脊髓损伤(SCI)后呼吸运动功能的恢复

 高颈段脊髓损伤(spinal cord injury,SCI)往往导致膈肌麻痹,了解如何恢复SCI患者膈神经的节律活动至关重要。控制膈运动神经元(phrenic motor neuron,PhMn)的兴奋性前运动神经元主要起源于同侧延髓,因此,当C2脊髓半离断(spinal cord hemisection,SH)后,损伤侧的下行冲动中断,同侧膈神经的节律消失。随后,潜在的对侧下行冲动逐渐增强(神经可塑性),使PhMn的节律性活动恢复。众多证据表明神经营养因子(如脑源性神经营养因子,brain derived neurotrophic factor, BDNF)通过原肌球蛋白相关激酶受体(如TrkB)在神经可塑性中发挥重要作用。我们的实验结果表明,在鞘膜内注射BDNF能促进PhMn节律性的恢复,而注射TrkB-Fc(一种可抑制细胞外BDNF的融合蛋白)则延迟恢复。应用腺病毒载体(adeno-associated viral vector,AVV)靶向诱导PhMn中TrkB的表达也可促进PhMn节律性的恢复,而Si-RNA诱导的PhMn中TrkB表达抑制则延缓恢复。总之,增强PhMn的BDNF-TrkB信号通路可能是促进SCI后功能恢复的有效治疗手段。     

Molecular characterization of the transition to mid-life in Caenorhabditis elegans

We present an initial molecular characterization of a morphological transition between two early aging states. In previous work, an age score reflecting physiological age was developed using a machine classifier trained on images of worm populations at fixed chronological ages throughout their lifespan. The distribution of age scores identified three stable post-developmental states and transitions. The first transition occurs at day 5 post-hatching, where a significant percentage of the population exists in both state I and state II. The temperature dependence of the timing of this transition (Q ₁₀?~?1.17) is too low to be explained by a stepwise process with an enzymatic or chemical rate-limiting step, potentially implicating a more complex mechanism. Individual animals at day 5 were sorted into state I and state II groups using the machine classifier and analyzed by microarray expression profiling. Despite being isogenic, grown for the same amount of time, and indistinguishable by eye, these two morphological states were confirmed to be molecularly distinct by hierarchical clustering and principal component analysis of the microarray results. These molecular differences suggest that pharynx morphology reflects the aging state of the whole organism. Our expression profiling yielded a gene set that showed significant overlap with those from three previous age-related studies and identified several genes not previously implicated in aging. A highly represented group of genes unique to this study is involved in targeted ubiquitin-mediated proteolysis, including Skp1-related (SKR), F-box-containing, and BTB motif adaptors.     

Clinical features of Poncet’s disease. From the description of 198 cases found in the literature

Poncet’s disease (PD) is an entity described as a reactive arthritis due to tuberculous infection elsewhere from the joints. PD existence has been questioned; however, more cases have been reported over the years. Due to its rare nature, little is known about the clinical picture of this disease and no prospective studies had been made to address this issue. We performed a systematic review of the written literature on PD in different databases using the key words “Poncet’s disease,” “tuberculous rheumatism,” and “tuberculous reactive arthritis.” Out of 78 articles, 198 patients were included in the analysis, plus our patient. Several characteristic patterns were found. Also, a review of the pathogenesis and some hypotheses are made. PD is a well-defined entity, which should be taken as a reactive arthritis for future studies given the increase in TB incidence and prevalence around the world, especially in high-burden countries.     

Patency of the supraclinoid internal carotid artery branches after flow diversion treatment. A meta-analysis

Background and purpose

Placement of flow-diverters across the ostia of major ICA branches carries a risk of arterial occlusion. We determined the rate of occlusion of the supraclinoid ICA branches and the related symptoms, following coverage with flow-diverters.

Impact of Frailty on Outcomes After Primary and Revision Total Hip Arthroplasty

Background

Frailty and disability from arthritis are closely intertwined and little is known about the impact of frailty on total hip arthroplasty (THA) outcomes. We hypothesized that higher preoperative frailty is associated with more adverse events following THA.

Congenital apical left ventricular aneurysm

Congenital ventricular aneurysm is an infrequently occurring disease entity that usually affects the left ventricle. Its etiopathology is unknown. Clinical presentation is variable, and the condition is potentially lethal in some cases. Various imaging techniques are useful in diagnosis and enable the condition to be differentiated from congenital left diverticulum. We present a patient with a calcified congenital ventricular aneurysm who presented with supraventricular and ventricular arrhythmias and who was treated by surgical resection.     

Transradial cardiac catheterization in patients with coronary bypass grafts: feasibility analysis and comparison with transfemoral approach.

The objective of this study was to analyze the feasibility and safety of transradial catheterization in patients with remote surgical cardiac revascularization. Selective catheterization of coronary bypass grafts might be more difficult and time-consuming from the radial artery as compared to the femoral route. This special patient subset has been either excluded or underrepresented in previous studies. Retrospective review was made of 304 cardiac diagnostic procedures performed from January 2001 through December 2004 in patients with coronary artery bypass grafts in a single center. Patients had to be considered eligible for both transradial and transfemoral approach to be included. Cases with double internal mammary or gastroepiploic grafts were excluded. Selection of the arterial access was individualized according to operator preferences. Among diagnostic cases, transradial access was attempted as first choice in 151 cases (left radial in 133) and transfemoral in 154. Total procedural time (41 +/- 22 vs. 40 +/- 23 min), fluoroscopy time (15 +/- 10 vs. 18 +/- 13 min), and dye volume (180 +/- 64 vs. 192 +/- 73 ml) were similar. Crossover rates were 4.0% in the transradial group and 1.3% in transfemoral (P = 0.28). Only two patients in transradial group needed transfemoral access because of failure to catheterize a bypass graft. Transradial angiography of coronary bypass grafts can be performed with similar success rates as compared with transfemoral procedures and without a significant time delay.     

Evidence of Epstein-Barr Virus Association with Gastric Cancer and Non-Atrophic Gastritis

Different lines of evidence support an association between Epstein-Barr virus (EBV) and gastric cancer (GC). The main understood risk factor to develop GC is infection by Helicobacter pylori (H. pylori), which triggers a local inflammatory response critical for progression from gastritis to GC. The role of EBV in early inflammatory gastric lesions has been poorly studied. A recent study proposed a cutoff value of 2000 EBV particles to identify patients with increased chances of infection of the gastric epithelium, which may favor the inflammatory process. To better understand the role of EBV in cancer progression, we analyzed 75 samples of GC, 147 control samples of non-tumor gastric tissue derived from GC patients and 75 biopsies from patients with non-atrophic gastritis (NAG). A first-round PCR was used for EBV detection in tumor and non-tumor controls and a more sensitive nested PCR for gastritis samples; both PCRs had lower detection limits above the proposed cutoff value. With this strategy 10.67% of GC, 1.3% of non-tumor controls and 8% of gastritis samples were found positive. An EBER1 in situ hybridization showed EBV infection of epithelial cells in GC and in a third of NAG samples, while in the other NAGs infection was restricted to the mononuclear cell infiltrate. EBV-positive GCs were enriched in lace and cribriform patterns, while these rare patterns were not observed in EBV negative samples. Our results support a role for EBV in GC and early precursor lesions, either as directly oncogenic infecting epithelial cells or indirectly as an inflammatory trigger.