胆管空肠Roux—en—y吻合术对老年胆道再生结石的远期疗效

目的探讨改良的胆总管空肠Roux—en—y吻合术对老年胆道再生结石患者的远期疗效。方法将自1990年7月至2002年7月本院收治的51例老年胆道结石复发的患者分为改良组与对照组。改良组31例，均行改良的胆总管空肠Roux—en—y吻合术；对照组20例为改良术式前收治的患者，行胆管十二指肠吻合术。对51例进行随访6～16年，统计两组远期效果及再手术率。结果改良组效果优、良者占93．6％，再手术率3．2％（1／31）；对照组效果优、良者占60．0％，再手术率35％，两组间优良率及再手术率差异有统计学意义（P〈0．01）。结论胆总管空肠Roux—en—y吻合术对老年胆道再生结石患者有良好的远期疗效。     

患者自我评估与嗓音声学分析的比较

目的分析嗓音疾病患者自我评估的可靠性及其与嗓音声学检测的相关性。方法对35例嗓音疾病患者进行自我评估和嗓音声学检测。采用嗓音障碍指数(voice handicap index，VHI)和嗓音相关生活质量(voicerelated quality of life，V—RQOL)评估法。嗓音声学检测主要测试基频微扰、振幅微扰及标准化噪声能量三个参数，将自我评估结果与嗓音声学检测结果进行相关分析。结果VHI的功能、生理和情感三个范畴之间与V—RQOL的生理一功能、社会一情感两个范畴间有相关性；声学检测三个参数间相关性良好；而嗓音自我评估与声学参数间无相关性。结论嗓音疾病患者自我评估方法是获得患者全面信息的重要方法．客观检查不能预测主观评估的结果．     

Neuronal pathway from floccular caudal zone contributing to vertical eye movements in cats—role of group y nucleus of vestibular nuclei

In ketamine-anesthetized cats, electric microstimulation of the group y nucleus of the vestibular nuclei evoked a slow and smooth upward eye movement. Destruction of the group y nucleus eliminated a slow and smooth downward eye movement evoked by stimulation of the caudal zone of the flocculus. These data support the interpretation that Purkinje cell activity in the caudal zone of the flocculus can evoke vertical eye movements by inhibiting the activity of neurons of the group y nucleus.     

人子宫内膜LewisY寡糖抗原的表达和调控

目的 :探讨雌、孕激素对月经周期中 Ley寡糖抗原表达的影响。方法 :取 32例子宫肌瘤术后患者的内膜 ,经病理检测 ,分为四组 :增生期、分泌期、分泌期服用米非司酮 ( Mifepristone)及增生期服用妇康片 (炔诺酮 ) ,每组 8例 ,每例均重复实验。应用免疫组化及 Westhern免疫印迹法 ,观察了Ley寡糖抗原的表达。结果 :( 1 )各组样品的 Ley寡糖抗原均分布于宫腔上皮细胞和腺腔上皮细胞表面 ;( 2 )每组样品中 Ley糖蛋白均有四种分子量 :68k D、60 k D、5 2 k D、2 7k D表达 ;( 3)两种分析方法结果均显示 :Ley糖蛋白在分泌期高表达 ,增生期低表达 ,两组间差异显著 ( P<0 .0 0 1 ) ;分泌期服用孕激素拮抗剂米非司酮则表达明显减少 ( P<0 .0 0 1 ) ;增生期服用妇康片 (主要含孕激素 )的表达较增生期明显增多 ( P<0 .0 0 1 ) ,其中以 68k D组分的变化最为显著。结论 :人子宫内膜 Ley寡糖抗原的表达受孕激素上调 ,其中以 68k D组分对孕激素最敏感     

Comparison of the effects of the 5-HT3 receptor antagonists WAY-100579 and ondansetron on spatial learning in the water maze in rats with excitotoxic lesions of the forebrain cholinergic projection system

The effects of the 5-HT₃ receptor antagonists, WAY-100579 and ondansetron (both at doses of 0.001, 0.01 and 0.1 mg/kg SC) and the muscarinic receptor agonist arecoline (1.0 mg/kg SC), on spatial learning and memory in the water maze were examined in rats after combined S-AMPA lesions to the nucleus basalis and medial septal brain regions. Lesioned rats showed substantially increased latency to find the submerged platform, and spent less time searching in the correct quadrant, and more time circling the periphery of the pool, relative to controls. Lesioned rats treated with WAY-100579, ondansetron and arecoline exhibited marked improvement in these parameters of learning relative to lesioned animals, with arecoline-treated animals showing the most substantial recovery. Linear dose-related trends of improvement were seen with both of the 5-HT₃ antagonists. In probe trials, testing retention of the platform position 24 and 72 h after the end of training, control rats exhibited substantial superiority relative to lesioned rats in accuracy of search in the training quadrant and former platform area, matched by rats treated with arecoline on the first, and by rats treated with the two higher doses of WAY-100579 and ondansetron on the second probe trial. These results are consistent with our previous studies which demonstrated that another selective 5-HT₃ receptor antagonist, WAY-100289, significantly reversed the cognitive deficits in water maze performance induced by ibotenic acid lesions of forebrain cholinergic projection system. Therefore, selective 5-HT₃ receptor antagonists may provide a novel effective therapy for treating cognitive deficits associated with degeneration of central cholinergic neurones, such as Alzheimer's disease or age-associated memory impairment.     

Recovery of dopamine in peripheral adrenergic nerves after reserpine treatment

Summary The endogenous levels of dopamine (DA) in the rat heart and submaxillary gland after a single, large dose of reserpine (10 mg/kg i.p.) were reduced to near zero within 1 h and were restored to normal within 48 h, while the noradrenaline (NA) levels reacted much more slowly. The data suggest that newly formed DA is rapidly taken up by the reserpine-sensitive mechanism of the amine storage granules. The more rapid restoration of DA than of NA levels may be due to preferential release of newly formed NA by the nerve impulse. Electrical stimulation of the cervical sympathetic with 5 Hz for 30 min 4 h after the administration of reserpine increased the DA level of the submaxillary gland of the stimulated side, suggesting an increased tyrosine hydroxylase activity during stimulation, also in nerve terminals affected by reserpine. The use of an inhibitor of monoamine oxidase (pargyline) and/or an inhibitor of dopamine -hydroxylase (FLA-63) did not significantly alter the increase of DA following nerve stimulation, suggesting that DA was protected by granular uptake. The stimulation-induced increase in DA was, however, much less in reserpine-treated than in normal animals, demonstrating the importance of the reserpine-sensitive uptake mechanisms for preserving newly formed DA.     

Evidence for genetic epistasis in human insulin resistance: the combined effect of PC-1 (K121Q) and PPARgamma2 (P12A) polymorphisms

Insulin resistance is believed to be under the control of several genes often interacting each other. However, whether genetic epistasis does in fact modulate human insulin sensitivity is unknown. In 338 healthy unrelated subjects from Sicily, all nondiabetic and not morbidly obese, we investigated whether two gene polymorphisms previously associated with insulin resistance (namely PC-1 K121Q and PPAR2 P12A) affect insulin sensitivity by interacting. PC-1 X121Q subjects showed higher level of fasting glucose, lower insulin sensitivity (by both the Matsuda insulin sensitivity index and M values at clamp, the latter performed in a subgroup of 113 subjects representative of the overall cohort) and higher insulin levels during the oral glucose tolerance test (OGTT) than PC-1 K121K subjects. In contrast, no difference in any of the measured variables was observed between PPAR2 P12P and X12A individuals. The deleterious effect of the PC-1 X121Q genotype on each of these three variables was significant and entirely dependent upon the coexistence of the PPAR2 P12P genotype. Among PPAR2 P12P carriers also fasting insulin and glucose levels during OGTT were higher in PC-1 X121Q than in K121K individuals. In contrast, no deleterious effect of the PC-1 X121Q genotype was observed among PPAR2 X12A carriers; rather, in these subjects a lower body mass index and consequently lower fasting insulin level was observed in PC-1 X121Q than in K121K carriers. Overall, a significant interaction between the two genes was observed on body mass index, insulin levels (both fasting and after OGTT) and both insulin sensitivity (i.e., insulin sensitivity index and M value) and insulin secretion (i.e., HOMA-B%) indexes.Abbreviations AUC Area under the curve - BMI Body mass index - HOMA-B% Homeostasis model assessment of percent -cell function - HOMA _IR Homeostasis model assessment of insulin resistance - ISI Insulin sensitivity index - OGTT Oral glucose tolerance test - PC-1 Plasma cell-1 glycoprotein - PPAR Peroxisome proliferator activated receptor     

Effects of bilateral subthalamic stimulation on gait kinematics and kinetics in Parkinson’s disease

Subthalamic nucleus (STN) stimulation, a recent surgical approach to Parkinsons disease (PD), has been shown to be effective in relieving motor symptoms. The present study carried out a full body gait analysis, during overground walking, on ten PD patients with bilaterally implanted STN stimulation devices. Walking performance was analyzed on the same day, in four conditions (Stim Off–Med Off, Stim On–Med Off, Stim Off–Med On, Stim On–Med On). The results showed that, on average, STN stimulation alone (S+M–) and l -dopa alone (S-M+), significantly increased gait speed, stride length and the lower limb joint Range of Motion (ROM) with respect to the basal condition (S–M–); also cadence was found to play a role in velocity increase, particularly when l -dopa was administered. Both treatments improved pelvis and trunk kinematics, and power production at the ankle and hip joints. The combination of the two treatments (S+M+) produced an additional effect on gait speed, stride length, ROM of knee and ankle joints, pelvis obliquity and trunk inclination. Given the additive and synergistic effects, it can be hypothesized that the two treatments have different mechanisms of action. Our results confirm the findings of earlier studies that employed treadmill walking.