Isoflurane-induced neuronal apoptosis in developing hippocampal neurons

We hypothesized that the P2X7 receptor may be the target of isoflurane, so we investigated the roles of the P2X7 receptor and inositol triphosphate receptor in calcium overload and neuronal apoptosis induced by isoflurane in cultured embryonic rat hippocampal neurons. Results showed that isoflurane induced widespread neuronal apoptosis and significantly increased cytoplasmic Ca 2+ . Blockade of P2X7 receptors or removal of extracellular Ca 2+ combined with blockade of inositol triphosphate receptors completely inhibited apoptosis or increase in cytoplasmic Ca 2+ . Removal of extracellular Ca 2+ or blockade of inositol triphosphate receptor alone could partly inhibit these effects of isoflurane. Isoflurane could directly activate P2X7-gated channels and induce inward currents, but did not affect the expression of P2X7 receptor protein in neurons. These findings indicate that the mechanism by which isoflurane induced neuronal apoptosis in rat developing brain was mediated by intracellular calcium overload, which was caused by P2X7 receptor mediated calcium influx and inositol triphosphate receptor mediated calcium release.     

Sleep Disturbances in Adults with Autism Spectrum Disorders and Severe Intellectual Impairments

Sleep disturbances are a significant problem for persons with developmental disabilities. These problems occur at a higher rate than what is observed in the typically developing population, and persons with Autism Spectrum Disorders (ASD) appear to be at a higher risk than individuals with other developmental disabilities. However, another major risk is intellectual disability (ID). These two groups of disorders overlap to a substantial degree. Thus, persons with ASD and ID appear to be particularly susceptible to sleep disturbances. These sleep problems can have serious consequences beyond sleep, particularly with respect to increased challenging behaviors and as an impediment to learning. Despite these concerns, adults with ASD and ID have been largely neglected with respect to the study of these nocturnal difficulties. In this report, 168 adults with ASD and ID were compared to 166 adults with ID alone in regard to sleep disturbance and related difficulties. Individuals in the ASD group presented with much higher rates of sleep disturbances, and greater severity of sleep disorder was related to the expression of more serious challenging behaviors. The implications of our results are discussed for future assessment and treatment of these disorders.     

水肿型胰腺炎向坏死型胰腺炎进展中VEGF的表达及意义

目的：探讨在胰腺微循环障碍加重过程中血管内皮生长因子（VEGF）的表达及意义。方法：将大鼠随机分为假手术对照组（N组）、急性水肿型胰腺炎组（AEP组）及急性坏死型胰腺炎组（ANP组）。于建模后6、12和24h,分别采用ELISA法检测各组血清中的VEGF、TNF-α及淀粉酶（AMY）含量,免疫组织化学方法检测各组胰腺组织中VEGF蛋白的表达情况,并分析比较。结果：AEP组与ANP组胰腺组织中各时相点VEGF染色评分均明显高于N组（P〈0．05）;建模6hANP组的评分显著高于AEP组（P〈0．05）,而12和24hANP组的评分均明显低于AEP组（P〈0．05）。ANP组和AEP组血清VEGF、TNF-α与AMY含量均显著高于N组（P〈O05）;ANP组与AEP组之间差异亦有统计学意义（P〈0．05）,但AEP组建模24hVEGF含量和12hAMY含量与ANP组差异无统计学意义（P〉0．05）;血清VEGF与TNF-α（正相关（P〈O.05）。结论：VEGF作为相对独立的微循环影响因素与全身炎症反应呈正相关,但在胰腺微循环障碍持续加重期,胰腺组织及血管内皮细胞严重受损,VEGF表达减少,胰腺坏死病变难以逆转。     

Sleep Disturbance in Chronic Hemodialysis Patients: The Impact of Depression and Anemia

Background. Many patients with end-stage renal disease who are undergoing chronic hemodialysis suffer from sleep disturbance. This paper was designed to study the severity and prevalence of sleep disorders and the factors affecting the syndromes in this unique patient group. Methods. We conducted this study by the use of questionnaires. Included in this study were a total of 245 patients at our center who had end-stage renal disease (ESRD) and who received hemodialysis thrice weekly for more than three months. Their demographic data and biochemical and hematologic parameters were analyzed. All patients were asked to complete two questionnaires (in a Chinese version) of the Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory second edition (BDI-II), either by themselves or with assistance from the medical staff. Results. One hundred and sixty-four patients completed both questionnaires with a response rate of 70.4%. Their mean age was 57.9 ± 11.8 (ranging from 23.1 to 83.7) years old. They had been receiving hemodialysis for an average of 49.1 ± 50.9 months before the study. The male to female ratio was 77:87. Seventy six (46.3%) patients had diabetes mellitus. The prevalence of sleep disturbance was 74.4% (122/164), defined as PSQI scores >5. The poor sleepers had higher BDI scores and a higher ratio of females comparing to the good sleepers. By a multivariate analysis, the BDI scores and female sex were the independent predictors of the patients being poor sleepers. In analyzing the poor sleepers, the BDI scores, durations of hemodialysis and hemoglobin levels were the independent factors for predicting the global PSQI scores. Conclusion. The questionnaire showed a high prevalence of insomnia in the dialytic population. The study also attributes a predictive role in sleep quality to gender, depression, dialytic duration, and hemoglobin levels. The data indicate that in the management of insomnia in this patient group, anemia and depression, both of which are potentially correctable, should be assessed.     

The role of sleep disturbance in the relationship between post-traumatic stress disorder and suicidal ideation

We tested if the risk of suicidal ideation in individuals with PTSD symptoms was dependent on comorbid sleep disturbance. Our cross-sectional sample included 2465 participants with complete data from the 21 year follow-up of the Mater University Study of Pregnancy (MUSP), a birth cohort study of young Australians. Using structural equation modelling with indirect pathways we found that 12 month PTSD symptoms did not directly predict suicidal ideation at 21 when adjusting for major depression symptoms, polyvictimization and gender. However, PTSD symptoms had an indirect effect on suicidal ideation via past-month sleep disturbance. Our results suggest that increased suicidal ideation in those with PTSD may result from the fact that PTSD sufferers often exhibit other comorbid psychiatric conditions which are themselves known to predict suicidal behaviours. Sleep disturbance may be targeted in those who experience PTSD to help prevent suicidal ideation.     

Relations among multiple peer influences, body dissatisfaction, eating disturbance, and self-esteem: a comparison of average weight, at risk of overweight, and overweight adolescent girls

OBJECTIVE: The goal of this study was to evaluate peer-related influences on appearance, body dissatisfaction, eating disturbance, and self-esteem in average weight, at risk of overweight, and overweight adolescent girls. METHODS: Three hundred twenty-five adolescent girls from high schools in Florida were assessed. Ninety met criteria for being at risk of overweight or overweight. Logistic and multiple regression analyses were used to evaluate group differences on all variables and to assess the amount of variance accounted for by peer-influence variables in the prediction of body dissatisfaction, eating disturbance, and self-esteem. RESULTS: Overweight and at risk of overweight girls scored higher than average weight girls on body dissatisfaction, dieting, and a peer measure that assessed negative comments and attributions about appearance. They also scored lower than average weight girls on self-report measures that assessed conversations about appearance and anti-dieting advice. How influential friends were in determining one's body image was a unique predictor of body dissatisfaction but only for the overweight and at risk of overweight group. CONCLUSIONS: Possible implications for clinical intervention programs are discussed along with directions for future research.     

广西1例儿童危重型甲型H5N6禽流感脑炎救治成功报告

目的总结南宁市第四人民医院确诊且救治成功1例儿童危重型甲型H5N6禽流感相关性脑炎病例临床特征以及诊疗经验。方法回顾性分析2021年11月24日南宁市第四人民医院收治的1例儿童危重型甲型H5N6禽流感脑炎病例的临床资料及治疗经过。结果本案例患儿,男性,3岁11月,因“发热9 d,意识障碍2 d”入院,病初以发热、咳嗽为表现,病后第2天出现呕吐,第3天出现乏力、嗜睡,第5天出现抽搐、意识障碍。经脑脊液、痰液、咽式子病原学检测出甲型流感病毒H5N6,确诊为儿童危重型甲型H5N6禽流感脑炎,积极快速有效抗病毒、抗感染、脱水治疗、镇静、抗癫痫等治疗,治疗后第9天,患儿神志转清,27 d后病情好转,转外院继续行康复治疗,分别于出院后2周、1月随访,患儿恢复良好。结论临床工作中,如早期与普通呼吸道疾病症状类似,同时合并神经系统受累症状,病情进展迅速,需警惕排查流感。禽流感发病前不一定有明确禽类接触史,禽流感病毒可能存在其他宿主,有待相关研究证实。人感染H5N6禽流感重症率高,死亡率高,病情进展迅速,发病人群主要为成人,儿童病例极少,多数病例以重症肺炎为主,以神经系统受累表现少见;早发现、早诊断禽流感,同时应用有效可行的综合治疗有望控制病情和改善预后。