阿尔茨海默病伴发视觉障碍研究进展

 阿尔茨海默病（AD）是老年人群常见的神经变性疾病,多以记忆力损害为首发症状,逐渐出现进行性认知功能受损和精神行为症状,对家庭和社会带来沉重的经济和照护负担。AD早期症状不明显,待诊断明确后的治疗效果差,因此,早期诊断尤为重要。研究发现,AD患者可出现视觉障碍,但尚无流行病学数据。目前AD的治疗包括非药物及药物等综合手段,AD伴发视觉障碍的治疗尚需研究。本文主要介绍AD视觉障碍的临床症状、发生机制、检测及评价手段,包括光学相干体层扫描、视觉诱发电位、视网膜微血管检查及神经影像学,以对AD患者的视觉障碍进行全面评价,寻找特异、敏感及简便的AD评估手段,为AD的早期诊断及早期干预提供依据。     

动物模型SAM小鼠及其在老年医学研究中的应用

快速衰老小鼠 (SAM)因其各系具有不同的系特异性病理表型而成为目前唯一最适于研究快速衰老的哺乳类模式动物。本文回顾了SAM小鼠的开发历史及其系谱资料和遗传背景 ,重点对近几年来SAM作为动物模型在老年医学研究中的应用现状 ,包括 :营养与代谢、环境与免疫、行为与脑科学、老年性淀粉样变、老年性骨质疏松、老年肺、老年相关的其他疾病及其遗传学等研究领域进行了分类概述。     

我国古代"情志相胜,以情胜情"的心理疗法及其对现代心理治疗的影响

我国中医学源远流长,其"情志相胜,以情胜情"的心理治疗理念、相应的具体治疗方法及案例,对于分析现代人的心理疾病、并针对性地进行临床治疗具有重要的作用.     

淋巴囊肿病病毒主要衣壳蛋白1.3 kb基因片段的原核表达

取淋巴囊肿病病毒感染牙鲆组织,蛋白酶K裂解,PCR法成功获得了淋巴囊肿病病毒主要衣壳蛋白1.3 kb基因片段.构建其原核表达载体,IPTG诱导表达.结果表明,该融合蛋白分子量约70 kD,可与抗LCDV多克隆血清特异反应.为LCDV基因工程疫苗的研制奠定了实验基础.     

Association of cystatin C level and cardiovascular prognosis for patients with preexisting coronary heart disease： a meta-analysis

The association of circulating levels of cystatin C （CysC） and risk of recurrent cardiovascular events in patients with preexisting coronary heart disease are uncertain. To qualitatively and quantitatively address this issue, we performed a random meta-analysis of results from prospective studies on the topic. We searched elec- tronic and printed sources （up to 16 October 2011） using keywords and retrieved articles for seven prospective studies according to the selection criteria. Data were abstracted and meta-analysis was performed using the random-effects model （RevMan 5.0.23 software）. The cohorts involved 4,576 patients with preexisting coronary heart disease （CHD） and normal or mild chronic kidney disease, and follow-up ranged from 5.6 to 40.6 months. Highest versus lowest baseline CysC level was signifi- cantly associated with increased risk of cardiovascular events （OR 2.30, 95 % CI 1.80-2.94）, all-cause mortality （OR 5.69, 95 % CI 3.70-8.74）, but not with recurrent MI （OR 1.75, 95 % CI 0.77-4.00）. In heterogeneity testing for studies reporting cardiovascular events and all-cause mor- tality, no significant heterogeneity was found, and exclu- sion of any single study did not alter the overall finding. For risk of recurrent MI, significant heterogeneity was found among the five trials （Z2= 13.16, P=0.01, 12 = 70 %） and exclusion of the Taglieri et al. [12] study from the analysis resulted in a rise in relative risk （OR 2.36, 95 % CI 1.09-5.15）. In conclusion, for patients with established CHD, high baseline level of CysC is associated with increased risk of cardiovascular events and all-cause death during long-term follow-up.     

小鼠同种异体骨髓移植GVHD模型的建立

目的选择C57BL/6(H-2b)→BALB/c(H-2d)、C57BL/6(H-2b)→CB6F1(H-2d/b)分别作为完全异基因移植和半相合基因移植的供、受者;建立小鼠移植物抗宿主病(GVHD)模型。结果此GVHD模型动物于移植后1周体重进行性下降,前3天平均每天下降2g左右,此后体重下降趋势有所减缓。第8~12d体重略有回升,第12d后体重再度开始下降。并伴有皱毛、弓背、脱毛、腹泻及肛门红肿,皮肤增厚等症象。移植后12d开始有小鼠死亡,至移植后3周小鼠全部死亡,死亡时平均体重下降10g左右。病理学检查结果显示,肝脏汇管区大量分叶核细胞和淋巴细胞浸润,肝血窦内也有淋巴细胞浸润;肝血窦和中央静脉扩张瘀血。肠粘膜下层有大量淋巴细胞及分叶核细胞浸润,肠粘膜上皮坏死脱落。皮肤真皮层毛细血管扩张,有淋巴细胞和分叶核细胞浸润,符合GVHD症象及病理诊断。结论本实验动物模型是可靠的,可用于GVHD防治的实验性研究。     

LOD score exclusion analyses for candidate disease susceptibility genes using case-parents design

The focus of almost all the association studies of candidate genes is to test for their importance. We recently developed a LOD score approach that can be used to test against the importance of candidate genes for complex diseases and quantitative traits in random samples. As a complementary method to regular association analyses, our LOD score approach is powerful but still affected by the population admixture, though it is more conservative. To control the confounding effect of population heterogeneity, we develop here a LOD score exclusion analysis using case?parents design, the basic design of the transmission disequilibrium test (TDT) approach that is immune to population admixture. In the analysis, specific genetic effects and inheritance models at candidate genes can be analyzed and if a LOD score is ≤-2.0, the locus can be excluded from having an effect larger than that specified. Simulations show that this approach has reasonable power to exclude a candidate gene having small genetic effects if it is not a disease susceptibility locus (DSL) with sample size often employed in TDT studies. Similar to association analyses with the TDT in nuclear families, our exclusion analyses are generally not affected by population admixture. The exclusion analyses may be implemented to rule out candidate genes with no or minor genetic effects as supplemental analyses for the TDT. The utility of the approach is illustrated with an application to test the importance of vitamin D receptor (VDR) gene underlying the differential risk to osteoporosis.     

论地铁土建设施病害治理及其在地铁安全运营方面的联动性

结合北京地铁过火桥梁修复、隧道局部沉降治理和桥梁病害支座更换三次重大的土建设施修复案例,说明了地铁土建设施的特殊性以及土建设施病害治理对保障土建设施安全运营方面的重要性.同时阐述了地铁土建设施的严格使用控制要求,以及各系统联动保障要求和社会影响等内容.本文提到的应急保障机制和联调联动机制可以为各级行政主管部门和各地地铁运营公司制定相关机制提供参考依据.     

大剂量前列腺素E1冲击治疗糖尿病足合并动脉病变前瞻性研究

目的观察大剂量前列腺素E1冲击治疗对糖尿病足合并外周动脉病变患者的疗效,并探讨其可能机制.方法前瞻性选取Wagner I~Ⅲ级的糖尿病足患者139例,分为大剂量前列腺素E1组(观察组)79例、传统计量组(对照组)60例.在给予常规治疗基础上,观察组给予前列腺素E1(40μg/d),连续治疗7 d,对照组给予常规剂量前列腺素E1(10μg/d),连续治疗14 d,随访3个月.分别与治疗前和治疗1个疗程后取糖尿病足创面中心肉芽组织行病理学观察,并采用ELISA法测定其中的NGF含量,放射免疫法测定EGF含量.比较两组患者治疗后3个月时伤口愈合情况、截肢率、踝肱指数和疼痛程度.结果观察组治疗1个疗程后创面组织HE染色可见新肉芽组织形成,对照组也可见新肉芽组织形成,但新生血管较少.治疗1个疗程后观察组患者NGF和EGF含量明显高于对照组,差异具有统计学意义(P0.05).治疗后3个月,观察组WagnerⅡ~Ⅲ级患者创面愈合率均明显高于对照组,差异具有统计学意义(P0.05);观察组WagnerⅡ级创面愈合时间明显短于对照组,差异具有统计学意义(P0.05);两组患者截肢率之间差异无统计学意义(P0.05).治疗后3个月,观察组WagnerⅡ级治疗后踝肱指数明显高于治疗前,差异具有统计学意义(P0.05).观察组患者VAS评分均明显低于治疗前,差异具有统计学意义(P0.05).结论大剂量前列腺素E1冲击治疗可明显提升WagnerⅡ~Ⅲ级合并外周动脉病变糖尿病足患者创面愈合率,缩短WagnerⅡ级患者愈合时间,缓解下肢疼痛;其可能机制与提升NGF,EGF因子水平有关.     

2000-2005年我国主要人鼠共患病的疫情和预防

我国已经证实的人鼠共患病按病原划分有5类20种,列出病名及其主要的啮齿动物宿主、传播媒介和地理分布。鼠疫、肾综合征出血热和钩端螺旋体病是我国3种主要人鼠共患病。通过分析监测数据,发现以上3种传染病在2000-2005年中发病人数大体上呈下降趋势。人鼠共患病预防措施包括控制传染源、切断传播途径和免疫接种。