老年学习记忆减退大鼠齿状回突触的定量研究

据老年大鼠在Ｍｏｒｒｉｓ水迷宫中的行为表现，将其分为老年学习记忆减退和学习记忆正常两部分，采用透射电镜观察、拍片，对齿状回中分子层触的数量和大小进行体视学定量分析。     

Confocal observation of senile plaques in Alzheimer's disease: Senile plaque morphology and relationship between senile plaques and astrocytes

Senile plaques In the brains of Alzheimer's disease (AD) were examined by confocal laser scanning microscopy (CLSM) with the following three findings. First, in sections stained with Congo red, the serial CLSM images of optical sections clearly revealed that a classic plaque is composed of a plaque core and a corona. Radially arranged process-like structures, corresponding to bundles of amyloid fibrils, formed amyloid cores and stronger signals were detected in the center of some cores. Second, in sections stained with Congo red and anti-gllal fibrillary acidic protein (GFAP), reactive astrocytes were found around the senile plaques and many astrocytlc processes surrounded the plaque cores and some processes had penetrated into them. Third, three-dimensional reconstruction on classic plaque revealed that the surface of classic plaque showed a 'coral-like' appearance.     

Immunity and depression: Insomnia,Retardation, and reduction of natural killer cell activity

Depressed patients show a reduction of natural killer (NK) cell activity which may be associated with specific depressive symptoms. The present study demonstrated that sleep disturbance and retardation, but not other depressive symptoms, were negatively correlated with NK activity in 38 depressed patients. Specific behavioral changes in depression such as sleep disturbance and retardation were found to predict 16% of the variance of cytotoxicity levels in depression.     

Daytime variation in performance and tiredness/sleepiness ratings in patients with insomnia, narcolepsy, sleep apnea and normal controls

Daytime tiredness or sleepiness and deficits in cognitive performance are common complaints in sleep disordered patients. Till now there are few studies comparing patients from different diagnostic groups of sleep disorders in the same experimental protocol. We studied the time course of cognitive functions and subjective alertness in a parallel group design with four groups of patients [narcolepsy, untreated or treated obstructive sleep apnea (OSA), or psychophysiological insomnia] and a control group of subjects without sleep complaints. Each group consisted of 10 subjects, matched for age and gender. After a night with polysomnography, subjects were studied for 10 h from 08:00 hours to 18:00 hours at 20 min intervals under standardized environmental conditions. Four psychological tests were applied, (1) a critical flicker fusion (CFF) test to measure optical fusion threshold (alertness); (2) a paper-and-pencil visual line tracking test (selective attention); (3) a visual analog scale (VAS) for tiredness/sleepiness; and (4) the Tiredness Symptoms Scale (TSS), a 14 items check list. Each test session lasted for 8 min, followed by a 12 min pause. The level and time course of cognitive performance and self-rating data were analysed with hierarchical linear mixed effects models. Cognitive tests showed decrements in alertness and selective attention in untreated patients with insomnia, narcolepsy, and sleep apnea. Narcoleptic patients and untreated OSA had a lower CFF threshold than controls, and for narcoleptic patients the time course differed from that of all other groups. In the visual tracking test the performance of all groups of patients was worse compared with normal controls. Self-rated tiredness/sleepiness was significantly more pronounced in the three groups of untreated patients than in control subjects.     

睡眠信念与态度量表在失眠患者健康教育中的应用

目的: 采用睡眠个人信念与态度量表探索患者睡眠障碍与哪些歪曲的信念有关,针对歪曲的信念进行睡眠实践教育,达到促进睡眠的目的.方法: 连续收集62例以失眠为主诉的患者,随机分成试验组与对照组,各31例,两组均在药物治疗及心理治疗基础上进行睡眠健康教育.试验组针对患者自身存在的歪曲信念态度进行健康教育,而对照组只进行常规的健康宣教.入组前及入组后每周,应用睡眠个人信念与态度量表(Dysfunctional Beliefs and Attitudes about Sleep Scale,DBAS)、匹茨堡睡眠指数量表(Pittsburgh Sleep Quality Index,PSQI)对两组进行测评,同时让患者评价睡眠时间、睡眠质量、睡眠效果和对健康教育接受程度.结果: 健康教育4周后试验组和对照组DBAS得分均高于人组时[(111.0±8.7)vs.(88.9±12.3)、(93.5±17.2)vs.(81.3±19.2),P:0.001、0.010],而PSQI得分均低于入组时[(5.5±2.1)vs.(10.9±4.4)、(9.0 ±2.1)vs.(11.5±3.6),均P=0.001];健康教育4周后对照组的DBAS得分低于实验组,而PSQI得分高于实验组.健康教育后试验组对睡眠时间、睡眠质量、睡眠效果满意的比例均明显提高,睡眠时间满意的比例由18/31到30/31,对睡眠质量满意比例由8/31变为23/31,对睡眠效果满意比例由8/31到21/31(均P＜0.05).试验组对睡眠时间满意的比例明显高于对照组(30/31 vs.14/31,P＜0.01),对健康教育的接受程度也明显高于对照组(18/31 vs.5/31,P＜0.05).结论: 试验组健康教育后患者的睡眠信念有了明显的改善,睡眠质量有了提高.     

Evolution of sleep and sleep EEG after hemispheric stroke

The evolution of subjective sleep and sleep electroencephalogram (EEG) after hemispheric stroke have been rarely studied and the relationship of sleep variables to stroke outcome is essentially unknown. We studied 27 patients with first hemispheric ischaemic stroke and no sleep apnoea in the acute (1-8 days), subacute (9-35 days), and chronic phase (5-24 months) after stroke. Clinical assessment included estimated sleep time per 24 h (EST) and Epworth sleepiness score (ESS) before stroke, as well as EST, ESS and clinical outcome after stroke. Sleep EEG data from stroke patients were compared with data from 11 hospitalized controls and published norms. Changes in EST (>2 h, 38% of patients) and ESS (>3 points, 26%) were frequent but correlated poorly with sleep EEG changes. In the chronic phase no significant differences in sleep EEG between controls and patients were found. High sleep efficiency and low wakefulness after sleep onset in the acute phase were associated with a good long-term outcome. These two sleep EEG variables improved significantly from the acute to the subacute and chronic phase. In conclusion, hemispheric strokes can cause insomnia, hypersomnia or changes in sleep needs but only rarely persisting sleep EEG abnormalities. High sleep EEG continuity in the acute phase of stroke heralds a good clinical outcome.     

Bayesian semiparametric joint modeling of longitudinal explanatory variables of mixed types and a binary outcome

Many prospective biomedical studies collect longitudinal clinical and lifestyle data that are both continuous and discrete. In some studies, there is interest in the association between a binary outcome and the values of these longitudinal measurements at a specific time point. A common problem in these studies is inconsistency in timing of measurements and missing follow-ups which can lead to few measurements at the time of interest. Some methods have been developed to address this problem, but are only applicable to continuous measurements. To address this limitation, we propose a new class of joint models for a binary outcome and longitudinal explanatory variables of mixed types. The longitudinal model uses a latent normal random variable construction with regression splines to model time-dependent trends in mean with a Dirichlet Process prior assigned to random effects to relax distribution assumptions. We also standardize timing of the explanatory variables by relating the binary outcome to imputed longitudinal values at a set time point. The proposed model is evaluated through simulation studies and applied to data from a cancer survivor study of participants in the Women's Health Initiative.     

中西医结合治疗高龄胆石症119例

目的 对临床高龄胆石症患者119例采用中西医结合方法治疗,以期取得最佳效果,方法 共223例70岁以上胆石症患者,治疗组119例采用中西医结合方法,对照组104例患者采用手术方法治疗,对治疗结果进行对比分析。结果 治疗线痊愈92例（77.3％）,出现各种并发症25例（21.0％）,死亡2例（1.7％）;对照组痊愈62例（59.6%）,出现各种并发症38例（36.5％）,死亡4例（3.9％）,2组比较均有显著差异（P＜0.05）。结论 高龄胆石症患者病史较长,有急诊入院多、伴多发症多、并发症发生率高的特点,采用中西医结合方法治疗明显优于单纯手术治疗,尤其是围手术期的中西医结合处理,对提高高龄胆石症患者的痊愈率有较大的临床意义。     

Prevalence of reported sleeplessness in northern Norway in relation to sex, age and season

As part of a comprehensive population health survey in the municipality of Tromsø, north of the Arctic Circle, men between 20 and 54 years and women between 20 and 49 years were presented a questionnaire containing questions about sleeplessness and its possible association with season. Of the 14,667 respondents, 41.7% of the women and 29.9% of the men said they were sometimes bothered by insomnia. Insomnia not associated with any special time of the year was reported by 16.9% of women and 16.2% of men; insomnia in the "dark period" (midwinter insomnia) was reported by 17.6% of women and 9.0% of men; insomnia in the midnight-sun period or in spring or autumn was much less common. Difficulty falling asleep was the most common type of insomnia, especially in winter and summer. Overall, the frequency of insomnia increased with increasing age, but with some notable differences with regard to type (initial insomnia showed little relation to age, whereas middle and late insomnia increased markedly with age) and seasonal type (insomnia in the midnight-sun period decreased with age, whereas the other seasonal types increased with age).     

活化血小板表达在早期诊断和监测老年糖尿病肾病中的价值

目的 :探讨α颗粒膜蛋白 (CD62 P)和溶酶体膜蛋白 (CD63 )活化表达对老年糖尿病肾病早期诊断和病情监测的临床价值。方法 :采用流式细胞仪测定 196例老年 2型糖尿病患者 (其中单纯糖尿病 94例 ,糖尿病肾病 10 2例 )血浆CD62 P和CD63 水平 ,并与 40例健康人进行比较。同时观察糖尿病肾病血糖控制后CD62 P和CD63 的变化。结果 :单纯糖尿病组CD62 P和CD63 高于健康人组 (P <0 .0 0 1) ,糖尿病肾病组高于单纯糖尿病组 (P <0 .0 0 1) ,对糖尿病肾病患者进行血糖控制和抗凝治疗 6个月后 ,CD62 P、CD63 和 2 4h尿白蛋白排泄率 (UAER)水平下降 ,与对照组比较有显著性差异。结论 :CD62 P和CD63 对老年糖尿病肾病的早期诊断和病情监测有重要的临床价值