中国和英国精神科医生对儿童多动行为症状的评估比较

目的 :比较不同文化背景的精神专科医生在评估多动症儿童各种症状表现时的一致程度 ,探讨文化对儿童多动症诊断可能产生的影响。方法 :使用单独或集体行为观察清单 ,让两地的精神科医生对儿童多动症的各种表现进行症状评估 ;所有的评估者均观察同一录像带上患儿的行为表现 ;对其评定结果进行统计和比较。结果 :儿童独自活动观察量表的 12项中有 11项症状条目评定结果类似 ,有 3项英国医生的评分高于中国医生 ,有 9项中国医生评分高于英国医生 ,其中 1项具有显著性差异。结论 :对行为表现和症状认知的文化差异可能使流行病学的研究出现不同的结果 ,即使使用统一的诊断标准和症状评分量表作为诊断工具 ,不同文化背景的国家 ,儿童多动症的患病率仍然可不一致     

2-Amino-4-phosphonobutyrate selectively eliminates late phases of long-term potentiation in rat hippocampus

The possible involvement of 2-amino-4-phosphonobutyrate (APB) recognition sites in mechanisms enabling the maintenance of long-term potentiation (LTP) was investigated in rat hippocampal slices. The action of D(-)- and L(+)-isomers of APB was tested on orthodromic EPSP and spike responses recorded extracellularly from CA1 pyramidal cells. If a moderate concentration (50 microM) of one or the other APB isomer was present during tetanization, posttetanic and early long-term potentiation developed nearly normally. However, from 2h onward LTP of both EPSP and spike potentiation was eliminated in an irreversible manner (8 h experiment). D-APB (L-isomer not tested) applied shortly after tetanization caused nearly the same delayed decline of LTP. No consistent effects of APB were seen in non-tetanized slices. Considering previous findings these data suggest that besides the obligatory NMDA receptor activation an APB-sensitive component expressed during and after tetanization is a necessary step for subsequent mechanisms enabling the late maintenance of LTP.     

Transient increase of raf protein kinase-like immunoreactivity in the rat dentate gyrus during long-term potentiation

Altered levels of cellular raf proteins (products of the raf protooncogenes) have been shown in the neurons of the dentate fascia of rats in response to high-frequency stimulation, with light microscopic immunohistochemistry by using polyclonal antibodies. No raf-1-like staining was seen in unstimulated tissue, while the pan-raf antibodies revealed immunoreactivity in the cytoplasm of neurons in the Ammon's horn and dentate fascia of rats and guinea pigs. The induction of long-term potentiation in the dentate fascia of freely-moving rats triggered the appearance of raf-1-like staining and increased the number of granule cells with pan-raf-like immunoreactivity. Since these proteins are serine/threonine-specific protein kinases, their appearance in long-term potentiation may indicate the activation of important cell membrane - nucleus transduction pathways.     

Neuropilin-1 Participates in Wound Angiogenesis

Angiogenesis, the formation of new capillaries from existing vasculature, plays an essential role in tissue repair. The rapid onset and predominance of proangiogenic factors optimizes healing in damaged tissues. One factor that directly mediates wound vessel angiogenesis is vascular endothelial growth factor (VEGF). Although much is known about the biology of VEGF and its cognate receptors, VEGFR1 and VEGFR2, the role of a recently identified co-receptor for VEGF, neuropilin-1, is not well understood. Using a murine model of dermal wound repair, we found that neuropilin-1 was abundantly expressed on new vasculature in healing wounds. Moreover, mice treated with anti-neuropilin-1 antibodies exhibited a significant decrease in vascular density within these wounds (67% decrease, P = 0.0132). In in vitro assays, VEGF induced formation of endothelial cord-like structures on collagen gel and endothelial cell migration toward VEGF was inhibited by antibodies directed against neuropilin-1. These results provide both in vitro and in vivo evidence for a critical role of neuropilin-1 in wound angiogenesis.     

Interleukin pattern, procalcitonin level and cellular immune status after endovascular aneurysm surgery

Endovascular repair of AAA's using stent grafts is considered to be a minimally invasive procedure. However, in some cases deleterious inflammatory reactions, e.g., flu-like postinterventional symptoms are observed. A few patients even develop a fatal "postimplantation syndrome". It is not clear whether these postoperative complications result from a) the inflammatory and immune response to the inserted graft material, b) alterations of the vascular endothelium during the implantation procedure, c) residual thrombotic material, or d) a combination of all these causes. This clinical trial aimed to prospectively investigate the association between inflammatory mediators like interleukin-1 receptor antagonist (IL-1RA), IL-6, and HLA-DR expression on monocytes and clinical outcome in patients after repair of abdominal aortic aneurysms (AAA). Fifteen patients treated with endovascular stent grafts for abdominal aortic aneurysm (AAA-E) were compared with 15 selected control patients who underwent a conventional surgical procedure (AAA-K) during the same period. Prior to intervention, there were no significant differences in marker levels. One hour postoperatively, IL-6 (421 pg/ml vs. 21 pg/ml) and IL-1RA (10,061 pg/ml versus 407 pg/ml) were significantly increased in the AAA-K-group, whereas in AAA-E patients, these parameters increased more gradually during the first postoperative day and did not reach the same level as in the control group. There was only a slight reduction of HLA-DR expression in both groups compared with baseline and no signs indicating a postimplantation syndrome were found. No excessive inflammatory response or complicated final outcome were observed. It is unclear if this can be explained by the prophylactic use of indometacin.     

Colorectal liver metastases: Current management and future perspectives

The liver is the commonest site of metastatic disease for patients with colorectal cancer, with at least 25% developing colorectal liver metastases (CRLM) during the course of their illness. The management of CRLM has evolved into a complex field requiring input from experienced members of a multi-disciplinary team involving radiology (cross sectional, nuclear medicine and interventional), Oncology, Liver surgery, Colorectal surgery, and Histopathology. Patient management is based on assessment of sophisticated clinical, radiological and biomarker information. Despite incomplete evidence in this very heterogeneous patient group, maximising resection of CRLM using all available techniques remains a key objective and provides the best chance of long-term survival and cure. To this end, liver resection is maximised by the use of downsizing chemotherapy, optimisation of liver remnant by portal vein embolization, associating liver partition and portal vein ligation for staged hepatectomy, and combining resection with ablation, in the context of improvements in the functional assessment of the future remnant liver. Liver resection may safely be carried out laparoscopically or open, and synchronously with, or before, colorectal surgery in selected patients. For unresectable patients, treatment options including systemic chemotherapy, targeted biological agents, intra-arterial infusion or bead delivered chemotherapy, tumour ablation, stereotactic radiotherapy, and selective internal radiotherapy contribute to improve survival and may convert initially unresectable patients to operability. Currently evolving areas include biomarker characterisation of tumours, the development of novel systemic agents targeting specific oncogenic pathways, and the potential re-emergence of radical surgical options such as liver transplantation.     

Alterations in calmodulin content in fractions of rat hippocampal slices during tetanic- and calcium-induced long-term potentiation

The content of cytosolic and membrane-bound calmodulin was radioimmunologically determined in fractions of rat hippocampal slices 5 min to 7 hours after long-term potentiation (LTP) had been induced by tetanization or exposure of slices to 4 mM Ca++. In light of concepts presuming multistage dynamics in LTP development as reflecting different cellular mechanisms, similar patterns of calmodulin alterations were observed with both models: The alterations in calmodulin content occurred during the early phase(s) of LTP development and continued for two and one hours during tetanic- and calcium-induced LTP, respectively. Thus, 5-30 min after LTP elicitation, membrane-bound calmodulin increased while cytosolic calmodulin diminished and, inversely, 30 min later an increase in cytosolic and decrease in membrane-bound calmodulin were observed. Consequently, the present results indicate that calmodulin was involved in the early phases(s) of LTP development in terms of a two-step translocation sequence. Hence, calmodulin translocation within both intracellular compartments may reflect the involvement of Ca++-calmodulin-dependent intraneuronal metabolic processes which might induce and/or temporarily maintain neuronal functional changes occurring immediately after repeated or intense stimulation of synaptic functions.     

多层螺旋CT评价先天性单冠状动脉畸形

目的 探讨16层螺旋CT（MSCT）冠状动脉造影诊断先天性单冠状动脉畸形的价值。资料与方法 回顾性分析4例先天性单冠状动脉患者的MSCT和常规X线冠状动脉造影（CCA）资料。对比两者在显示和诊断此病中的差异。仿真内镜技术用于评价异位开口及其与邻近正常冠状动脉开口的关系,多平面重建、曲面多平面重建、最大密度投影、容积成像等重建方法则用于评价变异冠状动脉的行径及其与邻近大血管的关系。结果 4例患者变异的冠状动脉全部为MSCT造影所显示并明确诊断。MSCT显示3例患者的左主干起源于右冠状动脉的近段,其中1例在CCA中左主干仅近段局部显影,未能明确诊断,另2例左冠状动脉虽显影,但较淡。1例右冠状动脉起源于左主干的末端,CCA则误为起源于回旋支。MSCT显示2例异常开口冠状动脉的近段狭窄,3支异常冠状动脉穿过主动脉根部和肺动脉或右室流出道的间隙,1支绕主动脉根部后方走行,而CCA均不能明确诊断。结论 MSCT显示先天性单冠状动脉明显优于CCA,凡疑及冠状动脉变异的患者,可首选非创伤性的MSCT冠状动脉造影检查。