Increased Orexin Expression Promotes Sleep/Wake Disturbances in the SOD1-G93A Mouse Model of Amyotrophic Lateral Sclerosis

Background:Sleep/wake disturbances in patients with amyotrophic lateral sclerosis (ALS) are well-documented,however,no animal or mechanistic studies on these disturbances exist.Orexin is a crucial neur...     

盐酸纳洛酮与盐酸纳美芬用于急性酒精中毒催醒的疗效比较

目的:比较盐酸纳洛酮与盐酸纳美芬用于急性酒精中毒催醒的临床疗效和安全性。方法:124例急性酒精中毒患者随机均分为对照组和观察组。两组患者均给予常规治疗。在此基础上,对照组昏睡者给予盐酸纳洛酮0.4 mg加入5%葡萄糖注射液20 ml中静脉推注,浅昏迷者给予盐酸纳洛酮0.8 mg加入5%葡萄糖注射液20 ml中静脉推注,所有患者再给予盐酸纳洛酮20μg/kg(剂量范围1.2².0 mg)加入5%葡萄糖注射液200 ml中静脉滴注;观察组患者给予盐酸纳美芬0.1 mg加入5%葡萄糖注射液25 ml中静脉推注后,浅昏迷者给予盐酸纳美芬0.2 mg加入5%葡萄糖注射液200 ml中静脉滴注,昏睡者给予盐酸纳美芬0.1mg加入5%葡萄糖注射液200 ml中静脉滴注。两组患者均治疗3 h后评价疗效,观察清醒时间、症状消失时间、用药剂量、平均住院时间、治疗费用及不良反应发生情况。结果:观察组患者总有效率显著高于对照组,清醒时间、症状消失时间、用药剂量、平均住院时间、主治药费、总费用、不良反应发生率均显著低于对照组,两组比较差异均有统计学意义(P<0.05)。结论:盐酸纳美芬用于急性酒精中毒催醒较盐酸纳洛酮疗效更显著,且治疗费用较低,安全性较好。     

Predictors of shorter sleep in early childhood

ObjectiveThe aim of this study was to identify socio-demographic and home environmental predictors of shorter sleep in early childhood, and to examine whether effects were mediated by the timing of bedtime or wake time.MethodsParticipants were from Gemini, a British birth cohort of twins, and included 1702 children; one randomly selected from each twin pair. Parents reported night-time sleep duration at an average age of 15.8 months (range 14–27 months) using a modified version of the Brief Infant Sleep Questionnaire. Multiple logistic regression models were used to identify predictors of shorter sleep for this study.ResultsUsing a cut-off of <11 h a night, shorter sleep was reported in 14.1% of children. Lower maternal education, non-white ethnic background, being male, low birth weight, living in a home with >1 older child and watching >1 h of TV in the evening were independently associated with shorter sleep. Mediation analyses showed that associations between education, ethnicity, evening TV viewing and sleep were driven predominantly by later bedtimes, while sex differences were driven predominantly by earlier wake times in boys.ConclusionIn this sample, multiple environmental factors were associated with shorter sleep in young children, with several operating predominantly through later bedtime. An emphasis on the importance of an early and consistent bedtime could help promote healthy sleep and reduce inequalities in child health.     

Single cell activity patterns of pedunculopontine tegmentum neurons across the sleep-wake cycle in the freely moving rats

Microinjections of the excitatory amino acid, L-glutamate into the cholinergic cell compartment of the pedunculopontine tegmentum (PPT) of the rat induces both wakefulness and/or rapid eye movement (REM) sleep depending on the glutamate dosage. However, no studies have systematically recorded the electrical activity of these cells in the freely moving rat across the sleep-wake cycle. In this study, we have recorded the spontaneous activity patterns of single PPT cells (n = 70) in the freely moving rat across the sleep-wake cycle. PPT neurons were classified into three groups based on patterns in their spontaneous activity. The first group of cells (12.86%) was more active during REM sleep than they were during wakefulness or slow-wave sleep (SWS). The second group of cells (60.0%) was more active during REM and wakefulness than during SWS. The firing rate of the third group of cells (27.14%) did not change as a function of behavioral state. This study also demonstrated that the level of activity within the cholinergic cell compartment of the PPT during SWS drops to 7.4% of that observed during wakefulness and that during REM sleep it changes to 65.5% of wakefulness levels. These findings indicate that in the freely moving rat, the discharging of PPT neurons correlates with wakefulness and REM sleep. Additionally, these neurons may be an integral part of the brainstem wakefulness and REM sleep-generating mechanisms in the rat.     

Thymic irradiation. An approach to chronic lymphocytic leukemia

Twenty-two patients with active chronic lymphocytic leukemia were treated with thymic irradiation; a full remission was achieved in 14 and a partial response in 7. In a similar group of 28 patients treated with chlorambucil, there were 7 full remissions, 5 partial responses, 6 with white cell control and 10 with no response. Thymic irradiation restored the leukocyte count to normal in 76 per cent of the cases (16 of 21) and the differential in 32 per cent (7 of 22), with complete resolution of lymphadenopathy in 81 per cent (17 of 21), hepatomegaly in 75 per cent (12 of 16), splenomegaly in 76 per cent (11 of 14) and symptoms in 100 per cent (20 of 20). Chlorambucil restored the leukocyte count to normal in 50 per cent (14 of 28) and the differential in 7 per cent (2 of 28), with complete resolution of lymphadenopathy in 43 per cent (9 of 21), hepatomegaly in 43 per cent (9 of 21), splenomegaly in 24 per cent (4 of 22) and symptoms in 64 per cent (16 of 25). Thymic irradiation produced a more rapid response even in patients resistant to chemotherapy and was more effective (11 of 12 or 92 per cent) than chlorambucil (7 of 22 or 33 per cent) in patients with hematocrit readings of less than 30 per cent and/or greater than 75 per cent infiltration of the bone marrow and a leukocyte count of more than 40,000 cells/mm³ and in patients with splenomegaly. Anemia was corrected in all three patients and thrombocytopenia in two of six patients treated with thymic irradiation. Chlorambucil corrected anemia in 2 of 11 patients and thrombocytopenia in 2 of 5 patients. Anemia developed in 5 of 17 patients and thrombocytopenia in 4 of 23 patients treated with chlorambucil and in no patients treated with thymic irradiation.     

Cross-validation of the factor structure of the McGill Pain Questionnaire

Low back pain patients' responses to the McGill Pain Questionnaire (MPQ) were factor analyzed using the principal factor method and direct oblique rotation procedures. Four factors were extracted that accounted for 55% of the total variance. Coefficients of congruence were computed in order to relate the current factors with those extracted in a previous factor analytic investigation. The results provided positive evidence that the sensory pressure, evaluative, and affective-sensory factors that were previously identified are stable dimensions underlying the MPQ responses of low back pain patients. However, it is necessary to conduct further cross-validation studies using patients from a wide variety of treatment settings.     

Sleep quality, chronotypes and preferential timing of attacks in migraine without aura

Clinical observations show that migraine attacks have a seasonal, menstrual and circadian timing, suggesting a role of chronobiological mechanisms and their alterations in the disease, but little experimental data exists about this issue. The aim of this study was to estimate sleep quality chronotypes and the possible circadian timing of attacks in migraneurs. One hundred patients suffering from migraine without aura according to the IHS criteria (2004), and 30 controls were enrolled. Morning and evening type subjects were more represented in migraine patients than in controls and showed a tendency towards worse sleep quality and higher disability. Forty–two percent of migraineurs presented more than 75% of their attacks at night. Morning and evening types rather than intermediate and differences between real and preferred times may represent stressors that can worsen the disease. A preferential timing for occurrence of migraine attacks during the night and early morning hours was documented.     

Second primary bronchogenic carcinomas after small cell carcinoma. Report of two cases and review of the literature

Second primary carcinomas of the lung are well described. However, their occurrence following initial diagnosis of small cell lung carcinoma is rare. The development and antemortem diagnosis of metachronous second primary bronchogenic carcinomas in two long-term (more than four years) survivors of small cell lung cancer is described. The histologic types of the second carcinomas were mucoepidermoid and bronchoalveolar. On the basis of a review of the literature, only eight similar cases have been reported; none of the second primaries was mucoepidermoid or bronchoalveolar. The question of whether second primaries after small cell lung cancer represent true metachronous carcinomas, different degrees of differentiation of the same tumor, or the emergence of a previously unrecognized synchronous tumor is discussed. The need for awareness of this complication and the necessity for life-long follow-up in long-term survivors of small cell lung cancer is emphasized.