The prevalence of dementia and Alzheimer's disease in Shanghai, China: impact of age, gender, and education

We report the prevalence rates for dementia and Alzheimer's disease (AD) obtained from a probability sample survey of 5,055 noninstitutionalized older persons in Shanghai, China. A two-stage procedure was used for case finding and case identification. A Chinese version of the Mini-Mental State Examination was used to determine cases of possible dementia. Three different cutoff points on this mental status test were used depending on the respondent's level of education. Clinical evaluations, based on functional assessments and psychiatric interview, medical and neurological examinations, three standardized mental status tests, and a selected group of psychometric tests, were made in the second stage of the study to ascertain the clinical diagnosis of dementia and AD utilizing the Diagnostic and Statistical Manual for Mental Disorders, edition 3 and National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria, respectively. The prevalence rate of dementia in persons 65 years and older was 4.6%. Clinically diagnosed AD accounted for 65% of the subjects with dementia. These findings indicate that the prevalence of dementia in Shanghai is very much higher than figures published earlier for China and Japan, and at the lower part of the range of values reported for community residents in the United States and other Western countries, but less than half of that reported in the recently published survey of the elderly in East Boston. Increasing age, gender (female), and low education are each highly significant and independent risk factors for dementia. One hypothesis to explain the increased prevalence in elderly women who had received no formal education invokes the possibility of an effect of early deprivation, perhaps lowering brain "reserve," allowing the symptoms of dementia to appear at an earlier date during disease progression.     

2型糖尿病及其血管并发症患者血清ACE活性的变化

This investigation was made with reference to the changes of serum angiotensin converting enzyme (SACE) activity in type 2 diabetes and its vascular complications. SACE activity was studied in 127 type 2 diabetic patients and 90 healthy persons by using a spectrophotometric assay. The results showed SACE activity was obviously higher in diabetic patients (459.51 +/- 175.85 U) than in healthy persons (321.14 +/- 121.27 U); SACE activity was significantly higher in type 2 diabetic patients with diabetic nephropathy (548.27 +/- 166.60 U) than in patients without diabetic nephropathy (383.2 +/- 139.00 U), but there was no difference between patients with microalbuminuria and macroalbuminuria; no statistical difference was detected in SACE activity between diabetic patients with diabetic retinopathy (465.64 +/- 178.93 U) and without retinopathy (449.07 +/- 170.04 U); SACE activity was not associated with the course of diabetes, blood pressure, blood lipid and blood glucose. These data suggest that raised SACE activity might only play a role in the initiation of type 2 diabetes and diabetic nephropathy, but not relate to the progress of diabetic nephropathy, the onset of diabetic retinopathy and hypertension.     

Urban-rural comparison of HBV and HCV infection prevalence in eastern China

The present study was initiated to make and urban-rural comparison of the prevalence of cases positive to hepatitis B and C virus(HBV and HCV,respectively)infection markers in densely populated eastern half of China.For this purpose.10 survey sites were selected,i.e.,six sites in urban areas(the city group;Beijing,shangahi and four provincial capitals)and four sites in rural areas(the village group;one village each in Jilin and Shandong provinces,and two villages in Shaanxi Province),About 50 adult women per site volunteered to participate,from whom 494 valid bllod samples were collected.Positivities to HBsAg(HBsAg^ ),anti-HBs(anti-HBs^ )and antiHBc(anti-HBc^ )were examined by RIA methods.and that to anti-HCV(anti-HCV^ )by either EIA or RIA.Those positive to any one of the three HBV infection markers were taken as HBV infection-positive(HBV^ ).The prevalence of HBsAg^ ,HBV^ and anti-HBc^ was 8%,70%and 2.7% in the city group,and 8%,65% and 2.0%in the village group,and no significant difference was found between the two groups.The overall prevalence was 8% for HBsAg^ ,68% for HBV^ ,and 2.4% for anti-HVC^ ,The results were discussed in reference to some 20 papers each on HBV^ and anti-HCV^ prevalence in China published since(1991),The reviewing of these papers of anti-HCV was low(well below 5%),and that no substantial difference was found between the rural and urban populations.     

Effects of intraperitoneal Ringer's lactate instillation and infusion on postsurgical adhesion formation

We compared the effects of continuous Ringer's lactate infusion and Ringer's lactate instillation on postsurgical adhesion formation in the rat model. The results show that intraperitoneal Ringer's lactate instillation reduces postsurgical adhesions. However, its efficacy is not improved by additional infusion of Ringer's lactate.     

α1-抗糜蛋白酶基因、早老素1基因 与阿尔茨海默病的相关分析

目的探讨中国汉族人中α１抗糜蛋白酶（ＡＡＣＴ）基因、早老素１（ＰＳ１）基因多态性与阿尔茨海默病（Ａｌｚｈｅｉｍｅｒｓｄｉｓｅａｓｅ,ＡＤ）的相关情况。方法应用ＰＣＲＲＦＬＰ方法,在１２３例患者和１４０例正常人中观察ＡＡＣＴ信号肽和ＰＳ１基因多态性的分布,进行关联分析。结果１ＡＤ患者与ＰＳ１基因等位基因１正关联,与等位基因２和基因型２／２负关联,但与１／１基因型无关;２ＡＡＣＴ信号肽基因多态性与ＡＤ无关联;３在三种ＰＳ１基因型中,ＡＡＣＴ信号肽基因多态性与ＡＤ均无关;４在ＡＡＣＴ基因ＡＡ、ＴＴ基因型中,ＰＳ１基因多态性与ＡＤ负关联,而ＴＡ型中ＰＳ１基因与ＡＤ无显著相关。结论中国人群中,ＡＤ与ＰＳ１基因２／２型负关联,而与ＡＡＣＴ信号肽基因多态性无关;ＡＡＣＴ信号肽和ＰＳ１基因多态性之间也无明显的相互影响。     

Decreased glutamate metabolism in cultured astrocytes in the presence of thiopental.

The effect of thiopental on glutamate metabolism was studied by 13C magnetic resonance spectroscopy. Cerebral cortical astrocytes were incubated with 0.5 mM [U-13C]glutamate for 2 hr in the presence of 0.5 or 1 mM thiopental. Labeled glutamate, glutamine, aspartate, and glutathione were observed in cell extracts, and glutamine, aspartate, and lactate in the medium. Not only present in the medium was uniformly labeled glutamate, but also glutamate derived from the tricarboxylic acid (TCA) cycle, and thus glutamate release could be detected. The amounts of [U-13C]glutamate and unlabeled glucose taken up by astrocytes were unchanged in the presence of 0.5 mM thiopental and decreased to about 50% and 80%, respectively when the concentration was increased to 1 mM. The amounts of most metabolites synthesized from [U-13C]glutamate were unchanged in the presence of 0.5 mM thiopental, but decreased [U-13C]glutamine, [U-13C]aspartate, and [U-13C]lactate were observed in the 1 mM group. Surprisingly, the amounts of [1,2,3-13C]glutamate, [2,3-13C]aspartate, and [3,4-13C]aspartate (2nd turn via the TCA cycle) were unchanged. However, this was not the case for [1,2-13C]lactate and [2,3-13C]lactate. Such variations indicate cellular compartmentation, possibly caused by a heterogeneous glutamate concentration within the cells affecting TCA cycle turnover rates differently.     

Molecular basis of defective anion transport in L cells expressing recombinant forms of CFTR

Cystic fibrosis (CF) is caused by mutations in the gene encodinga chloride channel called the CF transmembrane conductance regulator(CFTR). A single mutation in this gene, deletion of three nucleotidesthat leads to the absence of phenylalanine 508 (i.e., F508),is found on 70% of all CF chromosomes. To explore the molecularmechanism(s) responsible for defective chloride transport inpatients with CF, we have studied the processing, localization,and function of wild type (W.T.), F508 and G551D CFTR (a GDmissense mutation at position 551) in retrovirus transducedL cells. Cell transduced with W.T. CFTR expressed a 170 kd CFTRprotein that was endoglycosidase H (Endo H) resistant, localizedto the plasma membrane, and generated a cAMP-mediated anionconductance (G_Cl) when stimulated with standard concentrationsof forskolin (5 µM), cpt cAMP (400 µM) and IBMX(100 µM). The G551D CFTR was indistinguishable from W.T.CFTR with respect to post-translational processing and localization,but it did not produce a cAMP-activated G_CI in response to thestandard stimulation cocktail. However, raising the IBMX concentrationto 4 mM produced Gc, in G551D expressing cells. Cells transducedwith F508 CFTR expressed an Endo H sensitive CFTR protein (140kd) that was found in a cytosolic, perinuclear location. Thesecells did not respond to the standard cocktail, but 20% of cellsincreased G_CI when the cocktail contained 4 mM IBMX. Incubationof cells at 26°C for 48 hours prior to analysis elicitedresponses in F508 expressing cells at low IBMX concentrations,but had no effect on the responses of cells expressing W.T.or G551D CFTR. The response of F508 to 26°C was associatedwith plasma membrane localization of CFTR protein. These resultssuggest that there are two mechanisms whereby CFTR mutationslead to loss of cAMP-responsive GCI. First, shown by G551D CFTR,the protein can be processed and targeted to the plasma membranecorrectly, but lack full responsiveness to stimulation by cAMP.Second, as examplified by F508 CFTR, a partially functionalprotein which is not targeted to its correct cellular locationcan also lead to loss of the cAMP, responsive G_CI.     

透明质酸在宫颈上皮及宫颈癌组织中的表达

目的 :探讨透明质酸 (HA)在正常宫颈上皮及宫颈癌中的表达及其与肿瘤发生发展的关系。方法 :用免疫组化法检测 5 9例宫颈浸润癌、35例宫颈上皮内瘤样病变 (CIN)及11例正常宫颈组织中HA和CD4 4v6的表达。结果 :正常宫颈上皮不表达HA。慢性炎症者上皮底层细胞以及细胞间质表达HA ,随病变加重及CIN发生 ,HA表达增强。癌旁组织的上皮细胞HA呈强阳性表达 ,伴有基质HA强阳性染色。癌细胞HA阳性率为 6 7.2 7% ,与病理类型有关 ,角化癌高表达 ,而腺癌不表达 ,在低分化鳞癌中多见不规则灶性HA阴性区。宫颈鳞癌的肿瘤基质HA表达普遍增强。肿瘤基质的HA表达与CD4 4v6呈正相关。结论 :正常宫颈上皮不表达HA ,但炎症与致瘤因素可促使HA表达 ,HA的代谢失衡可能与宫颈癌的发生及浸润行为有关     

氯硝安定与安定溶液直肠给药用于惊厥急救的对照研究

目的以安定为对照，探讨氯硝安定溶液直肠给药对惊厥急救的实用价值。方法在２８例儿童中对比观察直肠注入氯硝安定与安定溶液的吸收速度和对脑电活动的影响，并比较两药对大鼠实验性惊厥的疗效。结果氯硝安定与安定溶液均能从直肠迅速吸收，皆于用药５分钟后达有效血浓度，分别于３～８分钟及２～８分钟对脑电活动产生显著影响，明显抑制癫痫样波发放，使美解眠诱发的惊厥致死率从对照组的７０％降为０。结论氯硝安定与安定溶液直肠给药，均能作为小儿惊厥抢救的有效措施。     

小儿咽侧间隙肿瘤4例报告

为探讨小儿咽侧间隙肿瘤的临床特征，报告４例小儿咽侧间隙肿瘤患者儿的诊治体会。结合临床提出诊断本病宜通过ＣＴ扫描，先确定肿瘤的大小和范围，再选择颈侧径路摘除肿瘤．结果治疗的４例患儿均获得了肯定的结果。并且提示手术中应保护重要的血管和神经。