JNK通路可能介导MPTP诱导的黑质神经元凋亡

目的 探讨氧化应激激活的c-jun NH2-terminal kinase(JNK)细胞凋亡通路在1-甲基-4-苯基-1，2，3，6-四氢吡啶(MPTP)诱导帕金森病(PD)小鼠黑质神经元凋亡中的可能作用。方法 采用MPTP制备PD小鼠模型，应用生化技术检测黑质区域谷胱甘肽(GSH)浓度及超氧化物歧化酶(SOD)活力，尼氏体染色和酪氨酸羟化酶(TH)免疫组织化学染色观察黑质神经元的损害情况，原位缺口末端标记(TUNEL)染色和活化型Caspase 3免疫组织化学染色观察黑质神经元的凋亡情况，同时采用蛋白兔疫印迹法检测磷酸化JNK及磷酸化c-jun蛋白表达水平。结果 MPTP诱导的PD小鼠黑质区域GSH浓度明显降低，SOD活力明显升高，黑质致密带尼氏体阳性神经元和TH阳性神经元显著脱失，磷酸化JNK及磷酸化c-jun蛋白表达水平上升，同时活化型Caspase 3表达阳性细胞增多，黑质神经元TUNEL染色的阳性率增高。结论 MPTP可诱导小鼠黑质神经元凋亡，机制与增强氧化应激并激活JNK细胞凋亡通路有关。     

脂肪饮食与胆石症关系的调查研究

本文通过荤食组、常食组、素食组与胆石症发病率关系的调查,发现荤食组的发病率14/35(40%)比其它两组8/35(22.85%)、2/35(5.71%)更高。同时发现与病人的高血脂水平呈正相关。荤食组的胆固醇和甘油三酯水平分别为5.4±0.85和1.88±1.02,并且比常食组5.08±1.18,1.76±0.62和素食组4.88±0.41,1.67±0.36更高。结果提示:限制大量的胆固醇和脂肪饮食可降低胆石症的发病率。     

Involvement of CDK4, pRB, and E2F1 in ginsenoside Rg_1 protecting rat cortical neurons from β-amyloid-induced apoptosis

AIM: To explore the possible mechanism of β-amyloid (Aβ)-induced apoptosis in rat cortical neurons and the protective effect of ginsenoside Rg_1. METHODS: AO-EB staining was used to quantify the apoptotic cells. DNA fragmentation was observed by gel electrophoresis. The levels of cyclin-dependent kinases-4 (CDK4) and phosphorylated pRB were detected by Western blot. RT-PCR was used to examine the expression of E2FI mRNA. RESULTS: Treatment with Aβ_(1-40) at the concentration of 20, 40, 80 mg/L for 48 h induced rat cortical neuron poptosis from 12.5％±1.5％(control) to 22.3％±1.4％, 38.8％±1.3％, 36.7％±1.4％, respectively. Pretreatment with Rg_1 at the dose of 0.5, 1, 2, 4, 8, 16 μmol/L for 24 h, then treatment with Aβ_(1-40)40 mg/L for 24 h, the percentage of apoptotic neurons decreased from 38.8％±1.3％ to 14.5％±1.3％, 13.3％±1.0％, 11.6％±0.29％, 11.8％±1.0％, 6.2％±0.8％, 5.8％±0.8％, respectively. After treatment with Aβ_(1-40)40 mg/L for 24 h, there were transient increases in CD     

American Geriatrics Society Policy Brief: COVID-19 and Nursing Homes

This policy brief sets forth the American Geriatrics Society's (AGS's) recommendations to guide federal, state, and local governments when making decisions about care for patients with coronavirus disease 2019 (COVID-19) in nursing homes (NHs) and other long-term care facilities (LTCFs). The AGS continues to review guidance set forth in peer-reviewed articles and editorials, as well as ongoing and updated guidance from the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, and other key agencies. This brief is based on the situation and any federal guidance/actions as of April 4, 2020. It is focused on NHs and other LTCFs, given their essential role in addressing the COVID-19 pandemic. J Am Geriatr Soc 68:908–911, 2020     

American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults

Potentially inappropriate medications (PIMs) continue to be prescribed and used as first-line treatment for the most vulnerable of older adults, despite evidence of poor outcomes from the use of PIMs in older adults. PIMs now form an integral part of policy and practice and are incorporated into several quality measures. The specific aim of this project was to update the previous Beers Criteria using a comprehensive, systematic review and grading of the evidence on drug-related problems and adverse drug events (ADEs) in older adults. This was accomplished through the support of The American Geriatrics Society (AGS) and the work of an interdisciplinary panel of 11 experts in geriatric care and pharmacotherapy who applied a modified Delphi method to the systematic review and grading to reach consensus on the updated 2012 AGS Beers Criteria. Fifty-three medications or medication classes encompass the final updated Criteria, which are divided into three categories: potentially inappropriate medications and classes to avoid in older adults, potentially inappropriate medications and classes to avoid in older adults with certain diseases and syndromes that the drugs listed can exacerbate, and finally medications to be used with caution in older adults. This update has much strength, including the use of an evidence-based approach using the Institute of Medicine standards and the development of a partnership to regularly update the Criteria. Thoughtful application of the Criteria will allow for (a) closer monitoring of drug use, (b) application of real-time e-prescribing and interventions to decrease ADEs in older adults, and (c) better patient outcomes.     

老龄大鼠脑缺血-再灌注神经细胞凋亡变化规律研究

目的　比较研究青年与老龄大鼠脑缺血再灌注 (I/R)后超微结构与神经细胞凋亡特征。方法　采用线栓法建立急性局灶性脑缺血再灌注损伤模型 ,观察缺血 3h及再灌注 3、6、12、2 4和 72 h脑组织超微结构变化及细胞凋亡。结果　老龄大鼠脑缺血 3h和 I/R12 h脑梗死面积较青年大鼠增大。随着 I/R时间延长 ,脑组织细胞损伤逐步加重 ,老龄大鼠较青年大鼠严重。细胞凋亡随着 I/R时间延长而明显增加 ,老龄大鼠出现的早、持续时间长。结论　老年脑缺血再灌注脑梗死面积增大、超微结构损伤和细胞凋亡出现得早且严重。     

中国老年糖尿病诊疗指南(2021年版)

随着我国老龄化的加剧,老年糖尿病的患病率明显增高,亟需对老年糖尿病患者进行规范化管理。国家老年医学中心、中华医学会老年医学分会以及中国老年保健协会糖尿病专业委员会组织专家撰写了《中国老年糖尿病诊疗指南(2021年版)》。本指南共十九章,内容包括老年糖尿病及其并发症的流行病学、临床特点、老年糖尿病患者的健康综合评估、血糖管理、动脉粥样硬化性心血管疾病危险因素管理、急慢性并发症管理、老年糖尿病共患疾病及特殊情况的管理等。本指南强调老年糖尿病患者存在高度异质性,需要综合评估,采取分层和个体化的管理策略。提出了适合老年糖尿病患者的血糖管理路径、简约治疗理念和“去强化治疗策略”。本指南的颁布将有助于指导和帮助临床医师对老年糖尿病患者进行全方位、全周期的规范化综合管理,改善中国老年糖尿病患者的临床结局。