褪黑素与睡眠、衰老及痴呆

褪黑素或称褪黑素(melatonin,MT)是松果体(pincealgland)分泌的一种胺类激素,松果体位于脑的背面,在视丘后部与四叠体交界处,是一个小的扁锥形腺体,其形状与大小与“松果”相似,故名松果体。松果体外有结缔组织被膜,实质由松果体细胞和神经胶质细胞构成。松果体细胞接受颈上神经节发出的交感节后纤维支配,把神经信息转换为激素分泌。松果体的活动呈现明显的周期性变化,昼夜周期中光照与黑暗的交替,引起褪黑素分泌量的昼夜波动。光照能抑制褪黑素的分泌,故白天血浆中浓度降低,而黑暗则刺激褪黑色分泌,故夜晚血中褪黑素升高。松果体在儿童中期发育至高峰,一般在7岁之后逐渐萎缩。45岁时分泌量仅为幼儿期1/2,80岁时降至极低水平,昼夜分泌节律趋于消失。     

多系统萎缩的临床与病理特点及诊断

目的 探讨多系统萎缩(multiple system atrophy,MSA)的临床和病理特点及诊断.方法 总结4例MSA患者资料,其中2例为病理资料,2例为临床资料.经解剖检验证实的MSA患者2例,通过苏术素-伊红(HE)、髓鞘染色(KB)及Gallyag-Braak(GB)银染色,并通过泛素、α-突触核蛋白等免疫组织化学染色进行观察.结果 4例患者均为男性,年龄分别为76、70、51及59岁.临床诊断:例1为帕金森综合征,例2为脊髓小脑共济失调,例3、例4均诊断为MSA.病理改变的大体所见:脑桥和小脑明显萎缩,壳核、苍白球、黑质也可见萎缩,脑室扩张.组织学所见:大脑皮质、黑质、纹状体、苍白球、脑桥核、下橄榄、无名质、迷走神绛背核、小脑、脊髓中间外侧角细胞及前角细胞等部位神经细胞脱失,胶质增生,上述部位自质可见广泛弥漫的少突胶质细胞胞质内缠结样包涵体.结论 临床上橄榄-脑桥-小脑萎缩常以脑桥、小脑及自主神经症状为主,Shy-Drager综合征以直立性低血压症状为主,纹状体黑质变性常以锥体外系症状为主.因上述3个疾病有共同的病理基础,故倾向于将其归为MSA的亚型.

Abstract：

Objective To study the clinical,pathological characteristics and diagnosis of multiple system atrophy(MSA).Methods Among 4 cases of MSA,2 of them were from clinical data,the other 2were frum pathological data.Two cases verified by autopsy were investigated using Hematoxylin-eosi,Kltiver.Barrera and Gallvas-Braak silver staining and confirmed by immunohistochemistry using ubiquitin,α-synuclein staining.Results All 4 patients were male.aged 51-76.Case No.1 wag diagnosed as Parkinson's svndrome.Case No.2 was diagnosed as spinal ataxia cerebella,and the other two eases were diagnosed as MSA.The following changes were found by pathological studies.Macroscopic atrophies were presented in pens and cerebella.as well as putamen,globus pallidus and substantia nigra.Cerebral ventricles were dilated.Neuronal lOSS and gliosis could be seen at cerebral cortex.nigrostriatal.globus pallidus,pontine nuclei,subslantia innominata,inferior olives,doral motor nucleus of vagus,cerebellum antl intermediolateral column of the spinal cord.In the white matter of these regions cytoplasmic inclusions bodies were extensively present in oligodendrocytes.Conclusions Olivopontocerebellar atrophy mainly shows the,clinical symptoms of pens,cerebellum,and autonomic nerves damage;Shy-Drager syndrome presents mainly with the erecting hypotenstion symptom,while striatonigral degeneration mainly involves extrapyramidal system.As these three diseases share the common basic pathological changes,they are preferred to be classified as the subtype of MSA.     

上矢状窦血栓的病理与临床研究

颅内静脉系统血栓形成（cerebral venous thrombosis,CVT）是一种少见的脑血管疾病。该病的临床表现复杂，轻者无明显症状，重者病情凶险，病死率高。不及时诊治，就会导致严重后果。近年来，由于影像学的发展和治疗手段的提高，使该病的诊断率和治愈率都大大提高。但在病理研究方面，     

原发性癫痫不同发作类型认知功能障碍的临床研究

目的 研究原发性癫痫不同发作类型认知功能损害的临床特点.方法 采用韦氏成人智力量表(WAIS-RC)分别对原发性癫痫3种发作类型-复杂部分性发作组(甲组)、部分性发作继发全面性发作组(乙组)、全面性癫痫组(丙组),进行全量表智商(FIQ)、言语智商(VIQ)、操作智商(PIQ)及智力因素(A、B、C)、退化指数研究.结果 乙组FIQ显著低于丙组(P＜0.05)、VIQ显著低于甲组、丙组(P＜0.05)、PIQ 3组无显著差异(P＞0.05);乙组C因素显著低于甲组、丙组(P＜0.05),3组A、B智力因素无显著差异(P＞0.05);3组退化指数无组间差异(df=3,F=2.516,P=0.063).结论 原发性癫痫不同发作类型认知功能损害的程度不同:部分性继发全面性发作对全量表智商、言语智商的影响较其他两种发作类型明显,其中对注意/记忆能力(C因素)损害更突出.     

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1概述颅内静脉窦血栓形成(cerebralvenousthrombosis,CVT)是一种并不少见的脑血管病。以往由于没有影像学的证据,临床确诊很困难。该病的临床表现复杂,轻者无明显症状,重者病情凶险,病死率高,如不及时诊治,就会导致严重后果。近年来,由于影像学的发展和治疗手段的提高,使该病的诊断率和治愈率都大大提高。1.1临床特点本病男、女均可发生,但仍以女性为多,男女比例约为1∶3,发病年龄以年轻人为多,起病形式以急性、亚急性或慢性发病,以亚急性起病较常见。主要的临床表现为:(1)进行性无缓解的头痛呕吐为最常见的临床表现;(2)部分患者除头痛,呕…