重症肌无力患者外周血单个核细胞凋亡调控基因Bcl-2 mRNA的表达及意义

目的探讨重症肌无力(MG)患者外周血单个核细胞(PBMC)凋亡调控基因Bcl-2mRNA表达水平与MG的关系。方法应用RT-PCR半定量方法检测45例MG患者(MG组)和30名健康对照组(NC组)PBMCBcl-2mRNA表达的相对含量,对MG患者病情按许贤豪绝对及相对评分法进行量化,激素治疗4周后测定Bcl-2mRNA表达水平。结果(1)MG患者PBMCBcl-2mRNA表达相对含量[(0.513±0.038)%]明显高于NC组[(0.371±0.045)%](P<0.05)。(2)病情以许贤豪绝对及相对标准评分为:轻、中、重及极重组,其PBMCBcl-2mRNA的相对含量分别为(0.466±0.047)%、(0.557±0.029)%、(0.561±0.052)%和(0.637±0.041)%,后3者明显高于轻度组患者(均P<0.05);Bcl-2mRNA的相对含量与其MG患者病情绝对评分呈明显正相关(r=0.767),且具有统计学意义(P<0.01)。(3)激素治疗后各组Bcl-2mRNA表达相对含量分别为(0.256±0.033)%、(0.475±0.045)%、(0.487±0.027)%和(0.481±0.051)%,与治疗前比较均明显降低(P<0.01);治疗后各组病情评分分别为4.29±1.70、20.12±10.79、27.29±11.50和32.20±16.80,均明显下降(P<0.01)。结论肾上腺皮质激素治疗后,MG患者随病情好转,伴PBMC的Bcl-2mRNA升高,提示:检测PBMC的Bcl-2mRNA有可能作为反映MG患者病情及免疫疗效的参数。     

重症肌无力患者胸腺凋亡基因Bcl-2和Fas的表达水平与临床的相关性

目的研究重症肌无力(MG)患者胸腺凋亡基因Bcl-2和Fas的表达水平与临床的相关性。方法应用流式细胞仪测定43例MG和11例心脏病(对照组)患者胸腺单个核细胞Bcl-2、Fas的表达水平,并与有关临床因素进行相关性分析。结果MG胸腺增生组Bcl-2阳性细胞数显著高于对照组(P<0·01),MG胸腺瘤组Bcl-2阳性细胞数与对照组比较差异无显著性(P>0·05)。MG组与对照组Fas阳性细胞数比较差异无显著性(P>0·05)。胸腺Bcl-2与Fas阳性细胞数之间,以及与伴或不伴胸腺异常(增生或胸腺瘤)患者的血清乙酰胆碱受体抗体(AchRAb)滴度、疾病分型、年龄和性别均无相关性。结论胸腺增生MG患者胸腺凋亡基因Bcl-2表达异常增高,胸腺Bcl-2和Fas的表达之间及与临床有关因素之间无相关性。     

NF-κB与Survivin基因在脑胶质瘤中的表达

目的探讨细胞核因子KB和Survivin基因在胶质瘤中的表达及其与肿瘤细胞凋亡的关系。方法分别采用原位杂交和免疫组织化学S—P法检测80例星形细胞瘤患者和10例正常脑组织Survivin mRNA和NF—KB的表达，用末端转移标记法（TUNEL）检测肿瘤组织的凋亡并计算其凋亡指数（AI）。结果星形细胞瘤组织中Survivin mRNA的阳性表达率明显高于对照组（P〈0．01），高度恶性组的阳性率明显高于低度恶性组（P〈0．01）；AI在星形细胞瘤中明显高于对照组（P〈0．01），而Survivin mRNA阳性组低于阴性组（P〈0．01）；NF—kB在星形细胞瘤中的表达明显高于对照组（P〈0．01），且Survivin mRNA阳性组明显高于阴性组（P〈0．05）。结论NF-kB与Survivin在星形细胞瘤中的表达密切相关，NF-kB的过表达可能通过上调Survivin mRNA的表达抑制星形细胞瘤细胞的凋亡．从而在肿瘤的发生、发展和治疗中发挥重要作用。     

重症肌无力患者血清连接素抗体与临床的关系

目的 探讨重症肌无力（MG）患者血清连接素抗体（Titin—Ab）水平与病情及胸腺异常的关系,以及其对诊断和预后判断的价值。方法 应用酶联免疫吸附法（ELISA）检测MG患者（MG组）52例、非MG（其他神经系统疾病）患者（NMG组）18例、健康对照者（NC组）50名血清中Titin—Ab水平,并对其中10例进行胸腺手术的MG患者随访。结果 MG组Titin—Ab阳性率为36．5％,NMG组和NC组均为阴性,MG组显著高于NC组和NMG组（均P〈0．01）;以MG伴胸腺瘤（MGT）组阳性率最高（83．3％）,MG伴胸腺萎缩（MGA）次之（37．5％）,胸腺正常的MG组为23．0％,MG伴胸腺增生组为阴性;Titin．Ab诊断MGT特异性高于胸腺CT（P〈0．05）。Titin—Ab阳性MG患者抗体水平与肌无力程度呈显著正相关（r=0．562,P〈0．01）;对10例不同胸腺病理类型的MG患者手术前后Titin—Ab测定显示差异具有显著性（P〈0．05）。结论 Titin—Ab阳性多见于MGT和MGA者,诊断MGT的特异性高于CT;Titin—Ab对MG的诊断、病情及预后判断均有帮助。     

灯盏细辛对缺氧复氧损伤的PC12细胞保护机制的研究

目的 探讨灯盏细辛对缺氧复氧（HR）损伤的PC12细胞保护机制。方法 将体外培养的PC12细胞分为正常对照（NC）组、HR组、灯盏细辛10μmol／L（E1）组、20μmol／L（E2）组、30μmol／L（E3）组。将HR组及E1～E3组细胞经HR处理后,测定各组细胞的存活率;通过Western Blot方法观察各组细胞Bcl-2和Bax蛋白含量的变化。结果 （1）与NC组比较,HR组的细胞存活率明显下降（P〈0．01）;与HR组比较,E1-E3组细胞存活率明显升高（均P〈0．01）,且呈剂量依赖性（P〈0．01）。（2）与NC组比较,HR组PC12细胞Bcl-2蛋白表达明显下降,Bax蛋白表达明显增加（均P〈0．01）;与HR组比较,E1-E3组PC12细胞Bcl-2表达明显增加,Bax表达明显下降,并呈剂量依赖性（均P〈0．01）。结论 灯盏细辛对HR损伤的PC12细胞保护作用是通过增加Bcl-2表达、抑制Bax表达的抗凋亡作用实现的。     

糖尿病大鼠蛛网膜下腔出血后海马组织中caspase-3、Bax和Bcl-2的表达及醒脑静干预的研究

目的探讨醒脑静对糖尿病大鼠蛛网膜下腔出血（sAH）后海马组织凋亡相关因子天冬氨酸特异性半胱氨酸蛋白酶（casDase-3）、Bax和Bcl-2表达的影响。方法成年雄性Wistar大鼠28只,按随机数字表法随机分为空白对照组（n=7）、糖尿病对照组（n=7）、糖尿病SAH组（n=7）和醒脑静治疗组（n=7）;采用链脲佐菌素（STZ）腹腔注射方法建立糖尿病大鼠模型,然后采用枕大池两次注血法建立糖尿病大鼠SAH模型。SAH后48h取海马组织,用实时聚合酶链式反应检测caspase-3、Bax及Bcl-2的mRNA的表达,并用免疫印迹法测定它们蛋白表达,进行验证。结果空白对照组和糖尿病对照组大鼠海马组织中的caspase-3、Bax和Bcl-2的mRNA表达量均无显著差异（P〉0．05）;与空白对照组和糖尿病对照组相比,糖尿病SAH组和醒脑静治疗组其mRNA表达量均显著升高（P〈0．05）;醒脑静治疗组caspase-3和BaxmRNA表达水平均显著低于糖尿病SAH组大鼠（P〈0．05）,而Bcl-2mRNA表达水平却明显高于糖尿病SAH组（P〈0．05）。它们蛋白表达变化与mRNA表达基本相符。结论醒脑静抑制糖尿病SAH大鼠海马组织促凋亡相关因子表达,而促进抗凋亡相关因子表达,从而发挥保护作用。     

硝普钠诱导胶质瘤细胞株U251细胞凋亡的研究

目的探讨一氧化氮（NO）供体药物硝普钠（SNP）对胶质瘤细胞株U251细胞凋亡诱导效应及其机制。方法以0．2、0．5、1．5和2．0mmol／L浓度SNP作用于U251细胞24h,甲基噻唑基四唑法检测U251细胞生长抑制率,Griess法检测其NO含量,流式细胞术检测其凋亡率,免疫印迹法检测SNP作用24h前后B淋巴细胞瘤-2基因（Bcl-2）、天冬氨酸特异性半胱氨酸蛋白酶3（caspase-3）在U251细胞的表达。结果不同浓度SNP对U251细胞生长均有抑制作用（P〈0．01）,且随SNP浓度升高而增强（P〈0．01）。U251细胞内NO含量随SNP浓度升高递增（P〈0．01）,并与细胞生长抑制率的呈正相关（P〈0．01）。不同浓度的SNP均能诱导U251细胞凋亡,且随浓度升高而增强（P〈0．01）。随SNP浓度升高U251细胞Bcl-2表达减少,caspase-3表达增加（P〈0．05）。结论SNP可抑制U251细胞生长并诱导其凋亡,其生长抑制效应可能与NO浓度有关,凋亡诱导作用与U251细胞Bcl-2下调和caspase-3上调有关。     

艾司西酞普兰对抑郁大鼠海马BDNF表达及细胞凋亡的影响

目的观察艾司西酞普兰对抑郁大鼠海马BDNF表达及细胞凋亡的影响,探讨其作用机制。方法40只雄性SD大鼠随机分为对照（A）、对照＋药（B）、抑郁模型（C）和抑郁模型＋药（D）组共4组,采用慢性不可预见性的温和刺激结合孤养法建立抑郁大鼠模型,TUNEL法检测海马细胞凋亡情况,实时荧光定量PCR方法检测海马BDNF、Bax、Bcl2、Caspase3mRNA的表达。结果（1）C组海马细胞凋亡数显著增加,与A组比较差异有统计学意义（P〈0．01）,而B组细胞凋亡数与A组差异无统计学意义（P〉0．05）;D组细胞凋亡数明显减少,与c组比较差异有统计学意义（P〈0．01）。（2）C组海马BDNF、Bel—2mRNA表达降低,Bax、Caspase3mRNA表达升高,与A组比较差异均有统计学意义（P〈0．01）;D组BDNF、Bcl2mRNA表达增加,Bax、Caspase3mRNA表达降低,与C组比较差异均有统计学意义（P〈0．01）。结论艾司西酞普兰可改善抑郁大鼠的抑郁行为及海马细胞凋亡,其机制可能是通过增加海马BDNFmRNA的表达,上调Bcl一2及下调Bax、Caspase3mRNA的表达,从而预防海马细胞凋亡而发挥脑保护的作用。     

缺氧对神经胶质细胞hif-1基因表达和凋亡的影响

目的探讨缺氧环境对培养的新生鼠大脑胶质细胞低氧诱导因子-1（HIF-1）基因表达和凋亡的影响。方法体外培养SD新生鼠大脑神经胶质细胞；实验分为对照组：正常培养6h（5％CO2、95％空气）和缺氧组：缺氧培养6h（5％CO2、1％O2、94％N2）。实时定量多聚酶链反应（PCR）方法测定细胞hif-1和bcl-2、bax基因表达。结果缺氧组hif-1mRNA表达高于对照组（P〈0．01）；缺氧组bcl-2mRNA表达低于对照组（P〈0．05），baxmRNA表达高于对照组（P〈0．01）。结果缺氧6h可引起胶质细胞hifmRNA表达增加但促进细胞凋亡。     

姜黄素对癫痫持续状态后海马内质网应激相关分子表达的影响

目的探讨姜黄素对癫痫持续状态（SE）后海马内质网应激（ERS）标志分子免疫球蛋白结合蛋白（BiP）和ERS相关促凋亡分子如生长停滞、DNA损害可诱导基因153（GADD153）表达的影响。方法将90只SD大鼠随机分人SE组、姜黄素组和对照组。建立氯化锂一匹罗卡品大鼠SE模型。应用半定量逆转录-聚合酶链反应（RT-PCR）动态观察SE后海马BiP和GADD153的转录状况。结果（1）与对照组相比，SE组SE后2、4、6、24hBiPmRNA表达升高（P〈0．01），6h达高峰，24h开始下降（P〈0．01），72h恢复至正常水平；姜黄素组BiP mRNA表达的动态变化同SE组类似，但显著低于SE组（P〈0．05或0．01）。（2）与对照组比，SE组SE后2、4、6、24、72hGADD153mRNA显著上调（P〈0．01），SE后2h达高峰，24h开始下降（P〈0．01）。姜黄素组仅于SE后2、4hGADD153mRNA表达明显高于对照组（P〈0．01），且较SE组低（P〈0．01）。结论姜黄素有可能成为在体抑制ERS的有效药物；减轻ERS、抑制GADD153表达可能是姜黄素在SE后发挥神经元保护作用的重要机制。     

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。