抑郁症患者治疗前后血浆皮质醇水平的变化

目的:探讨抑郁症患者治疗前后血浆皮质醇水平的变化。方法:对160例抑郁症患者给予抗抑郁药治疗6周,分别于治疗前及治疗后进行汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评估及血浆皮质醇水平检测。结果:本组治疗前后HAMD总分分别为(24.98±5.10)和(7.57±5.61);HAMA总分分别为(20.62±6.90)和(6.21±5.17);血浆皮质醇水平分别为(407.34±144.29)nmol/L和(354.64±137.13)nmol/L。治疗后HAMD总分、HAMA总分及血浆皮质醇水平较治疗前明显下降(P均<0.001);不同性别间血浆皮质醇水平差异无统计学意义(P>0.05);血浆皮质醇变化值与HAMD、HAMA减分率不相关(r=0.084,r=0.049;P均>0.05)。结论:抗抑郁药物治疗可显著降低抑郁症患者血浆皮质醇水平。     

脑梗死后认知功能障碍的相关因素分析

目的 探讨脑梗死后认知功能障碍的相关因素.方法 选取入住我院的127例脑梗死患者作为脑梗死组,83例正常人群为对照组,简易精神状态评分测定认知功能,分析脑梗死后影响认知功能障碍的相关因素.结果 对照组中,认知功能障碍者12例,发生率为14.5%.脑梗死组中,认知功能障碍者97例,发生率达76.3%,2组比较,差异有统计学意义.本研究中年龄、性别、高血压和冠心病与脑梗死后认知功能障碍无显著相关性.文化程度、运动与否、交流沟通与脑梗死后认知功能障碍呈负相关,而发病次数和并发糖尿病与脑梗死后认知功能障碍呈正相关性.结论 脑梗死后认知功能障碍与文化程度、运动、交流、发病次数和并发糖尿病密切相关.     

Ki-67 overexpression in WHO grade II gliomas is associated with poor postoperative seizure control

PurposeSeizures are the most common initial symptom in patients with low-grade gliomas, and approximately 30% of these patients still suffer from epilepsy after gross-total resection of the tumour. We examined the relationship between the overexpression of ki-67 in WHO grade II gliomas and seizure control.MethodsA series of 93 histologically confirmed WHO grade II glioma tissues were analysed through immunohistochemical staining for ki-67 expression. Follow-up visits regarding seizure control were scheduled at 12 months. The Engel classification was used to categorise patients’ seizure status.ResultsOf the 93 patients analysed, 65 (66.3%) patients initially presented with seizures. A total of 36 patients were diagnosed with WHO grade II oligodendrogliomas, 29 patients had oligoastrocytomas and 28 patients had astrocytomas. Ki-67 was over-expressed in 15 patients. One year after surgery poor seizure control was observed in 11 of these patients. In contrast, low ki-67 expression (<10%) was found in 78 patients. Poor seizure control was observed in 36 patients (difference between ki-67 over- and low expression groups P = 0.002). Logistic regression analysis revealed that patients with gross-total resection achieved better seizure control while ki-67 overexpression and age below 38 years were poor seizure control factors explained of the variance of seizure outcome (OR: 0.382, 4.354 and 1.822, respectively).ConclusionsIn WHO grade II gliomas, Ki-67 is a molecular marker which predicts poor seizure control of glioma patients after the resection of the tumour. Gross-total resection, ki-67 overexpression and age below 38 years significantly affect seizure prognosis.     

Electrophysiological and behavioral effects of group III metabotropic glutamate receptors on pallidal neurons in normal and parkinsonian rats

The globus pallidus plays a critical role in movement regulation. Glutamate being an important excitatory neurotransmitter modulates the activity of pallidal neurons through both ionotropic and metabotropic glutamate receptors (mGluRs). Morphological studies have shown that group III mGluRs are generally located presynaptically in the globus pallidus. Up to now, little is known about the in vivo electrophysiological effects of group III mGluRs on the pallidal neurons. This study investigated the electrophysiological and behavioral effects of group III mGluRs on pallidal neurons in both normal and 6‐hydroxydopamine (6‐OHDA) lesioned parkinsonian rats. Micropressure ejection of group III mGluR agonist, l ‐2‐amino‐4‐phosphonobutyrate (l ‐AP4), increased or decreased the firing rate of pallidal neurons in both normal and parkinsonian rats. The l ‐AP4‐induced excitatory effects on the lesioned side of parkinsonian rats (117.4 ± 17.2%) were stronger than that in normal rats (64.3 ± 10.1%). While the proportion of neurons that were unresponsive to l ‐AP4 on the lesioned side of parkinsonian rats (50%) was more than that of normal rats (13%). Unilateral microinjection of l ‐AP4 into the globus pallidus induced a contralateral dystonic posturing in the presence of systemic haloperidol administration. The selective group III mGluRs antagonist, (RS)‐α‐cyclopropyl‐4‐phosphonophenylglycine, had no effect on pallidal neurons when used alone and could block both l ‐AP4‐induced electrophysiological and behavioral effects. Combining electrophysiological and behavioral findings, we concluded that activation of group III mGluRs modulate the activity of pallidal neurons under both normal and parkinsonian state. Synapse 67:831–838, 2013 . © 2013 Wiley Periodicals, Inc.     

A review of healthcare service and education provision of Autism Spectrum Condition in mainland China

Little is known about the current situation regarding Autism Spectrum Conditions in mainland China. Electronic databases and bibliographies were searched to identify literature on service provision for ASC in both English and Chinese databases. 14 studies and 6 reports were reviewed. The findings of identified papers on service provision were summarized according to four settings for ASC including healthcare, mainstream education, private special education, and state-run special education. The literature on the situation of the healthcare system and educational services for children with ASC in China was profoundly limited. There were great financial problems faced by the parents of autistic children which were partly due to the under-developed healthcare and educational system for ASC.     

Suicide attempt and suicidal ideation and their associations with demographic and clinical correlates and quality of life in Chinese schizophrenia patients

Objectives

This study aimed to examine the prevalence and correlates of lifetime suicide attempts and current suicidal ideation in community-dwelling schizophrenia patients in China.

Method

A sample of 540 schizophrenia patients was randomly selected in Beijing, China. All subjects were interviewed using standardized assessment instruments and their basic socio-demographic and clinical data including history of suicide attempts were collected.

Results

The prevalence of lifetime suicide attempts and the point prevalence of suicidal ideation were 12.0 %, and 21.1 %, respectively. In multiple logistic regression analyses, the presence of lifetime suicide attempt was independently associated with rural residence, having major medical conditions and better social functioning, while higher likelihood of current suicidal ideation was associated with past suicide attempt, the severity of overall psychopathology and depressive symptoms and lower psychological quality of life (QOL).

Conclusion

Among Chinese outpatients with schizophrenia, increased current symptoms and poorer QOL were correlated with current suicidal ideation, while demographic factors and indicators of greater social support were mostly correlated with lifetime suicide attempts. This study may help to identify important subgroups of patients with schizophrenia at particularly high risk of suicidal behavior.     

Expression patterns and potential roles of SIRT1 in human medulloblastoma cells in vivo and in vitro

Medulloblastoma is a primitive neuroectodermal tumor, which originates in the cerebellum, presumably due to the alterations of some neurogenetic elements. Sirtuin 1 (SIRT1), a class III histone deacetylase (HDAC), regulates differentiation of neuronal stem cells but its status in medulloblastomas remains largely unknown. The current study aimed to address this issue by checking SIRT1 expression in noncancerous cerebellar tissues, medulloblastoma tissues and established cell lines. The roles of SIRT1 in proliferation and survival of UW228‐3 medulloblastoma cells were analyzed by SIRT1 small interfering RNA (siRNA) transfection and SIRT1 inhibitor nicotinamide treatment. The results revealed that the frequency of SIRT1 expression in medulloblastoma tissues was 64.17% (77/120), while only one out of seven tumor‐surrounding noncancerous cerebellar tissues showed restricted SIRT1 expression in the cells within the granule layer. Of the three morphological subtypes, the rates of SIRT1 detection in the large cell/anaplastic cell (79.07%; 34/43) and the classic medulloblastomas (60.29%; 41/68) are higher than that (22.22%; 2/9) in nodular/desmoplastic medulloblastomas (P < 0.01 and P < 0.05, respectively). Heterogeneous SIRT1 expression was commonly observed in classic medulloblastoma. Inhibition of SIRT1 expression by siRNA arrested 64.96% of UW228‐3 medulloblastoma cells in the gap 1 (G1) phase and induced 14.53% of cells to apoptosis at the 48‐h time point. Similarly, inhibition of SIRT1 enzymatic activity with nicotinamide brought about G1 arrest and apoptosis in a dose‐related fashion. Our data thus indicate: (i) that SIRT1 may act as a G1‐phase promoter and a survival factor in medulloblastoma cells; and (ii) that SIRT1 expression is correlated with the formation and prognosis of human medulloblastomas. In this context, SIRT1 would be a potential therapeutic target of medulloblastomas.     

前纵裂入路显微手术切除鞍上脑室内外型颅咽管瘤

目的 探讨前纵裂入路在鞍上脑室内外型颅咽管瘤显微手术切除中的应用,并比较与其他手术入路的优缺点.方法 回顾性分析22例采用前纵裂入路显微手术切除鞍上脑室内外型大型颅咽管瘤患者,分析手术技巧及术后效果.结果 肿瘤全切20例,次全切除2例,无手术死亡病例.术后发生电解质紊乱15例,尿量增多17例,2-7周后好转,术后1周内视力好转15例.随访6-60个月,肿瘤复发2例,均为12个月内复发.结论 前纵裂入路可直视下处理肿瘤在垂体漏斗部位的粘连,是鞍上脑室内外型颅咽管瘤较好的手术入路.     

Guided bone regeneration using collagen membranes for sinus augmentation

We investigated the effect of guided bony regeneration using collagen membranes for sinus augmentation in the first maxillary molars of 18 adult female beagle dogs. The teeth were extracted bilaterally and the sinus floors were lifted with simultaneous implantation. The grafted material composed of a combination of autografts and Bio-oss in a 2:1 ratio. On the experimental side in each dog, collagen membrane was folded at the lateral osteotomy window, at the apex of the implants, and at a certain part of the palatal bone. On the opposite (control) side, the collagen membrane covered the osteotomy window. Six animals were killed at each of 4, 12, and 24 weeks postoperatively. Gross observation, biomechanical testing, and histological examinations were made. On the experimental side, grafted materials showed no obvious resorption or subsidence, and a new bone had formed at the apex of the implants. On the control side, the grafted materials had been shifted and absorbed. Histological examination showed increased formation of a new bone in the experimental group, which matured over time. At 4 weeks, inflammatory cells were present in the control group, which showed less maturation of the new bone. The pull-out force increased with time and, at week 24, there was a significant difference in pull-out force between the two groups (p<0.01). Guided bony regeneration with the enfolded coverage of membrane can effectively reduce resorption of grafted bone on the apical surface of implants and stimulate formation of the new bone in sinus augmentation.