Hippocampal Glycogen Synthase Kinase 3β is Critical for the Antidepressant Effect of Cyclin-Dependent Kinase 5 Inhibitor in Rats

Cdk5 is a member of cyclin-dependent kinase (Cdk), a proline-directed serine/threonine kinase, and plays a key role in normal neural development and function. Evidence of previous study showed that chronic inhibition of Cdk5 in hippocampal dentate gyrus (DG) blocked the development of depressive-like symptoms, suggesting that Cdk5 plays a role in development of depression. Forced swim test, novelty-suppressed feeding test, and learned helplessness were used to evaluate the cellular and molecular mechanisms underlying the behavioral regulation of Cdk5 inhibitors in rats. Two Cdk5 inhibitors butyrolactone and roscovitine were used to investigate the possible antidepressant-like actions of Cdk5 blockade and the potential mechanisms. Systemic administration of butyrolactone (200 mg/kg, IP) or roscovitine (100 mg/kg, IP) produced effective antidepressant-like actions. Moreover, infusion (5 mM) of GSK3β activator LY294002 into DG abolished the antidepressant-like actions of butyrolactone and roscovitine, suggesting that inhibition of GSK3β might be involved in the antidepressant effect of Cdk5 inhibitors. Moreover, pretreatment of LY294002 (5 mM) blocked the antidepressant-like effect of butyrolactone and roscovitine in learned helplessness. Additionally, inescapable footshock induced a significant increase of GSK3β activity, while butyrolactone and roscovitine decreased GSK3β activity. In contrast, pretreatment of LY294002 prevented the inhibitory effects of butyrolactone and roscovitine on GSK3β activation. Finally, a specific GSK3β inhibitor, SB216763 (1 ng, DG), demonstrated an effective antidepressant-like action. These findings demonstrate that systemic administration of Cdk5 inhibitors produced antidepressant-like actions and that inhibition of GSK3β is involved in behavioral response of Cdk5 inhibitors.     

不同类型基底动脉闭塞机械取栓的疗效观察

目的评价机械取栓治疗不同类型基底动脉(BA)闭塞的疗效。方法回顾性分析2013年9月至2019年9月海军军医大学附属长海医院脑血管病中心连续收治的95例行机械取栓治疗的BA闭塞患者的临床资料。根据BA闭塞是否为串联病变,分为非串联病变组(67例)和串联病变组(28例)。比较两组血管成功再通(改良脑梗死溶栓分级2b~3级)的比例、90 d预后良好(改良Rankin量表评分为0~3分)的比例、术中挽救措施及不良事件发生率等的差异。结果与非串联病变组相比,串联病变组的年龄偏低(P=0.002),而男性(P=0.009)、有吸烟史(P=0.014)、缺血性卒中TOAST分型为大动脉粥样硬化型(P=0.001)以及存在一侧椎动脉发育不良(P=0.036)的比例更高。两组患者在术前及术后24 h的美国国立卫生院卒中量表评分、股动脉穿刺至BA再灌注时间、血管成功再通比例及90 d预后良好比例方面的差异均无统计学意义(均P>0.05)。串联病变组的发病至就诊时间(P=0.049)、发病至BA再灌注时间(P=0.046)均较非串联病变组延长,且术中挽救措施(包括单纯球囊扩张、急诊支架置入、静脉应用替罗非班)的使用比例均更高(均P<0.05)。两组在手术相关的不良事件及病死率方面的差异均无统计学意义(均P>0.05)。结论对于不同类型的BA闭塞患者,应用机械取栓治疗的临床结局及不良事件的发生率无明显差异,但该结论仍需进一步扩大样本量或进行随机对照试验加以证实。     

Comparison of Tc-99m MAA Planar Versus SPECT/CT Imaging for Lung Shunt Fraction Evaluation Prior to Y-90 Radioembolization: Are We Overestimating Lung Shunt Fraction?

CardioVascular and Interventional Radiology - To compare lung shunt fraction (LSF) prior to Y-90 radioembolization calculated using planar imaging versus SPECT/CT in patients with hepatocellular...     

PFNA置入位点设计对股骨粗隆间骨折患者疗效及安全性的影响

目的 探讨不同置入位点对股骨粗隆间骨折(IFF)患者股骨近端防旋髓内钉(PFNA)手术有效性及安全性的影响.方法 回顾性分析2015年3月—2018年11月常州市金坛区人民医院收治IFF患者122例,男性85例,女性37例;年龄60～79岁,平均70.1岁.按手术方式不同分为定位点内移组(63例)和PFNA组(59例).PFNA组行传统PFNA进针点置入髓内钉,定位点内移组则由传统PFNA定位点内移0.5～0.8cm置入髓内钉.比较两组患者围手术期指标、髓内钉一次置入成功率、术中透视次数,随访6个月采用Harris髋关节功能评分评价两组患者髋关节功能,并记录并发症情况.结果 两组患者住院时间和首次负重时间比较差异无统计学意义(P>0.05);定位点内移组手术时间、术中出血量、术中透视次数、骨折愈合时间均显著少于PFNA组[(63.55±17.81)min vs.(82.74±20.66)min、(41.22±12.69)mL vs.(63.58±14.59)mL、(5.13±1.77)次vs.(7.26±1.58)次、(4.12±1.33)个月vs.(5.14±1.27)个月,P<0.05].定位点内移组导针一次性置入成功率显著高于PFNA组(96.83％vs.84.75％),组间比较差异均有统计学意义(P<0.05).随访6个月,两组患者髋关节Harris评分优良率(93.65％vs.94.92％)比较差异无统计学意义(P>0.05).定位点内移组出现内固定物松动、断裂、螺旋刀片切割股骨头、髋内翻、骨折移位等并发症比例与PFNA组比较差异无统计学意义(P>0.05).结论 在PFNA术中将传统定位点内移0.5～0.8cm能够提高髓内钉一次性置入成功率,缩短手术时间,减少出血,避免术中多次透视,安全可靠.     

重症腰椎间盘突出症非手术治疗方法探讨及影像学分析

自1996年起我们运用腰椎牵抖整复及下肢拔伸、压腿等方法治疗82例腰椎间盘突出较巨大(突出物高度大于8 mm)临床疼痛症状明显、但因各种原因难以行手术的患者,取得比较满意的效果,现报告如下.……     

通用脊柱内固定系统治疗腰椎滑脱症

自2000年5月开始,采用椎板减压、横突间植骨融合及通用脊柱内固定系统[1](Universal spine system,USS)治疗23例腰椎滑脱症患者.具有早期随访临床疗效满意,复位效果良好,并发症少等优点,总结如下.……     

单纯髌骨腱膜缝合术治疗髌骨骨折44例

目的 讨论单纯髌腱缝合术治疗髌骨骨折压应力、张应力、聚合力的关系。方法 采用单纯髌前腱膜缝合术治疗髌骨骨 折44例,术后患肢165°～175°半屈曲位固定。结果 术后3个月功能恢复情况与髌骨内固定半年后膝关节活动功能相当。结 论 单纯髌前腱膜缝合术方法简单、能促进膝关节功能早期恢复及不需二次手术取内固定的优点。     

A 1470-nm laser combined with foam sclerotherapy in day surgery: a better choice for lower limb varicose veins

Day surgery is being more and more adopted by clinicians. Higher wavelength lasers give patients better experience than lower wavelength lasers, which makes it more suitable for day surgery. This study compares the short- and mid-term efficacy, postoperative morbidity, and patient satisfaction of “1470-nm endovenous laser ablation (EVLA) combining foam sclerotherapy in day surgery” with “810-nm EVLA with high ligation combining foam sclerotherapy in hospital surgery” on great saphenous vein (GSV) insufficiency postoperatively. A single-institution historical cohort study of 194 patients was performed in Shanghai Ninth People’s Hospital, China. Ninety-seven patients received 1470-nm EVLA combining foam sclerotherapy in day surgery (“1470-nm group”), and 97 patients received 810-nm EVLA with high ligation combining foam sclerotherapy in hospital surgery recommended by guidelines (“810-nm group”). No significant difference was found between the 1470-nm group and the 810-nm group in terms of GSV occlusion rate (both 100%), complication rate, and recurrence rate (8.2 vs. 11.3%) during the period of 1–12 months after surgery. Serious complications in the 1470-nm group and 810-nm group were 0 and 1.0%. Minor complications in the 1470-nm group and 810-nm group were ecchymosis at 20.6 and 18.6%, edema at 69.1 and 63.9%, and paresthesia around ankle at 0 and 3.1%, respectively. Advantage of the 1470-nm group over the 810-nm group was statistically significant considering the patient perioperative comfort and economic cost. Treatment of 1470-nm EVLA combining foam sclerotherapy in day surgery has similar efficacy as the 810-nm EVLA with high ligation combining foam sclerotherapy in hospital surgery in GSV insufficiency and is more comfortable with less incision, hospitalization procedure, and medical costs. It may be a new option for patients who are afraid or unable to be hospitalized.