Pretangles and neurofibrillary changes: Similarities and differences between AD and CBD based on molecular and morphological evolution

Pretangles are cytoplasmic tau immunoreactivity in neurons without apparent formation of fibrillary structures. In Alzheimer disease, such tau deposition is considered to represent a premature state prior to fibril formation (AD‐pretangles), later to form neurofibrillary tangles and finally ghost tangles. This morphological evolution from pretangles to ghost tangles is in parallel with their profile shift from four repeat (4R) tau‐positive pretangles to three repeat (3R) tau‐positive ghost tangles with both positive neurofibrillary tangles in between. This complementary shift of tau profile from 4R to 3R suggests that these tau epitopes are represented interchangeably along tangle evolution. Similar tau immunoreactivity without fibril formation is also observed in corticobasal degeneration (CBD‐pretangles). CBD‐pretangles and AD‐pretangles share: (i) selective 4R tau immunoreactivity without involvement of 3R tau; and (ii) argyrophilia with Gallyas silver impregnation. However, CBD‐pretangles neither evolve into ghost tangles nor exhibit 3R tau immunoreactivity even at the advanced stage. Because electron microscopic studies on these pretangles are quite limited, it remains to be clarified whether such differences in later evolution are related to their primary ultrastructures, potentially distinct between AD and CBD. As double staining for 3R and 4R tau clarified complementary shift from 4R to 3R tau along evolution from pretangles to ghost tangles, double immunoelectron microscopy, if possible, may clarify similar profile shifts in relation to each tau fibril at the ultrastructural dimension. This will provide a unique viewpoint on how molecular (epitope) representations are related to pathogenesis of fibrillary components.     

24例中晚期宫颈癌盆腔四野盒式体外照射临床观察

目的:探讨中晚期宫颈癌盆腔四野盒式照射的临床价值。方法:47例中晚期宫颈癌随机分为2组,治疗组24例,采用盆腔四野(前/后及左/右野)盒式照射,DT46～50Gy,每天一对对穿野照射,每野1Gy,每天2Gy,前后野与左右野剂量权重:1.3～1.5:1。同期后装治疗。对照组23例,采用盆腔前后野对穿照射,DT46～50Gy,每天2野,每野1Gy,两野剂量权重:1:1。同期后装治疗。结果:下消化道、膀胱、腹壁皮肤等急性放射反应有明显统计学差异,而两组近期疗效及血液系统急性放射反应无统计学差异。结论:宫颈癌盆腔四野盒式照射靶区剂量分布均匀,小肠、直肠、膀胱剂量低,放射反应小。     

Diffusion-weighted magnetic resonance imaging detects early neuropathology following four vessel occlusion ischemia in the rat

Early neuropathology following a prolonged duration of four-vessel occlusion (4 VO) ischemia in the rat was charted using magnetic resonance imaging (MRI). Animals received either 30 minutes of 4 VO (N = 6) or sham operation (N = 6) prior to in vivo assessment. Proton density and T(2) and combined T(2)/diffusion-weighted (T(2)/DW) MRI were performed at 6, 24, and 72 hours postocclusion. T(2)/DW imaging was the most effective sequence for delineating between injured and intact tissues, indicating neuropathology in the dorsolateral striatum at 24 hours and in the CA1/CA2 subfields of the hippocampus at 72 hours following ischemia. Apparent diffusion coefficient values were significantly reduced in the striatum (P = 0.03) and hippocampus (P = 0.005) at 24 and 72 hours, respectively. This is the first report, to our knowledge, of T(2)/DW imaging detecting lesions following 4 VO in accord with the known temporal evolution of ischemic brain damage.     

Does repetition of post‐tetanic count every 3 min during profound relaxation affect accelerographic recovery of atracurium blockade?

BACKGROUND: Post-tetanic count is a valuable method to assess profound neuromuscular blockade. However, subsequent responses to repetitive stimulation might be altered due to post tetanic facilitation (PTF). To avoid PTF, it has been advocated to limit the interval of stimulation from 6 to 10 min. The impact of PTF on 90% recovery of the TOF ratio has not been evaluated. Therefore, we assessed the effect of repetitive PTC stimulation on atracurium blockade with the primary outcome being the time to reach 90% TOF recovery in comparison to classical TOF stimulation. METHODS: After informed consent 20 patients ASA I-II, scheduled for peripheral surgery under general anaesthesia and requiring tracheal intubation were enrolled into the study. Anaesthesia was induced with fentanyl, propofol, and atracurium, 0.5 mg kg(-1). Neuromuscular characteristics were assessed at the adductor pollicis by a TOF Watch((R)) accelerometer (Organon, Teknika, Holland) on each arm. After onset of maximum neuromuscular blockade, repetitive PTC every 3 min on one arm and repetitive TOF stimulation every 15 s on the opposite arm was performed. The following parameters were recorded: onset of maximum blockade, mean time of PTC stimulation, the maximum number of responses to PTC, time of the first and second TOF responses, and recovery profile until 90% TOF ratio. RESULTS: Time to reach 90% TOF recovery was similar on both arms (48 +/- 9 min), with a difference of 16 +/- 38 s between the arms (P = 0.64). The first and second responses of the TOF on the PTC-stimulated arm appeared at 29 +/- 8 min and 33 +/- 7 min, respectively. On the other arm the responses appeared at 30 +/- 8 min and 35 +/- 8 min, respectively (P < 0.05). CONCLUSION: Repetitive PTC stimulation every 3 min hastened the first and second responses of the TOF stimulation but we could not detect a significant difference in the 90% recovery of TOF ratio during atracurium blockade.     

Middle turbinate lateralization: a simple treatment for rhinologic headache

OBJECTIVE: To introduce a minimally invasive method to eliminate the symptoms of contact-point rhinologic cephalgia. STUDY DESIGN: A prospective study of 55 patients with chronic nasal or glabellar pain and endoscopically proven nasal origin. METHODS: All 55 patients in whom endoscopic examination demonstrated a contact point between the middle turbinate and the nasal septum were treated by fracturing the middle turbinate lateralward using a small metal tongue depressor under 10% lidocaine HCL topical anesthesia. RESULTS: Of the treated cohort, 48 (87%) of the patients had complete clinical symptom resolution after one treatment and all had resolution after two treatments. Recurrence occurred in 1 patient. There were no short-term or long-term adverse sequelae. The results persisted at a mean follow-up time of 50 months (range, 6-84 mo). CONCLUSION: Middle turbinate lateralization is safe and effective in eliminating the symptoms of rhinologic cephalgia induced by contact point between the middle turbinate and nasal septum.     

金元四大家消渴类方药分析之新见

金元四大家在诊治消渴方面即借鉴了前人的经验又各有创新,对后世在辨证论治消渴类疾病影响巨大,对于消渴病的辨证论治逐渐形成体系。用现代数学方法分析四大家用药频率,根据《内经》及其他经典中记载消渴病分析的内容,提出上焦辨证消渴的方法。     

中医内外结合治疗腰腿疼痛116例

临床上,腰腿痛的原因是多方面的,中医属于＂腰痛＂、＂痹证＂等范畴,除了牵引、针灸、推拿等治疗方法和传统的口服中药方法治疗外,本人根据临床经验,把这些治疗方法综合运用,取得满意疗效.     

基于脾“中央土以灌四傍”理论研究《名医类案》情志致病的治疗规律

脾胃学说在中医基础理论中占据重要地位,历代医家均重视脾胃,当代医家临床也以脾胃为先。基于脾“中央土以灌四傍”理论,通过对《名医类案》中情志致病医案的脏腑调理和方剂使用进行数据频次分析,总结其治疗规律为以调理脾脏、益气养血为基础,脾脏和本脏同调或数脏同调,恢复脾与本脏的气机,为治疗与情志因素相关的疾病提供借鉴。     

半夏白术天麻汤提取液的血清指纹图谱研究

目的 比较半夏白术天麻汤4种方法提取液的血清指纹图谱。方法 取大白兔,ig半仿生-生物酶提取(SBEE)液,采集不同时刻的血样,分离含药血清,用HPLC法和UV法测定,将HPLC色谱峰数目、峰总面积以及紫外吸光度平均值标准化处理,加权求和后得综合评判Y值,以Y值大者为较佳采血时刻;然后对4种方法提取液此时刻的含药血清进行指纹图谱比较。结果 给药后2 h的含药血清综合评判Y值最大;4种方法提取液2 h含药血清以SBEE液综合评判Y值最大。结论 SBEE液含药血清较水提法、醇提法、SBE法提取液含药血清中成分量高。     

脾虚证与益气健脾治疗对T、B淋巴细胞活性影响的实验观察

为探讨脾虚证机体特异性免疫应答的变化及益气健脾中药的影响,采用利血平注射法复制脾虚证模型,观察分别代表细胞与体液免疫功能的T、B淋巴细胞活性变化、血清IgG,IgM的水平及益气健脾基本方剂四君子汤对它们的影响,结果脾虚证模型大鼠T细胞转化率及B细胞分泌的IgM水平显著降低,通过灌服四君子汤可明显预防两者的降低,因而认为脾虚证细胞与体液免疫均降低,而以细胞免疫的降低为主,益气健脾中药具有明显防治作用。