垂体多激素腺瘤的免疫病理研究

目的 探讨垂体多激素腺瘤的临床表现和免疫病理学特点，以提高其病理诊断的准确性。方法 选取1990年3月至2002年12月经手术切除的垂体多激素腺瘤103例进行免疫组化检测，其中18例另行双标记免疫组化染色。结果 全组以PRL-GH型垂体腺瘤最多，共10例（9．7％）。大多数病例只表现出一种内分泌症状，仅7例（6．8％）表现出两种不同的内分泌症状。垂体多激素腺瘤的免疫组化组合形式多样，2～6种激素组合均有。免疫组化、血清激素水平与内分泌症状之间相关性最好的激素是PRL。结论垂体多激素腺瘤的免疫组化检测对于其正确的病理诊断非常重要。     

120例垂体生长激素腺瘤及多激素腺瘤的临床和病理学特点分析

目的分析120例垂体生长激素（GH）腺瘤及多激素腺瘤患者的临床及病理学特征。方法回顾性分析120例免疫组化证实的垂体GH腺瘤及多激素腺瘤患者的临床资料,包括临床表现、生化改变、病理分型及侵袭性等。结果垂体腺瘤的好发年龄为20~50岁,男女发病比约为1：2,主要的临床表现为肢端肥大、头痛头晕、视力下降、视野缺损,女性患者表现有闭经、泌乳或月经紊乱。本组各种类型的垂体腺瘤的侵袭性比例：GH（＋）腺瘤为59.57%（28/47）、GH（＋）及PRL（＋）二种激素混合性瘤为35.48%（11/31）、GH（＋）和ACTH（＋）为33.33%（1/3）、GH（＋）和TSH（＋）为0（0/4）、GH（＋）和LH（＋）为33.33%（1/3）,以及GH（＋）及其它二种以上激素（＋）的多激素腺瘤34.38%（11/32）。单纯GH垂体腺瘤的侵袭性明显高于GH（＋）伴其它激素（＋）的垂体腺瘤的侵袭性（P0.05）。结论本组病例女性多于男性,单纯GH垂体腺瘤侵袭性明显高于其他类型的垂体腺瘤;病理免疫组化提示GH腺瘤除GH（＋）外,常常伴随其他激素（＋）。     

垂体腺瘤患者血浆神经肽Y与垂体激素水平相关性研究

目的 探讨垂体腺瘤患者血浆神经肽Y（NPY）与垂体激素之间的相关关系。方法 收集82例垂体腺瘤患者及20例对照组空腹静脉血3ml，进行血浆NPY放免测定分析，并与垂体激素水平进行相关分析。初步探讨NPY与部分其他临床指标之间的相关性。结果 （1）垂体腺瘤患者、泌乳素细胞腺瘤、生长激素细胞腺瘤、无内分泌功能细胞腺瘤及多分泌功能细胞腺瘤组中血浆NPY与PRL呈负相关。（2）垂体腺瘤患者血浆NPY与ACTH呈正相关。（3）促性腺激素细胞腺瘤中NPY与LH呈正相关而与GH呈负相关。（4）NPY在垂体腺瘤组与对照组中血浆含量明显不同，而且部分不同垂体腺瘤组之间也存在明显差异。（5）全组垂体腺瘤手术后血浆NPY的含量下降。结论 NPY参与了垂体腺瘤病理生理中下丘脑-垂体轴许多激素的调节，可能与垂体腺瘤的发生有关。     

非分泌性垂体腺瘤的显微外科手术策略

目的 探讨非分泌性垂体腺瘤治疗的显微外科手术策略。方法 回顾分析经手术证实的236例非分泌性垂体腺瘤的临床资料，采取四种显微手术策略：经蝶手术202例（85．59％），开颅手术15例（6．36％），经蝶＋开颅手术11例（4．66％），分次经蝶手术8例（3.39％）。结果 显微手术全切除171例（72．46％），次全切除65例（27．64％）。无同手术期严重并发症，视力视野改进占88．02%。甲状腺功能恢复正常占38．98％，血清催乳素水平恢复正常占70．63％。免疫组化研究提示促性腺激素细胞腺瘤占52．54％，裸细胞腺瘤占25．00％，大嗜酸粒细胞腺瘤占14．41％，静态促肾上腺皮质激素腺瘤占8．05％。结论 对于非分泌性垂体腺瘤，根据个性化的原则，采取不同的显微外科手术策略．可以取得满意的疗效。     

垂体腺瘤侵袭性与galectin-3蛋白表达及Ki-67标记指数的关系

目的探讨半乳糖凝集素-3（galectin-3）蛋白表达及Ki-67标记指数（Ki-67u）与垂体腺瘤侵袭性的关系。方法运用免疫组化sP法检测50例标本中galectin-3蛋白的表达及Ki-67LI,分析galectin-3蛋白的表达及Ki-67LI与垂体腺瘤侵袭性的内在关系。结果galectin-3蛋白表达局限于泌乳素（PRL）腺瘤、促肾上腺皮质激素（ACTH）腺瘤及部分多激素分泌型腺瘤,在其他类型垂体腺瘤中表达呈阴性;且即lectin-3在上述类型侵袭性腺瘤中的表达水平（galectin-3计分为3,264＋1．066）明显高于非侵袭性腺瘤（gaIectin-3计分为1．613±0．850）（P〈0．01）。Ki-67LI在侵袭性组和非侵袭性组分别为2．754±1．029和1．692±0：858,两组有显著性差异（P〈0．01）。在表达galectin-3蛋白的垂体腺瘤中其表达水平与Ki-67LI之间存在正相关性（r=0．916,P〈0．01）。结论在PRL、ACTH腺瘤及部分多激素分泌型腺瘤中,galectin-3蛋白的表达与Ki-67LI呈明显正相关性,同时检测二者可以作为评价此类型垂体腺瘤侵袭性的重要参考指标之一。     

α-干扰素和溴隐亭对垂体泌乳素腺瘤细胞的作用

目的研究α-干扰素(IFN-α)和溴隐亭(BC)对人垂体腺瘤细胞激素分泌的影响。方法将垂体泌乳素(PRL)腺瘤(15例)进行体外细胞培养,每例培养细胞随机分成IFN-α组、BC组、IFN-α BC组及对照组,观测lFN-α和BC干预后细胞PRL分泌量。结果15例垂体腺瘤培养成功12例;干预2d和4d时,IFN-α对58%(7/12例)和75%(9/12例)垂体腺瘤细胞分泌有明显抑制,其中,57%(4/7例)和86%(6/7例)侵袭性垂体腺瘤细胞分泌受到明显抑制;BC对41%(5/12例)垂体腺瘤细胞分泌无明显抑制作用,而IFN-α对其中2例和4例有明显抑制分泌效应(P<0.05或P< 0.01)。结论IFN-α对大多数垂体PRL腺瘤,尤其是侵袭性垂体腺瘤细胞激素分泌有抑制作用,对大多数BC不敏感的垂体PRL腺瘤细胞激素分泌亦有抑制效应。     

对多巴胺激动剂耐药的泌乳素腺瘤治疗策略

泌乳素腺瘤是最常见的激素分泌性垂体腺瘤，约占激素分泌性肿瘤的40％～60％。与其它类型垂体腺瘤治疗目标一样，泌乳素腺瘤治疗的目标是使异常分泌的垂体激素降至正常水平，减小肿瘤体积，去除占位效应．恢复垂体正常激素分泌功能。治疗由于过度分泌垂体激素所产生的并发症。目前对于泌乳素腺瘤的首选治疗药物是多巴胺激动剂。     

垂体泌乳素微腺瘤治疗进展简

垂体泌乳素（prolactin，PRL）腺瘤是最常见的功能性垂体腺瘤，在临床上占到了垂体肿瘤的40％，是引起高泌乳素血症的最常见原因。垂体泌乳素微腺瘤（micmprolactinoma，MIP）是直径〈10mm的PRL腺瘤，约占女性PRL腺瘤的60％。生育期女性多表现为少经或闭经、不育、溢乳。     

垂体瘤转化基因在垂体大腺瘤中表达的研究

目的 探讨垂体瘤转化基因（PTTG）在垂体大腺瘤中的表达及意义。方法收集经手术和病理证实的垂体大腺瘤患者40例，其中无功能腺瘤22例，生长激素（GH）腺瘤8例，泌乳素（PRL）腺瘤10例。同期经手术和病理证实的垂体微腺瘤11例为对照组，其中促肾上腺皮质激素（ACTH）腺瘤8例。PRL腺瘤3例。采用免疫组化技术（LSAB法）检测垂体大腺瘤和垂体微腺瘤中PTTG的表达水平。结合临床资料及影像学分级标准，分析PTTG表达水平与垂体大腺瘤发生机制、生物学行为之间的联系。结果40例垂体大腺瘤中均发现PTTG的表达显著高于垂体微腺瘤组（P〈0．01）。在侵袭性垂体大腺瘤中，PTTG的表达显著高于非侵袭性垂体大腺瘤（P〈0．01）。PTTG的表达与大腺瘤向鞍上生长的高度和向海绵窦侵袭性生长的程度显著相关（P〈0.05）。结论PTTG表达增高与垂体大腺瘤的生长以及肿瘤的侵袭性密切相关。PTTG的表达水平及结合影像学资料可以为患者预后及术后的辅助治疗提供可靠的判断依据。     

垂体腺瘤186例的病理学特征与临床研究

本文采用免疫组化及电镜观测分析了186例垂体腺瘤，根据激素分泌及超微结构特征将肿瘤分为11类。其中泌乳素腺病最常见（34．95％）；其次是生长激素腺癌（19．35％）；零细胞腺癌（16．67％）等。本文分析研究了35例术后复发的垂体康店后认为：嗜酸性干细胞腺癌和伴Nelson综合征的促肾上腺皮质激素腺瘤有术后复发的倾向；此外，侵袭性生长的腺瘤术后易于复发。     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

Modelling of movement of the lamprey: Control of oscillators

This article discusses the control methods of the central pattern generator (CPG). First a control model of the CPG is presented using 2 oscillators, and we suggest that phasic modulation to the CPG by means of phasic information is effective for controlling the phase difference between oscillators. Next, two models for controlling the CPG of a lamprey are proposed. One model describes a control system from the brain stem, in which the reticulospinal neurons control the CPG by receiving feedback signals and sending control signals to the neck region of the CPG. The other is a model for learning an localized control system to generate a desired motor pattern. By means of these models, a role of the efference copy is suggested.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

利培酮对精神分裂症患者生活质量的影响

目的：比较利培酮与氟哌啶醇对精神分裂症患者生活质量的影响。方法：对门诊72例服用氟哌啶醇及74例服用利培酮的精神分裂症患者用生活质量综合评定问卷（GQOLI）、阳性与阴性症状量表（PANSS）、副反应量表（TESS）进行评定。结果：利培酮组患者治疗后生活质量有所提高,而氟哌啶醇组患者生活质量有所下降。结论：利培酮治疗有利于患者提高生活质量。