经颅直流电刺激神经调控治疗慢性意识障碍的现状及前景

严重脑损伤导致的意识障碍（DOC），目前尚未有基于循证医学依据的指南。经颅直流电刺激（tDCS）是神经调控治疗DOC非常有前景的技术，已成为昏迷促醒治疗研究的热点。本文围绕tDCS的治疗效果、刺激参数、刺激靶点及促醒机制等方面的研究现状展开综述。     

The diagnostic value of FDG and amyloid PET in Alzheimer’s disease—A systematic review

PurposeBy 2050 it is projected that 115 million people worldwide will have Alzheimer’s Disease (AD) [1]. Recent attempts have been made to redefine the diagnostic criteria of AD to include markers of neurodegeneration – measurable by FDG-PET – and markers of amyloid accumulation – measurable by amyloid-PET.Materials and methodsA systematic review of the literature was performed to examine the current diagnostic use of amyloid and FDG PET. MEDLINE and EMBASE databases and the Cochrane Database were searched for relevant papersResults and discussionThis search resulted in twenty-nine papers on amyloid imaging, twenty-three papers on FDG-PET and eight papers which utilized both techniques. Both modalities are considered in turn with regards to their diagnostic accuracy, their role in mild cognitive impairment (MCI) and prognostication, their use in the differential diagnosis of AD and their clinical application. As evidenced from the current literature, both amyloid and FDG-PET meet criteria for suitable biomarkers for the diagnosis of AD. They both indicate pathophysiological processes, albeit at different stages of the Alzheimer’s process, and are distinct from normal patterns of aging.ConclusionBoth techniques have been shown to detect AD with high sensitivity and specificity compared to other neurodegenerative processes and cognitively normal age-matched individuals. However, future studies with standardised, uniform thresholds and a lengthier longitudinal follow-up need to be conducted to allow us to make surer conclusions about the future role of PET in clinical practice. In addition, comparison with post-mortem diagnosis, rather than clinical diagnosis with its acknowledged flaws, would result in more powerful statistical outcomes – which is becoming increasingly important given that several disease-modifying AD drugs are now in phase 3 trials.     

自噬、炎症反应及免疫功能异常在急性胰腺炎中的研究进展

急性胰腺炎(acute pancreatitis,AP)是临床较常见的由不同原因引起的一种急危重病,其发病机制复杂多样,易并发多脏器损伤,导致死亡率升高,故充分了解AP的发病机制可为临床早期干预、准确治疗及判断预后提供重要的参考价值。虽然启动该病发生和影响其进展的机制复杂多样,并且目前对AP的病理生理方面的认识已取得很大进步,但关键问题是其机制中精确而关键的分子机制尚不清楚,目前尚无特效的治疗方法。由于胰腺的解剖位置和担心获取人胰腺组织的操作会加重胰腺炎的严重程度而无法取样,因此,实验动物模型的研究证明,自噬、炎症反应和免疫功能异常在AP发病机制中的作用尤为重要。为此,本文探讨上述机制在AP中的作用,可能为AP的缓解及治疗提供新的靶点。     

The structure and ligand interactions of CD2: implications for T-cell function

Considerable progress has recently been made in understanding the structure and ligand interactions of the T-cell antigen CD2, to the extent that CD2 is now a useful paradigm for considering the structural basis of cell-cell recognition. Here, Simon Davis and Anton van der Merwe review the new data and consider their implications for T-cell function in the context of CD2-knockout experiments.     

A new assay system detecting antibody production and delayed-type hypersensitivity responses to trinitrophenyl hapten in an individual mouse

A new assay system detecting antibody production and delayed-type hypersensitivity (DTH) responses to trinitrophenyl hapten in an individual mouse (AS-DAD) was established. BALB/c mice were immunized intraperitoneally with varying amounts of 2,4,6-trinitrophenylated sheep red blood cells (TNP-SRBC) on day 0. Venous blood was collected on days 2, 4, 6, 8 and 10. Levels of anti-TNP IgM and IgG in serum were assayed by enzyme-linked immunosorbent assay (ELISA). After series of bleeding the mice were challenged with 2,4,6-trinitrobenzene sulfonic acid (TNBS) solution in the footpad on day 14. Footpad swelling was measured 24 or 48 h after the challenge. Peak responses of the anti-TNP IgM and IgG production were detected 4 or 6 days after the immunization with 10⁹ TNP-SRBC. Maximum DTH response was also observed with 10⁹ TNP-SRBC 24 h after the challenge on day 14. The antibody and DTH responses were also induced in other normal inbred strains such as C3H/He and DBA/1 but not BALB/c nu/nu mice. To evaluate AS-DAD in immunopharmacological studies, various immunomodulating agents were examined in BALB/c mice by subcutaneous administration on days 0, 1, 2 and 3. Cyclosporin or cyclophosphamide at 100 mg/kg/day completely inhibited not only the anti-TNP IgM and IgG production but also the TNP-specific DTH response. Prednisolone at 0.5 mg/kg/day had no significant effect on the IgM and IgG production, whereas it inhibited the TNP-specific DTH response. Interestingly, histamine-added mouse γ-globulin at 150 mg/kg/day clearly enhanced the anti-TNP IgM and IgG production, while it showed a suppressive effect on the TNP-specific DTH response. Levamisole at 5.0 mg/kg/day showed suppressive effects on the anti-TNP IgG production without affecting the IgM production and the DTH response. These results suggest that AS-DAD is useful for evaluating the immunopharmacological action of various agents.     

肉膜瓣覆盖在尿道板纵切卷管尿道成形术中的应用

目的:探讨肉膜覆盖在尿道板纵切卷管尿道成形术(TIP)中预防尿瘘的应用。方法:140例尿道下裂患者均行TIP术式修复,其中85例远端型尿道下裂采用纵行腹外侧阴茎肉膜瓣覆盖新尿道;55例近端形尿道下裂采用阴囊前动脉带蒂肉膜瓣覆盖新尿道。结果:12例患者出现尿道皮肤瘘,其中远端型尿道下裂患者7例;近端型尿道下裂5例。结论:远端型选择腹外侧阴茎肉膜瓣覆盖,近端型选择阴囊前动脉带蒂肉膜瓣覆盖,较少出现尿瘘的并发症,是TIP术中较理想的覆盖方式。     

姜黄素通过PPAR-γ途径促进人肾癌细胞的调亡

目的观察姜黄素对人肾癌细胞株A498细胞增殖和凋亡的影响,并探讨PPAR-γ途径在其中的作用。方法姜黄素(10、50、100μmol/L)处理A498细胞12、24、48h。采用MTT法测定细胞活力,并计算肿瘤细胞抑制率,流式细胞术测定细胞凋亡。实时定量PCR和Western Blot分别检测Bcl-2、Bax及PPAR-γmRNA和蛋白的表达。观察PPAR-γ阻断剂GW9662对姜黄素作用的影响。结果姜黄素(10、50、100μmol/L)分别处理人肾癌细胞株A498细胞24、48、72h后,以浓度和时间依赖的方式抑制细胞增殖促进细胞凋亡,同时以浓度依赖的方式下调了A498细胞中Bcl-2的表达,增加了Bax和PPAR-γ的表达。GW9662部分地消除了姜黄素对A498细胞增殖和凋亡的影响。结论姜黄素抑制人肾癌细胞增殖促进其凋亡,其机制涉及到PPAR-γ途径。     

Nervous tissue as an immune compartment: the dialect of the immune response in the CNS

Here, Zsuzsa Fabry and colleagues address the question of whether the unique cellular environment of the central nervous system (CNS) contributes to the observed differences in immunological functions between the CNS and other organs. In particular, they discuss the significance within the CNS of the blood-brain barrier, the nonconstitutive expression of major histocompatibility complex (MHC) molecules, the unusual set of potential antigen-presenting and effector cells, and the production of immune or neuromediators from various cellular sources.     

基于唾液代谢组学的口腔疾病研究新进展

唾液代谢组学是以唾液为研究对象,定性定量分析生物体内代谢物的变化以研究生物体疾病与健康的新兴学科。在口腔医学领域,采用唾液代谢组学研究发现,唾液代谢物与多种口腔疾病之间存在着联系。本文对近年来以唾液代谢组学为研究手段进行口腔疾病相关研究的进展进行综述,包括在口腔鳞状细胞癌、口腔黏膜癌前病变（口腔扁平苔藓和口腔黏膜白斑）、复发性阿弗他溃疡、原发性舍格伦综合征、早期儿童龋病、牙周炎、慢性根尖周炎、正畸后牙根吸收等方面的研究,对通过唾液代谢组学筛选出的相关差异代谢物和信号通路进行总结,通过这些差异代谢物,可以构建口腔疾病预测模型,对口腔疾病进行早期筛查、预后判断以及发病机制的研究。唾液代谢组学有望为口腔疾病的诊断提供一种无创性的方法,具有重要的临床意义。     

N-acetylcysteine causes a transient stimulation of neutrophil migration

Random migration of rabbit peritoneal neutrophils was enhanced in a chemokinetic way by N-acetylcysteine (NAC) in a small concentration range (10–400 μM). The enhancement was due to the cysteine moiety in the molecule, because cysteine equally caused a stimulation of random migration. The stimulating effect of NAC or cysteine largely disappeared when cells were preincubated with NAC or cysteine for 30 min before submission to chemotaxis, indicating that desensitization occurs. The stimulating effect of NAC was dependent on extracellular calcium. Because the Ca²⁺-dependence of migration by electroporated cells differed from that of intact cells, and because calcium channel blockers inhibited the effect of NAC, the calcium-dependent target is probably located inside the cell rather than on the cell surface. In contrast with fMLP, NAC did not cause an upregulation of CD11b expression of cells in suspension. Inhibitors of guanylate cyclase and of cGMP-dependent protein kinase (G-kinase) inhibited stimulation of migration by NAC, suggesting that cGMP played a decisive role in the stimulatory effect of NAC.