Parkinson’s disease (PD) is a slowly progressive neurodegenerative disorder with motor and non-motorsigns, which begins long before the diagnosis can be made. Pharmacotherapy with dopaminergic drugsis the mainstay of...Parkinson’s disease (PD) is a slowly progressive neurodegenerative disorder with motor and non-motorsigns, which begins long before the diagnosis can be made. Pharmacotherapy with dopaminergic drugsis the mainstay of PD therapy. There is no currently available cure or disease-modifying treatment. Dietand various foods have been proposed as possible risk factors for PD. Nutritional supplementation withomega-3 fatty acids, vitamin D, B vitamins, and coenzyme Q may have potential in the management ofPD. In addition, several strategies could possibly lead to the development of medical foods in PD. Forexample, ketogenic diets may have effects complementary to pharmacotherapy. Gut microbial dysbiosisand altered microbial metabolites found in PD may lead to chronic low-grade inflammation in gut andbrain. Interventions targeting gut microbiota, such as the supplementation of probiotics, may providenovel approaches to PD in regard to both symptomatic treatment and disease modification. High qualityrandomized controlled trials need to be conducted in order to evaluate whether these food-basedstrategies have symptomatic efficacy or the potential to delay the progression of PD.展开更多
In recent years,Parkinson’s Disease(PD)as a progressive syndrome of the nervous system has become highly prevalent worldwide.In this study,a novel hybrid technique established by integrating a Multi-layer Perceptron ...In recent years,Parkinson’s Disease(PD)as a progressive syndrome of the nervous system has become highly prevalent worldwide.In this study,a novel hybrid technique established by integrating a Multi-layer Perceptron Neural Network(MLP)with the Biogeography-based Optimization(BBO)to classify PD based on a series of biomedical voice measurements.BBO is employed to determine the optimal MLP parameters and boost prediction accuracy.The inputs comprised of 22 biomedical voice measurements.The proposed approach detects two PD statuses:0-disease status and 1-good control status.The performance of proposed methods compared with PSO,GA,ACO and ES method.The outcomes affirm that the MLP-BBO model exhibits higher precision and suitability for PD detection.The proposed diagnosis system as a type of speech algorithm detects early Parkinson’s symptoms,and consequently,it served as a promising new robust tool with excellent PD diagnosis performance.展开更多
Parkinson's disease is still incurable and the long-term care needs of patients represent a huge challenge for health systems.Palliative care as an alternative therapy can greatly alleviate the suffering and burde...Parkinson's disease is still incurable and the long-term care needs of patients represent a huge challenge for health systems.Palliative care as an alternative therapy can greatly alleviate the suffering and burden on patients and caregivers through effective medical symptom management,the provision of mental health support,and the development of health plans.This paper explores the current status and challenges regarding palliative care for patients with Parkinson's disease in recent years through a literature review approach.The findings can provide scientific evidence for researchers,clinical practitioners and policy makers in this field.We not only reviewed the systematic and effective therapy,but also concluded a new multidisciplinary cooperation model.TCM teams such as acupuncturists,TCM pharmacists and TCM physiotherapists should be key members of the new multidisciplinary team for the palliative care of Parkinson's disease.展开更多
INTRODUCTION: Parkinson’s disease (PD) is a disorder characterized by complex motor and non-motor symptoms that can be difficult for patients to accurately communicate. Wearable technologies portend improvements in a...INTRODUCTION: Parkinson’s disease (PD) is a disorder characterized by complex motor and non-motor symptoms that can be difficult for patients to accurately communicate. Wearable technologies portend improvements in assessment and monitoring of these symptoms, with their clinical utility currently being evaluated in routine clinical care. OBJECTIVE: To evaluate the clinical utility of the Personal KinetiGraph? (PKG?) Movement Recording System in the routine clinical care of persons with PD (PWP). METHODS: Clinically stable, non-demented PWP presented for two routine clinic visits that included: medication review, symptom review, neurological examination including the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) III/IV, and completion of a clinical management plan by a movement disorder specialist prior to review of the PKG report. After reviewing the PKG report, the clinician completed a modified clinical management plan taking into consideration the findings of the PKG. This was repeated at a second visit to evaluate various outcome measures following PKG-enhanced management. RESULTS: The PKG improved the assessment of PD symptoms and the response to treatment, while increasing patient activity levels and compliance. Clinical management plans enhanced by PKG led to different recommendations in 29.4% of cases compared with standard of care due to higher rates of bradykinesia, dyskinesia, tremor, and fluctuations identified by PKG. Using the PKG in the clinical management plan led to a change in medications in 75% (21/28) of patients and both a statistically significant difference and a clinically meaningful reduction in MDS-UPDRS III score of 4.8 (p = 0.028). Additionally, positive changes in both the clinician (17/28;61%) and patient-reported (13/24;54%) Global Impression of Improvement were reported. CONCLUSION: The PKG is a valuable tool in augmenting clinical management when utilized along with a clinical assessment.展开更多
Background: Compulsive behavior, dyskinesias, motor fluctuations, and hallucinations are common Parkinson’s disease (PD) medication side effects. These are yet to be examined in relation to race and level of educatio...Background: Compulsive behavior, dyskinesias, motor fluctuations, and hallucinations are common Parkinson’s disease (PD) medication side effects. These are yet to be examined in relation to race and level of education. The goal of this analysis was to identify socioeconomic or clinical variables that are associated with compulsive behavior, dyskinesias, motor fluctuations, and hallucinations in patients in a safety-net hospital. Methods: A movement disorder patient database containing 452 patients with idiopathic PD was analyzed for differences in PD medication side effects using univariate and multivariate logistic regression analysis. Race, sex, and level of education were evaluated as possible confounders. Results: A greater proportion of the patients in this study were Caucasian males. The only variable associated with compulsive behavior was age, with higher age having a protective effect (p = 0.0336). Disease duration (defined as time since the onset of symptoms), diagnosis duration (time since formal diagnosis), and level of education were significantly associated with dyskinesia inunivariate analysis (p =< 0.0001, <0.0001, 0.1236 respectively). However, diagnosis duration was the only variable significantly associated with dyskinesia in multivariate analysis (p = 0.0038), in addition to a borderline significant association when comparing individuals with graduate degree to those who had completed high school education or less (p = 0.0599), with a protective effect of higher education. Disease duration, diagnosis duration, and use of monoamineoxidase inhibitors were also significantly associated with motor fluctuations in the univariate analysis, while only diagnosis duration was significantly associated with motor fluctuations in multivariate analysis (p = 0.0035) with longer diagnosis duration associated with higher risk of motor fluctuations. Age, disease duration, and diagnosis duration were associated with an increased risk of hallucinations in univariate analysis (p =< 0.0001, <0.0001, <0.0001 respectively), but age and disease duration were the only variables associated with hallucinations in multivariate analysis (p = 0.0009, 0.1196 respectively). Race was not associated with a higher risk of compulsive behavior, dyskinesias, motor fluctuations, or hallucinations. Conclusion: Compulsive behavior, dyskinesias, motor fluctuations, and hallucinations in our PD population may be associated with differences in socioeconomic status and access to care, but not with differences in race.展开更多
目的探讨基于疾病诊断相关分组(diagnosis related groups,DRG)的精细化管理对提高医院病案管理质量的效果。方法选取如皋市中医院病案统计室的4名管理人员为研究对象,2021年1—12月开展常规病案管理设为对照组,2022年1—12月开展DRG精...目的探讨基于疾病诊断相关分组(diagnosis related groups,DRG)的精细化管理对提高医院病案管理质量的效果。方法选取如皋市中医院病案统计室的4名管理人员为研究对象,2021年1—12月开展常规病案管理设为对照组,2022年1—12月开展DRG精细化管理设为观察组,两组均随机纳入200份病历。比较两组病案质量、病案管理人员考核成绩与职业素养、管理模式满意度。结果观察组病案质量优良率为95.50%(191/200),高于对照组的99.50%(199/200),差异有统计学意义(χ^(2)=6.564,P<0.05)。观察组病案管理人员考核成绩、职业素养评分均优于对照组,差异有统计学意义(P均<0.05)。观察组对管理方式的满意度评分高于对照组,差异有统计学意义(P均<0.05)。结论在医院病案管理中采用基于DRG的精细化管理可改善病案质量,提升病案管理人员考核成绩、职业素养及对管理的满意度。展开更多
INTRODUCTION Parkinson＇s disease （PD） is the second most common neurodegenerative disorder in the world. In China, approximately 48-89% of Chinese patients with PD have been shown to be affected by sleep disorders,...INTRODUCTION Parkinson＇s disease （PD） is the second most common neurodegenerative disorder in the world. In China, approximately 48-89% of Chinese patients with PD have been shown to be affected by sleep disorders, in recent decades, there have been major advances in our understanding of the relationship between sleep disorders and PD, yet many questions remain unanswered.展开更多
Background:The cardinal features of Parkinson’s disease(PD)are bradykinesia,rigidity and rest tremor.Abnormal activity in the basal ganglia is predicted to underlie the mechanism of motor symptoms.This study aims to ...Background:The cardinal features of Parkinson’s disease(PD)are bradykinesia,rigidity and rest tremor.Abnormal activity in the basal ganglia is predicted to underlie the mechanism of motor symptoms.This study aims to characterize properties of oscillatory activity in the basal ganglia and motor thalamus in patients with PD.Methods:Twenty-nine patients with PD who underwent bilateral or unilateral electrode implantation for subthalamic nucleus(STN)DBS(n=11),unilateral pallidotomy(n=9)and unilateral thalamotomy(n=9)were studied.Microelectrode recordings in the STN,globus pallidus internus(GPi)and ventral oral posterior/ventral intermediate of thalamus(Vop/Vim)were performed.Electromyography of the contralateral limbs was recorded.Single unit characteristics including interspike intervals were analyzed.Spectral and coherence analyses were assessed.Mean spontaneous firing rate(MSFR)of neurons was calculated.Analysis of variance and χ^(2) test were performed.Results:Of 76 STN neurons,39.5% were 4–6 Hz band oscillatory neurons and 28.9% were β frequency band(βFB)oscillatory neurons.The MSFR was 44.2±7.6 Hz.Of 62 GPi neurons,37.1% were 4–6 Hz band oscillatory neurons and 27.4% were βFB neurons.The MSFR was 80.9±9.6 Hz.Of 44 Vop neurons,65.9% were 4–6 Hz band oscillatory neurons and 9%were βFB neurons.The MSFR was 24.4±4.2 Hz.Of 30 Vim oscillatory neurons,70% were 4–6 Hz band oscillatory neurons and 13.3% were β FB neurons.The MSFR was 30.3±3.6 Hz.Further analysis indicated that proportion of βFB oscillatory neurons in STN and GPi was higher than that of similar neurons in the Vop and Vim(P<0.05).Conversely,the proportion of 4–6 Hz band oscillatory neurons and tremor related neurons in the Vim and Vop was higher than that of STN and GPi(P<0.05).The highest MSFR was for GPi oscillatory neurons whereas the lowest MSFR was for Vop oscillatory neurons(P<0.005).Conclusion:The alterations in neuronal activity in basal ganglia play a critical role in generation of parkinsonism.β oscillatory activity is more prominent in basal ganglia than in thalamus suggesting that the activity likely results from dopaminergic depletion.While both basal ganglia and thalamus have tremor activity,the thalamus appears to play a more important role in tremor production,and basal ganglia β oscillatory activity might be the trigger.展开更多
BACKGROUND： Induced differentiation strategies and cytochemical properties of human embryonic stem ceils （hESCs） have been investigated. However, the electrophysiological functions of tyrosine hydroxylase （TH）-po...BACKGROUND： Induced differentiation strategies and cytochemical properties of human embryonic stem ceils （hESCs） have been investigated. However, the electrophysiological functions of tyrosine hydroxylase （TH）-positive cells dedved from hESCs remain unclear. OBJECTIVE： To investigate the differentiation efficiency of TH-positive cells from hESCs in vitro using modified four-step culture methods, including embryoid body formation, and to examine the functional characteristics of the differentiated TH-positive cells using electrophysiological techniques. DESIGN, TIME AND SETTING： Neuroelectrophysiology was performed at the Reproductive Medicine Center and Stem Cell Research Center, Peking University Third Hospital, and the Neuroscience Research Institute and Department of Neurobiology, Peking University, from September 2004 to August 2008. MATERIALS： The hESC line, PKU-1.1, a monoclonal cell line derived from a pre-implantation human blastocyst in the Reproductive Medical Center of Peking University Third Hospital. The patch clamp recording system was provided by the Neuroscience Research Institute and Department of Neurobiology, Peking University. METHODS： The hESC line was induced to differentiate into TH-positive cells in vitro using a modified four-step culture method, including the formation of embryoid body, as well as the presence of sonic hedgehog and fibroblast growth factor 8. The cell karyotype was assessed by G-banding karyotype analysis techniques and specific markers were detected immunocytochemically. Whole-cell configuration was obtained after obtaining a tight seal of over 1 GΩ. Ionic currents were detected by holding the cells at -70 mV and stepping to test voltages between -80 and 40 mV in 10-mV increments in voltage-clamp configuration. MAIN OUTCOME MEASURES： We measured the cell karyotype, specific cell markers, and the electrophysiological properties of the voltage-gated ion channels on the cell membrane of TH-positive dopaminergic cells differentiated from our hESCs line in vitro. RESULTS： The differentiated cells had a consistent appearance, and the majority of cells （〉 90%） expressed TH and β-tubulion, as well as the neural progenitor marker, nestino Cell karyotype analysis demonstrated that all of the hESCs had a stable and normal karyotype （46, XX） after differentiation. In addition, patch clamp recording showed that the 10 recorded TH-positive cells exhibited a fast inward current when the test voltage depolarized to -30 mV, and a delayed outward current when the test voltage depolarized to -10 mV. The peak of inward current was obtained at voltage between 10 mV and 0 mV, while the peak of outward current was obtained at 40 mV. The average peak of inward current density was （ -50.05 ± 15.50） pA/pF, and the average peak of outward current density was （41.98 ± 13.55） pA/pE CONCLUSION： More than 90% of the differentiated hESC-derived cells induced by the modified four-step culture method exhibit dopaminergic neuronal properties, including general electrophysiological functional properties, such as functional potassium and sodium channels.展开更多
Crohn’s disease(CD)is characterized by transmural inflammation of the gastrointestinal tract leading to inflammatory,stricturing and/or and fistulizing disease.Once a patient develops medically refractory disease,mec...Crohn’s disease(CD)is characterized by transmural inflammation of the gastrointestinal tract leading to inflammatory,stricturing and/or and fistulizing disease.Once a patient develops medically refractory disease,mechanical obstruction,fistulizing disease or perforation,surgery is indicated.Unfortunately,surgery is not curative in most cases,underscoring the importance of bowel preservation and adequate perioperative medical management.As many of the medications used to treat CD are immunosuppressive,the concern for postoperative infectious complications and anastomotic healing are particularly concerning;these concerns have to be balanced with preventing and treating residual or recurrent disease.We herein review the available literature and make recommendations regarding the preoperative,perioperative and postoperative administration of immunosuppressive medications in the current era of biological therapy for CD.Standardized algorithms for perioperative medical management would greatly assist future research for optimizing surgical outcomes and preventing disease recurrence in the future.展开更多
文摘Parkinson’s disease (PD) is a slowly progressive neurodegenerative disorder with motor and non-motorsigns, which begins long before the diagnosis can be made. Pharmacotherapy with dopaminergic drugsis the mainstay of PD therapy. There is no currently available cure or disease-modifying treatment. Dietand various foods have been proposed as possible risk factors for PD. Nutritional supplementation withomega-3 fatty acids, vitamin D, B vitamins, and coenzyme Q may have potential in the management ofPD. In addition, several strategies could possibly lead to the development of medical foods in PD. Forexample, ketogenic diets may have effects complementary to pharmacotherapy. Gut microbial dysbiosisand altered microbial metabolites found in PD may lead to chronic low-grade inflammation in gut andbrain. Interventions targeting gut microbiota, such as the supplementation of probiotics, may providenovel approaches to PD in regard to both symptomatic treatment and disease modification. High qualityrandomized controlled trials need to be conducted in order to evaluate whether these food-basedstrategies have symptomatic efficacy or the potential to delay the progression of PD.
文摘In recent years,Parkinson’s Disease(PD)as a progressive syndrome of the nervous system has become highly prevalent worldwide.In this study,a novel hybrid technique established by integrating a Multi-layer Perceptron Neural Network(MLP)with the Biogeography-based Optimization(BBO)to classify PD based on a series of biomedical voice measurements.BBO is employed to determine the optimal MLP parameters and boost prediction accuracy.The inputs comprised of 22 biomedical voice measurements.The proposed approach detects two PD statuses:0-disease status and 1-good control status.The performance of proposed methods compared with PSO,GA,ACO and ES method.The outcomes affirm that the MLP-BBO model exhibits higher precision and suitability for PD detection.The proposed diagnosis system as a type of speech algorithm detects early Parkinson’s symptoms,and consequently,it served as a promising new robust tool with excellent PD diagnosis performance.
基金funded by Youth Science Foundation Project of National Natural Science Foundation(CN)(81603565)the Graduate Research and Innovation Projects of Tianjin(CN)(2020YJSS179)the Graduate Research and Innovation Projects of Tianjin University of Traditional Chinese Medicine(CN)(YJSKC-20201030).
文摘Parkinson's disease is still incurable and the long-term care needs of patients represent a huge challenge for health systems.Palliative care as an alternative therapy can greatly alleviate the suffering and burden on patients and caregivers through effective medical symptom management,the provision of mental health support,and the development of health plans.This paper explores the current status and challenges regarding palliative care for patients with Parkinson's disease in recent years through a literature review approach.The findings can provide scientific evidence for researchers,clinical practitioners and policy makers in this field.We not only reviewed the systematic and effective therapy,but also concluded a new multidisciplinary cooperation model.TCM teams such as acupuncturists,TCM pharmacists and TCM physiotherapists should be key members of the new multidisciplinary team for the palliative care of Parkinson's disease.
文摘INTRODUCTION: Parkinson’s disease (PD) is a disorder characterized by complex motor and non-motor symptoms that can be difficult for patients to accurately communicate. Wearable technologies portend improvements in assessment and monitoring of these symptoms, with their clinical utility currently being evaluated in routine clinical care. OBJECTIVE: To evaluate the clinical utility of the Personal KinetiGraph? (PKG?) Movement Recording System in the routine clinical care of persons with PD (PWP). METHODS: Clinically stable, non-demented PWP presented for two routine clinic visits that included: medication review, symptom review, neurological examination including the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) III/IV, and completion of a clinical management plan by a movement disorder specialist prior to review of the PKG report. After reviewing the PKG report, the clinician completed a modified clinical management plan taking into consideration the findings of the PKG. This was repeated at a second visit to evaluate various outcome measures following PKG-enhanced management. RESULTS: The PKG improved the assessment of PD symptoms and the response to treatment, while increasing patient activity levels and compliance. Clinical management plans enhanced by PKG led to different recommendations in 29.4% of cases compared with standard of care due to higher rates of bradykinesia, dyskinesia, tremor, and fluctuations identified by PKG. Using the PKG in the clinical management plan led to a change in medications in 75% (21/28) of patients and both a statistically significant difference and a clinically meaningful reduction in MDS-UPDRS III score of 4.8 (p = 0.028). Additionally, positive changes in both the clinician (17/28;61%) and patient-reported (13/24;54%) Global Impression of Improvement were reported. CONCLUSION: The PKG is a valuable tool in augmenting clinical management when utilized along with a clinical assessment.
文摘Background: Compulsive behavior, dyskinesias, motor fluctuations, and hallucinations are common Parkinson’s disease (PD) medication side effects. These are yet to be examined in relation to race and level of education. The goal of this analysis was to identify socioeconomic or clinical variables that are associated with compulsive behavior, dyskinesias, motor fluctuations, and hallucinations in patients in a safety-net hospital. Methods: A movement disorder patient database containing 452 patients with idiopathic PD was analyzed for differences in PD medication side effects using univariate and multivariate logistic regression analysis. Race, sex, and level of education were evaluated as possible confounders. Results: A greater proportion of the patients in this study were Caucasian males. The only variable associated with compulsive behavior was age, with higher age having a protective effect (p = 0.0336). Disease duration (defined as time since the onset of symptoms), diagnosis duration (time since formal diagnosis), and level of education were significantly associated with dyskinesia inunivariate analysis (p =< 0.0001, <0.0001, 0.1236 respectively). However, diagnosis duration was the only variable significantly associated with dyskinesia in multivariate analysis (p = 0.0038), in addition to a borderline significant association when comparing individuals with graduate degree to those who had completed high school education or less (p = 0.0599), with a protective effect of higher education. Disease duration, diagnosis duration, and use of monoamineoxidase inhibitors were also significantly associated with motor fluctuations in the univariate analysis, while only diagnosis duration was significantly associated with motor fluctuations in multivariate analysis (p = 0.0035) with longer diagnosis duration associated with higher risk of motor fluctuations. Age, disease duration, and diagnosis duration were associated with an increased risk of hallucinations in univariate analysis (p =< 0.0001, <0.0001, <0.0001 respectively), but age and disease duration were the only variables associated with hallucinations in multivariate analysis (p = 0.0009, 0.1196 respectively). Race was not associated with a higher risk of compulsive behavior, dyskinesias, motor fluctuations, or hallucinations. Conclusion: Compulsive behavior, dyskinesias, motor fluctuations, and hallucinations in our PD population may be associated with differences in socioeconomic status and access to care, but not with differences in race.
文摘目的探讨基于疾病诊断相关分组(diagnosis related groups,DRG)的精细化管理对提高医院病案管理质量的效果。方法选取如皋市中医院病案统计室的4名管理人员为研究对象,2021年1—12月开展常规病案管理设为对照组,2022年1—12月开展DRG精细化管理设为观察组,两组均随机纳入200份病历。比较两组病案质量、病案管理人员考核成绩与职业素养、管理模式满意度。结果观察组病案质量优良率为95.50%(191/200),高于对照组的99.50%(199/200),差异有统计学意义(χ^(2)=6.564,P<0.05)。观察组病案管理人员考核成绩、职业素养评分均优于对照组,差异有统计学意义(P均<0.05)。观察组对管理方式的满意度评分高于对照组,差异有统计学意义(P均<0.05)。结论在医院病案管理中采用基于DRG的精细化管理可改善病案质量,提升病案管理人员考核成绩、职业素养及对管理的满意度。
文摘INTRODUCTION Parkinson＇s disease （PD） is the second most common neurodegenerative disorder in the world. In China, approximately 48-89% of Chinese patients with PD have been shown to be affected by sleep disorders, in recent decades, there have been major advances in our understanding of the relationship between sleep disorders and PD, yet many questions remain unanswered.
基金This work was supported by the National Natural Science Foundation of China(NSFC)(No.81371256,81171061,81361128012)Ministry of Education of Republic of China(BIBD-PXM2013-014226-07-000084)Seed Grant of International Alliance of Translational Neuroscience(PXM2014-014226-000015).
文摘Background:The cardinal features of Parkinson’s disease(PD)are bradykinesia,rigidity and rest tremor.Abnormal activity in the basal ganglia is predicted to underlie the mechanism of motor symptoms.This study aims to characterize properties of oscillatory activity in the basal ganglia and motor thalamus in patients with PD.Methods:Twenty-nine patients with PD who underwent bilateral or unilateral electrode implantation for subthalamic nucleus(STN)DBS(n=11),unilateral pallidotomy(n=9)and unilateral thalamotomy(n=9)were studied.Microelectrode recordings in the STN,globus pallidus internus(GPi)and ventral oral posterior/ventral intermediate of thalamus(Vop/Vim)were performed.Electromyography of the contralateral limbs was recorded.Single unit characteristics including interspike intervals were analyzed.Spectral and coherence analyses were assessed.Mean spontaneous firing rate(MSFR)of neurons was calculated.Analysis of variance and χ^(2) test were performed.Results:Of 76 STN neurons,39.5% were 4–6 Hz band oscillatory neurons and 28.9% were β frequency band(βFB)oscillatory neurons.The MSFR was 44.2±7.6 Hz.Of 62 GPi neurons,37.1% were 4–6 Hz band oscillatory neurons and 27.4% were βFB neurons.The MSFR was 80.9±9.6 Hz.Of 44 Vop neurons,65.9% were 4–6 Hz band oscillatory neurons and 9%were βFB neurons.The MSFR was 24.4±4.2 Hz.Of 30 Vim oscillatory neurons,70% were 4–6 Hz band oscillatory neurons and 13.3% were β FB neurons.The MSFR was 30.3±3.6 Hz.Further analysis indicated that proportion of βFB oscillatory neurons in STN and GPi was higher than that of similar neurons in the Vop and Vim(P<0.05).Conversely,the proportion of 4–6 Hz band oscillatory neurons and tremor related neurons in the Vim and Vop was higher than that of STN and GPi(P<0.05).The highest MSFR was for GPi oscillatory neurons whereas the lowest MSFR was for Vop oscillatory neurons(P<0.005).Conclusion:The alterations in neuronal activity in basal ganglia play a critical role in generation of parkinsonism.β oscillatory activity is more prominent in basal ganglia than in thalamus suggesting that the activity likely results from dopaminergic depletion.While both basal ganglia and thalamus have tremor activity,the thalamus appears to play a more important role in tremor production,and basal ganglia β oscillatory activity might be the trigger.
基金the National Natural Science Foundation of China, No. 30672239
文摘BACKGROUND： Induced differentiation strategies and cytochemical properties of human embryonic stem ceils （hESCs） have been investigated. However, the electrophysiological functions of tyrosine hydroxylase （TH）-positive cells dedved from hESCs remain unclear. OBJECTIVE： To investigate the differentiation efficiency of TH-positive cells from hESCs in vitro using modified four-step culture methods, including embryoid body formation, and to examine the functional characteristics of the differentiated TH-positive cells using electrophysiological techniques. DESIGN, TIME AND SETTING： Neuroelectrophysiology was performed at the Reproductive Medicine Center and Stem Cell Research Center, Peking University Third Hospital, and the Neuroscience Research Institute and Department of Neurobiology, Peking University, from September 2004 to August 2008. MATERIALS： The hESC line, PKU-1.1, a monoclonal cell line derived from a pre-implantation human blastocyst in the Reproductive Medical Center of Peking University Third Hospital. The patch clamp recording system was provided by the Neuroscience Research Institute and Department of Neurobiology, Peking University. METHODS： The hESC line was induced to differentiate into TH-positive cells in vitro using a modified four-step culture method, including the formation of embryoid body, as well as the presence of sonic hedgehog and fibroblast growth factor 8. The cell karyotype was assessed by G-banding karyotype analysis techniques and specific markers were detected immunocytochemically. Whole-cell configuration was obtained after obtaining a tight seal of over 1 GΩ. Ionic currents were detected by holding the cells at -70 mV and stepping to test voltages between -80 and 40 mV in 10-mV increments in voltage-clamp configuration. MAIN OUTCOME MEASURES： We measured the cell karyotype, specific cell markers, and the electrophysiological properties of the voltage-gated ion channels on the cell membrane of TH-positive dopaminergic cells differentiated from our hESCs line in vitro. RESULTS： The differentiated cells had a consistent appearance, and the majority of cells （〉 90%） expressed TH and β-tubulion, as well as the neural progenitor marker, nestino Cell karyotype analysis demonstrated that all of the hESCs had a stable and normal karyotype （46, XX） after differentiation. In addition, patch clamp recording showed that the 10 recorded TH-positive cells exhibited a fast inward current when the test voltage depolarized to -30 mV, and a delayed outward current when the test voltage depolarized to -10 mV. The peak of inward current was obtained at voltage between 10 mV and 0 mV, while the peak of outward current was obtained at 40 mV. The average peak of inward current density was （ -50.05 ± 15.50） pA/pF, and the average peak of outward current density was （41.98 ± 13.55） pA/pE CONCLUSION： More than 90% of the differentiated hESC-derived cells induced by the modified four-step culture method exhibit dopaminergic neuronal properties, including general electrophysiological functional properties, such as functional potassium and sodium channels.
文摘Crohn’s disease(CD)is characterized by transmural inflammation of the gastrointestinal tract leading to inflammatory,stricturing and/or and fistulizing disease.Once a patient develops medically refractory disease,mechanical obstruction,fistulizing disease or perforation,surgery is indicated.Unfortunately,surgery is not curative in most cases,underscoring the importance of bowel preservation and adequate perioperative medical management.As many of the medications used to treat CD are immunosuppressive,the concern for postoperative infectious complications and anastomotic healing are particularly concerning;these concerns have to be balanced with preventing and treating residual or recurrent disease.We herein review the available literature and make recommendations regarding the preoperative,perioperative and postoperative administration of immunosuppressive medications in the current era of biological therapy for CD.Standardized algorithms for perioperative medical management would greatly assist future research for optimizing surgical outcomes and preventing disease recurrence in the future.
