Prevalence and course of schizophrenia in a Chinese rural area

OBJECTIVE: To assess the characteristics and factors affecting course of schizophrenia in a Chinese rural area. METHOD: An epidemiological investigation was conducted to identify all the patients with schizophrenia among 149 231 people in Xinjin County, Chengdu. RESULTS: The total prevalence of schizophrenia was 4.13 per 1000 population. Males had an earlier mean age of onset (29.6 years) than females (32.3 years). Duration of illness before treatment and the total duration of illness were found to be significantly associated with level of remission. The status of treatment, family economy, housing, and families' care of patients had a significant effect on the clinical course of the illness. CONCLUSIONS: Duration of illness before treatment may be an important predictor of course in schizophrenia. Early treatment for the patients may produce higher level of improvement in prognosis. Education intervention and community-based service are urgent priorities for these patients.     

Neural (N-) cadherin,a synaptic adhesion molecule,is induced in hippocampal mossy fiber axonal sprouts by seizure

Aberrant mossy fiber sprouting and synaptic reorganization are plastic responses in human temporal lobe epilepsy, and in pilocarpine-induced epilepsy in rodents. Although the morphological features of the hippocampal epileptic reaction have been well documented, the molecular mechanisms underlying these structural changes are not understood. The classic cadherins, calcium-dependent cell adhesion molecules, are known to function in development in neurite outgrowth, synapse formation, and stabilization. In pilocarpine-induced status epilepticus, the expression of N-cadherin mRNA was sharply upregulated and reached a maximum level (1- to 2.5-fold) at 1- to 4 weeks postseizure in the granule cell layer and the pyramidal cell layer of CA3. N-cadherin protein was correspondingly increased and became concentrated in the inner molecular layer of the dentate gyrus, consistent with the position of mossy fiber axonal sprouts. Moreover, N-cadherin labeling was punctate; colocalized with definitive synaptic markers, and partially localized on polysialated forms of neural cell adhesion molecule (PSA-NCAM)-positive dendrites of granule cells in the inner molecular layer. Our findings show that N-cadherin is likely to be a key factor in responsive synaptogenesis following status epilepticus, where it functions as a mediator of de novo synapse formation.     

电针对大鼠局灶脑缺血/再灌注时大脑皮质cPKCα蛋白表达的影响

目的 :探讨电针双侧“合谷”穴区对Wistar大鼠局灶脑缺血 /再灌注时大脑皮质cPKCα蛋白表达的影响。方法 :线栓法闭塞Wistar大鼠大脑中动脉 ,制备局灶脑缺血 /再灌注模型。运用免疫组化法检测电针大鼠双侧“合谷”穴区对局灶脑缺血 /再灌注时大脑皮质cPKCα蛋白表达的影响。结果 :假手术组部分动物大脑皮质cPKCα蛋白弱表达 ,局灶脑缺血 3hr时大脑皮质cPKCα蛋白表达增加 ,但未达显著水平 (P >0 .0 5) ,再灌注 3hr、6hr时大脑皮质cPKCα蛋白表达明显增加(P <0 .0 1 ) ,而电针可以明显减少再灌注 3hr、6hr时大脑皮质cPKCα蛋白表达 (P <0 .0 1 )。结论 :电针“合谷”穴区可下调大脑皮质cPKCα蛋白表达 ,这可能与电针抗局灶脑缺血 /再灌注时脑细胞凋亡有关     

Slight impairment of Na+,K+-ATPase synergistically aggravates ceramide- and beta-amyloid-induced apoptosis in cortical neurons

Dysfunction of the Na(+),K(+)-ATPase (Na(+),K(+)-pump), due to reduced energy supply or increased endogenous ouabain-like inhibitors, likely occurs under pathological conditions in the central nervous system. In cultured mouse cortical neurons, we examined the hypothesis that a mild non-toxic inhibition of the Na(+),K(+)-ATPase could synergistically sensitize the vulnerability of neurons to normally non-lethal apoptotic signals. Ouabain at a low concentration of 0.1 microM slightly lessened the Na(+),K(+)-pump activity measured as an ouabain-sensitive current, yet did not affect K(+) homeostasis and viability of cortical neurons. Co-exposure to 0.1 microM ouabain plus non-lethal C(2)-ceramide (5 microM) or beta-amyloid 1-42 (5 microM), however, induced marked intracellular K(+) loss, caspase-3 cleavage, DNA laddering, and synergistically triggered neuronal death. The caspase inhibitor Z-Val-Ala-Asp(OMe)-fluoromethyl ketone (Z-VAD-FMK) predominantly blocked the caspase activation and neuronal death. These results suggest that slight impairment of Na(+),K(+)-pump activity may amplify the disruption of K(+) homeostasis in the presence of a non-lethal apoptotic insult, leading to activation of apoptotic cascade and substantial neuronal injury.     

延期手术对新生儿重症膈疝疗效的初步探讨

目的　探讨延期手术对新生儿重症膈疝的疗效和意义。方法　本文回顾 1985～ 2 0 0 3年复旦大学附属儿科医院收治的 2 0例重症新生儿先天性膈疝 (CDH)病例 ,其中 11例患儿进行了延期手术 ,最短 12h ,最长 5 4h ,平均2 5 3h ,3例围术期吸入一氧化氮 (NO)。以急诊手术 9例作为对照 ,对一般情况、围术期动脉血气、超声心动图结果、手术疗效和预后随访进行对照分析。结果　急诊手术组入院pH(7 19± 0 0 3)、PCO2 (18 4 3± 1 0 5 )kPa ,术后pH(7 2 4± 0 0 4 )、PCO2 (9 0 4± 4 6 6 )kPa ,术后平均呼吸机使用时间 4 0 7d ,其中 4例存活 ,5例死亡 ;延期手术组入院pH((7 19± 0 5 9)、PCO2 (6 89± 1 12 )kPa ,术前pH(7 37± 0 15 )、PCO2 (5 4 8± 2 2 6 )kPa ,都较入院有明显改善 ,术后pH(7 4 5± 0 0 2 )、PCO2 (5 0 5± 2 13)kPa ,恢复较急诊组理想 ,患者平均术后呼吸机使用时间 4 5 7d。延期组中患儿 10例存活 ,1例因术后严重肺炎无法脱离呼吸机 ,家属放弃治疗。结论　延期手术以及NO吸入等措施对于改善围手术期管理和稳定术前血流动力学指标及内环境有一定的作用 ,对降低新生儿先天性膈疝的病死率有积极的意义。     

A role for Drosophila Drac1 in neurite outgrowth and synaptogenesis in the giant fiber system

Recent studies have shown the small GTPases, Rac1, Rho, and CDC42, to have a role in axon guidance. To assess their participation in synapse assembly and function we have expressed various forms of Drac1 in the giant fiber system of Drosophila. Overexpression of wild-type Drac1 in the giant fiber (GF) lead to a disruption in axonal morphology; axons often terminate prematurely in a large swelling in the target area but lack the normal lateral bend where the synapse with the jump motor neuron would normally be found. Electrophysiological assays revealed longer latencies and lowering following frequencies indicating defects in the synapse between the GF and the tergotrochanteral motor neuron (TTMn). Thickened abnormal GF dendrites were also observed in the brain. Overexpression of the dominant-negative form of Drac1, (N17), resulted in axons that produced extra branches in the second thoracic neuromere (T2); however, the synaptic connection to the TTMn was present and functioned normally. Conversely, expression of the constitutively active form, Drac1(V12), resulted in a complete lack of neurite outgrowth and this was also seen with overexpression of Dcdc42(V12). In the absence of a GF, these flies showed no response in the jump (TTM) or flight (DLM) muscles upon brain stimulation. Taken together these results show that the balance of actin polymerization and depolymerization determines local process outgrowth and thereby synapse structure and function.     

CADASIL: the dermatologic diagnosis of a neurologic disease. Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy

Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an increasingly recognized neurologic disease characterized by pathognomonic changes to the small vessels, particularly in the brain and skin. Although much has recently been written about this disease in the neuropathology literature, to our knowledge nothing has appeared in the dermatology literature. We wish to call attention to the unique role dermatologists and dermatopathologists can play in the diagnosis of this disease. We review the condition's clinical, histologic, and ultrastructural features.     

缺血性卒中的梗死灶特点与中医辨证分型之间关系研究概况

本文拟从中经络与中脏腑分布情况,以及病灶大小、梗死灶部位与中医辨证分型间关系三方面,对梗死病灶特点与中医辨证分型之间关系的研究文献做一综述,并分析讨论之。1中经络与中脏腑分布情况研究大多数学者按照病情轻重不同将卒中分为中脏腑和中经络两大型,认为缺血性卒中中医辨