GlideScope视频喉镜和Macintosh直接喉镜在颈椎损伤患者气管插管中的应用比较

目的:比较GlideScope视频喉镜(加拿大Saturn生物技术有限公司)和普通直接喉镜在颈椎损伤患者气管插管中的难易,及两种工具插管对血液动力学的影响。方法:拟在经口气管插管全身麻醉下行择期手术的患者40例,ASAI级,年龄18～60岁,随机分为G组和M组(n=20)。常规麻醉诱导后,手法制动头颈部,G组采用GlideScope视频喉镜,M组用Macintosh直接喉镜行气管插管。分析比较两组声门暴露情况(Cormark-Lehane分级)以及暴露时间,试插次数,失败例数,有无助手辅助,插管前后心率与收缩压乘积(RPP)变化。结果:与M组比较,G组声门暴露情况较好,但暴露时间显著延长(P<0.05)。M组需要助手辅助及插管失败的比例均高于G组。两组RPP的变化在各个时点无显著差别。结论:在为颈椎损伤患者气管插管中,GlideScope视频喉镜能够更好的显露声门,降低插管难度,提高插管的成功率。     

The dangers of multi‐male groupings: trauma and healing in cercopithecoid monkeys from Cameroon

This study examines the potential linkage between social organization and trauma in a sample of cercopithecids from Cameroon. Skeletal trauma is described in a museum collection of eight sympatric monkey species. Macroscopic analysis was carried out on a total of 139 complete skeletons of mangabeys, colobines and guenons. Species in multi‐male groups were found to have higher fracture frequencies than those in uni‐male groups. These higher frequencies may be related to intra‐specific male–male aggression; however, similarities in fracture patterning between males and females in multi‐male groups suggest that other factors may be involved. Although fracture etiology may not be identified with certainty, this study suggests that predation may indirectly be a cause of traumatic injuries in those species of cercopithecid monkeys displaying multi‐male social organizations. The data presented also highlight the utility of museum collections as an additional resource in analyses of primate behavior, demonstrating that behavioral information does not die when the animal does. Am. J. Primatol. 71:567–573, 2009. © 2009 Wiley‐Liss, Inc.     

Microdialysis of dopamine interpreted with quantitative model incorporating probe implantation trauma

Although microdialysis is widely used to sample endogenous and exogenous substances in vivo, interpretation of the results obtained by this technique remains controversial. The goal of the present study was to examine recent criticism of microdialysis in the specific case of dopamine (DA) measurements in the brain extracellular microenvironment. The apparent steady-state basal extracellular concentration and extraction fraction of DA were determined in anesthetized rat striatum by the concentration difference (no-net-flux) microdialysis technique. A rate constant for extracellular clearance of DA calculated from the extraction fraction was smaller than the previously determined estimate by fast-scan cyclic voltammetry for cellular uptake of DA. Because the relatively small size of the voltammetric microsensor produces little tissue damage, the discrepancy between the uptake rate constants may be a consequence of trauma from microdialysis probe implantation. The trauma layer has previously been identified by histology and proposed to distort measurements of extracellular DA levels by the no-net-flux method. To address this issue, an existing quantitative mathematical model for microdialysis was modified to incorporate a traumatized tissue layer interposed between the probe and surrounding normal tissue. The tissue layers are hypothesized to differ in their rates of neurotransmitter release and uptake. A post-implantation traumatized layer with reduced uptake and no release can reconcile the discrepancy between DA uptake measured by microdialysis and voltammetry. The model predicts that this trauma layer would cause the DA extraction fraction obtained from microdialysis in vivo calibration techniques, such as no-net-flux, to differ from the DA relative recovery and lead to an underestimation of the DA extracellular concentration in the surrounding normal tissue.     

Age-related changes of elements in human thoracic ducts and azygos veins and relationships among elements

To elucidate compositional changes of the thoracic duct with aging, the authors investigated age-related changes of elements in the thoracic ducts in comparison with the azygos veins. The subjects consisted of 22 men and 1 woman, ranging in age from 65 to 95 yr. After ordinary dissection, the thoracic ducts and azygos veins were resected from the subjects and element contents were determined by inductively coupled plasma-atomic emission spectrometry. It was found that calcium appeared to increase in the thoracic duct with aging, but the other elements, such as phosphorus, sulfur, magnesium, iron, zinc, and sodium, did not change significantly with aging. In the azygos vein, both calcium and sulfur increased significantly with aging. Regarding the relationship among elements, extremely significant direct correlations were found among calcium, phosphorus, sulfur, and magnesium in the thoracic ducts, except for phosphorus and magnesium contents with a very significant direct correlation. In the azygos veins, significant direct correlations were found between calcium and sulfur contents and between sulfur and magnesium contents. However, no significant correlations were found among calcium, phosphorus, and magnesium in the azygos veins. These results revealed that with regard to the relationship among calcium, phosphorus, and magnesium, the thoracic duct was similar to the arteries, but not to the azygos vein.     

Traumatic Brain Injury Increases β-Amyloid Peptide 1-42 in Cerebrospinal Fluid

Abstract: The β-amyloid peptides, Aβ1-42 and Aβ1-40, were quantified in ventricular CSF taken daily for up to 3 weeks from six individuals with severe traumatic brain injury (TBI). There was considerable interindividual variability in the levels of Aβ peptides, but in general Aβ1-42 levels equalled or exceeded those of Aβ1-40. Averaging the daily totals of our trauma cohort revealed that the levels of Aβ1-42 and Aβ1-40 rose after injury, peaking in the first week and then declining toward control levels over the next 2 weeks. Aβ1-42 levels were on average two to three times higher in the trauma cohort than in CSF from nontrauma samples. Compared with nontrauma samples, the Aβ1-40/Aβ1-42 ratio decreased about fivefold in the trauma patients, further indicative of increased Aβ1-42 levels. The ratio remained low at all time points studied. No change was measured in the levels of β-amyloid precursor protein during the same interval. These results suggest that Aβ1-42 becomes elevated in the CSF after severe brain trauma.     

Stress protein synthesis and accumulation after traumatic injury of crayfish CNS

By several days after a crush injury of crayfish CNS, the wound site heals. Changes in protein synthesis and accumulation occur at the lesion site and nearby. During the first few hours, synthesis of 35, 70, 90, and 150 kDa proteins is induced in the injured tissue. By one day, the relative amounts of 70–90 kDa proteins increase dramatically, particularly at the crush site and adjacent to it. The 70 kDa proteins, which are related to mammalian stress proteins (SPs), remain elevated for at least one month in the traumatized region or nearby. The crushed tissue contains an SP70 isoform not present in its uncrushed counterpart. These biochemical changes may reflect the cellular changes that accompany wound healing and/or a cellular stress response to compensate for the lesion. Since similar adaptations occur in the mammalian CNS, they may represent a phylogenetically conserved attempt to retard or repair CNS tissue deterioration.     

The impact of early adversity and education on genetic and brain morphological predictors of cognitive ability

Cognitive ability is a strong predictor of occupational achievement, quality of life and physical health. While variation in cognition is strongly heritable and has been robustly associated with early environment and brain morphology, little is known about how these factors combine and interact to explain this variation in cognition. To address this, we modelled the relationship between common genetic variation, grey matter volume, early life adversity and education and cognitive ability in a UK Biobank sample of N = 5237 individuals using structural equation modelling. We tested the hypotheses that total grey matter volume would mediate the association between genetic variation and cognitive ability, and that early life adversity and educational attainment would moderate this relationship. Common genetic variation, grey matter volume and early life adversity were each significant predictors in the model, explaining ~15% of variation in cognitive ability. Contrary to our hypothesis, grey matter volume did not mediate the relation between genetic variation and cognition performance. Neither did early life adversity or educational attainment moderate this relation, although educational attainment was observed to moderate the relationship between grey matter volume and cognitive performance. We interpret these findings in terms of the modest explanatory value of currently estimated polygenic scores accounting for variation in cognitive performance (~5%), making potential mediating and moderating variables difficult to confirm.     

后路椎板减压螺钉置入术与椎管减压固定术治疗胸髓损伤对比研究

摘要 目的：探究后路椎板减压螺钉置入术与椎管减压固定术对胸髓损伤患者临床效果。方法：择取胸髓损伤患者54例,通过随机数字表法分为对照组27例,研究组27例。对照组采用后路椎板减压螺钉置入术,研究组采用椎管减压固定术治疗。统计两组患者相关手术指标情况;检测血清炎性因子水平;通过视觉模拟评分法（VAS）及Oswestry功能障碍指数（ODI）对两组患者疼痛程度及功能障碍程度进行评价;采用Frankel分级评估患者的脊髓损伤情况,对比两组术后效果。结果：术后与对照组相比,研究组手术时间、术中出血量、手术切口及住院时间均减少,具有统计学差异（均P<0.05）。术后1、3个月,与对照组相比,研究组白介素1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、VAS、ODI评分下降程度更为显著,Frankel分级情况上升程度更为显著,具有统计学差异（均P<0.05）。与对照组相比,研究组临床疗效更为显著,具有统计学差异（P<0.05）。结论：对胸髓损伤患者行椎管减压固定术的治疗效果较好,治疗后患者炎症水平降低,疼痛得到缓解,运动功能和神经功能得到恢复,整体疗效显著,值得临床推广。     

Germinal centres and the B-cell system. V

Summary Thoracic duct lymphocytes (TDL) were studied with respect to their capacity to give rise to germinal centres (GC) and to form primary antibody in an adoptive transfer system of the rat. Challenge with sheep erythrocytes (SRBC) 24h after lethal irradiation (900 rads) and syngeneic TDL reconstitution (10⁸) lead to conspicuous GC activity already 7 days after transfer. In contrast, using syngeneic bone marrow (BM) in the adoptive transfer system, no GC formation was observed over the period studied (14 days after reconstitution). Reconstitution experiments using in vivo-separated T-TDL (1–5 % s-Ig⁺) and B-TDL (>90% s-Ig⁺) subpopulations, either separately or in combination, indicated that GC originate from B-TDL but require T-TDL for induction.Abbreviations BM Bone Marrow - TDL Thoracic Duct Lymphocytes - GC Germinal Centre - SRBC Sheep Red Blood Cells - GCDC Germinal Centre-Derived Cells - GCPC Germinal Centre-Precursor Cells - DAB Mineral Salt Solution Dulbecco A + B - FCS Fetal Calf Serum - PALS Peri-Arteriolar Lymphocyte Sheath - AFCP Antibody-Forming Cell Precursors     

Inhibition of IL-17 prevents the progression of traumatic heterotopic ossification

Traumatic heterotopic ossification (HO) is the abnormal formation of bone in soft tissues as a consequence of injury. However, the pathological mechanisms leading to traumatic HO remain unknown. Here, we report that aberrant expression of IL-17 promotes traumatic HO formation by activating β-catenin signalling in mouse model. We found that elevated IL-17 and β-catenin levels are correlated with a high degree of HO formation in specimens from patients and HO animals. We also show that IL-17 initiates and promotes HO progression in mice. Local injection of an IL-17 neutralizing antibody attenuates ectopic bone formation in a traumatic mouse model. IL-17 enhances the osteoblastic differentiation of mesenchymal stem cells (MSCs) by activating β-catenin signalling. Moreover, inhibition of IL-17R or β-catenin signalling by neutralizing antibodies or drugs prevents the osteogenic differentiation of isolated MSCs and decreases HO formation in mouse models. Together, our study identifies a novel role for active IL-17 as the inducer and promoter of ectopic bone formation and suggests that IL-17 inhibition might be a potential therapeutic target in traumatic HO.