Diabetic kidney disease is one of the most severe chronic microvascular complications of diabetes and a primary cause of end-stage renal disease.Clinical studies have shown that renal inflammation is a key factor dete...Diabetic kidney disease is one of the most severe chronic microvascular complications of diabetes and a primary cause of end-stage renal disease.Clinical studies have shown that renal inflammation is a key factor determining kidney damage during diabetes.With the development of immunological technology,many studies have shown that diabetic nephropathy is an immune complex disease,and that most patients have immune dysfunction.However,the immune response associated with diabetic nephropathy and autoimmune kidney disease,or caused by ischemia or infection with acute renal injury,is different,and has a complicated pathological mechanism.In this review,we discuss the pathogenesis of diabetic nephropathy in immune disorders and the intervention mechanism,to provide guidance and advice for early intervention and treatment of diabetic nephropathy.展开更多
Background: Attention-Deficit/Hyperactivity Disorder (ADHD), one of the most common neurodevelopmental conditions of childhood, is associated with high rates of mood and behavioral disorders. Preliminary evidence sugg...Background: Attention-Deficit/Hyperactivity Disorder (ADHD), one of the most common neurodevelopmental conditions of childhood, is associated with high rates of mood and behavioral disorders. Preliminary evidence suggests that ADHD may also be associated with eating disorders (ED) or eating pathology (EP). This systematic review synthesizes the extant published literature on this association among youth ages 12-21 years. Methods: Literature searches were performed using Medline, Ovid/Psych Info, Google Scholar, and via manual inspection of bibliographies. Cross-sectional, case-control, and prospective studies published in English with sample sizes larger than 50, participant ages 12-21 years, and assessed ADHD and ED or EP, were considered for review. Case reports, feeding, and drug studies were excluded. Results: Preliminary searches yielded 337 articles;eight articles met inclusion/exclusion criteria. Two studies documented an association between ADHD and ED, and three studies found an association between ADHD and EP. Youth with ADHD were nearly 3 to 6 times more likely to develop an ED than youth without ADHD, and were also more likely to have higher rates of EP, body dissatisfaction, and desire to lose weight/ drive for thinness. Impulsivity was predictive of EP, and ADHD youth with co-occurring mood/behavioral disorders and punitive parental relationships were at higher risk. Conclusions: Five of eight studies documented an association between ADHD and ED or EP in adolescents. Future research is needed to confirm and refine further these findings. The findings have clinical implications, including the inclusion of ED/EP in screening and anticipatory guidance efforts. Evaluating whether medical management of ADHD may be efficacious in preventing and/or treating ED/EP is also warranted.展开更多
The fast aging human population requires new approaches to reliable diagnosis and proper treatment of dementia in elderly patients with psychiatric disorders such as bipolar disorder (BD) and schizophrenia (SCZ). As c...The fast aging human population requires new approaches to reliable diagnosis and proper treatment of dementia in elderly patients with psychiatric disorders such as bipolar disorder (BD) and schizophrenia (SCZ). As compared to other psychiatric disorders, BD and SCZ are characterized by increased and similar risk for dementia as well as cerebrovascular (CVD) and Parkinson’s (PD) diseases independent of the patient’s age. There are reports in the literature suggesting BD and SCZ in older patients could cause dementia without contribution from the neurodegenerative diseases, including Alzheimer’s disease (AD), due to the absence of the known neuropathology associated with cognitive decline in such individuals. This view contradicts a plethora of data highlighting AD as a major cause of dementia in the elderly. This issue was addressed by examining postmortem cerebral pathology in an 83-year-old female diagnosed with BD, SCZ, and PD (D1) and comparing it to that of a second donor (D2), an age-matched male diagnosed with Lewy Body Dementia (LBD). Upon thorough histochemical and immunohistochemical examinations of both brains, the PD and LBD diagnoses in D1 and D2 were not confirmed. Instead, AD-related pathology was observed in both subjects with AD advancing to its clinical stage (mild to moderate) only in D1. Diffuse β-amyloid peptide 1-42 (Aβ1-42) staining, most likely reflecting a presence of the Aβ1-42 soluble form, was also detected in cerebellar neurons and cerebellar extracellular space in D1 and D2. Cerebrovascular pathology was pronounced and distinct in both brains and included amyloid angiopathy, hyaline atherosclerosis, microbleeds, and dilated Virchow Robin spaces in D1 as well as thick-walled blood vessels with microbleeds in D2. It was concluded that a mixed AD and cerebrovascular pathology could mimic Lewy Body Disease and potentially contribute to dementia development in elderly BD and SCZ patients.展开更多
Extraintestinal manifestations occur in about one-third of patients living with inflammatory bowel disease(IBD) and may precede the onset of gastrointestinal symptoms by many years. Neurologic disorders associated wit...Extraintestinal manifestations occur in about one-third of patients living with inflammatory bowel disease(IBD) and may precede the onset of gastrointestinal symptoms by many years. Neurologic disorders associated with IBD are not frequent, being reported in 3% of patients, but they often represent an important cause of morbidity and a relevant diagnostic issue. In addition, the increasing use of immunosuppressant and biological therapies for IBD may also play a pivotal role in the development of neurological disorders of different type and pathogenesis. Hence, we provide a complete and profound review of the main features of neurological complications associated with IBD, with particular reference to those related to drugs and with a specific focus on their clinical presentation and possible pathophysiological mechanisms.展开更多
Immune-mediated mechanisms are involved in the pathogenesis of both cerebral vasculitis and Parkinson’s disease（PD, brainstem-predominant Lewy pathology）, but the presentation of cerebral vasculitis with comorbid L...Immune-mediated mechanisms are involved in the pathogenesis of both cerebral vasculitis and Parkinson’s disease（PD, brainstem-predominant Lewy pathology）, but the presentation of cerebral vasculitis with comorbid Lewy pathology has not yet been reported. Here we present a case of pathologically confirmed vasculitis in a 73-year-old male patient whose postmortem examination revealed Lewy pathology diagnostic of PD. This case study suggests a comorbidity of cerebral vasculitis and Lewy pathology, as well as potential pathogenic interactions between these two disorders with immune-mediated mechanisms.展开更多
209220 Clinical features and treatment of the hemorrhagic moyamoya disease/Duan Lian(Dept Neurosurg,Research Clinic,Acad Mil Med Sci,PLA,Beijing 100071)…∥Chin J Neurosurg.-2009,25(3).-201~204Objective To study th...209220 Clinical features and treatment of the hemorrhagic moyamoya disease/Duan Lian(Dept Neurosurg,Research Clinic,Acad Mil Med Sci,PLA,Beijing 100071)…∥Chin J Neurosurg.-2009,25(3).-201~204Objective To study the clinical features,bleeding reasons and strategies of the treatment of 61 patients with hemorrhagic moyamoya disease.Methods The clinical features of onset,bleeding location of the lesions and the type,characteristics of DSA images and therapeutic results were studied retrospectively.Results In all 61 patients,57 patients were adults.Most of them were cerebral hemorrhage breaking into ventricles.In all the hemisphere of hemorrhage,dilatation and abnormal branching of the AChA and P-CoM were observed in 52 patients,118 procedures of EDAS were performed,including superficial temporal basilar tip in 116 hemispheres and occipital artery in 2 hemispheres.There was no recurrence of hemorrhage in those operation patients.But 2 patients without EDAS died due to recurrence of hemorrhage Conclusion Dilatation and abnormal branching of the AChA and/or P-CoM are one of the main reasons for hemorrhagic events.The treatment of EDAS may be an effective method for preventing the recurrence of hemorrhage of hemorrhagic moyamoya disease.17 refs,2 figs.展开更多
The BCR/ABL fusion gene or the Ph^1-chromosome in the t(9;22)(q34;q11)exerts a high tyrokinase acticity,which is the cause of chronic myeloid leukemia(CML).The1990 Hannover Bone Marrow Classification separated CML fro...The BCR/ABL fusion gene or the Ph^1-chromosome in the t(9;22)(q34;q11)exerts a high tyrokinase acticity,which is the cause of chronic myeloid leukemia(CML).The1990 Hannover Bone Marrow Classification separated CML from the myeloproliferative disorders essential thrombocythemia(ET),polycythemia vera(PV)and chronic megakaryocytic granulocytic myeloproliferation(CMGM).The 2006-2008 European Clinical Molecular and Pathological(ECMP)criteria discovered 3variants of thrombocythemia:ET with features of PV(prodromal PV),"true"ET and ET associated with CMGM.The 2008 World Health Organization(WHO)-ECMP and 2014 WHO-CMP classifications defined three phenotypes of JAK2^(V617F)mutated ET:normocellular ET(WHO-ET),hypercelluar ET due to increased erythropoiesis(prodromal PV)and ET with hypercellular megakaryocytic-granulocytic myeloproliferation.The JAK2^(V617F)mutation load in heterozygous WHO-ET is low and associated with normal life expectance.The hetero/homozygous JAK2^(V617F)mutation load in PV and myelofibrosis is related to myeloproliferative neoplasm(MPN)disease burden in terms of symptomaticsplenomegaly,constitutional symptoms,bone marrow hypercellularity and myelofibrosis.JAK2 exon 12mutated MPN presents as idiopathic eryhrocythemia and early stage PV.According to 2014 WHO-CMP criteria JAK2 wild type MPL^(515)mutated ET is the second distinct thrombocythemia featured by clustered giant megakaryocytes with hyperlobulated stag-horn-like nuclei,in a normocellular bone marrow consistent with the diagnosis of"true"ET.JAK2/MPL wild type,calreticulin mutated hypercellular ET appears to be the third distinct thrombocythemia characterized by clustered larged immature dysmorphic megakaryocytes and bulky(bulbous)hyperchromatic nuclei consistent with CMGM or primary megakaryocytic granulocytic myeloproliferation.展开更多
AIM:To evaluate the clinical value of 2.0T SGR magnetic resonance angiography.METHODS:Using Elscint 2.0T SGR MR to scan 62 patients with cerebrovascular disease.Three dimensional models were reconstructed by 3D TOF wi...AIM:To evaluate the clinical value of 2.0T SGR magnetic resonance angiography.METHODS:Using Elscint 2.0T SGR MR to scan 62 patients with cerebrovascular disease.Three dimensional models were reconstructed by 3D TOF with 3D PC and treated with maximal intensity projection (MIP).RESULTS:MRA can clearly display normal vessel form and lesions.In these cases,there were 26 arteriovenous malformation (AVM) cases,12 intracranial aneurysm cases,7 moy moya disease cases and 18 arteriosclerosis and arterial occlusion cases.CONCLUSION:2.0T SGR MRA is a noninvasive and effective angiography method to diagnose vascular disease with clear localization and high final diagnosis rate.展开更多
Problem gambling is over-represented in patients treated for substance use disorders, but substance-specific prevalence of problem gambling is rarely reported. In specialized addiction treatment facilities for opioid ...Problem gambling is over-represented in patients treated for substance use disorders, but substance-specific prevalence of problem gambling is rarely reported. In specialized addiction treatment facilities for opioid maintenance treatment and for alcohol and prescription drug dependence, respectively, 129 patients were screened for problem gambling using the NODS-CLiP. The lifetime prevalence of problem gambling was markedly higher in opioid maintenance treatment (61 percent) than in alcohol and prescription drug dependence treatment (11 percent, p < 0.001). When controlling for gender and age, problem gambling remained significantly associated with opioid maintenance treatment. The present study demonstrated a very high prevalence of lifetime problem gambling in opioid maintenance treatment patients. This calls for active screening for problem gambling in substance use disorder patients, and mainly in treatment for opioid dependence.展开更多
基金Supported by the National Natural Science Foundation of China,No.82100883the Research Project of Educational Commission of Jilin Province of China,No.JJKH20231214KJ.
文摘Diabetic kidney disease is one of the most severe chronic microvascular complications of diabetes and a primary cause of end-stage renal disease.Clinical studies have shown that renal inflammation is a key factor determining kidney damage during diabetes.With the development of immunological technology,many studies have shown that diabetic nephropathy is an immune complex disease,and that most patients have immune dysfunction.However,the immune response associated with diabetic nephropathy and autoimmune kidney disease,or caused by ischemia or infection with acute renal injury,is different,and has a complicated pathological mechanism.In this review,we discuss the pathogenesis of diabetic nephropathy in immune disorders and the intervention mechanism,to provide guidance and advice for early intervention and treatment of diabetic nephropathy.
文摘Background: Attention-Deficit/Hyperactivity Disorder (ADHD), one of the most common neurodevelopmental conditions of childhood, is associated with high rates of mood and behavioral disorders. Preliminary evidence suggests that ADHD may also be associated with eating disorders (ED) or eating pathology (EP). This systematic review synthesizes the extant published literature on this association among youth ages 12-21 years. Methods: Literature searches were performed using Medline, Ovid/Psych Info, Google Scholar, and via manual inspection of bibliographies. Cross-sectional, case-control, and prospective studies published in English with sample sizes larger than 50, participant ages 12-21 years, and assessed ADHD and ED or EP, were considered for review. Case reports, feeding, and drug studies were excluded. Results: Preliminary searches yielded 337 articles;eight articles met inclusion/exclusion criteria. Two studies documented an association between ADHD and ED, and three studies found an association between ADHD and EP. Youth with ADHD were nearly 3 to 6 times more likely to develop an ED than youth without ADHD, and were also more likely to have higher rates of EP, body dissatisfaction, and desire to lose weight/ drive for thinness. Impulsivity was predictive of EP, and ADHD youth with co-occurring mood/behavioral disorders and punitive parental relationships were at higher risk. Conclusions: Five of eight studies documented an association between ADHD and ED or EP in adolescents. Future research is needed to confirm and refine further these findings. The findings have clinical implications, including the inclusion of ED/EP in screening and anticipatory guidance efforts. Evaluating whether medical management of ADHD may be efficacious in preventing and/or treating ED/EP is also warranted.
文摘The fast aging human population requires new approaches to reliable diagnosis and proper treatment of dementia in elderly patients with psychiatric disorders such as bipolar disorder (BD) and schizophrenia (SCZ). As compared to other psychiatric disorders, BD and SCZ are characterized by increased and similar risk for dementia as well as cerebrovascular (CVD) and Parkinson’s (PD) diseases independent of the patient’s age. There are reports in the literature suggesting BD and SCZ in older patients could cause dementia without contribution from the neurodegenerative diseases, including Alzheimer’s disease (AD), due to the absence of the known neuropathology associated with cognitive decline in such individuals. This view contradicts a plethora of data highlighting AD as a major cause of dementia in the elderly. This issue was addressed by examining postmortem cerebral pathology in an 83-year-old female diagnosed with BD, SCZ, and PD (D1) and comparing it to that of a second donor (D2), an age-matched male diagnosed with Lewy Body Dementia (LBD). Upon thorough histochemical and immunohistochemical examinations of both brains, the PD and LBD diagnoses in D1 and D2 were not confirmed. Instead, AD-related pathology was observed in both subjects with AD advancing to its clinical stage (mild to moderate) only in D1. Diffuse β-amyloid peptide 1-42 (Aβ1-42) staining, most likely reflecting a presence of the Aβ1-42 soluble form, was also detected in cerebellar neurons and cerebellar extracellular space in D1 and D2. Cerebrovascular pathology was pronounced and distinct in both brains and included amyloid angiopathy, hyaline atherosclerosis, microbleeds, and dilated Virchow Robin spaces in D1 as well as thick-walled blood vessels with microbleeds in D2. It was concluded that a mixed AD and cerebrovascular pathology could mimic Lewy Body Disease and potentially contribute to dementia development in elderly BD and SCZ patients.
文摘Extraintestinal manifestations occur in about one-third of patients living with inflammatory bowel disease(IBD) and may precede the onset of gastrointestinal symptoms by many years. Neurologic disorders associated with IBD are not frequent, being reported in 3% of patients, but they often represent an important cause of morbidity and a relevant diagnostic issue. In addition, the increasing use of immunosuppressant and biological therapies for IBD may also play a pivotal role in the development of neurological disorders of different type and pathogenesis. Hence, we provide a complete and profound review of the main features of neurological complications associated with IBD, with particular reference to those related to drugs and with a specific focus on their clinical presentation and possible pathophysiological mechanisms.
文摘Immune-mediated mechanisms are involved in the pathogenesis of both cerebral vasculitis and Parkinson’s disease（PD, brainstem-predominant Lewy pathology）, but the presentation of cerebral vasculitis with comorbid Lewy pathology has not yet been reported. Here we present a case of pathologically confirmed vasculitis in a 73-year-old male patient whose postmortem examination revealed Lewy pathology diagnostic of PD. This case study suggests a comorbidity of cerebral vasculitis and Lewy pathology, as well as potential pathogenic interactions between these two disorders with immune-mediated mechanisms.
文摘209220 Clinical features and treatment of the hemorrhagic moyamoya disease/Duan Lian(Dept Neurosurg,Research Clinic,Acad Mil Med Sci,PLA,Beijing 100071)…∥Chin J Neurosurg.-2009,25(3).-201~204Objective To study the clinical features,bleeding reasons and strategies of the treatment of 61 patients with hemorrhagic moyamoya disease.Methods The clinical features of onset,bleeding location of the lesions and the type,characteristics of DSA images and therapeutic results were studied retrospectively.Results In all 61 patients,57 patients were adults.Most of them were cerebral hemorrhage breaking into ventricles.In all the hemisphere of hemorrhage,dilatation and abnormal branching of the AChA and P-CoM were observed in 52 patients,118 procedures of EDAS were performed,including superficial temporal basilar tip in 116 hemispheres and occipital artery in 2 hemispheres.There was no recurrence of hemorrhage in those operation patients.But 2 patients without EDAS died due to recurrence of hemorrhage Conclusion Dilatation and abnormal branching of the AChA and/or P-CoM are one of the main reasons for hemorrhagic events.The treatment of EDAS may be an effective method for preventing the recurrence of hemorrhage of hemorrhagic moyamoya disease.17 refs,2 figs.
文摘The BCR/ABL fusion gene or the Ph^1-chromosome in the t(9;22)(q34;q11)exerts a high tyrokinase acticity,which is the cause of chronic myeloid leukemia(CML).The1990 Hannover Bone Marrow Classification separated CML from the myeloproliferative disorders essential thrombocythemia(ET),polycythemia vera(PV)and chronic megakaryocytic granulocytic myeloproliferation(CMGM).The 2006-2008 European Clinical Molecular and Pathological(ECMP)criteria discovered 3variants of thrombocythemia:ET with features of PV(prodromal PV),"true"ET and ET associated with CMGM.The 2008 World Health Organization(WHO)-ECMP and 2014 WHO-CMP classifications defined three phenotypes of JAK2^(V617F)mutated ET:normocellular ET(WHO-ET),hypercelluar ET due to increased erythropoiesis(prodromal PV)and ET with hypercellular megakaryocytic-granulocytic myeloproliferation.The JAK2^(V617F)mutation load in heterozygous WHO-ET is low and associated with normal life expectance.The hetero/homozygous JAK2^(V617F)mutation load in PV and myelofibrosis is related to myeloproliferative neoplasm(MPN)disease burden in terms of symptomaticsplenomegaly,constitutional symptoms,bone marrow hypercellularity and myelofibrosis.JAK2 exon 12mutated MPN presents as idiopathic eryhrocythemia and early stage PV.According to 2014 WHO-CMP criteria JAK2 wild type MPL^(515)mutated ET is the second distinct thrombocythemia featured by clustered giant megakaryocytes with hyperlobulated stag-horn-like nuclei,in a normocellular bone marrow consistent with the diagnosis of"true"ET.JAK2/MPL wild type,calreticulin mutated hypercellular ET appears to be the third distinct thrombocythemia characterized by clustered larged immature dysmorphic megakaryocytes and bulky(bulbous)hyperchromatic nuclei consistent with CMGM or primary megakaryocytic granulocytic myeloproliferation.
文摘AIM:To evaluate the clinical value of 2.0T SGR magnetic resonance angiography.METHODS:Using Elscint 2.0T SGR MR to scan 62 patients with cerebrovascular disease.Three dimensional models were reconstructed by 3D TOF with 3D PC and treated with maximal intensity projection (MIP).RESULTS:MRA can clearly display normal vessel form and lesions.In these cases,there were 26 arteriovenous malformation (AVM) cases,12 intracranial aneurysm cases,7 moy moya disease cases and 18 arteriosclerosis and arterial occlusion cases.CONCLUSION:2.0T SGR MRA is a noninvasive and effective angiography method to diagnose vascular disease with clear localization and high final diagnosis rate.
文摘Problem gambling is over-represented in patients treated for substance use disorders, but substance-specific prevalence of problem gambling is rarely reported. In specialized addiction treatment facilities for opioid maintenance treatment and for alcohol and prescription drug dependence, respectively, 129 patients were screened for problem gambling using the NODS-CLiP. The lifetime prevalence of problem gambling was markedly higher in opioid maintenance treatment (61 percent) than in alcohol and prescription drug dependence treatment (11 percent, p < 0.001). When controlling for gender and age, problem gambling remained significantly associated with opioid maintenance treatment. The present study demonstrated a very high prevalence of lifetime problem gambling in opioid maintenance treatment patients. This calls for active screening for problem gambling in substance use disorder patients, and mainly in treatment for opioid dependence.
