钙通道阻滞剂在认知障碍防治中的应用

认知障碍是一个具有重要医学和社会意义的问题，血管危险因素是其重要的病因。大量临床试验和汇总分析表明，钙通道阻滞剂不仅能治疗各种痴呆，还能预防急性缺血性卒中、高血压、蛛网膜下腔出血和脑外伤患者认知障碍的发生。     

多巴胺在运动改善帕金森病学习记忆障碍中的调节作用

<正>帕金森病(PD)是以黑质-纹状体多巴胺(DA)能神经元变性缺失为主要特征的一种中老年神经退行性疾病,主要临床表现包括运动障碍、认知障碍和情绪障碍等~(〔1〕),其中学习记忆障碍是认知障碍的重要表现之一。证据表明,PD患者与动物模型的中脑DA含量渐进性丧失将影响着诸如海马区等与学习     

缺血性卒中后认知障碍

缺血性卒中可导致不同程度的认知障碍,其发病率很高.认知障碍的早期诊断能提供最佳干预和治疗时机,并延缓疾病进展,因此越来越受到关注.文章对缺血性卒中后认知障碍的病因、发病机制、危险因素、诊断和防治方面的进展做了综述.     

脑小血管病相关认知障碍的中西医研究进展

从中医和西医角度出发对脑小血管病认知障碍的定义、发病机制、临床表现以及预防治疗进行综述,以期为临床治疗提供新的研究方法和思路。脑小血管病相关认知障碍是发病率较高的一种功能障碍性疾病,该病影响病人的日常生活、工作以及其他方面的功能,逐渐引起了社会的关注和重视。因此,对脑小血管病相关认知障碍进行及早的预防和治疗尤为重要。     

慢性脑缺血导致认知障碍的病理生理学机制

慢性脑缺血足一种常见的病理学状态,早期以认知功能损害为主要表现,最终导致持久或进展性认知障碍和神经功能缺损.慢性肭缺血引起的神经元损伤、突触异常、能量障碍以及中楸胆碱能和单胺能系统功能缺损是其导致认知障碍的病理生理学机制.     

慢性脑缺血导致认知障碍的病理生理学机制

慢性脑缺血足一种常见的病理学状态,早期以认知功能损害为主要表现,最终导致持久或进展性认知障碍和神经功能缺损.慢性肭缺血引起的神经元损伤、突触异常、能量障碍以及中楸胆碱能和单胺能系统功能缺损是其导致认知障碍的病理生理学机制.     

卒中后抑郁患者的认知障碍

卒中后抑郁是卒中患者的常见并发症，认知障碍是影响其疗效和生活质量的重要因素。事件相关电位对早期发现卒中后抑郁患者的认知障碍有较高的临床价值。     

应重视血管性认知障碍诊断标准的建立及临床研究

近年来,随着人们对痴呆研究的逐渐深入,一个新的概念-血管性认知障碍(vascular cognitive impair-ment,VCI)被提出。VCI是继轻度认知障碍(mild cognitive impairment,MCI)之后的一个全新概念,如果能对VCI展开深入的研究,有望能够更新对血管因素或血管病引起认知障碍或痴呆的理解,促进诊断和治疗水平的提高。     

血管性认知障碍的研究进展

血管性认知障碍包含一系列脑血管因素相关的认知紊乱。血管性认知障碍是全球第二大认知障碍类型,给社会和家庭带来了沉重的负担。本文主要综述血管性认知障碍的病因、病理机制、诊断和治疗。大部分脑血管认知障碍可归因于可控的危险因素、不可控的危险因素及其他危险因素。血管性认知障碍病理机制复杂,主要包括脑白质损伤及脑卒中、血脑屏障与神经血管单元的破坏及炎症和氧化应激。血管性认知障碍的治疗包括药物治疗和非药物治疗。本综述旨在为血管性认知障碍的基础、临床研究提供参考。     

帕金森病认知障碍的体液生物标志物研究进展

正帕金森病(PD)是一种常见的神经系统退行性疾病,常伴有非运动功能症状,包括认知障碍、情绪障碍、嗅觉和味觉障碍、睡眠障碍、自主神经功能障碍等。认知障碍是PD常见的非运动症状,影响患者的日常生活能力和质量,认知障碍出现在PD早期阶段,被认为是加速痴呆进展的危险因素之一[1]。因此,PD认知障碍发生发展的体液生物标志物备受关注,藉此为PD认知障碍的早期诊断与治疗提供机会。1 PD认知障碍的定义与分类     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Development of a technique of immunoadsorption of LDL-cholesterol

An immunoadsorption system for lowering plasma cholesterol was optimized. Several polyclonal and monoclonal antibodies were compared and the best results were obtained with goat polyclonal antibodies. The optimum quantity of antibodies to be immobilized on the gel was 5 mg/ml. Taking into account two variables, i.e., 1) that the regeneration must be as complete as possible and, 2) that immunoadsorbents must be used several times without a loss of adsorption capacity, desorption was achieved with 0.3 M glycine adjusted to pH 2.8. Antibody release from the immunoadsorbent was determined and can be minimized by glutaraldehyde treatment of the immunoadsorbent. Each phase, adsorption and desorption, respectively, was well-defined and synchronized, so that two columns could be used in parallel in an automated procedure. The kinetics of plasma protein removal demonstrated the efficiency and the specificity of the procedure.     

各类胆石氨基酸成份研究分析

148份胆石进行红外光谱分析。48份进行了化学检测。根据分析选出30份胆石分5组:纯胆固醇结石10例,胆固醇混合石7例,胆红素混合石10例,糖蛋白结石2例,黑结石1例。经处理上机检测氨基酸。结果显示:氨基酸以黑结石最高（226.93mg/g）,纯胆固醇结石最低,最低者1.37mg/g。胆石中,脂肪族氨基酸约占总量50％左右,其中甘氨酸占15.34％。混合性结石中,胆红素含量越高,氨基酸含量越高。色素结石的酸性氨基酸组份相对较碱性组份为高。而色素结石与胆固醇结石各种氨基酸百分含量基本相似。     

Mechanisms of action of antiresorptive therapies of postmenopausal osteoporosis

In the treatment of osteoporosis, the aim of the antiresorptive therapy is to restore bone density by decreasing bone remodeling. The process of bone remodeling plays a role in plasma calcium homeostasis and serves to modify bone architecture in order to meet changing mechanical needs, to maintain osteocyte viability, and to repair microdamage in bone matrix. Estrogen deficiency results in a number of detrimental effects on bone, including suppression of osteocyte survival as well as impairment of osteoblast response to mechanical stimuli and repair of ageing bone. In this review, effects of available antiresorptive therapies on endocrine regulations of bone metabolism in postmenopausal osteoporosis are compared. The aim of antiresorptive treatment is to ensure adequate bone remodeling, reparation of microdamage of bone, and increased bone strength. Ideally, this effect should be maintained long-term. Several agents are approved for the treatment of osteoporosis. Calcitonin transiently inhibits osteoclast activity without decreasing osteoblast collagen synthesis. Aminobisphosphonates decrease bone remodeling by decreasing osteoclast activity and by inducing osteoclast apoptosis. This allows more time for secondary mineralization to proceed to completion in the existing bone tissue mass, so increasing the mechanical resistance of bone to loading. Estrogens and raloxifene (a selective estrogen receptor modulator that acts as an estrogen agonist in bone) suppress bone remodeling to the premenopausal range, maintaining the function of osteoblasts and osteocytes. In the placebo-controlled osteoporosis treatment trials, all the above treatments reduced the risk of fractures. Raloxifene therapy was also associated with a favorable or neutral effect in the cardiovascular system, and a reduced incidence of breast cancer. Selection of appropriate drug for treatment of postmenopausal osteoporosis should take into account the long-term effect of the antiresorptive agent on bone. Moreover, the effects on other tissues ++should also be considered, and this encompasses both safety concerns, as well as the potentially beneficial effects on other tissues. Further investigation is needed to evaluate the different modes of action of these agents, and their long-term effects on bone and other tissues.     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Measurement of subjective quality of life of elders

There are two aims in this article, to define subjective quality of life and to suggest a way to standardize its measurement to enable comparisons to be made across studies. One of the unresolved issues in gerontological research has concerned the definition and measurement of quality of life (Lawton, 1991). This article focuses on subjective well-being, one of the four components proposed by Lawton (1991). There seems to be a growing consensus that most scales of well-being have at least two concepts in common, positive and negative affect. To test this hypothesis, two well-being scales, the Philadelphia Geriatric Center Morale Scale (Lawton, 1975) and the Center for Epidemiological Studies-Depression Scale (Radloff, 1977), were subjected to confirmatory factor analyses, using data on 1717 participants in the Australian Longitudinal Study of Ageing aged between 70 and 103 years. Each scale was shown to contain factors of positive and negative affect. The article concludes with a suggestion that the measurement of quality of life in elders should include, at a minimum, scales of positive and negative affect as well as other measures relevant to the aspect of quality of life under consideration.     

辽宁省城市体检人群代谢综合征肾脏损害调查研究

目的:探讨沈阳市代谢综合征(MS)人群肾脏损害情况。方法:选取辽宁省城市体检人群与社区人群进行分层抽样调查,共调查2000人,其中体检人群1000人,社区人群1000人(来自辽宁省各城市)。根据MS的诊断标准,研究对象被分为超重肥胖组(460人)和正常体重组(1540人),高血糖组(140人)和正常血糖组(1860人),高血压组(399人)和正常血压组(1601人),血脂异常组(486人)和血脂正常组(1514人),比较各分组间肾脏损害的患病率。结果:调查人群中肾脏损害患病率为15%,男性与女性之比为1:1。超重肥胖组和非超重肥胖组肾脏损害患病率分别为10%和1%;高血糖组和正常血糖组肾脏损害患病率分别为10%和1%;高血压组和正常血压组肾脏损害患病率分别为10%和2%;血脂异常组和血脂正常组肾脏损害患病率分别为10%和1%,以上两组间比较差异均有显著性(P0.01)。结论:辽宁省城市代谢综合征患者的肾脏损害患病率较正常人群显著升高。     

Heterogeneity of immunotypes of heat-labile enterotoxins of enterotoxigenic Escherichia coli of human origin

A new technique, checkerboard immunoblotting (CBIB), has been applied to detect and to differentiate heat-labile enterotoxins, (LTs), from enterotoxigenic strains of Escherichia coli of human origin using polyclonal and monoclonal antibodies. Optimal conditions of production and release of LTs were defined using CBIB. LT release was enhanced when E. coli cells were treated with 8 M urea. LT production was highest when E. coli strains were incubated with shaking (200 rpm) at 37 degrees C for 12 h in CAYE-2 medium. Two hundred and five strains of E. coli, isolated from patients with diarrhea in Japan, Thailand, the United States, Mexico, and Brazil, were examined for LT. Of 133 LT-positive strains, 4 (3%) produced an LT that reacted like H-LT-1 (originally isolated from E. coli strain H-74-114) while 126 strains (94.7%) produced LT that reacted like H-LT-2 (originally isolated from strain H-10407) or H-LT-3 (from strain H-240-3). Three strains of human origin (2.3%) produced an LT that reacted like P-LT (produced by E. coli strains of porcine origin). This study shows that CBIB, a simple, efficient, and practical assay, might be useful for epidemiologic surveys and for evaluation of serologic responses to LTs and antitoxic vaccines.     

Case of spontaneous regression of metastatic lesions of leiomyosarcoma of the esophagus

A rare case of spontaneous regression of esophageal leiomyosarcoma is reported. A 63-year-old woman underwent esophagectomy and reconstruction at our hospital after diagnosis of leiomyosarcoma. Nineteen months after esophagectomy, a coin lesion was detected in the right lung and right thoracotomy revealed pleural dissemination. The lesion in the right lung was resected and was confirmed histologically as recurrence of leiomyosarcoma. During further surgery, metastatic lesions were found in the spleen and pleura. However, all metastatic lesions were found to decrease without any anti-cancer therapy.