Evaluation and management of patients with pulmonary nontuberculous mycobacterial infections

Tuberculosis is responsible for more then 2 million deaths worldwide each year and vies with HIV as the world’s most fatal infectious disease. In many developing countries, attempts to control the spread of infection rely solely on identification and treatment of those with active disease, ignoring subclinical infection. However, in developed countries, large efforts are also expended to identify and give prophylactic drugs to people with latent tuberculosis infection. Until recently, the 100-year-old tuberculin skin test (Mantoux) has been the only available diagnostic test for latent tuberculosis infection, despite its many well-known limitations. Advances in scientific knowledge have led to the development of tests for tuberculosis that measure the production of interferon-γ by T-cells stimulated in vitro with Mycobacterium tuberculosis-specific antigens. These interferon-γ tests are highly specific and unaffected by prior Bacille Calmette–Guérin vaccination or immune reactivity to most atypical mycobacteria. They are more sensitive than the tuberculin skin test in detecting people with active tuberculosis, and their results correlate more closely with M. tuberculosis exposure risk factors than the tuberculin skin test in people likely to have latent tuberculosis infection. Science has caught up with one of the oldest diagnostic tests still in use worldwide, and the adoption of new, tuberculosis-specific interferon-γ-based tests should move us one step closer to better control of this insidious pathogen.     

TST术加外痔切剥治疗嵌頓环状混合痔临床疗效观察

目的：观察2种手术方式治疗嵌顿环状混合痔的临床疗效。方法：将60例患者随机分成2组,试验组30例采用我院的TST术加外痔切剥术,对照组30例采用外剥内扎术,术后均采用抗炎、止血、中药内服、坐浴、换药及对症治疗。观察两组住院天数、手术时间、术中出血量、肛门狭窄、尿潴留、术后疼痛、肛门功能、肛管静息压及肛管收缩压等情况。结果：2组间的临床治愈率、好转率比较均无显著性差异（P〉0.05）。2组住院天数、手术时间、术中出血量、肛门狭窄、尿潴留差异有统计学意义（P〈0.05）。2组之间术后疼痛、肛门功能、肛管静息压及肛管收缩压差异有统计学意义（P〈0.05）。结论：TST术加外痔切剥术,对于嵌顿环状混合痔的治疗,是一种较理想、安全、疗效确切的治疗手段。     

Lesion of the isthmo-optic nucleus impairs target selection for visually guided reaching

Flavonoids, which are polyphenolic compounds, have been reported to possess remarkable antioxidant and anti-inflammatory activities. Among the dietary flavonoids, fisetin (3,3′,4′,7-tetrahydroxyflavone) possesses a significant spectrum of biochemical and pharmacological actions. The present study aimed to investigate the antidepressant potential of fisetin and its possible mechanism. Two mouse models of despair tests were used to evaluate the antidepressant-like effect of fisetin. The results suggested that fisetin (10 and 20 mg/kg, p.o.) dose dependently inhibited the immobility time in both behavioral tests, while the doses that affected the immobile response did not affect locomotor activity. Two behavioral models, reserpine-induced hypothermia and ptosis, and p-chlorophenylalanine (PCPA)-induced depletion of serotonin, were used to explore the possible involvement of fisetin in the noradrenergic and serotonergic system. The higher dose of fisetin was found to effectively antagonize the hypothermia, but not ptosis, induced by reserpine. Pre-treatment with PCPA abolished the anti-immobility effect of fisetin in the forced swimming and tail suspension tests. Moreover, neurochemical assays showed that fisetin produced an increase in serotonin and noradrenaline levels in the frontal cortex and hippocampus. Monoamine oxidase (MAO) activity in the mouse brain was inhibited by 14.7% after treatment with fisetin, while MAO-B activity was not affected. These findings indicate that the antidepressant-like effect of fisetin involves the regulation of the central serotonin and noradrenaline levels.     

两种术式治疗高龄早期低位直肠癌的疗效比较

目的 评估选择性痔上黏膜切除术(tissue selecting therapy,TST)治疗高龄pT1低位直肠癌的临床疗效.方法 选择大连市友谊医院普通外科自2011年1月至2015年12月收治的高龄早期低位直肠癌(cT1N0M0)患者60例,按入院顺序奇偶法随机分成研究组和对照组,每组各30例,研究组选用TST局部...     

Antidepressant-like behavioral, neurochemical and neuroendocrine effects of naringenin in the mouse repeated tail suspension test

Our previous study demonstrated that the citrus bioflavonoid naringenin ameliorated behavioral alterations via the central serotonergic and noradrenergic systems in the tail suspension test (TST) induced mice. To better understand its pharmacological activity, mice were submitted to three 6min-TSTs one week apart (Day 1: test, Day 7: retest 1, Day 14: retest 2) followed by hippocampal glucocorticoid receptor (GR), monoamine neurotransmitters and serum corticosterone measurement. The results suggested that repeated TST detected the gradual increase in the efficacy of naringenin over time, additionally 1-day (20mg/kg), 7-day (10, 20mg/kg) and 14-day (5, 10, 20mg/kg) naringenin treatment markedly decreased the immobility time. Moreover, administration of naringenin for 14days (20mg/kg) increased hippocampal serotonin (5-HT), norepinephrine (NE) and GR levels, and reduced serum corticosterone levels in mice exposed to the repeated TST. Overall, the present study indicated that the re-exposure would facilitate the detection of the anti-immobility effects of antidepressant drugs in the mouse TST, and clearly demonstrated that the antidepressant-like effect of naringenin may be mediated by an interaction with neuroendocrine and neurochemical systems.     

Early-life social experiences in mice affect emotional behaviour and hypothalamic-pituitary-adrenal axis function

Rationale

Early-life stressful experiences are associated to alterations in behavioural responses and development of psychiatric and neurodegenerative diseases. In rodents, individual housing is considered as a stressful condition whilst enriched environment can protect against stress and its negative consequences. Neuroendocrine responses to stress can also be altered by early-life experiences and seem to contribute to behavioural alterations induced by changes in housing conditions.

Objective

To develop an improved procedure of social isolation throughout development (from pre-adolescence to adulthood) in CD1 mice and to elucidate its effects on behavioural parameters related to stress and neuroendocrine responses compared to enriched or social conditions.

Materials and methods

CD1 male mice (PND 21) were housed in social/standard conditions, enriched conditions or isolated conditions during seven weeks. After that, different relevant behaviours were evaluated, including locomotor activity, anxiety-like and despair behaviour. Levels of plasma corticosterone were also analysed before and after a stressful event.

Results

CD1 mice exposed to an isolated environment exhibited higher locomotion and anxiety-like responses than animals exposed to social or enriched conditions. In addition, isolated animals showed lower basal plasma corticosterone than social or enriched ones but after a stressful event the elevation of plasma corticosterone was higher, suggesting an enhanced response of the HPA axis to a novel and stressful situation.

Conclusions

Social interaction is an important feature to display an appropriate behavioural and neuronal development. Habituation to novel stimuli is impaired in subjects exposed to social isolation and induces increased excitability response to stressful events. Social deprivation increases the possibility of altered neuronal function and could facilitate the development of neuropsychiatric disorders in adulthood.     

Adenosine deaminase and tuberculous pericarditis--a systematic review with meta-analysis

BACKGROUNDS: Adenosine deaminase (ADA) activity in pericardial fluid is a valuable aid in the diagnosis of tuberculous pericarditis (TP), but there is no systematic review performed to evaluate the benefits of ADA activity as an adjunctive test for TP diagnosis. The objective of this systematic review was to evaluate the utility of ADA activity as a diagnostic marker of TP on patients presenting with pericardial effusion. METHODS: MEDLINE, LILACS and Cochrane Library databases (1980-2005) searches to identify articles related to adenosine deaminase activity on TP diagnosis. Articles with patients with at least one TP diagnostic criteria were included. The controls were patients with other pericardial diseases with moderate or large pericardial effusion. To calculate the sensitivity, specificity, as well as positive and negative likelihood ratios we extracted the total number of confirmed TP cases over all patients with pericardial effusion as well as the number of cases with ADA activity values of 40 U/L and over. RESULTS: Thirty one studies met our initial inclusion criteria and five articles were selected. The heterogeneity limited the specificity analysis (p=0.004). The method yielded a sensitivity and specificity of 88% and 83%, respectively. The SROC curve presented an area with a tendency towards 1 (value of 0.9539) and corroborates the diagnostic value of ADA activity. CONCLUSIONS: The present study confirms the clinical value of ADA activity as adjunctive diagnostic marker of TP among other causes of pericardial effusion.     

Assessing sudomotor impairment in patients with peripheral neuropathy: Comparison between electrochemical skin conductance and skin biopsy

Objective

Sudoscan provides a rapid assessment of sudomotor function based on the measurement of electrochemical skin conductance (ESC), which is thought to be proportional to small nerve fibres innervating the sweat glands. However, the relationship between ESC and small nerve fibre density on skin biopsy remains unclear.

Correspondence of maternal and paternal perception of school-aged children's sleep with in-home sleep-electroencephalography and diary-reports of children's sleep

ObjectiveParents are often the first to report children's sleep difficulties. The aim of the present study was to evaluate the accuracy of parent reports by examining the correspondence of maternal and paternal reports of children's sleep with in-home electroencephalography (EEG) sleep assessment and sleep diary reports.MethodsA total of 143 children (57 formerly very preterm born children) aged 7–12 years underwent one night of in-home sleep-EEG; mothers and fathers reported children's sleep-related behavior by using the German version of the Children's Sleep Habits Questionnaire, and children and parents together completed a sleep diary of children's sleep.ResultsLess EEG-derived total sleep time (TST) was associated with increased mother questionnaire reports of sleep duration problems, while less sleep efficiency (SE) and longer sleep onset latency (SOL) were associated with increased mother questionnaire reports of sleep onset delay. For fathers, only longer SOL was related to increased father questionnaire reports of sleep onset delay. The abovementioned associations did not change with children's increasing age and did not differ for boys and girls. More parent questionnaire reports of sleep duration problems, sleep onset delay, and night wakings were related to shorter diary reports of sleep duration, increased sleep latency, and more nocturnal awakenings, respectively.ConclusionsMother questionnaire reports of children's sleep corresponded moderately with objective measures of TST, SE, and SOL assessed with in-home sleep-EEG. Both mother and father questionnaire reports of children's sleep duration problems, sleep onset delay, and night wakings were related to diary reports of children's sleep.