超声技术在抑郁症诊疗中的作用研究及应用进展

超声波作为一种机械振动波,兼具波动效应、力学效应和热效应.这3种效应在临床中均有较大应用价值,可用于疾病的成像诊断、辅助给药、调控以及热消融治疗等.超声技术所具有的非侵入性、穿透力强、空间分辨率高等特性,使其在神经系统疾病的诊断和治疗中具有广泛的应用前景.而抑郁症作为一种常见的精神疾病,其诊断和治疗都面临很大的困难.因此,大量学者将超声技术应用于抑郁症诊疗.本文主要从超声成像、超声定点给药、超声调控、超声诱导抑郁几个方面总结近十年来超声技术在抑郁症中的应用,以期为研究抑郁症发病机制及诊疗提供一定的参考和帮助.     

肠道菌群与呼吸道感染患者免疫球蛋白的关系及其肠内营养的疗效

目的分析肠道菌群紊乱对呼吸道感染患者免疫球蛋白水平的影响,探讨肠内营养对此类患者的疗效。方法选取2016年2月至2018年12月在我院接受治疗的116例呼吸道感染患者作为观察组,进一步将其分为非菌群失调组(50例)和菌群失调组(66例),选取同期60例健康体检者作为对照组,比较各组对象肠道菌群失调情况和血清免疫球蛋白水平,同时对菌群失调患者在常规治疗基础上联合应用肠内营养治疗,观察其治疗效果。结果 (1)观察组患者肠道乳杆菌、双歧杆菌数量及双歧杆菌/大肠埃希菌比值(B/E)显著低于对照组,而肠球菌、大肠埃希菌数量显著高于对照组(均P0.05);观察组患者血清IgM、IgA、IgG水平均显著低于对照组(均P0.05);菌群失调组患者血清IgM、IgA、IgG水平均显著低于非菌群失调组(均P0.05)。(2)观察组患者肠道乳杆菌、双歧杆菌数量及B/E值与血清IgM、IgA、IgG水平呈显著正相关(均P0.05),而大肠埃希菌和肠球菌数量与之呈显著负相关(均P0.05)。(3)菌群失调组患者血清ALB、PA水平随治疗时间的延长而逐渐升高,CRP、PCT水平逐渐降低,IgM、IgA、IgG水平逐渐升高,乳杆菌、双歧杆菌数量和B/E值逐渐增加,大肠埃希菌和肠球菌数量逐渐减少(均P0.05)。结论呼吸道感染患者存在明显的肠道菌群失调情况,其与患者免疫球蛋白水平的降低有关,这可能是引发呼吸道感染的主要危险因素。肠内营养支持疗法能有效改善患者肠道菌群失调,降低血清炎性因子水平,增强机体免疫力,提高患者营养状况及治疗效果。     

Pollen limitation in the endangered Chinese endemic species Sinocalycanthus chinensis

Pollen limitation negatively impacts endangered and endemic plants with small fragmented populations, such as Sinocalycanthus chinensis, an endangered plant endemic to China. In this study, we analyzed the pollen limitation of the S. chinensis Damingshan (DMS) population in 2006, 2009, and 2010, and crossed plants with mates separated by different distances, both within and between populations. The DMS population exhibited strong pollen limitation in fruit set, seed set, and seeds per fruit in 2006, 2009, and 2010. The average accumulated pollen limitation (for fruit set times seeds per fruit) was 0.510 ± 0.180. Progeny crossed with pollen from intermediate neighboring plants within the same population (separated by 30–50 m from pollen recipients) had the lowest fitness. No optimal outcrossing distance was found within the DMS population. Progeny from crosses with the Shunxiwu (SXW) and Daleishan (DLS) populations performed relatively better, while those from crosses with Qingliangfeng (QLF) and Longxushan (LXS) populations performed worse. Compared with average reproductive success, outbreeding depression was found in progeny from crosses with the LXS and QLF populations. Reproductive success from pure self‐pollination indicated S. chinensis is self‐compatible. Geitonogamous selfing increased reproductive success. Based on geitonogamous selfing, the proportion of selfed offspring was relatively high. These results provide basic references for the conservation of this species.     

Genomic Consequences of Long-Term Population Decline in Brown Eared Pheasant

Population genetic theory and empirical evidence indicate that deleterious alleles can be purged in small populations. However, this viewpoint remains controversial. It is unclear whether natural selection is powerful enough to purge deleterious mutations when wild populations continue to decline. Pheasants are terrestrial birds facing a long-term risk of extinction as a result of anthropogenic perturbations and exploitation. Nevertheless, there are scant genomics resources available for conservation management and planning. Here, we analyzed comparative population genomic data for the three extant isolated populations of Brown eared pheasant (Crossoptilon mantchuricum) in China. We showed that C. mantchuricum has low genome-wide diversity and a contracting effective population size because of persistent declines over the past 100,000 years. We compared genome-wide variation in C. mantchuricum with that of its closely related sister species, the Blue eared pheasant (C. auritum) for which the conservation concern is low. There were detrimental genetic consequences across all C. mantchuricum genomes including extended runs of homozygous sequences, slow rates of linkage disequilibrium decay, excessive loss-of-function mutations, and loss of adaptive genetic diversity at the major histocompatibility complex region. To the best of our knowledge, this study is the first to perform a comprehensive conservation genomic analysis on this threatened pheasant species. Moreover, we demonstrated that natural selection may not suffice to purge deleterious mutations in wild populations undergoing long-term decline. The findings of this study could facilitate conservation planning for threatened species and help recover their population size.     

钙稳态调节蛋白2 Q87A突变增加抑郁易感性

钙稳态调节蛋白2（calcium homeostasis modulator 2,Calhm2）参与钙离子活动和ATP释放的调控. 本实验室的前期工作已经证实,Calhm2可以介导星形胶质细胞ATP的释放,在抑郁症的发生发展中起到重要作用. 为了进一步探究Calhm2在抑郁症发生发展中的分子机制,本文首先预测了Calhm2的ATP结合位点,即位于第87位点的谷氨酰胺（Q87）,并将其突变为丙氨酸（A）,建立了一个携带calhm2突变（Q87A）的小鼠品系. 随后,通过对原代星形胶质细胞的胞内和胞外ATP检测,发现Calhm2 Q87A突变导致星形胶质细胞ATP的释放下降;此外,通过对小鼠大脑海马切片的ATP检测,发现Calhm2 Q87A突变小鼠海马组织的ATP释放较正常小鼠下降;最后,通过给予慢性温和不可预知应激（chronic unpredictable mild stress,CUMS）来诱发小鼠抑郁样行为,发现Calhm2 Q87A突变小鼠抑郁样行为相对野生型小鼠表现得更为严重. 综上所述,本文发现Q87位点对Calhm2介导的星形胶质细胞ATP释放发挥重要作用,该位点的突变增加了外界压力刺激诱导抑郁样行为的易感性,进一步明确了Calhm2蛋白在抑郁症发生发展中的分子机制,为抑郁症相关疾病的诊断和治疗提供了新的理论基础.     

小胶质细胞极化与抑郁症关系的研究进展

小胶质细胞控制着中枢神经系统主要的免疫功能,在各种精神疾病中发挥重要作用. 某些信号通路的激活引发的神经炎症与抑郁症的发生有着密切的关系. 小胶质细胞是神经炎症的主要介导者,不同的刺激促进小胶质细胞极化,不同极化类型的小胶质细胞能分泌多种炎性细胞因子,在神经炎症调节中具有重要的作用. 临床研究和体内外实验研究表明,抑郁症与小胶质细胞极化介导的神经炎症有关. 小胶质细胞极化参与抑郁症发生发展的可能机制包括NF-κB信号通路激活、呼吸爆发、补体受体3信号通路、NLRP3炎症激活、cannibalism受体1、Notch-1信号通路和过氧化物酶体增殖物激活受体γ的激活. 本文就小胶质细胞极化与抑郁关系的研究进展作一综述.     

二十四式简化太极拳联合呼吸功能训练对中老年COPD患者肺功能、运动耐力及心理状态的影响

摘要 目的：探讨二十四式简化太极拳联合呼吸功能训练对中老年慢性阻塞性肺疾病（COPD）患者肺功能、运动耐力及心理状态的影响。方法：选取2019年4月~2020年8月期间我院收治的中老年COPD患者81例,按照信封抽签法分为对照组（40例,给予呼吸功能训练干预）和观察组（41例,给予二十四式简化太极拳联合呼吸功能训练干预）,均干预6个月。对比两组干预前、干预6个月后的肺功能、运动耐力、心理状态及生活质量。结果：两组干预6个月后用力肺活量（FVC）、1 秒用力呼气容积( FEV1)、FEV1/FVC升高,且观察组高于对照组（P<0.05）。两组干预6个月后呼吸症状、疾病影响、活动受限评分降低,且观察组低于对照组（P<0.05）。两组干预6个月后6 min步行试验（6MWT）距离延长,且观察组长于对照组（P<0.05）。两组干预6个月后人际关系、抑郁、偏执、敌对、焦虑、恐惧评分降低,且观察组低于对照组（P<0.05）。结论：中老年COPD患者经二十四式简化太极拳联合呼吸功能训练干预后,肺功能、运动耐力、生活质量及心理状态均得到显著改善,提示该康复训练方案可用于辅助中老年COPD患者的治疗。     

呼吸道感染患者多重耐药菌肺炎克雷伯菌的耐药及危险因素分析

摘要 目的：探讨与分析呼吸道感染患者多重耐药菌肺炎克雷伯菌的耐药及危险因素。方法：选择2015年1月到2020年2月本院诊治的呼吸道感染患者65例作为研究对象,收集患者的临床样本进行细菌分离与耐药分析,调查患者的临床资料并进行危险因素分析。结果：在呼吸道感染患者65例中,分离出多重耐药菌肺炎克雷伯菌32株,占比49.2 %,其中下呼吸道、上呼吸道、灌洗液、血液标本分别占50.0 %、9.4 %、25.0 %、6.3 %。32株多重耐药菌肺炎克雷伯菌对头孢曲松、头孢呋辛、氨苄西林、头孢吡肟、头孢噻肟的耐药率分别为71.9 %、87.5 %、96.9 %、84.4 %、81.3 %,对阿米卡星、头孢替坦、左氧氟沙星、亚胺培南、环丙沙星的敏感率分别为59.4 %、68.8 %、81.3 %、75.0 %、81.3 %。非条件 Logistic回归分析显示血型A型、碳青霉烯类抗菌药物使用、引流、机械通气、糖尿病等为导致多重耐药菌肺炎克雷伯菌感染的独立危险因素(P<0.05)。结论：多重耐药菌肺炎克雷伯菌感染在呼吸道感染患者中比较常见,对头孢呋辛、氨苄西林的耐药率比较高,对左氧氟沙星、环丙沙星的敏感率比较高,血型A型、碳青霉烯类抗菌药物使用、引流、机械通气、糖尿病等为导致多重耐药菌肺炎克雷伯菌感染的独立危险因素。