Pathological Changes of von Economo Neuron and Fork Neuron in Neuropsychiatric Diseases / 中国医学科学院学报

von Economo neuron (VEN) is a bipolar neuron characterized by a large spindle-shaped soma. VEN is generally distributed in the layer V of anterior insular lobe and anterior cingulate cortex. Fork neuron is another featured bipolar neuron. In recent years,many studies have illustrated that VEN and fork neurons are correlated with complicated cognition such as self-consciousness and social emotion. Studies in the development and morpholigies of these two neurons as well as their pathological changes in various neurological and psychiatric disorders have found that the abnormal number and functions of VEN can cause corresponding dysfunctions in social recognition and emotions both during the neuro-developmental stages of childhood and during the nerve degeneration in old age stage. Therefore, more attentions should be paid on the research of VEN and fork neurons in neuropsychiatric diseases.

Severe pathological manifestation of cerebral amyloid angiopathy correlates with poor outcome from cerebral amyloid angiopathy related intracranial hemorrhage / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Cerebral amyloid angiopathy (CAA) is one of the main causes of spontaneous intracranial hemorrhage (ICH). No established link is available between pathological scores of CAA and its outcome. This study aimed to identify the correlations between pathological severity and poor postoperative outcome in the Chinese population.</p><p><b>METHODS</b>Between May 2006 and April 2011, 367 consecutive patients who underwent surgery for CAA-related ICH in 71 hospitals throughout the mainland of China were enrolled in this study. Twelve months after surgery, we evaluated these patients' outcomes according to the modified Rankin Scale (mRS) and statistically correlated risk factors (demographics, medical history, pathological results, and surgical details) that are associated with a favorable (mRS < 3) and poor (mRS ≥ 3) outcome groups.</p><p><b>RESULTS</b>Risk factors for poor postoperative outcome in 367 patients with CAA-related ICH included advanced age (OR 1.034, 95%CI 1.001 - 1.067, P = 0.042), CAA pathology severity (OR 2.074, 95%CI 7.140 - 16.25, P < 0.001), lobar hematoma (OR 0.225, 95%CI 0.104 - 0.486, P < 0.001), presence of intraventricular hemorrhage (OR 0.478, 95%CI 0.229 - 1.001, P = 0.050), and/or subarachnoid hemorrhage (OR 2.629, 95%CI, 1.051 - 6.577, P = 0.039).</p><p><b>CONCLUSIONS</b>Poor postoperative outcome of patients with CAA-related ICH was more related to the severe pathological manifestation instead of other factors. Prior ischemia may present an early stage of CAA.</p>

Impact of fish oil enriched total parenteral nutrition on elderly patients after colorectal cancer surgery / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Polyunsaturated omega-3 fatty acids may beneficially influence healing processes and patient outcomes. The aim of this research was to study the clinical efficacy of fish oil enriched total parenteral nutrition in elderly patients after colorectal cancer surgery.</p><p><b>METHODS</b>Fifty-seven elderly patients with colorectal cancer were enrolled in this prospective, randomized, double-blind, controlled clinical trial. All patients received isocaloric and isonitrogenous total parenteral nutrition by continuous infusion (20 - 24 hours per day) for seven days after surgery. The control group (n = 28) received 1.2 g/kg soybean oil per day, whereas the treatment group (n = 29) received 0.2 g/kg fish oil and 1.0 g/kg soybean oil per day. Blood samples were taken pre-operatively, and at days one and eight after the operation. The plasma levels of CD4, CD8, CD4/CD8, interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were measured. Clinical outcomes were then analysed.</p><p><b>RESULTS</b>Patient characteristics were comparable between the two groups. At day eight post-surgery, IL-6, TNF-α and CD8 titres were lower in the treatment group when compared to the control group; these results reached statistical significance. In the treatment group, there were fewer infectious complications and incidences of systemic inflammatory response syndrome (SIRS), and shorter lengths of hospital stay were observed. The total cost of medical care was comparable for the two groups. No serious adverse events occurred in either group.</p><p><b>CONCLUSIONS</b>Fish oil 0.2 g/kg per day administrated to elderly patients after colorectal surgery was safe and may shorten the length of hospital stay and improve clinical outcomes.</p>

Expression of tau-related protein in spinal cord of patients with Alzheimer's disease / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the expression of tau-related protein in spinal cord of Chinese patients with Alzheimer's disease.</p><p><b>METHODS</b>Gallays-Braak stain and immunohistochemical study for tau protein (AT8) were carried out in the spinal cord tissue (T2, T8, T10, L2 and S2 segments) of 3 Chinese patients with Alzheimer's disease. Seven age-matched cases without evidence of dementia or neurologic disease were used as controls.</p><p><b>RESULTS</b>Neurofibrillary tangles were identified in the neurons of anterior horn in 2 Alzheimer's disease cases but none was observed in the controls. Tau-positive axons and astroglia were detected in all Alzheimer's disease cases. Tau immunoreactivity in spinal cord of the patients correlated with that in brain tissue.</p><p><b>CONCLUSION</b>The expression of tau-related protein is demonstrated in the spinal cord of Alzheimer's disease patients suggesting that axonal transport defect may play a role in the pathogenesis of Alzheimer's disease.</p>

A multicenter, phase III trial of hemocoagulase Agkistrodon: hemostasis, coagulation, and safety in patients undergoing abdominal surgery / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hemocoagulase Agkistrodon for injection is a single component thrombin which has passed phases I and II clinical trials. The purpose of this phase III clinical trial was to evaluate the effect of Hemocoagulase Agkistrodon on hemostasis and coagulation in abdominal skin and subcutaneous incisions and to assess the safety of this agent in surgical patients.</p><p><b>METHODS</b>This is a phase III, prospective, randomized, double-blind, and controlled multicenter clinical trial including 432 consecutive patients randomized into either a study group (injected with hemocoagulase Agkistrodon at 2 U, n = 324) or a control group (injected with hemocoagulase Atrox, n = 108). The hemostatic time, hemorrhagic volume, hemorrhagic volume per unit area, blood coagulation, and adverse events were measured and compared between the two groups.</p><p><b>RESULTS</b>The mean hemostatic time in the study group was (36.8 +/- 18.7) seconds; the hemorrhagic volume was (3.77 +/- 3.93) g; and the hemorrhagic volume per unit area was (0.091 +/- 0.125) g/cm(2). In the control group, the corresponding values were (38.1 +/- 19.7) seconds, (4.00 +/- 4.75) g, and (0.095 +/- 0.101) g/cm(2), respectively. No significant difference in values existed between the two groups (P > 0.05). Blood coagulation results and hepatic and renal function were also similar between the two groups. Adverse events were reported in two cases, but were deemed non-drug-related.</p><p><b>CONCLUSIONS</b>Hemocoagulase Agkistrodon has good hemostatic and coagulative function and is safe for the use of arresting capillary hemorrhage that occurs while incising the abdomen during surgery.</p>

Glial abnormalities in progressive supranuclear palsy and corticobasal degeneration / 中华病理学杂志

<p><b>OBJECTIVE</b>To study pathologic features of glial cells in progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) and to explore their pathologic significance.</p><p><b>METHODS</b>Brain tissues from 2 cases with PSP and 3 cases with CBD, all confirmed by autopsies, were examined by routine neuropathologic methods, Gallyas-Braak staining and tau immunostaining. Brain tissues from 6 Alzheimer's disease cases, 4 cases with Parkinson's disease and 6 elderly with no neurologic abnormality were used as controls.</p><p><b>RESULTS</b>Gallyas-Braak staining demonstrated tuft-shaped astrocytes and coiled-body oligodendroglial cells in the brain tissues of 2 cases with PSP and 3 cases with CBD. The tuft-shaped astrocytes appeared prominently in the frontal and parietal cortex, basal ganglia and grey matter of the brainstem. The coiled-body oligodendroglial cells were distributed widely in the white matter of the frontal and parietal lobes, basal ganglia, brainstem and cerebellum. However, astrocytic plaques, composed of degenerative stubby processes with radiating arrangement, only appeared in the frontal, parietal and cingular cortex, as well as in the striatum of 3 cases with CBD. The astrocytic plaques and tuft-shaped astrocytes coexisted in the same areas, including parietal and cingular cortex and striatum, in CBD. All these glial abnormalities showed tau-positive immunoreaction not found in control cases.</p><p><b>CONCLUSIONS</b>The tuft-shaped astrocytes and coiled-body oligodendroglial cells are common glial morphologic features of both PSP and CBD. Astrocytic plaques are also characteristically seen in CBD.</p>

Pathologic diagnosis of non-Alzheimer type dementia / 中华病理学杂志

<p><b>OBJECTIVE</b>To characterize histopathologic features of non-Alzheimer type dementia.</p><p><b>METHODS</b>Bodian, Gallyas-Braak silver staining, tau and ubiquitin immunohistochemistry were applied in an analysis of 22 cases of autopsy-proven neurodegenerative dementia. Appearance, distribution and immunoreactivity of neuronal and glial inclusions in the brain were observed. The final histological diagnoses were made according to the pathological criteria for several types of common non-Alzheimer type dementia.</p><p><b>RESULTS</b>Among the 22 cases of neurodegenerative dementia, 12 cases were identified as non-Alzheimer type dementia, including Pick's disease (2 cases), progressive supranuclear palsy (3 cases) and corticobasal degeneration (3 cases), dementia with Lewy bodies (1 case), and Parkinson's disease (3 cases). Another 10 cases consisted of pure Alzheimer's disease (AD, 9 cases) and AD combined with argyrophilic grain disease (1 case). Characteristic neuronal and glial inclusions, such as classical and cortical Lewy body, Pick body, Globous NFTs, astrocytic plaque and tufted astrocyte, argyrophilic grain were found in the brains of non-Alzheimer type dementia. Classical and cortical Lewy bodies were not argyrophilic but were immunoreactive to ubiquitin. Pick bodies, Globous NFTs, astrocytic plaques, tufted astrocytes and argyrophilic grains were all argyrophilic. Pick bodies showed tau and ubiquitin immunoreactivity. However, Globous NFTs, astrocytic plaques, tufted astrocytes, and argyrophilic grains were reactive only to tau immunohistochemistry.</p><p><b>CONCLUSIONS</b>Findings of characteristic neuronal and glial inclusions may help to differentiate non-Alzheimer type dementia from AD, and in conjunction with Gallyas-Braak staining and immunohistochemistry for tau and ubiquitin, to further define histopathologic subcategories of non-Alzheimer type dementia.</p>

Morphological and quantatitive capillary changes in aging human brain / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate morphological changes of capillary in aging brain and explore the role of vascular factor in brain aging.</p><p><b>METHODS</b>Twenty-eight brains of individuals (mean age 65 years) who died without clinical or pathological involvement of nervous system and 6 brains of Alzheimer's disease (AD) patients (mean age 83 years) were obtained at autopsy. Sections from frontal lobe, occipital lobe, striatum and hippocampus of normal subjects and sections from hippocampus of AD patients were used for hematoxylin eosin (HE), lox fast blue (LFB), toluidine blue stains and ulex europaeus agglutinin (UEA) immunostaining. After observations of morphological changes of neuron and capillary, computer-aid image analysis was performed to quantify numerical density and area density of neuron and capillary in frontal lobe, occipital lobe, putamen, CA3 sector of normal subjects and CA3 sector of AD patients. Numerical ratio and area ratio of neuron and capillary were then calculated. Correlations between neuron/capillary ratio and age were estimated using Pearson's correlation test. Difference of neuron/capillary ratio in CA3 sectors between AD patients and advanced aged normal subjects (> 75 years) was analyzed with Student's t-test.</p><p><b>RESULTS</b>Several pathological microvascular changes, including increased tortuosity, looping, bundling, stringing, and effacement of endothelia were seen in aged subjects and more prevalent in AD patients. Numerical ratio and area ratio of neuron and capillary of frontal lobe, occipital lobe and putamen significantly increased with age in normal aging subjects.</p><p><b>CONCLUSIONS</b>Morphological changes and relative decrease in number and capacity of capillary in aging brain may reduce cerebral blood flow and metabolism, and consequently result in functional impairment of aging brain. Vascular factors may play an important role in the development of brain aging.</p>