神经节、丘脑、小脑网状结构及神经元的神经束和传导系统。

是一套复杂的神经环路。

锥体外系的反应指震颤麻痹,静坐不能、急性张力障碍和迟发性运动障碍等神经系统锥体外系的症状,常是抗精神病药物的副反应。

?4、非经典的抗精神病药物(atypical antipsychotic agents):近年来问世的一些抗精神病药物。

和传统的吩噻嗪类和氟哌啶醇药物不同,其拮抗多巴胺受体的作用较弱,可能是产生多巴胺和5-羟色胺受体的双相调节作用,其锥体外系的副反应较少,具有明显治疗精神病阳性和阴性症状的作用。

代表药物如氯氮平。

?5、构效关系(structure-activity relationship,SAR):在同一基本结构的一系列药物中,药物结构的变化,引起药物活性的变化的规律称该类药物的构效关系。

其研究对揭示该类药物的作用机制、寻找新药等有重要意义。

6、选择性5-羟色胺再摄取抑制剂(selective serotonin-reuptake inhibitors,SSRIS):通过选择性的阻碍突触间隙中的神经递质5-羟色胺的再摄取,提高5-羟色胺的浓度,产生抗抑郁作用的一类药物。

血脑屏障2013.11 (1)

血脑屏障2013.11 (1)

Trojan horse hypothesis
瘦素抵抗引起的肥胖症 (Leptin-resistant induced Obesit 2.转运系统异常
William A Banks:
“…In this sense,obesity is a disease of the BBB”
The Blood-Brain Barrier as a Cause of Obesity Current Pharmaceutical Design, Volume 14, Number 16, June 2008 , pp. 1606-1614(9)
NVU): 组成血脑屏障的各成分与邻近
的神经细胞共同组成的功能单位,主 要以旁分泌的方式在生理和病理条件 下相互影响、相互作用。包括神经元、 星形胶质细胞、小胶质细胞、血管内 皮细胞、血管周细胞、基底膜以及细 胞外基质。
NVU in Alzheimer's Disease
5.其它血脑屏障相关疾病
周细胞(Pericyte)
• 属于血管平滑肌细胞系 • 与内皮细胞共用基膜 • 与内皮细胞之间存在特化连接
周细胞
包裹脑微小/毛细血管30%-70%
周细胞的功能
周细胞的缩血管作用
星形胶质细胞终足(Astrocyte end-foot)
调节水分子进出脑组织 调节电解质代谢 调节小血管通透性
二、血脑屏障实验室研究与临床检测方法
1. 动物实验
示踪原理:伊文氏蓝(Evans Blue)静脉注
射入血,可透过被破坏的血脑屏障,迅速与 脑组织中的白蛋白结合,使脑组织染色。
Electron microscopy
体外实验——联合细胞培养
2. 建立血脑屏障开放模型

脑脊液 PPT课件

脑脊液 PPT课件
浑浊 易凝 无色、透明 无变化 阴性 不增高
陈旧性出血
清晰、透明 不易凝
红色、黄褐色或柠檬色 皱缩 阳性
继发性或反应性增高
外观—透明度
1.清晰、透明:正常、VE、神经性梅毒。 2.浊度:明显混浊、混浊、轻度混浊、毛玻璃样混浊。
见于细胞数增多(WBC>300×106/L);蛋白质和病 原菌增多等。
外观—薄膜与凝块
也存在经室管膜、脑和脊髓软膜及 沿脑和脊神经鞘入淋巴管和血管周 围间隙的少量吸收途径
左、右侧脑室脉络丛 —经室间孔→第三脑 室—经中脑水管→第 四脑室—经正中孔、 外侧孔→蛛网膜下隙 →蛛网膜粒→上矢状 窦→窦汇→左右横窦 →左右乙状窦→颈内 静脉
脑脊液的作用
缓冲外力对脑、脊髓、神经根等的影响 调节颅内压力和平衡脑血流量 充当清除CNS某些新陈代谢产物与毒素的媒介 营养脑神经 脑脊液检查在临床针对神经系统疾病,尤其是中枢神经系 统疾病的诊断、鉴别诊断和预后判断有极其重要的意义
一、脑脊液标本采集
★3个无菌试管中,每个试管1~2ml
第1管 细菌培养 第2管 化学分析和免疫学检查 第3管 理学及显微镜检查
临床上采集脑脊液最常用、最安全的方法: 侧卧位腰椎穿刺术
外观颜色检查
正常CSF是无色透明液体。
1. 红色:穿刺损伤、SAS (睡眠呼吸暂停综合症)或脑室出血。 如为蛛网膜下腔出血,三管试验均匀血性,静置不凝固,离心后上
酸与镁的含量较高
血、脑脊液、脑之间 _ 血-脑屏障(blood-brain barrier,BBB)
blood brain barrier (BBB)作用
脉络丛上皮细胞对各种物质的选择性:
★ 最易通过物质: 氯、钠、镁离子及乙醇
★ 不易通过物质: 清蛋白、葡萄糖、钙离子 、乳酸、氨基酸、 尿素和肌酐

妇产英文词汇词汇解读

妇产英文词汇词汇解读

Aabactio 人工流产abactus venter 人工流产abdomen circumference 腹围abdominal 腹部的abdominal cellotomy 腹式开腹术abdominal cesarean section 腹式剖宫产abdominal delivery 剖宫产abdominal drainage 经腹引流abdominal hysterectomy 腹式子宫切除术abdominal part 腹部abdominal pregnancy 腹腔妊娠abdominal pressure 腹压abdominal salpingectomy 腹式输卵管切除术,剖腹输卵管切除术abdominal salpingo-oophorectomy 腹式输卵管卵巢切除术,剖腹输卵管卵巢切除术abdominal stalk 脐带,腹蒂abdominal tubal sterilization 腹式输卵管绝育术abdominal version 外倒转术abdominopelvic cavity 盆腹腔abdominoscopy 腹腔镜检法abdominouterectomy 腹式子宫切除术,剖腹子宫切除术abdominouterotomy 腹式子宫切开术,剖腹子宫切开术aberratio mensium 月经迷乱,倒经aberratio menstruorum 月经迷乱,倒经ability to conceive 受孕能力ablatio placentae 胎盘早期剥离abnormal bleeding 异常出血abnormal labor 异常分娩abnormal pregnancy 异常妊娠abnormal uterine action 产力异常ABO blood group ABO血型ABO incompatibility ABO血型不合,ABO不合aborticide 堕胎,堕胎药abortifacient agents 堕胎药abortion 流产abortion applicant 要求流产者abortion on demand 要求流产abortionist 堕胎者abortus 流产儿abruptio placenta 胎盘早期剥离abruption of normally implanted placenta 正常位置胎盘早期剥离abscess 脓肿abscess of Bartholin gland 前庭大腺脓肿absence of uterus 无子宫absence of vagina 无阴道accessory placentae 副胎盘accessory placenta 副胎盘accidental abortion 意外流产accouchee 产妇accouchement 生产,分娩acquired dysmenorrhea 继发性痛经acquired immune deficiency syndrome 获得性免疫缺陷综合征,爱滋病acromio-iliac presentation 肩髋先露,横产位active pill days 有效避孕期acute cervicitis 急性宫颈炎acute fatty liver of pregnancy 妊娠急性脂肪肝acute pelvic inflammatory disease 急性盆腔炎acute salpingitis 急性输卵管炎acute salpingo-oophoritis 急性输卵管卵巢炎acyesis 不孕,不育acyeterion 避孕药adenexa 附件adenomas endometrioides ovarii 卵巢子宫内膜异位adenomatous glandular hyperplasia of endometham 子宫内膜腺型增生过长adenomatous hyperplasia 腺瘤型增生过长adenomyosis 子宫内膜异位症,子宫腺肌病,肌腺瘤adenomyosis externa 子宫外子宫内膜异位症adenomyosis interna 子宫内子宫内膜异位症adherent placenta 粘连性胎盘adhesion of cervical cannel 宫颈粘合adhesion of IUD 宫内节育器粘连aditus ad pelvis 骨盆上口aditus pelvis 骨盆入口,骨盆口aditus vaginae 阴道口adnexa uteri 子宫附件adnexal disease 子宫附件疾病adnexectomy 子宫附件切除术,附件切除adnexitis 子宫附件炎,附件炎adosculation 体外受精afterpains 产后宫缩痛afterwaters 后羊水air embolism 空气栓塞algomenorrhea 痛经amenia 闭经,停经amenorrhea due to uterine lesion 子宫性闭经amnionic fliud embolism 羊水栓塞ampullar lactiferae 输乳管壶腹,输乳管瘘ampullary pregnancy 输卵管壶腹部妊娠amputation of cervix 宫颈切除术anastomosis of tube 输卵管吻合术anatomic internal os 解剖学内口anatomy 解剖学angle of subpubic arch 耻骨弓角度ankylocolpos 阴道闭锁annexitis 子宫附件炎,附件炎anovaria 无卵巢anovular menstruation 无排卵性月经,不排卵性月经anovulatory bleeding 无排卵性出血anovulatory dysfunctional uterine bleeding 无排卵性功能失调性子宫出血anoxia neonatorum 新生儿缺氧anoxic ischemic encephalopathy 缺氧缺血性脑病anteflexion of uterus 子宫前屈antenatal 产前的,出生前的antenatal care 产前保健,产前护理antenatal diagnosis 产前诊断antenatal genetic diagnosis 产前遗传诊断antepartum eclampsia 产前子痫antepartum fetal death 产前胎儿死亡anterior colporrhaphy 阴道前壁修补术anthropoid pelvis 类人猿型骨盆anti-sperm antibody 抗精子抗体anticonceptive 避孕药anticoncipiens 避孕药apoplexia uteroplacenta 子宫胎盘卒中arrested labor 产程停滞art insem 人工受精arteria ovarica 卵巢动脉arteria urerina 子宫动脉arteria vaginalis 阴道动脉arteriae pudendae externae 阴部外动脉artificial abortion 人工流产artificial abortion-vacuum aspiration 负压吸引人工流产术artificial vagina 人工阴道Asherman syndrome 子宫腔粘连综合征,阿谢曼综合征,阿氏综合征,宫腔粘连综合征asphyxia livida 青紫窒息asphyxia neonatorum 新生儿窒息asphyxia pallida 苍白窒息atresia hymenalis 处女膜闭锁atresia of cervix 子宫颈闭锁aresia of hymen 处女膜闭锁atresia of vagina 阴道闭锁atypical epithelium 不典型上皮atypical hyperplasia 不典型增生atypical hyperplasia of endometrium 子宫内膜不典型增生Bbarrenness 不孕症,不育症bartholinitis 前庭大腺炎basal body temperature 基础体温baseline heart rate 胎心率基线badeline oscillation 基线摆动benign mole 良性葡萄胎benign trophoblastic disease 良性滋养细胞疾病bilanual gynecological examination 妇科双合诊检查biparietal diameter 双顶径bispinous diameter 坐骨棘间径blennometritis 子宫内膜炎blood brain barrier 血脑屏障blood group 血型bloody show 见红bony birth canal 骨产道bony pelvis 骨盆borderline ovarian tumors 卵巢交界性肿瘤botryoid sarcoma of uterus 子宫葡萄状肉瘤Bowen disease 鲍文病broad ligament 阔韧带bruit placentaire 胎盘杂音Ccancer in situ 原位癌carcinoma cervicis uteri 子宫颈癌carcinoma colli uteri 子宫颈癌carcinoma in situ of cervix 宫颈原位癌carcinoma in situ of uterine cervix 宫颈原位癌carcinoma of ovary 卵巢癌carcinoma of vulva 外阴癌carcinoma ovarii 卵巢癌carcinoma tubae 输卵管癌carcinoma vulvae 外阴癌cardinal ligament 主韧带cavity of uterus 子宫腔celio-salpingo-oothecectomy 腹式输卵管卵巢切除术central placenta previa 中央前置胎盘,完全前置胎盘cephalotomy 穿颅术cephalotracter 产钳cervical adeno-squamous carcinoma 宫颈腺-鳞癌cervical dilatation 宫颈扩张cervical dysplasia 宫颈非典型增生cervical ectropion 宫颈外翻cervical endometritis 宫颈内膜炎cervical hypertrophy 宫颈肥大cervical laceration 宫颈裂伤cervical mucus 宫颈黏液cervical pregnancy 宫颈妊娠cervical squamous cell dysplasia 宫颈鳞状上皮非典型增生cervlcal laccration 宫颈裂伤childbirth without pain 无痛分娩chorioadenoma 绒毛膜腺癌,恶性葡萄胎choriocarcinoma 绒毛膜癌chorionic gonadotropin hormone 绒毛膜促性腺激素chronic pelvic inflammatory disease 慢性盆腔炎chronic pelvic parametritis 慢性盆腔结缔组织炎chronic salpingitis 慢性输卵管炎chronic salpingo-ocphoritis 慢性输卵管卵巢炎chronic vulvar dystrophy 慢性外阴营养不良claustrum virginale 处女膜colpoplasty 阴道成形术colpopoiesis 阴道成形术colporrhaphia anterior 阴道前壁缝合术colporrhaphia anterior-posterior 阴道前后壁修补术colporrhaphia posterior 阴道后壁修补术colposcope 阴道镜commissura labiorum posterior 阴唇后联合complete hysterectomy 全子宫切除术complete placenta previa 中央前置胎盘,完全前置胎盘condom 阴茎套condyloma 湿疣condyloma acuminata 外阴尖锐湿疣congenital absence of uterus 先天性无子宫congenital absence of vagina 先天性无阴道,先天性阴道阙如congenital adrenal cortical hyperplasia 先天性肾上腺皮质增生症conization of cervix 宫颈锥切术conization of the cervix 宫颈锥形切除术conjugata diagonalis 对角径conjugata vera obstetrica 产科结合径,产科直径conjugata of inlet 入口前后径conjugata of outlet 出口前后径conjugata vera 真结合径conservative myomectomy 保守性肌瘤摘除术constriction rings 子宫痉挛性狭窄环contact bleeding 接触性出血contracted pelvic inlet 骨盆入口狭窄contracted pelvic outlet 骨盆出口狭窄contraction stress test 宫缩应激试验cord around neck 脐带绕颈cornual pregnancy 宫角妊娠,子宫角妊娠corona radiata 辐射冠,放射冠corpora atretica 闭锁卵泡corpora luteum graviditatis 妊娠黄体,真黄体corpora pampiniforme 卵巢冠corporeal cesarean section 古典式剖宫产术cortex of ovary 卵巢皮质crown-heel length 顶踵长,冠踵长,立高crowning of head 胎头着冠culdocentesis 后穹隆穿刺术curettage of the uterine cavity 刮宫术cyesiognosis 妊娠诊断cysthitis 女阴炎cystic hyperplasia of endometrium 子宫内膜囊腺型增生过长cysto urethrocele 尿道膀胱膨出cystocele 膀胱膨出cystocele perinealis 会阴膀胱膨出cystocele vaginalis 阴道膀胱膨出cystoma ovarii 卵巢囊肿cydtoma paraovarii 卵巢冠囊肿Ddecidua 蜕膜decidua basalis 底蜕膜,基蜕膜decidua capsularis 包蜕膜decidua interuteroplacentalis 底蜕膜,基蜕膜decidua parietalis 壁蜕膜decidua reaction 蜕膜反应decidua reflexa 包蜕膜decidua serotina 底蜕膜decidual cast 蜕膜管型deep lying placenta 低置胎盘deep transverse arrest 持续性枕横位defloration 处女膜破裂delayed amniotic fluid embolism 迟发型羊水栓塞delivery before arrival 急产delivery date rule 分娩日期规律delivery mechanism 分娩机制delivery room 分娩室,产房denticular hymen 锯齿状处女膜descensus uteri 子宫脱垂descensus vaginae anterior 阴道前壁脱垂descent vaginae posterior 阴道后壁脱垂diabetic vulvitis 糖尿病性外阴炎diagnostic curettage 诊断性刮宫diagnostic fractional curettage 诊断性分段刮宫diagnostic puncture 诊断性穿刺diagonal 对角线,斜的diaphragma pelvis 盆膈diaphragma urogenitale 尿生殖膈diastematelytria 阴道纵裂diastematometria 子宫纵裂difficult delivery 难产difficult labour 难产dilatation of uterine cervix 宫颈扩张术disseminated intravascular coagulation 播散性血管内凝血,弥散性血管内凝血dysfunctional uterine bleeding 功能失调性子宫出血Eearly deceleration 早期减速early delivery 早产early invasive carcinoma 早期浸润癌eccyesis 异位妊娠,子宫外孕eclampsia 子痫eclampsia intrapartum 产时子痫,产间子痫eclampsia puerperalis 产惊,产后子痫eclamptic coma 子痫昏迷ectopia of IUD 宫内节育器异位ectopic fetation 异位妊娠ectopic gestation 异位妊娠electrocauterization of cervix 宫颈电烙术emmenia 月经endocervical scraping smear 宫颈管刮片endometiosis externa 外在性子宫内膜异位症endometrial carcinoma of uterus 子宫内膜癌endometrial tuberculosis 子宫内膜结核endometrorrhagia 子宫出血,血崩episiohematoma 外阴血肿episioitis 外阴炎epithelial tumor of ovary 卵巢上皮性肿瘤excision of Bartholin gland cyst 前庭大腺囊肿切除术excision of cervical polyp 宫颈息肉摘除术excision of cervical stump 宫颈残端切除术excision of imperforate hymen 无孔性处女膜切开术expulsion of IUD 宫内节育器脱落extended hysterectomy 次广泛子宫全切除术extraperitoneal cesarean section 腹膜外剖宫产术Ffallectomy 输卵管切除术falling of womb 子宫脱垂fetal heart rate 胎心率fetal heart rate-baseline 胎心率基线fetal heart rate-baseline variability 胎心率基线变异fetal heart rate monitoring 胎心率监测fetal heart sound 胎心音,胎儿心音fetal lung maturity 胎儿肺成熟度fetal macrosomia 巨大胎儿fetal position 胎方位,胎位fetal posture 胎势fetal presentation 胎先露foetal membranes 胎膜foetus papyraceus 纸样胎儿,压扁胎forceps delivery 产钳分娩fractional curettage of uterus 分段刮宫术frenulum clitoridis 阴蒂系带frenulum labiorum pudendi 阴唇系带frenulum of clitoris 阴蒂系带fronto-anterior position 额前位fronto-dextra anterior 右额前位fronto-dextra posterior 右额后位fronto-dextra transverse 右额横位fronto-laeva anterior 左额前位fronto-laeva posterior 左额后位fronto-lavea transverse 左额横位fronto-occipital diameter 枕额径,前后径fronto-posterior position 额后位fronto-transverse position 额横位frontomental diameter 枕颏径frozen pelvis 冰冻骨盆full-term birth 足月产full-term living birth 足月活婴full-term normal delivery 足月顺产full-term normal vaginal delivery 足月正常阴道分娩fundus of uterus 子宫底Ggalactorrhea-amenorrhea syndrome 乳泌-闭经综合征galea forceps 头皮钳gestational diabetes mellitus 妊娠糖尿病granulosa theca cell tumor 颗粒-卵泡膜细胞瘤gravida 产妇graviditas fimbriae tubarica 输卵管伞graviditas tubaria 输卵管妊娠graviditas tubaria ampullaris 输卵管壶部妊娠graviditas tubaria infundibularis 输卵管漏斗部妊娠graviditas tubaria interstitialis 输卵管间质部妊娠graviditas tubaria isthmica 输卵管峡部妊娠graviditas tuboabdominalis 输卵管腹腔妊娠graviditas tuboovarialis 输卵管卵巢妊娠greater lip of pudendum 大阴唇greater pelvis 大骨盆greater vestibular gland 前庭大腺greater length 最大长度,最大身长Hhabitual abortion 习惯性流产haemophilis vaginitis 嗜血杆菌阴道炎haemorrhagia ovulations 排卵出血head locking 胎头交锁height-weight-age table 身高体重年龄对照表heterotopic endometriosis 子宫内膜异位症hiphasic basal body temperature 双相基础体温Hunter ligament 亨特韧带,子宫圆韧带hydatid pregnancy 葡萄胎妊娠hydatidenmole 葡萄胎,水泡状胎块hydatidiform mole 葡萄胎hydrocephalus 脑积水,水脑hydrosalpinx 输卵管积水hymen 处女膜hymen cribriformis 筛状处女膜hymen falciformia 镰状处女膜hymen fimbriatus 伞状处女膜hymen imperforatus 无孔处女膜,处女膜闭锁hymenalatresic 处女膜闭锁hyperprolactinaemic amenorrhoea 高生乳素血症性闭经,高泌乳素血症性闭经hypertension syndrome of pregnancy 妊娠高血压综合征hyperthyroidism 甲状腺功能亢进hypofunction of corpus luteum 黄体功能不足hypoplasia of the uterus 子宫发育不全hypothalamic-pituitary-ovarian axis 下丘脑-垂体-卵巢轴Iinclination of pelvis 骨盆倾斜度Llaparotrachelotomy 子宫颈切开剖宫产术,子宫下段剖宫产术last menstrual period 末次月经left fronto-anterior 左额前位left fronto-posterior 左额后位left fronto-transverse 左额横位left mentoanterior 左颏前位left mentotransverse 左颏横位left mintoposterior 左颏后位left occipitoanterior 左枕前位left occipitoposterior 左枕后位left occipitotransverse 左枕横位left sacroanterior 左骶前位left sacroposterior 左骶后位left sacrotransverse 左骶横位left scapuloanterior 左肩前位left scapuloposterior 左肩后位leiomyoma-uteri 子宫平滑肌瘤lochia alba 白色恶露lochia cruenta 红色恶露lochia rubra 血性恶露lochia serosa 浆液恶露low cesarean section 子宫下段剖宫产Mmalignant hydatidiform mole 恶性葡萄胎Manchester operation 曼澈斯特手术maternal mortality rate 孕产妇死亡率,母体死亡率mediolateral episiotomy 会阴正中旁切开,会阴侧切术membrana agnina 羊膜membrana caduca 蜕膜metastatic carcinoma of ovary 卵巢转移性癌metastatic choriocarcinoma 转移性绒毛膜癌metroscopy 子宫镜检查,宫腔镜检查missed abortion 稽留流产myoma of the uterus 子宫肌瘤myoma of uterus 子宫肌瘤myoma submucosum 黏膜下肌瘤myoma subserosum 浆膜下肌瘤myoma uteri 子宫肌瘤myomectomy 子宫肌瘤切除术,肌瘤挖出术myxoma peritonei 腹膜黏液瘤NNaboth cyst 子宫颈腺囊肿,纳博特囊肿,纳氏囊natural labor 顺产,自然分娩Oobstetric forceps delivery 产钳术obstetrician 产科医师obstetrician-gynaecologist 妇产科医师old primipara 高年初产妇oophoritic cysts 卵巢囊肿oothecocyesis 卵巢妊娠oothecoma 卵巢瘤oothecorrhexis 卵巢破裂ovariam-ascites-pleural effusion syndrome 卵巢-腹水-胸水综合征,麦格斯综合征ovarian amenorrhea 卵巢性闭经ovarian ligament 卵巢固有韧带ovariosalpingectomy 卵巢输卵管切除术,输卵管卵巢切除术ovarium 卵巢ovulatory dysfunctional uterine bleeding 排卵功能失调性子宫出血oxytocin challenge test 催产素激惹试验Ppainless delivery 无痛分娩painless labor 无痛分娩partus immaturus 早产partus maturus 足月产partus precipitatus 急产partus serotinus 过期产pelvic axis 骨盆轴pelvic cavity 骨盆腔pelvic congestion syndrome 盆腔淤血综合征pelvic diaphragm 盆膈pelvic inlet plane 入口平面pelvic midplane 中骨盆平面pelvic outlet plane 出口平面pelvimeter 骨盆测量器perimenopausal syndrome 围绝经期综合征,更年期综合征perineal laceration 1°会阴1°撕裂perineal laceration 2°会阴2°撕裂perineal laceration 3°会阴3°撕裂perineal lateralis 会阴侧切开术periodoscope 分娩日期计算表peritoneal dropsy 腹水physiologic retraction ring 生理性缩复环placenta accreta 侵入性胎盘,植入性胎盘plural pregnancy 多胎妊娠post term infant 过期产儿postmenopausal bleeding 绝经后出血,绝经后流血postmenopausal genital hemorrhage 绝经后生殖道出血postmenopausal osteoporosis 绝经后骨质疏松postpartum hemorrhage 产后出血pregnancy with IUD in situ 带器妊娠proper ligament 卵巢固有韧带protracted active phase dilatation 活跃期宫口扩张停滞puncture of posterior fornix of vagina 阴道后穹隆穿刺pyometra 宫腔积脓pyometritis 化脓性子宫炎pyometrium 子宫积脓Rrepair of old perineal laceration 陈旧性会阴裂伤修补术retention of menses 经血潴留rupture of tubal pregnancy 输卵管妊娠破裂Ssafe period contraception 安全期避孕sarcoma botryoides 葡萄状肉瘤,葡萄样肉瘤Ttocomonitor 分娩监护仪trichomonous vaginitis 滴虫性阴道炎Uuterine sarcoma 子宫肉瘤uterine serosa 子宫浆膜Vvaginal cuff 阴道断端vaginal hysterectomy 阴道式子宫切除术,阴道子宫切除术vaginal secretion 阴道分泌物vaginal smear 阴道涂片vaginitis hemoptulus vaginalis 阴道嗜血杆菌性阴道炎velamentous insertion 帆状附着,脐带帆状附着velamentous placenta 帆状胎盘venae ovarica dextra 右卵巢静脉venae ovarica sinistra 右卵巢静脉vesico-uterine fistula 膀胱子宫瘘vesico-vaginal fistula 膀胱阴道瘘vesicocervical fistula 膀胱子宫颈瘘vesicular mole 水泡状胎块,葡萄胎vulneratio hymenalis 处女膜损伤vulva condyloma acuminata 外阴尖锐湿疣vulval basal cell carcinoma 女阴基底细胞癌vulval Bowen disease 女阴原位癌vulvopathy 外阴病阿普加评分Apgar score癌性腹膜炎cancerous peritonitis,carcinomatous peritonitis,peritonitis carcinomatosa癌转移cancerometastasis爱滋病病毒human immunodeficiency virus按期服用避孕丸sequential pills按期口服避孕丸sequentials巴氏腺Bartholin gland白斑leukoplakia,leukasmus,tacheblanche白斑病leukopathia,leucoderma白斑病外阴炎leukoplakic vulvitis白斑病性角化不良leukoplakic dyskeratosis白带leulomatorrhea vaginalis,leukorrhea,fluor albus,leukomatorrhea vaginalis,profluvium muliebre,whites白色恶露lochia alba,alba lochia白色念珠菌Saccharomyces albicans,candida albicans白色念珠菌性阴道炎Candida albicans vaginitis包蜕膜decidua capsularis,decidua reflexa,capsular deciduas保守性肌瘤摘除术conservative myomectomy鲍文病Bowen disease暴发子痫fulminant eclampsia闭经suppression of menses,suppressed menstruation,amenia ,amenorrhea闭经的amenorrheal,amenerrheic,amenorrheic壁内的intramural壁内肌瘤intraparietal myoma壁内平滑肌瘤intramural leiomyoma壁蜕膜decidua parietalis,decidua vera避孕药anticoncipiens,anticonceptive,acyeterion,contraceptive agents 避孕药膜contraceptive film边缘性前置胎盘placenta praevia marginalis扁平骨盆platypelloid pelvis,Deventer diameter pelvis,flat pelvis,pelvis plana扁平骨盆flat pelvis,flattened pelvis扁平湿疣condyloma lata变异减速variable deceleration变异型心率减慢variable decelerations表皮epiderm表皮癌epidermal carcinoma表皮样畸胎瘤epidermoid teratoma表皮样微小癌epidermoid microcarcinoma表皮样原位癌epidermoid carcinoma in situ表皮增殖如疣epidermoma冰冻骨盆frozen pelvis并发先兆子痫superimposed preeclampsia并合肌瘤synaetosis并脑独眼畸胎cyclocephalus并脑畸形cyclencephalus并胚duplicitas,duplicity并躯联胎syssomus并头联胎symphyocephalus,syncephalus,synencephalus,sycephalus,deradelphus,duplicitas cruciata并腿畸形sireniform fetus,symphysoskelia,symmelus,symmelia并眼畸形symphysopsia,synopsia,synophthalmia,synophthalmus,synopsy,anophthalmus cyclopica,fused eyeball并指/趾dactylium,dactylosymphysis并指/趾缺指/趾畸形ectrosyndactylia并指/趾者syndactylus并指并趾畸形syndactyly并指畸形symphysodactylia,aschistodactylia病毒学Virology病毒诱发的肿瘤virus induced tumor病理缩复环pathologic retraction ring不典型增生atypical hyperplasia不全中隔子宫uterus subseptus不完全流产incomplete abortion不完全破裂incomplete rupture不协调性子宫收缩incoordinated uterine action不锈钢麻花环宫内节育器stainless steel“ma-hua”ring IUD不锈钢圆环宫内节育器stainless steel ring IUD不孕症barrenness,infertility部分性葡萄胎partial hydatid mole部分性前置胎盘partial placenta praevia,placenta praevia partialis,incomplete placenta previa部分子宫切除术partial hysteretomy残端妊娠stump pregnancy残角妊娠pregnancy in rudimentary born残角子宫rudimentary horn of uterus残留卵巢综合征residual ovary syndrome产程停滞arrested labor产程图partogram产道裂伤laceration of birth canal产妇parturient,puerpera,puerperant,accouchee,lying-in woman 产后出血postpartum hemorrhage产后宫缩痛afterpains产后静脉炎puerperal phlebitis产后血栓形成puerperal thrombosis产后子宫内膜炎puerperal endometritis产后子宫炎lochiometritis产后子痫eclampsia postpartum,eclampsia puerperalis产间子痫eclampsia intrapartum产科出血obstetric hemorrhage产科医师obsterist,obstetrician,accoucheur产科医师助理obstetrical physician assistant产力异常abnormal uterine action产前保健prenatal care,antenatal care产前估计胎儿成熟度prenatal estimation of fetal maturity产前遗传诊断antenatal genetic diagnosis产前子痫antepartum eclampsia产钳分娩forceps delivery产钳术obstetric forceps delivery,instrumental extraction产褥感染puerperal infection,infection puerperalis产褥股白肿phlegmasia alba dolens puerperarum产褥期puerperium,puerperal state,ramus pubicus arteriae epigapuerperal state,lying-in,stegmonth产褥期精神病puerperal psychosis产伤birth trauma,birth injury,birth injuries陈旧性会阴裂伤修补术repair of old perineal laceration成熟卵泡Graafian follicle持续性枕横位persistent occipitotransverse position,deep transverse arrest,transverse arrest持续性枕后位persistent occipitoposterior position,persistant posterior occipit position耻骨弓pubic arch耻骨弓角度angle of subpubic arch,subpubic angle出口产钳outlet forceps出口横径transverse outlet出口后矢状径posterior sagittal diameter of outlet,posterior sagittal diameter,posterior sagittal of outlet出口平面pelvic outlet plane出口前后径the anterior-posterior outlet diameter,conjugate of outlet出生缺陷birth defect,birth defects出血点petechia初产妇unipara,primipara初潮first menstruation初次妊娠的primigravid初级卵母细胞primary oocyte,first oocyte初级卵泡primary follicle,folliculi ovarici primarii,folliculi oophori primarii初乳colostrum,breastings,neogala,fore milk处女膜闭锁atresia of hymen,imperforate hymen,atresia hymenalis,unperforated hymen,hymen imperforatus,hymen occlutus,hymenalatresic处女膜裂伤leceration of the hymen处女膜破裂defloration处女膜破损ruptured hymen处女膜切除hymenectomy处女膜损伤vulneratio hymenalis处女膜完整hymen intactus,intact hymen穿颅术craniotomy,cephalotomy,eccephalosis,transforation垂体功能减退症hypopituitarism雌激素撤退性出血estrogen withdrawal bleeding雌激素试验estrogen test雌激素替代疗法estrogen replacement therapy雌激素与肌酐比值estrogen/creatinine ratio,estrogen to creatinine ratio次广泛子宫全切除术extended hysterectomy单纯外阴切除术simple vulvectomy低位产钳术low forceps delivery滴虫病trichomoniasis滴虫性阴道炎trichomonous vaginitis,Trichomonas vaginitis,colpitistrichomonadis滴虫阴道炎trichomonal vaginitis底蜕膜decidua basalis,decidua serotina,decidua interuteroplacentalis第二产程second stage of labor第三产程third stage of labor,placental stage,opsitocia第一产程first stage of labor堕胎abort,feticide,foeticide,aborticide堕胎药abortive,abortifacient,ambiotic remedy,abortifacient agents,abortient,abortigenic,aborticide恶露lochia,lyma恶性子宫绒毛膜上皮癌malignant uteri chorion-epithelioma负压吸引人工流产术artificial abortionvacuum aspiration附件切除术ecphyadectomy,annexectomy腹膜外剖宫产术extraperitoneal cesarean section,Latzko cesarean section腹膜外引流extraperitoneal drainage腹膜外子宫切除术extraperitoneal hysterectomy腹腔积血hematocelia,hemoperitoneum,hematocoelia腹式输卵管绝育术abdominal tubal sterilization腹式输卵管卵巢切除术abdominal salpingo-oophorectomy,celio-salpingo-oothecectomy腹式输卵管切除术abdominal salpingectomy,celiosalpingectomy腹式子宫卵巢输卵管切除术celiohysterosalpingo-oothecectomy感染性休克septic shock高龄初产妇elderly primipara高泌乳素血症性闭经hyperprolactinaemic amenorrhoea高张性子宫乏力hypertonic uterine inertia更年期climacteric period,climacterium,climacter,perimenopausal period,perimenopause,age critique,climacteric,involution period 功能失调性子宫出血dysfunctional uterine bleeding宫颈cervix,cervix uteri宫颈癌carcinoma of uterine cervix,cancer of cervix宫颈电烙术electrocauterization of cervix宫颈电灼术cauterization of cervix宫颈刮片cervical scraping smear宫颈管刮片endocervical scraping smear宫颈非典型增生cervical dysplasia宫颈浸润癌invasive carcinoma of cervix宫颈鳞型细胞癌squamous cell carcinoma of cervix宫颈鳞状上皮非典型增生cervical squamous cell dysplasia宫颈黏液检查cervical mucus examination宫颈锥切术conization of cervix宫内发育迟缓intrauterine growth retardation宫内感染intrauterine infection宫内节育器intrauterine device,intrauterine contraceptive device 宫内节育器排出intrauterine device expulsion宫内节育器嵌顿incarceration of IUD宫内节育器脱落expulsion of IUD宫内节育器移位displacement of IUD宫内节育器异位ectopia of IUD宫内节育器粘连adhesion of IUD宫内节育器子宫完全性穿孔complete perforation of uterus by宫腔镜hysteroscope,uteroscope宫腔镜检查hysteroscopy,uteroscopy宫缩乏力uterine inertia宫缩应激试验contraction stress test古典式剖宫产术classical cesarean section,corporeal cesarean section骨盆漏斗韧带ligament infundibulum pelvicun,infundibulopelvic ligament,ligamenta infundibulo-pelvinum骨盆入口狭窄contracted pelvic inlet骨盆外测量external pelvimetry刮宫术dilatation and curettage,curettage of the uterine cavity,intrauterine curettage过期产儿post term infant过期妊娠prolonged pregnancy,postterm pregnancy红色恶露rubra lochia,lochia cruenta后穹隆posterior fornix后穹隆穿刺术puncture of posterior fornix后穹隆切开术posterior colpotomy壶腹部妊娠graviditas ampullaris黄体功能不足inadepuate luteal function会阴1°撕裂perineal laceration1°会阴2°撕裂perineal laceration2°会阴3°撕裂perineal laceration3°会阴侧切术lateral episiotomy基线摆动baseline oscillation计划分娩programed delivery计划生育planned childbirth,planning parenthood,family planning 经闭-乳溢综合征amenorrhea-galactorrhea syndrome痉挛性痛经spasmodic dysmenorrhea痉挛性狭窄环constriction ring扩张宫颈和刮宫术dilation and curettage,dilatation and curettage扩张宫颈和清宫术dilatation and evacuation卵巢浆液乳头状癌sero-papillary cancer of the ovary卵巢浆液性囊腺瘤ovarian serous cystadenoma,serous cystadenoma of ovary卵巢交界性肿瘤borderline ovarian tumors卵巢颗粒泡膜细胞瘤granulose theca cell tumor of ovary卵巢颗粒细胞瘤granulose cell tumor of ovary卵巢克鲁肯伯格瘤Krukenberg tumor of ovary卵巢破裂oothecorrhexis,ovariorrhexis卵巢巧克力囊肿chocolate cyst of ovary难免流产inevitable abortion,imminent abortion女性生殖系统female reproductive system女性外生殖器官demale external genital organs排卵ovulation,ovulatio排卵期月经kleine regel排卵功能失调性子宫出血ovulatory dysfunctional uterine bleeding 前庭大腺囊肿Bartholin cyst前庭大腺脓肿abscess of Bartholin gland,Bartholin gland abscess全子宫切除术panhysterectomy,complete hysterectomy全子宫输卵管卵巢切除术panhysteros-alpingo-oophorectomy全子宫输卵管切除术panhysteros-alpingectomy人工阴道成形术Baldwin operation妊娠高血压综合征pregnancy induced hypertension syndrome,hypertension syndrome of pregnancy,edema-proteinuria-hypertension syndrome生殖器脱垂edeoptosis输卵管积脓pyosalpinx输卵管间质部妊娠interstitial tubal pregnancy,graviditas tubariainterstitialis,interstitial pregnancy,salpingysterocyesis输卵管流产tubal abortion输卵管卵巢脓肿tubo-ovarian abscess输卵管切除术salpingectomy,tubal resection,fallectomy,fallotoimy 输卵管妊娠破裂rupture of tubal pregnancy,tubal rupture双相基础体温biphasic basal body temperature,hiphasic basal body temperature胎盘早期剥离premature separation of placenta,premature separation of normally implanted placenta胎盘滞留placental retention,retentio placentae,retained placenta,retention of placenta头颅血肿cephalohematoma,cephalhematoma头盆不称cephalopelvic disproportion外阴尖锐湿疣condyloma acuminata外阴阴道炎vulvovaginitis完全性前置胎盘total placenta praevia,placenta praevia tolalis 无脑儿anencephaly,anencephalus无排卵性功能失调性子宫出血anovulatory dysfunctional uterine bleeding无痛分娩painless labor,painless delivery,garturition insensibilis,childbirth without pain无阴道absence of vagina无应激试验non stress test腺瘤型增生过长adenomatous hyperplasia血性恶露lochia rubra,lochia sanguinea要求流产abortion on demand要求流产者abortion applicant阴道膀胱瘘colpocystosyrinx阴道膀胱瘘修补术repair of vesicovaginal fistula阴道后壁膨出douglascele阴道后壁脱垂prolapse vaginae posterior,descent vaginae posterior阴道后穹隆posterior vaginal fornix阴道后穹隆切开术posterior colpotomy阴道毛滴虫Trichomonas vaginalis阴道毛滴虫病trichomoniasis vaginalis阴道嗜血杆菌haemophilus vaginalis阴道嗜血杆菌性阴道炎vaginitis hemoptulus vaginalis原发性宫缩无力primary uterine inertia原发性痛经primary dysmenorrhea诊断性分段刮宫diagnostic fractional curettage诊断性刮宫diagnostic curettage,exploratory curettage子宫肌腺病endometriosis interna子宫颈展平effacement子宫颈锥形切除术endocervicectomy子宫痉挛性狭窄环constriction rings子宫内膜囊腺型增生过长cystic hyperplasia of endometrium子宫内膜息肉polyp of endometrium,endometrial polyp子宫内膜腺型增生过长adenomatous glandular hyperplasia of endometham子宫内膜样腺癌endometrium like adenocarcinoma,endometrioid adenocarcinoma,endometrioid adenoma子宫内膜异位症endometriosis,endometriosis uterina,adenomyosis,heterotopic endometriosis子宫托pessary,hysterophore。

血脑屏障[严选材料]

血脑屏障[严选材料]
Ensure material exchange
专业调研
13
4.决定血脑屏障通透性的因素
• 物质的脂溶性 • 物质的亲水性 • 与血浆蛋白的结合程度 • 载体转运系统 • 发育的影响 ……
专业调研
14
5.血脑屏障各组分详解
血管腔面
a
内皮细胞
b
紧密连接
c
基膜
d
周细胞
e4
星星形形胶胶质质细细胞胞终终足足
Basement membrane Pericytes
End -feet of astrocytes
专业调研
11
中枢和外周毛细血管的差别
外周
CNS
内皮细胞
有窗孔、多小泡
无窗孔、缺乏小泡
内皮细胞连接
有间隙
紧密连接
周细胞
很少

基膜

胶质细胞

有 星形胶质细胞终足
内皮细胞含有的酶 无

内皮细胞是否能收 含收缩蛋白,对组织
物质交换非常丰富
专业调研
3
Following questions
毒素 H2O
药物
ATP
专业调研
4
How to protect?
BRAIN
BLOOD
BCB
CSF
专业调研
5
一、什么是血脑屏障
血脑屏障(blood-brain barrier, BBB):在血液和脑之间,选择性 地阻止某些物质由血进入脑的屏 障。
—— Semin Immunopathol (2010)
专业调研
40
多发性硬化 (Multiple sclerosis)
专业调研

血脑屏障Blood-Brain Barrier

血脑屏障Blood-Brain Barrier
21
increasing Lipophilicity too much results in negative effect
22
Replace Carboxylic Acid Groups to improve brain penetration
23
decrease pKa to improve brain penetration
24
Add intramolecular bond to increase brain penetration
25
Increase metabolic stability to improve brain penetration
26
Thanks!
27
Phosphatidylserine
5
High efflux activity and uptake transport
6
Brain distribution mechanisms mechanisms limit the access of compounds to brain cells by affecting the distribution of compound to or within the brain
11
Summarize the major mechanisms affecting brain exposure
12
Brain–CSF Barrier
13
Interpreting Data for Brain Penetration The most commonly used brain penetration data is B/P; its log is Log BB. B/P > 0.3 is used as a minimum guideline for CNS discovery projects. yet some commercial CNS drugs have B/P < 0.1. B/P is is calculated from various data:

血脑屏障的机制与功能研究

血脑屏障的机制与功能研究

血脑屏障的机制与功能研究血脑屏障(Blood Brain Barrier, BBB)是脑部神经系统的一种保护性结构,它能够阻止大多数药物、细菌、病毒等有害物质进入大脑,同时维持脑内环境的稳定。

BBB的建立和维持需要多个细胞类型的密切协作,其中包括微血管内皮细胞、astrocytes以及pericytes。

在本文中,我们将探讨BBB的机制和功能以及近年来关于BBB的研究进展。

BBB的机制BBB的机制主要是由微血管内皮细胞和astrocytes共同构成的血脑屏障基质来维护的。

微血管内皮细胞是BBB的主要组成部分,它们形成密实的血管内膜,使大分子物质无法通过,同时可以通过上皮细胞间紧密连接部分形成紧密连接,阻挡细胞外液体的渗透。

Microvilli扩大了微血管表面积,增加了脑部的氧气和营养的供给。

Astrocytes则通过足突形成被称为紧密交界处的典型网状结构,使BBB更具完整性。

BBB的功能BBB通过以下途径来保持脑内环境的稳定和保护脑部免受有害物质的侵害:1.阻止细菌及病毒进入大脑BBB能够阻止大多数药物、细菌、病毒及其他有害物质从血流中进入大脑,在大脑内形成相对稳定的生理环境,保证大脑不受细菌、毒素等侵害。

2.维护脑部代谢活动BBB防止外部有害物质切断了脑内代谢通路,维护血液–脑屏障的结构稳定,限制内源性有害物质、代谢产物的进入,维持神经细胞的功能。

3.维持电化学平衡BBB维持脑内外离子的稳态,自动调节离子的比例和浓度,防止神经细胞受到影响而导致电化学平衡失调。

BBB的研究进展BBB的研究是神经科学领域的一个热门课题。

经过多年的研究,科学家们已不仅仅了解了BBB的构成和功能,还发现了BBB在一些疾病的治疗中的重要作用。

1. BBB在多发性硬化中的研究多发性硬化(Multiple Sclerosis, MS)是一种神经系统疾病,病因未明,至今仍没有根治。

研究发现,患有MS的患者的 BBB会呈现损伤和不稳定现象,如有病变区域的 BBB,通透性会有所增加,导致有害物质进入脑部。

血脑屏障讲座课件

血脑屏障讲座课件
蛋白结合率:
血浆中许多化合物是与血浆蛋白结合的。小分子化合物如激素,与血浆蛋白 质结合后就不容易透过血脑屏障,因此无从发挥其生理效应;必须待其游离 以后才能通过屏障发挥其效应。
即使通过受体介导的转运,
也不能保障药物“穿”得过血脑屏障

因为转运蛋白的数量和其所能辅助进入细胞的蛋白数量是有限的,另外,每
MPTP:一种可使血脑屏障受损的化学物质, 模拟脑卒中状态。
M.F. Saulino, et al. J Neuro Rese. 1994, 37:384.
11 11
障, 还能有效修复血脑屏障
Sham
Control
Low Dose Middle Dose High Dose
* High Dose Group与Control Group比:P<0.05;# Middle Dose Group与Control Group比, P<0.05。
一个抗体上所能连接的蛋白的数量也是有限的,那么对于需要高剂量才能发
挥作用的药物而言,利用内皮细胞膜上的一些转运蛋白来辅助药物进入BBB,
” 这种方法可能并不适用。
——Kreuter 教授
有限的转运蛋白数量导致生物大分子在全身循环的生物利用度低, 在脑内的生物利用度更低
产品 NGF 1 NGF 2 NGF 3 NGF4
面对血脑屏障, 神经生长因子,挤不进,穿
不过,破不开
脑苷肌肽透过血脑屏障充分发挥药理作用
外源性牛脑神经节苷脂混合物,经静脉注射后可透过血 脑屏障,进入脑组织中发挥神经保护作用。
经MPTห้องสมุดไป่ตู้-处理后, 3H-BBG透过受损血脑屏障的量
3H-BBG透过正常血脑屏障的量

血脑屏障(英文版) PPT

血脑屏障(英文版) PPT
lack claudin-5 a severely compromised and leaky blood–brain barrier die shortly after birth TJs is not solely related to the expression and presence of claudins and occludin ,but is also influenced by the way these proteins are organized and interact
1.3.4 Neurotoxins The BBB shields the CNS from neurotoxic substances
*endogenous metabolites *Proteins *xenobiotics ingested in the diet or from the environment
The tight junctions TJs
and junctional adhesion molecules (JAMs)
In EAE and GBM selective of claudin-3 loss of BBB integrity permeability are associated with inflammatory events at the BBB
Factors restrict the entry of compounds into theCNS
* polar surface area(PSA)
*rotatable bonds in the molecule and a molecular weight in excess of 450 Da * A high affinity of binding to plasma proteins with a low off-rate These factors are not always an absolute indication

血脑屏障

血脑屏障

载体运转系统
脑毛细血管内皮细胞有多种载体蛋白, 能将血中物质运出内皮细胞。载体蛋白有 较高的选择性,一种载体蛋白常只能转运 一种物质,脑血管内皮细胞的特异性载体 蛋白,可使一些难于通过血脑屏障的物质 顺利转运迅速入脑
生物转化作用
某些物质在通过脑毛细血管内皮细胞时将遭受到
胞浆内酶系统的作用而被破坏,所以即使能进入毛细血 管内皮细胞的物质也不一定都能通过血脑屏障而进入脑 实质。现已发现脑毛细血管内皮细胞含有单胺氧化酶 (MAO)可使属于单胺类的神经递质(如儿茶酚胺,5-羟 色胺等,见后)氧化分解,又γ-氨基丁酸(GABA)虽然 可被脑毛细血管内皮细胞摄入,但却又遭受细胞内 GABA转氨酶的作用而被破坏,如果用β-氨基乙酸抑 制该酶则GABA是可以进入脑组织的。脑毛细血管壁内 的这种生物转化作用加强了血脑屏障的屏蔽功能,使脑 组织的内环境免受血液中化学成份骤然变动的影响
ห้องสมุดไป่ตู้
血脑屏障作用
1.阻止某些物质(多半是有害的)由血 液进入脑组织的结构
2.减少受甚至不受循环血液中有害物质 的损害
3.保持脑组织内环境的基本稳定 4.维持中枢神经系统正常生理状态
血脑屏障通透性
物质通过血脑屏障的两方面影响因素: •物质本身的性质和状态 •血脑屏障的结构和功能。
物质的亲脂性与亲水性
(紧密连接支持结构的基础)
3.细胞骨架蛋白
(维持紧密连接的稳定)
主要结构--内皮细胞
• 脑血管内皮细胞与其他组织内 皮细胞的主要区别在于前者具 有复杂的紧密连接和丰富的线 粒体,但缺少跨膜转运的质膜小 泡(plasma vesicle) 以及缺乏细 胞孔。
•另外, 脑血管细胞内皮细胞的胞 膜上含有一些特殊蛋白: 碱性磷 酸酶、r - 谷氨酸转肽酶、糖转 蛋白、转铁蛋白受体等。

第四节 脑屏障

第四节 脑屏障

第四节脑屏障中枢神经系统内神经元的正常功能活动需要其周围的微环境保持一定的稳定性,而维持这种稳定性的结构称脑屏障。

它能选则性地允许某些物质通过,阻止另一些物质通过。

按形态特点,脑屏障可分为三类(图20-15)。

一、血-脑屏障血-脑屏障blood-brain barrier(BBB)位于血液与脑和脊髓的神经细胞之间,其结构基础是:1.脑和脊髓内的毛细血管内皮,由于该内皮细胞无窗孔、内皮细胞之间为紧密连接,从而阻碍大分子物质通过,但允许水和某些离子通过;2.毛细血管基膜;3.胶质膜,它由星形胶质细胞的终足围绕在毛细血管基膜的外面形成。

在中枢神经的某些部位缺乏血-脑屏障,如正中隆起、连合下器、穹窿下器、终板血管器、脉络丛、松果体、神经垂体等。

这些部位的毛细血管内皮细胞有窗孔,内皮细胞之间借桥粒相连(缝隙连接),可使蛋白和大分子物质自由通过。

二、血-脑脊液屏障血-脑脊液屏障blood-cerebrospinalfluid barrier位于脑室脉络丛的毛细血管与脑脊液之间,其结构基础主要是脉络丛上皮细胞间隙的顶部有闭锁小带。

脉络丛的毛细血管内皮细胞上有窗孔,因此该屏障仍有一定的通透性。

三、脑脊液-脑屏障脑脊液-脑屏障cerebrospinalfluid-brain barrier位于脑室和蛛网膜下隙的脑脊液与脑和脊髓的神经细胞之间,其结构基础为:室管膜上皮、软脑膜和软膜下胶质膜。

由于室管膜上皮没有闭锁小带,因而不能有效地限制大分子物质通过,加上软脑膜和它下面的胶质膜的屏障作用也很弱,因此,脑脊液的化学成分与脑组织细胞外液的成分大致相同。

在正常情况下,脑屏障能使脑和脊髓免受内、外环境中各种物理和化学因素的影响,从而维持相对稳定的状态。

当脑屏障损伤时(如炎症、外伤、血管病等),其通透性可发生改变,从而使脑和脊髓神经细胞受到各种致病因素的影响,因而导致脑水肿、脑出血、免疫异常等严重后果。

然而,所谓屏障并不是绝对的,无论从结构上还是从功能上脑屏障都只是相对的,这不仅因为脑的某些部位没有血-脑屏障,而且由于在脑屏障的三个组成部分中,脑脊液-脑屏障的结构最不完善,可使脑脊液和脑内神经元的细胞外液互相交通。

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Structure of Blood Brain Barrier
Source: Bock et al
Differences between BMEC and normal endothelial cells
• Structural differences:
– Absence of fenestrations – More extensive tight junctions (TJ)
Pericytes:
• Cells of microvessels including capillaries, venules, and arterioles that wrap around endothelial cells. • Provide structural support and vasodynamic capacity to microvasculature. • Role in structural stability of vessel wall • Endothelial cells associated with pericytes are more resistance to apoptosis than isolated endothelial cells
• Structural and functional barrier which impedes and regulates the influx of most compounds from blood to brain • Formed by brain microvascular endothelial cells (BMEC), astrocyte end feet and pericytes • Essential for normal function of CNS • Regulates passage of molecules in and out of brain to maintain neural environment. • Responsible for metabolic activities such as the metabolism of L-dopa to regulate its concentration in the brain.
Cytoplasmic accessory proteins
• (ZO-1, ZO-2, ZO-3, cingulin etc)
– These link membrane proteins to actin – maintenance of structural and functional integrity of endothelium – crosslink transmembrane proteins.
BMEC intercellular space
Source: BaБайду номын сангаасlabh et al
Barrier function of JAM
• Homotypic binding between JAM molecules on adjacent endothelial cells acts as a barrier for circulating leukocytes • Heterotypic binding of endothelial JAM to leukocyte JAM might guide transmigration of leukocytes across interendothelial junctions • So factors that decrease leukocyte migration must either strengthen homotypic interactions or weaken heterotypic interactions.
• 1950s: Electron microscopy demonstrated that the outermost layers of endothelial cells in brain capillaries are fused together
What is the Blood Brain Barrier?
• Functional differences:
– Impermeable to most substances – Sparse pinocytic vesicular transport – Increased expression of transport and carrier proteins: receptor mediated endocytosis – No gap junctions, only tight junctions – Limited paracellular and transcellular transport
Source: Ballabh et al
Occludin
– 65kDa phosphoprotein, – 1° structure very different from claudin – Regulatory proteins: alters paracellular permeability.
Blood Brain Barrier: Structure, Function and Bypass by Microorganisms
Presented by: Syeda Kashfi Qadri
Discovery
• 1885: Paul Ehrlich: intravenous dyes in experimental organisms caused staining of all organs except the brain • 1913: Edwin Goldmann put forward hypothesis that the cerebral capillaries provide anatomical basis for a physiological barrier between brain and the rest of the body
– – – – Claudin Occludin Junction Adhesion Molecules Accessory proteins
Claudin
– 22kDa phosphoprotein – 4 transmembrane domains – localized in TJ strands
• Breakdown of BBB in tissue surrounding brain tumors occurs with concomitant loss of 55kDa occludin expression
Junction Adhesion Molecules:
• 40kDa • Integral membrane protein, single transmembrane region • Belongs to immunoglobulin superfamily • Localizes at tight junctions • Involved in cell-to-cell adhesion and monocyte transmigration through BBB • Regulates paracellular permeability and leukocyte migration • Also found on circulating leukocytes, platelets and lymphoid organs.
Integrity of BBB
• • • • Tight Junctions Adherens Junctions Pericytes Astrocyte end feet
Tight Junctions between BMEC
Source: Ballabh et al
• • • • •
Appear at sites of apparent fusion between outer leaflets of plasma membrane of endothelial cells Continuous Anastomosing Intramenbranous strands or fibrils on P face with complementary groove on E face Protein components:
• Membrane associated guanylate kinaselike proteins (MAGUKS)
– subunits function as protein binding molecules – role in organization the plasma membrane
Source: Ballabh et al
Barrier Function of Occludin and Claudin
• Assemble into heteropolymers and form intramembranous strands which contain channels allowing selective diffusion of ions and hydrophilic molecules.
– Indicates role of PC in structural integrity and genesis of the BBB
• Phagocytic activity
Astrocyte end feet
• • • • • • Star shaped glial cells Provides biochemical support for BMEC Influence of morphogenesis and organization of vessel wall Factors released by astrocytes involved in postnatal maturation of BBB Direct contact between endothelial cells and astrocytes necessary to generate BBB (Rubin et al, 1991) Co-regulate function by the secretion of soluble cytokines such as (LIF, leukemia inhibiting factor), Ca2+ dependent signals by intracellular IP-3 and gap junction dependent pathways, and second messenger pathways involving extracellular diffusion of purinergic messenger.
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