Olfactory deficits in mice overexpressing human wildtype alpha-synuclein

Accumulation of α-synuclein in neurons of the central and peripheral nervous system is a hallmark of sporadic Parkinson's disease (PD) and mutations that increase α-synuclein levels cause familial PD. Transgenic mice overexpressing α-synuclein under the Thy1 promoter (Thy1-aSyn) have high levels of α-synuclein expression throughout the brain but no loss of nigrostriatal dopamine neurons up to 8 months, suggesting that they may be useful to model pre-clinical stages of PD. Olfactory dysfunction often precedes the onset of the cardinal motor symptoms of PD by several years and includes deficits in odor detection, discrimination and identification. In the present study, we measured olfactory function in 3- and 9-month-old male Thy1-aSyn mice with a buried pellet test based on latency to find an exposed or hidden odorant, a block test based on exposure to self and non-self odors, and a habituation/dishabituation test based on exposure to non-social odors. In a separate group of mice, α-synuclein immunoreactivity was assessed in the olfactory bulb. Compared with wildtype littermates, Thy1-aSyn mice could still detect and habituate to odors but showed olfactory impairments in aspects of all three testing paradigms. Thy1-aSyn mice also displayed proteinase K-resistant α-synuclein inclusions throughout the olfactory bulb. These data indicate that overexpression of α-synuclein is sufficient to cause olfactory deficits in mice similar to that observed in patients with PD. Furthermore, the buried pellet and block tests provided sufficient power for the detection of a 50% drug effect, indicating their usefulness for testing novel neuroprotective therapies.     

Choreathetoid movement as an unusual presentation of subdural haematoma

Summary  Subdural haematomas can present with a wide variety of symptoms. An atypical presentation can be movement disorders. The key feature is that the history of onset is more rapid than with neurological conditions such as Parkinson’s disease. The symptoms can also be an acute worsening of pre-existing disorder. The case discussed involved an 80 year old woman with bilateral choreathetoid movements attributed to a unilateral chronic subdural haematoma. The haematoma was surgically drained and the symptoms resolved. Sporadic reports of similar cases of movement disorders associated with subdural haematomas exist in the literature, but rarely do unilateral haematomas present with bilateral symptoms. Pressure effects, neurotransmitter abnormality and ischaemia have been postulated as reasons for this type of presentation. Unexplained and sudden movement disorders might warrant imaging to rule out a subdural haematoma as the cause. Correspondence: Mrs. G. Pickett, Salford Royal Hospital, Stott Lane, Salford M6 8HD, UK.     

STN DBS of Advanced Parkinson's Disease Experienced in a Specialized Monitoring Unit with a Prospective Protocol

Objective

In the evaluation of patients with Parkinson''s disease (PD), most neurologists only see their patients during a limited period of their fluctuating 24-hour-a-day lives. This study aimed to assess the short-term outcome of STN stimulation for patients with advanced PD evaluated in a 24-hour monitoring unit for movement disorder (MUMD) using a prospective protocol.

Methods

Forty-two patients with advanced PD consecutively treated with bilateral STN stimulation using multi-channel microelectrode recording were included in this study. All patients were evaluated using a 24-hour MUMD with a video recording/editing system and were evaluated with a prospective protocol of the Unified Parkinson''s Disease Rating Scale, Hoehn and Yahr Staging, Schwab and England Activities of Daily Living, levodopa equivalent daily dose (LEDD), Short Form-36 Health Survey, and neuropsychological tests. Magnetic resonance (MR) images of the brain were performed prior to and six months after surgery.

Results

All patients were evaluated at three and six months after surgery. There was a rapid and significant improvement of the motor symptoms, especially in tremor and rigidity, after STN stimulation with low morbidity. Dyskinesia was markedly decreased with much lowered LEDD values by 50% after STN stimulation. 1.5T MR images were safely taken according to the manufacturer''s guidelines at six months after surgery without any adverse effects in 41 patients treated with STN stimulations.

Conclusion

Evaluations in a 24-hour monitoring unit could reduce the dose of medication efficiently to an optimal level with patients''comfort and improve the clinical symptoms in harmony with STN stimulation.     

角膜病患者滴眼液使用规范现况的调查分析

目的　调查角膜病患者滴眼液规范使用现况,为正确使用滴眼液的健康教育提供指导。方法　将2021年8月至2022年2月在济南市第二人民医院眼科病房接收的角膜病患者346例作为调查对象,由经过培训后的1名眼科专科护士观测患者未开展滴眼液使用相关教育前的滴眼液使用过程,并评价其眼药水滴注行为的规范性;采用济南市第二人民医院眼科病房设计的《滴眼液规范使用认知调查表》调查角膜病患者滴眼液规范使用相关认知。结果　346例患者中,男156例（45.09%）,女190例（54.91%）;年龄30岁及以下36例（10.40%）,>30～40岁32例（9.25%）,>40～50岁47例（13.58%）,>50～60岁87例（25.14%）,>60～70岁94例（27.17%）,>70岁50例（14.45%）。专科护士对346例角膜病患者1次滴眼液使用行为观测发现,43.93%（152/346）的患者在滴注眼药水前未洗手;41.53%（49/118）的患者滴注混悬液型眼药水前未摇匀;41.62%（144/346）的患者滴注眼药水未选择正确的仰卧头后仰位;43.93%（152/346）的患者滴注眼药水时眼睛未向头顶方向看;43.06%（149/346）的患者眼药水孔直接与眼球接触;53.47%（185/346）的患者滴注时瓶口和睫毛接触;63.29%（219/346）的患者眼药水滴注时未按压鼻泪管;仅27.27%（42/154）的患者在眼药水外溢后正确选择了纸巾擦拭;36.13%（125/346）的患者滴注后立即揉按眼睛;69.08%（239/346）的患者滴注完毕后未执行牵拉眼睑并闭眼1 min以上的正确行为。问卷调查显示,346例患者中,34.97%（121/346）的患者认为滴注2种及以上眼药水时,间隔时间>10 min;53.18%（184/346）的患者认为滴眼液需兼顾温度、光线,参考说明书妥善保存;56.36%（195/346）的患者认为需根据医生或滴眼液说明书的建议滴眼;55.49%（192/346）的患者认为滴眼液开封后,需注意保质期;56.07%（194/346）的患者认为在2种及以上滴眼液滴注时需先滴刺激性弱的,后滴刺激性强的;58.96%（204/346）的患者认为每次眼药水滴注量为1～2滴;73.41%（254/346）的患者认为滴眼后出现异常症状需立即停药/就医;73.70%（255/346）的患者认为滴眼液药品颜色改变、浑浊时立即停用;47.40%（164/346）的患者认为滴眼液使用期间,无需限制饮食,52.60%（182/346）的患者认为滴眼液使用期间应根据说明书或医嘱限制某些食物摄入;仅56.36%（195/346）的患者在使用滴眼液前阅读了说明书。结论　角膜病患者滴眼液规范使用行为及认知并不理想,眼科护理人员需重视滴眼液使用的相关宣教,促进滴眼液的规范使用。     

GC法同时测定冰珍去翳滴眼液中冰片和苯氧乙醇的含量

目的：建立气相色谱法同时测定冰珍去翳滴眼液中冰片及苯氧乙醇的含量。方法： 采用DB-WAX毛细管色谱柱（30 m × 0.32 mm,0.25 μm）;FID检测器;进样口温度200 ℃,检测器温度为250 ℃;载气为氮气,流速为1 mL·min-1。采用程序升温法：起始温度130 ℃,保持10 min,以25 ℃·min-1升至200 ℃,保持5 min。结果：天然冰片、苯氧乙醇的质量浓度分别在0.011 54～0.115 4 mg·mL-1（r=0.999 9）、0.064 87～0.648 7 mg·mL-1（r=0.999 9）范围内线性关系良好;平均回收率分别为96.3%（RSD=1.65%）、95.1%（RSD=1.62%）。结论：该方法专属性好,准确度高,重复性好,可用于冰珍去翳滴眼液的质量控制。     

复明片联合曲伏前列素滴眼液治疗开角型青光眼的临床研究

目的 探讨复明片联合曲伏前列素滴眼液治疗开角型青光眼的临床疗效。方法 选取2017年10月—2021年1月在洛阳市第三人民医院眼科治疗的142例开角型青光眼患者,根据随机数字法将所有患者分为对照组和治疗组,每组各组71例。对照组外用曲伏前列素滴眼液,睡前1滴/次,1次/d。治疗组在对照组治疗基础上口服复明片,5片/次,3次/d。两组连续用药30 d。观察两组的临床疗效,比较两组临床症状缓解情况,眼动脉血流指标和血清学因子水平。结果 治疗后,治疗组总有效率是98.59%,显著高于对照组的84.51%（P＜0.05）。治疗后,治疗组视力模糊、眼胀、视力下降、头痛缓解时间均显著短于对照组（P＜0.05）。治疗后,两组眼动脉血流阻力指数（RI）、动脉收缩期最大流速（PSV）均较治疗前显著降低,但舒张末期血流速度（EDV）显著升高（P＜0.05）;治疗后,治疗组眼动脉血流指标改善优于对照组（P＜0.05）。治疗后,两组患者血清白细胞介素-6（IL-6）、白细胞介素-1β（IL-1β）、干扰素-γ（IFN-γ）、内皮素-1（ET-1）水平均较治疗前显著降低（P＜0.05）;治疗后,治疗组血清因子水平低于对照组（P＜0.05）。结论 复明片联合曲伏前列素滴眼液治疗开角型青光眼具有较好的临床疗效,可明显改善眼部血流指标,能有效降低眼部炎症状态,值得临床推广使用。     

试验用药品的冷链管理研究

厚朴酚及和厚朴酚是一对疏水性烯丙基联苯酚类结构的同分异构体,具有许多相同的药理作用,如抗炎、抗氧化、抗肿瘤、抗微生物等。厚朴酚及和厚朴酚是钙离子通道阻滞剂,能抑制胃肠道平滑肌收缩;也能促进胃动素和胃泌素分泌,增强胃肠道内Cajal间质细胞内质网上的三磷酸肌醇受体和兰尼碱受体的表达和受体活性,促进内质网释放钙离子,激活Cajal间质细胞的起搏电流,增强胃肠道的节律性收缩。因此。厚朴酚及和厚朴酚对胃排空和胃肠推进运动产生双向调节作用：当各种病理因子引起胃肠道运动功能低下时表现为促进胃排空和胃肠推进运动;当各种病理因子引起胃肠运动亢进时,表现为对抗亢进。加之它们的抗氧化和抗炎作用可保护肠黏膜免遭伤害,提高脓毒症所致的胃肠道运动障碍,也能对抗各种肠炎和泻药所致的腹泻。     

熊胆开明片联合曲伏前列素滴眼液治疗原发性开角型青光眼的临床研究

目的 探讨熊胆开明片联合曲伏前列素滴眼液治疗原发性开角型青光眼的临床疗效。方法 选择2020年8月—2022年4月开封市中心医院收治的原发性开角型青光眼患者150例（292眼）,采用随机数字表法将所有患者分为对照组（75例,147眼）和治疗组（75例,145眼）。对照组患者滴眼曲伏前列素滴眼液,1滴/次,每晚1次。治疗组患者在对照组基础上口服熊胆开明片,4片/次,3次/d。两组均治疗30d。观察两组临床疗效,比较两组的眼压、视野、眼部血流动力学、氧化应激、视觉相关生活质量（VRQL）评分、视觉诱发电位。结果 治疗后,治疗组的总有效率为92.41%,高于对照组的总有效率80.27%,组间比较差异有显著性（P＜0.05）。治疗后,两组眼压、视野缺损均显著下降（P＜0.05）,治疗后,治疗组的眼压、视野缺损均显著小于对照组（P＜0.05）。治疗后,两组收缩期血流峰值速度（PSV）、舒张末期血流速度（EDV）均显著升高,阻力指数（RI）显著下降（P＜0.05）;治疗后治疗组患者的PSV、EDV明显高于对照组,RI明显低于对照组（P＜0.05）。治疗后,两组P100波振幅显著升高,P100波潜伏期显著下降（P＜0.05）;治疗后治疗组的P100波振幅高于对照组,P100波潜伏期低于对照组（P＜0.05）。治疗后,两组行走、读写、暗适应、驾驶、家务劳动、室外活动评分和总分均显著升高（P＜0.05）,治疗后治疗组患者行走、读写、暗适应、驾驶、家务劳动、室外活动评分和总分均明显高于对照组（P＜0.05）。治疗后,两组超氧化物歧化酶（SOD）水平明显升高,丙二醛（MDA）、晚期蛋白氧化产物（AOPP）水平明显下降（P＜0.05）,治疗后治疗组的SOD水平明显高于对照组,MDA、AOPP水平明显低于对照组（P＜0.05）。结论 熊胆开明片联合曲伏前列素滴眼液治疗原发性开角型青光眼,可降低眼压,减轻视野缺损,改善氧化应激、视觉诱发电位和眼部血流动力学,提升视觉相关生活质量,安全有效。     

运动想象疗法联合认知干预对术后动脉瘤蛛网膜下隙出血病人的影响

目的:探讨运动想象疗法联合认知干预对动脉瘤蛛网膜下隙出血(aSAH)病人术后肢体运动功能、认知功能及生活质量的影响。方法:2018年10月—2020年6月采用方便抽样法选取92例aSAH病人为研究对象,应用信封随机分组法将病人分为观察组、对照组,每组46例,对照组术后行常规康复训练,观察组实施运动想象疗法联合认知干预,干预时间为3个月。干预前后采用美国国立卫生院神经功能缺损评分(NIHSS)、简易精神状态检查表(MMES)评价病人的认知功能;采用Holden功能步行分级(FAC)、Berg平衡量表(BBS)、Fugly-Meyer评定评分评价病人的运动功能;采用世界卫生组织生存质量测定量表-100(WHOQOL-100)评价病人的生活质量。结果:干预后观察组病人NIHSS评分低于对照组(P<0.05),而简易精神状态检查表(MMES)评分高于对照组(P<0.05);干预后观察组病人FAC、BBS、Fugly-Meyer评定评分及生活质量总评分较对照组明显改善(P<0.05)。结论:运动想象疗法联合认知干预能有效改善aSAH病人运动及认知功能,提高病人生活质量。