Placental Impact of Dietary Supplements: More Than Micronutrients

PurposeMaternal nutrition is a key modifier of fetal growth and development. However, many maternal diets in the United States do not meet nutritional recommendations. Dietary supplementation is therefore necessary to meet nutritional goals. The effects of many supplements on placental development and function are poorly understood. In this review, we address the therapeutic potential of maternal dietary supplementation on placental development and function in both healthy and complicated pregnancies.MethodsThis is a narrative review of original research articles published between February 1970 and July 2020 on dietary supplements consumed during pregnancy and placental outcomes (including nutrient uptake, metabolism and delivery, as well as growth and efficiency). Impacts of placental changes on fetal outcomes were also reviewed. Both human and animal studies were included.FindingsWe found evidence of a potential therapeutic benefit of several supplements on maternal and fetal outcomes via their placental impacts. Our review supports a role for probiotics as a placental therapeutic, with effects that include improved inflammation and lipid metabolism, which may prevent preterm birth and poor placental efficiency. Supplementation with omega-3 fatty acids (as found in fish oil) during pregnancy tempers the negative effects of maternal obesity but may have little placental impact in healthy lean women. The beneficial effects of choline supplementation on maternal health and fetal growth are largely attributable to its placental impacts. l-arginine supplementation has a potent provascularization effect on the placenta, which may underlie its fetal growth–promoting properties.ImplicationsThe placenta is exquisitely sensitive to dietary supplements. Pregnant women should consult their health care practitioner before continuing or initiating use of a dietary supplement. Because little is known about impacts of many supplements on placental and long-term offspring health, more research is required before robust clinical recommendations can be made.     

侵袭性牙周炎患者血清IL-2、IL-10和β-防御素-2检测的临床意义

目的:探讨侵袭性牙周炎患者治疗前后血清IL-2、IL-10和β-防御素-2水平的变化及临床意义。方法:应用放射免疫分析和酶联法对40例侵袭性牙周炎患者进行了治疗前后血清IL-2、IL-10和β-防御素-2检测,并与35名正常健康人作比较。结果:侵袭性牙周炎患者在治疗前IL-2和β-防御素-2的水平均显著地低于正常人组(P<0.01),而IL-10水平又显著地高于正常人组(P<0.01)。经治疗3个月后与正常人组比较仍有显著性差异(P<0.05)。结论:侵袭性牙周炎患者血清IL-2和β-防御素-2水平的降低与IL-10水平的升高可能是侵袭性牙周炎的独立危险因素。     

慢性牙周炎患者治疗前后血清IGF-Ⅱ、IL-6、IL-8和β-防御素-3检测的临床意义

目的:探讨了慢性牙周炎患者治疗前后血清IGF-Ⅱ、IL-6、IL-8和β-防御素-3检测的临床意义。方法:应用放射免疫分析和酶联法对33例慢性牙周炎患者进行了治疗前后血清IGF-Ⅱ、IL-6、IL-8和β-防御素-3的检测,并与35名正常健康人作比较。结果:慢性牙周炎患者在治疗前IGF-Ⅱ、IL-6、IL-8水平非常显著地高于正常人组(P<0.01),但是血清β-防御素-3水平显著低于正常人组(P<0.01),经综合治疗3个月后四项指标检测则与正常人组比较无显著性差异(P>0.05)。结论:IGF-Ⅱ、IL-6、IL-8和β-防御素-3以不同方式参与了患者的发病,其水平的检测对了解病情和指导治疗具有重要的临床价值。     

牙周病患者治疗前后血清IL-2、SIL-2R、SOD、LPO和GSH-PX检测的临床评价

目的:探讨牙周病患者治疗前后血清IL-2、SIL-2R和SOD、LPO和GSH-PX水平的变化及临床意义。方法:应用放射免疫分析、酶联法和生化法对40例牙周病患者进行了治疗前后血清IL-2、SIL-2R、SOD、LPO和GSH-PX检测,并与35名正常人作比较。结果:牙周病患者在治疗前血清IL-2、SOD、GSH-PX水平非常显著地低于正常人组(P<0.01),而SIL-2R、LPO水平又非常显著地高于正常人组(P<0.01),经治疗3个月后则与正常人组比较无显著性差异(P>0.05)。血清IL-2水平与SOD、GSH-PX水平呈正相关(r=0.6011、0.5782,P<0.01),而与SIL-2R、LPO水平呈显著负相关(r=-0.4814、-0.5051,P<0.01)。结论:检测牙周病患者血清IL-2、SIL-2R、SOD、LPO和GSH-PX水平的变化对了解病情、观察预后均有一定的临床价值。     

基于多学科协作团队的急救护理路径在创伤性休克患者中的应用

目的:探讨基于多学科协作团队(MDT)的急救护理路径在创伤性休克患者中的应用效果。方法:选取2018年1月—2019年12月连云港市第一人民医院急诊抢救室收治的创伤性休克患者200例为研究对象。其中2018年1—12月收治的112例患者为对照组,给予常规急救护理措施;2019年1—12月收治的108例患者为观察组,实施基于MDT的急救护理路径。比较两组患者院内抢救反应时间、抢救结果和家属满意度差异。结果:观察组患者抢救介入时间为(8.4±5.8)min,急诊停留时间为(15.0±4.3)min,术前准备时间为(10.4±3.2)min,低于对照组的(14.1±6.7)、(19.7±4.1)、(13.6±3.5)min,差异均有统计学意义(P<0.05)。观察组抢救成功率高于对照组(90.7%vs.73.2%)、患者多器官功能障碍综合征发生率低于对照组(7.4%vs.17.0%)、窒息发生率低于对照组(4.6%vs.13.4%),差异均有统计学意义(P<0.05)。观察组患者家属满意度评分高于对照组[(40.8±3.6)vs.(37.4±3.8)分],差异有统计学意义(P<0.05)。结论:基于MDT的急救护理路径可缩短创伤性休克患者的院内抢救反应时间,提高抢救成功率和患者家属满意度,降低并发症发生率。     

三维塑型钛网颅骨成形术在颅骨缺损修复中的应用

目的研究三维塑型钛网颅骨成形术在颅骨缺损修复中的效果。方法将45例额颞部颅骨缺损患者随机分为观察组(n=29)和对照组(n=16),观察组采用三维塑形钛网行颅骨成形术,对照组采用二维钛网人工塑形进行颅骨修补。比较2组美容满意度相关指标。结果术后随访3个月,观察组颅骨修补侧和健侧头型对称29例,颞肌塌陷1例;对照组颅骨修补侧和健侧头型对称12例,颞肌塌陷4例,头皮感染6例,线结外露5例,钛网翘起或外露3例,皮下积液3例。2组美容满意度相关指标和发生常见并发症患者例数比较,差异均有统计学意义(P<0.05)。结论三维塑型钛网颅骨成形术常见并发症发生率较低,患者美容满意度较高。     

社区老年抑郁症延续照护需求及社会干预对策

目的研究老年抑郁症出院患者的照护需求,提出社区长期延续照护及社会干预对策。方法采用入户调查法,以2010~2012年连云港市某医院60岁以上抑郁症出院患者215例为研究对象,对该人群社区和家庭长期照护及医疗护理服务供需情况进行调查。结果老年抑郁症人群社区延续照护主要依靠家庭,由家庭成员照护者148人,占68.84%;由保姆或钟点工照护者24人,占11.16%;由专业护理人员进行照护者43人,占20.00%。结论老年抑郁症人群的长期照护和社会支持问题是老年学领域亟待解决的民生问题,应建立相应的社会性干预对策。     

肛周毛母细胞瘤1例

临床资料患者,女性,64岁。患者于1年前发现右侧臀部肛周2cm处肿块,初始仅发现一蚕豆大小硬块,伴有出血,色红,急诊于当地医院,予以手术切除,术式不详,后出血症状缓解。1d前患者出现肛周剧烈疼痛,遂于2014年07月19日收入院。既往无特殊病史。专科查体:右臀部肛周2cm处发现一"X"形肿块,长约3cm×2cm,压痛明显,肿块表面可见色素沉着。辅助检查及实验室检查:快速空腹静脉血糖值为9.0mmol/l,余血、尿、便及生化常规未见明显异常。入院诊断:肛周肿块,肛周皮肤癌待查。2014年07月16日我院门诊取组织病理送