比较MoCA和MMSE在卒中后认知功能筛查中的应用

目的：比较蒙特利尔认知评估量表（Montreal Cognitive Assessment,MoCA）和简易智能量表（mini-mental state examination,MMSE）在急性缺血性脑卒中后认知损害筛查中的应用。方法：对65例缺血性脑卒中患者在发病14天内应用简易精神状态检查量表（Mini-mental State Examination,MMSE）和MoCA进行神经心理评估。其中12例患者在发病3-6个月后应用MMSE、MoCA和神经心理成套测验进行神经心理评估。以MMSE〈23分、MoCA〈21为分界值,受教育年限小于12年加1分,文盲加2分。结果：MMSE的平均分值为25.2±4.3,MoCA的平均分值为18.6±5.7。37例患者MoCA评分显示有认知损害,但其中19例患者（29%）MMSE评分显示正常。28例MoCA评估显示认知正常的患者的MMSE评分均显示认知正常。视空间与执行功能、注意和语言重复测试受损最常见,定向和命名受损较少。在3-6个月的随访期内,12例患者中1例诊断为血管性痴呆患者的MoCA的分值上升1分,MMSE分值无变化;5例认知正常患者、3例轻度认知损害无痴呆的患者和3例中度认知损害无痴呆的患者MMSE和MoCA平均分值均有不同程度的上升,视空间与执行功能平均得分值在2次检测中无明显变化。结论：MoCA较MMSE检出血管性认知功能障碍患者敏感性更高,对认知变化更为敏感。     

姜黄素预防高原缺氧大鼠认知功能障碍的电生理机制

目的:探讨姜黄素(curcumin)预防高原缺氧大鼠认知功能障碍的电生理机制。方法:将30只成年雄性SD大鼠随机分为健康对照组、模型组(Model组)、姜黄素[按体重60mg/(kg.d)]治疗组(curcumin组)。造模后,检测脑片水平的海马的LTP变化,并运用膜片钳技术检测海马CA1区神经元的电生理变化。结果:(1)给予HFS刺激后各组均可诱发LTP并持续1h以上,与对照组比较模型组组HFS刺激后LTP明显被抑制(P<0.05),姜黄素可减轻缺氧所致的LTP抑制(P<0.05);(2)高原缺氧使海马CA1神经元阈电位升高,动作电位(AP)数量减少,兴奋性降低,姜黄素干预可明显减轻高原缺氧对细胞神经元的抑制。结论:姜黄素可显著改善高原缺氧大鼠认知功能障碍,其可能机制是通过维持海马CA1细胞的兴奋性减轻高原缺氧对认知功能的损伤。     

Will a 385 million year‐struggle for light become a struggle for water and for carbon? – How trees may cope with more frequent climate change‐type drought events

Trees are exceptional organisms that have evolved over some 385 million years and have overtaken other plants in order to harvest light first. However, this advantage comes with a cost: trees must transport water all the way up to their crowns and inherent physical limitations make them vulnerable to water deficits. Because climate change scenarios predict more frequent extreme drought events, trees will increasingly need to cope with water stress. Recent occurrences of climate change‐type droughts have had severe impacts on several forest ecosystems. Initial experimental studies have been undertaken and show that stomatal control of water loss hinders carbon assimilation and could lead to starvation during droughts. Other mechanisms of drought‐induced mortality are catastrophic xylem dysfunction, impeded long‐distance transport of carbohydrates (translocation) and also symplastic failure (cellular breakdown). However, direct empirical support is absent for either hypothesis. More experimental studies are necessary to increase our understanding of these processes and to resolve the mystery of drought‐related tree mortality. Instead of testing the validity of particular hypothesis as mechanisms of drought‐induced tree mortality, future research should aim at revealing the temporal dynamics of these mechanisms in different species and over a gradient of environmental conditions. Only such studies will reveal whether the struggle for light will become a struggle for water and/or for carbon in drought‐affected areas.     

认知风格、内外向和情绪对军人认知反应能力的影响

该文主要通过测评研究认知风格、内外向和情绪对军人认知反应能力的影响。结果表明,场独立性者对图形的认知反应能力比场依赖性者强,情绪稳定性高者的认知反应能力好于情绪稳定性低者,外向性格者的认知反应能力总体上要高于内向性格者。     

热射病合并多器官功能障碍综合征持续静- 静脉血液滤过治疗的护理

目的:探讨热射病合并多器官功能障碍综合征(MODS)持续静-静脉血液滤过(CVVH)的治疗作用并总结护理要点。方法:回顾分析2008年5月至2010年9月,我院收治的6例热射病合并MODS,及时运用CVVH并采取综合治疗措施,对治疗和护理进行总结。结果:6例患者5例痊愈,1例死亡。通过早期积极采用CVVH联合综合治疗措施,可快速降低患者体温,防止因高热引起的恶性循环。结论:CVVH是热射病合MODS有效治疗方法,其可早期纠正电解质及酸碱紊乱,且对代谢产物和炎症因子的清除也有重要作用。期间严密的观察与护理,以及配合治疗的连续性,是成功救治这类患者的关键。     

系统生物学在认知功能障碍研究中的应用

认知功能障碍可导致患者日常生活能力、社会适应能力明显下降,严重影响患者的生活质量。根据近年来众多研究显示,认知功能障碍的发生发展与基因、蛋白质、微生物等内环境因素的失调和紊乱有关。基于系统生物学的研究,梳理了近年来国内外研究学者在代谢组学、蛋白质组学、基因组学和肠道微生物组学层面对认知功能障碍的研究,并对系统生物学在认知功能障碍中的应用前景进行了展望,以期为认知功能障碍相关研究提供参考。     

AT2R agonist NP‐6A4 mitigates aortic stiffness and proteolytic activity in mouse model of aneurysm

Clinical and experimental studies show that angiotensin II (AngII) promotes vascular pathology via activation of AngII type 1 receptors (AT1Rs). We recently reported that NP‐6A4, a selective peptide agonist for AngII type 2 receptor (AT2R), exerts protective effects on human vascular cells subjected to serum starvation or doxorubicin exposure. In this study, we investigated whether NP‐6A4–induced AT2R activation could mitigate AngII‐induced abdominal aortic aneurism (AAA) using AngII‐treated Apoe^?/? mice. Male Apoe^?/? mice were infused with AngII (1 µg/kg/min) by implanting osmotic pumps subcutaneously for 28 days. A subset of mice was pre‐treated subcutaneously with NP‐6A4 (2.5 mg/kg/day) or vehicle for 14 days prior to AngII, and treatments were continued for 28 days. NP‐6A4 significantly reduced aortic stiffness of the abdominal aorta induced by AngII as determined by ultrasound functional analyses and histochemical analyses. NP‐6A4 also increased nitric oxide bioavailability in aortic tissues and suppressed AngII‐induced increases in monocyte chemotactic protein‐1, osteopontin and proteolytic activity of the aorta. However, NP‐6A4 did not affect maximal intraluminal aortic diameter or AAA incidences significantly. These data suggest that the effects of AT2R agonist on vascular pathologies are selective, affecting the aortic stiffness and proteolytic activity without affecting the size of AAA.     

Age‐related deterioration of motor function in male and female 5xFAD mice from 3 to 16 months of age

Alzheimer's disease (AD) is a neurodegenerative disorder that leads to age‐related cognitive and sensori‐motor dysfunction. There is an increased understanding that motor dysfunction contributes to overall AD severity, and a need to ameliorate these impairments. The 5xFAD mouse develops the neuropathology, cognitive and motor impairments observed in AD, and thus may be a valuable animal model to study motor deficits in AD. Therefore, we assessed age‐related changes in motor ability of male and female 5xFAD mice from 3 to 16 months of age, using a battery of behavioral tests. At 9‐10 months, 5xFAD mice showed reduced body weight, reduced rearing in the open‐field and impaired performance on the rotarod compared to wild‐type controls. At 12‐13 months, 5xFAD mice showed reduced locomotor activity on the open‐field, and impaired balance on the balance beam. At 15‐16 months, impairments were also seen in grip strength. Although sex differences were observed at specific ages, the development of motor dysfunction was similar in male and female mice. Given the 5xFAD mouse is commonly on a C57BL/6 × SJL hybrid background, a subset of mice may be homozygous recessive for the Dysf ^im mutant allele, which leads to muscular weakness in SJL mice and may exacerbate motor dysfunction. We found small effects of Dysf ^im on motor function, suggesting that Dysf ^im contributes little to motor dysfunction in 5xFAD mice. We conclude that the 5xFAD mouse may be a useful model to study mechanisms that produce motor dysfunction in AD, and to assess the efficacy of therapeutics on ameliorating motor impairment.     

Prostatic irradiation-induced sexual dysfunction: A review and multidisciplinary guide to management in the radical radiotherapy era (Part II on Urological Management)

Prostate cancer is the most common malignancy in men and the second leading cause of cancer-related death in men. Radiotherapy is a curative option that is administered via external beam radiation, brachytherapy, or in combination. Sexual dysfunction is a common toxicity following radiotherapy, similar to men undergoing radical prostatectomy, but the etiology is different. The pathophysiology of radiation-induced sexual dysfunction is multi-factorial, and the toxicity is a major cause of impaired quality of life among long-term prostate cancer survivors. Management of a patient’s sexual function during and after radiotherapy requires multidisciplinary coordination of care between radiation oncology, urology, psychiatry, pharmacy, and dermatology. This review provides a framework for clinicians to better understand prostatic radiotherapy-induced sexual dysfunction diagnosis, evaluation, and a patient-centered approach to toxicity preventive strategies and management.     

Mossy cell synaptic dysfunction causes memory imprecision via miR‐128 inhibition of STIM2 in Alzheimer's disease mouse model

Recently, we have reported that dentate mossy cells (MCs) control memory precision via directly and functionally innervating local somatostatin (SST) inhibitory interneurons. Here, we report a discovery that dysfunction of synaptic transmission between MCs and SST cells causes memory imprecision in a mouse model of early Alzheimer's disease (AD). Single‐cell RNA sequencing reveals that miR‐128 that binds to a 3′UTR of STIM2 and inhibits STIM2 translation is increasingly expressed in MCs from AD mice. Silencing miR‐128 or disrupting miR‐128 binding to STIM2 evokes STIM2 expression, restores synaptic function, and rescues memory imprecision in AD mice. Comparable findings are achieved by directly engineering MCs with the expression of STIM2. This study unveils a key synaptic and molecular mechanism that dictates how memory maintains or losses its details and warrants a promising target for therapeutic intervention of memory decays in the early stage of AD.