小胶质细胞激活在多巴胺神经元变性损伤中的作用

帕金森病（Parkinson’s disease,PD）的主要病理特征是黑质纹状体通路的多巴胺（dopamine,DA）神经元退行性变性和缺失。研究表明,小胶质细胞（microglia）激活在DA神经元变性损伤中起关键作用。在受到各种病理因素刺激时,小胶质细胞大量激活,产生前炎性细胞因子和神经毒性因子,启动或加重神经元损伤,导致DA神经元进行性变性死亡。文章综述了近年来关于小胶质细胞激活对DA神经元损伤作用的研究进展,以期对PD发病机制及治疗药物研究提供参考。     

利用果蝇模型研究帕金森病的发病机制

帕金森病（Parkinson′s disease PD)是发病率仅次于阿尔兹海默症的一类神经退行性疾病,其基本病理特征是黑质致密区多巴胺(DA)神经元变性伴胞浆内嗜酸性包涵体即Lewy小体形成,导致尾状核、壳核中DA含量减少及黑质纹状体通路破坏。迄今为止,导致多巴胺能神经元退变的原因仍不十分清楚。目前与家族性PD有关的基因位点已经发现了13个,其中鉴定并报道有突变的有6个：α-SYN(PARK1/4)、Parkin(PARK2)、UCHL1(PARK5)、PINK1(PARK6)、DJ-1(PARK7)和LRRK2(PARK8)。果蝇因其遗传学上的优势而被广泛地应用于人类疾病的研究。果蝇神经系统DA的合成与人类类似,同时果蝇的DA系统也参与了运动控制,因此,目前普遍认为,果蝇DA神经元的死亡导致运动功能障碍与PD发病的情况具有可比性。果蝇含有Parkin,PINK1、DJ-1和LRRK2等PD发病相关基因的同源基因,因此它是一种非常重要的PD模型。文中综述了目前以果蝇模型为主要方法研究PD发病机制的最新进展。     

中医药治疗神经退行性疾病的研究进展

神经退行性疾病是神经元或髓鞘减少所致的神经系统性疾病,随着年龄的增加,患者表现为选择性神经元功能障碍.神经退行性疾病主要包括阿尔茨海默病(Alzheimer's disease,AD)、帕金森病(Parkinson's disease, PD)、亨廷顿病(Huntington's disease,HD)、肌萎缩性侧索硬化(amyotrophic lateral sclerosis,ALS)、脊髓小脑共济失调(spinocerebellar ataxia, SCA)、Pick、多发性硬化(multiple sclerosis, MS)、小脑萎缩症、脊髓性肌萎缩症等.目前,研究最多的有AD、PD、HD和ALS,神经退行性疾病已成为全球迫切解决的问题,加强对神经退行性疾病机制探讨和发现治疗手段对医学和社会具有重大意义.中医药对神经退行性疾病治疗具有巨大潜力.本文就中医药对常见神经退行性疾病病因病机和治疗做出简要阐述,为神经退行性疾病中医诊断与治疗奠定基础.     

神经炎症与帕金森病的关系研究进展

帕金森病（Parkinson’s disease，PD）是一种以中脑黑质致密部多巴胺（dopamine，DA）能神经元进行性退变为主要病理特征的中枢神经系统（central nervous ststem,CNS）变性疾病。其病因和发病机理目前尚不清楚，主要病理变化是在黑质致密部等处DA能神经元严重缺失，残留神经元胞浆内出现嗜酸性包涵体，称路易小体（Lewy bodies，LBs），纹状体DA含量下降。PD是一个集遗传、环境、生理退化与病理损害等多因素造成的错综复杂、交互影响的一个改变过程。小胶质细胞（microglia，MI）是脑内重要的免疫细胞，有多项研究认为MI的激活及神经炎症反应可能参与了PD神经变性的发病过程。同时有研究发现，抑制MI的激活或抗炎治疗可对DA神经元变性起到缓解作用。     

帕金森病与氧化应激

帕金森病(Parkinson’s disease，PD)是人类最常见的一种中枢神经系统退行性变化疾病，它的病理变化主要为黑质内多巴胺(dopamine，DA)能神经元的退变和消失。DA能神经元的退行性变可能与氧化应激、氧自由基的形成及神经毒素等有关。抗氧化治疗及神经保护治疗已成为目前治疗PD的重要手段并在实验及临床中取得了一定成效。     

帕金森病发病机制与诊治的基础与临床研究进展

帕金森病(PD)是中老年常见的神经系统变性疾病,由于其具有高患病率、高致残率和慢性病程的特点,对PD早期诊断、治疗及预防的研究已成为各国相关领域科学家共同关注的热点和焦点.课题组利用前期工作建立起来的PD临床资源库和应用基础研究平台,着眼于转化医学,紧紧围绕PD的发病机制和临床治疗开展研究工作,研究成果的主要创新发现:①PD患者血清IgG及C5a可诱导小胶质细胞活化并对多巴胺(DA)能神经元产生损伤作用,首次探讨了突触共核蛋白在DA能神经元内的转运与小胶质细胞持续激活有关;②中药单体姜黄素、红景天甙、雷公藤TW397对PD细胞和动物模型具有保护与治疗作用;③转染Neurturin或IL-10的C17.2神经干细胞和转染Neurturin的骨髓基质干细胞对PD大鼠模型具有保护与治疗作用;④报道了我国PD患者的疾病经济负担及药物经济学现况,主持制定我国第一、二部《中国帕金森病治疗指南》,主编了《帕金森病》系列专著,为进一步合理、规范我国的PD治疗起到了重要的指导和推动作用.研究成果获得2010年教育部自然科学奖一等奖.     

氨基酸类神经递质在帕金森病发病机制中作用的研究进展

帕金森病(PD)是一种常见的神经退行性疾病,其病理生理改变是黑质-纹状体通路的多巴胺(DA)能神经元变性、死亡而导致纹状体DA含量减少。但其确切机制目前并未阐明。近年来研究发现,纹状体内DA的缺失并不是PD的惟一病理基础,脑内其他神经递质如谷氨酸(G lu)、天冬氨酸、γ-氨基丁酸(GABA)和甘氨酸这4种氨基酸类神经递质也可能参与PD的发病过程。其中,兴奋性氨基酸,尤其是G lu递质与PD的发生和发展的相关性研究已经成为近年来国际学术界研究的一个前沿课题。这些研究为PD的治疗指明了新方向。本文就它们在PD发病机制中所起作用的研究予以综述。     

远志皂苷对脂多糖诱导的帕金森病模型大鼠的作用及机制研究

目的 通过模拟中药口服、疗程用药的方式,探究远志皂苷(Tenuigenin,TEN)对细菌脂多糖(lipopolysaccharide, LPS)诱导的帕金森病(Parkinson's disease, PD)模型大鼠的作用及机制。方法 实验分5个组,通过动物行为学测试、大鼠黑质及血浆中炎性反应因子含量测定、黑质多巴胺(dopamine,DA)能神经元存活率检测和主要脏器组织形态学切片观察,研究TEN对炎症性PD模型大鼠的作用及机制。结果 TEN能够改善炎症性PD模型大鼠的行为学损伤,降低黑质DA能神经元的病死率,抑制黑质炎性反应因子含量,对主要脏器的组织形态学无影响。结论 TEN对PD模型大鼠具有神经保护作用,其机制与抗感染活性密切相关。     

MAPK信号转导通路在神经退行性疾病中的研究进展

神经退行性疾病作为老年人群中的一种常见病,严重威胁人类的健康。在中枢神经系统发育过程中,神经元及/或其髓鞘结构或功能的改变可引起各种神经退行性疾病的产生,如阿尔茨海默病(AD)、帕金森病(PD)、肌萎缩性侧索硬化(ALS)等。目前研究认为丝裂原活化蛋白激酶(MAPK)是一种丝氨酸/苏氨酸(Ser/Thr)激酶,广泛表达于中枢神经系统,在细胞外各种因子的刺激下,通过调控细胞增殖、分化、生长及凋亡等重要过程,而参与多种神经退行性疾病的病理过程。本文就MAPK信号通路在神经退行性疾病中的最新研究进行相关综述。     

帕金森病的发病机制和治疗研究进展*

帕金森病是病因不明的进行性神经系统退行性疾病之一,其病理特征为黑质致密部（SNpc）多巴胺（DA）能神经元变性坏死、纹状体多巴胺递质减少、路易小体（LB）的出现,以及神经胶质细胞增生等。临床症状以运动迟缓、肌强直、静止性震颤、姿势步态不稳等为特征,部分患者可能会出现一些非运动症状。目前研究PD发病机制的报道有很多,但PD的具体发病机制尚未完全明确。PD的临床治疗都是对症治疗,治疗方法有很多,虽然都有效果,但也都有缺陷。本文就PD的发病机制和治疗进展进行综述。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.