糖尿病小鼠学习记忆能力减退与海马锥体细胞树突棘变化的相关性

目的探讨代谢异常导致的海马区树突棘变化与认知功能障碍的关系。方法通过水迷宫实验检测动物学习记忆变化,通过Gol-gi-Cox染色结合体视学半定量技术分析海马CA1区锥体细胞树突棘密度变化。结果 2型糖尿病(T2DM)小鼠在一个月出现胰岛素抵抗,并伴随持续的高血糖及高胆固醇血症。2个月出现学习记忆能力下降(P<0.05),随时间延长而加重,4个月后海马CA1区锥体细胞树突棘密度显著下降(P<0.01)。结论研究结果表明T2DM持续高血糖,高血脂可能直接导致海马区神经细胞树突棘丢失,突触可塑性下降,从而出现认知功能障碍。     

亚甲蓝对APP/PS1小鼠海马CA1区树突棘密度的保护作用

目的探讨亚甲蓝(MB)对APP/PS1转基因小鼠海马CA1区树突棘密度改变及学习记忆能力改善的影响。方法 APP/PS1小鼠及相同品系的3月龄野生小鼠,随机分为3组,每组10只:正常对照组,为野生小鼠。模型组,为APP/PS1小鼠;治疗组,3月龄的APP/PS1小鼠口服亚甲蓝25 mg·kg-1·d-1;连续用药4个月。待3组小鼠均为7月龄时,跳台实验测试3组小鼠的学习记忆能力;高尔基染色观察各组海马CA1区树突棘密度的变化。结果亚甲蓝治疗组小鼠跳台试验错误次数减少,小鼠跳台试验的潜伏期明显延长(P<0.01);治疗组与模型组相比海马CA1区树突棘密度明显增加(P<0.01),治疗组与对照组无统计学差异(P>0.05)。结论亚甲蓝可能是通过增加海马CA1区树突棘密度来改善APP/PS1小鼠的学习记忆能力。     

代谢型谷氨酸受体5在老年小鼠及Fmr1敲除小鼠海马CA1区轴棘突触的配布

目的观察代谢型谷氨酸受体5(mGluR5)在老年小鼠及Fmr1基因敲除(FMR1-KO)小鼠海马CA1区轴棘突触的配布变化。方法选用3月龄(对照组)、22月龄(老年组)雄性C57BL/6小鼠以及3月龄雄性C57BL/6种系的Fm r1敲-除小鼠各3只。经心灌注固定、震动切片,以银加强纳金包埋前免疫电镜技术对mGluR5在海马CA1区腔隙分子层轴棘突触的突触后分布进行分析。结果 mGluR5标记颗粒主要分布于轴棘突触突触后树突棘质膜内面,突触后致密斑上未见mGluR5标记物的存在。对照组小鼠海马CA1区腔隙分子层轴棘突触mGluR5有29.87%的标记颗粒位于距突触后致密斑边缘60nm的区域内;老年组小鼠有27.02%的标记颗粒位于距突触后致密斑边缘60nm的区域内,与正常组小鼠比较无显著差异;而FMR1-KO小鼠有20.01%的标记颗粒位于距突触后致密斑边缘60nm的区域内,与正常组小鼠比较具有显著差异(P0.01)。结论衰老未改变海马CA1区轴棘突触mGluR5的配布,Fmr1基因敲除则引起海马CA1区轴棘突触mGluR5配布的改变。     

SAMP8海马CA1区突触素表达及针刺的干预作用

目的观察早老性痴呆模型8月龄快速老化小鼠(SAMP8)海马突触素的表达变化及针刺对其表达的影响。方法将30只SAMP8分成P8组和针刺组,以同月龄抗老化小鼠SAMR1为R1组,采用HE染色法观察各组小鼠海马CA1区锥体细胞形态的改变,以real-time PCR和免疫组织化学法观察各组小鼠海马CA1区突触素基因和蛋白的表达情况。结果 SAMP8海马CA1区的锥体细胞排列、形态及结构都明显受到损伤,针刺对其有改善作用。进一步研究发现P8组海马突触素基因和蛋白的表达量与R1组相比明显减少(P0.05),而针刺能增加其表达量(P0.05)。结论 SAMP8海马突触存在分子和形态学的损伤,针刺可通过增加突触素的表达发挥治疗阿尔茨海默病(AD)的作用。     

老年小鼠突触可塑性和记忆功能变化与nNOS表达的关系

目的 对老年小鼠突触可塑性和记忆能力变化与海马nNOS表达变化之间的关系进行探讨.方法 2月龄(青年)和16月龄(老年)昆明小鼠分别用Y型迷宫测试自发交替和活动能力,离体脑片细胞外观测海马长时程增强(LTP)的变化,免疫组化检测海马nNOS阳性细胞表达的变化.结果 老年小鼠的自发交替的百分率和活动能力较青年小鼠明显下降(P＜0.01),离体海马脑片LTP诱发成功率和群峰电位振幅增大率明显下降(P＜0.01),海马CA1区、齿状回的nNOS阳性细胞的染色强度减弱(P＜0.01).结论 小鼠在衰老过程中会伴有突触可塑性和记忆功能降低,其病理机制和nNOS神经元丧失有关.     

三七总皂苷对机械通气致脑损伤大鼠海马神经元及突触相关蛋白PSD-95、GAP-43的影响

目的 探究三七总皂苷(PNS)对机械通气(MV)致脑损伤大鼠海马神经元突触可塑性的影响。方法 SD大鼠采用随机数字表法分为对照(Control)组、MV组、MV+PNS组,每组18只。MV组和MV+PNS组大鼠行MV,Control组大鼠气管插管后进行自主呼吸,未行MV。MV+PNS组大鼠于MV前15 min尾静脉注射PNS 15.844 mg/kg, Control组及MV组于MV前15 min腹腔注射等量生理盐水。MV后,Morris水迷宫实验测量大鼠的认知功能;苏木素-伊红(HE)染色观察海马组织病理学变化;高尔基染色观察海马神经元的树突棘密度;免疫组化法检测海马神经元谷氨酸受体(GluR)1的表达;Western印迹检测海马组织突触后密度蛋白(PSD)-95、生长相关蛋白(GAP)-43蛋白表达。结果 与Control组相比,MV组逃避潜伏期显著延长,穿越平台所在位置次数、树突棘密度、海马CA1区GluR1阳性表达和海马组织PSD-95、GAP-43蛋白表达显著减少(P<0.05),海马CA1区神经元未见明显病理学改变;与MV组相比,MV+PNS组逃避潜伏期显著缩短,穿越...     

人血白蛋白对实验性蛛网膜下腔出血后认知功能的改善作用

目的探讨静脉即刻给予人血白蛋白(ALB)是否对蛛网膜下腔出血(SAH)远期认知功能预后具有改善作用。方法选取270~320g成年SD 2月龄雄性大鼠80只,随机分为假手术组、生理盐水组、低剂量组(ALB 0.63g/kg)和高剂量组(ALB 1.25g/kg),每组20只。采用血管刺破方法建立大鼠SAH模型。在建模后29d开始进行认知功能评估,采用新事物认知实验进行短时和长时工作记忆能力测试;Morris水迷宫实验进行空间记忆能力评价;高尔基染色和蛋白印迹实验检测树突棘密度及突触相关蛋白表达。结果低、高剂量组大鼠短时和长时工作记忆能力都较生理盐水组大鼠明显提高(P=0.001)。与生理盐水组比较,低、高剂量组大鼠第3天潜伏期(P=0.015,P=0.019)和第4、5天游泳距离(P=0.015,P=0.017)明显缩短,穿越原平台位置次数显著提高(P=0.018,P=0.027)。与生理盐水组比较,低剂量组显著提高海马区树突刺密度(P=0.025);高剂量组显著提高皮质及海马区树突棘密度(P=0.026,P=0.016);低、高剂量组大鼠突触相关蛋白表达水平明显提高(P0.05)。结论ALB可能通过提高SAH大鼠树突棘密度和突触相关蛋白含量,促进认知功能恢复。     

金属硫蛋白3对快速老化痴呆模型小鼠海马组织学变化的影响

目的研究金属硫蛋白(MT)3对快速老化痴呆模型小鼠(SAMP8)海马结构CA1区神经元组织学变化的影响。方法给小鼠不同浓度MT3及盐水腹腔注射28 d,处死小鼠后应用光镜和电镜观察制备标本海马结构神经元的变化。结果快速老化小鼠对照小鼠(SAMR1)海马CA1区锥体细胞排列较整齐、均匀,胞膜完整,染色质分布均匀,细胞核呈圆形或椭圆形,核仁清楚,细胞器清晰可见。SAMP8组海马CA1区可见锥体细胞稀疏、排列紊乱,大部分神经元肿胀、空化,出现凋亡细胞,很多胞核固缩深染,胶质细胞增多,有较多脂褐素沉积。低、中、高浓度MT3组海马CA1区锥体细胞较空白对照组结构较清晰,排列较整齐均匀。神经元核基质呈轻度空化改变,胞质内都可见线粒体、粗面内质网及脂褐素,胶质细胞减少。高浓度MT3组的超微结构最接近于SAMR1组,但仍处于老化状态。结论 SAMP8海马有组织结构和超微结构的改变。MT3对SAMP8海马锥体细胞有保护的作用。     

快速老化小鼠P8海马神经元突触结构与功能可塑性

目的从海马神经元突触结构与功能可塑性角度探讨阿尔茨海默病(AD)认知功能缺损的可能原因。方法以10月龄快速老化小鼠(SAMP)8为AD模型,同月龄抗快速老化小鼠(SAMR)1为正常对照,采用Morris水迷宫实验评价动物学习记忆能力,透射电镜观察海马CA1区神经元突触超微结构,在体长时程增强(LTP)记录观察海马前穿通纤维-齿状回(PP-DG)通路神经元突触传递效能。结果与SAMR1比较,SAMP8逃避潜伏期延长(P=0.000),穿越有效区次数减少(P=0.046);海马CA1区神经元突触后致密带变薄(P=0.000),突触间隙增宽(P=0.024),突触界面曲率下降(P=0.000);海马PP-DG通路LTP诱发率(P=0.362)、群峰电位(P=0.900)及潜伏期(P=0.394)差异无统计学意义。结论海马CA1区突触超微结构受损可能是导致SAMP8学习记忆能力下降的原因,CA1区与DG区在AD病理上可能扮演不同角色。     

脑老化及阿尔茨海默病患者脑中突触密度改变的研究

目的　观察正常人增龄过程中突触素表达的变化 ,研究脑老化中不同部位突触密度的改变 ,并与阿尔茨海默病 (AD)患者比较。方法　应用突触素免疫组织化学方法 ,观察 2 8例正常增龄病例 (2 3～ 10 0岁 ,分为成年组 ,老年组 ,>75岁组 )尸检脑标本的额叶、枕叶、壳核、海马及 6例AD患者 (AD组 )的海马标本。测算 3组各部位突触素密度 ,并分析其与年龄之间的相关性 ,比较 >75岁组与AD组海马CA3区突触素密度的差异。结果　老年组脑额叶、枕叶、壳核及海马CA3区突触密度与年龄呈负相关。AD组海马CA3区突触密度低于 >75岁组且差异有显著性意义 ,P <0 .0 1。结论　脑老化过程中额叶、枕叶、海马CA3区与壳核突触密度随年龄增加下降 ,AD组突触密度较正常增龄病例有所降低。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

CagA-Hp抗体IgG与胃炎的组织学分析

研究幽门螺杆菌(Hp)感染与胃炎的关系。方法对204例慢性胃炎患者胃粘膜进行观察分析,并测定其中137例Hp阳性患者血清CagA-Hp抗体IgG水平,与组织学对照。结果慢性萎缩性胃炎伴肠上皮化生患者血清CagA抗体IgG明显高于对照组(P＜0.01);其他类型胃炎患者血清CagA抗体IgG水平无明显增高(P＞0.05)。结论CagA-Hp可能是导致慢性萎缩性胃炎伴肠上皮化生的因素之一,对这类患者应密切随访观察。     

慢阻肺急性加重期患者预后的影响因素分析

目的探讨慢性阻塞性肺病急性加重期(AECOPD)患者预后的相关危险因素。方法回顾性调查、收集58例AECOPD患者可能影响其预后的相关因素,并对其分别进行单因素分析。并进行Logistic多元逐步回归进行多因素分析,筛选影响AECOPD患者预后的独立危险因素。结果单因素分析后将结果 P0.1的因素纳入多因素Logistic回归,分析发现是否合并呼吸衰竭、气促程度、白细胞计数、APACHEⅡ、应用抗氧化剂、慢阻肺治疗依从性为影响AECOPD患者预后不佳的独立因素(P0.05)。结论根据AECOPD患者预后的独立危险因素,及早判断,选择合适的后续治疗方案,对提高其生存率及生存质量具有重要意义。     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Results of treatment of fistula-in-ano

To evaluate the application of Parks' classification in the management of patients with fistula-in-ano, a study was undertaken to assess the outcome of surgery, especially with respect to the recurrence rate and alteration of continence. A retrospective analysis of 160 consecutive patients who were classified at the time of operation was conducted. The distribution of fistulas was as follows: intersphincteric, 41.9 percent, transsphincteric, 52.1 percent, suprasphincteric, 1.3 percent, extrasphincteric, 0. A horseshoe extension occurred in 8.8 percent of the fistulas and 3.8 percent did not exactly conform to the classification as they were either complex or combinations of more than one type of fistula. The sole immediate postoperative complication was bleeding, which occurred one week postoperatively and ceased spontaneously (0.7 percent). Alteration in continence occurred in 6 percent of patients with 2.6 percent experiencing temporary incontinence to flatus, 1.3 percent to liquid stool, and 0.7 percent to solid stool. Permanent loss of control for flatus occurred in one patient (0.7 percent) and for liquid stool in one patient (0.7 percent). No patients suffered loss of control for solid stool. Recurrence developed in 6.3 percent of patients, all between five and 25 months postoperatively. Classifcation was found to be a useful guide in the operative management of patients with fistula-in-ano. Read at the joint meeting of the American Society of Colon and Rectal Surgeons with the Section of Colo-Proctology, Royal Society of Medicine, and the Section of Colonic and Rectal Surgery, Royal Australasian College of Surgeons, New Orleans, Louisiana, May 6 to 11, 1984.