The cholinergic system 胆碱能系统
1. Multiple neuronal pathways are destroyed in AD. Damage occurs in any nerve cell population located in or traveling through plaque-laden areas. AD 中有大量神经通路损伤。损伤发生在任何位于或经过斑聚集部位的细胞群落。
2. Most profoundly damage are the cholinergic pathways, particularly those neurons located at the base of the
forebrain. 最严重的损伤是胆碱能通路，特别是位于前脑基底部位的神经元。
3. Problems:
a) cholinergic cell loss does not appear to be the disease-producing event, but a secondary
consequence
of
AD
pathology;胆碱能细胞的缺失不是疾病产生的原因，而是AD病理发展的结果。
b) cholinergic neurons are only one of many neuronal pathways destroyed in AD. 胆碱能神经元仅是多种受损神经通路中的一个。
cholinergic [,k??l?'n?:d??k] adj. 类胆碱的 multiple ['m?lt?pl]
adj. 多重的；多样的；许多的 n. 倍数；[电] 并联 pathway ['pɑ:θwe?] n. 路，道；途径，路径 cell population: 细胞群体 travel through: 经过 laden ['le?d(?)n]
adj. 负载的；装满的；苦恼的 v. 装载（lade的过去分词） vt. 装载（等于lade）
vi. 装载（等于 lade ） profoundly [pr?'fa?ndl?] adv. 深刻地；深深地；极度地
consequence ['k?ns?kw(?)ns] n. 结果；重要性；推论 pathology [p?'θ?l?d??] n. 病理学（复数pathologies）
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Estrogen 雌激素
1. Women appear to be at greater risk for
estrogen ['estr?d??n]: n. 雌性激素
developing AD but not other dementias. dementia [d ? 'men ? ? ] 女性有更高的风险发展成为AD，而不是其它类型痴呆。 2.
Experiments
in
vivo
and
intro-estrogen promotes synaptic
growth and prevents cell damage. 体内和体外试验，雌激素促进突触生长和阻止细胞损害。
3. Epidemiologic studies: the incidence of AD on follow-up was 5.8% in the 156 women taking estrogen at any time after menopause, compared with 16.3% in the 968 nonestrogen users. AD发病率：156个绝经后任何时期服用雌激素的妇女-- 5.8%；968个没有服用的妇女16.3%。
n. [内科] 痴呆
promote [pr?'m??t]
vi. 成为王后或其他大于卒的子 vt. 促进；提升；推销；发扬 synaptic [s?'n?pt?k; sa?-] adj. 突触的；（染色体）联合的
epidemiologic ['epi,di:mi?'l?d?ik,-k?l] adj. 流行病学的；传染病学的 incidence ['?ns?d(?)ns]
n. 发生率；影响；[光] 入射；影响范围
menopause ['men?p?:z] n. 更年期；活动终止期
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Clinical presentation 1 临床表现 1
Unlike dementia due to stroke, the onset of AD is almost imperceptible, without abrupt changes in cognition or function. Deficits occur progressively over time and are global, affecting multiple areas of cognition. 不像卒中的痴呆发作，AD早期几乎是细微的，没有认知或功能的突发性改变。症状渐进性发生并且是全面的影响认知区域。
Loss of memory is typically the presenting patient complaint, and is frequently brought to the clinician’s attention by a family member. 记忆缺失典型表现为病人的主诉，并且经常由于家属的提供引起医师的注意。 Memory
is
a
nonspecific
term
representing many diverse areas of cognitive function (recall, recognization, calculation, and orientation).记忆是一个代表认知功能不同区域的非特异性名词（回忆，识别，计算，定向）。
presentation [prez(?)n'te??(?)n] n. 展示；描述，陈述；介绍；赠送 dementia [d?'men??]: n. [内科] 痴呆 stroke [str??k]: 中风 | 击球 | 冲程 imperceptible [?mp?'sept?b(?)l] adj. 感觉不到的；极细微的 abrupt [?'br?pt]
abrupt change: 突变；陡变 cognition [k?g'n??(?)n] n. 认识；知识；认识能力 deficit ['def?s?t; ]: n. 赤字；不足额 progressively [pr?'gresivli]: adv. 渐进地；日益增多地 global ['gl??b(?)l]
adj. 全球的；总体的；球形的
typically ['t?p?k?l?]
adv. 代表性地；作为特色地
nonspecific [,n?nspi'sifik] adj. [医] 非特异性的；非特殊的 diverse [da?'v??s; 'da?v??s]
adj. 不同的；多种多样的；变化多的 calculation [k?lkj?'le??(?)n] n. 计算；估计；计算的结果 orientation [,?:r??n'te??(?)n; ,?r-] n. 方向；定向；适应；情况介绍；
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Clinical presentation 2 临床表现 2
Crucial to understanding the plight of persons with AD is to understand that “loss of memory” means the inability crucial ['kru:?(?)l]
adj. 重要的；决定性的；定局的；决断的 plight [pla?t]
n. 困境；境况；誓约 vt. 保证；约定 to extract and use all previously learned formations, activity, and experience.理解AD病人情况的关键是明白“记忆缺失”意味着提炼和运用所有以前学过的活动和经验的障碍。
Getting lost traveling to familiar locations. 去熟悉的地方会迷路
Forgetting appointments. 忘记约会
Misplacing items-key 遗忘物品，如钥匙
Difficulties handing money.处理钱困难
Increase need for list.有列表的需要
Difficulties performing routine tasts at home or work.很难履行家庭和工作的常规义务。
inability [?n?'b?l?t?] n. 无能力；无才能 extract [‘ekstr?kt]
vt. 提取；取出；摘录；榨取 n. 汁；摘录；榨出物；选粹 experience [?k'sp??r??ns; ek-] n. 经验；经历；体验 vt. 经验；经历；体验
familiar [f?'m?l??]
adj. 熟悉的；常见的；亲近的 n. 常客；密友 item ['a?t?m]
n. 条款，项目；一则；一件商品（或物品）
difficulties ['d?f?,k?ltiz]
n. 困难（difficulty的复数）；磨难
performing [p?'f??m??] adj. 表演的；履行的
v. 表演（perform的ing形式）；履行
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Clinical presentation 3 临床表现 3
For treatment and assessment purposes, it is helpful to divided AD symptoms into
cognitive
symptoms
and
assessment [?'sesm?nt] n. 评定；估价 purpose ['p?:p?s] n. 目的；用途；意志 vt. 决心；企图；打算 cognitive ['k?ɡn?t?v] noncognitive (behavioral) symptoms.为了治疗和诊断目的，将AD 症状分为认知障碍和非认知障碍（行为障碍）
Cognitive symptoms are present in all patients reaching the final stages of the illness, whereas behavioral symptoms are less predictable. 认知障碍是所有病人最后阶段都会发生，然而行为障碍很少能够预知。
adj. 认知的，认识的 symptom ['s?m(p)t?m] n. [临床] 症状；征兆 behavioral [bi'heivj?r?l] adj. 行为的
stage [ste?d?]
n. 阶段；舞台；戏剧；驿站 vt. 举行；上演；筹划
vi. 举行；适于上演；乘驿车旅行predictable [pr?'d?kt?b(?)l] adj. 可预言的
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