胰高血糖素样多肽1—治疗糖尿病的多肽,是治疗阿尔茨海默病的新希望?(英文)

胰高血糖素样多肽1(Glucagon-like peptide,GLP)已被证明是有前景的II型糖尿病(Type 2 diabetes mellitus,T2DM)治疗剂。阿尔茨海默病(Alzheimer’s disease,AD)和T2DM具有在淀粉样蛋白β(Amyloid β,A β),tau 蛋白磷酸化和葡萄糖合成酶3等方面的共同的病理生理特征。GLP-1具有神经营养特性,并能降低脑淀粉样蛋白水平。过去几十年对AD的广泛研究使我们认识到对其治疗应针对Aβ和tau蛋白。总结这些之后发现,GLP-1可能有希望用于治疗AD。本文综述了GLP-1的生物化学和生理学特征,T2DM和AD的共同的病理生理特征,以及GLP-1在治疗T2MD和改善AD某些病理变化方面的新进展。     

胰高血糖素样肽1(GLP-1)改善阿尔茨海默病大鼠模型的认知功能及其机制研究

目的 探讨胰高血糖素样肽1(GLP-1)改善阿尔茨海默病大鼠认知功能的机制。方法 以正常成年雄性SD大鼠为研究对象,将其随机分为正常对照组、AD模型组、AD模型+GLP-1干预组和AD模型+PPARγ抑制剂+GLP-1干预组; 其中AD模型组以侧脑室注射STZ(3 mg/kg,10 μL)制造AD模型,AD模型+GLP-1干预组在AD造模基础上每日腹腔注射利拉鲁肽(200 μg/kg,10 μL),连续给药28 d,AD模型+PPARγ抑制剂+GLP-1干预组在AD造模基础上侧脑室注射PPARγ抑制剂GW9662(2.5 nmol/g,10 μL),随后腹腔注射利拉鲁肽(200 μg/kg,10 μL)并连续给药28 d; 观察4组大鼠在Morris水迷宫中的学习和记忆能力变化; ELISA方法观察各组大鼠海马Aβ42的水平; Western blot观察各组大鼠海马PPARγ蛋白表达水平。结果 与AD模型组比较,GLP-1干预后的AD大鼠在Morris水迷宫中学习和记忆能力明显改善,海马Aβ42的水平显著降低,海马PPARγ蛋白表达水平显著升高(P<0.05); 与AD模型+GLP-1干预组比较,AD模型+PPARγ抑制剂+GLP-1干预组大鼠海马PPARγ蛋白表达水平显著降低,在Morris水迷宫中学习和记忆能力明显下降,海马Aβ42的水平显著增高(P<0.05)。结论 GLP-1可能通过激活PPARγ抑制Aβ 蓄积,从而起到改善阿尔茨海默病的认知功能作用。     

胰高血糖素样多肽1-治疗糖尿病的多肽,是治疗阿尔茨海默病的新希望?

胰高血糖素样多肽l（Glucagon-like peptide,GLP）已被证明是有前景的Ⅱ型糖尿病（Type 2 diabetes mellitus,T2DM）治疗剂。阿尔茨海默病（Alzheimer’s disease,AD）和T2DM具有在淀粉样蛋白β（Amyloid β,Aβ）,tau蛋白磷酸化和葡萄糖合成酶3等方面的共同的病理生理特征。GLP-1具有神经营养特性,并能降低脑淀粉样蛋白水平。过去几十年对AD的广泛研究使我们认识到对其治疗应针对Aβ和tau蛋白。总结这些之后发现,GLP-1可能有希望用于治疗AD。本文综述了GLP-1的生物化学和生理学特征,T2DM和AD的共同的病理生理特征,以及GLP-1在治疗T2MD和改善AD某些病理变化方面的新进展。     

miRNA在阿尔茨海默病发病机制中作用的研究进展

阿尔茨海默病(AD)是一种发病率较高的神经退行性疾病,可严重影响患者及家属的生活质量。miRNA可通过调控AD中淀粉样蛋白前体(APP)、β-分泌酶1(BACE1)、tau等生物标志物的表达和神经炎症相关的胶质细胞的激活影响AD的发病机制。本文综述近年来miRNA在AD发病机制中作用的研究,为进一步探索miRNA对AD诊断及治疗的策略提供依据和思路。     

胰高血糖素样肽1及其类似物治疗阿尔茨海默病作用机制研究进展

研究发现阿尔茨海默病(AD)的许多病理特征和认知功能下降可能与脑内胰岛素抵抗有关。对AD动物模型和轻度认知功能障碍患者的脑组织进行研究,结果表明应用胰高血糖素样肽1(GLP-1)类似物如利拉鲁肽、艾塞那肽治疗后,脑内胰岛素抵抗和许多病理特征减少或是逆转。这一研究结果为GLP-1类似物对AD的潜在治疗研究提供理论基础。对GLP-1及其类似物在AD中的潜在治疗作用做一综述。     

糖尿病与阿尔茨海默病的研究进展

目前受阿尔茨海默病（AD）困扰的患者数量呈指数型增长，但AD 的发病机制仍不明晰，现 有治疗方法只是姑息治疗。有研究发现2 型糖尿病患者患AD 概率很高，且约四分之三的AD 患者患 2型糖尿病，提示糖尿病可能与AD存在一定关系。目前研究发现有许多因素将糖尿病和AD联系在一起， 如Aβ、tau 蛋白、突触损伤、氧化应激、晚期糖基化终末产物（AGEs）的产生、免疫功能异常等。现着重 介绍糖尿病通过上述联系引发AD 的相关分子机制。     

miRNA在阿尔茨海默病发病机制中作用的研究进展

阿尔茨海默病（AD）是一种发病率较高的神经退行性疾病,可严重影响患者及家属的生活质量。miRNA可通过调控AD中淀粉样蛋白前体（APP）、β-分泌酶1（BACE1）、tau等生物标志物的表达和神经炎症相关的胶质细胞的激活影响AD的发病机制。本文综述近年来miRNA在AD发病机制中作用的研究,为进一步探索miRNA对AD诊断及治疗的策略提供依据和思路。     

反应性星形胶质细胞在AD进展及治疗中的分子机制研究现状

近年来研究发现反应性星形胶质细胞(RAS)可通过促进β-淀粉样蛋白(Aβ)的产生沉积、加剧Aβ的神经毒性及神经递质释放障碍等多种机制影响阿尔茨海默病(AD)病理过程。另外, 目前以靶向清除Aβ为主要机制的药物治疗疗效仍不确切, 而新近研究表明大多数AD相关基因在RAS中呈显著表达, 因此, 通过药物干预调节RAS的形态及功能, 或许能为AD的治疗提供新的思路。笔者现进一步就近年来RAS在AD进展及治疗中的具体分子机制的研究现状进行综述, 以期为RAS作为靶点预防及治疗AD提供更多的参考依据。     

海马神经功能亢进与阿尔茨海默病的关系

阿尔茨海默病(AD)是一种最常见的神经系统变性疾病,主要表现为进行性的认知功能下降,影响日常生活能力以及精神行为异常.研究发现,AD早期海马神经功能亢进.海马神经功能亢进是一种维持记忆功能的代偿机制,但通过对动物模型研究发现,海马神经活动正常的动物模型的认知功能保存较好;海马神经功能亢进的动物模型伴有认知功能障碍,并且...     

胰高血糖素样肽1受体激动剂在神经保护方面的研究进展

近年来的研究发现,与糖尿病并发的多种神经系统疾病,可随着治疗糖尿病的胰高血糖素样肽1受体激动剂(GLP-1RA)的使用而得到改善,但其具体机制尚不完全清楚。天然的GLP-1是进食诱导刺激回肠和结肠的L细胞分泌的肠肽类激素,其可促进胰岛素的合成和分泌。为克服GLP-1半衰期短而开发的多种长效GLP-1RA已经在临床上广泛应用,如艾塞那肽、利拉鲁肽、阿必鲁肽、度拉糖肽等,这些药物表现出在控制血糖水平和体重上的优势。由于GLP-1受体广泛分布于胰腺、肺、脑、心脏、肾和胃肠等组织细胞膜上,因此GLP-1RA的作用不仅仅在治疗糖尿病方面。已有的报道表明,GLP-1RA还具有显著的神经、心血管、肾脏保护,以及抗呼吸道炎症和减脂等多种作用。GLP-1受体在脑中亦有广泛分布,且GLP-1RA可有效通过脑血管屏障。GLP-1RA与相应受体结合,可激活PKA、PI3K/AKT、ERK、MEK等多个激酶信号通路,调节神经递质传递,这可能是GLP-1RA实现抗炎、减少氧化应激、抑制凋亡、减少DNA损伤、神经细胞修复,最终达到神经保护的途径。该文结合基础及临床研究,对GLP-1RA在缺血性脑卒中、认知功能障碍、...     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

Release of endogenous catecholamines from slices of hypothalamus of rats

The release of endogenous catecholamines from superfused slices of rat hypothalamus was studied under basal conditions and during release evoked by 40 mM K⁺. Catecholamines in superfusates, and in extracts of the tissue after stimulation, were isolated by column chromatography and quantitated by liquid chromatography with electrochemical detection. Norepinephrine (NE) was not consistently demonstrable in superfusate collected under basal conditions, but 40 mM K⁺ caused the release of from 2 to 4 ng/g of tissue per min. The addition of cocaine to the superfusate caused increases in basal and evoked release of NE. Epinephrine (E) could be measured in superfusates of slices from male but not female rats and then only when cocaine was added to the superfusate. Accordingly, the concentration of E in hypothalamus was greater in male rats than in female rats. Dopamine (DA) was not consistently measurable in the spontaneous overflow from slices either in the presence or absence of cocaine. K⁺-evoked release of DA could be demonstrated in slices from female rats. The addition of cocaine increased the evoked release of DA from slices from both sexes. Corticosterone, added to cocaine, had no effects on the efflux of any of the catecholamines. The experiments suggest that neuronal reuptake of all catecholamines is very efficient in the hypothalamus both under basal conditions and during evoked release.     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

《绵阳市社会心理服务工作管理办法》解读

2018年,国家卫生健康委员会等10部委联合发布《关于印发全国社会心理服务体系建设试点工作方案的通知》,四川省绵阳市被列为全国第一批试点地区。绵阳市人民政府依据《中华人民共和国精神卫生法》等相关法律法规和文件精神,结合前期调查研究和社会心理服务工作的试点实际,编制出台了《绵阳市社会心理服务工作管理办法》,并于2021年12月25日起施行。本文围绕社会心理服务的相关概念、办法总则、重点内容、保障措施等方面进行解读,以期为社会心理服务工作的规范、持续和有效开展提供参考。     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

阿立哌唑对精神分裂症患者生活质量的影响

目的:比较阿立哌唑与利培酮对精神分裂症患者生活质量的影响。方法:60例精神分裂患者随机平分为两组各30例,分别给予阿立哌唑和利培酮治疗。疗程8周。用生活质量综合评定问卷-74(GQOLI-74)、阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及不良反应。结果:阿立哌唑与利培酮均能显著提高精神分裂症患者生活质量,但阿立哌唑在改善GQOLI-74总分、躯体健康及社会功能维度优于利培酮。结论:阿立哌唑治疗有利于提高精神分裂症患者生活质量。