泛素-蛋白酶体通路在神经系统中的生物学功能

概述了泛素-蛋白酶体通路(ubiquitin-proteasome system,UPS)的组成及其作用机理,着重阐述了其在神经系统中的生物学功能,主要包括UPS在神经元发育、突触的功能、突触的可塑性以及神经性疾病等方面的研究现状,为进一步揭示神经元的生长发育机理以及神经性疾病的研究提供参考。     

Trigemino‐Cardiac Reflex as Lethal Mechanism in a Suicidal Fire Death Case

In the vast majority of immediate fire deaths, the mechanism of death is inhalation of toxic gases (especially carbon monoxide), direct thermal injury, or neurogenic shock due to the redistribution of the body's blood volume produced by surface heat on the skin. We present a suicidal case that is unusual because the mechanism of immediate fire death could arguably be explained in terms of a primitive autonomic reflex/the trigemino‐cardiac reflex. Although this reflex is well known to surgeons and anesthetists, with possible lethal consequences in the course of invasive surgical procedures on the head and neck region, it is much less familiar to forensic pathologists.     

电针治疗不完全性脊髓损伤神经源性膀胱23例

目的 观察电针治疗不完全性脊髓损伤神经源性膀胱的疗效。方法 将43例脊髓损伤性神经源性膀胱患者按照入院顺序随机分为治疗组（23例）和对照组（20例）,对照组患者给予膀胱训练4周,治疗组患者加用电针治疗。治疗前后观察两组24 h排尿次数、每次尿量、每周尿失禁次数、膀胱容量和残余尿量的变化。结果 治疗后两组患者的24 h排尿次数、每周尿失禁次数、残余尿量均较治疗前显著下降(P<0.01),膀胱容量和每次尿量显著增加(P<0.01);治疗组在降低膀胱残余尿量和升高膀胱容量方面显著优于对照组（P<0.01）。结论 电针结合膀胱训练可明显改善脊髓损伤性神经源性膀胱患者的膀胱功能。     

Is There a Relationship Between Bladder Outlet Obstruction due to Benign Prostatic Hyperplasia and Pulmonary Thromboembolism?

Benign prostatic hyperplasia with chronic bladder outlet obstruction has been associated with deep venous thrombosis (DVT) and fatal pulmonary thromboembolism (PTE). To evaluate this further, 60 autopsy cases of men with PTE were compared with 60 age-matched controls. The criteria for outlet obstruction were macroscopic prostatic enlargement with bladder trabeculation and benign prostatic hyperplasia on microscopy. Ten of the 60 men (16.7%) with fatal PTE had evidence of bladder outlet obstruction (age 57-78 years; mean 71.4 years). Of the 60 controls, 12 had evidence of bladder outlet obstruction (20%) (age 67-86 years; mean 75.5 years). No significant relationship could be demonstrated between bladder outlet obstruction and fatal PTE cases (p = 0.8). Given reports of this association, however, it is possible that bladder distension with venous compression may act as a risk modifier in certain individuals in association with other significant comorbidities, but this risk appears low.     

Applying the Chinese Shichen for a Healthy Body and Mind

正Gall Bladder MeridianThe Gall Bladder Meridian works dynamically in Zishi(from 11 p.m.to 1 a.m.).Going to sleep before Zishi means that the gall bladder is able to complete the process of metabolism.In the morning,people will feel refreshed with no dark circles around the eyes.Reminder:Stay relaxed,keep warm and sleep well.     

Spontaneous Rupture of the Gall Bladder: An Unusual Forensic Diagnosis

Peritonitis secondary to spontaneous rupture/perforation of the gall bladder is a rare condition overall and is even less common in the forensic population. We report the case of a middle‐aged man who died from generalized peritonitis from gall bladder perforation due to acute acalculous cholecystitis. This condition usually occurs in critical patients with systemic illness, and although the exact pathogenesis remains unclear, the development of acalculous cholecystitis appears to be multifactorial. Antemortem diagnosis is reliant upon clinical presentation, laboratory data, and radiologic studies. Surgery and appropriate antibiotics are mainstays of treatment; however, there is an emerging role for minimally invasive procedures. Histopathologic features show significant overlap with the calculous type. Although increasing numbers of acalculous cholecystitis have been diagnosed in the critically ill, the fatal presentation of a perforated gall bladder following an undiagnosed case of acute acalculous cholecystitis is unusual in a nonhospitalized and ambulatory man.     

艾灸联合西医常规疗法治疗糖尿病神经源性膀胱36例

目的 观察艾灸联合西医常规疗法治疗糖尿病神经源性膀胱的临床疗效。方法 将72例糖尿病神经源性膀胱患者随机分为对照组和观察组,每组36例,对照组进行西医常规治疗,观察组在此基础上采用秩边、气海、关元、肾俞、脾俞、三焦俞等穴位艾灸治疗,疗程2周。观察并比较两组患者临床疗效,治疗前后分别观察中医证候积分和检测膀胱残余尿量。结果 观察组临床疗效明显优于对照组,差异具有统计学意义（P<0.05）;两组治疗后中医证候积分和膀胱残余尿量均较治疗前显著降低（P<0.05）,但观察组治疗前后中医证候积分和残余尿量降低值显著大于对照组（P<0.05）。结论 艾灸联合西医常规疗法治疗糖尿病神经源性膀胱的近期临床疗效确切。     

中西医结合治疗间质性膀胱炎9例分析

目的 观察中西医结合疗法治疗间质性膀胱炎的临床疗效。方法 共纳入9例间质性膀胱炎患者。在膀胱水扩张术联合膀胱即时药物灌注术治疗的基础上,配合行气止痛、清热利湿中药内服。治疗前后分别观察盆腔疼痛与尿急/尿频症状（pelvic pain, urgency and frequency, PUF）评分及间质性膀胱炎症状指数（interstitial cystitis symptom index, ICSI）。结果 与治疗前比较,治疗后患者PUF评分和ICSI显著降低 （P<0.01）。 结论 膀胱水扩张术、膀胱即时药物灌注术结合行气止痛、清热利湿中药内服对间质性膀胱炎具有显著疗效。     

Applying the Chinese Shichen for a Healthy Body and Mind

正Urinary Bladder Meridian The Urinary Bladder Meridian is most active during Shenshi(from 3 to 5 p.m.).During this period body fluids are at optimum level.People feel comfortable due to replenished body fluids that nourish the body.The urinary bladder stores body fluids and water,and circulates body fluids while excreting urine.     

干细胞治疗神经性勃起功能障碍的研究现状

神经性勃起功能障碍(neurogenic erectile dysfunction,NED)的发生与勃起功能相关神经的损伤密切相关.最近,干细胞对阴茎勃起神经的修复和保护作用的临床前研究已经成为热点.本文综述了神经源性胚胎干细胞(NESCs)、肌源性干细胞(MDSCs)、脂肪源性干细胞(ASCs)和间充质干细胞(MSCs)等在NED方面的研究进展.早期研究显示干细胞或基因修饰的干细胞对ED治疗持久有效,并可能成功治愈ED.干细胞有望应用于NED的临床治疗.干细胞作为新的治疗方法应用于临床后,将会对法医临床学鉴定提出新的挑战.