脑红蛋白与缺血缺氧性脑损伤

脑红蛋白(neuroglobin,Ngb)是携氧球蛋白家族成员之一,主要以单体形式存在于神经细胞中,与脑内氧供应密切相关.脑缺血缺氧能诱导Ngb高表达,并作为一种内源性神经保护因子保护神经元免受缺血缺氧性损害.文章对Ngb的分布、结构、功能及其在缺血缺氧性脑损伤中的保护作用和机制做了综述.     

缺血缺氧性脑损伤治疗的新方法--神经干细胞移植

神经干细胞(NSC)是一群较原始的、能自我更新并具有多种分化潜能的细胞,可分化成神经元、少突胶质细胞和星形细胞.在生理条件下,体内的NSC通常保持静息状态;神经损伤后,内源性NSC可因微环境的改变而被激活、迁移和分化,以替代损伤的细胞和重建神经环路;遗传修饰后,外源性NSC移植显示了很大的治疗潜力,为今后缺血缺氧性脑损伤的治疗提供了新的手段.     

缺血缺氧性脑损伤治疗的新方法——神经干细胞移植

神经干细胞（NSC）是一群较原始的，能自我更新并具有多种分化潜能的细胞，可分化成神经元，少突胶质细胞和星形细胞。在生理条件下，体现人的NSC通常保持静息状态；神经损伤后，内源性NSC可因微环境的改变而被激活，迁移和分化 。以替代损伤的细胞和重建神经环路；遗传修饰后，外源性NSC移植显示了很大的治疗潜力，为今后缺血缺氧性脑损伤的治疗提供了新的手段。     

缺血缺氧性脑损伤动物模型

已在许多动物,如猴、狗、大鼠、小鼠、兔、猪等建立缺血缺氧性脑损伤动物模型.这些模型为新生儿缺血缺氧性脑损伤的研究提供了大量重要信息.但是,不同种属对各种类型缺血性损伤的易感性存在差异.文章对利用不同种属动物制作的缺血缺氧性脑损伤模型做了综述.     

神经节苷脂GM1与神经系统疾病

神经节苷脂是一类含唾液酸的鞘糖脂,在脑内的含量非常丰富.它不但能够促进神经细胞分化、神经突生长以及突触形成,而且参与了神经可塑性的凋节和脑损伤后的功能恢复.GM1是迄今研究最为深入的神经节苷脂,对细胞内C4~(2+)稳态的调节被认为是GM1神经营养/神经保护作用的基础,而它与神经营养因子的相互作用则是其神经保护作用的关键.此外,它还具有抗兴奋性毒性、抗氧化、扩血管等作用.各种神经变性疾病以及缺血缺氧性脑病均与神经元脱失和凋亡有关,而GM1的神经营养/神经保护作用能在这些疾病的治疗中发挥重要作用.目前,GM1已被广泛用于帕金森病、卒中、新生儿缺血缺氧性脑病、脑外伤、脊髓损伤以及周围神经病的治疗,对其作用机制的进一步研究有望为上述疾病的治疗提供新的思路.     

新生大鼠缺血缺氧后胶质性谷氨酸转运体的表达及GM1的干预研究

目的探讨新生大鼠缺血缺氧性脑损伤后胶质性谷氨酸转运体的表达及神经节苷脂（GM1）的干预作用。方法通过建立新生大鼠缺血缺氧性脑损伤动物模型，应用免疫组化方法，观察缺血缺氧后不同时期大脑皮质胶质性谷氨酸转运体EAATI、EAAT2的动态表达度GM1对其表达的影响。结果缺血缺氧后6hEAAT1的表达开始上升、第2d达高峰，第3d恢复到假手术组水平；EAAT2的表达在缺血缺氧后12h开始上升，第3d达高峰，第5d恢复到假手术组水平；GM1干预组脑组织损伤明显减轻，EAAT1和EAAT2的表达较单纯缺血缺氧组显著增加（P〈0．01），持续时间延长。结论缺血缺氧诱导胶质性谷氨酸转运体的表达，GM1提高胶质性谷氨酸转运体的表达可能是GM1脑保护作用的重要机制之一。     

缺血缺氧性脑损伤对新生鼠脑内神经干细胞的影响

目的观察新生鼠缺血缺氧性损伤后皮层及海马神经干细胞的变化。方法采用新生7d龄SD大鼠制作新生鼠缺血缺氧性脑病模型（HIE），行免疫组化染色，巢蛋白（Nestin）标记神经干细胞。结果正常SD大鼠新生早期的皮层及海马存在一定数量的Nestin阳性细胞，随年龄增加而减少；缺血缺氧后．新生SD大鼠皮层损伤区及其周围、对侧镜区和双侧海马都出现Nestin阳性细胞增多，并以病灶边缘曼加突出，在皮层伤后3d即出现高峰，而海马的高峰期在伤后7d，然后都逐渐减少，至伤后28d均与正常组无差别。结论缺血缺氧能促使新生SD大鼠皮层及海马的神经干细胞增多。     

神经发生在脑缺血中的保护作用

近年来,已对缺血性脑损伤的内源性和外源性保护机制开展了大量研究,并发现脑缺血能刺激细胞增殖和神经发生.文章对脑缺血诱导神经干细胞增殖、定向迁移和分化的保护机制以及外源性因子的应用对缺血后神经发生的促进作用进行了综述.     

NT-3联合NSCs移植治疗乳鼠缺血缺氧性脑损伤的电生理评价

目的探讨神经营养因子3(NT-3)与神经干细胞(NSCs)联合移植治疗乳鼠缺血缺氧性脑损伤(HIBD)后的神经电生理现象。方法 10只7日龄Wistar乳鼠随机分配到对照组,50只7日龄Wistar乳鼠制备HIBD模型,存活37只,将其随机分配到NSCs移植组、NT-3联合NSCs移植组、脑损伤组。3 d后NT-3联合NSCs移植组移植NSCs及NT-3,NSCs移植组只移植NSCs,脑损伤组移植PBS。移植后3周、7周时进行神经电生理检测,然后取脑组织行HE染色。结果神经电生理:与脑损伤组相比,移植后3周时,NSCs移植组、NT-3联合NSCs移植组乳鼠的后肢股四头肌复合动作电位(CMAP)波幅明显增高、潜伏期缩短,以NT-3联合NSCs移植组为著(P均<0.05);移植后7周时,CMAP波幅明显增高(P<0.05),潜伏期缩短不明显;移植后3、7周时HE染色:脑损伤组损伤侧侧脑室旁正常组织结构破坏,出现多个大小不一的囊腔;NSCs移植组侧脑室旁正常组织结构有所恢复,囊变少见;NT-3联合NSCs移植组损伤侧侧脑室周围组织结构恢复更好。结论 NT-3联合NSCs移植可使HIBD乳鼠后肢股四头肌CMAP波幅明显增高、潜伏期缩短。     

脑缺血与内源性神经保护

脑缺血后一系列损伤级联反应既可启动缺血性脑损伤的诸多环节 ,又可启动内源性神经保护机制 ,增强内源性神经保护效应对限制缺血损伤和促进可逆性受损的神经组织的修复和再生至关重要。文章就近年来内源性神经保护的机制和内源性神经保护增效剂方面的研究作了综述。     

Calcium channel antagonists part V: Second-generation agents

Summary Second-generation agents include new dihydropyridines, such as amlodipine, felodipine, isradipine, nicardipine, nimodipine, nisoldipine, and nitrendipine. Verapamil-like agents include tiapamil, gallopamil, and anipamil. Among the diphenylalkylamines, bepridil is of special interest. New preparations of existing agents include slow-release formulations of nifedipine, verapamil, and diltiazem. From all these agents will be selected those that are longer-acting and provide higher vascular selectivity.     

Immunoglobulin allotypes are not associated with HLA-antigens,autoantibodies and clinical symptoms in systemic lupus erythematosus

Summary Immunoglobulin heavy chain (G1m, G2m, G3m, A2m) and kappa light chain (Km) allotype and phenotype frequencies of 323 central European Caucasian patients with systemic lupus erythematosus (SLE) were examined and correlated with various genetic, serologic and clinical markers of SLE. No significant associations were found between immunoglobulin allotypes or phenotypes and all 20 parameters tested (nephritis, vasculitis, arthralgias, photosensitivity, discoid lesions, central nervous system disease, Raynaud's phenomenon, sex, anti-Ro, anti-La, anti-nRNP, HLA-DR1-DR7, HLA phenotypes B8-DR3, B7-DR2). It could therefore be assumed that Gm, A2m and Km allotypes were not associated with HLA-antigens and had no influence on the serologic and clinical expression of SLE.E. Albert, M. Baur, A. Corvetta, H. Deicher, J. Frey, F. Krapf, B. Lang, J. R. Kalden, H. J. Lakomek, H. H. Peter, C. Rittner, P. Schneider, S. Seuchter, P. Späth     

Cinedefecography and electromyography in the diagnosis of nonrelaxing puborectalis syndrome

A prospective study was undertaken to assess the correlation between electromyography (EMG) and cinedefecography (CD) for the diagnosis of nonrelaxing puborectalis syndrome (NRPR). Clinical criteria for NRPR included straining, incomplete evacuation, tenesmus, and the need for enemas, suppositories, or digitation. EMG criteria included failure to achieve a significant decrease in electrical activity of the puborectalis (PR) during attempted evacuation. CD criteria included either paradoxical contraction or failure of relaxation of the PR along with incomplete evacuation. In addition, other etiologies for incomplete evacuation, such as rectoanal intussusception or nonemptying rectocele, were excluded by proctoscopy and defecography in all cases. One hundred twelve patients with constipation, 81 females and 31 males, with a mean age of 59 (range, 12–83) years were studied by routine office evaluation, CD, and EMG. Forty-two patients (37 percent) had evidence of NRPR on CD (rectal emptying: none, 24; incomplete, 18). Twenty-eight of these patients (67 percent) also had evidence of NRPR on EMG. EMG findings of NRPR were present in 12 of 70 patients (17 percent) with normal rectal emptying. Conversely, 14 of 72 patients (19 percent) with normal PR relaxation on EMG had an NRPR pattern on CD. The sensitivity and specificity for the EMG diagnosis of NRPR were 67 percent and 83 percent, and the positive and negative predictive values were 70 percent and 80 percent, respectively. Conversely, if EMG is considered as the ideal test for the diagnosis of NRPR, CD had a sensitivity of 70 percent, a specificity of 80 percent, and positive and negative predictive values of 66 percent and 82 percent, respectively. In summary, sensitivity, specificity, and predictive values of EMG and CD are suboptimal. Therefore, a combination of these two tests is suggested for the diagnosis of NRPR.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, San Francisco, California, June 7 to 12, 1992.Dr. Ger was a visiting colorectal surgeon from the Section of Colon and Rectal Surgery, Department of Surgery, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan, R.O.C.     

Calcium channel antagonists part V: Second-generation agents

Summary Second-generation agents include new dihydropyridines, such as amlodipine, felodipine, isradipine, nicardipine, nimodipine, nisoldipine, and nitrendipine. Verapamil-like agents include tiapamil, gallopamil, and anipamil. Among the diphenylalkylamines, bepridil is of special interest. New preparations of existing agents include slow-release formulations of nifedipine, verapamil, and diltiazem. From all these agents will be selected those that are longeracting and provide higher vascular selectivity.[This article appeared in Cardiovascular Drugs and Therapy, 2:191–203, 1988.]     

新疆食虫目动物

作者通过多年实地采集,并整理了本所30年存放的食虫目动物标本。到目前为止,新疆食虫目动物有2科4属7种9亚种。对各个种(亚种)的形态、地理分布和生态学作了记述。猬科Erinaceidae:(1)大耳猬淡色亚种 Hemiechinus auritus albulus Stoliczka,1872(2)大耳猬吐鲁番亚种 Hemiechinus auritusturfanicus Matschie,1911.科 Soricidae;(3)天山Sorex asper Thomas,1914(4)小科克苏河亚种Sorex minutus heptapotamicus Stroganov,1956 (5)西藏指名亚种 Sorex thibetanus thibetanusStroganov,1952(6)白腹蒙古亚种 Crocidura leucodon myoides Blanford,1875(7)白腹阿拉本图亚种Crocidura leucodonHeptapotamicus stroganov,1956(8)小伊犁亚种 Croidura suaveolens ilesisMillev,1901(9)水远东亚种 Neomysfodiens orientis Thomas,1914。     

How Is the Liver Primed or Sensitized for Alcoholic Liver Disease?

This article represents the proceedings of a symposium at the 2000 ISBRA Meeting in Yokohama, Japan. The chairs were Hidekazu Tsukamoto and Yoshiyuki Takei. The presentations were (1) Tribute to Professor Rajendar K. Chawla, by Craig J. McClain; (2) Dysregulated TNF signaling in alcoholic liver disease, by Craig J. McClain, S. Joshi-Barve, D. Hill, J Schmidt, I. Deaciuc, and S. Barve; (3) The role of mitochondria in ethanol-mediated sensitization of the liver, by Anna Colell, Carmen Garcia-Ruiz, Neil Kaplowitz, and Jose C. Fernandez-Checa; (4) A peroxisome proliferator (bezafibrate) can prevent superoxide anion release into hepatic sinusoid after acute ethanol administration, by Hirokazu Yokoyama, Yukishige Okamura, Yuji Nakamura, and Hiromasa Ishii; (5) S-adenosylmethionine affects tumor necrosis factor-α gene expression in macrophages, by Rajendar K. Chawla, S. Barve, S. Joshi-Barve, W. Watson, W. Nelson, and C. McClain; (6) Iron, retinoic acid and hepatic macrophage TNFα gene expression in ALD, by Hidekazu Tsukamoto, Min Lin, Mitsuru Ohata, and Kenta Motomura; and (7) Role of Kupffer cells and gut-derived endotoxin in alcoholic liver injury, by N. Enomoto, K. Ikejima, T. Kitamura, H. Oide, Y. Takei, M. Hirose, B. U. Bradford, C. A. Rivera, H. Kono, S. Peter, S. Yamashina, A. Konno, M. Ishikawa, H. Shimizu, N. Sato, and R. Thurman.     

布鲁菌分子分型方法应用研究进展

布鲁菌属细菌是布病的病原菌。当前,用于布鲁菌属细菌分型的方法有多种,而布鲁菌分子分型方法在布病的分子流行病学调查、病原菌的快速分型鉴定、病原菌的溯源分析和菌株之间差异关系的分析过程中被广泛应用并具有十分重要的作用。本文就常用的布鲁菌的核酸探针技术(DNA probes)、聚合酶链式反应(PCR)、实时定量PCR(Real-time PCR)、16SrDNA鉴定、PCR限制性片段长度多态性( PCR-RFLP)、单核苷酸多态性分析(SNP)、脉冲场凝胶电泳(PFGE)、多位点序列分型(MLST)、多位点串联重复序列分析(VNTR/MLVA)等分子分型方法的应用研究进展予以综述。     

Les atteintes rénales au cours des hémopathies malignes. Stratégie diagnostique

Kidney involvement is frequent in hematologic malignancies. It is associated with adverse outcome and treatment difficulties. It can affect every area of the renal parenchyma (tubules, interstitium, glomerulus, vessels). Various mechanisms could be implicated: deposits of immunoglobulin fractions or crystals, renal infiltration by malignant cells, urinary tract obstruction, paraneoplastic or storage glomerulopathies… Diagnostic strategy relies on the clinical presentation: acute renal failure, chronic kidney disease, glomerular proteinuria with or without nephrotic syndrome, tubular proteinuria, hydroelectrolytic disorders. In this review, we detail the diagnostic tests that are needed for the detection and the follow-up of renal involvement in hematologic malignancies, and clarify the indications of renal biopsy. We propose diagnostic strategies of renal involvement in myeloma, Waldenström's disease, high grade lymphomas and acute leukemias, low grade lymphomas and chronic leukemias. The adverse effects of treatments (chemotherapy, radiotherapy, stem cell graft …) are not addressed in this review.     

Risk factors for enterococcal bacteremia in allogeneic hematopoietic stem cell transplant recipients

M. Mikulska, V. Del Bono, R. Prinapori, L. Boni, A.M. Raiola, F. Gualandi, M.T. Van Lint, A. Dominietto, T. Lamparelli, P. Cappellano, A. Bacigalupo, C. Viscoli. Risk factors for enterococcal bacteremia in allogeneic hematopoietic stem cell transplant recipients.
Transpl Infect Dis 2010: 12: 505–512. All rights reserved Abstract: Bacteremia is a well known cause of morbidity and mortality in hematopoietic stem cell transplant (HSCT) recipients and enterococci are among the most frequently isolated pathogens. The aim of this study was to identify risk factors for enterococcal bacteremia during the first 30 days after allogeneic HSCT. A retrospective case–control study was performed; for each case, 3 controls were randomly selected among 306 patients transplanted during the study period (January 1, 2004 to December 31, 2007). Odds ratios (OR) with 95% confidence intervals (CI) were calculated for variables influencing the risk for bacteremia. Overall, 33 patients developed enterococcal bacteremia, within a median of 9 days after HSCT (range, 2–24). The cumulative incidence was 10.8%. Multivariate analysis identified the following variables as risk factors for enterococcal bacteremia: donor and transplant type (greater risk for mismatched related or cord blood) (OR=8.98, 95% CI, 1.65–48.99 and OR=7.52, 95% CI, 1.56–36.31, respectively, P=0.047); severe (grades 3–4) mucositis (OR=9.04, 95% CI, 1.97–41.52, P=0.018); pharyngeal enterococcal colonization (OR=4.48, 95% CI, 1.11–18.03, P=0.035); and previous empirical therapy with cephalosporins (OR=4.16, 95% CI, 0.93–18.66 for 1–7 days of therapy, and OR=7.31, 95% CI, 1.78–30.12 for 8–23 days, P=0.018). Higher Karnofsky score (≥50) and previous empirical therapy with glycopeptides were associated with a decreased risk (OR=0.25, 95% CI, 0.06–0.97, P=0.045 and OR=0.11, 95% CI, 0.02–0.59, P=0.010, respectively). The crude mortality at 7 and 30 days was 12% (4/33) and 24% (8/33), respectively. Enterococcal bacteremia is frequent after allogeneic HSCT. The factors associated with this infection are type of transplant, pharyngeal colonization, severe mucositis, and use of cephalosporins. Good general conditions and the use of vancomycin were associated with lower risk of enterococcal bacteremia.     

Étiologies et orientation diagnostique devant un flush

The flush is a transient and recurrent erythema of the upper region of the body, due to a sudden arterial dilatation. First, physicians should confirm the flush and ascertain the location and timing of skin manifestations. The rapid onset and location of the skin rash to the face and anterior chest are the main characteristics of flush. In most of the cases, the flush is emotional, but this should remain a diagnosis of exclusion, as flush may be the presenting manifestation of many systemic or neoplastic disorders. Therefore, a comprehensive diagnostic work-up is necessary, including clinical, biological, and imaging testing. Neoplastic and endocrine causes of flush include VIPoma, carcinoid syndrome, medullary thyroid cancer, mastocytosis, renal cell carcinoma, and pheochromocytoma. Mast cell activation syndrome has been recently described, but it remains a diagnosis of exclusion. This review will first present the different causes of flush, and then will propose a diagnostic algorithm for the physician.