阿尔茨海默病与路易体痴呆的脑葡萄糖代谢比较

目的 比较阿尔茨海默病与路易体痴呆在脑葡萄糖代谢方面的特征.方法 本研究入选了28例阿尔茨海默病(AD)患者和25例路易体痴呆(DLB)患者.受试者静脉注射示踪刺18F脱氧葡萄糖(18F-FDG),然后接受头部正电子发射断层扫描(PET).应用迭代法重建的脑图像,分别取额叶皮层、顶叶皮层、颞叶皮层、枕叶皮层、小脑皮层、尾状核头、壳核为感兴趣区(ROI).以脑内各ROI与小脑半球ROI的FDG摄取强度的比值为指标进行分析和比较.结果 AD在颞叶前部、顶叶皮层FDG摄取下降,额、顶、颞、枕叶、壳核、尾状核皮层感兴趣区与小脑皮层的FDG代谢比值分别为(0.861±0.173)、(0.625±0.149)、(0.598 ±0.185)、(0.914±0.214)、(1.030 ±0.084)、(0.997±0.102);DLB在额叶前部皮层、颞叶前部皮层、顶叶后部皮层、纹状体的FDG摄取均下降,额、顶、颞、枕叶、壳核、尾状核皮层感兴趣区与小脑皮层的FDG代谢比值分别为(0.538±0.147)、(0.615±0.138)、(0.587 ±0.142)、(0.415 ±0.107)、(0.685 ±0.094)、(0.547 ±0.103).DLB在枕叶皮层、额叶皮层、纹状体的FDG摄取下降比AD显著,差异有统计学意义(P均＜0.01).结论 AD与DLB在皮层和基底节的葡萄糖代谢特征存在显著差异.这些特征有助于两者的鉴别诊断.     

Safety and efficacy of blood glucose management practices at a diabetes camp

AIM: Camps are an important part of diabetic management in children yet data on the safety and efficacy of camps are limited. We assessed the safety and efficacy of blood glucose management guidelines at summer camps for diabetic children. METHODS: Consistent management guidelines were implemented during 10 consecutive diabetes camps held in the same facility between 1998 and 2002. Using the entire sample of campers aged 9-13 years, we analysed insulin dosage alterations, the frequency of hypoglycaemia (<4 mmol/L), hyperglycaemia (>15 mmol/L) and ketosis and evaluated our overnight management guidelines. The effects of sex, year, age, insulin regimen and duration of diagnosis on hypoglycaemia frequency were determined. RESULTS: Mean insulin doses decreased 19.2% (95% confidence interval 16.9-21.6%) by the last day of camp (day 6) relative to the day prior to camp. Mean blood glucose levels were 11.4 mmol/L before breakfast and the main evening meal, 11.3 mmol/L before bed, 10.8 mmol/L at midnight and 9.4 mmol/L at 3 am. Of the 10 839 readings analysed, 984 (9.1%) were below 4 mmol/L (0.5 per camper/day) with no clinical grade 3 (seizure or coma) hypoglycaemia. Hypoglycaemia frequency was independent of sex, year, age, insulin regimen and duration of diagnosis (all P > 0.05). There were 2570 (23.7%) readings above 15 mmol/L (1.4 per camper/day) but only 42 (0.4%) were associated with significant ketosis. CONCLUSION: Children at diabetes camps experience considerable blood glucose variability; however, the careful application of monitoring and management guidelines can avoid serious adverse events.     

N-tosyl- -phenylalanyl-chloromethylketone reduces hypoxic–ischemic brain injury in rat pups

N-tosyl- -phenylalanyl-chloromethylketone (TPCK) in vitro blocks apoptotic pathways leading to cell death. We wished to see if TPCK would reduce brain injury in vivo. Seven-day-old rat pups had the right carotid artery ligated and then received either vehicle or TPCK (5 to100 mg/kg i.p.). They were then given 8% oxygen for 2.25 h. Twenty-two days later, the cerebral hemispheres were weighed to determine the reduction in size in the right hemisphere. TPCK decreased the reduction in right hemisphere weight from 15±3% (vehicle, n=20), to 4±2% (10 mg/kg, n=19, P<0.01). TPCK reduced the number of cells staining for DNA breaks 3 days after injury from 1729±275 mm⁻² (vehicle, n=8) to 550±236 mm⁻² (10 mg/kg TPCK, n=9, P<0.01), decreased the amount of DNA fragmentation 3 days after injury by gel electrophoreses (20 mg/kg, n=16, P<0.01) and eliminated the increase in nitric oxide metabolites 6 h after injury (vehicle 1.5±0.4, n=10; and 20 mg/kg TPCK 0.0±0.1 nM/mg protein, n=10, P<0.001). TPCK pretreatment in the newborn rat model of hypoxic–ischemic brain injury reduces DNA fragmentation, nitric oxide production and brain injury.     

Clinicopathological studies on diffuse Lewy body disease

With reports of dementia cases with numerous cortical Lewy bodies and our proposal that this be named ‘diffuse Lewy body disease’ (DLBD), this condition has received a great deal of attention, first in Japan and subsequently in Europe and North America. In the early 1990s, similar types of nomenclature were considered, and at the First International Workshop in 1995, it was proposed that ‘dementia with Lewy bodies’ be used as a generic term for Lewy body dementia, including the DLBD form. We review our previous clinicopathological findings and describe our recent immunohistochemical studies on DLBD.     

玻璃体切除术治疗复杂性眼内异物

目的：评价玻璃体切除术治疗眼内异物伤的效果及相关因素。方法：回顾性分析1996年4月－1999年10月间经玻璃体手术治疗的复杂性眼内异物45例（48眼）的临床资料。结果：玻璃体手术后,47眼成功地摘出异物,成功率为97.9％。术后视力提高33眼（68.8％）,不变10眼（20.8％）,下降5眼（10.4％）。视力＞0.02 34眼（70.8％）,其中视力≥0.1者9眼,最佳矫正视力0.8。术后14眼视网膜脱离复位（77.7％）。结论：玻璃体手术治疗可有效地摘出复杂性眼内异物,提高术后视力,同时处理其并发症。     

Efficient immunogenic peptide antigen delivery to dendritic cells using an ESCRT-mediated extracellular vesicle formation method

In the activation of cell-mediated adaptive immune responses that play major roles in the elimination of virus-infected or tumor cells, it is important that dendritic cells present antigen peptides on major histocompatibility complex (MHC) class I molecules and activate pathogen-specific cytotoxic T lymphocytes (CTL). As exogenous peptide antigens are generally presented on MHC class II but not class I, the development of a method for exogenous antigen delivery that facilitates MHC class I presentation is necessary for a potentially effective vaccine that is expected to provoke cell-mediated adaptive immune responses. Here, we developed extracellular vesicles that incorporate antigenic proteins by utilizing endosomal sorting complexes required for transport (ESCRT)-mediated vesicle formation pathway. Furthermore, we proved that these vesicles could deliver their contents to the cytoplasm of dendritic cells and activate antigen-specific CTLs. These technologies could be applied to the development of novel CTL-inducing peptide vaccines.     

胃镜下使用透明帽取食管异物的舒适护理效果分析

目的 探讨舒适护理在胃镜下使用透明帽取食管异物中的应用及效果.方法 回顾性分析50例食管异物患者的临床资料,均在胃镜下使用透明帽处理,配合舒适护理,观察手术成功率及并发症情况.结果 50例食管异物患者成功率为100％,均未出现食管穿孔、大出血及窒息等并发症.结论 将舒适护理应用于胃镜下使用透明帽取食管异物治疗,可提高异物取出成功率并避免严重并发症的发生.     

Banana peel culture as an indigenous medium for easy identification of late-sporulation human fungal pathogens

Aim: Fungi are increasing in incidence as human pathogens and newer and rarer species are continuously being encountered. Identifying these species from growth on regular culture media may be challenging due to the absence of typical features. An indigenous and cheap medium, similar to the natural substrate of these fungi, was standardised in our laboratory as an aid to species identification in a conventional laboratory setting. Materials and Methods: Ripe banana peel pieces, sterilised in an autoclave at 121°C temperature and 15 lbs pressure for 15 min promoted good growth of hyphae and pycnidia or acervuli in coelomycetes, flabelliform and medusoid fruiting bodies of basidiomycetes and fruit bodies such as cleistothecium in ascomycetes. The growth from the primary isolation medium was taken and inoculated onto the pieces of double-autoclaved ripe banana peel pieces in a sterile glass Petri dish with some moisture (sprinkles of sterile distilled water). A few sterile coverslips were placed randomly inside the Petri dish for the growing fungus to stick on to it. The plates were kept at room temperature and left undisturbed for 15–20 days. At a time, one coverslip was taken out and placed on a slide with lactophenol cotton blue and focused under the microscope to look for fruit bodies. Results: Lasiodiplodia theobromae, Macrophomina phaseolina, Nigrospora sphaerica, Chaetomium murorum, Nattrassia mangiferae and Schizophyllum commune were identified by characteristic features from growth on banana peel culture. Conclusions: Banana peel culture is a cheap and effective medium resembling the natural substrate of fungi and is useful for promoting characteristic reproductive structures that aid identification.     

RNA干扰抑制内皮细胞韦伯潘力氏小体的释放

目的探讨利用RNA干扰方法抑制内皮细胞韦伯潘力氏小体(WPB)释放的效果和意义,为防治心血管病和开发小分子RNA药物奠定基础。方法设计腺病毒介导的针对调节WPB释放的关键蛋白N-乙基顺丁烯二酰亚胺敏感因子(NSF)N端功能区的小发卡RNA(shRNA),筛选鉴定收获病毒,使用NSF shRNA转染人主动脉内皮细胞为实验组、阴性对照病毒感染为阴性组、不加任何干扰为空白组,RT-PCR和Western blot法观察对NSFmRNA及蛋白表达的抑制作用,免疫荧光染色观察对WPB释放的影响。结果用携带NSF shRNA的腺病毒感染内皮细胞后,实验组NSF mRNA表达与空白组(P=0.02)及阴性组(P=0.035)比较,差异有统计学意义;实验组NSFmRNA表达随时间延长持续下降,24、48及72 h明显下降,差异有统计学意义(P=0.048)。实验组NSF蛋白表达,与空白组(P=0.031)及阴性组(P=0.004)比较.差异有统计学意义;而空白组与阴性组差异无统计学意义(P=0.249)。免疫荧光染色显示,NSF-shRNA腺病毒感染,明显抑制凝血酶诱导的WPB释放。结论携带NSF-shRNA的腺病毒感染人主动脉内皮细胞,能明显抑制NSF mRNA及蛋白表达,抑制凝血酶诱导的WPB释放,对未来动脉粥样硬化及急性冠状动脉综合征的防治有一定的参考价值。