The aging hippocampus: cognitive, biochemical and structural findings

Aging is often accompanied by learning and memory problems, many of which resemble deficits associated with hippocampal damage. Studies of aging in nonhuman animals have demonstrated hippocampus-related memory decline, and point to a possible locus for impairments associated with normal and pathological aging in humans. Two well-characterized hippocampus-dependent tasks in nonhuman animal literature are the Morris water task (MWT) and the transverse patterning discrimination task (TPDT). We employed the virtual MWT and the TPDT to assess hippocampus-dependent cognition in humans. Magnetic resonance imaging and proton magnetic resonance spectroscopy were employed to measure hippocampal volume and neurochemistry respectively. Age-related deficits were observed in performance on both hippocampus-dependent tasks. This pattern of impairment was accompanied by decreased hippocampal NAA/Cre ratios and volume, both of which imply neuronal loss and/or decrease in neuronal density. Collectively, our results suggest that hippocampus undergoes structural and biochemical changes with normal aging and that these changes may represent an important component of age-related deterioration in hippocampus-dependent cognition.     

不同强度跑步运动与二甲双胍联用对2型糖尿病并发骨质疏松大鼠的骨密度、骨吸收、胰岛素敏感性的影响效果研究

目的讨论不同运动强度跑步与二甲双胍联用对2型糖尿病并发骨质疏松(diabetic osteoporosis,DOP)模型大鼠骨密度、骨吸收、胰岛素敏感性的影响效果,为在运动处方与药物处方联用方案中药物使用和运动强度的合理制定提供依据。方法对120只SD大鼠购回后进行15 d适应性饲养。选取100只大鼠建立DOP动物模型,剩余20只大鼠正常饲养。检验DOP动物模型情况,建模成功的大鼠随机分为模型对照组(DM组)、二甲双胍组(metformin,MF组)、低强度跑步+二甲双胍组(LM组)、中强度跑步+二甲双胍组(MM组)、高强度跑步+二甲双胍组(HM组),正常饲养的20只大鼠为对照组(C组)。全部大鼠进行前测,内容包括骨密度(bone mineral density,BMD)、空腹血糖浓度(fasting plasma glucose,FPG)、空腹胰岛素水平(fasting insulin,FINS)、胰岛素抵抗指数(homeostasis model assessment insulin resistance,HOMA-IR)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesteroll,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesteroll,HDL-C)、抗酒石酸盐酸性磷酸酶(tartrate resistant acid phosphatase,TRACP)、尿脱氧吡啶喏啉(deoxypyridinoline,DPD)、生物力学性能等指标。前测结束后,各组大鼠按计划进行为期12周的干预,干预结束后进行后测。结果大鼠体质量方面,在干预的第4、8、12周C组大鼠体质量显著高于DM组、LM组、MM组、HM组、MF组(P0. 05),LM组大鼠体质量显著低于DM组(P0. 05)。骨密度方面,LM组、MM组、HM组、MF组大鼠后测骨密度显著高于前测和DM组后测结果,但仍然明显低于C组(P0. 05)。在骨代谢方面,LM组、MM组、HM组、MF组大鼠后测尿羟脯氨酸、尿DPD、血浆TRACP值显著高低于前测和DM组后测结果,但仍然明显高于C组(P0. 05)。在糖代谢方面,LM组、MM组、HM组、MF组大鼠FPG、FINS后测值显著低于本组前测值、DM组和HM组后测结果,但明显高于C组(P0. 05)。在胰岛素抵抗方面,MM组、HM组、MF组大鼠HOMA-IR后测值显著高低于本组前测值、MF组和HM组后测结果,但明显高于LM和MM组(P0. 05)。在脂代谢方面,LM组、MM组、HM组、MF组大鼠甘油三酯(triglyceride,TG)、TC、LDL-C后测值显著低于本组前测值、DM组后测结果,但明显高于C组(P0. 05)。LM组TG、TC、LDL-C指标后测值显著低于HM组、MF组(P0. 05)。LM组、MM组、HM组、MF组大鼠HDL-C指标后测值显著高于本组前测值、DM组后测结果,但明显低于C组(P0. 05)。结论二甲双胍搭配跑步的干预方案能够保持大鼠体重,降低血脂、血糖,缓解胰岛素抵抗,增加骨密度,减少骨吸收。其中二甲双胍搭配中低强度跑步方案在体重控制、降低血脂血糖、缓解胰岛素抵抗方面优于二甲双胍搭配高强度跑步方案。二甲双胍搭配高强度跑步方案对于2型糖尿病并发骨质疏松大鼠骨密度改善效果与二甲双胍搭配中低强度跑步方案相比具有优势。     

运动与女性原发性骨质疏松症

目的探讨运动对预防女性原发性骨质疏松症（ＰＯＰ）的影响。方法于１９９３～１９９７年间,在健康体检中随机抽样观察女性绝经１年以上,无内科、外科、妇科等影响钙磷代谢的疾患,在１年内未服用过钙磷制剂及激素类药物者,共６６人。按其年龄、绝经后时间、参加运动与否分为两组。运动组３３名,均能长期参加户外体育运动者,每天不少于１小时,每周参加运动不少３天,坚持１年以上;对照组,另３３人是从不参加户外体力活动者。调查两组人员的病史,进行全面的健康检查,应用中国测试所研制的单光子骨密度仪,测量非优势前臂桡骨尺骨中、远１／３交界处的骨矿含量（ＢＭＣ）及骨密度（ＢＭＤ）。检测血钙、血磷、血碱性磷酸酶。按照全国１３个市骨矿含量调查合作组拟定的原发性骨质疏松症综合诊断评分法进行评定。结果运动组的ＰＯＰ、骨折等骨关节病率明显低于对照组（Ｐ＜０．０１）;桡骨密度运动组高于对照组（Ｐ＜０．０５）。结论运动可以减少中老年人的骨矿丢失,延缓ＰＯＰ的发生,倡导体力活动对防治ＰＯＰ有积极作用。     

Testicular size: the effects of aging, malnutrition, and illness

Paired testicular volumes and weights, as well as age, height, and weight, were recorded from a series of 1056 consecutive necropsies on adult males ranging in age from 18 to 96 years. These data were analyzed to examine the effects of age, nutritional state (standardized body weight), and illness on testicular size. Testicular volume and weight were related by a constant density of 1.038 g/ml, regardless of testicular size, age or illness. Mean testicular volume was correlated with height (r = 0.470), weight (r = 0.504), body surface area (r = 0.549) and standardized body weight (r = 0.152). Advancing age, malnutrition, alcoholism, malignancy, and a chronic, terminal illness were each individual risk factors for reduced testicular size, whereas diabetes, narcotic or other drug usage, and pelvic injury were not associated with reduced testicular volume. Since advancing age, reduced standardized body weight, and some disease states were all associated with diminution of testicular size, the interaction of age, malnutrition, and illness on testicular size were examined by statistical modeling, using multivariate logistic regression and covariance analysis. The associations of alcoholism, malignancy, and chronic, terminal illness with decreased testicular volume were independent of aging or nutritional state. The effects of chronic, terminal illness were mostly explained by the concurrent effects of reductions in standardized body weight (malnutrition). After exclusion of men with diseases shown to be associated with decreased testicular size, he specific effects of age alone demonstrated a reduction in testicular volume only in the 8th decade of life.(ABSTRACT TRUNCATED AT 250 WORDS)     

老年骨质疏松症患者认知功能状况调查研究

目的 通过老年骨质疏松症患者认知功能状况调查研究,探讨老年骨质疏松症认知功能相关因素.方法 选择完成骨密度(BMD)检查444例骨质疏松症老年人(年龄≥60岁)为研究对象,由经过统一培训的医务人员进行问卷调查,调查问卷包括:基本情况、实验室检查项目、简易精神状况量表、临床痴呆评定量表、日常生活能力量表.采用SAS 9....     

轻度认知障碍并发失眠症老年患者的抚触保健操干预

目的探讨抚触保健操对轻度认知障碍并发失眠症老年患者的干预效果。方法对34例轻度认知障碍并发失眠症老年患者在常规护理基础上行抚触保健操干预,每周3次,每次30min,连续8周。干预前后使用匹兹堡睡眠指数量表(PSQI)、睡眠日志(SD)、Epworth嗜睡量表(ESS)进行疗效评价。结果干预后PSQI总分及各成分评分显著降低,SD总睡眠时间、睡眠效率、入睡时间得到改善,ESS总分降低,与干预前比较差异有统计学意义(均P0.01)。结论抚触保健操干预可改善轻度认知障碍伴失眠症老年患者的睡眠状况和日间功能障碍。     

Intestinal lactase activity and calcium absorption in the aging female with osteoporosis

Summary In 11 postmenopausal women with histologically proven osteoporosis and normal lactose tolerance a direct correlation between calcium absorption and intestinal lactase activity was observed. The results suggest that varying degrees of relative deficiencies in intestinal lactase might contribute to the graded decrease in calcium absorption which characterizes the aging female population.     

平衡及肌力运动操降低老年患者跌倒

目的探讨平衡及肌力运动操降低老年患者跌倒的效果。方法将80例具有一定行走能力的老年患者随机分为对照组和观察组各40例。对照组采用常规预防跌倒的措施并强调加强散步等体育锻炼;观察组在此基础上,进行平衡及肌力运动操训练。结果训练8周后观察组Berg平衡量表评分及Motricity指数中下肢肌力积分显著高于对照组(均P0.01);观察组住院期间跌倒发生率低于对照组。结论平衡及肌力运动操能提高老年患者的平衡能力及肌力,从而降低老年患者的跌倒风险。     

骨质疏松症认知评估的测量

大众对骨质疏松症的认知程度,是实现早期诊治的重要原因。近年来,关于骨质疏松症认知评估的研究逐渐增多,本文将以往骨质疏松症认知测评工具研究进行文献回顾,发现相关工具的构建较少,主要见于国外,这些工具的维度主要涉及疾病基础情况、危险因素、预防、治疗等,国内研究甚少,且已有工具的信效度还有待进一步考究。     

传统功法治疗原发性骨质疏松症临床研究进展

原发性骨质疏松症是以骨组织微结构破坏、骨量减少、骨脆性增加、易发生骨折为特征的一类全身慢性退行性疾病。使用抗骨质疏松药物周期长、费用高、存在不良反应等,影响患者的生活质量。本文通过检索知网、万方、PubMed等相关数据库,对应用太极拳、八段锦、五禽戏、易筋经等四种传统功法治疗原发性骨质疏松症引起的骨密度下降、疼痛、平衡协调功能等临床问题进行总结,分析现存问题,进一步明确传统功法最优化的干预方案。     

互动与手指操干预对老年糖尿病患者认知功能的影响

目的 探讨互动与手指操干预对老年糖尿病患者认知功能的改善作用.方法 将60例老年糖尿病并存轻度认知功能障碍患者随机分为两组各30例.对照组采用常规护理方法,观察组在常规方法上增加互动与手指操干预,拓展延伸服务,持续6个月后用MMSE、ADL评价效果.结果 观察组干预后MMSE评分高于对照组干预后及本组干预前,ADL评分低于对照组干预后及本组干预前(P＜0.05,P＜0.01).结论 老年糖尿病患者的认知水平随时间的推移呈下降趋势,互动与手指操干预可以有效地延缓认知障碍的发展.     

应用鲑鱼降钙素及物理疗法联合治疗原发性骨质疏松症

目的观察鲑鱼降钙素（Calcitonin，CT）和低频脉冲电磁场（low frequency transduction pulsedelectromagnetic fields）治疗联合作用在治疗原发性骨质疏松症（primary osteoporosis）中的效果，比较联合作用与单纯应用药物所产生的效果的异同。方法将存在骨质疏松性骨痛同时经DEXA骨密度仪（BMD machines）检测T值低于标准值2．0以下的老龄原发性骨质疏松症患者76人随机分为两组：①单纯应用鲑鱼降钙素组（36人）；②联合应用药物及低频电磁场组（36人），两组同时每日给予钙而奇D600片1粒，CT按每日肌肉注射50IU，10d后改为隔日肌注50IU连续应用2个月，低频电磁场治疗采用天津金希统公司生产的XT2000B型OP治疗仪，频率为20～40Hz，每天治疗20min，共治疗30d，6个月后复查骨密度。结果两组均取得较好的镇痛效果（分别为84％和97％），同时骨密度均有所增加。结论联合治疗能够更进一步增加腰椎骨密度，在镇痛方面也能取得更好的效果。     

特发性尿钙增多症合并骨质疏松1例并文献分析

特发性尿钙增多症（ idiopathic hypercalciuria,IH）的概念由Albright[1]等人于1953年提出,指在正常钙摄入的情况下,排除各种继发因素,血钙正常,24小时尿钙＞4 mg／kg（0．1 mmol／kg）及尿Ca／Cr＞0．21即可诊断的一种疾病。临床上IH并不少见,有报道成人尿石症伴IH者达40％～60％,而小儿尿石症中仅2％～5％是由IH所致。但IH合并严重骨质疏松者少有报道,现将我院内分泌科1例IH合并骨质疏松报道如下。     

The effects of physiotherapy for female urinary incontinence: individual compared with group treatment

OBJECTIVES: To compare, in a randomized trial, the effects of individual and group physiotherapy for urinary incontinence in women referred by their general practitioner (GP). PATIENTS AND METHODS: The study included women of all ages (mean 47.8 years) with stress, urge or mixed incontinence; 126 received individual and 404 group treatment. Both groups undertook the same pelvic floor exercises and bladder training, and received the same information. The effects were measured soon after treatment and again 9 months later. The main outcome measures were objective changes in the severity of incontinence, frequency of urine loss and frequency of nocturnal urine loss. The trial was nationwide; 25 physiotherapists and 337 GPs participated. RESULTS: There were no significant differences in effect between the groups; after individual treatment the severity of incontinence improved in 60% of the patients and the mean (95% confidence interval, CI) frequency of urine loss decreased, by -8.7 (-6.4 to -11.1) times/week. After group therapy continence improved in 57% and the frequency of urine loss decreased, by -8.4 (-6.8 to -10.0) times/week. For women who had nocturnal urine loss (at baseline), the frequency decreased after individual treatment by -11.2 (4 to -26.4) and after group therapy by -14 (-9.1 to -18.9) times/month. All improvements persisted in full for up to 9 months. CONCLUSION: Individual and group physiotherapy are equally effective for at least 9 months in improving incontinence in women. Factors should be sought that can predict the effectiveness of therapy, and thus better select those patients most likely to benefit from therapy.     

锻炼配合抗骨吸收剂治疗绝经后骨质疏松症的临床研究

目的 探讨身体锻炼配合抗骨吸收剂在治疗绝经后骨质疏松症中的作用。方法 对照、动态检查腰椎、左右髋部骨密度（BMD）变化率及四肢和脊柱骨折发生率。结果 主动进行身体运动和缺乏运动的妇女BMD均显升高，尤以新近运动1年内升高最明显，达6．76％－9．79％（P＜0．05），1年后常年运动组、新近运动组和缺乏运动组的BMD增长率无显意义的差别（P＜0．05）；常年运动组和新近运动组的第2年骨折率低于缺乏运动的病人。结论 身体锻炼配合抗骨吸收剂治疗绝经后骨质疏松症时，以新近运动BMD增长最快，常年运动组骨折率最低。