Alzheimer氏病的病理生理学和病因学

Alzheimer氏病的病理生理学 一、老化和Alzheimer氏病的形态学变化Terry和Dayies观察到正常老化脑的重量比青年人的平均脑重减少7～8％,同时还看到在青年人,脑本身占颅腔的92％,而在老年人脑仅占颅腔的     

Alzheimer氏病的免疫学参数

痴呆在65岁以上人群的发病率约5～7％,80岁以上则上升到20％。而Alzheimlr氏病约为老年性痴呆的一半。该病的特点是老年斑和神经原纤维变性同时存在,其病因不明。可能与免疫紊乱有关,第一,老年斑内含有淀粉样沉淀物,这样沉淀物常见于骨髓瘤、类风湿关节炎和其它免疫性疾患。第二,患者血清中抗脑抗体增多。因为与衰老有关联的Alzheimer氏病具有自身免疫性疾病的某些特征,为了研究该病的免疫功能,作者对41例平均78岁的Alzheimer氏病人作了各项免疫学检测,并以年龄、性别配对的41名健     

TRH刺激试验和Alzheimer氏病

已有证据提示,Alzheinler氏病可能存在下丘脑——垂体轴异常。曾有两篇报告,在Alzheimer患者的丘脑下部发现有老年斑和神经纤维缠结。Pouplard等报告,在27名Alzheimer患者尸检腺体中发现有催乳素(PRL)分泌细胞自体抗体者占96％(正常对照组为14％),而Philpot等采用术后新鲜标本,未能重复这个发现。三种垂体前叶激素:促甲状腺激素(TSH),PRL和生长激素(GH)可被促甲状腺激素释放激素(TRH)激活。已报告在抑郁症、酒精中毒、躁狂症和神经性厌食患者中,TRH刺激试验异常。本文设想,用TRH刺激试验探索Alzheinler氏病下丘脑——垂体功能。作者对9名男性Alzheimer患者和9名男性健康对照者进行研究。Alzheimer组,年龄55～74岁,平均63.4岁,头部CT扫描符合Alzheimer氏     

Lev氏病的心电图

随着社会人口的老龄化，Lev氏病的发病率逐渐增高，现报告1例。     

Alzheimer病性脑梗塞与重度淀粉样血管病及高血压的关系

Alzheimer病患者易患卒中的因素包括载脂蛋白E_4及脑淀粉样血管病。脑淀粉样血管病可呈现Alzheimer病的特点,其发病率达90％。文献已表明Alzheimer病与卒中有关,但其对脑血管病作用机理所知甚少。本文对145例Alzheimer病患者的尸体进行了解剖研究。 结果 轻度淀粉样血管病与重度淀粉样血管病相比,高血压、血清胆固醇水平、糖尿病、冠心病等的发病率均无显著差异。但重度淀粉样血管病脑梗塞     

一种能够改善记忆的新药

匈牙利的一种抗衰老药Vinpocetine可能具有改善或恢复多发性梗塞性痴呆(MID)和中风患者记忆力的功效。美国已完成了关于用Vinpocetine治疗MID患者的八个中心的研究,1987年将开展此药对Alzheimer氏病疗效试验观察。在德、意、日等国的多起研究中,60～70％患者的病情已有所改善,20～30％改善显著。德国试验是从中风后48小时开     

痰瘀同治法治疗血管性痴呆的理论探讨

血管性痴呆(vascular dementia,VD),是由于脑血管病变引起或与脑血管病变有关的痴呆,是继Alzheimer病(AD)之后第二常见痴呆.严重者丧失生活能力,给患者家庭和社会带来沉重负担.在欧美等国家VD占老年痴呆的10％～20％,而在亚洲国家,由于该地区的高中风率使VD的发病率较高[1].我国VD的发病率占痴呆发病率的20％左右,并呈迅速增长趋势.因此,VD的防治成为国内外医学界的紧迫课题.     

Alzheimer氏病的治疗及改善脑代谢药的应用

一、Alzheimer氏病的治疗Alzheimer氏病(AD)原发于神经系统,包括历来的AD病及老年性痴呆。其病变的实质和发生机理还不明确,现尚无根本的防治方法。 Bowen氏等(1976)报告AD病人脑内乙酰胆碱转移酶(CAT)活性下降。Whitehouse氏等     

抗菌素能引起克隆氏病吗?

50年代初期,克隆氏病还是一种罕见的疾病,自从50年代中期,克隆氏病象一种流行的疾病,呈戏剧性的增多,首先在北欧和美国发现。美国、苏格兰、英格兰和瑞士发病率最多。有色人与欧洲南部人中有增多趋势。城市人口比农村人口感染率高,如农村人移居到城市,其克隆氏病发病率就增加。这种流行的,克隆氏病的传播与50年代开始应用抗菌素是并行的。到70年代中期,在许多国家发病率有一个大的升高。在前面提到的国家,发病率没有进一步的升高,反而在美国、英格兰     

老年性痴呆和Alzheimer氏病的新观点

痴呆为大脑功能改变的一种状态,病因是多方面的,最常见的是Alzheimer氏病(A病)。与老年性痴呆相同的临床和病理,也可在老年前期和40岁以上的Down氏综合征患者的尸检中见到。这些观察都支持一种假说,即所发现的老年人脑组织变性可能是由一种疾病引起,而不是衰老的预期结果。既往人们误把这种病归于脑血管供血不全,但对脑组织病理学观察发现,只有20～30％老年血管粥样改变可解释痴呆的临床表现。而且有人证明,在一些病例中所见到的脑血流量减少可能是继发于脑组织萎缩;而且有60～70％具有痴呆临床表现的老年人都表现出A病的典型症状。过去A病一词仅代表老年前期痴呆,即患者发病年龄在60岁以下,但现在人们认识到老年前期痴呆和老年痴呆的Alzheimer型的病理是相同的,所以如今此病名不再受发病年龄的限制。     

Research and Evaluation of the Influence of the Construction of the Gate and the Influence of the Piston Velocity on the Distribution of Gases into the Volume of the Casting

Distribution of gasses to the cast volume and volume of pores can be maintained within the acceptable limits by means of correct setting of technological parameters of casting and by selection of suitable structure and gating system arrangement. The main idea of this paper solves the issue of suitability of die casting adjustment—i.e., change of technological parameters or change of structural solution of the gating system—with regards to inner soundness of casts produced in die casting process. Parameters which were compared included height of a gate and velocity of a piston. The melt velocity in the gate was used as a correlating factor between the gate height and piston velocity. The evaluated parameter was gas entrapment in the cast at the end of the filling phase of die casting cycle and at the same time percentage of porosity in the samples taken from the main runner. On the basis of the performed experiments it was proved that the change of technological parameters, particularly of pressing velocity of the piston, directly influences distribution of gasses to the cast volume.     

县级以下综合医疗机构医务人员对现代结控知识的认识现状调查

目的本文旨在了解医务人员现代结控知识掌握的现状及培训效果?方法于培训前后进行问卷调查,内容包括:病例发现?结核病诊断及化疗?结果培训前疫情报告和转诊,回答正确者占75.2%?71.7%;对临床表现?查痰和诊断依据,回答正确者占83.5%?42.5%?40.8%;抗痨药物?用药方法?化疗原则?短化方案?短化疗程?治愈标准六项,回答正确者占58%?14.4%?20.8%?9.2%?17%?24.3%?培训后再次调查发现,90%以上医务人员对现代结控基本知识已掌握?结论各级医务人员现代结控知识是很贫乏的,因此,对其进行系统培训是极为必要的,此项工作省时?省力?投入少,可收到事半功倍的效果。     

Weighing the QT Intervals with the Slope or the Amplitude of the T Wave

Objective: The reproducibility of QT interval measurements is low, even for the mean QT interval based on the standard ECG. In this study we analyzed whether the reproducibility of the mean weighed QT interval was better than the simple mean QT interval. The weighing was based on the amplitude of the T wave or the slope of the steepest tangent on the terminal part of the T wave. Material and methods: 12‐lead ECGs of 130 postmyocardial infarction patients were obtained. The QT intervals were measured by the tangent‐method on two occasions by the same observer Mismatch QT intervals were defined as QT intervals that were measured at only one occasion. Sixteen ECGs were rejected. The data were split into 34 and 80 ECGs for optimization and validation of the weighing, respectively. The weighed QT dispersion was calculated as the weighed mean of the three longest minus the weighed mean of the three shortest QT intervals. Results: Weighing with the slope increased the reproducibility by 41% (P = 3 10^‐6), but weighing with the amplitude reduced it by 20% (P = 0.02). However, if measurements with errors above 75 ms were rejected, weighing with the slope or the amplitude increased the reproducibility with 26% and 20% (P = 0.02), respectively. Weighing did not change the reproducibility of the weighed QT dispersion. Conclusion: Weighing with the slope improved the reproducibility of the mean weighed QT interval. However, if measurements with errors above 75 ms were rejected, weighing with the amplitude also increased the reproducibility. Weighing did not change the reproducibility of the weighed QT dispersion. Weighing is particularly efficient at reducing the negative impact of mismatch QT intervals on the reproducibility. A.N.E. 2002;7(1):4–9     

大骨节病病区水,粮实验对动物的骨和软骨中化学元素组成的影响

用质子激发 X 线荧光分析方法(PIXE)测定了大骨节病病区和非病区的水、粮以及用该水粮喂养的大白鼠的肋软骨和硬骨中22种化学元素的含量。结果发现水粮中存在差异的元素反应在用该水粮喂养的大白鼠的骨、软骨中也存在差异,含量都低的元素有 P、Mn、Cu、As、Zn。都高的有铅。其中锌低在水、粮、硬骨和软骨中都完全一致呈非常显著性差异(p<0.01)。提示病区水、粮中化学元素对骨质的影响不是单一元素缺乏或过多所致,而是多种元素的复合因素。     

Assessment of the Soft-Tissue Seal at the Interface between the Base of the Fixed Denture Pontic and the Oral Mucosa

Fixed dentures (bridges) are often selected as a treatment option for a defective prosthesis. In this study, we assess the contact condition between the base of the pontic and oral mucosa, and examine the effect of prosthetic preparation and material biocompatibility. The molars were removed and replaced with experimental implants with a free-end type bridge superstructure after one week. In Experiment 1, we assessed different types of prosthetic pre-treatment: (1) the untreated control group (Con: mucosa recovering from the tooth extraction); (2) the laser irradiation group (Las: mucosa recovering after the damage caused by a CO₂ laser); and (3) the tooth extraction group (Ext: mucosa recovering immediately after the teeth extraction). In Experiment 2, five materials (titanium, zirconia, porcelain, gold-platinum alloy, and self-curing resin) were placed at the base of the bridge pontic. Four weeks after the placement of the bridge, the mucosa adjacent to the pontic base was histologically analyzed. In Experiment 1, the Con and Las groups exhibited no formation of an epithelial sealing structure on the pontic base. In the Ext group, adherent epithelium was observed. In Experiment 2, the sealing properties at the pontic interface were superior for titanium and the zirconia compared with those made of porcelain or gold-platinum alloy. In the resin group, a clear delay in epithelial healing was observed.     

高胆红素血症对肿瘤标志物测定的影响探讨

目的探讨高胆红素血症对Ca19-9、Ca24-2和CEA检测的影响.方法对320例胆管、胆囊良恶性疾病病人,15例胆囊炎病人的胆汁和血清以及10例肝硬化、10例黄疸肝炎病人进行Ca19-9、Ca24-2和CEA检测.结果在良性胆管、胆囊疾病中,Ca19-9的假阳性最高;在胆红素增高的良性疾病中,Ca19-9假阳性率达46.7%;15例胆汁和血清以及10例肝硬化和10例黄疸肝炎病人中,Ca19-9的假阳性率分别为93%、20%、80%和80%.结论高胆红素血症对Ca19-9检测影响最明显,胆囊、胆管良恶性疾病鉴别时,以Ca24-2和CEA检测为佳.     

Hepato-pancreato-biliary fat: the good, the bad and the ugly

Obesity has become epidemic in the United States, in Europe, and in many urban areas in the developing world. The globalization of certain 'fast foods' and 'soft drinks' may, in part, be contributing to this epidemic. Diets high in saturated fatty acids and trans fats as well as drinks that have high fructose corn syrup levels may be particularly harmful. Recent research suggests that fat is a dynamic endocrine organ and that visceral fat is associated with the metabolic syndrome. Central obesity leads to organ steatosis and altered serum adipokines including reduced adiponectin and markedly elevated leptin. This abnormal adipokine milieu results in increased tissue infiltration of monocytes and macrophages which produce proinflammatory cytokines that alter organ function. Over many years, the combination of steatosis and local inflammation leads to fibrosis and eventually to cancer. Nonalcoholic fatty liver disease (NAFLD) is a precursor for nonalcoholic steatohepatitis (NASH). NAFLD and NASH (1) lead to cirrhosis and hepatocellular carcinoma, (2) increase the risk of liver resection, and (3) compromise the outcome of liver transplantation. Similarly, in the pancreas nonalcoholic fatty pancreas disease (NAFPD) may lead to nonalcoholic steatopancreatitis (NASP). NAFPD and NASP may (1) promote the development of chronic pancreatitis and pancreatic cancer, (2) exacerbate the severity of acute pancreatitis, and (3) increase the risk of pancreatic surgery. In the gallbladder nonalcoholic fatty gallbladder disease (NAFGBD, cholecystosteatosis) may lead to steatocholecystitis. Cholecystosteatosis may be an explanation for (1) the increased incidence of chronic acalculous cholecystitis and (2) the increased number of cholecystectomies.