Parasite-based interventions in systemic lupus erythematosus (SLE): A systematic review

BackgroundThe hygiene hypothesis proposed in 1989 expresses that allergic and infectious diseases are inversely related. Accordingly, it has been demonstrated that infection with some microorganisms such as parasites and helminths can provide a potential immunity and prevent the onset of some life-threatening autoimmune diseases like systemic lupus erythematosus (SLE). Therefore, in this comprehensive study, we systematically reviewed and discussed the use of live parasites or parasitic products in the treatment of mouse models of SLE.MethodsThe present systematic review was performed using the following search terms: (“systemic lupus erythematosus” OR “SLE” OR “lupus”) AND (“parasite” OR “protozoa” OR “helminths” OR “worms” OR “helminth” OR “worm”) in PubMed, Scopus, and Web of Science online databases. We included studies reporting the effect of any intervention using parasites or parasitic-based products on animal models of SLE, which were published until January 20th, 2021 without any language or date restrictions. For each included study, we extracted the authors' names, publication year, type of animal, number of groups, types of intervention, sample size, changes in immunologic cells, auto-Abs, cytokines, and blood cells count, urine analysis, histological analysis of kidney/spleen/liver, outcome and survival. (PROSPERO CRD42020160460).ResultsA total of 17 eligible articles were included in this systematic review. Sixteen out of the 17 studies reported immunomodulating changes in immunologic cells, cytokines, and/or auto-Abs in mouse models of SLE after using parasitic interventions compared to not-infected or control groups. Moreover, 14 studies reported decreased level of proteinuria and/or favorable kidney, liver, or spleen histological changes.ConclusionIn conclusion, we have demonstrated that parasites like Hymenolepis microstoma, TPC and ES-62 from Acanthocheilonema viteae, Plasmodium chabaudi, Schistosoma mansoni, and Toxoplasma gondii have favorable immunomodulating effects on SLE outcomes in lupus-prone mice.     

Eosinophilic esophagitis

ObjectiveTo review the understanding of the pathogenesis of eosinophilic esophagitis (EoE) and the role of the immune system in the disease process.Data SourcesPeer-reviewed articles on EoE from PubMed searching for “Eosinophilic Esophagitis and fibrosis” in the period of 1995 to 2013.Study SelectionsStudies on the clinical and immunologic features, pathogenesis, and management of EoE.ResultsRecent work has revealed that thymic stromal lymphopoietin and basophil have an increased role in the pathogenesis of disease. Additional understanding on the role of fibrosis in EoE is emerging.ConclusionThe incidence of EoE is increasing like most atopic disease. Similar to other allergic diseases, EoE is treated with topical steroids and/or allergen avoidance.     

间充质干细胞外泌体在神经系统疾病修复过程中的作用与应用

文题释义：外泌体：是直径在30-120 nm的封闭脂质囊泡,属于多泡体分泌的细胞外囊泡。多种细胞在生理或病理情况下都能分泌外泌体。外泌体作为细胞间重要信息交流工具,在新型组织修复、疾病治疗与诊断领域有重要的前景。 间充质干细胞：是中胚层的一种多能干细胞,具有自我更新、向多种间充质系列细胞(如成骨、成软骨及成脂肪细胞等)或非间充质系列细胞分化、分泌细胞因子和细胞外囊泡、免疫调节、来源广泛等特点,被广泛用于组织修复研究。 背景：由于血脑屏障的存在,大分子药物无法通过血脑屏障进入脑部组织发挥药效,导致很多神经系统疾病、神经退行性疾病无法得到有效的治疗。近年来研究发现间充质干细胞外泌体以其体积微小、可装载脂质、蛋白、核酸等信号物质的特点,对脑血管病、阿尔茨海默症、癫痫、脊髓损伤等疾病具有组织修复的功效,逐渐成为治疗神经系统疾病的重要工具。 目的：从宏观与微观角度对间充质干细胞外泌体在神经系统疾病修复过程中的作用进行分析总结,并提出在外泌体基础研究和临床试验中存在的问题和注意事项。 方法：以“exosomes,extracellular vesicles,MSCs,mesenchymal stem cells,neurodegenerative diseases”为英文检索词,通过计算机检索PubMed数据库,纳入描述间充质干细胞来源外泌体的特性及修复作用的文章,排除重复与不相关文章,最终整理出35篇文献进行综述。 结果与结论：间充质干细胞外泌体具有易穿过血脑屏障、携带丰富的信号物质等生物学特点,在动物疾病模型中发挥重要作用,如抗炎、促进神经元生长、维持神经元数量、促进神经突重塑等;经过修饰后的外泌体可发挥比天然外泌体更有效的组织修复功能,可作为分子药物载体应用于特定的神经系统疾病治疗中。 ORCID: 0000-0002-1791-666X(高振橙) 中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程     

骨关节炎动物模型的选择

背景:目前骨关节炎的发病原因尚不清楚,而且也没有有效的治疗手段。选择合适的动物模型会给骨关节炎的动物实验创造一个良好的条件。目的:对骨关节炎的不同实验动物及不同造模方式作一综述。方法:检索中国期刊全文数据库(CNKI)、万方数据库、维普数据库和PubMed数据库2013年1月至2018年7月的相关文章,以“骨关节炎、模型动物、大鼠、小鼠、豚鼠、兔、狗、羊”,英文检索词为“Osteoarthritis、Models、Animals、Mice、Rats、Rabbits、Dogs、Goats、guinea pigs、sheep”进行检索,剔除重复文献,选取与骨关节炎动物模型相关的文章,进行整理和分析。结果与结论:小鼠、大鼠、豚鼠、兔、狗、羊等动物都可作为骨关节炎研究的动物模型。而在研究骨关节炎动物实验的时候,正确选择动物模型和造模方式是很重要的。非手术模型避免了手术对于关节其他部位的损伤,更符合骨关节炎的病理过程,但是对于造模方法难以掌控,容易造成误差,且不能模拟创伤改变。手术模型通过手术破坏组织而造成关节损伤,进展快,效果明显,是短期研究的最佳选择。不同的实验动物和造模方案各有其优缺点,需要根据实验的需求合理选择。     

Trained innate immunity

The innate immune system acts rapidly in an identical and nonspecific way every time the body is exposed to pathogens. As such, it cannot build and maintain immunological memory to help prevent reinfection. Researchers contend that trained immunity is influenced by intracellular metabolic pathways and epigenetic remodeling. The purpose of this review was to explore the topic of trained innate immunity based on the results of relevant previous studies. This systematic review entailed identifying articles related to trained innate immunity. The sources were obtained from PubMed using different search terms that included “trained innate immunity,” “trained immunity,” “trained,” “innate,” “immunity,” and “immune system.” Boolean operators were used to combine terms and phrases. A review of previous study results revealed that little is currently known about the molecular and cellular processes that mediate or induce a trained immune response in animals. However, it is believed that alterations in the phenotypes of cell populations and the numbers of specific cells may play a critical role in mediating the trained immune response. Increasing evidence shows that the protective processes and actions that occur during a secondary infection are not entirely linked to the adaptive immune system. Instead, these events also involve heightened activation of innate immune cells. While trained innate immune cells may have a shorter memory, they assist in the fight against pathogens and provide cross-protection. Identification of the mechanisms and molecules that underlie trained innate immunity has highlighted important features of the human immune response. Such advances continue to open doors for future research on how the body responds to disease-causing pathogens.

     

Impact of nasopharyngeal microbiota on the development of respiratory tract diseases

Knowledge of whether and how respiratory microbiota composition can prime the immune system and provide colonisation resistance, limiting consecutive pathobiont overgrowth and infections, is essential to improving the prevention and therapy of respiratory disorders. Modulation of dysbiotic ecosystems or reconstitution of missing microbes might be a possible measure to reduce respiratory diseases. The aim of this review is to analyse the role of nasopharyngeal microbiota in the development of respiratory tract disease in paediatric-age subjects. PubMed was used to search for all studies published over the last 15 years using the following key words: “microbiota” or “microbioma” and “nasopharyngeal” or “respiratory” or “nasal” and “children” or “paediatric” or “infant”. Analysis of the literature showed that respiratory microbiota can regulate health and disease development in the respiratory tract. Like the gut microbiota, the respiratory microbiota is established at birth, and early respiratory microbiota composition determines bacterial succession patterns and respiratory health in children. Protective and dangerous bacteria have been identified, and this can be considered the base for developing new approaches to diseases that respond poorly to traditional interventions. Reconstitution of missing microbes can be achieved by the administration of pre- and probiotics. Modulation of respiratory microbiota by favouring colonisation of the upper respiratory tract by beneficial commensals can interfere with the proliferation and activity of resident pathobionts and is a possible new measure to reduce the risk of disease. However, further studies are needed because a deeper understanding of these and related issues can be transferred to clinical practice.     

消退素在牙髓、根尖周及牙周组织炎症环境中的活髓保存及再生作用

背景:细菌感染是牙髓及根尖周组织感染的主要病因,保存活髓和再生牙髓逐渐成为临床治疗牙髓及根尖周疾病的重要研究方向。消退素(resolvin)是ω-3多不饱和脂肪酸衍生而来的脂质介质,具有促进组织炎症消退、炎症状态恢复的作用。目的:回顾消退素在炎症调控中的研究进展及其在牙髓、根尖周及牙周组织炎症中的应用,以期为临床牙髓组织炎症状态的恢复及再生提供研究基础。方法:应用计算机在PubMed数据库、维普数据库、万方数据库及中国知网(CNKI)中国期刊全文数据库检索2014年1月至2020年6月相关文献,以“消退素,作用,信号通路”为中文检索词,以“resolvin,effect,signaling pathway”为英文检索词,最终纳入35篇文献归纳总结消退素的作用;以“消退素,牙髓炎,根尖周炎,牙周炎,口腔”为中文检索词,以“resolvin,pulptitis,periapical,periodontitis,dental”为英文检索词,最终纳入31篇文献归纳总结消退素在口腔不同组织和疾病中的应用,其余3篇解释说明文章内容。结果与结论:文章系统回顾了消退素的种类及作用,详细回顾了消退素在牙髓、根尖周及牙周组织炎症性疾病中的作用及机制,为其临床应用于牙髓组织炎症后的活髓保存及再生提供研究依据。     

The effect of the Internet on decision-making during pregnancy: a systematic review

The purpose of this review is to explain how the Internet affects decision-making in pregnancy. A systematic review was carried out in accordance with the guidelines developed by the National Institute of Health Research at York University. The PubMed, EBSCOhost, Ulakbim Medical Database, Turkish Medline, Web of Science, and Scopus databases were scanned. Three keywords in the titles, abstracts, and keywords of the articles were searched for in the Medical Subject Headings: “Pregnancy,” “Decision-making,” and “Internet.” A total of 1143 articles were found in the first screening. Duplicate articles were removed. The remaining articles were reviewed according to the inclusion criteria. Only articles about healthy pregnant women were accessed, and only full-text research articles published in English were used. Seventeen articles met the inclusion criteria. The sample size varied between 9 and 7092. Most studies reported that pregnant women use the Internet as a source of information about pregnancy. Pregnancy, development of the fetus, labor, neonatal health, and nutrition were the subjects most researched. It was found that women with a higher education, who were young, nulliparous, and primigravid, looked for more information on the Internet. The Internet affects decisions about the type of delivery, drug use in pregnancy, and physical activity. Using the Internet had a positive effect on the decision-making processes of pregnant women, increased their awareness, and had a visible effect on this process.

     

间充质干细胞线粒体转移治疗修复组织损伤的作用

文题释义： 间充质干细胞：为长梭形、贴壁生长的多能干细胞,具有多向分化潜能和自我更新能力,可调节免疫功能、促进血管再生、改善微环境与分泌功能及促进再生修复等,除来源于骨髓外,也可从羊膜、胎盘、牙髓、脐带、脂肪、骨骼肌等多种组织中分离获得,间充质干细胞制剂已开始应用于脑卒中、心肌梗死、急性肾功能衰竭等临床治疗。 线粒体转移：正常细胞的线粒体可通过多种途径转移到线粒体形态和功能障碍的细胞,恢复细胞有氧呼吸及正常线粒体DNA功能等,改善受损组织细胞的能量供应,具有疾病治疗作用。 背景：间充质干细胞因其众多优点被应用于多种疾病治疗,线粒体转移是间充质干细胞疗法的重要机制之一。 目的：综述间充质干细胞通过线粒体转移在各类组织损伤中发挥的作用。 方法：由第一作者以“stem cells,mitochondrial transfer,cell communication,rescue and repair,tissue injury”为英文关键词,以“干细胞,线粒体转移,细胞通讯,修复,组织损伤”为中文关键词,检索2008至2019年期间收录在PubMed、中国知网、万方数据库中的文献,纳入间充质干细胞的线粒体转移作用和机制及治疗组织损伤相关的文献,排除重复与相关性弱的文献,对64篇文献进行总结分析。 结果与结论：间充质干细胞被应用于如脑卒中、心肌梗死、急性肾功能衰竭等多种疾病治疗,线粒体转移作为干细胞治疗的一种新机制被人们广泛关注,已被认为是组织损伤的潜在疗法;线粒体转移已发现由隧道管形成、间隙连接、微囊泡、细胞融合和分离等不同模式介导,但线粒体转移在组织损伤中的具体机制还未完全阐明,其在组织损伤修复中的具体作用也有待进一步了解。 ORCID: 0000-0003-0918-6182(王张玲) 中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程     

Immune recognition of citrullinated epitopes

Conversion of arginine into citrulline is a post‐translational modification that is observed in normal physiological processes. However, abnormal citrullination can provoke autoimmunity by generating altered self‐epitopes that are specifically targeted by autoantibodies and T cells. In this review we discuss the recognition of citrullinated antigens in human autoimmune diseases and the role that this modification plays in increasing antigenic diversity and circumventing tolerance mechanisms. Early published work demonstrated that citrullinated proteins are specifically targeted by autoantibodies in rheumatoid arthritis and that citrullinated peptides are more readily presented to T cells by arthritis‐susceptible HLA class II ‘shared epitope’ proteins. Emerging data support the relevance of citrullinated epitopes in other autoimmune diseases, including type 1 diabetes and multiple sclerosis, whose susceptible HLA haplotypes also preferentially present citrullinated peptides. In these settings, autoimmune patients have been shown to have elevated responses to citrullinated epitopes derived from tissue‐specific antigens. Contrasting evidence implicates autophagy or perforin and complement‐mediated membrane attack as inducers of ectopic citrullination. In either case, the peptidyl deiminases responsible for citrullination are activated in response to inflammation or insult, providing a mechanistic link between this post‐translational modification and interactions with the environment and infection. As such, it is likely that immune recognition of citrullinated epitopes also plays a role in pathogen clearance. Indeed, our recent data suggest that responses to citrullinated peptides facilitate recognition of novel influenza strains. Therefore, increased understanding of responses to citrullinated epitopes may provide important insights about the initiation of autoimmunity and recognition of heterologous viruses.     

生物携氧治疗剂的研究：作用与应用

文题释义：生物携氧治疗剂：是指具有载氧气功能、维持血液渗透压和酸碱平衡及扩充血容量的人工制剂。目前主要有氟碳化合物和血红蛋白类氧载体两大类。与简单的扩容剂相比,生物携氧治疗剂除能维持血液渗透压、酸碱平衡和血容量外,还具有较好的携氧能力,能向局部缺氧组织输氧。是临床上一种具有广阔的应用前景的携氧制剂。 血红蛋白类氧载体(Hemoglobin-based oxgen carriers,HBOCs)：是一类通过血红蛋白分子表面化学修饰或分子间交联而形成分子量较大的血红蛋白制品,原料血红蛋白主要来源于人或动物血,目前应用较为广泛的是戊二醛聚合猪血红蛋白(pPolyCHb)和戊二醛聚合牛血红蛋(HBOC-201)。 背景：健康人献血虽然一定程度地缓解了临床用血的燃眉之急,但是单纯依靠健康人献血已不能从根本上解决血源短缺和血液安全性的问题。 目的：结合生物携氧治疗剂开发的意义,对生物携氧治疗剂所独有的特点进行阐述,总结近年来对生物携氧治疗剂的研究现状及应用进展,为进一步研究生物携氧治疗剂的作用及临床应用提供一定的理论基础。 方法：作者检索CNKI、万方、Pub Med等数据库中自2015年1月至2019年8月的相关文章,英文检索词为“blood substitute, hemoglobin oxygen carrier, artificial blood,oxygen-carrying therapeutic agent”,中文检索词为“血液代用品,血红蛋白类氧载体,人工血液,携氧治疗剂”,检索文献类型为研究原著、综述。初检文章418篇,再经过严格筛选后,对符合要求的46篇文献进行分类综述。 结果与结论：生物携氧治疗剂的临床效果较好,可维持血液渗透压、酸碱平衡和血容量,还具有较好的携氧能力,能向局部缺氧组织输氧并维持较长时间。它还具有易于贮存、便于运输等特点。生物携氧治疗剂在外科手术中得到广泛的应用,对扩充血容量、加快术后恢复有很大帮助,故其研发对于外科创伤及复苏、失血性休克、恶性贫血、心肌梗死等疾病均具有重要意义,并体现出良好的临床应用前景。 ORCID: 0000-0002-0365-4638(黄文华) 中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程     

Formaldehyde exposure and its effects during pregnancy: Recommendations for laboratory attendance based on available data

Formalin is commonly used in fixation of cadaveric specimens. Exposure to formaldehyde, a component of formalin and a known carcinogen, during gross anatomy laboratory dissection is a continuing concern for pregnant students and instructors. Since there is little literature on this specific topic, the current review was compiled in the hope of offering recommendations to pregnant students and instructors who are engaged in human anatomical dissection where formalin is used. Relevant articles were obtained through searches of PubMed and Google Scholar for the terms “formaldehyde,” “pregnant,” “formalin,” and “exposure.” A literature search was conducted for chemical information and articles about exposure as issued by government regulatory agencies and chemical companies that produce formaldehyde. This led to the compilation of 29 articles each of which included references to previous, relevant, human research. The reviewed literature contains data strongly suggesting that pregnancy can be affected by formaldehyde exposure. Therefore, on the basis our analysis, female students who might be pregnant should avoid formaldehyde exposure, including that in a gross anatomy laboratory. Instructors should find other means of ensuring anatomical competence for these students. Clin. Anat. 28:972–979, 2015. © 2015 Wiley Periodicals, Inc.     

Anatomical variations in distal portion of the thoracic duct—A systematic review

The objective of this study was to identify and analyze the anatomical variations in the termination of the thoracic duct (TD) in cadavers or patients by anatomical dissections and surgical or radiological procedures for better knowledge of the interindividual variations through a systematic review. The search strategy included PubMed and reference tracking. Studies were identified by searching the electronic Medline databases. The search terms included “TD,” “Jugular Vein,” “Subclavian Vein,” or “Cervical,” and the protocol used is reported herein. These search results yielded 20 qualitative review articles out of the 275 articles consulted. We collected all the important data from these 20 articles with 1,352 TD analyzed by varying sources in our search. Regarding the characteristics of the studies and the anatomy of the TD, the results were heterogeneous. The TD most commonly terminates in the internal jugular vein in 54.05% of cases (95% confidence interval [CI]: 54.03; 54.07), in the jugular-venous angle in 25.79% (95% CI: 25.77; 25.81), and in the subclavian vein in 8.16% of cases (95% CI: 8.14;8.18). Other terminations were found in 12% of cases. This systematic review provided an overview of the variations in the distal portion of the TD. This study can be helpful for surgeons in selecting the most appropriate methods to achieve successful surgical results and avoid complications, such as chylothorax; it also offers detailed information on the cervical termination of the TD in new diagnostic and therapeutic methods involving the TD. Clin. Anat. 32:99–107, 2019. © 2019 Wiley Periodicals, Inc.     

Tungiasis: a neglected epidermal parasitic skin disease of marginalized populations—a call for global science and policy

Tungiasis (sand flea disease) is an ectoparasitic skin disease caused by the female sand flea/jigger flea (Tunga penetrans). As poverty is the major driving force of the disease, it can be called as a poverty-associated plague. It is one of the emerging neglected diseases in Latin America, Caribbean, sub-Saharan Africa, and India. The aim of the present scrutiny was to assess the public health impact of tungiasis, associated risk factors, and emerging opportunities to prevent and control tungiasis. Searches of PubMed, Google Scholar, and online search engines (Google, AOL, and Yahoo) using keywords “parasitic skin disease,” “tungiasis,” “sand flea,” “ tungiasis-associated risk factors,” “tungiasis prevention and control,” and their synonyms were used as a source of references. Searches were made without time limitations. Of 167 potential articles identified by these criteria, 51 appropriate were selected for review. Tungiasis is widespread in the resource-constrained settings of low-income economies. In the tropics, it is highly prevalent among the impoverished populations, but the associated risk factors are often poorly identified and remain uncontrolled. Though it is a self-limiting disease with considerable morbidity, the parasite may cause subsequent secondary morbidity through life-threatening complications and infections like cellulitis, tetanus, and death. However, the direct and indirect sociocultural, economic, and health impact of tungiasis is often undervalued and misunderstood. A systematic assessment on disease burden is still dearth and deficient. Over the decades, tungiasis has been largely neglected by the scientific community, policy makers, and healthcare stakeholders. In the endemic regions, even tungiasis is not listed for the disease control priorities in the regional, national, and international agenda. The majority of the epidermal parasitic skin diseases particularly tungiasis needs a sustainable global scientific research and control policy. This urges intensive efforts to develop a road map that delivers a clear vision towards zero new infection by designing low-cost prevention and control strategies. Besides, there is an urgency to develop culturally appropriate communication techniques and workable collaboration on a global scale by bringing all the stakeholders of endemic countries.     

MicroRNA影响椎间盘退变过程的研究进展及可发展空间

文题释义：miRNA：属于一种受内源性非蛋白质编码调控的单链小分子RNA,可以调控人体近1/3的蛋白编码基因参与机体发育与疾病发生,与许多生物进程的调控密切关联,包括生长发育、细胞增殖、凋亡和分化等。其不仅在许多正常人体发育过程中起着关键作用,而且与多种疾病的发生和发展有关。 自噬：是细胞通过溶酶体吞噬和降解自身细胞质和细胞器的过程。自噬在生长、发育、细胞稳定和成熟分化等方面起着重要作用,作为一种独立的Ⅱ型程序性细胞死亡过程,自噬与细胞凋亡存在着密切关联。 背景：在细胞与分子水平上明确MicroRNA(miRNA)在椎间盘退变过程的作用机制,可为早预防或治疗椎间盘退变继发的一系列脊柱疾患提供新的思路。 目的：综述miRNA在椎间盘退变原因和机制中的研究现状。 方法：应用计算机检索PubMed数据库、万方数据库和中国知网数据库,英文检索词为“miRNA、Intervertebral disc degeneration、Extracellular matrix、Apoptosis、Autophagy、Cartilage endplate、Nucleus pulposus、Fibrous ring”,中文检索词为“miRNA、椎间盘退变、细胞外基质、凋亡、自噬、软骨终板、髓核、纤维环”,最终纳入58篇文章进行综述。 结果与结论：miRNA在椎间盘退变过程中的作用已被广泛研究,部分具体机制得到验证;研究多局限于髓核组织,对软骨终板及纤维环报道较少;随着miRNA深入研究,临床方面的研究仍有较大发展空间。 ORCID: 0000-0002-2312-4255(胡宝阳) 中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程     

“零缺血”技术在肾肿瘤保留肾单位手术中的研究进展

目的 总结“零缺血”技术在肾肿瘤保留肾单位手术中的研究进展。方法 以“肾肿瘤”“零缺血”“肾部分切除术”“保留肾单位手术”“栓塞”“激光”“水刀”“微波消融”“射频消融”和“renal cell carcinoma”“kidney neoplasms”“zero ischemia”“off-clamp partial nephrectomy”“ nephron sparing surgery”“embolization”“laser”“water jet”“microwave”“frequency ablation”为中、英文关键词,在中国知网、万方数据库、SinoMed、PubMed等中英文数据库中检索2002年1月—2018年8月间有关“零缺血”相关技术,以及其在肾肿瘤保留肾单位手术中应用的相关文献,检索到文献1 482篇,剔除内容不符合、无法获取全文、重复性研究或存在设计缺陷的文献,最终纳入42篇文献,对其进行总结、分析。结果 “零缺血”技术是基于对供应肾肿瘤的段动脉进行解剖分离并给予特异性阻断,或者在切除肿瘤时不阻断肾蒂血管的方法。在治疗肾肿瘤的同时,可最大限度地保护肾脏功能,在肾肿瘤的治疗中具有重要作用,可操作性强;但应关注该技术的相关并发症。结论 “零缺血”技术在肾肿瘤保留肾单位手术中具有重要作用,显示出了很好的应用前景;但其安全性、实用性仍需进一步研究探讨。     

骨质疏松性少肌性肥胖综合征的诊断、治疗及相关影响因素

文题释义： 骨质疏松性少肌性肥胖：是一种复杂的全身性疾病,往往对机体的活动能力造成负面影响,其发病机制可能与衰老或其他疾病有关,且多发生于老年群体。其包括3种反映体成分异常的症状：骨质疏松症、少肌症和肥胖。 少肌症：是一个较传统的术语,用来描述与年龄相关的肌肉质量和力量的广泛性丧失。据报道,少肌症的发生发展常伴随一些并发症的发生,如身体功能下降、障碍和生活质量差等。 背景：研究表明,骨质疏松症、少肌症和肥胖是影响骨折、高血压和血脂异常等代谢性疾病的重要影响因素。 目的：阐述骨质疏松性少肌性肥胖的患病现况、影响因素,及其对骨折、血脂异常的影响,探讨饮食和运动在预防骨质疏松性少肌性肥胖发生中的作用,为骨质疏松性少肌性肥胖的防治提供理论依据。 方法：通过关键词“osteosarcopenic obesity,sarcopenic obesity,osteoporosis,sarcopenia,obesity,fracture,dyslipidemia,骨质疏松性少肌性肥胖综合征,血脂异常”检索PubMed、WANFANG DATA数据库1990年至2018年发表的相关文章,限定语言为“English”或“中文”。共纳入71篇文献进行分析探讨。 结果与结论：①骨质疏松性少肌性肥胖患病率存在显著的年龄、性别、民族或种族差异;②目前骨质疏松性少肌性肥胖的诊断虽尚未有国际统一标准,但欧洲、亚洲、美国等大洲或国家已出现相应的诊断标准;③骨质疏松性少肌性肥胖的发生发展不仅受生活、饮食习惯的影响,还受基因、细胞因子和代谢性激素等因素的作用;④骨质疏松性少肌性肥胖对骨折、血脂异常的影响远大于单纯性骨质疏松症、少肌症和肥胖对二者的作用。 ORCID: 0000-0003-1898-651X(陈兴才);0000-0001-6717-8231(孔存青) 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

蛛网膜颗粒的研究进展

目的 总结蛛网膜颗粒(AG)的相关研究进展,为临床更好地开展AG的研究提供理论依据。方法 以“蛛网膜颗粒”“蛛网膜绒毛”“颅内高压”“脑静脉窦血栓”和“arachnoid granulation”“arachnoid villi”“intracranial hypertension”“cerebral venous sinus thrombosis”等为关键词分别在中国知网、万方数据库和PubMed等数据库检索1960年1月—2018年9月关于AG或蛛网膜绒毛的文献,并对AG的组织学特点、解剖形态、影像学研究及其在相关脑血管疾病发生中的作用等方面的研究成果进行归纳分析。结果 AG是蛛网膜绒毛增大形成的肉眼可见的正常解剖结构,两者的组成部分和功能相似。AG最常出现在上矢状窦,其次是横窦。巨大AG(＞10 mm)可引起静脉窦堵塞、颅内高压、甚至颅骨的外压型改变等。脑静脉血管造影是观察AG的优选方法,可结合CT、MRI等与相关性脑血管疾病鉴别诊断。结论 熟练掌握AG的组织解剖结构及影像学表现是研究临床病理状态下AG变化的重要基础。     

Can supplementation with vitamin D reduce the risk or modify the course of autoimmune diseases? A systematic review of the literature

ObjectiveTo evaluate whether vitamin D levels are related to the risk of developing autoimmune diseases and whether supplementation with vitamin D can modify the course of the diseases.MethodsWe reviewed the most relevant papers published from January 1973 to October 2011, using Medline and EMBASE and the search terms “vitamin D”; “autoimmune disease”; “autoimmunity”; “rheumatoid arthritis”; “systemic lupus erythematosus”; “scleroderma”; “systemic sclerosis”; “type 1 diabetes”; “multiple sclerosis”; and “undifferentiated connective tissue disease”. We selected studies on the environmental, genetic and epidemiologic association of vitamin D with autoimmune diseases.Using the strategy described, we identified 1268 articles. 331 articles were eliminated on the basis of the title and another 703 on the basis of the abstract, since they were considered irrelevant for the purposes of the study. Full-text examination was performed on the remaining 234 studies, and a further 15 studies were excluded from the review, since the results had been confirmed or superseded by more recent research. Finally, a systematic review was conducted on 219 articles concerning cross-sectional data on: vitamin D levels and autoimmune diseases; interventional data on vitamin D supplementation in autoimmune diseases; prospective data linking vitamin D level or intake to autoimmune disease risk.ResultsPhysiopathology studies confirm that hypovitaminosis D, in genetically predisposed subjects, can impair self tolerance by compromising the regulation of dendritic cells, of regulatory T-lymphocytes and of Th1 cells. Cross-sectional studies show that levels of vitamin D < 30 ng/mL are present in a significant percentage, not only in patients with autoimmune disease, but also in healthy subjects (30–77%), and link profound deficiency (< 10 ng/mL) with aggravation of symptomatology, while genetic studies associate polymorphism of vitamin D receptors to various autoimmune diseases. Among experimental studies on humans, only those on type-1 diabetes prove that the risks are significantly reduced in infants treated with vitamin D after the 7th month (OR 0.71, 95% CI, 0.60 to 0.84) and that a dose–response effect exists.ConclusionsBasic, genetic, and epidemiological studies indicate a potential role of vitamin D in the prevention of autoimmune diseases, but randomized and controlled trials are necessary to establish the clinical efficacy of vitamin D supplementation in ill or at-risk subjects.