Alzheimer病患者脑脊液中炎前和抗炎细胞因子以及凋亡信号分子的变化

目的探讨炎前和抗炎细胞因子以及凋亡在阿尔茨海默病(AD)不同临床阶段神经病理损伤机制中的作用。方法用夹心式酶联免疫吸附法测定轻、中、重度AD患者、血管性痴呆(VD)患者与正常老年人脑脊液中白介素1β(IL1β)、肿瘤坏死因子α(TNFα)和白介素1受体拮抗剂(IL1ra)的水平;以蛋白印记法及激酶活性测定法检测半胱天冬氨酸蛋白酶3(caspase3)的表达和活性。结果各AD组患者脑脊液中IL1β、TNFα的水平较其他组不同程度升高,而IL1ra则不同程度降低。各AD组组间比较结果显示,随着痴呆程度的加重,IL1β与TNFα水平相应增高,IL1ra却相应下降,其中重度与轻度AD比较差异有显著性(P<0.05);轻、中度AD尤其是中度AD患者caspase3含量和活性较VD患者及正常老年人明显升高(P<0.05或P<0.01),重度AD患者caspase3含量和活性虽显著高于正常老年人,但较之于轻、中度AD患者反呈下降趋势。相关分析显示,各AD患者脑脊液中炎前和抗炎细胞因子水平与caspase3表达量和活性之间无显著相关。结论炎前和抗炎细胞因子表达失衡造成的级联反应在AD脑损害过程中起重要作用,过度凋亡可能是轻、中度AD患者神经元退变的主要原因之一,而在重度AD患者凋亡可能不再是其脑损害的主要方式。     

利培酮对血清细胞因子的研究

目的 探讨利培酮对精神分裂症患者血清细胞因子的影响。方法 对39例精神分裂症患者给予利培酮治疗6周,在治疗前后检测血清IL－6,IL－8,IFN－γ和TNF－α水平,并采用PANSS、TESS量表评估临床症状变化及药物副反应。结果 利培酮治疗后血清IL－6水平显著下降,血清IL－8,IFN－γ和TNF－α水平变化不显著。治疗前血清IL－6水平与PANSS阳性因子分显著正相关,血清IL－6减分率与药物最高剂量呈显著正相关;而其余三种细胞因子与PANSS总分及药物剂量无相关;四种细胞因子的减分率与TESS无相关。结论 精神分裂症精神症状可能与细胞因子的功能异常有关,利培酮可能因抑制IL－6的生成而起到免疫抑制作用。     

多发性硬化患者IFN-γ及IL-10分泌性T细胞的变化

目的　通过计数促炎症性细胞因子IFN γ及抗炎症性细胞因子IL 10分泌性T细胞数目 ,观察多发性硬化 (MS)患者此两类细胞因子 (CK)的变化。方法　采用酶联免疫斑点 (Elispot)技术检测MS患者、其他神经疾病 (OND)患者及正常对照组 (NC)外周血 (PB)及脑脊液 (CSF)中MBP及其他抗原反应性IFN γ和IL 10分泌性T细胞数目 ,并对活动期与缓解期MS及甲基强的松龙 (MP)冲击疗法前后MS患者PB中两种CK分泌性T细胞数目进行了比较。结果　活动期MS患者PB及CSF中IFN γ及IL 10分泌性T细胞数目较OND及NC组明显增多 (P <0 0 5) ,CSF中MBP反应性T细胞差异更为显著 (P <0 0 1)。MS患者PB中IL 10分泌性T细胞数在缓解期较活动期明显升高 (P <0 0 5)。MP治疗后IFN γ分泌性T细胞数目明显减少 ,而IL 10分泌细胞数目明显增多 (P <0 0 1)。结论　在MS发病机制中IFN γ起促进作用 ,而IL 10有保护作用 ,是促、抗炎症性CK的比值而非按顺序的表达决定MS的活动性。MP疗法的部分机制可能是调节CK网络的平衡     

癫痫患儿的血清细胞因子水平变化及其意义

目的：探讨白细胞介素－2（IL－2）、肿瘤坏死因子-α（TNF－α）和干扰素－α（IFN－α）对癫痫患儿的神经免疫调节作用。方法：采用双抗体夹心酶联免疫吸附试验（ELISA）检测40例癫痫患儿血清中IL－2、TNF－α和IFN－α的水平，并与年龄和性别相匹配的38例对照组（正常儿童）进行比较。结果：癫痫组血清IL－2、TNF－α和IFN－α水平均明显高于对照组（P＜0．001）。相关分析发现癫痫患儿血清IL－2与TNF－α水平之间呈显著正相关（γ＝0．441，P＜0．01）。结论：癫痫患儿的免疫系统处于活化状态，细胞因子水平的失衡参与了癫痫的免疫病理过程。     

首发精神分裂症患者血浆细胞因子水平及利培酮治疗的影响

目的探讨利培酮治疗前后首发精神分裂症患者血浆细胞因子水平的变化。方法45例首发精神分裂症患者用固定剂量的利培酮进行6周治疗,采用酶联免疫吸附法(ELISA)对治疗前后血浆白介素2(IL2)、白介素6(IL6)、白介素8(IL8)以及α肿瘤坏死因子(TNFα)进行了检测。以20例健康志愿者为对照。结果治疗前精神分裂症患者血浆IL2、IL6、IL8、TNFα水平均显著高于对照组(t=5.259,P<0.01;t=4.115,P<0.01;t=2.608,P<0.05;t=2.464,P<0.05);治疗后患者组血浆IL2、IL6水平有显著下降(t=3.797、3.387,P<0.01),而IL8和TNFα水平变化不明显(t=0.124、1.119,P>0.05)。结论精神分裂症患者存在IL2、IL6、IL8、TNFα介导的免疫功能紊乱,利培酮可能通过抑制IL2、IL6的生成而对精神分裂症的免疫功能紊乱进行纠正。     

丙戊酸对实验性自身免疫性神经炎大鼠保护作用的机制

目的观察丙戊酸(VAP)对实验性自身免疫性神经炎(EAN)大鼠的保护作用及其机制。方法实验大鼠随机分为VAP高剂量组、VAP低剂量组、EAN模型组、正常组,应用P2 57-81多肽与完全弗氏佐剂的混合液诱导EAN模型。VAP于免疫当天至第15d每天腹腔内注射。观察各组大鼠发病情况和坐骨神经组织病理学变化,检测外周血中Th17细胞和Foxp3+Treg细胞含量,检测淋巴结中TNF-α、IFN-γ、IL-17、TGF-βmRNA表达。结果 VAP高剂量组的最初发病时间迟于EAN组(P<0.05),其高峰期临床评分显著低于EAN组(P<0.05),坐骨神经炎性细胞浸润较EAN组明显减少;VAP高剂量组和低剂量组外周血中Th17细胞比例较EAN组显著减少(P<0.05),Foxp3+Treg细胞比例较EAN组显著增加(P<0.05),淋巴结中促炎细胞因子TNF-α、IFN-γ及IL-17mRNA表达与EAN组比较明显下降(P<0.05),VAP高剂量组抑炎细胞因子TGF-βmRNA表达与EAN组比较明显升高(P<0.05)。结论 VAP对EAN有治疗作用,这种作用可能与其能够增加Foxp3+Treg细胞和抑炎细胞因子TGF-β含量、减少TH17细胞含量和促炎细胞因子的表达有关。     

甲基强的松龙对多发性硬化免疫功能的影响

目的　通过计数细胞因子IFN γ和IL 10分泌细胞 ,检测多发性硬化 (MS)患者外周血单个核细胞IFN γ和IL 10分泌细胞水平 ,观察大剂量甲基强的松龙治疗对MS患者Th1及Th2细胞因子的影响。方法　将外周血单个核细胞暴露于中枢神经系统髓鞘素抗原髓鞘碱性蛋白进行体外短时间培养 ,用酶联免疫斑点试验(ELISPOT)检测IL 10和IFN γ分泌细胞 ,同时检测其他神经病组 (OND)及健康对照组。结果　显示MS患者IFN γ分泌细胞水平高于对照组 ,甲基强的松龙使MS患者IFN γ分泌细胞减少 ,对IL 10分泌细胞无明显影响。结论　MS患者存在Th1 Th2细胞因子的失衡 ,甲基强的松龙能抑制MSTh1类细胞因子IFN γ的产生 ,恢复其两类细胞因子之间的平衡而对MS患者产生治疗作用     

中枢神经系统炎性脱髓鞘患者血清AQP-4抗体与细胞因子的研究

目的研究中枢神经系统炎性脱髓鞘疾病患者血清水通道蛋白(AQP-4)抗体、细胞因子干扰素-γ(IFN-γ)及白细胞介素-4(IL-4)水平,以及AQP-4抗体与IFN-γ和IL-4间的相关性,探讨视神经脊髓炎(NMO)和多发性硬化(MS)的发病机制。方法入选患者共130例,其中NMO患者41例,MS患者59例,临床孤立综合征(CIS)患者15例,其他神经系统疾病患者15例。采用细胞转染的间接免疫荧光法检测患者血清AQP-4抗体滴度,ELISA法检测患者血清IFN-γ和IL-4水平,比较各组患者血清AQP-4抗体、IFN-γ和IL-4水平并分析AQP-4抗体与IFN-γ及IL-4的相关性。结果 NMO组血清AQP-4抗体滴度显著高于MS组、CIS组及其他疾病组(均P0.05),而IFN-γ和IL-4水平与另3组比较差异无统计学意义(均P0.05);MS组血清AQP-4抗体滴度与CIS组及其他疾病组比较差异无统计学意义(均P0.05)。NMO组血清AQP-4抗体滴度与IFN-γ和IL-4呈正相关(r分别为0.36、0.35,均P0.05),MS组血清AQP-4抗体滴度与IFN-γ及IL-4无相关性(r分别为0.03、-0.10,均P0.05)。结论血清AQP-4抗体可用于鉴别NMO和MS及其他炎性脱髓鞘病;NMO患者血清AQP-4抗体增高可能与细胞因子IFN-γ和IL-4有一定关系。     

急性脑血管病合并多器官功能障碍综合征细胞因子变化的研究

目的探讨急性脑血管疾病合并MODS患者血清中细胞因子HMGB-1、TNF-α、IL-6及IFN-γ水平的变化及其意义。方法28例确诊的急性脑血管疾病合并MODS患者(MODS组)、31例单纯脑血管病患者(单纯ACVD组)及健康受试者28例(健康对照组),应用Western blot方法分析其血清HMGB-1水平,ABC-ELISA法测定血清中TNF-α、IL-6及IFN-γ浓度。结果MODS组、单纯ACVD组及健康对照组3组之间比较,血清中HMGB-1、TNF-α及IL-6水平有显著性差异(P<0.05),但MODS组患者血清中IFN-γ水平与单纯ACVD组无显著性差异(P>0.05)。MODS组中脑梗死和脑出血患者组间HMGB-1、TNF-α、IL-6及IFN-γ水平比较无统计学差异(P>0.05)。MODS组患者血清中HMGB-1水平与MODS评分的关系经相关性分析二者之间成正相关(P<0.05),但MODS组患者血清中TNF-α、IL-6、IFN-γ水平与MODS评分无相关性。结论HMGB-1、TNF-α及IL-6可作为预测急性脑血管病发生MODS的指标,干预HMGB-1可能阻止急性脑血管病后MODS的发生。     

脑出血患者血肿周围组织补体激活与炎性反应的相关性研究

目的研究脑出血患者血肿周围组织补体激活与炎性反应的关系。方法对30例脑出血患者(实验组)在手术时于血肿旁约1cm处取少许脑组织,按发病到手术的时间将实验组分为<6h组(6例),6~12h组(7例),12~24h组(5例),24~72h组(6例),>72h组(6例)。从前2组中选7例患者(对照组)在手术入颅路径上远离血肿处取少许脑组织。应用免疫组化染色,逆转录-聚合酶链反应(RT-PCR)分别观察补体C3和补体抑制剂(Clusterin)的表达与炎性细胞的浸润、胶质细胞增生、炎性细胞因子的表达情况。结果与对照组相比,脑出血患者C3表达高峰在12~72h(P<0.05~0.01),Clusterin表达于12~72h有增高趋势,但无统计学意义;炎性细胞浸润从6~12h逐渐明显,12~72h达高峰(P<0.05~0.01);小胶质细胞、星形胶质细胞于24~72h后增生明显(均P<0.01);肿瘤坏死因子-α(TNF-α)表达于12~72h达高峰(P<0.05~0.01),后逐渐降低。RT-PCR显示:TNF-αmRNA的表达与蛋白表达基本一致;白细胞介素(IL)-1β(IL-1β)和IL-6mRNA表达于12~72h达峰值(均P<0.01)。相关因素分析显示:C3表达与炎性细胞浸润和胶质细胞增生及与细胞因子表达呈显著正相关(r=0.42~0.80;P<0.05~0.01),而Clusterin与上述表达无相关性。结论脑出血患者血肿周围组织补体激活与炎性反应有密切关系。     

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。     

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.     

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.     

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.     

《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。     

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。