抑郁症的认知功能和生活事件对照研究

目的 探讨抑郁症患者的认知功能及其与生活事件问的相关.方法 在山西医科大学第一附属医院精神卫生科门诊收集100例抑郁症患者,采用威斯康星卡分类测验(WCST)系统了解其认知功能的情况,同时对其进行生活事件量表(LES)测验,并将测验结果与正常人群对照.结果 ①抑郁症组和对照组的认知功能在威斯康星卡分类测验(WCST)的...     

自噬相关基因及信号通路在口腔肿瘤发生发展中的影响

自噬是依赖溶酶体进行的一种高保守的细胞自我保护行为,可作为促进或预防癌症的重要因素.自噬作用与肿瘤的类型及发展程度相关,对自噬途径的了解有助于提高肿瘤的诊断和治疗.研究表明自噬与口腔肿瘤的发生发展密切相关,自噬相关基因及信号通路对口腔肿瘤起着双重调节作用.本文综述了在口腔肿瘤中自噬相关调节机制及治疗作用的最新进展.     

Association of the manganese superoxide dismutase gene Ala–9Val polymorphism with clinical phenotypes and tardive dyskinesia in schizophrenic patients

Objective

Several recent studies that have investigated the genetic association between the manganese superoxide dismutase (MnSOD) gene Ala–9Val single-nucleotide polymorphism (SNP) and tardive dyskinesia (TD) have produced conflicting results. This study was to investigate whether this SNP was associated with clinical phenotypes and antipsychotic-induced tardive dyskinesia (TD) in schizophrenia in a genetically homogeneous Han Chinese inpatient population.

Methods

Genotyping was performed for the MnSOD gene Ala–9Val SNP in Chinese schizophrenia patients with (n = 176) and without TD (n = 346). The severity of TD was assessed using the abnormal involuntary movement scale (AIMS), and psychopathology using the Positive and Negative Syndrome Scale (PANSS).

Results

The frequencies of genotypes and alleles did not differ significantly between schizophrenic patients with and without TD (both p > 0.05). Also, there was no significant difference in the AIMS total score between the Val/Val and Ala allele carrier groups (p > 0.05). However, the PANSS negative symptom subscore was significantly higher in patients with Val/Val genotype (21.8 ± 7.3) than those with Ala alleles (20.1 ± 7.7) (t = 2.32, p = 0.03).

Conclusion

While the MnSOD gene Ala–9Val polymorphism did not play a major role in the susceptibility to TD in schizophrenic patients, it might be associated with negative symptoms of schizophrenia.     

Arthroscopic findings in the knees of preadolescent children: Report of 23 cases

Purpose: The aim of this review was to correlate the preoperative clinical diagnoses and the diagnostic arthroscopic findings in preadolescents with knee problems. We also studied the incidence of different types of knee pathology in this age group. Type of Study: Consecutive case series. Materials and Methods: Twenty-three preadolescents, 13 girls and 10 boys under the age of 13 years, presenting with mechanical knee problems underwent knee arthroscopy after clinical assessment. Results: Symptomatic plica synovialis was found to be the most frequent pathology (n = 8). This pathology was far more common in girls compared with boys. Anterior cruciate ligament injuries (n = 4) followed symptomatic plica synovialis in frequency. This was an isolated injury in all cases. The arthroscopic findings were negative in 4 patients. Conclusion: In 61% of preadolescent patients, the clinical diagnoses and arthroscopic findings were compatible and correct. The main error tended to be misdiagnosis of meniscal pathology (4 patients) and overdiagnosis (5 cases of negative arthroscopy).Arthroscopy: The Journal of Arthroscopic and Related surgery, Vol 16, No 8 (November-December), 2000: pp 793–795     

Are hospitalized Parkinson’s disease patients more likely to carry a do-not-resuscitate order?

While DNR utilization is a complex subjective phenomenon, the effect of such a decision can collectively influence attitudes of care. The role of palliative care in advanced PD has been under appreciated. We reviewed the Healthcare Cost and Utilization Project’s National Inpatient Sample (NIS) database from 2012 for all hospitalizations ⩾65 years. We identified PD by using ICD-9-CM code 332.0 and DNR status with ICD code – V49.86 entered during the same admission as a secondary diagnosis. We estimated risk of mortality by the 3 M™ All Patient Refined DRG (APR DRG) classification System and generated multivariate regression models to assess associations between DNR and PD after adjusting for confounders. Finally, we tested for interaction by risk of mortality. We analyzed 12,700,000 hospitalizations with age ⩾65 years in 2012, of which 246625 (1.94%) pts had PD. Proportion of DNR utilization was higher among PD patients vs. those without, 20895 (8.47%) vs. 723090 (5.8%) (p < 0.01). In multivariable regression analysis, PD patients were associated with higher odds of DNR utilization [Adjusted Odds ratio (aOR): 1.26, 95% CI: 1.21, 1.30, p < 0.001]. Finally, the odds of DNR utilization increased significantly with APR-DRG stage [aOR: 1 vs. 1.61 (Stage 2) vs. 2.46 (Stage 3) vs. 3.61 (Stage 4); p < 0.0001]. PD patients have higher odds of DNR utilization than the general population, which worsens with increasing objective risk of mortality. This is likely correlated with perception of end of life and importance of QOL with increasing severity of overall illness.     

Blockade of corticotropin‐releasing hormone receptor 1 attenuates early‐life stress‐induced synaptic abnormalities in the neonatal hippocampus

Adult individuals with early stressful experience exhibit impaired hippocampal neuronal morphology, synaptic plasticity and cognitive performance. While our knowledge on the persistent effects of early‐life stress on hippocampal structure and function and the underlying mechanisms has advanced over the recent years, the molecular basis of the immediate postnatal stress effects on hippocampal development remains to be investigated. Here, we reported that repeated blockade of corticotropin‐releasing hormone receptor 1 (CRHR1) ameliorated postnatal stress‐induced hippocampal synaptic abnormalities in neonatal mice. Following the stress exposure, pups with fragmented maternal care showed retarded dendritic outgrowth and spine formation in CA3 pyramidal neurons and reduced hippocampal levels of synapse‐related proteins. During the stress exposure, repeated blockade of glucocorticoid receptors (GRs) by daily administration of RU486 (100 µg g^?1) failed to attenuate postnatal stress‐evoked synaptic impairments. Conversely, daily administration of the CRHR1 antagonist antalarmin hydrochloride (20 µg g^?1) in stressed pups normalized hippocampal protein levels of synaptophysin, postsynaptic density‐95, nectin‐1, and nectin‐3, but not the N‐methyl‐d ‐aspartate receptor subunits NR1 and NR2A. Additionally, GR or CRHR1 antagonism attenuated postnatal stress‐induced endocrine alterations but not body growth retardation. Our data indicate that the CRH‐CRHR1 system modulates the deleterious effects of early‐life stress on dendritic development, spinogenesis, and synapse formation, and that early interventions of this system may prevent stress‐induced hippocampal maldevelopment. © 2014 Wiley Periodicals, Inc.     

Circulating Calprotectin (cCLP) in autoimmune diseases

Background and aimCalprotectin (CLP) is a heterodimeric complex formed by two S100 proteins (S100A8/A9), which plays a pivotal role in innate immunity. Due to its intrinsic cytotoxic and proinflammatory properties, CLP controls cell differentiation, proliferation and NETosis and has been associated with a wide range of rheumatic diseases.Our review summarizes the widespread interest in circulating CLP (cCLP) as a biomarker of neutrophil-related inflammation, in autoimmune rheumatic disease (ARD) and non-ARD.MethodsA thorough literature review was performed using PubMed and EMBASE databases searching for circulating calprotectin and synonyms S100A8/A9, myeloid-related protein 8/14 (MRP8/MRP14), calgranulin A/B and L1 protein in addition to specific ARDs and autoimmune non-rheumatic diseases. We selected only English-language articles and excluded abstracts without the main text.ResultsHigh cCLP serum levels are associated with worse structural outcomes in rheumatoid arthritis and to a lesser extent, in spondyloarthritis. In addition, cCLP can predict disease relapse in some autoimmune diseases including systemic lupus erythematosus (SLE), anti-neutrophil cytoplasmic antibodies-associated vasculitis (AAV) and some severe manifestations of connective tissue diseases, such as glomerulonephritis in SLE, AAV, juvenile idiopathic arthritis, adult-onset Still’s disease and lung fibrosis in systemic sclerosis. Therefore, cCLP levels enable the identification of patients who need an accurate and tight follow-up.The clinical usefulness of cCLP as an inflammatory marker has been suggested for inflammatory/autoimmune non-rheumatic diseases, and especially for the monitoring of the inflammatory bowel diseases patients. Currently, there are only a few studies that evaluated the cCLP efficacy as a clinical biomarker in inflammatory/autoimmune non-rheumatic diseases with controversial results. Future studies are warranted to better clarify the role of cCLP in relation to the disease severity in myasthenia gravis, multiple sclerosis, chronic inflammatory demyelinating polyneuropathy, Graves’ orbitopathy, autoimmune bullous diseases and uveitis.ConclusionOur literature review supports a relevant role of cCLP as potential prognostic biomarker mirroring local or systemic inflammation, especially in chronic inflammatory rheumatic diseases.