Assessment of resin perfusion in hepatic failure in vitro and in vivo

AIM:To observe the adsorbent effect of resin on endotoxin,cytokine,bilirubin in plasma of patients with hepatic failureand to determine the resin perfusion as an artificial liversupport system in the treatment of hepatic failure.METHODS:One thousand milliliters of discarded plasmawas collected from each of 6 severe hepatitis patients treatedwith plasma exchange.The plasma was passed through aresin perfusion equipment for 1-2 h via extracorporealcirculation,and then absorbent indicators of transaminase,bilirubin,blood ammonia,endotoxin and cytokines wereexamined.In the meantime,study of in vivo resin plasmaperfusion was performed on 7 severe hepatitis patients tocompare the changes of endotoxin and cytokines in bloodbefore and after perfusion.RESULTS:The levels of total bilirubin,endotoxin,interleukin1β and TNF-α in plasma were significantly decreased afterin vitro resin plasma perfusion.The levels of interleukin 1β,TNF-α and endotoxin in blood were also evidently declinedafter in vivo resin plasma perfusion.Nevertheless,no obviouschanges in IL-6,creatinine (Cr) and urea nitrogen (UN),bloodammonia and electrolytes were found both in vitroand in vivo.CONCLUSION:Bilirubin,endotoxin and cytokines in plasmaof patients with hepatic failure can be effectively adsorbedby resin in vitro.Most cytokines and endotoxin in plasma canalso be effectively removed by resin in vivo.It demonstratesthat resin perfusion may have good treatment efficacy onhepatic failure and can be expected to slow down theprogression of hepatic failure.     

Characteristics of the tuberculosis epidemic in schools in Qingdao in 2010—2019

作者通过《中国疾病预防控制信息系统》的子系统《结核病信息管理系统》,收集2010—2019年青岛市登记职业为“学生”的患者资料、肺结核登记例数(不包括结核性胸膜炎),以及收集《青岛统计年鉴》学生人口数资料,分析学生肺结核登记情况及流行病学特征。结果显示,2019年学生肺结核登记发病率为11.91/10万(175/1468777),较2010年(16.53/10万,212/1282589)降低27.95%,呈下降趋势,差异有统计学意义(Z_趋势=-6.567,P<0.001);2010—2019年每年3、4月份为登记发病例数的高峰,在全年中占比为24.42%(443/1814);19~<22岁患者(大学阶段)在报告患者总例数中的占比最高(43.16%,783/1814);被动方式发现1650例,占90.96%(1650/1814);2010—2019年学生患者就诊延迟占比为62.24%(1129/1814)。研究认为,青岛市学生肺结核登记发病率整体处于较低水平,但仍需要继续重视学生肺结核的防控工作,并加强开展健康教育,提高学生的防病意识。     

What's new in lymphedema therapy in America?

There is much confusion among American medical professionals regarding the treatment of lymphedema. Much of it has to do with the fact that lymphedema falls between the cracks of all standard specialties in modern American practice. Partially for this reason and because of a general misconception among American physicians that lymphedema is not a serious problem, the condition has been virtually ignored and deprioritized for many decades. This study is intended to clarify the confusion and reasons for apathy toward the subject of lymphedema and its treatment.Lymphedema, for the most part ignored or poorly treated in the United States, is currently being effectively treated by complete (or complex) decongestive physiotherapy (CDP) in many American facilities. CDP was introduced to the United States by the author in 1989 and is a gentle, effective, cost-effective, safe, and noninvasive treatment. It is and must be performed by specially trained therapists under the supervision of lymphologists with expertise in lymphedema, its diagnosis, treatment, complications, and natural history.This article describes the author's experience in treating 1000 upper and 1000 lower extremity lymphedema patients by the CDP method. These patients were treated between 1989 and 1995 for an average of 25 tretments, each patient returning for a follow-up examination 1 year after the completion of his or her course of treatment. The variables recorded in this study were as follows: the patient's sex, type of lymphedema, and volumetric reduction achieved immediately following treatment and as measured 1 year after treatment. The therapy and follow-up procedures are explained in detail and examples (before and after photos) of actual cases are included.Based on the results of this study and others, it is the author's opinion that CDP therapy is superior to any surgical procedures currently being used and to the pneumatic pump therapies often erroneously recommended for this condition.Presented at the 16th Annual Congress, The Phlebology Society of America, New York, New York, March 1996.     

Crohn''''s disease in one mixed-race population in Brazil

AIM: To evaluate the classification and severity of Crohn's disease in different racial groups.METHODS: Patients with Crohn's disease from the outpatient clinic of the University Hospital Prof. Edgard Santos were enrolled in the study. This hospital is a reference centre for inflammatory bowel disease. Race was determined using self-identification. The Vienna's classification was applied for all subjects. The severity of Crohn's disease was determined according to the number of surgical procedures, hospital admissions in the last year and treatment with steroids and immunosuppressors. Statistical analysis was calculated using t test for means, χ2 or F for proportions. A P value < 0.05 was considered to be significant.RESULTS: Sixty-five patients were enrolled. Non-white patients were more frequently diagnosed with Crohn's disease in the age less than 40 years than white patients. The behaviour of disease was similar in both groups with a high frequency of the penetrating form. There was a tendency for non-white patients to have a greater frequency of hospital admissions in the last year compared to white subjects. Non-whites also had a higher rate of colonic and upper gastrointestinal involvement, and were also more frequently on treatment with immunossupressors than white patients although this difference was not statistically significant.CONCLUSION: Non-white patients with Crohn's diseasehad an earlier diagnosis and appeared to have had a more severe disease presentation than white patients.     

What's new in consolidation therapy in AML?

Intensive induction chemotherapy followed by postremission treatment with either high-dose cytarabine-based regimens, autologous or allogeneic hematopoietic stem cell transplantation is still recognized as the main road toward cure in acute myeloid leukemia (AML). Pretreatment risk classification remains a key determinant of type and intensity of post-remission therapy. Still, high-dose cytarabine-based consolidation therapy is a cornerstone of postremission therapy with some recent adjustments regarding dosage and schedule. Current approvals of midostaurin, gemtuzumab ozogamicin, CPX-351, and ivosidenib as well as enasidenib comprise induction as well as consolidation therapy. In recent years measurable residual disease assessment is increasingly used to dynamically fine tune treatment during postremission treatment.     

What's new in recurrent pericarditis in 2011?

Recurrent pericarditis are common and their management remains a matter of debate. Their precise pathophysiology is unclear, and both innate and adaptative immunity seem involved. An extensive work-up seeking for etiology seems to be unnecessary during the first episode of acute pericarditis, whereas it is mandatory in recurrent pericarditis. Despite extensive investigations, up to 80 % of recurrent pericarditis remains of unknown origin. Colchicin associated to non steroidal antiinflammatory drugs is the first line treatment whereas immunosuppressive drugs are exceptionally required.     

PKCα negatively regulates in vitro proplatelet formation and in vivo platelet production in mice

Proplatelet formation is a part of the intricate process by which platelets are generated by their precursor cell, the megakaryocyte. The processes that drive megakaryocyte maturation and platelet production are however still not well understood. The protein kinase C (PKC) family of serine/threonine kinases has been demonstrated as an important regulator of megakaryocyte maturation and proplatelet formation, but little investigation has been made on the individual isoforms. We have previously shown, in mouse models, that PKCα plays a vital role in regulating platelet function, so in this study we aimed to investigate the role of PKCα in megakaryocyte function using the same Prkca^?/? mice. We assessed the role of global PKC and specifically PKCα in proplatelet formation in vitro, analyzed polyploidy in Prkca^?/?-derived megakaryocytes and followed platelet recovery in platelet-depleted Prkca^?/? mice. We show reduced proplatelet formation in the presence of global PKC blockade. However, in the presence of a selective classical PKC isoform inhibitor, Go6976, proplatelet formation was conversely enhanced. PKCα null megakaryocytes also showed enhanced proplatelet formation, as well as a shift to greater polyploidy. In vivo, platelet production was enhanced in response to experimentally induced immune thrombocytopenia. In conclusion, our data indicate that classical PKC isoforms, and more specifically PKCα, are negative regulators of proplatelet formation. PKCα appears to negatively regulate endomitosis, with the enhanced polyploidy observed in Prkca^?/?-derived megakaryocytes. In vivo, these observations may culminate in the observed ability of Prkca^?/? mice to recover more rapidly from a thrombocytopenic insult.     

Regional differences in coeliac disease prevalence in Scandinavia?

BACKGROUND: According to investigations from the central region of Sweden (Link?ping), Norway, and Finland based on antibody screening, the prevalence of coeliac disease (CD) is around 1:300 (0.33%). In Denmark surveys in paediatric departments have shown a prevalence of only 1:10,000. The aim of the present study was to study the prevalence of CD in southern Sweden. METHODS: From October 1996 to February 1997, 1970 healthy blood donors were screened for CD in a serial procedure: first IgA and IgG gliadin antibodies (GA) and then endomysial antibodies in those positive for GA. RESULTS: One patient had previously known CD. Two patients had gastrointestinal symptoms and an increased number of intraepithelial lymphocytes, with improvement on a gluten-free diet. Three of 185 GA-positive blood donors had endomysial antibodies and biopsy-verified CD. Thus, 4 of 1970 blood donors had classic CD, resulting in a prevalence of 1:492 (0.20%)--that is, rather similar to that found in Link?ping, Sweden, and in Finland and Norway. If the two persons with gluten-sensitive diarrhoea were also included, the prevalence was 6:1970 = 1:328, or 0.30%. CONCLUSIONS: The prevalence of classic CD (1:492) in southern Sweden is comparable to that found in the rest of Scandinavia, except for Denmark.     

Toxoplasmosis in China

Three cases of human toxoplasmosis are reported, totalling six cases of humaninfection recorded in China. These cases are reviewed to check the validity of thediagnosis of the disease. It is considered that all the six cases were authentic toxoplas-     

Do glucocorticoids in droppings reflect baseline level in birds captured in the wild? A case study in snow geese

Baseline glucocorticoid (CORT) levels in plasma are increasingly used as physiological indices of the relative condition or health of individuals and populations. The major limitation is that CORT production is stimulated by the stress associated with capture and handling. Measuring fecal CORT is one way to solve this problem because elevation of fecal CORT usually does not occur before 1-12 h after a stressful event in captive animals. However, the effect of capture and handling on fecal CORT levels has seldom been investigated in the wild. In a first experiment, we validated that fecal CORT levels starts to increase in droppings (a mixture of fecal and urinary material) about 1-2 h following injection of CORT-release hormone (ACTH) in captive greater snow geese (Chen caerulescens atlantica). In a second experiment, we investigated whether dropping and plasma CORT were related and if the capture affected fecal CORT levels in wild birds. Baseline CORT was obtained by bleeding individuals within 4 min after capture. No relationship was found between baseline and CORT in droppings shortly after capture (<4 min). In addition, CORT levels in droppings increased linearly with time after capture and was already elevated by a factor two 40 min after capture. The different turnover time of CORT between urine and feces could explain such results. We conclude that droppings cannot provide an index of basal CORT levels in snow geese captured in the wild. Such a result contrast with previous studies conducted on habituated, captive animals. We thus recommend that use of droppings as a non-invasive technique to measure baseline CORT be restricted to non-manipulated individuals in the wild.     

Are changes in cognitive functioning in older adults related to changes in subjective complaints?

In many areas of intellectual functioning, age-related declines in older adults' performance and increases in subjective complaints about intellectual performance are observed. However, the literature mostly reports very low relations between functioning and respective complaints. This finding could be the consequence of examining the relation between subjective complaints and the perceived level of functioning. If, however, persons are sensitive to relative changes in performance, they might base their subjective judgment on changes in the level of cognitive functioning. With 202 subjects (mean age=63 years) and two measurements, the authors examine (a) the relation between functioning and complaints at each measurement point, and (b) the relation between changes in functioning and changes in complaints between the measurement points with latent difference variables. The results indicate that there is no relation between level of functioning and level of complaints, but that there is a substantial relation between changes in functioning and complaints.     

What's hot in inflammatory bowel disease in 2011?

Ulcerative colitis and Crohn's disease(CD) are the two major forms of inflammatory bowel disease(IBD).In this highlight topic series of articles,the most recent advances in the IBD field are reviewed,especially the newly described cytokines,including the therapeutic implications for their manipulation.In addition,the interplay between the intestinal microbiota and the host is reviewed,including the role of defensins and dysbiosis in CD pathogenesis.Finally,the importance of the non immune systems such as en...     

Ageing in Place in Hong Kong—Challenges and Opportunities in a Capitalist Chinese City

In 1997, Hong Kong was returned to China, but it has retained its capitalist socio-economic order under the socialist People’s Republic. It is a Chinese city in which ethnic Chinese constitute a majority of the population. Like other advanced economies, Hong Kong has a gradually ageing population. The virtue of respecting the older people, as a facet of traditional Chinese normative order, is facing challenges from rapid social changes. Urban development has posed a considerable threat to implementing the policy of ‘ageing in place’. Divergent paths are being taken in the public and private sectors respectively in the effort to enable older people to remain living in familiar physical and social environments. Market forces in private sector redevelopment usually bring about gentrification, which results in the dislocation of older people. In the public sector, massive public housing programmes can be beneficial to older people affected by re-development by permitting in-situ relocation. The government’s community care policy also helps to achieve ageing-in-place. This paper provides an account and analysis of the challenges and opportunities in accomplishing the principle of ageing-in-place in the capitalist Chinese city of Hong Kong.

β-Thalassemia Haplotypes in Romania in the Context of Genetic Mixing in the Mediterranean Area

The purpose of this meta-study was to investigate β-thalassemia (β-thal) mutations and their chromosomal background in order to highlight the origin and spread of thalassemia alleles in the European and Mediterranean areas. Screening of more than 100 new Romanian β-thal alleles was also conducted. The results suggest an ancient introduction of mutations at codon 39 (C?>?T) (HBB: c.118C?>?T) and IVS-I-6 (T?>?C) (HBB: c.92?+?6T?>?C) in Romania. A comparative study was performed based on restriction fragment length polymorphism (RFLP) haplotypes associated with β-thal mutations in Romania and in Mediterranean countries. Each common β-thal allele from different populations exhibits a high degree of haplotype similarity, a sign of a clear unicentric origin for the IVS-I-110 (G?>?A) (HBB: c.93-21G?>?A), IVS-I-6, IVS-II-745 (C?>?G) (HBB: c.316-106C?>?G) and codon 39 mutations (the 17a [+?????????+?+], 13c [???+?+???????+], 17c [?+???????????+] and 14a [??+?+???+?+?+?] ancestral RFLP background, respectively), followed by recurrent recombination events. This study also showed that geographic distances played a major role in shaping the spread of the predominant β-thal alleles, whereas no genetic boundaries were detected between broad groups of populations living in the Middle East, Europe and North Africa. The analyses revealed some discrepancies concerning Morocco and Serbia, which suggest some peculiar genetic flows. Marked variations in β^A were observed between Southeast Asia and the Mediterranean, whereas a relative genetic homogeneity was found around the Mediterranean Basin. This homogeneity is undoubtedly the result of the high level of specific historic human migrations that occurred in this area.     

Advances in clinical research of hepatocellular carcinoma in China

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IKKβ inhibition prevents fat-induced beta cell dysfunction in vitro and in vivo in rodents

Aims/hypothesis

We have previously shown that oxidative stress plays a causal role in beta cell dysfunction induced by fat. Here, we address whether the proinflammatory kinase inhibitor of (nuclear factor) κB kinase β (IKKβ), which is activated by oxidative stress, is also implicated.

Methods

Fat (oleate or olive oil) was infused intravenously in Wistar rats for 48 h with or without the IKKβ inhibitor salicylate. Thereafter, beta cell function was evaluated in vivo using hyperglycaemic clamps or ex vivo in islets isolated from fat-treated rats. We also exposed rat islets to oleate in culture, with or without salicylate and 4(2′-aminoethyl)amino-1,8-dimethylimidazo(1,2-a)quinoxaline; BMS-345541 (BMS, another inhibitor of IKKβ) and evaluated beta cell function in vitro. Furthermore, oleate was infused in mice treated with BMS and in beta cell-specific Ikkb-null mice.

Results

48 h infusion of fat impaired beta-cell function in vivo, assessed using the disposition index (DI), in rats (saline: 1.41 ± 0.13; oleate: 0.95 ± 0.11; olive oil [OLO]: 0.87 ± 0.15; p < 0.01 for both fats vs saline) and in mice (saline: 2.51 ± 0.39; oleate: 1.20 ± 0.19; p < 0.01 vs saline) and ex vivo (i.e., insulin secretion, units are pmol insulin islet^?1 h^?1) in rat islets (saline: 1.51 ± 0.13; oleate: 1.03 ± 0.10; OLO: 0.91 ± 0.13; p < 0.001 for both fats vs saline) and the dysfunction was prevented by co-infusion of salicylate in rats (oleate + salicylate: 1.30 ± 0.09; OLO + salicylate: 1.33 ± 0.23) or BMS in mice (oleate + BMS: 2.25 ± 0.42) in vivo and by salicylate in rat islets ex vivo (oleate + salicylate: 1.74 ± 0.31; OLO + salicylate: 1.54 ± 0.29). In cultured islets, 48 h exposure to oleate impaired beta-cell function ([in pmol insulin islet^?1 h^?1] control: 0.66 ± 0.12; oleate: 0.23 ± 0.03; p < 0.01 vs saline), an effect prevented by both inhibitors (oleate + salicylate: 0.98 ± 0.08; oleate + BMS: 0.50 ± 0.02). Genetic inhibition of IKKβ also prevented fat-induced beta-cell dysfunction ex vivo ([in pmol insulin islet^?1 h^?1] control saline: 0.16 ± 0.02; control oleate: 0.10 ± 0.02; knockout oleate: 0.17 ± 0.04; p < 0.05 control saline vs. control oleate) and in vivo (DI: control saline: 3.86 ± 0.40; control oleate: 1.95 ± 0.29; knockout oleate: 2.96 ± 0.24; p < 0.01 control saline vs control oleate).

Conclusions/interpretation

Our results demonstrate a causal role for IKKβ in fat-induced beta cell dysfunction in vitro, ex vivo and in vivo.