肺耐药蛋白在子宫内膜癌中表达及其临床意义

目的 探讨肺耐药蛋白(LRP)在子宫内膜癌治疗中的作用及预后关系。方法 采用免疫组化染色SP法，检测30例石蜡包埋的子宫内膜癌中LRP的表达，并对应用化疗后的效果进行分析。结果 (1)LRP阳性表达率80％(24／30)；(2)LRP表达阳性者的化疗有效率约为45．8％，明显低于LRP表达阴性者(83．3％)；(3)LRP的表达与腹水相关，与患者年龄、临床分期、组织分级无关；(4)LRP表达阴性患者预后明显优于阳性。结论 LRP是评价子宫内膜癌化疗耐药性和预后可靠指标。     

Recombinant congenic strains of mice from B10.D2 and DBA/2: Their contribution to behavior genetic research and application to audiogenic seizures

Recombinant congenic strains (RCS) represent a series of related strains, each of which carries a small fraction of the genome of one strain (donor strain) on the genetic background of another strain (background strain). Recombinant inbred strains (RIS) are commonly used to identify major gene segregation and linkage and associations between behavior and quantitative trait loci, whereas recombinant congenic strains (RCS) open other complementary leads. The variability in the reactivity of RCS to a trait is thus the expression of few minor-effect genes originating from the donor strain, because the probability that major genes are present in any one RCS is low. Unlike RIS in which minor-effect genes are often masked by major genes, RCS enable the effects of minor genes to be studied. With our method, for a given trait, an estimate can be made of the gene strength distribution as well as an estimate of the minimal number of genes involved having a certain strength.This study was supported by the Centre National de la Recherche Scientifique (URA 1924 and CSEAL-UPS 44, CNRS), Université René-Descartes, Paris V UFR Biomédicale, and the Fondation pour la Recherche Médicale.     

Open-field behavior and the peripheral sympathetic nervous system in the MR/N and MNR/N rat strains

The Maudsley Reactive (MR) and Maudsley Non-Reactive (MNR) strains of rats, respectively selected by P. L. Broadhurst for high and low open-field defecation (OFD), were acquired by the National Institutes of Health in 1963 at the 21st generation of inbreeding and have been inbred as the MR/N and MNR/N strains at that location for more than 40 generations. The present experiment shows that, despite the lack of deliberate selection for more than 40 generations, the strains still differ predictably in OFD. Strain differences in open-field activity, originally found to be inversely associated with those in OFD, have also been preserved. The existence of an association between the peripheral sympathetic system and OFD originally established in the Har derivation of the Maudsley strains was also confirmed in the MR/N and MNR/N strains: MR/N male rats, with the relatively higher levels of OFD, exhibited lower concentrations of norepinephrine (NE) in spleen and descending colon than MNR/N rats. The pattern of biochemical and morphological findings obtained in this study and previous data indicate that the MNR/N and the MNR/Har strains are both derived from the British stocks of this strain carrying the agouti allele (AA). A distinction should be made between these strains and the MNRA/Har strain, which carries the nonagouti allele (aa) and which has been genetically isolated from the Nonreactive strains bearing the agouti allele since early in the selection experiment.Supported by Grant GM 28874 from the National Institute of General Medical Sciences.     

Prolactin concentration in plasma and susceptibility to mammary tumors in female rats from different strains treated chronically with estradiol-17β

Summary Prolactin is associated with the development of mammary tumors in rats. The aim of the present study was to evaluate whether strain differences in susceptibility to the development of mammary tumors could be explained by genetic differences in the response of the pituitary to chronic stimulation by estrogens. Prolactin levels were measured in plasma from rats of the Sprague-Dawley, Wistar WAG/Rij and Brown Norway BN/BiRij strains before and at different times after subcutaneous implantation of estradiol-17 in cholesterol/paraffin pellets. In all strains plasma prolactin was elevated from the second week after implantation of the pellet, although there were quantitative differences between the responses. At 32 weeks after implantation of the pellets the plasma level of prolactin in Sprague-Dawley rats was 1247 ± 367 ng NIAMDD prolactin RP-1/ml (mean ± S.E.M), whereas Wistar WAG/Rij and Brown Norway BN/BiRij had plasma prolactin levels of 679 ± 211 and 182 ± 19 ng/ml respectively. Between 52 and 104 weeks after implantation these values rose to 4016 ± 1116, 5004 ± 1053 and 808 ± 129 ng/ml respectively. The plasma concentration of prolactin of rats in this age group was strongly associated with the occurrence of pituitary adenomas in all three strains. In untreated rats, the concentration of prolactin in the plasma increased with age to only 200–400 ng/ml at 12–24 months of age but no significant differences were observed between the three rat strains. It is concluded that observed differences in spontaneous and estrogen-mediated mammary tumor development in these rat strains cannot be explained by genetic differences in the plasma concentration of prolactin. The development of malignant mammary tumors after estrogen treatment appears to be associated with the extent of the increase in plasma prolactin induced by the estrogen.     

Evaluation of an Ileorectostomised Rat Model for Resistant Starch Determination

The human ileostomy model, widely considered the benchmark for determining in vivo starch digestibility, has disadvantages. The ileorectostomised rat model (IRM) is a possible surrogate but evidence as to its validity is scant. In this preliminary study, the resistant starch (RS) content of test breads made from refined low (LAW-R) and high amylose wheat (HAW-R) flours was established in a randomised cross-over trial involving six human ileostomy participants. Starch digestibility of refined breads and diets made from these flours was then evaluated in ileorectostomised rats using a similar experimental format. Physical performance measures and other data were also collected for the rat model. The amount of RS in the low- and high-amylose breads as measured using the human model was 0.8 ± 0.1 and 6.5 ± 0.3 g/100 g, respectively. The RS level of HAW-R bread determined using ileorectostomised rats was 5.5 ± 0.8 g/100 g, about 15% less than that recorded in the human study, whereas for conventional wheat breads the models produced similar RS values. While offering promise, further validation using a wide variety of starchy food products is needed before the IRM can be considered an acceptable alternative for RS determination.     

The Impact of Diet and Fibre Fractions on Plasma Adipocytokine Levels in Prediabetic Adults

The impact of diet and fibre fractions on adipocytokines in obese subjects with a risk of diabetes has not been investigated in detail yet. The purpose of the study is to evaluate the effects of a 12-month lifestyle intervention with different fibre profiles (resistant starch (RS)—rich fibre, or ordinary food fibre profiles) on adipocytokine levels. Fifty participants are divided into two groups (RS group and Fibre group). The groups differ only in the percentage of the recommended level of the RS consumed as a fraction of the same total fibre amount. The applied dietary intervention includes intake of 7531 KJ/daywith a total fibre portion of 25–35 g/dayfor both groups that includes 15 g/day of RS for the RS group only. The levels of leptin, adiponectin, apelin, resistin, tumor necrosis factor (TNF)-alpha and C-reactive protein (CRP) are measured, and their relationship to anthropometric and biochemical parameters is estimated. Along with significant body weight loss, only leptin is significantly reduced by 13% in the RS group while in the Fibre group, apelin levels are significant (−21%). Polynomial regression shows a negative correlation between RS intake and adiponectin (R2 = 0.145) and resistin level (R2 = 0.461) in the RS group. This study indicates the possibility that fibre fractions differently influence the outcome of lifestyle interventions, as well as their adipocytokine levels, in obese prediabetic adults.     

Association between Fruit and Vegetable Intakes and Mental Health in the Australian Diabetes Obesity and Lifestyle Cohort

Increasing prevalence of mental health disorders within the Australian population is a serious public health issue. Adequate intake of fruits and vegetables (FV), dietary fibre (DF) and resistant starch (RS) is associated with better mental and physical health. Few longitudinal studies exist exploring the temporal relationship. Using a validated food frequency questionnaire, we examined baseline FV intakes of 5845 Australian adults from the AusDiab study and estimated food group-derived DF and RS using data from the literature. Perceived mental health was assessed at baseline and 5 year follow up using SF-36 mental component summary scores (MCS). We conducted baseline cross-sectional analysis and prospective analysis of baseline dietary intake with perceived mental health at 5 years. Higher baseline FV and FV-derived DF and RS intakes were associated with better 5 year MCS (p < 0.001). A higher FV intake (754 g/d vs. 251 g/d, Q4 vs. Q1) at baseline had 41% lower odds (OR = 0.59: 95% CI 0.46–0.75) of MCS below population average (<47) at 5 year follow up. Findings were similar for FV-derived DF and RS. An inverse association was observed with discretionary food-derived DF and RS. This demonstrates the association between higher intakes of FV and FV-derived DF and RS with better 5 year mental health outcomes. Further RCTs are necessary to understand mechanisms that underlie this association including elucidation of causal effects.     

An Overview of the Treatment Options Used for the Management of COVID-19 in Pakistan: Retrospective Observational Study

BackgroundSince the first reports of COVID-19 infection, the foremost requirement has been to identify a treatment regimen that not only fights the causative agent but also controls the associated complications of the infection. Due to the time-consuming process of drug discovery, physicians have used readily available drugs and therapies for treatment of infections to minimize the death toll.ObjectiveThe aim of this study is to provide a snapshot analysis of the major drugs used in a cohort of 1562 Pakistani patients during the period from May to July 2020, when the first wave of COVID-19 peaked in Pakistan.MethodsA retrospective observational study was performed to provide an overview of the major drugs used in a cohort of 1562 patients with COVID-19 admitted to the four major tertiary-care hospitals in the Rawalpindi-Islamabad region of Pakistan during the peak of the first wave of COVID-19 in the country (May-July 2020).ResultsAntibiotics were the most common choice out of all the therapies employed, and they were used as first line of treatment for COVID-19. Azithromycin was the most prescribed drug for treatment. No monthly trend was observed in the choice of antibiotics, and these drugs appeared to be a random but favored choice throughout the months of the study. It was also noted that even antibiotics used for multidrug resistant infections were prescribed irrespective of the severity or progression of the infection. The results of the analysis are alarming, as this approach may lead to antibiotic resistance and complications in immunocompromised patients with COVID-19. A total of 1562 patients (1064 male, 68.1%, and 498 female, 31.9%) with a mean age of 47.35 years (SD 17.03) were included in the study. The highest frequency of patient hospitalizations occurred in June (846/1562, 54.2%).ConclusionsGuidelines for a targeted treatment regime are needed to control related complications and to limit the misuse of antibiotics in the management of COVID-19.     

成年手术患者手术部位多重耐药菌感染及影响因素分析

目的 探讨手术部位多重耐药（MDRO）菌感染情况及危险因素,为手术部位感染的预防和治疗提供循证参考。方法 以2019—2020年焦作市某医院行手术治疗的成年患者作为研究对象,收集基本情况、疾病患者情况,从医院病历信息系统中调取患者手术及术前相关检测指标、用药情况等内容,对出现发热、切口红肿、引流液异常等疑似感染症状体征患者采集感染部位生物样本用于病原学培养及检测。采用描述流行病学分析方法对MDRO菌感染情况进行分析,并采用单、多因素分析方法对MDRO菌感染影响因素进行分析。结果 7 820例进行手术治疗患者共发生MDRO菌感染250例,感染率为3.20%,其中金黄色葡萄球菌感染6例,鲍曼不动杆菌感染14例,铜绿假单胞菌感染29例,肺炎克雷伯菌感染34例,大肠埃希菌感染167例。多因素Logistic回归分析显示,糖尿病（OR=3.578）、肿瘤（OR=4.135）、贫血（OR=4.701）、入住ICU（OR=5.045）、脏器穿孔（OR=2.414）、切口分类为Ⅱ或Ⅲ类（OR=2.284、3.013）、手术有风险（OR=5.135）、抗菌药物应用≥2种（OR=2.340）、抗菌药物疗程≥5 d（OR=4.759）、再手术（OR=2.036）是成年手术患者发生MDRO菌感染的危险因素。结论 成年手术患者手术部位MDRO菌感染较为常见,相关危险因素较多,临床可根据以上因素加强围手术管理,减少MDRO菌感染的发生。     

心胸外科患者多重耐药菌感染及危险因素分析

目的探讨心胸外科住院患者多重耐药菌(MDRO)感染的特征及其危险因素。方法回顾性调查632例发生医院感染的心胸外科患者,根据其是否发生MDRO感染分为MDRO组和非MDRO组,计算MDRO感染率并分析多重耐药菌株分布,筛选影响心胸外科患者MDRO感染的相关危险因素。结果心胸外科患者MDRO感染发生率为15.19%(96/632),多重耐药菌株以鲍曼不动杆菌、金黄色葡萄球菌、铜绿假单胞菌等为主;多因素分析结果显示,影响心胸外科患者MDRO感染的危险因素包括年龄(OR=2.094)、基础疾病(OR=3.056)、机械通气(OR=4.158)、留置导管(OR=4.914)、低白蛋白血症(OR=5.197)、联合使用广谱抗菌药物(OR=3.536)、频繁更换抗菌药物(OR=4.272)等。结论心胸外科医院感染患者中具有较高的MDRO感染发生比例,影响其发生MDRO感染的危险因素较多,应尽早采取预防措施,降低MDRO感染发生率。