Medical English | Day19
2014/11/25 医学生

    

    

     percutaneous

     [,p?kj?'te?n?s]

     adj. 经皮的；经由皮肤的

     词根per-表通过

     pervade 遍及；弥漫

     perambulate巡行；巡视；漫步

     perforate 穿孔

     词组Percutaneous plating内固定

     percutaneous coronary经皮冠状动脉介入治疗

     Percutaneous injection局部注射

     percutaneous cholangiography经皮胆管造影术

     例句Percutaneous valve replacement : how far are we from there?

     经皮瓣膜置换术离我们还有多远?。

     www.365heart.com

     Questionfirst aid Q&A for step1

     Glucose is transported into human cells by two different families of membrane-associated carrier proteins: the glucose transporter facilitators(GLUT) and the sodium-coupled glucose transporters (SGLT). If a patient has a defect in the non-sodium-coupled glucose transporters,which cell line is still able to acquire glucose?

     (A) Adipocytes

     (B) Enterocytes

     (C) Erythrocytes

     (D) Hepatocytes

     (E) Myocytes

     (F) Pancreatic beta cells

     葡萄糖通过两种膜相关运载蛋白转运至细胞，一种是葡萄糖易化扩散转运蛋白(GLUT)，一种是钠结合转运蛋白(SGLT)。如果一位患者非钠结合转运蛋白有缺陷，下列哪个细胞系仍然能够获取葡萄糖？

     (A) 脂肪细胞

     (B) 肠细胞

     (C) 红细胞

     (D) 肝细胞

     (E) 肌细胞

     (F) 胰岛 beta 细胞

     Answer

     The correct answer is B.

     This patient would likely have a defect of

     glucose transporter 1,which transports glucose across the blood-brain barrier. A family of glucose transporters (GLUT1-5) is responsible for cellular uptake in many cell types. However, enterocytes and nephrons acquire glucose through cotransport with sodium ion.

     正确答案是B.这位患者可能有葡萄糖易化扩散转运蛋白1的缺陷，这种蛋白转运葡萄糖通过血脑屏障。葡萄糖转运蛋白(GLUT1-5) 对许多类型的细胞摄取葡萄糖有作用。但是，肠细胞和神经细胞转运葡萄糖则是通过与钠离子共转运的方式。

     The dorsal medial prefrontal (anterior cingulate) cortex—amygdala aversive amplification circuit in unmedicated generalised and social anxiety disorders: an observational study

     前扣带皮层和杏仁体在焦虑症表现中的角色

     Oliver J Robinson .Marissa Krimsky .Lynne Lieberman .Phillip Allen . Katherine Vytal .Christian Grillon

     Lancet Psychiatry

     2014-10-27

     索引：Lancet Psychiatry. 2014; 294-302.

     中文摘要来源：医纬达

     Background

     In four previous studies, we have delineated the role of positive circuit coupling between the dorsal medial prefrontal (anterior cingulate) cortex and the amygdala during aversive processing in healthy people under stress. This translational circuit—the aversive amplification circuit—is thought to drive adaptive, harm-avoidant behaviour in threatening environments. We assess the role of this circuit in the pathological manifestation of anxiety disorders.

     Methods

     For this single-site study, 45 unmedicated participants (22 with generalised and/or social anxiety disorder and 23 healthy controls) were recruited via advertisements from the metropolitan area of Washington, DC (USA). People who applied to participate in the study had to pass an initial telephone screen and comprehensive screening by a clinician at the National Institutes of Health (NIH; Bethesda, MD, USA). People with a contraindicated medical disorder, past or current psychiatric disorders other than anxiety disorders, and those using psychoactive medications or illicit drugs were excluded. Eligible individuals could participate as either a healthy control or a patient, depending on diagnosis. They were asked to use a button box to complete a simple emotion identification task (fearful vs happy faces; 44 trials of each) during functional MRI at the NIH. Functional imaging analysis consisted of event-related activation analysis and psychophysiological interaction connectivity analysis of regions coupled with the amygdala during task performance.

     Findings

     A diagnosis-by-valence interaction was recorded in whole-brain amygdalaconnectivity within the dorsal medial prefrontal (anterior cingulate) cortexclusters identified in our previous study, driven by significantly increasedcircuit coupling during processing of fearful faces versus happy faces inanxious, but not healthy, participants. Importantly, and in accordance withcontemporary theoretical approaches to psychiatry, circuit coupling correlatedpositively with self-reported anxious symptoms, which provides evidence of acontinuous association between the circuit and subjective symptoms.

     Interpretation

     In this study and our previous work, we track the functional role of one neural circuit from its involvement in adaptive threat biases under stress, to its chronic engagement in anxiety disorders in the absence of experimentally induced stress. Thus, we uniquely map a mood and anxiety-related circuit across its adaptive and maladaptive stages. Clinically, this study could provide a step towards a more mechanistic continuum-based approach to anxiety disorder diagnosis and might ultimately lead to more targeted treatments for patients with anxiety disorders.

     背景资料

     在之前四项研究中，我们已勾画了承受压力健康人群规避过程中，背内侧前额叶(前扣带)皮层和杏仁体间正回路耦合所扮演的角色。 这一转化回路为规避放大回路，认为它在受威胁性环境中推动适应、避害行为。 我们评估了该回路在焦虑症病理性表现中扮演的角色。

     方法

     在该单中心研究中，通过广告从(美国)华盛顿特区都市圈招募了 45 名未服药的参与者(22 名患有广泛和/或社交焦虑症，23 名为健康对照)。 申请参加该研究的人员，须通过初次电话筛选，和国立卫生研究院(NIH；美国马里兰州贝塞斯达)医生的综合筛选。 患有医学禁忌疾病、过去或目前患有除焦虑症外精神障碍、和使用精神药物或违禁药物的人员被排除在外。 根据诊断，合格的人员可作为健康对照或患者参加研究。 在 NIH 的功能性 MRI 期间，要求他们使用一个按钮盒完成一项简单的情感识别任务(恐惧对比开心的人脸；各 44 次试验)。 功能成像分析对任务完成过程中杏仁核偶联区域进行分析，由事件相关激活分析和心理生理相互作用关系分析组成。

     研究结果

     在我们之前的研究中，在全脑杏仁体联系的背内侧前额叶(前扣带)皮层簇内记录到了诊断所需的双向情感反应，面对恐惧对比开心人脸时，焦虑使回路耦合明显增加，但健康参与者不会出现这种情况。 值得重视的是，根据现代精神病学理论方法，还发现回路耦合与患者自己报告的焦虑症状正相关，这为回路和主观症状的连续相关提供了证据。

     解读

     在本研究和我们之前的工作中，我们对一条神经回路从压力之下的适应性威胁偏倚，到其在无试验诱导压力之下焦虑症中的长期偏倚中扮演的功能性角色进行了追踪。 因此，我们在其适应和适应不良阶段，单独对情绪和焦虑相关回路绘制了图谱。 在临床上，该研究使焦虑症诊断朝更具机械性的连续方法迈出了一个台阶，并可能最终开发出对焦虑症患者更有针对性的治疗方法。

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