轻微脑功能失调的双生子研究初步报告

报告MBD双生子研究结果,均可排除脑损害及发育迟缓病因,7对单卵双生子的同病率为85.7％,3对异卵双生子的同病率为33.3％。异卵双生子的男性均患病,显示遗传因素与MBD有密切关系,男性较女性发病高。     

上海浦东新区55岁及以上人口轻度认知功能障碍及影响因素的调查

目的:探讨上海55岁及以上老年人轻度认知障碍(MCI)的患病率及危险因素的流行病学特征。方法:2011年7月至2012年7月实施抽样调查上海市浦东新区≥55岁户籍人群,应用PPS(probability proportional to size)抽样法,根据Petersen诊断标准、问卷调查及临床医师复核诊断,分析MCI患病率及危险因素。结果:抽取居民4 600人,实际调查4 086人,调查率88.83%。4 086人中,患有MCI者(MCI组)612例,占14.98%,患有阿尔茨海默病者(AD组)201例,占4.92%,正常智力者(正常智力组)3 273例。MCI患病率:女性高于男性(χ2=11.52,P=0.003),且随年龄增长而增高(χ2=196.80,P=0.000);文盲和小学文化程度者高于初中及以上者(χ2=227.03,P=0.000);体力劳动者高于脑力劳动者(χ2=16.76,P=0.000)。以罹患MCI作为应变量,将年龄、性别、高血压、糖尿病、高脂血症、吸烟史、受教育程度等因素中与MCI相关的变量作为自变量,进行二变量的线性Logistic回归分析显示,共病高血压、糖尿病、高脂血症及吸烟、受教育程度低、高龄等易感因素具有独立影响意义(P0.05或P0.01),其中共病高血压、受教育程度低及高龄与AD组的易感因素相同。结论:有效防治高血压、糖尿病及高脂血症等代谢性疾病有利于减少MCI的发生发展。     

内蒙古包头蒙古族、汉族轻度认知障碍患病率及危险因素的民族差异性研究

目的对内蒙古包头蒙古族和汉族轻度认知障碍(MCI)者的流行现状、影响因素进行对照分析,了解其民族差异性。方法采用多级整群随机抽样方式,结合集中和入户调查,对内蒙古包头的11个旗县区65岁以上的人群进行MCI的流行病学调查。结果 (1)蒙古族老年人MCI组患病率10.98%,标化患病率11.00%较汉族老年人MCI组患病率9.90%,标化患病率10.60%略高,但差异无统计学意义(P0.05)。(2)两民族均呈现出随年龄增加MCI患病率呈逐渐增高的趋势(P0.05)。民族间差异无统计学意义(P0.05)。(3)同民族不同性别间比较、同性别不同民族间比较,MCI患病率之间的差异均无统计学意义(P0.05)。(4)两民族均呈现出教育水平越低,MCI患病率越高(P0.05)。民族间差异无统计学意义(P0.05)。结论内蒙古包头地区蒙古族和汉族的MCI患病率均无明显性别差异,均随年龄增长及教育水平降低而增高,两民族间无差异。     

婚姻质量对轻度认知功能障碍及阿尔茨海默病患病的影响

目的:探究婚姻质量对轻度认知功能障碍(MCI)及阿尔茨海默病(AD)患病的影响。方法:运用系统随机抽样法抽取自贡市青杠林社区≥60岁老年居民400人;采用自编的一般情况调查表、婚姻状况表收集入组者人口学等资料;应用简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)对入组者进行认知功能评估;依据《国际疾病分类》第10版(ICD-10)中MCI及AD的诊断标准对有认知功能损害者(MMSE26分及MoCA26分)进行诊断;分析婚姻状况对MCI及AD的影响。结果:共345人完成调查,根据目前的婚姻状态分为单身组(47人)及在婚组(298人)。MCI及AD患病率单身组(34.04%,19.15%)明显高于在婚组(20.13%,9.73%)(χ~2=6.133,χ~2=8.157;P均0.05)。MCI及AD女性患者中,单身组MMSE及MoCA评分明显低于在婚组(P0.05或P0.01);男性患者中,两组间MMSE及MoCA评分差异无统计学意义。二分类Logistic回归分析显示有子女支持、正性解决冲突、共同承担家庭经济负担是MCI与AD患病的保护因素。结论:婚姻是MCI和AD的保护因素,女性较男性更需要婚姻的保护。     

精神分裂症双生子非同病率研究

采用两种不同的方法计算双生子中精神分裂症患者的同病率和非同病率,表明MZ(同卵双生子)中精神分裂症同病率较DZ(异卵双生子)高2.5～3倍。同时,按Gottesman和Shields法计算出MZ中精神分裂症遗传率(h~2)的估计值为87.6％。两者都证明精神分裂症患者发病中遗传效应起了重要作用。但MZ非同病率高达52％～60％,提示了其他因素对精神分裂症发病的作用。环境因素中祖辈及父母对子女的教养值得重视。另外,病前个性和人际关系虽然主要受遗传因素影响,但亦可能影响精神分裂症的发病。     

精神分裂症12对双生子调查分析

目的：了解精神分裂症双生子同病率情况。方法；对12例精神分裂症双生子进行同病率调查。结果：单卵同病率（CMZ）为44.4%，二卵同病率（CDZ）为33.3%。单卵同病的两患者首次发病年龄较接近。结论：精神分裂症的病因中，遗传因素是一个重要方面。     

老年高血压病患者认知功能障碍程度与磁共振弥散加权成像表观弥散系数的关系

目的:研究老年高血压病患者认知功能障碍程度与头颅各部位磁共振弥散加权成像(MR-DWI)的表观弥散系数(ADC)值的关系,探讨轻度认知功能障碍(MCI)早期诊断和评估的参考指标。方法:入选60~80岁的老年高血压病患者40例进行现状调查。运用蒙特利尔认知量表(MoCA)和临床痴呆评定量表(CDR)对入选患者进行认知功能评定并分组:认知功能正常组8例、轻度认知功能障碍(MCI)组22例和痴呆组(VaD)10例。行MR-DWI检查,测算头颅各解剖部位ADC值。采用SPSS16.0软件进行数据统计分析。结果:①认知功能正常组和MCI组与VaD组比较,MoCA和CDR评分差异均有显著统计学意义(P<0.01)。②认知功能正常组和MCI组与VaD组比较,舒张压差异有统计学意义(P<0.01),收缩压差异无统计学意义(P>0.05)。③认知功能正常组和MCI组与VaD组比较,左侧半卵圆中心、右侧海马和左侧内囊ADC值差异有统计学意义(P<0.05)。④认知功能正常组与MCI组比较,右侧海马ADC值差异有统计学意义(P<0.0167);MCI组与VaD组比较,左侧内囊差异有统计学意义(P<0.0167)。结论:老年高血压病患者收缩压水平与认知功能相关。左侧半卵圆中心、右侧海马、左侧内囊区功能结构变化与认知功能密切相关。早期右侧海马区改变显著,后期左侧内囊区改变明显。     

焦虑和抑郁症状与老年认知功能障碍的相关性研究

目的调查研究社区≥50岁老年人认知功能障碍与焦虑、抑郁症状的关系。方法采用横断面调查,对≥50岁的社区居民进行全套神经系统体检、神经心理测试,根据国际统一的诊断标准诊断痴呆和轻度认知功能障碍(MCI)。采用Logistic回归模型分析焦虑、抑郁症状与痴呆和MCI的相关性。结果完成全部测试项目的3 738名研究对象中,155例(4.1%)被诊断为痴呆(痴呆组),691例(18.5%)被诊断为MCI(MCI组)。2 892名(77.4%)无痴呆和MCI的研究对象为认知功能正常(正常组)。经多因素分析校正多个变量后发现,男性患者抑郁症状得分每增加1分,患痴呆相对正常组患病率增高6.2%(OR=1.062,95%CI:1.020~1.105),预测概率范围为(0.01,0.10);女性患者抑郁症状得分每增加1分,患痴呆或MCI相对正常组患病率增高4.6%(OR=1.046,95%CI:1.013~1.079)、3.2%(OR=1.032,95%CI:1.017~1.047),预测概率范围分别为(0.01,0.10)、(0.12,0.36),焦虑症状得分每增加1分,患MCI相对正常组患病率增高2.2%(OR=1.022,95%CI:1.005~1.040),预测概率范围为(0.10,0.28)。结论横断面调查发现痴呆与越高的抑郁症状得分有关;在女性中,MCI与越高的焦虑、抑郁症状得分有关;在男性中则无这种关系存在。     

轻度认知功能障碍淋巴细胞及炎症蛋白检测

目的探讨MCI认知功能与淋巴细胞及炎症蛋白的关系。方法研究阿尔茨海默病（AD,36例）、轻度认知障碍（MCI,34例）及认知功能正常老年人（认知正常组,36人）的外周血淋巴细胞亚群、免疫球蛋白及炎性蛋白的差异。结果认知正常组、MCI组与AD患者的免疫球蛋白G（IgG）浓度中位数依次为10.5g/L、10.6g/L、13.1g/L（χ2=14.28,P〈0.01）;辅助性T淋巴细胞（TH）比例的中位数依次为41%、35%、37%（χ2=9.96,P〈0.01）;三组间差异有统计学意义。其中认知正常组与MCI组的IgG差异无统计学意义（Z=0.64,P=0.52）,而AD组IgG水平高于MCI组（Z=3.26,P〈0.01）和认知正常组（Z=3.22,P〈0.01）;认知正常组TH高于AD组（Z=2.55,P〈0.05）和MCI组（Z=2.95,P〈0.01）,而MCI组与AD组的TH差异无统计学意义（Z=0.18,P=0.86）。结论 IgG可能在AD与MCI、认知功能正常者的鉴别方面具有重要意义;TH水平降低可能是认知功能受损的标志。     

老年高干人群轻度认知功能障碍调查及危险因素分析

目的 了解年龄≥65岁的高干人员轻度认知功能障碍的患病情况及其相关危险因素,为进行有效防治提供参考依据.方法 选取在广州市第一人民医院体检的老年高干454例为研究对象,分别给予简易精神状态量表(mini mental state examination,MMSE)的认知量表和蒙特利尔认知量表(Montreal cognitive assessment,MoCA)评估,进行两种量表得分相关性分析和MCI检出率比较.同时根据临床诊断标准将研究对象分为正常组(96名)和MCI组(337例),分析轻度认知功能障碍的相关危险因素.结果 MoCA和MMSE得分显著相关(r ＝ 0.563,P ＜ 0.01),MoCA检出率(78.98%)大于MMSE检出率(45.96%).年龄、抑郁得分、收缩压、高血压在两组之间的差异有显著统计学意义(P ＜ 0.01).MCI组中,年龄、高血压和抑郁得分均是MCI的独立危险因素(P ＜ 0.01).结论 老年高干人群中,年龄、高血压和抑郁均是MCI的独立危险因素,有针对性的对其干预可减少痴呆的发生.     

Leukodiapedesis and leukocyte migration in the leptomeninges and in the subarachnoid space

Summary Pleocytosis in cerebrospinal fluid and infiltration of the leptomeningeal tissue have been studied after injection of ferritin into the subarachnoid space (SAS) of cats.The most important source of granulocytes in the leptomeninges are the relatively large veins of the pia mater, which have very thin walls. Passing between the lining cells of the pia mater the granulocytes leave the connective tissue space of the pia mater and reach the SAS. Leukodiapedesis has also been observed in veins crossing the SAS. During this process, gaps between the lining cells of the perivascular leptomeningeal sheath may develop. There are two possible ways for the granulocytes to pass from the vascular pia mater to the avascular arachnoidea: either they migrate actively on the surface of the leptomeningeal trabeculae or they reach the arachnoidea passively by the circulation of the cerebrospinal fluid. Leukodiapedesis in the vessels of the dura mater occurs relatively seldom and would not be able to cause the occasionally massive infiltration of the arachnoidea.

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Zusammenfassung Nach subarachnoidaler Ferritin-Injektion wurde an Katzen die Entstehung der Liquorpleozytose und die Infiltration des leptomeningealen Gewebes beobachtet.Die weitlumigen, dünnwandigen venösen Gefäße der Pia mater stellen die wichtigsten Quellen der Granulozyten im leptomeningealen Bereich dar. Die Granulozyten verlassen den pialen Bindegewebsraum, indem sie zwischen den Lining-cells der Pia mater hindurch in den Subarachnoidalraum gelangen. Venen, die den Subarachnoidalraum durchqueren, weisen ebenfalls Leukodiapedesevorgänge auf. Zwischen den Lining-cells der perivasculären Scheide treten dabei offenbar Lücken auf. Den Granulozyten stehen zwei Möglichkeiten zur Verfügung, um die gefäßlose Arachnoidea von der vaskularisierten Pia mater aus zu erreichen: Entweder wandern sie aktiv über das leptomeningeale. Balkenwerk oder sie gelangen passiv mit der Liquorzirkulation dorthin. Hinweise auf Leukozytenaustritte aus den Duragefäßen sind vergleichsweise selten und würden die mitunter hochgradige Infiltration der Arachnoidea wohl nicht bewirken können.

     

Fighting in the aged male mouse increases the expression of TrkA and TrkB in the subventricular zone and in the hippocampus

In the present study, we investigate the effect of aggressive behavior and release of nerve growth factor (NGF) on brain progenitor cells. We found that the condition of subordination enhances the level of NGF in the subventricular zone and hippocampus whereas dominance elevates brain derived neurotrophic factor (BDNF). It was also found that mRNA-TrkA is over-expressed in the subventricular zone and hippocampus of dominant and subordinate mice, whereas mRNA-TrkB is increased in the subventricular zone of both dominants and subordinates and in the hippocampus of dominant mice. Fighting was also associated with increased presence of proliferating cells in the hippocampus stained with the nuclear marker bromodeoxyuridine (BrdU). Moreover, the brain of subordinate mice displayed tyrosine hydroxylase (TH) immunoreactivity in the wall of the periventricular region of the third ventricles and a marked neuropeptide Y (NPY) presence in the hippocampus co-expressed with BrdU. These results provide additional evidence that agonistic behavior in the aged mouse alters neurotrophin levels and increases brain progenitor cells number. The functional significance of these findings is discussed.     

Diurnal variation in the concentrations of catecholamines and indoleamines in the median eminence and in the intermediate and posterior lobes of the pituitary gland of the male rat

Diurnal changes in monoamine concentrations were studied in the median eminence and in the intermediate and posterior lobes of the pituitary gland of the male rat. The concentrations of serotonin (5-HT), 5-hydroxyindoleacetic acid (5-HIAA), noradrenaline (NA) and dopamine (DA) were analyzed at 7 time points over a 24-h period. Diurnal variation was analyzed by analysis of variance (ANOVA) with time of day as a class variable as well as by 24 h and 12 h cosine curve fittings. There were marked time-dependent changes in the median eminence concentrations of 5-HT (ANOVA: P = 0.0085), 5-HIAA (P = 0.003) and NA (P = 0.0003). Cosine curves with 24-h periods fit the data points with peaks around 13.00 h. DA levels also varied with an apparent 24-h rhythm in the median eminence, but the changes did not reach the level of significance in the ANOVA. In the intermediate lobe of the pituitary gland, the concentrations of DA varied significantly during the course of the 24-h cycle (P = 0.0011) and were well-fitted to a 24-h cosine wave. The 5-HIAA levels also showed marked diurnal changes (P = 0.025) with an evident 12-h rhythm. In contrast, NA and 5-HT concentrations did not appear to vary during the 24-h cycle. In the posterior lobe of the pituitary gland. DA had a 24-h rhythm (P = 0.0005) similar to the intermediate lobe. NA and indoleamine levels did not show any significant variation.(ABSTRACT TRUNCATED AT 250 WORDS)     

Alzheimer's disease in the old and the young

This study concerns differences between Alzheimer's disease in the old and the young. Literature differentiating Alzheimer's disease from ‘senile dementia’ is reviewed. Two groups of mental hospital patients with Alzheimer brain changes at autopsy are compared. They comprised the 17 oldest and 17 youngest of the 56 ptients with definite Alzheimer changes in a series of 212 consecutive autopsies. The younger group had been first hospitalized at later ages than the older group, and were more likely to have been demented at admission. The older group had mostly been diagnosed as schizophrenic (mainly paranoid) on admission. Neuropathologically the younger group showed more severe Alzheimer changes of all kinds. The changes in the older group tended to be limited to the hippocampus, whereas in the younger group they showed extension into the frontal and occipital cortex and were also found in subcortical gray matter. Lipofuscin was more abundant in the older group, so that a discrepancy between very severe Alzheimer changes and less abundant lipofuscin characterizes the younger cases.