Alzheimer’s Disease Aβ-Amyloid Plaque Morphology Varies According to APOE Isotype

Background: The apolipoprotein E (APOE, gene;apoE, protein) ε4 allele is the most commonly identified genetic risk factor for typical late-onset sporadic Alzheimer’s disease (AD). Each APOE ε4 allele roughly triples the relative risk for AD compared to that of the reference allele, APOE ε3. Methods: We have employed hyperspectral fluorescence imaging with an amyloid-specific, conformation-sensing probe, p-FTAA, to elucidate protein aggregate structure and morphology in fresh frozen prefrontal cortex samples from human postmortem AD brain tissue samples from patients homozygous for either APOE ε3 or APOE ε4. Results: As expected APOE ε4/ε4 tissues had a significantly larger load of CAA than APOE ε3/ε3. APOE isoform-dependent morphological differences in amyloid plaques were also observed. Amyloid plaques in APOE ε3/ε3 tissue had small spherical cores and large coronas while amyloid plaques in APOE ε4/ε4 tissues had large irregular and multi-lobulated plaques with relatively smaller coronas. Despite the different morphologies of their cores, the p-FTAA stained APOE ε3/ε3 amyloid plaque cores had spectral properties identical to those of APOE ε4/ε4 plaque cores. Conclusions: These data support the hypothesis that one mechanism by which the APOE ε4 allele affects AD is by modulating the macrostructure of pathological protein deposits in the brain. APOE ε4 is associated with a higher density of amyloid plaques (as compared to APOE ε3). We speculate that multilobulated APOE ε4-associated plaques arise from multiple initiation foci that coalesce as the plaques grow.

Innate and adaptive immunity in inflammatory bowel disease

Inflammatory bowel diseases are the consequence of a dysregulated mucosal immune system. The mucosal immune system consists of two arms, innate and adaptive immunity, that have been studied separately for a long time. Functional studies from in vivo models of intestinal inflammation as well as results from genome-wide association studies strongly suggest a crossregulation of both arms. The present review will illustrate this interaction by selecting examples from innate immunity and adaptive immunity, and their direct impact on each other. Broadening our view by focusing on the cross-regulated areas of the mucosal immune system will not only facilitate our understanding of disease, but furthermore will allow identification of future therapeutic targets.

Extraluminal factors contributing to inflammatory bowel disease

Many identified and yet unknown factors contribute to the pathogenesis of inflammatory bowel disease(IBD).The genome-wide association studies clearly support the earlier developed concept that IBD occurs in genetically predisposed individuals who are exposed to distinct environmental factors,which together result in dysregulation of the mucosal immune system.Thus,the majority of previous studies have focused on the immune response within the intestinal wall.The present review aims to emphasize the contribution of three extraluminal structures to this inflammatory process,namely the mesenteric fat tissue,the lymphatics and the microvasculature.Broadening our view across the intestinal wall will not only facilitate our understanding of the disease,but will also us to identify future therapeutic targets.

关节穿刺在假体周围感染诊断及治疗中的应用与意义

背景:假体周围感染的诊断是临床研究的难点和重点。关节穿刺检查是术前诊断假体周围感染的常用方法,由于关节穿刺方便操作和容易普及,近年来很多与关节液相关的检查逐步应用于临床诊断假体周围感染,但是很多方法仍存在争议。目的:综述国内、外有关假体周围感染穿刺液检查诊断方法的最新研究进展。方法:由第一作者检索近10年(2008年至2018年)期间PubMed、WebofScience、CNKI数据库中收录的与关节穿刺液诊断假体周围感染的相关文献。英文检索词“periprostheticjointinfection,prostheticjointinfection,synovialfluid,jointpuncture,articularpuncture”;中文检索词“假体周围感染,人工关节感染,关节液,关节穿刺”。共检索到584篇文献,通过阅读文献题目、摘要以及全文后,52篇文章纳入研究。结果与结论:①术前关节穿刺检查是诊断假体周围感染不可缺少的一部分;②目前还没有能够单独诊断假体周围感染的关节穿刺检查方法,把一些检查方法结合起来使用可提高诊断的准确性;③在超声引导下穿刺,比传统的穿刺方法以及透视下穿刺更有优势;④虽然一些新的诊断方法有一定的优势,但是传统的血培养检查以及白细胞计数仍然是诊断假体周围感染不可替代的一部分。

多杀巴斯德菌致假体周围感染

目的分析多杀巴斯德菌致假体周围感染的特点。方法计算机检索Pubmed、Cochrane Library、Web of Science数据库自1998年1月至2018年1月多杀巴斯德菌引起假体周围感染的相关文献,根据纳入标准与排除标准进一步筛选。结果共收集9篇文献。其中6篇来自欧洲国家,3篇来自美国。入选文献中共10例患者。平均年龄70(57～84)岁,女性患者6例。膝关节感染7例,髋关节感染2例,肩关节感染1例。8例与猫接触相关,1例与马接触相关,1例与狗接触相关。5例合并既往病史,其中4例与多杀巴斯德菌假体周围感染危险因素相关。5例X线报告中2例X线发现有假体松动。白细胞计数、C反应蛋白、血浆沉降率均高于正常值,6例关节穿刺液培养结果均为阳性。在抗生素治疗加手术干预的所有病例中,≥1年随访结果显示治愈。结论多杀巴斯德菌假体周围感染患者多数存在明确的动物接触史。早期诊断并通过手术加抗生素治疗可以获得良好的预后。

小的皮质下缺血性卒中的反向不匹配和病灶增大

目的梗死通常形成于最初低灌注组织的区域内。我们前瞻性研究小的皮质下卒中病人,其梗死灶增大是否可超出受累血管分布区之外。方法 19例连续的卒中病人。

人工关节置换术后假体周围感染的临床诊断

人工关节置换失败的原因包括无菌性松动、关节脱位、假体感染、假体断裂等。假体周围感染是人工关节置换术后最严重的并发症,它给患者带来巨大的痛苦、同时伴随着长期的住院时间以及医疗花费。随着发病率的不断增加,假体周围感染的诊断变得越来越重要。本文对假体周围感染的临床表现、影像学、血液学检查、组织病理学、关节穿刺与关节液培养、微生物学的有效方法进行分析,为临床诊断提供有价值的参考。