咀嚼肌痉挛

咀嚼肌痉挛是一种临床罕见疾病,表现为单侧嚼肌突发阵发性、不自主地抽搐发作。伴或不伴有单侧面萎缩或局部硬皮病,其发病机制至今尚不明确,国内外报道极少,目前为止,仅26例具有肌电图支持的病例报道。文章复习了相关文献,对其病因、发病机制、诊断原则、治疗方法等作了系统综述。     

高血压大鼠主动脉条血管反应性的变化

血管对加压物质反应性的增高是高血压发病机制中的一个重要方面,但其机制迄今尚未完全阐明。近年来关于血管组织内肾素-血管紧张素系统在高血压发生中的作用受到广泛注意,然而有关实验报道还不多。本实验对高血压大鼠主动脉组织中去甲肾上腺素(NE)与血管紧张素Ⅱ(AⅡ)的含量及其对此两种物质的反应性进行了研究,以探讨高血压发病的血管机制。     

女性Duchenne/Becker型肌营养不良症携带者发病机理的研究进展

Duchenne/Becker型肌营养不良(DMD/BMD)是一类常见的X连锁隐性遗传病,多见于男性患者,女性携带者一般不发病,因为女性体内会发生随机的X染色体失活,而使体内呈现镶嵌型。目前,越来越多的文献报道DMD/BMD女性携带者发病的病例,其症状有轻有重,但发病机制尚不明了,大多数研究认为与X染色体的偏斜失活有关,即携带DMD突变的X染色体异常活化,使正常DMD基因弱或无表达,从而无法生成正常功能的dystrophin蛋白,表现为DMD/BMD。本文主要综述了X偏斜失活与DMD女性携带者发病相关性的研究进展。     

病毒感染与骨髓衰竭

本文综述了病毒感染引起骨髓抑制或衰竭的临床资料和近年来对其发病机制的研究状况。研究表明病毒感染与骨髓衰竭密切相关,其发病机制主要是通过病毒对骨髓干细胞的直接破坏或免疫损伤所致,亦可能因破坏了骨髓的基质细胞,造成微环境损伤而影响骨髓的造血功能。     

下行易化系统及其参与神经病理痛的机制

神经病理痛是指由中枢或外周神经系统损伤或疾病引起的疼痛综合征.神经病理痛是临床上常见的一种疾病,但是其发病机制不甚清楚,临床上也缺乏有效的治疗手段.近年来的研究除了集中于痛觉的上行传导及中枢机制,以及痛觉的下行抑制之外,也证明下行易化系统激活参与神经病理痛的发病机制.本文拟对此进行综述,希望为治疗神经病理痛提供新思路.     

早期干预早产儿呼吸暂停的临床观察

呼吸暂停是指呼吸停止超过20 s并伴有心动过缓和紫绀,其发病率与胎龄和体重有关。因呼吸暂停而导致的缺氧是一种严重的临床症状,若不及时处理,长时间缺氧可引起脑损害,可致死或致残。以往认为原发性呼吸暂停与早产儿中枢神经系统结构或功能不成熟有关,最近有学者认为其发病机制     

外伤性视神经病变最新治疗进展

外伤性视神经病(TON)最常见的原因是颅脑外伤,虽然其发病率不高,但是视力受损后果严重,特别是双侧视神经受损,大部分患者为青壮年,儿童患者占20%。其发病机制到目前为止仍未完全阐明,不同的医疗机构诊断和治疗不完全相同,临床疗效也千差万别。本文通过查阅近年最新文献,对外伤性视神经病变的最新研究进展从视神经解剖、发病机制、诊断、治疗(保守、手术)等方面分别进行综述。希望能够明确其发病机制,找到疗效确切的临床诊断和治疗方法。     

PINK1-Parkin通路与线粒体自噬

正帕金森病(Parkinson's disease,PD)由英国医生James Parkinson于1817年首次报道,表现为中脑黑质多巴胺能神经元(dopaminergic neurons)凋亡、并以肌张力增强、运动障碍为主要临床症状,其多发于中老年人,呈散发性或家族性,是重要神经退行性疾病之一。探索帕金森病的发病机制,一直是世界医学界研究热点。近年来发现,线粒体功能异常密切参与帕金森病发病。PINK1是线粒体质量控制(mitochondrial quality control)主要调节子,其可被诸多线粒体损伤因素激活,从而磷酸化其下游     

神经嵴发育异常导致综合征型耳聋的机制

综合征型耳聋(Syndromic hearing loss, SHL)现已报道400多种,大多数发病率低,临床常见的有Waardenburg综合征(WS)、先天性小耳畸形综合征、前庭导水管扩大综合征等。因SHL具有极强的临床和遗传异质性,所以对其遗传基础及发病机制的研究变得十分困难。以SOX10和PAX3为中心的基因作用网络引起的神经嵴细胞功能异常与WS、小耳畸形及前庭导水管扩大等表型相关。本课题组前期研究也证实该基因网络参与WS的发病机制。文章针对神经嵴发育异常导致相关综合征型耳聋的发病机制的研究进展进行了系统的阐述,分析并归纳了与综合征型耳聋发病相关的神经嵴发育异常基因互作网络,以期为系统地研究常见综合征型耳聋致病基因的定位克隆以及发病机制提供研究思路和理论基础。     

微量泵注射乌拉地尔治疗肾性高血压急症的护理

肾性高血压是指肾脏疾病引起的高血压,是由肾实质疾患或肾动脉狭窄引起,其发病机制为＂容量依赖性＂或＂肾素依赖性＂。肾性高血压通常较顽固,尽管大多数肾性高血压患者长期口服多种降压药或服用剂量、频率较其他高血压患者多,但部分患者仍控制不理想,甚至出现血压严重升高。     

家族性三叉神经痛

三叉神经痛是一种临床常见疾病,典型的三叉神经痛主要表现为阵发性、闪电样的疼痛发作,疼痛剧烈,常无法忍受,呈电灼、针刺、撕裂样,每次发作持续时间数秒至数分钟不等。疼痛多发生于单侧,常有扳机点表现,其多表现为散发,而家族性三叉神经痛报道罕见,至今世界范围内报道仅50余个家系,其临床表现及发病特点与散发性三叉神经痛存在明显差别,尽管散发三叉神经痛患者的病因为责任血管压迫三叉神经REZ区已被普遍接受,但关于家族性三叉神经痛的病因是否为血管压迫存在争议,其遗传模式也没有达成一致的意见,文章复习了相关文献,并通过对这些文献进行分析综合,结合我们治疗三叉神经痛的经验,对其病因、发病机制、诊断和治疗原则、遗传模式等作了系统综述。     

Recommendations from the Consensus Conference on Hypertension in the Elderly.

Since 1978 there have been dramatic advances in the understanding of the pathophysiologic features of unstable angina pectoris and in the availability of new therapies of proven efficacy. Coronary artery spasm has been shown to be an important mechanism of acute myocardial ischemia in patients with unstable angina, and coronary thrombosis has been established as an early event in the development of acute myocardial infarction and, possibly, sudden death. Intravenous nitrates and oral calcium antagonists have been made available and are now widely used. Acetylsalicylic acid has been shown to be of benefit. Improved techniques of myocardial preservation and the introduction of percutaneous transluminal coronary angioplasty have modified the surgical management of coronary artery disease.     

A missense Glu298Asp variant in the endothelial nitric oxide synthase gene is associated with coronary spasm in the Japanese

Coronary spasm plays an important role in the pathogenesis of not only variant angina but also ischemic heart disease in general. However, the precise mechanism(s) by which coronary spasm occurs remains to be elucidated. Coronary spasm may arise from interactions between environmental and genetic factors. Endothelial derived nitric oxide (NO) has been implicated in the control of vascular tone. We have recently shown that both basal and acetylcholine (ACh)-induced NO activities are impaired in the coronary arteries of patients with coronary spasm. The purpose of this study has been to elucidate the possible variants that occur in the coding region of the endothelial nitric oxide synthase (eNOS) gene and that may be associated with coronary spasm. After initial screening in the entire 26 coding regions of the eNOS gene, we found a missense Glu298Asp variant in exon 7 in patients with coronary spasm. We subsequently performed a larger scale study involving 113 patients with coronary spasm and 100 control subjects, who were all diagnosed by intracoronary injection of ACh. The analysis revealed a significant difference in the distribution of the variant between the coronary spasm group (21.2%) and control group (9.0%; P=0.014 for dominant effect). Thus, we have found the missense Glu298Asp variant in the eNOS gene by the analysis of its entire 26 coding regions. The variant is significantly associated with coronary spasm. Received: 2 February 1998 / Accepted: 9 April 1998     

Cell entry mechanism of coronaviruses: implication in their pathogenesis

Coronaviruses infect many species of animals, including humans. Among them, murine coronavirus, mouse hepatitis virus (MHV) has been well studied as a model of human diseases, such as hepatitis and demyelinating disease. An agent causing severe acute respiratory disease (SARS), SARS coronavirus (SARS-CoV), is a newcomer in this genus, however, it is now one of the most studied coronaviruses due to its medical impact. The receptors of those two viruses have been identified and their cell entry mechanism has been actively investigated. Recently, SARS-CoV cell entry mechanism is shown to be different from that of other enveloped viruses, including MHV. In this review, cell entry mechanism of those two viruses is described, stressing on the difference and similarity found between those two viruses.     

Oxidatively-modified and glycated proteins as candidate pro-inflammatory toxins in uremia and dialysis patients

End stage renal disease (ESRD) patients accumulate blood hallmarks of protein glycation and oxidation. It is now well established that these protein damage products may represent a heterogeneous class of uremic toxins with pro-inflammatory and pro-oxidant properties. These toxins could be directly involved in the pathogenesis of the inflammatory syndrome and vascular complications, which are mainly sustained by the uremic state and bioincompatibility of dialysis therapy. A key underlying event in the toxicity of these proteinaceous solutes has been identified in scavenger receptor-dependent recognition and elimination by inflammatory and endothelial cells, which once activated generate further and even more pronounced protein injuries by a self-feeding mechanism based on inflammation and oxidative stress-derived events. This review examines the literature and provides original information on the techniques for investigating proteinaceous pro-inflammatory toxins. We have also evaluated therapeutic - either pharmacological or dialytic - strategies proposed to alleviate the accumulation of these toxins and to constrain the inflammatory and oxidative burden of ESRD.     

Glucagon-like peptides 1 and 2 in health and disease: A review

The gut derived peptides, glucagon-like peptides 1 and 2 (GLP-1 and GLP-2), are secreted following nutrient ingestion. GLP-1 and another gut peptide, glucose-dependent insulinotropic polypeptide (GIP) are collectively referred to as ‘incretin’ hormones, and play an important role in glucose homeostasis. Incretin secretion shares a complex interdependent relationship with both postprandial glycemia and the rate of gastric emptying. GLP-1 based therapies are now well established in the management of type 2 diabetes, while recent literature has suggested potential applications to treat obesity and protect against cardiovascular and neurological disease. The mechanism of action of GLP-2 is not well understood, but it shows promise as an intestinotropic agent.     

Geminiviruses: Genome structure and gene function

The plant pathogenic single‐strand DNA‐containing geminiviruses have been the recent focus of intense investigation, owing both to their agronomic importance and to their potential as vectors for the expression of foreign genes in plants. Molecular genetic studies have provided detailed information on the genomic organization of many of these viruses. A greater genetic complexity has been demonstrated among the members of this viral family than had previously been suspected, as well as an apparently rapid rate of evolution of genetic diversity. We now recognize fundamental differences in the genome structure and organization of the whitefly‐ and leafhopper‐transmitted viruses, as well as among those geminiviruses infecting dicotyledonous or monocotyledonous hosts. This knowledge has provided new insights into the evolution of these viruses. The viral genes involved in replication and in systemic movement in the plant have been defined, and viral origins for single‐strand (ss) and double‐strand (ds) DNA replication have been mapped to small nucleotide regions. With the structural features of the viral genomes now well defined, current efforts are focused on elucidating the molecular aspects of viral gene regulation and interactions with host‐cell components that lead to the production of disease. Recent progress in determining the mechanism of replication and systemic movement and the contributions of these to symptom and disease development are discussed in the context of the potential for genetically engineering disease‐resistant plants.